Clinical trial allocation in multinational pharmaceutical companies - a qualitative study on influential factors.

PubMed

Dombernowsky, Tilde; Haedersdal, Merete; Lassen, Ulrik; Thomsen, Simon F

2017-06-01

Clinical trial allocation in multinational pharmaceutical companies includes country selection and site selection. With emphasis on site selection, the overall aim of this study was to examine which factors pharmaceutical companies value most when allocating clinical trials. The specific aims were (1) to identify key decision makers during country and site selection, respectively, (2) to evaluate by which parameters subsidiaries are primarily assessed by headquarters with regard to conducting clinical trials, and (3) to evaluate which site-related qualities companies value most when selecting trial sites. Eleven semistructured interviews were conducted among employees engaged in trial allocation at 11 pharmaceutical companies. The interviews were analyzed by deductive content analysis, which included coding of data to a categorization matrix containing categories of site-related qualities. The results suggest that headquarters and regional departments are key decision makers during country selection, whereas subsidiaries decide on site selection. Study participants argued that headquarters primarily value timely patient recruitment and quality of data when assessing subsidiaries. The site-related qualities most commonly emphasized during interviews were study population availability, timely patient recruitment, resources at the site, and site personnel's interest and commitment. Costs of running the trials were described as less important. Site personnel experience in conducting trials was described as valuable but not imperative. In conclusion, multinational pharmaceutical companies consider recruitment-related factors as crucial when allocating clinical trials. Quality of data and site personnel's interest and commitment are also essential, whereas costs seem less important. While valued, site personnel experience in conducting clinical trials is not imperative.

Reconciling PM10 analyses by different sampling methods for Iron King Mine tailings dust.

PubMed

Li, Xu; Félix, Omar I; Gonzales, Patricia; Sáez, Avelino Eduardo; Ela, Wendell P

2016-03-01

The overall project objective at the Iron King Mine Superfund site is to determine the level and potential risk associated with heavy metal exposure of the proximate population emanating from the site's tailings pile. To provide sufficient size-fractioned dust for multi-discipline research studies, a dust generator was built and is now being used to generate size-fractioned dust samples for toxicity investigations using in vitro cell culture and animal exposure experiments as well as studies on geochemical characterization and bioassay solubilization with simulated lung and gastric fluid extractants. The objective of this study is to provide a robust method for source identification by comparing the tailing sample produced by dust generator and that collected by MOUDI sampler. As and Pb concentrations of the PM10 fraction in the MOUDI sample were much lower than in tailing samples produced by the dust generator, indicating a dilution of Iron King tailing dust by dust from other sources. For source apportionment purposes, single element concentration method was used based on the assumption that the PM10 fraction comes from a background source plus the Iron King tailing source. The method's conclusion that nearly all arsenic and lead in the PM10 dust fraction originated from the tailings substantiates our previous Pb and Sr isotope study conclusion. As and Pb showed a similar mass fraction from Iron King for all sites suggesting that As and Pb have the same major emission source. Further validation of this simple source apportionment method is needed based on other elements and sites.

Analysis of laparoscopic port site complications: A descriptive study

PubMed Central

Karthik, Somu; Augustine, Alfred Joseph; Shibumon, Mundunadackal Madhavan; Pai, Manohar Varadaraya

2013-01-01

CONTEXT: The rate of port site complications following conventional laparoscopic surgery is about 21 per 100,000 cases. It has shown a proportional rise with increase in the size of the port site incision and trocar. Although rare, complications that occur at the port site include infection, bleeding, and port site hernia. AIMS: To determine the morbidity associated with ports at the site of their insertion in laparoscopic surgery and to identify risk factors for complications. SETTINGS AND DESIGN: Prospective descriptive study. MATERIALS AND METHODS: In the present descriptive study, a total of 570 patients who underwent laparoscopic surgeries for various ailments between August 2009 and July 2011 at our institute were observed for port site complications prospectively and the complications were reviewed. STATISTICAL ANALYSIS USED: Descriptive statistical analysis was carried out in the present study. The statistical software, namely, SPSS 15.0 was used for the analysis of the data. RESULTS: Of the 570 patients undergoing laparoscopic surgery, 17 (3%) had developed complications specifically related to the port site during a minimum follow-up of three months; port site infection (PSI) was the most frequent (n = 10, 1.8%), followed by port site bleeding (n = 4, 0.7%), omentum-related complications (n = 2; 0.35%), and port site metastasis (n = 1, 0.175%). CONCLUSIONS: Laparoscopic surgeries are associated with minimal port site complications. Complications are related to the increased number of ports. Umbilical port involvement is the commonest. Most complications are manageable with minimal morbidity, and can be further minimized with meticulous surgical technique during entry and exit. PMID:23741110

Timing of nest vegetation measurement may obscure adaptive significance of nest-site characteristics: A simulation study.

PubMed

McConnell, Mark D; Monroe, Adrian P; Burger, Loren Wes; Martin, James A

2017-02-01

Advances in understanding avian nesting ecology are hindered by a prevalent lack of agreement between nest-site characteristics and fitness metrics such as nest success. We posit this is a result of inconsistent and improper timing of nest-site vegetation measurements. Therefore, we evaluated how the timing of nest vegetation measurement influences the estimated effects of vegetation structure on nest survival. We simulated phenological changes in nest-site vegetation growth over a typical nesting season and modeled how the timing of measuring that vegetation, relative to nest fate, creates bias in conclusions regarding its influence on nest survival. We modeled the bias associated with four methods of measuring nest-site vegetation: Method 1-measuring at nest initiation, Method 2-measuring at nest termination regardless of fate, Method 3-measuring at nest termination for successful nests and at estimated completion for unsuccessful nests, and Method 4-measuring at nest termination regardless of fate while also accounting for initiation date. We quantified and compared bias for each method for varying simulated effects, ranked models for each method using AIC, and calculated the proportion of simulations in which each model (measurement method) was selected as the best model. Our results indicate that the risk of drawing an erroneous or spurious conclusion was present in all methods but greater with Method 2 which is the most common method reported in the literature. Methods 1 and 3 were similarly less biased. Method 4 provided no additional value as bias was similar to Method 2 for all scenarios. While Method 1 is seldom practical to collect in the field, Method 3 is logistically practical and minimizes inherent bias. Implementation of Method 3 will facilitate estimating the effect of nest-site vegetation on survival, in the least biased way, and allow reliable conclusions to be drawn.

Third Culture Kids: Transition and Persistence When Repatriating to Attend University

ERIC Educational Resources Information Center

Jennison Smith, Virginia M

2011-01-01

Scope and Method of Study. This qualitative study used heuristic phenomenology and involved 20 interviews at 3 different sites, 2 focus groups, formal and informal observations, and the analysis of various artifacts including photos, drawings, and documents. Findings and Conclusions. Third culture kids are a diverse group of individuals who spent…

Evolution of the Florida Launch Site Architecture: Embracing Multiple Customers, Enhancing Launch Opportunities

NASA Technical Reports Server (NTRS)

Colloredo, Scott; Gray, James A.

2011-01-01

The impending conclusion of the Space Shuttle Program and the Constellation Program cancellation unveiled in the FY2011 President's budget created a large void for human spaceflight capability and specifically launch activity from the Florida launch Site (FlS). This void created an opportunity to re-architect the launch site to be more accommodating to the future NASA heavy lift and commercial space industry. The goal is to evolve the heritage capabilities into a more affordable and flexible launch complex. This case study will discuss the FlS architecture evolution from the trade studies to select primary launch site locations for future customers, to improving infrastructure; promoting environmental remediation/compliance; improving offline processing, manufacturing, & recovery; developing range interface and control services with the US Air Force, and developing modernization efforts for the launch Pad, Vehicle Assembly Building, Mobile launcher, and supporting infrastructure. The architecture studies will steer how to best invest limited modernization funding from initiatives like the 21 st elSe and other potential funding.

Subepidermal moisture surrounding pressure ulcers in persons with a spinal cord injury: A pilot study

PubMed Central

Harrow, Jeffrey John; Mayrovitz, Harvey N.

2014-01-01

Objective Characterization of a non-invasive method of quantifying subepidermal moisture (SEM) surrounding stages III and IV pressure ulcers (PrUs) in spinal cord injury (SCI). Design Prospective, single-visit, single-rater, observational study, using repeated-measures analysis. Method Setting-inpatient units of one VA SCI Center. Participants Convenience sample of 16 subjects with SCI with stage III or IV PrUs over sacrum or ischium. Interventions Measurement with the MoistureMeter-D, a hand-held device using 300 MHz electromagnetic waves. Outcome measures Dielectric constant, a dimensionless number which increases with the moisture content. Each subject had a PrU site and a control site. Measurements were made at each site, on intact skin, at four points spaced angularly around the site, in triplicate. Results (1) Short-term, single-rater relative error was 2.5%. (2) Order effect: first readings were higher than second readings in 55 of 64 measurement sets. Order effect was significant for control sites (P < 0.0001) but not for PrU sites. (3) Angular effect: SEM varied by angle at the PrU sites (P < 0.01); 12 o'clock position the highest and 6 o'clock the lowest. (4) Ability to differentiate PrUs from intact skin: SEM at PrU sites was greater by 9.0% than control sites (P < 0.05). (5) Site effect: SEM was higher at sacral locations than ischial at control sites by 20% (P < 0.005). Conclusions SEM differentiates PrUs from intact skin. Future study designs must take into account order, angular, and site effects on this measure. This information will inform designers of future studies of SEM in healing of PrUs. PMID:25398030

