Survival after severe trauma and survival benchmarked against predicted risk improved significantly at our center during the past 12 years despite generally increasing age and worsening injuries. Advances in trauma care have kept pace with an aging population and greater severity of injury, but overall survival has not improved.

To identify previously unrecognized sources for acquiring acute hepatitis B and non-A, non-B (NANB) hepatitis, we interviewed patients with these types of hepatitis who were reported to two county health departments in the United States and matched control subjects for known and potential risk factors for acquiring hepatitis. Of 218 patients with hepatitis B and 140 patients with NANB hepatitis, 46% and 53%, respectively, had no commonly recognized source for infection. When these patients were compared with control subjects, significantly more patients with hepatitis B had multiple heterosexual partners, accounting for 14% of all hepatitis B infections; more patients with NANB hepatitis either had sexual or household contact with a person who had hepatitis in the past or had multiple heterosexual partners, accounting for 11% of all NANB infections. This is the first study to suggest that heterosexual transmission may play an important role in the spread of NANB hepatitis.

ABSTRACTConventional triage algorithms assume unlimited medical resource availability. After a nuclear detonation, medical resources are likely to be particularly limited, suggesting that conventional triage algorithms need to be rethought. To test various hypotheses related to the prioritization of victims in this setting, we developed the model of resource- and time-based triage (MORTT). This model uses information on time to death, probability of survival if treated and if untreated, and time to treat various types of traumatic injuries in an agent-based model in which the time of medical practitioners or materials can be limited. In this embodiment, MORTT focuses solely on triage for surgical procedures in the first 48 hours after a nuclear detonation. MORTT determines the impact on survival based on user-selected prioritization of victims by severity or type of injury. Using MORTT, we found that in poorly resourced settings, prioritizing victims with moderate life-threatening injuries over victims with severe life-threatening injuries saves more lives and reduces demand for intensive care, which is likely to outstrip local and national capacity. Furthermore, more lives would be saved if victims with combined injury (ie, trauma plus radiation >2 Gy) are prioritized after nonirradiated victims with similar trauma.(Disaster Med Public Health Preparedness. 2011;5:S98-S110)

Stink bugs (Heteroptera: Pentatomidae), including Nezara viridula (L.), Euschistus servus (Say), and Chinavia hilaris (Say), are economic pests in farmscapes where they move within and between closely associated crop and non-crop habitats. Thus, field edges in these farmscapes include not only crop-to-crop interfaces but also those edges adjoining non-crop habitats. We examined the influence of field edges on colonization of stink bugs in southeastern USA farmscapes composed of typical combinations of corn, peanut, and cotton. For E. servus and N. viridula, egg-to-adult development and presence of both sexes on all crops indicated that the crops served as reproductive plants. Adult C. hilaris were rarely found on corn and on crops associated with it, and they were present mainly in cotton in peanut-cotton farmscapes. Mature crop height was significantly higher for corn than for cotton and significantly higher for cotton over peanut, and an edge effect in dispersal of stink bugs into a crop was detected up to 4.6, 8.2, and 14.6 m from the crop-to-crop interface in corn, cotton, and peanut, respectively. These results suggest that stink bug dispersal into a crop decreases as crop height increases. The first stink bug-infested crop at the crop-to-crop interface was the most significant contributor of colonizing stink bugs to an adjacent crop. An edge effect in dispersal of stink bug adults was detected in corn next to non-woodlands and woodlands and in cotton adjacent to woodlands. Edge effects were never detected in side edges of peanut. Overall, our results indicate that both plant height and host plant suitability can influence edge-mediated dispersal of stink bugs at field edges.