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  1. International Literacy Year (ILY), 1990.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France).

    Information is presented in recognition of the United Nations General Assembly proclamation of 1990 as International Literacy Year (ILY). It is shown that, in 1985, there were an estimated 889 million adult illiterates in the world (more than 25% of the adult population), and more than 100 million children of primary school age in developing…

  2. International Literacy Year (ILY). Unesco Adult Education Information Notes. Special Number--No. 4.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France). Div. of Primary Educ., Literacy & Adult Educ., Educ. in Rural Areas

    This issue contains several articles dealing with the International Literacy Year (ILY) proclaimed the United Nations (UN) for the year 1990. The first article, "1990, Proclaimed International Literacy Year by the United Nations," discusses the purpose of the observance of the ILY, namely the contribution to greater understanding by…

  3. Integrating Information Literacy Instruction (ILI) through Resource-Based School Projects: An Interpretive Exploration

    ERIC Educational Resources Information Center

    Yu, Halida; Noordin, Siti Arpah; Mokhtar, Sobariah Awang; Abrizah, A.

    2011-01-01

    Resource-based school projects have good potential to be an effective approach in information literacy instruction (ILI). These projects offer the opportunity for students to engage in information problem-solving learning activities and employ various learning skills, including information literacy (IL). The researchers seek to explore ILI through…

  4. International Literacy Year (ILY). Unesco Adult Education Information Notes. Special Number--No. 4.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France). Div. of Primary Educ., Literacy & Adult Educ., Educ. in Rural Areas

    This issue contains several articles dealing with the International Literacy Year (ILY) proclaimed the United Nations (UN) for the year 1990. The first article, "1990, Proclaimed International Literacy Year by the United Nations," discusses the purpose of the observance of the ILY, namely the contribution to greater understanding by…

  5. Extremely arid soils of the Ili Depression in Kazakhstan

    NASA Astrophysics Data System (ADS)

    Lebedeva, M. P.; Gerasimova, M. I.; Golovanov, D. L.; Yamnova, I. A.

    2015-01-01

    On the basis of macro- and micromorphological and analytical studies of extremely arid soils of the Ili Depression in Kazakhstan, a comparative analysis of pedogenetic processes shaping these soils on piedmont plains of different ages and heights is performed. The types of soil horizons and their combinations are analyzed in the context opf modern Russian and international soil classification systems. The genesis of extremely arid soils is controlled by the climatic conditions and by their geomorphic position on alluvial fans of piedmont plains. The following processes are diagnosed in these soils: soil crusting with vesicular porosity, the development of desert pavements with rock varnish, rubification, surface salinization, and iron depletion around the pores. It is suggested that the initial factor-based name (extremely arid) of these soils can be replaced by the name vesicular-crusty soils with the corresponding AKL diagnostic horizon, which is more consistent with the principles of substantive-genetic classification systems. In order to determine the classification position of these soils in terms of the new Russian soil classification system, new diagnostic horizons—AKL and CS—have to be introduced in this system. According to the WRB classification, the studied soils belong to the group of Gypsisols; the soil with strong salinization fits the criteria of the group of Solonchaks. A qualifier [yermic] is to be added to reflect the development of desert pavement and vesicular layer under extreme arid conditions.

  6. Density- and wavefunction-normalized Cartesian spherical harmonics for <i>l> ≤ 20

    SciTech Connect

    Michael, J. Robert; Volkov, Anatoliy

    2015-03-01

    The widely used pseudoatom formalism in experimental X-ray charge-density studies makes use of real spherical harmonics when describing the angular component of aspherical deformations of the atomic electron density in molecules and crystals. The analytical form of the density-normalized Cartesian spherical harmonic functions for up to <i>l> ≤ 7 and the corresponding normalization coefficients were reported previously by Paturle & Coppens. It was shown that the analytical form for normalization coefficients is available primarily forl ≤ 4. Only in very special cases it is possible to derive an analytical representation of the normalization coefficients for 4 < <i>l> ≤ 7. In most cases for <i>l> > 4 the density normalization coefficients were calculated numerically to within seven significant figures. In this study we review the literature on the density-normalized spherical harmonics, clarify the existing notations, use the Paturle–Coppens method in the Wolfram Mathematicasoftware to derive the Cartesian spherical harmonics for <i>l> ≤ 20 and determine the density normalization coefficients to 35 significant figures, and computer-generate a Fortran90 code. The article primarily targets researchers who work in the field of experimental X-ray electron density, but may be of some use to all who are interested in Cartesian spherical harmonics.

  7. Estimation of carbon storage and carbon density of forest vegetation in Ili River Valley, Xinjiang

    NASA Astrophysics Data System (ADS)

    jing, Guo; renping, Zhang; ranghui, Wang; aimaiti, Yusupujiang; tuerdi, Asiyemu; dongya, Zhang

    2016-11-01

    Study on the forest carbon storage, carbon density and spatial distribution characteristic are helpful for improving the accuracy of carbon estimation and providing the practical basis for better policy making. In this research, the compiled data of 'Xinjiang Forest Resources Survey Results' in 2011 was used as a source data, by using the biomass-volume regression model and average biomass method, the carbon storage, carbon density and spatial distribution of forest resources in Ili River Valley region were analyzed. Results show that, the total biomass, carbon storage and average carbon density in Ili River valley were 69.647Tg, 34.823Tg and 41.45Mg/hm2 C respectively. From the aspect of spatial distribution, the northwest region of Ili River Valley has high carbon storage and the southeast region has low carbon storage. The southwest region has low carbon density and the northeast region has high carbon density. The value of forest Carbon storage from high to low was: Arbor > Shrub > Sparse forest > Odd tree > Economic forest > Scattered trees. Mature arbor forest plays an important role in maintaining the balance of carbon dioxide and oxygen in Ili River Valley region.

  8. Analyzing Idioms and Their Frequency in Three Advanced ILI Textbooks: A Corpus-Based Study

    ERIC Educational Resources Information Center

    Alavi, Sepideh; Rajabpoor, Aboozar

    2015-01-01

    The present study aimed at identifying and quantifying the idioms used in three ILI "Advanced" level textbooks based on three different English corpora; MICASE, BNC and the Brown Corpus, and comparing the frequencies of the idioms across the three corpora. The first step of the study involved searching the books to find multi-word…

  9. Distribution of Influenza-Like Illness (ILI) by Occupation in Washington State, September 2009–August 2010

    PubMed Central

    Anderson, Naomi J.; Bonauto, David K.; Fan, Z. Joyce; Spector, June T.

    2012-01-01

    Objectives : We aim to estimate the prevalence of influenza-like illness (ILI) by occupation and to identify occupations associated with increased ILI prevalence. Methods Between September 2009 and August 2010, the Centers for Disease Control (CDC) included questions on ILI symptoms on the Behavioral Risk Factor Surveillance System (BRFSS). Washington State collects the occupation of all employed BRFSS respondents. ILI prevalence and prevalence ratios (PR) were calculated by occupational group. Results There were 8,758 adult, currently employed, non-military respondents to the Washington BRFSS during the study period. The ILI prevalence for all employed respondents was 6.8% (95% Confidence Interval (95% CI) = 6.1, 7.6). PRs indicated a lower prevalence of ILI in Technicians (PR = 0.4, 95% CI = 0.2, 0.9) and Truck Drivers (PR = 0.2, 95% CI = 0.1, 0.7) and higher prevalence in Janitors and Cleaners (PR = 2.5, 95% CI = 1.3, 4.7) and Secretaries (PR = 2.4, 95% CI = 1.1, 5.4). Conclusions Some occupations appear to have higher prevalence of ILI than others. These occupational differences may be explained, in part, by differing levels of social contact with the public or contact with contaminated surfaces at work, or by other occupational factors such as stress or access to health care resources. PMID:23152808

  10. Rapid identification of Streptococcus intermedius by PCR with the ily gene as a species marker gene.

    PubMed

    Goto, Takatsugu; Nagamune, Hideaki; Miyazaki, Aiko; Kawamura, Yoshiaki; Ohnishi, Ooki; Hattori, Kanako; Ohkura, Kazuto; Miyamoto, Kazuaki; Akimoto, Shigeru; Ezaki, Takayuki; Hirota, Katsuhiko; Miyake, Yoichiro; Maeda, Takuya; Kourai, Hiroki

    2002-02-01

    Streptococcus intermedius belongs to the anginosus group of streptococci (AGS) and is associated with endogenous infections leading to abscesses in the oral cavity and at deepseated sites, such as the brain and liver. Two other species, S. anginosus and S. constellatus, and some presently unnamed taxa, are also classified as AGS. Recently, S. constellatus subsp. pharyngis, a new subspecies with biochemical characteristics similar to S. intermedius, was described with the potential for causing confusion when trying to identify isolates of these two species routinely with commercial identification kits, such as Rapid ID32 Strep and Fluo-Card Milleri. To correctly identify S. intermedius, this study attempted to develop an accurate PCR identification system with the ily gene as a species marker. This approach relies on amplification of an 819-bp fragment of the ily gene and its 3'-flanking region and is shown here to be specific for S. intermedius strains among all other streptococcal species. Moreover, this PCR system was applicable in direct rapid PCR with whole bacterial cells and TaKaRa Z-Taq (TaKaRa), a highly efficient DNA polymerase, as the template and DNA amplification enzyme, respectively.

  11. Size-differentiated REE characteristics and environmental significance of aeolian sediments in the Ili Basin of Xinjiang, NW China

    NASA Astrophysics Data System (ADS)

    Chen, Xiuling; Song, Yougui; Li, Jinchan; Fang, Hong; Li, Zhizhong; Liu, Xiuming; Li, Yue; Orozbaev, Rustam

    2017-08-01

    Aeolian loess in the Ili Basin is an important geological archive for studying the changes in paleoclimate and sources of dust particles. Size-differentiated rare earth elements (REE) may help to distinguish potential dust sources. This study investigates the size-differentiated REE characteristics from three sites including the Zhaosu loess and the Kekdala desert sediments from the Ili Basin, and the Chaona loess from the Chinese Loess Plateau (CLP). Our results show that the patterns of variation of the REE characteristics in different size fractions can act as improved source tracers for aeolian sediments. Moreover, the REE characteristics of the <2 μm particles are sensitive indicators for distinguishing dust particles transported over long distances in the semi-arid areas with limited pedogenesis such as the Ili Basin. However, it should be interpreted cautiously in the CLP due to the post-depositional chemical weathering. The REE characteristics of coarse fractions are effective tracers for tracking changes in proximal dust sources and regional boundary level circulations. Our study has implications for identifying the exact source(s) of the Ili loess, which is helpful to understand paleoclimate changes and westerly circulation patterns in Central Asia.

  12. The Invertebrate Lysozyme Effector ILYS-3 Is Systemically Activated in Response to Danger Signals and Confers Antimicrobial Protection in C. elegans

    PubMed Central

    Gravato-Nobre, Maria João; Vaz, Filipa; Filipe, Sergio; Chalmers, Ronald; Hodgkin, Jonathan

    2016-01-01

    Little is known about the relative contributions and importance of antibacterial effectors in the nematode C. elegans, despite extensive work on the innate immune responses in this organism. We report an investigation of the expression, function and regulation of the six ilys (invertebrate-type lysozyme) genes of C. elegans. These genes exhibited a surprising variety of tissue-specific expression patterns and responses to starvation or bacterial infection. The most strongly expressed, ilys-3, was investigated in detail. ILYS-3 protein was expressed constitutively in the pharynx and coelomocytes, and dynamically in the intestine. Analysis of mutants showed that ILYS-3 was required for pharyngeal grinding (disruption of bacterial cells) during normal growth and consequently it contributes to longevity, as well as being protective against bacterial pathogens. Both starvation and challenge with Gram-positive pathogens resulted in ERK-MAPK-dependent up-regulation of ilys-3 in the intestine. The intestinal induction by pathogens, but not starvation, was found to be dependent on MPK-1 activity in the pharynx rather than in the intestine, demonstrating unexpected communication between these two tissues. The coelomocyte expression appeared to contribute little to normal growth or immunity. Recombinant ILYS-3 protein was found to exhibit appropriate lytic activity against Gram-positive cell wall material. PMID:27525822

  13. Tectonic and sedimentary evolution of the Ili Basin (northern Tien Shan, Kazakhstan)

    NASA Astrophysics Data System (ADS)

    Kley, J.; Voigt, T.; Seib, N.; Kober, M.

    2010-12-01

    The Tien Shan active intraplate orogen of Central Asia exhibits strong along-strike variations in structure. Its northern front in southeastern Kazakhstan is characterized by a fragmented array of anticlinal basement highs whose wavelengths range from c. 5 to 30 km. Range-bounding faults are mostly E- to ENE-trending thrust or reverse faults and SE-trending dextral strike-slip faults. Faults of large displacement (more than several tens of meters) are conspicuously absent. The synclinal lows between the basement highs preserve Cenozoic strata of Oligocene to Quaternary age, probably deposited in a once continuous basin (the Ili Basin) and recording the entire history of Tien Shan uplift. Very gentle, long-wavelength folds affect the Cenozoic strata. As far as visible, the basement is always folded conformably. The basin fill starts in the middle Oligocene (mammal fossils; Indricotherium horizon). The facies of these oldest deposits is characterized by fluvial deposits of a large river system and varying flood-plain deposits with intense soil formation (calcretes and gypsisols). Transport directions and quartz content of the sediments suggest they were not sourced from the nearby mountain ranges present today. The fluvial succession is followed by late Oligocene to early Miocene lake deposits which reflect the transition from an evaporitic lake/playa system to freshwater lacustrine conditions. The Oligocene to Early Miocene deposits are limited to a small area in the core of the Aktau anticline and show no relationship to the sediment succession overlying the basement in the uplifts surrounding the Aktau mountains in the north and west. There, alluvial and fluvial deposits of middle Miocene(?) age rest on deeply weathered paleosurfaces. Transport is mainly to the south. Changes in colour, grain size and ratio of channel to interchannel deposits probably reflect climatic changes. Rapid facies and thickness-changes allow the reconstruction of several alluvial fans

  14. [Environmental geochemical baseline of heavy metals in soils of the Ili river basin and pollution evaluation].

    PubMed

    Zhao, Xin-Ru; Nasier, Telajin; Cheng, Yong-Yi; Zhan, Jiang-Yu; Yang, Jian-Hong

    2014-06-01

    Environmental geochemical baseline models of Cu, Zn, Pb, As, Hg were established by standardized method in the ehernozem, chestnut soil, sierozem and saline soil from the Ili river valley region. The theoretical baseline values were calculated. Baseline factor pollution index evaluation method, environmental background value evaluation method and heavy metal cleanliness evaluation method were used to compare soil pollution degrees. The baseline factor pollution index evaluation showed that As pollution was the most prominent among the four typical types of soils within the river basin, with 7.14%, 9.76%, 7.50% of sampling points in chernozem, chestnut soil and sierozem reached the heavy pollution, respectively. 7.32% of sampling points of chestnut soil reached the permitted heavy metal Pb pollution index in the chestnut soil. The variation extent of As and Pb was the largest, indicating large human disturbance. Environmental background value evaluation showed that As was the main pollution element, followed by Cu, Zn and Pb. Heavy metal cleanliness evaluation showed that Cu, Zn and Pb were better than cleanliness level 2 and Hg was the of cleanliness level 1 in all four types of soils. As showed moderate pollution in sierozem, and it was of cleanliness level 2 or better in chernozem, chestnut soil and saline-alkali soil. Comparing the three evaluation systems, the baseline factor pollution index evaluation more comprehensively reflected the geochemical migration characteristics of elements and the soil formation processes, and the pollution assessment could be specific to the sampling points. The environmental background value evaluation neglected the natural migration of heavy metals and the deposition process in the soil since it was established on the regional background values. The main purpose of the heavy metal cleanliness evaluation was to evaluate the safety degree of soil environment.

  15. 3D modeling of circumferential SH guided waves in pipeline for axial cracking detection in ILI tools.

    PubMed

    Wang, Shen; Huang, Songling; Zhao, Wei; Wei, Zheng

    2015-02-01

    In this paper, SH (shear horizontal) guided waves propagating in the circumferential direction of pipeline are modeled in 3 dimensions, with the aim for axial cracking detection implementation in ILI (in-line inspection) tools in mind. A theoretical formulation is given first, followed by an explanation about the 3D numerical modeling work. Displacement wave structures from the simulation and dispersion equation are compared to verify the effectiveness of the FEM package. Transverse slots along the axial direction are modeled to simulate axial cracking. Reflection and transmission coefficients curves are obtained to provide insight in using circumferential SH guided waves for quantitative testing of axial pipeline cracking. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Bacterial endophytes of Trans-Ili Alatau region's plants as promising components of a microbial preparation for agricultural use.

    PubMed

    Mukasheva, Togzhan; Berzhanova, Ramza; Ignatova, Lyudmila; Omirbekova, Anel; Brazhnikova, Yelena; Sydykbekova, Raikhan; Shigaeva, Maya

    2016-01-01

    In this study, 382 isolates of bacterial endophytes from tissues of plants grown in the foothills and piedmont plains of the Trans-Ili Alatau were isolated. It was found that certain strains actively produce indole-3-acetic acid (IAA) in a medium containing l-tryptophan. Among the strains studied, 26 strains (66%) showed a positive response to production of IAA. Bacteria synthesized IAA in the range of 18.6 ± 1.1 to 82.4 ± 2.3 µg/ml. IAA was synthesized more actively by Streptosporangium sp. KK1 (44.1 µg/ml), Rhodococcus sp. KK 2 (42.5 µg/ml), Streptomyces tendae KK3 (44.9 µg/ml) strains. The most active auxin's producer is a Jeotgalicoccus halotolerans BAK1 strain, whose total level of IAA production reached 82.4 µg/ml. Such strains as Streptomyces griseorubiginosis KK4, Streptomyces sp. KK5 and Jeotgalicoccus halotolerans BAK1 were found to have a significant stimulating effect which was reflected in the increase of the length of the roots of soybean and barley. As a result, 8 promising strains with fungicidal, growth-stimulating, phosphorus dissolving and enzymatic activities were selected for the further development of highly microbiological preparations for crop research.

  17. Land-use impacts on profile distribution of labile and recalcitrant carbon in the Ili River Valley, northwest China.

    PubMed

    Liu, Xiang; Li, Lanhai; Qi, Zhiming; Han, Jiangang; Zhu, Yongli

    2017-05-15

    There is a growing evidence that the decomposition of recalcitrant carbon (C) can be stimulated by environmental changes, such as fresh C supply and increased temperature. However, the effect of land-use on profile distribution of recalcitrant C content is still poorly understood. In this study, soil samples were collected to a depth of 100cm from pastures and four major croplands including maize field, wheat field, paddy and apple orchard in the Ili River Valley, northwest China, to investigate the effects of land-use on profile distribution of labile organic C (LOC), semi-labile organic C (SLOC), recalcitrant organic C (ROC) and their relative proportions in total organic C (TOC), and evaluate whether such effects can be different between topsoil (0-20cm) and subsoil (20-100cm). The results showed that soil ROC accounting for 49.4-66.3% of TOC for different land-uses, implying that ROC is the major form of soil organic C (SOC). Soil TOC contents of croplands were 20.4-85.2% lower than those of pastures along the soil profile, indicating that SOC pool may be decreased by agricultural land-uses. The lower contents of LOC, SLOC and ROC in croplands than in pastures suggested that the decreases in TOC content in croplands are not only due to the decreases in labile C pool but also the reductions in recalcitrant C pool. The differences in SOC fractions among land-uses were similar in topsoil and subsoil, while the proportions of each SOC fraction in TOC did not differ significantly between the two soil layers in most cases, indicating that each SOC fraction in subsoil can be also influenced by land-use types. Therefore, it is suggested that the ROC in subsoil, which plays a crucial role in C sequestration, should be taken into account when estimating the effect of land-use on SOC kinetic. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. The prevalence and subjective handicap of epilepsy in Ilie--a rural riverine community in South West Nigeria: a door-to-door survey.

    PubMed

    Mustapha, A F; Preux, P M; Sanya, E O; Akinleye, C A

    2014-08-01

    The prevalence of epilepsy is high in tropical countries, particularly in Africa with an estimated mean prevalence of 15 per 1000. There is lack of recent data on epilepsy prevalence in Nigeria. The main objective of this study was to determine the prevalence of epilepsy in Ilie in South West (SW) Nigeria, and the secondary objectives were to determine the clinical characteristics, the seizure types with electroencephalography (EEG) recording, the pattern of treatment, and to evaluate the subjective handicap of people with epilepsy (PWE). The study, which was descriptive cross-sectional, was carried out in Ilie, a rural community in South West Nigeria, using a simple random sampling technique. The survey was done in 2 phases from January 2013 to April 2013. Phase 1: Door-to-door screening using the WHO Neuroscience Research Protocol to detect neurological disorders by health workers. Phase 2: Individuals with positive screening had complete neurologic examination by neurologists as well as an EEG recording. The questionnaires for survey of epilepsy in tropical countries and subjective handicap of epilepsy were administered to all PWE. Two thousand two hundred twelve individuals from 231 households were screened during the first phase, and 33 cases of neurologic diseases were detected. During the second phase, 10 cases were confirmed to be epilepsy by neurologists, thus giving a crude lifetime prevalence of 10/2212=4.5/1000 population (95% CI=2.30-8.04). The prevalence of epilepsy in Ilie in South West Nigeria is rather low compared with previous figures from studies in rural Africa. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Hydrogeochemical and isotopic composition of groundwater in the Horgos River Watershed in the NorthWestern Ili Basin in Sinkiang Province, China

    NASA Astrophysics Data System (ADS)

    Jin, S. H.; Jiang, J. Y.; Rao, J. P.

    2016-08-01

    In this study, hydrogeochemical and stable environmental isotopic (oxygen-18 and deuterium) data of groundwater in the Horgos River watershed in the north-western Ili Basin were examined to determine the groundwater chemical characteristics, as well as the origins of the groundwater and surface water. The quaternary aquifer's structure and spatial distribution is complex. Hydrogeochemical data shows that the groundwater is alkaline due to the presence of bicarbonate as the dominant anion. In the north, the dominant groundwater cation was Ca2+ while Mg2+ ions were highest in the south. In addition, water types varied from HCO3-SO4-Ca and HCO3-SO4-Ca-Mg to HCO3-SO4-Mg-Ca and SO4-HCO3-Mg-Ca. Overall, the groundwater in this study showed high total hardness. The dissolving and evaporation inspissation were considered the main controlling factors. Isotopic data (oxygen-18 and deuterium) indicated that the Horgos River was the main recharge source for the groundwater, which rapidly infiltrated across sandstone macropores. Furthermore, surface water and shallow groundwater were significantly affected by evaporation.

  20. Geochemistry of the Miocene oil shale (Hançili Formation) in the Çankırı-Çorum Basin, Central Turkey: Implications for Paleoclimate conditions, source-area weathering, provenance and tectonic setting

    NASA Astrophysics Data System (ADS)

    Vosoughi Moradi, A.; Sarı, A.; Akkaya, P.

    2016-07-01

    The geochemistry of oil shale units of Hançili Formation in the Çankırı-Çorum Basin (Central Turkey) was studied using various chemical analyses. The mineralogical composition of the samples were preliminarily investigated using Pearson's correlation coefficients of selected elements, indicating that the samples contain abundant clay minerals as well as K-feldspar and carbonate. The K2O/Al2O3 and SiO2/Al2O3 ratios indicate that the major proportion of clay minerals is composed of smectite. Si, Al, Ti, K, Na, and Fe reside in clay minerals, while Ca, Mg, and Mn are mostly associated with carbonates (e.g., calcite and dolomite) and phosphorous (P) is present as apatite. The total REE content of the oil shale range from 19 to 113 ppm. The chondrite-normalized patterns of the oil shale show LREE enrichments, HREE deficits, negative Eu anomalies and negligible Ce anomalies. In general, major, trace and rare earth element abundances suggest that the studied oil shale in the Çankırı-Çorum Basin are mainly from the intermediate rocks, mixed with small amounts of basic rocks, and that their source rocks are mostly deposited in the continental collision setting. The REE geochemistry of the oil shale suggests that these samples were derived from a consistent terrigenous source and the Eu anomaly was inherited from the source rocks. The paleoclimate index (C-value), varies between 0.07 and 1.22 reflecting a generally semi-arid to humid conditions. In addition, Rb/Sr ( 0.22) and Sr/Cu ( 9.09) ratios support the idea that warm and humid conditions prevailed during deposition of the Hançili Formation. Sr/Ba ratios (0.54-3.7) of the studied samples suggest a paleoenvironment with variable salinity. The co-variation among this factor and paleoclimate indicators suggest that variations in climatic conditions exerted a primary control on salinity. The substantially low C-value and Rb/Sr ratio and significantly high ratios of Sr/Cu and Sr/Ba and also elevated carbonate

  1. SOVRaD - A Digest of Recent Soviet R and D Articles. Volume 1, Numbers 5-6, May-June 1975

    DTIC Science & Technology

    1975-06-01

    Pavlov , and Yu. Ye. Ochakovskiy. Light " scattering properties of sea water. IN: Sb. Gidrofiz. i gidrooptühT" issled. v...polymer materials and glass). Ivanova, Ivan , energ. in-t, 1974, 135 p. (KL. 18/7*. m8l^). Babayev. A.A. Stabilizatsiya

  2. Recollections of a translator (Russian title: Vstrecha v verhah ili vospominania perevodchika)

    NASA Astrophysics Data System (ADS)

    Gaina, Alex

    The article includes recollections of the author-translator from few meetings in Moscow during 70-th years of the XX-th century. The recollections includes a visit to Moscow of a Romanian delegation of trade-unions, a visit of Nicolae Ceausescu and Elena Ceausescu to Moscow in november 1977 in view of the 60-th years of the Revolution of October celebration. A visit by Nicu Ceausescu, physicist and the leader of the Union of Communist Youth of Romania, to Central Comitee of the All Union Communist Youth Organization of the USSR (Komsomol) in Moscow during a transit fly to Beijing (China) is reported also. The recollections reffers also the following persons: Andrey Gromyko- minister of the foreign office of the USSR, Geidar Aliev - 1-st secretary of the Central Commitee of the Azerbaijan S.S.R. Communist party, Grigor'ev- a secretary of the Soviet Komsomol (All Union Organization of Communist Youth) and other.

  3. The identification of medieval fevers according to Al-Isra'ili, Avenzoar and Bernard Gordon.

    PubMed

    Muñoz, Carmen Peña; Irueste, Fernando Girón

    2005-12-01

    In this work, which derives from a study into the prevention of illness in medieval Spain, and which forms part of a larger work on medieval fevers in all their aspects, we concern ourselves with their causes, symptoms, prognostications and treatment. We are grateful for the support of the British Academy and The Wellcome Trust in funding this study. Through this work we aim to establish a certain order in the fevers which figure in medical texts of the Middle Ages which we have analysed. We have grouped them, following the example of Galen, according to their point of origin: spirits, humours and solid matter. Then, within each of these categories, we have classified them by the spirit or humour affected. The basic elements of each fever are described in order to differentiate them. We offer, finally, over one hundred names by which the different fevers can be known.

  4. Investing in Adult Literacy: Lessons and Implications. ILI Technical Report TR98-03.

    ERIC Educational Resources Information Center

    Eisemon, Thomas Owen; Marble, Kari; Crawford, Michael

    Despite its low volume of lending for adult literacy and nonformal education, the World Bank acquired significant project experience in the 1960s and 1970s. Enthusiasm for nonformal education waned in the 1980s; increasing priority was given to help governments to achieve universal primary education as the principal means of making societies…

  5. Precise Coulomb Wave Functions for a Wide Range of Complex <i>l>, η, and z

    SciTech Connect

    Michel, Nicolas L

    2007-01-01

    A new algorithm to calculate Coulomb wave functions with all of its arguments complex is proposed. For that purpose, standard methods such as continued fractions and power/asymptotic series are combined with direct integrations of the Schroedinger equation in order to provide very stable calculations, even for large values of |{eta}| or |{lm}({ell})|. Moreover, a simple analytic continuation for R(z)<0 is introduced, so that this zone of the complex z-plane does not pose any problem. This code is particularly well suited for low-energy calculations and the calculation of resonances with extremely small widths. Numerical instabilities appear, however, when both |{eta}| and |{lm}({ell})| are large and |R({ell})| comparable or smaller than |{lm}({ell})|. Catalogue number:ADYO{_}v1{_}0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADYO{_}v1{_}0 Program obtainable from: CPC Program Library, Queen's University of Belfast, N. Ireland Licensing provisions: none Computers on which the program has been tested: DELL GX400 Operating systems: Linux, Windows Programming language used: C++ No. of bits in a word: 64 No. of processors used: 1 Has the code been vectorized?: no No. of bytes in distributed program, including test data, etc.: 33 092 No. of lines in distributed program, including test data, etc.: 3210 Distribution format:tar.gz Nature of physical problem: The calculation of Coulomb wave functions with all of their arguments complex is revisited.

  6. Istoriya al'ternativnykh techenij v planetnoj kosmogonii (gomogennaya ili geterogennaya akkretsiya) %t The history of two alternative concepts in planetary cosmogony (homogeneous of heterogeneous accretion)

    NASA Astrophysics Data System (ADS)

    Rezanov, I. A.

    Initially the hypotheses of Kant, Laplace, and other authors implied homogeneous accretion of planets from uniform material. O. Yu. Schmidt shared this idea. The idea of heterogeneous accretion was proposed in the mid-1940s by V. G. Fesenkov, who demonstrated that the iron cores of planets started to form prior to their silicate mantles. The obvious increase in average planet density with decreasing distance from the Sun suggests that the protoplanetary nebula was also heterogeneous - iron concentrated closer to the Sun, probably under the effect of its magnetic field. In the second half of the 20th century, planetary cosmogony developed against the background of continuous dispute between the adherents of homogeneous and heterogeneous planetary accretion. The confrontation still exists, although arguments in favour of heterogeneous accretion increase in weight. The dilemma under discussion is directly related to modern tectonic concepts, because it is necessary to find an answer to the question whether the core originated from the differentiation of the Earth's material or our planet had a core from the beginning.

  7. Predictors of MERS-CoV infection: A large case control study of patients presenting with ILI at a MERS-CoV referral hospital in Saudi Arabia.

    PubMed

    Mohd, Hamzah A; Memish, Ziad A; Alfaraj, Sarah H; McClish, Donna; Altuwaijri, Talal; Alanazi, Marzouqah S; Aloqiel, Saleh A; Alenzi, Ahmed M; Bafaqeeh, Fahad; Mohamed, Amal M; Aldosari, Kamel; Ghazal, Sameeh

    A case control study to better characterize the clinical features, laboratory, and radiological abnormalities associated with MERS-CoV infection in order to help with early identification of this syndrome from other respiratory infections. Eighty patients admitted to a hospital in Riyadh, diagnosed with MERS-CoV infection based on RT-PCR were matched on age, sex, and the presence of a co-morbid condition on a basis of 1:2 to other patients admitted with respiratory symptoms and tested negative for MERS-CoV on RT-PCR. None of the reported MERS-CoV presenting symptoms was significantly associated with being infected with MERS-CoV. On the other hand, WBC count was significantly lower in patients with confirmed MERS-CoV infection (median 5.7 vs 9.3, P: 0.0004). Neutrophil count was as well significantly lower in MERS-CoV patients (median 3.7 vs 6.7, P: 0.0001). Both AST, and ALT values were significantly higher in MERS-CoV infected group (AST median 42 vs 36, P: 0.03, and ALT median 33 vs 28, P: 0.003). Overall our MERS-CoV mortality rate was (10%) below the national figure of (40%). None of the presenting symptoms are specific for MERS-CoV infection. And out of all the investigations WBC, neutrophil counts, AST and ALT values have some predictive utility. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Examining Secondary School Students' Safe Computer and Internet Usage Awareness: An Example from Bartin Province=Lise Ögrencilerinin Güvenli Bilgisayar ve Internet Kullanim Farkindaliklarinin Incelenmesi: Bartin Ili Örnegi

    ERIC Educational Resources Information Center

    Yilmaz, Ramazan; Karaoglan Yilmaz, F. Gizem; Özturk, H. Tugba; Karademir, Tugra

    2017-01-01

    Information and Communication Technologies (ICT) have been rapidly prevailed among the children and youths. Personal technologies facilitating the students to gain some learning experiences both in and out of the schools also include many threats. It is important for students to have high awareness of safe internet and computer use to overcome…

  9. DOT`s perspective on in-line inspection

    SciTech Connect

    Ulrich, L.W.

    1996-08-01

    The Department of Transportation and its Office of Pipeline Safety have been involved with in-line inspection (ILI) pigs since the construction of the Alaska crude oil pipeline in the early 1970s. Two Congressionally mandated reports concerning ILI pigs and a regulation requiring new and replaced pipe and components to be designed and constructed to accommodate ILI pigs have been issued by the Department. Although there is no present federal requirement to run ILI pigs, they are required by the Office of Pipeline Safety in selected compliance cases. The Department will continue to use ILI pigs in compliance cases. It also supports future ILI pig research, and the use of ILI pig surveys incorporated in any pipeline operator`s future risk management plans developed as safety alternatives to the established pipeline safety regulations. The Department also in the future may require ILI pigs to be run on some pipelines.

  10. Influenza like Illness among Medical Residents Anticipates Influenza Diffusion in General Population: Data from a National Survey among Italian Medical Residents

    PubMed Central

    Restivo, Vincenzo; Costantino, Claudio; Mammina, Caterina; Vitale, Francesco

    2016-01-01

    The aim of this multicentre study was to assess incidence of influenza like illness (ILI) among Italian medical residents (MRs) during 2011–2012 influenza season, to detect variables associated with ILI and to compare estimated ILI incidence among MRs and general population. A cross-sectional survey was carried out throughout an anonymous questionnaire administered to all MRs attending the post-graduate medical schools of 18 Italian Universities. At the same time an analysis of the ILI incidence in the Italian general population was conducted through the Italian Influenza Surveillance Network. Of a total of 2,506 MRs, 1,191 (47.5%) reported at least one ILI episode. A higher proportion of ILIs was reported by MRs of Central (25.0% with ILI vs 20.2% without ILI) and Southern Italy (40.2% with ILI vs. 36.4 without ILI) compared to Northern Italy (34.8% with ILI vs. 43.4% without ILI) (p<0.001). Italian MRs had a higher cumulative incidence of ILIs (546.7 episodes per 1,000 vs. 75.9 episodes per 1,000) and an earlier peak (January 2012 vs. February 2012), compared to general population due to higher number of contacts in hospital setting. MRs reported a high rate of ILI infection probably in association with their working activities. These data suggest the need to offer an earlier influenza vaccination to HCWs than general population with the aim to both prevent ILI and its transmission to patients. PMID:27997602

  11. The association between benzodiazepines and influenza-like illness-related pneumonia and mortality: a survival analysis using UK Primary Care data.

    PubMed

    Nakafero, Georgina; Sanders, Robert D; Nguyen-Van-Tam, Jonathan S; Myles, Puja R

    2016-11-01

    Bacterial superinfections, including pneumonia, are frequent complications of influenza-like illness (ILI). Clinical and laboratory evidence suggests that benzodiazepines and Z-drugs may influence susceptibility to infections and mortality. We investigated whether benzodiazepines and zopiclone modify the occurrence of ILI-related pneumonia and mortality. We obtained data on 804 051 ILI patients from a comprehensive primary care database, the Clinical Practice Research Datalink. The follow-up period started from the diagnosis of ILI for 30 days. Pneumonia and deaths occurring within the 30-day follow-up period were considered as potentially 'ILI related'. Exposure to benzodiazepines and zopiclone was determined in the period preceding a diagnosis of ILI with current use defined as a prescription for benzodiazepines in the month prior to ILI diagnosis. Cox regression was used for the analyses. Adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) are presented. Influenza-like illness-related pneumonia and mortality were noted in 1117 and 707 ILI patients, respectively. Current exposure to benzodiazepines was associated with increased occurrence of both ILI-related pneumonia and mortality (ILI-related pneumonia adjusted HR 4.24, 95%CI [2.27, 7.95]; ILI-related mortality adjusted HR 20.69, 95%CI [15.54, 27.54]). A similar increase in ILI-related mortality but not pneumonia was observed with current zopiclone use (ILI-related mortality adjusted HR 10.86, 95%CI [6.93, 17.02]; ILI-related pneumonia adjusted HR 1.97, 95%CI [0.63, 6.12]). Benzodiazepines may increase the likelihood of pneumonia and mortality related to ILI. A cautionary approach to prescribing benzodiazepine is suggested in people known to be at increased risk of pneumonia or mortality. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  12. DOT`s perspective on in-line inspection

    SciTech Connect

    Ulrich, L.W.

    1996-12-01

    The US Department of Transportation (DOT) and its Office of Pipeline Safety (OPS) have been involved with in-line inspection (ILI) pigs since the construction of the Alaska crude oil pipeline. Congressionally mandated reports concerning ILI pigs, and a regulation requiring new and replaced pipe and components be designed and constructed to accommodate ILI pigs, were issued by DOT. DOT also may mandate ILI pigs to be run on some pipelines. There is no current federal requirement to run ILI pigs. They are required by OPS in selected compliance cases. DOT supports future ILI pig research. The use of ILI pig surveys, incorporated in pipeline operators` future risk management plans developed as safety alternatives to the established pipeline safety regulations, will be supported.

  13. Emergency department and 'Google flu trends' data as syndromic surveillance indicators for seasonal influenza.

    PubMed

    Thompson, L H; Malik, M T; Gumel, A; Strome, T; Mahmud, S M

    2014-11-01

    We evaluated syndromic indicators of influenza disease activity developed using emergency department (ED) data - total ED visits attributed to influenza-like illness (ILI) ('ED ILI volume') and percentage of visits attributed to ILI ('ED ILI percent') - and Google flu trends (GFT) data (ILI cases/100 000 physician visits). Congruity and correlation among these indicators and between these indicators and weekly count of laboratory-confirmed influenza in Manitoba was assessed graphically using linear regression models. Both ED and GFT data performed well as syndromic indicators of influenza activity, and were highly correlated with each other in real time. The strongest correlations between virological data and ED ILI volume and ED ILI percent, respectively, were 0·77 and 0·71. The strongest correlation of GFT was 0·74. Seasonal influenza activity may be effectively monitored using ED and GFT data.

  14. Influenza-like illness in a Vietnamese province: epidemiology in correlation with weather factors and determinants from the surveillance system.

    PubMed

    Minh An, Dao Thi; Ngoc, Nguyen Thi Bich; Nilsson, Maria

    2014-12-01

    Background Seasonal influenza affects from 5 to 15% of the world's population annually and causes an estimated 250,000-500,000 deaths worldwide. The World Health Organization (WHO) recommends 'sentinel surveillance' for influenza-like illness (ILI) because it is simple and calls for standardized methods at a relatively low cost that can be implemented throughout the world. In Vietnam, ILI is a key priority for public health also because of its annually recurring temporal pattern. Two major factors, on which the spread of influenza depends, are the strain of the virus and its rate of mutation, since flu strains constantly mutate as they compete with host immune systems. In the context of global climate change, the role of climatic factors has been discussed, as they may significantly contribute to the cause of large outbreaks of ILI. Objectives 1) To describe the epidemiology of ILI in Ha Nam province, Vietnam; 2) to seek scientific evidence on the association of ILI occurrence with weather factors in Ha Nam province; and 3) to analyze factors from the Ha Nam ILI surveillance system that contribute to explaining the correlation between the ILI and the weather factors. Design A data set of 89,270 monthly reported ILI cases from 2008 to 2012 in Ha Nam was used to describe ILI epidemiological characteristics. Spearman correlation analyses between ILI cases and weather factors were conducted to identify which preceding period of months and weather patterns influenced the occurrence of ILI cases. Ten in-depth interviews with health workers in charge of recording and reporting ILI cases at different levels of the ILI surveillance system were conducted to gain a deeper understanding of factors contributing to explaining the relation between the ILI and the weather factors. Results The results indicated that the ILI occurred annually in all districts of the Ha Nam province in the five studied years. An epidemic occurred in 2009 with the number of cases three times higher

  15. Influenza-like illness in a Vietnamese province: epidemiology in correlation with weather factors and determinants from the surveillance system

    PubMed Central

    Minh An, Dao Thi; Bich Ngoc, Nguyen Thi; Nilsson, Maria

    2014-01-01

    Background Seasonal influenza affects from 5 to 15% of the world's population annually and causes an estimated 250,000–500,000 deaths worldwide. The World Health Organization (WHO) recommends ‘sentinel surveillance’ for influenza-like illness (ILI) because it is simple and calls for standardized methods at a relatively low cost that can be implemented throughout the world. In Vietnam, ILI is a key priority for public health also because of its annually recurring temporal pattern. Two major factors, on which the spread of influenza depends, are the strain of the virus and its rate of mutation, since flu strains constantly mutate as they compete with host immune systems. In the context of global climate change, the role of climatic factors has been discussed, as they may significantly contribute to the cause of large outbreaks of ILI. Objectives 1) To describe the epidemiology of ILI in Ha Nam province, Vietnam; 2) to seek scientific evidence on the association of ILI occurrence with weather factors in Ha Nam province; and 3) to analyze factors from the Ha Nam ILI surveillance system that contribute to explaining the correlation between the ILI and the weather factors. Design A data set of 89,270 monthly reported ILI cases from 2008 to 2012 in Ha Nam was used to describe ILI epidemiological characteristics. Spearman correlation analyses between ILI cases and weather factors were conducted to identify which preceding period of months and weather patterns influenced the occurrence of ILI cases. Ten in-depth interviews with health workers in charge of recording and reporting ILI cases at different levels of the ILI surveillance system were conducted to gain a deeper understanding of factors contributing to explaining the relation between the ILI and the weather factors. Results The results indicated that the ILI occurred annually in all districts of the Ha Nam province in the five studied years. An epidemic occurred in 2009 with the number of cases three times

  16. Influenza-like illness in a Vietnamese province: epidemiology in correlation with weather factors and determinants from the surveillance system.

    PubMed

    Minh An, Dao Thi; Ngoc, Nguyen Thi Bich; Nilsson, Maria

    2014-01-01

    Seasonal influenza affects from 5 to 15% of the world's population annually and causes an estimated 250,000-500,000 deaths worldwide. The World Health Organization (WHO) recommends 'sentinel surveillance' for influenza-like illness (ILI) because it is simple and calls for standardized methods at a relatively low cost that can be implemented throughout the world. In Vietnam, ILI is a key priority for public health also because of its annually recurring temporal pattern. Two major factors, on which the spread of influenza depends, are the strain of the virus and its rate of mutation, since flu strains constantly mutate as they compete with host immune systems. In the context of global climate change, the role of climatic factors has been discussed, as they may significantly contribute to the cause of large outbreaks of ILI. 1) To describe the epidemiology of ILI in Ha Nam province, Vietnam; 2) to seek scientific evidence on the association of ILI occurrence with weather factors in Ha Nam province; and 3) to analyze factors from the Ha Nam ILI surveillance system that contribute to explaining the correlation between the ILI and the weather factors. A data set of 89,270 monthly reported ILI cases from 2008 to 2012 in Ha Nam was used to describe ILI epidemiological characteristics. Spearman correlation analyses between ILI cases and weather factors were conducted to identify which preceding period of months and weather patterns influenced the occurrence of ILI cases. Ten in-depth interviews with health workers in charge of recording and reporting ILI cases at different levels of the ILI surveillance system were conducted to gain a deeper understanding of factors contributing to explaining the relation between the ILI and the weather factors. The results indicated that the ILI occurred annually in all districts of the Ha Nam province in the five studied years. An epidemic occurred in 2009 with the number of cases three times higher than the average threshold. There was a

  17. Influence of observable and unobservable exposure on the patient's risk of acquiring influenza-like illness at hospital.

    PubMed

    Payet, C; Voirin, N; Ecochard, R; Vanhems, P

    2016-07-01

    During outbreaks of hospital-acquired influenza-like illness (HA-ILI) healthcare workers (HCWs), patients, and visitors are each a source of infection for the other. Quantifying the effects of these various exposures will help improve prevention and control of HA-ILI outbreaks. We estimated the attributability of HA-ILI to: (1) exposure to recorded or unrecorded sources; (2) exposure to contagious patient or contagious HCW; (3) exposure during observable or unobservable contagious period of the recorded sources; and, (4) the moment of exposure. Among recorded sources, 59% [95% credible interval (CrI) 34-83] of HA-ILI of patients was associated with exposure to contagious patients and 41% (95% CrI 17-66) with exposure to contagious HCWs. Exposure during the unobservable contagiousness period of source patients accounted for 49% (95% CrI 19-75) of HA-ILI, while exposure during the unobservable contagiousness period of source HCWs accounted for 82% (95% CrI 51-99) of HA-ILI. About 80% of HA-ILIs were associated with exposure 1 day earlier. Secondary cases of HA-ILI might appear as soon as the day after the detection of a primary case highlighting the explosive nature of HA-ILI spread. Unobservable transmission was the main cause of HA-ILI transmission suggesting that symptom-based control measures alone might not prevent hospital outbreaks. The results support the rapid implementation of interventions to control influenza transmission.

  18. Intermedilysin induces EGR-1 expression through calcineurin/NFAT pathway in human cholangiocellular carcinoma cells

    SciTech Connect

    Susilowati, Heni; Okamura, Hirohiko; Hirota, Katsuhiko; Shono, Masayuki; Yoshida, Kaya; Murakami, Keiji; Tabata, Atsushi; Nagamune, Hideaki; Haneji, Tatsuji; Miyake, Yoichiro

    2011-01-07

    Research highlights: {yields} ILY leads to the accumulation of [Ca{sup 2+}]i in the nucleus in HuCCT1 cells. {yields} ILY induced activation of NFAT1 through a calcineurin-dependent pathway. {yields} Calcineuri/NFAT pathway is involved in EGR-1 expression in response to ILY treatment. -- Abstract: Intermedilysin (ILY) is a cholesterol-dependent cytolysin produced by Streptococcus intermedius, which is associated with human brain and liver abscesses. Although intrahepatic bile duct cells play a valuable role in the pathogenesis of liver abscess, the molecular mechanism of ILY-treated intrahepatic bile duct cells remains unknown. In this study, we report that ILY induced a nuclear accumulation of intracellular calcium ([Ca{sup 2+}]i) in human cholangiocellular cells HuCCT1. We also demonstrate that 10 ng/ml ILY induced NFAT1 dephosphorylation and its nuclear translocation in HuCCT1 cells. In contrast to the result that ILY induced NF-{kappa}B translocation in human hepatic HepG2 cells, ILY did not affect NF-{kappa}B localization in HuCCT1 cells. Dephosphorylation and nuclear translocation of NFAT1 caused by ILY were prevented by [Ca{sup 2+}]i calcium chelator, BAPTA/AM, and calcineurin inhibitors, cyclosporine A and tacrolimus. ILY induced early growth response-1 (EGR-1) expression and it was inhibited by the pre-treatment with cyclosporine A, indicating that the calcineurin/NFAT pathway was involved in EGR-1 expression in response to ILY. ILY-induced calcineurin/NFAT1 activation and sequential EGR-1 expression might be related to the pathogenesis of S. intermedius in human bile duct cells.

  19. The impact of influenza-like illness in young children on their parents: a quality of life survey.

    PubMed

    Chow, Maria Yui Kwan; Yin, Jiehui Kevin; Heron, Leon; Morrow, Angela; Dierig, Alexa; Booy, Robert; Leask, Julie

    2014-06-01

    Influenza-like illness can cause excess paediatric morbidity and burden on parents. We determined the quality of life (QoL) impact of children's influenza-like illness (ILI) on their parents. We conducted a prospective cohort study in childcare centres and a general practice in Sydney, Australia. Using PAR-ENT-QoL, we measured QoL of parents of children aged 6 months-3 years before the 2010 influenza season, then again for parents of children with ILI (ILI group) using SF-12v2 Acute Form and PAR-ENT-QoL, and contemporaneously for parents of aged-matched children without ILI (non-ILI group). Of 381 children enrolled from 90 childcare centres, 105 developed ILI. PAR-ENT-QoL scores of the ILI group were significantly lower in the post-ILI follow-up interviews than at baseline (60.99 vs. 79.77, p < 0.001), and those of non-ILI group at follow-up interviews (60.99 vs. 84.05, p < 0.001). SF-12v2 scores of the ILI group were also significantly lower than those of non-ILI group: physical component summary (50.66 vs. 53.16, p = 0.011) and mental component summary (45.67 vs. 53.66, p < 0.001). Two factors were significantly associated with parental QoL: total time spent caring child during ILI and whether the child had severe ILI or not. Correlations between PAR-ENT-QoL and SF-12v2 scores were satisfactory. Parents had significantly lower QoL while their child had ILI, compared with before ILI and with parents of children without ILI. The public health impact of ILI in children on the QoL in families is far from negligible. QoL measurement can complement economic evaluation of ILI disease burden and provide a more complete picture of impact.

  20. Effect of influenza-like illness and other wintertime respiratory illnesses on worker productivity: The child and household influenza-illness and employee function (CHIEF) study.

    PubMed

    Palmer, Liisa A; Rousculp, Matthew D; Johnston, Stephen S; Mahadevia, Parthiv J; Nichol, Kristin L

    2010-07-12

    Acute respiratory illnesses (ARI), comprising influenza-like illness (ILI) and other wintertime respiratory illnesses (ORI), impose substantial health and economic burdens on the United States. Little is known about the impact of ILI among household members (HHM), particularly children, on employees' productivity. To quantify the impact of employee and HHM-ILI and ARI on employee productivity, a prospective, observational cohort study was conducted among employees from three large US companies. Employees who had at least one child living at home (N=2013) completed a monthly survey during the 2007-2008 influenza season, reporting the number of days missed from work and hours of presenteeism due to: (1) personal ILI, (2) HHM-ILI, and (3) personal and HHM-ARI. Employee ILI ranged from 4.8% (April) to 13.5% (February). Employees reporting ILI reported more absences than employees not reporting ILI (72% vs 30%, respectively; P<0.001). Overall, 61.2% of employees surveyed had at least one child with an ILI; these employees missed more days of work due to HHM illness than employees without an ARI-ill child (0.9 days vs 0.3 days, respectively; P<0.001). Employees with ILI were less productive, on average, for 4.8h each day that they worked while sick, 2.5h of which was attributable to ILI. HHM illnesses accounted for 17.7% (1389/7868 days) of employee absenteeism, over half of which was due to HHM-ARI. ILI causes a significant amount of employee absence. Household members, particularly children, comprise a sizable proportion of general illness and injury-related employee absences. Copyright 2010 Elsevier Ltd. All rights reserved.

  1. Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

    PubMed

    Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

    2016-03-01

    The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

  2. Personality, psychological stress, and self-reported influenza symptomatology

    PubMed Central

    Smolderen, Kim GE; Vingerhoets, Ad JJM; Croon, Marcel A; Denollet, Johan

    2007-01-01

    Background Psychological stress and negative mood have been related to increased vulnerability to influenza-like illness (ILI). This prospective study re-evaluated the predictive value of perceived stress for self-reported ILI. We additionally explored the role of the negative affectivity and social inhibition traits. Methods In this study, 5,404 respondents from the general population were assessed in terms of perceived stress, personality, and control variables (vaccination, vitamin use, exercise, etc.). ILI were registered weekly using self-report measures during a follow-up period of four weeks. Results Multivariable logistic regression analysis on ILI was performed to test the predictive power of stress and personality. In this model, negative affectivity (OR = 1.05, p = 0.009), social inhibition (OR = 0.97, p = 0.011), and perceived stress (OR = 1.03, p = 0.048) predicted ILI reporting. Having a history of asthma (OR = 2.33, p = < 0.0001) was also associated with ILI reporting. Older age was associated with less self-reported ILI (OR = 0.98, P = 0.017). Conclusion Elderly and socially inhibited persons tend to report less ILI as compared to their younger and less socially inhibited counterparts. In contrast, asthma, trait negative affectivity, and perceived stress were associated with higher self-report of ILI. Our results demonstrate the importance of including trait markers in future studies examining the relation between stress and self-report symptom measures. PMID:18036207

  3. Epidemiology and viral etiology of the influenza-like illness in corsica during the 2012-2013 Winter: an analysis of several sentinel surveillance systems.

    PubMed

    Minodier, Laëtitia; Arena, Christophe; Heuze, Guillaume; Ruello, Marc; Amoros, Jean Pierre; Souty, Cécile; Varesi, Laurent; Falchi, Alessandra

    2014-01-01

    Influenza-like illness (ILI) surveillance is important to identify circulating and emerging/reemerging strains and unusual epidemiological trends. The present study aimed to give an accurate picture of the 2012-2013 ILI outbreak in Corsica by combining data from several surveillance systems: general practice, emergency general practice, hospital emergency units, intensive care units, and nursing homes. Twenty-eight respiratory viruses were retrospectively investigated from patients in general practice with ILI. Sequence analysis of the genetic changes in the hemagglutinin gene of influenza viruses (A(H1N1)pdm2009, A(H3N2) and B) was performed. The trends in ILI/influenza consultation rates and the relative illness ratios (RIRs) of having an ILI consultation were estimated by age group for the different surveillance systems analyzed. Of the 182 ILI patients enrolled by general practitioners, 57.7% tested positive for influenza viruses. Phylogenetic analyses suggested a genetic drift for influenza B and A(H3N2) viruses. The ILI/influenza surveillance systems showed similar trends and were well correlated. In accordance with virological data, the RIRs of having an ILI consultation were highest among the young (<15 years old) and decreased with age. No clusters of acute respiratory illness were declared by the sentinel nursing homes. This study is noteworthy in that it is the first extensive description of the 2012-2013 ILI outbreak in Corsica as monitored through several surveillance systems. To improve ILI surveillance in Corsica, a consortium that links together the complementary regional surveillance ILI systems described here is being implemented.

  4. Age-Related Differences in the Accuracy of Web Query-Based Predictions of Influenza-Like Illness

    PubMed Central

    Domnich, Alexander; Panatto, Donatella; Signori, Alessio; Lai, Piero Luigi; Gasparini, Roberto; Amicizia, Daniela

    2015-01-01

    Background Web queries are now widely used for modeling, nowcasting and forecasting influenza-like illness (ILI). However, given that ILI attack rates vary significantly across ages, in terms of both magnitude and timing, little is known about whether the association between ILI morbidity and ILI-related queries is comparable across different age-groups. The present study aimed to investigate features of the association between ILI morbidity and ILI-related query volume from the perspective of age. Methods Since Google Flu Trends is unavailable in Italy, Google Trends was used to identify entry terms that correlated highly with official ILI surveillance data. All-age and age-class-specific modeling was performed by means of linear models with generalized least-square estimation. Hold-out validation was used to quantify prediction accuracy. For purposes of comparison, predictions generated by exponential smoothing were computed. Results Five search terms showed high correlation coefficients of > .6. In comparison with exponential smoothing, the all-age query-based model correctly predicted the peak time and yielded a higher correlation coefficient with observed ILI morbidity (.978 vs. .929). However, query-based prediction of ILI morbidity was associated with a greater error. Age-class-specific query-based models varied significantly in terms of prediction accuracy. In the 0–4 and 25–44-year age-groups, these did well and outperformed exponential smoothing predictions; in the 15–24 and ≥ 65-year age-classes, however, the query-based models were inaccurate and highly overestimated peak height. In all but one age-class, peak timing predicted by the query-based models coincided with observed timing. Conclusions The accuracy of web query-based models in predicting ILI morbidity rates could differ among ages. Greater age-specific detail may be useful in flu query-based studies in order to account for age-specific features of the epidemiology of ILI. PMID:26011418

  5. Influenza surveillance using electronic health records in the American Indian and Alaska Native population

    PubMed Central

    Keck, James W; Redd, John T; Cheek, James E; Layne, Larry J; Groom, Amy V; Kitka, Sassa; Bruce, Michael G; Suryaprasad, Anil; Amerson, Nancy L; Cullen, Theresa; Bryan, Ralph T; Hennessy, Thomas W

    2014-01-01

    Objective Increasing use of electronic health records (EHRs) provides new opportunities for public health surveillance. During the 2009 influenza A (H1N1) virus pandemic, we developed a new EHR-based influenza-like illness (ILI) surveillance system designed to be resource sparing, rapidly scalable, and flexible. 4 weeks after the first pandemic case, ILI data from Indian Health Service (IHS) facilities were being analyzed. Materials and methods The system defines ILI as a patient visit containing either an influenza-specific International Classification of Disease, V.9 (ICD-9) code or one or more of 24 ILI-related ICD-9 codes plus a documented temperature ≥100°F. EHR-based data are uploaded nightly. To validate results, ILI visits identified by the new system were compared to ILI visits found by medical record review, and the new system's results were compared with those of the traditional US ILI Surveillance Network. Results The system monitored ILI activity at an average of 60% of the 269 IHS electronic health databases. EHR-based surveillance detected ILI visits with a sensitivity of 96.4% and a specificity of 97.8% based on chart review (N=2375) of visits at two facilities in September 2009. At the peak of the pandemic (week 41, October 17, 2009), the median time from an ILI visit to data transmission was 6 days, with a mode of 1 day. Discussion EHR-based ILI surveillance was accurate, timely, occurred at the majority of IHS facilities nationwide, and provided useful information for decision makers. EHRs thus offer the opportunity to transform public health surveillance. PMID:23744788

  6. Awakening the Languages. Challenges of Enduring Language Programs: Field Reports from 15 Programs from Arizona, New Mexico and Oklahoma.

    ERIC Educational Resources Information Center

    Linn, Mary S.; Naranjo, Tessie; Nicholas, Sheilah; Slaughter, Inee; Yamamoto, Akira; Zepeda, Ofelia

    The Indigenous Language Institute (ILI) collaborates with indigenous language communities to combat language decline. ILI facilitates community-based language programs, increases public awareness of language endangerment, and disseminates information on language preservation and successful language revitalization programs. In response to numerous…

  7. Influenza-Like Illness among University Students: Symptom Severity and Duration Due to Influenza Virus Infection Compared to Other Etiologies

    ERIC Educational Resources Information Center

    Mullins, Jocelyn; Cook, Robert; Rinaldo, Charles; Yablonsky, Eric; Hess, Rachel; Piazza, Paolo

    2011-01-01

    Objective: University students with influenza-like illness (ILI) were assessed to determine whether symptom severity, duration, or missed days of school or work varied according to etiology. Participants: Sixty persons presenting to a university health clinic with ILI symptoms during 3 consecutive influenza seasons completed baseline survey and…

  8. Stratigraphy and Glacial-Marine Sediments of the Amerasian Basin, Central Arctic Ocean.

    DTIC Science & Technology

    1981-02-01

    lpho 11 isditlera. wohii h Figure 17 thicknesi (if unit (in centimtetres. All fractional sluesl are prohhbi reflects the thiiiiess of unit I in thesi ...thre cioniffir g 29t t Ilis ss iereas Tit-e piiift and lfs/ efl IIJI-1.1 Ii i Ili( silts liitite resersal is getferall% sets shiarp andI ini tis resptl 5

  9. The Implementation of Web 2.0 Technology for Information Literacy Instruction in Thai University Libraries

    ERIC Educational Resources Information Center

    Sawetrattanasatian, Oranuch

    2014-01-01

    Web 2.0 technology has drawn much attention recently as a fascinating tool for Information Literacy Instruction (ILI), especially in academic libraries. This research was aimed to investigate the implementation of Web 2.0 technology for ILI in Thai university libraries, in terms of information literacy skills being taught, types of Web 2.0…

  10. US EPA, Pesticide Product Label, FORD'S DIAZINON 1% ME ...

    EPA Pesticide Factsheets

    2011-04-19

    ... 2 •• s' aapf of ... 1 :~ :IJ=ia=:~':I::' :: r- It .ta. .1 .... 7 't fl .. ... of the uject: _ • l1li: -- to I ,. .<11 t ' _ ' IJ t 11&-. rI IAI r- ILI..S I _ I'IK , .... _ ... "_lat.. b ., _ '.', for ...

  11. A placebo-controlled trial of Korean red ginseng extract for preventing influenza-like illness in healthy adults.

    PubMed

    Ha, Ki-Chan; Kim, Min-Gul; Oh, Mi-Ra; Choi, Eun-Kyung; Back, Hyang-Im; Kim, Sun-Young; Park, Eun-Ok; Kwon, Dae-Young; Yang, Hye-Jeong; Kim, Min-Jeong; Kang, Hee-Joo; Lee, Ju-Hyung; Choi, Kyung-Min; Chae, Soo-Wan; Lee, Chang-Seop

    2012-02-08

    Standardized Korean red ginseng extract has become the best-selling influenza-like illness (ILI) remedy in Korea, yet much controversy regarding the efficacy of the Korean red ginseng (KRG) in reducing ILI incidence remains. The aim of the study is to assess the efficacy of the KRG extract on the ILI incidence in healthy adults. We will conduct a randomized, double-blind, placebo-controlled study at the onset of the influenza seasons. A total of 100 subjects 30-70 years of age will be recruited from the general populations. The subjects will be instructed to take 9 capsules per day of either the KRG extract or a placebo for a period of 3 months. The primary outcome measure is to assess the frequency of ILI onset in participated subjects. Secondary variable measures will be included severity and duration of ILI symptoms. The ILI symptoms will be scored by subjects using a 4-point scale. This study is a randomized placebo controlled trial to evaluate the efficacy of the KRG extract compared to placebo and will be provided valuable new information about the clinical and physiological effects of the KRG extract on reduction of ILI incidence including flu and upper respiratory tract infections. The study has been pragmatically designed to ensure that the study findings can be implemented into clinical practice if KRG extract can be shown to be an effective reduction strategy in ILI incidence. NCT01478009.

  12. Influenza-Like Illness among University Students: Symptom Severity and Duration Due to Influenza Virus Infection Compared to Other Etiologies

    ERIC Educational Resources Information Center

    Mullins, Jocelyn; Cook, Robert; Rinaldo, Charles; Yablonsky, Eric; Hess, Rachel; Piazza, Paolo

    2011-01-01

    Objective: University students with influenza-like illness (ILI) were assessed to determine whether symptom severity, duration, or missed days of school or work varied according to etiology. Participants: Sixty persons presenting to a university health clinic with ILI symptoms during 3 consecutive influenza seasons completed baseline survey and…

  13. Writing Dictated Words and Picture Names: Syllabic Boundaries Affect Execution in Spanish

    ERIC Educational Resources Information Center

    Alvarez, Carlos J.; Cottrell, David; Afonso, Olivia

    2009-01-01

    Two experiments examined the role of syllables in writing Spanish words. In Experiment 1, participants had to write single words that were aurally presented. The interletter intervals (ILIs) between critical letters were measured. Longer ILIs were found in the intersyllabic than the intrasyllabic condition. In Experiment 2, the inputs were…

  14. Release of Multiple Hormones by a Direct Action of Interleukin-1 on Pituitary Cells

    DTIC Science & Technology

    1987-10-23

    monolayer culture was investigated. Recombinant human IL-I beta stimulated the secretion of adrenocorticotropic hormone, luteinizing hormone, growth ... hormone , and thyroid-stimulating hormone. Prolactin secretion by the monolayers was inhibited by similar doses. These concentrations of IL-I are within

  15. Association of indoor air pollution from coal combustion with influenza-like illness in housewives.

    PubMed

    Wang, Bin; Liu, Yingying; Li, Zhenjiang; Li, Zhiwen

    2016-09-01

    An association of influenza-like illness (ILI) with outdoor air pollution has been reported. However, the effect of indoor air pollution on ILI was rarely investigated. We aimed to determine an association of indoor air pollution from coal combustion (IAPCC) and lifestyle with ILI risk in housewives, and the modification effect of phase II metabolic enzyme genes. We recruited 403 housewives for a cross-sectional study in Shanxi Province, China, including 135 with ILI frequency (≥1 time per year in the past ten years) as the case group and 268 with ILI frequency (<1 times per year) as the control group. Information on their energy usage characteristics and lifestyle was collected by questionnaires, as well as the single nucleotide polymorphisms (SNPs) of epoxide hydrolase 1 (rs1051740 and rs2234922), N-acetyltransferase 2 (rs1041983), and glutathione S-transferase (rs1695). We used exposure index to indicate the level of IAPCC among housewives. Our results revealed that the exposure index was positively correlated with ILI frequency. A significant dose-response trend between the exposure index and ILI risk was found with or without adjusting for confounders. Cooking frequency in kitchen with coal as primary fuel and ventilation frequency in the living room or bedroom with a coal-fueled stove for heating during the heating season were two important risk factors to affect ILI frequency. Only rs1051740 was found to be associated with exposure index, whereas it didn't have interaction effect with exposure index on ILI frequency. In conclusion, IAPCC and SNPs of rs1051740 were both associated with ILI frequency.

  16. Clinical characteristics of asthmatic patients with influenza-like illness and risk of severe exacerbations in Mexico.

    PubMed

    Paulin-Prado, Paulina; Nishimura, Katherine; Freimanis-Hance, Laura; Hunsberger, Sally; Beigel, John; Fraga, Arturo Galindo; Ortiz Hernandez, Ana A; Llamosas-Gallardo, Beatriz; Moreno-Espinosa, Sarbelio; Magaña-Aquino, Martin; Ruiz Palacios, Guillermo M; Ramirez-Venegas, Alejandra

    2016-05-01

    Patients with chronic inflammatory lung diseases, such as asthma, are at higher risk for influenza-like illness (ILI) complications. Viral infections are known to trigger asthma exacerbations, but a thorough description of the clinical characteristics of ILI-associated asthma exacerbations and the role of viruses as a risk factor for severe exacerbation (SE) in ILI has not been published yet. To investigate risk factors for SE in patients with ILI and asthma. Patients with ILI symptoms were recruited from 6 hospitals of Mexico (LaRed sites) during 2010 to 2014. Those with a previous asthma diagnosis and ILI symptoms and who were 5 years or older were included. Patients were assigned as cases or controls based on symptoms reported. SE was defined when participants presented with wheezing or dyspnea and required hospitalization. A total of 486 patients with ILI and a diagnosis of asthma were included. There were no differences in the proportion, number, or type of viral illness among those with and without SE. Those with SE were less likely to report ILI symptoms. Muscle pain and nasal drip were predictors for patients not progressing to SE. A delay in seeking medical care was associated with SE (odds ratio, 2.93; 95% CI, 1.46-5.88). The presence of a particular virus did not predict SE. ILI symptoms in asthma patients are not associated with severe exacerbation. Patients with asthma should be encouraged to seek early medical care when ILI symptoms are first noticed to prevent serious complications. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. Impact of Influenza on Outpatient Visits, Hospitalizations, and Deaths by Using a Time Series Poisson Generalized Additive Model.

    PubMed

    Guo, Ru-ning; Zheng, Hui-zhen; Ou, Chun-quan; Huang, Li-qun; Zhou, Yong; Zhang, Xin; Liang, Can-kun; Lin, Jin-yan; Zhong, Hao-jie; Song, Tie; Luo, Hui-ming

    2016-01-01

    The disease burden associated with influenza in developing tropical and subtropical countries is poorly understood owing to the lack of a comprehensive disease surveillance system and information-exchange mechanisms. The impact of influenza on outpatient visits, hospital admissions, and deaths has not been fully demonstrated to date in south China. A time series Poisson generalized additive model was used to quantitatively assess influenza-like illness (ILI) and influenza disease burden by using influenza surveillance data in Zhuhai City from 2007 to 2009, combined with the outpatient, inpatient, and respiratory disease mortality data of the same period. The influenza activity in Zhuhai City demonstrated a typical subtropical seasonal pattern; however, each influenza virus subtype showed a specific transmission variation. The weekly ILI case number and virus isolation rate had a very close positive correlation (r = 0.774, P < 0.0001). The impact of ILI and influenza on weekly outpatient visits was statistically significant (P < 0.05). We determined that 10.7% of outpatient visits were associated with ILI and 1.88% were associated with influenza. ILI also had a significant influence on the hospitalization rates (P < 0.05), but mainly in populations <25 years of age. No statistically significant effect of influenza on hospital admissions was found (P > 0.05). The impact of ILI on chronic obstructive pulmonary disease (COPD) was most significant (P < 0.05), with 33.1% of COPD-related deaths being attributable to ILI. The impact of influenza on the mortality rate requires further evaluation. ILI is a feasible indicator of influenza activity. Both ILI and influenza have a large impact on outpatient visits. Although ILI affects the number of hospital admissions and deaths, we found no consistent influence of influenza, which requires further assessment.

  18. The Fine Temporal Structure of the Rat Licking Pattern: What Causes the Variabiliy in the Interlick Intervals and How is it Affected by the Drinking Solution?

    PubMed Central

    2013-01-01

    Licking is a repetitive behavior controlled by a central pattern generator. Even though interlick intervals (ILIs) within bursts of licks are considered fairly regular, the conditions that affect their variability are unknown. We analyzed the licking pattern in rats that licked water, 10% sucrose solution, or 10% ethanol solution, in 90-min recording sessions after 4h of water deprivation. The histograms of ILIs indicate that licking typically occurred at a preferred ILI of about 130−140ms with evidence of bimodal or multimodal distributions due to occasional licking failures. We found that the longer the pause between bursts of licks, the shorter was the first ILI of the burst. When bursts of licks were preceded by a pause >4 s, the ILI was the shortest (~110ms) at the beginning of the burst, and then it increased rapidly in the first few licks and slowly in subsequent licks. Interestingly, the first ILI of a burst of licks was not significantly different when licking any of the 3 solutions, but subsequent licks exhibited a temporal pattern characteristic of each solution. The rapid deceleration in intraburst licking rate was due to an increase from ~27ms to ~56ms in the tongue-spout contact duration while the intercontact interval was only slightly changed (80−90ms). Therefore, the contact duration seems to be the major factor that increases the variability in the ILIs and could be another means for the rat to adjust the amount of fluid ingested in each individual lick. PMID:23902635

  19. Role of catabolite control protein A in the regulation of intermedilysin production by Streptococcus intermedius.

    PubMed

    Tomoyasu, Toshifumi; Tabata, Atsushi; Hiroshima, Riki; Imaki, Hidenori; Masuda, Sachiko; Whiley, Robert A; Aduse-Opoku, Joseph; Kikuchi, Ken; Hiramatsu, Keiichi; Nagamune, Hideaki

    2010-09-01

    Streptococcus intermedius is an opportunistic pathogen of humans that causes purulent infections, including brain and liver abscesses. This pathogen secretes a human-specific cytolysin, intermedilysin, which has been recognized as a major virulence factor. However, most of the expressional control mechanisms of ily are still unknown. To determine these mechanisms, we analyzed the nucleotide sequence of the ily promoter region. We found a highly homologous region to the catabolite-repressible element (cre) in the ily promoter region and observed a considerable decrease in the amount of secreted intermedilysin when cells were grown in a culture medium containing high concentrations of glucose/utilizable carbohydrates. Disruption of the ccpA gene, which encodes catabolite control protein A, did not induce catabolite repression of ily by glucose/utilizable carbohydrates. In cre mutants, catabolite repression of ily was partially restored, and purified catabolite control protein A bound to an oligonucleotide containing the cre consensus sequence in the ily promoter region. In addition, a prolonged lag phase and slower doubling time of the ccpA mutant cells were observed. Our data show that S. intermedius can modulate ily expression and growth rate through catabolite control protein A-mediated monitoring of the extracellular glucose/utilizable carbohydrate concentration.

  20. Eight Years of the Great Influenza Survey to Monitor Influenza-Like Illness in Flanders

    PubMed Central

    Vandendijck, Yannick; Faes, Christel; Hens, Niel

    2013-01-01

    In 2003, an internet-based monitoring system of influenza-like illness (ILI), the Great Influenza Survey (GIS), was initiated in Belgium. For the Flemish part of Belgium, we investigate the representativeness of the GIS population and assess the validity of the survey in terms of ILI incidence during eight influenza seasons (from 2003 through 2011). The validity is investigated by comparing estimated ILI incidences from the GIS with recorded incidences from two other monitoring systems, (i) the Belgian Sentinel Network and (ii) the Google Flu Trends, and by performing a risk factor analysis to investigate whether the risks on acquiring ILI in the GIS population are comparable with results in the literature. A random walk model of first order is used to estimate ILI incidence trends based on the GIS. Good to excellent correspondence is observed between the estimated ILI trends in the GIS and the recorded trends in the Sentinel Network and the Google Flu Trends. The results of the risk factor analysis are in line with the literature. In conclusion, the GIS is a useful additional surveillance network for ILI monitoring in Flanders. The advantages are the speed at which information is available and the fact that data is gathered directly in the community at an individual level. PMID:23691162

  1. Effects of school breaks on influenza-like illness incidence in a temperate Chinese region: an ecological study from 2008 to 2015

    PubMed Central

    Chu, Yanhui; Wu, Zhenyu; Ji, Jiayi; Sun, Jingyi; Sun, Xiaoyu; Qin, Guoyou; Qin, Jingning; Xiao, Zheng; Ren, Jian; Qin, Di; Zheng, Xueying; Wang, Xi-Ling

    2017-01-01

    Objective To assess the effects of winter/summer school breaks on occurrences of influenza-like illness (ILI). Methods We jointly analysed ILI surveillance data with the timing of school breaks in a temperate district in Beijing, China from 2008 to 2015. ILI incidence rate ratios (IRRs) of schoolchildren (5–14 and 15–24 years of age) to adults (25–59 and >60 years of age) were used to measure the age shift of ILI incidence before, during and after the 4-week winter/7-week summer breaks. Serfling-based Poisson regression model with adjustment for unmeasured confounders was built to further assess the effect of winter school breaks. Results ILI incidences were consistently lower during winter breaks than before winter breaks for all age groups. IRRs of younger schoolchildren aged 5–14 to adults were higher during winter school breaks than before breaks, while the opposite was true for the IRRs of older schoolchildren aged 15–24 to adults. Schoolchildren-to-adults IRRs during summer breaks were significantly lower than before or after school breaks (p<0.001). Conclusions Both winter and summer breaks were associated with reductions of ILI incidences among schoolchildren and adults. Our study contributes additional evidence on the effects of school breaks on ILI incidence, suggesting school closure could be effective in controlling influenza transmission in developing countries. PMID:28264827

  2. Cationic Ionic Liquids Organic Ligands Based Metal-Organic Frameworks for Fabrication of Core-Shell Microspheres for Hydrophilic Interaction Liquid Chromatography.

    PubMed

    Dai, Qian; Ma, Junqian; Ma, Siqi; Wang, Shengyu; Li, Lijun; Zhu, Xianghui; Qiao, Xiaoqiang

    In this study, new metal-organic frameworks (MOFs) nanocrystals modified SiO2 core-shell microspheres were designed with cationic ionic liquids (ILs) 1,3-bis(4-carboxybutyl)imidazolium bromide (ILI) as organic ligands. By further adjustment the growth cycles, the new ILI-01@SiO2 core-shell stationary phase was facilely fabricated. The developed stationary phase was respectively characterized via element analysis, thermogravimetric analysis, scanning electron microscopy, X-ray diffraction, and Fourier transform infrared spectrometry. Because the introduction of cationic imidazolium-based ILs ILI for fabrication of the MOFs nanocrystals shell, the new stationary phase exhibits the retention mechanism of hydrophilic interaction liquid chromatography (HILIC). Many polar samples, such as amides, vitamins, nucleic acid bases, and nucleosides, were utilized to investigate the performance of the prepared ILI-01@SiO2 column. Compared to the conventional aminosilica column, the new ILI-01@SiO2 column displays high separation selectivity in a shorter separation time. Furthermore, the new ILI-01@SiO2 column was also used for detection of illegal melamine addition in the baby formula. All the above results demonstrate the new ILI-01@SiO2 core-shell stationary phase is of good potentials for high-selectivity separation the polar samples.

  3. Intermedilysin is essential for the invasion of hepatoma HepG2 cells by Streptococcus intermedius.

    PubMed

    Sukeno, Akiko; Nagamune, Hideaki; Whiley, Robert A; Jafar, Syed I; Aduse-Opoku, Joseph; Ohkura, Kazuto; Maeda, Takuya; Hirota, Katsuhiko; Miyake, Yoichiro; Kourai, Hiroki

    2005-01-01

    Streptococcus intermedius causes endogenous infections leading to abscesses. This species produces intermedilysin (ILY), a human-specific cytolysin. Because of the significant correlation between higher ILY production levels by S. intermedius and deep-seated abscesses, we constructed ily knockout mutant UNS38 B3 and complementation strain UNS38 B3R1 in order to investigate the role of ILY in deep-seated infections. Strain UNS38 reduced the viability of human liver cell line HepG2 at infection but not of rat liver cell line BRL3A. Isogenic mutant strain UNS38 B3 was not cytotoxic in either cell line. Quantification of S. intermedius revealed that in infected HepG2 cells UNS38 but not UNS38 B3 increased intracellularly concomitantly with increasing cell damage. This difference between UNS38 and UNS38 B3 was not observed with UNS38 B3R1. Invasion and proliferation in BRL3A cells was not observed. Masking UNS38 or UNS38 B3R1 with ILY antibody drastically decreased adherence and invasion of HepG2. Moreover, coating strain UNS38 B3 with ILY partially restored adherence to HepG2 but without subsequent bacterial growth. At 1 day post-infection, many intact UNS38 were detected in the damaged phagosomes of HepG2 with bacterial proliferation observed in the cytoplasm of dead HepG2 after an additional 2 day incubation. These results indicate that surface-bound ILY on S. intermedius is an important factor for invasion of human cells by this bacterium and that secretion of ILY within host cells is essential for subsequent host cell death. These data strongly implicate ILY as an important factor in the pathogenesis of abscesses in vivo by this streptococcus.