Epidemiologic analysis of prevalence of the hyperhidrosis*

PubMed Central

Estevan, Fernanda Alvarenga; Wolosker, Marina Borri; Wolosker, Nelson; Puech-Leão, Pedro

2017-01-01

Background The present paper aims to study the prevalence of the various manifestations of hyperhidrosis in patients who sought treatment in a specialized ambulatory in the state of São Paulo. Objectives Opposite to previous studies, this paper studies the different combinations of sweating sites, not being restricted to the main complaint site of the patients, but taking into consideration secondary complaints patients may present. Methods This was a retrospective approach of a database containing more than 1200 patients in which were mapped: combination of sweating sites, age of onset, age spectrum, mean age, body mass index and gender of patients. Patients were categorized into four groups based on their main sweating site - palmar, plantar, axillary and facial. Results We concluded that hyperhidrosis appears frequently in more than one site, being the main complaint that affects the most patients palmar hyperhidrosis, which appears early in the patients during adolescence. When there are two sites of sweating, the most frequent combination is palmar + plantar, and when there are three sites of sweating the most frequent combinations are palmar + plantar + axillary and axillary + palmar + plantar. Study limitations This research has casuistics limited to a single care service for patients with hyperhidrosis. Conclusion It is necessary to keep in mind that the disease manifests itself mainly in more than one location, with different intensities in each of the patients, generating a significant impairment of their quality of life. PMID:29166497

Comprehensive profiling of retroviral integration sites using target enrichment methods from historical koala samples without an assembled reference genome

PubMed Central

Alquezar-Planas, David E.; Ishida, Yasuko; Courtiol, Alexandre; Timms, Peter; Johnson, Rebecca N.; Lenz, Dorina; Helgen, Kristofer M.; Roca, Alfred L.; Hartman, Stefanie

2016-01-01

Background. Retroviral integration into the host germline results in permanent viral colonization of vertebrate genomes. The koala retrovirus (KoRV) is currently invading the germline of the koala (Phascolarctos cinereus) and provides a unique opportunity for studying retroviral endogenization. Previous analysis of KoRV integration patterns in modern koalas demonstrate that they share integration sites primarily if they are related, indicating that the process is currently driven by vertical transmission rather than infection. However, due to methodological challenges, KoRV integrations have not been comprehensively characterized. Results. To overcome these challenges, we applied and compared three target enrichment techniques coupled with next generation sequencing (NGS) and a newly customized sequence-clustering based computational pipeline to determine the integration sites for 10 museum Queensland and New South Wales (NSW) koala samples collected between the 1870s and late 1980s. A secondary aim of this study sought to identify common integration sites across modern and historical specimens by comparing our dataset to previously published studies. Several million sequences were processed, and the KoRV integration sites in each koala were characterized. Conclusions. Although the three enrichment methods each exhibited bias in integration site retrieval, a combination of two methods, Primer Extension Capture and hybridization capture is recommended for future studies on historical samples. Moreover, identification of integration sites shows that the proportion of integration sites shared between any two koalas is quite small. PMID:27069793

Shift work and chronic disease: the epidemiological evidence

PubMed Central

Armstrong, M. E. G.; Cairns, B. J.; Key, T. J.; Travis, R. C.

2011-01-01

Background Shift work, including night work, has been hypothesized to increase the risk of chronic diseases, including cancer, cardiovascular disease (CVD), metabolic syndrome and diabetes. Recent reviews of evidence relating to these hypotheses have focussed on specific diseases or potential mechanisms, but no general summary of the current data on shift work and chronic disease has been published. Methods Systematic and critical reviews and recent original studies indexed in PubMed prior to 31 December 2009 were retrieved, aided by manual searches of reference lists. The main conclusions from reviews and principle results from recent studies are presented in text and tables. Results Published evidence is suggestive but not conclusive for an adverse association between night work and breast cancer but limited and inconsistent for cancers at other sites and all cancers combined. Findings on shift work, in relation to risks of CVD, metabolic syndrome and diabetes are also suggestive but not conclusive for an adverse relationship. Conclusions Heterogeneity of study exposures and outcomes and emphasis on positive but non-significant results make it difficult to draw general conclusions. Further data are needed for additional disease endpoints and study populations. PMID:21355031

Site selection feasibility for a solar energy system on the Fairbanks Federal Building

NASA Technical Reports Server (NTRS)

1978-01-01

A feasibility study was performed for the installation of a solar energy system on the Federal Building in Fairbanks, Alaska, a multifloor office building with an enclosed parking garge. The study consisted of determining the collectable solar energy at the Fairbanks site on a monthly basis and comparing this to the monthly building heating load. Potential conventional fuel savings were calculated on a monthly basis and the overall economics of the solar system applications were considered. Possible solar system design considerations, collector and other system installation details, interface of the solar system with the conventional HVAC systems, and possible control modes were all addressed. Conclusions, recommendations and study details are presented.

Leadership Strategies in Implementation of High-School Standards-Based Grading Systems

ERIC Educational Resources Information Center

Pritzl, Jerome

2016-01-01

This multi-site case study examined leadership strategies used during successful implementation of standards-based grading systems in three Wisconsin high schools. It found that leaders' reported commitment, patience, and persistence showed evidence of sustainable, high-functioning systems. It drew two main conclusions: first, school leaders need…

Easier operation and similar power of 10 g monofilament test for screening diabetic peripheral neuropathy.

PubMed

Zhang, Qi; Yi, Na; Liu, Siying; Zheng, Hangping; Qiao, Xiaona; Xiong, Qian; Liu, Xiaoxia; Zhang, Shuo; Wen, Jie; Ye, Hongying; Zhou, Linuo; Li, Yiming; Hu, Renming; Lu, Bin

2018-01-01

Objective The 10 g Semmes-Weinstein monofilament evaluation (SWME) of 4 sites on each foot is recommended for distal symmetric polyneuropathy screening and diagnosis. A similar method has been proposed to diagnose 'high-risk' (for ulceration) feet, using 3 sites per foot. This study compared the effectiveness of SWME for testing 3, 4 and 10 sites per foot to identify patients with diabetic neuropathy. Methods We included 3497 subjects in a SWME of 10 sites; records from the 10-site SWME were used for a SWME of 3 and 4 sites. Neuropathy symptom scores and neuropathy deficit scores were evaluated to identify patients with diabetic peripheral neuropathy. Results The sensitivities of the 10 g SWME for 3, 4 and 10 sites were 17.8%, 19.0% and 22.4%, respectively. The Kappa coefficients for the SWME tests of 3, 4 and 10 sites were high (range: 0.78-0.93). Conclusions There were no significant differences in the effectiveness of 3-, 4- and 10-site SWME testing for diabetic peripheral neuropathy screening. SWME testing of 3 sites on each foot may be sufficient to screen for diabetic neuropathy.

RNA Polymerase Collision versus DNA Structural Distortion: Twists and Turns Can Cause Break Failure

PubMed Central

Pannunzio, Nicholas R.; Lieber, Michael R.

2016-01-01

Summary The twisting of DNA due to the movement of RNA polymerases is the basis of numerous classic experiments in molecular biology. Recent mouse genetic models indicate that chromosomal breakage is common at sites of transcriptional turbulence. Two key studies on this point mapped breakpoints to sites of either convergent or divergent transcription, but arrived at different conclusions as to which is more detrimental and why. The issue turns on whether DNA strand separation is the basis for the chromosomal instability or collision of RNA polymerases? PMID:27153532

Deltoid Injections of Risperidone Long-acting Injectable in Patients with Schizophrenia

PubMed Central

Quiroz, Jorge A.; Rusch, Sarah; Thyssen, An; Kushner, Stuart

2011-01-01

Background Risperidone long-acting injectable was previously approved for treatment of schizophrenia as biweekly injections in the gluteal muscle only. We present data on local injection-site tolerability and safety of risperidone long-acting injectable and comparability of systemic exposure of deltoid versus gluteal injections. Methods Risperidone long-acting injectable was administered in an open-label, single-dose, two-way crossover study, with patients randomized to receive either 25mg gluteal/37.5mg deltoid crossover in two treatment periods or 50mg gluteal/50mg deltoid injections crossover; each treatment period was separated by an 85-day observation period (Study 1) and an open-label, multiple-dose study (4 sequential 37.5mg or 50mg deltoid injections every 2 weeks) (Study 2). The pharmacokinetic results from both the studies have already been published. Results In Study 1 (n=170), the majority of patients had no local injection-site findings, based on investigator and patient-rated evaluations. In Study 2 (n=53), seven of the 51 patients who received at least two deltoid injections discontinued (primary endpoint). However, none of the discontinuations were due to injection-site related reasons. The 90-percent upper confidence limit of the true proportion of injection-site issue withdrawals was 5.7 percent. No moderate or severe injection-site reactions were reported. Conclusion Intramuscular injections via the deltoid and gluteal sites are equivalent routes of administration of risperidone long-acting injectable with respect to local injection-site tolerability. The overall safety and tolerability profile of risperidone long-acting injectable was comparable when administered as an intramuscular injection in the deltoid (37.5mg and 50mg) and gluteal (25mg and 50mg) sites. PMID:21779538

The Role of Community Resource Assessments in the Development of 15 Adolescent Health Community-Researcher Partnerships

PubMed Central

Deeds, Bethany Griffin; Straub, Diane M.; Willard, Nancy; Castor, Judith; Ellen, Jonathan; Peralta, Ligia

2009-01-01

Background Connect to Protect (C2P): Partnerships for Youth Prevention Interventions is an initiative that alters the community’s structural elements to reduce youth HIV rates. Objectives This study details a community resource assessment and describes how resources were evaluated in the context of local needs. Methods Fifteen sites developed a community resource list, conducted a brief survey, created a youth service directory, and mapped where disease prevalence and community resources intersected. Sites also completed a survey to review and verify local site findings. Results On average, sites identified 267 potential community resources. Sites narrowed their resource list to conduct a brief survey with 1,162 agencies; the site average was 78. Final products of this process included maps comparing resources with risk data. Conclusions The evaluation of local resources is an important initial step in partnership development and is essential for the success of health promotion and disease prevention interventions that target adolescents. PMID:20208189

Increased Rate of Hospitalization for Diabetes and Residential Proximity of Hazardous Waste Sites

PubMed Central

Kouznetsova, Maria; Huang, Xiaoyu; Ma, Jing; Lessner, Lawrence; Carpenter, David O.

