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1.
J Environ Qual ; 52(4): 873-885, 2023.
Article in English | MEDLINE | ID: mdl-37145888

ABSTRACT

Phosphorus (P) budgets can be useful tools for understanding nutrient cycling and quantifying the effectiveness of nutrient management planning and policies; however, uncertainties in agricultural nutrient budgets are not often quantitatively assessed. The objective of this study was to evaluate uncertainty in P fluxes (fertilizer/manure application, atmospheric deposition, irrigation, crop removal, surface runoff, and leachate) and the propagation of these uncertainties to annual P budgets. Data from 56 cropping systems in the P-FLUX database, which spans diverse rotations and landscapes across the United States and Canada, were evaluated. Results showed that across cropping systems, average annual P budget was 22.4 kg P ha-1 (range = -32.7 to 340.6 kg P ha-1 ), with an average uncertainty of 13.1 kg P ha-1 (range = 1.0-87.1 kg P ha-1 ). Fertilizer/manure application and crop removal were the largest P fluxes across cropping systems and, as a result, accounted for the largest fraction of uncertainty in annual budgets (61% and 37%, respectively). Remaining fluxes individually accounted for <2% of the budget uncertainty. Uncertainties were large enough that determining whether P was increasing, decreasing, or not changing was inconclusive in 39% of the budgets evaluated. Findings indicate that more careful and/or direct measurements of inputs, outputs, and stocks are needed. Recommendations for minimizing uncertainty in P budgets based on the results of the study were developed. Quantifying, communicating, and constraining uncertainty in budgets among production systems and multiple geographies is critical for engaging stakeholders, developing local and national strategies for P reduction, and informing policy.


Subject(s)
Fertilizers , Phosphorus , Manure , Uncertainty , Agriculture
2.
Anesthesiology ; 135(1): 31-56, 2021 07 01.
Article in English | MEDLINE | ID: mdl-34046679

ABSTRACT

BACKGROUND: Although there are thousands of published recommendations in anesthesiology clinical practice guidelines, the extent to which these are supported by high levels of evidence is not known. This study hypothesized that most recommendations in clinical practice guidelines are supported by a low level of evidence. METHODS: A registered (Prospero CRD42020202932) systematic review was conducted of anesthesia evidence-based recommendations from the major North American and European anesthesiology societies between January 2010 and September 2020 in PubMed and EMBASE. The level of evidence A, B, or C and the strength of recommendation (strong or weak) for each recommendation was mapped using the American College of Cardiology/American Heart Association classification system or the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. The outcome of interest was the proportion of recommendations supported by levels of evidence A, B, and C. Changes in the level of evidence over time were examined. Risk of bias was assessed using Appraisal of Guidelines for Research and Evaluation (AGREE) II. RESULTS: In total, 60 guidelines comprising 2,280 recommendations were reviewed. Level of evidence A supported 16% (363 of 2,280) of total recommendations and 19% (288 of 1,506) of strong recommendations. Level of evidence C supported 51% (1,160 of 2,280) of all recommendations and 50% (756 of 1,506) of strong recommendations. Of all the guidelines, 73% (44 of 60) had a low risk of bias. The proportion of recommendations supported by level of evidence A versus level of evidence C (relative risk ratio, 0.93; 95% CI, 0.18 to 4.74; P = 0.933) or level of evidence B versus level of evidence C (relative risk ratio, 1.63; 95% CI, 0.72 to 3.72; P = 0.243) did not increase in guidelines that were revised. Year of publication was also not associated with increases in the proportion of recommendations supported by level of evidence A (relative risk ratio, 1.07; 95% CI, 0.93 to 1.23; P = 0.340) or level of evidence B (relative risk ratio, 1.05; 95% CI, 0.96 to 1.15; P = 0.283) compared to level of evidence C. CONCLUSIONS: Half of the recommendations in anesthesiology clinical practice guidelines are based on a low level of evidence, and this did not change over time. These findings highlight the need for additional efforts to increase the quality of evidence used to guide decision-making in anesthesiology.