  4. LacR mutations are frequently observed in Streptococcus intermedius and are responsible for increased intermedilysin production and virulence.

    PubMed

    Tomoyasu, Toshifumi; Imaki, Hidenori; Masuda, Sachiko; Okamoto, Ayumi; Kim, Hyejin; Waite, Richard D; Whiley, Robert A; Kikuchi, Ken; Hiramatsu, Keiichi; Tabata, Atsushi; Nagamune, Hideaki

    2013-09-01

    Streptococcus intermedius secretes a human-specific cytolysin, intermedilysin (ILY), which is considered to be the major virulence factor of this pathogen. We screened for a repressor of ily expression by using random gene disruption in a low-ILY-producing strain (PC574). Three independent high-ILY-producing colonies that had plasmid insertions within a gene that has high homology to lacR were isolated. Validation of these observations was achieved through disruption of lacR in strain PC574 with an erythromycin cassette, which also led to higher hemolytic activity, increased transcription of ily, and higher cytotoxicity against HepG2 cells, compared to the parental strain. The direct binding of LacR within the ily promoter region was shown by a biotinylated DNA probe pulldown assay, and the amount of ILY secreted into the culture supernatant by PC574 cells was increased by adding lactose or galactose to the medium as a carbon source. Furthermore, we examined lacR nucleotide sequences and the hemolytic activity of 50 strains isolated from clinical infections and 7 strains isolated from dental plaque. Of the 50 strains isolated from infections, 13 showed high ILY production, 11 of these 13 strains had one or more point mutations and/or an insertion mutation in LacR, and almost all mutations were associated with a marked decline in LacR function. These results strongly suggest that mutation in lacR is required for the overproduction of ILY, which is associated with an increase in pathogenicity of S. intermedius.

  5. Intensive lifestyle intervention improves physical function among obese adults with knee pain: findings from the Look AHEAD trial.

    PubMed

    Foy, Capri G; Lewis, Cora E; Hairston, Kristen G; Miller, Gary D; Lang, Wei; Jakicic, John M; Rejeski, W Jack; Ribisl, Paul M; Walkup, Michael P; Wagenknecht, Lynne E

    2011-01-01

    Lifestyle interventions have resulted in weight loss or improved physical fitness among individuals with obesity, which may lead to improved physical function. This prospective investigation involved participants in the Action for Health in Diabetes (Look AHEAD) trial who reported knee pain at baseline (n = 2,203). The purposes of this investigation were to determine whether an Intensive Lifestyle Intervention (ILI) condition resulted in improvement in self-reported physical function from baseline to 12 months vs. a Diabetes Support and Education (DSE) condition, and whether changes in weight or fitness mediated the effect of the ILI. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and physical function subscales, and WOMAC summary score. ILI participants exhibited greater adjusted mean weight loss (s.e.) vs. DSE participants (-9.02 kg (0.48) vs. -0.78 kg (0.49); P < 0.001)). ILI participants also demonstrated more favorable change in WOMAC summary scores vs. DSE participants (β (s.e.) = -1.81 (0.63); P = 0.004). Multiple regression mediation analyses revealed that weight loss was a mediator of the effect of the ILI intervention on change in WOMAC pain, function, and summary scores (P < 0.001). In separate analyses, increased fitness also mediated the effect of the ILI intervention upon WOMAC summary score (P < 0.001). The ILI condition resulted in significant improvement in physical function among overweight and obese adults with diabetes and knee pain. The ILI condition also resulted in significant weight loss and improved fitness, which are possible mechanisms through which the ILI condition improved physical function.

  6. Intensive Lifestyle Intervention Improves Physical Function Among Obese Adults With Knee Pain: Findings From the Look AHEAD Trial

    PubMed Central

    Foy, Capri G.; Lewis, Cora E.; Hairston, Kristen G.; Miller, Gary D.; Lang, Wei; Jakicic, John M.; Rejeski, W. Jack; Ribisl, Paul M.; Walkup, Michael P.; Wagenknecht, Lynne E.

    2011-01-01

    Lifestyle interventions have resulted in weight loss or improved physical fitness among individuals with obesity, which may lead to improved physical function. This prospective investigation involved participants in the Action for Health in Diabetes (Look AHEAD) trial who reported knee pain at baseline (n = 2,203). The purposes of this investigation were to determine whether an Intensive Lifestyle Intervention (ILI) condition resulted in improvement in self-reported physical function from baseline to 12 months vs. a Diabetes Support and Education (DSE) condition, and whether changes in weight or fitness mediated the effect of the ILI. Outcome measures included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and physical function subscales, and WOMAC summary score. ILI participants exhibited greater adjusted mean weight loss (s.e.) vs. DSE participants (−9.02 kg (0.48) vs. −0.78 kg (0.49); P < 0.001)). ILI participants also demonstrated more favorable change in WOMAC summary scores vs. DSE participants (β (s.e.) = −1.81 (0.63); P = 0.004). Multiple regression mediation analyses revealed that weight loss was a mediator of the effect of the ILI intervention on change in WOMAC pain, function, and summary scores (P < 0.001). In separate analyses, increased fitness also mediated the effect of the ILI intervention upon WOMAC summary score (P < 0.001). The ILI condition resulted in significant improvement in physical function among overweight and obese adults with diabetes and knee pain. The ILI condition also resulted in significant weight loss and improved fitness, which are possible mechanisms through which the ILI condition improved physical function. PMID:20559303

  7. Space-time epidemiology and effect of meteorological parameters on influenza-like illness in Phitsanulok, a northern province in Thailand.

    PubMed

    Nimbalkar, Prakash Madhav; Tripathi, Nitin Kumar

    2016-11-21

    Influenza-like illness (ILI) is an acute respiratory disease that remains a public health concern for its ability to circulate globally affecting any age group and gender causing serious illness with mortality risk. Comprehensive assessment of the spatio-temporal dynamics of ILI is a prerequisite for effective risk assessment and application of control measures. Though meteorological parameters, such as rainfall, average relative humidity and temperature, influence ILI and represent crucial information for control of this disease, the relation between the disease and these variables is not clearly understood in tropical climates. The aim of this study was to analyse the epidemiology of ILI cases using integrated methods (space-time analysis, spatial autocorrelation and other correlation statistics). After 2009s H1N1 influenza pandemic, Phitsanulok Province in northern Thailand was strongly affected by ILI for many years. This study is based on ILI cases in villages in this province from 2005 to 2012. We used highly precise weekly incidence records covering eight years, which allowed accurate estimation of the ILI outbreak. Comprehensive methodology was developed to analyse the global and local patterns of the spread of the disease. Significant space-time clusters were detected over the study region during eight different periods. ILI cases showed seasonal clustered patterns with a peak in 2010 (P>0.05-9.999 iterations). Local indicators of spatial association identified hotspots for each year. Statistically, the weather pattern showed a clear influence on ILI cases and it strongly correlated with humidity at a lag of 1 month, while temperature had a weaker correlation.

  8. Positive- and Negative-Control Pathways by Blood Components for Intermedilysin Production in Streptococcus intermedius.

    PubMed

    Tomoyasu, Toshifumi; Yamasaki, Takahiro; Chiba, Shinya; Kusaka, Shingo; Tabata, Atsushi; Whiley, Robert A; Nagamune, Hideaki

    2017-09-01

    Streptococcus intermedius is an opportunistic bacterial pathogen secreting a human-specific cytolysin called intermedilysin (ILY) as a major pathogenic factor. This bacterium can degrade glycans into monosaccharides using two glycosidases, multisubstrate glycosidase A (MsgA) and neuraminidase (NanA). Here, we detected a stronger hemolytic activity mediated by ILY when S. intermedius PC574 was cultured in fetal bovine serum (FBS) than when it was grown in the standard culture medium. FBS-cultured cells also showed higher MsgA and NanA activity, although overproduction of ILY in FBS was undetectable in mutants nanA-null and msgA-null. Addition of purified MsgA and NanA to the FBS resulted in a release of 2.8 mM galactose and 4.3 mM N-acetylneuraminic acid; these sugar concentrations were sufficient to upregulate the expression of ILY, MsgA, and NanA. Conversely, when strain PC574 was cultured in human plasma, no similar increase in hemolytic activity was observed. Moreover, addition of human plasma to the culture in FBS appeared to inhibit the stimulatory effect of FBS on ILY, MsgA, and NanA, although there were individual differences among the plasma samples. We confirmed that human plasma contains immunoglobulins that can neutralize ILY, MsgA, and NanA activities. In addition, human plasma had a neutralizing effect on cytotoxicity of S. intermedius toward HepG2 cells in FBS, and a higher concentration of human plasma was necessary to reduce the cytotoxicity of an ILY-high-producing strain than an ILY-low-producing strain. Overall, our data show that blood contains factors that stimulate and inhibit ILY expression and activity, which may affect pathogenicity of S. intermedius. Copyright © 2017 American Society for Microbiology.

  9. Hospital Triage System for Adult Patients Using an Influenza-Like Illness Scoring System during the 2009 Pandemic—Mexico

    PubMed Central

    Rodriguez-Noriega, Eduardo; Gonzalez-Diaz, Esteban; Morfin-Otero, Rayo; Gomez-Abundis, Gerardo F.; Briseño-Ramirez, Jaime; Perez-Gomez, Hector Raul; Lopez-Gatell, Hugo; Alpuche-Aranda, Celia M.; Ramírez, Ernesto; López, Irma; Iguala, Miguel; Chapela, Ietza Bojórquez; Zavala, Ethel Palacios; Hernández, Mauricio; Stuart, Tammy L.; Villarino, Margarita Elsa; Widdowson, Marc-Alain; Waterman, Steve; Uyeki, Timothy; Azziz-Baumgartner, Eduardo

    2010-01-01

    Background Pandemic influenza A (H1N1) virus emerged during 2009. To help clinicians triage adults with acute respiratory illness, a scoring system for influenza-like illness (ILI) was implemented at Hospital Civil de Guadalajara, Mexico. Methods A medical history, laboratory and radiology results were collected on emergency room (ER) patients with acute respiratory illness to calculate an ILI-score. Patients were evaluated for admission by their ILI-score and clinicians' assessment of risk for developing complications. Nasal and throat swabs were collected from intermediate and high-risk patients for influenza testing by RT-PCR. The disposition and ILI-score of those oseltamivir-treated versus untreated, clinical characteristics of 2009 pandemic influenza A (H1N1) patients versus test-negative patients were compared by Pearson's Χ2, Fisher's Exact, and Wilcoxon rank-sum tests. Results Of 1840 ER patients, 230 were initially hospitalized (mean ILI-score = 15), and the rest were discharged, including 286 ambulatory patients given oseltamivir (median ILI-score = 11), and 1324 untreated (median ILI-score = 5). Fourteen (1%) untreated patients returned, and 3 were hospitalized on oseltamivir (median ILI-score  = 19). Of 371 patients tested by RT-PCR, 104 (28%) had pandemic influenza and 42 (11%) had seasonal influenza A detected. Twenty (91%) of 22 imaged hospitalized pandemic influenza patients had bilateral infiltrates compared to 23 (38%) of 61 imaged hospital test-negative patients (p<0.001). One patient with confirmed pandemic influenza presented 6 days after symptom onset, required mechanical ventilation, and died. Conclusions The triaging system that used an ILI-score complimented clinicians' judgment of who needed oseltamivir and inpatient care and helped hospital staff manage a surge in demand for services. PMID:20498718

  10. Uncovering the relationships between military community health and affects expressed in social media

    DOE PAGES

    Volkova, Svitlana; Charles, Lauren E.; Harrison, Josh; ...

    2017-06-08

    Military populations present a small, unique community whose mental and physical health impacts the security of the nation. Recent literature has explored social media's ability to enhance disease surveillance and characterize distinct communities with encouraging results. We present a novel analysis of the relationships between influenza-like illnesses (ILI) clinical data and affects (i.e., emotions and sentiments) extracted from social media around military facilities. Our analyses examine (1) differences in affects expressed by military and control populations, (2) affect changes over time by users, (3) differences in affects expressed during high and low ILI seasons, and (4) correlations and cross-correlations betweenmore » ILI clinical visits and affects from an unprecedented scale –171M geo-tagged tweets across 31 global geolocations. Key findings include: Military and control populations dier in the way they express affects in social media over space and time. Control populations express more positive and less negative sentiments and less sadness, fear, disgust, and anger emotions than military. However, affects expressed in social media by both populations within the same area correlate similarly with ILI visits to military health facilities. We have identified potential responsible co-factors leading to location variability, e.g., region or state locale, military service type and/or the ratio of military to civilian populations. For most locations, ILI proportions positively correlate with sadness and neutral sentiment, which are the affects most often expressed during high ILI season. The ILI proportions negatively correlate with fear, disgust, surprise, and positive sentiment. These results are similar to the low ILI season where anger, surprise, and positive sentiment are highest. Finally, cross-correlation analysis shows that most affects lead ILI clinical visits, i.e. are predictive of ILI data, with affect-ILI leading intervals dependent on geo

  11. Using Web and social media for influenza surveillance.

    PubMed

    Corley, Courtney D; Cook, Diane J; Mikler, Armin R; Singh, Karan P

    2010-01-01

    Analysis of Google influenza-like-illness (ILI) search queries has shown a strongly correlated pattern with Centers for Disease Control (CDC) and Prevention seasonal ILI reporting data. Web and social media provide another resource to detect increases in ILI. This paper evaluates trends in blog posts that discuss influenza. Our key finding is that from 5th October 2008 to 31st January 2009, a high correlation exists between the frequency of posts, containing influenza keywords, per week and CDC influenza-like-illness surveillance data.

  12. Using Web and Social Media for Influenza Surveillance

    SciTech Connect

    Corley, Courtney D.; Cook, Diane; Mikler, Armin R.; Singh, Karan P.

    2010-01-04

    Analysis of Google influenza-like-illness (ILI) search queries has shown a strongly correlated pattern with Centers for Disease Control (CDC) and Prevention seasonal ILI reporting data.Web and social media provide another resource to detect increases in ILI. This paper evaluates trends in blog posts that discuss influenza. Our key finding is that from 5-October 2008 to 31-January 2009 a high correlation exists between the frequency of posts, containing influenza keywords, per week and CDC influenza-like-illness surveillance data.

  13. Genetic relationships between internal diseases diagnosed at slaughter and carcass traits in Japanese Black cattle.

    PubMed

    Inoue, K; Honda, T; Oyama, K

    2015-06-01

    The objective of this paper was to estimate the genetic parameters of certain internal diseases (multifocal necrosis in the liver [MNL], bovine abdominal fat necrosis [BFN], and inflammation of the large intestine [ILI]) and to investigate relationships between the internal diseases and carcass traits (carcass weight [CW], rib eye area [REA], rib thickness [RT], subcutaneous fat thickness, and beef marbling score [BMS]). Records of the internal diseases and the carcass traits of 5,788 Japanese Black cattle were used for this study. The data for all the diseases were recorded as binary data as to whether the disease was observed (1) or not (0). Genetic parameters were estimated using linear and threshold animal models. The prevalence rates of MNL, BFN, and ILI were 16.1, 23.0, and 6.8%, respectively, and heritability estimates ± posterior SD were 0.18 ± 0.06, 0.28 ± 0.06, and 0.18 ± 0.06, respectively. The genetic correlations of MNL with BFN and ILI were -0.23 (P = 0.19) and -0.49 (P < 0.05), respectively. In contrast, the correlation between BFN and ILI was positive and high (0.96; < 0.05). The phenotypic correlations of the internal diseases with the carcass traits were weak and not different from 0 except for those of BFN and ILI with CW, REA, and RT, which were all negative (P < 0.05) and ranged from -0.21 (ILI and CW) to -0.05 (BFN and RT). The genetic correlations of MNL with the carcass traits were all weak and not significant. In contrast, the genetic correlations of BFN and ILI with CW, REA, and RT were all negative and significant (P < 0.05) between BFN and CW (-0.36) and between BFN and RT (-0.33). However, the genetic correlations for BFN and ILI with BMS were all positive at 0.21 P( = 0.16) and 0.39 (P < 0.05), respectively. The estimated heritability of the internal diseases suggests that they can be genetically improved. Genetic relationships of BFN and ILI with meat quantity traits were favorable for beef cattle breeding, because lower disease

  14. Respiratory Syncytial Virus and Other Respiratory Viral Infections in Older Adults With Moderate to Severe Influenza-like Illness

    PubMed Central

    Falsey, Ann R.; McElhaney, Janet E.; Beran, Jiri; van Essen, Gerrit A.; Duval, Xavier; Esen, Meral; Galtier, Florence; Gervais, Pierre; Hwang, Shinn-Jang; Kremsner, Peter; Launay, Odile; Leroux-Roels, Geert; McNeil, Shelly A.; Nowakowski, Andrzej; Richardus, Jan Hendrik; Ruiz-Palacios, Guillermo; St Rose, Suzanne; Devaster, Jeanne-Marie; Oostvogels, Lidia; Durviaux, Serge; Taylor, Sylvia

    2014-01-01

    Background. Few studies have prospectively assessed viral etiologies of acute respiratory infections in community-based elderly individuals. We assessed viral respiratory pathogens in individuals ≥65 years with influenza-like illness (ILI). Methods. Multiplex reverse-transcriptase polymerase chain reaction identified viral pathogens in nasal/throat swabs from 556 episodes of moderate-to-severe ILI, defined as ILI with pneumonia, hospitalization, or maximum daily influenza symptom severity score (ISS) >2. Cases were selected from a randomized trial of an adjuvanted vs nonadjuvanted influenza vaccine conducted in elderly adults from 15 countries. Results. Respiratory syncytial virus (RSV) was detected in 7.4% (41/556) moderate-to-severe ILI episodes in elderly adults. Most (39/41) were single infections. There was a significant association between country and RSV detection (P = .004). RSV prevalence was 7.1% (2/28) in ILI with pneumonia, 12.5% (8/64) in ILI with hospitalization, and 6.7% (32/480) in ILI with maximum ISS > 2. Any virus was detected in 320/556 (57.6%) ILI episodes: influenza A (104/556, 18.7%), rhinovirus/enterovirus (82/556, 14.7%), coronavirus and human metapneumovirus (each 32/556, 5.6%). Conclusions. This first global study providing data on RSV disease in ≥65 year-olds confirms that RSV is an important respiratory pathogen in the elderly. Preventative measures such as vaccination could decrease severe respiratory illnesses and complications in the elderly. PMID:24482398

  15. Current Trends in Regional Therapy for Melanoma: Lessons Learned from 225 Regional Chemotherapy Treatments between 1995 and 2010 at a Single Institution

    PubMed Central

    Raymond, Amanda K; Beasley, Georgia M; Broadwater, Gloria; Augustine, Christina K; Padussis, James C; Turley, Ryan; Peterson, Bercedis; Seigler, Hilliard; Pruitt, Scott K; Tyler, Douglas S

    2011-01-01

    Background Hyperthermic isolated limb perfusion (HILP) and isolated limb infusion (ILI) are utilized to manage advanced extremity melanoma but no consensus exists as to which treatment is preferable and how to monitor patients post-treatment. Study Design Using a prospectively-maintained database, we reviewed our experience with melphalan based HILP (that included 62 first time and 10 second time) and ILI (that included 126 first time and 18 second time) procedures performed in 188 patients. PET/CT was obtained 3 months post regional treatment for one year and then every 6 months thereafter. Results The overall response rate (complete response (CR) + partial response (PR)) of HILP was 81% (80% CI: 73-87%) while the overall response rate from ILI was 43% (80% CI: 37-49%) for first time procedures only. HILP had a CR rate of 55% with a median duration of 32 months, while ILI had a CR rate of 30% with median duration of 24 months. Patients who experienced a regional recurrence after initial regional treatment were more likely to achieve a CR following repeat HILP (50%, n = 10) compared to repeat ILI (28%, n = 18). Although the spectrum of toxicity was similar for ILI and HILP, the likelihood of rare catastrophic complication of limb loss was greater with HILP (2/62) than ILI (0/122). PET/CT was effective for surveillance after regional therapy to identify regional nodal and pulmonary disease that was not clinically evident, but often amenable to surgical resection (25/49, 51% of cases). In contrast, PET/CT was not effective at predicting complete response to treatment with an accuracy of only 50%. Conclusions In the largest single institution regional therapy series reported to date, we found that while ILI is effective, and well-tolerated, HILP is a more definitive way to control advanced disease. PMID:21493111

  16. Reduction in Weight and Cardiovascular Disease Risk Factors in Individuals With Type 2 Diabetes: One-Year Results of the Look AHEAD Trial

    PubMed Central

    2008-01-01

    Objective The effectiveness of intentional weight loss in reducing cardiovascular disease (CVD) events in type 2 diabetes is unknown. This report describes one-year changes in CVD risk factors in a trial designed to examine the long-term effects of an intensive lifestyle intervention on the incidence of major CVD events. Research Design and Methods A multi-centered randomized controlled trial of 5,145 individuals with type 2 diabetes, aged 45–74 years, with body mass index ≥25 kg/m2 (≥27 kg/m2 if taking insulin). An Intensive Lifestyle Intervention (ILI) involving group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical activity was compared to a Diabetes Support and Education (DSE) condition. Results Participants assigned to ILI lost an average 8.6% of their initial weight versus 0.7% in DSE group (p<0.001). Mean fitness increased in ILI by 20.9% versus 5.8% in DSE (p<0.001). A greater proportion of ILI participants had reductions in diabetes, hypertension, and lipid-lowering medicines. Mean HbA1c dropped from 7.3% to 6.6% in ILI (p<0.001) versus from 7.3% to 7.2% in DSE. Systolic and diastolic pressure, triglycerides, HDL-cholesterol, and urine albumin/creatinine improved significantly more in ILI than DSE participants (all p<0.01). Conclusions At 1 year, ILI resulted in clinically significant weight loss in persons with type 2 diabetes. This was associated with improved diabetes control and CVD risk factors and reduced medicine use in ILI versus DSE. Continued intervention and follow-up will determine whether these changes are maintained and will reduce CVD risk. Trial Registration clinicaltrials.gov Identifier: NCT00017953 PMID:17363746

  17. Common Ground: An Interactive Visual Exploration and Discovery for Complex Health Data

    DTIC Science & Technology

    2015-12-01

    negative findings (e.g., “patient denies cough ”) as well as probabilities based on state- of-the-art Bayesian classifiers. However, the data did not...selected cough , sore throat, fever and ILI. On the right, the user has selected runny nose and cough . The distribution of encounters vs. probability...probability(x-axis) of having Influenza for encounters with cough , fever, sore throat and ILI (left) compared to encounters with cough and runny nose

  18. Hepatic macrophage iron aggravates experimental alcoholic steatohepatitis

    PubMed Central

    Xiong, Shigang; She, Hongyun; Zhang, An-Sheng; Wang, Jiaohong; Mkrtchyan, Hasmik; Dynnyk, Alla; Gordeuk, Victor R.; French, Samuel W.; Enns, Caroline A.; Tsukamoto, Hidekazu

    2008-01-01

    One prime feature of alcoholic liver disease (ALD) is iron accumulation in hepatic macrophages/Kupffer cells (KC) associated with enhanced NF-κB activation. Our recent work demonstrates a peroxynitrite-mediated transient rise in intracellular labile iron (ILI) as novel signaling for endotoxin-induced IKK and NF-κB activation in rodent KC. The present study investigated the mechanism of KC iron accumulation and its effects on ILI response in experimental ALD. We also tested ILI response in human blood monocytes. Chronic alcohol feeding in rats results in increased expression of transferrin (Tf) receptor-1 and hemochromatosis gene (HFE), enhanced iron uptake, an increase in nonheme iron content, and accentuated ILI response for NF-κB activation in KC. Ex vivo treatment of these KC with an iron chelator abrogates the increment of iron content, ILI response, and NF-κB activation. The ILI response is evident in macrophages derived from human blood monocytes by PMA treatment but not in vehicle-treated monocytes, and this differentiation-associated phenomenon is essential for maximal TNF-α release. PMA-induced macrophages load iron dextran and enhance ILI response and TNF-α release. These effects are reproduced in KC selectively loaded in vivo with iron dextran in mice and more importantly aggravate experimental ALD. Our results suggest enhanced iron uptake as a mechanism of KC iron loading in ALD and demonstrate the ILI response as a function acquired by differentiated macrophages in humans and as a priming mechanism for ALD. PMID:18599584

  19. Resolution No. 44/127. International Literacy Year, 15 December 1989.

    PubMed

    1989-01-01

    The UN General Assembly Resolution No. 44/127, December 15, 1989, on International Literacy Year (ILY) begin with the General Assembly recalling past resolutions relevant to literacy, i.e., the Universal Declaration of Human Rights and the International Covenant on Economic, Social, and Cultural Rights, where the right of every individual to education is recognized, and the realization that eradication of illiteracy is one of the paramount objectives of the International Development Strategy for the Third UN Development Decade and should become one of the objectives of the strategy for the 4th UN development decade, and that illiteracy seriously hinders the process of economic and social development and the cultural and spiritual advancement of society, and that functional literacy and adequate education represents an indispensable element for development and for the harnessing of science, technology, and human resources for economic and social progress. The resolution commends the United Nations Educational, Scientific and Cultural Organization, which has assumed the role of lead organization for ILY, for its work to ensure adequate preparation for ILY, and commends those Governments establishing national committees and programs aimed at meeting the objectives of the ILY. The Assembly expresses its appreciation to the specialized agencies and other organizations of the UN for their contribution to the preparation for ILY; welcomes the convening of the World Conference on Education for All, to be held in Thailand in March 1990 under the joint sponsorship of the UN Educational, Scientific, and Cultural Organization, the UN Development Program, the UN Children's Fund, and the World Bank. It invites relevant organizations to take appropriate measures towards achieving the objectives of ILY, requests wide publicity to the activities and measures to be undertaken during ILY, and requests a report on the implementation of the program for ILY.

  20. Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes: results from the Look AHEAD trial.

    PubMed

    Unick, Jessica L; Beavers, Daniel; Jakicic, John M; Kitabchi, Abbas E; Knowler, William C; Wadden, Thomas A; Wing, Rena R

    2011-10-01

    Rates of severe obesity (BMI ≥40 kg/m(2)) are on the rise, and effective treatment options are needed. We examined the effect of an intensive lifestyle intervention (ILI) on weight loss, cardiovascular disease (CVD) risk, and program adherence in participants with type 2 diabetes who were severely obese compared with overweight (BMI 25 to <30 kg/m(2)), class I (BMI 30 to <35 kg/m(2)), and class II (BMI 35 to <40 kg/m(2)) obese participants. Participants in the Action for Health in Diabetes (Look AHEAD) trial were randomly assigned to ILI or diabetes support and education (DSE). DSE participants received a less intense educational intervention, whereas ILI participants received an intensive behavioral treatment to increase physical activity (PA) and reduce caloric intake. This article focuses on the 2,503 ILI participants (age 58.6 ± 6.8 years). At 1 year, severely obese participants in the ILI group lost -9.04 ± 7.6% of initial body weight, which was significantly greater (P < 0.05) than ILI participants who were overweight (-7.43 ± 5.6%) and comparable to class I (-8.72 ± 6.4%) and class II obese (-8.64 ± 7.4%) participants. All BMI groups had comparable improvements in fitness, PA, LDL cholesterol, triglycerides, blood pressure, fasting glucose, and HbA(1c) at 1 year. ILI treatment session attendance was excellent and did not differ among weight categories (severe obese 80% vs. others 83%; P = 0.43). Severely obese participants in the ILI group had similar adherence, percentage of weight loss, and improvement in CVD risk compared with less obese participants. Behavioral weight loss programs should be considered an effective option for this population.

  1. Investigating obesity as a risk factor for influenza-like illness during the 2009 H1N1 influenza pandemic using the Health Survey for England.

    PubMed

    Murphy, Rachel; Fragaszy, Ellen B; Hayward, Andrew C; Warren-Gash, Charlotte

    2017-01-01

    Following the 2009 H1N1 influenza pandemic, obesity was shown to be associated with severe influenza outcomes. It remains unclear whether obesity was a risk factor for milder influenza-like illness (ILI). To determine whether obesity was associated with an increased risk of self-reported ILI during the 2009 H1N1 influenza pandemic using Health Survey for England (HSE) 2010 cross-sectional data. This study used HSE data collected from English households between January and December 2010. Weight and height measurements were taken by trained fieldworkers to determine obesity. ILI was defined as a positive response to the question "Have you had a flu-like illness where you felt feverish and had a cough or sore throat?" with illness occurring between May and December 2009. Multivariable logistic regression was used to evaluate the association between obesity and ILI. The study comprised 8407 participants (6984 adults, 1436 children), among whom 24.7% (95% CI: 23.6-25.9) were classified as obese. Of obese participants, 12.8% (95% CI: 11.1-14.8) reported ILI compared to 11.8% (95% CI: 10.8-12.8) of non-obese participants. The adjusted OR for ILI associated with obesity was 1.16 (95% CI: 0.98-1.38, P=.093). For adults and children, the adjusted ORs were 1.16 (95% CI: 0.97-1.38, P=.101) and 1.26 (95% CI: 0.72-2.21, P=.422), respectively. Household survey data showed no evidence that obesity was associated with an increase in self-reported ILI during the 2009 H1N1 influenza pandemic in England. Further studies using active prospective ILI surveillance combined with laboratory reporting would reduce bias and improve accuracy of outcome measurements. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  2. Costs and benefits of influenza vaccination and work productivity in a Colombian company from the employer's perspective.

    PubMed

    Morales, Alvaro; Martinez, Maria M; Tasset-Tisseau, Anne; Rey, Elena; Baron-Papillon, Florence; Follet, Alain

    2004-01-01

    This study was designed to evaluate the effects of an employee influenza vaccination campaign, measured in terms of health and economic benefits. Colombian bank employees volunteered to take part in this prospective observational study involving two groups: vaccinated and nonvaccinated. Socioeconomic and health status information, including influenza-like symptoms, sick leave, and postvaccination adverse events, were collected via questionnaires. Cost-benefit analyses were performed to determine whether the employer would save money overall by paying for the vaccination program. Between October 2000 and May 2001, 424 vaccinated subjects and 335 nonvaccinated subjects volunteered to join the study. Cumulative incidence of influenza-like illness (ILI) was lower among vaccinated (14.6%) than nonvaccinated subjects (39.4%). Fever was the most common ILI symptom (93% of all reported ILI). Absence rates because of ILI were similar in the two groups (2.59%-2.69%). Assuming that employees with ILI who continue to work have reduced effectiveness (30%-70% of normal) the employer can save 6.4 US dollars to 25.8 US dollars per vaccinated employee based on labor costs alone. This saving increases to 89.3 US dollars to 237.8 US dollars when operating income is also considered. Sensitivity analyses indicate that the vaccination program will be cost saving for vaccination coverage above 20% and ILI rates above 10%. Among the studied volunteers, ILI has significant impact on work productivity in terms of indirect costs. Implementing an influenza vaccination program would reduce the burden of ILI and save substantial amounts of money for the company.

  3. Impact of weight loss on ankle-brachial index and interartery blood pressures.

    PubMed

    Espeland, Mark A; Lewis, Cora E; Bahnson, Judy; Knowler, William C; Regensteiner, Judith G; Gaussoin, Sarah A; Beavers, Daniel; Johnson, Karen C

    2014-04-01

    To assess whether weight loss improves markers of peripheral artery disease and vascular stenosis. The Action for Health in Diabetes randomized clinical trial compared intensive lifestyle intervention (ILI) for weight loss to a control condition of diabetes support and education (DSE) in overweight or obese adults with type 2 diabetes. Annual ankle and brachial blood pressures over four years were used to compute ankle-brachial indices (ABIs) and to assess interartery blood pressure differences in 5018 participants. ILI, compared to DSE, produced 7.8% (Year 1) to 3.6% (Year 4) greater weight losses. These did not affect prevalence of low (<0.90) ABI (3.60% in DSE versus 3.14% in ILI; P = 0.20) or elevated (>1.40) ABI (7.52% in DSE versus 7.59% in ILI: P = 0.90), but produced smaller mean (SE) maximum interartery systolic blood pressure differences among ankle sites [19.7 (0.2) mmHg for ILI versus 20.6 (0.2) mmHg for DSE (P < 0.001)] and between arms [5.8 (0.1) mmHg for ILI versus 6.1 (0.1) mmHg for DSE (P = 0.01)]. Four years of intensive behavioral weight loss intervention did not significantly alter prevalence of abnormal ABI, however, it did reduce differences in systolic blood pressures among arterial sites. Copyright © 2013 The Obesity Society.

  4. Economic losses related to internal diseases in Japanese black cattle.

    PubMed

    Inoue, Keiichi; Honda, Takeshi; Oyama, Kenji

    2016-05-01

    The objective of this study was to estimate the direct economic losses due to the condemnation of the liver and large intestine because of internal diseases (multifocal necrosis in the liver (MNL) and inflammation of the large intestine (ILI)), and the indirect losses because of reductions in carcass performance from MNL, bovine abdominal fat necrosis (BFN) and ILI using data from 5383 Japanese Black cattle. Direct losses were estimated by multiplying the price of the condemned part by the frequency of its occurrence owing to the disease. Similarly, indirect losses were estimated as the product of unit carcass price and reduction in carcass weight (CW) due to the disease. The direct impact on the beef cattle industry from MNL and ILI was estimated at around $1.29 million (US$1 = ¥120) per year. A least-squares analysis showed that MNL had no influence on any carcass trait, whereas BFN and ILI significantly reduced CW, rib eye area and darkened the beef. ILI also reduced rib thickness. The indirect losses from BFN and ILI were estimated as a maximum of $131.7 and $256.4 per animal and around $6.26 million and $4.03 million for the industry, respectively, mostly because of the reduction in CW.

  5. Hygiene Behaviors Associated with Influenza-Like Illness among Adults in Beijing, China: A Large, Population-Based Survey.

    PubMed

    Wu, Shuangsheng; Ma, Chunna; Yang, Zuyao; Yang, Peng; Chu, Yanhui; Zhang, Haiyan; Li, Hongjun; Hua, Weiyu; Tang, Yaqing; Li, Chao; Wang, Quanyi

    2016-01-01

    The objective of this study was to identify possible hygiene behaviors associated with the incidence of ILI among adults in Beijing. In January 2011, we conducted a multi-stage sampling, cross-sectional survey of adults living in Beijing using self-administered anonymous questionnaires. The main outcome variable was self-reported ILI within the past year. Multivariate logistic regression was used to identify factors associated with self-reported ILI. A total of 13003 participants completed the questionnaires. 6068 (46.7%) of all participants reported ILI during the past year. After adjusting for demographic characteristics, the variables significantly associated with a lower likelihood of reporting ILI were regular physical exercise (OR 0.80; 95% CI 0.74-0.87), optimal hand hygiene (OR 0.87; 95% CI 0.80-0.94), face mask use when going to hospitals (OR 0.87; 95% CI 0.80-0.95), and not sharing of towels and handkerchiefs (OR 0.68; 95% CI 0.63-0.73). These results highlight that personal hygiene behaviors were potential preventive factors against the incidence of ILI among adults in Beijing, and future interventions to improve personal hygiene behaviors are needed in Beijing.

  6. Sentinel surveillance of influenza-like-illness in two cities of the tropical country of Ecuador: 2006-2010.

    PubMed

    Douce, Richard W; Aleman, Washington; Chicaiza-Ayala, Wilson; Madrid, Cesar; Sovero, Merly; Delgado, Franklin; Rodas, Mireya; Ampuero, Julia; Chauca, Gloria; Perez, Juan; Garcia, Josefina; Kochel, Tadeusz; Halsey, Eric S; Laguna-Torres, V Alberto

    2011-01-01

    Tropical countries are thought to play an important role in the global behavior of respiratory infections such as influenza. The tropical country of Ecuador has almost no documentation of the causes of acute respiratory infections. The objectives of this study were to identify the viral agents associated with influenza like illness (ILI) in Ecuador, describe what strains of influenza were circulating in the region along with their epidemiologic characteristics, and perform molecular characterization of those strains. This is a prospective surveillance study of the causes of ILI based on viral culture of oropharyngeal specimens and case report forms obtained in hospitals from two cities of Ecuador over 4 years. Out of 1,702 cases of ILI, nine viral agents were detected in 597 patients. During the time of the study, seven genetic variants of influenza circulated in Ecuador, causing six periods of increased activity. There appeared to be more heterogeneity in the cause of ILI in the tropical city of Guayaquil when compared with the Andean city of Quito. This was the most extensive documentation of the viral causes of ILI in Ecuador to date. Influenza was a common cause of ILI in Ecuador, causing more than one outbreak per year. There was no well defined influenza season although there were periods of time when no influenza was detected alternating with epidemics of different variant strains.

  7. An Intensive Lifestyle Intervention Is an Effective Treatment of Morbid Obesity: The TRAMOMTANA Study—A Two-Year Randomized Controlled Clinical Trial

    PubMed Central

    Burguera, Bartolomé; Jesús Tur, Juan; Escudero, Antonio Jorge; Alos, María; Pagán, Alberto; Cortés, Baltasar; González, Xavier Francesc; Soriano, Joan B.

    2015-01-01

    Bariatric surgery is currently the most effective therapy to induce weight loss in morbidly obese patients. Objective. This controlled, clinical trial with a two-year intervention was aimed at comparing the efficacy of two nonsurgical approaches versus bariatric surgery, on body weight changes and metabolic parameters in morbidly obese patients. Methods. Patients were randomized to an Intensive Lifestyle Intervention (ILI) (n = 60) or Conventional Obesity Therapy (COT) (n = 46). The ILI group received behavioral therapy and nutritional counseling. The COT group received standard medical treatment. They were compared with a third group, Surgical Obesity Group (SOG) (n = 37). Results. Patients who received ILI had a greater percentage of weight loss than patients receiving COT (−11.3% versus −1.6%; p < 0.0044). Interestingly 31.4% of patients included in the ILI group were no longer morbidly obese after just six months of intervention, increasing to 44.4% after 24 months of intervention. The percentage weight loss in SOG was −29.6% after that same period of time. Conclusions. ILI was associated with significant weight loss when compared to COT, in a group of patients with obesity. An ILI approach could be an alternative therapy to patients with obesity, who are not candidates to undergo bariatric surgery. This trial is registered with EudraCT 2009-013737-24. PMID:26257780

  8. Sentinel Surveillance of Influenza-Like-Illness in Two Cities of the Tropical Country of Ecuador: 2006–2010

    PubMed Central

    Douce, Richard W.; Aleman, Washington; Chicaiza-Ayala, Wilson; Madrid, Cesar; Sovero, Merly; Delgado, Franklin; Rodas, Mireya; Ampuero, Julia; Chauca, Gloria; Perez, Juan; Garcia, Josefina; Kochel, Tadeusz; Halsey, Eric S.; Laguna-Torres, V. Alberto

    2011-01-01

    Background Tropical countries are thought to play an important role in the global behavior of respiratory infections such as influenza. The tropical country of Ecuador has almost no documentation of the causes of acute respiratory infections. The objectives of this study were to identify the viral agents associated with influenza like illness (ILI) in Ecuador, describe what strains of influenza were circulating in the region along with their epidemiologic characteristics, and perform molecular characterization of those strains. Methodology/Findings This is a prospective surveillance study of the causes of ILI based on viral culture of oropharyngeal specimens and case report forms obtained in hospitals from two cities of Ecuador over 4 years. Out of 1,702 cases of ILI, nine viral agents were detected in 597 patients. During the time of the study, seven genetic variants of influenza circulated in Ecuador, causing six periods of increased activity. There appeared to be more heterogeneity in the cause of ILI in the tropical city of Guayaquil when compared with the Andean city of Quito. Conclusions/Significance This was the most extensive documentation of the viral causes of ILI in Ecuador to date. Influenza was a common cause of ILI in Ecuador, causing more than one outbreak per year. There was no well defined influenza season although there were periods of time when no influenza was detected alternating with epidemics of different variant strains. PMID:21887216

  9. Impact of Weight Loss on Ankle-Brachial Index and Inter-Artery Blood Pressures in Overweight and Obese Adults with Diabetes

    PubMed Central

    Espeland, Mark A.; Lewis, Cora E.; Bahnson, Judy; Knowler, William C.; Regensteiner, Judith G.; Gaussoin, Sarah A.; Beavers, Daniel; Johnson, Karen C.

    2013-01-01

    Objective To assess whether weight loss improves markers of peripheral artery disease and vascular stenosis. Design and Methods The Action for Health in Diabetes randomized clinical trial compared intensive lifestyle intervention (ILI) for weight loss to a control condition of diabetes support and education (DSE) in overweight or obese adults with type 2 diabetes. Annual ankle and brachial blood pressures over four years were used compute ankle-brachial indices (ABIs) and to assess inter-artery blood pressure differences in 5018 participants. Results ILI, compared to DSE, produced 7.8% (Year 1) to 3.6% (Year 4) greater weight losses. These did not affect prevalence of low (<0.90) ABI (3.60% in DSE versus 3.14% in ILI; p=0.20) or elevated (>1.40) ABI (7.52% in DSE versus 7.59% in ILI: p=0.90), but produced smaller mean (SE) maximum inter-artery systolic blood pressure differences among ankle sites [19.7 (0.2) mmHg for ILI versus 20.6 (0.2) mmHg for DSE (p<0.001)] and between arms [5.8 (0.1) mmHg for ILI versus 6.1 (0.1) mmHg for DSE (p=0.01)]. Conclusions Four years of intensive behavioral weight loss intervention did not significantly alter prevalence of abnormal ABI, however it did reduce differences in systolic blood pressures among arterial sites. PMID:24174392

  10. Lifestyle intervention and/or statins for the reduction of C-reactive protein in type 2 diabetes: From the Look AHEAD Study

    PubMed Central

    Belalcazar, L.M.; Haffner, S.M.; Lang, W.; Hoogeveen, R.C.; Rushing, J.; Schwenke, D.C.; Tracy, R.P.; Pi-Sunyer, F.X.; Kriska, A.M.; Ballantyne, C.M.

    2013-01-01

    Objective Cardiovascular risk remains high despite statin use. Overweight/obese diabetic persons usually have normal/low LDL-cholesterol but high C-reactive protein (CRP) levels. We aimed to examine the effects of intensive lifestyle intervention for weight loss (ILI) on CRP levels in overweight/obese diabetic individuals by statin use. Design and Methods Look AHEAD was a randomized trial in overweight/obese type 2 diabetic individuals testing whether ILI would reduce cardiovascular mortality, when compared to usual care. We evaluated CRP changes in 1,431 participants with biomarker levels, who remained on or off statin treatment for 1-year. Results The reduction in CRP levels with ILI at 1 year in men and women on statins was −44.9 and −42.3 %, respectively, compared to −13.7 and −21.0 % for those on statins and usual care (p<0.0001). At 1 year, median CRP levels were: 1.8 mg/L in participants randomized to ILI on statin therapy; 2.6 mg/L for those on statins randomized to usual care and 2.9 mg/L for participants not on statins but randomized to ILI. Weight loss was associated with 1-year CRP reduction (p<0.0001) in statin and non-statin users. Conclusions Our findings suggest that in overweight/obese diabetic persons, ILI and statin therapy may have substantial additive anti-inflammatory benefits. PMID:23512860

  11. Cluster randomised controlled trial to examine medical mask use as source control for people with respiratory illness

    PubMed Central

    MacIntyre, Chandini Raina; Zhang, Yi; Chughtai, Abrar Ahmad; Seale, Holly; Zhang, Daitao; Chu, Yanhui; Zhang, Haiyan; Rahman, Bayzidur; Wang, Quanyi

    2016-01-01

    Rationale Medical masks are commonly used by sick individuals with influenza-like illness (ILI) to prevent spread of infections to others, but clinical efficacy data are absent. Objective Determine whether medical mask use by sick individuals with ILI protects well contacts from related respiratory infections. Setting 6 major hospitals in 2 districts of Beijing, China. Design Cluster randomised controlled trial. Participants 245 index cases with ILI. Intervention Index cases with ILI were randomly allocated to medical mask (n=123) and control arms (n=122). Since 43 index cases in the control arm also used a mask during the study period, an as-treated post hoc analysis was performed by comparing outcomes among household members of index cases who used a mask (mask group) with household members of index cases who did not use a mask (no-mask group). Main outcome measure Primary outcomes measured in household members were clinical respiratory illness, ILI and laboratory-confirmed viral respiratory infection. Results In an intention-to-treat analysis, rates of clinical respiratory illness (relative risk (RR) 0.61, 95% CI 0.18 to 2.13), ILI (RR 0.32, 95% CI 0.03 to 3.13) and laboratory-confirmed viral infections (RR 0.97, 95% CI 0.06 to 15.54) were consistently lower in the mask arm compared with control, although not statistically significant. A post hoc comparison between the mask versus no-mask groups showed a protective effect against clinical respiratory illness, but not against ILI and laboratory-confirmed viral respiratory infections. Conclusions The study indicates a potential benefit of medical masks for source control, but is limited by small sample size and low secondary attack rates. Larger trials are needed to confirm efficacy of medical masks as source control. Trial registration number ACTRN12613000852752; Results. PMID:28039289

  12. Assessing the burden of paediatric influenza in Europe: the European Paediatric Influenza Analysis (EPIA) project.

    PubMed

    Paget, W John; Balderston, Catherine; Casas, Inmaculada; Donker, Gé; Edelman, Laurel; Fleming, Douglas; Larrauri, Amparo; Meijer, Adam; Puzelli, Simona; Rizzo, Caterina; Simonsen, Lone

    2010-08-01

    The European Paediatric Influenza Analysis (EPIA) project is a multi-country project that was created to collect, analyse and present data regarding the paediatric influenza burden in European countries, with the purpose of providing the necessary information to make evidence-based decisions regarding influenza immunisation recommendations for children. The initial approach taken is based on existing weekly virological and age-specific influenza-like illness (ILI) data from surveillance networks across Europe. We use a multiple regression model guided by longitudinal weekly patterns of influenza virus to attribute the weekly ILI consultation incidence pattern to each influenza (sub)type, while controlling for the effect of respiratory syncytial virus (RSV) epidemics. Modelling the ILI consultation incidence during 2002/2003-2008 revealed that influenza infections that presented for medical attention as ILI affected between 0.3% and 9.8% of children aged 0-4 and 5-14 years in England, Italy, the Netherlands and Spain in an average season. With the exception of Spain, these rates were always higher in children aged 0-4 years. Across the six seasons analysed (five seasons were analysed from the Italian data), the model attributed 47-83% of the ILI burden in primary care to influenza virus infection in the various countries, with the A(H3N2) virus playing the most important role, followed by influenza viruses B and A(H1N1). National season averages from the four countries studied indicated that between 0.4% and 18% of children consulted a physician for ILI, with the percentage depending on the country and health care system. Influenza virus infections explained the majority of paediatric ILI consultations in all countries. The next step will be to apply the EPIA modelling approach to severe outcomes indicators (i.e. hospitalisations and mortality data) to generate a complete range of mild and severe influenza burden estimates needed for decision making concerning

  13. Household-level risk factors for secondary influenza-like illness in a rural area of Bangladesh.

    PubMed

    Weaver, Anne M; Khatun-E-Jannat, Kaniz; Cercone, Emily; Krytus, Kimberly; Sohel, Badrul Munir; Ahmed, Makhdum; Rahman, Mustafizur; Azziz-Baumgartner, Eduardo; Yu, Jihnhee; Fry, Alicia M; Luby, Stephen P; Ram, Pavani K

    2017-02-01

    To describe household-level risk factors for secondary influenza-like illness (ILI), an important public health concern in the low-income population of Bangladesh. Secondary analysis of control participants in a randomised controlled trial evaluating the effect of handwashing to prevent household ILI transmission. We recruited index-case patients with ILI - fever (<5 years); fever, cough or sore throat (≥5 years) - from health facilities, collected information on household factors and conducted syndromic surveillance among household contacts for 10 days after resolution of index-case patients' symptoms. We evaluated the associations between household factors at baseline and secondary ILI among household contacts using negative binomial regression, accounting for clustering by household. Our sample was 1491 household contacts of 184 index-case patients. Seventy-one percentage reported that smoking occurred in their home, 27% shared a latrine with one other household and 36% shared a latrine with >1 other household. A total of 114 household contacts (7.6%) had symptoms of ILI during follow-up. Smoking in the home (RRadj 1.9, 95% CI: 1.2, 3.0) and sharing a latrine with one household (RRadj 2.1, 95% CI: 1.2, 3.6) or >1 household (RRadj 3.1, 95% CI: 1.8-5.2) were independently associated with increased risk of secondary ILI. Tobacco use in homes could increase respiratory illness in Bangladesh. The mechanism between use of shared latrines and household ILI transmission is not clear. It is possible that respiratory pathogens could be transmitted through faecal contact or contaminated fomites in shared latrines. © 2016 John Wiley & Sons Ltd.

  14. Wikipedia Usage Estimates Prevalence of Influenza-Like Illness in the United States in Near Real-Time

    PubMed Central

    McIver, David J.; Brownstein, John S.

    2014-01-01

    Circulating levels of both seasonal and pandemic influenza require constant surveillance to ensure the health and safety of the population. While up-to-date information is critical, traditional surveillance systems can have data availability lags of up to two weeks. We introduce a novel method of estimating, in near-real time, the level of influenza-like illness (ILI) in the United States (US) by monitoring the rate of particular Wikipedia article views on a daily basis. We calculated the number of times certain influenza- or health-related Wikipedia articles were accessed each day between December 2007 and August 2013 and compared these data to official ILI activity levels provided by the Centers for Disease Control and Prevention (CDC). We developed a Poisson model that accurately estimates the level of ILI activity in the American population, up to two weeks ahead of the CDC, with an absolute average difference between the two estimates of just 0.27% over 294 weeks of data. Wikipedia-derived ILI models performed well through both abnormally high media coverage events (such as during the 2009 H1N1 pandemic) as well as unusually severe influenza seasons (such as the 2012–2013 influenza season). Wikipedia usage accurately estimated the week of peak ILI activity 17% more often than Google Flu Trends data and was often more accurate in its measure of ILI intensity. With further study, this method could potentially be implemented for continuous monitoring of ILI activity in the US and to provide support for traditional influenza surveillance tools. PMID:24743682

  15. Wikipedia usage estimates prevalence of influenza-like illness in the United States in near real-time.

    PubMed

    McIver, David J; Brownstein, John S

    2014-04-01

    Circulating levels of both seasonal and pandemic influenza require constant surveillance to ensure the health and safety of the population. While up-to-date information is critical, traditional surveillance systems can have data availability lags of up to two weeks. We introduce a novel method of estimating, in near-real time, the level of influenza-like illness (ILI) in the United States (US) by monitoring the rate of particular Wikipedia article views on a daily basis. We calculated the number of times certain influenza- or health-related Wikipedia articles were accessed each day between December 2007 and August 2013 and compared these data to official ILI activity levels provided by the Centers for Disease Control and Prevention (CDC). We developed a Poisson model that accurately estimates the level of ILI activity in the American population, up to two weeks ahead of the CDC, with an absolute average difference between the two estimates of just 0.27% over 294 weeks of data. Wikipedia-derived ILI models performed well through both abnormally high media coverage events (such as during the 2009 H1N1 pandemic) as well as unusually severe influenza seasons (such as the 2012-2013 influenza season). Wikipedia usage accurately estimated the week of peak ILI activity 17% more often than Google Flu Trends data and was often more accurate in its measure of ILI intensity. With further study, this method could potentially be implemented for continuous monitoring of ILI activity in the US and to provide support for traditional influenza surveillance tools.

  16. Monitoring Influenza Activity in the United States: A Comparison of Traditional Surveillance Systems with Google Flu Trends

    PubMed Central

    Ortiz, Justin R.; Zhou, Hong; Shay, David K.; Neuzil, Kathleen M.; Fowlkes, Ashley L.; Goss, Christopher H.

    2011-01-01

    Background Google Flu Trends was developed to estimate US influenza-like illness (ILI) rates from internet searches; however ILI does not necessarily correlate with actual influenza virus infections. Methods and Findings Influenza activity data from 2003–04 through 2007–08 were obtained from three US surveillance systems: Google Flu Trends, CDC Outpatient ILI Surveillance Network (CDC ILI Surveillance), and US Influenza Virologic Surveillance System (CDC Virus Surveillance). Pearson's correlation coefficients with 95% confidence intervals (95% CI) were calculated to compare surveillance data. An analysis was performed to investigate outlier observations and determine the extent to which they affected the correlations between surveillance data. Pearson's correlation coefficient describing Google Flu Trends and CDC Virus Surveillance over the study period was 0.72 (95% CI: 0.64, 0.79). The correlation between CDC ILI Surveillance and CDC Virus Surveillance over the same period was 0.85 (95% CI: 0.81, 0.89). Most of the outlier observations in both comparisons were from the 2003–04 influenza season. Exclusion of the outlier observations did not substantially improve the correlation between Google Flu Trends and CDC Virus Surveillance (0.82; 95% CI: 0.76, 0.87) or CDC ILI Surveillance and CDC Virus Surveillance (0.86; 95%CI: 0.82, 0.90). Conclusions This analysis demonstrates that while Google Flu Trends is highly correlated with rates of ILI, it has a lower correlation with surveillance for laboratory-confirmed influenza. Most of the outlier observations occurred during the 2003–04 influenza season that was characterized by early and intense influenza activity, which potentially altered health care seeking behavior, physician testing practices, and internet search behavior. PMID:21556151

  17. Comparison of Influenza Epidemiological and Virological Characteristics between Outpatients and Inpatients in Zhejiang Province, China, March 2011–June 2015

    PubMed Central

    Cheng, Wei; Yu, Zhao; Liu, Shelan; Zhang, Xueying; Wang, Xiaoxiao; Cai, Jian; Ling, Feng; Chen, Enfu

    2017-01-01

    Given the rapid rate of global spread and consequently healthcare costs related to influenza, surveillance plays an important role in monitoring the emerging pandemics in China. However, the characteristics of influenza in Southeast of China haven’t been fully studied. Our study use the surveillance data collected from 16 sentinel hospitals across Zhejiang Province during March 2011 through June 2015, including the demographic information and respiratory specimens from influenza-like illness (ILI) patients and severe acute respiratory illness (SARI) patients. As analysis results, most SARI and ILI patients were in the age group of 0–4 years old (62.38% of ILI and 71.54% of SARI). The respiratory specimens have statistically significantly higher positive rate for influenza among ILI patients than that among SARI patients (p < 0.001). The comparison between ILI patients and SARI patients shows no statistically significantly difference in detecting influenza virus type and influenza A virus subtype. The SARI and ILI patients were found to be positively correlated for overall positive rate (r = 0.63, p < 0.001), the weekly percentage of A(H1N1)pdm09 (r = 0.51, p < 0.001), influenza B virus (r = 0.17, p = 0.013), and A/H3N2 (r = 0.43, p < 0.001) among all the positive numbers. Our study demonstrated that the activities of influenza virus, including its subtypes, had a similar temporal pattern between ILI and SARI cases. PMID:28241447

  18. Relative differences in resting-state brain connectivity associated with long term intensive lifestyle intervention.

    PubMed

    Casanova, Ramon; Hayasaka, Satoru; Saldana, Santiago; Bryan, Nick R; Demos, Kathryn E; Desiderio, Lisa; Erickson, Kirk I; Espeland, Mark A; Nasrallah, Ilya M; Wadden, Thomas; Laurienti, Paul J

    2016-12-01

    A number of studies have reported that type 2 diabetes mellitus (T2DM) is associated with alterations in resting-state activity and connectivity in the brain. There is also evidence that interventions involving physical activity and weight loss may affect brain functional connectivity. In this study, we examined the effects of nearly 10 years of an intensive lifestyle intervention (ILI), designed to induce and sustain weight loss through lower caloric intake and increased physical activity, on resting-state networks in adults with T2DM. We performed a cross-sectional comparison of global and local characteristics from functional brain networks between individuals who had been randomly assigned to ILI or a control condition of health education and support. Upon examining brain networks from 312 participants (average age: 68.8 for ILI and 67.9 for controls), we found that ILI participants (N=160) had attenuated local efficiency at the network-level compared with controls (N=152). Although there was no group difference in the network-level global efficiency, we found that, among ILI participants, nodal global efficiency was elevated in left fusiform gyrus, right middle frontal gyrus, and pars opercularis of right inferior frontal gyrus. These effects were age-dependent, with more pronounced effects for older participants. Overall these results indicate that the individuals assigned to the ILI had brain networks with less regional and more global connectivity, particularly involving frontal lobes. Such patterns would support greater distributed information processing. Future studies are needed to determine if these differences are associated with age-related compensatory function in the ILI group or worse pathology in the control group. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Cluster randomised controlled trial to examine medical mask use as source control for people with respiratory illness.

    PubMed

    MacIntyre, Chandini Raina; Zhang, Yi; Chughtai, Abrar Ahmad; Seale, Holly; Zhang, Daitao; Chu, Yanhui; Zhang, Haiyan; Rahman, Bayzidur; Wang, Quanyi

    2016-12-30

    Medical masks are commonly used by sick individuals with influenza-like illness (ILI) to prevent spread of infections to others, but clinical efficacy data are absent. Determine whether medical mask use by sick individuals with ILI protects well contacts from related respiratory infections. 6 major hospitals in 2 districts of Beijing, China. Cluster randomised controlled trial. 245 index cases with ILI. Index cases with ILI were randomly allocated to medical mask (n=123) and control arms (n=122). Since 43 index cases in the control arm also used a mask during the study period, an as-treated post hoc analysis was performed by comparing outcomes among household members of index cases who used a mask (mask group) with household members of index cases who did not use a mask (no-mask group). Primary outcomes measured in household members were clinical respiratory illness, ILI and laboratory-confirmed viral respiratory infection. In an intention-to-treat analysis, rates of clinical respiratory illness (relative risk (RR) 0.61, 95% CI 0.18 to 2.13), ILI (RR 0.32, 95% CI 0.03 to 3.13) and laboratory-confirmed viral infections (RR 0.97, 95% CI 0.06 to 15.54) were consistently lower in the mask arm compared with control, although not statistically significant. A post hoc comparison between the mask versus no-mask groups showed a protective effect against clinical respiratory illness, but not against ILI and laboratory-confirmed viral respiratory infections. The study indicates a potential benefit of medical masks for source control, but is limited by small sample size and low secondary attack rates. Larger trials are needed to confirm efficacy of medical masks as source control. ACTRN12613000852752; Results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  20. Eight-Year Weight Losses with an Intensive Lifestyle Intervention: The Look AHEAD Study

    PubMed Central

    2014-01-01

    Objective To evaluate 8-year weight losses achieved with intensive lifestyle intervention (ILI) in the Look AHEAD (Action for Health in Diabetes) study. Design and Methods Look AHEAD assessed the effects of intentional weight loss on cardiovascular morbidity and mortality in 5,145 overweight/obese adults with type 2 diabetes, randomly assigned to ILI or usual care (i.e., diabetes support and education [DSE]). The ILI provided comprehensive behavioral weight loss counseling over 8 years; DSE participants received periodic group education only. Results All participants had the opportunity to complete 8 years of intervention before Look AHEAD was halted in September 2012; ≥88% of both groups completed the 8-year outcomes assessment. ILI and DSE participants lost (mean±SE) 4.7±0.2% and 2.1±0.2% of initial weight, respectively (p<0.001) at year 8; 50.3% and 35.7%, respectively, lost ≥5% (p<0.001), and 26.9% and 17.2%, respectively, lost ≥10% (p<0.001). Across the 8 years ILI participants, compared with DSE, reported greater practice of several key weight-control behaviors. These behaviors also distinguished ILI participants who lost ≥10% and kept it off from those who lost but regained. Conclusions Look AHEAD’s ILI produced clinically meaningful weight loss (≥5%) at year 8 in 50% of patients with type 2 diabetes and can be used to manage other obesity-related co-morbid conditions. Trial Registration clinicaltrials.gov Identifier: NCT00017953 PMID:24307184

  1. Partial meal replacement plan and quality of the diet at one year: Action for Health in Diabetes (Look AHEAD) Trial

    PubMed Central

    Raynor, Hollie A.; Anderson, Andrea M.; Miller, Gary D.; Reeves, Rebecca; Delahanty, Linda M.; Vitolins, Mara Z.; Harper, Patricia; Mobley, Connie; Konersman, Kati; Mayer-Davis, Elizabeth

    2014-01-01

    Background Little is known about diet quality with a reduced-energy, low-fat, partial meal replacement (PMR) plan, especially in individuals with type 2 diabetes. The Action for Health in Diabetes (Look AHEAD) trial implemented a PMR plan in the intensive lifestyle intervention (ILI). Objective Compare dietary intake and percent meeting fat-related and food group dietary recommendations in ILI and diabetes support and education (DSE) groups at 12 months. Design Randomized controlled trial, comparing ILI to DSE, at 0- and 12-months. Participants/setting From 16 United States sites, the first 50% of participants (aged 45 to 76 years, overweight or obese, with type 2 diabetes) were invited to complete dietary assessments. Complete 0- and 12-month dietary assessments (collected between 2001 and 2004) were available on 2,397 participants (46.6% of total participants), with 1,186 randomized to DSE and 1,211 randomized to ILI. Main outcome measures A food frequency questionnaire assessed intake: energy; percent energy from protein, fat, carbohydrate, polyunsaturated fatty acids (PUFA), and saturated fats; trans fatty acids; cholesterol; fiber; weekly meal replacements (MRs); and daily servings from food groups from the Food Guide Pyramid. Statistical analyses performed Mixed-factor analyses of covariance (ANCOVA), using Proc MIXED with a repeated statement, with age, sex, race/ethnicity, education, and income controlled. Unadjusted chi-square tests compared percent meeting fat-related and food group recommendations at 12 months. Results At 12 months, ILI had a significantly lower fat and cholesterol intake and greater fiber intake than DSE. ILI consumed more servings/day of fruits; vegetables; and milk, yogurt & cheese; and fewer servings/day of fats, oils & sweets than DSE. A greater percentage of ILI than DSE participants met fat-related and most food group recommendations. Within ILI, a greater percentage of participants consuming ≥ 2 MRs/day than < 1 MR/day met most

  2. A case study of the New York City 2012-2013 influenza season with daily geocoded Twitter data from temporal and spatiotemporal perspectives.

    PubMed

    Nagar, Ruchit; Yuan, Qingyu; Freifeld, Clark C; Santillana, Mauricio; Nojima, Aaron; Chunara, Rumi; Brownstein, John S

    2014-10-20

    Twitter has shown some usefulness in predicting influenza cases on a weekly basis in multiple countries and on different geographic scales. Recently, Broniatowski and colleagues suggested Twitter's relevance at the city-level for New York City. Here, we look to dive deeper into the case of New York City by analyzing daily Twitter data from temporal and spatiotemporal perspectives. Also, through manual coding of all tweets, we look to gain qualitative insights that can help direct future automated searches. The intent of the study was first to validate the temporal predictive strength of daily Twitter data for influenza-like illness emergency department (ILI-ED) visits during the New York City 2012-2013 influenza season against other available and established datasets (Google search query, or GSQ), and second, to examine the spatial distribution and the spread of geocoded tweets as proxies for potential cases. From the Twitter Streaming API, 2972 tweets were collected in the New York City region matching the keywords "flu", "influenza", "gripe", and "high fever". The tweets were categorized according to the scheme developed by Lamb et al. A new fourth category was added as an evaluator guess for the probability of the subject(s) being sick to account for strength of confidence in the validity of the statement. Temporal correlations were made for tweets against daily ILI-ED visits and daily GSQ volume. The best models were used for linear regression for forecasting ILI visits. A weighted, retrospective Poisson model with SaTScan software (n=1484), and vector map were used for spatiotemporal analysis. Infection-related tweets (R=.763) correlated better than GSQ time series (R=.683) for the same keywords and had a lower mean average percent error (8.4 vs 11.8) for ILI-ED visit prediction in January, the most volatile month of flu. SaTScan identified primary outbreak cluster of high-probability infection tweets with a 2.74 relative risk ratio compared to medium

  3. Adiponectin and the mediation of HDL-cholesterol change with improved lifestyle: the Look AHEAD Study.

    PubMed

    Belalcazar, L Maria; Lang, Wei; Haffner, Steven M; Hoogeveen, Ron C; Pi-Sunyer, F Xavier; Schwenke, Dawn C; Balasubramanyam, Ashok; Tracy, Russell P; Kriska, Andrea P; Ballantyne, Christie M

    2012-12-01

    Adipose tissue dysfunction plays a key role in the development of the metabolic abnormalities characteristic of type 2 diabetes (T2DM) and participates actively in lipid metabolism. Adiponectin, found abundantly in circulation and a marker of adipose health, is decreased in obese persons with T2DM. We investigated whether the changes in adiponectin with an intensive lifestyle intervention (ILI) for weight loss could potentially mediate the increase in low HDL-cholesterol (HDL-C) with ILI. Adiponectin and its fractions were determined using an ELISA with selective protease treatment in 1,397 participants from Look AHEAD, a trial examining whether ILI will reduce cardiovascular events in overweight/obese subjects with T2DM when compared with a control arm, diabetes support and education (DSE). Multivariable regression and mediational analyses were performed for adiponectin and its high-molecular-weight (HMW) and non-HMW fractions. ILI increased baseline HDL-C by 9.7% and adiponectin by 11.9%; changes with DSE were 1.3% and 0.2%, respectively (P < 0.0001). In a model including changes in weight, fitness, triglycerides, and glucose control and that adjusted for demographics and medical history, adiponectin changes remained significantly associated with HDL-C change. Data supported the contribution of changes in both HMW- and non-HMW-adiponectin to the improvement in HDL-C with ILI.

  4. The effect of school dismissal on rates of influenza-like illness in New York City schools during the spring 2009 novel H1N1 outbreak.

    PubMed

    Egger, Joseph R; Konty, Kevin J; Wilson, Elisha; Karpati, Adam; Matte, Thomas; Weiss, Don; Barbot, Oxiris

    2012-03-01

    The effects of individual school dismissal on influenza transmission have not been well studied. During the spring 2009 novel H1N1 outbreak, New York City implemented an individual school dismissal policy intended to limit influenza transmission at schools with high rates of influenza-like illness (ILI). Active disease surveillance data collected by the New York City Health Department on rates of ILI in schools were used to evaluate the impact. Sixty-four schools that met the Health Department's criteria for considering dismissal were included in the analysis. Twenty-four schools that met criteria subsequently dismissed all classes for approximately 1 school week. A regression model was fit to these data, estimating the effect of school dismissal on rates of in-school ILI following reconvening, adjusting for potential confounders. The model estimated that, on average, school dismissal reduced the rate of ILI by 7.1% over the entire average outbreak period. However, a large proportion of in-school ILI occurred before dismissal criteria were met. A separate model estimated that school absenteeism rates were not significantly affected by dismissal. Results suggest that individual school dismissal could be considered in situations where schools have a disproportionate number of high-risk students or may be unable to implement recommended preventive or infection control measures. Future work should focus on developing more sensitive indicators of early outbreak detection in schools and evaluating the impact of school dismissal on community transmission. © 2012, American School Health Association.

  5. Induction of canine in vitro reactivity to alloantigen following intralymphatic immunization.

    PubMed

    Bubbers, J E; Paman, R L; Juillard, G J

    1981-01-01

    An experimental model has been developed using the dog to study the induction of systemic cell-mediated immunity following intralymphatic immunization (ILI) with allogenic cells. As detected in one-way mixed lymphocyte cultures, blastogenically-reactive immune peripheral blood lymphocytes were observed after the third ILI with 10(7) cells. The in vitro reactivity was augmented by a fourth ILI to a node not previously injected indicating that a response in one node was followed by the trafficing of memory cells to other nodes. No immune PBL were detected after four ILI with lower doses of 10(3) cells. However, these dogs subsequently responded to a single injection of 10(7) cells with high levels of immune lymphocytes which were detectable for up to 24 days. Apparently, ILI with 10(3) or 10(5) cells, while insufficient to produce detectable levels of alloreactive lymphocytes were sufficient for lymphocyte priming. Results obtained with this model will aid in ongoing human trials of intralymphatic immunotherapy of malignant disease.

  6. Perfusion and infusion for melanoma in-transit metastases in the era of effective systemic therapy.

    PubMed

    Grünhagen, Dirk J; Kroon, Hidde M; Verhoef, Cornelis

    2015-01-01

    The management of melanoma in-transit metastases (IT-mets) is challenging. For many years, the absence of effective systemic therapy has prompted physicians to focus on regional therapies for melanoma confined to the limb. The introduction of isolated limb perfusion (ILP) and isolated limb infusion (ILI) has enabled effective delivery of cytotoxic drugs in an isolated circuit, so as to overcome systemic toxicity and maximize local response. Both techniques have evolved over years and both tumor necrosis factor (TNF)-alpha-based ILP and ILI have distinct indications. The development of new systemic treatment options for patients with melanoma in the past decade has shed a new light on melanoma therapy. The present manuscript focuses on the modern role of ILI and ILP in the treatment of patients with melanoma with in-transit metastases in the era of effective systemic therapy. The response and control rates of ILI/ILP are still superior to rates achieved with systemic agents. The extent of disease in patients with stage III disease, however, warrants effective systemic treatment to prolong survival. There is great potential in combining rapid response therapy such as ILI/ILP with systemic agents for sustainable response. Trial results are eagerly awaited.

  7. Outbreak of influenza in an overseas student travel group--Taiwan 2008.

    PubMed

    Tsou, Tsung-Pei; Lin, Chien-Hui; Lo, Yi-Chun; Li, Yi-Syue; Chiu, Chan-Hsien

    2010-05-01

    Influenza is a frequent cause of acute respiratory illness (ARI). In July 2008, we conducted a retrospective cohort study to investigate an influenza outbreak occurring in an overland travel group of overseas students. ARI was defined as the presence of any respiratory symptom such as cough, rhinorrhoea, sore throat or stuffy nose. Influenza-like illness (ILI) was defined as ARI plus fever > or =38 degrees C. Throat swabs were taken from symptomatic participants and a real-time polymerase chain reaction (RT-PCR) was performed. One hundred and seventy participants were interviewed. Forty-four (26%) had an ARI and 22 (13%) had an ILI. Of the 33 specimens collected, 18 (54%) were positive for influenza A/H3N2. Taiwanese group leaders had increased risk of acquiring both ARI and ILI (ARI relative risk (RR) 2.2, 95% confidence interval (CI) 1.3-3.7 and ILI RR 2.8, 95% CI 1.2-6.3). Fifteen participants were vaccinated. The vaccine effectiveness was 52% for ILI (p = 0.70). The outbreak stopped after cohorting and the use of surgical masks. Vaccination appeared to be effective in preventing infection.

  8. Flu Near You: Crowdsourced Symptom Reporting Spanning 2 Influenza Seasons

    PubMed Central

    Smolinski, Mark S.; Baltrusaitis, Kristin; Chunara, Rumi; Olsen, Jennifer M.; Wójcik, Oktawia; Santillana, Mauricio; Nguyen, Andre; Brownstein, John S.

    2015-01-01

    Objectives. We summarized Flu Near You (FNY) data from the 2012–2013 and 2013–2014 influenza seasons in the United States. Methods. FNY collects limited demographic characteristic information upon registration, and prompts users each Monday to report symptoms of influenza-like illness (ILI) experienced during the previous week. We calculated the descriptive statistics and rates of ILI for the 2012–2013 and 2013–2014 seasons. We compared raw and noise-filtered ILI rates with ILI rates from the Centers for Disease Control and Prevention ILINet surveillance system. Results. More than 61 000 participants submitted at least 1 report during the 2012–2013 season, totaling 327 773 reports. Nearly 40 000 participants submitted at least 1 report during the 2013–2014 season, totaling 336 933 reports. Rates of ILI as reported by FNY tracked closely with ILINet in both timing and magnitude. Conclusions. With increased participation, FNY has the potential to serve as a viable complement to existing outpatient, hospital-based, and laboratory surveillance systems. Although many established systems have the benefits of specificity and credibility, participatory systems offer advantages in the areas of speed, sensitivity, and scalability. PMID:26270299

  9. Detection of Excess Influenza Severity: Associating Respiratory Hospitalization and Mortality Data With Reports of Influenza-Like Illness by Primary Care Physicians

    PubMed Central

    van Asten, Liselotte; Meijer, Adam; van Pelt, Wilfrid; Nagelkerke, Nico J. D.; Donker, Gé A.; van der Sande, Marianne A. B.; Koopmans, Marion P. G.

    2010-01-01

    Objectives. We explored whether excesses in influenza severity can be detected by combining respiratory syndromic hospital and mortality data with data on influenza-like illness (ILI) cases obtained from general practitioners. Methods. To identify excesses in the severity of influenza infections in the population of the Netherlands between 1999 and 2005, we looked for increases in influenza-associated hospitalizations and mortality that were disproportionate to the number of ILI cases reported by general practitioners. We used generalized estimating equation regression models to associate syndromic hospital and mortality data with ILI surveillance data obtained from general practitioners. Virus isolation and antigenic characterization data were used to interpret the results. Results. Disproportionate increases in hospitalizations and mortality (relative to ILI cases reported by general practitioners) were identified in 2003/04 during the A/Fujian/411/02(H3N2) drift variant epidemic. Conclusions. Combined surveillance of respiratory hospitalizations and mortality and ILI data obtained from general practitioners can capture increases in severe influenza-associated illness that are disproportionate to influenza incidence rates. Therefore, this novel approach should complement traditional seasonal and pandemic influenza surveillance in efforts to detect increases in influenza case fatality rates and percentages of patients hospitalized. PMID:20864730

  10. Inductive linkage identification on building blocks of different sizes and types

    NASA Astrophysics Data System (ADS)

    Chen, Ying-ping; Chuang, Chung-Yao; Huang, Yuan-Wei

    2012-12-01

    The goal of linkage identification is to obtain the dependencies among decision variables. Such information or knowledge can be applied to design crossover operators and/or the encoding schemes in genetic and evolutionary methods. Thus, promising sub-solutions to the problem will be disrupted less likely, and successful convergence may be achieved more likely. To obtain linkage information, a linkage identification technique, called Inductive Linkage Identification (ILI), was proposed recently. ILI was established upon the mechanism of perturbation and the idea of decision tree learning. By constructing a decision tree according to decision variables and fitness difference values, the interdependent variables will be determined by the adopted decision tree learning algorithm. In this article, we aim to acquire a better understanding on the characteristics of ILI, especially its behaviour under problems composed of different-sized and different-type building blocks (BBs) which are not overlapped. Experiments showed that ILI can efficiently handle BBs of different sizes and is insensitive to BB types. Our experimental observations indicate the flexibility and the applicability of ILI on various elementary BB types that are commonly adopted in related experiments.

  11. Reversible lipid accumulation and associated division arrest of Mycobacterium avium in lipoprotein-induced foamy macrophages may resemble key events during latency and reactivation of tuberculosis.

    PubMed

    Caire-Brändli, Irène; Papadopoulos, Alexia; Malaga, Wladimir; Marais, David; Canaan, Stéphane; Thilo, Lutz; de Chastellier, Chantal

    2014-02-01

    During the dormant phase of tuberculosis, Mycobacterium tuberculosis persists in lung granulomas by residing in foamy macrophages (FM) that contain abundant lipid bodies (LB) in their cytoplasm, allowing bacilli to accumulate lipids as intracytoplasmic lipid inclusions (ILI). An experimental model of FM is presented where bone marrow-derived mouse macrophages are infected with M. avium and exposed to very-low-density lipoprotein (VLDL) as a lipid source. Quantitative analysis of detailed electron microscope observations showed the following results. (i) Macrophages became foamy, and mycobacteria formed ILI, for which host triacylglycerides, rather than cholesterol, was essential. (ii) Lipid transfer occurred via mycobacterium-induced fusion between LB and phagosomes. (iii) Mycobacteria showed a thinned cell wall and became elongated but did not divide. (iv) Upon removal of VLDL, LB and ILI declined within hours, and simultaneous resumption of mycobacterial division restored the number of mycobacteria to the same level as that found in untreated control macrophages. This showed that the presence of ILI resulted in a reversible block of division without causing a change in the mycobacterial replication rate. Fluctuation between ILI either partially or fully extending throughout the mycobacterial cytoplasm was suggestive of bacterial cell cycle events. We propose that VLDL-driven FM constitute a well-defined cellular system in which to study changed metabolic states of intracellular mycobacteria that may relate to persistence and reactivation of tuberculosis.

  12. Impact of an intensive lifestyle intervention on use and cost of medical services among overweight and obese adults with type 2 diabetes: the action for health in diabetes.

