A 36-Year-Old Patient With Crohn Disease and Bilateral Pleural Effusions.

A 36-year-old man with severe Crohn disease complicated by urethral strictures and enterocutaneous and enterovesicular fistulas presented for several weeks of poor appetite, weight loss, failure to thrive, and newly worsening altered mentation. Further history revealed he chronically did not urinate through his urethra, but rather "leaked" through multiple enterocutaneous fistulas in his abdomen and perineum. Medications included ustekinumab (anti-IL12/IL23 monoclonal antibody) for Crohn disease, methadone, and hydrocodone.

Unprecedented toxic blooms of Microcystis spp. in 2019 in the Chowan River, North Carolina.

The Chowan River flows from southern Virginia through northeastern North Carolina and into the Albemarle Sound, a part of the second largest U.S. estuary.

Obstetric Life Support Education for Maternal Cardiac Arrest: A Randomized Clinical Trial.

Importance: Management of maternal cardiac arrest (MCA) requires understanding the unique physiology of pregnancy and modifications to life support. Health care professionals have historically demonstrated inadequate knowledge and skills necessary to treat MCA.

Objective: To evaluate the effect of Obstetric Life Support (OBLS) education on health care professionals' cognitive performance, skills, and self-efficacy in managing MCA.

Expanding the Application of Sentinel-2 Chlorophyll Monitoring across United States Lakes.

Eutrophication of inland lakes poses various societal and ecological threats, making water quality monitoring crucial. Satellites provide a comprehensive and cost-effective supplement to traditional in situ sampling. The Sentinel-2 MultiSpectral Instrument (S2 MSI) offers unique spectral bands positioned to quantify chlorophyll , a water-quality and trophic-state indicator, along with fine spatial resolution, enabling the monitoring of small waterbodies.

Using the ROX Index to Predict Treatment Outcome for High-Flow Nasal Cannula and/or Noninvasive Ventilation in Patients With COPD Exacerbations.

Background: The ratio of oxygen saturation index (ROX index; or S /F /breathing frequency) has been shown to predict risk of intubation after high-flow nasal cannula (HFNC) support among adults with acute hypoxemic respiratory failure primarily due to pneumonia. However, its predictive value for other subtypes of respiratory failure is unknown. This study investigated whether the ROX index predicts liberation from HFNC or noninvasive ventilation (NIV), intubation with mechanical ventilation, or death in adults admitted for respiratory failure due to an exacerbation of COPD.

Maple samara flight is robust to morphological perturbation and united by a classic drag model.

Winged, autorotating seeds from the genus Acer, have been the subject of study for botanists and aerodynamicists for decades. Despite this attention and the relative simplicity of these winged seeds, there are still considerable gaps in our understanding of how samara dynamics are informed by morphological features. Additionally, questions remain regarding the robustness of their dynamics to morphological alterations such as mass change by moisture or area change by damage.

Impact of Atmospheric Correction on Classification and Quantification of Seagrass Density from WorldView-2 Imagery.

Mapping the seagrass distribution and density in the underwater landscape can improve global Blue Carbon estimates. However, atmospheric absorption and scattering introduce errors in space-based sensors' retrieval of sea surface reflectance, affecting seagrass presence, density, and above-ground carbon () estimates. This study assessed atmospheric correction's impact on mapping seagrass using WorldView-2 satellite imagery from Saint Joseph Bay, Saint George Sound, and Keaton Beach in Florida, USA.

Satellite and cyanobacteria monitoring: Understanding the impact of monitoring frequency on management decisions.

Cyanobacterial harmful algal blooms (cyanoHABs) in reservoirs can be transported to downstream waters via scheduled discharges. Transport dynamics are difficult to capture in traditional cyanoHAB monitoring, which can be spatially disparate and temporally discontinuous. The introduction of satellite remote sensing for cyanoHAB monitoring provides opportunities to detect where cyanoHABs occur in relation to reservoir release locations, like canal inlets.

Successful treatment of SARS-CoV-2 in an immunocompromised patient with persistent infection for 245 days: A case report.