Subject(s)
Anesthesiologists , Anesthesiology/standards , Evidence-Based Medicine/methods , Perioperative Care/standards , Practice Guidelines as Topic , Anesthesiology/methods , Europe , Humans , North America , Perioperative Care/methods , Societies, Medical
3.
Sci Total Environ ; 754: 142047, 2021 Feb 01.
Article in English | MEDLINE | ID: mdl-33254852

ABSTRACT

The magnitude of nitrogen (N) and phosphorus (P) exported from agricultural fields via subsurface tile drainage systems is determined by site-specific interactions between weather, soil, field, and management characteristics. Here, we used multiple regression analyses to evaluate the influence of 29 controls of precipitation event-driven discharge, nitrate (NO3--N) load, and dissolved reactive P (DRP) load from subsurface tile drains, leveraging a unique dataset of ~7000 precipitation events observed across 40 agricultural fields (n = 190 site years) instrumented to collect continuous water quality samples. We calculated marginal effects of significant controls and assessed the modifying influence of event rainfall, duration, and intensity, and antecedent precipitation. Tile discharge was strongly and positively influenced by previous 7-day precipitation and total rainfall and negatively influenced by daily temperature and tile spacing. Both tile NO3--N and DRP loads were positively influenced by transport and source variables, including event discharge and total fertilizer applied as well as soil test P (STP) in the case of tile DRP load; factors with the strongest negative influence on tile NO3--N and DRP loads were related to time of year. The strength and direction of both positive and negative controls also varied with precipitation characteristics. For example, the positive influence of event discharge on nutrient loads lessened as event duration, event intensity, and previous 7-day precipitation increased, while the positive influence of N and P sources strengthened, particularly in response to extreme (or maximum) events. Results here demonstrate the predominant role of transport and source controls while accounting for interactive effects among site-specific characteristics and underscore the importance of storm dynamics when managing N and P loss from agricultural fields.

5.
Mol Imaging ; 18: 1536012119829986, 2019.
Article in English | MEDLINE | ID: mdl-31044647

ABSTRACT

OBJECTIVE: The goal is to evaluate avelumab, an anti-PD-L1 monoclonal immunoglobulin G antibody labeled with zirconium-89 in human PD-L1-expressing cancer cells and mouse xenografts for clinical translation. METHODS: [89Zr]Zr-DFO-PD-L1 monoclonal antibody (mAb) was synthesized using avelumab conjugated to desferrioxamine. In vitro binding studies and biodistribution studies were performed with PD-L1+MDA-MB231 cells and MDA-MB231 xenograft mouse models, respectively. Biodistributions were determined at 1, 2, 3, 5, and 7 days post coinjection of [89Zr]Zr-DFO-PD-L1 mAb without or with unlabeled avelumab (10, 20, 40, and 400 µg). RESULTS: [89Zr]Zr-DFO-PD-L1 mAb exhibited high affinity (Kd ∼ 0.3 nM) and detected moderate PD-L1 expression levels in MDA-MB231 cells. The spleen and lymph nodes exhibited the highest [89Zr]Zr-DFO-PD-L1 mAb uptakes in all time points, while MDA-MB231 tumor uptakes were lower but highly retained. In the unlabeled avelumab dose escalation studies, spleen tissue-muscle ratios decreased in a dose-dependent manner indicating specific [89Zr]Zr-DFO-PD-L1 mAb binding to PD-L1. In contrast, lymph node and tumor tissue-muscle ratios increased 4- to 5-fold at 20 and 40 µg avelumab doses. CONCLUSIONS: [89Zr]Zr-DFO-PD-L1 mAb exhibited specific and high affinity for PD-L1 in vitro and had target tissue uptakes correlating with PD-L1 expression levels in vivo. [89Zr]Zr-DFO-PD-L1 mAb uptake in PD-L1+tumors increased with escalating doses of avelumab.