    PubMed

    Espeland, Mark A; Glick, Henry A; Bertoni, Alain; Brancati, Frederick L; Bray, George A; Clark, Jeanne M; Curtis, Jeffrey M; Egan, Caitlin; Evans, Mary; Foreyt, John P; Ghazarian, Siran; Gregg, Edward W; Hazuda, Helen P; Hill, James O; Hire, Don; Horton, Edward S; Hubbard, Van S; Jakicic, John M; Jeffery, Robert W; Johnson, Karen C; Kahn, Steven E; Killean, Tina; Kitabchi, Abbas E; Knowler, William C; Kriska, Andrea; Lewis, Cora E; Miller, Marsha; Montez, Maria G; Murillo, Anne; Nathan, David M; Nyenwe, Ebenezer; Patricio, Jennifer; Peters, Anne L; Pi-Sunyer, Xavier; Pownall, Henry; Redmon, J Bruce; Rushing, Julia; Ryan, Donna H; Safford, Monika; Tsai, Adam G; Wadden, Thomas A; Wing, Rena R; Yanovski, Susan Z; Zhang, Ping

    2014-09-01

    To assess the relative impact of an intensive lifestyle intervention (ILI) on use and costs of health care within the Look AHEAD trial. A total of 5,121 overweight or obese adults with type 2 diabetes were randomly assigned to an ILI that promoted weight loss or to a comparison condition of diabetes support and education (DSE). Use and costs of health-care services were recorded across an average of 10 years. ILI led to reductions in annual hospitalizations (11%, P = 0.004), hospital days (15%, P = 0.01), and number of medications (6%, P < 0.001), resulting in cost savings for hospitalization (10%, P = 0.04) and medication (7%, P < 0.001). ILI produced a mean relative per-person 10-year cost savings of $5,280 (95% CI 3,385-7,175); however, these were not evident among individuals with a history of cardiovascular disease. Compared with DSE over 10 years, ILI participants had fewer hospitalizations, fewer medications, and lower health-care costs. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  13. Influenza A(H1N1)pdm09 outbreak detected in inter-seasonal months during the surveillance of influenza-like illness in Pune, India, 2012-2015.

    PubMed

    Gurav, Y K; Chadha, M S; Tandale, B V; Potdar, V A; Pawar, S D; Shil, P; Deoshatwar, A R; Aarthy, R; Bhushan, A

    2017-07-01

    An outbreak of influenza A(H1N1)pdm09 was detected during the ongoing community-based surveillance of influenza-like illness (ILI). Among reported 119 influenza A(H1N1)pdm09 cases (59 cases in the year 2012 and 60 cases in 2015) in summer months, common clinical features were fever (100%), cough (90·7%), sore throat (85·7%), nasal discharge (48·7%), headache (55·5%), fatigue (18·5%), breathlessness (3·4%), and ear discharge (1·7%). Rise in ILI cases were negatively correlated with the seasonal factors such as relative humidity (Karl Pearson's correlation coefficient, i.e. r = -0·71 in the year 2012 and r = -0·44 in the year 2015), while rise in ILI cases were positively correlated with the temperature difference (r = 0·44 in the year 2012 and r = 0·77 in the year 2015). The effective reproduction number R, was estimated to be 1·30 in 2012 and 1·64 in 2015. The study highlights the rise in unusual influenza activity in summer month with high attack rate of ILI among children aged ⩽9 years. Children in this age group may need special attention for influenza vaccination. Influenza A(H1N1)pdm09 outbreak was confirmed in inter-seasonal months during the surveillance of ILI in Pune, India, 2012-2015.

  14. Reversible Lipid Accumulation and Associated Division Arrest of Mycobacterium avium in Lipoprotein-Induced Foamy Macrophages May Resemble Key Events during Latency and Reactivation of Tuberculosis

    PubMed Central

    Caire-Brändli, Irène; Papadopoulos, Alexia; Malaga, Wladimir; Marais, David; Canaan, Stéphane; Thilo, Lutz

    2014-01-01

    During the dormant phase of tuberculosis, Mycobacterium tuberculosis persists in lung granulomas by residing in foamy macrophages (FM) that contain abundant lipid bodies (LB) in their cytoplasm, allowing bacilli to accumulate lipids as intracytoplasmic lipid inclusions (ILI). An experimental model of FM is presented where bone marrow-derived mouse macrophages are infected with M. avium and exposed to very-low-density lipoprotein (VLDL) as a lipid source. Quantitative analysis of detailed electron microscope observations showed the following results. (i) Macrophages became foamy, and mycobacteria formed ILI, for which host triacylglycerides, rather than cholesterol, was essential. (ii) Lipid transfer occurred via mycobacterium-induced fusion between LB and phagosomes. (iii) Mycobacteria showed a thinned cell wall and became elongated but did not divide. (iv) Upon removal of VLDL, LB and ILI declined within hours, and simultaneous resumption of mycobacterial division restored the number of mycobacteria to the same level as that found in untreated control macrophages. This showed that the presence of ILI resulted in a reversible block of division without causing a change in the mycobacterial replication rate. Fluctuation between ILI either partially or fully extending throughout the mycobacterial cytoplasm was suggestive of bacterial cell cycle events. We propose that VLDL-driven FM constitute a well-defined cellular system in which to study changed metabolic states of intracellular mycobacteria that may relate to persistence and reactivation of tuberculosis. PMID:24478064

  15. Identifying influenza-like illness presentation from unstructured general practice clinical narrative using a text classifier rule-based expert system versus a clinical expert.

    PubMed

    MacRae, Jayden; Love, Tom; Baker, Michael G; Dowell, Anthony; Carnachan, Matthew; Stubbe, Maria; McBain, Lynn

    2015-10-06

    We designed and validated a rule-based expert system to identify influenza like illness (ILI) from routinely recorded general practice clinical narrative to aid a larger retrospective research study into the impact of the 2009 influenza pandemic in New Zealand. Rules were assessed using pattern matching heuristics on routine clinical narrative. The system was trained using data from 623 clinical encounters and validated using a clinical expert as a gold standard against a mutually exclusive set of 901 records. We calculated a 98.2 % specificity and 90.2 % sensitivity across an ILI incidence of 12.4 % measured against clinical expert classification. Peak problem list identification of ILI by clinical coding in any month was 9.2 % of all detected ILI presentations. Our system addressed an unusual problem domain for clinical narrative classification; using notational, unstructured, clinician entered information in a community care setting. It performed well compared with other approaches and domains. It has potential applications in real-time surveillance of disease, and in assisted problem list coding for clinicians. Our system identified ILI presentation with sufficient accuracy for use at a population level in the wider research study. The peak coding of 9.2 % illustrated the need for automated coding of unstructured narrative in our study.

  16. Hepatoprotective Effects of Total Triterpenoids and Total Flavonoids from Vitis vinifera L against Immunological Liver Injury in Mice

    PubMed Central

    Liu, Tao; Zhao, Jun; Ma, Long; Ding, Yusong; Su, Deqi

    2012-01-01

    Suosuo grape (the fruits of Vitis vinifera L) has been used for prevention and treatment of liver diseases in Uighur folk medicine in China besides its edible value. In this study, the hepatoprotective effects of total triterpenoids (VTT) and total flavonoids (VTF) from Suosuo grape were evaluated in Bacille-Calmette-Guerin- (BCG-) plus-lipopolysaccharide- (LPS-) induced immunological liver injury (ILI) in mice. Various dose groups (50, 150, and 300 mg/kg) of VTT and VTF alleviated the degree of liver injury of ILI mice, effectively reduced the BCG/LPS-induced elevated liver index and spleen index, hepatic nitric oxide (NO), and malondialdehyde (MDA) content, increased liver homogenate alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and restored hepatic superoxide dismutase (SOD) activity in ILI mice. VTT and VTF also significantly inhibited intrahepatic expression of Th1 cytokines (IFN-γ and IL-2) in ILI mice and increased intrahepatic expression of Th2 cytokines (IL-4 and IL-10). Moreover, the increased Bax/Bcl-2 ratio was significantly downregulated by VTT and VTF in liver tissue of ILI mice. These results are comparable to those of biphenyl dicarboxylate (DDB, the reference hepatoprotective agent) and suggest that VTT and VTF play a protective role against immunological liver injury, which may have important implications for our understanding of the immunoregulatory mechanisms of this plant. PMID:22262981

  17. Intermedilysin-receptor interactions during assembly of the pore complex: assembly intermediates increase host cell susceptibility to complement-mediated lysis.

    PubMed

    LaChapelle, Stephanie; Tweten, Rodney K; Hotze, Eileen M

    2009-05-08

    Intermedilysin (ILY) is an unusual member of the family of cholesterol-dependent cytolysins because it binds to human CD59 (hCD59) rather than directly to cholesterol-rich membranes. Binding of ILY to hCD59 initiates a series of conformational changes within the toxin that result in the conversion of the soluble monomer into an oligomeric membrane-embedded pore complex. In this study the association of ILY with its membrane receptor has been examined throughout the assembly and formation of the pore complex. Using ILY mutants trapped at various stages of pore assembly, we show ILY remains engaged with hCD59 throughout the assembly of the prepore oligomer, but it disengages from the receptor upon the conversion to the pore complex. We further show that the assembly intermediates increase the sensitivity of the host cell to lysis by its complement membrane attack complex, apparently by blocking the hCD59-binding site for complement proteins C8alpha and C9.

  18. Impact of an Intensive Lifestyle Intervention on Use and Cost of Medical Services Among Overweight and Obese Adults With Type 2 Diabetes: The Action for Health in Diabetes

    PubMed Central

    Glick, Henry A.; Bertoni, Alain; Brancati, Frederick L.; Bray, George A.; Clark, Jeanne M.; Curtis, Jeffrey M.; Egan, Caitlin; Evans, Mary; Foreyt, John P.; Ghazarian, Siran; Gregg, Edward W.; Hazuda, Helen P.; Hill, James O.; Hire, Don; Horton, Edward S.; Hubbard, Van S.; Jakicic, John M.; Jeffery, Robert W.; Johnson, Karen C.; Kahn, Steven E.; Killean, Tina; Kitabchi, Abbas E.; Knowler, William C.; Kriska, Andrea; Lewis, Cora E.; Miller, Marsha; Montez, Maria G.; Murillo, Anne; Nathan, David M.; Nyenwe, Ebenezer; Patricio, Jennifer; Peters, Anne L.; Pi-Sunyer, Xavier; Pownall, Henry; Redmon, J. Bruce; Rushing, Julia; Ryan, Donna H.; Safford, Monika; Tsai, Adam G.; Wadden, Thomas A.; Wing, Rena R.; Yanovski, Susan Z.; Zhang, Ping

    2014-01-01

    OBJECTIVE To assess the relative impact of an intensive lifestyle intervention (ILI) on use and costs of health care within the Look AHEAD trial. RESEARCH DESIGN AND METHODS A total of 5,121 overweight or obese adults with type 2 diabetes were randomly assigned to an ILI that promoted weight loss or to a comparison condition of diabetes support and education (DSE). Use and costs of health-care services were recorded across an average of 10 years. RESULTS ILI led to reductions in annual hospitalizations (11%, P = 0.004), hospital days (15%, P = 0.01), and number of medications (6%, P < 0.001), resulting in cost savings for hospitalization (10%, P = 0.04) and medication (7%, P < 0.001). ILI produced a mean relative per-person 10-year cost savings of $5,280 (95% CI 3,385–7,175); however, these were not evident among individuals with a history of cardiovascular disease. CONCLUSIONS Compared with DSE over 10 years, ILI participants had fewer hospitalizations, fewer medications, and lower health-care costs. PMID:25147253

  19. Hepatoprotective Effects of Total Triterpenoids and Total Flavonoids from Vitis vinifera L against Immunological Liver Injury in Mice.

    PubMed

    Liu, Tao; Zhao, Jun; Ma, Long; Ding, Yusong; Su, Deqi

    2012-01-01

    Suosuo grape (the fruits of Vitis vinifera L) has been used for prevention and treatment of liver diseases in Uighur folk medicine in China besides its edible value. In this study, the hepatoprotective effects of total triterpenoids (VTT) and total flavonoids (VTF) from Suosuo grape were evaluated in Bacille-Calmette-Guerin- (BCG-) plus-lipopolysaccharide- (LPS-) induced immunological liver injury (ILI) in mice. Various dose groups (50, 150, and 300 mg/kg) of VTT and VTF alleviated the degree of liver injury of ILI mice, effectively reduced the BCG/LPS-induced elevated liver index and spleen index, hepatic nitric oxide (NO), and malondialdehyde (MDA) content, increased liver homogenate alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, and restored hepatic superoxide dismutase (SOD) activity in ILI mice. VTT and VTF also significantly inhibited intrahepatic expression of Th1 cytokines (IFN-γ and IL-2) in ILI mice and increased intrahepatic expression of Th2 cytokines (IL-4 and IL-10). Moreover, the increased Bax/Bcl-2 ratio was significantly downregulated by VTT and VTF in liver tissue of ILI mice. These results are comparable to those of biphenyl dicarboxylate (DDB, the reference hepatoprotective agent) and suggest that VTT and VTF play a protective role against immunological liver injury, which may have important implications for our understanding of the immunoregulatory mechanisms of this plant.

  20. The role of weather on the relation between influenza and influenza-like illness.

    PubMed

    van Noort, Sander P; Águas, Ricardo; Ballesteros, Sébastien; Gomes, M Gabriela M

    2012-04-07

    Influenza epidemics, enabled by viral antigenic drift, occur invariably each winter in temperate climates. However, attempts to correlate the magnitude of virus change and epidemic size have been unsatisfactory. The incidence of influenza is not typically measured directly, but rather derived from the incidence of influenza-like illness (ILI), a clinical syndrome. Weather factors have been shown to influence the manifestation of influenza-like symptoms. We fitted an influenza transmission model to time series of influenza-like illness as monitored from 2003 to 2010 by two independent symptomatic surveillance systems (Influenzanet and EISN) in three European countries. By assuming that seasonality only acts upon the manifestation of symptoms, the model shows a significant correlation between the absolute humidity and temperature at the time of infection, and the proportion of influenza infections fulfilling the clinical ILI case definition, the so-called ILI factor. When a weather-dependent ILI factor is included in the model, the epidemic size of influenza-like illness becomes dependent not only on the susceptibility of the population at the beginning of the epidemic season but also on the weather conditions during which the epidemic unfolds. The combination reduces season-to-season variation in epidemic size and, interestingly, leads to a non-monotonic trend whereby the largest ILI epidemic occurs for moderate initial susceptibility. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Cre-inducible human CD59 mediates rapid cell ablation after intermedilysin administration

    PubMed Central

    Feng, Dechun; Dai, Shen; Liu, Fengming; Ohtake, Yosuke; Zhou, Zhou; Wang, Hua; Zhang, Yonggang; Kearns, Alison; Peng, Xiao; Zhu, Faliang; Hayat, Umar; Li, Man; He, Yong; Xu, Mingjiang; Zhao, Chunling; Cheng, Min; Zhang, Lining; Wang, Hong; Yang, Xiaofeng; Ju, Cynthia; Bryda, Elizabeth C.; Gordon, Jennifer; Khalili, Kamel; Hu, Wenhui; Li, Shuxin; Qin, Xuebin

    2016-01-01

    Cell ablation is a powerful tool for studying cell lineage and/or function; however, current cell-ablation models have limitations. Intermedilysin (ILY), a cytolytic pore-forming toxin that is secreted by Streptococcus intermedius, lyses human cells exclusively by binding to the human complement regulator CD59 (hCD59), but does not react with CD59 from nonprimates. Here, we took advantage of this feature of ILY and developed a model of conditional and targeted cell ablation by generating floxed STOP-CD59 knockin mice (ihCD59), in which expression of human CD59 only occurs after Cre-mediated recombination. The administration of ILY to ihCD59+ mice crossed with various Cre-driver lines resulted in the rapid and specific ablation of immune, epithelial, or neural cells without off-target effects. ILY had a large pharmacological window, which allowed us to perform dose-dependent studies. Finally, the ILY/ihCD59-mediated cell-ablation method was tested in several disease models to study immune cell functionalities, hepatocyte and/or biliary epithelial damage and regeneration, and neural cell damage. Together, the results of this study demonstrate the utility of the ihCD59 mouse model for studying the effects of cell ablation in specific organ systems in a variety of developmental and disease states. PMID:27159394

  2. Estimating the influenza vaccine effectiveness in elderly on a yearly basis using the Spanish influenza surveillance network--pilot case-control studies using different control groups, 2008-2009 season, Spain.

    PubMed

    Savulescu, Camelia; Valenciano, Marta; de Mateo, Salvador; Larrauri, Amparo

    2010-04-01

    We conducted a case-control and screening method studies to estimate influenza vaccine effectiveness (IVE) in the age group >or=65 years, based on the Spanish Influenza Sentinel Surveillance System (SISSS). Cases (influenza laboratory-confirmed) were compared to influenza-negative ILI patients (test-negative) and patients without ILI since the beginning of the season (non-ILI). For the screening method, cases' vaccination coverage was compared to the vaccination coverage of the GPs' catchment population. The results suggested a protective effect of the vaccine against laboratory-confirmed influenza in elderly in 2008-2009. The screening method and the test-negative control designs enable estimating IVE using exclusively SISSS data.

  3. New proposal for the treatment of viral warts with intralesional injection of 5-aminolevulinic acid photodynamic therapy.

    PubMed

    Kim, Jung Eun; Kim, Sun Ji; Hwang, Jong Ik; Lee, Kyung Jin; Park, Hyun Jeong; Cho, Baik Kee

    2012-06-01

    Although photodynamic therapy (PDT) using intralesional injection (ILI) can theoretically enhance the efficacy of the PDT, the effect of ILI-PDT on warts has not been reported in the literature so far. Eight patients with multiple viral warts were enrolled in the study. PDT was performed after the incubation for 1 h, followed by the ILI of aminolevulinic acid (ALA) into the warts. The treatment was repeated at 2-3 week intervals. Fifty percent of patients showed good to cure response. Complete remission was observed in two patients. There was no apparent correlation between the initial severity of warts and the likelihood of response. No one reported severe adverse reaction. The present study suggests that intralesional administration of ALA might be a safe and effective treatment option of thick treatment-resistant warts and can be performed with a shorter incubation period.

  4. The reliability of tweets as a supplementary method of seasonal influenza surveillance.

    PubMed

    Aslam, Anoshé A; Tsou, Ming-Hsiang; Spitzberg, Brian H; An, Li; Gawron, J Mark; Gupta, Dipak K; Peddecord, K Michael; Nagel, Anna C; Allen, Christopher; Yang, Jiue-An; Lindsay, Suzanne

    2014-11-14

    Existing influenza surveillance in the United States is focused on the collection of data from sentinel physicians and hospitals; however, the compilation and distribution of reports are usually delayed by up to 2 weeks. With the popularity of social media growing, the Internet is a source for syndromic surveillance due to the availability of large amounts of data. In this study, tweets, or posts of 140 characters or less, from the website Twitter were collected and analyzed for their potential as surveillance for seasonal influenza. There were three aims: (1) to improve the correlation of tweets to sentinel-provided influenza-like illness (ILI) rates by city through filtering and a machine-learning classifier, (2) to observe correlations of tweets for emergency department ILI rates by city, and (3) to explore correlations for tweets to laboratory-confirmed influenza cases in San Diego. Tweets containing the keyword "flu" were collected within a 17-mile radius from 11 US cities selected for population and availability of ILI data. At the end of the collection period, 159,802 tweets were used for correlation analyses with sentinel-provided ILI and emergency department ILI rates as reported by the corresponding city or county health department. Two separate methods were used to observe correlations between tweets and ILI rates: filtering the tweets by type (non-retweets, retweets, tweets with a URL, tweets without a URL), and the use of a machine-learning classifier that determined whether a tweet was "valid", or from a user who was likely ill with the flu. Correlations varied by city but general trends were observed. Non-retweets and tweets without a URL had higher and more significant (P<.05) correlations than retweets and tweets with a URL. Correlations of tweets to emergency department ILI rates were higher than the correlations observed for sentinel-provided ILI for most of the cities. The machine-learning classifier yielded the highest correlations for many of

  5. Effects of hand hygiene campaigns on incidence of laboratory-confirmed influenza and absenteeism in schoolchildren, Cairo, Egypt.

    PubMed

    Talaat, Maha; Afifi, Salma; Dueger, Erica; El-Ashry, Nagwa; Marfin, Anthony; Kandeel, Amr; Mohareb, Emad; El-Sayed, Nasr

    2011-04-01

    To evaluate the effectiveness of an intensive hand hygiene campaign on reducing absenteeism caused by influenza-like illness (ILI), diarrhea, conjunctivitis, and laboratory-confirmed influenza, we conducted a randomized control trial in 60 elementary schools in Cairo, Egypt. Children in the intervention schools were required to wash hands twice each day, and health messages were provided through entertainment activities. Data were collected on student absenteeism and reasons for illness. School nurses collected nasal swabs from students with ILI, which were tested by using a qualitative diagnostic test for influenza A and B. Compared with results for the control group, in the intervention group, overall absences caused by ILI, diarrhea, conjunctivitis, and laboratory-confirmed influenza were reduced by 40%, 30%, 67%, and 50%, respectively (p<0.0001 for each illness). An intensive hand hygiene campaign was effective in reducing absenteeism caused by these illnesses.

  6. Effects of Hand Hygiene Campaigns on Incidence of Laboratory-confirmed Influenza and Absenteeism in Schoolchildren, Cairo, Egypt

    PubMed Central

    Afifi, Salma; Dueger, Erica; El-Ashry, Nagwa; Marfin, Anthony; Kandeel, Amr; Mohareb, Emad; El-Sayed, Nasr

    2011-01-01

    To evaluate the effectiveness of an intensive hand hygiene campaign on reducing absenteeism caused by influenza-like illness (ILI), diarrhea, conjunctivitis, and laboratory-confirmed influenza, we conducted a randomized control trial in 60 elementary schools in Cairo, Egypt. Children in the intervention schools were required to wash hands twice each day, and health messages were provided through entertainment activities. Data were collected on student absenteeism and reasons for illness. School nurses collected nasal swabs from students with ILI, which were tested by using a qualitative diagnostic test for influenza A and B. Compared with results for the control group, in the intervention group, overall absences caused by ILI, diarrhea, conjunctivitis, and laboratory-confirmed influenza were reduced by 40%, 30%, 67%, and 50%, respectively (p<0.0001 for each illness). An intensive hand hygiene campaign was effective in reducing absenteeism caused by these illnesses. PMID:21470450

  7. Effective Translation of an Intensive Lifestyle Intervention for Hispanic Women With Prediabetes in a Community Health Center Setting

    PubMed Central

    Van Name, Michelle A.; Magenheimer, Elizabeth A.; Li, Fangyong; Dziura, James D.; Montosa, Abmaridel; Patel, Anisha; Tamborlane, William V.

    2016-01-01

    OBJECTIVE The Diabetes Prevention Program (DPP) demonstrated that weight loss from intensive lifestyle intervention (ILI) in adults with prediabetes could decrease progression to type 2 diabetes. Inner-city, low-income Hispanic women are at high risk for developing type 2 diabetes; however, this type of intervention is not well established in this group. We hypothesized that a DPP intervention modified for a community health center (CHC) setting would decrease weight and improve metabolic measures in Hispanic women with prediabetes. RESEARCH DESIGN AND METHODS Women diagnosed with prediabetes on a screening oral glucose tolerance test were recruited from a CHC. Participants (90% of whom were Hispanic) were randomized to either usual care (age 43 ± 9.7 years, BMI 35.2 ± 7.3 kg/m2) or ILI (age 43.8 ± 10.8 years, BMI 35.4 ± 8.5 kg/m2), structured as 14 weeks of group sessions focused on food choices, behavior change, physical activity, and weight loss. One year after enrollment, 122 women repeated baseline measures. RESULTS Groups had similar baseline weight, BMI, and fasting and 2-h glucose. One year later, the ILI group had lost 3.8 kg (4.4%), while the usual care group had gained 1.4 kg (1.6%, P < 0.0001). Two-hour glucose excursion decreased 15 mg/dL (0.85 mmol/L) in the ILI and 1 mg/dL (0.07 mmol/L) in the usual care group (P = 0.03). Significant decreases favoring the ILI group were noted in BMI, percent body fat, waist circumference, and fasting insulin. CONCLUSIONS A 14-week ILI program based on the DPP can effectively be translated into a predominantly Hispanic CHC setting, resulting in decreased weight, improved fasting insulin, and smaller glucose excursions 1 year after enrolling in the program. PMID:26908915

  8. One-Year Weight Losses in the Look AHEAD Study: Factors Associated with Success

    PubMed Central

    Wadden, Thomas A.; West, Delia S.; Neiberg, Rebecca; Wing, Rena R.; Ryan, Donna H.; Johnson, Karen C.; Foreyt, John; Hill, James O.; Trence, Dace; Vitolins, Mara

    2009-01-01

    This report provides a further analysis of the first year weight losses in the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with success. Participants were a total of 5,145 men and women with type 2 diabetes who were recruited at 16 sites and randomly assigned to an intensive lifestyle intervention (ILI) or a control condition, Diabetes Support and Education (DSE). During year 1, participants in ILI received comprehensive diet and physical activity counseling in 42 group and individual sessions, compared with 3 educational sessions for DSE participants. As reported previously, at the end of the year, ILI participants lost 8.6% of initial weight, compared to 0.7% for DSE (p < 0.001). Within the ILI group, all racial/ethnic groups achieved clinically significant weight losses (≥ 5.5%), although there were significant differences among groups. For the year, ILI participants attended an average of 35.4 treatment sessions and reported exercising a mean of 136.6 min/week and consuming a total of 360.9 meal replacement products. Greater self-reported physical activity was the strongest correlate of weight loss, followed by treatment attendance and consumption of meal replacements. The use of orlistat, during the second half of the year, increased weight loss only marginally in those ILI participants who had lost < 5% of initial weight during the first 6 months and chose to take the medication thereafter as a toolbox option. The lifestyle intervention was clinically effective in all subsets of an ethnically and demographically diverse population. PMID:19180071

  9. Face Mask Use and Control of Respiratory Virus Transmission in Households

    PubMed Central

    Cauchemez, Simon; Dwyer, Dominic E.; Seale, Holly; Cheung, Pamela; Browne, Gary; Fasher, Michael; Wood, James; Gao, Zhanhai; Booy, Robert; Ferguson, Neil

    2009-01-01

    Many countries are stockpiling face masks for use as a nonpharmaceutical intervention to control virus transmission during an influenza pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non–fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households. Mask use adherence was self-reported. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. We found that adherence to mask use significantly reduced the risk for ILI-associated infection, but <50% of participants wore masks most of the time. We concluded that household use of face masks is associated with low adherence and is ineffective for controlling seasonal respiratory disease. However, during a severe pandemic when use of face masks might be greater, pandemic transmission in households could be reduced. Many countries are stockpiling face masks for use as nonpharmaceutical interventions to reduce viral transmission during an influenza pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non–fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. Intent-to-treat analysis showed no significant difference in the relative risk of ILI in the mask use groups compared with the control group; however, <50% of those in the mask use groups reported wearing masks most of the time. Adherence to mask use was associated with a significantly reduced risk of ILI-associated infection. We concluded that household use of masks is associated with low adherence and is ineffective in controlling seasonal ILI. If adherence were greater, mask use might reduce transmission during a severe influenza pandemic. PMID:19193267

  10. Four-Year Weight Losses in the Look AHEAD Study: Factors Associated with Long-Term Success

    PubMed Central

    Wadden, Thomas A.; Neiberg, Rebecca H.; Wing, Rena R.; Clark, Jeanne M.; Delahanty, Linda M.; Hill, James O.; Krakoff, Jonathan; Otto, Amy; Ryan, Donna H.; Vitolins, Mara Z.

    2011-01-01

    This report provides a further analysis of the year 4 weight losses in the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with long-term success. A total of 5145 overweight/obese men and women with type 2 diabetes were randomly assigned to an intensive lifestyle intervention (ILI) or a usual care group, referred to as Diabetes Support and Education (DSE). ILI participants were provided approximately weekly group or individual treatment in year 1; continued but less frequent contact was provided in years 2–4. DSE participants received three group educational sessions in all years. As reported previously, at year 4, ILI participants lost an average of 4.7% of initial weight, compared with 1.1% for DSE (p<0.0001). More ILI than DSE participants lost ≥5% (46% vs 25%, p<0.0001) and ≥10% (23% vs 10%, p<0.0001) of initial weight. Within the ILI, acheivement of both the 5% and 10% categorical weight losses at year 4 was strongly related to meeting these goals at year 1. A total of 887 participants in ILI lost ≥10% at year 1, of whom 374 (42.2%) achieved this loss at year 4. Participants who maintained the loss, compared with those who did not, attended more treatment sessions and reported more favorable physical activity and food intake at year 4. These results provide critical evidence that a comprehensive lifestyle intervention can induce clinically significant weight loss (i.e., ≥5%) in overweight/obese participants with type 2 diabetes and maintain this loss in more than 45% of patients at 4 years. PMID:21779086

  11. Influenza-like illness-related emergency department visits: Christmas and New Year holiday peaks and relationships with laboratory-confirmed respiratory virus detections, Edmonton, Alberta, 2004-2014.

    PubMed

    Martin, Leah J; Im, Cindy; Dong, Huiru; Lee, Bonita E; Talbot, James; Meurer, David P; Mukhi, Shamir N; Drews, Steven J; Yasui, Yutaka

    2017-01-01

    Emergency department (ED) visit volumes can be especially high during the Christmas-New Year holidays, a period occurring during the influenza season in Canada. Using daily data, we examined the relationship between ED visits for the chief complaint "cough" (for Edmonton, Alberta residents) and laboratory detections for influenza A and respiratory syncytial virus (RSV) (for Edmonton and surrounding areas), lagged 0-5 days ahead, for non-pandemic years (2004-2008 and 2010-2014) using multivariable linear regression adjusting for temporal variables. We defined these cough-related visits as influenza-like illness (ILI)-related ED visits and, for 2004-2014, compared Christmas-New Year holiday (December 24-January 3) and non-holiday volumes during the influenza season (October-April). Adjusting for temporal variables, ILI-related ED visits were significantly associated with laboratory detections for influenza A and RSV. During non-pandemic years, the highest peak in ILI-related visit volumes always occurred during the holidays. The median number of holiday ILI-related visits/day (42.5) was almost twice the non-holiday median (24) and was even higher in 2012-2013 (80) and 2013-2014 (86). Holiday ILI-related ED visit volumes/100 000 population ranged from 56.0 (2010-2011) to 117.4 (2012-2013). In contrast, lower visit volumes occurred during the holidays of pandemic-affected years (2008-2010). During non-pandemic years, ILI-related ED visit volumes were associated with variations in detections for influenza A and RSV and always peaked during the Christmas-New Year holidays. This predictability should be used to prepare for, and possibly prevent, this increase in healthcare use; however, interventions beyond disease prevention strategies are likely needed. © 2016 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  12. Spatio-Temporal Synchrony of Influenza in Cities across Israel: The “Israel Is One City” Hypothesis

    PubMed Central

    Barnea, Oren; Huppert, Amit; Katriel, Guy; Stone, Lewi

    2014-01-01

    We analysed an 11-year dataset (1998–2009) of Influenza-Like Illness (ILI) that was based on surveillance of ∽23% of Israel's population. We examined whether the level of synchrony of ILI epidemics in Israel's 12 largest cities is high enough to view Israel as a single epidemiological unit. Two methods were developed to assess the synchrony: (1) City-specific attack rates were fitted to a simple model in order to estimate the temporal differences in attack rates and spatial differences in reporting rates of ILI. The model showed good fit to the data (R2  =  0.76) and revealed considerable differences in reporting rates of ILI in different cities (up to a factor of 2.2). (2) A statistical test was developed to examine the null hypothesis (H0) that ILI incidence curves in two cities are essentially identical, and was tested using ILI data. Upon examining all possible pairs of incidence curves, 77.4% of pairs were found not to be different (H0 was not rejected). It was concluded that all cities generally have the same attack rate and follow the same epidemic curve each season, although the attack rate changes from season to season, providing strong support for the “Israel is one city” hypothesis. The cities which were the most out of synchronization were Bnei Brak, Beersheba and Haifa, the latter two being geographically remote from all other cities in the dataset and the former geographically very close to several other cities but socially separate due to being populated almost exclusively by ultra-orthodox Jews. Further evidence of assortative mixing of the ultra-orthodox population can be found in the 2001–2002 season, when ultra-orthodox cities and neighborhoods showed distinctly different incidence curves compared to the general population. PMID:24622820

  13. Analysis of 2009 pandemic influenza A/H1N1 outcomes in 19 European countries: association with completeness of national strategic plans

    PubMed Central

    Meeyai, Aronrag; Cooper, Ben S; Coker, Richard

    2013-01-01

    Objective To describe changes in reported influenza activity associated with the 2009 H1N1 pandemic in European countries and determine whether there is a correlation between these changes and completeness of national strategic pandemic preparedness. Design A retrospective correlational study. Setting Countries were included if their national strategic plans had previously been analysed and if weekly influenza-like illness (ILI) data from sentinel networks between week 21, 2006 and week 20, 2010 were more than 50% complete. Outcome measures For each country we calculated three outcomes: the percentage change in ILI peak height during the pandemic relative to the prepandemic mean; the timing of the ILI peak and the percentage change in total cases relative to the prepandemic mean. Correlations between these outcomes and completeness of a country's national strategic pandemic preparedness plan were assessed using the Pearson product–moment correlation coefficient. Results Nineteen countries were included. The ILI peak occurred earlier than the mean seasonal peak in 17 countries. In 14 countries the pandemic peak was higher than the seasonal peak, though the difference was large only in Norway, the UK and Greece. Nine countries experienced more total ILI cases during the pandemic compared with the mean for prepandemic years. Five countries experienced two distinct pandemic peaks. There was no clear pattern of correlation between overall completeness of national strategic plans and pandemic influenza outcome measures and no evidence of association between these outcomes and components of pandemic plans that might plausibly affect influenza outcomes (public health interventions, vaccination, antiviral use, public communication). Amongst the 17 countries with a clear pandemic peak, only the correlation between planning for essential services and change in total ILI cases significantly differed from zero: correlation coefficient (95% CI) 0.50 (0.02, 0.79). Conclusions

  14. Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial

    PubMed Central

    Wing, R.; Wadden, T. A.; Knowler, W. C.; Lawlor, M.; Evans, M.; Killean, T.; Montez, M.; Espeland, M. A.; Zhang, P.

    2017-01-01

    Summary Objective The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10 years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention. Methods The ILI was designed to promote weight loss and increase physical activity. It involved a combination of group plus individual intervention sessions, with decreasing frequency of contact over the 10 years. The intervention incorporated a variety of strategies, including meal replacement products, to improve weight loss outcomes. The costs of intervention delivery were derived from staff surveys of effort and from records of intervention materials from the 16 US academic clinical trial sites. Costs were calculated from the payer perspective and presented in 2012 dollars. Results During the first year, when intervention delivery was most intensive, the annual cost of intervention delivery, averaged (standard deviation) across clinical sites, was $2,864.6 ($513.3) per ILI participant compared with $202.4 ($76.6) per DSE participant. As intervention intensity declined, costs decreased, such that from years 5 to 9 of the trial, the annual cost of intervention was $1,119.8 ($227.7) per ILI participant and $102.9 ($33.0) per DSE participant. Staffing accounted for the majority of costs throughout the trial, with meal replacements and materials to promote adherence accounting for smaller shares. Conclusions The sustained weight losses produced by the Look AHEAD intervention were supported by intervention costs that were within the range of other weight loss programmes. Future work will include an evaluation of the cost‐effectiveness of the ILI and will contain additional follow

  15. Forecasting influenza in Hong Kong with Google search queries and statistical model fusion

    PubMed Central

    Ramirez Ramirez, L. Leticia; Nezafati, Kusha; Zhang, Qingpeng; Tsui, Kwok-Leung

    2017-01-01

    Background The objective of this study is to investigate predictive utility of online social media and web search queries, particularly, Google search data, to forecast new cases of influenza-like-illness (ILI) in general outpatient clinics (GOPC) in Hong Kong. To mitigate the impact of sensitivity to self-excitement (i.e., fickle media interest) and other artifacts of online social media data, in our approach we fuse multiple offline and online data sources. Methods Four individual models: generalized linear model (GLM), least absolute shrinkage and selection operator (LASSO), autoregressive integrated moving average (ARIMA), and deep learning (DL) with Feedforward Neural Networks (FNN) are employed to forecast ILI-GOPC both one week and two weeks in advance. The covariates include Google search queries, meteorological data, and previously recorded offline ILI. To our knowledge, this is the first study that introduces deep learning methodology into surveillance of infectious diseases and investigates its predictive utility. Furthermore, to exploit the strength from each individual forecasting models, we use statistical model fusion, using Bayesian model averaging (BMA), which allows a systematic integration of multiple forecast scenarios. For each model, an adaptive approach is used to capture the recent relationship between ILI and covariates. Results DL with FNN appears to deliver the most competitive predictive performance among the four considered individual models. Combing all four models in a comprehensive BMA framework allows to further improve such predictive evaluation metrics as root mean squared error (RMSE) and mean absolute predictive error (MAPE). Nevertheless, DL with FNN remains the preferred method for predicting locations of influenza peaks. Conclusions The proposed approach can be viewed a feasible alternative to forecast ILI in Hong Kong or other countries where ILI has no constant seasonal trend and influenza data resources are limited. The

  16. Cost of intervention delivery in a lifestyle weight loss trial in type 2 diabetes: results from the Look AHEAD clinical trial.

    PubMed

    Rushing, J; Wing, R; Wadden, T A; Knowler, W C; Lawlor, M; Evans, M; Killean, T; Montez, M; Espeland, M A; Zhang, P

    2017-03-01

    The Action for Health in Diabetes (Look AHEAD) trial was a randomized controlled clinical trial to compare the effects of 10 years of intensive lifestyle intervention (ILI) with a control condition of diabetes support and education (DSE) on health outcomes in over 5,000 participants with type 2 diabetes. The ILI had significantly greater weight losses than DSE throughout the trial. The goal of this analysis is to describe the cost of delivering the intervention. The ILI was designed to promote weight loss and increase physical activity. It involved a combination of group plus individual intervention sessions, with decreasing frequency of contact over the 10 years. The intervention incorporated a variety of strategies, including meal replacement products, to improve weight loss outcomes. The costs of intervention delivery were derived from staff surveys of effort and from records of intervention materials from the 16 US academic clinical trial sites. Costs were calculated from the payer perspective and presented in 2012 dollars. During the first year, when intervention delivery was most intensive, the annual cost of intervention delivery, averaged (standard deviation) across clinical sites, was $2,864.6 ($513.3) per ILI participant compared with $202.4 ($76.6) per DSE participant. As intervention intensity declined, costs decreased, such that from years 5 to 9 of the trial, the annual cost of intervention was $1,119.8 ($227.7) per ILI participant and $102.9 ($33.0) per DSE participant. Staffing accounted for the majority of costs throughout the trial, with meal replacements and materials to promote adherence accounting for smaller shares. The sustained weight losses produced by the Look AHEAD intervention were supported by intervention costs that were within the range of other weight loss programmes. Future work will include an evaluation of the cost-effectiveness of the ILI and will contain additional follow-up data.

  17. Influenza-like-illness and clinically diagnosed flu: disease burden, costs and quality of life for patients seeking ambulatory care or no professional care at all.

    PubMed

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to €51-€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries.

  18. Effect of 1 year of an intentional weight loss intervention on bone mineral density in type 2 diabetes: results from the Look AHEAD randomized trial.

    PubMed

    Schwartz, Ann V; Johnson, Karen C; Kahn, Steven E; Shepherd, John A; Nevitt, Michael C; Peters, Anne L; Walkup, Michael P; Hodges, Amelia; Williams, Carrie C; Bray, George A

    2012-03-01

    Intentional weight loss is an important component of treatment for overweight patients with type 2 diabetes, but the effects on bone density are not known. We used data from the Look AHEAD trial to determine the impact of an intensive lifestyle weight loss intervention (ILI) compared with diabetes support and education (DSE) on changes in bone mineral density (BMD) over 12 months. Overweight and obese adults with type 2 diabetes were randomly assigned to ILI or DSE. In a substudy of BMD conducted at 5 of 16 clinical centers, hip, spine, and whole body dual X-ray absorptiometry scans were obtained at baseline and 1-year later on 642 of 739 ILI and 632 of 740 DSE participants. At baseline, mean age was 58.4 years, and average body mass index was 35.2 kg/m(2). Total hip BMD T-score was <-2.5 in 1% and <-1.0 in 8%. At 1 year, weight loss was greater in ILI than DSE (-8.6% versus -0.7%), and glycemic control and fitness were also improved. Bone loss over 1 year was greater in ILI at the total hip (-1.4% versus -0.4%; p < 0.001) and femoral neck (-1.5% versus -0.8%; p = 0.009), but change in BMD for the lumbar spine and whole body did not differ between groups. In ILI, bone loss at the total hip was independently associated with weight loss in men and women and with poorer glycemic control in men, but was not associated with changes in fitness. One year of an intensive lifestyle intervention in adults with type 2 diabetes, resulting in weight loss, was associated with a modest increase in hip bone loss despite improved fitness and glycemic control.

  19. Influenza infection in the intensive care unit: Four years after the 2009 pandemic.

    PubMed

    Pérez-Carrasco, Marcos; Lagunes, Leonel; Antón, Andrés; Gattarello, Simone; Laborda, César; Pumarola, Tomás; Rello, Jordi

    2016-03-01

    The role of influenza viruses in severe acute respiratory infection (SARI) in Intensive Care Units (ICU) remains unknown. The post-pandemic influenza A(H1N1)pdm09 period, in particular, has been poorly studied. To identify influenza SARI patients in ICU, to assess the usefulness of the symptoms of influenza-like illness (ILI), and to compare the features of pandemic vs. post-pandemic influenza A(H1N1) pdm09 infection. A prospective observational study with SARI patients admitted to ICU during the first three post-pandemic seasons. Patient demographics, characteristics and outcomes were recorded. An influenza epidemic period (IEP) was defined as >100 cases/100,000 inhabitants per week. One hundred sixty-three patients were diagnosed with SARI. ILI was present in 65 (39.9%) patients. Influenza infection was documented in 41 patients, 27 (41.5%) ILI patients, and 14 (14.3%) non-ILI patients, 27 of them during an IEP. Influenza A viruses were mainly responsible. Only five patients had influenza B virus infection, which were non-ILI during an IEP. SARI overall mortality was 22.1%, and 15% in influenza infection patients. Pandemic and post-pandemic influenza infection patients shared similar clinical features. During influenza epidemic periods, influenza infection screening should be considered in all SARI patients. Influenza SARI was mainly caused by subtype A(H1N1)pdm09 and A(H3N2) in post-pandemic seasons, and no differences were observed in ILI and mortality rate compared with a pandemic season. Copyright © 2015 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  20. Flutracking weekly online community survey of influenza-like illness annual report, 2010.

    PubMed

    Dalton, Craig B; Carlson, Sandra J; Butler, Michelle T; Feisa, John; Elvidge, Elissa; Durrheim, David N

    2011-12-01

    Flutracking is a national weekly online survey of influenza-like illness (ILI) completed by community members. Flutracking integrates participants' ILI symptom information with their influenza vaccination status to monitor influenza activity and field vaccine effectiveness (FVE). This report summarises results from the 2010 Flutracking season compared with previous seasons. Nationally, participation in Flutracking has more than doubled between 2008 and 2010, with 5,346 new participants enrolled or recruited in 2010 and a peak weekly participation of 10,773. By the end of the 2010 season, 5,904 of 9,109 (64.8%) participants had received the monovalent pandemic vaccine and/or the 2010 seasonal vaccine. From 2007 to 2010 FVE calculations demonstrated that the seasonal vaccine was effective except in 2009 during the pandemic. Peak 2010 ILI activity occurred in early June and August, and peak weekly 2010 ILI rates (4.2% among unvaccinated participants) were lower than the peak ILI rates during the 2009 pandemic (6.0% among unvaccinated participants). However, the decrease in laboratory notifications was much larger than the decrease in Flutracking rates. In summary, the number of Flutracking participants continued to steadily increase over the 2010 influenza season. The system has shown value in providing weekly vaccination uptake data during and beyond the 2009 influenza pandemic, as well as rapid FVE estimates that are qualitatively aligned with findings from other analyses of vaccine efficacy. Flutracking has also provided estimates of weekly community ILI activity that were not biased by health seeking behaviour and clinician testing practices.

  1. Effects of previous episodes of influenza and vaccination in preventing laboratory-confirmed influenza in Navarre, Spain, 2013/14 season.

    PubMed

    Castilla, Jesús; Navascués, Ana; Fernández-Alonso, Mirian; Reina, Gabriel; Albéniz, Esther; Pozo, Francisco; Álvarez, Nerea; Martínez-Baz, Iván; Guevara, Marcela; García-Cenoz, Manuel; Irisarri, Fátima; Casado, Itziar; Ezpeleta, Carmen

    2016-06-02

    We estimated whether previous episodes of influenza and trivalent influenza vaccination prevented laboratory-confirmed influenza in Navarre, Spain, in season 2013/14. Patients with medically-attended influenza-like illness (MA-ILI) in hospitals (n = 645) and primary healthcare (n = 525) were included. We compared 589 influenza cases and 581 negative controls. MA-ILI related to a specific virus subtype in the previous five seasons was defined as a laboratory-confirmed influenza infection with the same virus subtype or MA-ILI during weeks when more than 25% of swabs were positive for this subtype. Persons with previous MA-ILI had 30% (95% confidence interval (CI): -7 to 54) lower risk of MA-ILI, and those with previous MA-ILI related to A(H1N1)pdm09 or A(H3N2) virus, had a, respectively, 63% (95% CI: 16-84) and 65% (95% CI: 13-86) lower risk of new laboratory-confirmed influenza by the same subtype. Overall adjusted vaccine effectiveness in preventing laboratory-confirmed influenza was 31% (95% CI: 5-50): 45% (95% CI: 12-65) for A(H1N1)pdm09 and 20% (95% CI: -16 to 44) for A(H3N2). While a previous influenza episode induced high protection only against the same virus subtype, influenza vaccination provided low to moderate protection against all circulating subtypes. Influenza vaccine remains the main preventive option for high-risk populations.

  2. Four-year weight losses in the Look AHEAD study: factors associated with long-term success.

    PubMed

    Wadden, Thomas A; Neiberg, Rebecca H; Wing, Rena R; Clark, Jeanne M; Delahanty, Linda M; Hill, James O; Krakoff, Jonathan; Otto, Amy; Ryan, Donna H; Vitolins, Mara Z

    2011-10-01

    This report provides a further analysis of the year 4 weight losses in the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with long-term success. A total of 5,145 overweight/obese men and women with type 2 diabetes were randomly assigned to an intensive lifestyle intervention (ILI) or a usual care group, referred to as Diabetes Support and Education (DSE). ILI participants were provided approximately weekly group or individual treatment in year 1; continued but less frequent contact was provided in years 2-4. DSE participants received three group educational sessions in all years. As reported previously, at year 4, ILI participants lost an average of 4.7% of initial weight, compared with 1.1% for DSE (P < 0.0001). More ILI than DSE participants lost ≥ 5% (46% vs. 25%, P < 0.0001) and ≥ 10% (23% vs. 10%, P < 0.0001) of initial weight. Within the ILI, achievement of both the 5% and 10% categorical weight losses at year 4 was strongly related to meeting these goals at year 1. A total of 887 participants in ILI lost ≥ 10% at year 1, of whom 374 (42.2%) achieved this loss at year 4. Participants who maintained the loss, compared with those who did not, attended more treatment sessions and reported more favorable physical activity and food intake at year 4. These results provide critical evidence that a comprehensive lifestyle intervention can induce clinically significant weight loss (i.e., ≥ 5%) in overweight/obese participants with type 2 diabetes and maintain this loss in more than 45% of patients at 4 years.

  3. One-year weight losses in the Look AHEAD study: factors associated with success.

    PubMed

    Wadden, Thomas A; West, Delia S; Neiberg, Rebecca H; Wing, Rena R; Ryan, Donna H; Johnson, Karen C; Foreyt, John P; Hill, James O; Trence, Dace L; Vitolins, Mara Z

    2009-04-01

    This report provides a further analysis of the first year weight losses in the Look AHEAD (Action for Health in Diabetes) study and identifies factors associated with success. Participants were a total of 5,145 men and women with type 2 diabetes who were recruited at 16 sites and randomly assigned to an intensive lifestyle intervention (ILI) or a control condition, Diabetes Support and Education (DSE). During year 1, participants in ILI received comprehensive diet and physical activity counseling in a total of 42 group and individual sessions, compared with three educational sessions for DSE participants. As reported previously, at the end of the year, ILI participants lost 8.6% of initial weight, compared to 0.7% for DSE (P < 0.001). Within the ILI group, all racial/ethnic groups achieved clinically significant weight losses (>5.5%), although there were significant differences among groups. For the year, ILI participants attended an average of 35.4 treatment sessions and reported exercising a mean of 136.6 min/week and consuming a total of 360.9 meal replacement products. Greater self-reported physical activity was the strongest correlate of weight loss, followed by treatment attendance and consumption of meal replacements. The use of orlistat, during the second half of the year, increased weight loss only marginally in those ILI participants who had lost <5% of initial weight during the first 6 months and chose to take the medication thereafter as a toolbox option. The lifestyle intervention was clinically effective in all subsets of an ethnically and demographically diverse population.

  4. Impact of intensive lifestyle intervention on depression and health-related quality of life in type 2 diabetes: the Look AHEAD Trial.

    PubMed

    Rubin, Richard R; Wadden, Thomas A; Bahnson, Judy L; Blackburn, George L; Brancati, Frederick L; Bray, George A; Coday, Mace; Crow, Scott J; Curtis, Jeffrey M; Dutton, Gareth; Egan, Caitlin; Evans, Mary; Ewing, Lin; Faulconbridge, Lucy; Foreyt, John; Gaussoin, Sarah A; Gregg, Edward W; Hazuda, Helen P; Hill, James O; Horton, Edward S; Hubbard, Van S; Jakicic, John M; Jeffery, Robert W; Johnson, Karen C; Kahn, Steven E; Knowler, William C; Lang, Wei; Lewis, Cora E; Montez, Maria G; Murillo, Anne; Nathan, David M; Patricio, Jennifer; Peters, Anne; Pi-Sunyer, Xavier; Pownall, Henry; Rejeski, W Jack; Rosenthal, Renate H; Ruelas, Valerie; Toledo, Katie; Van Dorsten, Brent; Vitolins, Mara; Williamson, Donald; Wing, Rina R; Yanovski, Susan Z; Zhang, Ping

    2014-06-01

    We examined the effects of an intensive lifestyle intervention (ILI), compared with a diabetes support and education (DSE) control intervention, on long-term changes in depression symptoms, antidepressant medication (ADM) use, and health-related quality of life (HRQoL) in overweight/obese individuals with type 2 diabetes. Look AHEAD was a multisite randomized controlled trial of 5,145 overweight/obese participants assigned to ILI (designed to produce weight loss) or DSE and followed for a median of 9.6 years. The Beck Depression Inventory (BDI) was administered at baseline, annually at years 1-4, and again at year 8. Mean BDI scores and incidence of BDI scores ≥10, indicative of likely mild or greater depression, were examined. Annually through year 10, participants reported their ADM use and completed the Medical Outcomes Study Short Form 36 (SF-36) questionnaire, which yields physical component summary (PCS) and mental component summary (MCS) scores. ILI significantly reduced the incidence of mild or greater depression symptoms (BDI scores ≥10) compared with DSE (hazard ratio [HR] = 0.85; 95% CI 0.75-0.97; P = 0.0145). Although SF-36 PCS scores worsened over time in both groups, ILI participants reported better physical function than DSE throughout the first 8 years (all P values <0.01). There were no significant differences between treatment arms in the proportion of participants who used ADMs or in SF-36 MCS scores. ILI for overweight/obese patients with type 2 diabetes may reduce the risk of developing clinically significant symptoms of depression and preserve physical HRQoL. These findings should be considered when evaluating the potential benefits of ILIs. © 2014 by the American Diabetes Association.

  5. Spatio-temporal synchrony of influenza in cities across Israel: the "Israel is one city" hypothesis.

    PubMed

    Barnea, Oren; Huppert, Amit; Katriel, Guy; Stone, Lewi

    2014-01-01

    We analysed an 11-year dataset (1998-2009) of Influenza-Like Illness (ILI) that was based on surveillance of ∽23% of Israel's population. We examined whether the level of synchrony of ILI epidemics in Israel's 12 largest cities is high enough to view Israel as a single epidemiological unit. Two methods were developed to assess the synchrony: (1) City-specific attack rates were fitted to a simple model in order to estimate the temporal differences in attack rates and spatial differences in reporting rates of ILI. The model showed good fit to the data (R2  =  0.76) and revealed considerable differences in reporting rates of ILI in different cities (up to a factor of 2.2). (2) A statistical test was developed to examine the null hypothesis (H0) that ILI incidence curves in two cities are essentially identical, and was tested using ILI data. Upon examining all possible pairs of incidence curves, 77.4% of pairs were found not to be different (H0 was not rejected). It was concluded that all cities generally have the same attack rate and follow the same epidemic curve each season, although the attack rate changes from season to season, providing strong support for the "Israel is one city" hypothesis. The cities which were the most out of synchronization were Bnei Brak, Beersheba and Haifa, the latter two being geographically remote from all other cities in the dataset and the former geographically very close to several other cities but socially separate due to being populated almost exclusively by ultra-orthodox Jews. Further evidence of assortative mixing of the ultra-orthodox population can be found in the 2001-2002 season, when ultra-orthodox cities and neighborhoods showed distinctly different incidence curves compared to the general population.

  6. Influenza-Like-Illness and Clinically Diagnosed Flu: Disease Burden, Costs and Quality of Life for Patients Seeking Ambulatory Care or No Professional Care at All

    PubMed Central

    Bilcke, Joke; Coenen, Samuel; Beutels, Philippe

    2014-01-01

    This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011–2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5–6 symptoms over a 6-day period; required 1.6 physician visits and 86–91% took medication. An average episode amounted to €51–€53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries. PMID:25032688

  7. Gripenet: an internet-based system to monitor influenza-like illness uniformly across Europe.

    PubMed

    van Noort, S P; Muehlen, M; Rebelo de Andrade, H; Koppeschaar, C; Lima Lourenço, J M; Gomes, M G M

    2007-07-01

    Gripenet has been monitoring the activity of influenza-like-illness (ILI) with the aid of volunteers via the internet in the Netherlands and Belgium since 2003 and in Portugal since 2005. In contrast with the traditional system of sentinel networks of mainly primary care physicians coordinated by the European Influenza Surveillance Scheme (EISS), Gripenet obtains its data directly from the population. Any resident of the three countries can participate in Gripenet by completing an application form on the appropriate websites (http://www.griepmeting.nl for the Netherlands and Belgium, http://www.gripenet.pt for Portugal), which contains various medical, geographic and behavioural questions. Participants report weekly on the website any symptoms they have experienced since their last visit. ILI incidence is determined on the basis of a uniform case definition. In the 2006/2007 season, 19,623 persons participated in Gripenet in the Netherlands, 7,025 in Belgium and 3,118 in Portugal. The rise, peak and decline of ILI activity occurred at similar times according to Gripenet and EISS. However, ILI attack rates in the Netherlands (6.6%), Belgium (6.1%) and Portugal (5.6%) were remarkably more similar in Gripenet than in EISS (0.8%, 3.9%, and 0.6% respectively). Monitoring ILI activity with the direct participation of volunteers provides similar incidence curves compared to the traditional system coordinated by EISS. Whereas EISS provides an established system whose data is validated by virology tests, Gripenet is a fast and flexible monitoring system whose uniformity allows for direct comparison of ILI rates between countries. A current objective of Gripenet is to engage more European countries.

  8. Influenza-like illness in residential care homes: a study of the incidence, aetiological agents, natural history and health resource utilisation.

    PubMed

    Hui, D S; Woo, J; Hui, E; Foo, A; Ip, M; To, K-W; Cheuk, E S C; Lam, W-Y; Sham, A; Chan, P K S

    2008-08-01

    Influenza-like illness (ILI) among elderly people living in residential care homes (RCHEs) is a common cause for hospitalisation. A study was undertaken to examine the incidence, underlying aetiology, natural history and associated healthcare resource utilisation related to ILI in the RCHE population. A prospective study of ILI in four RCHEs in Shatin, Hong Kong was conducted from April 2006 to March 2007. Each RCHE was monitored daily for the occurrence of ILI and followed up until resolution of illness or death. Clinical features were recorded and sputum, nasopharyngeal aspirate, blood and urine specimens were examined for underlying aetiology. 259 episodes of ILI occurred in 194 subjects, with mild peaks in winter and summer, over a sustained level throughout the year. The infectious agent was identified in 61.4% of all episodes, comprising bacterial infection in 53.3% and viral in 46.7%. Multiple infections occurred in 16.2% of subjects. The most frequent organism was Streptococcus pneumoniae, followed by respiratory syncytial virus, Pseudomonas aeruginosa, metapneumovirus and parainfluenza virus types 1 and 3. Clinical features did not vary according to the underlying aetiology, the common presenting features being a decrease in general condition, cognitive and functional deterioration, and withholding of food in addition to fever and respiratory symptoms. Overall, mortality at 1 month/discharge was 9.7%. Infection with methicillin-resistant Staphylococcus aureus, low body mass index and poor function predisposed to mortality. No association was observed between influenza vaccination status and underlying aetiology, clinical features or outcome. The clinical presentation of ILI is non-specific and is mainly due to bacterial and viral infections other than influenza in the RCHE population.

  9. Effect of a Lifestyle Intervention on Change in Cardiorespiratory Fitness in Adults with Type 2 Diabetes: Results from the Look AHEAD Study

    PubMed Central

    Jakicic, John M.; Jaramillo, Sarah A.; Balasubramanyam, Ashok; Bancroft, Barbara; Curtis, Jeffery M.; Mathews, Anne; Pereira, Mark; Regensteiner, Judith G.; Ribisl, Paul M.

    2008-01-01

    Objective To examine the effect of an intensive lifestyle weight loss intervention (ILI) compared to diabetes support and education (DSE) on changes in fitness and physical activity in the Look AHEAD trial. Design Randomized clinical trial to compare a lifestyle intervention for weight loss with a diabetes support and education condition in individuals with type 2 diabetes. Subjects Data from 4,376 overweight or obese adults with type 2 diabetes (age = 58.7±6.8 years, BMI = 35.8±5.8 kg/m2) who completed one-year of the Look AHEAD trial and had available fitness data were analyzed. Intervention Subjects were randomly assigned to DSE or ILI. DSE received standard-care plus 3 education sessions over the one-year period. ILI included individual and group contact throughout the year, restriction in energy intake, and 175 min/wk of prescribed physical activity. Measurements Fitness was assessed using a submaximal graded exercise test. Physical activity was assessed via questionnaire in a subset of 2,221 subjects. Results Change in fitness was statistically greater in ILI vs. DSE after adjustment for baseline fitness (20.9% vs. 5.7%) (p<0.0001). Multivariate analysis showed that change in fitness was greater in overweight vs. obese Class II and III (p<0.05). Physical activity increased by 892±1694 kcal/wk in ILI vs. 108±1254 kcal/wk in DSE (p<0.01). Changes in fitness (r=0.41) and physical activity (r=0.42) were significantly correlated with weight loss (p<0.0001). Conclusions The ILI was effective in increasing physical activity and improving cardiorespiratory fitness in overweight and obese individuals with type 2 diabetes. This effect may add to weight loss in improving metabolic control in patients in lifestyle intervention programs. PMID:19153582

  10. Impact of Intensive Lifestyle Intervention on Depression and Health-Related Quality of Life in Type 2 Diabetes: The Look AHEAD Trial

    PubMed Central

    2014-01-01

    OBJECTIVE We examined the effects of an intensive lifestyle intervention (ILI), compared with a diabetes support and education (DSE) control intervention, on long-term changes in depression symptoms, antidepressant medication (ADM) use, and health-related quality of life (HRQoL) in overweight/obese individuals with type 2 diabetes. RESEARCH DESIGN AND METHODS Look AHEAD was a multisite randomized controlled trial of 5,145 overweight/obese participants assigned to ILI (designed to produce weight loss) or DSE and followed for a median of 9.6 years. The Beck Depression Inventory (BDI) was administered at baseline, annually at years 1–4, and again at year 8. Mean BDI scores and incidence of BDI scores ≥10, indicative of likely mild or greater depression, were examined. Annually through year 10, participants reported their ADM use and completed the Medical Outcomes Study Short Form 36 (SF-36) questionnaire, which yields physical component summary (PCS) and mental component summary (MCS) scores. RESULTS ILI significantly reduced the incidence of mild or greater depression symptoms (BDI scores ≥10) compared with DSE (hazard ratio [HR] = 0.85; 95% CI 0.75–0.97; P = 0.0145). Although SF-36 PCS scores worsened over time in both groups, ILI participants reported better physical function than DSE throughout the first 8 years (all P values <0.01). There were no significant differences between treatment arms in the proportion of participants who used ADMs or in SF-36 MCS scores. CONCLUSIONS ILI for overweight/obese patients with type 2 diabetes may reduce the risk of developing clinically significant symptoms of depression and preserve physical HRQoL. These findings should be considered when evaluating the potential benefits of ILIs. PMID:24855155

  11. The Look AHEAD Trial: Implications for Lifestyle Intervention in Type 2 Diabetes Mellitus

    PubMed Central

    Dutton, Gareth R.; Lewis, Cora E.

    2015-01-01

    Given the array of adverse health consequences of obesity, including increased risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), the Look AHEAD trial (N=5,145) was conducted to test the hypothesis that an intensive lifestyle intervention (ILI) for weight loss would achieve significantly greater reductions in CVD morbidity and mortality than a control condition of diabetes support and education (DSE) among participants with T2DM. A number of significant and long-term improvements were observed for ILI, including body weight, physical fitness and physical function, glucose control, quality-of-life (QoL), and healthcare costs. However, ILI did not significantly reduce CVD-related morbidity/mortality (i.e., CVD death, non-fatal MI, non-fatal stroke, hospitalized angina) after nearly 10 years of follow-up. There was a suggestion of heterogeneity of response based on the history of prior CVD at baseline (p=0.06). Despite the overall lack of CVD risk reduction, ILI remains important for care of patients with T2DM, particularly when accompanied by medication management. In particular, ILI may be an appealing option for patients wanting to minimize medication intensification. Also, ILI carries with it other potential benefits important to patients (e.g., improvements in physical functioning and QoL). Based on data from other trials, intensive medication management, such as tight glycemic control, is not without potential risks, which should be weighed in making treatment decisions. Future research is needed to determine if results observed in this trial would be replicated among younger patients, those without established T2DM, and/or those with no pre-existing CVD. PMID:25936906

  12. Forecasting influenza in Hong Kong with Google search queries and statistical model fusion.

    PubMed

    Xu, Qinneng; Gel, Yulia R; Ramirez Ramirez, L Leticia; Nezafati, Kusha; Zhang, Qingpeng; Tsui, Kwok-Leung

    2017-01-01

    The objective of this study is to investigate predictive utility of online social media and web search queries, particularly, Google search data, to forecast new cases of influenza-like-illness (ILI) in general outpatient clinics (GOPC) in Hong Kong. To mitigate the impact of sensitivity to self-excitement (i.e., fickle media interest) and other artifacts of online social media data, in our approach we fuse multiple offline and online data sources. Four individual models: generalized linear model (GLM), least absolute shrinkage and selection operator (LASSO), autoregressive integrated moving average (ARIMA), and deep learning (DL) with Feedforward Neural Networks (FNN) are employed to forecast ILI-GOPC both one week and two weeks in advance. The covariates include Google search queries, meteorological data, and previously recorded offline ILI. To our knowledge, this is the first study that introduces deep learning methodology into surveillance of infectious diseases and investigates its predictive utility. Furthermore, to exploit the strength from each individual forecasting models, we use statistical model fusion, using Bayesian model averaging (BMA), which allows a systematic integration of multiple forecast scenarios. For each model, an adaptive approach is used to capture the recent relationship between ILI and covariates. DL with FNN appears to deliver the most competitive predictive performance among the four considered individual models. Combing all four models in a comprehensive BMA framework allows to further improve such predictive evaluation metrics as root mean squared error (RMSE) and mean absolute predictive error (MAPE). Nevertheless, DL with FNN remains the preferred method for predicting locations of influenza peaks. The proposed approach can be viewed a feasible alternative to forecast ILI in Hong Kong or other countries where ILI has no constant seasonal trend and influenza data resources are limited. The proposed methodology is easily tractable

  13. Four-Year Change in Cardiorespiratory Fitness and Influence on Glycemic Control in Adults With Type 2 Diabetes in a Randomized Trial

    PubMed Central

    Jakicic, John M.; Egan, Caitlin M.; Fabricatore, Anthony N.; Gaussoin, Sarah A.; Glasser, Stephen P.; Hesson, Louise A.; Knowler, William C.; Lang, Wei; Regensteiner, Judith G.; Ribisl, Paul M.; Ryan, Donna H.

    2013-01-01

    OBJECTIVE To examine an intensive lifestyle intervention (ILI) compared with diabetes support and education (DSE) on 4-year change in fitness and physical activity (PA), and to examine the effect of change in fitness and PA, adjusting for potential confounders, on glycemic control in the Look AHEAD Trial. RESEARCH DESIGN AND METHODS Subjects were overweight/obese adults with type 2 diabetes mellitus (T2DM) with available fitness data at 4 years (n = 3,942).This clinical trial randomized subjects to DSE or ILI. DSE subjects received standard care plus information related to diet, PA, and social support three times per year. ILI subjects received weekly intervention contact for 6 months, which was reduced over the 4-year period, and were prescribed diet and PA. Measures included weight, fitness, PA, and HbA1c. RESULTS The difference in percent fitness change between ILI and DSE at 4 years was significant after adjustment for baseline fitness and change in weight (3.70 vs. 0.94%; P < 0.01). At 4 years, PA increased by 348 (1,562) kcal/week in ILI vs. 105 (1,309) kcal/week in DSE (P < 0.01). Fitness change at 4 years was inversely related to change in HbA1c after adjustment for clinical site, treatment, baseline HbA1c, prescribed diabetes medication, baseline fitness, and weight change (P < 0.01). Change in PA was not related to change in HbA1c. CONCLUSIONS A 4-year ILI increased fitness and PA in overweight/obese individuals with T2DM. Change in fitness was associated with improvements in glycemic control, which provides support for interventions to improve fitness in adults with T2DM. PMID:23223405

  14. The Look AHEAD Trial: Implications for Lifestyle Intervention in Type 2 Diabetes Mellitus.

    PubMed

    Dutton, Gareth R; Lewis, Cora E

    2015-01-01

    Given the array of adverse health consequences of obesity, including increased risk for type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), the Look AHEAD trial (N=5145) was conducted to test the hypothesis that an intensive lifestyle intervention (ILI) for weight loss would achieve significantly greater reductions in CVD morbidity and mortality than a control condition of diabetes support and education (DSE) among participants with T2DM. A number of significant and long-term improvements were observed for ILI, including body weight, physical fitness and physical function, glucose control, quality-of-life (QoL), and healthcare costs. However, ILI did not significantly reduce CVD-related morbidity/mortality (i.e., CVD death, non-fatal MI, non-fatal stroke, hospitalized angina) after nearly 10 years of follow-up. There was a suggestion of heterogeneity of response based on the history of prior CVD at baseline (p=0.06). Despite the overall lack of CVD risk reduction, ILI remains important for care of patients with T2DM, particularly when accompanied by medication management. In particular, ILI may be an appealing option for patients wanting to minimize medication intensification. Also, ILI carries with it other potential benefits important to patients (e.g., improvements in physical functioning and QoL). Based on data from other trials, intensive medication management, such as tight glycemic control, is not without potential risks, which should be weighed in making treatment decisions. Future research is needed to determine if results observed in this trial would be replicated among younger patients, those without established T2DM, and/or those with no pre-existing CVD. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Effect of intensive lifestyle intervention on sexual dysfunction in women with type 2 diabetes: results from an ancillary Look AHEAD study.

    PubMed

    Wing, Rena R; Bond, Dale S; Gendrano, Isaias Noel; Wadden, Thomas; Bahnson, Judy; Lewis, Cora E; Brancati, Frederick; Schneider, Stephen; Kitabchi, Abbas E; Van Dorsten, Brent; Rosen, Raymond C

    2013-10-01

    Sexual dysfunction is a prevalent problem in obese women with type 2 diabetes. This study examined the effects of intensive lifestyle intervention (ILI) in these women. Look AHEAD is a 16-center, randomized, controlled trial evaluating the health effects of ILI compared with a control group (diabetes support and education [DSE]). The Look AHEAD Sexual Function Ancillary study included 375 female participants at five Look AHEAD sites. Participants completed the Female Sexual Function Inventory (FSFI) and Beck Depression Inventory (BDI), and assessments of weight and cardiovascular risk factors at baseline and 1 year were made. At baseline, 50% of the 229 participants who reported being sexually active met criteria for female sexual dysfunction (FSD); only BDI score was related to FSD. One-year weight losses were greater in the ILI group than in the DSE group (7.6 vs. 0.45 kg; P<0.001). Among women with FSD at baseline, those in the ILI group (N=60) compared with those in the DSE group (N=53) were significantly more likely to remain sexually active (83 vs. 64%; P<0.008), reported greater improvement in total FSFI scores and in most FSFI domains (P<0.05), and were more likely to experience remission of FSD (28 vs. 11%; P<0.04) at 1 year. No significant differences between ILI and DSE were seen in women who did not have FSD at baseline. Participation in ILI appeared to have beneficial effects on sexual functioning among obese women with diabetes, particularly in those who had FSD at baseline.

  16. Application of Superplastic Steels.

    DTIC Science & Technology

    1978-06-01

    fit(. 1 -1 1 Ili - I I, in I I ’i I% I%% d f-F itrl !( It- rct Ii ined I hvir -ri,-, illa I flit Ili. and dri)( int I, 1111( I 1 111 , Ill it fli ... 1 -11 11;1(1 d(+ illd rt., r -t 1 1 i/cd lift, It linc _-,r:imcd rut I tirt I fit- 1;! 11 ;111! _" h , It I I. ’I) I t 0 1 1 1 1 f , 1. I, I ii;t t r

  17. Four-Year Physical Activity Levels among Intervention Participants with Type 2 Diabetes.

    PubMed

    Unick, Jessica L; Gaussoin, Sarah A; Hill, James O; Jakicic, John M; Bond, Dale S; Hellgren, Margareta; Johnson, Karen C; Peters, Anne L; Coday, Mace; Kitzman, Dalane W; Bossart, Suzette; Wing, Rena R

    2016-12-01

    Physical activity (PA) has numerous health benefits, particularly for those with diabetes. However, rates of long-term PA participation are often poor. This study examined the effect of an intensive lifestyle intervention (ILI) on objectively assessed PA for a 4-yr period among older adults with type 2 diabetes. Data from 2400 participants (age = 59.3 ± 6.9 yr, body mass index = 36.1 ± 5.9 kg·m) with accelerometry data from the Look AHEAD trial were included in the analyses. Participants randomized to ILI were instructed to reduce caloric intake and progress to ≥175 min·wk of moderate-to-vigorous-intensity PA (MVPA), whereas those randomized to Diabetes Support and Education (DSE) served as the control group. PA was measured at baseline, year 1, and year 4 using an RT3 accelerometer, and bout-related MVPA (PA ≥3 METs, accumulated in bouts of ≥10 min in duration) was calculated. Despite no differences at baseline (ILI = 93.4 ± 152.7 vs DSE = 88.4 ± 143.6 min·wk), bout-related MVPA was significantly greater in ILI compared with DSE at year 1 (151.0 ± 213.5 vs 87.5 ± 145.1 min·wk, P < 0.0001) and year 4 (102.9 ± 195.6 vs 73.9 ± 267.5 min·wk, P < 0.001), and more ILI participants achieved ≥175 min·wk at year 1 (29.1% vs 16.3%, P < 0.001) and year 4 (18.3% vs 10.0%, P < 0.001). Forty-one percent of ILI participants who achieved ≥175 min·wk at year 1 maintained this threshold of PA at year 4. However, the majority of ILI participants never achieved the ≥175 min·wk threshold. When measured objectively and compared with DSE, ILI engaged in significantly more bout-related MVPA for a 4-yr period. However, future intervention strategies should target the large percentage of individuals who fail to reach the MVPA goal as result of a lifestyle intervention.

  18. Using Google Flu Trends data in forecasting influenza-like-illness related ED visits in Omaha, Nebraska.

    PubMed

    Araz, Ozgur M; Bentley, Dan; Muelleman, Robert L

    2014-09-01

    Emergency department (ED) visits increase during the influenza seasons. It is essential to identify statistically significant correlates in order to develop an accurate forecasting model for ED visits. Forecasting influenza-like-illness (ILI)-related ED visits can significantly help in developing robust resource management strategies at the EDs. We first performed correlation analyses to understand temporal correlations between several predictors of ILI-related ED visits. We used the data available for Douglas County, the biggest county in Nebraska, for Omaha, the biggest city in the state, and for a major hospital in Omaha. The data set included total and positive influenza test results from the hospital (ie, Antigen rapid (Ag) and Respiratory Syncytial Virus Infection (RSV) tests); an Internet-based influenza surveillance system data, that is, Google Flu Trends, for both Nebraska and Omaha; total ED visits in Douglas County attributable to ILI; and ILI surveillance network data for Douglas County and Nebraska as the predictors and data for the hospital's ILI-related ED visits as the dependent variable. We used Seasonal Autoregressive Integrated Moving Average and Holt Winters methods with3 linear regression models to forecast ILI-related ED visits at the hospital and evaluated model performances by comparing the root means square errors (RMSEs). Because of strong positive correlations with ILI-related ED visits between 2008 and 2012, we validated the use of Google Flu Trends data as a predictor in an ED influenza surveillance tool. Of the 5 forecasting models we have tested, linear regression models performed significantly better when Google Flu Trends data were included as a predictor. Regression models including Google Flu Trends data as a predictor variable have lower RMSE, and the lowest is achieved when all other variables are also included in the model in our forecasting experiments for the first 5 weeks of 2013 (with RMSE = 57.61). Google Flu Trends data

  19. Comparison of five influenza surveillance systems during the 2009 pandemic and their association with media attention

    PubMed Central

    2013-01-01

    Background During the 2009 influenza pandemic period, routine surveillance of influenza-like-illness (ILI) was conducted in The Netherlands by a network of sentinel general practitioners (GPs). In addition during the pandemic period, four other ILI/influenza surveillance systems existed. For pandemic preparedness, we evaluated the performance of the sentinel system and the others to assess which of the four could be useful additions in the future. We also assessed whether performance of the five systems was influenced by media reports during the pandemic period. Methods The trends in ILI consultation rates reported by sentinel GPs from 20 April 2009 through 3 January 2010 were compared with trends in data from the other systems: ILI cases self-reported through the web-based Great Influenza Survey (GIS); influenza-related web searches through Google Flu Trends (GFT); patients admitted to hospital with laboratory-confirmed pandemic influenza, and detections of influenza virus by laboratories. In addition, correlations were determined between ILI consultation rates of the sentinel GPs and data from the four other systems. We also compared the trends of the five surveillance systems with trends in pandemic-related newspaper and television coverage and determined correlation coefficients with and without time lags. Results The four other systems showed similar trends and had strong correlations with the ILI consultation rates reported by sentinel GPs. The number of influenza virus detections was the only system to register a summer peak. Increases in the number of newspaper articles and television broadcasts did not precede increases in activity among the five surveillance systems. Conclusions The sentinel general practice network should remain the basis of influenza surveillance, as it integrates epidemiological and virological information and was able to maintain stability and continuity under pandemic pressure. Hospital and virological data are important during a

  20. Real-time surveillance of laboratory confirmed influenza based on the Danish microbiology database (MiBa).

    PubMed

    Voldstedlund, Marianne; Haahr, Malene; Emborg, Hanne-Dorthe; Bang, Henrik; Krause, Tyra

    2013-01-01

    The Danish microbiology database (MiBa) is a national database that automatically accumulates patient test results from all Danish Departments of Clinical Microbiology. As an example for use of MiBa, we describe the real-time surveillance of laboratory confirmed influenza established in October 2012. It functions without any extra burdens of reporting by laboratories or clinicians. This is an important improvement of the existing surveillance for influenza like illness (ILI) which includes only limited virological testing. The MiBa based surveillance adds complete national virological data which are specific for influenza, in contrast to ILI, and serves as a tool for regional and national preparedness and planning.

  1. Seasonal influenza vaccine effectiveness against medically attended influenza illness among children aged 6-59 months, October 2011-September 2012: A matched test-negative case-control study in Suzhou, China.

    PubMed

    Wang, Yin; Zhang, Tao; Chen, Liling; Greene, Carolyn; Ding, Yunfang; Cheng, Yuejia; Yang, Chao; Zeng, Shanshan; Hua, Jun; Zhou, Suizan; Song, Ying; Luan, Lin; Zhang, Jun; Zhao, Genming

    2016-05-05

    Seasonal influenza infections among young children in China lead to substantial numbers of hospitalizations and financial burden. This study assessed the seasonal influenza vaccine effectiveness (VE) against laboratory confirmed medically attended influenza illness among children in Suzhou, China, from October 2011-September 2012. We conducted a test-negative case-control study among children aged 6-59 months who sought care at Soochow University Affiliated Children's Hospital (SCH) from October 2011-September 2012. A case was defined as a child with influenza-like illness (ILI) or severe acute respiratory infection (SARI) with an influenza-positive nasopharyngeal swab by rRT-PCR. Controls were selected from children presenting with ILI or SARI without laboratory confirmed influenza. We conducted 1:1 matching by age and admission date. Vaccination status was verified from the citywide immunization system database. VE was calculated with conditional logistic regression: (1-OR)×100%. During the study period, 2634 children aged 6-59 months presented to SCH with ILI (1975) or SARI (659) and were tested for influenza. The vaccination records were available for 69% (1829; ILI: 1354, SARI: 475). Among those, 23% (427) tested positive for influenza, and were included as cases. Among influenza positive cases, the vaccination rates were 3.2% for SARI and 4.5% for ILI. Among controls, the vaccination rates were 13% for SARI, and 11% for ILI. The overall VE against lab-confirmed medically attended influenza virus infection was 67% (95% CI: 41-82). The VE for SARI was 75% (95% CI: 11-93) and for ILI was 64% (95% CI: 31-82). The seasonal influenza vaccine was effective against medically attended lab-confirmed influenza infection in children aged 6-59 months in Suzhou, China in the 2011-12 influenza season. Increasing seasonal influenza vaccination among young children in Suzhou may decrease medically attended influenza-associated ILI and SARI cases in this population. Copyright

  2. Healthcare seeking behavior of patients with influenza like illness: comparison of the summer and winter influenza epidemics.

