A practical approach to designing syndromic surveillance systems for livestock and poultry

The field of animal syndromic surveillance (SyS) is growing, with many systems being developed worldwide. Now is an appropriate time to share ideas and lessons learned from early SyS design and implementation. Based on our practical experience in animal health SyS, with additions from the public health and animal health SyS literature, we put forward for discussion a 6-step approach to designing SyS systems for livestock and poultry. The first step is to formalise policy and surveillance goals which are considerate of stakeholder expectations and reflect priority issues (1). Next, it is important to find consensus on national priority diseases and identify current surveillance gaps. The geographic, demographic, and temporal coverage of the system must be carefully assessed (2). A minimum dataset for SyS that includes the essential data to achieve all surveillance objectives while minimizing the amount of data collected should be defined. One can then compile an inventory of the data sources available and evaluate each using the criteria developed (3). A list of syndromes should then be produced for all data sources. Cases can be classified into syndrome classes and the data can be converted into time series (4). Based on the characteristics of the syndrome-time series, the length of historic data available and the type of outbreaks the system must detect, different aberration detection algorithms can be tested (5). Finally, it is essential to develop a minimally acceptable response protocol for each statistical signal produced (6). Important outcomes of this pre-operational phase should be building of a national network of experts and collective action and evaluation plans. While some of the more applied steps (4 and 5) are currently receiving consideration, more emphasis should be put on earlier conceptual steps by decision makers and surveillance developers (1-3).

Indeterminate QunatiFERON-TB Gold In-Tube assay results in association with procedural specimen collection in children

BACKGROUND. The development of interferon-gamma release assays (IGRA) has introduced powerful tools in diagnosing latent tuberculosis infection (LTBI) and may play a critical role in the future of tuberculosis diagnosis. However, there have been reports of high indeterminate results in young patient populations (0-18 years). This study investigated results of the QunatiFERON-TB Gold In-Tube (QFT-GIT) IGRA in a population of children (0-18 years) at Texas Children's Hospital in association with specimen collection procedures using surrogate variables. ^ METHODS. A retrospective case-control study design was used for this investigation. Cases were defined as having QFT-GIT indeterminate results. Controls were defined as having either positive or negative results (determinates). Patients' admission status, staff performing specimen collection, and specific nurse performing specimen collection were used as surrogates to measure specimen collection procedures. ^ To minimize potential confounding, abstraction of patients' electronic medical records was performed. Abstracted data included patients' medications and evaluation at the time of QFT-GIT specimen collection in addition to their medical history. QFT-GIT related data was also abstracted. Cases and controls were characterized using chi-squared tests or Fisher's exact tests across categorical variables. Continuous variables were analyzed using one-way ANOVA and t-tests for continuous variables. A multivariate model was constructed by backward stepwise removal of statistically significant variables from univariate analysis. ^ RESULTS. Patient data was abstracted from 182 individuals aged 0-18 years from July 2010 to August 2011 at Texas Children's Hospital. 56 cases (indeterminates) and 126 controls (determinates) were enrolled. Cancer was found to be an effect modifier with subsequent stratification resulting in a cancer patient population too small to analyze (n=13). Subsequent analyses excluded these patients. ^ The exclusion of cancer patients resulted in a population of 169 patients with 49 indeterminates (28.99%) and 120 determinates (71.01%), with mean ages of 9.73 (95% CI: 8.03, 11.43) years and 11.66 (95% CI: 10.75, 12.56) years (p = 0.033), respectively. Median age of patients who were indeterminates and determinates were 12.37 and 12.87 years, respectively. Lack of data for our specific nurse surrogate (QFTNurse) resulted in its exclusion from analysis. The final model included only our remaining surrogate variables (QFTStaff and QFTInpatientOutpatient). The staff collecting surrogate (QFTStaff) was found to be modestly associated with indeterminates when nurses collected the specimen (OR = 1.54, 95% CI: 0.51, 4.64, p = 0.439) in the final model. Inpatients were found to have a strong and statistically significant association with indeterminates (OR = 11.65, 95% CI: 3.89, 34.9, p < 0.001) in the final model. ^ CONCLUSION. Inpatient status was used as a surrogate for indication of nurse drawn blood specimens. Nurses have had little to no training regarding shaking of tubes versus phlebotomists regarding QFT-GIT testing procedures. This was also measured by two other surrogates; specifically a medical note stating whether a nurse or phlebotomist collected the specimen (QFTStaff) and the name and title of the specific nurse if collection was performed by a nurse (QFTNurse). Results indicated that inpatient status was a strong and statistically significant factor for indeterminates, however, nurse collected specimens and indeterminate results had no statistically significant association in non-cancer patients. The lack of data denoting the specific nurse performing specimen collection excluded the QFTNurse surrogate in our analysis. ^ Findings suggests training of staff personnel in specimen procedures may have little effect on the number of indeterminates while inpatient status and thus possibly illness severity may be the most important factor for indeterminate results in this population. The lack of congruence between our surrogate measures may imply that our inpatient surrogate gauged illness severity rather than collection procedures as intended. ^ Despite the lack of clear findings, our analysis indicated that more than half of indeterminates were found in specimens drawn by nurses and as such staff training may be explored. Future studies may explore methods in measuring modifiable variables during pre-analytical QFT-GIT procedures that can be discerned and controlled. Identification of such measures may provide insight into ways to lowering indeterminate QFT-GIT rates in children.^

