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"Ward, Brian R"
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The story of medicine
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Book
River arsenic levels declining
Ongoing monitoring shows that arsenic concentrations in the Moira River have been substantially reduced since this ministry took control of the abandoned [Deloro] mine site. Since 1983, when the ministry installed an arsenic treatment plant, the amount of arsenic going into the Moira River has been reduced by over 80 per cent. The goal of the final remediation work is to ensure that arsenic levels in the Moira River consistently meet Ontario water quality objectives. In 1999, before the Moira River study was finalized, we sent a joint letter to all property owners along the river system advising them not to drink untreated water. The letter stated that if people choose to use the river or the lake as their drinking water source, they should treat the water to remove arsenic, as well as bacteria (which is always necessary for water taken from lakes and rivers). Distillation and reverse osmosis were recommended as treatment methods for arsenic removal, and a health unit contact was provided for further information.
Newspaper Article
Landfill followed rules
Landfilling is an acceptable, approved method of managing petroleum-contaminated soil. The Ontario Ministry of Environment and Energy followed the regulations and normal practices that apply to similar clean-ups in the province. The ministry did not violate any of the provincial rules. I trust that this clarifies the ministry's actions in undertaking the clean-up in an efficient, environmentally sound manner. It will enable the MacIntyres to re-establish their normal lifestyle, and it will permit the province to proceed with recovering the costs on behalf of the taxpayers of Ontario.
Newspaper Article
Historical (1700–2012) Global Multi-Model Estimates of the Fire Emissions from the Fire Modeling Intercomparison Project (FireMIP)
Fire emissions are critical for carbon and nutrient cycles, climate, and air quality. Dynamic Global Vegetation Models (DGVMs) with interactive fire modeling provide important estimates for long-term and large-scale changes of fire emissions. Here we present the first multi-model estimates of global gridded historical fire emissions for 1700-2012, including carbon and 33 species of trace gases and aerosols. The dataset is based on simulations of nine DGVMs with different state-of-the-art global fire models that participated in the Fire Modeling Intercomparison Project (FireMIP), using the same and standardized protocols and forcing data, and the most up-to-date fire emission factor table from field and laboratory studies over various land cover types. We evaluate the simulations of present-day fire emissions by comparing them with satellite-based products. Evaluation results show that most DGVMs simulate present-day global fire emission totals within the range of satellite-based products, and can capture the high emissions over the tropical savannas, low emissions over the arid and sparsely vegetated regions, and the main features of seasonality. However, most of the models fail to simulate the interannual variability, partly due to a lack of modeling peat fires and tropical deforestation fires. Historically, all models show only a weak trend in global fire emissions before ~1850s, consistent with multi-source merged historical reconstructions. The long-term trends among DGVMs are quite different for the 20th century, with some models showing an increase and others a decrease in fire emissions, mainly as a result of the discrepancy in their simulated responses to human population density change and land-use and land-cover change (LULCC). Our study provides a basic dataset for developing regional and global multi-source merged historical reconstructions and merging methods, and analyzing historical changes of fire emissions and their uncertainties as well as their role in the Earth system. It also highlights the importance of accurately modeling the responses of fire emissions to LULCC and population density change in reducing uncertainties in historical reconstructions of fire emissions and providing more reliable future projections.
Journal Article
Evaluating alternative hypotheses for the early evolution and diversification of ants
Ants are the world's most diverse and ecologically dominant eusocial organisms. Resolving the phylogeny and timescale for major ant lineages is vital to understanding how they achieved this success. Morphological, molecular, and paleontological studies, however, have presented conflicting views on early ant evolution. To address these issues, we generated the largest ant molecular phylogenetic data set published to date, containing approximately equal to 6 kb of DNA sequence from 162 species representing all 20 ant subfamilies and 10 aculeate outgroup families. When these data were analyzed with and without outgroups, which are all distantly related to ants and hence long-branched, we obtained conflicting ingroup topologies for some early ant lineages. This result casts strong doubt on the existence of a poneroid clade as currently defined. We compare alternate attachments of the outgroups to the ingroup tree by using likelihood tests, and find that several alternative rootings cannot be rejected by the data. These alternatives imply fundamentally different scenarios for the early evolution of ant morphology and behavior. Our data strongly support several notable relationships within the more derived formicoid ants, including placement of the enigmatic subfamily Aenictogitoninae as sister to Dorylus army ants. We use the molecular data to estimate divergence times, employing a strategy distinct from previous work by incorporating the extensive fossil record of other aculeate Hymenoptera as well as that of ants. Our age estimates for the most recent common ancestor of extant ants range from approximately equal to 115 to 135 million years ago, indicating that a Jurassic origin is highly unlikely.