Subject(s)
Antibodies, Monoclonal/administration & dosage , B7-H1 Antigen/metabolism , Breast Neoplasms/drug therapy , Deferoxamine/chemistry , Radioisotopes/chemistry , Zirconium/chemistry , Animals , Antibodies, Monoclonal/chemistry , Antibodies, Monoclonal/pharmacokinetics , Antibodies, Monoclonal, Humanized , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/metabolism , Dose-Response Relationship, Drug , Down-Regulation , Female , Gene Expression Regulation, Neoplastic/drug effects , Humans , Immunoconjugates , Mice , Positron-Emission Tomography , Tissue Distribution , Treatment Outcome , Xenograft Model Antitumor Assays
6.
Cancer Biother Radiopharm ; 34(4): 238-244, 2019 May.
Article in English | MEDLINE | ID: mdl-30767667

ABSTRACT

Objective: 18F-albumin, a vascular imaging agent, may have potential to assess tumor responses to anti-angiogenic therapies. In these studies tumor distribution volume of 18F-albumin were first determined in various human tumor xenografts from biodistribtuion measurments and then one of the tumor type was used to evaluate changes in 18F-albumin uptake in anti-angiognic tumor model. Method: 18F-albumin was synthesized via conjugation of 6-[18F]fluoronicotinic acid-2,3,5,6-tetrafluorophenyl ester, [18F]F-Py-TFP, with rat albumin. From the biodistribution of 18F-albumin in various human tumor xenografts tumor distribution volumes (DVs; tumor%ID/g:blood%ID/g) were first determined at various time points. Then, the ability of 18F-albumin to detect tumor angiogenic inhibition in one of these tumor types (U87MG) following treatment with sunitinib was evaluated by position emission tomography (PET) imaging at 0, 7, 14, and 21 days post treatment. Caliper measurements of tumor dimensions were also made at these same times. At Day 21, following imaging, biodistributions, autoradiography of tumor tissues and tumor blood vessel counts (CD31 IHC) were performed. Results: 18F-albumin retention in various tumors steadily increased over time with U87MG tumor exhibiting the highest uptake (DV) at all times. Significant decreases in 18F-albumin DVs were observed one week post-treatement (-39%) vs. controls whereas tumor caliper volumes were not significantly decreased until days 14 and 21. At day 21 the significant decrease in DVs in the treatment group (-44%) paralleled biodistribution DV measurements and was consistent with autoradiography and CD31 IHC findings. Conclusion: These data suggest that 18F-albumin DVs obtained by imaging may serve as an early biomarker of the effectiveness of anti-angiogenic therapy and thus aid in patient management and treatment planning.


Subject(s)
Albumins/administration & dosage , Fluorodeoxyglucose F18/administration & dosage , Neoplasms/diagnostic imaging , Neovascularization, Pathologic/diagnostic imaging , Radiopharmaceuticals/administration & dosage , Albumins/chemistry , Albumins/pharmacokinetics , Angiogenesis Inhibitors/therapeutic use , Animals , Antineoplastic Agents/therapeutic use , Cell Line, Tumor , Female , Fluorodeoxyglucose F18/chemistry , Fluorodeoxyglucose F18/pharmacokinetics , Humans , Mice , Mice, Nude , Neoplasms/blood supply , Neoplasms/drug therapy , Neoplasms/pathology , Neovascularization, Pathologic/drug therapy , Neovascularization, Pathologic/pathology , Positron-Emission Tomography/methods , Radiopharmaceuticals/chemistry , Radiopharmaceuticals/pharmacokinetics , Sunitinib/therapeutic use , Tissue Distribution , Treatment Outcome , Xenograft Model Antitumor Assays
7.
Nucl Med Biol ; 62-63: 63-70, 2018.
Article in English | MEDLINE | ID: mdl-29929114