Seawater carbonate chemistry, primary production, biomass and calcification of plankton and bacteria, 2009

Production (abundance and biomass) and net calcification rates of the coccolithophorid Pleurochrysis carterae under different partial pressures of CO2 (pCO2) were examined using short (15, 24 and 39 h), long (7 d) and dark (7 d) incubation experiments. Short incubations were conducted at ambient, 500 and 820 ppm pCO2 levels in natural seawater that was enriched with nutrients and inoculated with P. carterae. Long incubations were conducted at ambient and 1200 ppm pCO2 levels in natural seawater (0.2 µm filtered as well as unfiltered) that was enriched with nutrients and inoculated with P. carterae. Dark incubations were conducted at ambient and 1200 ppm pCO2 in unfiltered seawater that was inoculated with P. carterae. The abundance and biomass of coccolithophorids increased with pCO2 and time. The abundance and biomass of most noncalcifying phytoplankton also increased, and were hardly affected by CO2 inputs. Net calcification rates were negative in short incubations during the pre-bloom phase regardless of pCO2 levels, indicating dissolution of calcium carbonate. Further, the negative values of net calcification in short incubations became less negative with time. Net calcification rates were positive in long incubations during blooms regardless of pCO2 level, and the rate of calcification increased with pCO2. Our results show that P. carterae may adapt to increased (~1200 ppm) pCO2 level with time, and such increase has little effect on the ecology of noncalcifying groups and hence in ecosystem dynamics. In dark incubations, net calcification rates were negative, with the magnitude being dependent on pCO2 levels.

¿El o los campos? Tipología de explotaciones agropecuarias arroceras de la Provincia de Corrientes en la Argentina

Las agroindustrias se presentan como uno de los sectores más dinámicos para el crecimiento del Producto Bruto y del volumen de la mano de obra de la provincia de Corrientes en la argentina. Para nuestro objetivo, entre todas las agroindustrias que funcionan en esa provincia hemos escogido los establecimientos dedicados al cultivo y secado (fase preindustrial) del arroz, en tanto se trata de una actividad propia cuyo impacto trasciende la fase primaria, dado el alto grado de integración vertical de dicha actividad. El objetivo de la investigación que da origen a este estudio es conocer, en sentido amplio, una de las dimensiones de la productividad en el sector: la estructura productiva y del empleo en el sector primario del caI, por cuanto entendemos que la misma constituye un elemento fundamental en los niveles de productividad alcanzados por los heterogéneos integrantes del Complejo agroindustrial

¿El o los campos? Tipología de explotaciones agropecuarias arroceras de la Provincia de Corrientes en la Argentina

Las agroindustrias se presentan como uno de los sectores más dinámicos para el crecimiento del Producto Bruto y del volumen de la mano de obra de la provincia de Corrientes en la argentina. Para nuestro objetivo, entre todas las agroindustrias que funcionan en esa provincia hemos escogido los establecimientos dedicados al cultivo y secado (fase preindustrial) del arroz, en tanto se trata de una actividad propia cuyo impacto trasciende la fase primaria, dado el alto grado de integración vertical de dicha actividad. El objetivo de la investigación que da origen a este estudio es conocer, en sentido amplio, una de las dimensiones de la productividad en el sector: la estructura productiva y del empleo en el sector primario del caI, por cuanto entendemos que la misma constituye un elemento fundamental en los niveles de productividad alcanzados por los heterogéneos integrantes del Complejo agroindustrial