Journal Article
Effects of climate and irrigation on GRACE-based estimates of water storage changes in major US aquifers
Understanding climate and human impacts on water storage is critical for sustainable water-resources management. Here we assessed climate and human drivers of total water storage (TWS) variability from Gravity Recovery and Climate Experiment (GRACE) satellites compared with drought severity and irrigation water use in 14 major aquifers in the United States. Results show that long-term variability in TWS tracked by GRACE satellites is dominated by interannual variability in most of the 14 major US aquifers. Low TWS trends in the humid eastern U.S. are linked to low drought intensity. Although irrigation pumpage in the humid Mississippi Embayment aquifer exceeded that in the semi-arid California Central Valley, a surprising lack of TWS depletion in the Mississippi Embayment aquifer is attributed to extensive streamflow capture. Marked storage depletion in the semi-arid southwestern Central Valley and south-central High Plains totaled ∼90 km
3
, about three times greater than the capacity of Lake Mead, the largest U.S. reservoir. Depletion in the Central Valley was driven by long-term droughts (⩽5 yr) amplified by switching from mostly surface water to groundwater irrigation. Low or slightly rising TWS trends in the northwestern (Columbia and Snake Basins) US are attributed to dampening drought impacts by mostly surface water irrigation. GRACE satellite data highlight synergies between climate and irrigation, resulting in little impact on TWS in the humid east, amplified TWS depletion in the semi-arid southwest and southcentral US, and dampened TWS deletion in the northwest and north central US Sustainable groundwater management benefits from conjunctive use of surface water and groundwater, inefficient surface water irrigation promoting groundwater recharge, efficient groundwater irrigation minimizing depletion, and increasing managed aquifer recharge. This study has important implications for sustainable water development in many regions globally.
Journal Article
An increase in glycoprotein concentration on extracellular virions dramatically alters vaccinia virus infectivity and pathogenesis without impacting immunogenicity
The extracellular virion (EV) form of Orthopoxviruses is required for cell-to-cell spread and pathogenesis, and is the target of neutralizing antibodies in the protective immune response. EV have a double envelope that contains several unique proteins that are involved in its intracellular envelopment and/or subsequent infectivity. One of these, F13, is involved in both EV formation and infectivity. Here, we report that replacement of vaccinia virus F13L with the molluscum contagiosum virus homolog, MC021L, results in the production of EV particles with significantly increased levels of EV glycoproteins, which correlate with a small plaque phenotype. Using a novel fluorescence-activated virion sorting assay to isolate EV populations based on glycoprotein content we determine that EV containing either higher or lower levels of glycoproteins are less infectious, suggesting that there is an optimal concentration of glycoproteins in the outer envelope that is required for maximal infectivity of EV. This optimal glycoprotein concentration was required for lethality and induction of pathology in a cutaneous model of animal infection, but was not required for induction of a protective immune response. Therefore, our results demonstrate that there is a sensitive balance between glycoprotein incorporation, infectivity, and pathogenesis, and that manipulation of EV glycoprotein levels can produce vaccine vectors in which pathologic side effects are attenuated without a marked diminution in induction of protective immunity.
Journal Article
Phylogenomic methods outperform traditional multi-locus approaches in resolving deep evolutionary history: a case study of formicine ants
Background
Ultraconserved elements (UCEs) have been successfully used in phylogenomics for a variety of taxa, but their power in phylogenetic inference has yet to be extensively compared with that of traditional Sanger sequencing data sets. Moreover, UCE data on invertebrates, including insects, are sparse. We compared the phylogenetic informativeness of 959 UCE loci with a multi-locus data set of ten nuclear markers obtained via Sanger sequencing, testing the ability of these two types of data to resolve and date the evolutionary history of the second most species-rich subfamily of ants in the world, the Formicinae.