    PubMed

    Meng, Huaiqing; Liao, Qiuyan; Suen, Lorna Kwai Ping; O'Donoghue, Margaret; Wong, Chit Ming; Yang, Lin

    2016-09-20

    Influenza often causes winter and summer epidemics in subtropical regions, but few studies have investigated the difference in healthcare seeking behavior of patients with influenza-like illness (ILI) between these two epidemics. Household telephone surveys were conducted using random digit dialing in Hong Kong during July-August 2014 and March-April 2015. One adult from each household was interviewed for ILI symptoms and associated healthcare seeking behaviour of themselves and one child in the household (if any), during the preceding 30 days. Healthcare seeking behavior of respondents with self-reported ILI was compared between summer and winter influenza. Logistic regression was used to explore the factors associated with healthcare seeking behavior. Among 516 and 539 adult respondents in the summer and winter surveys, 22.6 and 38.0 % reported ILI symptoms, and 40.9 and 46.8 % of them sought medical care, respectively. There was no significant difference in healthcare seeking behavior between the summer and winter epidemics, except a higher proportion of self-medication in summer in the adult respondents. Among 155 and 182 children reported by the adults in both surveys, the proportion of self-reported ILI was 32.9 and 40.1 % in the summer and winter surveys, respectively. Of these children, 47.1 and 56.2 % were brought for medical consultation in summer and winter, respectively. Women, adults with diabetes and those with symptoms of cough, shortness of breath, and runny nose were more likely to seek medical consultations for ILI symptoms. The factors associated with seeking medical consultations in children with ILI symptoms included being female, age under 10 years, and with symptoms of sore throat or vomiting. Those older than 60 years were less likely to self-medicate, whereas regular smokers and those with symptom of sore throat were more likely to do so. Healthcare seeking behavior of the general public was not significantly different between these

  3. Comparison of five influenza surveillance systems during the 2009 pandemic and their association with media attention.

    PubMed

    de Lange, Marit M A; Meijer, Adam; Friesema, Ingrid H M; Donker, Gé A; Koppeschaar, Carl E; Hooiveld, Mariëtte; Ruigrok, Nel; van der Hoek, Wim

    2013-09-24

    During the 2009 influenza pandemic period, routine surveillance of influenza-like-illness (ILI) was conducted in The Netherlands by a network of sentinel general practitioners (GPs). In addition during the pandemic period, four other ILI/influenza surveillance systems existed. For pandemic preparedness, we evaluated the performance of the sentinel system and the others to assess which of the four could be useful additions in the future. We also assessed whether performance of the five systems was influenced by media reports during the pandemic period. The trends in ILI consultation rates reported by sentinel GPs from 20 April 2009 through 3 January 2010 were compared with trends in data from the other systems: ILI cases self-reported through the web-based Great Influenza Survey (GIS); influenza-related web searches through Google Flu Trends (GFT); patients admitted to hospital with laboratory-confirmed pandemic influenza, and detections of influenza virus by laboratories. In addition, correlations were determined between ILI consultation rates of the sentinel GPs and data from the four other systems. We also compared the trends of the five surveillance systems with trends in pandemic-related newspaper and television coverage and determined correlation coefficients with and without time lags. The four other systems showed similar trends and had strong correlations with the ILI consultation rates reported by sentinel GPs. The number of influenza virus detections was the only system to register a summer peak. Increases in the number of newspaper articles and television broadcasts did not precede increases in activity among the five surveillance systems. The sentinel general practice network should remain the basis of influenza surveillance, as it integrates epidemiological and virological information and was able to maintain stability and continuity under pandemic pressure. Hospital and virological data are important during a pandemic, tracking the severity, molecular

  4. Staffing Cyber Operations (Briefing Charts)

    DTIC Science & Technology

    2015-05-01

    w hi ch p os iti on s co ns tit ut e D ire ct P ar tic ip at io n in C yb er sp ac e H os til iti es (D P H ) = C yb er sp ac e C om ba ta...un ity  ID A a lte rn at iv e la rg el y su bs tit ut es c iv ili an s fo r e nl is te d pe rs on ne l a nd co nt ra ct or s  M ili ta ry a

  5. Environmental Studies of Little River Inlet, Horry County, South Carolina and Brunswick County, North Carolina.

    DTIC Science & Technology

    1976-09-01

    Phylum Entoprocta Barentsia .&racilis + Phylum Bryozoa ALejon id Ium hauf [1 + , Table 9. (continued) s ocies_- LRI-1 LRi-2 LRI-3 LRI-4 LRI-5- LRI-6...Phylum Entoprocta Pedicel-lin-a cornla- + + ri Phylum Bryozoa Anguiiella palm-itj + + Bowerhankia gracilis + + *Aeverri Ili i setif-orn + Membranipora

  6. Fuel/Engine/Airframe Trade-Off Study.

    DTIC Science & Technology

    1980-09-01

    34Effect of ,IP-5 Properties on Hot Gas Corrosion and Flame Radiation," Phillips Petroleum Company Report 3753-64R. 1%4. 50. Butze, H. F., R. C. Ehlers ...mm - 4444 .𔃾 .- 40im 40 13 The tnk fel tmpertureis masure in he N. 3 ain ank ili coprtet n displayed in the cockpit. The flight crew, therefore, has

  7. An Infection Control Program for a 2009 Influenza A H1N1 Outbreak in a University-Based Summer Camp

    ERIC Educational Resources Information Center

    Tsalik, Ephraim L.; Cunningham, Coleen K.; Cunningham, Hannah M.; Lopez-Marti, Maria G.; Sangvai, Devdutta G.; Purdy, William K.; Anderson, Deverick J.; Thompson, Jessica R.; Brown, Monte; Woods, Christopher W.; Jaggers, L. Brett; Hendershot, Edward F.

    2011-01-01

    Objectives: Describe two 2009-H1N1 influenza outbreaks in university-based summer camps and the implementation of an infection control program. Participants: 7,906 campers across 73 residential camps from May 21-August 2, 2009. Methods: Influenza-like-illness (ILI) was defined as fever with cough and/or sore throat. Influenza A was identified…

  8. Lightning Data Analysis.

    DTIC Science & Technology

    1983-12-01

    was flown in block being initiated in a pre-trigger mode by South Florida in the vicinity of a network an incoming signal exceeding a pre-set thresh- of...froit rectl. nreaSUFred during inrkvs t,)ttuneuJIi ikt 1to iei: 10 Ili,. tire calculated Fourier amplitude sprectra Switzedlnd 1271 it all 11] 28).J

  9. Skill Set Requirements for Nurses Deployed with an Expeditionary Medical Unit Based on Lessons Learned

    DTIC Science & Technology

    2008-01-01

    pediatrics , psychiatry, dentistry , and oral surgery. Gastroenterologists, infectious disease specialists, and pediatricians were deployed as general...and family practice. The nursing staff specialties included critical care, obstetric/gyneco- logic, pediatric , and medical-surgical nurses, fam- ily...and post- anesthesia care environments. Although few knew each other before coming together as a full EMF detachment in March 2006, the diverse

  10. A Description and Comparative Analysis of Two Competing Automated SHORAD-C2 Systems.

    DTIC Science & Technology

    1983-03-01

    ongoing modification program to ulgrade all Chaparral systems by adding an idectificaticn friend or foe (Ili) capability. The missile is a supersonic...main TOC (DTOC) ann the tactical command IFost ( AC Cl-). The division airspece management element (DAM!) is an integral yart ot the DfOC and

  11. Lifestyle intervention improves heart rate recovery from exercise in adults with Type 2 diabetes: Results from the Look AHEAD Study

    USDA-ARS?s Scientific Manuscript database

    The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined ...

  12. A 1-year lifestyle intervention for weight loss in individuals with type 2 diabetes reduces high C-reactive protein levels and identifies metabolic predictors of change

    USDA-ARS?s Scientific Manuscript database

    OBJECTIVE: We examined whether a 1-year intensive lifestyle intervention (ILI) for weight loss reduced elevated high-sensitivity C-reactive protein (hs-CRP) levels in obese individuals with diabetes and identified metabolic and fitness predictors of hs-CRP change. RESEARCH DESIGN AND METHODS: Look A...

  13. The look AHEAD trial: bone loss at four-year follow-up in type 2 diabetes

    USDA-ARS?s Scientific Manuscript database

    OBJECTIVE: To determine whether an intensive lifestyle intervention (ILI) designed to sustain weight loss and improve physical fitness in overweight or obese persons with type 2 diabetes was associated with bone loss after 4 years of follow-up. RESEARCH DESIGN AND METHODS: This randomized controlled...

  14. Description and Evaluation of the 2009–2010 Pennsylvania Influenza Sentinel School Monitoring System

    PubMed Central

    Marriott, Chandra K.; Ostroff, Stephen; Waller, Kirsten

    2011-01-01

    Objectives. We described and evaluated the 2009–2010 Pennsylvania Influenza Sentinel School Monitoring System, a voluntary sentinel network of schools that report data on school absenteeism and visits to the school nurse for influenza-like illness (ILI). Methods. Participating schools provided daily absenteeism and ILI data on a weekly basis through an online survey. We used participation and weekly response rates to determine acceptability, timeliness, and simplicity. We assessed representativeness by comparing participating schools with nonparticipating schools. We compared monitoring system data with statewide reports of laboratory-confirmed influenza. Results. Of the 3244 Pennsylvania public schools, 367 (11%) enrolled in the system. On average, 79% of enrolled schools completed the survey each week. Although the peak week of elevated absenteeism coincided with the peak of statewide laboratory-confirmed influenza cases, the correlation between absenteeism and state data was nonsignificant (correlation coefficient = 0.10; P = .56). Trends in ILI correlated significantly with state data (correlation coefficient = 0.67; P < .001). Conclusions. The school-based sentinel system is a simple, acceptable, reliable device for tracking absenteeism and ILI in schools. Further analyses are necessary to determine the comparative value of this system and other influenza surveillance systems. PMID:21566024

  15. Virological surveillance of influenza-like illness among children in Ghana, 2008-2010.

    PubMed

    Bonney, Joseph H K; Kronmann, Karl C; Lindan, Christina P; Asante, Ivy A; Parbie, Prince; Aboagye, James; Amankwah, Joseph; Odoom, John Kofi; Adjabeng, Michael; Nzussouo, Ndahwouh Talla; Ahadzie, Lawson; Barthel, Robert Vince; Cornelius, Clair; Amofah, George; Oyofo, Buhari; Ampofo, William K

    2012-12-15

    The global annual attack rate for influenza is estimated to be 10%-20% in children, although limited information exists for Africa. In 2007, Ghana initiated influenza surveillance by routine monitoring of acute respiratory illness to obtain data on circulating strains. We describe influenza surveillance in children <11 years old who had influenza-like illness (ILI) from January 2008 to December 2010. Oropharyngeal swabs from pediatric outpatients with ILI attending any of 22 health facilities across the country were submitted. We tested swabs for influenza virus using molecular assays, virus isolation, and hemagglutination assays. Of the 2810 swabs, 636 (23%) were positive for influenza virus. The percentage of positives by gender was similar. The proportion of ILI cases positive for influenza increased with age from 11% (31/275) in infants (aged 0-1 years) to 31% (377/1219) among children aged 5-10 years (P < .001). The majority of cases were influenza A (90%), of which 60% were influenza A(H1N1)pdm09. In all 3 years, influenza activity appeared slightly higher during May through July. During the 3 years of influenza surveillance in Ghana, children aged <11 years bore a high burden of influenza-associated ILI.

  16. Combining Search, Social Media, and Traditional Data Sources to Improve Influenza Surveillance.

    PubMed

    Santillana, Mauricio; Nguyen, André T; Dredze, Mark; Paul, Michael J; Nsoesie, Elaine O; Brownstein, John S

    2015-10-01

    We present a machine learning-based methodology capable of providing real-time ("nowcast") and forecast estimates of influenza activity in the US by leveraging data from multiple data sources including: Google searches, Twitter microblogs, nearly real-time hospital visit records, and data from a participatory surveillance system. Our main contribution consists of combining multiple influenza-like illnesses (ILI) activity estimates, generated independently with each data source, into a single prediction of ILI utilizing machine learning ensemble approaches. Our methodology exploits the information in each data source and produces accurate weekly ILI predictions for up to four weeks ahead of the release of CDC's ILI reports. We evaluate the predictive ability of our ensemble approach during the 2013-2014 (retrospective) and 2014-2015 (live) flu seasons for each of the four weekly time horizons. Our ensemble approach demonstrates several advantages: (1) our ensemble method's predictions outperform every prediction using each data source independently, (2) our methodology can produce predictions one week ahead of GFT's real-time estimates with comparable accuracy, and (3) our two and three week forecast estimates have comparable accuracy to real-time predictions using an autoregressive model. Moreover, our results show that considerable insight is gained from incorporating disparate data streams, in the form of social media and crowd sourced data, into influenza predictions in all time horizons.

  17. US EPA, Pesticide Product Label, PEE GEE EP 4 CONTAINS ...

    EPA Pesticide Factsheets

    2011-04-14

    ... < \\'" ' T" '< .. Contains 4 PEE GEE • Lbs. Ethyl • Parathion 11\\ ,.: ! 11~1'-UIL\\!" li-tl-tl l (, •• I ' \\ - 1 , \\ I ( '1, ' I\\LI; II '\\ i ,I i I i I.' Pit: , !. I r '.'!' r" ,I l'i' ...

  18. Microsoft Word - Summary of Tests SRUs.docx

    EPA Pesticide Factsheets

    2015-09-10

    ... (/}::I ll) ;;o -· en ::I ::I ,.... c::: ceo ., mz""' - " ~~ 9: ... I ~en~ Q) "T! -· IliA ::::.1 ,;v ::::.1 :;. ~ ceo -a -< z "8 ... 1\\.) 9 :::+ = 0'1 0'1 )> c-1 ~~ ~9: ...

  19. US EPA, Pesticide Product Label, GUTHION FRUIT TREE ...

    EPA Pesticide Factsheets

    2011-04-21

    ... 1-\\ c: r IV Fir '.j ( i H r' DILN 1 S ... I'li 'y ';ICifl,."J (' .• , f j \\ ) ! I' I 1 , . l , oL' f' /'l., r,.· I '.. J: ~ () ) r ,t ii, • t l! . J , \\ (1 ' l ".,. t \\ fir) (1 r 1 , in! ...

  20. Effect of 1 year of an intentional weight loss intervention on bone mineral density in type 2 diabetes: Results from the Look AHEAD randomized trial

    USDA-ARS?s Scientific Manuscript database

    Intentional weight loss is an important component of treatment for overweight patients with type 2 diabetes, but the effects on bone density are not known. We used data from the Look AHEAD trial to determine the impact of an intensive lifestyle weight loss intervention (ILI) compared with diabetes s...

  1. Midcourse correction to a clinical trial when the event rate is underestimated: The Look AHEAD (Action of health in diabetes) study

    USDA-ARS?s Scientific Manuscript database

    The Look AHEAD (Action for Health in Diabetes) Study is a long-term clinical trial that aims to determine the cardiovascular disease (CVD) benefits of an intensive lifestyle intervention (ILI) in obese adults with type 2 diabetes. The study was designed to have 90% statistical power to detect an 18%...

  2. Impact of weight loss on ankle-brachial index and interartery blood pressures

    USDA-ARS?s Scientific Manuscript database

    Objective: To assess whether weight loss improves markers of peripheral artery disease and vascular stenosis. Methods: The Action for Health in Diabetes randomized clinical trial compared intensive lifestyle intervention (ILI) for weight loss to a control condition of diabetes support and education...

  3. Assessing the Effectiveness of Cumulative Sum Normal- and Poisson-Based Tests for Detecting Rare Diseases

    DTIC Science & Technology

    2010-12-01

    21 iid independent and identically distributed ILI Influenza -Like Illness Norm Normal Distribution Probability Density Function Pois Poisson...In epidemiology, is a carrier, especially an animal such as an arthropod that transfers an infective agent from one host to another. Zoonosis : A

  4. The Effect of School Dismissal on Rates of Influenza-Like Illness in New York City Schools during the Spring 2009 Novel H1N1 Outbreak

    ERIC Educational Resources Information Center

    Egger, Joseph R.; Konty, Kevin J.; Wilson, Elisha; Karpati, Adam; Matte, Thomas; Weiss, Don; Barbot, Oxiris

    2012-01-01

    Background: The effects of individual school dismissal on influenza transmission have not been well studied. During the spring 2009 novel H1N1 outbreak, New York City implemented an individual school dismissal policy intended to limit influenza transmission at schools with high rates of influenza-like illness (ILI). Methods: Active disease…

  5. An Evaluation of the Intensity of Mentoring: Child Outcomes

    ERIC Educational Resources Information Center

    Lambert, Richard; Gallagher, Peggy A.; Abbott-Shim, Martha

    2015-01-01

    This study examines the intensity effect of a mentoring intervention for Head Start teachers, the Individualised Learning Intervention (ILI), as it impacts child social emotional outcomes. Pairs of Mentor and Protégé teachers across three sites in two states were randomly assigned to intervention and control groups. Mentors in the intervention…

  6. Environmental persistence of the nucleopolyhedrosis virus of the gypsy moth, Lymantria dispar L

    Treesearch

    J.D. Podgwaite; Kathleen Stone Shields; R.T. Zerillo; R.B. Bruen

    1979-01-01

    A bioassay technique was used to estimate the concentrations of infectious gypsy moth nucleopolyhedrosis virus (NPV) that occur naturaIly in leaf, bark, litter, and soil samples taken from woodland plots in Connecticut and Pennsylvania. These concentrations were then compared to those in samples taken sequentially after treatment of these plots with NPV. Results...

  7. 78 FR 20091 - Certain Pasta From Italy: Notice of Partial Rescission of Antidumping Duty Administrative Review

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-04-03

    ...-Pasta Granoro S.r.L. (Granoro), Pastificio Gallo Natale & F. Ili S.r.L. (Gallo), Fiamma Vesuviana S.r.L..., 2012, the Department selected Gallo and Granoro as additional mandatory respondents. On February 8... review will continue with respect to Poiatti, Delverde,\\9\\ Gallo, Fiamma, ] Zaffiri, Rummo, Tandoi, and...

  8. Air Warfare

    DTIC Science & Technology

    2002-03-01

    though his own theoretical views were more akin to those of Mitchell. This is not surprising when one considers that as early as his plebe year at the...permit the airship the more read- ily to be trimmed. Ballonets are provided, as a rule, for each compartment. The Army airship Roma was of this type

  9. Effect on polymorphonuclear cell function of a human-specific cytotoxin, intermedilysin, expressed by Streptococcus intermedius.

    PubMed

    Macey, M G; Whiley, R A; Miller, L; Nagamune, H

    2001-10-01

    Streptococcus intermedius is a member of the normal flora of the mouth but is also an opportunistic pathogen associated with purulent infections at oral and nonoral sites. Intermedilysin (ILY) has been shown to be a cytolysin capable of generating pores in the cell membrane of erythrocytes demonstrable by electron microscopy. This effect has been shown to be specific for human cells. Since polymorphonuclear cells (PMNs) are the main cell involved in innate immunity we investigated the effect of purified intermedilysin from Streptococcus intermedius on PMN function. Active ILY at a concentration of 40 ng/microl caused a significant decrease in the number of intact PMNs after 60 min. The active cytolysin, when compared with heat-inactivated ILY, did not appear to be chemotactic for the PMNs but did cause an increase in intracellular calcium, with increased cell surface CD11b expression, metabolic burst, and phagocytosis of Staphylococcus aureus. These findings may have implications for the role of ILY in deep-seated abscesses.

  10. Profiling the Youth Leader: Personality and Emotional Intelligence Trends and Their Relationship to Leadership Skills

    ERIC Educational Resources Information Center

    McElravy, L. J.; Hastings, Lindsay J.

    2014-01-01

    The transfer of leadership to younger generations is an important factor in agricultural communities and is likely one reason developing leaders is a central mission of many youth organizations, including 4-H and FFA. In adults, researchers have extensively explored the relationship between personality traits and leadership (Judge, Bono, Ilies,…

  11. Flutracking weekly online community survey of influenza-like illness annual report, 2015.

    PubMed

    Dalton, Craig B; Carlson, Sandra J; Durrheim, David N; Butler, Michelle T; Cheng, Allen C; Kelly, Heath A

    2016-12-24

    Flutracking is a national online community influenza-like illness (ILI) surveillance system that monitors weekly ILI activity and impact in the Australian community. This article reports on the 2015 findings from Flutracking. From 2014 to 2015 there was a 38.5% increase in participants to 27,824 completing at least 1 survey with a peak weekly response of 25,071 participants. The 2015 Flutracking national ILI weekly fever and cough percentages peaked in late August at 5.0% in the unvaccinated group, in the same week as the national counts of laboratory confirmed influenza peaked. A similar percentage of Flutracking participants took two or more days off from work or normal duties in 2015 (peak level 2.3%) compared with 2014 (peak level 2.5%) and the peak weekly percentage of participants seeking health advice was 1.6% in both 2014 and 2015. Flutracking fever and cough peaked in the same week as Influenza Complications Alert Network surveillance system influenza hospital admissions. The percentage of Flutracking participants aged 5 to 19 years with cough and fever in 2015 was the highest since 2011. The 2015 season was marked by a transition to predominantly influenza B strain circulation, which particularly affected younger age groups. However, for those aged 20 years and over, the 2015 national Flutracking influenza season was similar to 2014 in community ILI levels and impact.

  12. Department of Defense In-House RDT&E Activities

    DTIC Science & Technology

    1973-10-30

    Electronic Proving Ground ---............... ....-... 20 Electronic Warfare Laboratory- --------.. ...... 21 Electronics Technology and Devices Laboratory...Electronic Warfare Laboratory Electronics Command Army Materiel Command Electronics Technology 9 Devices Laboratory Electronics Command Army Materiel Command... TECHNOLOGY 51HM HITVAL PROGRAM FLUIDIC SAFING AND ARMING SYSTEM FOR SURFACE TO SURFACE MISSILE APPL I .~~..FUN T IONSIEGUIPRINT ICAP&R ILI TIES NUC

  13. Combining Search, Social Media, and Traditional Data Sources to Improve Influenza Surveillance

    PubMed Central

    Santillana, Mauricio; Nguyen, André T.; Dredze, Mark; Paul, Michael J.; Nsoesie, Elaine O.; Brownstein, John S.

    2015-01-01

    We present a machine learning-based methodology capable of providing real-time (“nowcast”) and forecast estimates of influenza activity in the US by leveraging data from multiple data sources including: Google searches, Twitter microblogs, nearly real-time hospital visit records, and data from a participatory surveillance system. Our main contribution consists of combining multiple influenza-like illnesses (ILI) activity estimates, generated independently with each data source, into a single prediction of ILI utilizing machine learning ensemble approaches. Our methodology exploits the information in each data source and produces accurate weekly ILI predictions for up to four weeks ahead of the release of CDC’s ILI reports. We evaluate the predictive ability of our ensemble approach during the 2013–2014 (retrospective) and 2014–2015 (live) flu seasons for each of the four weekly time horizons. Our ensemble approach demonstrates several advantages: (1) our ensemble method’s predictions outperform every prediction using each data source independently, (2) our methodology can produce predictions one week ahead of GFT’s real-time estimates with comparable accuracy, and (3) our two and three week forecast estimates have comparable accuracy to real-time predictions using an autoregressive model. Moreover, our results show that considerable insight is gained from incorporating disparate data streams, in the form of social media and crowd sourced data, into influenza predictions in all time horizons. PMID:26513245

  14. The Effect of School Dismissal on Rates of Influenza-Like Illness in New York City Schools during the Spring 2009 Novel H1N1 Outbreak

    ERIC Educational Resources Information Center

    Egger, Joseph R.; Konty, Kevin J.; Wilson, Elisha; Karpati, Adam; Matte, Thomas; Weiss, Don; Barbot, Oxiris

    2012-01-01

    Background: The effects of individual school dismissal on influenza transmission have not been well studied. During the spring 2009 novel H1N1 outbreak, New York City implemented an individual school dismissal policy intended to limit influenza transmission at schools with high rates of influenza-like illness (ILI). Methods: Active disease…

  15. An Infection Control Program for a 2009 Influenza A H1N1 Outbreak in a University-Based Summer Camp

    ERIC Educational Resources Information Center

    Tsalik, Ephraim L.; Cunningham, Coleen K.; Cunningham, Hannah M.; Lopez-Marti, Maria G.; Sangvai, Devdutta G.; Purdy, William K.; Anderson, Deverick J.; Thompson, Jessica R.; Brown, Monte; Woods, Christopher W.; Jaggers, L. Brett; Hendershot, Edward F.

    2011-01-01

    Objectives: Describe two 2009-H1N1 influenza outbreaks in university-based summer camps and the implementation of an infection control program. Participants: 7,906 campers across 73 residential camps from May 21-August 2, 2009. Methods: Influenza-like-illness (ILI) was defined as fever with cough and/or sore throat. Influenza A was identified…

  16. Contributions to the American Meteorological Society’s 26th International Conference on Radar Meteorology at Norman, Oklahoma, on May 24-28, 1993

    DTIC Science & Technology

    1993-04-01

    Ms~ns~ ~ Prepared for the Federal Aviation Administration. Documient Is available to dhe public through the National Technical Inforination Service ...detecton iultipe Dopplr aniealy, adjoint iethd Trminal Dopplr Inie.t i, Trmina, ’ ,,thr Temiial Ar , S or,, .ili National Technical Information Service ...Period Covered Department of Transportation Project Report Federal Aviation Administration Systems Research and Development Service 14. Sponsoring Agency

  17. Four-year change in cardiorespiratory fitness and influence on glycemic control in adults with Type 2 diabetes in a randomized trial

    USDA-ARS?s Scientific Manuscript database

    OBJECTIVE To examine an intensive lifestyle intervention (ILI) compared with diabetes support and education (DSE) on 4-year change in fitness and physical activity (PA), and to examine the effect of change in fitness and PA, adjusting for potential confounders, on glycemic control in the Look AHEAD ...

  18. Utilizing spatiotemporal analysis of influenza-like illness and rapid tests to focus swine-origin influenza virus intervention

    PubMed Central

    Wilson, J. Gaines; Ballou, Jessica; Yan, Chris; Fisher-Hoch, Susan P.; Reininger, Belinda; Gay, Jennifer; Salinas, Jennifer; Sanchez, Pablo; Salinas, Yvette; Calvillo, Fidel; Lopez, Leonel; deLima, Ionara P.; McCormick, Joseph B.

    2010-01-01

    In the spring of 2009, a novel strain of H1N1 swine-origin influenza A virus (S-OIV) emerged in Mexico and the United States, and soon after was declared a pandemic by the World Health Organization. This work examined the ability of real-time reports of influenza-like illness (ILI) symptoms and rapid influenza diagnostic tests (RIDTs) to approximate the spatiotemporal distribution of PCR-confirmed S-OIV cases for the purposes of focusing local intervention efforts. Cluster and age-adjusted relative risk patterns of ILI, RIDT and S-OIV were assessed at a fine spatial scale at different time and space extents within Cameron County, Texas on the U.S.-Mexico border. Space-time patterns of ILI and RIDT were found to effectively characterize the areas with highest geographical risk of S-OIV within the first two weeks of the outbreak. Based on these results, ILI and/or RIDT may prove to be acceptable indicators of the location of S-OIV hotspots. Given that S-OIV data is often difficult to obtain real-time during an outbreak, these findings may be of use to public health officials targeting prevention and response efforts during future flu outbreaks. PMID:20810301

  19. International Literacy Year 1990: Building the Momentum. Report of the Meeting of the International Task Force on Literacy (2nd, West Berlin, Federal Republic of Germany, June 5-10, 1988).

    ERIC Educational Resources Information Center

    Marshall, Judith

    This report provides materials from the second meeting of the International Task Force on Literacy (ITFL), which focused on specific goals and targets for nongovernmental organization (NGO) mobilization for 1990, International Literacy Year (ILY). Section 2 discusses issues that emerged as central to work in literacy, including literacy,…

  20. Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes

    USDA-ARS?s Scientific Manuscript database

    Rates of severe obesity (BMI greater than or equal to 40 kg/m(2)) are on the rise, and effective treatment options are needed. We examined the effect of an intensive lifestyle intervention (ILI) on weight loss, cardiovascular disease (CVD) risk, and program adherence in participants with type 2 diab...

  1. Effectiveness of lifestyle interventions for individuals with severe obesity and type 2 diabetes

    USDA-ARS?s Scientific Manuscript database

    OBJECTIVEdRates of severe obesity (BMI$40 kg/m2) are on the rise, and effective treatment options are needed.We examined the effect of an intensive lifestyle intervention (ILI) on weight loss, cardiovascular disease (CVD) risk, and program adherence in participants with type 2 diabetes who were seve...

  2. Effect of travel on influenza epidemiology.

    PubMed

    Belderok, Sanne-Meike; Rimmelzwaan, Guus F; van den Hoek, Anneke; Sonder, Gerard J B

    2013-06-01

    To assess the attack and incidence rates for influenza virus infections, during October 2006-October 2007 we prospectively studied 1,190 adult short-term travelers from the Netherlands to tropical and subtropical countries. Participants donated blood samples before and after travel and kept a travel diary. The samples were serologically tested for the epidemic strains during the study period. The attack rate for all infections was 7% (86 travelers) and for influenza-like illness (ILI), 0.8%. The incidence rate for all infections was 8.9 per 100 person-months and for ILI, 0.9%. Risk factors for infection were birth in a non-Western country, age 55-64 years, and ILI. In 15 travelers with fever or ILI, influenza virus infection was serologically confirmed; 7 of these travelers were considered contagious or incubating the infection while traveling home. Given the large number of travelers to (sub)tropical countries, travel-related infection most likely contributes to importation and further influenza spread worldwide.

  3. An Evaluation of the Intensity of Mentoring: Child Outcomes

    ERIC Educational Resources Information Center

    Lambert, Richard; Gallagher, Peggy A.; Abbott-Shim, Martha

    2015-01-01

    This study examines the intensity effect of a mentoring intervention for Head Start teachers, the Individualised Learning Intervention (ILI), as it impacts child social emotional outcomes. Pairs of Mentor and Protégé teachers across three sites in two states were randomly assigned to intervention and control groups. Mentors in the intervention…

  4. Principles for Dealing with Large Programs and Large Data Files in Policy Studies

    DTIC Science & Technology

    1988-02-01

    analyzing large data sets systematically. Acceso ; For NTISCR&I N; ID VI. TA.3[ --,istr.ibo!’.., Dist IQ (I ! o Avft. i..,,ily C eSpecial IA 1-€t "v...compartmentalized. Also, when multiple researchers use the same data set, compertmentalization allows easy comparison (or even standardization) of

  5. Oseltamivir overuse at a Chicago hospital during the 2009 influenza pandemic and the poor predictive value of influenza-like illness criteria.

    PubMed

    Aziz, Mariam; Vasoo, Shawn; Aziz, Zaid; Patel, Sejal; Eltoukhy, Noha; Singh, Kamaljit

    2012-04-01

    We report on the overuse of oseltamivir at Rush University Medical Center, Chicago during the 2009 H1N1 influenza pandemic. Of 210 patients with suspected influenza who underwent respiratory virus reverse transcription polymerase chain reaction (RT-PCR) testing, 113 (54%) received empiric oseltamivir therapy. However, only 50 treated patients (44%) had laboratory confirmed 2009 H1N1. Factors associated with oseltamivir use included a younger median age (including age < 5 y), subjective fever, cough, rhinorrhea, myalgias, higher median temperature, and fulfilment of the US Centers For Disease Control and Prevention (CDC) influenza-like illness (ILI) criteria. However, on multivariate analysis, only subjective fever (p = 0.006, odds ratio (OR) 3.1, 95% confidence interval (CI) 1.4-6.7) and fulfilment of CDC ILI criteria (p = 0.001, OR 3.6, 95% CI 1.7-7.5) were significantly associated with the receipt of oseltamivir. The CDC ILI criteria had a poor positive predictive value of 43% (95% CI 33.3-53.3) for 2009 H1N1. While the ILI criteria are a useful epidemiologic tool, it is too imprecise for direct patient care.

  6. Feasibility Study of 5.56 MM Folded Ammunition/Weapon System

    DTIC Science & Technology

    1976-09-01

    DeflectLon at Nodes Located on I.D ............ .. 18 II. Comparison of Internal Diameter Deflections ........... ... 19 Ili. Hardness Readings of Heat...4 2. Ammunition/Weapon System Comparison ......... ............ 5 3. Conventional vs Folded Packing Volume... Comparisons ..... . 4. Ca rtr Ig Compnrtsnris ..l.s ....... ................... . .... List of Illustrations - Cont’d Figure Pae 5. Design Analysis

  7. "Pedagogias Del Camaleon"/Pedagogies of the Chameleon: Identity and Strategies of Survival for Transnational Indigenous Latino Immigrants in the US South

    ERIC Educational Resources Information Center

    Machado-Casas, Margarita

    2012-01-01

    Based on a 3-year qualitative research study that took place in a new immigrant-receiving community in North Carolina, the manuscript examines the implications of transnational cultural and sociolinguistic patterns of multilingual indigenous Latino immigrants (ILIs), and its effects on their survival in the US. Utilizing narrative analysis, it…

  8. "Pedagogias Del Camaleon"/Pedagogies of the Chameleon: Identity and Strategies of Survival for Transnational Indigenous Latino Immigrants in the US South

    ERIC Educational Resources Information Center

    Machado-Casas, Margarita

    2012-01-01

    Based on a 3-year qualitative research study that took place in a new immigrant-receiving community in North Carolina, the manuscript examines the implications of transnational cultural and sociolinguistic patterns of multilingual indigenous Latino immigrants (ILIs), and its effects on their survival in the US. Utilizing narrative analysis, it…

  9. Symbolic Model Checking for Sequential Circuit Verification

    DTIC Science & Technology

    1993-07-15

    Emerson, and. Sistla [17] is mod- ilied to represent state graphs using hmM deision diarg ns (BDDs) [7] and parfitoned wuaition relstions [10, 11]. Because...Verlag. [17] E. M. Clarke, E. A. Emerson, and A. P. Sistla . Automatic verification of finite-state concurrent systems using temporal logic

  10. Etiology of Influenza-Like Illnesses from Sentinel Network Practitioners in Réunion Island, 2011-2012

    PubMed Central

    Brottet, Elise; Jaffar-Bandjee, Marie-Christine; Li-Pat-Yuen, Ghislaine; Filleul, Laurent

    2016-01-01

    In Réunion Island, despite an influenza surveillance established since 1996 by the sentinel general practitioner’s network, little is known about the etiology of Influenza like-illness (ILI) that differs from influenza viruses in a tropical area. We set up a retrospective study using nasal swabs collected by sentinel GPs from ILI patients in 2011 and 2012. A total of 250 swabs were randomly selected and analyzed by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) including research of 18 viruses and 4 bacteria. We detected respiratory viruses in 169/222 (76.1%) samples, mostly rhinovirus (23.4%), influenza A virus (21.2%), influenza B virus (12.6%), coronavirus (4.9%) and Human metapneumovirus (3.6%). Nine swabs (5.3% of positive swabs) revealed co-infections with two viruses identified, among which six concerned co-infections with influenza viruses. We observed important seasonal differences, with circulation of Human Metapneumoviruses, RSV A and B and coronavirus only during summer; whereas parainfluenza viruses were identified only during winter. In conclusion, this study highlights a substantial circulation of multiple respiratory pathogens in Réunion Island throughout the year. It shows that ILI are not only attributable to influenza and underlines the need for biological surveillance. As the use of multiplex RT-PCR showed its efficacy, it is now used routinely in the surveillance of ILI. PMID:27654509

  11. Student Perceptions of Information Literacy Instruction: The Importance of Active Learning

    ERIC Educational Resources Information Center

    Detlor, Brian; Booker, Lorne; Serenko, Alexander; Julien, Heidi

    2012-01-01

    This study investigates the merits of employing active learning strategies in the delivery of information literacy instruction (ILI). Traditional approaches to the teaching of information literacy skills--where students are passive recipients of the information they receive--are challenged. Rather, methods that encourage students to actively…

  12. A study of the health and economic effects of influenza-like illness on the working population under different working environments of a large corporation in Hong Kong.

    PubMed

    Lee, Kenneth K C; Li, Shu Chuen; Kwong, Kai Sun; Chan, Thomas Y K; Lee, Vivian W Y; Lau, Joseph T F

    2008-01-01

    The incidence, health and economic impacts of influenza-like illness (ILI) among the working population in Hong Kong had never been studied. Due to the nature of the disease, ILIs can have a significant impact on the operation of a corporation in terms of loss of productivity and reduced work performance. The present study was undertaken to determine the health and economic impacts of ILIs under different environmental conditions on the working population of a large corporation. Over 2,000 employees of a large corporation in the travelling and tourism industry were studied with three different types of working environment (confined, typical office and well ventilated) by two structured questionnaires. The most affected group in terms of productivity and health was the group working in a confined area, whilst those working in a well-ventilated area were least affected. However, symptoms of the confined area group seemed to disappear faster. The infection rate appeared to vary according to work environment for the studied population. Policies on preventive measures and early treatment are important for a corporation to reduce loss in productivity due to ILIs.

  13. Techniques for Detecting Carbon Fiber Contamination on Surfaces

    DTIC Science & Technology

    1980-01-01

    Laboratory (DRIIAR-RI.) IINCLASS IlI. 11:) Aberdeen Prov ing Groun~d, MI) 21005 1I. DECL NSSIFICATOrONRSN SCHEDULE IN. DISTRIBUTION STATEMENT (of Chia RvwoG...Preliminary tests indicated that many readily available o!ls fluor . esced brightly enough to be readily visible in a darkened room and that their film thickness

  14. Evaluation of 2009 pandemic influenza A (H1N1) exposures and illness among physicians in training

    PubMed Central

    de Perio, Marie A.; Brueck, Scott E.; Mueller, Charles A.; Milne, Caroline K.; Rubin, Michael A.; Gundlapalli, Adi V.; Mayer, Jeanmarie

    2015-01-01

    Background A cluster of influenza-like illness (ILI) among physicians in training during the 2009 influenza A (H1N1) pandemic (pH1N1) led to a health hazard evaluation. Methods We conducted a cross-sectional study to examine exposures, infection control practices, ILI prevalence, and transmission among physicians in training at 4 affiliated hospitals during the pandemic. We administered an electronic survey and met with physicians in training and hospital personnel. Results Of the 88 responding physicians, 85% reported exposure to pH1N1. Exposures occurred at work from patients or coworkers and outside of work from coworkers, household members, or the community. Thirteen cases of ILI were reported in May-June 2009; 10 respondents reported working while ill (duration, 1-4 days). Between 13% and 88% of respondents knew which personal protective equipment (PPE) was recommended when caring for influenza patients at the 4 hospitals. The most common reasons for not using PPE were not knowing that a patient had pH1N1 or ILI and not having PPE readily available. Conclusions Physicians in training have gaps in their knowledge of and adherence to recommended PPE and compliance with work restrictions. Our findings underscore the importance of installing isolation precaution signage, making PPE readily available near patients with influenza, and facilitating work restrictions for ill health care personnel. PMID:22622511

  15. US EPA, Pesticide Product Label, SCEPTER 70 DG ...

    EPA Pesticide Factsheets

    2011-04-13

    ... ()h,"nc all pre caul ion an ... 111;111 }";! org:lIl1( IB:1ItCf Ihe Ii: III (If }/\\ plllt pi :--:l"llll)f jlr I I_',\\{lllt..' Oil 111l'dlll.11 .'.Iil" of i',h:ateT thau ,lOll nr!~;lIli,- 1ll:IItcr ...

  16. US EPA, Pesticide Product Label, , 02/22/1974

    EPA Pesticide Factsheets

    2011-04-14

    ... lll'd ,trip' in Ihl' fi,'ld. hp,',ien<,' h •• , ,1111\\1 n Ih.ll lh('m il.11 mi\\ing in Ih(' ,"i I Il(I Ul\\ 10 .I d"plh .IpIIIII\\im.II,'lv unl' ... di ... ( rn~ to " dt'plh 01 loUr IIH IH· .... ...

  17. Embedded Librarianship and Teacher Education: A Neuroeducational Paradigm Using Guided Inquiry

    ERIC Educational Resources Information Center

    Warner, Signia; Templeton, Lolly

    2010-01-01

    This article focuses on a course-embedded guided inquiry project initiated by a senior librarian and an education professor to promote an understanding of how the brain functions and to experiment with brain-targeted teaching techniques. Information literacy instruction (ILI) takes place in the electronic classroom in the Educational Resources…

  18. The East Jakarta Project: surveillance for highly pathogenic avian influenza A(H5N1) and seasonal influenza viruses in patients seeking care for respiratory disease, Jakarta, Indonesia, October 2011-September 2012.

    PubMed

    Storms, A D; Kusriastuti, R; Misriyah, S; Praptiningsih, C Y; Amalya, M; Lafond, K E; Samaan, G; Triada, R; Iuliano, A D; Ester, M; Sidjabat, R; Chittenden, K; Vogel, R; Widdowson, M A; Mahoney, F; Uyeki, T M

    2015-12-01

    Indonesia has reported the most human infections with highly pathogenic avian influenza (HPAI) A(H5N1) virus worldwide. We implemented enhanced surveillance in four outpatient clinics and six hospitals for HPAI H5N1 and seasonal influenza viruses in East Jakarta district to assess the public health impact of influenza in Indonesia. Epidemiological and clinical data were collected from outpatients with influenza-like illness (ILI) and hospitalized patients with severe acute respiratory infection (SARI); respiratory specimens were obtained for influenza testing by real-time reverse transcription-polymerase chain reaction. During October 2011-September 2012, 1131/3278 specimens from ILI cases (34·5%) and 276/1787 specimens from SARI cases (15·4%) tested positive for seasonal influenza viruses. The prevalence of influenza virus infections was highest during December-May and the proportion testing positive was 76% for ILI and 36% for SARI during their respective weeks of peak activity. No HPAI H5N1 virus infections were identified, including hundreds of ILI and SARI patients with recent poultry exposures, whereas seasonal influenza was an important contributor to acute respiratory disease in East Jakarta. Overall, 668 (47%) of influenza viruses were influenza B, 384 (27%) were A(H1N1)pdm09, and 359 (25%) were H3. While additional data over multiple years are needed, our findings suggest that seasonal influenza prevention efforts, including influenza vaccination, should target the months preceding the rainy season.

  19. Weight loss treatment influences untreated spouses and the home environment: evidence of a ripple effect.

    PubMed

    Gorin, A A; Wing, R R; Fava, J L; Jakicic, J M; Jeffery, R; West, D S; Brelje, K; Dilillo, V G

    2008-11-01

    To examine whether a weight loss program delivered to one spouse has beneficial effects on the untreated spouse and the home environment. We assessed untreated spouses of participants in three sites of Look AHEAD, a multicenter randomized controlled trial evaluating the impact of intentional weight loss on cardiovascular outcomes in overweight individuals with type 2 diabetes. Participants and spouses (n=357 pairs) were weighed and completed measures of diet and physical activity at 0 and 12 months. Spouses completed household food and exercise environment inventories. We examined differences between spouses of participants assigned to the intensive lifestyle intervention (ILI) or to the enhanced usual care (DSE; diabetes support and education). Spouses of ILI participants lost -2.2+/-4.5 kg vs -0.2+/-3.3 kg in spouses of DSE participants (P<0.001). In addition, more ILI spouses lost > or =5% of their body weight than DSE spouses (26 vs 9%, P<0.001). Spouses of ILI participants also had greater reductions in reported energy intake (P=0.007) and percent of energy from fat (P=0.012) than DSE spouses. Spouse weight loss was associated with participant weight loss (P<0.001) and decreases in high-fat foods in the home (P=0.05). The reach of behavioral weight loss treatment can extend to a spouse, suggesting that social networks can be utilized to promote the spread of weight loss, thus creating a ripple effect.

  20. US EPA, Pesticide Product Label, OC CLENCIDE ...

    EPA Pesticide Factsheets

    2011-04-21

    ... 11 ... III .... 01111 lOll fOl' ~ to ;j lIIiuUh!S. H"llIm·,'. lll' .... f' \\lolita Iu)I.!1Il.· ',\\tll', .tI,,j dl\\. ro: ll.Jt :"dIlLln·:-, . f'an [0 1t'1II0V(! .~IW"'''' 111111 ;twi Il";I\\'\\' soli. ...

  1. US EPA, Pesticide Product Label, PGC 6, 12/05/1995

    EPA Pesticide Factsheets

    2011-04-14

    ... I~t~,:,~ l~~i}~~tion ,1~.,..n~,,~r;c,lude th~ us~ ofp'5tf~;~~ labeling as alter- ... afl~lslcr L~'. ~(_IJ-l~ )k( .J.-Jsk i '1\\ 'chn i Cd 1 Ili ]I'ctm J 12-r,2l-~' 12n ...

  2. Characteristics of patients with influenza-like illness, severe acture respiratory illness, and laboratory-confirmed influenza at a major children's hospital in Angola, 2009-2011.

    PubMed

    Cardoso, Yolanda; Oliveira, Erika; Vasconcelos, Jocelyne; Cohen, Adam L; Francisco, Moises

    2012-12-15

    There are no published data on influenza trends in Angola, where pneumonia is a leading cause of death among young children. This study aims to describe the seasonal trends, types, and subtypes of influenza virus recovered from patients with respiratory illness who were admitted to the major children's hospital in Angola from May 2009 through April 2011. Nasal and oral swabs were collected from patients seen in the outpatient clinic with influenza-like illness (ILI) or hospitalized with severe acute respiratory illness (SARI) and tested for influenza virus by polymerase chain reaction assays. Of 691 samples collected, 334 (48%) were from case patients with ILI, and 357 (52%) were from case patients with SARI. Most (86%) of these children were <5 years of age. Thirty-nine samples (47% SARI, 53% outpatient) tested positive for influenza virus, including 2009 pandemic influenza A virus subtype H1N1 (A[H1N1]pdm09; n = 9), influenza A virus subtype H3, likely H3N2 (n = 12), and influenza B virus (n = 18). The proportion of specimens positive for influenza virus was 5% for ILI cases and 6% for SARI cases. After the peak of A(H1N1)pdm09 infection from May through September of 2009, additional peaks of ILI and SARI were seen, especially during February-April 2010. Influenza virus causes a small but preventable number of pneumonia cases among children in Angola.

  3. [Fungus, Metarrhizium anisopliae, as a possible regulator of the number of horseflies].

    PubMed

    Saubenova, O G

    1976-01-01

    In water bodies of the flood-plains of the Ili and Turgen rivers (Alma-Ata district) there were found larvae of Tabanus autumnalis infected with the fungus Metarrhizium anisopliae. Experiments on the infection of T. autumnalis with this fungus yielded 100% mortality of larvae and adult insects. The possibility of creation of an artificial infection nidus under natural conditions was established.

  4. Laboratory Transmission of Japanese Encephalitis, West Nile Viruses and Getah by Mosquitoes (Diptera:Culicidae) Collected Near Camp Greaves, Gyeonggi Province, Republic of Korea, 2003

    DTIC Science & Technology

    2006-02-28

    WNV)arebothmembers of the JEV serogroup (fam- ily Flaviviridae , genus Flavivirus). Although most in- fections in humans with either of these viruses...ability to transmitWestNile virus (familyFlaviviridae, genus Flavivirus, WNV), Japanese encephalitis virus (family Flaviviridae , genus Flavivirus, JEV...and Getah virus (family Togaviridae , genus Alphavirus, GETV) under laboratory conditions. Both Culex pipiens pallens Coquillett and Culex

  5. US EPA, Pesticide Product Label, , 02/15/1983

    EPA Pesticide Factsheets

    2011-04-14

    ... witb fluid fertilizers. !~~~a~~~i~~_~~_~~t_~~l~_f~~~ili~~~~ Dry bulk fertilizers (except single superphosphate, treble super phosphate and nitrate ...

  6. Viral respiratory infections among Hajj pilgrims in 2013.

    PubMed

    Barasheed, Osamah; Rashid, Harunor; Alfelali, Mohammad; Tashani, Mohamed; Azeem, Mohammad; Bokhary, Hamid; Kalantan, Nadeen; Samkari, Jamil; Heron, Leon; Kok, Jen; Taylor, Janette; El Bashir, Haitham; Memish, Ziad A; Haworth, Elizabeth; Holmes, Edward C; Dwyer, Dominic E; Asghar, Atif; Booy, Robert

    2014-12-01

    Middle East respiratory syndrome coronavirus (MERS-CoV) has emerged in the Arabian Gulf region, with its epicentre in Saudi Arabia, the host of the 'Hajj' which is the world's the largest mass gathering. Transmission of MERS-CoV at such an event could lead to its rapid worldwide dissemination. Therefore, we studied the frequency of viruses causing influenza-like illnesses (ILI) among participants in a randomised controlled trial at the Hajj 2013. We recruited 1038 pilgrims from Saudi Arabia, Australia and Qatar during the first day of Hajj and followed them closely for four days. A nasal swab was collected from each pilgrim who developed ILI. Respiratory viruses were detected using multiplex RT-PCR. ILI occurred in 112/1038 (11%) pilgrims. Their mean age was 35 years, 49 (44%) were male and 35 (31%) had received the influenza vaccine pre-Hajj. Forty two (38%) pilgrims had laboratory-confirmed viral infections; 28 (25%) rhinovirus, 5 (4%) influenza A, 2 (2%) adenovirus, 2 (2%) human coronavirus OC43/229E, 2 (2%) parainfluenza virus 3, 1 (1%) parainfluenza virus 1, and 2 (2%) dual infections. No MERS-CoV was detected in any sample. Rhinovirus was the commonest cause of ILI among Hajj pilgrims in 2013. Infection control and appropriate vaccination are necessary to prevent transmission of respiratory viruses at Hajj and other mass gatherings.

  7. Lifestyle intervention improves heart rate recovery from exercise in adults with type 2 diabetes: Results from the Look AHEAD study

    USDA-ARS?s Scientific Manuscript database

    The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT), and (2) to determine the independent and combined...

  8. Aircraft Armament for Air-To-Ground Operations

    DTIC Science & Technology

    1951-11-30

    bomba , Va was set -qual 500 ft./sec.; for guns, V. uas set equal to zero. Actual values of 17-9 as taken fron trajectory Table I are shown for comarison...general- yIly fouind in firing tests corrected for •’y. These values are approximately (6). 9 mile - Bomba 9 midls - Rockets 5 mils - Ouns Release

  9. Lifestyle intervention and/or statins for the reduction of C-reactive Protein in Type 2 diabetes: From the Look AHEAD Study

    USDA-ARS?s Scientific Manuscript database

    Objective: Cardiovascular risk remains high despite statin use. Overweight/obese diabetic persons usually have normal/low LDL-cholesterol but high C-reactive protein (CRP) levels. We aimed to examine the effects of intensive lifestyle intervention for weight loss (ILI) on CRP levels in overweight/ob...

  10. US EPA, Pesticide Product Label, TERR-O-GAS 67, 11/11 ...

    EPA Pesticide Factsheets

    2011-04-14

    ... tlf'!lILI'; Irrlidtlnq to th p t',I,~(. ' I'n d;J;'~. 'rH~ ')1 tr,Jrl"'lft"'III(1 t,) )t~ll'r fIJI'fdlflf"',. ~ II, ... Vdl"li. WC

  11. Estimating the disease burden of 2009 pandemic influenza A(H1N1) from surveillance and household surveys in Greece.

    PubMed

    Sypsa, Vana; Bonovas, Stefanos; Tsiodras, Sotirios; Baka, Agoritsa; Efstathiou, Panos; Malliori, Meni; Panagiotopoulos, Takis; Nikolakopoulos, Ilias; Hatzakis, Angelos

    2011-01-01

    The aim of this study was to assess the disease burden of the 2009 pandemic influenza A(H1N1) in Greece. Data on influenza-like illness (ILI), collected through cross-sectional nationwide telephone surveys of 1,000 households in Greece repeated for 25 consecutive weeks, were combined with data from H1N1 virologic surveillance to estimate the incidence and the clinical attack rate (CAR) of influenza A(H1N1). Alternative definitions of ILI (cough or sore throat and fever>38°C [ILI-38] or fever 37.1-38°C [ILI-37]) were used to estimate the number of symptomatic infections. The infection attack rate (IAR) was approximated using estimates from published studies on the frequency of fever in infected individuals. Data on H1N1 morbidity and mortality were used to estimate ICU admission and case fatality (CFR) rates. The epidemic peaked on week 48/2009 with approximately 750-1,500 new cases/100,000 population per week, depending on ILI-38 or ILI-37 case definition, respectively. By week 6/2010, 7.1%-15.6% of the population in Greece was estimated to be symptomatically infected with H1N1. Children 5-19 years represented the most affected population group (CAR:27%-54%), whereas individuals older than 64 years were the least affected (CAR:0.6%-2.2%). The IAR (95% CI) of influenza A(H1N1) was estimated to be 19.7% (13.3%, 26.1%). Per 1,000 symptomatic cases, based on ILI-38 case definition, 416 attended health services, 108 visited hospital emergency departments and 15 were admitted to hospitals. ICU admission rate and CFR were 37 and 17.5 per 100,000 symptomatic cases or 13.4 and 6.3 per 100,000 infections, respectively. Influenza A(H1N1) infected one fifth and caused symptomatic infection in up to 15% of the Greek population. Although individuals older than 65 years were the least affected age group in terms of attack rate, they had 55 and 185 times higher risk of ICU admission and CFR, respectively.

  12. Estimating the Disease Burden of 2009 Pandemic Influenza A(H1N1) from Surveillance and Household Surveys in Greece

    PubMed Central

    Sypsa, Vana; Bonovas, Stefanos; Tsiodras, Sotirios; Baka, Agoritsa; Efstathiou, Panos; Malliori, Meni; Panagiotopoulos, Takis; Nikolakopoulos, Ilias; Hatzakis, Angelos

    2011-01-01

    Background The aim of this study was to assess the disease burden of the 2009 pandemic influenza A(H1N1) in Greece. Methodology/Principal Findings Data on influenza-like illness (ILI), collected through cross-sectional nationwide telephone surveys of 1,000 households in Greece repeated for 25 consecutive weeks, were combined with data from H1N1 virologic surveillance to estimate the incidence and the clinical attack rate (CAR) of influenza A(H1N1). Alternative definitions of ILI (cough or sore throat and fever>38°C [ILI-38] or fever 37.1–38°C [ILI-37]) were used to estimate the number of symptomatic infections. The infection attack rate (IAR) was approximated using estimates from published studies on the frequency of fever in infected individuals. Data on H1N1 morbidity and mortality were used to estimate ICU admission and case fatality (CFR) rates. The epidemic peaked on week 48/2009 with approximately 750–1,500 new cases/100,000 population per week, depending on ILI-38 or ILI-37 case definition, respectively. By week 6/2010, 7.1%–15.6% of the population in Greece was estimated to be symptomatically infected with H1N1. Children 5–19 years represented the most affected population group (CAR:27%–54%), whereas individuals older than 64 years were the least affected (CAR:0.6%–2.2%). The IAR (95% CI) of influenza A(H1N1) was estimated to be 19.7% (13.3%, 26.1%). Per 1,000 symptomatic cases, based on ILI-38 case definition, 416 attended health services, 108 visited hospital emergency departments and 15 were admitted to hospitals. ICU admission rate and CFR were 37 and 17.5 per 100,000 symptomatic cases or 13.4 and 6.3 per 100,000 infections, respectively. Conclusions/Significance Influenza A(H1N1) infected one fifth and caused symptomatic infection in up to 15% of the Greek population. Although individuals older than 65 years were the least affected age group in terms of attack rate, they had 55 and 185 times higher risk of ICU admission and CFR

  13. The Na conductance in the sarcolemma and the transverse tubular system membranes of mammalian skeletal muscle fibers

    PubMed Central

    DiFranco, Marino

    2011-01-01

    Na (and Li) currents and fluorescence transients were recorded simultaneously under voltage-clamp conditions from mouse flexor digitorum brevis fibers stained with the potentiometric dye di-8-ANEPPS to investigate the distribution of Na channels between the surface and transverse tubular system (TTS) membranes. In fibers rendered electrically passive, voltage pulses resulted in step-like fluorescence changes that were used to calibrate the dye response. The effects of Na channel activation on the TTS voltage were investigated using Li, instead of Na, because di-8-ANEPPS transients show anomalies in the presence of the latter. Na and Li inward currents (INa, ILi; using half of the physiological ion concentration) showed very steep voltage dependences, with no reversal for depolarizations beyond the calculated equilibrium potential, suggesting that most of the current originates from a noncontrolled membrane compartment. Maximum peak ILi was ∼30% smaller than for INa, suggesting a Li-blocking effect. ILi activation resulted in the appearance of overshoots in otherwise step-like di-8-ANEPPS transients. Overshoots had comparable durations and voltage dependence as those of ILi. Simultaneously measured maximal overshoot and peak ILi were 54 ± 5% and 773 ± 53 µA/cm2, respectively. Radial cable model simulations predicted the properties of ILi and di-8-ANEPPS transients when TTS access resistances of 10–20 Ωcm2, and TTS-to-surface Na permeability density ratios in the range of 40:60 to 70:30, were used. Formamide-based osmotic shock resulted in incomplete detubulation. However, results from a subpopulation of treated fibers (low capacitance) provide confirmatory evidence that a significant proportion of ILi, and the overshoot in the optical signals, arises from the TTS in normal fibers. The quantitative evaluation of the distribution of Na channels between the sarcolemma and the TTS membranes, as provided here, is crucial for the understanding of the radial and

  14. Influenzanet: Citizens Among 10 Countries Collaborating to Monitor Influenza in Europe.

    PubMed

    Koppeschaar, Carl E; Colizza, Vittoria; Guerrisi, Caroline; Turbelin, Clément; Duggan, Jim; Edmunds, W John; Kjelsø, Charlotte; Mexia, Ricardo; Moreno, Yamir; Meloni, Sandro; Paolotti, Daniela; Perrotta, Daniela; van Straten, Edward; Franco, Ana O

    2017-09-19

    The wide availability of the Internet and the growth of digital communication technologies have become an important tool for epidemiological studies and health surveillance. Influenzanet is a participatory surveillance system monitoring the incidence of influenza-like illness (ILI) in Europe since 2003. It is based on data provided by volunteers who self-report their symptoms via the Internet throughout the influenza season and currently involves 10 countries. In this paper, we describe the Influenzanet system and provide an overview of results from several analyses that have been performed with the collected data, which include participant representativeness analyses, data validation (comparing ILI incidence rates between Influenzanet and sentinel medical practice networks), identification of ILI risk factors, and influenza vaccine effectiveness (VE) studies previously published. Additionally, we present new VE analyses for the Netherlands, stratified by age and chronic illness and offer suggestions for further work and considerations on the continuity and sustainability of the participatory system. Influenzanet comprises country-specific websites where residents can register to become volunteers to support influenza surveillance and have access to influenza-related information. Participants are recruited through different communication channels. Following registration, volunteers submit an intake questionnaire with their postal code and sociodemographic and medical characteristics, after which they are invited to report their symptoms via a weekly electronic newsletter reminder. Several thousands of participants have been engaged yearly in Influenzanet, with over 36,000 volunteers in the 2015-16 season alone. In summary, for some traits and in some countries (eg, influenza vaccination rates in the Netherlands), Influenzanet participants were representative of the general population. However, for other traits, they were not (eg, participants underrepresent the

  15. Influenza vaccination among the elderly in Bangkok.

    PubMed

    Plasai, Valaikanya; Lertmaharit, Somrat; Viputsiri, Ong-Arj; Pongpanich, Sathirakorn; Panichpathompong, Usa; Tarnmaneewongse, Veerachai; Baron-Papillon, Florence; Cheunkitmongkol, Sunate

    2006-01-01

    This study aimed to determine the effectiveness of influenza vaccinations among the elderly in Bangkok in reducing influenza-like illness (ILI) and influenza-related complications. Using a non-randomized, controlled, prospective methodology, healthy, active people aged 60 years or more, living in the Bangkok Metropolitan Administration (BMA) area, were studied. The two study cohorts comprised 519 persons in the vaccinated group and 520 in the non-vaccinated group. The outcome under study was influenza-like illness (ILI), as reported by the study volunteers. The two groups were comparable for most socio-demographic characteristics, except for gender, level of education, marital status, and smoking habit. The age range was 60-88 years (mean: 68 years). Females outnumbered males in both groups, with ratio of female to male of 2.6:1 and 1.9:1 in the vaccinated and non-vaccinated groups, respectively. The top three co-morbidities among these groups were hypertension, diabetes mellitus, and heart disease, in that order. Only 1% of the volunteers reported lung disease as co-morbidity. During the 12-month study period, a total of 107 volunteers reported ILI in both groups, with 38 persons in the vaccinated group and 69 persons in the non-vaccinated group. There were 46 ILI episodes in the vaccinated group, and 86 in the non-vaccinated group, for a total of 132 episodes. The incidence rates rates of influenza in this population, therefore, were 8.9% for the vaccinated and 16.9% for the non-vaccinated groups; with a reduction in the rate of reported ILI and doctor visits of 8%. Vaccine effectiveness was rated at 47.6%, crude risk ratio at 1.9 (1.33-2.75), and adjusted risk ratio at 1.92 (95% CI: 1.25-2.95), after adjustment for gender, marital status, education, and smoking habit. No complications due to ILI were observed in this population during the study period. Hospitalizations during this period were due to non-ILI related causes, such as cancer and accident.

  16. Influenza epidemic surveillance and prediction based on electronic health record data from an out-of-hours general practitioner cooperative: model development and validation on 2003-2015 data.

    PubMed

    Michiels, Barbara; Nguyen, Van Kinh; Coenen, Samuel; Ryckebosch, Philippe; Bossuyt, Nathalie; Hens, Niel

    2017-01-18

    Annual influenza epidemics significantly burden health care. Anticipating them allows for timely preparation. The Scientific Institute of Public Health in Belgium (WIV-ISP) monitors the incidence of influenza and influenza-like illnesses (ILIs) and reports on a weekly basis. General practitioners working in out-of-hour cooperatives (OOH GPCs) register diagnoses of ILIs in an instantly accessible electronic health record (EHR) system. This article has two objectives: to explore the possibility of modelling seasonal influenza epidemics using EHR ILI data from the OOH GPC Deurne-Borgerhout, Belgium, and to attempt to develop a model accurately predicting new epidemics to complement the national influenza surveillance by WIV-ISP. Validity of the OOH GPC data was assessed by comparing OOH GPC ILI data with WIV-ISP ILI data for the period 2003-2012 and using Pearson's correlation. The best fitting prediction model based on OOH GPC data was developed on 2003-2012 data and validated on 2012-2015 data. A comparison of this model with other well-established surveillance methods was performed. A 1-week and one-season ahead prediction was formulated. In the OOH GPC, 72,792 contacts were recorded from 2003 to 2012 and 31,844 from 2012 to 2015. The mean ILI diagnosis/week was 4.77 (IQR 3.00) and 3.44 (IQR 3.00) for the two periods respectively. Correlation between OOHs and WIV-ISP ILI incidence is high ranging from 0.83 up to 0.97. Adding a secular trend (5 year cycle) and using a first-order autoregressive modelling for the epidemic component together with the use of Poisson likelihood produced the best prediction results. The selected model had the best 1-week ahead prediction performance compared to existing surveillance methods. The prediction of the starting week was less accurate (±3 weeks) than the predicted duration of the next season. OOH GPC data can be used to predict influenza epidemics both accurately and fast 1-week and one-season ahead. It can also be used to

  17. Lifestyle Intervention for Weight Loss and Cardiometabolic Changes in the Setting of Glucokinase Regulatory Protein (GCKR) Inhibition: GCKR-Leu446Pro Variant in Look AHEAD

    PubMed Central

    Belalcazar, L. Maria; Papandonatos, George D.; Erar, Bahar; Peter, Inga; Alkofide, Hadeel; Balasubramanyam, Ashok; Brautbar, Ariel; Kahn, Steven E.; Knowler, William C.; Ballantyne, Christie M.; McCaffery, Jeanne M.; Huggins, Gordon S.

    2015-01-01

    Background Glucokinase regulatory protein (GCKR) inhibitors offer a novel treatment approach for glucose control in diabetes; however their cardiometabolic effects, particularly in relation to increased triglycerides and C-reactive protein (CRP) levels are of concern. GCKR Leu446Pro is a common variant associated with reduced GCKR function, increased triglycerides and CRP. Methods and Results We investigated whether a 1-year intensive lifestyle intervention for weight loss (ILI) would avert the unfavorable cardiometabolic effects associated with GCKR Leu446Pro when compared to a diabetes support and education arm (DSE) in overweight/obese individuals with type 2 diabetes with triglyceride (n=3,214) and CRP (n=1,411) data participating in a randomized lifestyle intervention study for weight loss, Look AHEAD (Action for Health in Diabetes). Once demographics, medication use and baseline adiposity and fitness were accounted for, ILI did not modify the baseline association of GCKR-Leu446Pro with elevated triglycerides (β± SE= 0.067 ± 0.013, p= 1.5×10−7 and β± SE= 0.052 ± 0.015, p=5×10−4) or with elevated CRP (β± SE= 0.136 ± 0.034, p=5.1×10−5and β± SE= 0.903 ± 0.038, p=0.015) in the overall sample and Non-Hispanic Whites, respectively. The lack of a protective effect from ILI at 1-year when compared to DSE (ILI versus DSE interaction for triglyceride and CRP change, respectively: p= 0.64 and 0.37 in the overall sample; p= 0.27 and 0.05 in Non-Hispanic Whites) persisted after additional adjustment for changes in adiposity and fitness. Conclusions Moderate improvements in adiposity and fitness with ILI did not mitigate the adverse cardiometabolic effects of GCKR inhibition in overweight/obese individuals with diabetes. PMID:26578543

  18. A Phase I Multi-Institutional Study of Systemic Sorafenib in Conjunction with Regional Melphalan for In-Transit Melanoma of the Extremity

    PubMed Central

    Raymond, A.; Sanders, G.; Selim, M. A.; Peterson, B. L.; Brady, M. S.; Davies, M. A.; Augustine, C.; Tyler, D. S.

    2015-01-01

    Background Isolated limb infusion with melphalan (ILIM) corrected for ideal body weight (IBW) is a well-tolerated treatment for patients with in-transit extremity melanoma with an approximate 29 % complete response (CR) rate. Sorafenib, a multi-kinase inhibitor, has been shown to augment tumor response to chemotherapy in preclinical studies. Methods A multi-institutional, dose-escalation, phase I study was performed to evaluate the safety and antitumor activity of sorafenib in combination with ILI-M. Patients with AJCC stage IIIB/IIIC/IV melanoma were treated with sorafenib starting at 400 mg daily for 7 days before and 7 days after ILI-M corrected for IBW. Toxicity, drug pharmacokinetics, and tumor protein expression changes were measured and correlated with clinical response at 3 months. Results A total of 20 patients were enrolled at two institutions. The maximum tolerated dose (MTD) of sorafenib in combination with ILI-M was 400 mg. Four dose-limiting toxicities occurred, including soft tissue ulcerations and compartment syndrome. There were three CRs (15 %) and four partial responses (20 %). Of patients with the Braf mutation, 83 % (n = 6) progressed compared with only 33 % without (n = 12). Short-term sorafenib treatment did alter protein expression as measured with reverse phase protein array (RPPA) analysis, but did not inhibit protein expression in the MAP kinase pathway. Sorafenib did not alter melphalan pharmacokinetics. Conclusion This trial defined the MTD of systemically administered sorafenib in combination with ILI-M. Although some responses were seen, the addition of sorafenib to ILI-M did not appear to augment the effects of melphalan but did increase regional toxicity. PMID:22549288

  19. Outbreaks of health care-associated influenza-like illness in France: Impact of electronic notification.

    PubMed

    Munier-Marion, Elodie; Bénet, Thomas; Dananché, Cédric; Soing-Altach, Sophan; Maugat, Sylvie; Vaux, Sophie; Vanhems, Philippe

    2017-06-21

    Mandatory notification of health care-associated (HA) infections, including influenza-like illness (ILI) outbreaks, has been implemented in France since 2001. In 2012, the system moved to online electronic notification of HA infections (e-SIN). The objectives of this study are to describe ILI outbreak notifications to Santé publique France (SPF), the French national public health agency, and to evaluate the impact of notification dematerialization. All notifications of HA ILI outbreaks between July 2001 and June 2015 were included. Notifications before and after e-SIN implementation were compared regarding notification delay and information exhaustiveness. Overall, 506 HA ILI outbreaks were reported, accounting for 7,861 patients and health care professionals. Median delay between occurrence of the first case and notification was, respectively, 32 and 13 days before and after e-SIN utilization (P < .001). Information exhaustiveness was improved by electronic notification regarding HA status (8.5% of missing data before and 2.3% after e-SIN, P = .003), hypotheses of cause (25.4% of missing data before vs 8.0% after e-SIN, P < .001), and level of event control (23.7% of missing data before vs 7.5% after e-SIN, P < .001). HA influenza notifications, including HA ILI or influenza, to health authorities are essential to guide decisional instances and health care practices. Electronic notifications have improved the timeliness and quality of information transmitted. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. A Randomized Study on the Effect of Weight Loss on Obstructive Sleep Apnea Among Obese Patients With Type 2 Diabetes

    PubMed Central

    Foster, Gary D.; Borradaile, Kelley E.; Sanders, Mark H.; Millman, Richard; Zammit, Gary; Newman, Anne B.; Wadden, Thomas A.; Kelley, David; Wing, Rena R.; Pi-Sunyer, F. Xavier; Reboussin, David; Kuna, Samuel T.

    2010-01-01

    Background The belief that weight loss improves obstructive sleep apnea (OSA) has limited empirical support. The purpose of this 4-center study was to assess the effects of weight loss on OSA over a 1-year period. Methods The study included 264 participants with type 2 diabetes and a mean (SD) age of 61.2 (6.5) years, weight of 102.4 (18.3) kg, body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) of 36.7 (5.7), and an apnea-hypopnea index (AHI) of 23.2 (16.5) events per hour. The participants were randomly assigned to either a behavioral weight loss program developed specifically for obese patients with type 2 diabetes (intensive lifestyle intervention [ILI]) or 3 group sessions related to effective diabetes management (diabetes support and education [DSE]). Results The ILI participants lost more weight at 1 year than did DSE participants (10.8 kg vs 0.6 kg; P < .00l). Relative to the DSE group, the ILI intervention was associated with an adjusted (SE) decrease in AHI of 9.7 (2.0) events per hour (P < .001). At 1 year, more than 3 times as many participants in the ILI group than in the DSE group had total remission of their OSA, and the prevalence of severe OSA among ILI participants was half that of the DSE group. Initial AHI and weight loss were the strongest predictors of changes in AHI at 1 year (P<.01). Participants with a weight loss of 10 kg or more had the greatest reductions in AHI. Conclusions Physicians and their patients can expect that weight loss will result in significant and clinically relevant improvements in OSA among obese patients with type 2 diabetes. Trial Registration clinicaltrials.gov Identifier: NCT00194259 PMID:19786682

  1. Cost-effectiveness study on influenza prevention in Hong Kong.

    PubMed

    Fitzner, K A; Shortridge, K F; McGhee, S M; Hedley, A J

    2001-06-01

    Recent studies confirm that influenza vaccination confers health benefits and reduces direct and indirect costs associated with the illness. However, these studies did not examine the situation in southern China, a hypothetical influenza epicentre for the emergence of pandemic influenza viruses. Surveillance data were collected in Hong Kong in 1993/94 and used economic model was used to estimate the medical and social costs associated with influenza-like illness (ILI) and to predict the cost-effectiveness of implementing an influenza prevention programme. The estimated ILI incidence was 110/1000. It was highest in those between 1 and 25 years of age while the rate of hospitalization was highest in the elderly. Influenza occurred throughout the study period, which was a mild influenza year. The model predicted more than 660000 ILI cases in a non-epidemic year, in which influenza B virus predominated, with an average ILI-associated cost of HK$283/case (US$36) and vaccination-associated costs of HK$74 (US$9.50) per vaccinated individual. The medical, social and monetary costs of ILI in Hong Kong were not observed to be large when compared with those in more developed countries where there is a clearly defined influenza season and recognized disease burden. From the perspective of a susceptible individual, the vaccine was cost-effective but from the perspective of society it was not, even with the most cost-effective strategy of targeting the elderly. However, if the vaccine were effective in controlling newly emerging and highly virulent strains, targeted vaccination programmes might be highly cost-effective.

  2. Surveillance and clinical characterization of influenza in a university cohort in Singapore.

    PubMed

    Tan, Aidan Lyanzhiang; Virk, Ramandeep Kaur; Tambyah, Paul Anantharajah; Inoue, Masafumi; Lim, Elizabeth Ai-Sim; Chan, Ka-Wei; Chelvi, C Senthamarai; Ooi, Say-Tat; Chua, Catherine; Tan, Boon-Huan

    2015-01-01

    Southeast Asia is a potential locus for the emergence of novel influenza strains. However, information on influenza within the region is limited. This study was to determine the proportion of influenza-like illness (ILI) caused by influenza A and B viruses in a university cohort in Singapore, identify important distinctive clinical features of influenza infection and potential factors associated with influenza infection compared with other causes of ILI. A surveillance study was conducted from 2007 to 2009, at the University Health and Wellness Centre, National University of Singapore (NUS). Basic demographic information and nasopharyngeal swabs were collected from consenting students and staff with ILI, with Influenza A and B identified by both culture and molecular methods. Proportions of influenza A and B virus infections in subjects with ILI were 153/500 (30.6%) and 11/500 (2.2%) respectively. The predominant subtype was A/H1N1, including both the seasonal strain (20/153) and the pandemic strain (72/153). The clinical symptom of fever was more common in subjects with laboratory confirmed influenza than other ILIs. On-campus hostel residence and being a student (compared with staff) were associated with increased risk of laboratory confirmed influenza A/H1N1 2009 infection. This study provides a baseline prevalence of influenza infection within young adults in Singapore in a university setting. Potential risk factors, such as hostel residence, were identified, allowing for more targeted infection control measures in the event of a future influenza pandemic.

  3. Surveillance and Clinical Characterization of Influenza in a University Cohort in Singapore

    PubMed Central

    Tan, Aidan Lyanzhiang; Virk, Ramandeep Kaur; Tambyah, Paul Anantharajah; Inoue, Masafumi; Lim, Elizabeth Ai-Sim; Chan, Ka-Wei; Chelvi, C. Senthamarai; Ooi, Say-Tat; Chua, Catherine; Tan, Boon-Huan

    2015-01-01

    Background Southeast Asia is a potential locus for the emergence of novel influenza strains. However, information on influenza within the region is limited. Objectives This study was to determine the proportion of influenza-like illness (ILI) caused by influenza A and B viruses in a university cohort in Singapore, identify important distinctive clinical features of influenza infection and potential factors associated with influenza infection compared with other causes of ILI. Methodology A surveillance study was conducted from 2007 to 2009, at the University Health and Wellness Centre, National University of Singapore (NUS). Basic demographic information and nasopharyngeal swabs were collected from consenting students and staff with ILI, with Influenza A and B identified by both culture and molecular methods. Results Proportions of influenza A and B virus infections in subjects with ILI were 153/500 (30.6%) and 11/500 (2.2%) respectively. The predominant subtype was A/H1N1, including both the seasonal strain (20/153) and the pandemic strain (72/153). The clinical symptom of fever was more common in subjects with laboratory confirmed influenza than other ILIs. On-campus hostel residence and being a student (compared with staff) were associated with increased risk of laboratory confirmed influenza A/H1N1 2009 infection. Conclusions This study provides a baseline prevalence of influenza infection within young adults in Singapore in a university setting. Potential risk factors, such as hostel residence, were identified, allowing for more targeted infection control measures in the event of a future influenza pandemic. PMID:25790305

  4. Lifestyle Intervention Improves Heart Rate Recovery from Exercise in Adults with Type 2 Diabetes: Results from the Look AHEAD Study

    PubMed Central

    Ribisl, Paul M.; Gaussoin, Sarah A.; Lang, Wei; Bahnson, Judy; Connelly, Stephanie A.; Horton, Edward S.; Jakicic, John M.; Killean, Tina; Kitzman, Dalane W.; Knowler, William C.; Stewart, Kerry J.; Research Group, Look AHEAD

    2012-01-01

    The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined effects of weight loss and fitness changes upon HRR. In 4503 participants (45–76 years) who completed 1 year of intervention, HRR was measured after a submaximal GXT to compare the influence of (ILI) with (DSE) upon HRR. Participants assigned to ILI lost an average 8.6% of their initial weight versus 0.7% in DSE group (P < 0.001) while mean fitness increased in ILI by 20.9% versus 5.8% in DSE (P < 0.001). At Year 1, all exercise and HRR variables in ILI improved (P < 0.0001) versus DSE: heart rate (HR) at rest was lower (72.8 ± 11.4 versus 77.7 ± 11.7 b/min), HR range was greater (57.7 ± 12.1 versus 53.1 ± 12.4 b/min), HR at 2 minutes was lower (89.3 ± 21.8 versus 93.0 ± 12.1 b/min), and HRR was greater (41.25 ± 22.0 versus 37.8 ± 12.5 b/min). Weight loss and fitness gain produced significant separate and independent improvements in HRR. PMID:23227314

  5. Lifestyle intervention improves heart rate recovery from exercise in adults with type 2 diabetes: results from the Look AHEAD study.

