scholarly journals Acute symptoms of mild to moderate COVID-19 are highly heterogeneous across individuals and over time

2021 ◽  
Author(s):  
Thomas L Rodebaugh ◽  
Madelyn R Frumkin ◽  
Angela M Reiersen ◽  
Eric J Lenze ◽  
Michael S Avidan ◽  
...  
Keyword(s):  
Temporal Dynamics ◽  
Survey Methods ◽  
Clinical Care ◽  
Clinical Deterioration ◽  
Symptom Profiles ◽  
Fluctuating Course ◽  
The Common ◽  
Symptom Changes ◽  
Over Time

Abstract Background The symptoms of COVID-19 appear to be heterogenous, and the typical course of these symptoms is unknown. Our objectives were to characterize the common trajectories of COVID-19 symptoms and assess how symptom course predicts other symptom changes as well as clinical deterioration. Methods 162 participants with acute COVID-19 responded to surveys up to 31 times for up to 17 days. Several statistical methods were used to characterize the temporal dynamics of these symptoms. Because nine participants showed clinical deterioration, we explored whether these participants showed any differences in symptom profiles. Results Trajectories varied greatly between individuals, with many having persistently severe symptoms or developing new symptoms several days after being diagnosed. A typical trajectory was for a symptom to improve at a decremental rate, with most symptoms still persisting to some degree at the end of the reporting period. The pattern of symptoms over time suggested a fluctuating course for many patients. Participants who showed clinical deterioration were more likely to present with higher reports of severity of cough and diarrhea. Conclusion The course of symptoms during the initial weeks of COVID-19 is highly heterogeneous and is neither predictable nor easily characterized using typical survey methods. This has implications for clinical care and early-treatment clinical trials. Additional research is needed to determine whether the decelerating improvement pattern seen in our data is related to the phenomenon of patients reporting long-term symptoms, and whether higher symptoms of diarrhea in early illness presages deterioration.

Raptor Prey Remains

2020 ◽  
Author(s):  
Ed Drewitt
Keyword(s):  
Feeding Ecology ◽  
Prey Species ◽  
Local Level ◽  
Body Parts ◽  
Change Over Time ◽  
The Common ◽  
Prey Remains ◽  
Over Time ◽  
Prey Populations

Are you curious about the remains of an animal you have found? This compilation of the most likely found body parts of animals eaten by raptors will help you identify your discovery. Including over 100 species of bird and mammal prey of raptors such as sparrowhawks, peregrines and hen harriers, this photographic guide highlights the common feathers, fur and other body parts found at raptor nests, roosts, plucking posts and other opportunistic spots. Discovering what raptors eat is an important part of confirming their feeding ecology and how this might change over time, vary on a local level or in response to changing prey populations, as well as dispelling myths and assumptions about what certain raptor species eat. Diet studies are vital for the conservation of raptor species; the more we know about what they need for survival the more we can predict and plan long-term for the protection and survival of raptors that may be vulnerable and in decline. This is the first book to show in detail the actual parts of a bird, mammal or other animal that you are likely to find in a garden, woodland or beneath a raptor roost. As more people take an interest in raptors and watch species such as peregrines via webcams and through watch groups, there is greater opportunity for finding prey remains. This book provides the first and most important step in identifying a prey species.

Long-Term Methods for High-Definition Image Maps of Benthic Surveys

2013 ◽  
Vol 47 (6) ◽  
pp. 7-15
Author(s):  
Laurie Penland ◽  
Barrett Brooks ◽  
Edgardo Ochoa
Keyword(s):  
Survey Methods ◽  
Health Assessment ◽  
Measurement Tool ◽  
High Definition ◽  
Production Methods ◽  
Benthic Survey ◽  
Reef Health ◽  
Structured Approach ◽  
Over Time

AbstractCoral reef health assessment has relied on benthic photographic surveys as an essential measurement tool for decades. The emergence of gigapixel image (1 billion pixels) stitching technologies makes possible the creation of high-definition benthic image map surveys (HDBIMS). These image maps provide the traditional overall percentage coverage data. In addition, they allow zoom capabilities in such detail that scientists can, for example, count the polyps on a coral head. While the image maps are easily viewed over the Internet, they are challenging to produce. Numerous previous studies have contributed to the advancement of high-definition benthic survey methods. This ongoing HDBIMS study is focused on production methods that (1) produce the best image quality for the lowest cost, (2) provide accurate and repeatable results at any depth over time, and (3) utilize off-the-shelf (OTS) stitching software that allows accurate results that can be reviewed in the field. This structured approach to image acquisition, integrated with the OTS grid-oriented stitching software, produces highly accurate benthic image maps.