ABSTRACT

INTRODUCTION: Equilibrium single-photon radionuclide imaging methods for assessing cardiac function and the integrity of the vascular system have long been in use for both clinical and research purposes. However, positron-emitting blood pool agents that could provide PET equivalents to these (and other) clinical procedures have not yet been adopted despite technical imaging advantages offered by PET. Our goal was to develop a PET blood pool tracer that not only meets necessary in vivo biological requirements but can be produced with an uncomplicated and rapid synthesis method which would facilitate clinical translation. Herein, albumin labeled with fluorine-18 was synthesized using a one-pot method and evaluated in vitro and in vivo in rats. METHODS: A ligand (NODA-Bz-TFPE), containing NODA attached to a tetrafluorophenylester (TFPE) via a phenyl linker (Bz), was labeled with aluminum fluoride (Al[18F]F). Conjugation of the serum albumin with the ligand (Al[18F]F-NODA-Bz-TFPE), followed by purification (size exclusion chromatography), yielded the final product (Al[18F]F-NODA-Bz-RSA/HSA). In vitro stability was evaluated in human serum albumin by HPLC. Rat biodistributions and whole-body PET imaging over a 4 h time course were used for the in vivo evaluation. RESULTS: This synthesis exhibited an overall radiochemical yield of 45 ±â€¯10% (n = 30), a 50-min radiolabeling time, a radiochemical purity >99% and apparent stability up to 4 h in human serum. Blood had the highest retention of Al[18F]F-NODA-Bz-RSA at all times with a blood half-life of 5.2 h in rats. Al[18F]F-NODA-Bz-RSA distribution in most rat tissues remained relatively constant for up to 1 h, indicating that the tissue radioactivity content represents the respective tissue plasma volume. Dynamic whole-body PET images were in agreement with these findings. CONCLUSIONS: A new ligand has been developed and radiolabeled with Al[18F]F that allows rapid (50-min) preparation of fluorine-18 serum albumin in one-pot. In addition to increased synthetic efficiency, the construct appears to be metabolically stable in rats. This method could encourage wider use of PET to quantify cardiac function and tissue vascular integrity in both research and clinical settings.


Subject(s)
Fluorine Radioisotopes , Positron-Emission Tomography/methods , Serum Albumin/chemical synthesis , Serum Albumin/pharmacokinetics , Animals , Chemistry Techniques, Synthetic , Drug Stability , Humans , Male , Radiochemistry , Rats , Serum Albumin/chemistry , Serum Albumin/metabolism , Tissue Distribution
8.
Anesth Analg ; 127(5): 1146-1154, 2018 11.
Article in English | MEDLINE | ID: mdl-29782404

ABSTRACT

The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research, established by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks, a public-private partnership with the US Food and Drug Administration, convened a second meeting of sedation experts from a variety of clinical specialties and research backgrounds to develop recommendations for procedural sedation research. The previous meeting addressed efficacy and patient- and/or family-centered outcomes. This meeting addressed issues of safety, which was defined as "the avoidance of physical or psychological harm." A literature review identified 133 articles addressing safety measures in procedural sedation clinical trials. After basic reporting of vital signs, the most commonly measured safety parameter was oxygen saturation. Adverse events were inconsistently defined throughout the studies. Only 6 of the 133 studies used a previously validated measure of safety. The meeting identified methodological problems associated with measuring infrequent adverse events. With a consensus discussion, a set of core and supplemental measures were recommended to code for safety in future procedural clinical trials. When adopted, these measures should improve the integration of safety data across studies and facilitate comparisons in systematic reviews and meta-analyses.


Subject(s)
Clinical Trials as Topic/methods , Conscious Sedation/methods , Endpoint Determination , Hypnotics and Sedatives/therapeutic use , Outcome and Process Assessment, Health Care/methods , Patient Outcome Assessment , Research Design , Conscious Sedation/adverse effects , Consensus , Humans , Hypnotics and Sedatives/adverse effects , Patient Safety , Risk Assessment , Risk Factors , Treatment Outcome
9.
Anesth Analg ; 126(3): 956-967, 2018 03.
Article in English | MEDLINE | ID: mdl-28922236

ABSTRACT

Objective evaluations comparing different techniques and approaches to pediatric procedural sedation studies have been limited by a lack of consistency among the outcome measures used in assessment. This study reviewed those existing measures, which have undergone psychometric analysis in a pediatric procedural sedation setting, to determine to what extent and in what circumstances their use is justified across the spectrum of procedures, age groups, and techniques. The results of our study suggest that a wide range of measures has been used to assess the efficacy and effectiveness of pediatric procedural sedation. Most lack the evidence of validity and reliability that is necessary to facilitate rigorous clinical trial design, as well as the evaluation of new drugs and devices. A set of core pediatric sedation outcome domains and outcome measures can be developed on the basis of our findings. We believe that consensus among all stakeholders regarding appropriate domains and measures to evaluate pediatric procedural sedation is possible and that widespread implementation of such recommendations should be pursued.