2007-01-01

Background Epidemiologic studies suggest that there may be an association between environmental exposure to persistent organic pollutants (POPs) and diabetes. Objective The aim of this study was to test the hypothesis that residential proximity to POP-contaminated waste sites result in increased rates of hospitalization for diabetes. Methods We determined the number of hospitalized patients 25–74 years of age diagnosed with diabetes in New York State exclusive of New York City for the years 1993–2000. Descriptive statistics and negative binomial regression were used to compare diabetes hospitalization rates in individuals who resided in ZIP codes containing or abutting hazardous waste sites containing POPs (“POP” sites); ZIP codes containing hazardous waste sites but with wastes other than POPs (“other” sites); and ZIP codes without any identified hazardous waste sites (“clean” sites). Results Compared with the hospitalization rates for diabetes in clean sites, the rate ratios for diabetes discharges for people residing in POP sites and “other” sites, after adjustment for potential confounders were 1.23 [95% confidence interval (CI), 1.15–1.32] and 1.25 (95% CI, 1.16–1.34), respectively. In a subset of POP sites along the Hudson River, where there is higher income, less smoking, better diet, and more exercise, the rate ratio was 1.36 (95% CI, 1.26–1.47) compared to clean sites. Conclusions After controlling for major confounders, we found a statistically significant increase in the rate of hospitalization for diabetes among the population residing in the ZIP codes containing toxic waste sites. PMID:17366823

Orthogonal use of a human tRNA synthetase active site to achieve multi-functionality

PubMed Central

Zhou, Quansheng; Kapoor, Mili; Guo, Min; Belani, Rajesh; Xu, Xiaoling; Kiosses, William B.; Hanan, Melanie; Park, Chulho; Armour, Eva; Do, Minh-Ha; Nangle, Leslie A.; Schimmel, Paul; Yang, Xiang-Lei

2011-01-01

Protein multi-functionality is an emerging explanation for the complexity of higher organisms. In this regard, while aminoacyl tRNA synthetases catalyze amino acid activation for protein synthesis, some also act in pathways for inflammation, angiogenesis, and apoptosis. How multiple functions evolved and their relationship to the active site is not clear. Here structural modeling analysis, mutagenesis, and cell-based functional studies show that the potent angiostatic, natural fragment of human TrpRS associates via Trp side chains that protrude from the cognate cellular receptor VE-cadherin. Modeling indicates that (I prefer the way it was because the conclusion was reached not only by modeling, but more so by experimental studies.)VE-cadherin Trp side chains fit into the Trp-specific active site of the synthetase. Thus, specific side chains of the receptor mimic (?) amino acid substrates and expand the functionality of the active site of the synthetase. We propose that orthogonal use of the same active site may be a general way to develop multi-functionality of human tRNA synthetases and other proteins. PMID:20010843

Oral Chlamydia trachomatis in Patients with Established Periodontitis

PubMed Central

Reed, Susan G.; Lopatin, Dennis E.; Foxman, Betsy; Burt, Brian A.

2009-01-01

Periodontitis is considered a consequence of a pathogenic microbial infection at the periodontal site and host susceptibility factors. Periodontal research supports the association of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, and Bacteroides forsythus, and periodontitis; however causality has not been demonstrated. In pursuit of the etiology of periodontitis, we hypothesized that the intracellular bacteria, Chlamydia trachomatis, may play a role. As a first step, a cross-sectional study of dental school clinic patients with established periodontitis were assessed for the presence of C. trachomatis in the oral cavity, and in particular from the lining epithelium of periodontal sites. C. trachomatis was detected using a direct fluorescent monoclonal antibody (DFA) in oral specimens from 7% (6/87) of the patients. Four patients tested positive in specimens from the lining epithelium of diseased periodontal sites, one patient tested positive in healthy periodontal sites, and one patient tested positive in the general mucosal specimen. In conclusion, this study provides preliminary evidence of C. trachomatis in the periodontal sites. Planned studies include the use of a more precise periodontal epithelial cell collection device, the newer nucleic acid amplification techniques to detect C. trachomatis, and additional populations to determine the association of C. trachomatis and periodontitis. PMID:11218493

Analysis of Biomechanical Effects of Different Sites and Modes of Orthodontic Loading On Arch Expansion in a Preadolescent Mandible: An FEA Study.

PubMed

Haresh, Ajmera Deepal; Pradeep, Singh; Song, Jinlin; Wang, Chao; Fan, Yubo

2018-05-11

The aim of commencing treatment in younger age is to rectify the developing dento-alveolar, skeletal and muscular imbalances. With growing dependence on arch development and expansion, the pendulum is oscillating more towards the non-extraction treatment lately, in resolving constriction and crowding issues. Since, a limited number of attempts have been made for mandibular expansion, this study aimes to evaluate the effect of different modes and sites of loading on the expansion of preadolescent mandible using biomechanics. To address the research purpose, a total of 9 Finite Element models were simulated. Biomechanical response of the mandibular bone and dentition was analyzed under different loading conditions including site and mode, using the simulated FE models. The values of displacement envisaged by the FE models, predict hybrid mode to offer substantial expansion of the mandibular bone as compared to tooth borne and bone borne. In addition, biomechanical effect of site II on mandibular expansion in terms of displacement on X-axis, was significant. In conclusion, the results of our study suggest hybrid mode at site II to be better option for true bony expansion in preadolescent mandible.

Incidence and risk factors for surgical site infection in general surgeries 1

PubMed Central

de Carvalho, Rafael Lima Rodrigues; Campos, Camila Cláudia; Franco, Lúcia Maciel de Castro; Rocha, Adelaide De Mattia; Ercole, Flávia Falci

2017-01-01

ABSTRACT Objective: to estimate the incidence of surgical site infection in general surgeries at a large Brazilian hospital while identifying risk factors and prevalent microorganisms. Method: non-concurrent cohort study with 16,882 information of patients undergoing general surgery from 2008 to 2011. Data were analyzed by descriptive, bivariate and multivariate analysis. Results: the incidence of surgical site infection was 3.4%. The risk factors associated with surgical site infection were: length of preoperative hospital stay more than 24 hours; duration of surgery in hours; wound class clean-contaminated, contaminated and dirty/infected; and ASA index classified into ASA II, III and IV/V. Staphyloccocus aureus and Escherichia coli were identified. Conclusion: the incidence was lower than that found in the national studies on general surgeries. These risk factors corroborate those presented by the National Nosocomial Infection Surveillance System Risk Index, by the addition of the length of preoperative hospital stay. The identification of the actual incidence of surgical site infection in general surgeries and associated risk factors may support the actions of the health team in order to minimize the complications caused by surgical site infection. PMID:29211190

Utility of the Measurement of Carboxyhemoglobin Level at the Site of Acute Carbon Monoxide Poisoning in Rural Areas.

PubMed

Onodera, Makoto; Fujino, Yasuhisa; Kikuchi, Satoshi; Sato, Masayuki; Mori, Kiyofumi; Beppu, Takaaki; Inoue, Yoshihiro

2016-01-01

Objective. This study examined the hypothesis that correlations exist between the carbon monoxide exposure time and the carboxyhemoglobin concentration at the site of carbon monoxide poisoning, using a pulse carbon monoxide oximeter in rural areas or the carboxyhemoglobin concentration measured at a given medical institution. Background. In previous studies, no definitive relationships between the arterial blood carboxyhemoglobin level and the severity of carbon monoxide poisoning have been observed. Method. The subjects included patients treated for acute carbon monoxide poisoning in whom a medical emergency team was able to measure the carboxyhemoglobin level at the site of poisoning. We examined the relationship between the carboxyhemoglobin level at the site of poisoning and carbon monoxide exposure time and the relationships between the arterial blood carboxyhemoglobin level and carbon monoxide exposure time. Results. A total of 10 patients met the above criteria. The carboxyhemoglobin levels at the site of poisoning were significantly and positively correlated with the exposure time (rs = 0.710, p = 0.021), but the arterial blood carboxyhemoglobin levels were not correlated with the exposure time. Conclusion. In rural areas, the carboxyhemoglobin level measured at the site of carbon monoxide poisoning correlated with the exposure time.

Treatment of localized gingival recession using the free rotated papilla autograft combined with coronally advanced flap by conventional (macrosurgery) and surgery under magnification (microsurgical) technique: A comparative clinical study

PubMed Central

Pandey, Suraj; Mehta, D. S.