Background: Immunocompromised patients receiving B-cell-depleting therapies are at increased risk of persistent SARS-CoV-2 infection, with many experiencing fatal outcomes. We report a successful outcome in a patient with rheumatoid arthritis (RA) on rituximab diagnosed with COVID-19 in July 2020 with persistent infection for over 245 days.

Results: The patient received numerous treatment courses for persistent COVID-19 infection, including remdesivir, baricitinib, immunoglobulin and high doses of corticosteroids followed by a prolonged taper due to persistent respiratory symptoms and cryptogenic organizing pneumonia.

Differences in Abdominal Muscle Thickness, Strength, and Endurance in Persons Who Are Runners, Active, and Inactive.

Background: Core musculature is important for efficiency during activities including running. Both abdominal muscle strength and endurance contribute to this efficiency. The purpose of this study is to determine what differences and relationships exist in abdominal muscle thickness, strength, and endurance among persons who are runners, active, and inactive.

Forecasting freshwater cyanobacterial harmful algal blooms for Sentinel-3 satellite resolved U.S. lakes and reservoirs.

This forecasting approach may be useful for water managers and associated public health managers to predict near-term future high-risk cyanobacterial harmful algal blooms (cyanoHAB) occurrence. Freshwater cyanoHABs may grow to excessive concentrations and cause human, animal, and environmental health concerns in lakes and reservoirs. Knowledge of the timing and location of cyanoHAB events is important for water quality management of recreational and drinking water systems.

Assessing the relationship between cyanobacterial blooms and respiratory-related hospital visits: Green bay, Wisconsin 2017-2019.

Potential acute and chronic human health effects associated with exposure to cyanobacteria and cyanotoxins, including respiratory symptoms, are an understudied public health concern. We examined the relationship between estimated cyanobacteria biomass and the frequency of respiratory-related hospital visits for residents living near Green Bay, Lake Michigan, Wisconsin during 2017-2019. Remote sensing data from the Cyanobacteria Assessment Network was used to approximate cyanobacteria exposure through creation of a metric for cyanobacteria chlorophyll-a (Chl).

Assessing the suitability of lakes and reservoirs for recreation using Landsat 8.

Water clarity has long been used as a visual indicator of the condition of water quality. The clarity of waters is generally valued for esthetic and recreational purposes. Water clarity is often assessed using a Secchi disk attached to a measured line and lowered to a depth where it can be no longer seen.

Assessing potential of the Geostationary Littoral Imaging and Monitoring Radiometer (GLIMR) for water quality monitoring across the coastal United States.

The Geostationary Littoral Imaging and Monitoring Radiometer (GLIMR) will provide unique high temporal frequency observations of the United States coastal waters to quantify processes that vary on short temporal and spatial scales. The frequency and coverage of observations from geostationary orbit will improve quantification and reduce uncertainty in tracking water quality events such as harmful algal blooms and oil spills. This study looks at the potential for GLIMR to complement existing satellite platforms from its unique geostationary viewpoint for water quality and oil spill monitoring with a focus on temporal and spatial resolution aspects.

Validation of a Simulation-Based Resuscitation Curriculum for Maternal Cardiac Arrest.

Objective: To assess the knowledge, skills, and self-efficacy of health care participants completing a simulation-based blended learning training curriculum on managing maternal medical emergencies and maternal cardiac arrest (Obstetric Life Support).

Methods: A formative assessment of the Obstetric Life Support curriculum was performed with a prehospital cohort comprising emergency medical services professionals and a hospital-based cohort comprising health care professionals who work primarily in hospital or urgent care settings and respond to maternal medical emergencies. The training consisted of self-guided precourse work and an instructor-led simulation course using a customized low-fidelity simulator.

Recent changes in cyanobacteria algal bloom magnitude in large lakes across the contiguous United States.

Cyanobacterial blooms in inland lakes produce large quantities of biomass that impact drinking water systems, recreation, and tourism and may produce toxins that can adversely affect public health. This study analyzed nine years of satellite-derived bloom records and compared how the bloom magnitude has changed from 2008-2011 to 2016-2020 in 1881 of the largest lakes across the contiguous United States (CONUS). We determined bloom magnitude each year as the spatio-temporal mean cyanobacteria biomass from May to October and in concentrations of chlorophyll-a.