Subject(s)
Anesthesia/methods , Clinical Trials as Topic/methods , Outcome Assessment, Health Care/methods , Anesthesia/trends , Child , Humans , Outcome Assessment, Health Care/trends , Prospective Studies , Reproducibility of Results , Treatment Outcome
10.
Nucl Med Biol ; 53: 29-36, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28797928

ABSTRACT

INTRODUCTION: Quantitative small animal radionuclide imaging studies are often carried out with the intention of estimating the total radioactivity content of various tissues such as the radioactivity content of mouse xenograft tumors exposed to putative diagnostic or therapeutic agents. We show that for at least one specific application, positron projection imaging (PPI) and PET yield comparable estimates of absolute total tumor activity and that both of these estimates are highly correlated with direct well-counting of these same tumors. These findings further suggest that in this particular application, PPI is a far more efficient data acquisition and processing methodology than PET. METHODS: Forty-one athymic mice were implanted with PC3 human prostate cancer cells transfected with prostate-specific membrane antigen (PSMA (+)) and one additional animal (for a total of 42) with a control blank vector (PSMA (-)). All animals were injected with [18F] DCFPyl, a ligand for PSMA, and imaged for total tumor radioactivity with PET and PPI. The tumors were then removed, assayed by well counting for total radioactivity and the values between these methods intercompared. RESULTS: PET, PPI and well-counter estimates of total tumor radioactivity were highly correlated (R2>0.98) with regression line slopes near unity (0.95

Subject(s)
Cell Transformation, Neoplastic , Positron-Emission Tomography/methods , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/pathology , Animals , Humans , Male , Mice , Radioactive Tracers , Radioactivity
12.
J Environ Qual ; 46(2): 466-469, 2017 Mar.
Article in English | MEDLINE | ID: mdl-28380548

ABSTRACT

The Western Lake Erie Basin (WLEB) was inundated with precipitation during June and July 2015 (two to three times greater than historical averages), which led to significant nutrient loading and the largest in-lake algal bloom on record. Using discharge and concentration data from three spatial scales (0.18-16,000 km), we contrast the patterns in nitrate (NO-N) and dissolved reactive phosphorus (DRP) concentration dynamics and discuss potential management implications. Across all scales, NO-N concentration steadily declined with each subsequent rainfall event as it was flushed from the system. In contrast, DRP concentration persisted, even on soils at or below agronomic P levels, suggesting that legacy P significantly contributes to nutrient loads in the WLEB. These findings highlight the need to revisit current P fertility recommendations and soil testing procedures to increase P fertilizer use efficiency and to more holistically account for legacy P.


Subject(s)
Eutrophication , Phosphorus/chemistry , Environmental Monitoring , Fertilizers , Lakes
13.
J Environ Qual ; 46(6): 1413-1423, 2017 Nov.
Article in English | MEDLINE | ID: mdl-29293822

ABSTRACT

The contribution of macropore flow to phosphorus (P) loadings in tile-drained agricultural landscapes remains poorly understood at the field scale, despite the recognized deleterious impacts of contaminant transport via macropore pathways. A new subroutine that couples existing matrix-excess and matrix-desiccation macropore flow theory and a modified P routine is implemented in the Agricultural Policy Environmental eXtender (APEX) model. The original and modified formulation were applied and evaluated for a case study in a poorly drained field in Western Ohio with 31 months of surface and subsurface monitoring data. Results highlighted that a macropore subroutine in APEX improved edge-of-field discharge calibration and validation for both tile and total discharge from satisfactory and good, respectively, to very good and improved dissolved reactive P load calibration and validation statistics for tile P loads from unsatisfactory to very good. Output from the calibrated macropore simulations suggested median annual matrix-desiccation macropore flow contributions of 48% and P load contributions of 43%, with the majority of loading occurring in winter and spring. While somewhat counterintuitive, the prominence of matrix-desiccation macropore flow during seasons with less cracking reflects the importance of coupled development of macropore pathways and adequate supply of the macropore flow source. The innovative features of the model allow for assessments of annual macropore P contributions to tile drainage and has the potential to inform P site assessment tools.


