Sarcopenia is a Poor Predictor of Outcomes in Elective Colectomy for Diverticulitis.

Background: Sarcopenia is associated with adverse perioperative outcomes in patients undergoing operations for malignancy, but its influence on patients undergoing elective colectomy for diverticulitis is unknown. We hypothesized that sarcopenia is associated with adverse perioperative events in patients undergoing elective colectomy for diverticulitis.

Methods: Comorbidities, operative characteristics, and postoperative complications were extrapolated from our institutional EMR in patients undergoing elective colectomy for diverticulitis from 2016 to 2020.

Mifepristone induced liver injury in a patient with Cushing syndrome: a case report and review of the literature.

Background: Mifepristone, also known as RU-486, is an anti-progestational steroid with similar chemical structure to anabolic steroids. Given as a single dose in conjunction with misoprostol, mifepristone is used to induce medical abortion. Mifepristone administered chronically at a higher dose is also approved for the management of hypercortisolism.

Response to Comment on "No consistent ENSO response to volcanic forcing over the last millennium".

Robock claims that our analysis fails to acknowledge that pan-tropical surface cooling caused by large volcanic eruptions may mask El Niño warming at our central Pacific site, potentially obscuring a volcano-El Niño connection suggested in previous studies. Although observational support for a dynamical response linking volcanic cooling to El Niño remains ambiguous, Robock raises some important questions about our study that we address here.

On the essentials of drought in a changing climate.

Droughts of the future are likely to be more frequent, severe, and longer lasting than they have been in recent decades, but drought risks will be lower if greenhouse gas emissions are cut aggressively. This review presents a synopsis of the tools required for understanding the statistics, physics, and dynamics of drought and its causes in a historical context. Although these tools have been applied most extensively in the United States, Europe, and the Amazon region, they have not been as widely used in other drought-prone regions throughout the rest of the world, presenting opportunities for future research.

No consistent ENSO response to volcanic forcing over the last millennium.

The El Niño-Southern Oscillation (ENSO) shapes global climate patterns yet its sensitivity to external climate forcing remains uncertain. Modeling studies suggest that ENSO is sensitive to sulfate aerosol forcing associated with explosive volcanism but observational support for this effect remains ambiguous. Here, we used absolutely dated fossil corals from the central tropical Pacific to gauge ENSO's response to large volcanic eruptions of the last millennium.

Bacterial taxonomic composition of the postpartum cow uterus and vagina prior to artificial insemination1.

The current study characterized the taxonomic composition of the uterine and vaginal bacterial communities during estrous synchronization up to timed artificial insemination (TAI). Postpartum beef cows (n = 68) were subjected to pre-synchronization step 21 d prior to TAI (day -21), followed by an industry standard 7 Day Co-Synch on day -9 and TAI on day 0. Uterine and vaginal flushes were collected on days -21, -9, and -2 of the protocol and pH was immediately recorded.

Uterine and vaginal bacterial community diversity prior to artificial insemination between pregnant and nonpregnant postpartum cows1.

The present study evaluated the bovine vaginal and uterine bacterial community diversity and its relationship to fertility. Postpartum beef cows (n = 68) were synchronized beginning on day -21 and ending with timed artificial insemination (TAI) on day 0. Pregnancy was diagnosed 30 d after TAI.

Testing Hopkins' Bioclimatic Law with PhenoCam data.

Premise Of The Study: We investigated the spatial and temporal patterns of vegetation phenology with phenometrics derived from PhenoCam imagery. Specifically, we evaluated the Bioclimatic Law proposed by Hopkins, which relates phenological transitions to latitude, longitude, and elevation.

Methods: "Green-up" and "green-down" dates-representing the start and end of the annual cycles of vegetation activity-were estimated from measures of canopy greenness calculated from digital repeat photography.

Mid-latitude net precipitation decreased with Arctic warming during the Holocene.

The latitudinal temperature gradient between the Equator and the poles influences atmospheric stability, the strength of the jet stream and extratropical cyclones. Recent global warming is weakening the annual surface gradient in the Northern Hemisphere by preferentially warming the high latitudes; however, the implications of these changes for mid-latitude climate remain uncertain. Here we show that a weaker latitudinal temperature gradient-that is, warming of the Arctic with respect to the Equator-during the early to middle part of the Holocene coincided with substantial decreases in mid-latitude net precipitation (precipitation minus evapotranspiration, at 30° N to 50° N).

Healthcare cost prediction: Leveraging fine-grain temporal patterns.