2013-01-01

Background: The aim of the present study was to evaluate and compare the conventional (macro-surgical) and microsurgical approach in performing the free rotated papilla autograft combined with coronally advanced flap surgery in treatment of localized gingival recession. Materials and Methods: A total of 20 sites from 10 systemically healthy patients were selected for the study. The selected sites were randomly divided into experimental site A and experimental site B by using the spilt mouth design. Conventional (macro-surgical) approach for site A and micro-surgery for site B was applied in performing the free rotated papilla autograft combined with coronally advanced flap. Recession depth (RD), recession width (RW) clinical attachment level (CAL.) and width of keratinized tissue (WKT.) were recorded at baseline, 3 months and 6 months post-operatively. Results: Both (macro- and microsurgery) groups showed significant clinical improvement in all the parameters (RD, RW, CAL and WKT). However, on comparing both the groups, these parameters did not reach statistical significance. Conclusion: Both the surgical procedures were equally effective in treatment of localized gingival recession by the free rotated papilla autograft technique combined with coronally advanced flap. However, surgery under magnification (microsurgery) may be clinically better than conventional surgery in terms of less post-operative pain and discomfort experienced by patients at the microsurgical site. PMID:24554888

The correlation of methylation levels measured using Illumina 450K and EPIC BeadChips in blood samples

PubMed Central

Logue, Mark W; Smith, Alicia K; Wolf, Erika J; Maniates, Hannah; Stone, Annjanette; Schichman, Steven A; McGlinchey, Regina E; Milberg, William; Miller, Mark W

2017-01-01

Aim: We examined concordance of methylation levels across the Illumina Infinium HumanMethylation450 BeadChip and the Infinium MethylationEPIC BeadChip. Methods: We computed the correlation for 145 whole blood DNA samples at each of the 422,524 CpG sites measured by both chips. Results: The correlation at some sites was high (up to r = 0.95), but many sites had low correlation (55% had r < 0.20). The low correspondence between 450K and EPIC measured methylation values at many loci was largely due to the low variability in methylation values for the majority of the CpG sites in blood. Conclusion: Filtering out probes based on the observed correlation or low variability may increase reproducibility of BeadChip-based epidemiological studies. PMID:28809127

Drain tube migration into the anastomotic site of an esophagojejunostomy for gastric small cell carcinoma: short report

PubMed Central

2010-01-01

Background Intraluminal migration of a drain through an anastomotic site is a rare complication of gastric surgery. Case Presentation We herein report the intraluminal migration of a drain placed after a lower esophagectomy and total gastrectomy with Roux-en-Y anastomosis for gastric small cell carcinoma. Persistent drainage was noted 1 month after surgery, and radiographic studies were consistent with drain tube migration. Endoscopy revealed the drain had migrated into the esophagojejunostomy anastomotic site. The drain was removed from outside of abdominal wound while observing the anastomotic site endoscopically. The patient was treated with suction via a nasogastric tube drain for 5 days, and thereafter had an uneventful recovery. Conclusions Though drain tube migration is a rare occurrence, it should be considered in patients with persistent drainage who have undergone gastric surgery. PMID:20492665

Treatability studies performed in support of an engineering evaluation/cost analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Myers, J.M.; Mueller, J.P.; Sundquist, J.A.

1995-12-31

The Southern Shipbuilding Corporation (SSC) site is located on 54 acres of wooded land adjacent to Bayou Bonfouca, approximately 1.8 miles downstream of the Bayou Bonfouca National Priorities List (NPL) Superfund site in Slidell, St. Tammany Parish, Louisiana. Two one-acre, impoundments on the SSC site were used to store wastes generated from vessel cleaning. Wastes stored in the impoundments are migrating into Bayou Bonfouca, which empties into Lake Pontchartrain. In addition, the impoundments are frequently invaded by flood waters. The US EPA Emergency Response Branch (EPA-ERB) performed a site investigation which indicated that the majority of the contamination is petroleum-relatedmore » and that the compounds of concern are polycyclic aromatic hydrocarbons (PARs). The wastes are generally contained with the two impoundments and surrounding soils. As part of an Engineering Evaluation/Cost Basis (EE/CA) of potential response action alternatives, four treatability studies were performed. A thermal treatment (incineration) study was performed at the EPA`s Incineration Research Facility (IRF). Biodegradation remedy selection feasibility assessment was conducted on-site. A remedy screening soil washing study was also performed by TAT. A solidification/stabilization (S/S) study was conducted through EPA`s Risk Reduction Engineering Laboratory (RREL) to ascertain if the PAHs could be immobilized within a solid matrix. Experimental objectives, dead methodology and conclusions for these studies are presented as they relate to potential response actions being evaluated at the SSC site.« less

Comparison of platelet rich plasma and synthetic graft material for bone regeneration after third molar extraction.

PubMed

Nathani, Dipesh B; Sequeira, Joyce; Rao, B H Sripathi

2015-01-01

To compare the efficacy of Platelet rich plasma and synthetic graft material for bone regeneration after bilateral third molar extraction. This study was conducted in 10 patients visiting the outpatient department of Oral & Maxillofacial Surgery, Yenepoya Dental College & Hospital. Patients requiring extraction of bilateral mandibular third molars were taken for the study. Following extraction, PRP (Platelet Rich Plasma) was placed in one extraction socket and synthetic graft material in form granules [combination of Hydroxyapatite (HA) and Bioactive glass (BG)] in another extraction socket. The patients were assessed for postoperative pain and soft tissue healing. Radiological assessment of the extraction site was done at 8, 12 and 16 weeks interval to compare the change in bone density in both the sockets. Pain was less on PRP site when compared to HA site. Soft tissue evaluation done using gingival healing index given by Landry et al showed better healing on PRP site when compared to HA site. The evaluation of bone density by radiological assessment showed the grey level values calculated at 4 months at the PRP site were comparatively higher than HA site. The study showed that the platelet rich plasma is a better graft material than synthetic graft material in terms of soft tissue and bone healing. However a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of both the materials.

Preceptor Perceptions of Virtual Quality Assurance Experiential Site Visits.

PubMed

Clarke, Cheryl L; Schott, Kathryn A; Arnold, Austin D

2018-05-01

Objective. To determine preceptor perceptions of the value of experiential quality assurance site visits between virtual and onsite visits, and to gauge preceptor opinions of the optimal method of site visits based on the type of visit received. Methods. Site visits (12 virtual and 17 onsite) were conducted with 29 APPE sites located at least 200 miles from campus. Participating preceptors were invited to complete an online post-visit survey adapted from a previously validated and published survey tool measuring preceptor perceptions of the value of traditional onsite visits. Results. Likert-type score averages for survey questions ranged from 4.2 to 4.6 in the virtual group and from 4.3 to 4.7 in the onsite group. No statistically significant difference was found between the two groups. Preceptors were more inclined to prefer the type of visit they received. Preceptors receiving onsite visits were also more likely to indicate no visit type preference. Conclusion. Preceptors perceived value from both onsite and virtual site visits. Preceptors who experienced virtual site visits highly preferred that methodology. This study suggests that virtual site visits may be a viable alternative for providing experiential quality assurance site visits from a preceptor's perspective.

MX Siting Investigation. Geotechnical Evaluation. Detailed Aggregate Resources Study. Pahroc Study Area, Nevada.

DTIC Science & Technology

1981-06-05

source is a fairly limited outcrop of calcareous sandstone classified as dolomite rock (Do). Class RBIb Sources: Pour basin-fill sources within the study...Paleozoic rocks consist of limestone, dolomite , and quartzite with interbedded sandstone and shale. These units are generally exposed along the northern...categories simplify discussion and presentation without altering the conclusions of the study. 2.2.1 Rock Units Dolomite rocks (Do) and carbonate rocks

Prediction of citrullination sites by incorporating k-spaced amino acid pairs into Chou's general pseudo amino acid composition.

PubMed

Ju, Zhe; Wang, Shi-Yun

2018-04-22

As one of the most important and common protein post-translational modifications, citrullination plays a key role in regulating various biological processes and is associated with several human diseases. The accurate identification of citrullination sites is crucial for elucidating the underlying molecular mechanisms of citrullination and designing drugs for related human diseases. In this study, a novel bioinformatics tool named CKSAAP_CitrSite is developed for the prediction of citrullination sites. With the assistance of support vector machine algorithm, the highlight of CKSAAP_CitrSite is to adopt the composition of k-spaced amino acid pairs surrounding a query site as input. As illustrated by 10-fold cross-validation, CKSAAP_CitrSite achieves a satisfactory performance with a Sensitivity of 77.59%, a Specificity of 95.26%, an Accuracy of 89.37% and a Matthew's correlation coefficient of 0.7566, which is much better than those of the existing prediction method. Feature analysis shows that the N-terminal space containing pairs may play an important role in the prediction of citrullination sites, and the arginines close to N-terminus tend to be citrullinated. The conclusions derived from this study could offer useful information for elucidating the molecular mechanisms of citrullination and related experimental validations. A user-friendly web-server for CKSAAP_CitrSite is available at 123.206.31.171/CKSAAP_CitrSite/. Copyright © 2017. Published by Elsevier B.V.

Leadership and Gender: Conclusions Drawn from Wildrose School

ERIC Educational Resources Information Center

Burns, Amy M.

2006-01-01

In this article, I present the findings of a single-site case study which examined the role of gender in constituent group perceptions of effective female leadership. First, a brief description of the Wildrose School community context is presented followed by an overview of relevant literature on female leadership. The emergent themes regarding…

ACTIVE AND SPECTATOR ADSORBATE SPECIES DURING NO DECOMPOSITION OVER CU-ZSM-5: TRANSIENT IR, SITE-POISONING, AND PROMOTION STUDIES (R823529)

EPA Science Inventory

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

Stable Isotopes of Sr and Pb as Tracers of Sources of Airborne Particulate Matter in Kyrgyzstan

EPA Science Inventory

ConclusionsElemental concentrations were higher at the LIDAR site compared to the Bishkek site. Also, concentrations were higher during dust than non-dust events at both sites.The Sr isotopic ratios suggest dust from another region, such as from Western China, Africa, or Middle E...