    PubMed

    Ribisl, Paul M; Gaussoin, Sarah A; Lang, Wei; Bahnson, Judy; Connelly, Stephanie A; Horton, Edward S; Jakicic, John M; Killean, Tina; Kitzman, Dalane W; Knowler, William C; Stewart, Kerry J

    2012-01-01

    The primary aims of this paper were (1) to evaluate the influence of intensive lifestyle weight loss and exercise intervention (ILI) compared with diabetes support and education (DSE) upon Heart Rate Recovery (HRR) from graded exercise testing (GXT) and (2) to determine the independent and combined effects of weight loss and fitness changes upon HRR. In 4503 participants (45-76 years) who completed 1 year of intervention, HRR was measured after a submaximal GXT to compare the influence of (ILI) with (DSE) upon HRR. Participants assigned to ILI lost an average 8.6% of their initial weight versus 0.7% in DSE group (P < 0.001) while mean fitness increased in ILI by 20.9% versus 5.8% in DSE (P < 0.001). At Year 1, all exercise and HRR variables in ILI improved (P < 0.0001) versus DSE: heart rate (HR) at rest was lower (72.8 ± 11.4 versus 77.7 ± 11.7 b/min), HR range was greater (57.7 ± 12.1 versus 53.1 ± 12.4 b/min), HR at 2 minutes was lower (89.3 ± 21.8 versus 93.0 ± 12.1 b/min), and HRR was greater (41.25 ± 22.0 versus 37.8 ± 12.5 b/min). Weight loss and fitness gain produced significant separate and independent improvements in HRR.

  6. Fiber Intake and PAI-1 in type 2 diabetes: Look AHEAD Trial Findings at Baseline and Year 1

    PubMed Central

    Belalcazar, L. Maria; Anderson, Andrea M.; Lang, Wei; Schwenke, Dawn C.; Haffner, Steven M.; Yatsuya, Hiroshi; Rushing, Julia; Vitolins, Mara Z.; Reeves, Rebecca; Pi-Sunyer, F. Xavier; Tracy, Russell P.; Ballantyne, Christie M.

    2014-01-01

    Plasminogen Activator Inhibitor 1 (PAI-1) is elevated in obese individuals with type 2 diabetes (T2DM) and may contribute, independently of traditional factors, to increased cardiovascular disease (CVD) risk. Fiber intake may decrease PAI-1 levels. We examined the associations of fiber intake and its changes with PAI-1, before and during an intensive lifestyle intervention for weight loss (ILI) in 1,701 Look AHEAD participants with dietary, fitness and PAI-1 data at baseline and 1-year. Look AHEAD was a randomized CVD trial in 5,145 overweight/obese subjects with T2DM, comparing ILI (goal of ≥7% reduction in baseline weight) with a control arm of diabetes support and education (DSE). ILI participants were encouraged to consume vegetables, fruits and grain products low in sugar and fat. At baseline, median fiber intake was 17.9 g/d. Each 8.3 g/day higher fiber intake was associated with a 9.2% lower PAI-1 level (p=0.008); this association persisted after weight and fitness adjustments (p=0.03). Higher baseline intake of fruit (p=0.019) and high-fiber grain and cereal (p=0.029) were related to lower PAI-1 levels. Although successful in improving weight and physical fitness at 1-year, ILI in Look AHEAD resulted in small increases in fiber intake (4.1g/day, compared with -2.35 g/day with DSE), which were not related to PAI-1 change (p=0.34). Only 31.3% of ILI participants (39.8% of women; 19.1% of men) met daily fiber intake recommendations. Increasing fiber intake in overweight/obese individuals with diabetes interested in weight loss is challenging. Future studies evaluating changes in fiber consumption during weight loss interventions are warranted. PMID:25131348

  7. Prospective Multicenter Phase II Trial of Systemic ADH-1 in Combination With Melphalan via Isolated Limb Infusion in Patients With Advanced Extremity Melanoma

    PubMed Central

    Beasley, Georgia M.; Riboh, Jonathan C.; Augustine, Christina K.; Zager, Jonathan S.; Hochwald, Steven N.; Grobmyer, Stephen R.; Peterson, Bercedis; Royal, Richard; Ross, Merrick I.; Tyler, Douglas S.

    2011-01-01

    Purpose Isolated limb infusion (ILI) with melphalan (M-ILI) dosing corrected for ideal body weight (IBW) is a well-tolerated treatment for patients with in-transit melanoma with a 29% complete response rate. ADH-1 is a cyclic pentapeptide that disrupts N-cadherin adhesion complexes. In a preclinical animal model, systemic ADH-1 given with regional melphalan demonstrated synergistic antitumor activity, and in a phase I trial with M-ILI it had minimal toxicity. Patients and Methods Patients with American Joint Committee on Cancer (AJCC) stage IIIB or IIIC extremity melanoma were treated with 4,000 mg of ADH-1, administered systemically on days 1 and 8, and with M-ILI corrected for IBW on day 1. Drug pharmacokinetics and N-cadherin immunohistochemical staining were performed on pretreatment tumor. The primary end point was response at 12 weeks determined by Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Results In all, 45 patients were enrolled over 15 months at four institutions. In-field responses included 17 patients with complete responses (CRs; 38%), 10 with partial responses (22%), six with stable disease (13%), eight with progressive disease (18%), and four (9%) who were not evaluable. Median duration of in-field response among the 17 CRs was 5 months, and median time to in-field progression among 41 evaluable patients was 4.6 months (95% CI, 4.0 to 7.1 months). N-cadherin was detected in 20 (69%) of 29 tumor samples. Grade 4 toxicities included creatinine phosphokinase increase (four patients), arterial injury (one), neutropenia (one), and pneumonitis (one). Conclusion To the best of our knowledge, this phase II trial is the first prospective multicenter ILI trial and the first to incorporate a targeted agent in an attempt to augment antitumor responses to regional chemotherapy. Although targeting N-cadherin may improve melanoma sensitivity to chemotherapy, no difference in response to treatment was seen in this study. PMID:21343562

  8. Arterial Stiffness, Lifestyle Intervention and a Low-Calorie Diet in Morbidly Obese Patients—A Nonrandomized Clinical Trial

    PubMed Central

    Nordstrand, N; Gjevestad, E; Hertel, JK; Johnson, LK; Saltvedt, E; Røislien, J; Hjelmesæth, J

    2013-01-01

    Objective Arterial stiffness is an independent predictor of cardiovascular morbidity and mortality. This study aimed to compare the 7-week effect of a low-calorie diet (LCD) and an intensive lifestyle intervention program (ILI) on arterial stiffness in morbidly obese individuals. Design and Methods Nonrandomized clinical trial. The LCD provided 900 kcal/day, and participants in the LCD group were instructed to maintain their habitual physical activity level. The ILI included two 90-min supervised training sessions 3 days a week at moderate to high intensity (4-8 METs) and a caloric restriction of 1000 kcal/day. Results A total of 179 individuals completed the study, 88 (56 women) in the ILI group and 91 (57 women) in the LCD group. High-fidelity applanation tonometry (Millar®, Sphygmocor®) was used to measure carotid-femoral pulse wave velocity (PWV). After adjustment for relevant confounders, the ILI group had a significantly greater reduction in PWV than the LCD group; −0.4 (−0.6, −0.1) m/s, P = 0.004. When compared to the LCD group, the ILI group showed a larger reduction in systolic and diastolic blood pressure −5 (−9, −1) and −5 (−7, −2) mmHg, P = 0.038 and P ≤ 0.001 respectively, whereas no difference was observed regarding pulse pressure, P = 0.661. No significant differences between groups were found regarding the loss of fat mass, P = 0.259, but the loss of muscle mass was larger in the LCD group, 0.8 (0.5, 1.1) kg, P ≤ 0.001. Conclusion Despite the limitations of a nonrandomized design, our findings indicate that for morbidly obese individuals a moderate caloric restriction combined with aerobic physical exercise is associated with a greater decline in PWV than a LCD alone. PMID:23712971

  9. Monitoring over-the-counter medication sales for early detection of disease outbreaks--New York City.

    PubMed

    Das, Debjani; Metzger, K; Heffernan, R; Balter, S; Weiss, D; Mostashari, F

    2005-08-26

    Over-the-counter (OTC) medications are frequently used during the initial phase of illness, and increases in their sales might serve as an early indicator of communitywide disease outbreaks. Since August 2002, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has tracked OTC medication sales to enhance detection of natural and intentional infectious disease outbreaks. This report describes the surveillance system and presents results from retrospective analyses and a comparison between citywide trends in OTC medication sales and emergency department (ED) visits. Sales data transmitted daily to DOHMH are categorized into two groups: influenza-like illness (ILI), which includes cough and influenza medications, and gastrointestinal illness (GI), which includes major brand and generic antidiarrheals. Cyclical, linear regression models were used to identify significant (p<0.05) increases in the daily ratio of ILI to analgesics sales (analgesics are used as a denominator in the absence of total sales). Daily and weekly average ratios of GI to analgesic sales were analyzed. Citywide trends in OTC ILI and GI medication sales were compared with ED visits for fever/influenza and diarrhea syndromes. Citywide ILI drug sales were highest during annual influenza epidemics and elevated during spring and fall allergy seasons, similar to trends in the ED fever/influenza syndrome. ILI sales did not consistently provide earlier warning than the ED system of communitywide influenza. GI drug sales increased during the fall and peaked during early winter and after the blackout of August 2003. Unlike ED diarrheal visits, GI medication sales did not substantially increase during late winter (February-March). Citywide OTC medication sales can provide indications of communitywide illness, including annual influenza epidemics. Antidiarrheal medication sales were more sensitive to increases in GI caused by norovirus and influenza than illness caused by rotavirus. OTC

  10. Changes in the prevalence of influenza-like illness and influenza vaccine uptake among Hajj pilgrims: A 10-year retrospective analysis of data.

    PubMed

    Alfelali, Mohammad; Barasheed, Osamah; Tashani, Mohamed; Azeem, Mohammad Irfan; El Bashir, Haitham; Memish, Ziad A; Heron, Leon; Khandaker, Gulam; Booy, Robert; Rashid, Harunor

    2015-05-21

    Influenza is an important health hazard among Hajj pilgrims. For the last ten years, pilgrims are being recommended to take influenza vaccine before attending Hajj. Vaccination coverage has increased in recent years, but whether there has been any change in the prevalence of influenza-like illness (ILI) is not known. In this analysis, we examined the changes in the rate of ILI against seasonal influenza vaccine uptake among Hajj pilgrims over the last decade. Data for this analysis is a synthesis of raw and published data from eleven Hajj seasons between 2005 and 214. For seven Hajj seasons the data were obtained from studies involving pilgrims of UK, Saudi Arabia and Australia; and for the remaining four Hajj seasons data were abstracted from published studies involving pilgrims from multiple countries. The data from both sources were synthesised to estimate the relative risk (RR) of acquisition of ILI in vaccinated versus unvaccinated pilgrims. The pooled sample size of the included studies was 33,213 with most pilgrims being in the age band of 40-60 years (range: 0.5 to 95 years) and a male to female ratio of 1.6. The pilgrims originated, in order of frequency, from Iran, Australia, France, UK, Saudi Arabia, Indonesia, India, Algeria, Ivory Coast, Nigeria, Somalia, Turkey, Syria, Sierra Leone and USA. Except for one year (2008), data from individual years did not demonstrate a noticeable change in the rate of ILI against influenza vaccine coverage, however the combined data from all studies suggest that the prevalence of ILI decreased among Hajj pilgrims as the vaccine coverage increased over the last decade (RR 0.2, P<0.01). This analysis suggests that influenza vaccine might be beneficial for Hajj pilgrims. However, controlled trials aided by molecular diagnostic tools could confirm whether such an effect is real or ostensible. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Effect of the influenza virus rapid antigen test on a physician's decision to prescribe antibiotics and on patient length of stay in the emergency department.

    PubMed

    Jeong, Hye Won; Heo, Jung Yeon; Park, Jung Soo; Kim, Woo Joo

    2014-01-01

    Influenza virus infection is a common reason for visits to the emergency department (ED) during the influenza season. A rapid and accurate diagnosis of influenza virus infection is important to reduce unnecessary antibiotic prescription and to improve patient care. The aim of this study was to examine whether using the Influenza Virus Rapid Antigen Test (IVRAT) in the ED affects the decision to prescribe antibiotics or the length of hospital stay (LOS). Data from patients suffering from an influenza-like illness (ILI) and who were discharged after visiting the ED at Chungbuk National University Hospital were reviewed over two influenza seasons: 2010-2011, when IVRAT was not used in the ED, and 2011-2012, when it was. The numbers of antibiotic prescriptions issued and the ED LOS during these two seasons were then compared. The number of antibiotic prescriptions was significantly lower in 2011-2012 (54/216, 25.0%) than in 2010-2011 (97/221, 43.9%; P<0.01). However, the median ED LOS for patients in 2011-2012 was much longer than that of patients in 2010-2011 (213 minutes vs. 257 minutes; P<0.01). During the 2011-2012 influenza season, 73 ILI patients showed a positive IVRAT result whereas 123 showed a negative result. Upon discharge, antibiotics were given to 42/123 (34.1%) ILI patients with a negative IVRAT result, but to only 7/73 (9.6%) patients with a positive IVRAT result (P<0.01). Performing IVRAT in the ED reduced the prescription of antibiotics to ILI patients discharged after ED care. However, the ED LOS for patients who underwent IVRAT was longer than that for patients who did not. Thus, performing IVRAT in the ED reduces the unnecessary prescription of antibiotics to ILI patients during the influenza season.

  12. The influence of rapid influenza diagnostic testing on antibiotic prescribing patterns in rural Thailand.

    PubMed

    Bhavnani, Darlene; Phatinawin, Ladarat; Chantra, Somrak; Olsen, Sonja J; Simmerman, James M

    2007-07-01

    Rapid influenza diagnostic testing is potentially a useful means to decrease inappropriate prescription of antibiotics. We studied the impact of access to rapid influenza test results on antibiotic prescribing and other patient management practices for outpatients with influenza-like illness (ILI) in a rural province in Eastern Thailand. A medical record review was performed for 300 patients of all ages selected from five outpatient departments using a 1:2 ratio of ILI cases with and without influenza infection identified by the QuickVue rapid test. Chi-square analysis or Fisher's exact test was used to compare patient management practices (antibiotic prescriptions, individual treatments administered, additional tests ordered, and related hospitalization) between rapid test positive and negative patients. Logistic regression was used to evaluate the effect of rapid test results on patient management practices for ILI. Eighty-two percent of all patients with ILI were prescribed antibiotics. Patients with a positive rapid test were less likely to be prescribed antibiotics than those with a negative result (73% vs. 87%, respectively, p=0.003). The likelihood of antibiotic prescription for influenza positive patients was 0.41 times the likelihood for influenza negative patients (95% CI 0.23-0.74, p=0.003). There was no significant difference in the frequency of other patient management practices between influenza positive and negative patients. Thai outpatients with ILI are prescribed antibiotics at a frequency approximately twice that reported in the USA. Having access to a rapid influenza test result was associated with a significant decrease in antibiotic prescription. Improved access to rapid influenza testing and expanded physician education may reduce inappropriate antibiotic use and improve patient care.

  13. Epidemiological and Virological Characteristics of Influenza in Chongqing, China, 2011-2015

    PubMed Central

    Qi, Li; Xiong, Yu; Xiao, Bangzhong; Tang, Wenge; Ling, Hua; Long, Jiang; Xiao, Dayong; Zhao, Han; Ye, Sheng; Chen, Shuang; Yu, Zhen; Li, Qin

    2016-01-01

    Background Chongqing is the largest municipality and located in Southwestern of China, with over 30 million registered inhabitants. There are few reports regarding the epidemiology of influenza in Chongqing. The objective of the paper is to explore the epidemiology of influenza in Chongqing, in order to provide scientific basis for prevention and control of influenza. Methodology /Principal Findings From 2011 to 2015, we collected information on influenza-like illness (ILI) patients fulfilling the case definition, and took nasalpharyngeal or throat swabs specimens from ILI cases per week at the 7 sentinel hospitals. Specimens were tested by reverse transcription-polymerase chain reaction(RT-PCR) for influenza. Descriptive epidemiology was applied to analyze the epidemiology and etiology of influenza. A total of 9,696,212 cases were enrolled, of which 111,589 were ILI. Of those 24,868 samples from ILI cases, 13.3% (3,314/24,868) tested positive for influenza virus (65.7% influenza A, 34.1% influenza B, and 0.2% influenza A and B co-infection). Among the influenza A viruses, 71.3% were seasonal influenza A(H3N2) and 28.7% were influenza A(H1N1)pdm09. No cases of seasonal A(H1N1) were detected. The isolation rate was highest in children aged 5–14 years old. Influenza activity consistently peaked during January-March in 2011–2015, and June-July in 2012, 2014 and 2015. Conclusions Influenza is an important public health problem among ILI patients in Chongqing, especially among school-aged children. It might be beneficial to prioritize influenza vaccination for school-aged children and implement the school-based intervention to prevent and mitigating influenza outbreaks in Chongqing, particularly during the seasonal peaks. PMID:27936139

  14. A Case Study of the New York City 2012-2013 Influenza Season With Daily Geocoded Twitter Data From Temporal and Spatiotemporal Perspectives

    PubMed Central

    Yuan, Qingyu; Freifeld, Clark C; Santillana, Mauricio; Nojima, Aaron; Chunara, Rumi; Brownstein, John S

    2014-01-01

    Background Twitter has shown some usefulness in predicting influenza cases on a weekly basis in multiple countries and on different geographic scales. Recently, Broniatowski and colleagues suggested Twitter’s relevance at the city-level for New York City. Here, we look to dive deeper into the case of New York City by analyzing daily Twitter data from temporal and spatiotemporal perspectives. Also, through manual coding of all tweets, we look to gain qualitative insights that can help direct future automated searches. Objective The intent of the study was first to validate the temporal predictive strength of daily Twitter data for influenza-like illness emergency department (ILI-ED) visits during the New York City 2012-2013 influenza season against other available and established datasets (Google search query, or GSQ), and second, to examine the spatial distribution and the spread of geocoded tweets as proxies for potential cases. Methods From the Twitter Streaming API, 2972 tweets were collected in the New York City region matching the keywords “flu”, “influenza”, “gripe”, and “high fever”. The tweets were categorized according to the scheme developed by Lamb et al. A new fourth category was added as an evaluator guess for the probability of the subject(s) being sick to account for strength of confidence in the validity of the statement. Temporal correlations were made for tweets against daily ILI-ED visits and daily GSQ volume. The best models were used for linear regression for forecasting ILI visits. A weighted, retrospective Poisson model with SaTScan software (n=1484), and vector map were used for spatiotemporal analysis. Results Infection-related tweets (R=.763) correlated better than GSQ time series (R=.683) for the same keywords and had a lower mean average percent error (8.4 vs 11.8) for ILI-ED visit prediction in January, the most volatile month of flu. SaTScan identified primary outbreak cluster of high-probability infection tweets with

  15. Comparing Prescription Sales, Google Trends and CDC Data as Flu Activity Indicators

    PubMed Central

    Patwardhan, Avinash; Lorber, David

    2013-01-01

    Objective To examine if the prescription sales data from a large retail pharmacy chain in the US were comparable to Google Flu trends and CDC’s US ILI Network data as flu activity indicator. Introduction In a 2007 survey of public health officials in the United States, International Society for Disease Surveillance found that only 7% used pharmacy prescription sales data for surveillance (1). There have been many reports suggesting effective use of prescription sales data in syndromic surveillance (2, 3, 4, 5). Community pharmacies can provide a valuable supplementary tool for syndromic surveillance of infectious diseases. Methods We extracted five years of de-identified prescription sales data from the proprietary pharmacy computer system of a large retail pharmacy chain in the United States. The prescriptions were written for the common drugs for the treatment of influenza: Amantadine, Os-eltamivir, Rimantadine, and Zanamivir. We acquired Google Flu trends national aggregate counts data that represented the estimates of the ILI cases per 100,000 physician visits. We acquired CDC ILINET data for 2007. We calculated Pearson ‘r’ between our data and Google and CDC data. We also created comparable trends graphs after converting the counts of the influenza scripts and the counts of the Google estimated ILI cases to logarithmic scale. Results The Pearson ‘r’ between the aggregate counts of scripts for all the four drugs and the Google estimates of the ILI cases for years 2007, 2008, 2009, 2010, and 2011 were 0.85 (95% CI, 0.75–0.91), 0.92 (95% CI, 0.86–0.95), 0.91(95% CI, 0.85–0.95), 0.88 (95% CI, 0.80–0.93), and 0.87 (95% CI, 0.78–0.92) and 0.92 (95% CI, 0.90–0.94) for years 2007 through 2011 together. The Pearson ‘r’ between the aggregate counts of scripts and the CDC % unweighted ILI (2007) was 0.97 (95% CI, 0.95–0.98). Conclusions A strong to very strong correlation between prescription sales data and Google Flu trends and CDC’s ILI

  16. Early detection for cases of enterovirus- and influenza-like illness through a newly established school-based syndromic surveillance system in Taipei, January 2010 ~ August 2011.

    PubMed

    Weng, Ting Chia; Chan, Ta Chien; Lin, Hsien Tang; Chang, Chia Kun Jasper; Wang, Wen Wen; Li, Zheng Rong Tiger; Cheng, Hao-Yuan; Chu, Yu-Roo; Chiu, Allen Wen-Hsiang; Yen, Muh-Yong; King, Chwan-Chuen

    2015-01-01

    School children may transmit pathogens with cluster cases occurring on campuses and in families. In response to the 2009 influenza A (H1N1) pandemic, Taipei City Government officials developed a School-based Infectious Disease Syndromic Surveillance System (SID-SSS). Teachers and nurses from preschools to universities in all 12 districts within Taipei are required to daily report cases of symptomatic children or sick leave requests through the SID-SSS. The pre-diagnosis at schools is submitted firstly as common pediatric disease syndrome-groups and re-submitted after confirmation by physicians. We retrieved these data from January 2010 to August 2011 for spatio-temporal analysis and evaluated the temporal trends with cases obtained from both the Emergency Department-based Syndromic Surveillance System (ED-SSS) and the Longitudinal Health Insurance Database 2005 (LHID2005). Through the SID-SSS, enterovirus-like illness (EVI) and influenza-like illness (ILI) were the two most reported syndrome groups (77.6% and 15.8% among a total of 19,334 cases, respectively). The pre-diagnosis judgments made by school teachers and nurses showed high consistency with physicians' clinical diagnoses for EVI (97.8%) and ILI (98.9%). Most importantly, the SID-SSS had better timeliness with earlier peaks of EVI and ILI than those in the ED-SSS. Furthermore, both of the syndrome groups in these two surveillance systems had the best correlation reaching 0.98 and 0.95, respectively (p<0.01). Spatio-temporal analysis observed the patterns of EVI and ILI both diffuse from the northern suburban districts to central Taipei, with ILI spreading faster. This novel system can identify early suspected cases of two important pediatric infections occurring at schools, and clusters from schools/families. It was also cost-effective (95.5% of the operation cost reduced and 59.7% processing time saved). The timely surveillance of mild EVI and ILI cases integrated with spatial analysis may help public

  17. Burden of Influenza and Respiratory Syncytial Virus Infection in Pregnant Women and Infants Under 6 Months in Mongolia: A Prospective Cohort Study

    PubMed Central

    Chaw, Liling; Kamigaki, Taro; Burmaa, Alexanderyn; Urtnasan, Chuluunbatiin; Od, Ishiin; Nyamaa, Gunregjaviin; Nymadawa, Pagbajabyn; Oshitani, Hitoshi

    2016-01-01

    Background Pregnant women and infants under 6 months are at risk of influenza-related complications. Limited information exists on their community burden of respiratory viruses. Methods and Findings This prospective, observational open cohort study was conducted in Baganuur district, Ulaanbaatar, Mongolia during 2013/14 and 2014/15 influenza seasons. Influenza-like illness (ILI) and severe acute respiratory infection (sARI) were identified by follow-up calls twice a week. For those identified, influenza and respiratory syncytical virus (RSV) were tested by point-of-care test kits. We calculated overall and stratified (by trimester or age group) incidence rates (IR) and used Cox proportional hazard regression for risk factor analyses. Among 1260 unvaccinated pregnant women enrolled, overall IRs for ILI, sARI and influenza A were 11.8 (95% confidence interval (C.I):11.2–12.4), 0.1 (95%C.I:0.0–0.4), and 1.7 (95%C.I:1.5–1.9) per 1,000person-days, respectively. One sARI case was influenza A positive. IRs and adjusted hazard ratios (Adj.HR) for ILI and influenza A were lowest in the third trimester. Those with co-morbidity were 1.4 times more likely to develop ILI [Adj.HR:1.4 (95%C.I:1.1–1.9)]. Among 1304 infants enrolled, overall ILI and sARI IRs were 15.2 (95%C.I:14.5–15.8) and 20.5 (95%C.I:19.7–21.3) per 1,000person-days, respectively. From the tested ILI (77.6%) and sARI (30.6%) cases, the overall positivity rates were 6.3% (influenza A), 1.1% (influenza B) and 9.3% (RSV). Positivity rates of influenza A and RSV tend to increase with age. sARI cases were 1.4 times more likely to be male [Adj.HR:1.4 (95%C.I:1.1–1.8)]. Among all influenza A and RSV positive infants, 11.8% and 68.0% were respectively identified among sARI hospitalized cases. Conclusion We observed low overall influenza A burden in both groups, though underestimation was likely due to point-of-care tests used. For infants, RSV burden was more significant than influenza A. These findings

  18. Rapid detection of pandemic influenza in the presence of seasonal influenza

    PubMed Central

    2010-01-01

    Background Key to the control of pandemic influenza are surveillance systems that raise alarms rapidly and sensitively. In addition, they must minimise false alarms during a normal influenza season. We develop a method that uses historical syndromic influenza data from the existing surveillance system 'SERVIS' (Scottish Enhanced Respiratory Virus Infection Surveillance) for influenza-like illness (ILI) in Scotland. Methods We develop an algorithm based on the weekly case ratio (WCR) of reported ILI cases to generate an alarm for pandemic influenza. From the seasonal influenza data from 13 Scottish health boards, we estimate the joint probability distribution of the country-level WCR and the number of health boards showing synchronous increases in reported influenza cases over the previous week. Pandemic cases are sampled with various case reporting rates from simulated pandemic influenza infections and overlaid with seasonal SERVIS data from 2001 to 2007. Using this combined time series we test our method for speed of detection, sensitivity and specificity. Also, the 2008-09 SERVIS ILI cases are used for testing detection performances of the three methods with a real pandemic data. Results We compare our method, based on our simulation study, to the moving-average Cumulative Sums (Mov-Avg Cusum) and ILI rate threshold methods and find it to be more sensitive and rapid. For 1% case reporting and detection specificity of 95%, our method is 100% sensitive and has median detection time (MDT) of 4 weeks while the Mov-Avg Cusum and ILI rate threshold methods are, respectively, 97% and 100% sensitive with MDT of 5 weeks. At 99% specificity, our method remains 100% sensitive with MDT of 5 weeks. Although the threshold method maintains its sensitivity of 100% with MDT of 5 weeks, sensitivity of Mov-Avg Cusum declines to 92% with increased MDT of 6 weeks. For a two-fold decrease in the case reporting rate (0.5%) and 99% specificity, the WCR and threshold methods

  19. Syndromic Surveillance for Influenza in the Emergency Department–A Systematic Review

    PubMed Central

    Hiller, Katherine M.; Stoneking, Lisa; Min, Alice; Rhodes, Suzanne Michelle

    2013-01-01

    The science of surveillance is rapidly evolving due to changes in public health information and preparedness as national security issues, new information technologies and health reform. As the Emergency Department has become a much more utilized venue for acute care, it has also become a more attractive data source for disease surveillance. In recent years, influenza surveillance from the Emergency Department has increased in scope and breadth and has resulted in innovative and increasingly accepted methods of surveillance for influenza and influenza-like-illness (ILI). We undertook a systematic review of published Emergency Department-based influenza and ILI syndromic surveillance systems. A PubMed search using the keywords “syndromic”, “surveillance”, “influenza” and “emergency” was performed. Manuscripts were included in the analysis if they described (1) data from an Emergency Department (2) surveillance of influenza or ILI and (3) syndromic or clinical data. Meeting abstracts were excluded. The references of included manuscripts were examined for additional studies. A total of 38 manuscripts met the inclusion criteria, describing 24 discrete syndromic surveillance systems. Emergency Department-based influenza syndromic surveillance has been described worldwide. A wide variety of clinical data was used for surveillance, including chief complaint/presentation, preliminary or discharge diagnosis, free text analysis of the entire medical record, Google flu trends, calls to teletriage and help lines, ambulance dispatch calls, case reports of H1N1 in the media, markers of ED crowding, admission and Left Without Being Seen rates. Syndromes used to capture influenza rates were nearly always related to ILI (i.e. fever +/− a respiratory or constitutional complaint), however, other syndromes used for surveillance included fever alone, “respiratory complaint” and seizure. Two very large surveillance networks, the North American DiSTRIBuTE network and

  20. Viral Etiology of Influenza-Like Illnesses in Antananarivo, Madagascar, July 2008 to June 2009

    PubMed Central

    Razanajatovo, Norosoa Harline; Richard, Vincent; Hoffmann, Jonathan; Reynes, Jean-Marc; Razafitrimo, Girard Marcellin; Randremanana, Rindra Vatosoa; Heraud, Jean-Michel

    2011-01-01

    Background In Madagascar, despite an influenza surveillance established since 1978, little is known about the etiology and prevalence of viruses other than influenza causing influenza-like illnesses (ILIs). Methodology/Principal Findings From July 2008 to June 2009, we collected respiratory specimens from patients who presented ILIs symptoms in public and private clinics in Antananarivo (the capital city of Madagascar). ILIs were defined as body temperature ≥38°C and cough and at least two of the following symptoms: sore throat, rhinorrhea, headache and muscular pain, for a maximum duration of 3 days. We screened these specimens using five multiplex real time Reverse Transcription and/or Polymerase Chain Reaction assays for detection of 14 respiratory viruses. We detected respiratory viruses in 235/313 (75.1%) samples. Overall influenza virus A (27.3%) was the most common virus followed by rhinovirus (24.8%), RSV (21.2%), adenovirus (6.1%), coronavirus OC43 (6.1%), influenza virus B (3.9%), parainfluenza virus-3 (2.9%), and parainfluenza virus-1 (2.3%). Co-infections occurred in 29.4% (69/235) of infected patients and rhinovirus was the most detected virus (27.5%). Children under 5 years were more likely to have one or more detectable virus associated with their ILI. In this age group, compared to those ≥5 years, the risk of detecting more than one virus was higher (OR = 1.9), as was the risk of detecting of RSV (OR = 10.1) and adenovirus (OR = 4.7). While rhinovirus and adenovirus infections occurred year round, RSV, influenza virus A and coronavirus OC43 had defined period of circulation. Conclusions In our study, we found that respiratory viruses play an important role in ILIs in the Malagasy community, particularly in children under 5 years old. These data provide a better understanding of the viral etiology of outpatients with ILI and describe for the first time importance of these viruses in different age group and their period of circulation

  1. Viral etiology of influenza-like illnesses in Antananarivo, Madagascar, July 2008 to June 2009.

    PubMed

    Razanajatovo, Norosoa Harline; Richard, Vincent; Hoffmann, Jonathan; Reynes, Jean-Marc; Razafitrimo, Girard Marcellin; Randremanana, Rindra Vatosoa; Heraud, Jean-Michel

    2011-03-03

    In Madagascar, despite an influenza surveillance established since 1978, little is known about the etiology and prevalence of viruses other than influenza causing influenza-like illnesses (ILIs). From July 2008 to June 2009, we collected respiratory specimens from patients who presented ILIs symptoms in public and private clinics in Antananarivo (the capital city of Madagascar). ILIs were defined as body temperature ≥38°C and cough and at least two of the following symptoms: sore throat, rhinorrhea, headache and muscular pain, for a maximum duration of 3 days. We screened these specimens using five multiplex real time Reverse Transcription and/or Polymerase Chain Reaction assays for detection of 14 respiratory viruses. We detected respiratory viruses in 235/313 (75.1%) samples. Overall influenza virus A (27.3%) was the most common virus followed by rhinovirus (24.8%), RSV (21.2%), adenovirus (6.1%), coronavirus OC43 (6.1%), influenza virus B (3.9%), parainfluenza virus-3 (2.9%), and parainfluenza virus-1 (2.3%). Co-infections occurred in 29.4% (69/235) of infected patients and rhinovirus was the most detected virus (27.5%). Children under 5 years were more likely to have one or more detectable virus associated with their ILI. In this age group, compared to those ≥5 years, the risk of detecting more than one virus was higher (OR = 1.9), as was the risk of detecting of RSV (OR = 10.1) and adenovirus (OR = 4.7). While rhinovirus and adenovirus infections occurred year round, RSV, influenza virus A and coronavirus OC43 had defined period of circulation. In our study, we found that respiratory viruses play an important role in ILIs in the Malagasy community, particularly in children under 5 years old. These data provide a better understanding of the viral etiology of outpatients with ILI and describe for the first time importance of these viruses in different age group and their period of circulation.

  2. Early Detection for Cases of Enterovirus- and Influenza-Like Illness through a Newly Established School-Based Syndromic Surveillance System in Taipei, January 2010 ~ August 2011

    PubMed Central

    Weng, Ting Chia; Chan, Ta Chien; Li, Zheng Rong Tiger; Cheng, Hao-Yuan; Chu, Yu-Roo; Chiu, Allen Wen-Hsiang; Yen, Muh-Yong; King, Chwan-Chuen

    2015-01-01

    School children may transmit pathogens with cluster cases occurring on campuses and in families. In response to the 2009 influenza A (H1N1) pandemic, Taipei City Government officials developed a School-based Infectious Disease Syndromic Surveillance System (SID-SSS). Teachers and nurses from preschools to universities in all 12 districts within Taipei are required to daily report cases of symptomatic children or sick leave requests through the SID-SSS. The pre-diagnosis at schools is submitted firstly as common pediatric disease syndrome-groups and re-submitted after confirmation by physicians. We retrieved these data from January 2010 to August 2011 for spatio-temporal analysis and evaluated the temporal trends with cases obtained from both the Emergency Department-based Syndromic Surveillance System (ED-SSS) and the Longitudinal Health Insurance Database 2005 (LHID2005). Through the SID-SSS, enterovirus-like illness (EVI) and influenza-like illness (ILI) were the two most reported syndrome groups (77.6% and 15.8% among a total of 19,334 cases, respectively). The pre-diagnosis judgments made by school teachers and nurses showed high consistency with physicians’ clinical diagnoses for EVI (97.8%) and ILI (98.9%). Most importantly, the SID-SSS had better timeliness with earlier peaks of EVI and ILI than those in the ED-SSS. Furthermore, both of the syndrome groups in these two surveillance systems had the best correlation reaching 0.98 and 0.95, respectively (p<0.01). Spatio-temporal analysis observed the patterns of EVI and ILI both diffuse from the northern suburban districts to central Taipei, with ILI spreading faster. This novel system can identify early suspected cases of two important pediatric infections occurring at schools, and clusters from schools/families. It was also cost-effective (95.5% of the operation cost reduced and 59.7% processing time saved). The timely surveillance of mild EVI and ILI cases integrated with spatial analysis may help public

  3. Optimizing A syndromic surveillance text classifier for influenza-like illness: Does document source matter?

    PubMed

    South, Brett R; South, Brett Ray; Chapman, Wendy W; Chapman, Wendy; Delisle, Sylvain; Shen, Shuying; Kalp, Ericka; Perl, Trish; Samore, Matthew H; Gundlapalli, Adi V

    2008-11-06

    Syndromic surveillance systems that incorporate electronic free-text data have primarily focused on extracting concepts of interest from chief complaint text, emergency department visit notes, and nurse triage notes. Due to availability and access, there has been limited work in the area of surveilling the full text of all electronic note documents compared with more specific document sources. This study provides an evaluation of the performance of a text classifier for detection of influenza-like illness (ILI) by document sources that are commonly used for biosurveillance by comparing them to routine visit notes, and a full electronic note corpus approach. Evaluating the performance of an automated text classifier for syndromic surveillance by source document will inform decisions regarding electronic textual data sources for potential use by automated biosurveillance systems. Even when a full electronic medical record is available, commonly available surveillance source documents provide acceptable statistical performance for automated ILI surveillance.

  4. Multiple Viral Infection Detected from Influenza-Like Illness Cases in Indonesia.

    PubMed

    Adam, Kindi; Pangesti, Krisna Nur Andriana; Setiawaty, Vivi

    2017-01-01

    Influenza is one of the common etiologies of the upper respiratory tract infection (URTI). However, influenza virus only contributes about 20 percent of influenza-like illness patients. The aim of the study is to investigate the other viral etiologies from ILI cases in Indonesia. Of the 334 samples, 266 samples (78%) were positive at least for one virus, including 107 (42%) cases of multiple infections. Influenza virus is the most detected virus. The most frequent combination of viruses identified was adenovirus and human rhinovirus. This recent study demonstrated high detection rate of several respiratory viruses from ILI cases in Indonesia. Further studies to determine the relationship between viruses and clinical features are needed to improve respiratory disease control program.

  5. Face mask use and control of respiratory virus transmission in households.

    PubMed

    MacIntyre, C Raina; Cauchemez, Simon; Dwyer, Dominic E; Seale, Holly; Cheung, Pamela; Browne, Gary; Fasher, Michael; Wood, James; Gao, Zhanhai; Booy, Robert; Ferguson, Neil

    2009-02-01

    Many countries are stockpiling face masks for use as a nonpharmaceutical intervention to control virus transmission during an influenza pandemic. We conducted a prospective cluster-randomized trial comparing surgical masks, non-fit-tested P2 masks, and no masks in prevention of influenza-like illness (ILI) in households. Mask use adherence was self-reported. During the 2006 and 2007 winter seasons, 286 exposed adults from 143 households who had been exposed to a child with clinical respiratory illness were recruited. We found that adherence to mask use significantly reduced the risk for ILI-associated infection, but <50% of participants wore masks most of the time. We concluded that household use of face masks is associated with low adherence and is ineffective for controlling seasonal respiratory disease. However, during a severe pandemic when use of face masks might be greater, pandemic transmission in households could be reduced.

  6. Investigating the effect of high spring incidence of pandemic influenza A(H1N1) on early autumn incidence.

    PubMed

    Burkom, H; Kniss, K; Meltzer, M; Brammer, L; Elbert, Y; Finelli, L; Swerdlow, D

    2012-12-01

    A pandemic H1N1 infection wave in the USA occurred during spring 2009. Some hypothesized that for regions affected by the spring wave, an autumn outbreak would be less likely or delayed compared to unaffected regions because of herd immunity. We investigated this hypothesis using the Outpatient Influenza-like Illness (ILI) Network, a collaboration among the Centers for Disease Control and Prevention, health departments, and care providers. We evaluated the likelihood of high early autumn incidence given high spring incidence in core-based statistical areas (CBSAs). Using a surrogate incidence measure based on influenza-related illness ratios, we calculated the odds of high early autumn incidence given high spring incidence. CBSAs with high spring ILI ratios proved more likely than unaffected CBSAs to have high early autumn ratios, suggesting that elevated spring illness did not protect against early autumn increases. These novel methods are applicable to planning and studies involving other infectious diseases.

  7. Commuter Mobility and the Spread of Infectious Diseases: Application to Influenza in France

    PubMed Central

    Charaudeau, Segolene; Pakdaman, Khashayar; Boëlle, Pierre-Yves

    2014-01-01

    Commuting data is increasingly used to describe population mobility in epidemic models. However, there is little evidence that the spatial spread of observed epidemics agrees with commuting. Here, using data from 25 epidemics for influenza-like illness in France (ILI) as seen by the Sentinelles network, we show that commuting volume is highly correlated with the spread of ILI. Next, we provide a systematic analysis of the spread of epidemics using commuting data in a mathematical model. We extract typical paths in the initial spread, related to the organization of the commuting network. These findings suggest that an alternative geographic distribution of GP accross France to the current one could be proposed. Finally, we show that change in commuting according to age (school or work commuting) impacts epidemic spread, and should be taken into account in realistic models. PMID:24416152

  8. Commuter mobility and the spread of infectious diseases: application to influenza in France.

    PubMed

    Charaudeau, Segolene; Pakdaman, Khashayar; Boëlle, Pierre-Yves

    2014-01-01

    Commuting data is increasingly used to describe population mobility in epidemic models. However, there is little evidence that the spatial spread of observed epidemics agrees with commuting. Here, using data from 25 epidemics for influenza-like illness in France (ILI) as seen by the Sentinelles network, we show that commuting volume is highly correlated with the spread of ILI. Next, we provide a systematic analysis of the spread of epidemics using commuting data in a mathematical model. We extract typical paths in the initial spread, related to the organization of the commuting network. These findings suggest that an alternative geographic distribution of GP accross France to the current one could be proposed. Finally, we show that change in commuting according to age (school or work commuting) impacts epidemic spread, and should be taken into account in realistic models.

  9. Association between early influenza vaccination and the reduction of influenza-like syndromes in health care providers.

    PubMed

    Saadeh-Navarro, Evelyn; Garza-González, Elvira; Salazar-Montalvo, Raúl Gabino; Rodríguez-López, Juan Manuel; Mendoza-Flores, Lidia; Camacho-Ortiz, Adrián

    2016-02-01

    A comparison of 2 different influenza seasons (2013-2014 and 2014-2015) where early vaccination among health care providers (HCPs) in the latter was the difference. Differences in leave of absence because of influenza-like illness (ILI) (52 vs 15 [total number of leave of absence issued], P < .001) and total days of lost work (218 vs 68, P < .001) were found for the 2013-2014 and 2014-2015 seasons, respectively. An association between earlier influenza vaccination among HCPs and a reduction in ILI, leave of absence, and days of lost work was found. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  10. [EFFICACY AND SECURITY OF A CONVENTIONAL PROCEDURE OF PLASMAPHERESIS IN COMPLEX OF TREATMENT OF NONBILIARY ACUTE PANCREATITIS IN EARLY PHASE OF THE DISEASE].

    PubMed

    Mishalov, V G; Markulan, L Yu; Matveyev, R M

    2016-02-01

    Abstract Efficacy and security of a plasmapheresis procedure in complex of treatment of nonbiliary acute pancreatitis in early phase of the disease were established, basing on the treatment results analysis in 48 patients. The plasmapheresis results were estimated in accordance to changes revealed in the intoxication leukocytic index (ILI), a general protein (GP) content, general calcium (GC) in the blood plasm and of the activated partial thrombin time (APTHT). Application of plasmapheresis in patients, suffering purulent pancreatitis in the enzymal phase, have guaranteed a staged reduction of ILI by (34.86 ± 1.27)%, the APTHT enhancement from (35.15 ± 0.37) to (52.01 ± 0.62) sec, a trustworthy lowering of the GP by (4.35 ± 0.02) g/L at average and of GC in a blood plasmby (10.45 ± 0.38)%.

  11. Multiple Viral Infection Detected from Influenza-Like Illness Cases in Indonesia

    PubMed Central

    Adam, Kindi

    2017-01-01

    Influenza is one of the common etiologies of the upper respiratory tract infection (URTI). However, influenza virus only contributes about 20 percent of influenza-like illness patients. The aim of the study is to investigate the other viral etiologies from ILI cases in Indonesia. Of the 334 samples, 266 samples (78%) were positive at least for one virus, including 107 (42%) cases of multiple infections. Influenza virus is the most detected virus. The most frequent combination of viruses identified was adenovirus and human rhinovirus. This recent study demonstrated high detection rate of several respiratory viruses from ILI cases in Indonesia. Further studies to determine the relationship between viruses and clinical features are needed to improve respiratory disease control program. PMID:28232948

  12. Preparedness for the prevention and control of influenza outbreaks on passenger ships in the EU: the SHIPSAN TRAINET project communication.

    PubMed

    Mouchtouri, Va; Black, N; Nichols, G; Paux, T; Riemer, T; Rjabinina, J; Schlaich, C; Menel Lemos, C; Kremastinou, J; Hadjichristodoulou, C

    2009-05-28

    Passenger ships carry a large number of people in confined spaces. A case of the new influenza A (H1N1) virus aboard a passenger ship is an expected event and would lead to rapid spread of the virus, if preventive measures are not in place. However, many cruise lines have detailed policies and procedures to deal with cases of influenza like illness (ILI). The EU SHIPSAN and SHIPSAN TRAINET projects include in their objectives guidelines for the prevention and control of communicable diseases aboard passenger ships. A literature review showed that from 1997 to 2005, nine confirmed outbreaks of influenza were linked to passenger ships, with attack rates up to 37%. It is important to establish and maintain a surveillance system for ILI aboard passenger ships, in order to systematically collect data that can help to determine the baseline illness levels. Monitoring these will enable early identification of outbreaks and allow timely implementation of control measures.

  13. Case series of rash associated with influenza B in school children

    PubMed Central

    Skowronski, Danuta M; Chambers, Catharine; Osei, William; Walker, Jill; Petric, Martin; Naus, Monika; Li, Yan; Krajden, Mel

    2015-01-01

    This case series describes morbilliform and other rash presentations among schoolchildren during a March 2014 outbreak of influenza-like illness (ILI) in British Columbia, Canada. Multiplex nucleic acid testing of nasopharyngeal specimens and paired serologic investigations identified that influenza B, characterized as B/Massachusetts/02/2012-like (Yamagata-lineage), was the only viral aetiology and most likely cause of ILI and rash. An association between influenza B and rash has been described infrequently elsewhere, and not previously in North America. Influenza B should be considered in the differential diagnosis of febrile exanthem. Evaluation of the nature, incidence and contributing agent–host–environment interactions, and immunologic mechanisms to possibly explain influenza-associated rash is warranted. PMID:25382064

  14. Automatic detection of tweets reporting cases of influenza like illnesses in Australia

    PubMed Central

    2015-01-01

    Early detection of disease outbreaks is critical for disease spread control and management. In this work we investigate the suitability of statistical machine learning approaches to automatically detect Twitter messages (tweets) that are likely to report cases of possible influenza like illnesses (ILI). Empirical results obtained on a large set of tweets originating from the state of Victoria, Australia, in a 3.5 month period show evidence that machine learning classifiers are effective in identifying tweets that mention possible cases of ILI (up to 0.736 F-measure, i.e. the harmonic mean of precision and recall), regardless of the specific technique implemented by the classifier investigated in the study. PMID:25870759

  15. Operation HARDTACK. Volume 2. Radiological Safety. Extracted Version

    DTIC Science & Technology

    1979-10-01

    POJOA , C J~~’/𔄃( Vera )L (Levoy)e ((Oscar) * / (Re RIBAI(Tom)______ (I(Van) (Fred)R iliS~~ ~ ~ OF S;3 IE/1 NYA Avn (I(Henry) DEEP ENTRANC Radiologica...Bikini fer 75 iles and north for 3C mieae, 50 miles outo to confirm thse vstarn- ,. x sn’ o.f tie fallout patte:-n, Ve!!o-:t ara predicZ31 alo g a...Osar ’ (Ruby BIJI (L( Vera ) DEEP ENTRANCE PHOTO TOWERERONU (Osca()M) F Arin 0 /X (V n 4 TADPTE TEAK AND ORANGE EVENT OPERATION HARDTACK - In view of

  16. Case series of rash associated with influenza B in school children.

    PubMed

    Skowronski, Danuta M; Chambers, Catharine; Osei, William; Walker, Jill; Petric, Martin; Naus, Monika; Li, Yan; Krajden, Mel

    2015-01-01

    This case series describes morbilliform and other rash presentations among schoolchildren during a March 2014 outbreak of influenza-like illness (ILI) in British Columbia, Canada. Multiplex nucleic acid testing of nasopharyngeal specimens and paired serologic investigations identified that influenza B, characterized as B/Massachusetts/02/2012-like (Yamagata-lineage), was the only viral aetiology and most likely cause of ILI and rash. An association between influenza B and rash has been described infrequently elsewhere, and not previously in North America. Influenza B should be considered in the differential diagnosis of febrile exanthem. Evaluation of the nature, incidence and contributing agent-host-environment interactions, and immunologic mechanisms to possibly explain influenza-associated rash is warranted. © 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

  17. Do Genetic Modifiers of HDL-C and Triglyceride Levels also Modify Their Response to a Lifestyle Intervention in the Setting of Obesity and Type-2 Diabetes Mellitus? The Look AHEAD Study

    PubMed Central

    Huggins, Gordon S.; Papandonatos, George D.; Erar, Bahar; Belalcazar, L. Maria; Brautbar, Ariel; Ballantyne, Christie; Kitabchi, Abbas E.; Wagenknecht, Lynne E.; Knowler, William C.; Pownall, Henry J.; Wing, Rena R.; Peter, Inga; McCaffery, Jeanne M.

    2014-01-01

    Background High-density lipoprotein cholesterol (HDL-C) and triglycerides are cardiovascular risk factors susceptible to lifestyle behavior modification and genetics. We hypothesized that genetic variants identified by genome-wide association studies (GWASs) as associated with HDL-C or triglyceride levels will modify 1-year treatment response to an intensive lifestyle intervention (ILI), relative to a usual care of diabetes support and education (DSE). Methods and Results We evaluated 82 SNPs, representing 31 loci demonstrated by GWAS to be associated with HDL-C and/or triglycerides, in 3,561 participants who consented for genetic studies and met eligibility criteria. Variants associated with higher baseline HDL-C levels, cholesterol ester transfer protein (CETP) rs3764261 and hepatic lipase (LIPC) rs8034802, were found to be associated with HDL-C increases with ILI (p=0.0038 and 0.013, respectively) and had nominally significant treatment interactions (p=0.047 and 0.046, respectively). The fatty acid desaturase-2 (FADS-2) rs1535 variant, associated with low baseline HDL-C (p=0.017), was associated with HDL-C increases with ILI (0.0037) and had a nominal treatment interaction (p= 0.035). ApoB (rs693) and LIPC (rs8034802) SNPs showed nominally significant associations with HDL-C and triglyceride changes with ILI and a treatment interaction (p<0.05). A PGS1 SNP (rs4082919) showed the most significant triglyceride treatment interaction in the full cohort (p=0.0009). Conclusions This is the first study to identify genetic variants modifying lipid responses to a randomized lifestyle behavior intervention in overweight/obese diabetic individuals. The effect of genetic factors on lipid changes may differ from the effects on baseline lipids and are modifiable by behavioral intervention. PMID:23861364

  18. A System Approach to Navy Medical Education and Training. Volume II.

    DTIC Science & Technology

    1974-08-31

    the classroom lecture as traditionally presented by a teacher to the more sophisticated mediated program for self- instruction. The training aids, like...z-~ Ilk4 1- ca - I0 -L ci ILI LL- .40 kn Ca- cc a LL 1 Li US ifi 0i C U.. OvI I.- Cc, of efL " Ui -LL Ij c 0 IC Ia. LL, U- 0 I-f - a- ~~4m vi .a7 -aa

  19. Improving Adiponectin Levels in Individuals With Diabetes and Obesity: Insights From Look AHEAD.

    PubMed

    Belalcazar, L Maria; Lang, Wei; Haffner, Steven M; Schwenke, Dawn C; Kriska, Andrea; Balasubramanyam, Ashok; Hoogeveen, Ron C; Pi-Sunyer, F Xavier; Tracy, Russell P; Ballantyne, Christie M

    2015-08-01

    This study investigated whether fitness changes resulting from lifestyle interventions for weight loss may independently contribute to the improvement of low adiponectin levels in obese individuals with diabetes. Look AHEAD (Action for Health in Diabetes) randomized overweight/obese individuals with type 2 diabetes to intensive lifestyle intervention (ILI) for weight loss or to diabetes support and education (DSE). Total and high-molecular weight adiponectin (adiponectins), weight, and cardiorespiratory fitness (submaximal exercise stress test) were measured in 1,397 participants at baseline and at 1 year, when ILI was most intense. Regression analyses examined the associations of 1-year weight and fitness changes with change in adiponectins. ILI resulted in greater improvements in weight, fitness, and adiponectins at 1 year compared with DSE (P < 0.0001). Weight loss and improved fitness were each associated with changes in adiponectins in men and women (P < 0.001 for all), after adjusting for baseline adiponectins, demographics, clinical variables, and treatment arm. Weight loss contributed an additional 4-5% to the variance of change in adiponectins than did increased fitness in men; in women, the contributions of improved fitness (1% greater) and of weight loss were similar. When weight and fitness changes were both accounted for, weight loss in men and increased fitness in women retained their strong associations (P < 0.0001) with adiponectin change. Improvements in fitness and weight with ILI were favorably but distinctly associated with changes in adiponectin levels in overweight/obese men and women with diabetes. Future studies need to investigate whether sex-specific biological determinants contribute to the observed associations. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  20. Optimizing Human Cognition

    DTIC Science & Technology

    2013-01-01

    flOOBa 1. ll..LTC dMPFC vMPFC AUTOBIOGRAPHICAL MEMORY ENVISIONING THE FUTURE THEORY OF MIND MORAL DECISION MAKING f iGURf 12 . The cleb.d: Ml...1!-.e lilcrature il:; lralc lhogeJ)Cro!ily. (A) Autob;ogrOjlhicol merT-ory: subjecb lO:Co:.onl o lp«i1e.. p~1 ~ from memory . (8) Envisioning rt.e

  1. Geomorphological Investigation of the Atchafalaya Basin, Area West, Atchafalaya Delta, and Terrebonne Marsh. Volume 1.

    DTIC Science & Technology

    1986-04-01

    rl.... eort o’. dpIrIrisaII Of iii r cii iiiiiir i~ili piocidki~s. DISCLAIMER NOTICE THIS DOCUMENT IS BEST QUALITY PRACTICABLE. THE COPY FURNISHED TO...controlled mosaics of panchromatic photography (1:24,000) flown in December 1955 and October 1956 was also used. The high quality of the color...valley or by flood flow crevassing a short distance upstream of the abandoned channel segment. Abandonment usually occurs because of an improved

  2. Benign Breast Disease: Toward Molecular Prediction of Breast Cancer Risk

    DTIC Science & Technology

    2005-06-01

    David W. Hillman, M.S., Vera J. Suman, Ph.D., JoJohnson, R.N., Cassann Blake, M.D, Thea TIsty, PhD., Celine M. Vachon, Ph.D., L.Joseph Melton IlI, M.D...structures. For comparison, a normal lobule is on the left side. Panel C alo shows proliferative hyperplasia without atypia. This is modeiate ductal

  3. Cost Effectiveness Study of Wastewater Management Systems for Selected U.S. Coast Guard Vessels. Volume 2. Effectiveness Assessment of Candidate Systems

    DTIC Science & Technology

    1977-03-01

    wisLiILI 10 L 1.0" (ConLinued) AnAr•. IstAl . acf Anil. An,,. Effectiveness Attriute Data and Ratings for Viable Syst mVessel Combinations WMS GALLATIN...experience, iAnL til. Cow etc. Anal. An&L, (Cont’d.) Effectiveness Attribute Data and Ratings for Viable Systqm/Vessel Combnat ns WMS -GALLATIN

  4. One-Year Changes in Symptoms of Depression and Weight in Overweight/Obese Individuals with Type 2 Diabetes in the Look AHEAD study

    PubMed Central

    Faulconbridge, Lucy F.; Wadden, Thomas A.; Rubin, Richard R.; Wing, Rena R.; Walkup, Michael P.; Fabricatore, Anthony N.; Coday, Mace; Van Dorsten, Brent; Mount, David L.; Ewing, Linda J.

    2011-01-01

    Depressed individuals are frequently excluded from weight loss trials because of fears that weight reduction may precipitate mood disorders, as well as concerns that depressed participants will not lose weight satisfactorily. The present study examined participants in the Look AHEAD study to determine whether moderate weight loss would be associated with incident symptoms of depression and suicidal ideation, and whether symptoms of depression at baseline would limit weight loss at 1 year. Overweight/obese adults with type 2 diabetes (n=5145) were randomly assigned to an Intensive Lifestyle Intervention (ILI) or a usual care group, Diabetes Support and Education (DSE). Of these, 5129 participants completed the Beck Depression Inventory (BDI) and had their weight measured at baseline and 1 year. Potentially significant symptoms of depression were defined by a BDI score ≥10. Participants in ILI lost 8.6±6.9% of initial weight at 1 year, compared to 0.7±4.8% for DSE (P<0.001, effectsize=−1.33), and had a reduction of 1.4±4.7 points on the BDI, compared to 0.4±4.5 for DSE (P<0.001, effectsize=0.23). At 1 year, the incidence of potentially significant symptoms of depression was significantly (RR=0.66, 95%CI=0.5,0.8; P<0.001) lower in the ILI than DSE group (6.3% vs. 9.6%). In the ILI group, participants with and without symptoms of depression lost 7.8±6.7% and 8.7±6.9%, respectively, a difference not considered clinically meaningful. Intentional weight loss was not associated with the precipitation of symptoms of depression, but instead appeared to protect against this occurrence. Mild (or greater) symptoms of depression at baseline did not prevent overweight/obese individuals with type 2 diabetes from achieving significant weight loss. PMID:22016099

  5. Annual Progress Report, Fiscal Year 1980

    DTIC Science & Technology

    1980-10-01

    body Temperature Cognitive Function Altit•de Acclim.2.tization Catecholamine Cold Induced Vasodilation Anaerobic Power Chemoreceptors Cold Injury Ili;, i... Cold Injury and Hypothermia 41 002 Development and Characterization of Models to Study Acute Mountain Sickness and High Alcitude Pulmonary Edema in...Performance WORK UNIT NUMBER AND TITLE 041 Prophylaxis Susceptibility and Predisposing Factors of Cold Injury 167 042 Models of Heat Disabilities: Treatment

  6. Army Sustainability and Leadership in Energy and Environmental Design

    DTIC Science & Technology

    2010-08-01

    environmental impacts and hu- man benefits of each credit. The impacts and benefits are defined as the environmental or human effect of the design...and credits (6) section focuses on environmental impact of materials brought into the project (materials selection) and the mini- mization of landfill...environment.”3 By Mrs. Rebecca C. Wingfield Army Sustainability and Leadership in Energy and Environmental Design i ili i i i l i Three Pillars of

  7. Age Distribution of Influenza Like Illness Cases during Post-Pandemic A(H3N2): Comparison with the Twelve Previous Seasons, in France

    PubMed Central

    Turbelin, Clément; Souty, Cécile; Pelat, Camille; Hanslik, Thomas; Sarazin, Marianne; Blanchon, Thierry; Falchi, Alessandra

    2013-01-01

    In France, the 2011–2012 influenza epidemic was characterized by the circulation of antigenically drifted influenza A(H3N2) viruses and by an increased disease severity and mortality among the elderly, with respect to the A(H1N1)pdm09 pandemic and post-pandemic outbreaks. Whether the epidemiology of influenza in France differed between the 2011–2012 epidemic and the previous outbreaks is unclear. Here, we analyse the age distribution of influenza like illness (ILI) cases attended in general practice during the 2011–2012 epidemic, and compare it with that of the twelve previous epidemic seasons. Influenza like illness data were obtained through a nationwide surveillance system based on sentinel general practitioners. Vaccine effectiveness was also estimated. The estimated number of ILI cases attended in general practice during the 2011–2012 was lower than that of the past twelve epidemics. The age distribution was characteristic of previous A(H3N2)-dominated outbreaks: school-age children were relatively spared compared to epidemics (co-)dominated by A(H1N1) and/or B viruses (including the 2009 pandemic and post-pandemic outbreaks), while the proportion of adults over 30 year-old was higher. The estimated vaccine effectiveness (54%, 95% CI (48, 60)) was in the lower range for A(H3N2) epidemics. In conclusion, the age distribution of ILI cases attended in general practice seems to be not different between the A(H3N2) pre-pandemic and post-pandemic epidemics. Future researches including a more important number of ILI epidemics and confirmed virological data of influenza and other respiratory pathogens are necessary to confirm these results. PMID:23755294

  8. Population-based Surveillance for Medically Attended Human Parainfluenza Viruses From the Influenza Incidence Surveillance Project, 2010–2014

    PubMed Central

    Finelli, Lyn; Whitaker, Brett; Fowlkes, Ashley

    2016-01-01

    Background: Parainfluenza viruses (PIV) have been shown to contribute substantially to pediatric hospitalizations in the United States. However, to date, there has been no systematic surveillance to estimate the burden among pediatric outpatients. Methods: From August 2010 through July 2014, outpatient health care providers with enumerated patient populations in 13 states and jurisdictions participating in the Influenza Incidence Surveillance Project conducted surveillance of patients with influenza-like illness (ILI). Respiratory specimens were collected from the first 10 ILI patients each week with demographic and clinical data. Specimens were tested for multiple respiratory viruses, including PIV1–4, using reverse transcriptase–polymerase chain reaction assays. Cumulative incidence was calculated using provider patient population size as the denominator. Results: PIVs 1–3 were detected in 8.0% of 7716 ILI-related outpatient specimens: 30% were PIV1, 26% PIV2 and 44% PIV3. PIV circulation varied noticeably by year and type, with PIV3 predominating in 2010–2011 (incidence 110 per 100,000 children), PIV1 in 2011–2012 (89 per 100,000), dual predominance of PIV2 and PIV3 (88 and 131 per 100,000) in 2012–2013 and PIV3 (100 per 100,000) in 2013–2014. The highest incidence of PIV detections was among patients aged <5 years (259–1307 per 100,000). The median age at detection for PIV3 (3.4 years) was significantly lower than the median ages for PIV1 (4.5 years) and PIV2 (7.0 years; P < 0.05). Conclusions: PIVs 1–3 comprise a substantial amount of medically attended pediatric ILI, particularly among children aged <5 years. Distinct seasonal circulation patterns as well as significant differences in rates by age were observed between PIV types. PMID:26974891

  9. Final Technical Report for Contract Number N00014-81-K-0457.

    DTIC Science & Technology

    1986-01-01

    hydration of peridotite at relatively low (< 450’ C) temperatures. Seismic velocities of the peridotites are lowered to crustal values, and hence the...earth called ophiolite model for the oceanic crust. In would serpentinize the mantle peridotites and sciences. The oceanic crust, which we define as that...turn, overlie units of massive ary within the mantle peridotite , and as much ily studied by indirect means, usually seismic and cumulate gabbros, which

  10. Medical Surveillance Monthly Report. Volume 19, Number 5

    DTIC Science & Technology

    2012-05-01

    agents and have vary- ing geographic distributions. In the U.S. tickborne diseases include Lyme disease, Rocky Mountain spotted fever (RMSF...4,6,7 Tick vectors of Rocky Mountain Spotted Fever (RMSF) and other diseases Dermacentor variabilis, the American dog tick or wood tick, is found in...more read- ily detected than Ixodes species. Dermacentor andersoni, the Rocky Mountain wood tick, is found in the west- ern and northern U.S. and is a

  11. The use of Aotus Trivirgatus and Macaca Mulatta as Tools for Studies on Prevention and Therapy of Infections with Plasmodium Falciparum and Plasmodium Vivax

    DTIC Science & Technology

    1976-08-13

    ily three new agents were examined for blood schizonticidal activity. One of these, WR-226, 253, a quino - linemethanol, exhibited activity equal...schizonticidal activity. One of these, WR-226, 253, a quino - linemethanol, exhibited activity equal to or surpassing that of WR-142, 490 (mefloquine...promising quino - linemethanols (cf Figure 1). These features, coupled with demonstrable activity against infections with trophozoites of the B

  12. Forecasting the 2013–2014 influenza season using Wikipedia

    DOE PAGES

    Hickmann, Kyle S.; Fairchild, Geoffrey; Priedhorsky, Reid; ...

    2015-05-14

    Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are appliedmore » to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed.« less

  13. Forecasting the 2013–2014 influenza season using Wikipedia

    SciTech Connect

    Hickmann, Kyle S.; Fairchild, Geoffrey; Priedhorsky, Reid; Generous, Nicholas; Hyman, James M.; Deshpande, Alina; Del Valle, Sara Y.; Salathé, Marcel

    2015-05-14

    Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are applied to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed.

  14. AFHRL Annual Report FY 81.

    DTIC Science & Technology

    1981-01-01

    priogramrs andl for inupro’.ed piersoeunel Comrntd for flte si’leitjii aiid ila~’.if jat un (iti both ciassification. *riese’ rmeasures A..ill replaice...nfevlripirng ’Aiirk plans for fir’ PAS ’Airhic’f beraiva r’ffr’ti~r’ I (11etliber 1981. \\t thai time. all ’I’vell Ili ca I A v11 iv vellit. I I Is 4

  15. Corrosion and Biofouling of OTEC System Surfaces - Design Factors

    DTIC Science & Technology

    1978-11-01

    coupled with fracture mechan- ics can be used to determine the maximum flaw size that can be tolerated in a given material and to define the level of...inspection required to locate flaws of this critical size . ILI The following materials are recognized to be susceptible to stress corrosion cracking in...large amounts of downtime. Since OTEC plants Pe significantly different from any system built to date in both size and operating characteristics, there is

  16. A System Approach to Navy Medical Education and Training. Appendix 22. Otolaryngology Technician.

    DTIC Science & Technology

    1974-08-31

    SURGERY 27 IREASSURE/CAL APPREHENSIVE (ANXIOUS) PATIENT 28 IREASSURE APPREHENSIVE PARENTS OF PEDIATRIC PATIENT 29 IREASSURE/CAL4 CHILDREN FOR EXAMINATION...CONTROL PATIENT PHYSICALLYE.G.ARM HOLD 33 IRESTRAIN/CONTROL CHILDREN FOR EXAMINATION/TREAT4ENT/TEST 34 ITEACH PATIENT/FA4ILY SIDE EFFECTS OF MEDICATI134E.G...TO PATIENT/ IFAMILY 44 IEXPLAIN/ANSWER PATIENT’S QUESTIONS REGARDING SYMPTCMS/DISEASE/ TREATMENT 45 IINSTRUCT PARENTS ON CARE OF CHILDREN WITH

  17. Nowcasting influenza outbreaks using open-source media report.

    SciTech Connect

    Ray, Jaideep; Brownstein, John S.

    2013-02-01

    We construct and verify a statistical method to nowcast influenza activity from a time-series of the frequency of reports concerning influenza related topics. Such reports are published electronically by both public health organizations as well as newspapers/media sources, and thus can be harvested easily via web crawlers. Since media reports are timely, whereas reports from public health organization are delayed by at least two weeks, using timely, open-source data to compensate for the lag in %E2%80%9Cofficial%E2%80%9D reports can be useful. We use morbidity data from networks of sentinel physicians (both the Center of Disease Control's ILINet and France's Sentinelles network) as the gold standard of influenza-like illness (ILI) activity. The time-series of media reports is obtained from HealthMap (http://healthmap.org). We find that the time-series of media reports shows some correlation ( 0.5) with ILI activity; further, this can be leveraged into an autoregressive moving average model with exogenous inputs (ARMAX model) to nowcast ILI activity. We find that the ARMAX models have more predictive skill compared to autoregressive (AR) models fitted to ILI data i.e., it is possible to exploit the information content in the open-source data. We also find that when the open-source data are non-informative, the ARMAX models reproduce the performance of AR models. The statistical models are tested on data from the 2009 swine-flu outbreak as well as the mild 2011-2012 influenza season in the U.S.A.

  18. Human Health Exposure Assessment for Rocky Mountain Arsenal. Volume 8. Response to Comments on the Draft Exposure Assessment Version 4.1

    DTIC Science & Technology

    1990-09-01

    restrictions will necessa:ily prevent the selection of such a cleanup at the Arsenal . EPA guidance clearly illustrates how unacceptable it is to base this...necessarily prevent the selection of such a cleanup at the Arsenal . EPA guidance clearly illustrates how unacceptable it is to base this Exposure...90277ROI VOLUME VIII AD-A279_ 056 ORIGINAL PIOGRAM MANAGER FOR ROCKY MOUNTAIN ARSENAL U.S. ARMY MATERIEL COMMAND - COMMITTED TO PROTECTION OF THE

  19. Predictive Modelling of Operative Performance by Means of Personality Traits - Implications for Selection of Personnel

    DTIC Science & Technology

    2010-06-02

    selection of personnel working under high psychological stress, task load and risk. Selection of e.g. military pilots by means of personality traits as well...Resources. Digman, J.M. 1997, Higher-Order factors of the Big Five, Journal of Personality and Social Psychology , 73, 1246-1256. Gorsuch, R.L. (1974...Bono, J. E., Ilies, R., & Gerhardt, M. (2002). Personality and leadership: A qualitative and quantitative review. Journal of Applied Psychology , 87

  20. Computer-Aided Structural Engineering (CASE) Project. Sliding Stability of Concrete Structures (CSLIDE).

    DTIC Science & Technology

    1987-10-01

    of CASE (G-CASE) Projects % LL Acoession For By-- Av1b10 tY CJ,. .; -. Di~t vS Uncla.q-qif fpd SECURITY CLASIFICATION OF THIS PAGE% %’ %1 .% P REFACE...lllllllllllllI Illllllllllhll 1-4. M ILI 1ŗ mg AS .1 0 Sf~ )Y ROW 1NON (’M CARI * S ljp v lp. IL 57. The final results of Problem 4, paragraph 51a, using the

  1. A History of Russian and Soviet Naval Development.

    DTIC Science & Technology

    1988-03-01

    her Eastward expansion. This disquieting period ended with the accession of the Romanov dynasty to the throne 17 ILI 96t Figur 2.317th entuy EAnso ARf...Naval developments during the first two regimes of the Romanov dynasty were small in scale. During the reign of Michael (1613-1645) Cossack pirates...59] By selecting Kiev as his power base, Oleg established the Kievan State, a dynasty which would last until the Mongol invasion of the thirteenth

  2. Prospective surveillance study of acute respiratory infections, influenza-like illness and seasonal influenza vaccine in a cohort of juvenile idiopathic arthritis patients

    PubMed Central

    2013-01-01

    Background Acute respiratory infections (ARI) are frequent in children and complications can occur in patients with chronic diseases. We evaluated the frequency and impact of ARI and influenza-like illness (ILI) episodes on disease activity, and the immunogenicity and safety of influenza vaccine in a cohort of juvenile idiopathic arthritis (JIA) patients. Methods Surveillance of respiratory viruses was conducted in JIA patients during ARI season (March to August) in two consecutive years: 2007 (61 patients) and 2008 (63 patients). Patients with ARI or ILI had respiratory samples collected for virus detection by real time PCR. In 2008, 44 patients were immunized with influenza vaccine. JIA activity index (ACRPed30) was assessed during both surveillance periods. Influenza hemagglutination inhibition antibody titers were measured before and 30-40 days after vaccination. Results During the study period 105 ARI episodes were reported and 26.6% of them were ILI. Of 33 samples collected, 60% were positive for at least one virus. Influenza and rhinovirus were the most frequently detected, in 30% of the samples. Of the 50 JIA flares observed, 20% were temporally associated to ARI. Influenza seroprotection rates were higher than 70% (91-100%) for all strains, and seroconversion rates exceeded 40% (74-93%). In general, response to influenza vaccine was not influenced by therapy or disease activity, but patients using anti-TNF alpha drugs presented lower seroconversion to H1N1 strain. No significant differences were found in ACRPed30 after vaccination and no patient reported ILI for 6 months after vaccination. Conclusion ARI episodes are relatively frequent in JIA patients and may have a role triggering JIA flares. Trivalent split influenza vaccine seems to be immunogenic and safe in JIA patients. PMID:23510667

  3. Respiratory infections and gastrointestinal illness on a cruise ship: A three-year prospective study.

    PubMed

    Pavli, Androula; Maltezou, Helena C; Papadakis, Antonis; Katerelos, Panagiotis; Saroglou, Georgios; Tsakris, Athanasios; Tsiodras, Sotirios

    2016-01-01

    Cruise ships carry a large number of people in confined spaces providing an environment for transmission of infections. The aim of this study is to estimate the incidence of and describe the spectrum of respiratory infections and gastrointestinal illness among passengers and crew of cruise Ship A. The study was carried out from January 2011 to December 2013 on cruise Ship A, including passengers and crew who presented with symptoms suggestive of acute respiratory infection (ARI), influenza-like illness (ILI) and gastrointestinal illness (GI). Advice about preventive measures of respiratory and gastrointestinal infections and influenza vaccination was given to passengers and crew. Data were collected by using one standardized form per patient. The most common destination was Northern Europe (90.7%). The mean duration of cruise was 10.6 days; 440 passengers and 421 crew members who sought medical attention were studied (mean age 72.6 ± 9.5 and 33 ± 7 years, respectively). ILI, ARI and GI were diagnosed in 32.7%, 15.9%, 17% and 10.9%, 80%, 0.2% of ill passengers and crew, respectively. The association of ARI, ILI and GI incidence in passengers was statistically significant with season, destination and duration of travel; the incidence for all illnesses was higher during winter, for travel to South America and for >14 days (p-value<0.001). ARI, ILI and GI continue to pose a burden on cruise travel; therefore pre-travel advice is crucial for passengers and crew regarding respiratory and gastrointestinal infections. Surveillance and implementation of control measures are important for outbreak prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. AFOSR/AFRPL Rocket Propulsion Research Meeting Held at Lancaster, California on 12-15 March 1984. Abstracts and Agenda

    DTIC Science & Technology

    1984-02-01

    Pennsylvania State University, University Park, PA 1030 31 PLASMA INITIATION MECHANISMS, ABSORPTION OR CW LASER ENERGY AND MIXING FLUID MECHANICS...ILiJIDIZED BED SPACE POWER SYSTEMS. Owen C Jones, Jr, Rensselaer Polytechnic Institute, Troy, NY 0830 Invited: NASA SPONSORED RESEARCH ON NONCONVENTIONAL...founded. Suppressants 0 apparently work by one or more of three mechanisms: (1) energy loss due to viscous dissipation due to drag forces, (2

  5. Terrain Considerations and Data Base Development for the Design and Testing of Devices to Detect Intruder-Induced Ground Motion

    DTIC Science & Technology

    1978-05-01

    fill and top-layer soils are poorly compacted. Site 2 is on a hill which is underlair by tonalite (quartz diorite ). Top-layer soils are loose residual...tonalite (quartz diorite ) and diorite . The Recent alluvial deposits are generally unconsolidated. A depth greater than 400 m has been reported for the...the abyssal rocks (tonalite and diorite ) and consist primarIly of sandy loums (SM and SC). Residual soils range in color from dark brown or brown to

  6. Effectiveness and safety of the A-H1N1 vaccine in children: a hospital-based case–control study

    PubMed Central

    2011-01-01

    Objective To verify whether vaccination against the A-H1N1 virus in the paediatric population was effective in preventing the occurrence of influenza-like illness (ILI) or was associated with adverse events of special interest. Design, setting and patients A case–control analysis was performed as part of surveillance of children hospitalised through the emergency departments of eight paediatric hospitals/wards for ILI, neurological disorders, non-infectious muco-cutaneous diseases and vasculitis, thrombocytopaenia and gastroduodenal lesions. Results Among 736 children enrolled from November 2009 to August 2010, only 25 had been vaccinated with the pandemic vaccine. Out of 268 children admitted for a diagnosis compatible with the adverse events of special interest, six had received the A-H1N1 vaccine, although none of the adverse events occurred within the predefined risk windows. Only 35 children out of 244 admitted with a diagnosis of ILI underwent laboratory testing: 11 were positive and 24 negative for the A-H1N1 virus. None of the A-H1N1 positive children had received the pandemic vaccine. The OR of ILI associated with any influenza vaccination was 0.9 (95% CI 0.1 to 5.5). Conclusions The study provides additional information on the benefit–risk profile of the pandemic vaccine. No sign of risk associated with the influenza A-H1N1 vaccine used in Italy was found, although several limitations were observed: in Italy, pandemic vaccination coverage was low, the epidemic was almost over by mid December 2009 and the A-H1N1 laboratory test was performed only during the epidemic phase (in <10% of children). This study supports the importance of the existing network of hospitals for the evaluation of signals relevant to new vaccines and drugs. PMID:22021877

  7. A diagnostic one-step real-time reverse transcription polymerase chain reaction method for accurate detection of influenza virus type A

    PubMed Central

    Behzadi, Mohammad Amin; Alborzi, Abdolvahab

    2016-01-01

    Introduction Influenza A is known as a public health concern worldwide. In this study, a novel one-step real-time reverse transcription polymerase chain reaction (rtRT-PCR) assay was designed and optimized for the detection of influenza A viruses. Material and methods The primers and probe were designed based on the analysis of 90 matrix nucleotide sequence data of influenza type A subtypes from the GenBank database of the National Center for Biotechnology Information (NCBI). The influenza virus A/Tehran/5652/2010 (H1N1 pdm09) was used as a reference. The rtRT-PCR assay was optimized, compared with that of the World Health Organization (WHO), and its analytical sensitivity, specificity and reproducibility were evaluated. In total, 64 nasopharyngeal swabs from patients with influenza-like illness (ILI) and 41 samples without ILI symptoms were tested for the virus, using conventional cell culture, direct immunofluorescence antibody (DFA) methods, and one-step rtRT-PCR with the designed primer set and probe and the WHO’s. Results The optimized assay results were similar to the WHO’s. The optimized assay results were similar to WHO’s, with non-significant differences for 10–103 copies of viral RNA/reaction (p > 0.05). It detected 10 copies of viral RNA/reaction with high reproducibility and no cross reactivity with other respiratory viruses. A specific cytopathic effect was observed in 6/64 (9.37%) of the ILI group using conventional culture and DFA staining methods; however, it was not seen in non-ILI. Also, the results of our assay and the WHO’s were similar to those of viral isolation and DFA staining. Conclusions Given the high specificity, sensitivity and reproducibility of this novel assay, it can serve as a reliable diagnostic tool for the detection of influenza A viruses in clinical specimens and lab experiments. PMID:27904520

  8. Outbreak of H3N2 Influenza at a US Military Base in Djibouti during the H1N1 Pandemic of 2009

    PubMed Central

    Cosby, Michael T.; Pimentel, Guillermo; Nevin, Remington L.; Fouad Ahmed, Salwa; Klena, John D.; Amir, Ehab; Younan, Mary; Browning, Robert; Sebeny, Peter J.