¿El o los campos? Tipología de explotaciones agropecuarias arroceras de la Provincia de Corrientes en la Argentina

Las agroindustrias se presentan como uno de los sectores más dinámicos para el crecimiento del Producto Bruto y del volumen de la mano de obra de la provincia de Corrientes en la argentina. Para nuestro objetivo, entre todas las agroindustrias que funcionan en esa provincia hemos escogido los establecimientos dedicados al cultivo y secado (fase preindustrial) del arroz, en tanto se trata de una actividad propia cuyo impacto trasciende la fase primaria, dado el alto grado de integración vertical de dicha actividad. El objetivo de la investigación que da origen a este estudio es conocer, en sentido amplio, una de las dimensiones de la productividad en el sector: la estructura productiva y del empleo en el sector primario del caI, por cuanto entendemos que la misma constituye un elemento fundamental en los niveles de productividad alcanzados por los heterogéneos integrantes del Complejo agroindustrial

Contribution to Load-Frequency Regulation of a Hydropower Plant with Long Tail-Race Tunnel

In this paper, a hydroelectric power plant with long tail-race tunnel has been modelled for assessing its contribution to secondary regulation reserve. Cavitation problems, caused by the discharge conduit length, are expected downstream the turbine where low pressure appears during regulation manoeuvres. Therefore, governor's gains should be selected taking into account these phenomena. On the other hand, regulation services bidden by the plant operator should fulfil TSO (Transmission System Operator) quality requirements. A methodology for tuning governor PI gains is proposed and applied to a Hydro power plant in pre-design phase in northwest area of Spain. The PI gains adjustment proposed provides a proper plant response, according to some established indexes, while avoiding cavitation phenomena.

Evaluation of a Quality Improvement Intervention for Anesthetic Management of Acute Ischemic Stroke Patients Undergoing Endovascular Therapy

Thesis (Master's)--University of Washington, 2016-06

Adoption of a sedation scoring system and sedation guideline in an intensive care unit

Aim. The paper presents a study assessing the rate of adoption of a sedation scoring system and sedation guideline. Background. Clinical practice guidelines including sedation guidelines have been shown to improve patient outcomes by standardizing care. In particular sedation guidelines have been shown to be beneficial for intensive care patients by reducing the duration of ventilation. Despite the acceptance that clinical practice guidelines are beneficial, adoption rates are rarely measured. Adoption data may reveal other factors which contribute to improved outcomes. Therefore, the usefulness of the guideline may be more appropriately assessed by collecting adoption data. Method. A quasi-experimental pre-intervention and postintervention quality improvement design was used. Adoption was operationalized as documentation of sedation score every 4 hours and use of the sedation and analgesic medications suggested in the guideline. Adoption data were collected from patients' charts on a random day of the month; all patients in the intensive care unit on that day were assigned an adoption category. Sedation scoring system adoption data were collected before implementation of a sedation guideline, which was implemented using an intensive information-giving strategy, and guideline adoption data were fed back to bedside nurses. After implementation of the guideline, adoption data were collected for both the sedation scoring system and the guideline. The data were collected in the years 2002-2004. Findings. The sedation scoring system was not used extensively in the pre-intervention phase of the study; however, this improved in the postintervention phase. The findings suggest that the sedation guideline was gradually adopted following implementation in the postintervention phase of the study. Field notes taken during the implementation of the sedation scoring system and the guideline reveal widespread acceptance of both. Conclusion. Measurement of adoption is a complex process. Appropriate operationalization contributes to greater accuracy. Further investigation is warranted to establish the intensity and extent of implementation required to positively affect patient outcomes.