Reduced hypothalamic-pituitary-adrenal axis activity in chronic multi-site musculoskeletal pain: partly masked by depressive and anxiety disorders

PubMed Central

2014-01-01

Background Studies on hypothalamic-pituitary-adrenal axis (HPA-axis) function amongst patients with chronic pain show equivocal results and well-controlled cohort studies are rare in this field. The goal of our study was to examine whether HPA-axis dysfunction is associated with the presence and the severity of chronic multi-site musculoskeletal pain. Methods Data are from the Netherlands Study of Depression and Anxiety including 1125 subjects with and without lifetime depressive and anxiety disorders. The Chronic Pain Grade questionnaire was used to determine the presence and severity of chronic multi-site musculoskeletal pain. Subjects were categorized into a chronic multi-site musculoskeletal pain group (n = 471) and a control group (n = 654). Salivary cortisol samples were collected to assess HPA-axis function (awakening level, 1-h awakening response, evening level, diurnal slope and post-dexamethasone level). Results In comparison with the control group, subjects with chronic multi-site musculoskeletal pain showed significantly lower cortisol level at awakening, lower evening level and a blunted diurnal slope. Lower cortisol level at awakening and a blunted diurnal slope appeared to be restricted to those without depressive and/or anxiety disorders, who also showed a lower 1-h awakening response. Conclusions Our results suggest hypocortisolemia in chronic multi-site musculoskeletal pain. However, if chronic pain is accompanied by a depressive or anxiety disorder, typically related to hypercortisolemia, the association between cortisol levels and chronic multi-site musculoskeletal pain appears to be partly masked. Future studies should take psychopathology into account when examining HPA-axis function in chronic pain. PMID:25007969

Fractional Skin Harvesting: Autologous Skin Grafting without Donor-site Morbidity

PubMed Central

Wang, Ying; Farinelli, William A.; Jiménez-Lozano, Joel; Franco, Walfre; Sakamoto, Fernanda H.; Cheung, Evelyn J.; Purschke, Martin; Doukas, Apostolos G.; Anderson, R. Rox

2013-01-01

Background: Conventional autologous skin grafts are associated with significant donor-site morbidity. This study was conducted to determine feasibility, safety, and efficacy of a new strategy for skin grafting based on harvesting small columns of full-thickness skin with minimal donor-site morbidity. Methods: The swine model was used for this study. Hundreds of full-thickness columns of skin tissue (~700 µm diameter) were harvested using a custom-made harvesting device, and then applied directly to excisional skin wounds. Healing in donor and graft sites was evaluated over 3 months by digital photographic measurement of wound size and blinded, computer-aided evaluation of histological features and compared with control wounds that healed by secondary intention or with conventional split-thickness skin grafts (STSG). Results: After harvesting hundreds of skin columns, the donor sites healed rapidly without scarring. These sites reepithelialized within days and were grossly and histologically indistinguishable from normal skin within 7 weeks. By contrast, STSG donor sites required 2 weeks for reepithelialization and retained scar-like characteristics in epidermal and dermal architecture throughout the experiment. Wounds grafted with skin columns resulted in accelerated reepithelialization compared with ungrafted wounds while avoiding the “fish-net” patterning caused by STSG. Conclusion: Full-thickness columns of skin can be harvested in large quantities with negligible long-term donor-site morbidity, and these columns can be applied directly to skin wounds to enhance wound healing. PMID:25289241

Interpreting large-scale experiments on effects of trawling on benthic fauna: an empirical test of the potential effects of spatial confounding in experiments without replicated control and trawled areas.

PubMed

Lindegarth; Valentinsson; Hansson; Ulmestrand

2000-03-15

Disturbances due to trawling and dredging is a serious threat to assemblages of benthic marine animals. We tested hypotheses about effects of trawling on benthic assemblages in a manipulative field experiment, using gear and intensities relevant to future management of trawling in a Swedish fjord. Three trawled and three control sites were sampled at several times before and after trawling was initiated. This paper describes how conclusions about effects of trawling might differ between experiments involving replicate sites and experiments using only one trawled and one control site, as in several recent studies. Analyses of selected taxa showed that abundances of many species changed differently among control sites. Differences in temporal change between pairs of single trawled and control sites were also frequent. Neither the quantitative nor the qualitative nature of differences between treatments could, however, be coherently interpreted among the different combinations of trawled and control sites. This is consistent with results obtained from analyses using all sites, which showed no consistent effects of trawling on any of these taxa. These results provide empirical evidence that spatial confounding may cause serious problems to formal interpretation of experiments, which use only one control and one trawled area. Such potential problems can best be solved by ensuring that the study incorporates more than one control site.

Implementation of Evidence-Based Employment Services in Specialty Mental Health

PubMed Central

Hamilton, Alison B; Cohen, Amy N; Glover, Dawn L; Whelan, Fiona; Chemerinski, Eran; McNagny, Kirk P; Mullins, Deborah; Reist, Christopher; Schubert, Max; Young, Alexander S

2013-01-01

Objective. Study a quality improvement approach for implementing evidence-based employment services at specialty mental health clinics. Data Sources/Study Setting. Semistructured interviews with clinicians and administrators before, during, and after implementation. Qualitative field notes, structured baseline and follow-up interviews with patients, semistructured interviews with patients after implementation, and administrative data. Study Design. Site-level controlled trial at four implementation and four control sites. Hybrid implementation–effectiveness study with mixed methods intervention evaluation design. Data Collection/Extraction Methods. Site visits, in-person and telephone interviews, patient surveys, patient self-assessment. A total of 801 patients completed baseline surveys and 53 clinicians and other clinical key stakeholders completed longitudinal qualitative interviews. Principal Findings. At baseline, sites varied in the availability, utilization, and quality of supported employment. Each site needed quality improvement for this service, though for differing reasons, with some needing development of the service itself and others needing increased service capacity. Improvements in knowledge, attitudes, beliefs, and referral behaviors were evident in mid- and postimplementation interviews, though some barriers persisted. Half of patients expressed an interest in working at baseline. Patients at implementation sites were 2.3 times more likely to receive employment services during the study year. Those who had a service visit were more likely to be employed at follow-up than those who did not. Conclusions. Studies of implementation and effectiveness require mixed methods to both enhance implementation in real time and provide context for interpretation of complex results. In this study, a quality improvement approach resulted in superior patient-level outcomes and improved clinician knowledge, attitudes, and behaviors, in the context of substantial variation among sites. PMID:24138608

Data report for the geologic and scenic quality evaluation of selected sand and gravel sites on the Wind River Indian Reservation, Wyoming

USGS Publications Warehouse

Langer, William H.; Van Gosen, Bradley S.; Arbogast, Belinda; Lindsey, David A.

2011-01-01

In April 2005, the U.S. Geological Survey (USGS) conducted field studies on the Wind River Indian Reservation, Wyoming, to inventory and evaluate sand and gravel deposits underlying river terraces on tribal lands along the Wind River. This report contains the results for 12 sites of sand and gravel deposits evaluated for their potential use as aggregate in Portland cement concrete, asphalt, and base course. The report provides the results of: * The USGS geologic studies and engineering tests. * A conclusion and recommendation for the best use of sand and gravel materials. * Calculations of available sand and gravel materials. * A scenic quality landscape inventory and evaluation.

Quantum Chemical Modeling of Enzymatic Reactions: The Case of Decarboxylation.

PubMed

Liao, Rong-Zhen; Yu, Jian-Guo; Himo, Fahmi

2011-05-10

We present a systematic study of the decarboxylation step of the enzyme aspartate decarboxylase with the purpose of assessing the quantum chemical cluster approach for modeling this important class of decarboxylase enzymes. Active site models ranging in size from 27 to 220 atoms are designed, and the barrier and reaction energy of this step are evaluated. To model the enzyme surrounding, homogeneous polarizable medium techniques are used with several dielectric constants. The main conclusion is that when the active site model reaches a certain size, the solvation effects from the surroundings saturate. Similar results have previously been obtained from systematic studies of other classes of enzymes, suggesting that they are of a quite general nature.

Isolation of anticancer drug TAXOL from Pestalotiopsis breviseta with apoptosis and B-Cell lymphoma protein docking studies

PubMed Central

Kathiravan, G.; Sureban, Sripathi M.; Sree, Harsha N.; Bhuvaneshwari, V.; Kramony, Evelin

2012-01-01

Background: Extraction and investigation of TAXOL from Pestalotiopsis breviseta (Sacc.) using protein docking, which is a computational technique that samples conformations of small molecules in protein-binding sites. Scoring functions are used to assess which of these conformations best complements the protein binding site and active site prediction. Materials and Methods: Coelomycetous fungi P. breviseta (Sacc.) Steyaert was screened for the production of TAXOL, an anticancer drug. Results: TAXOL production was confirmed by the following methods: Ultraviolet (UV) spectroscopic analysis, Infrared analysis, High performance liquid chromatography analysis (HPLC), and Liquid chromatography mass spectrum (LC-MASS). TAXOL produced by the fungi was compared with authentic TAXOL, and protein docking studies were performed. Conclusion: The BCL2 protein of human origin showed a higher affinity toward the compound paclitaxel. It has the binding energy value of −13.0061 (KJ/Mol) with four hydrogen bonds. PMID:24808664

Short-term occupancy and abundance dynamics of the Oregon spotted frog (Rana pretiosa) across its core range

USGS Publications Warehouse

Adams, Michael J.; Pearl, Christopher A.; Mccreary, Brome; Galvan, Stephanie

2014-01-01

The Oregon spotted frog (Rana pretiosa) occupies only a fraction of its original range and is listed as Threatened under the Endangered Species Act. We surveyed 93 sites in a rotating frame design (2010–13) in the Klamath and Deschutes Basins, Oregon, which encompass most of the species’ core extant range. Oregon spotted frogs are declining in abundance and probability of site occupancy. We did not find an association between the probability that Oregon spotted frogs disappear from a site (local extinction) and any of the variables hypothesized to affect Oregon spotted frog occupancy. This 4-year study provides baseline data, but the 4-year period was too short to draw firm conclusions. Further study is essential to understand how habitat changes and management practices relate to the status and trends of this species.