scholarly journals Challenges of Track Access Charges Model Redesign

2021 ◽  
Vol 13 (24) ◽  
pp. 13512
Author(s):  
Branislav Bošković ◽  
Mirjana Bugarinović ◽  
Gordana Savić ◽  
Ratko Djuričić
Keyword(s):  
Statistical Analysis ◽  
Survey Methods ◽  
Model Development ◽  
Charge System ◽  
Charge Model ◽  
Regulatory Bodies ◽  
Significant Divergence ◽  
The Common ◽  
Access Charges

It has been exactly 20 years since the common grounds for the design of track access charges (TAC) were laid for the European railways by the publication of Directive 2001/14/EC. However, these grounds were defined broadly, thus resulting in significant divergence both in the models applied by countries and during the model redesign within one country over the course of time. The participants in the process of charge system redesign includes all stakeholders from a country’s railway sector (infrastructure manager, train operating companies, the ministries responsible for transport, finance and economy, government, and regulatory bodies). Their opinions and requirements are often opposed, and they all need to be acknowledged simultaneously. This paper aims to solve the issue of ensuring continuity in the charge model redesign while achieving a balance between the requirements of all stakeholders. Moreover, it tackles the issue of producing a sustainable long-term TAC model by using survey methods and statistical analysis. The proposed approach was tested in practice during the access charge model redesign for the railways of Montenegro. The results show the importance of continual enhancement in TAC model development as one of the challenges and key precursors for the harmonization of all stakeholders’ requirements.

Coaching Wisdom in the Workplace: Coaching from an Integrative Model of Wisdom

2021 ◽  
Author(s):  
Sarah Smith
Keyword(s):  
Common Good ◽  
Psychological Research ◽  
Integrative Model ◽  
Human Flourishing ◽  
High Stakes ◽  
Dynamic Factors ◽  
Workplace Coaching ◽  
The Common ◽  
Over Time

Wisdom has long fascinated philosophers and theologians, hailed by many as the key to human flourishing and the pinnacle of human development. From this perspective its relevance to coaching seems indisputable, if somewhat aspirational. At the same time, we are facing some of the most demanding challenges humans have collectively faced. Leaders face ill-defined problems requiring an ability to embrace uncertainty, to engage in foresight, thinking both long-term and systemically towards the common good. In this high stakes context, accessing wiser reasoning ‘in time’ and developing wisdom ‘over time’ may be vital, for both client and coach. Whilst wisdom is often seen as beyond the reach of most people, there are times when we are all somewhat wiser than at other times. Drawing on the psychological research on wisdom, this chapter will present coaches with an integrative model of wisdom, outlining dynamic factors and interventions that influence its development and its expression. It asks readers to deeply consider what role coaching can play in developing wiser individuals, wiser organisations and workplaces.

scholarly journals Long-Term Longitudinal Stability of Kidney Filtration Marker Measurements: Implications for Epidemiological Studies and Clinical Care

2020 ◽  
Author(s):  
Amy B Karger ◽  
John H Eckfeldt ◽  
Gregory P Rynders ◽  
Juhi Chaudhari ◽  
Shiyuan Miao ◽  
...  
Keyword(s):  
Cystatin C ◽  
Clinical Care ◽  
Close Monitoring ◽  
Longitudinal Stability ◽  
Diagnostic Laboratory ◽  
Percentage Difference ◽  
Target Values ◽  
The Mean ◽  
Over Time

Abstract Background Establishment and improvement of glomerular filtration rate estimating equations requires accurate and precise laboratory measurement procedures (MPs) for filtration markers. The Advanced Research and Diagnostic Laboratory (ARDL) at the University of Minnesota, which has served as the central laboratory for the Chronic Kidney Disease Epidemiology Collaboration since 2009, has implemented several quality assurance measures to monitor the accuracy and stability of filtration marker assays over time. Methods To assess longitudinal stability for filtration marker assays, a 40-sample calibration panel was created using pooled serum, divided into multiple frozen aliquots stored at −80 °C. ARDL monitored 4 markers—creatinine, cystatin C, beta-2-microglobulin (B2M) and beta-trace protein—measuring 15 calibration panel aliquots from 2009 to 2019. Initial target values were established using the mean of the first 3 measurements performed in 2009–10, and differences from target were monitored over time. New MPs for cystatin C and B2M were added in 2012, with target values established using the first measurement. Results The mean percentage difference from mean target values across time was <2% for all original MPs (−0.59% for creatinine; −0.94% for cystatin C; −0.82% for B2M; 1.24% for beta-trace protein). Conclusions Close monitoring of filtration marker trends with a calibration panel at ARDL demonstrates remarkable long-term stability of the MPs. Routine use of a calibration panel for both research studies and clinical care is recommended for filtration markers where longitudinal monitoring is important to detect analytical biases, which can mask or confound true clinical trends in patients.

scholarly journals Long-term urban carbon dioxide observations reveal spatial and temporal dynamics related to urban characteristics and growth

