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Biomedical subjects

Mark Estes

Publications and source records attributed to Mark Estes.

4 recordsLinked to original sources

Estimation of biogenic emissions with satellite-derived land use and land cover data for air quality modeling of Houston-Galveston ozone nonattainment area.

The Houston-Galveston Area (HGA) is one of the most severe ozone non-attainment regions in the US. To study the effectiveness of controlling anthropogenic emissions to mitigate regional ozone nonattainment problems, it is necessary to utilize adequate datasets describing the environmental conditions that influence the photochemical reactivity of the ambient atmosphere. Compared to the anthropogenic emissions from point and mobile sources, there are large uncertainties in the locations and amounts of biogenic emissions. For regional air quality modeling applications, biogenic emissions are not directly measured but are usually estimated with meteorological data such as photo-synthetically active solar radiation, surface temperature, land type, and vegetation database. In this paper, we characterize these meteorological input parameters and two different land use land cover datasets available for HGA: the conventional biogenic vegetation/land use data and satellite-derived high-resolution land cover data. We describe the procedures used for the estimation of biogenic emissions with the satellite derived land cover data and leaf mass density information. Air quality model simulations were performed using both the original and the new biogenic emissions estimates. The results showed that there were considerable uncertainties in biogenic emissions inputs. Subsequently, ozone predictions were affected up to 10 ppb, but the magnitudes and locations of peak ozone varied each day depending on the upwind or downwind positions of the biogenic emission sources relative to the anthropogenic NOx and VOC sources. Although the assessment had limitations such as heterogeneity in the spatial resolutions, the study highlighted the significance of biogenic emissions uncertainty on air quality predictions. However, the study did not allow extrapolation of the directional changes in air quality corresponding to the changes in LULC because the two datasets were based on vastly different LULC category definitions and uncertainties in the vegetation distributions.

Air Pollution↗

Device trials in heart failure: a focused summary.

Despite considerable progress in heart failure management with pharmacologic agents, measures to bring about significant improvements in morbidity and mortality are still needed. Cardiac resynchronization therapy (CRT) is a means to enhance myocardial function by stimulating the failing left ventricle at or near the time of right ventricular activation to synchronize ventricular depolarization. Current data from randomized, controlled trials suggest that CRT benefits patients with moderate to severe heart failure and have shown that this therapy significantly reduces mortality and hospital admissions in this group. In addition to CRT, implantable cardioverter-defibrillators have been evaluated in heart failure patients with significantly reduced left ventricular function and have been shown to reduce mortality from sudden cardiac death. This article summarizes recent device trials and discusses how best to apply their results to clinical practice.

Cardiac Pacing, Artificial↗

Use of the AutoCapture Pacing System with implantable defibrillator leads.

INTRODUCTION: Previous studies using various bipolar pacemaker leads have shown that the AutoCapture (AC) Pacing System is able to verify ventricular capture and regulate pacing output, increasing patient safety with respect to unexpected threshold changes and potentially prolonging device longevity. An increasing number of patients with implantable cardioverter defibrillators (ICDs) require ventricular pacing that contributes to a shortening of longevity of these systems. This prospective study tested the compatibility of the AC system with bipolar ICD leads. METHODS: The AC algorithm was evaluated prior to ICD testing in 30 ICD recipients. A single coil, active fixation, true bipolar ventricular lead was implanted in 21 patients, and a dual coil, passive fixation, integrated bipolar ventricular lead was implanted in 9 patients. A ventricular evoked response sensitivity test and an AC threshold test were performed using a pacemaker with the ventricular AC algorithm. RESULTS: AC was recommended in 22/30 (73.3%) of implants, including 20/21 (95.2%) with the single coil and 2/9 (22.2%) with the dual coil lead. Mean polarization was lower (1.23 +/- 0.95 mV vs 3.70 +/- 2.33 mV, P = 0.013) while the mean evoked response was higher (18.04 +/- 8.29 mV vs 10.13 +/- 4.22 mV, P = 0.002) with the single coil leads. CONCLUSION: Automatic threshold tracking using the AC is compatible with ICD leads. Leads with lower polarization and greater evoked response are more likely to result in recommendation of AC use. Use of this system offers the potential for increasing ICD generator longevity and improving patient safety in response to late unexpected threshold increases.

Aged↗