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PURPOSE: The goal of this study was to evaluate the performance of a pediatric stratification tool that incorporates health and non-medical determinants to identify children and youth with special health care needs (CYSHCN) patients according to increasing levels of complexity and compare this method to existing tools for pediatric populations. METHODS: This retrospective cohort study examined pediatric patients aged 0 to 21 years who received care at our institution between 2012 and 2015. We used the St. Luke’s Children’s Acuity Tool (SLCAT) to evaluate mean differences in dollars billed, number of encounters, and number of problems on the problem list and compared the SLCAT to the Pediatric Chronic Conditions Classification System version2 (CCCv2). RESULTS: Results indicate that the SLCAT assigned pediatric patients into levels reflective of resource utilization and found that children with highly complex chronic conditions had significantly higher utilization than those with mild and/or moderate complex conditions. The SLCAT found 515 patients not identified by the CCCv2. Nearly half of those patients had a mental/behavioral health diagnosis. CONCLUSIONS: The findings of this study provide evidence that a tiered classification model that incorporates all aspects of a child’s care may result in more accurate identification of CYSHCN. This would allow for primary care provider and care coordination teams to match patients and families with the appropriate amount and type of care coordination services.

Immunologic, physiologic, and behavioral responses to a combined viral-bacterial respiratory challenge were explored in beef steers (initial BW 293 kg). Steers (n = 24) were inoculated intranasally with bovine herpes virus-1 (2×108 PFU) and intratracheally with Mannheimia haemolytica (MH, 2.15×1010 CFU) on days -3 and 0, respectively, (n = 16; VB), or similarly inoculated with phosphate-buffered saline (n = 8; PBS). Venous and arterial blood were collected on -3, -1, 0, 2, 3, 5, 7, 10, and 14 relative to MH challenge for CBC, haptoglobin, and arterial blood oxygen saturation analysis. Continuously recorded variables included rumen temperature, activity, rumination, DMI, and feeding behavior. Data were analyzed with a repeated-measures mixed model (SAS 9.4) with fixed effects of day, inoculation, and the interaction. Bunk visit frequency and DMI were reduced (P < 0.01) in VB steers throughout the 14 d post-MH period compared to PBS steers. Rumination (days 1, 7) and activity (days 1, 2, 4–8, and 11–13) were reduced (P < 0.03) in VB steers vs PBS steers. Rumen temperature was elevated (P < 0.04) in VB steers until day 6 post MH inoculation. Neutrophil concentrations (days 2 and 3), platelets (days 7–14), fibrinogen (days 2–10), and haptoglobin (days 2–7) were elevated (P < 0.05) in VB vs PBS steers. Hematocrit was depressed (P < 0.05) in VB steers on days 3–10. The VB steers had decreased (P < 0.05) arterial SO2% and pO2 than PBS steers; however, the inoculation × day interaction was not significant. Results indicate that the experimental VB challenge substantially altered rumen temperature, DMI, feeding behavior, rumination and immunological response as expected. Arterial sO2% and pO2 concentrations were reduced minimally by VB challenge, indicating challenges in using blood gas to detect BRD in beef cattle.

Background There is a need for pediatric medical devices that accommodate the unique physiology and anatomy of pediatric patients that is increasingly receiving more attention. However, there is limited literature on the programs within children's hospitals and academia that can support pediatric device development. We describe our experience with pediatric device design utilizing collaborations between a children's hospital and two engineering schools. Methods Utilizing the academic year as a timeline, unmet pediatric device needs were identified by surgical faculty and matched with an engineering mentor and a team of students within the Capstone Engineering Design programs at two universities. The final prototypes were showcased at the end of the academic year and if appropriate, provisional patent applications were filed. Results All twelve teams successfully developed device prototypes, and five teams obtained provisional patents. The prototypes that obtained provisional patents included a non-operative ureteral stent removal system, an evacuation device for small kidney stone fragments, a mechanical leech, an anchoring system of the chorio-amniotic membranes during fetal surgery, and a fetal oxygenation monitor during fetoscopic procedures. Conclusions Capstone Engineering Design programs in partnership with surgical faculty at children's hospitals can play an effective role in the prototype development of novel pediatric medical devices. Levels of evidence N/A – No clinical subjects or human testing was performed.

(2020). ‘Living shores: interacting with southern Africa’s marine ecosystems’ by George Branch and Margo Branch. African Journal of Marine Science: Vol. 42, No. 1, pp. 129-129.