2018 ◽  
Vol 115 (12) ◽  
pp. 2912-2917 ◽  
Author(s):  
Logan E. Mitchell ◽  
John C. Lin ◽  
David R. Bowling ◽  
Diane E. Pataki ◽  
Courtenay Strong ◽  
...  
Keyword(s):  
Population Growth ◽  
Rural Areas ◽  
Temporal Dynamics ◽  
Salt Lake ◽  
Nonlinear Relationship ◽  
Emission Inventories ◽  
Urban Core ◽  
Decadal Scale ◽  
Over Time

Cities are concentrated areas of CO2 emissions and have become the foci of policies for mitigation actions. However, atmospheric measurement networks suitable for evaluating urban emissions over time are scarce. Here we present a unique long-term (decadal) record of CO2 mole fractions from five sites across Utah’s metropolitan Salt Lake Valley. We examine “excess” CO2 above background conditions resulting from local emissions and meteorological conditions. We ascribe CO2 trends to changes in emissions, since we did not find long-term trends in atmospheric mixing proxies. Three contrasting CO2 trends emerged across urban types: negative trends at a residential-industrial site, positive trends at a site surrounded by rapid suburban growth, and relatively constant CO2 over time at multiple sites in the established, residential, and commercial urban core. Analysis of population within the atmospheric footprints of the different sites reveals approximately equal increases in population influencing the observed CO2, implying a nonlinear relationship with CO2 emissions: Population growth in rural areas that experienced suburban development was associated with increasing emissions while population growth in the developed urban core was associated with stable emissions. Four state-of-the-art global-scale emission inventories also have a nonlinear relationship with population density across the city; however, in contrast to our observations, they all have nearly constant emissions over time. Our results indicate that decadal scale changes in urban CO2 emissions are detectable through monitoring networks and constitute a valuable approach to evaluate emission inventories and studies of urban carbon cycles.

Abstract 331: Trajectories of Sequential Organ Failure Assessment (sofa) Scores After Cardiac Arrest

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Kate Flickinger ◽  
Patrick J Coppler ◽  
McKenzie Brown ◽  
Jonathan Elmer
Keyword(s):  
Cardiac Arrest ◽  
Sequential Organ Failure Assessment ◽  
Organ Failure ◽  
Temporal Dynamics ◽  
Clinical Care ◽  
Group 4 ◽  
Failure Assessment ◽  
Initial Rhythm ◽  
Group 3 ◽  
Over Time

Cardiac arrest (CA) often results in multi-system organ failure (MSOF). The Sequential Organ Failure Assessment (SOFA) Score is a tool based on the assessment of 6 physiological systems and can quantify severity of MSOF. Understanding the epidemiology, temporal dynamics and anticipated course of MSOF after CA is critical to both clinical care and prognostication. We included patients treated at a single center after CA from 2010-2019, regardless of arrest location or etiology. We electronically extracted all medication, laboratory, ventilator, intake and output data. We calculated SOFA scores daily for up to five days (or until death or discharge). We used group-based trajectory modeling (GBTM, also known as growth curve mixture modeling) to identify groups of patients with distinct trajectories of SOFA over time. We started by fitting trajectories with third order polynomials then sequentially eliminated higher order terms with non-significant coefficients. We used AIC and BIC to determine the number of groups. We included 2,740 patients, of whom most (1,633; 59%) were male, with mean (SD) age of 59 (16) years. Most arrests (2,106; 76%) occurred out-of-hospital and 837 (30%) had a shockable initial rhythm. Overall survival to discharge was 38%. Bilirubin was infrequently checked in this cohort, so we excluded the liver subscale of SOFA from total SOFA calculation making maximum SOFA 20. Mean presenting SOFA was 6 (3), and mean SOFA on day 2 was 6 (4). We identified 5 groups of patients with unique trajectories of SOFA over time. Baseline demographics and survival differed across trajectory groups. Despite showing delayed MOSF onset with rapidly rising SOFA from baseline to day 2, 26% of Group 4 still survived to discharge, while Group 3, which had an initially severe but rapidly improving MSOF had a 32% survival rate. Unique patterns of MSOF after CA can be identified using GBTM. Delayed onset of severe MSOF is less prognostically ominous than commonly believed by clinicians.