Subject(s)
Agriculture , Models, Theoretical , Phosphorus/analysis , Water Pollutants/analysis , Environmental Monitoring , Ohio , Water Movements
14.
J Environ Qual ; 46(6): 1306-1313, 2017 Nov.
Article in English | MEDLINE | ID: mdl-29293845

ABSTRACT

The Phosphorus Index (PI) has been the cornerstone for phosphorus (P)-based management and planning over the past twenty years, yet field-scale evaluation of many state PIs has been limited. In this study, P loads measured in surface runoff and tile discharge from 40 agricultural fields in Ohio with prevailing management practices were used to evaluate the Ohio PI. Annual P loads were highly variable among fields (dissolved reactive P: 0.03-4.51 kg ha, total P: 0.03-6.88 kg ha). Both measured annual dissolved reactive P ( = 0.36, < 0.001) and total P ( = 0.25, < 0.001) loads were significantly related to Ohio PI score. The relationship between measured load and PI score substantially improved when averaged annual field values were used (dissolved reactive P: = 0.71, total P: = 0.73), indicating that the Ohio PI should be utilized to evaluate average annual risk of P loss, rather than as an annual risk tool. Comparison between the Ohio PI and other established local and national metrics resulted in large differences in potential P management recommendations for the monitored fields. In the near term, revision of Ohio PI risk categories and management recommendations using local P loading thresholds is needed. To meet the minimum criteria for state PI tools, future research efforts should focus on using measured field data (i) to incorporate new input factors (i.e., P application timing and leaching potential) into the Ohio PI, and (ii) to calibrate and validate the Ohio PI to provide better P risk assessments and management recommendations.


Subject(s)
Phosphorus/analysis , Water Quality , Agriculture , Environmental Monitoring , Ohio , Risk Assessment
15.
Anesth Analg ; 124(3): 821-830, 2017 03.
Article in English | MEDLINE | ID: mdl-27622720

ABSTRACT

The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research, established by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks public-private partnership with the US Food and Drug Administration, convened a meeting of sedation experts from a variety of clinical specialties and research backgrounds with the objective of developing recommendations for procedural sedation research. Four core outcome domains were recommended for consideration in sedation clinical trials: (1) safety, (2) efficacy, (3) patient-centered and/or family-centered outcomes, and (4) efficiency. This meeting identified core outcome measures within the efficacy and patient-centered and/or family-centered domains. Safety will be addressed in a subsequent meeting, and efficiency will not be addressed at this time. These measures encompass depth and levels of sedation, proceduralist and patient satisfaction, patient recall, and degree of pain experienced. Consistent use of the recommended outcome measures will facilitate the comprehensive reporting across sedation trials, along with meaningful comparisons among studies and interventions in systematic reviews and meta-analyses.


Subject(s)
Biomedical Research/standards , Clinical Trials as Topic/standards , Endpoint Determination/standards , Hypnotics and Sedatives/standards , Patient Safety/standards , Patient-Centered Care/standards , Anesthesia/adverse effects , Anesthesia/standards , Biomedical Research/methods , Clinical Trials as Topic/methods , Congresses as Topic/standards , Conscious Sedation/methods , Conscious Sedation/standards , District of Columbia , Endpoint Determination/methods , Humans , Hypnotics and Sedatives/adverse effects , Hypnotics and Sedatives/therapeutic use , Patient Satisfaction , Patient-Centered Care/methods , Treatment Outcome
16.
Ground Water ; 55(1): 136-148, 2017 01.
Article in English | MEDLINE | ID: mdl-27618484