Results
Phylogenetic analyses show that UCEs are superior in resolving ancient and shallow relationships in formicine ants, demonstrated by increased node support and a more resolved phylogeny. Phylogenetic informativeness metrics indicate a twofold improvement relative to the 10-gene data matrix generated from the identical set of taxa. We were able to significantly improve formicine classification based on our comprehensive UCE phylogeny. Our divergence age estimations, using both UCE and Sanger data, indicate that crown-group Formicinae are older (104–117 Ma) than previously suggested. Biogeographic analyses infer that the diversification of the subfamily has occurred on all continents with no particular hub of cladogenesis.
Conclusions
We found UCEs to be far superior to the multi-locus data set in estimating formicine relationships. The early history of the clade remains uncertain due to ancient rapid divergence events that are unresolvable even with our genomic-scale data, although this might be largely an effect of several problematic taxa subtended by long branches. Our comparison of divergence ages from both Sanger and UCE data demonstrates the effectiveness of UCEs for dating analyses. This comparative study highlights both the promise and limitations of UCEs for insect phylogenomics, and will prove useful to the growing number of evolutionary biologists considering the transition from Sanger to next-generation sequencing approaches.
Journal Article
The role of telehealth in sepsis care in rural emergency departments: A qualitative study of emergency department sepsis telehealth user perspectives
Sepsis is a leading cause of hospitalization and death in the United States, and rural patients are at particularly high risk. Telehealth has been proposed as one strategy to narrow rural-urban disparities. The objective of this study was to understand why rural emergency department (ED) staff use provider-to-provider telehealth (tele-ED) and how tele-ED care changes the care for rural patients with sepsis.
We conducted a qualitative interview study between February 15, 2022, and May 22, 2023, with participants from upper Midwest rural EDs and tele-ED hub physicians in a single tele-ED network that delivers provider-to-provider consultation for sepsis patients. One interviewer conducted individual telephone interviews, then we used standard qualitative methods based on modified grounded theory to identify themes and domains.
We interviewed 27 participants, and from the interviews we identified nine themes within three domains. Participants largely felt tele-ED for sepsis was valuable in their practice. We identified that telehealth was consulted to facilitate interhospital transfer, provide surge capacity for small teams, to adhere with provider scope-of-practice policies, for inexperienced providers, and for patients with increased severity of illness or complex comorbidities. Barriers to tele-ED use and impact included increased sepsis care standardization, provider reluctance, and sepsis diagnostic uncertainty. Additionally, we identified that real-time education and training were important secondary benefits identified from tele-ED use.
Tele-ED care was used by rural providers for sepsis treatment, but many barriers existed that may have limited potential benefits to its use.
Journal Article
Portable, bedside, low-field magnetic resonance imaging for evaluation of intracerebral hemorrhage
Radiological examination of the brain is a critical determinant of stroke care pathways. Accessible neuroimaging is essential to detect the presence of intracerebral hemorrhage (ICH). Conventional magnetic resonance imaging (MRI) operates at high magnetic field strength (1.5–3 T), which requires an access-controlled environment, rendering MRI often inaccessible. We demonstrate the use of a low-field MRI (0.064 T) for ICH evaluation. Patients were imaged using conventional neuroimaging (non-contrast computerized tomography (CT) or 1.5/3 T MRI) and portable MRI (pMRI) at Yale New Haven Hospital from July 2018 to November 2020. Two board-certified neuroradiologists evaluated a total of 144 pMRI examinations (56 ICH, 48 acute ischemic stroke, 40 healthy controls) and one ICH imaging core lab researcher reviewed the cases of disagreement. Raters correctly detected ICH in 45 of 56 cases (80.4% sensitivity, 95%CI: [0.68–0.90]). Blood-negative cases were correctly identified in 85 of 88 cases (96.6% specificity, 95%CI: [0.90–0.99]). Manually segmented hematoma volumes and ABC/2 estimated volumes on pMRI correlate with conventional imaging volumes (ICC = 0.955,
p
= 1.69e-30 and ICC = 0.875,
p
= 1.66e-8, respectively). Hematoma volumes measured on pMRI correlate with NIH stroke scale (NIHSS) and clinical outcome (mRS) at discharge for manual and ABC/2 volumes. Low-field pMRI may be useful in bringing advanced MRI technology to resource-limited settings.
Conventional magnetic resonance imaging (MRI) operates at a high magnetic field strength and requires a strict access-controlled environment, making MRI often inaccessible. Here, the authors present a portable low-field MRI device that detects intracerebral hemorrhage with high accuracy.
Journal Article