Auger electron spectroscopy for the determination of sex and age related Ca/P ratio at different bone sites

DOE Office of Scientific and Technical Information (OSTI.GOV)

Balatsoukas, Ioannis; Kourkoumelis, Nikolaos; Tzaphlidou, Margaret

The Ca/P ratio of normal cortical and trabecular rat bone was measured by Auger electron spectroscopy (AES). Semiquantitative analysis was carried out using ratio techniques to draw conclusions on how age, sex and bone site affect the relative composition of calcium and phosphorus. Results show that Ca/P ratio is not sex dependent; quite the opposite, bone sites exhibit variations in elemental stoichiometry where femoral sections demonstrate higher Ca/P ratio than rear and front tibias. Age-related changes are more distinct for cortical bone in comparison with the trabecular bone. The latter's Ca/P ratio remains unaffected from all the parameters under study.more » This study confirms that AES is able to successfully quantify bone mineral main elements when certain critical points, related to the experimental conditions, are addressed effectively.« less

The role of aeolian sediment in the preservation of archaeological sites in the Colorado River corridor, Grand Canyon, Arizona: final report on research activities, 2003-2006

USGS Publications Warehouse

Draut, Amy E.; Rubin, David M.

2007-01-01

This report summarizes a three-year study of aeolian sedimentary processes in the Colorado River corridor, Grand Canyon, Arizona, and discusses the relevance of those processes to the preservation of archaeological sites. Findings are based upon detailed sedimentary and geomorphic investigations conducted in three areas of the river corridor, continuous measurements of wind, precipitation, and aeolian sediment transport at six locations for up to 26 months, short-term field study at 35 other sites, examination of historical aerial photographs, and review of data collected and analyzed by previous studies. Detailed results of this study, which involved collaboration with scientists at the Grand Canyon Monitoring and Research Center, National Park Service, Northern Arizona University, the Hopi Tribe, and GeoArch, Inc., have been published previously in topical USGS Open-File Reports (Draut and Rubin, 2005, 2006), a USGS Scientific Investigations Report (Draut and others, 2005), and will be discussed in two forthcoming journal articles. This report serves as an overview of the results and contains new conclusions regarding aeolian sedimentary processes in the Colorado River Ecosystem and their relevance to many archaeological sites.

Validation of a Remote Sensing Model to Identify Simulium damnosum s.l. Breeding Sites in Sub-Saharan Africa

PubMed Central

Jacob, Benjamin G.; Novak, Robert J.; Toe, Laurent D.; Sanfo, Moussa; Griffith, Daniel A.; Lakwo, Thomson L.; Habomugisha, Peace; Katabarwa, Moses N.; Unnasch, Thomas R.

2013-01-01

Background Recently, most onchocerciasis control programs have begun to focus on elimination. Developing an effective elimination strategy relies upon accurately mapping the extent of endemic foci. In areas of Africa that suffer from a lack of infrastructure and/or political instability, developing such accurate maps has been difficult. Onchocerciasis foci are localized near breeding sites for the black fly vectors of the infection. The goal of this study was to conduct ground validation studies to evaluate the sensitivity and specificity of a remote sensing model developed to predict S. damnosum s.l. breeding sites. Methodology/Principal Findings Remote sensing images from Togo were analyzed to identify areas containing signature characteristics of S. damnosum s.l. breeding habitat. All 30 sites with the spectral signature were found to contain S. damnosum larvae, while 0/52 other sites judged as likely to contain larvae were found to contain larvae. The model was then used to predict breeding sites in Northern Uganda. This area is hyper-endemic for onchocerciasis, but political instability had precluded mass distribution of ivermectin until 2009. Ground validation revealed that 23/25 sites with the signature contained S. damnosum larvae, while 8/10 sites examined lacking the signature were larvae free. Sites predicted to have larvae contained significantly more larvae than those that lacked the signature. Conclusions/Significance This study suggests that a signature extracted from remote sensing images may be used to predict the location of S. damnosum s.l. breeding sites with a high degree of accuracy. This method should be of assistance in predicting communities at risk for onchocerciasis in areas of Africa where ground-based epidemiological surveys are difficult to implement. PMID:23936571

Engaging, Recruiting, and Retaining Black Men Who Have Sex With Men in Research Studies: Don’t Underestimate the Importance of Staffing—Lessons Learned From HPTN 061, the BROTHERS Study

PubMed Central

Magnus, Manya; Franks, Julie; Griffith, Sam; Arnold, Michael P.; Goodman, Krista; Wheeler, Darrell P.

2014-01-01

Context HIV/AIDS in the United States continues to primarily impact men who have sex with men (MSM), with disproportionately high rates among black MSM. Objective The purpose of this study was to identify factors that may influence engagement and retention of black MSM in HIV research. Design and Participants This was a qualitative evaluation of study implementation within a multisite, prospective, observational study (HIV Prevention Trials Network 061, BROTHERS) that enrolled 1553 black MSM in 6 cities throughout the United States. Data collection for this evaluation included a written, structured survey collected from each of the sites describing site characteristics including staff and organizational structure, reviews of site standard operating procedures, and work plans; semistructured key informant interviews were conducted with site coordinators to characterize staffing, site-level factors facilitating or impeding effective community engagement, study recruitment, and retention. Data from completed surveys and site standard operating procedures were collated, and notes from key informant interviews were thematically coded for content by 2 independent reviewers. Results Several key themes emerged from the data, including the importance of inclusion of members of the community being studied as staff, institutional hiring practices that support inclusive staffing, cultivating a supportive working environment for study implementation, and ongoing relationships between research institutions and community. Conclusions This study underscores the importance of staffing in implementing research with black MSM. Investigators should consider how staffing and organizational structures affect implementation during study design and when preparing to initiate study activities. Ongoing monitoring of community engagement can inform and improve methods for engagement and ensure cultural relevance while removing barriers for participation. PMID:24406940

Spatial distribution of source locations for particulate nitrate and sulfate in the upper-midwestern United States

NASA Astrophysics Data System (ADS)

Zhao, Weixiang; Hopke, Philip K.; Zhou, Liming

Two back-trajectory analysis methods designed to be used with multiple site data, simplified quantitative transport bias analysis (SQTBA) and residence time weighted concentration (RTWC), were applied to nitrate and sulfate concentration data from two rural sites (the Mammoth Cave National Park and the Great Smoky Mountain National Park) and five urban sites (Chicago, Cleveland, Detroit, Indianapolis, and St. Louis) for an intensive investigation on the spatial patterns of origins for these two species in the upper-midwestern area. The study was made by dividing the data into five categories: all sites and all seasons, rural sites in summer, rural sites in winter, urban sites in summer, and urban sites in winter. A general conclusion was that the origins of the nitrate in these seven sites were mainly in the upper-midwestern areas, while the sulfate in these seven sites were mainly from the Ohio and Tennessee River Valley areas. The upper-midwestern areas are regions of high ammonia emissions rather than high NO x emissions. In the winter, metropolitan areas showed the highest nitrate emission potential suggesting the importance of local NO x emissions. In the summer, ammonia emissions from fertilizer application in the lower midwestern area made a significant contribution to nitrate in the rural sites of this study. The impact of the wind direction prevalence on the source spatial patterns was observed by comparing the urban and rural patterns of the summer. The differences between the results of two methods are discussed and suggestions for applying these methods are also provided.

Integrating care for high-risk patients in England using the virtual ward model: lessons in the process of care integration from three case sites

PubMed Central

Lewis, Geraint; Vaithianathan, Rhema; Wright, Lorraine; Brice, Mary R; Lovell, Paul; Rankin, Seth; Bardsley, Martin

2013-01-01

Background Patients at high risk of emergency hospitalisation are particularly likely to experience fragmentation in care. The virtual ward model attempts to integrate health and social care by offering multidisciplinary case management to people at high predicted risk of unplanned hospitalisation. Objective To describe the care practice in three virtual ward sites in England and to explore how well each site had achieved meaningful integration. Method Case studies conducted in Croydon, Devon and Wandsworth during 2011–2012, consisting of semi-structured interviews, workshops, and site visits. Results Different versions of the virtual wards intervention had been implemented in each site. In Croydon, multidisciplinary care had reverted back to one-to-one case management. Conclusions To integrate successfully, virtual ward projects should safeguard the multidisciplinary nature of the intervention, ensure the active involvement of General Practitioners, and establish feedback processes to monitor performance such as the number of professions represented at each team meeting. PMID:24250284

Comparison between surgical and standing percutaneous contact Nd:YAG laser periosteal transection for potential treatment of equine limb deformities

NASA Astrophysics Data System (ADS)

Tate, Lloyd P.; Baines, Steven J.; Meuten, Donald J.; Stefanacci, J.