Fatigue trajectories in long-term non-Hodgkin lymphoma survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e20053-e20053
Author(s):  
Matthew Roger LeBlanc ◽  
Sheryl Zimmerman ◽  
Mariam Kayle ◽  
Thomas William LeBlanc ◽  
Kathryn Elizabeth Hudson ◽  
...  
Keyword(s):  
General Population ◽  
Hodgkin Lymphoma ◽  
Clinical Care ◽  
Ptsd Symptoms ◽  
Population Mean ◽  
Non Hodgkin Lymphoma ◽  
Experienced Fatigue ◽  
Over Time ◽  
Population Norm

e20053 Background: Fatigue is a common and distressing effect of cancer and its treatment. Prior research suggests fatigue persists long after diagnosis and treatment in non-Hodgkin lymphoma (NHL) survivors. This study aimed to identify distinct trajectories of fatigue in NHL survivors and predictors of trajectories that could inform clinical care. Methods: Our secondary analysis used data from a longitudinal study of NHL survivors (n = 886) at least 2 years post-diagnosis. Fatigue was measured using the SF-36 vitality subscale across three time points. Prior literature informed the selection of baseline demographic (e.g. age, gender, race) and disease characteristics [e.g. NHL type, comorbidities, post-traumatic stress disorder (PTSD)] explored as possible predictors of fatigue trajectories. We used group-based trajectory modeling to identify distinct groups of patients experiencing similar patterns of fatigue. Variables significant in bivariate analysis were included in a stepwise multinomial logistic regression to identify factors predictive of group membership. Results: We identified four distinct trajectories that suggest levels of fatigue persist unchanged over time. The Low Fatigue Group (15.6%) experienced less fatigue than the general population. The Population Norm Group (42.5%) experienced a similar level of fatigue to the general population mean. The Significant Fatigue Group (27.5%) experienced fatigue levels almost one standard deviation worse than the general population. The Worst Fatigue Group (14.3%) experienced fatigue almost two standard deviations worse than the population norm. PTSD symptoms and comorbidity scores were predictive of levels of fatigue over time. Greater age at diagnosis increases the odds survivors experienced worse fatigue than the population mean (Table). Conclusions: Levels of fatigue experienced early in an NHL patients’ disease trajectory may persist for many years. Higher levels of PTSD symptoms and comorbidities were predictive of worse fatigue over time. Early interventions addressing PTSD symptoms and comorbidities may improve long term fatigue outcomes. [Table: see text]

Articulatory Generalization in Two Word-Medial, Ambisyllabic Contexts

1988 ◽  
Vol 19 (3) ◽  
pp. 251-258 ◽  
Author(s):  
Virginia I. Wolfe ◽  
Suzanne D. Blocker ◽  
Norma J. Prater
Keyword(s):  
Common View ◽  
Perceptual Salience ◽  
The Common ◽  
Unitary Concept ◽  
Over Time

Articulatory generalization of velar cognates /k/, /g/ in two phonologically disordered children was studied over time as a function of sequential word-morpheme position training. Although patterns of contextual acquisition differed, correct responses to the word-medial, inflected context (e.g., "picking," "hugging") occurred earlier and exceeded those to the word-medial, noninflected context (e.g., "bacon," "wagon"). This finding indicates that the common view of the word-medial position as a unitary concept is an oversimplification. Possible explanations for superior generalization to the word-medial, inflected position are discussed in terms of coarticulation, perceptual salience, and the representational integrity of the word.

The foundations of peaceful coexistence after the war ... Mosul is a model

2019 ◽  
pp. 178
Author(s):  
Omar Hashim Thanon
Keyword(s):  
Ethnic Diversity ◽  
Psychological Consequences ◽  
Peaceful Coexistence ◽  
Negative Effects ◽  
Mass Displacement ◽  
The Common ◽  
Near Term ◽  
Post War ◽  
Common Destiny

Since peaceful coexistence reflects in its various aspects the concept of harmony between the members of the same society with their different national, religious and sectarian affiliations, as well as their attitudes and ideas, what brings together these are the common bonds such as land, interests and common destiny. But this coexistence is exposing for crises and instability and the theft of rights and other that destroy the communities with their different religious, national, sectarian, ethnic aspects, especially if these led to a crisis of fighting or war, which produces only destruction and mass displacement, ttherefore, the process of bridging the gap between the different parts of society in the post-war phase through a set of requirements that serve as the basis for the promotion of peaceful coexistence within the same country to consolidate civil and community peace in order to create a general framework and a coherent basis to reconstruct the community again.      Hence the premise of the research by asking about the extent of the possibility and ability of the community of religious and ethnic diversity, which has been exposed to these crises, which aimed at this diversity, basically to be able to rise and re-integrate within the same country and thus achieve civil and community peace, and Mosul is an example for that, the negative effects of the war and the accomplices of many criminal acts have given rise to hatred and fear for all, leading to the loss of livelihoods, which in the long term may have devastating social and psychological consequences.        To clarify all of this, the title of the first topic was a review of the concept and origin of peaceful coexistence. While the second topic dealt with the requirements of peaceful coexistence and social integration in Mosul, the last topic has identified the most important challenges facing the processes of coexistence and integration in Mosul. All this in order to paint a better future for the conductor at all levels in the near term at the very least to achieve the values of this peaceful coexistence, especially in the post-war period.

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