SUMMARY Africa's political leaders, local communities, governments, conservation and tourism organizations, bilateral and multilateral aid agencies, the private sector and NGOs are increasingly embracing Transfrontier Conservation Areas (TFCAs) in recognition of their role in conserving biodiversity, socioeconomic development and promoting a culture of peace. The establishment of the Kgalagadi Transfrontier Park has provided a useful model for demonstrating the institutional arrangements for TFCA establishment, which have to address political and legal issues, regional support, the role of government departments and conservation agencies, community participation and financial requirements. Two proposed TFCAs, namely the Three-Nations Namib Desert TFCA (South Africa/Namibia/Angola) and the Upper Zambezi/Okavango TFCA (Angola/Botswana/Namibia/Zambia/Zimbabwe) are described and examined in more detail in relation to the benefits they can bring to the participating countries and their role in conserving globa...

Africa’s political leaders, governments, conservation and tourism organizations, bilateral and multilateral aid agencies, the private sector, local communities and NGOs are increasingly embracing Transfrontier Conservation Areas (TFCAs) in recognition of their role in conserving biodiversity, socio-economic development and promoting a culture of peace and regional co-operation. This chapter examines how and when TFCAs evolved from the conservation concept of a ‘Peace Park’ and were subsequently developed in the Southern African Development Community (SADC), with particular reference to the origin of the Peace Parks Foundation (PPF) and its role in their establishment. It reviews the objectives of TFCA establishment, and describes the development and institutional processes followed by SADC in their establishment. The chapter continues with a discussion on the benefits and challenges of TFCA development that have been encountered and concludes that with a genuine commitment by all parties to develop, implement and manage each TFCA according to its specific needs and geographical, economic and political constraints, the future looks encouraging.

Investigations were carried out in 1989 to determine the evapotranspiration (ET) of alfalfa when irrigated with saline waste water coming from the evaporation of fresh water in the cooling towers of Utah Power and Light Company Electrical Power Plant at Huntington in central Utah, U.S.A. The primary goal is to dispose of the waste water from the power plant by irrigation and to maximize salt deposition in the soil, maximize crop ET, minimize runoff from the soil surface, and minimize leaching to the ground water. Using the Bowen ratio-energy balance method, alfalfa evapotranspiration was measured at an experimental site for each 20-minute period during the 1989 irrigation season. Using a simplified seasonal water balance, the results showed that cumulative irrigation plus rain was less than evapotranspiration for the 1989 irrigation season. This means that for the long term in addition to irrigation and precipitation some water was withdrawn from the soil for alfalfa crop water requirements (ETa). Short term evaluations showed that because of unforeseen heavy rain (thunder showers) in this mountainous area between irrigations, ETa was occasionally less than irrigation plus rain. This means the excess water was stored in the soil for later use. The average value for ETa/ETp (potential ET) for the 1989 irrigation season was 0.47 but occasionally the ratio was greater than unity. Short-term studies (Hanks et al. 1990 a) indicate that yield and ETa are likely to decrease only slightly for the coming years if saline irrigation water is applied. This method of investigation can be applied to any industrial processes which produce waste water.

Virtual instrumentation, using software application tools and off the shelf plug‐in cards to turn your computer into an instrument, is a very economical, attractive, and flexible method to perform audio analysis. Plug‐in digital signal processing (DSP) boards provide personal computers with a level of processing power that was once restricted to all but the most powerful mainframe computers. These boards transform the PC into a parallel processing environment, delivering millions of floating point operations per second (MFLOPS) or more to numerically intensive tasks. Couple this with high‐quality A/D converters and virtual instrumentation software tools and you have a powerful environment for building applications ranging from digital audio to underwater acoustics to vibration and modal analysis. This paper details a real‐time acquisition and analysis DSP application using a 16‐bit delta‐sigma A/D converter and an AT&T WE DSP32C‐based plug‐in board to acquire and process restricted band audio frequency (dc to 5 kHz) information. A real‐time restricted band one‐third‐octave analyzer was implemented using a AT computer and a plug‐in board equipped with a digital signal processor and an audio frequency A/D converter. The restricted band one‐third‐octave analyzer provides the AT computer with enough power to meet or replace several stand‐alone one‐third‐octave analyzers, and virtual instrumentation tools allow ease of configuration for new applications.

The validity of numerical solutions of nonsteady-state, one-dimensional, vertical drainage problems was evaluated by comparison with experimental data. Experimental data included simultaneous measurements of fluid pressure using a pressure transducer, and fluid content using gamma radiation. The results of 13 numerical solutions involving five porous media and two or three boundary conditions for each are summarized. Several approximate solutions to the vertical drainage problem were evaluated and the limitations of each discussed. The flow rate was related to the position of the saturated front during primary drainage. During secondary drainage, the change in flow rate was not dependent on the recession of the saturated zone, but was related to the unsaturated hydraulic conductivity and the differential fluid capacity above the saturated zone for the porous material and fluid involved. Characteristic changes in fluid pressure distribution with time are summarized.