Adaptive responses of wild mungbean (Vigna radiata ssp sublobata) to photo-thermal environment. I. Phenology

The phenology of 11 diverse accessions of wild mungbean was observed under natural and artificial photoperiod - temperature conditions, in order to examine whether genotypic differences might be attributed to adaptive responses to photo-thermal conditions. There was large variation in phenological response among accessions and across environments, much of which was due to differences in the duration of the pre-flowering phase. Accessions that flowered earlier tended to flower for longer, apart from 2 earlier flowering, inland Australian lines that were also earlier maturing. The patterns of response in time from sowing to flowering over environment were consistent with quantitative short-day photoperiodic adaptation, a conclusion supported by the effects of artificial day-length extension and by 'goodness of fit' of the observed responses to standard models relating rate of development to photoperiod and temperature. The fitted models indicated that rate of development towards flowering was hastened by warmer temperatures, and delayed by longer day lengths, with differential sensitivity between accessions to both factors. The models also suggested that photoperiod was more important for accessions collected closer to the equator, which were generally later flowering as a consequence. Conversely, temperature was relatively more important in lines from higher latitudes. Modelling also suggested that the period from first flowering to maturity was sensitive to photoperiod and temperature. Again, longer days appeared to prolong growth and delay maturity. However, cooler temperatures accelerated rather than slowed maturity, by suppressing further vegetative growth. The variation observed indicated that there is considerable scope for using the wild population to broaden the adaptation of cultivated mungbean. In particular, the unusual response of a late-flowering, photoperiod-insensitive accession warrants further study to establish whether the wild population contains a unique 'long juvenile' trait analogous to that being used for improving phenological adaptation in soybean.

The analysis and prediction of the quantity and composition of household refuse

This thesis describes the development of a simple and accurate method for estimating the quantity and composition of household waste arisings. The method is based on the fundamental tenet that waste arisings can be predicted from information on the demographic and socio-economic characteristics of households, thus reducing the need for the direct measurement of waste arisings to that necessary for the calibration of a prediction model. The aim of the research is twofold: firstly to investigate the generation of waste arisings at the household level, and secondly to devise a method for supplying information on waste arisings to meet the needs of waste collection and disposal authorities, policy makers at both national and European level and the manufacturers of plant and equipment for waste sorting and treatment. The research was carried out in three phases: theoretical, empirical and analytical. In the theoretical phase specific testable hypotheses were formulated concerning the process of waste generation at the household level. The empirical phase of the research involved an initial questionnaire survey of 1277 households to obtain data on their socio-economic characteristics, and the subsequent sorting of waste arisings from each of the households surveyed. The analytical phase was divided between (a) the testing of the research hypotheses by matching each household's waste against its demographic/socioeconomic characteristics (b) the development of statistical models capable of predicting the waste arisings from an individual household and (c) the development of a practical method for obtaining area-based estimates of waste arisings using readily available data from the national census. The latter method was found to represent a substantial improvement over conventional methods of waste estimation in terms of both accuracy and spatial flexibility. The research therefore represents a substantial contribution both to scientific knowledge of the process of household waste generation, and to the practical management of waste arisings.

Decision-making under extreme *uncertainty: Rethinking hazard -related perceptions and action

Understanding who evacuates and who does not has been one of the cornerstones of research on the pre-impact phase of both natural and technological hazards. Its history is rich in descriptive illustrations focusing on lists of characteristics of those who flee to safety. Early models of evacuation focused almost exclusively on the relationship between whether warnings were heard and ultimately believed and evacuation behavior. How people came to believe these warnings and even how they interpreted the warnings were not incorporated. In fact, the individual seemed almost removed from the picture with analysis focusing exclusively on external measures. ^ This study built and tested a more comprehensive model of evacuation that centers on the decision-making process, rather than decision outcomes. The model focused on three important factors that alter and shape the evacuation decision-making landscape. These factors are: individual level indicators which exist independently of the hazard itself and act as cultural lenses through which information is heard, processed and interpreted; hazard specific variables that directly relate to the specific hazard threat; and risk perception. The ultimate goal is to determine what factors influence the evacuation decision-making process. Using data collected for 1998's Hurricane Georges, logistic regression models were used to evaluate how well the three main factors help our understanding of how individuals come to their decisions to either flee to safety during a hurricane or remain in their homes. ^ The results of the logistic regression were significant emphasizing that the three broad types of factors tested in the model influence the decision making process. Conclusions drawn from the data analysis focus on how decision-making frames are different for those who can be designated “evacuators” and for those in evacuation zones. ^