1994-09-01

Medial and lateral aspects of both radiuses were subjected to periosteal transection of nine healthy equine foals. One site per foal was subjected to surgical periosteal transection and elevation under general anesthesia. The remaining three sites of each foal after injection of a local anesthetic received Nd:YAG contact percutaneous periosteal transection. All radiuses were evaluated radiographically prior to periosteal transection and immediately prior to euthanasia. Foals were euthanized at 3 days, 31 to 34 days, and 67 days post-periosteal transection and gross postmortem and histologic examination performed on each site. Radiographically, periosteal proliferation occurred at all the conventional surgery sites and a majority of the percutaneous laser sites by 30 days post-treatment and was present at 67 days. No limb angulations were noted to occur in any of the foals. The conclusion of the study was that Nd:YAG percutaneous laser periosteal transection was successful in producing periosteal obliteration but with a different histologic appearance than that produced by conventional surgery.

A comparison of phone-based and onsite-based fidelity for Assertive Community Treatment in Indiana

PubMed Central

McGrew, John H.; Stull, Laura G.; Rollins, Angela L.; Salyers, Michelle P.; Hicks, Lia J.

2014-01-01

Objective This study investigated the reliability, validity, and role of rater expertise in phone-administered fidelity assessment instrument based on the Dartmouth Assertive Community Treatment Scale (DACTS). Methods An experienced rater paired with a research assistant without fidelity assessment experience or a consultant familiar with the treatment site conducted phone based assessments of 23 teams providing assertive community treatment in Indiana. Using the DACTS, consultants conducted on-site evaluations of the programs. Results The pairs of phone raters revealed high levels of consistency [intraclass correlation coefficient (ICC)=.92] and consensus (mean absolute difference of .07). Phone and on-site assessment showed strong agreement (ICC=.87) and consensus (mean absolute difference of .07) and agreed within .1 scale point, or 2% of the scoring range, for 83% of sites and within .15 scale point for 91% of sites. Results were unaffected by the expertise level of the rater. Conclusions Phone based assessment could help agencies monitor faithful implementation of evidence-based practices. PMID:21632738

A computational study of CH 4 storage in porous framework materials with metalated linkers: connecting the atomistic character of CH 4 binding sites to usable capacity

DOE PAGES

Tsivion, Ehud; Mason, Jarad A.; Gonzalez, Miguel. I.; ...

2016-03-29

In order to store natural gas (NG) inexpensively at adequate densities for use as a fuel in the transportation sector, new porous materials are being developed. Our work uses computational methods to explore strategies for improving the usable methane storage capacity of adsorbents, including metal-organic frameworks (MOFs), that feature open-metal sites incorporated into their structure by postsynthetic modification. The adsorption of CH 4 on several open-metal sites is studied by calculating geometries and adsorption energies and analyzing the relevant interaction factors. Approximate site-specific adsorption isotherms are obtained, and the open-metal site contribution to the overall CH 4 usable capacity ismore » evaluated. It is found that sufficient ionic character is required, as exemplified by the strong CH 4 affinities of 2,2'-bipyridine-CaCl 2 and Mg, Ca-catecholate. In addition, it is found that the capacity of a single metal site depends not only on its affinity but also on its geometry, where trigonal or "bent" low-coordinate exposed sites can accommodate three or four methane molecules, as exemplified by Ca-decorated nitrilotriacetic acid. The effect of residual solvent molecules at the open-metal site is also explored, with some positive conclusions. Not only can residual solvent stabilize the open-metal site, surprisingly, solvent molecules do not necessarily reduce CH 4 affinity, but can contribute to increased usable capacity by modifying adsorption interactions.« less

Generalized trends in the formation energies of perovskite oxides.

PubMed

Zeng, ZhenHua; Calle-Vallejo, Federico; Mogensen, Mogens B; Rossmeisl, Jan

2013-05-28

Generalized trends in the formation energies of several families of perovskite oxides (ABO3) and plausible explanations to their existence are provided in this study through a combination of DFT calculations, solid-state physics analyses and simple physical/chemical descriptors. The studied elements at the A site of perovskites comprise rare-earth, alkaline-earth and alkaline metals, whereas 3d and 5d metals were studied at the B site. We also include ReO3-type compounds, which have the same crystal structure of cubic ABO3 perovskites except without A-site elements. From the observations we extract the following four conclusions for the perovskites studied in the present paper: for a given cation at the B site, (I) perovskites with cations of identical oxidation state at the A site possess close formation energies; and (II) perovskites with cations of different oxidation states at the A site usually have quite different but ordered formation energies. On the other hand, for a given A-site cation, (III) the formation energies of perovskites vary linearly with respect to the atomic number of the elements at the B site within the same period of the periodic table, and the slopes depend systematically on the oxidation state of the A-site cation; and (IV) the trends in formation energies of perovskites with elements from different periods at the B site depend on the oxidation state of A-site cations. Since the energetics of perovskites is shown to be the superposition of the individual contributions of their constituent oxides, the trends can be rationalized in terms of A-O and B-O interactions in the ionic crystal. These findings reveal the existence of general systematic trends in the formation energies of perovskites and provide further insight into the role of ion-ion interactions in the properties of ternary compounds.

Reported consent processes and demographics: a substudy of the INSIGHT Strategic Timing of AntiRetroviral Treatment trial

PubMed Central

Denning, Eileen; Sharma, Shweta; Smolskis, Mary; Touloumi, Giota; Walker, Sarah; Babiker, Abdel; Clewett, Megan; Emanuel, Ezekiel; Florence, Eric; Papadopoulos, Antonios; Sánchez, Adriana; Tavel, Jorge; Grady, Christine

2014-01-01

Objectives Efforts are needed to improve informed consent of participants in research. The Strategic Timing of AntiRetroviral Therapy (START) study provides a unique opportunity to study the effect of length and complexity of informed consent documents on understanding and satisfaction among geographically diverse participants. Methods Interested START sites were randomised to use either the standard consent form or the concise consent form for all of the site’s participants. Results A total of 4473 HIV-positive participants at 154 sites worldwide took part in the Informed Consent Substudy, with consent given in 11 primary languages. Most sites sent written information to potential participants in advance of clinic visits, usually including the consent form. At about half the sites, staff reported spending less than an hour per participant in the consent process. The vast majority of sites assessed participant understanding using informal nonspecific questions or clinical judgment. Conclusions These data reflect the interest of START research staff in evaluating the consent process and improving informed consent. The START Informed Consent Substudy is by far the largest study of informed consent intervention ever conducted. Its results have the potential to impact how consent forms are written around the world. PMID:25711320

An Automated and Minimally Invasive Tool for Generating Autologous Viable Epidermal Micrografts

PubMed Central

Osborne, Sandra N.; Schmidt, Marisa A.; Harper, John R.

2016-01-01

ABSTRACT OBJECTIVE: A new epidermal harvesting tool (CelluTome; Kinetic Concepts, Inc, San Antonio, Texas) created epidermal micrografts with minimal donor site damage, increased expansion ratios, and did not require the use of an operating room. The tool, which applies both heat and suction concurrently to normal skin, was used to produce epidermal micrografts that were assessed for uniform viability, donor-site healing, and discomfort during and after the epidermal harvesting procedure. DESIGN: This study was a prospective, noncomparative institutional review board–approved healthy human study to assess epidermal graft viability, donor-site morbidity, and patient experience. SETTING: These studies were conducted at the multispecialty research facility, Clinical Trials of Texas, Inc, San Antonio. PATIENTS: The participants were 15 healthy human volunteers. RESULTS: The average viability of epidermal micrografts was 99.5%. Skin assessment determined that 76% to 100% of the area of all donor sites was the same in appearance as the surrounding skin within 14 days after epidermal harvest. A mean pain of 1.3 (on a scale of 1 to 5) was reported throughout the harvesting process. CONCLUSIONS: Use of this automated, minimally invasive harvesting system provided a simple, low-cost method of producing uniformly viable autologous epidermal micrografts with minimal patient discomfort and superficial donor-site wound healing within 2 weeks. PMID:26765157

A method for the quantitative site-specific study of the biochemistry within dental plaque biofilms formed in vivo.

PubMed

Robinson, C; Kirkham, J; Percival, R; Shore, R C; Bonass, W A; Brookes, S J; Kusa, L; Nakagaki, H; Kato, K; Nattress, B

1997-01-01

The study of plaque biofilms in the oral cavity is difficult as plaque removal inevitably disrupts biofilm integrity precluding kinetic studies involving the penetration of components and metabolism of substrates in situ. A method is described here in which plaque is formed in vivo under normal (or experimental) conditions using a collection device which can be removed from the mouth after a specified time without physical disturbance to the plaque biofilm, permitting site-specific analysis or exposure of the undisturbed plaque to experimental conditions in vitro. Microbiological analysis revealed plaque flora which was similar to that reported from many natural sources. Analytical data can be related to plaque volume rather than weight. Using this device, plaque fluoride concentrations have been shown to vary with plaque depth and in vitro short-term exposure to radiolabelled components may be carried out, permitting important conclusions to be drawn regarding the site-specific composition and dynamics of dental plaque.