Objective: To design and assess a method to leverage individuals' temporal data for predicting their healthcare cost. To achieve this goal, we first used patients' temporal data in their fine-grain form as opposed to coarse-grain form. Second, we devised novel spike detection features to extract temporal patterns that improve the performance of cost prediction.

Exacerbation of the 2013-2016 Pan-Caribbean Drought by Anthropogenic Warming.

The Caribbean islands are expected to see more frequent and severe droughts from reduced precipitation and increased evaporative demand due to anthropogenic climate change. Between 2013 and 2016, the Caribbean experienced a widespread drought due in part to El Niño in 2015-2016, but it is unknown whether its severity was exacerbated by anthropogenic warming. This work examines the role of recent warming on this drought, using a recently developed high-resolution self-calibrating Palmer Drought Severity Index data set.

Supervised Learning Methods for Predicting Healthcare Costs: Systematic Literature Review and Empirical Evaluation.

An important informatics tool for controlling healthcare costs is accurately predicting the likely future healthcare costs of individuals. To address this important need, we conducted a systematic literature review and identified five methods for predicting healthcare costs. To enable a direct comparison of these different approaches, we empirically evaluated the predictive performance of each reported approach, as well as other state-of-the-art supervised learning methods, using data from University of Utah Health Plans for October 2013 through October 2016.

Relative impacts of mitigation, temperature, and precipitation on 21st-century megadrought risk in the American Southwest.

Megadroughts are comparable in severity to the worst droughts of the 20th century but are of much longer duration. A megadrought in the American Southwest would impose unprecedented stress on the limited water resources of the area, making it critical to evaluate future risks not only under different climate change mitigation scenarios but also for different aspects of regional hydroclimate. We find that changes in the mean hydroclimate state, rather than its variability, determine megadrought risk in the American Southwest.

Unprecedented 21st century drought risk in the American Southwest and Central Plains.

In the Southwest and Central Plains of Western North America, climate change is expected to increase drought severity in the coming decades. These regions nevertheless experienced extended Medieval-era droughts that were more persistent than any historical event, providing crucial targets in the paleoclimate record for benchmarking the severity of future drought risks. We use an empirical drought reconstruction and three soil moisture metrics from 17 state-of-the-art general circulation models to show that these models project significantly drier conditions in the later half of the 21st century compared to the 20th century and earlier paleoclimatic intervals.

Assessing Medicare's hospital pay-for-performance programs and whether they are achieving their goals.

Three separate pay-for-performance programs affect the amount of Medicare payment for inpatient services to about 3,400 US hospitals. These payments are based on hospital performance on specified measures of quality of care. A growing share of Medicare hospital payments (6 percent by 2017) are dependent upon how hospitals perform under the Hospital Readmissions Reduction Program, the Value-Based Purchasing Program, and the Hospital-Acquired Condition Reduction Program.

Coronary calcium scores 6 years after bariatric surgery.

Background: Obesity is associated with elevated coronary artery calcium (CAC), a marker of coronary atherosclerosis that is strongly predictive of cardiovascular events. We evaluated the effects of marked weight loss achieved through Roux-en-Y gastric bypass surgery (GBS) on CAC scores.

Methods: We performed echocardiography and computed tomography of the heart in 149 subjects 6 years after enrollment in a prospective registry evaluating the cardiovascular effects of GBS.

Warming experiments underpredict plant phenological responses to climate change.

Warming experiments are increasingly relied on to estimate plant responses to global climate change. For experiments to provide meaningful predictions of future responses, they should reflect the empirical record of responses to temperature variability and recent warming, including advances in the timing of flowering and leafing. We compared phenology (the timing of recurring life history events) in observational studies and warming experiments spanning four continents and 1,634 plant species using a common measure of temperature sensitivity (change in days per degree Celsius).

Snapshot of hospital quality reporting and pay-for-performance under Medicare.

This paper examines the impact that Medicare pay-for-performance (P4P) might have upon hospital payment. It uses the initial two quarters of a national quality database to model financial gains or losses using the Premier Hospital Quality Incentive Demonstration rules, as well as the P4P approach recommended by the Medicare Payment Advisory Commission (MedPAC). Findings reveal variation among all types of hospitals and across all measures within each of the three conditions studied: heart attack, heart failure, and pneumonia.

Vertical migration by the marine dinoflagellate Prorocentrum triestinum maximises photosynthetic yield.

Although vertical migration has been widely documented in many dinoflagellate species, the adaptive advantages of the strategy remain unclear. To investigate relationships between diurnal vertical migration and depth-related variation in photosynthetic yield in a marine dinoflagellate, Prorocentrum triestinum (Schiller), two experimental approaches were adopted. First, vertical distribution patterns of P.