Time, Cost, and Environmental Impact Analysis for Sustainable Design at Multiple Building Levels

Construction projects are complex endeavors that require the involvement of different professional disciplines in order to meet various project objectives that are often conflicting. The level of complexity and the multi-objective nature of construction projects lend themselves to collaborative design and construction such as integrated project delivery (IPD), in which relevant disciplines work together during project conception, design and construction. Traditionally, the main objectives of construction projects have been to build in the least amount of time with the lowest cost possible, thus the inherent and well-established relationship between cost and time has been the focus of many studies. The importance of being able to effectively model relationships among multiple objectives in building construction has been emphasized in a wide range of research. In general, the trade-off relationship between time and cost is well understood and there is ample research on the subject. However, despite sustainable building designs, relationships between time and environmental impact, as well as cost and environmental impact, have not been fully investigated. The objectives of this research were mainly to analyze and identify relationships of time, cost, and environmental impact, in terms of CO2 emissions, at different levels of a building: material level, component level, and building level, at the pre-use phase, including manufacturing and construction, and the relationships of life cycle cost and life cycle CO2 emissions at the usage phase. Additionally, this research aimed to develop a robust simulation-based multi-objective decision-support tool, called SimulEICon, which took construction data uncertainty into account, and was capable of incorporating life cycle assessment information to the decision-making process. The findings of this research supported the trade-off relationship between time and cost at different building levels. Moreover, the time and CO2 emissions relationship presented trade-off behavior at the pre-use phase. The results of the relationship between cost and CO2 emissions were interestingly proportional at the pre-use phase. The same pattern continually presented after the construction to the usage phase. Understanding the relationships between those objectives is a key in successfully planning and designing environmentally sustainable construction projects.

Seawater carbonate chemistry and processes during experiments with phytoplankton Emiliania huxleyi (strain Bergen 2005), 2010

The response of the coccolithophore Emiliania huxleyi to rising CO2 concentrations is well documented for acclimated cultures where cells are exposed to the CO2 treatments for several generations prior to the experiment. The exact number of generations required for acclimation to CO2-induced changes in seawater carbonate chemistry, however, is unknown. Here we show that Emiliania huxleyi's short-term response (26 h) after cultures (grown at 500 µatm) were abruptly exposed to changed CO2 concentrations (~190, 410, 800 and 1500 ?atm) is similar to that obtained with acclimated cultures under comparable conditions in earlier studies. Most importantly, from the lower CO2 levels (190 and 410 ?atm) to 750 and 1500 µatm calcification decreased and organic carbon fixation increased within the first 8 to 14 h after exposing the cultures to changes in carbonate chemistry. This suggests that Emiliania huxleyi rapidly alters the rates of essential metabolical processes in response to changes in seawater carbonate chemistry, establishing a new physiological "state" (acclimation) within a matter of hours. If this relatively rapid response applies to other phytoplankton species, it may simplify interpretation of studies with natural communities (e.g. mesocosm studies and ship-board incubations), where often it is not feasible to allow for a pre-conditioning phase before starting experimental incubations.

An augmented reality pipeline to create scenes with coherent illumination using textured cuboids

Shadows and illumination play an important role when generating a realistic scene in computer graphics. Most of the Augmented Reality (AR) systems track markers placed in a real scene and retrieve their position and orientation to serve as a frame of reference for added computer generated content, thereby producing an augmented scene. Realistic depiction of augmented content with coherent visual cues is a desired goal in many AR applications. However, rendering an augmented scene with realistic illumination is a complex task. Many existent approaches rely on a non automated pre-processing phase to retrieve illumination parameters from the scene. Other techniques rely on specific markers that contain light probes to perform environment lighting estimation. This study aims at designing a method to create AR applications with coherent illumination and shadows, using a textured cuboid marker, that does not require a training phase to provide lighting information. Such marker may be easily found in common environments: most of product packaging satisfies such characteristics. Thus, we propose a way to estimate a directional light configuration using multiple texture tracking to render AR scenes in a realistic fashion. We also propose a novel feature descriptor that is used to perform multiple texture tracking. Our descriptor is an extension of the binary descriptor, named discrete descriptor, and outperforms current state-of-the-art methods in speed, while maintaining their accuracy.