    2013-01-01

    Background Influenza pandemics have significant operational impact on deployed military personnel working in areas throughout the world. The US Department of Defense global influenza-like illness (ILI) surveillance network serves an important role in establishing baseline trends and can be leveraged to respond to outbreaks of respiratory illness. Objective We identified and characterized an operationally unique outbreak of H3N2 influenza at Camp Lemonnier, Djibouti occurring simultaneously with the H1N1 pandemic of 2009 [A(H1N1)pdm09]. Methods Enhanced surveillance for ILI was conducted at Camp Lemonnier in response to local reports of a possible outbreak during the A(H1N1)pdm09 pandemic. Samples were collected from consenting patients presenting with ILI (utilizing a modified case definition) and who completed a case report form. Samples were cultured and analyzed using standard real-time reverse transcriptase PCR (rt-RT-PCR) methodology and sequenced genetic material was phylogenetically compared to other published strains. Results rt-RT-PCR and DNA sequencing revealed that 25 (78%) of the 32 clinical samples collected were seasonal H3N2 and only 2 (6%) were A(H1N1)pdm09 influenza. The highest incidence of H3N2 occurred during the month of May and 80% of these were active duty military personnel. Phylogenetic analysis revealed that sequenced H3N2 strains were genetically similar to 2009 strains from the United States of America, Australia, and South east Asia. Conclusions This outbreak highlights challenges in the investigation of influenza among deployed military populations and corroborates the public health importance of maintaining surveillance systems for ILI that can be enhanced locally when needed. PMID:24339995

  9. Military Energy Alternatives Conference

    DTIC Science & Technology

    2012-03-08

    Power Generation and Alternative Energy Branch US Army RDECOM CERDEC CP&ID Power Division Aberdeen Proving Ground, MD...RDER-CCA-PG PG A E - C R – 1 2– 0 1 M ili ta ry E ne rg y A lte rn at iv es C on fe re nc e Military Energy ...TITLE AND SUBTITLE Military Energy Alternatives Conference 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Jonathan

  10. Expendable Remotely Piloted Vehicles for Strategic Offensive Airpower Roles

    DTIC Science & Technology

    1996-06-01

    nautics. A comparison with the term cyborg may be helpful in under- standing this concept. Webster’s dictionary defines a cyborg as “a human being who...swiveled lasers fore and aft, small tachyon power plants below the lasers. Everything automated; the machine would land us as quickly as possible and then...directs vehicle one towards the next target—an electrical power plant . This particular target has heav­ ily defended aim points, so she selects three

  11. Forecasting the 2013-2014 influenza season using Wikipedia.

    PubMed

    Hickmann, Kyle S; Fairchild, Geoffrey; Priedhorsky, Reid; Generous, Nicholas; Hyman, James M; Deshpande, Alina; Del Valle, Sara Y

    2015-05-01

    Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are applied to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed.

  12. Forecasting the 2013–2014 Influenza Season Using Wikipedia

    PubMed Central

    Hickmann, Kyle S.; Fairchild, Geoffrey; Priedhorsky, Reid; Generous, Nicholas; Hyman, James M.; Deshpande, Alina; Del Valle, Sara Y.

    2015-01-01

    Infectious diseases are one of the leading causes of morbidity and mortality around the world; thus, forecasting their impact is crucial for planning an effective response strategy. According to the Centers for Disease Control and Prevention (CDC), seasonal influenza affects 5% to 20% of the U.S. population and causes major economic impacts resulting from hospitalization and absenteeism. Understanding influenza dynamics and forecasting its impact is fundamental for developing prevention and mitigation strategies. We combine modern data assimilation methods with Wikipedia access logs and CDC influenza-like illness (ILI) reports to create a weekly forecast for seasonal influenza. The methods are applied to the 2013-2014 influenza season but are sufficiently general to forecast any disease outbreak, given incidence or case count data. We adjust the initialization and parametrization of a disease model and show that this allows us to determine systematic model bias. In addition, we provide a way to determine where the model diverges from observation and evaluate forecast accuracy. Wikipedia article access logs are shown to be highly correlated with historical ILI records and allow for accurate prediction of ILI data several weeks before it becomes available. The results show that prior to the peak of the flu season, our forecasting method produced 50% and 95% credible intervals for the 2013-2014 ILI observations that contained the actual observations for most weeks in the forecast. However, since our model does not account for re-infection or multiple strains of influenza, the tail of the epidemic is not predicted well after the peak of flu season has passed. PMID:25974758

  13. A Fundamental Study of a New Fabrication Technique for Fiber Reinforced Aluminum Matrix Composites.

    DTIC Science & Technology

    1980-04-20

    addition of discontinuous fibers to partially solid slurries and completely liquid matrices was investigated. In the first phase of the program...produceg y the slurry process. D 1473 em-fOm OF v Nov s is OBSOLETE SECURITY CLASSIFICATION OF THIS PAGE (Ohm Date Entered) ~/ CURITV CLASSIFICATION OF...TABLE OF CONTENTS Page I. INTRODUCTION. .. .. .... ...... . .... ..... .... II. FABRICATION USING METAL SLURRIE -INTERFACE INTERACTIONS .. .. ... 2 IlI

  14. US EPA, Pesticide Product Label, , 08/30/1973

    EPA Pesticide Factsheets

    2011-04-14

    ... 0 " c_ I DIRECliONS fOil USE A,'" Iftl' rt!cu:mnf"lIfl • .,1 :tn'INUlt lit IIINla) !",III • ;11';lIli,llIy 'i'It-.1 Mqnv I.II1Se 1I1I1I('r '''Ifllin" f!UIIIIII"fI' ""III" Ih.~ 1:II.k I • lIu! ...

  15. Low-Intensity Conflicts and the United States Marine Corps

    DTIC Science & Technology

    1991-04-05

    POLI CY Back in 1i;:-:7 the United States Congress saw the immediate need for. policy and guidance i-, low-intensity conflicts. They directed the...s: RolIEs in Low’- Intersi ty ConiflIicts. " ilI itai-y F-.eview, Vaol - 2, 1 J anVi’.Aa -y 1990 , p.~-. Armstrong, Charles L . "The Decl1inie of Lovi

  16. High added value of a population-based participatory surveillance system for community acute gastrointestinal, respiratory and influenza-like illnesses in Sweden, 2013-2014 using the web.

    PubMed

    Pini, A; Merk, H; Carnahan, A; Galanis, I; VAN Straten, E; Danis, K; Edelstein, M; Wallensten, A

    2017-04-01

    In 2013-2014, the Public Health Agency of Sweden developed a web-based participatory surveillance system, Hӓlsorapport, based on a random sample of individuals reporting symptoms weekly online, to estimate the community incidence of self-reported acute gastrointestinal (AGI), acute respiratory (ARI) and influenza-like (ILI) illnesses and their severity. We evaluated Hӓlsorapport's acceptability, completeness, representativeness and its data correlation with other surveillance data. We calculated response proportions and Spearman correlation coefficients (r) between (i) incidence of illnesses in Hӓlsorapport and (ii) proportions of specific search terms to medical-advice website and reasons for calling a medical advice hotline. Of 34 748 invitees, 3245 (9·3%) joined the cohort. Participants answered 81% (139 013) of the weekly questionnaires and 90% (16 351) of follow-up questionnaires. AGI incidence correlated with searches on winter-vomiting disease [r = 0·81, 95% confidence interval (CI) 0·69-0·89], and ARI incidence correlated with searches on cough (r = 0·77, 95% CI 0·62-0·86). ILI incidence correlated with the web query-based estimated incidence of ILI patients consulting physicians (r = 0·63, 95% CI 0·42-0·77). The high response to different questionnaires and the correlation with other syndromic surveillance systems suggest that Hӓlsorapport offers a reasonable representation of AGI, ARI and ILI patterns in the community and can complement traditional and syndromic surveillance systems to estimate their burden in the community.

  17. Assessing physicians' in training attitudes and behaviors during the 2009 H1N1 influenza season: a cross-sectional survey of medical students and residents in an urban academic setting.

    PubMed

    May, Larissa; Katz, Rebecca; Johnston, Lindsay; Sanza, Megan; Petinaux, Bruno

    2010-09-01

    Despite concern for hospital-based transmission of influenza, little research has been carried out on perceptions and behaviors of physicians in training with regard to influenza-like illness (ILI), especially in light of the recent H1N1 pandemic. We aimed to evaluate self-reported episodes of ILI among medical students and residents to determine the impact of ILI on school and clinical performance, absenteeism, and patterns of preventive measures used by this population both in and out of the healthcare setting. We anonymously surveyed medical students and residents at an urban institution between November 3 and December 11, 2009. Data were analyzed separately for medical students and residents for frequency of close-ended responses. Open-ended answers were analyzed thematically. Our Institutional Review Board exempted this study from review. Forty-five percent of medical students and 53% of resident respondents perceived the risk of acquiring H1N1 at school or work as high, and although 43% of medical students and 66% of resident respondents had received the influenza vaccination and most reported increasing non-pharmaceutical preventive measures, 9% of medical students and 61% of residents with one or more episodes of ILI chose to continue to attend class or work when ill. Although students and residents report high risk of infection because of work- or school-related activities, many involved in patient care activities do not comply with recommended infection control precautions. Educational campaigns should be developed and infection control guidelines should be included in routine medical student and resident curricular activities.

  18. Molecular Identification of Adenoviruses Associated with Respiratory Infection in Egypt from 2003 to 2010

    DTIC Science & Technology

    2014-01-30

    0.01) (Table 2). Only 28% of isolates were recovered from samples during the typical influenza virus season (September-February). From the beginning of...Non- influenza Respiratory Viruses , in Hospital Physician Infectious Diseases Board Review Manual, M. V, Editor. Wayne, PA: Turner White...As part of a surveillance program aimed at identifying the etiology of influenza -like illness (ILI) in Egypt, we characterized 105 adenovirus isolates

  19. Epidemiological features of influenza circulation in swine populations: A systematic review and meta-analysis.

    PubMed

    Baudon, Eugénie; Peyre, Marisa; Peiris, Malik; Cowling, Benjamin John

    2017-01-01

    The emergence of the 2009 influenza pandemic virus with a swine origin stressed the importance of improving influenza surveillance in swine populations. The objectives of this systematic review and meta-analysis were to describe epidemiological features of swine influenza (SI) across the world and identify factors impacting swine influenza virus surveillance. The systematic review followed the PRISMA guidelines. Articles published after 1990 containing data on SI on pig and herd-level seroprevalence, isolation and detection rates, and risk factors were included. Meta-regression analyses using seroprevalence and virological rates were performed. A total of 217 articles were included. Low avian influenza (AI) seroprevalence (means pig = 4.1%; herd = 15%) was found, showing that AIV do not readily establish themselves in swine while SIV seroprevalence was usually high across continents (influenza A means pig = 32.6-87.8%; herd = 29.3-100%). Higher pig density and number of pigs per farm were shown by the meta-regression analyses and/or the risk factor articles to be associated with higher SI seroprevalence. Lower seroprevalence levels were observed for countries with low-to-medium GDP. These results suggest that larger industrial farms could be more at risk of SIV circulation. Sampling swine with influenza-like illness (ILI) was positively associated with higher isolation rates; most studies in Europe, Latin and North America were targeting swine with ILI. To improve understanding of SI epidemiology, standardization of the design and reporting of SI epidemiological studies is desirable. Performance of SI surveillance systems in low-to-medium GDP countries should be evaluated to rule out technical issues linked to lower observed SIV prevalence. Targeting certain swine age groups, farming systems and swine with ILI may improve the surveillance cost-effectiveness. However, focusing on pigs with ILI may bias virus detection against strains less virulent for swine but

  20. Epidemiological features of influenza circulation in swine populations: A systematic review and meta-analysis

    PubMed Central

    Peyre, Marisa; Peiris, Malik; Cowling, Benjamin John

    2017-01-01

    Background The emergence of the 2009 influenza pandemic virus with a swine origin stressed the importance of improving influenza surveillance in swine populations. The objectives of this systematic review and meta-analysis were to describe epidemiological features of swine influenza (SI) across the world and identify factors impacting swine influenza virus surveillance. Methods The systematic review followed the PRISMA guidelines. Articles published after 1990 containing data on SI on pig and herd-level seroprevalence, isolation and detection rates, and risk factors were included. Meta-regression analyses using seroprevalence and virological rates were performed. Results A total of 217 articles were included. Low avian influenza (AI) seroprevalence (means pig = 4.1%; herd = 15%) was found, showing that AIV do not readily establish themselves in swine while SIV seroprevalence was usually high across continents (influenza A means pig = 32.6–87.8%; herd = 29.3–100%). Higher pig density and number of pigs per farm were shown by the meta-regression analyses and/or the risk factor articles to be associated with higher SI seroprevalence. Lower seroprevalence levels were observed for countries with low-to-medium GDP. These results suggest that larger industrial farms could be more at risk of SIV circulation. Sampling swine with influenza-like illness (ILI) was positively associated with higher isolation rates; most studies in Europe, Latin and North America were targeting swine with ILI. Conclusions To improve understanding of SI epidemiology, standardization of the design and reporting of SI epidemiological studies is desirable. Performance of SI surveillance systems in low-to-medium GDP countries should be evaluated to rule out technical issues linked to lower observed SIV prevalence. Targeting certain swine age groups, farming systems and swine with ILI may improve the surveillance cost-effectiveness. However, focusing on pigs with ILI may bias virus detection

  1. Actors: A Model of Concurrent Computation in Distributed Systems.

    DTIC Science & Technology

    1985-06-01

    RD-A157 917 ACTORS: A MODEL OF CONCURRENT COMPUTATION IN 1/3- DISTRIBUTED SY𔃿TEMS(U) MASSACHUSETTS INST OF TECH CRMBRIDGE ARTIFICIAL INTELLIGENCE...EmmmmmmEmmmmmE mmmmmmmmmmmmmmlfllfllf EEEEEEEmmmmmEE Sa~WNVS AO nflWl ,VNOIJVN 27 n- -o :1 ~ili0 Technical Report 844 Actors: A Model Of Concurrent...Computation In Distributed Systems Gui A. Aghai MIT Artificial Intelligence Laboratory Thsdocument ha. been cipp -oved I= pblicrelease and sale; itsI

  2. Effects of JP-8 on Molecular and Histological Parameters Related to Acute Skin Irritation

    DTIC Science & Technology

    2000-06-01

    role in the inflammatory response by causing dilation of the vasculature (Vallance and Collier, 1994). NO is produced from the amino acid L-arginine by...in such a short period. JP-8 would have to diffuse through the stratum corneum and into the epidermis to initiate the transcription and translation...there is a shield or umbrella of IL-I alpha in the stratum corneum and epidermis which can start a complicated sequence of inflammatory actions in the

  3. Epidemiology of Meningococcal Disease in Northeastern Africa

    DTIC Science & Technology

    1987-01-01

    meningococcal meningits in Bamako, Mali: epidemiological features and analysis of vaccine efficacy, Lancet, ii, 315, 1982. 17. Kilpatrickt, MW. E., Maill. 1. A...r LIE) DTIC , . [iE LE CTE ili D PUBLICATION REPORT 1514 33/88 EPIDEMIOLOGY OF MENINGOCOCCAL DISEASE IN NORTHEASTERN AFRICA BY John E. Sippel, and...to the southern regions of the Sudan. Like the disease in the sub-Siaharan region, meningococcal meningitis in the Nile Valley is seaso- nal and most

  4. The Effects of Nuclear Weapons

    DTIC Science & Technology

    1977-01-01

    between 25,000- and 94 AIR BLAST :H4ENOMEN\\ IN AIR AND SF.TRFACE BURSTS 50,0nJ-feet altitudes. Thesie conditions that they reach thL grovnd at...E., and J. L. BocKF’otr01, Chicago, lIli-tois, 1954. "Probabilistic Air Blast Failure Criteria for *BANISTER, J, R., and L, J. VORTMAN, " Efle ,:t U

  5. Multi-class determination of personal care products and pharmaceuticals in environmental and wastewater samples by ultra-high performance liquid-chromatography-tandem mass spectrometry.

    PubMed

    Gracia-Lor, Emma; Martínez, Marian; Sancho, Juan V; Peñuela, Gustavo; Hernández, Félix

    2012-09-15

    In this work, a multi-class method for the simultaneous determination of 17 emerging contaminants, including pharmaceuticals and personal care products, has been developed. Target analytes were two anti-inflammatories, a lipid regulator agent, two angiotensin II antagonists, two antiepileptic drugs and a diuretic. Among personal care products, four preservatives and five UV filters were included. The method is based on solid-phase extraction (SPE) using Oasis HLB cartridges followed by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Up to three simultaneous transitions per compound were acquired to assure a reliable identification. A detailed study of the extraction process efficiency and matrix effects was carried out in surface water and effluent wastewater. The use of isotope-labeled internal standards (ILIS) was tested to compensate both potential SPE losses during sample extraction and signal suppression/enhancement observed, especially in EWW. Satisfactory correction in all water samples was only ensured when the own analyte ILIS was used. The use of analogues ILIS was a rather useful approach for correction in the majority of the samples tested when analyte ILIS was unavailable. The method was successfully validated in five different surface water (SW) samples and five effluent wastewater (EWW) samples spiked at two concentration levels (0.05 and 0.5 μg/L in SW; 0.1 and 0.5 μg/L in EWW). The developed method was applied to the analysis of 22 samples (SW and EWW) from the Spanish Mediterranean area and 51 reservoir water samples from Colombia. Personal care products were frequently detected, with the highest concentrations corresponding to benzophenone and benzophenone-4 (samples from Spain), and methylparaben (samples from Colombia). Several pharmaceuticals were detected in the Spanish samples, where irbesartan and valsartan - two Angiotensin II antagonists that are not commonly monitored in the aquatic environment

  6. Cellular Localization of Infrared Sources.

    DTIC Science & Technology

    1992-01-01

    metastasis. 14. SUBJECT TERMS 1S. NUMBER OF PAGES infrared, phototaxis ,mammalian cells,tissue cufture,motility, centrioles. Ili PRICE CODE 17...investigation of phototaxis and photosensitivity in general of mammalian cells in a*d;o the infrared may have far reaching consequences for all medical...suggested that the effect W was not a simple form of phototaxis , but that the cells were able to distinguish ’n_ between several individual light sources

  7. US EPA, Pesticide Product Label, EDISON SOUTH, 03/15 ...

    EPA Pesticide Factsheets

    2011-04-14

    ... ffR&e~,pr9dfJf?t, Rame F~II: ~e.~~~ffl!3e.r '" Ne'!~!'I~er: [If,,we.ef9f:~~§S ~re net a prClBlemj ili:s~i'! pl'9dUiitRa,:"e If y,!il.~ Ji1~vel~~kill,fa.l1 ' .... ...

  8. Segregation of Virulent Influenza A(H1N1) Variants in the Lower Respiratory Tract of Critically Ill Patients during the 2010–2011 Seasonal Epidemic

    PubMed Central

    Piralla, Antonio; Pariani, Elena; Rovida, Francesca; Campanini, Giulia; Muzzi, Alba; Emmi, Vincenzo; Iotti, Giorgio A.; Pesenti, Antonio; Conaldi, Pier Giulio; Zanetti, Alessandro; Baldanti, Fausto

    2011-01-01

    Background Since its appearance in 2009, the pandemic influenza A(H1N1) virus circulated worldwide causing several severe infections. Methods Respiratory samples from patients with 2009 influenza A(H1N1) and acute respiratory distress attending 24 intensive care units (ICUs) as well as from patients with lower respiratory tract infections not requiring ICU admission and community upper respiratory tract infections in the Lombardy region (10 million inhabitants) of Italy during the 2010–2011 winter-spring season, were analyzed. Results In patients with severe ILI, the viral load was higher in bronchoalveolar lavage (BAL) with respect to nasal swab (NS), (p<0.001) suggesting a higher virus replication in the lower respiratory tract. Four distinct virus clusters (referred to as cluster A to D) circulated simultaneously. Most (72.7%, n = 48) of the 66 patients infected with viruses belonging to cluster A had a severe (n = 26) or moderate ILI (n = 22). Amino acid mutations (V26I, I116M, A186T, D187Y, D222G/N, M257I, S263F, I286L/M, and N473D) were observed only in patients with severe ILI. D222G/N variants were detected exclusively in BAL samples. Conclusions Multiple virus clusters co-circulated during the 2010–2011 winter-spring season. Severe or moderate ILI were associated with specific 2009 influenza A(H1N1) variants, which replicated preferentially in the lower respiratory tract. PMID:22194826

  9. National Program for Inspection of Non-Federal Dams. Engineering and Design.

    DTIC Science & Technology

    1979-09-26

    From TM 5-809-10/’ NAVFAC P-355,’AFM 88-3, Chapter 13; April 1973 *Elko I 4* 33 San 1906 v Stockton 2 Franisc so< Modesto + 38 󈧎 CBishop. *Fresno 1N 7...wicih have I sear Inisistm1ei with It ilie t welvue mnrth period 49 Stat * 863. lmlrlesiatel prrioir to rthe oiiacttinrt of t his Ac(t Joy a State

  10. Undesirable Performance Characteristics of Existing Model-Reference Adaptive Control Algorithms.

    DTIC Science & Technology

    1981-03-15

    Iffect s can Oneci n i n t h., -r s ’ Ilie analytical. techni-ques thiat: have Ihen drvc Iolped are ’.tu-t modi ficat ions to the existinga)oithsa...observed by Narendra and Peterson [4] in terms of a scalar example. In order to obtain practical insights as well as analytical results, a simple...proposed by Narendra and Valavani [51 its scalar version consists of the following system of -4- nonlinear differential equations for the output

  11. Extended Appearance Potential Fine Structure Analysis: Oxygen on Aluminum (100),

    DTIC Science & Technology

    1979-01-01

    applying a high-pass digital filter6 (Fig. 3). Taking a third derivative would serve the sam function, but enhances noise and has less physical basis...Gaithersburg, Md., 1978). One could obtain pasteurized spectra without the preliminary subtraction and with more applications of the digital filter...165, and J. A. Tossell, private comunication . - ._ . . K ....... , . ’. ll ilI - 11 - (23) R. L. Wells and T. Fort, Surface Set. 33, 172 (1972). (24) P

  12. A Global Approach to Parameter Estimation of Chaotic Dynamical Systems.

    DTIC Science & Technology

    1992-12-01

    ily of complex quadratic polynomials . We demonstrate how to exploit the complexity of global geometrical phase space structures of nonlinear 2.1 The...Quadratic Family dynamical systems and their dependence on parameter Given any complex quadratic polynomial p(:) = a:.! + variations in order to obtain...b•2 + r) tional maps obtained from Newton’s method on complex , 2 cubic polynomials . We show how to transform the esti- -(aZ + 2abz + b-’ + c) - b

  13. Braking of an Aircraft Tire on Grooved and Porous Asphaltic Concrete.

    DTIC Science & Technology

    1983-01-01

    friction overlay, and the saw-cut grooves spaced at 3 inches is omparable. 17. Key Words 18. Distribution Statement 1unway Surface Treatment, Hydroplaning ...Technical Center. T1 IlI, TABLE OF CONTENTS Page EXECUTIVE SUMMARY vii INTRODUCTION I OBJECTIVES 2 BACKGROUND 2 Aircraft Tire Hydroplaning 2 Runway...Grooving 3 Grooving, Drainage, and Hydroplaning 4 TESTING APPROACH 5 EXPERIMENTAL PROGRAM 6 Test Facility and Equipment 6 Test Sections 7 Test Parameters 9

  14. Transversus Abdominis Plane Versus Ilioinguinal and Iliohypogastric Nerve Blocks for Analgesia Following Open Inguinal Herniorrhaphy*

    PubMed Central

    Stav, Anatoli; Reytman, Leonid; Stav, Michael-Yohay; Troitsa, Anton; Kirshon, Mark; Alfici, Ricardo; Dudkiewicz, Mickey; Sternberg, Ahud

    2016-01-01

    Objectives We hypothesized that preoperative (pre-op) ultrasound (US)-guided posterior transversus abdominis plane block (TAP) and US-guided ilioinguinal and iliohypogastric nerve block (ILI+IHG) will produce a comparable analgesia after Lichtenstein patch tension-free method of open inguinal hernia repair in adult men. The genital branch of the genitofemoral nerve will be blocked separately. Methods This is a prospective, randomized, controlled, and observer-blinded clinical study. A total of 166 adult men were randomly assigned to one of three groups: a pre-op TAP group, a pre-op ILI+IHG group, and a control group. An intraoperative block of the genital branch of the genitofemoral nerve was performed in all patients in all three groups, followed by postoperative patient-controlled intravenous analgesia with morphine. The pain intensity and morphine consumption immediately after surgery and during the 24 hours after surgery were compared between the groups. Results A total of 149 patients completed the study protocol. The intensity of pain immediately after surgery and morphine consumption were similar in the two “block” groups; however, they were significantly decreased compared with the control group. During the 24 hours after surgery, morphine consumption in the ILI+IHG group decreased compared with the TAP group, as well as in each “block” group versus the control group. Twenty-four hours after surgery, all evaluated parameters were similar. Conclusion Ultrasound-guided ILI+IHG provided better pain control than US-guided posterior TAP following the Lichtenstein patch tension-free method of open inguinal hernia repair in men during 24 hours after surgery. (ClinicalTrials.gov number: NCT01429480.) PMID:27487311

  15. Effects of Flowfield Turbulence on Asymmetric Vortices over a Slender Body

    DTIC Science & Technology

    1989-12-01

    S.V PORT TO #4 73 4510 FOR IL=I TO 3 4520 THYME = TIMER 4530 CALL OUTPUT(RELAY.ACT.01,STEPPER) 4540 CHKTIME = TIMER 4550 IF CHKTIME < ( THYME + DELAY1...TO PORT 8 4620 FOR JJ=l TO 5 4630 CALL OUTPUT(RELAY.ACT.01,STEPPER) 4640 CHKTIME = TIMER 4650 IF CHKTIME < ( THYME + DELAY2) GOTO 4640 4660 REM EACH

  16. Public Health Colloquium Conference Report

    DTIC Science & Technology

    2010-07-01

    seeing an increased occurrence of patients presenting with influenza-like illness (ILI): fever, chills, vomiting, headache and backache. A small ...lesions on their face, neck, hands and forearms. In most instances, clinicians begin to suspect a pox -like virus and immediately take steps to...to continue the discussion and follow up on actions. • Add another small group discussion to the agenda and mix the participants so that we have

  17. DoD Mail-Order Pharmacy Evaluation.

    DTIC Science & Technology

    1996-04-01

    dependents. This monumental increase is due primar- ily to the fact that the retiree population is older. The older the age group, the more prescription...co in in o c\\i CM (D^COONit^lflOO’-OOKDWCOCOffiOO •<tcocMinococot-~<»<»in’>3-i^cococoincu<e<» inTj- coro ^cococo^ i^t^Tft^ooomco co" co o" co" o

  18. Vaccines for Hantaviruses: Progress and Issues

    DTIC Science & Technology

    2012-01-01

    511ISSN 1476-058410.1586/ERV.12.15www.expert-reviews.com Editorial Hantaviruses , hemorrhagic fever with renal syndrome & hantavirus pulmonary...syndrome The Hantavirus genus of the fam- ily Bunyaviridae comprises more than 20 viruses, including several human patho- gens. Hantaviruses are...issues Expert Rev. Vaccines 11(5), 511–513 (2012) Keywords: hantavirus pulmonary syndrome • hantaviruses • hemorrhagic fever with renal syndrome

  19. Navy Combat SAR (Combat Search and Rescue): Past, Present, and Future?

    DTIC Science & Technology

    1988-04-01

    8217 be obtained throus- thre interl ibrarV lo an desk of A it- ILi.ersitM.::,’.. M.:ele 1 Air Force Base., Al abara 35112-55C4 (tel P hone : [ 205) 29 3...it sad disarraY. The committee found eviden ’:e of . di sioi nted. uncoordinated., re91 eted and total :1... unsatisf actori level of effort amon and

  20. Detection of influenza vaccine effectiveness among nursery school children: Lesson from a season with cocirculating respiratory syncytial virus

    PubMed Central

    Nakata, Keiko; Fujieda, Megumi; Miki, Hitoshi; Fukushima, Wakaba; Ohfuji, Satoko; Maeda, Akiko; Kase, Tetsuo; Hirota, Yoshio

    2015-01-01

    In the winter influenza epidemic season, patients with respiratory illnesses including respiratory syncytial virus (RSV) infections increase among young children. Therefore, we evaluated the effectiveness of influenza vaccine against influenza-like illness (ILI) using a technique to identify outbreaks of RSV infection and to distinguish those patients from ILI patients. The study subjects were 101 children aged 12 to 84 months attending nursery school. We classified the cases into 6 levels based on the definitions of ILI for outcomes. We established observation periods according to information obtained from regional surveillance and rapid diagnostic tests among children. Multivariate odds ratios (ORs) for each case classification were obtained using a logistic regression model for each observation period. For the entire observation period, ORs for cases with fever plus respiratory symptoms were reduced marginally significantly. For the local influenza epidemic period, only the OR for the most serious cases was significantly decreased (0.20 [95%CI: 0.04-0.94]). During the influenza outbreak among the nursery school children, multivariate ORs for fever plus respiratory symptoms decreased significantly (≥ 38.0°C plus ≥ one symptoms: 0.23 [0.06-0.91), ≥ 38.0°C plus ≥ 2 symptoms: 0.21 [0.05-0.85], ≥ 39.0°C plus ≥ one symptoms: 0.18 [0.04-0.93] and ≥ 39.0°C plus ≥ 2 symptoms: 0.16 [0.03-0.87]). These results suggest that confining observation to the peak influenza epidemic period and adoption of a strict case classification system can minimize outcome misclassification when evaluating the effectiveness of influenza vaccine against ILI, even if influenza and RSV cocirculate in the same season. PMID:25714791

  1. Demonstration of Concept (Draft)

    DTIC Science & Technology

    1994-08-03

    DemonWtratlon of Concept (DRAFT) August 3, 1994 Table of Contents (continued) SectionPage 4,0 Mathematical Model for Computing Delivery Time ................................. 4...for Computing Delivery Time ....................................... 4-1 Secure Solutions, Inc. Contract No. N00039-93-C-0099 Ili Detnonstration of...Authentication * * 0 0 Access Control *1 1 1 Non-repudiation * * The Phase I made the qualitative observation that the delivery time through a

  2. Outbreak of H3N2 influenza at a US military base in Djibouti during the H1N1 pandemic of 2009.

    PubMed

    Cosby, Michael T; Pimentel, Guillermo; Nevin, Remington L; Fouad Ahmed, Salwa; Klena, John D; Amir, Ehab; Younan, Mary; Browning, Robert; Sebeny, Peter J

    2013-01-01

    Influenza pandemics have significant operational impact on deployed military personnel working in areas throughout the world. The US Department of Defense global influenza-like illness (ILI) surveillance network serves an important role in establishing baseline trends and can be leveraged to respond to outbreaks of respiratory illness. We identified and characterized an operationally unique outbreak of H3N2 influenza at Camp Lemonnier, Djibouti occurring simultaneously with the H1N1 pandemic of 2009 [A(H1N1)pdm09]. Enhanced surveillance for ILI was conducted at Camp Lemonnier in response to local reports of a possible outbreak during the A(H1N1)pdm09 pandemic. Samples were collected from consenting patients presenting with ILI (utilizing a modified case definition) and who completed a case report form. Samples were cultured and analyzed using standard real-time reverse transcriptase PCR (rt-RT-PCR) methodology and sequenced genetic material was phylogenetically compared to other published strains. rt-RT-PCR and DNA sequencing revealed that 25 (78%) of the 32 clinical samples collected were seasonal H3N2 and only 2 (6%) were A(H1N1)pdm09 influenza. The highest incidence of H3N2 occurred during the month of May and 80% of these were active duty military personnel. Phylogenetic analysis revealed that sequenced H3N2 strains were genetically similar to 2009 strains from the United States of America, Australia, and South east Asia. This outbreak highlights challenges in the investigation of influenza among deployed military populations and corroborates the public health importance of maintaining surveillance systems for ILI that can be enhanced locally when needed.

  3. A Study of Cutoff Bendways on the Tombigbee River

    DTIC Science & Technology

    1981-11-01

    was determined in the field using a Secchi disk . Water samples were preserved )n iLi L.A returned to the laboratory for anal- y,-is of turbidity... North Carolina Biological Survey Publication 1980-12, North Carolina State Museum of Natural History, Raleigh. Leopold, L. B, Wolman, M. G., and...carbon dioxide, total alkalinity, ammonia nitrogen, nitrate and nitrite nitrogen, orthophosphorus, and total phosphorus (APHA 1975). 13. Standard

  4. Islamic Fundamentalism in Pakistan. Its Characters and Prospects

    DTIC Science & Technology

    1991-01-01

    For although Pakistan was founded as a Muslim homeland, it was not at all the intention of its founder, Muhammad Ali Jinnah , that the state should be...origin: "* The founder of Pakistan, Muhammad ’ Ali Jinnah , was of Isma’ili background; "* Yahya Khan, former Commander in Chief of the Army, and then...more interested in socialist policies or regional issues. Islam entered more fully into the political debate when former Prime Minister Zulfikar Ali

  5. Principles and Experience of the On-Condition Application of Oils and Working Fluids to Aeronautical Engineering

    DTIC Science & Technology

    1996-04-01

    8217: ,..,,~i:..li 1 6.0 5.0 "T• 12 "t3 "tch "t rem Fig. 1 Dynamics of varying the MH-7.5y oil kinematic viscosity taken as the governing parameter in the...Program Technical Support Center".Pensacola,Florids, USA, p. 120,1994. 5. Gerd Koolhaas , Jurgen Frank. "Experiences in the Condition Monitoring

  6. Geochemistry of hot springs and fumarolic gases from the Banda Arc

    NASA Astrophysics Data System (ADS)

    Poorter, R. P. E.; Varekamp, J. C.; Sriwana, T.; Van Bergen, M. J.; Erfan, R. D.; Suharyono, K.; Wirakusumah, A. D.; Vroon, P. Z.

    Geothermometry carried out on hot springs occurring on the volcanic non-active Islands of Ambon and Haruku indicates minimum subsurface temperatures of 180°C; for Alor Island we obtained a temperature of 170°C. The hydrothermal systems of these islands are likely crack and fault dominated. Hot springs on the islands with active volcanism indicate subsurface temperatures of 180 to 250°C. The chemical and isotopic compositions of fumarolic gases from the active volcanoes Banda Api in the Banda Archipelago, Serawerna on Teon, Wurlali on Damar and Ili Lewotolo on Lomblen are reported here for the first time. The measured fumarolic gas temperatures ranged from 98°C to 170°C for Banda Api, Laworkawra, Legatala, Serawerna, Wurlali and Sirung volcanoes and reached 490°C for Ili Lewotolo volcano. The main gas components are H 2O, CO 2 and SO 2; CO 2 predominates over (SO 22 + H 2S). The calculated gas equilibrium temperature for Wurlali is 700°C and for Ili Lewotolo more than 1000°C. Stable carbon isotope data for Wurlali ( δ13C = -3.3 % 0) and for Ili Lewotolo ( δ13C = -2.9 % 0) volcanoes are similar to those for other Indonesian volcanoes. The bulk sulfur is relatively rich in the heavy isotope. The 3He/ 4He (R/R A) ratios vary between 1.0 and 3.6, which is low for subduction related volcanoes. A contribution from continental crust or sediment-derived radiogenic 4He is suggested.

  7. ASOP-3: A Program for the Minimum-Weight Design of Structures Subjected to Strength and Deflection Constraints

    DTIC Science & Technology

    1976-12-01

    COMMANDER *■ mm L PARHER. Col, USAF Chief, Structural Mechanics Division AF Flight Dynamics Laboratory Copies of this report should not be...tlHiiiiiiilllfh’fcrr-- "-’ i.-.—;lwu,M,UL.,ili.ti1i,,,f,,w K.mu,mmiimmmmimmmmmmm - mmmm IS FOREWORD This report was prepared by the Structural Mechanics ...of the Structural Mechanics Division, Air Force Flight Dynamics Laboratory, Air Force Systems Command, Wright-Patterson Air Force Base, Ohio. Dr

  8. Drought effects on conifers in the Pacific Northwest, 1958-59.

    Treesearch

    T.W. Childs

    1960-01-01

    The summer of 1958 was unusuaIly hot in most of Oregon and Washington, and that of 1959 was unusually dry except in western Washington. Killing of young conifers, similar to that in northern Idaho, was common in a few localities in northwestern Washington by the end of the 1958 growing season, but did not continue in 1959 and was not seen elsewhere. Various other...

  9. Final Environmental Assessment: Central Issue Facility at Joint Base McGuire-Dix-Lakehurst, New Jersey

    DTIC Science & Technology

    2013-05-01

    fhcilities, they wero found to be substantially llhcr¢d ~t the time of su.rvey in 2002 ond l<’ td :(.’tl the. integrity to be considered for eligibility fo...comm~:teiaJ truck 1raffic fmn1 ~;~is1ing h,."\\•els during operation of lh" fucil ilies. 1 he- t3ci1itie~ eum .-n11,- uM:d for cemr.:d Issue nnd

  10. Ovarian Cancer Risk and Survival in BRCA 1/2 Carriers

    DTIC Science & Technology

    2005-09-01

    7. Gwinn ML, Lee NC, Rhodes PH, Layde PM, Rubin GL (1990) tiveness of OCs and tubal ligation indicate a substantial Pregnancy , breast feeding, and...focus our explorations. Our results to date (4) show that factors protective in general (oral contraceptive use, bearing children, tubal ligation...assays were successful and our preliminary data suggested that the ILI 8-M137 SNP may be associated with tumor stage and histologic subtype, suggesting

  11. Using age, triage score, and disposition data from emergency department electronic records to improve Influenza-like illness surveillance.

    PubMed

    Savard, Noémie; Bédard, Lucie; Allard, Robert; Buckeridge, David L

    2015-05-01

    Markers of illness severity are increasingly captured in emergency department (ED) electronic systems, but their value for surveillance is not known. We assessed the value of age, triage score, and disposition data from ED electronic records for predicting influenza-related hospitalizations. From June 2006 to January 2011, weekly counts of pneumonia and influenza (P&I) hospitalizations from five Montreal hospitals were modeled using negative binomial regression. Over lead times of 0-5 weeks, we assessed the predictive ability of weekly counts of 1) total ED visits, 2) ED visits with influenza-like illness (ILI), and 3) ED visits with ILI stratified by age, triage score, or disposition. Models were adjusted for secular trends, seasonality, and autocorrelation. Model fit was assessed using Akaike information criterion, and predictive accuracy using the mean absolute scaled error (MASE). Predictive accuracy for P&I hospitalizations during non-pandemic years was improved when models included visits from patients ≥65 years old and visits resulting in admission/transfer/death (MASE of 0.64, 95% confidence interval (95% CI) 0.54-0.80) compared to overall ILI visits (0.89, 95% CI 0.69-1.10). During the H1N1 pandemic year, including visits from patients <18 years old, visits with high priority triage scores, or visits resulting in admission/transfer/death resulted in the best model fit. Age and disposition data improved model fit and moderately reduced the prediction error for P&I hospitalizations; triage score improved model fit only during the pandemic year. Incorporation of age and severity measures available in ED records can improve ILI surveillance algorithms. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. US EPA, Pesticide Product Label, MB-1100, 07/31/1978

    EPA Pesticide Factsheets

    2011-04-21

    ... ()r ;IIJl1d'. I',·, '1,.1\\ '" Il.flIJlft'd' I' t!1:, 011',", (l!ll.lI'ltnq P1I' IH'..,!If',dl' ," I", ~,tll·.J"·, ;'Olld', ", PI;II,,, :,d H !lIJlrl.HH'I' I ont.]c· p., " II/!' ,. Id 1",' f II, 'IL'I:' "r t" ...

  13. The impact of altitude on hospitalization and hospital mortality from pandemic 2009 influenza A (H1N1) virus pneumonia in Mexico.

    PubMed

    Pérez-Padilla, Rogelio; García-Sancho, Cecilia; Fernández, Rosario; Franco-Marina, Francisco; López-Gatell, Hugo; Bojórquez, Ietza

    2013-01-01

    To determine the effect of altitude of residence on influenza A (H1N1). We analyzed 207 135 officially notified of influenza-like illness (ILI) cases, 23 048 hospitalizations and 573 deaths during the first months of the novel pandemic influenza A H1N1 virus, to examine if residents of high altitude had more frequently these adverse outcomes. Adjusted rates for hospitalization and hospital mortality rates increased with altitude, probably due to hypoxemia.

  14. The Department of Defense Statement on Critical Technologies for Export Control by Dr. Ruth M. Davis Deputy Under Secretary of Defense for Research and Advanced Technology Before the Subcommittee on International Economic Policy and Trade Committee on Foreign Affairs of the United States House of Representatives 96th Congress, First Session,

    DTIC Science & Technology

    1979-03-22

    I . fLu presumflpt ion of a set Of ii 1tr Cit i-1t1~ m0 sim I 11"’ in nmmhorv I and re Ia t i veIy% s tabl e overI t imt . 11 i S i ILi aor> no t )’ ~o...and conversion. End Products: o Undersea vehicles Submar ines Bottom crawlers Torpedoes Craft to a1id swimmers o Research and Exploration Seismic

  15. Motor Theory of Auditory Perception.

    DTIC Science & Technology

    1987-09-24

    1979) after deafening. Lesioning the Uva of adult birds induced a systematic problem in song production - the time/frequency structure of syllables...on the snowflake plot. 10 a f4 0N ILI~ %r I5 Figure Effects of Uva lesions upon vocalizations. a) Stereotyped song delivered by an adult male before... lesioning Uva . b) After lesioning , the time/frequency structure of each individual syllables is delivered as in the intact bird’s song, but the order

  16. Polar Mesospheric Waves and Structure

    DTIC Science & Technology

    1993-05-01

    1 1 1 4:1 93--1.2336 i .* .:: *• lIIlIli hiiIIIl~lii SDL/93-039 Page i May 1993 FORWORD * The Department of the Navy/Office of Naval Research awarded...that the inner scale of the electron fluctuation spectrum decreases at least as fast as e- 1/4, which is the case for neutral turbulence. ŔI I SDL

  17. A Reference Manual for the Egyptian Defense Forces Cost Model

    DTIC Science & Technology

    1992-07-01

    dicuments to report the results of Its work. Reports are the most authoritative and moat carefully considered products IDA publishes. They normaIly...supplies for the initial days of wartime operations "" Foreign Military Sales (FMS) Modernization: Costs associated with the acquisition of weapon systems ...military equipment, facilities, and other major support systems using FMS credits. " * Projects: Costs incurred in one-time activities such as the

  18. Unclassified Publications of Lincoln Laboratory 1 January - 31 December 1992. Volume 18

    DTIC Science & Technology

    1992-12-31

    675 1 METAL CUTTING JA-6716 METHYLAMINE JA-6736 METAL EPITAXIAL SEMICONDUCTOR FIELD-EFFECT TRANSISTOR MICHELSON INTERFEROMETER (See MESFET) JA-6793...1282 Lasers ADA25 1001 6761 Gain and Noise Figure in Cox, C.H. IlI lEE Proc. J, Analogue Fibre -Optic Links Optoelectron., Vol. 139, No. 4, August 1992...9995 FABRY-PEROT INTERFEROMETER FILTER MATCHING MS-9576 JA-6348, JA-6756 FALSE ALARM REJECTION FILTERED NOISE APPROXIMATIONS MS-9280 MS- 10042 FAR

  19. Type-specific clinical characteristics of adenovirus-associated influenza-like illness at five US military medical centers, 2009-2014.

    PubMed

    Koren, Michael A; Arnold, John C; Fairchok, Mary P; Lalani, Tahaniyat; Danaher, Patrick J; Schofield, Christina M; Rajnik, Michael; Hansen, Erin A; Mor, Deepika; Chen, Wei-Ju; Ridoré, Michelande; Burgess, Timothy H; Millar, Eugene V

    2016-09-01

    Adenovirus is a recognized cause of influenza-like illness (ILI). The proportion of ILI attributable to adenovirus is not known. Moreover, knowledge gaps remain with respect to the epidemiologic, virologic, and clinical characteristics of adenovirus-associated ILI among otherwise healthy individuals. An observational, longitudinal study of <65-year-old patients with febrile ILI at five medical centers was conducted from 2009 to 2014. Nasopharyngeal specimens obtained at enrollment were first tested by single-reaction PCR for adenovirus, then further evaluated by a multiplex PCR assay for other respiratory viral pathogens. Symptoms over a 28-day period were collected. We enrolled 1536 individuals, among whom 43 (2·8%) were positive for adenovirus. The median age of cases was 3·4 years (range: 4 months to 41 years). Three were hospitalized. Species and serotype information was available for 33 (76·7%) cases. Species C (n = 21) was the most common, followed by B3 (n = 9) and one each of E4a, D46, and A. Species C infections were more frequent in children (P < 0·01). Half of the cases were positive for at least one other respiratory viral pathogen. Symptoms were generally mild and most commonly included cough (90%), fatigue (79%), rhinorrhea (74%), loss of appetite (71%), and sore throat (64%). Children with non-C adenovirus infection were more likely to report sore throat (P = 0·05) and hoarseness (P = 0·06) than those with species C infection. Adenovirus is frequently detected with other respiratory viruses. Persons with non-C adenovirus infections reported more severe symptoms, suggesting there may be species-specific differences in virulence and/or host response to infection. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  20. Surveillance of influenza in Indonesia, 2003–2007.

    PubMed

    Kosasih, Herman; Roselinda; Nurhayati; Klimov, Alexander; Xiyan, Xu; Lindstrom, Stephen; Mahoney, Frank; Beckett, Charmagne; Burgess, Timothy H; Blair, Patrick J; Uyeki, Timothy M; Sedyaningsih, Endang R

    2013-05-01

    Longitudinal data are limited about the circulating strains of influenza viruses and their public health impact in Indonesia. We conducted influenza surveillance among outpatients and hospitalized patients with influenza-like illness (ILI) across the Indonesian archipelago from 2003 through 2007. Demographic, clinical data, and respiratory specimens were collected for 4236 ILI patients tested for influenza virus infection by RT-PCR and viral culture. Influenza A and B viruses co-circulated year-round with seasonal peaks in influenza A virus activity during the rainy season (December–January). During 2003–2007, influenza viruses were identified in 20·1% (4236 ⁄ 21 030) of ILI patients, including 20·1% (4015 ⁄ 20 012) of outpatients, and 21·7% (221 ⁄ 1018) of inpatients. One H5N1 case was identified retrospectively in an outpatient with ILI. Antigenic drift in circulating influenza A and B virus strains was detected during the surveillance period in Indonesia. In a few instances, antigenically drifted viruses similar to the World Health Organization (WHO) vaccine strains were detected earlier than the date of their designation by WHO. Influenza A and B virus infections are an important cause of influenza-like illness among outpatients and hospitalized patients in Indonesia. While year-round circulation of influenza viruses occurs, prevention and control strategies should be focused upon the seasonal peak during rainy season months. Ongoing virologic surveillance and influenza disease burden studies in Indonesia are important priorities to better understand the public health impact of influenza in South-East Asia and the implications of influenza viral evolution and global spread.

  1. Operation JANGLE. Airborne Particle Studies. Project 2.5a-1

    DTIC Science & Technology

    1979-10-01

    QW CZ..., ILI . AUG 14 1980 Extract version prepared for: Director D DEFENSE NUCLEAR AGENCY LQ Washington. D.C. 20305 .. -’ Wshigton D.C. OApproved...of the Classification Management Division of the Defense Nuclear Agency,. It. KEY WORDS (Contha.. on re*, e.s ide II neessary anid Identify by bloek...mmh16t) Nuclear Atmospheric Tests Operation JANGLE Rad •oactivity Measurements Instruments (Design/Calibration) Fractionation Rdioactive Particles 3L

  2. Microscopic Study of the Influence of Impurities on Interface Bonding.

    DTIC Science & Technology

    1985-01-25

    using 005 4m alumina and lightly etching the surface in a mild HCI- methanol solution. Oxidized specimens can then be made when requir- .. 49 ONR- 1984, C... Mechanical Engineering/Materials Science and Engineering -I " ilis docujmfnt hi~s Uc -;:, ’--v~- tr, p ublc y .ecf .... sa 2,C, .,.- ...ji 85 03 11 085...Report Office of Naval Research - January 25, 1985 Contract N00014-83-K-0143 PRINCIPAL INVESTIGATOR: HARRIS L. MARCUS Mechanical Engineering/Materials

  3. Effects of a lifestyle intervention on REM sleep-related OSA severity in obese individuals with type 2 diabetes.

    PubMed

    Shechter, Ari; Foster, Gary D; Lang, Wei; Reboussin, David M; St-Onge, Marie-Pierre; Zammit, Gary; Newman, Anne B; Millman, Richard P; Wadden, Thomas A; Jakicic, John M; Strotmeyer, Elsa S; Wing, Rena R; Pi-Sunyer, F Xavier; Kuna, Samuel T

    2017-05-31

    The aim of this study was to determine if an intensive lifestyle intervention (ILI) reduces the severity of obstructive sleep apnea (OSA) in rapid-eye movement (REM) sleep, and to determine if longitudinal changes in glycaemic control are related to changes in OSA severity during REM sleep over a 4-year follow-up. This was a randomized controlled trial including 264 overweight/obese adults with type 2 diabetes (T2D) and OSA. Participants were randomized to an ILI targeted to weight loss or a diabetes support and education (DSE) control group. Measures included anthropometry, apnea-hypopnea index (AHI) during REM sleep (REM-AHI) and non-REM sleep (NREM-AHI) and glycated haemoglobin (HbA1c) at baseline and year 1, year 2 and year 4 follow-ups. Mean baseline values of REM-AHI were significantly higher than NREM-AHI in both groups. Both REM-AHI and NREM-AHI were reduced significantly more in ILI versus DSE, but these differences were attenuated slightly after adjustment for weight changes. Repeated-measure mixed-model analyses including data to year 4 demonstrated that changes in HbA1c were related significantly to changes in weight, but not to changes in REM-AHI and NREM-AHI. Compared to control, the ILI reduced REM-AHI and NREM-AHI during the 4-year follow-up. Weight, as opposed to REM-AHI and NREM-AHI, was related to changes in HbA1c. The findings imply that weight loss from a lifestyle intervention is more important than reductions in AHI for improving glycaemic control in T2D patients with OSA. © 2017 European Sleep Research Society.

  4. Facemasks, Hand Hygiene, and Influenza among Young Adults: A Randomized Intervention Trial

    PubMed Central

    Aiello, Allison E.; Perez, Vanessa; Coulborn, Rebecca M.; Davis, Brian M.; Uddin, Monica; Monto, Arnold S.

    2012-01-01

    Limited vaccine availability and the potential for resistance to antiviral medications have led to calls for establishing the efficacy of non-pharmaceutical measures for mitigating pandemic influenza. Our objective was to examine if the use of face masks and hand hygiene reduced rates of influenza-like illness (ILI) and laboratory-confirmed influenza in the natural setting. A cluster-randomized intervention trial was designed involving 1,178 young adults living in 37 residence houses in 5 university residence halls during the 2007–2008 influenza season. Participants were assigned to face mask and hand hygiene, face mask only, or control group during the study. Discrete-time survival models using generalized estimating equations to estimate intervention effects on ILI and confirmed influenza A/B infection over a 6-week study period were examined. A significant reduction in the rate of ILI was observed in weeks 3 through 6 of the study, with a maximum reduction of 75% during the final study week (rate ratio [RR] = 0.25, [95% CI, 0.07 to 0.87]). Both intervention groups compared to the control showed cumulative reductions in rates of influenza over the study period, although results did not reach statistical significance. Generalizability limited to similar settings and age groups. Face masks and hand hygiene combined may reduce the rate of ILI and confirmed influenza in community settings. These non-pharmaceutical measures should be recommended in crowded settings at the start of an influenza pandemic. Trail Registration Clinicaltrials.gov NCT00490633 PMID:22295066

  5. Short message service sentinel surveillance of influenza-like illness in Madagascar, 2008–2012

    PubMed Central

    Rajatonirina, Soatiana; Heraud, Jean-Michel; Randrianasolo, Laurence; Orelle, Arnaud; Razanajatovo, Norosoa Harline; Raoelina, Yolande Nirina; Ravolomanana, Lisette; Rakotomanana, Fanjasoa; Ramanjato, Robinson; Randrianarivo-Solofoniaina, Armand Eugène

    2012-01-01

    Abstract Problem The revision of the International Health Regulations (IHR) and the threat of influenza pandemics and other disease outbreaks with a major impact on developing countries have prompted bolstered surveillance capacity, particularly in low-resource settings. Approach Surveillance tools with well-timed, validated data are necessary to strengthen disease surveillance. In 2007 Madagascar implemented a sentinel surveillance system for influenza-like illness (ILI) based on data collected from sentinel general practitioners. Setting Before 2007, Madagascar’s disease surveillance was based on the passive collection and reporting of data aggregated weekly or monthly. The system did not allow for the early identification of outbreaks or unexpected increases in disease incidence. Relevant changes An innovative case reporting system based on the use of cell phones was launched in March 2007. Encrypted short message service, which costs less than 2 United States dollars per month per health centre, is now being used by sentinel general practitioners for the daily reporting of cases of fever and ILI seen in their practices. To validate the daily data, practitioners also report epidemiological and clinical data (e.g. new febrile patient’s sex, age, visit date, symptoms) weekly to the epidemiologists on the research team using special patient forms. Lessons learnt Madagascar’s sentinel ILI surveillance system represents the country’s first nationwide “real-time” surveillance system. It has proved the feasibility of improving disease surveillance capacity through innovative systems despite resource constraints. This type of syndromic surveillance can detect unexpected increases in the incidence of ILI and other syndromic illnesses. PMID:22589573

  6. Interservice Procedures for Instructional Systems Development. Executive Summary and Model

    DTIC Science & Technology

    1975-08-01

    Knowledge of Recults 151 Precading paga blank ILI I{I I•I 152 LO - Learning Objective LS - Learning Step MOOR - Military Occupational Data Bank MOS...effects in the production of an audio pro- gram. AUDIOVISUALMEDIA:. Refers to any device such as television or film which ,is~both seen and heard...34upon the content of a film, television program, etc. ’* • iNUMERICAL SCALE: Measuremeat device which associates verbal, descrip,- tions of social

  7. A Study of the Four-Ball Wear Machine

    DTIC Science & Technology

    1950-09-01

    JJ&cöm.ilie_tes.t cup and measured. The average of the major and minor axes is considered the measure of wear. Th« reason TO? these OeCUliar scar...iiii*,sKa.ture chart of the three Navy -symbol :petrole>im oils examinee! is A’ ••4 <•• *%+\\*i-I<T lAmnA ^Q4 shown in Figure 22. A

  8. Standardization of Program EAGLE - Numerical Grid Generation System

    DTIC Science & Technology

    1988-12-01

    NA1ILIS( NVAR ) NDIMI( NVAR ) f NDIM2( NVAR v a NAML.ST( 2) C DIMENSION ICHR( NCVAL ),INTGR( NYVAi. ) Y RFAIS ( NRVA! C DIMENSION CI3ATAC NDAT ) TDAT...INTEGER AND RK’AL. IN THE C ARRAY "COATA,. C C NRDAT - TOTAL NUIMBER OF RFAI . VALUES IN THE ARRAY ’RDAI’. C C CHARACTER*(*) STRING , CDATA CHARACTER*20

  9. TACOM-TARDEC Tech Base Plan Supporting FCS

    DTIC Science & Technology

    2007-11-02

    Sold ier Perf orm ance Ride Vibration R ide V ibration Shock Motion Sickness M ob ili ty Mission Module Offline reliability models Loads Ground...evaluate mobility, steering , braking, cooling and suspension performance vs. requirements METRIC:* • Increase mobility by 15% TRL=6 Conduct...Affordability metrics from programs impact the concept design and technology selection Technology Protection Plan Is it required? Yes Modeling and

  10. Daily Migraine Prevention and Its Influence on Resource Utilization in the Military Health System

    DTIC Science & Technology

    2006-08-01

    of migraine and the evolution of treatment. One of the earliest known references comes from a historical Mesopotamian text dated around 3000 B.C...care resource utilization. b. Economic Impact and Resource Utilization Associated with Migraine The Natio t for 3.5 million ambulatory visits...prom aine patients who met one or more of th . T ily Migraine Prevention by the International Headache Consortium oted the use of daily

  11. Influenza surveillance in Europe: comparing intensity levels calculated using the moving epidemic method

    PubMed Central

    Vega, Tomás; Lozano, José E; Meerhoff, Tamara; Snacken, René; Beauté, Julien; Jorgensen, Pernille; Ortiz de Lejarazu, Raúl; Domegan, Lisa; Mossong, Joël; Nielsen, Jens; Born, Rita; Larrauri, Amparo; Brown, Caroline

    2015-01-01

    Objectives Although influenza-like illnesses (ILI) and acute respiratory illnesses (ARI) surveillance are well established in Europe, the comparability of intensity among countries and seasons remains an unresolved challenge. The objective is to compare the intensity of ILI and ARI in some European countries. Design and setting Weekly ILI and ARI incidence rates and proportion of primary care consultations were modeled in 28 countries for the 1996/1997–2013/2014 seasons using the moving epidemic method (MEM). We calculated the epidemic threshold and three intensity thresholds, which delimit five intensity levels: baseline, low, medium, high, and very high. The intensity of 2013/2014 season is described and compared by country. Results The lowest ILI epidemic thresholds appeared in Sweden and Estonia (below 10 cases per 100 000) and the highest in Belgium, Denmark, Hungary, Poland, Serbia, and Slovakia (above 100 per 100 000). The 2009/2010 season was the most intense, with 35% of the countries showing high or very high intensity levels. The European epidemic period in season 2013/2014 started in January 2014 in Spain, Poland, and Greece. The intensity was between low and medium and only Greece reached the high intensity level, in weeks 7 to 9/2014. Some countries remained at the baseline level throughout the entire surveillance period. Conclusions Epidemic and intensity thresholds varied by country. Influenza-like illnesses and ARI levels normalized by MEM in 2013/2014 showed that the intensity of the season in Europe was between low and medium in most of the countries. Comparing intensity among seasons or countries is essential for understanding patterns in seasonal epidemics. An automated standardized model for comparison should be implemented at national and international levels. PMID:26031655

  12. Respiratory viral infections and effects of meteorological parameters and air pollution in adults with respiratory symptoms admitted to the emergency room

    PubMed Central

    Silva, Denise R; Viana, Vinícius P; Müller, Alice M; Livi, Fernando P; Dalcin, Paulo de Tarso R

    2014-01-01

    Background Respiratory viral infections (RVIs) are the most common causes of respiratory infections. The prevalence of respiratory viruses in adults is underestimated. Meteorological variations and air pollution are likely to play a role in these infections. Objectives The objectives of this study were to determine the number of emergency visits for influenza-like illness (ILI) and severe acute respiratory infection (SARI) and to evaluate the association between ILI/SARI, RVI prevalence, and meteorological factors/air pollution, in the city of Porto Alegre, Brazil, from November 2008 to October 2010. Methods Eleven thousand nine hundred and fifty-three hospitalizations (adults and children) for respiratory symptoms were correlated with meteorological parameters and air pollutants. In a subset of adults, nasopharyngeal aspirates were collected and analyzed through IFI test. The data were analyzed using time-series analysis. Results Influenza-like illness and SARI were diagnosed in 3698 (30·9%) and 2063 (17·7%) patients, respectively. Thirty-seven (9·0%) samples were positive by IFI and 93 of 410 (22·7%) were IFI and/or PCR positive. In a multivariate logistic regression model, IFI positivity was statistically associated with absolute humidity, use of air conditioning, and presence of mold in home. Sunshine duration was significantly associated with the frequency of ILI cases. For SARI cases, the variables mean temperature, sunshine duration, relative humidity, and mean concentration of pollutants were singnificant. Conclusions At least 22% of infections in adult patients admitted to ER with respiratory complaints were caused by RVI. The correlations among meteorological variables, air pollution, ILI/SARI cases, and respiratory viruses demonstrated the relevance of climate factors as significant underlying contributors to the prevalence of RVI. PMID:24034701

  13. Experimental Polyurethane Foam Roof Systems - II.

    DTIC Science & Technology

    1983-01-01

    reflect the effects of cloud cover, windspeed, and radiation from the roof during early morning and late evening hours. Measurement of the area under the...INN \\k I, N’. tlir’I’iii V A I \\’A SIurelS42r. K110i tlIe. I ct Ili Solair i imip .\\r nill. Kiw\\\\, tMe. I N I C(I’ 0)1,4 (IC, Ni’rtolk. \\.A ( ( I

  14. Two-Sample Inference for Median Survival Times Based on One-Sample Procedures for Censored Survival Data

    DTIC Science & Technology

    1988-08-01

    BTI ..iLi. CoP The Pennsylvania State University Department of Statistics V111 University Park, Pennsylvania TECHNICAL REPORTS AND PREPRINTS Number...compare confidence intervals for the median survival times of four dosage regimens 5-fluorouracil. Refer to Brookmeyer and Crowley (1982a) for a...ANSFIELD, F., KLOTZ, J., and THE CENTRAL ONCOLOGY GROUP (1977), "A Phase III 4-. Study Comparing the Clincial Utility of Four- Dosage Regimens of 5

  15. Human Volunteer Studies with Campylobacter jejuni

    DTIC Science & Technology

    1993-01-01

    AD-A271 892 1 April 1993 Reprint Human Volunteer Studies with Campylobacter jejuni Army Project Order 90PP0820 Robert E. Black, Daniel Perlman, Mary...the Outer Membrane Proteins of Campylobacter Jejuni for Vaccine Development Approved for public release; distribution unlimited NTxxeISfl RFor...8217?- NTIS CRA&I ILI •. O C T 2 9 19 9 3 E; . ... ~~~......................• * ....v ,. Ly Codes •27c 5-t Spcial Campylobacter , Vaccines, Biotechnology, ID

  16. Effect of Improved Fitness beyond Weight Loss on Cardiovascular Risk Factors in Individuals with Type 2 Diabetes in the Look AHEAD Study

    PubMed Central

    Gibbs, Bethany Barone; Brancati, Frederick L.; Chen, Haiying; Coday, Mace; Jakicic, John M.; Lewis, Cora; Stewart, Kerry J.; Clark, Jeanne M.

    2013-01-01

    Background Because lifestyle-induced improvements in cardiovascular risk factors vary substantially across individuals with type 2 diabetes, we investigated the extent to which increases in fitness explain cardiovascular risk factor improvements independent of weight loss in a lifestyle intervention. Methods We studied 1-year changes in Look AHEAD, a randomized trial comparing an intensive lifestyle intervention (ILI) to a diabetes support and education control group (DSE) in adults with type 2 diabetes. Assessments included weight, fitness, blood pressure (BP), glucose, HbA1c, and lipids. We evaluated the effects of changes in weight and fitness on changes in cardiovascular risk factors by study arm, using R2 from multiple linear regression. Results Analyses included participants with fitness data at baseline and 1-year (n=4,408; 41% male, 36% non-White, mean age 58.7± 6.8 years). Weight change alone improved R2 for explaining changes in risk factors up to 8.2% in ILI and 1.7% in DSE. Fitness change alone improved R2 up to 3.9% in ILI and 0.8% in DSE. After adjusting for weight change, fitness was independently associated (p<0.05) with improvements in R2 for glucose (+0.7%), HbA1c (+1.1 %), HDL cholesterol (+0.4%) and triglycerides (+0.2%) in ILI and DBP (+0.3%), glucose (+0.3%), HbA1c (+0.4%), and triglycerides (+0.1%) in DSE. Taken together, weight and fitness changes explained from 0.1–9.3% of the variability in cardiovascular risk factor changes. Conclusion Increased fitness explained statistically significant but small improvements in several cardiovascular risk factors beyond weight loss. Further research identifying other factors that explain cardiovascular risk factor change is needed. PMID:23012688

  17. National Dam Safety Program. Otsego Lake Dam (Inventory Number N.Y. 361), Susquehanna River Basin, Otsego County, New York. Phase I Inspection Report,

    DTIC Science & Technology

    1981-07-01

    o0 ,c 0 ILI 20 . .0 0 O~N(........... 4-iii in4 Ot 0. I.t* .n-n .. . ...... NMI. U.2~ fa. . . . . . . . . .. . . . . . . . . .. . -’V - Ovn !-a...C FLAHERT Y DAC .51 R aI-C- 006 UNCLASSIFIED NL 6 7 fffffffff~l %- ab * ,bm - ; a ePp;; w r i -. r r..r...rr...’ r IL~~I . V ~ u OVN WFM m n x In. on

  18. Mycobacterium marinum Degrades Both Triacylglycerols and Phospholipids from Its Dictyostelium Host to Synthesise Its Own Triacylglycerols and Generate Lipid Inclusions

    PubMed Central

    2017-01-01

    During a tuberculosis infection and inside lipid-laden foamy macrophages, fatty acids (FAs) and sterols are the major energy and carbon source for Mycobacterium tuberculosis. Mycobacteria can be found both inside a vacuole and the cytosol, but how this impacts their access to lipids is not well appreciated. Lipid droplets (LDs) store FAs in form of triacylglycerols (TAGs) and are energy reservoirs of prokaryotes and eukaryotes. Using the Dictyostelium discoideum/Mycobacterium marinum infection model we showed that M. marinum accesses host LDs to build up its own intracytosolic lipid inclusions (ILIs). Here, we show that host LDs aggregate at regions of the bacteria that become exposed to the cytosol, and appear to coalesce on their hydrophobic surface leading to a transfer of diacylglycerol O-acyltransferase 2 (Dgat2)-GFP onto the bacteria. Dictyostelium knockout mutants for both Dgat enzymes are unable to generate LDs. Instead, the excess of exogenous FAs is esterified predominantly into phospholipids, inducing uncontrolled proliferation of the endoplasmic reticulum (ER). Strikingly, in absence of host LDs, M. marinum alternatively exploits these phospholipids, resulting in rapid reversal of ER-proliferation. In addition, the bacteria are unable to restrict their acquisition of lipids from the dgat1&2 double knockout leading to vast accumulation of ILIs. Recent data indicate that the presence of ILIs is one of the characteristics of dormant mycobacteria. During Dictyostelium infection, ILI formation in M. marinum is not accompanied by a significant change in intracellular growth and a reduction in metabolic activity, thus providing evidence that storage of neutral lipids does not necessarily induce dormancy. PMID:28103313

  19. Structure of Ordinary Ice I sub h. Part 2: Defects in Ice. Volume 2: Dislocations and Plane Defects

    DTIC Science & Technology

    1994-05-01

    of formation of pro- D diffusion coefficient tonic defects DH diffusion coefficient of hydrogen in ice yni activation volume of protonic defects’ Di...diffusion coefficient of interstitials motion D, self-diffusion coefficient h separation of the Peierls troughs D. (val) exp(S- J Ili =1-,11for i=1...2,3, 4 D., diffusion coefficient of vacancies ji flux density of defects (i = 1, 2, 3, 4) D electric displacement vector JAdi, displacement current e

  20. Report: NSF Instrumentation and Laboratory Improvement Grants in Chemistry

    NASA Astrophysics Data System (ADS)

    1997-01-01

    The 1996 awards in chemistry under the Instrumentation and Laboratory Improvement Program (ILI) of the Division of Undergraduate Education (DUE) have been announced and are listed below. The ILI program provides matching funds in the range of 5,000 to 100,000 for purchasing equipment for laboratory improvement. Since the recipient institution must provide matching funds equaling or exceeding the NSF award, the supported projects range in cost from 10,000 to over 200,000. The 311 chemistry proposals requesting 13 million constituted 21% of the total number of proposals submitted to the ILI program. A total of 3.9 million was awarded in support of 110 projects in chemistry. The instruments requested most frequently were high field NMRs, GC/MS instruments, computers for data analysis, and FT-IRs; next most commonly requested were UV-vis spectrophotometers, followed by HPLCs, lasers, computers for molecular modeling, AAs, and GCs. In addition, one award was made this year in chemistry within the Leadership in Laboratory Development category. The next deadline for submission of ILI proposals is November 14, 1997. Guidelines for the preparation of proposals are found in the DUE Program Announcement (NSF 96-10), which may be obtained by calling (703) 306-1666 or by e-mail: undergrad@nsf.gov. Other information about DUE programs and activities and abstracts of the funded proposals can be found on the DUE Home Page at http://www.ehr.nsf.gov/EHR/DUE/start.htm. We thank Sandra D. Nelson, Science Education Analyst in DUE, for assistance in data gathering.

  1. Impact of influenza vaccination on respiratory illness rates in children attending private boarding schools in England, 2013-2014: a cohort study.

    PubMed

    Brousseau, N; Green, H K; Andrews, N; Pryse, R; Baguelin, M; Sunderland, A; Ellis, J; Pebody, R

    2015-12-01

    Several private boarding schools in England have established universal influenza vaccination programmes for their pupils. We evaluated the impact of these programmes on the burden of respiratory illnesses in boarders. Between November 2013 and May 2014, age-specific respiratory disease incidence rates in boarders were compared between schools offering and not offering influenza vaccine to healthy boarders. We adjusted for age, sex, school size and week using negative binomial regression. Forty-three schools comprising 14 776 boarders participated. Almost all boarders (99%) were aged 11-17 years. Nineteen (44%) schools vaccinated healthy boarders against influenza, with a mean uptake of 48·5% (range 14·2-88·5%). Over the study period, 1468 respiratory illnesses were reported in boarders (5·66/1000 boarder-weeks); of these, 33 were influenza-like illnesses (ILIs, 0·26/1000 boarder-weeks) in vaccinating schools and 95 were ILIs (0·74/1000 boarder-weeks) in non-vaccinating schools. The impact of vaccinating healthy boarders was a 54% reduction in ILI in all boarders [rate ratio (RR) 0·46, 95% confidence interval (CI) 0·28-0·76]. Disease rates were also reduced for upper respiratory tract infections (RR 0·72, 95% CI 0·61-0·85) and chest infections (RR 0·18, 95% CI 0·09-0·36). These findings demonstrate a significant impact of influenza vaccination on ILI and other clinical endpoints in secondary-school boarders. Additional research is needed to investigate the impact of influenza vaccination in non-boarding secondary-school settings.

  2. Towards an Agent-Based, Autonomous Tactical System for C4ISR Operations

    DTIC Science & Technology

    2008-12-01

    collaboration within these new information societies, intelligence sys- tems can no longer fully rely on human operators for manual control of all the...Huhns, 2005). Usually agents are small in comparison to today’s manual , monolithic computer systems this is be- cause an agent’s power is derived...to-peer (P2P) network of reg- istries. - Engage with P2P event-based middleware ( EBM ). The P2P- EBM approach was finally chosen primar- ily

  3. Mycobacterium marinum Degrades Both Triacylglycerols and Phospholipids from Its Dictyostelium Host to Synthesise Its Own Triacylglycerols and Generate Lipid Inclusions.

    PubMed

    Barisch, Caroline; Soldati, Thierry

    2017-01-01

    During a tuberculosis infection and inside lipid-laden foamy macrophages, fatty acids (FAs) and sterols are the major energy and carbon source for Mycobacterium tuberculosis. Mycobacteria can be found both inside a vacuole and the cytosol, but how this impacts their access to lipids is not well appreciated. Lipid droplets (LDs) store FAs in form of triacylglycerols (TAGs) and are energy reservoirs of prokaryotes and eukaryotes. Using the Dictyostelium discoideum/Mycobacterium marinum infection model we showed that M. marinum accesses host LDs to build up its own intracytosolic lipid inclusions (ILIs). Here, we show that host LDs aggregate at regions of the bacteria that become exposed to the cytosol, and appear to coalesce on their hydrophobic surface leading to a transfer of diacylglycerol O-acyltransferase 2 (Dgat2)-GFP onto the bacteria. Dictyostelium knockout mutants for both Dgat enzymes are unable to generate LDs. Instead, the excess of exogenous FAs is esterified predominantly into phospholipids, inducing uncontrolled proliferation of the endoplasmic reticulum (ER). Strikingly, in absence of host LDs, M. marinum alternatively exploits these phospholipids, resulting in rapid reversal of ER-proliferation. In addition, the bacteria are unable to restrict their acquisition of lipids from the dgat1&2 double knockout leading to vast accumulation of ILIs. Recent data indicate that the presence of ILIs is one of the characteristics of dormant mycobacteria. During Dictyostelium infection, ILI formation in M. marinum is not accompanied by a significant change in intracellular growth and a reduction in metabolic activity, thus providing evidence that storage of neutral lipids does not necessarily induce dormancy.

  4. Impact Damage to Composite Structures

    DTIC Science & Technology

    1986-02-01

    Security Classification of Document UNCLASSIFIED 6. Title IMPACT DAMAGE TO COMPOSITE STRUCTURES 7. Presented at 8. Authar(s)/Editor(s) Various 10...materials Composite structures Structural analysis Mechanical properties Impact strength Damage 14. Abstract The Structures and Materials Panel...POSTGRADUATE SCHOOL MOMTEREY, CAL1F.QRN.IA 9,19ili AGARD-R-729 AGARD REPORT No.729 Impact Damage to Composite Structures * DISTRIBUTION AND AVAILABILITY

  5. Roughness Effects on Compressor Outlet Guide Vanes at High Reynolds Number and High Turning Angle.

    DTIC Science & Technology

    1982-11-01

    controlled environment was necessary to reduce the effects of ambient temperture fluctuations on the resistance of the bridoe circuit of the anemormeter...RD-Ai24 688 ROUGHNESS EFFECTS ON COMPRESSOR OUTLET GUIDE YANES AT I HIGH REYNOLDS NUMBE..(U) AR FORCE INST OF TECH IRIGHT-PRTTERSONRRFB OH SCHOOL OF...RESOLUTION TEST CHART ~.~~-NAONAL BUREAU OF STAMDOARDS-1963-A AF....ED , . - . . . .Genovese ili t~t.V ROUGHESS EFFECTS ON COMP RROTT .AND HIGH

  6. Exploring a Proposed WHO Method to Determine Thresholds for Seasonal Influenza Surveillance

    PubMed Central

    Tay, Ee Laine; Grant, Kristina; Kirk, Martyn; Mounts, Anthony; Kelly, Heath

    2013-01-01

    Introduction Health authorities find thresholds useful to gauge the start and severity of influenza seasons. We explored a method for deriving thresholds proposed in an influenza surveillance manual published by the World Health Organization (WHO). Methods For 2002-2011, we analysed two routine influenza-like-illness (ILI) datasets, general practice sentinel surveillance and a locum medical service sentinel surveillance, plus laboratory data and hospital admissions for influenza. For each sentinel dataset, we created two composite variables from the product of weekly ILI data and the relevant laboratory data, indicating the proportion of tested specimens that were positive. For all datasets, including the composite datasets, we aligned data on the median week of peak influenza or ILI activity and assigned three threshold levels: seasonal threshold, determined by inspection; and two intensity thresholds termed average and alert thresholds, determined by calculations of means, medians, confidence intervals (CI) and percentiles. From the thresholds, we compared the seasonal onset, end and intensity across all datasets from 2002-2011. Correlation between datasets was assessed using the mean correlation coefficient. Results The median week of peak activity was week 34 for all datasets, except hospital data (week 35). Means and medians were comparable and the 90% upper CIs were similar to the 95th percentiles. Comparison of thresholds revealed variations in defining the start of a season but good agreement in describing the end and intensity of influenza seasons, except in hospital admissions data after the pandemic year of 2009. The composite variables improved the agreements between the ILI and other datasets. Datasets were well correlated, with mean correlation coefficients of >0.75 for a range of combinations. Conclusions Thresholds for influenza surveillance are easily derived from historical surveillance and laboratory data using the approach proposed by WHO. Use

  7. When Leaders Fail: Living with the Consequences of Missed Coaching Opportunities

    DTIC Science & Technology

    2002-02-01

    performance feedback gathered from the learner’s boss, peers , and sub- ordinates), performance reviews, inter- views, and personality instruments. In...of her work. Still, the person whom I had gotten to know appreciated continuous learning , was approachable, smiled eas- ily, and had a natural...standing that training and a suitable learning curve will backfill the candi- date’s knowledge gaps. And sometimes that development, along with some

  8. US EPA, Pesticide Product Label, , 09/06/1972

    EPA Pesticide Factsheets

    2011-04-21

    ... It" ;1(',,' tJ-11I('h 1'11\\\\ "'1'.I('!lI~ I I)' .; II: .... ill" "'1" ft. ... t i,'. ;I!, nllId : .... hih;l~ '.rllIlIl!d jlllf:l~r·:lt:"~. ...