ABSTRACT

Delineating hydrologic and pedogenic factors influencing groundwater flow in riparian zones is central in understanding pathways of water and nutrient transport. In this study, we combined two-dimensional time-lapse electrical resistivity imaging (ERI) (depth of investigation approximately 2 m) with hydrometric monitoring to examine hydrological processes in the riparian area of FD-36, a small (0.4 km2 ) agricultural headwater basin in the Valley and Ridge region of east-central Pennsylvania. We selected two contrasting study sites, including a seep with groundwater discharge and an adjacent area lacking such seepage. Both sites were underlain by a fragipan at 0.6 m. We then monitored changes in electrical resistivity, shallow groundwater, and nitrate-N concentrations as a series of storms transitioned the landscape from dry to wet conditions. Time-lapse ERI revealed different resistivity patterns between seep and non-seep areas during the study period. Notably, the seep displayed strong resistivity reductions (∼60%) along a vertically aligned region of the soil profile, which coincided with strong upward hydraulic gradients recorded in a grid of nested piezometers (0.2- and 0.6-m depth). These patterns suggested a hydraulic connection between the seep and the nitrate-rich shallow groundwater system below the fragipan, which enabled groundwater and associated nitrate-N to discharge through the fragipan to the surface. In contrast, time-lapse ERI indicated no such connections in the non-seep area, with infiltrated rainwater presumably perched above the fragipan. Results highlight the value of pairing time-lapse ERI with hydrometric and water quality monitoring to illuminate possible groundwater and nutrient flow pathways to seeps in headwater riparian areas.


Subject(s)
Groundwater , Water Quality , Environmental Monitoring , Hydrology , Nitrates , Pennsylvania
17.
J Pain ; 17(11): 1137-1149, 2016 11.
Article in English | MEDLINE | ID: mdl-27522950

ABSTRACT

Thorough assessment and reporting of adverse events (AEs) facilitates a detailed understanding of a treatment's risk-benefit profile. Although the Consolidated Standards of Reporting Trials (CONSORT) 2004 statement provides recommendations regarding AE reporting, adherence to these standards is often inadequate. We investigated AE reporting in clinical trials of intravenous and invasive pain treatments published in 6 major anesthesiology and pain journals between 2000 to 2003 and 2006 to 2012. We examined whether AE reporting improved after publication of the 2004 CONSORT recommendations and also comprehensively reviewed AE assessment using the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) AE reporting recommendations. No improvement was found overall in CONSORT harms reporting scores from pre- to postpublication of the CONSORT recommendations, with only 5 of 10 fulfilled on average. AE reporting assessed using the ACTTION coding manual was generally inadequate, and 8% of articles failed to report any AE information at all. Anesthesiology and pain journals were similar in AE reporting quality, although industry-sponsored trials reported more AE information than nonindustry sponsored trials. Improvement is needed in AE reporting in analgesic clinical trials. The CONSORT checklist and ACTTION AE recommendations can assist investigators and editors in improving clinical trial transparency and quality. PERSPECTIVE: This systematic review of AE reporting in intravenous and invasive pain treatment trials shows that little improvement has been made since the 2004 CONSORT harms reporting guidelines. Better assessment and reporting of treatment AEs is necessary to understand the full clinical effect of intravenous and invasive treatments.


Subject(s)
Analgesics/adverse effects , Clinical Trials as Topic , Pain/drug therapy , Administration, Intravenous , Databases, Bibliographic/statistics & numerical data , Humans
18.
Anesth Analg ; 122(1): 152-70, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26678470

ABSTRACT

Successful procedural sedation represents a spectrum of patient- and clinician-related goals. The absence of a gold-standard measure of the efficacy of procedural sedation has led to a variety of outcomes being used in clinical trials, with the consequent lack of consistency among measures, making comparisons among trials and meta-analyses challenging. We evaluated which existing measures have undergone psychometric analysis in a procedural sedation setting and whether the validity of any of these measures support their use across the range of procedures for which sedation is indicated. Numerous measures were found to have been used in clinical research on procedural sedation across a wide range of procedures. However, reliability and validity have been evaluated for only a limited number of sedation scales, observer-rated pain/discomfort scales, and satisfaction measures in only a few categories of procedures. Typically, studies only examined 1 or 2 aspects of scale validity. The results are likely unique to the specific clinical settings they were tested in. Certain scales, for example, those requiring motor stimulation, are unsuitable to evaluate sedation for procedures where movement is prohibited (e.g., magnetic resonance imaging scans). Further work is required to evaluate existing measures for procedures for which they were not developed. Depending on the outcomes of these efforts, it might ultimately be necessary to consider measures of sedation efficacy to be procedure specific.