Temporal Stability of Seagrass Extent, Leaf Area, and Carbon Storage in St. Joseph Bay, Florida: a Semi-automated Remote Sensing Analysis.

Seagrasses are globally recognized for their contribution to blue carbon sequestration. However, accurate quantification of their carbon storage capacity remains uncertain due, in part, to an incomplete inventory of global seagrass extent and assessment of its temporal variability. Furthermore, seagrasses are undergoing significant decline globally, which highlights the urgent need to develop change detection techniques applicable to both the scale of loss and the spatial complexity of coastal environments.

Perspectives on user engagement of satellite Earth observation for water quality management.

The management and governance of our surface waters is core to life and prosperity on our planet. However, monitoring data are not available to many potential users and the disparate nature of water bodies makes consistent monitoring across so many systems difficult. While satellite Earth observation (EO) offers solutions, there are numerous challenges that limit the use of satellite EO for water monitoring.

Providing a framework for seagrass mapping in United States coastal ecosystems using high spatial resolution satellite imagery.

Seagrasses have been widely recognized for their ecosystem services, but traditional seagrass monitoring approaches emphasizing ground and aerial observations are costly, time-consuming, and lack standardization across datasets. This study leveraged satellite imagery from Maxar's WorldView-2 and WorldView-3 high spatial resolution, commercial satellite platforms to provide a consistent classification approach for monitoring seagrass at eleven study areas across the continental United States, representing geographically, ecologically, and climatically diverse regions. A single satellite image was selected at each of the eleven study areas to correspond temporally to reference data representing seagrass coverage and was classified into four general classes: land, seagrass, no seagrass, and no data.

Identifying lakes at risk of toxic cyanobacterial blooms using satellite imagery and field surveys across the United States.

Harmful algal blooms caused by cyanobacteria are a threat to global water resources and human health. Satellite remote sensing has vastly expanded spatial and temporal data on lake cyanobacteria, yet there is still acute need for tools that identify which waterbodies are at-risk for toxic cyanobacterial blooms. Algal toxins cannot be directly detected through imagery but monitoring toxins associated with cyanobacterial blooms is critical for assessing risk to the environment, animals, and people.

Satellites quantify the spatial extent of cyanobacterial blooms across the United States at multiple scales.

Previous studies indicate that cyanobacterial harmful algal bloom (cyanoHAB) frequency, extent, and magnitude have increased globally over the past few decades. However, little quantitative capability is available to assess these metrics of cyanoHABs across broad geographic scales and at regular intervals. Here, the spatial extent was quantified from a cyanobacteria algorithm applied to two European Space Agency satellite platforms-the MEdium Resolution Imaging Spectrometer (MERIS) onboard Envisat and the Ocean and Land Colour Instrument (OLCI) onboard Sentinel-3.

Satellites for long-term monitoring of inland U.S. lakes: The MERIS time series and application for chlorophyll-a.

Lakes and other surface fresh waterbodies provide drinking water, recreational and economic opportunities, food, and other critical support for humans, aquatic life, and ecosystem health. Lakes are also productive ecosystems that provide habitats and influence global cycles. Chlorophyll concentration provides a common metric of water quality, and is frequently used as a proxy for lake trophic state.

Pulsed field ablation in patients with complex consecutive atrial tachycardia in conjunction with ultra-high density mapping: Proof of concept.

Introduction: Catheter-ablation (CA) of consecutive left atrial tachycardias (LAT) can be challenging. Pulsed field ablation (PFA) yields a novel nonthermal CA technology for treatment of atrial fibrillation (AF). There is no data regarding PFA of LAT.

Potential for commercial PlanetScope satellites in oil response monitoring.

Extraction of petroleum oil resources may result in oil spills in the aquatic environment. Active and passive satellites are generally limited in either spatial coverage, temporal revisit periods, or spatial resolution when tracking surface oil slicks. PlanetScope passive satellites are reported to have near daily global coverage at a resolution of 3.