  9. US EPA, Pesticide Product Label, DAWSON (R) 37 ...

    EPA Pesticide Factsheets

    2011-04-21

    ... I'U' l'lll,h l'\\I~ \\\\ 1111 \\\\ .I[ll t"l ,I[ it.I,1 :'" l]llll,lfl' l"LI.\\ \\)(CT()1\\. I) .. 11111 fl'lhl' 1I"dIIIH':": . ... "lllh IliI"'Il)'I:"'11 \\\\111 1,1' ('lll',I,lt-rc i ,I 1',111 "~f fiJi, l.lhel, ...

  10. US EPA, Pesticide Product Label, SA-50 BRAND 1% ...

    EPA Pesticide Factsheets

    2011-04-14

    ... i,lI'!... lIId fa 't' I'Il1lh"r ;1J'l'li, :11" .. :-_ IIi .. ... hI' :-aluralt'd. \\Vllt'n caLlI' ; ~ /,1 0 kwk rllhlw!':-, ar~' us,·d U~e 1 galion uf :Oil' luli"ll fIJI' t Ll('h ~() flo ui ('a!JI,·. ...

  11. Face mask use by patients in primary care.

    PubMed

    Tischendorf, Jessica S; Temte, Jonathan L

    2012-02-01

    Face masks are recommended for patients with respiratory symptoms to reduce influenza transmission. Little knowledge exists regarding actual utilization and acceptance of face masks in primary care. Compare distribution of face masks to clinic and community trends in respiratory infection (RI) and influenza-like illness (ILI); estimate the annual need for face masks in primary care. Retrospective observational study of practice data from a 31-week period starting in October 2009. Family practice clinic in Madison, Wis. Patients with fever, cough, or other respiratory symptoms as evaluated by reception staff. Age, sex, and weekly counts of individuals receiving a face mask, as well as counts of RI and ILI patients based on ICD-9 coding from 27 statewide clinics. Face mask counts were 80% of RI counts for the clinic and reflected the demographics of the clinic population. Distribution was correlated to prevalence of RI (R = 0.783, P < 0.001) and ILI (R = 0.632, P < 0.001). Annually, 8% of clinic visits were for RI. The high percentage of face mask use among RI patients reflects the feasibility of this intervention to help control influenza transmission in a primary care setting. Using the present data, clinics can estimate the annual need for face masks.

  12. Effectiveness of the monovalent influenza A(H1N1)2009 vaccine in Navarre, Spain, 2009-2010: cohort and case-control study.

    PubMed

    Castilla, Jesús; Morán, Julio; Martínez-Artola, Víctor; Fernández-Alonso, Mirian; Guevara, Marcela; Cenoz, Manuel García; Reina, Gabriel; Alvarez, Nerea; Arriazu, Maite; Elía, Fernando; Salcedo, Esther; Barricarte, Aurelio

    2011-08-11

    We defined a population-based cohort (596,755 subjects) in Navarre, Spain, using electronic records from physicians, to evaluate the effectiveness of the monovalent A(H1N1)2009 vaccine in preventing influenza in the 2009-2010 pandemic season. During the 9-week period of vaccine availability and circulation of the A(H1N1)2009 virus, 4608 cases of medically attended influenza-like illness (MA-ILI) were registered (46 per 1000 person-years). After adjustment for sociodemographic covariables, outpatient visits and major chronic conditions, vaccination was associated with a 32% (95% CI: 8-50%) reduction in the overall incidence of MA-ILI. In a test negative case-control analysis nested in the cohort, swabs from 633 patients were included, and 123 were confirmed for A(H1N1)2009 influenza. No confirmed case had received A(H1N1)2009 vaccine versus 9.6% of controls (p<0.001). The vaccine effectiveness in preventing laboratory-confirmed influenza was 89% (95% CI: 36-100%) after adjusting for age, health care setting, major chronic conditions and period. Pandemic vaccine was effective in preventing MA-ILI and confirmed cases of influenza A(H1N1)2009 in the 2009-2010 season. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. Clinical characteristics and outcomes of influenza and other influenza-like illnesses in Mexico City

    PubMed Central

    Galindo-Fraga, Arturo; Ortiz-Hernández, Ana A.; Ramírez-Venegas, Alejandra; Vázquez, Rafael Valdez; Moreno-Espinosa, Sarbelio; Llamosas-Gallardo, Beatriz; Pérez-Patrigeon, Santiago; Salinger, Maggie; Freimanis, Laura; Huang, Chiung-yu; Gu, Wenjuan; Guerrero, M. Lourdes; Beigel, John; Ruiz-Palacios, Guillermo M.

    2013-01-01

    Summary Background Influenza-like illnesses (ILI) are estimated to cause millions of deaths annually. Despite this disease burden, the etiologic causes of ILI are poorly described for many geographical regions. Methods Beginning in April 2010, we conducted an observational cohort study at five hospitals in Mexico City, enrolling subjects who met the criteria for ILI. Evaluations were conducted at enrollment and on day 28, with the collection of clinical data and a nasopharyngeal swab (or nasal aspirate in children). Swabs were tested by multiplex PCR for 15 viral pathogens and real-time PCR for influenza. Results During the first year, 1065 subjects were enrolled in this study, 55% of whom were hospitalized; 24% of all subjects were children. One or more pathogens were detected by PCR in 64% of subjects, most commonly rhinovirus (25% of all isolates) and influenza (24% of isolates). Six percent of subjects died, and of those, 54% had no pathogen identified. Rhinovirus was the most common pathogen among those who died, although it did not have the highest case fatality rate. Conclusions Multiple respiratory viruses beyond influenza are associated with significant morbidity and mortality among adults and children in Mexico City. Detection of these agents could be useful for the adjustment of antibiotic treatment in severe cases. PMID:23416208

  14. Participatory Syndromic Surveillance of Influenza in Europe.

    PubMed

    Guerrisi, Caroline; Turbelin, Clément; Blanchon, Thierry; Hanslik, Thomas; Bonmarin, Isabelle; Levy-Bruhl, Daniel; Perrotta, Daniela; Paolotti, Daniela; Smallenburg, Ronald; Koppeschaar, Carl; Franco, Ana O; Mexia, Ricardo; Edmunds, W John; Sile, Bersabeh; Pebody, Richard; van Straten, Edward; Meloni, Sandro; Moreno, Yamir; Duggan, Jim; Kjelsø, Charlotte; Colizza, Vittoria

    2016-12-01

    The growth of digital communication technologies for public health is offering an unconventional means to engage the general public in monitoring community health. Here we present Influenzanet, a participatory system for the syndromic surveillance of influenza-like illness (ILI) in Europe. Through standardized online surveys, the system collects detailed profile information and self-reported symptoms volunteered by participants resident in the Influenzanet countries. Established in 2009, it now includes 10 countries representing more than half of the 28 member states of the European Union population. The experience of 7 influenza seasons illustrates how Influenzanet has become an adjunct to existing ILI surveillance networks, offering coherence across countries, inclusion of nonmedically attended ILI, flexibility in case definition, and facilitating individual-level epidemiological analyses generally not possible in standard systems. Having the sensitivity to timely detect substantial changes in population health, Influenzanet has the potential to become a viable instrument for a wide variety of applications in public health preparedness and control. © The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail journals.permissions@oup.com.

  15. The effects of Fast ForWord Language on the phonemic awareness and reading skills of school-age children with language impairments and poor reading skills.

    PubMed

    Loeb, Diane Frome; Gillam, Ronald B; Hoffman, LaVae; Brandel, Jayne; Marquis, Janet

    2009-11-01

    To examine the efficacy of Fast ForWord Language (FFW-L) and 2 other interventions for improving the phonemic awareness and reading skills of children with specific language impairment with concurrent poor reading skills. A total of 103 children (age 6;0 to 8;11 [years;months]) with language impairment and poor reading skills participated. The children received either FFW-L computerized intervention, a computer-assisted language intervention (CALI), an individualized language intervention (ILI), or an attention control (AC) computer program. The children in the FFW-L, CALI, and ILI conditions made significantly greater gains in blending sounds in words compared with the AC group at immediate posttest. Long-term gains 6 months after treatment were not significant but yielded a medium effect size for blending sounds in words. None of the interventions led to significant changes in reading skills. The improvement in phonemic awareness, but not reading, in the FFW-L, CALI, and ILI interventions limits their use with children who have language impairment and poor reading skills. Similar results across treatment conditions suggest that acoustically modified speech was not a necessary component for improving phonemic awareness.

  16. Establishing seasonal and alert influenza thresholds in Cambodia using the WHO method: implications for effective utilization of influenza surveillance in the tropics and subtropics.

    PubMed

    Ly, Sovann; Arashiro, Takeshi; Ieng, Vanra; Tsuyuoka, Reiko; Parry, Amy; Horwood, Paul; Heng, Seng; Hamid, Sarah; Vandemaele, Katelijn; Chin, Savuth; Sar, Borann; Arima, Yuzo

    2017-01-01

    To establish seasonal and alert thresholds and transmission intensity categories for influenza to provide timely triggers for preventive measures or upscaling control measures in Cambodia. Using Cambodia's influenza-like illness (ILI) and laboratory-confirmed influenza surveillance data from 2009 to 2015, three parameters were assessed to monitor influenza activity: the proportion of ILI patients among all outpatients, proportion of ILI samples positive for influenza and the product of the two. With these parameters, four threshold levels (seasonal, moderate, high and alert) were established and transmission intensity was categorized based on a World Health Organization alignment method. Parameters were compared against their respective thresholds. Distinct seasonality was observed using the two parameters that incorporated laboratory data. Thresholds established using the composite parameter, combining syndromic and laboratory data, had the least number of false alarms in declaring season onset and were most useful in monitoring intensity. Unlike in temperate regions, the syndromic parameter was less useful in monitoring influenza activity or for setting thresholds. Influenza thresholds based on appropriate parameters have the potential to provide timely triggers for public health measures in a tropical country where monitoring and assessing influenza activity has been challenging. Based on these findings, the Ministry of Health plans to raise general awareness regarding influenza among the medical community and the general public. Our findings have important implications for countries in the tropics/subtropics and in resource-limited settings, and categorized transmission intensity can be used to assess severity of potential pandemic influenza as well as seasonal influenza.

  17. Clinical presentations for influenza and influenza-like illness in young, immunized soldiers.

    PubMed

    McNeill, K Mills; Vaughn, Beverly L; Brundage, Mary B; Li, Yuanzhang; Poropatich, Ron K; Gaydos, Joel C

    2005-01-01

    Concern about respiratory diseases in soldiers increased in the late 1990s as production of the successful adenovirus vaccines stopped and the possibilities of an emergent pandemic influenza strain and use of bioweapons by terrorists were seriously considered. Current information on the causes and severity of influenza-like illness (ILI) was lacking. Viral agents and clinical presentations were described in a population of soldiers highly immunized for influenza. Using standard virus isolation techniques, 10 agents were identified in 164 (48.2%) of 340 soldiers hospitalized for ILI. Influenza isolates (29) and adenoviruses (98) occurred most frequently. Most influenza cases were caused by influenza A and probably resulted from a mismatch between circulating and vaccine viruses. Most (58.5%) patients with an adenovirus had a chest radiograph; 31.3% of these had an infiltrate. Clinical findings did not differentiate ILI caused by the various agents. Only 29 cases of influenza occurred in approximately 7,200 person-years of observation, supporting the use of influenza vaccine.

  18. A new space of the face: The bucco-mandibular space.

    PubMed

    Iwanaga, Joe; Kamura, Yasuhiko; Tanaka, Tsuyoshi; Watanabe, Koichi; Kusukawa, Jingo; Oskouian, Rod J; Tubbs, R Shane

    2017-10-01

    Our previous studies based on intraoral dissection of fresh cadavers demonstrated the fissure and loose connective tissues behind the mucosa between the incisivus labii inferioris (ILI) and buccinator (BM) muscles. However, this raised new questions about the relationship among these muscles, the fissure and the buccal space. To our knowledge, no pathway to the oral cavity from the buccal space has been previously demonstrated, although such a pathway would better explain some routes of infection. Therefore, the aim of this study was to clarify the relationship among the mimetic muscles attached to the mandible, the fissure, and the buccal space. Twenty sides from 10 fresh frozen adult cadaveric Caucasian heads were used. The relationships among the ILI, BM, mandible, and buccal space were investigated with dissection and fluoroscopy. In all specimens, the fissure between the lateral border of the ILI and the anterior border of the BM formed the entrance of a space (here termed the bucco-mandibular space), which corresponded to the buccal mucosa in the premolar region. The superior border of this space was formed by the platysma and associated fascia, which was continuous with the masseteric fascia. This fascia clearly separated this space from the buccal space, which was located lateral to the BM and superior to this space. Clin. Anat. 30:958-962, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  19. Outcomes of a Pilot Hand Hygiene Randomized Cluster Trial to Reduce Communicable Infections Among US Office-Based Employees

    PubMed Central

    DuBois, Cathy L.Z.; Grey, Scott F.; Kingsbury, Diana M.; Shakya, Sunita; Scofield, Jennifer; Slenkovich, Ken

    2015-01-01

    Objective: To determine the effectiveness of an office-based multimodal hand hygiene improvement intervention in reducing self-reported communicable infections and work-related absence. Methods: A randomized cluster trial including an electronic training video, hand sanitizer, and educational posters (n = 131, intervention; n = 193, control). Primary outcomes include (1) self-reported acute respiratory infections (ARIs)/influenza-like illness (ILI) and/or gastrointestinal (GI) infections during the prior 30 days; and (2) related lost work days. Incidence rate ratios calculated using generalized linear mixed models with a Poisson distribution, adjusted for confounders and random cluster effects. Results: A 31% relative reduction in self-reported combined ARI-ILI/GI infections (incidence rate ratio: 0.69; 95% confidence interval, 0.49 to 0.98). A 21% nonsignificant relative reduction in lost work days. Conclusions: An office-based multimodal hand hygiene improvement intervention demonstrated a substantive reduction in self-reported combined ARI-ILI/GI infections. PMID:25719534

  20. Disentangling the roles of cholesterol and CD59 in intermedilysin pore formation

    PubMed Central

    Boyd, Courtney M.; Parsons, Edward S.; Smith, Richard A. G.; Seddon, John M.; Ces, Oscar; Bubeck, Doryen

    2016-01-01

    The plasma membrane provides an essential barrier, shielding a cell from the pressures of its external environment. Pore-forming proteins, deployed by both hosts and pathogens alike, breach this barrier to lyse target cells. Intermedilysin is a cholesterol-dependent cytolysin that requires the human immune receptor CD59, in addition to cholesterol, to form giant β-barrel pores in host membranes. Here we integrate biochemical assays with electron microscopy and atomic force microscopy to distinguish the roles of these two receptors in mediating structural transitions of pore formation. CD59 is required for the specific coordination of intermedilysin (ILY) monomers and for triggering collapse of an oligomeric prepore. Movement of Domain 2 with respect to Domain 3 of ILY is essential for forming a late prepore intermediate that releases CD59, while the role of cholesterol may be limited to insertion of the transmembrane segments. Together these data define a structural timeline for ILY pore formation and suggest a mechanism that is relevant to understanding other pore-forming toxins that also require CD59. PMID:27910935

  1. Performance of case definitions for influenza surveillance.

    PubMed

    Jiang, L; Lee, V J; Lim, W Y; Chen, M I; Chen, Y; Tan, L; Lin, R T; Leo, Y S; Barr, I; Cook, A R

    2015-06-04

    Influenza-like illness (ILI) case definitions, such as those from the European Centre for Disease Control and Prevention, World Health Organization (WHO) and United States Centers for Disease Control and Prevention, are commonly used for influenza surveillance. We assessed how various case definitions performed during the initial wave of influenza A(H1N1) pdm09 infections in Singapore on a cohort of 727 patients with two to three blood samples and whose symptoms were reviewed fortnightly from June to October 2009. Using seroconversion (≥ 4-fold rise) to A/California/7/2009 (H1N1), we identified 36 presumptive influenza A(H1N1)pdm09 episodes and 664 episodes unrelated to influenza A(H1N1)pdm09. Cough, fever and headache occurred more commonly in presumptive influenza A(H1N1)pdm09. Although the sensitivity was low (36%), the recently revised WHO ILI case definition gave a higher positive predictive value (42%) and positive likelihood ratio (13.3) than the other case definitions. Results including only episodes with primary care consultations were similar. Individuals who worked or had episodes with fever, cough or sore throat were more likely to consult a physician, while episodes with Saturday onset were less likely, with some consultations skipped or postponed. Our analysis supports the use of the revised WHO ILI case definition, which includes only cough in the presence of fever defined as body temperature ≥ 38 °C for influenza surveillance.

  2. Transmission of Influenza on International Flights, May 2009

    PubMed Central

    Foxwell, A. Ruth; Roberts, Leslee; Lokuge, Kamalini

    2011-01-01

    Understanding the dynamics of influenza transmission on international flights is necessary for prioritizing public health response to pandemic incursions. A retrospective cohort study to ascertain in-flight transmission of pandemic (H1N1) 2009 and influenza-like illness (ILI) was undertaken for 2 long-haul flights entering Australia during May 2009. Combined results, including survey responses from 319 (43%) of 738 passengers, showed that 13 (2%) had an ILI in flight and an ILI developed in 32 (5%) passengers during the first week post arrival. Passengers were at 3.6% increased risk of contracting pandemic (H1N1) 2009 if they sat in the same row as or within 2 rows of persons who were symptomatic preflight. A closer exposed zone (2 seats in front, 2 seats behind, and 2 seats either side) increased the risk for postflight disease to 7.7%. Efficiency of contact tracing without compromising the effectiveness of the public health intervention might be improved by limiting the exposed zone. PMID:21762571

  3. Increased Rates of Respiratory and Diarrheal Illnesses in HIV-Negative Persons Living With HIV-Infected Individuals in a Densely Populated Urban Slum in Kenya

    PubMed Central

    Wong, Joshua M.; Cosmas, Leonard; Nyachieo, Dhillon; Williamson, John M.; Olack, Beatrice; Okoth, George; Njuguna, Henry; Feikin, Daniel R.; Burke, Heather; Montgomery, Joel M.; Breiman, Robert F.

    2015-01-01

    Background Prolonged pathogen shedding and increased duration of illness associated with infections in immunosuppressed individuals put close human immunodeficiency virus (HIV)–negative contacts of HIV-infected persons at increased risk of exposure to infectious pathogens. Methods We calculated incidence and longitudinal prevalence (number of days per year) of influenzalike illness (ILI), diarrhea, and nonspecific febrile illness during 2008 from a population-based surveillance program in the urban slum of Kibera (Kenya) that included 1830 HIV-negative household contacts of HIV-infected individuals and 13 677 individuals living in exclusively HIV-negative households. Results For individuals ≥5 years old, incidence was significantly increased for ILI (risk ratio [RR], 1.47; P < .05) and diarrhea (RR, 1.41; P < .05) in HIV-negative household contacts of HIV-infected individuals compared with exclusively HIV-negative households. The risk of illness among HIV-negative persons was directly proportional to the number of HIV-infected persons living in the home for ILI (RR, 1.39; P < .05) and diarrhea (RR, 1.36; P < .01). We found no increased rates of illness in children <5 years old who lived with HIV-infected individuals. Conclusions Living with HIV-infected individuals is associated with modestly increased rates of respiratory and diarrheal infections in HIV-negative individuals >5 years old. Targeted interventions are needed, including ensuring that HIV-infected persons are receiving appropriate care and treatment. PMID:25722292

  4. Estimating dynamic transmission model parameters for seasonal influenza by fitting to age and season-specific influenza-like illness incidence.

    PubMed

    Goeyvaerts, Nele; Willem, Lander; Van Kerckhove, Kim; Vandendijck, Yannick; Hanquet, Germaine; Beutels, Philippe; Hens, Niel

    2015-12-01

    Dynamic transmission models are essential to design and evaluate control strategies for airborne infections. Our objective was to develop a dynamic transmission model for seasonal influenza allowing to evaluate the impact of vaccinating specific age groups on the incidence of infection, disease and mortality. Projections based on such models heavily rely on assumed 'input' parameter values. In previous seasonal influenza models, these parameter values were commonly chosen ad hoc, ignoring between-season variability and without formal model validation or sensitivity analyses. We propose to directly estimate the parameters by fitting the model to age-specific influenza-like illness (ILI) incidence data over multiple influenza seasons. We used a weighted least squares (WLS) criterion to assess model fit and applied our method to Belgian ILI data over six influenza seasons. After exploring parameter importance using symbolic regression, we evaluated a set of candidate models of differing complexity according to the number of season-specific parameters. The transmission parameters (average R0, seasonal amplitude and timing of the seasonal peak), waning rates and the scale factor used for WLS optimization, influenced the fit to the observed ILI incidence the most. Our results demonstrate the importance of between-season variability in influenza transmission and our estimates are in line with the classification of influenza seasons according to intensity and vaccine matching.

  5. Utility of the ESSENCE Surveillance System in Monitoring the H1N1 Outbreak.

    PubMed

    Holtry, Rekha S; Hung, Lang M; Lewis, Sheri H

    2010-01-01

    The Electronic Surveillance System for the Early Notification of Community-Based Epidemics (ESSENCE) enables health care practitioners to detect and monitor health indicators of public health importance. ESSENCE is used by public health departments in the National Capital Region (NCR); a cross-jurisdictional data sharing agreement has allowed cooperative health information sharing in the region since 2004. Emergency department visits for influenza-like illness (ILI) in the NCR from 2008 are compared to those of 2009. Important differences in the rates, timing, and demographic composition of ILI visits were found. By monitoring a regional surveillance system, public health practitioners had an increased ability to understand the magnitude and character of different ILI outbreaks. This increased ability provided crucial community-level information on which to base response and control measures for the novel 2009 H1N1 influenza outbreak. This report underscores the utility of automated surveillance systems in monitoring community-based outbreaks. There are several limitations in this study that are inherent with syndrome-based surveillance, including utilizing chief complaints versus confirmed laboratory data, discerning real disease versus those healthcare-seeking behaviors driven by panic, and reliance on visit counts versus visit rates.

  6. Dissemination of the Look AHEAD Lifestyle Intervention in the United States Air Force: Study Rationale, Design and Methods

    PubMed Central

    Krukowski, Rebecca A.; Hare, Marion E.; Talcott, Gerald W.; Johnson, Karen C.; Richey, Phyllis A.; Kocak, Mehmet; Balderas, Jennifer; Colvin, Lauren; Keller, Patrick L.; Waters, Teresa M.; Klesges, Robert C.

    2014-01-01

    Despite an increase in overweight and obesity similar to the civilian population, there have been few randomized controlled trials examining behavioral weight management interventions in the military settings. This paper describes the design, intervention development and analysis plan of the Fit Blue study, a randomized controlled behavioral weight loss trial taking place in the United States Air Force. This study compares two adapted versions of the efficacious Look AHEAD Intensive Lifestyle Intervention (ILI), a counselor-initiated condition and a self-paced condition. Also described are the unique steps required when conducting military-based health promotion research and adaptations made to the Look AHEAD intervention to accommodate the military environment. To our knowledge, this is the first translation of the Look AHEAD ILI in the military setting and one of the first translations of the ILI in general. If successful, this intervention could be disseminated to the entire U.S. Military as this project is designed to overcome the barriers and utilize the facilitators for weight loss that are unique to a military population. Programs validated in military populations can have a major public health impact given that with 1.4 million active duty personnel, the Department of Defense is the nation’s largest employer. However, while this intervention is designed for a military population and there are unique aspects of the military that may enhance weight loss interventions, the diversity of the study population should help inform obesity efforts in both civilian and military settings. PMID:25545025

  7. The Effects of Fast ForWord Language on the Phonemic Awareness and Reading Skills of School-Age Children With Language Impairments and Poor Reading Skills

    PubMed Central

    Loeb, Diane Frome; Gillam, Ronald B.; Hoffman, LaVae; Brandel, Jayne; Marquis, Janet

    2012-01-01

    Purpose To examine the efficacy of Fast For-Word Language (FFW-L) and 2 other interventions for improving the phonemic awareness and reading skills of children with specific language impairment with concurrent poor reading skills. Method A total of 103 children (age 6;0 to 8;11 [years;months]) with language impairment and poor reading skills participated. The children received either FFW-L computerized intervention, a computer-assisted language intervention (CALI), an individualized language intervention (ILI), or an attention control (AC) computer program. Results The children in the FFW-L, CALI, and ILI conditions made significantly greater gains in blending sounds in words compared with the AC group at immediate posttest. Long-term gains 6 months after treatment were not significant but yielded a medium effect size for blending sounds in words. None of the interventions led to significant changes in reading skills. Conclusion The improvement in phonemic awareness, but not reading, in the FFW-L, CALI, and ILI interventions limits their use with children who have language impairment and poor reading skills. Similar results across treatment conditions suggest that acoustically modified speech was not a necessary component for improving phonemic awareness. PMID:19564439

  8. Multi-class determination of around 50 pharmaceuticals, including 26 antibiotics, in environmental and wastewater samples by ultra-high performance liquid chromatography-tandem mass spectrometry.

    PubMed

    Gracia-Lor, Emma; Sancho, Juan V; Hernández, Félix

    2011-04-22

    A multi-class method for the simultaneous quantification and confirmation of 47 pharmaceuticals in environmental and wastewater samples has been developed. The target list of analytes included analgesic and anti-inflammatories, cholesterol lowering statin drugs and lipid regulators, antidepressants, anti-ulcer agents, psychiatric drugs, ansiolitics, cardiovasculars and a high number (26) of antibiotics from different chemical groups. A common pre-concentration step based on solid-phase extraction with Oasis HLB cartridges was applied, followed by ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) measurement. All compounds were satisfactorily determined in just one single injection, with a chromatographic run time of only 10 min. The process efficiency (combination of the matrix effect and the extraction process recovery) for the 47 selected compounds was evaluated in nine effluent wastewater (EWW) samples, and the use of different isotope-labelled internal standards (ILIS) was investigated to correct unsatisfactory values. Up to 12 ILIS were evaluated in EWW and surface water (SW). As expected, the ILIS provided satisfactory correction for their own analytes. However, the use of these ILIS for the rest of pharmaceuticals was problematic in some cases. Despite this fact, the correction with analogues ILIS was found useful for most of analytes in EWW, while was not strictly required in the SW tested. The method was successfully validated in SW and EWW at low concentration levels, as expected for pharmaceuticals in these matrices (0.025, 0.1 and 0.5 μg/L in SW; 0.1 and 0.5 μg/L in EWW). With only a few exceptions, the instrumental limits of detection varied between 0.1 and 8 pg. The limits of quantification were estimated from sample chromatograms at the lowest spiked levels tested and normally were below 20 ng/L for SW and below 50 ng/L for EWW. The developed method was applied to the analysis of around forty water samples (river

  9. Influenza-Like Illness Sentinel Surveillance in Peru

    PubMed Central

    Laguna-Torres, V. Alberto; Gómez, Jorge; Ocaña, Víctor; Aguilar, Patricia; Saldarriaga, Tatiana; Chavez, Edward; Perez, Juan; Zamalloa, Hernán; Forshey, Brett; Paz, Irmia; Gomez, Elizabeth; Ore, Roel; Chauca, Gloria; Ortiz, Ernesto; Villaran, Manuel; Vilcarromero, Stalin; Rocha, Claudio; Chincha, Omayra; Jiménez, Gerardo; Villanueva, Miguel; Pozo, Edwar; Aspajo, Jackeline; Kochel, Tadeusz

    2009-01-01

    Background Acute respiratory illnesses and influenza-like illnesses (ILI) are a significant source of morbidity and mortality worldwide. Despite the public health importance, little is known about the etiology of these acute respiratory illnesses in many regions of South America. In 2006, the Peruvian Ministry of Health (MoH) and the US Naval Medical Research Center Detachment (NMRCD) initiated a collaboration to characterize the viral agents associated with ILI and to describe the clinical and epidemiological presentation of the affected population. Methodology/Principal Findings Patients with ILI (fever ≥38°C and cough or sore throat) were evaluated in clinics and hospitals in 13 Peruvian cities representative of the four main regions of the country. Nasal and oropharyngeal swabs, as well as epidemiological and demographic data, were collected from each patient. During the two years of this study (June 2006 through May 2008), a total of 6,835 patients, with a median age of 13 years, were recruited from 31 clinics and hospitals; 6,308 were enrolled by regular passive surveillance and 527 were enrolled as part of outbreak investigations. At least one respiratory virus was isolated from the specimens of 2,688 (42.6%) patients, with etiologies varying by age and geographical region. Overall the most common viral agents isolated were influenza A virus (25.1%), influenza B virus (9.7%), parainfluenza viruses 1, 2, and 3, (HPIV-1,-2,-3; 3.2%), herpes simplex virus (HSV; 2.6%), and adenoviruses (1.8%). Genetic analyses of influenza virus isolates demonstrated that three lineages of influenza A H1N1, one lineage of influenza A H3N2, and two lineages of influenza B were circulating in Peru during the course of this study. Conclusions To our knowledge this is the most comprehensive study to date of the etiologic agents associated with ILI in Peru. These results demonstrate that a wide range of respiratory pathogens are circulating in Peru and this fact needs to be

  10. Evaluating Google, Twitter, and Wikipedia as Tools for Influenza Surveillance Using Bayesian Change Point Analysis: A Comparative Analysis

    PubMed Central

    Hopkins, Richard S; Cook, Robert L; Striley, Catherine W

    2016-01-01

    Background Traditional influenza surveillance relies on influenza-like illness (ILI) syndrome that is reported by health care providers. It primarily captures individuals who seek medical care and misses those who do not. Recently, Web-based data sources have been studied for application to public health surveillance, as there is a growing number of people who search, post, and tweet about their illnesses before seeking medical care. Existing research has shown some promise of using data from Google, Twitter, and Wikipedia to complement traditional surveillance for ILI. However, past studies have evaluated these Web-based sources individually or dually without comparing all 3 of them, and it would be beneficial to know which of the Web-based sources performs best in order to be considered to complement traditional methods. Objective The objective of this study is to comparatively analyze Google, Twitter, and Wikipedia by examining which best corresponds with Centers for Disease Control and Prevention (CDC) ILI data. It was hypothesized that Wikipedia will best correspond with CDC ILI data as previous research found it to be least influenced by high media coverage in comparison with Google and Twitter. Methods Publicly available, deidentified data were collected from the CDC, Google Flu Trends, HealthTweets, and Wikipedia for the 2012-2015 influenza seasons. Bayesian change point analysis was used to detect seasonal changes, or change points, in each of the data sources. Change points in Google, Twitter, and Wikipedia that occurred during the exact week, 1 preceding week, or 1 week after the CDC’s change points were compared with the CDC data as the gold standard. All analyses were conducted using the R package “bcp” version 4.0.0 in RStudio version 0.99.484 (RStudio Inc). In addition, sensitivity and positive predictive values (PPV) were calculated for Google, Twitter, and Wikipedia. Results During the 2012-2015 influenza seasons, a high sensitivity of 92

  11. Long Term Effects of a Lifestyle Intervention on Weight and Cardiovascular Risk Factors in Individuals with Type 2 Diabetes: Four Year Results of the Look AHEAD Trial

    PubMed Central

    2011-01-01

    Objective Lifestyle interventions produce short-term improvements in glycemia and cardiovascular disease (CVD) risk factors in individuals with type 2 diabetes, but no long-term data are available. We examined the effects of a lifestyle intervention on changes in weight, fitness and cardiovascular (CVD) risk factors over 4 years. Research Design and Methods Look AHEAD is a multi-center randomized clinical trial comparing the effects of intensive lifestyle intervention (ILI) and diabetes support and education (DSE, control group) on the incidence of major CVD events in 5145 individuals with type diabetes, aged 45 to 76 years, who were overweight or obese (BMI > 25 kg/m2). Participants have ongoing intervention and annual assessments. Results Averaged across four years of follow-up, participants in ILI had greater percent weight losses than those in DSE (−6.15% vs −0.88%, p<.0001) and greater improvements in fitness (12.74% vs. 1.96%, p < .0001), HbA1c (A1c, −0.36% vs. 0.09%, p<.0001), systolic blood pressure (SBP, −5.33 vs. −2.97 mmHg, p<.0001), diastolic blood pressure (DBP, −2.92 vs. −2.48 mmHg, p<.012), HDL-cholesterol (HDL-C, 3.67 vs. 1.97 mg/dl, p<.0001), and triglycerides (−25.56 vs. −19.75 mg/dl, p<.0006). Reductions in LDL-C were greater in DSE than ILI (−11.27 vs. −12.84 mg/dl, p=.009), but adjusted for medication use, changes in LDL-C did not differ between the two groups. Although the greatest benefits were often seen at 1 year, ILI participants still had greater improvements than DSE in weight, fitness, HbA1c, SBP, and HDL-C at 4 years. Conclusions Intensive lifestyle intervention can produce and maintain significant weight losses and improvements in fitness in individuals with type 2 diabetes. Across four years of follow-up, those in ILI had better overall levels of glycemic control, blood pressure, HDL-C and triglycerides, and thus spent considerable time with lower CVD risk. Whether this translates to reduction in CVD events will

  12. Evaluating Google, Twitter, and Wikipedia as Tools for Influenza Surveillance Using Bayesian Change Point Analysis: A Comparative Analysis.

    PubMed

    Sharpe, J Danielle; Hopkins, Richard S; Cook, Robert L; Striley, Catherine W

    2016-10-20

    Traditional influenza surveillance relies on influenza-like illness (ILI) syndrome that is reported by health care providers. It primarily captures individuals who seek medical care and misses those who do not. Recently, Web-based data sources have been studied for application to public health surveillance, as there is a growing number of people who search, post, and tweet about their illnesses before seeking medical care. Existing research has shown some promise of using data from Google, Twitter, and Wikipedia to complement traditional surveillance for ILI. However, past studies have evaluated these Web-based sources individually or dually without comparing all 3 of them, and it would be beneficial to know which of the Web-based sources performs best in order to be considered to complement traditional methods. The objective of this study is to comparatively analyze Google, Twitter, and Wikipedia by examining which best corresponds with Centers for Disease Control and Prevention (CDC) ILI data. It was hypothesized that Wikipedia will best correspond with CDC ILI data as previous research found it to be least influenced by high media coverage in comparison with Google and Twitter. Publicly available, deidentified data were collected from the CDC, Google Flu Trends, HealthTweets, and Wikipedia for the 2012-2015 influenza seasons. Bayesian change point analysis was used to detect seasonal changes, or change points, in each of the data sources. Change points in Google, Twitter, and Wikipedia that occurred during the exact week, 1 preceding week, or 1 week after the CDC's change points were compared with the CDC data as the gold standard. All analyses were conducted using the R package "bcp" version 4.0.0 in RStudio version 0.99.484 (RStudio Inc). In addition, sensitivity and positive predictive values (PPV) were calculated for Google, Twitter, and Wikipedia. During the 2012-2015 influenza seasons, a high sensitivity of 92% was found for Google, whereas the PPV for

  13. Prevalence of influenza-like illness and seasonal and pandemic H1N1 influenza vaccination coverage among workers--United States, 2009-10 influenza season.

    PubMed

    Luckhaupt, Sara E; Calvert, Geoffrey M; Li, Jia; Sweeney, Marie; Santibanez, Tammy A

    2014-03-14

    During an influenza pandemic, information about the industry and occupation (I&O) of persons likely to be infected with influenza virus is important to guide key policy decisions regarding vaccine prioritization and exposure-control measures. Health-care personnel (HCP) might have increased opportunity for exposure to influenza infection, and they have been prioritized for influenza vaccination because of their own risk and the risk that infected HCP pose to patients. To identify other groups of workers that might be at increased risk for pandemic influenza infection, influenza-like illness (ILI) and vaccination coverage data from the 2009 National H1N1 Flu Survey (NHFS), which was conducted during October 2009 through June 2010, were analyzed. In a representative sample of 28,710 employed adults, 5.5% reported ILI symptoms in the month before the interview, and 23.7% received the 2009 pandemic H1N1 (pH1N1) influenza vaccine. Among employed adults, the highest prevalence of ILI was reported by those employed in the industry groups "Real estate and rental and leasing" (10.5%) and "Accommodation and food services" (10.2%), and in the occupation groups "Food preparation and serving related" (11.0%) and "Community and social services" (8.3%). Both seasonal influenza and pH1N1 vaccination coverage were relatively low in all of these groups of workers. Adults not in the labor force (i.e., homemakers, students, retired persons, and persons unable to work) had ILI prevalence and pH1N1 vaccination coverage similar to those found in all employed adults combined; in contrast, ILI prevalence was higher and pH1N1 vaccination coverage was lower among unemployed adults (i.e., those looking for work). These results suggest that adults employed in certain industries and occupations might have increased risk for influenza infection, and that the majority of these workers did not receive seasonal or pH1N1 influenza vaccine. Unemployed adults might also be considered a high risk group

  14. Integrated Land Information System - a relevant step for development of information background for PEEX?

    NASA Astrophysics Data System (ADS)

    Shvidenko, Anatoly; Schepaschenko, Dmitry; Baklanov, Alexander

    2014-05-01

    PEEX, as a long-term multidisciplinary integrated study, needs a systems design of a relevant information background. The idea of development of an Integrated Land Information System (ILIS) for the region as an initial step of future advanced integrated observing systems is considered as a promising way. The ILIS could serve (1) for introduction of a unified system of classification and quantification of environment, ecosystems and landscapes; (2) as a benchmark for tracing the dynamics of land use - land cover and ecosystems parameters, particularly for forests; (3) as a systems background for empirical assessment of indicators of an interest (e.g., components of biogeochemical cycles); (4) comparisons, harmonizing and mutual constraints of the results obtained by different methods; (5) for parameterization of surface fluxes for the 'atmosphere-land' system; (6) for use in divers models and for models' validation; (7) for downscaling of available information to a required scale; (8) for understanding of gradients for up-scaling of "point" data, etc. The ILIS is presented in form of multi-layer and multi-scale GIS that includes a hybrid land cover (HLC) by a definite date and corresponding legends and attributive databases. The HLC is based on relevant combination of a "multi" remote sensing concept that includes sensors of different type and resolution and ground data. The ILIS includes inter alia (1) general geographical and biophysical description of the territory (landscapes, soil, vegetation, hydrology, bioclimatic zones, permafrost etc.); (2) diverse datasets of measurements in situ; (3) sets of empirical and semi-empirical aggregation and auxiliary models, (4) data on different inventories and surveys (forest inventory, land account, results of forest monitoring); (5) spatial and temporal description of anthropogenic and natural disturbances; (5) climatic data with relevant temporal resolution etc. The ILIS should include only the data with known

  15. Can Positron Emission Tomography and Computed Tomography Be a Substitute for Bone Marrow Biopsy in Detection of Bone Marrow Involvement in Patients with Hodgkin's or Non-Hodgkin's Lymphoma?

    PubMed

    Çetin, Güven; Çıkrıkçıoğlu, M Ali; Özkan, Tuba; Karatoprak, Cumali; Ar, M Cem; Eşkazan, Ahmet Emre; Ayer, Mesut; Cerit, Abdullah; Gözübenli, Kübra; Uysal, Betül Börkü; Erdem, Simge; Ergül, Nurhan; Tatar, Gamze; Çermik, T Fikret

    2015-09-01

    Amaç: Positron emisyon tomografi ve bilgisayarlı tomografi (PET/CT) lenfomanın tedavi ve evreleme algoritmasının önemli bir parçası oldu. Biz çalışmamız da agresiv seyirli non Hodgkin lenfoma (aNHL) ve Hodgkin lenfomalı (HL) hastalarda kemik iliği tutulumunu göstermede kemik iliği biyopsisi (BMB) ile PET/CT sonuçlarını karşılaştırmayı amaçladık. Gereç ve Yöntemler: Çalışmaya 2008-2012 yılları arasında İstanbul’daki 3 büyük hastanede HL ve aNHL tanısı konulan 297 hasta belirlendi. Bu hastaların dosyası retrospektif olarak tarandı ve çalışma kriterlerine uygun 161 hasta çalışmaya alındı. Hastaların başlangıç evrelemesi için PET/CT ve BMB yapıldı. Kemik iliği biyopsisi, kemik iliği tutulumunu değerlendirmede standart referans olarak kabul edildi. Bulgular: Hastaların 61’inde (38%) HL ve 100’ünde (62%) aNHL vardı. Değerlendirilen 126 hastada (78%) (52 HL, 74 aNHL) PET/CT ve BMB arasında uyumlu sonuçlar olduğu görüldü. Bu hastalardan 20’sinde kemik iliği tutulumu bakımından PET/CT ve BMB sonuçları pozitif ve 106 hastanın PET/CT ve BMB negatif bulundu. Diğer taraftan 35 hastada (9 HL, 26 aNHL) uyumsuzluk vardı. Bu hastaların da 16’sında BMB pozitif iken PET/CT sonuçları negatif bulundu. Geri kalan 19 hastada BMB negatif ve PET/CT sonuçları pozitif saptandı. Sonuç: Biz aNHL ve HL hastalarını değerlendirmede tek başına yeterli olmamasına rağmen, PET/CT nin kemik iliği infiltrasyonunu belirlemede etkili olduğunu gözlemledik. Lenfomalı hastalarda kemik iliği infiltrasyonunu belirlemede; BMB ve PET/CT birbirinin tamamlayıcısı olarak düşünülmelidir. Fokal tutulumdan şüphelenildiğinde, BMB ve PET/CT’nin birlikte yapılması hastalığın evrelemesinde daha doğru sonuçlar verebilir.

  16. Correlation of Minimum Apparent Diffusion Coefficient and Maximum Standardized Uptake Value of the Primary Tumor with Clinicopathologic Characteristics in Endometrial Cancer.

    PubMed

    Sürer Budak, Evrim; Toptaş, Tayfun; Aydın, Funda; Öner, Ali Ozan; Çevikol, Can; Şimşek, Tayup

    2017-02-05

    Amaç: Endometrium kanserinde (EK) primer tümörün maksimum standardize tutulum değeri (SUVmaks) ve minimum görünen difüzyon katsayısının (ADCmin) klinikopatolojik özellikler ile olan ilişkisini araştırmak ve bunların öngörü gücünü belirlemektir. Yöntem: 18F-fluorodeoksiglukoz (FDG) pozitron emisyon tomografisi/bilgisayarlı tomografi (PET/BT) ve difüzyon ağırlıklı-manyetik rezonans görüntüleme (DA-MRG) ile preoperatif değerlendirmeyi takiben evreleme cerrahisi yapılan toplamda 45 hasta, planlı veri toplama yapılan prospektif bir olgu serisine dahil edildiler. Çalışma verileri arasındaki ilişkiler çoklu doğrusal regresyon analizi ile araştırıldı. Bulgular: Ortalama ADCmin ve SUVmaks sırasıyla 0,72±0,22 ve 16,54±8,73 olarak bulundu. Tek değişkenli analizde yaş, myometriyal invazyon (Mİ) ve lenfovasküler alan tutulumu (LVAT) ADCmin ile ilişkili potansiyel faktörler olarak bulunurken, yaş, evre, tümör büyüklüğü, LVAT ve metastatik lenf düğümlerinin sayısı SUVmaks ile ilişkili potansiyel değişkenler olarak tespit edildiler. Diğer taraftan, çok değişkenli analizde Mİ, ADCmin (p=0,007) ve SUVmaks (p=0,024) ile ilişkili tek anlamlı değişkendi. Derin Mİ en iyi, ≤0,77’lik [%93,7 duyarlılık, %48,2 özgüllük ve %93,0 negatif öngörü değeri (NPD)] bir ADCmin kesim değeri ve >20,5’lik (%62,5 duyarlılık, %86,2 özgüllük ve %81,0 NPD) bir SUVmaks kesim değeri ile öngörülebiliyordu. Ne var ki, her iki tanısal test birbirlerinden anlamlı şekilde farklı değildi (p=0,266). Sonuç: Klinikopatolojik özelliklerden yalnızca Mİ bağımsız ve anlamlı şekilde SUVmaks ve ADCmin ile ilişkiliydi. Ne var ki, her iki parametrenin ideal olmayan öngörü performansları nedeniyle 18F-FDG PET/BT veya DA-MRG’nin rutin kullanımı şu noktada önerilemez.

  17. Health related quality of life after gastric bypass or intensive lifestyle intervention: a controlled clinical study

    PubMed Central

    2013-01-01

    Background There is little robust evidence relating to changes in health related quality of life (HRQL) in morbidly obese patients following a multidisciplinary non-surgical weight loss program or laparoscopic Roux-en-Y Gastric Bypass (RYGB). The aim of the present study was to describe and compare changes in five dimensions of HRQL in morbidly obese subjects. In addition, we wanted to assess the clinical relevance of the changes in HRQL between and within these two groups after one year. We hypothesized that RYGB would be associated with larger improvements in HRQL than a part residential intensive lifestyle-intervention program (ILI) with morbidly obese subjects. Methods A total of 139 morbidly obese patients chose treatment with RYGB (n=76) or ILI (n=63). The ILI comprised four stays (seven weeks) at a specialized rehabilitation center over one year. The daily schedule was divided between physical activity, psychosocially-oriented interventions, and motivational approaches. No special diet or weight-loss drugs were prescribed. The participants completed three HRQL-questionnaires before treatment and 1 year thereafter. Both linear regression and ANCOVA were used to analyze differences between weight loss and treatment for five dimensions of HRQL (physical, mental, emotional, symptoms and symptom distress) controlling for baseline HRQL, age, age of onset of obesity, BMI, and physical activity. Clinical relevance was assessed by effect size (ES) where ES<.49 was considered small, between .50-.79 as moderate, and ES>.80 as large. Results The adjusted between group mean difference (95% CI) was 8.6 (4.6,12.6) points (ES=.83) for the physical dimension, 5.4 (1.5–9.3) points (ES=.50) for the mental dimension, 25.2 (15.0–35.4) points (ES=1.06) for the emotional dimension, 8.7 (1.8–15.4) points (ES=.37) for the measured symptom distress, and 2.5 for (.6,4.5) fewer symptoms (ES=.56), all in favor of RYGB. Within-group changes in HRQOL in the RYGB group were large for

  18. Holocene River Dynamics, Climate Change and Floodwater Farming in the Watersheds of the Pamir and Tien Shan Mountains of Inner Asia

    NASA Astrophysics Data System (ADS)

    Macklin, M. G.; Panyushkina, I. P.; Toonen, W. H. J.

    2014-12-01

    The Ili, Syr Dayra and Amu Dayra rivers of Inner Asia are emerging as critical areas for the development of irrigation-based agriculture in the ancient world. Following research by Russian archaeologists in the 1970s it is evident that these watersheds had flourishing riverine civilizations comparable to those in Mesopotamia and the Indus Valley. But unlike these areas where the relationship between Holocene river dynamics, climate change and floodwater farming is increasingly underpinned by radiometric dating, the alluvial archaeology of Inner Asia is significantly under researched. To address this, a major multi-disciplinary research program was begun in 2011 centred on the Talgar catchment, a south-bank tributary of the Ili river, southeast Kazakhstan. Building on archaeological excavations and surveys conducted over the past 20 years, we have undertaken one of the most detailed investigations of Holocene people-river environment interactions in Inner Asia. River development has been reconstructed over the last 20,000 years and human settlement histories from the Eneolithic to the Medieval period documented. Periods of Holocene river aggradation and high water levels in Lake Balkhash and Aral Sea correspond with cooler and wetter neoglacial episodes while river entrenchment and floodplain soil development are associated with warmer and drier conditions. Floodwater farming in the Talgar river reached its acme in the late Iron Age (400-200 cal. BC) with more than 60 settlement sites and 550 burial mounds. This corresponds to a period of reduced flood flows, river stability and glacier retreat in the Tien Shan headwaters. A new hydroclimatic-based model for the spatial and temporal dynamics of floodwater farming in the Ili, Syr Dayra and Amu Dayra watersheds is proposed, which explains the large scale expansion (down-river) and contraction (up-river) of settlements since the first use of irrigation in the Neolithic through to the late Medieval period.

  19. Dissemination of the Look AHEAD intensive lifestyle intervention in the United States Air Force: study rationale, design and methods.

    PubMed

    Krukowski, Rebecca A; Hare, Marion E; Talcott, Gerald W; Johnson, Karen C; Richey, Phyllis A; Kocak, Mehmet; Balderas, Jennifer; Colvin, Lauren; Keller, Patrick L; Waters, Teresa M; Klesges, Robert C

    2015-01-01

    Despite an increase in overweight and obesity similar to the civilian population, there have been few randomized controlled trials examining behavioral weight management interventions in the military settings. This paper describes the design, intervention development and analysis plan of the Fit Blue study, a randomized controlled behavioral weight loss trial taking place in the United States Air Force. This study compares two adapted versions of the efficacious Look AHEAD Intensive Lifestyle Intervention (ILI), a counselor-initiated condition and a self-paced condition. Also described are the unique steps required when conducting military-based health promotion research and adaptations made to the Look AHEAD intervention to accommodate the military environment. To our knowledge, this is the first translation of the Look AHEAD ILI in the military setting and one of the first translations of the ILI in general. If successful, this intervention could be disseminated to the entire U.S. Military as this project is designed to overcome the barriers and utilize the facilitators for weight loss that are unique to a military population. Programs validated in military populations can have a major public health impact given that with 1.4 million active duty personnel, the Department of Defense is the nation's largest employer. However, while this intervention is designed for a military population and there are unique aspects of the military that may enhance weight loss interventions, the diversity of the study population should help inform obesity efforts in both civilian and military settings. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Evaluating influenza vaccine effectiveness among hemodialysis patients using a natural experiment

    PubMed Central

    McGrath, Leah J; Kshirsagar, Abhijit V; Cole, Stephen R; Wang, Lily; Weber, David J; Stürmer, Til; Brookhart, M. Alan

    2014-01-01

    Background Although the influenza vaccine is recommended for end-stage renal disease (ESRD) patients, little is known about its effectiveness. Observational studies of vaccine effectiveness (VE) are challenging because vaccinated persons may be healthier than unvaccinated persons. Methods Using United States Renal Data System data, we estimated VE for influenza-like illness (ILI), influenza/pneumonia hospitalization, and mortality in adult, hemodialysis patients using a natural experiment created by year-to-year variation in the match of the influenza vaccine to the circulating virus. Matched (1998, 1999, 2001) and unmatched (1997) years among vaccinated patients were compared using Cox proportional hazards models. Ratios of hazard ratios compared vaccinated patients between two years and unvaccinated patients between two years. VE was calculated as 1 - effect measure. Results Vaccination rates were <50% each year. Conventional analysis comparing vaccinated to unvaccinated patients produced average VE estimates of 13%, 16%, and 30% for ILI, influenza/pneumonia hospitalization and mortality respectively. When restricted to the pre-influenza period, results were even stronger, indicating bias. The pooled ratio of HRs comparing matched seasons to a placebo season resulted in a VE of 0% (95% CI: −3,2%) for ILI, 2% (95% CI: −2,5%) for hospitalization, and 0% (95% CI: −3,3%) for death. Conclusions Relative to a mismatched year, we found little evidence of increased VE in subsequent, well-matched years, suggesting that the current influenza vaccine strategy may have a smaller effect on morbidity and mortality in the ESRD population than previously thought. Alternate strategies (high dose vaccine, adjuvanted vaccine, multiple doses) should be investigated. PMID:22493462

  1. Establishing seasonal and alert influenza thresholds in Cambodia using the WHO method: implications for effective utilization of influenza surveillance in the tropics and subtropics

    PubMed Central

    Ly, Sovann; Arashiro, Takeshi; Ieng, Vanra; Tsuyuoka, Reiko; Parry, Amy; Horwood, Paul; Heng, Seng; Hamid, Sarah; Vandemaele, Katelijn; Chin, Savuth; Sar, Borann

    2017-01-01

    Objective To establish seasonal and alert thresholds and transmission intensity categories for influenza to provide timely triggers for preventive measures or upscaling control measures in Cambodia. Methods Using Cambodia’s influenza-like illness (ILI) and laboratory-confirmed influenza surveillance data from 2009 to 2015, three parameters were assessed to monitor influenza activity: the proportion of ILI patients among all outpatients, proportion of ILI samples positive for influenza and the product of the two. With these parameters, four threshold levels (seasonal, moderate, high and alert) were established and transmission intensity was categorized based on a World Health Organization alignment method. Parameters were compared against their respective thresholds. Results Distinct seasonality was observed using the two parameters that incorporated laboratory data. Thresholds established using the composite parameter, combining syndromic and laboratory data, had the least number of false alarms in declaring season onset and were most useful in monitoring intensity. Unlike in temperate regions, the syndromic parameter was less useful in monitoring influenza activity or for setting thresholds. Conclusion Influenza thresholds based on appropriate parameters have the potential to provide timely triggers for public health measures in a tropical country where monitoring and assessing influenza activity has been challenging. Based on these findings, the Ministry of Health plans to raise general awareness regarding influenza among the medical community and the general public. Our findings have important implications for countries in the tropics/subtropics and in resource-limited settings, and categorized transmission intensity can be used to assess severity of potential pandemic influenza as well as seasonal influenza. PMID:28409056

  2. Are School Absences Correlated with Influenza Surveillance Data in England? Results from Decipher My Data-A Research Project Conducted through Scientific Engagement with Schools.

    PubMed

    Aldridge, Robert W; Hayward, Andrew C; Field, Nigel; Warren-Gash, Charlotte; Smith, Colette; Pebody, Richard; Fleming, Declan; McCracken, Shane

    2016-01-01

    School aged children are a key link in the transmission of influenza. Most cases have little or no interaction with health services and are therefore missed by the majority of existing surveillance systems. As part of a public engagement with science project, this study aimed to establish a web-based system for the collection of routine school absence data and determine if school absence prevalence was correlated with established surveillance measures for circulating influenza. We collected data for two influenza seasons (2011/12 and 2012/13). The primary outcome was daily school absence prevalence (weighted to make it nationally representative) for children aged 11 to 16. School absence prevalence was triangulated graphically and through univariable linear regression to Royal College of General Practitioners (RCGP) influenza like illness (ILI) episode incidence rate, national microbiological surveillance data on the proportion of samples positive for influenza (A+B) and with Rhinovirus, RSV and laboratory confirmed cases of Norovirus. 27 schools submitted data over two respiratory seasons. During the first season, levels of influenza measured by school absence prevalence and established surveillance were low. In the 2012/13 season, a peak of school absence prevalence occurred in week 51, and week 1 in RCGP ILI surveillance data. Linear regression showed a strong association between the school absence prevalence and RCGP ILI (All ages, and 5-14 year olds), laboratory confirmed cases of influenza A & B, and weak evidence for a linear association with Rhinovirus and Norovirus. This study provides initial evidence for using routine school illness absence prevalence as a novel tool for influenza surveillance. The network of web-based data collection platforms we established through active engagement provides an innovative model of conducting scientific research and could be used for a wide range of infectious disease studies in the future.

  3. A common variant in the CLDN7/ELP5 locus predicts adiponectin change with lifestyle intervention and improved fitness in obese individuals with diabetes

    PubMed Central

    Papandonatos, George D.; McCaffery, Jeanne M.; Peter, Inga; Pajewski, Nicholas M.; Erar, Bahar; Allred, Nicholette D.; Balasubramanyam, Ashok; Bowden, Donald W.; Brautbar, Ariel; Pi-Sunyer, F. Xavier; Ballantyne, Christie M.; Huggins, Gordon S.

    2015-01-01

    Overweight/obese individuals with Type 2 diabetes have low adiponectin levels, which may improve with lifestyle changes. We investigated whether genetic variants associated with adiponectin levels in genome-wide association studies (GWAS) would also be related with adiponectin changes in response to an intensive lifestyle intervention (ILI), potentially through mechanisms altering the adipose microenvironment via weight loss and/or improved cardiorespiratory fitness. Look AHEAD was a randomized trial comparing the cardiovascular benefits of ILI-induced weight loss and physical activity compared with diabetes support and education among overweight/obese individuals with Type 2 diabetes. In a subsample of Look AHEAD with adiponectin data and genetic consent (n = 1,351), we evaluated the effects of 24 genetic variants, demonstrated by GWAS to be cross-sectionally associated with adiponectin, on adiponectin change 1-yr postintervention. We explored via mediational analyses whether any differential effects by treatment arm were occurring through weight loss and/or improved fitness. A variant, rs222857, in the CLDN7 locus, potentially associated with epithelial barrier integrity and tight junction physiology, and a putative cis expression quantitative trail locus for elongator acetyltransferase complex subunit 5 (ELP5), predicted adiponectin increases within ILI (log-adiponectin in overall sample per copy: β ± SE = 0.05 ± 0.02, P = 0.008; in non-Hispanic whites: 0.06 ± 0.02, P = 0.009). The favorable effects of rs222857 (minor allele frequency 45.5%) appeared to be mediated by mechanisms associated with improved fitness, and not weight loss. This is the first study to identify a genetic variant that modifies adiponectin response to lifestyle intervention in overweight/obese diabetic individuals. PMID:25759378

  4. Timing and Spatial Distribution of Loess in Xinjiang, NW China.

    PubMed

    Li, Yun; Song, Yougui; Yan, Libin; Chen, Tao; An, Zhisheng

    2015-01-01

    Central Asia is one of the most significant loess regions on Earth, with an important role in understanding Quaternary climate and environmental change. However, in contrast to the widely investigated loess deposits in the Chinese Loess Plateau, the Central Asian loess-paleosol sequences are still insufficiently known and poorly understood. Through field investigation and review of the previous literature, the authors have investigated the distribution, thickness and age of the Xinjiang loess, and analyzed factors that control these parameters in the Xinjiang in northwest China, Central Asia. The loess sediments cover river terraces, low uplands, the margins of deserts and the slopes of the Tianshan Mountains and Kunlun Mountains and are also present in the Ili Basin. The thickness of the Xinjiang loess deposits varies from several meters to 670 m. The variation trend of the sand fraction (>63 μm) grain-size contour can indicate the local major wind directions, so we conclude that the NW and NE winds are the main wind directions in the North and South Xinjiang, and the westerly wind mainly transport dust into the Ili basin. We consider persistent drying, adequate regional wind energy and well-developed river terraces to be the main factors controlling the distribution, thickness and formation age of the Xinjiang loess. The well-outcropped loess sections have mainly developed since the middle Pleistocene in Xinjiang, reflecting the appearance of the persistent drying and the present air circulation system. However, the oldest loess deposits are as old as the beginning of the Pliocene in the Tarim Basin, which suggests that earlier aridification occurred in the Tarim Basin rather than in the Ili Basin and the Junggar Basin.

  5. The Unrecognized Burden of Influenza in Young Kenyan Children, 2008-2012.

    PubMed

    McMorrow, Meredith L; Emukule, Gideon O; Njuguna, Henry N; Bigogo, Godfrey; Montgomery, Joel M; Nyawanda, Bryan; Audi, Allan; Breiman, Robert F; Katz, Mark A; Cosmas, Leonard; Waiboci, Lilian W; Duque, Jazmin; Widdowson, Marc-Alain; Mott, Joshua A

    2015-01-01

    Influenza-associated disease burden among children in tropical sub-Saharan Africa is not well established, particularly outside of the 2009 pandemic period. We estimated the burden of influenza in children aged 0-4 years through population-based surveillance for influenza-like illness (ILI) and acute lower respiratory tract illness (ALRI). Household members meeting ILI or ALRI case definitions were referred to health facilities for evaluation and collection of nasopharyngeal and oropharyngeal swabs for influenza testing by real-time reverse transcription polymerase chain reaction. Estimates were adjusted for health-seeking behavior and those with ILI and ALRI who were not tested. During 2008-2012, there were 9,652 person-years of surveillance among children aged 0-4 years. The average adjusted rate of influenza-associated hospitalization was 4.3 (95% CI 3.0-6.0) per 1,000 person-years in children aged 0-4 years. Hospitalization rates were highest in the 0-5 month and 6-23 month age groups, at 7.6 (95% CI 3.2-18.2) and 8.4 (95% CI 5.4-13.0) per 1,000 person-years, respectively. The average adjusted rate of influenza-associated medically attended (inpatient or outpatient) ALRI in children aged 0-4 years was 17.4 (95% CI 14.2-19.7) per 1,000 person-years. Few children who had severe laboratory-confirmed influenza were clinically diagnosed with influenza by the treating clinician in the inpatient (0/33, 0%) or outpatient (1/109, 0.9%) settings. Influenza-associated hospitalization rates from 2008-2012 were 5-10 times higher than contemporaneous U.S. estimates. Many children with danger signs were not hospitalized; thus, influenza-associated severe disease rates in Kenyan children are likely higher than hospital-based estimates suggest.

  6. Enhancing spatial detection accuracy for syndromic surveillance with street level incidence data

    PubMed Central

    2010-01-01

    Background The Department of Defense Military Health System operates a syndromic surveillance system that monitors medical records at more than 450 non-combat Military Treatment Facilities (MTF) worldwide. The Electronic Surveillance System for Early Notification of Community-based Epidemics (ESSENCE) uses both temporal and spatial algorithms to detect disease outbreaks. This study focuses on spatial detection and attempts to improve the effectiveness of the ESSENCE implementation of the spatial scan statistic by increasing the spatial resolution of incidence data from zip codes to street address level. Methods Influenza-Like Illness (ILI) was used as a test syndrome to develop methods to improve the spatial accuracy of detected alerts. Simulated incident clusters of various sizes were superimposed on real ILI incidents from the 2008/2009 influenza season. Clusters were detected using the spatial scan statistic and their displacement from simulated loci was measured. Detected cluster size distributions were also evaluated for compliance with simulated cluster sizes. Results Relative to the ESSENCE zip code based method, clusters detected using street level incidents were displaced on average 65% less for 2 and 5 mile radius clusters and 31% less for 10 mile radius clusters. Detected cluster size distributions for the street address method were quasi normal and sizes tended to slightly exceed simulated radii. ESSENCE methods yielded fragmented distributions and had high rates of zero radius and oversized clusters. Conclusions Spatial detection accuracy improved notably with regard to both location and size when incidents were geocoded to street addresses rather than zip code centroids. Since street address geocoding success rates were only 73.5%, zip codes were still used for more than one quarter of ILI cases. Thus, further advances in spatial detection accuracy are dependant on systematic improvements in the collection of individual address information. PMID

  7. Evaluation of Sampling Recommendations From the Influenza Virologic Surveillance Right Size Roadmap for Idaho.

    PubMed

    Rosenthal, Mariana; Anderson, Katey; Tengelsen, Leslie; Carter, Kris; Hahn, Christine; Ball, Christopher

    2017-08-24

    The Right Size Roadmap was developed by the Association of Public Health Laboratories and the Centers for Disease Control and Prevention to improve influenza virologic surveillance efficiency. Guidelines were provided to state health departments regarding representativeness and statistical estimates of specimen numbers needed for seasonal influenza situational awareness, rare or novel influenza virus detection, and rare or novel influenza virus investigation. The aim of this study was to compare Roadmap sampling recommendations with Idaho's influenza virologic surveillance to determine implementation feasibility. We calculated the proportion of medically attended influenza-like illness (MA-ILI) from Idaho's influenza-like illness surveillance among outpatients during October 2008 to May 2014, applied data to Roadmap-provided sample size calculators, and compared calculations with actual numbers of specimens tested for influenza by the Idaho Bureau of Laboratories (IBL). We assessed representativeness among patients' tested specimens to census estimates by age, sex, and health district residence. Among outpatients surveilled, Idaho's mean annual proportion of MA-ILI was 2.30% (20,834/905,818) during a 5-year period. Thus, according to Roadmap recommendations, Idaho needs to collect 128 specimens from MA-ILI patients/week for situational awareness, 1496 influenza-positive specimens/week for detection of a rare or novel influenza virus at 0.2% prevalence, and after detection, 478 specimens/week to confirm true prevalence is ≤2% of influenza-positive samples. The mean number of respiratory specimens Idaho tested for influenza/week, excluding the 2009-2010 influenza season, ranged from 6 to 24. Various influenza virus types and subtypes were collected and specimen submission sources were representative in terms of geographic distribution, patient age range and sex, and disease severity. Insufficient numbers of respiratory specimens are submitted to IBL for influenza

  8. Evaluation of Sampling Recommendations From the Influenza Virologic Surveillance Right Size Roadmap for Idaho

    PubMed Central

    2017-01-01

    Background The Right Size Roadmap was developed by the Association of Public Health Laboratories and the Centers for Disease Control and Prevention to improve influenza virologic surveillance efficiency. Guidelines were provided to state health departments regarding representativeness and statistical estimates of specimen numbers needed for seasonal influenza situational awareness, rare or novel influenza virus detection, and rare or novel influenza virus investigation. Objective The aim of this study was to compare Roadmap sampling recommendations with Idaho’s influenza virologic surveillance to determine implementation feasibility. Methods We calculated the proportion of medically attended influenza-like illness (MA-ILI) from Idaho’s influenza-like illness surveillance among outpatients during October 2008 to May 2014, applied data to Roadmap-provided sample size calculators, and compared calculations with actual numbers of specimens tested for influenza by the Idaho Bureau of Laboratories (IBL). We assessed representativeness among patients’ tested specimens to census estimates by age, sex, and health district residence. Results Among outpatients surveilled, Idaho’s mean annual proportion of MA-ILI was 2.30% (20,834/905,818) during a 5-year period. Thus, according to Roadmap recommendations, Idaho needs to collect 128 specimens from MA-ILI patients/week for situational awareness, 1496 influenza-positive specimens/week for detection of a rare or novel influenza virus at 0.2% prevalence, and after detection, 478 specimens/week to confirm true prevalence is ≤2% of influenza-positive samples. The mean number of respiratory specimens Idaho tested for influenza/week, excluding the 2009-2010 influenza season, ranged from 6 to 24. Various influenza virus types and subtypes were collected and specimen submission sources were representative in terms of geographic distribution, patient age range and sex, and disease severity. Conclusions Insufficient numbers of

  9. Real-time epidemic monitoring and forecasting of H1N1-2009 using influenza-like illness from general practice and family doctor clinics in Singapore.

    PubMed

    Ong, Jimmy Boon Som; Chen, Mark I-Cheng; Cook, Alex R; Lee, Huey Chyi; Lee, Vernon J; Lin, Raymond Tzer Pin; Tambyah, Paul Ananth; Goh, Lee Gan

    2010-04-14

    Reporting of influenza-like illness (ILI) from general practice/family doctor (GPFD) clinics is an accurate indicator of real-time epidemic activity and requires little effort to set up, making it suitable for developing countries currently experiencing the influenza A (H1N1-2009) pandemic or preparing for subsequent epidemic waves. We established a network of GPFDs in Singapore. Participating GPFDs submitted returns via facsimile or e-mail on their work days using a simple, standard data collection format, capturing: gender; year of birth; "ethnicity"; residential status; body temperature (degrees C); and treatment (antiviral or not); for all cases with a clinical diagnosis of an acute respiratory illness (ARI). The operational definition of ILI in this study was an ARI with fever of 37.8 degrees C or more. The data were processed daily by the study co-ordinator and fed into a stochastic model of disease dynamics, which was refitted daily using particle filtering, with data and forecasts uploaded to a website which could be publicly accessed. Twenty-three GPFD clinics agreed to participate. Data collection started on 2009-06-26 and lasted for the duration of the epidemic. The epidemic appeared to have peaked around 2009-08-03 and the ILI rates had returned to baseline levels by the time of writing. This real-time surveillance system is able to show the progress of an epidemic and indicates when the peak is reached. The resulting information can be used to form forecasts, including how soon the epidemic wave will end and when a second wave will appear if at all.

  10. Timing and Spatial Distribution of Loess in Xinjiang, NW China

    PubMed Central

    Li, Yun; Song, Yougui; Yan, Libin; Chen, Tao; An, Zhisheng

    2015-01-01

    Central Asia is one of the most significant loess regions on Earth, with an important role in understanding Quaternary climate and environmental change. However, in contrast to the widely investigated loess deposits in the Chinese Loess Plateau, the Central Asian loess–paleosol sequences are still insufficiently known and poorly understood. Through field investigation and review of the previous literature, the authors have investigated the distribution, thickness and age of the Xinjiang loess, and analyzed factors that control these parameters in the Xinjiang in northwest China, Central Asia. The loess sediments cover river terraces, low uplands, the margins of deserts and the slopes of the Tianshan Mountains and Kunlun Mountains and are also present in the Ili Basin. The thickness of the Xinjiang loess deposits varies from several meters to 670 m. The variation trend of the sand fraction (>63 μm) grain-size contour can indicate the local major wind directions, so we conclude that the NW and NE winds are the main wind directions in the North and South Xinjiang, and the westerly wind mainly transport dust into the Ili basin. We consider persistent drying, adequate regional wind energy and well-developed river terraces to be the main factors controlling the distribution, thickness and formation age of the Xinjiang loess. The well-outcropped loess sections have mainly developed since the middle Pleistocene in Xinjiang, reflecting the appearance of the persistent drying and the present air circulation system. However, the oldest loess deposits are as old as the beginning of the Pliocene in the Tarim Basin, which suggests that earlier aridification occurred in the Tarim Basin rather than in the Ili Basin and the Junggar Basin. PMID:25970617

  11. Are School Absences Correlated with Influenza Surveillance Data in England? Results from Decipher My Data—A Research Project Conducted through Scientific Engagement with Schools

    PubMed Central

    Aldridge, Robert W.; Hayward, Andrew C.; Field, Nigel; Warren-Gash, Charlotte; Smith, Colette; Pebody, Richard; Fleming, Declan; McCracken, Shane

    2016-01-01

    Background School aged children are a key link in the transmission of influenza. Most cases have little or no interaction with health services and are therefore missed by the majority of existing surveillance systems. As part of a public engagement with science project, this study aimed to establish a web-based system for the collection of routine school absence data and determine if school absence prevalence was correlated with established surveillance measures for circulating influenza. Methods We collected data for two influenza seasons (2011/12 and 2012/13). The primary outcome was daily school absence prevalence (weighted to make it nationally representative) for children aged 11 to 16. School absence prevalence was triangulated graphically and through univariable linear regression to Royal College of General Practitioners (RCGP) influenza like illness (ILI) episode incidence rate, national microbiological surveillance data on the proportion of samples positive for influenza (A+B) and with Rhinovirus, RSV and laboratory confirmed cases of Norovirus. Results 27 schools submitted data over two respiratory seasons. During the first season, levels of influenza measured by school absence prevalence and established surveillance were low. In the 2012/13 season, a peak of school absence prevalence occurred in week 51, and week 1 in RCGP ILI surveillance data. Linear regression showed a strong association between the school absence prevalence and RCGP ILI (All ages, and 5–14 year olds), laboratory confirmed cases of influenza A & B, and weak evidence for a linear association with Rhinovirus and Norovirus. Interpretation This study provides initial evidence for using routine school illness absence prevalence as a novel tool for influenza surveillance. The network of web-based data collection platforms we established through active engagement provides an innovative model of conducting scientific research and could be used for a wide range of infectious disease studies

  12. Sentinel surveillance of influenza-like illness in two hospitals in Maracay, Venezuela: 2006-2010.

    PubMed

    Comach, Guillermo; Teneza-Mora, Nimfa; Kochel, Tadeusz J; Espino, Carlos; Sierra, Gloria; Camacho, Daria E; Laguna-Torres, V Alberto; Garcia, Josefina; Chauca, Gloria; Gamero, Maria E; Sovero, Merly; Bordones, Slave; Villalobos, Iris; Melchor, Angel; Halsey, Eric S

    2012-01-01

    Limited information exists on the epidemiology of acute febrile respiratory illnesses in tropical South American countries such as Venezuela. The objective of the present study was to examine the epidemiology of influenza-like illness (ILI) in two hospitals in Maracay, Venezuela. We performed a prospective surveillance study of persons with ILI who presented for care at two hospitals in Maracay, Venezuela, from October 2006 to December 2010. A respiratory specimen and clinical information were obtained from each participant. Viral isolation and identification with immunofluorescent antibodies and molecular methods were employed to detect respiratory viruses such as adenovirus, influenza A and B, parainfluenza, and respiratory sincytial virus, among others. There were 916 participants in the study (median age: 17 years; range: 1 month--86 years). Viruses were identified in 143 (15.6%) subjects, and one participant was found to have a co-infection with more than one virus. Influenza viruses, including pandemic H1N1 2009, were the most frequently detected pathogens, accounting for 67.4% (97/144) of the viruses detected. Adenovirus (15/144), parainfluenza virus (13/144), and respiratory syncytial virus (11/144) were also important causes of ILI in this study. Pandemic H1N1 2009 virus became the most commonly isolated influenza virus during its initial appearance in 2009. Two waves of the pandemic were observed: the first which peaked in August 2009 and the second--higher than the preceding - that peaked in October 2009. In 2010, influenza A/H3N2 re-emerged as the most predominant respiratory virus detected. Influenza viruses were the most commonly detected viral organisms among patients with acute febrile respiratory illnesses presenting at two hospitals in Maracay, Venezuela. Pandemic H1N1 2009 influenza virus did not completely replace other circulating influenza viruses during its initial appearance in 2009. Seasonal influenza A/H3N2 was the most common influenza

  13. Estimating influenza outpatients' and inpatients' incidences from 2009 to 2011 in a tropical urban setting in the Philippines

    PubMed Central

    Tallo, Veronica L; Kamigaki, Taro; Tan, Alvin G; Pamaran, Rochelle R; Alday, Portia P; Mercado, Edelwisa S; Javier, Jenaline B; Oshitani, Hitoshi; Olveda, Remigio M

    2014-01-01

    Objectives Although the public health significance of influenza in regions with a temperate climate has been widely recognized, information on influenza burden in tropical countries, including the Philippines, remains limited. We aimed to estimate influenza incidence rates for both outpatients and inpatients then characterized their demographic features. Design An enhanced surveillance was performed from January 2009 to December 2011 in an urbanized highland city. The influenza-like illness (ILI) surveillance involved all city health centers and an outpatient department of a tertiary government hospital. The severe acute respiratory infection (sARI) surveillance was also conducted with one government and four private hospitals since April 2009. Nasal and/or oropharyngeal swabs were collected and tested for influenza A, influenza B, and respiratory syncytial virus. Results and Conclusions We obtained 5915 specimens from 13 002 ILI cases and 2656 specimens from 10 726 sARI cases throughout the study period. We observed year-round influenza activity with two possible peaks each year. The overall influenza detection rate was 23% in the ILI surveillance and 9% in the sARI surveillance. The mean annual outpatient incidence rate of influenza was 5·4 per 1000 individuals [95% confidence interval (CI), 1·83–12·7], and the mean annual incidence of influenza-associated sARI was 1·0 per 1000 individuals (95% CI, 0·03–5·57). The highest incidence rates were observed among children aged <5 years, particularly those aged 6–23 months. Influenza posed a certain disease burden among inpatients and outpatients, particularly children aged <5 years, in an urbanized tropical city of the Philippines. PMID:24393336

  14. Systolic Blood Pressure Control Among Individuals With Type 2 Diabetes: A Comparative Effectiveness Analysis of Three Interventions

    PubMed Central

    Probstfield, Jeffery; Hire, Donald; Redmon, J. Bruce; Evans, Gregory W.; Coday, Mace; Lewis, Cora E.; Johnson, Karen C.; Wilmoth, Sharon; Bahnson, Judy; Dulin, Michael F.; Green, Jennifer B.; Knowler, William C.; Kitabchi, Abbas; Murillo, Anne L.; Osei, Kwame; Rehman, Shakaib U.; Cushman, William C.

    2015-01-01

    BACKGROUND The relative effectiveness of 3 approaches to blood pressure control—(i) an intensive lifestyle intervention (ILI) focused on weight loss, (ii) frequent goal-based monitoring of blood pressure with pharmacological management, and (iii) education and support—has not been established among overweight and obese adults with type 2 diabetes who are appropriate for each intervention. METHODS Participants from the Action for Health in Diabetes (Look AHEAD) and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) cohorts who met criteria for both clinical trials were identified. The proportions of these individuals with systolic blood pressure (SBP) <140mm Hg from annual standardized assessments over time were compared with generalized estimating equations. RESULTS Across 4 years among 480 Look AHEAD and 1,129 ACCORD participants with baseline SBPs between 130 and 159mm Hg, ILI (OR = 1.46; 95% CI = [1.18–1.81]) and frequent goal-based monitoring with pharmacotherapy (OR = 1.51; 95% CI = [1.16–1.97]) yielded higher rates of blood pressure control compared to education and support. The intensive behavioral-based intervention may have been more effective among individuals with body mass index >30kg/m2, while frequent goal-based monitoring with medication management may be more effective among individuals with lower body mass index (interaction P = 0.047). CONCLUSIONS Among overweight and obese adults with type 2 diabetes, both ILI and frequent goal-based monitoring with pharmacological management can be successful strategies for blood pressure control. CLINICAL TRIALS REGISTRY clinicaltrials.gov identifiers NCT00017953 (Look AHEAD) and NCT00000620 (ACCORD). PMID:25666468

  15. Sleep architecture following a weight loss intervention in overweight and obese patients with obstructive sleep apnea and type 2 diabetes: relationship to apnea-hypopnea index.