Subject(s)
Anesthesia/methods , Clinical Trials as Topic/methods , Endpoint Determination , Hypnotics and Sedatives/administration & dosage , Research Design , Anesthesia/adverse effects , Anesthesia/standards , Clinical Trials as Topic/standards , Consciousness/drug effects , Endpoint Determination/standards , Humans , Hypnotics and Sedatives/adverse effects , Motor Activity/drug effects , Pain Measurement , Pain Threshold/drug effects , Patient Satisfaction , Predictive Value of Tests , Quality Indicators, Health Care , Reproducibility of Results , Research Design/standards , Surveys and Questionnaires , Treatment Outcome , Wakefulness/drug effects
19.
J Environ Qual ; 44(2): 486-94, 2015 Mar.
Article in English | MEDLINE | ID: mdl-26023967

ABSTRACT

Phosphorus (P) transport from agricultural fields continues to be a focal point for addressing harmful algal blooms and nuisance algae in freshwater systems throughout the world. In humid, poorly drained regions, attention has turned to P delivery through subsurface tile drainage. However, research on the contributions of tile drainage to watershed-scale P losses is limited. The objective of this study was to evaluate long-term P movement through tile drainage and its manifestation at the watershed outlet. Discharge data and associated P concentrations were collected for 8 yr (2005-2012) from six tile drains and from the watershed outlet of a headwater watershed within the Upper Big Walnut Creek watershed in central Ohio. Results showed that tile drainage accounted for 47% of the discharge, 48% of the dissolved P, and 40% of the total P exported from the watershed. Average annual total P loss from the watershed was 0.98 kg ha, and annual total P loss from the six tile drains was 0.48 kg ha. Phosphorus loads in tile and watershed discharge tended to be greater in the winter, spring, and fall, whereas P concentrations were greatest in the summer. Over the 8-yr study, P transported in tile drains represented <2% of typical application rates in this watershed, but >90% of all measured concentrations exceeded recommended levels (0.03 mg L) for minimizing harmful algal blooms and nuisance algae. Thus, the results of this study show that in systematically tile-drained headwater watersheds, the amount of P delivered to surface waters via tile drains cannot be dismissed. Given the amount of P loss relative to typical application rates, development and implementation of best management practices (BMPs) must jointly consider economic and environmental benefits. Specifically, implementation of BMPs should focus on late fall, winter, and early spring seasons when most P loading occurs.

20.
J Environ Qual ; 44(2): 467-85, 2015 Mar.
Article in English | MEDLINE | ID: mdl-26023966

ABSTRACT

Phosphorus (P) loss from agricultural fields and watersheds has been an important water quality issue for decades because of the critical role P plays in eutrophication. Historically, most research has focused on P losses by surface runoff and erosion because subsurface P losses were often deemed to be negligible. Perceptions of subsurface P transport, however, have evolved, and considerable work has been conducted to better understand the magnitude and importance of subsurface P transport and to identify practices and treatments that decrease subsurface P loads to surface waters. The objectives of this paper were (i) to critically review research on P transport in subsurface drainage, (ii) to determine factors that control P losses, and (iii) to identify gaps in the current scientific understanding of the role of subsurface drainage in P transport. Factors that affect subsurface P transport are discussed within the framework of intensively drained agricultural settings. These factors include soil characteristics (e.g., preferential flow, P sorption capacity, and redox conditions), drainage design (e.g., tile spacing, tile depth, and the installation of surface inlets), prevailing conditions and management (e.g., soil-test P levels, tillage, cropping system, and the source, rate, placement, and timing of P application), and hydrologic and climatic variables (e.g., baseflow, event flow, and seasonal differences). Structural, treatment, and management approaches to mitigate subsurface P transport-such as practices that disconnect flow pathways between surface soils and tile drains, drainage water management, in-stream or end-of-tile treatments, and ditch design and management-are also discussed. The review concludes by identifying gaps in the current understanding of P transport in subsurface drains and suggesting areas where future research is needed.

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