    PubMed

    Shechter, Ari; St-Onge, Marie-Pierre; Kuna, Samuel T; Zammit, Gary; RoyChoudhury, Arindam; Newman, Anne B; Millman, Richard P; Reboussin, David M; Wadden, Thomas A; Jakicic, John M; Pi-Sunyer, F Xavier; Wing, Rena R; Foster, Gary D

    2014-11-15

    To determine if weight loss and/ or changes in apnea-hypopnea index (AHI) improve sleep architecture in overweight/ obese adults with type 2 diabetes (T2D) and obstructive sleep apnea (OSA). This was a randomized controlled trial including 264 overweight/ obese adults with T2D and OSA. Participants were randomized to an intensive lifestyle intervention (ILI) or a diabetes and support education (DSE) control group. Measures included anthropometry, AHI, and sleep at baseline and year-1, year-2, and year-4 follow-ups. Changes in sleep duration (total sleep time [TST]), continuity [wake after sleep onset (WASO)], and architecture stage 1, stage 2, slow wave sleep, and REM sleep) from baseline to year 1, 2, and 4 did not differ between ILI and DSE. Repeated-measure mixed-model analyses including data from baseline through year-4 for all participants demonstrated a significant positive association between AHI and stage 1 sleep (p < 0.001), and a significant negative association between AHI and stage 2 (p = 0.01) and REM sleep (p < 0.001), whereas changes in body weight had no relation to any sleep stages or TST. WASO had a significant positive association with change in body weight (p = 0.009). Compared to control, the ILI did not induce significant changes in sleep across the 4-year follow-up. In participants overall, reduced AHI in overweight/ obese adults with T2D and OSA was associated with decreased stage 1, and increased stage 2 and REM sleep. These sleep architecture changes are more strongly related to reductions in AHI than body weight, whereas WASO may be more influenced by weight than AHI. NCT00194259. © 2014 American Academy of Sleep Medicine.

  16. Prospective association of a genetic risk score and lifestyle intervention with cardiovascular morbidity and mortality among individuals with type 2 diabetes: the Look AHEAD randomised controlled trial.

    PubMed

    2015-08-01

    Both obesity and genetics contribute to cardiovascular disease (CVD). We examined whether a genetic risk score (GRS) prospectively predicted cardiovascular morbidity and mortality among overweight/obese individuals with type 2 diabetes and whether behavioural weight loss could diminish this association. Look AHEAD (Action for Health in Diabetes) is a randomised controlled trial to determine the effects of intensive lifestyle intervention (ILI), including weight loss and physical activity, relative to diabetes support and education, on cardiovascular outcomes among overweight/obese individuals with type 2 diabetes. Of the participants, 4,016 provided consent for genetic analyses and had DNA samples passing quality control procedures. These secondary data analyses focused on whether a GRS derived from 153 single nucleotide polymorphisms (SNPs) associated with coronary artery disease in the most recent genome-wide association study predicted cardiovascular morbidity and mortality over a median of 9.6 years of follow-up, and whether ILI would diminish this association. The GRS significantly predicted the primary composite endpoint of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalisation for angina in the full sample (HR, 95% CI per 1 SD increase in GRS: 1.19 [1.10, 1.28]) and among individuals with no known history of CVD at baseline (HR 1.18 [95% CI 1.07, 1.30]). In no case did ILI significantly alter this association. A GRS comprised of SNPs significantly predicts cardiovascular morbidity and mortality over 9.6 years of follow-up in Look AHEAD. Lifestyle intervention did not alter the genetic association. NCT00017953; NCT01270763.

  17. Estimates of 2012/13 influenza vaccine effectiveness using the case test-negative control design with different influenza negative control groups.

    PubMed

    Nunes, Baltazar; Machado, Ausenda; Guiomar, Raquel; Pechirra, Pedro; Conde, Patrícia; Cristovão, Paula; Falcão, Isabel

    2014-07-31

    In recent years several reports of influenza vaccine effectiveness (VE) have been made early for public health decision. The majority of these studies use the case test-negative control design (TND), which has been showed to provide, under certain conditions, unbiased estimates of influenza VE. Nevertheless, discussions have been taken on the best influenza negative control group to use. The present study aims to contribute to the knowledge on this field by comparing influenza VE estimates using three test-negative controls: all influenza negative, non-influenza respiratory virus and pan-negative. Incident ILI patients were prospectively selected and swabbed by a sample of general practitioners. Cases were ILI patients tested positive for influenza and controls ILI patients tested negative for influenza. The influenza negative control group was divided into non-influenza virus control group and pan-negative control group. Data were collected on vaccination status and confounding factors. Influenza VE was estimated as one minus the odds ratio of been vaccinated in cases versus controls adjusted for confounding effect by logistic regression. Confounder adjusted influenza VE against medically attended laboratory-confirmed influenza was 68.4% (95% CI: 20.7-87.4%) using all influenza negatives controls, 82.1% (95% CI: 47.6-93.9%) using non-influenza controls and 49.4% (95% CI: -44.7% to 82.3%) using pan-negative controls. Influenza VE estimates differed according to the influenza negative control group used. These results are in accordance with the expected under the hypothesis of differential viral interference between influenza vaccinated and unvaccinated individuals. Given the wide importance of TND study further studies should be conducted in order to clarify the observed differences. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Detection of human influenza virus in Yucatan, Mexico.

    PubMed

    Ayora-Talavera, Guadalupe; Góngora-Biachi, Renán A; López-Martínez, Irma; Moguel-Rodríguez, William; Pérez-Carrillo, Humberto; Vázquez-Zapata, Víctor; Bastarrachea-Vázquez, Diliana; Canto-Cab, Armando

    2002-01-01

    Influenza virus is the most common cause of Acute Respiratory Infections (ARI) world wide. In patients with chronic condition, infection by the influenza virus can cause complications such as pneumonia which may have fatal outcome. The aim of this work was to determine the frequency of human influenza virus in outpatients with influenza-like illness (ILI) and in those patients admitted to hospital with community acquired pneumonia (CAP) in Yucatan, Mexico (October 1998-July 1999). Throat swabs were collected from ILI and CAP patients and processed to detect respiratory viruses. All clinical samples were tested for seven respiratory viruses using a rapid indirect immunofluorescence test (IFI). Clinical samples with positive results for influenza virus by IFI were inoculated into chick embryo eggs and/or MDCK cells for viral isolation. All influenza virus isolates were typed using the WHO influenza Kit 1998-1999. A total of 288 clinical samples were collected. Influenza virus type A was diagnosed in 29 clinical samples (10%), no other respiratory viruses were identified. Influenza virus was present with 8.9% (17 out of 189) in ILI patients, whereas with 12.12% (12 out of 99) in CAP patients. Influenza virus was detected from December to July. Six viral isolates were obtained and identified as influenza A (H3N2). Human influenza virus is certainly a cause of ARI and pneumonia in Yucatan, Mexico. The results showed that influenza virus contributes to at least 8.9% of the ARI, and more importantly to 12% of CAP patients. Positive cases were present in a different pattern to temperate zones where the peak of incidence occurs during autumn and winter.

  19. Systolic Blood Pressure Control Among Individuals With Type 2 Diabetes: A Comparative Effectiveness Analysis of Three Interventions.

    PubMed

    Espeland, Mark A; Probstfield, Jeffery; Hire, Donald; Redmon, J Bruce; Evans, Gregory W; Coday, Mace; Lewis, Cora E; Johnson, Karen C; Wilmoth, Sharon; Bahnson, Judy; Dulin, Michael F; Green, Jennifer B; Knowler, William C; Kitabchi, Abbas; Murillo, Anne L; Osei, Kwame; Rehman, Shakaib U; Cushman, William C

    2015-08-01

    The relative effectiveness of 3 approaches to blood pressure control-(i) an intensive lifestyle intervention (ILI) focused on weight loss, (ii) frequent goal-based monitoring of blood pressure with pharmacological management, and (iii) education and support-has not been established among overweight and obese adults with type 2 diabetes who are appropriate for each intervention. Participants from the Action for Health in Diabetes (Look AHEAD) and the Action to Control Cardiovascular Risk in Diabetes (ACCORD) cohorts who met criteria for both clinical trials were identified. The proportions of these individuals with systolic blood pressure (SBP) <140 mm Hg from annual standardized assessments over time were compared with generalized estimating equations. Across 4 years among 480 Look AHEAD and 1,129 ACCORD participants with baseline SBPs between 130 and 159 mm Hg, ILI (OR = 1.46; 95% CI = [1.18-1.81]) and frequent goal-based monitoring with pharmacotherapy (OR = 1.51; 95% CI = [1.16-1.97]) yielded higher rates of blood pressure control compared to education and support. The intensive behavioral-based intervention may have been more effective among individuals with body mass index >30 kg/m2, while frequent goal-based monitoring with medication management may be more effective among individuals with lower body mass index (interaction P = 0.047). Among overweight and obese adults with type 2 diabetes, both ILI and frequent goal-based monitoring with pharmacological management can be successful strategies for blood pressure control. clinicaltrials.gov identifiers NCT00017953 (Look AHEAD) and NCT00000620 (ACCORD). © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  20. Impact of a weight management program on health-related quality of life in overweight adults with type 2 diabetes.

    PubMed

    Williamson, Donald A; Rejeski, Jack; Lang, Wei; Van Dorsten, Brent; Fabricatore, Anthony N; Toledo, Katie

    2009-01-26

    Inconsistent findings have been reported regarding improved health-related quality of life (HRQOL) after weight loss. We tested the efficacy of a weight management program for improving HRQOL in overweight or obese adults diagnosed as having type 2 diabetes mellitus. We conducted a randomized multisite clinical trial at 16 outpatient research centers with 2 treatment arms and blinded measurements at baseline and the end of year 1. A total of 5145 participants (mean [SD] age, 58.7 [6.9] years; mean [SD] body mass index [calculated as weight in kilograms divided by height in meters squared], 36.0 [5.9]; 59.5% women; 63.1% white) were randomized to an intensive lifestyle intervention (ILI) or to diabetes support and education (DSE). Main outcome measures included the 36-Item Short-Form Health Survey physical component summary (PCS) and mental health component summary (MCS) scores and Beck Depression Inventory II (BDI-II) scores. Baseline mean (SD) scores were 47.9 (7.9) for PCS, 54.0 (8.1) for MCS, and 5.7 (5.0) for BDI-II. Improved HRQOL was demonstrated by the PCS and BDI-II scores (P < .001) in the ILI arm compared with the DSE arm. The largest effect was observed for the PCS score (difference, -2.91; 99% confidence interval, -3.44 to -2.37). The greatest HRQOL improvement occurred in participants with the lowest baseline HRQOL levels. Mean (SD) changes in weight (ILI, -8.77 [8.2] kg and DSE, -0.86 [5.0] kg), improved fitness, and improved physical symptoms mediated treatment effects associated with the BDI-II and PCS. Overweight adults diagnosed as having type 2 diabetes experienced significant improvement in HRQOL by enrolling in a weight management program that yielded significant weight loss, improved physical fitness, and reduced physical symptoms. clinicaltrials.gov Identifier: NCT00017953.

  1. Türk Lise Öğrencilerinde Okul Terkinin Yordanması: Aracı ve Etkileşim Değişkenleri ile Bir Model Testi

    PubMed Central

    Özer, Arif; Gençtanirim, Dilek; Ergene, Tuncay

    2011-01-01

    Bu araştırmada ilk olarak, dürtüsel davranma ile okulu terk etme riski arasındaki ilişkiye disiplin cezası almanın, antisosyal davranışların ve sigara-alkol kullanımının aracılık edip etmediği incelenmiştir. İkinci olarak, öğretmen desteği ve antisosyal davranış etkileşiminin okulu terk etme riski üzerindeki etkisi test edilmiştir. Araştırma grubunu 2009-2010 yılında Ankara İlinde genel liselere devam eden 478 öğrenci oluşturmuştur. Sonuçlar okulu terk etme riskini aile ve arkadaş desteğinin azalttığını, dürtüsel davranmanın ise artırdığını göstermiştir. Ayrıca disiplin cezası, alkol-sigara kullanma ve antisosyal davranışlar okulu terk etme riskini artıran aracı değişkenlerdir. Antisosyal davranışlarla okulu terk etme arasındaki ilişki öğretmen desteğine bağlı olarak değişmektedir. Öğrencilerin cinsiyet ve başarıları ile okulu terk etme riskleri arasında anlamlı bir ilişki bulunmamaktadır. PMID:22003257

  2. Agent based modeling of "crowdinforming" as a means of load balancing at emergency departments.

    PubMed

    Neighbour, Ryan; Oppenheimer, Luis; Mukhi, Shamir N; Friesen, Marcia R; McLeod, Robert D

    2010-01-01

    This work extends ongoing development of a framework for modeling the spread of contact-transmission infectious diseases. The framework is built upon Agent Based Modeling (ABM), with emphasis on urban scale modelling integrated with institutional models of hospital emergency departments. The method presented here includes ABM modeling an outbreak of influenza-like illness (ILI) with concomitant surges at hospital emergency departments, and illustrates the preliminary modeling of 'crowdinforming' as an intervention. 'Crowdinforming', a component of 'crowdsourcing', is characterized as the dissemination of collected and processed information back to the 'crowd' via public access. The objective of the simulation is to allow for effective policy evaluation to better inform the public of expected wait times as part of their decision making process in attending an emergency department or clinic. In effect, this is a means of providing additional decision support garnered from a simulation, prior to real world implementation. The conjecture is that more optimal service delivery can be achieved under balanced patient loads, compared to situations where some emergency departments are overextended while others are underutilized. Load balancing optimization is a common notion in many operations, and the simulation illustrates that 'crowdinforming' is a potential tool when used as a process control parameter to balance the load at emergency departments as well as serving as an effective means to direct patients during an ILI outbreak with temporary clinics deployed. The information provided in the 'crowdinforming' model is readily available in a local context, although it requires thoughtful consideration in its interpretation. The extension to a wider dissemination of information via a web service is readily achievable and presents no technical obstacles, although political obstacles may be present. The 'crowdinforming' simulation is not limited to arrivals of patients at

  3. Real-Time Epidemic Monitoring and Forecasting of H1N1-2009 Using Influenza-Like Illness from General Practice and Family Doctor Clinics in Singapore

    PubMed Central

    Ong, Jimmy Boon Som; Chen, Mark I-Cheng; Cook, Alex R.; Lee, Huey Chyi; Lee, Vernon J.; Lin, Raymond Tzer Pin; Tambyah, Paul Ananth; Goh, Lee Gan

    2010-01-01

    Background Reporting of influenza-like illness (ILI) from general practice/family doctor (GPFD) clinics is an accurate indicator of real-time epidemic activity and requires little effort to set up, making it suitable for developing countries currently experiencing the influenza A (H1N1 -2009) pandemic or preparing for subsequent epidemic waves. Methodology/Principal Findings We established a network of GPFDs in Singapore. Participating GPFDs submitted returns via facsimile or e-mail on their work days using a simple, standard data collection format, capturing: gender; year of birth; “ethnicity”; residential status; body temperature (°C); and treatment (antiviral or not); for all cases with a clinical diagnosis of an acute respiratory illness (ARI). The operational definition of ILI in this study was an ARI with fever of 37.8°C or more. The data were processed daily by the study co-ordinator and fed into a stochastic model of disease dynamics, which was refitted daily using particle filtering, with data and forecasts uploaded to a website which could be publicly accessed. Twenty-three GPFD clinics agreed to participate. Data collection started on 2009-06-26 and lasted for the duration of the epidemic. The epidemic appeared to have peaked around 2009-08-03 and the ILI rates had returned to baseline levels by the time of writing. Conclusions/Significance This real-time surveillance system is able to show the progress of an epidemic and indicates when the peak is reached. The resulting information can be used to form forecasts, including how soon the epidemic wave will end and when a second wave will appear if at all. PMID:20418945

  4. Use of neuraminidase inhibitors in primary health care during pandemic and seasonal influenza between 2009 and 2013

    PubMed Central

    Blanchon, Thierry; Geffrier, Félicité; Turbelin, Clément; Daviaud, Isabelle; Laouénan, Cédric; Duval, Xavier; Lambert, Bruno; Hanslik, Thomas; Mosnier, Anne; Leport, Catherine

    2015-01-01

    Background In a context of controversy about influenza antiviral treatments, this study assessed primary health care physicians’ prescription of neuraminidase inhibitors (NIs) in France during pandemic and seasonal influenza between 2009 and 2013. Methods This observational study, using data recorded in three national databases, estimated the rate of NIs’ prescription among influenza like-illness (ILI) patients seen in GPs’ and paediatricians’ consultations, and determined factors associated with this prescription according to a multivariate analysis. NIs’ delivery by pharmacists was also evaluated. Results Rates of NIs’ prescription were estimated to 61.1% among ILI patients with a severe influenza risk factor seen in GPs’ consultation during the A(H1N1)pdm2009 pandemic versus an average rate of 25.9% during the three following seasonal influenza epidemics. Factors associated with NIs’ prescription were a chronic disease in patients under 65 years (OR, 14.85; 95%CI, 13.00–16.97) and in those aged ≥ 65 and older (OR, 7.54; 5.86–9.70), an age 65 years in patients without chronic disease (OR, 1.35; 1.04–1.74), a pregnancy (OR, 10.63; 7.67–15.76), obesity (OR, 4.67; 3.50–6.22), and a consultation during the pandemic A(H1N1)pdm2009 (OR, 3.19; 2.93–3.48). The number of antiviral treatments delivered by pharmacists during the A(H1N1)pdm2009 pandemic was 835 per 100 000 inhabitants, and an average of 275 per 100 000 inhabitants during the three following seasonal influenza epidemics. Conclusions Although physicians seem to follow the recommended indications for NIs in primary health care practice, this study confirms the low rate of NIs prescription to ILI patients with a severe influenza risk factor, especially during seasonal epidemics. PMID:25687219

  5. Viral aetiology influenza like illnesses in Santa Cruz, Bolivia (2010–2012)

    PubMed Central

    2014-01-01

    Background Acute respiratory infections represent a serious public health issue worldwide but virological aetiologies of Influenza Like Illnesses (ILIs) remain largely unknown in developing countries. This study represents the first attempt to characterise viral aetiologies of ILIs in Bolivia. Methods It was performed in Santa Cruz city from January 2010 to September 2012, based on 564 naso-pharyngeal swabs collected in a National Reference Laboratory and real-time PCR techniques, viral cultures and phylogenetic analyses. Results 50.2% of samples were positive for at least one virus with influenza viruses (Flu A: ~15%; Flu B: ~9%), rhinoviruses (~8%), coronaviruses (~5%) and hRSV (~4%) being the most frequently identified. The pattern of viral infections varied according to age groups. The elucidation rate was the highest (>60%) amongst patients under 10 yo and the lowest (<40%) amongst patients ≥60 yo. Nearly 3% of samples showed dual viral infections. Epidemiological peaks were associated with a predominant virus but generally included 30-50% of infections by different viruses. Unexpectedly, the frequency of influenza in the 0–4 yo population was very low and a complete hRSV eclipse occurred in 2011. Genetic analyses indicated that distinct evolutionary lineages of Flu A(H1N1)pdm2009, Flu A/H3N2 and Flu B have co-circulated in Bolivia in the study period, originating from Central and North America, Europe, Asia and Australia. Conclusion Our results emphasise the requirement for a reinforced epidemiological and genetic follow-up of influenza and other ILIs in Bolivia to further inform the preparation of vaccines used in the region, guide vaccination campaigns and improve the medical management of patients. PMID:24564892

  6. School-Located Influenza Vaccination Reduces Community Risk for Influenza and Influenza-Like Illness Emergency Care Visits

    PubMed Central

    Tran, Cuc H.; Sugimoto, Jonathan D.; Pulliam, Juliet R. C.; Ryan, Kathleen A.; Myers, Paul D.; Castleman, Joan B.; Doty, Randell; Johnson, Jackie; Stringfellow, Jim; Kovacevich, Nadia; Brew, Joe; Cheung, Lai Ling; Caron, Brad; Lipori, Gloria; Harle, Christopher A.; Alexander, Charles; Yang, Yang; Longini, Ira M.; Halloran, M. Elizabeth; Morris, J. Glenn; Small, Parker A.

    2014-01-01

    Background School-located influenza vaccination (SLIV) programs can substantially enhance the sub-optimal coverage achieved under existing delivery strategies. Randomized SLIV trials have shown these programs reduce laboratory-confirmed influenza among both vaccinated and unvaccinated children. This work explores the effectiveness of a SLIV program in reducing the community risk of influenza and influenza-like illness (ILI) associated emergency care visits. Methods For the 2011/12 and 2012/13 influenza seasons, we estimated age-group specific attack rates (AR) for ILI from routine surveillance and census data. Age-group specific SLIV program effectiveness was estimated as one minus the AR ratio for Alachua County versus two comparison regions: the 12 county region surrounding Alachua County, and all non-Alachua counties in Florida. Results Vaccination of ∼50% of 5–17 year-olds in Alachua reduced their risk of ILI-associated visits, compared to the rest of Florida, by 79% (95% confidence interval: 70, 85) in 2011/12 and 71% (63, 77) in 2012/13. The greatest indirect effectiveness was observed among 0–4 year-olds, reducing AR by 89% (84, 93) in 2011/12 and 84% (79, 88) in 2012/13. Among all non-school age residents, the estimated indirect effectiveness was 60% (54, 65) and 36% (31, 41) for 2011/12 and 2012/13. The overall effectiveness among all age-groups was 65% (61, 70) and 46% (42, 50) for 2011/12 and 2012/13. Conclusion Wider implementation of SLIV programs can significantly reduce the influenza-associated public health burden in communities. PMID:25489850

  7. Dynamic and accurate assessment of acetaminophen-induced hepatotoxicity by integrated photoacoustic imaging and mechanistic biomarkers in vivo.

    PubMed

    Brillant, Nathalie; Elmasry, Mohamed; Burton, Neal C; Rodriguez, Josep Monne; Sharkey, Jack W; Fenwick, Stephen; Poptani, Harish; Kitteringham, Neil R; Goldring, Christopher E; Kipar, Anja; Park, B Kevin; Antoine, Daniel J

    2017-10-01

    The prediction and understanding of acetaminophen (APAP)-induced liver injury (APAP-ILI) and the response to therapeutic interventions is complex. This is due in part to sensitivity and specificity limitations of currently used assessment techniques. Here we sought to determine the utility of integrating translational non-invasive photoacoustic imaging of liver function with mechanistic circulating biomarkers of hepatotoxicity with histological assessment to facilitate the more accurate and precise characterization of APAP-ILI and the efficacy of therapeutic intervention. Perturbation of liver function and cellular viability was assessed in C57BL/6J male mice by Indocyanine green (ICG) clearance (Multispectral Optoacoustic Tomography (MSOT)) and by measurement of mechanistic (miR-122, HMGB1) and established (ALT, bilirubin) circulating biomarkers in response to the acetaminophen and its treatment with acetylcysteine (NAC) in vivo. We utilised a 60% partial hepatectomy model as a situation of defined hepatic functional mass loss to compared acetaminophen-induced changes to. Integration of these mechanistic markers correlated with histological features of APAP hepatotoxicity in a time-dependent manner. They accurately reflected the onset and recovery from hepatotoxicity compared to traditional biomarkers and also reported the efficacy of NAC with high sensitivity. ICG clearance kinetics correlated with histological scores for acute liver damage for APAP (i.e. 3h timepoint; r=0.90, P<0.0001) and elevations in both of the mechanistic biomarkers, miR-122 (e.g. 6h timepoint; r=0.70, P=0.005) and HMGB1 (e.g. 6h timepoint; r=0.56, P=0.04). For the first time we report the utility of this non-invasive longitudinal imaging approach to provide direct visualisation of the liver function coupled with mechanistic biomarkers, in the same animal, allowing the investigation of the toxicological and pharmacological aspects of APAP-ILI and hepatic regeneration. Copyright © 2017

  8. Paid sick days and stay-at-home behavior for influenza.

    PubMed

    Piper, Kaitlin; Youk, Ada; James, A Everette; Kumar, Supriya

    2017-01-01

    Access to paid sick days (PSD) differs by workplace size, race/ethnicity, gender, and income in the United States. It is not known to what extent decisions to stay home from work when sick with infectious illnesses such as influenza depend on PSD access, and whether access impacts certain demographic groups more than others. We examined demographic and workplace characteristics (including access to PSD) associated with employees' decisions to stay home from work for their own or a child's illness. Linking the 2009 Medical Expenditure Panel Survey (MEPS) consolidated data file to the medical conditions file, we used multivariate Poisson regression models with robust variance estimates to identify factors associated with missed work for an employee's own or a child's illness/injury, influenza-like-illness (ILI), and influenza. Controlling for gender, race/ethnicity, education, and income, access to PSD was associated with a higher probability of staying home for an employee's own illness/injury, ILI, or influenza, and for a child's illness/injury. Hispanic ethnicity was associated with a lower prevalence of staying home for the employee's own or a child's illness compared to non-Hispanic Whites. Access to PSD was associated with a significantly greater increase in the probability of staying home among Hispanics than among non-Hispanic Whites. Women had a significantly higher probability of staying home for their child's illness compared to men, suggesting that women remain the primary caregivers for ill children. Our results indicate that PSD access is important to encourage employees to stay home from work when sick with ILI or influenza. Also, PSD access may be important to enable stay-at-home behavior among Hispanics. We conclude that access to PSD is likely to reduce the spread of disease in workplaces by increasing the rate at which sick employees stay home from work, and reduce the economic burden of staying home on minorities, women, and families.

  9. Viral aetiology influenza like illnesses in Santa Cruz, Bolivia (2010-2012).

    PubMed

    Delangue, Julie; Roca Sanchez, Yelin; Piorkowski, Géraldine; Bessaud, Maël; Baronti, Cécile; Thirion-Perrier, Laurence; Mafayle, Roxana Loayza; Ardaya, Cinthia Avila; Aguilera, Gabriela Añez; Guzman, Jimmy Revollo; Riera, Javier Lora; de Lamballerie, Xavier

    2014-02-24

    Acute respiratory infections represent a serious public health issue worldwide but virological aetiologies of Influenza Like Illnesses (ILIs) remain largely unknown in developing countries. This study represents the first attempt to characterise viral aetiologies of ILIs in Bolivia. It was performed in Santa Cruz city from January 2010 to September 2012, based on 564 naso-pharyngeal swabs collected in a National Reference Laboratory and real-time PCR techniques, viral cultures and phylogenetic analyses. 50.2% of samples were positive for at least one virus with influenza viruses (Flu A: ~15%; Flu B: ~9%), rhinoviruses (~8%), coronaviruses (~5%) and hRSV (~4%) being the most frequently identified. The pattern of viral infections varied according to age groups. The elucidation rate was the highest (>60%) amongst patients under 10 yo and the lowest (<40%) amongst patients ≥60 yo. Nearly 3% of samples showed dual viral infections. Epidemiological peaks were associated with a predominant virus but generally included 30-50% of infections by different viruses. Unexpectedly, the frequency of influenza in the 0-4 yo population was very low and a complete hRSV eclipse occurred in 2011. Genetic analyses indicated that distinct evolutionary lineages of Flu A(H1N1)pdm2009, Flu A/H3N2 and Flu B have co-circulated in Bolivia in the study period, originating from Central and North America, Europe, Asia and Australia. Our results emphasise the requirement for a reinforced epidemiological and genetic follow-up of influenza and other ILIs in Bolivia to further inform the preparation of vaccines used in the region, guide vaccination campaigns and improve the medical management of patients.

  10. Pilot Randomised Controlled Trial to Test Effectiveness of Facemasks in Preventing Influenza-like Illness Transmission among Australian Hajj Pilgrims in 2011.

    PubMed

    Barasheed, Osamah; Almasri, Nedal; Badahdah, Al-Mamoon; Heron, Leon; Taylor, Janette; McPhee, Kenneth; Ridda, Iman; Haworth, Elizabeth; Dwyer, Dominic E; Rashid, Harunor; Booy, Robert

    2014-01-01

    Studies to determine the effectiveness of facemasks in preventing influenza have been inconclusive, largely due to small sample size. The Hajj pilgrimage, where the incidence of influenza and other respiratory infections is high, provides an excellent opportunity to test the effectiveness of facemasks against syndromic and laboratory-confirmed infections. Hence, a pilot study was conducted among Australian pilgrims to assess the feasibility of such a large-scale trial in the coming years. At the 2011 Hajj, tents were randomised to 'supervised mask use' versus 'no supervised mask use'. Pilgrims with ILI symptoms for ≤3 days were recruited as 'cases' and those who slept within 2 meters of them as 'contacts'. Surgical facemasks were provided to cases and contacts in the 'mask' tents, but not in the 'control' tents. Pilgrims in both groups were given diaries to record their respiratory symptoms. Nasal or pharyngeal swabs were collected from the cases and contacts with ILI for point-of-care and nucleic acid tests. A total of 22 tents were randomised to 'mask' (n=12) or 'control' (n=10). There were 164 pilgrims recruited; 75 in 'mask' and 89 in 'control' group. Mask use compliance was 76% in the 'mask' group and 12% in the 'control' group. Based on developing syndromic ILI, less contacts became symptomatic in the 'mask' tents compared to the 'control' tents (31% versus 53%, p= 0.04). However, laboratory results did not show any difference between the two groups. This pilot study shows that a large trial to assess the effectiveness of facemasks use at Hajj is feasible.

  11. Importance of employee vaccination against influenza in preventing cases in long-term care facilities.

    PubMed

    Wendelboe, Aaron M; Avery, Catherine; Andrade, Bernardo; Baumbach, Joan; Landen, Michael G

    2011-10-01

    Employees of long-term care facilities (LTCFs) who have contact with residents should be vaccinated against influenza annually to reduce influenza incidence among residents. This investigation estimated the magnitude of the benefit of this recommendation. The New Mexico Department of Health implemented active surveillance in all of its 75 LTCFs during influenza seasons 2006-2007 and 2007-2008. Information about the number of laboratory-confirmed cases of influenza and the proportion vaccinated of both residents and direct-care employees in each facility was collected monthly. LTCFs reporting at least 1 case of influenza (defined alternately by laboratory confirmation or symptoms of influenza-like illness [ILI]) among residents were compared with LTCFs reporting no cases of influenza. Regression modeling was used to obtain adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for the association between employee vaccination coverage and the occurrence of influenza outbreaks. Covariates included vaccination coverage among residents, the staff-to-resident ratio, and the proportion of filled beds. Seventeen influenza outbreaks were reported during this 2-year period of surveillance. Eleven of these were laboratory confirmed (n = 21 residents) and 6 were defined by ILI (n = 40 residents). Mean influenza vaccination coverage among direct-care employees was 51% in facilities reporting outbreaks and 60% in facilities not reporting outbreaks (P = .12). Increased vaccination coverage among direct-care employees was associated with fewer reported outbreaks of laboratory-confirmed influenza (aOR, 0.97 [95% CI, 0.95-0.99]) and ILI (aOR, 0.98 [95% CI, 0.96-1.00]). High vaccination coverage among direct-care employees helps to prevent influenza in LTCFs.

  12. Spatial variability of recent glacier area changes in the Tien Shan Mountains, Central Asia, using Corona (~ 1970), Landsat (~ 2000), and ALOS (~ 2007) satellite data

    NASA Astrophysics Data System (ADS)

    Narama, Chiyuki; Kääb, Andreas; Duishonakunov, Murataly; Abdrakhmatov, Kanatbek

    2010-03-01

    Geographic variability of the recent changes of glacier coverage in the Tien Shan Mountains, Central Asia, is assessed using Corona KH-4B satellite photographs for 1968-1971, Landsat 7 ETM+data for 1999-2002, and ALOS/PRISM and AVNIR data for 2006-2008. The four mountain regions investigated (Pskem, Ili-Kungöy, At-Bashy, and SE-Fergana) cover several distributed glacierized areas in the Tien Shan Mountain system, a region that is affected by highly variable local precipitation regimes. Over the 30 years investigated between ~ 1970 and ~ 2000, glacier area decreased by 19% in the Pskem region, 12% in the Ili-Kungöy region, 12% in the At-Bashy region, and 9% in the SE-Fergana region. In the last 7 years (~ 2000 to ~ 2007), glacier area shrank by 5% in the Pskem region, 4% in the Ili-Kungöy region, 4% in the At-Bashy region, and 0% in the SE-Fergana region. Glacier behavior has varied markedly in these regions. The most dramatic glacier shrinkage has occurred in the outer ranges of the Tien Shan Mountains. Recent glacier area loss has resulted from rising summer temperatures. Regional differences of glacier-area changes related to local climate conditions, to the altitudinal distribution of glacier areas, and to the relative proportion of glaciers in different size classes. The observed accelerated glacier shrinkage is expected to have two impacts on the more populated outer ranges: 1) water shortages during summer and 2) increased threat from glacier hazards such as glacier lake outburst floods (GLOFs) and ice avalanches.

  13. One-year changes in symptoms of depression and weight in overweight/obese individuals with type 2 diabetes in the Look AHEAD study.

    PubMed

    Faulconbridge, Lucy F; Wadden, Thomas A; Rubin, Richard R; Wing, Rena R; Walkup, Michael P; Fabricatore, Anthony N; Coday, Mace; Van Dorsten, Brent; Mount, David L; Ewing, Linda J

    2012-04-01

    Depressed individuals are frequently excluded from weight loss trials because of fears that weight reduction may precipitate mood disorders, as well as concerns that depressed participants will not lose weight satisfactorily. The present study examined participants in the Look AHEAD study to determine whether moderate weight loss would be associated with incident symptoms of depression and suicidal ideation, and whether symptoms of depression at baseline would limit weight loss at 1 year. Overweight/obese adults with type 2 diabetes (n = 5,145) were randomly assigned to an Intensive Lifestyle Intervention (ILI) or a usual care group, Diabetes Support and Education (DSE). Of these, 5,129 participants completed the Beck Depression Inventory (BDI) and had their weight measured at baseline and 1 year. Potentially significant symptoms of depression were defined by a BDI score ≥10. Participants in ILI lost 8.6 ± 6.9% of initial weight at 1 year, compared to 0.7 ± 4.8% for DSE (P < 0.001, effect size = 1.33), and had a reduction of 1.4 ± 4.7 points on the BDI, compared to 0.4 ± 4.5 for DSE (P < 0.001, effect size = 0.23). At 1 year, the incidence of potentially significant symptoms of depression was significantly lower in the ILI than DSE group (6.3% vs. 9.6%) (relative risk (RR) = 0.66, 95% confidence interval (CI) = 0.5, 0.8; P < 0.001). In the ILI group, participants with and without symptoms of depression lost 7.8 ± 6.7% and 8.7 ± 6.9%, respectively, a difference not considered clinically meaningful. Intentional weight loss was not associated with the precipitation of symptoms of depression, but instead appeared to protect against this occurrence. Mild (or greater) symptoms of depression at baseline did not prevent overweight/obese individuals with type 2 diabetes from achieving significant weight loss.

  14. Selective Perception for Robot Driving

    DTIC Science & Technology

    1992-05-01

    92 Min [1,6] +If-then-els Node function [3, 6] [1, 7] -Node value [2, 3 [1, 31 [ fase ,true] [1, 6] [5, 7] Figure 6-7.- Example of interval value...Max(xy) is UxuU, and Min (xy) is L.nL) " If PL Upper bound= . p=True Ie U p= Fase Lower bound = {L p= TrueILy p=False 23’se Upper bound = I U. U... Sensible Planning- Focusing Perceptual Attention. In Proceedings of AAAI-91. AAAI, 1991. [Clune 881 Clune, E.; Crisman, J.; Klinker, G.; and Webb, J

  15. Dew Point Evaporative Comfort Cooling

    DTIC Science & Technology

    2012-11-01

    NREL’s Commercial Buildings Research team, including James Page, Andrew Parker , Michael Deru, and Brent Griffith, provided laboratory and field...ily A ve ra ge E le ct ric al E ff ic ie nc y (k W /t on ) Daily Average Electrical Efficiency, Training Facility 2010 Unit 1 Unit 2 Unit 3 0...le ct ric al E ff ic ie nc y (k w /t on ) Daily Average Electrical Efficiency, Training Facility 2011 Unit 1 Unit 2 Unit 3 52 The theater and

  16. Southeast PAVE PAWS Radar System. Environmental Assessment.

    DTIC Science & Technology

    1983-03-01

    alternate site for PAVE PANS , are located in Lanier County. 74 - C. U’ ILI Ii IeI IdI / C Ii al 12 W0 -MEEK 75a Construction and operation of SEPP... cerebro - * spinal fluid). The energy in a pulse arriving at such a boundary is converted into an abrupt increase in momentum that is locally thermal- ized...of the general concerns expressed following review of the Draft Environmental Impact Statements for the Otis ANG Base and Beale AFB PAVE PANS

  17. Bottom-up assessment of the Net Ecosystem Carbon Balance of Russian forests in 2010 for comparison to Top-down estimates.

    NASA Astrophysics Data System (ADS)

    Maksyutov, S. S.; Shvidenko, A.; Shchepashchenko, D.

    2014-12-01

    The verified full carbon assessment of Russian forests (FCA) is based on an Integrated Land Information System (ILIS) that includes a multi-layer and multi-scale GIS with basic resolution of 1 km and corresponding attributive databases. The ILIS aggregates all available information about ecosystems and landscapes, sets of empirical and semi-empirical data and aggregations, data of different inventories and surveys, and multi-sensor remote sensing data. The ILIS serves as an information base for application of the landscape-ecosystem approach (LEA) of the FCA and as a systems design for comparison and mutual constraints with other methods of study of carbon cycling of forest ecosystems (eddy covariance; process models; inverse modeling; and multi-sensor application of remote sensing). The LEA is based on a complimentary use of the flux-based method with some elements of the pool-based method. Introduction of climatic parameters of individual years in the LEA, as well as some process-based elements, allows providing a substantial decrease of the uncertainties of carbon cycling yearly indicators of forest ecosystems. Major carbon pools (live biomass, coarse woody debris, soil organic carbon) are estimated based on data on areas, distribution and major biometric characteristics of Russian forests presented in form of the ILIS for the country. The major fluxes accounted for include Net Primary Production (NPP), Soil Heterotrophic Respiration (SHR), as well as fluxes caused by decomposition of Coarse Woody Debris (CWD), harvest and use of forest products, fluxes caused by natural disturbances (fire, insect outbreaks, impacts of unfavorable environment) and lateral fluxes to hydrosphere and lithosphere. Use of landscape-ecosystem approach resulted in the NECB at 573±140 Tg C yr-1 (CI 0.9). While the total carbon sink is high, large forest areas, particularly on permafrost, serve as a carbon source. The ratio between net primary production and soil heterotrophic

  18. Estimates of Pandemic Influenza Vaccine Effectiveness in Europe, 2009–2010: Results of Influenza Monitoring Vaccine Effectiveness in Europe (I-MOVE) Multicentre Case-Control Study

    PubMed Central

    Valenciano, Marta; Kissling, Esther; Cohen, Jean-Marie; Oroszi, Beatrix; Barret, Anne-Sophie; Rizzo, Caterina; Nunes, Baltazar; Pitigoi, Daniela; Larrauri Cámara, Amparro; Mosnier, Anne; Horvath, Judith K.; O'Donnell, Joan; Bella, Antonino; Guiomar, Raquel; Lupulescu, Emilia; Savulescu, Camelia; Ciancio, Bruno C.; Kramarz, Piotr; Moren, Alain

    2011-01-01

    Background A multicentre case-control study based on sentinel practitioner surveillance networks from seven European countries was undertaken to estimate the effectiveness of 2009–2010 pandemic and seasonal influenza vaccines against medically attended influenza-like illness (ILI) laboratory-confirmed as pandemic influenza A (H1N1) (pH1N1). Methods and Findings Sentinel practitioners swabbed ILI patients using systematic sampling. We included in the study patients meeting the European ILI case definition with onset of symptoms >14 days after the start of national pandemic vaccination campaigns. We compared pH1N1 cases to influenza laboratory-negative controls. A valid vaccination corresponded to >14 days between receiving a dose of vaccine and symptom onset. We estimated pooled vaccine effectiveness (VE) as 1 minus the odds ratio with the study site as a fixed effect. Using logistic regression, we adjusted VE for potential confounding factors (age group, sex, month of onset, chronic diseases and related hospitalizations, smoking history, seasonal influenza vaccinations, practitioner visits in previous year). We conducted a complete case analysis excluding individuals with missing values and a multiple multivariate imputation to estimate missing values. The multivariate imputation (n = 2902) adjusted pandemic VE (PIVE) estimates were 71.9% (95% confidence interval [CI] 45.6–85.5) overall; 78.4% (95% CI 54.4–89.8) in patients <65 years; and 72.9% (95% CI 39.8–87.8) in individuals without chronic disease. The complete case (n = 1,502) adjusted PIVE were 66.0% (95% CI 23.9–84.8), 71.3% (95% CI 29.1–88.4), and 70.2% (95% CI 19.4–89.0), respectively. The adjusted PIVE was 66.0% (95% CI −69.9 to 93.2) if vaccinated 8–14 days before ILI onset. The adjusted 2009–2010 seasonal influenza VE was 9.9% (95% CI −65.2 to 50.9). Conclusions Our results suggest good protection of the pandemic monovalent vaccine against medically attended pH1N1 and no

  19. Some Efficient Random Number Generators for Micro Computers.

    DTIC Science & Technology

    1983-09-01

    bytt:bytel; CONST 1IKLT z 1221; ( other good values are: 2937, 393, 4199, 4293,) b5in ( 9237,14789,15125,17245) seed.int : MULT I sed.int +; Rlyte...Ili](B) Z ..X ....... X ........ x ........ S A * *-------- Figure I: Relationship betueen bits in a Tausuorthe sequence. Here B) is defined as a...Ii]c )R od@ -----------------------------I *here li] = the i-th number produced by the generator. Ii+I] the (i41)-th number produced by the geerator

  20. Focused Ion Beam Fabrication of Graded Channel Fet’s in GaAs and Si.

    DTIC Science & Technology

    1988-02-03

    GRAS AMD SICU) MASSACHUSETTS INST OF TECH CAMBRIDGE RESEARCH LAS OF-ILECTRONICS J NELUG ILIS 03 FEB 88 UNCLASSIFIED NDA9B3-85-C-82.- F/G 7/2 ULEEE...Jacob, Graduate Student, Electrical Eng. and Computer Science Henri Lezec, Graduate Student, Electrical Eng. and Computer Science Christian Musil ...Laterally Graded Current Monitoring DC Bias(V) Q Gunn Diode ResistorI-I Frequency Smoothly Tunable w/ DC Bias *-40 dBn !! j ---- 6 Ghz at 35 V 12.2 Ghz

  1. AGARD Index of Publications, 1977 - 1979.

    DTIC Science & Technology

    1980-08-01

    HIGH N79- 22000 # General Dynamics/Fort Worth. Tex. ANGLE OF ATTACK SPIN RECOVERY DESIGN GUIDELINES FOR THE APPLICATION OF FORE- J J Cornish, IlI and M W...wing was determined G Y In AGARD High Angle of Attack Aerodyn Jan 1979 27 p refs (For primary document see N79-21996 13-01) N79- 22000 # Deutsche...gives the picture of the boundary layer including the variables It is argued that adequate closure techniques are transition development from iso -Mach

  2. Computer Modeling of Direct Path, Backscattered Bottom Reverberations for the Acoustic Reverberation Special Research Program (ARSRP)

    DTIC Science & Technology

    1990-10-01

    34 .. .:. ..... . . ... H3Od KV38 F-0 (cc .ILI 0 L) C7C) LS..i~i *Q p a 5 -- ,s g v -J -J C)c Z1 E~ KV3 K’o - S.- ’ " , ’ , ~~.. .... ..... . ......., , -inn *Q o c "<g - aa...a -IC) | *."I I I I!-) Sa ao <o o3~ INY3U U) CQC CC) -C0 r- 0 - CD C> CC CC)) ZJ3M~d KV3 ct: Loo 00 00 CE~ ~ ~ ..... 43~ NV3 C’,) I 0 I

  3. ’MODESRCH’, An Improved Computer Program for Obtaining ELF/VLF/LF Mode Constants in an Earth-Ionosphere Waveguide

    DTIC Science & Technology

    1976-10-01

    0 RHO = O*C i TA-LT=iu.0 RAt T 3. Gt"AX = 50 SEP = 091 TVSt-=-1 .0 LUB=-Io0 C NUFLAG = 0 COEFi’U(1L .) b1 C UL FPU ( 21 *5UF C OEf! U ( 3 te= 4E F)’PNU...Lt20 Ili ITI TLE(K)=I BCD ( K) 11. READ 904vJITtENS(1),ENS(1) 904t FC2RMAT IF7,295XtE9.2tEIO.2) IF (H7 .LT, 0.0) GO TO 15 HTS(J) =E 1T ANC, HTS(J

  4. Influenza Risk Management: Lessons Learned from an A(H1N1) pdm09 Outbreak Investigation in an Operational Military Setting

    DTIC Science & Technology

    2013-07-10

    Organization/U.S. Centers for Disease Control and Prevention influenza-like illness case definition [fever (T > 100.5˚F/38˚C) in addition to cough and/or sore...H1N1) pdm09-positive individuals. While still not ideal, using cough as the sole screening criteria would have increased sensitivity to 73...CDC) ILI case definition [fever (T > 100.5˚F/ 38˚C) in addition to cough and/or sore throat in the previous 72 hours]. History/unknown history of

  5. Evaluation of an Influenza-Like Illness Case Definition in the Diagnosis of Influenza Among Patients with Acute Febrile Illness in Cambodia

    DTIC Science & Technology

    2010-01-01

    ILI) is often defined as fever (>38.0°C) with cough or sore throat. In this study, we tested the sensitivity, specificity, and positive and negative...include fever, cough , sore throat, headache, muscle aches, nasal congestion and weakness [9]. These symptoms can be non-specific and do not easily distin...include fever (≥ 38°C) with one or more respiratory symptoms (e.g., cough or sore throat). These clinical algorithms have been studied in children and

  6. Word Frequency Analysis. MOS: 82C. Skill Levels 1 & 2.

    DTIC Science & Technology

    1981-05-01

    Army Soldier’s Manual for the MOS/Skill Level designated in the title (item 4). This frequency count reflects only skill levels ]IlI and excludes the... WESIT 7 111r. KIAE4, 6 ArIIIST FC 6 AFIF- f~r ’AI AA AKVt~ A C PSIAI KT 1. MI14 f Al CKtlI f. 901110 r VI III INY 0- tw II 1, 1s 111lt~,0171 A cririI-’L A

  7. Remarks on "Comments on 'On q-non-extensive statistics with non-Tsallisian entropy' " [Physica A 466 (2017) 160

    NASA Astrophysics Data System (ADS)

    Jizba, Petr; Korbel, Jan

    2017-02-01

    Recently in Ilić and Stanković (2017) have suggested that there may be problem for the class of hybrid entropies introduced in Jizba and Arimitsu (2004). In this Comment we point out that the problem can be traced down to the q-additive entropic chain rule and to a peculiar behavior of the De Finetti-Kolmogorov relation for escort distributions. However, despite this, one can still safely use the proposed hybrid entropies in most of the statistical-thermodynamics considerations.

  8. Remedial Investigation/Feasibility Study, Operable Unit 5, Elmendorf AFB, Anchorage, Alaska. Volume 3. Appendices K - T

    DTIC Science & Technology

    1994-03-04

    MS 9119 8270 314SS 121-14-2 2.4-4D[NrM0T0L13E14 40 13 13011( Soil QC SS310 -MS 91319 8270 E1455 W&3-0-2 Z6-44D1rmOTOL13E1E 40 ILI 130KG. oil QC 55310...for life stages in species iden- tified by the department as the most sensitive , biologically important species in a particular location, whichever...department as being the most sensitive , biologically important to the location, or exceed criteria cited in USEPA Oualitv Criteria for Water (18 AAC Ch

  9. The Snow Characteristics of Aircraft Skis

    DTIC Science & Technology

    1947-01-01

    bottoms are given in Table 1. The skis of different shapes were surfaced with beeswax scraped to a very smooth surface. When damaged this surface...could be restored very eas- ily. Since the low friction of smooth beeswax on snow was a relatively small part of the total slid- ing resistance of...different skis unless the skis were tested at the same time. For this reason. Ski B surfaced with beeswax was always used as one of the two skis in a

  10. Analysis of the TRIGA Reactor Pool Water

    DTIC Science & Technology

    1993-08-01

    AD-A270 956 L11L1I~I1 11 11 :1Ji ili! August 1993 AFRRI 93-5 TECHNICAL REPORT Analysis of the TRIGA Reactor Pool Water L OCT 1 93 John Dickson Robert...COVER~ED I August 1993 Technical Report 4 TITLE AND SUBTITLE S.FNDN NUMBERS Analysis of the TRIGA Reactor Pool Water PE: NWED QAXM 6, AUTHOR(S) Dickson...AVAILABIIY STATEMENT 1 2b. DISTRIBUTION CODE Approved for public release; distribution unlimited. 13. ABSTRACT tMaxtm -um 200 words ) 14. SUBJECTTERMS 1S

  11. Air Force Maintenance Technician Performance Measurement.

    DTIC Science & Technology

    1979-12-28

    tests utility. An alternative to eith -er usin: exis :n -r or soliciting manager oninions as to aceea-ili_ to develoo critericn-referenced test...34 Educational ind Psycholozica 1 :,’easuremeni, 1950, 10, 159-186. Callanier, Bruce. "Hikes: 1 out of 3 ’ takes r-." ir Fr. Times , July 2, 1o7-, p.4...R G A N I Z A T IO N N A M E A N D A D R S A R E A P HO R U I T N U M B E R AFIT STUDENT AT: Arizona State Univ II. CONTROLLING OFFICE NAME AND

  12. Molecular characterization of adenovirus circulating in Central and South America during the 2006–2008 period

    PubMed Central

    García, Josefina; Sovero, Merly; Laguna‐Torres, Victor Alberto; Gomez, Jorge; Chicaiza, Wilson; Barrantes, Melvin; Sanchez, Felix; Jimenez, Mirna; Comach, Guillermo; De Rivera, Ivette L.; Agudo, Roberto; Arango, Ana E.; Barboza, Alma; Aguayo, Nicolas; Kochel, Tadeusz J.

    2009-01-01

    Background  Human Adenoviruses are recognized pathogens, causing a broad spectrum of diseases. Serotype identification is critical for epidemiological surveillance, detection of new strains and understanding of HAdvs pathogenesis. Little data is available about HAdvs subtypes in Latin America. Methods  In this study, we have molecularly characterized 213 adenoviruses collected from ILI presenting patients, during 2006‐08, in Central and South America. Results  Our results indicate that 161(76%) adenoviruses belong to subgroup C, 45 (21%) to subgroup B and 7 (3%) to subtype E4. PMID:19903214

  13. Lighting and Astronomy

    DTIC Science & Technology

    2009-12-01

    ago. Bright light is becoming a form of advertising. Figure 1. The sky over Mauna Kea , Hawaii, is affected by outdoor lighting in communit ies from...8217 chris Luginbuhl is an astronomer at the US Naval observatory Flagstaff station in Arizona. connie walker is an associate scientist and education...specialist " tf," N"iio".iOpalut-nraronomy Observatory in Arizona and director of both the lnternational Year of Astrono.my , ;il;;;;i; n*ui"n"rt

  14. Studies of Altered Response to Infection Induced by Severe Injury

    DTIC Science & Technology

    1989-02-01

    this elevated TNF occurs concomitant to an elevation in MO PGE . Prophylacti treatment with IL-4 was shown to downregulate both TNF and PGE2 while...treatment with indometh acin decreased PGE2 but caused increased TNF release. Our data indicated that post-trauma increases in the number of Mo expressing...the 72KD receptor for IgG(FcRI) is correlated to the immunosuppressed patients’ Mo increased production of IL-6, TNF, and decreased IL-I productioI

  15. Safety and Efficacy of Isolated Limb Infusion Chemotherapy for Advanced Locoregional Melanoma in Elderly Patients: An Australian Multicenter Study.

    PubMed

    Kroon, Hidde M; Coventry, Brendon J; Giles, Mitchell H; Henderson, Michael A; Speakman, David; Wall, Mark; Barbour, Andrew; Serpell, Jonathan; Paddle, Paul; Smithers, Bernard M; Thompson, John F

    2017-08-10

    Isolated limb infusion (ILI) offers a minimally invasive treatment option for locally advanced extremity melanoma. The aim of the current study was to evaluate the safety and efficacy of ILI in elderly patients in an Australian multicenter setting. The results of 316 first ILI procedures, performed between 1992 and 2008 in five Australian institutions, were identified and analyzed, with the main focus on elderly patients (≥75 years of age). All institutions used the same protocol: melphalan was circulated in the isolated limb for 20-30 min (±actinomycin D), and toxicity, responses, and survival were recorded. Characteristics of patients aged ≥75 years (n = 148) were similar to those aged <75 years (n = 168), except that older patients had more melanoma deposits (median 4 vs. 5; p = 0.035) and lower limb volumes (5.4 vs. 6.5 L; p = 0.001). Median drug circulation times were lower in the older group (21 vs. 24 min; p = 0.04), and older patients experienced less limb toxicity (grade III/IV in 22 and 37% of patients, respectively; p = 0.003). A complete response (CR) was seen in 27% of patients aged ≥75 years and in 38% of patients aged <75 years (p = 0.06), while overall response rates were 72 and 77%, respectively (p = 0.30). No difference in survival was seen (p = 0.69). The ILI technique proved safe and effective in elderly patients. When present, toxicity was localized, and lower compared with younger patients, possibly due to shorter drug circulation times. CR rates were higher in younger patients, although not significantly, while overall response and survival were equal. Optimization of perioperative factors in elderly patients may allow response rates to be raised further, while maintaining low toxicity.

  16. Protocol for a randomised controlled trial examining the impact of a web-based personally controlled health management system on the uptake of influenza vaccination rates.

    PubMed

    Lau, Annie Y S; Sintchenko, Vitali; Crimmins, Jacinta; Magrabi, Farah; Gallego, Blanca; Coiera, Enrico

    2012-04-02

    Online social networking and personally controlled health management systems (PCHMS) offer a new opportunity for developing innovative interventions to prevent diseases of public health concern (e.g., influenza) but there are few comparative studies about patterns of use and impact of these systems. A 2010 CONSORT-compliant randomised controlled trial with a two-group parallel design will assess the efficacy of a web-based PCHMS called Healthy.me in facilitating the uptake of influenza vaccine amongst university students and staff. Eligible participants are randomised either to obtain access to Healthy.me or a 6-month waitlist. Participants complete pre-study, post-study and monthly surveys about their health and utilisation of health services. A post-study clinical audit will be conducted to validate self-reports about influenza vaccination and visits to the university health service due to influenza-like illness (ILI) amongst a subset of participants. 600 participants older than 18 years with monthly access to the Internet and email will be recruited. Participants who (i) discontinue the online registration process; (ii) report obtaining an influenza vaccination in 2010 before the commencement of the study; or (iii) report being influenced by other participants to undertake influenza vaccination will be excluded from analysis. The primary outcome measure is the number of participants obtaining influenza vaccination during the study. Secondary outcome measures include: number of participants (i) experiencing ILI symptoms, (ii) absent from or experiencing impairment in work or study due to ILI symptoms, (iii) using health services or medications due to ILI symptoms; (iv) expressing positive or negative attitudes or experiences towards influenza vaccination, via their reasons of receiving (or not receiving) influenza vaccine; and (v) their patterns of usage of Healthy.me (e.g., frequency and timing of hits, duration of access, uptake of specific functions). This

  17. Understanding the Soviet Threat: The Necessity of Analyzing Soviet Military Thought and Actions from a Soviet Perspective.

    DTIC Science & Technology

    1987-12-01

    UNCL SSIFIEDD F / /6 L smmomhhmmohmlm i lflfflfllflfflfllflf 0 Xmin IlI"- ti , )0 368 111111.1- 11. MICROCOPY RESOLUTION TEST CHARI - A ,)RIlib -;A~r...to discriminate friends from enemies is a sign of intellectual maturity. . . some qualities of American mentality look like signs of emotional and...1516 ML mhhmohmohmhI S S 0 S 11111 1.0 ~’~J""~ liii.- IML IIIII~ LI~ I" 111111.1 ~ SIII" 11111 1.411111 S MICROCOPY RESOLUTION TEST CHART ’)R~AU

  18. Meat Entree Operation Guides Developed for Use in Fort Lee Interim Central Food Preparation Facility

    DTIC Science & Technology

    1978-11-01

    sauce H ot sauce , tabasco C ol-Flo 67, starch V inegar 11.40 (1 bag...5 0 37.50 60.00. K ettle N 2 · · sauce O nion, dehyd, slic e d 5290 0 .5 0 .. 1 .5 0 2 .5 0 4.00 C h ili pow der 14480. 0 .1 4...30.1+0 W orcestershire sauce . 160~0 0.26 0.78 1..30 2.08. P ot & ’W trlp H ot ~ u c g7 T abasgg l ~ 0 8:g8- ~:8~- ~:dB ~=~ • col-

  19. Induction of TNF-A and IL-1 in Human Tuberculosis (CIC3)

    DTIC Science & Technology

    1992-01-27

    AD-A259 308 MIPR NO: 90MM0581 TITLE: INDUCTION OF TNF-A AND IL-1 IN HUMAN TUBERCULOSIS (CIC3) PRINCIPAL INVESTIGATOk: Greg T. Anders CONTRACTING...DATES COVERED 1 27 January 19921 Final Report 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Induction of TNF-A and IL-i in Human Tuberculosis MIPR No. (CIC3...SU•4ECT TERMS IS. NUMBER OF PAGES Interleukin-1; Tumor; Tuberculosis ; RAII; Volunteers 16. PRICE COO( 17. SECURITY CLASSIFICATION I$. SECURITY

  20. Dredging Operations Technical Support Program: Engineering Design and Environmental Assessment of Dredged Material Overflow from Hydraulically Filled Hopper Barges in Mobile Bay, Alabama

    DTIC Science & Technology

    1990-09-01

    26 0370. APO LIGHT* OVERFWLOW3025 3- DEGNRT 03.2H 01- FIX*4 AUTOUT 0 FI SAMPLER SOLR .TH4* 0. AUTO - FIX 5rP 34 o 0 +Y v So0 04.21 NOTENTET SCEETSML...04 00 %c D LIr W) M0 C D 4 % D a’’.OH- C- 0Cl Cc’ LO J N 0 4c.a% 44 -4 00a *r4 a 100 11 W’ ILI a’ a’ aW 11 cc N1 z 4 4W r 4rI PIrlrt 41 00 00 0 00 cu

  1. Acousto-Optic Beam Steering Study

    DTIC Science & Technology

    1994-08-01

    8217111 INK $ 1 1 illl iII Ill i, R L-TR-94-121 !1!1Il t 11I1!I!11! ilI, / Final Technical Report August 1994 ACOUSTO - OPTIC BEAM STEERING STUDY Harris...contractual obligations or notices on a specific document require that it be returned. For i ..........I ,, ACOUSTO - OPTIC BEAM STEERING STUDY H. W...4. TITLE AND SUBTITLE 5. FUNDING NUMBERS ACOUSTO - OPTIC BEAM STEERING STUDY C - F30602-91-C-0131 PE - 63215C 6. AUTHOR(S) PR - 1405 TA - 02 H. W

  2. Acquisition, Design Modification, Assembly, and Ground Test of NPS hummingbird Remotely Piloted Helicopter

    DTIC Science & Technology

    1993-09-01

    3019 cite I SIC-SO IC III Calt low0 Seltekbli I SIC-Wi It on cutI 35m1 ltti-il %uIt I "IC-0 I104IlI C1111= a-INt* * Crated A wommit of badh for...WILL REQUIRE RE-ADJUSTMENT OF CARBURETTOR NEEDLE JETS . 57 Fuel Consumption .................. Approx. 5.6 litrcs/hour e 5250 revimin Against propeller...SERVICING. MAKE SURE ALL SAFETY (91tARDS ARE REPLACED AND SECURED. 70 The initial carburettor "Hi" and "Lo" needle jets and the idle- stop screw are

  3. Summaries of Research 1984.

    DTIC Science & Technology

    1984-01-01

    FIBROSIS * ACTA PAEDIATAILA aCANDI14AVICA 1984 NOV;73616:712-7 INFECTIONS I)1EASES 3M463750808Ao.b2 REPORT NO.16 ANTIGENS. BACTEAIAL V CYSTIC FIBROSIS ...ANTI1BIOTICS BACTEROIDES FRAPi.I S BACTEROIDES MELANINJGENICUS eACTEROIDES MICE , AD A145 266 NMRI 84-0009 HENKENS RW 4ERRILL SP WILLIAIS TJ DYNAMIC...FeAt.ILIS GRLLjPS IN MIXED INFECTIJNS. INFECTION ANU) IrnIUNITY 1984 APR;4*(I):1e-5 INFECTIOUS O1.tASES NA. ANTIBIOTICS BACTERIAL INFECElLJNS BACTEROIDES

  4. The Changeable Interaction betweeen Soils and Pressure Cells; Tests and Reviews at the Waterways Experiment Station

    DTIC Science & Technology

    1976-06-01

    two silk bands . The diameter is 1.50 in., the total thickness only 0.06 in., and the thickness-diameter ratio is 1/24, or about the same as for the...b.tween tne coefficient of ear’.n pressuze at rest, K , and the Poisson ratio is K = Ili = (15,-A) 0 a) 1- V But the value of K for grenuilar materidls car ...diameter of 95 cm and a height of 62 cm, whereas the pressure cell had i36 0 TEWATERFILLD RUBER USH 0 ....... SAND FILL A. TRIAXIAL CALIBRATION E~QUIPMAENT

  5. Vaccine effectiveness in preventing laboratory-confirmed influenza in primary care patients in a season of co-circulation of influenza A(H1N1)pdm09, B and drifted A(H3N2), I-MOVE Multicentre Case-Control Study, Europe 2014/15.

    PubMed

    Valenciano, Marta; Kissling, Esther; Reuss, Annicka; Rizzo, Caterina; Gherasim, Alin; Horváth, Judit Krisztina; Domegan, Lisa; Pitigoi, Daniela; Machado, Ausenda; Paradowska-Stankiewicz, Iwona Anna; Bella, Antonino; Larrauri, Amparo; Ferenczi, Annamária; Lazar, Mihaela; Pechirra, Pedro; Korczyńska, Monika Roberta; Pozo, Francisco; Moren, Alain

    2016-01-01

    Influenza A(H3N2), A(H1N1)pdm09 and B viruses co-circulated in Europe in 2014/15. We undertook a multicentre case-control study in eight European countries to measure 2014/15 influenza vaccine effectiveness (VE) against medically-attended influenza-like illness (ILI) laboratory-confirmed as influenza. General practitioners swabbed all or a systematic sample of ILI patients. We compared the odds of vaccination of ILI influenza positive patients to negative patients. We calculated adjusted VE by influenza type/subtype, and age group. Among 6,579 ILI patients included, 1,828 were A(H3N2), 539 A(H1N1)pdm09 and 1,038 B. VE against A(H3N2) was 14.4% (95% confidence interval (CI): -6.3 to 31.0) overall, 20.7% (95%CI: -22.3 to 48.5), 10.9% (95%CI -30.8 to 39.3) and 15.8% (95% CI: -20.2 to 41.0) among those aged 0-14, 15-59 and  ≥60  years, respectively. VE against A(H1N1)pdm09 was 54.2% (95%CI: 31.2 to 69.6) overall, 73.1% (95%CI: 39.6 to 88.1), 59.7% (95%CI: 10.9 to 81.8), and 22.4% (95%CI: -44.4 to 58.4) among those aged 0-14, 15-59 and  ≥60 years respectively. VE against B was 48.0% (95%CI: 28.9 to 61.9) overall, 62.1% (95%CI: 14.9 to 83.1), 41.4% (95%CI: 6.2 to 63.4) and 50.4% (95%CI: 14.6 to 71.2) among those aged 0-14, 15-59 and ≥60 years respectively. VE against A(H1N1)pdm09 and B was moderate. The low VE against A(H3N2) is consistent with the reported mismatch between circulating and vaccine strains.

  6. Inorganic Halogen Oxidizers.

    DTIC Science & Technology

    1984-02-22

    this series of compounds is needed to verify this effect. The F NMR spectra of these salts were recorded in an- hydrous HF solutions at 29 °C. In...The yield of only 55% for CIF6BF4 can be attributed to the following factors: (i) hang-up of some mother liquor on »he filter cake; (ii) possibly...basis of NF4HF:. With most of ’me Ni4Ili2 * allies losi being due lo hang up of some mother liquor on the CsSbF6 filter cake during the metathc teal

  7. Analysis of Thermal Imagery Collected at Yuma I, Yuma, Arizona

    DTIC Science & Technology

    1994-08-01

    ee .~c * cc cc c a t r i C...l n t 1 1 1 n - t i n 1z - z A. a n li in t ,1 n -l ......... .... AD.. 333333 as3 E Ban E2 Apend E IageMeft -Oiuaf0 .. .n...ili ---- - - Ila 10 si V 0 4 .: a ,..*a43 217 a- a a a. .. .A G18 Apend G Iage etris-Oloal -. 00 Wj. 331s 0.000.08 883.8833333.388 1i nI q-f 13 :1f

  8. Heatstroke Pathophysiology: The Energy Depletion Model

    DTIC Science & Technology

    1989-06-12

    have reduced metabolic efficiency as a function of work capacity. Physostigmine, a reversible cholinesterase inhibitor (90), causes acetylcholine to...likely explanation (19) for the net loss of K+ from working muscle and the hyperkalemia seen during exercise (83). Sejersted (77) has made an important...ai iI I I~li I II=I=OImIi 38. 0U 0) cm =q ~ i 4-g aC 4 00v +1 == 0-u +1 -+1 Cc E a 04.!00C LnUEa .s L c Cc Lo E -co ai +1 +1o2 0 E 1E CL 39 Figure 1

  9. Basic Processes of Plasma Propulsion.

    DTIC Science & Technology

    1987-08-01

    s T*S IFI /G i’ u A "m = - ILI l ~2 U0k.. ’~la BASIC PROCESSES OF PLASMA PROPULSION Herbert 0. Schrade Institut fir Raumfahrtsysteme Universitat...discharge channel with respect to a small disturbance. IZ4 q, , L No cl W) 03Cii >i 04 -9- Depending on the amouunt of e given in eqs. (la) and (Ib) and...available at the University of Stuttgart about a year ago. H. 0. Schrade, M. Auweter-Kurtz and H. L . Kurtz, "Basic Processes of Plasma Propulsion

  10. Powered Wheels in the Turned Mode Operating on Yielding Soils

    DTIC Science & Technology

    1976-09-01

    after Schuring , 1966) ... ........ 6 2.2. Conditions of a Wheel on Yielding Soil ..... ........... 7 2.3. Development of Trail Moment SF.C from An...forces and moments applied to the axle and at the interface area. Figure 2.1 (after Schuring , 1966) illustrates the possible combination of torque and...Horizontal Axle Pull P of a Free-Bodied Wheel (after Schuring , 1966). il ll l !ili l I m I U I 1 I II li i~ l6I TORQUE M o PULL P NEGA TI VE SLIP POS1TI

  11. Immunosuppressive effects of multipotent mesenchymal stromal cells on graft-versus-host disease in rats following allogeneic bone marrow transplantation.

    PubMed

    Nevruz, Oral; Avcu, Ferit; Ural, A Uğur; Pekel, Aysel; Dirican, Bahar; Safalı, Mükerrem; Akdağ, Elvin; Beyzadeoğlu, Murat; Ide, Tayfun; Sengül, Ali

    2013-09-01

    Amaç: Graft versus host hastalığı (GVHH) , başarılı bir kemik iliği nakli için önemli bir engel oluşturmaktadır. Multipotent mezenşimal stromal hücrelerin (MSH) immünsupresif etkileri, in vivo ve in vitro olarak gösterilmiş olmakla birlikte, GVHH’ nı önleme yönünde klinik uygulamalarda bulunmaktadır . Gereç ve Yöntemler: Bu çalışmanın amacı ratlarda kemik iliği nakli sonrası oluşturulan GVHH’nı önleme ve tedavi etmede MSH nin etkinliğinin incelenmesidir. Bu amaçla 49 Sprague Dawley cinsi rat rastegele 4 çalışma, 3 kontrol grubuna ayrılmış ve gruplara MSH de içeren farklı GVHH önleyici tedaviler uygulanmıştır. Kemik iliği nakli sonrası GVHH skorlaması ve yaşama süreleri incelenmiştir. Bulgular: Tüm ışınlanmış ve önleyici tedavi verilmemiş ratlar ölmüştür. MSH nin önleyici uygulamaları, standart GVHD önleyici tedavileri kadar etkin bulunmuştur. MSH uygulamaları, GVHH nın gözlemsel ve histolojik bulgularını ve CD4+/CD8+ oranını azaltmaktadır.Ayrıca MSH uygulanan gruplarda CD25+ T hücrelerinin in vivo oranıda daha yüksek olup, Allojeneik kemik iliği nakli sonrası standart GVHH tedavisi uygulananlara göre plazma İnterlökin-2 seviyesinin daha yüksek olarak saptanmıştır. Sonuç: Bulgularımız MSH uygulamasının, GVHH nın hem önlenme hem de tedavi edilmesinde etkin olduğunu göstermiştir. Ancak bu bulguların geniş ölçekli çalışmalarla desteklenmesi gerekmektedir.

  12. The Role of the U.S. Army Forces Command in Project New Arrivals. Reception and Care of Refugees from Vietnam,

    DTIC Science & Technology

    1981-09-01

    form of a sudden major increase in the price of oil which caused a heavy drawdown in those funds available for the purchase of necessary hardware. ŕ...LIFE, pp. 1-6 -1-8. 26 CHART I p’-., ’. ftf -I3 oiL Iln C,, ’"’’’’ 3 ii U ili ,.~~L C.2illl i * -p4 i / .27 °0c CDC* VIABLE b OPERATION NEW LIFE US...Clothing, Equipment, U.S. Amy Housekeeping, etc. III Petroleum, Oils , and JCS Lubricants IV Construction Materials U.S. Army -- except for U.S. Navy work

  13. Data Analysis in Vocational/Technical (VOTEC) Manpower and Personnel Studies

    DTIC Science & Technology

    1993-03-24

    Skewness -. 668 5 x Sk*• .637 R-1- 3.000 Mininwa 3.000 Maxi- 6.000 sun S6.000 Valid cases 12 Missing cases 0 • III 10 valid C Value Label Value Fraquency...Ill 15 . 222 ) .2081 .2502 .2912 .6083 IlI 16 .2141 .2649 .2895 .2852 .44ce Ill 17 .1285 .2741 .2141 .2463 .5925 U 1.I 18 .2474 .2885 .31698 .3720 .4469...Diff CI for Diff Equal -. 27 81 .784 .295 (-. 668 , .506)1 Unequal -. 33 17.81 .746 .246 (-.598, .436) Variazle of Canes Mean So SE of Mean 111i20 CONTROL

  14. Dermal Sensitization Potential of DIGL-RP Solid Propellant in Guinea Pigs

    DTIC Science & Technology

    1989-10-01

    y ’,c. ADM$$ S (ft, SWOt , &Wd ZIP Cod 7b. ADDRESS (City, State, arid ZIP Code) Letterman Army Institute of Research Fort Detrick Presidio of San...The opinions or assertions contained herein -are the private views of the author( s ) and are not to be construed as official or as reflecting the...AVAILARlII Ily Of RFPORT 01. DELFICATION IOOWNGRAOINSHELEI’IVM oI li.IIIII:A.; DISTRJ13LITION I:;IN.IM 4. PERFORMING ORGANIZATION REMR NUMBER( S ) S

  15. Epidemiology of influenza B/Yamagata and B/Victoria lineages in South Africa, 2005-2014

    PubMed Central

    Treurnicht, Florette K.; Tempia, Stefano; Hellferscee, Orienka; Mtshali, Senzo; Cohen, Adam L.; Buys, Amelia; McAnerney, Johanna M.; Besselaar, Terry G.; Pretorius, Marthi; von Gottberg, Anne; Walaza, Sibongile; Cohen, Cheryl; Madhi, Shabir A.; Venter, Marietjie

    2017-01-01

    Background Studies describing the epidemiology of influenza B lineages in South Africa are lacking. Methods We conducted a prospective study to describe the circulation of influenza B/Victoria and B/Yamagata lineages among patients of all ages enrolled in South Africa through three respiratory illness surveillance systems between 2005 and 2014: (i) the Viral Watch (VW) program enrolled outpatients with influenza-like illness (ILI) from private healthcare facilities during 2005–2014; (ii) the influenza-like illnesses program enrolled outpatients in public healthcare clinics (ILI/PHC) during 2012–2014; and (iii) the severe acute respiratory illnesses (SARI) program enrolled inpatients from public hospitals during 2009–2014. Influenza B viruses were detected by virus isolation during 2005 to 2009 and by real-time reverse transcription polymerase chain reaction from 2009–2014. Clinical and epidemiological characteristics of patients hospitalized with SARI and infected with different influenza B lineages were also compared using unconditional logistic regression. Results Influenza viruses were detected in 22% (8,706/39,804) of specimens from patients with ILI or SARI during 2005–2014, of which 24% (2,087) were positive for influenza B. Influenza B viruses predominated in all three surveillance systems in 2010. B/Victoria predominated prior to 2011 (except 2008) whereas B/Yamagata predominated thereafter (except 2012). B lineages co-circulated in all seasons, except in 2013 and 2014 for SARI and ILI/PHC surveillance. Among influenza B-positive SARI cases, the detection of influenza B/Yamagata compared to influenza B/Victoria was significantly higher in individuals aged 45–64 years (adjusted odds ratio [aOR]: 4.2; 95% confidence interval [CI]: 1.1–16.5) and ≥65 years (aOR: 12.2; 95% CI: 2.3–64.4) compared to children aged 0–4 years, but was significantly lower in HIV-infected patients (aOR: 0.4; 95% CI: 0.2–0.9). Conclusion B lineages co

  16. The Role of IL-17 in the Angiogenesis of Rheumatoid Arthritis

    DTIC Science & Technology

    2012-07-01

    3710 –9. 38. Lee JH, Cho ML , Kim JI, Moon YM, Oh HJ, Kim GT, et al. Interleukin 17 (IL-17) increases the expression of Toll-like recep- tor-2, 4, and...from 8 patients (1 :20 dilution) were incubated with antibodies to IL-I7 (I 0 f!g/ ml ), VEGF (IO f!g/ ml ), or both as well as isotype control or...levels above Ad-control is greater for CXCLI (40 fold) compared to CXCL5 (10 fold) the absolute joint concentrations for CXCLI (I600 pg/ ml ) and CXCL5

  17. Hydrogen Evolution Rates for Mine Batteries and Selection of a Hydrogen Getter; Information on

    DTIC Science & Technology

    1979-02-01

    Mk 113 Mod 0 F96, 15 25 Mk 112 Mod 0 F, 8 9 Mk 109 Mod 0 F, 6 8 Hk 111 Mod 0 F, 4 7 Mk 110 Mod 0 F, 4 7 1k 117 Mod 0 3-AH, 18 6 N1k 119 Mod 1 R-4R, 12...Department Approved by: i -. Technic ir o INAVMI NEIIGRFAC 6 _J , ik LI1 FIGURE ~’" I’$ _.TUETDCOTIE K2 Cuivc~fltratiof of Ily.Tco~en (1 . E.L.) co0 0 0 0

  18. Investigation of Heat Transfer to a Flat Plate in a Shock Tube.

    DTIC Science & Technology

    1987-12-01

    as the driven gas whose properties are identified by region 1. The gases of both regions initially have no velocity. When the diaphragm is ruptured... inSe CIc E m ’! i M oV I’)c Ci *C’ C4 P1 *s2ijns o L~EOL191 E L 0 J ILi cu cu ESC. an CI: c.I- S 9 5K * 0 C~ * 6. c i CDT 5~4 I ’- LLJ I: U _ T I 0uC

  19. Journal of the United States Artillery. Volume 56, Number 1, January 1922

    DTIC Science & Technology

    1922-01-01

    more acti\\’e interest bott in the Regular Army and the National Guard. THE POIXT OF VIE\\\\’ Before proceeding further let me clear the deck, so to speak...PRrNTING PLANT, COAST ART:IliL:mY ScHom. 1922 ~ ll-16-22-1000. USAADS Library N\\"U:Fort Bliss, Texas 7’:1ŗ»1 Report Documentation Page Form ApprovedOMB...34Dick Bill," the seaboard states took very little interest in coast defense prob- lems for some time. However, in 1906 a beginni~ was made and a few of

  20. Influenza vaccine effectiveness among adult patients in a University of Lyon hospital (2004-2009).

    PubMed

    Amour, Sélilah; Voirin, Nicolas; Regis, Corinne; Bouscambert-Duchamp, Maude; Comte, Brigitte; Coppéré, Brigitte; Pires-Cronenberger, Silene; Lina, Bruno; Vanhems, Philippe

    2012-01-20

    The aim of this study was to estimate influenza vaccine effectiveness (IVE) against laboratory-confirmed influenza among hospitalized patients. A case-control investigation was based on the prospective surveillance of influenza-like illness (ILI) during five flu seasons. We compared influenza-positive cases and influenza-negative controls. Unadjusted overall IVE was 62% (95% confidence interval 24% to 81%). We found that IVE was lower during the 2004-05 flu season (11%; 95% CI -232% to 76%) when the vaccine and circulating viruses were mismatched. Expansion of the study to other hospitals could provide IVE estimates earlier in the season, for different age groups and emerging virus strains.