Prevalence of Malaria, Dengue, and Chikungunya Significantly Associated with Mosquito Breeding Sites

PubMed Central

Islam, Mohammad Nazrul; ZulKifle, Mohammad; Sherwani, Arish Mohammad Khan; Ghosh, Susanta Kumar; Tiwari, Satyanarayan

2011-01-01

Objectives: To observe the prevalence of malaria, dengue, and chikungunya and their association with mosquito breeding sites. Methods: The study was observational and analytical. A total of 162 houses and 670 subjects were observed during the study period. One hundred forty-two febrile patients were eligible for the study. After obtaining informed consent from all febrile patients, 140 blood samples were collected to diagnose malaria, dengue, and chikungunya. Larval samples were collected by the standard protocol that follows. Correlation of data was performed by Pearson correlation test. Results: Forty-seven blood samples were found positive: 33 for chikungunya, 3 for dengue, and 11 for malaria. Fifty-one out of 224 larval samples were found positive. Out of the 51 positive samples, 37 were positive for Aedes, 12 were positive for Anopheles, and two were positive for Culex larvae. Interpretation and Conclusion: Mosquito-borne fevers, especially malaria, dengue, and chikungunya, have shown a significant relationship with mosquito breeding sites. PMID:23610486

Medial Tibial Stress Syndrome: Muscles Located at the Site of Pain

PubMed Central

Brown, Ato Ampomah

2016-01-01

Objective. The purpose of this study was to examine the relationship between the location of the MTSS pain (posteromedial border of tibia) and the muscles that originate from that site. Method. The study was conducted in the Department of Anatomy of the School of Medical Sciences, University of Cape Coast, and involved the use of 22 cadaveric legs (9 paired and 4 unpaired) from 11 males and 2 females. Findings. The structures that were thus observed to attach directly to the posteromedial border of the tibia were the soleus, the flexor digitorum longus, and the deep crural fascia. The soleus and flexor digitorum longus muscles were observed to attach directly to the posteromedial border of the tibia. The tibialis posterior muscle had no attachment to this site. Conclusion. The findings of this study suggest that if traction is the cause of MTSS then soleus and the flexor digitorum muscles and not the tibialis posterior muscle are the likely cause of MTSS. PMID:27066291

A randomized comparative prospective study of platelet-rich plasma, platelet-rich fibrin, and hydroxyapatite as a graft material for mandibular third molar extraction socket healing.

PubMed

Dutta, Shubha Ranjan; Passi, Deepak; Singh, Purnima; Sharma, Sarang; Singh, Mahinder; Srivastava, Dhirendra

2016-01-01

The purpose of this study was to compare the efficacy of platelet-rich plasma (PRP), platelet-rich fibrin (PRF), and hydroxyapatite (HA) for reduction of pain and swelling, absence of dry socket, soft tissue healing, and bone regeneration after mandibular third molar extraction in human patients. Forty patients requiring extraction of mandibular third molars were randomly grouped as control, PRP, PRF, and HA-treated. The patients were assessed for postoperative pain, swelling, dry socket, and soft tissue healing on the 3 rd , 7 th , and 14 th day of postoperative periods depending on the standard methods. Radiological assessment of the extraction site was done at 1, 2, and 6 months interval to compare the change in bone density in the sockets in control and treated patients. Pain and swelling were less on PRP and PRF site when compared to HA and control site. PRP and PRF site showed better soft tissue healing when compared to HA and control site. Radiographic assessment showed comparatively lesser bone density values in PRP, PRF, and control site at 1, 2, and 6 months than HA site. Our study showed that PRP and PRF are better graft materials than HA regarding pain, swelling, dry socket, and soft tissue healing. Bone regeneration is induced promptly by HA as compared to other graft materials. However, a more elaborate study with a larger number of clinical cases is very much essential to be more conclusive regarding the efficacy of the graft materials.

Ten Steps to Conducting a Large, Multi-Site, Longitudinal Investigation of Language and Reading in Young Children

PubMed Central

Farquharson, Kelly; Murphy, Kimberly A.

2016-01-01

Purpose: This paper describes methodological procedures involving execution of a large-scale, multi-site longitudinal study of language and reading comprehension in young children. Researchers in the Language and Reading Research Consortium (LARRC) developed and implemented these procedures to ensure data integrity across multiple sites, schools, and grades. Specifically, major features of our approach, as well as lessons learned, are summarized in 10 steps essential for successful completion of a large-scale longitudinal investigation in early grades. Method: Over 5 years, children in preschool through third grade were administered a battery of 35 higher- and lower-level language, listening, and reading comprehension measures (RCM). Data were collected from children, their teachers, and their parents/guardians at four sites across the United States. Substantial and rigorous effort was aimed toward maintaining consistency in processes and data management across sites for children, assessors, and staff. Conclusion: With appropriate planning, flexibility, and communication strategies in place, LARRC developed and executed a successful multi-site longitudinal research study that will meet its goal of investigating the contribution and role of language skills in the development of children's listening and reading comprehension. Through dissemination of our design strategies and lessons learned, research teams embarking on similar endeavors can be better equipped to anticipate the challenges. PMID:27064308

Prediction of lysine glutarylation sites by maximum relevance minimum redundancy feature selection.

PubMed

Ju, Zhe; He, Jian-Jun

2018-06-01

Lysine glutarylation is new type of protein acylation modification in both prokaryotes and eukaryotes. To better understand the molecular mechanism of glutarylation, it is important to identify glutarylated substrates and their corresponding glutarylation sites accurately. In this study, a novel bioinformatics tool named GlutPred is developed to predict glutarylation sites by using multiple feature extraction and maximum relevance minimum redundancy feature selection. On the one hand, amino acid factors, binary encoding, and the composition of k-spaced amino acid pairs features are incorporated to encode glutarylation sites. And the maximum relevance minimum redundancy method and the incremental feature selection algorithm are adopted to remove the redundant features. On the other hand, a biased support vector machine algorithm is used to handle the imbalanced problem in glutarylation sites training dataset. As illustrated by 10-fold cross-validation, the performance of GlutPred achieves a satisfactory performance with a Sensitivity of 64.80%, a Specificity of 76.60%, an Accuracy of 74.90% and a Matthew's correlation coefficient of 0.3194. Feature analysis shows that some k-spaced amino acid pair features play the most important roles in the prediction of glutarylation sites. The conclusions derived from this study might provide some clues for understanding the molecular mechanisms of glutarylation. Copyright © 2018 Elsevier Inc. All rights reserved.

Single-site Laparoscopic Colorectal Surgery Provides Similar Clinical Outcomes Compared to Standard Laparoscopic Surgery: An Analysis of 626 Patients

PubMed Central

Sangster, William; Messaris, Evangelos; Berg, Arthur S.; Stewart, David B.

2015-01-01

BACKGROUND Compared to standard laparoscopy, single-site laparoscopic colorectal surgerymay potentially offer advantages by creating fewer surgical incisions and providing a multi-functional trocar. Previous comparisons, however, have been limited by small sample sizes and selection bias. OBJECTIVE To compare 60-day outcomes between standard laparoscopic and single-site laparoscopic colorectal surgery patients undergoing elective and urgent surgeries. DESIGN This was an unselected retrospective cohort study comparing patients who underwent elective and unplanned standard laparoscopic or single-site laparoscopic colorectal resections for benign and malignant disease between 2008 and 2014. Outcomes were compared using univariate analyses. SETTING This study was conducted at a single institution. PATIENTS A total of 626 consecutive patients undergoing laparoscopic colorectal surgery were included. MAIN OUTCOME MEASURES Morbidity and mortality within 60 postoperative days. RESULTS 318 (51%) and 308 (49%) patients underwent standard laparoscopic and single-site laparoscopic procedures, respectively. No significant difference was noted in mean operative time (Standard laparoscopy 182.1 ± 81.3 vs. Single-site laparoscopy 177±86.5, p=0.30) and postoperative length of stay (Standard laparoscopy 4.8±3.4 vs. Single-site laparoscopy 5.5 ± 6.9, p=0.14). Conversions to laparotomy and 60-day readmissions were also similar for both cohorts across all procedures performed. A significant difference was identified in the number of patients who developed postoperative complications (Standard laparoscopy 19.2% vs. Single-site laparoscopy 10.7%, p=0.004), especially with respect to surgical-site infections (Standard laparoscopy 11.3% vs. Single-site laparoscopy 5.8%, p=0.02). LIMITATIONS This was a retrospective, single institution study. CONCLUSIONS Single-site laparoscopic colorectal surgery demonstrates similar results to standard laparoscopic colorectal surgery in regards to operative time, length of stay and readmissions. Single-site laparoscopic colorectal surgery may provide advantages in limiting the development of certain complications such as superficial surgical-site infections. PMID:26252848

Comparison of Piezosurgery and Conventional Rotary Instruments for Removal of Impacted Mandibular Third Molars: A Randomized Controlled Clinical and Radiographic Trial

PubMed Central

Shokry, Mohamed; Aboelsaad, Nayer

2016-01-01

The purpose of this study was to test the effect of the surgical removal of impacted mandibular third molars using piezosurgery versus the conventional surgical technique on postoperative sequelae and bone healing. Material and Methods. This study was carried out as a randomized controlled clinical trial: split mouth design. Twenty patients with bilateral mandibular third molar mesioangular impaction class II position B indicated for surgical extraction were treated randomly using either the piezosurgery or the conventional bur technique on each site. Duration of the procedure, postoperative edema, trismus, pain, healing, and bone density and quantity were evaluated up to 6 months postoperatively. Results. Test and control sites were compared using paired t-test. There was statistical significance in reduction of pain and swelling in test sites, where the time of the procedure was statistically increased in test site. For bone quantity and quality, statistical difference was found where test site showed better results. Conclusion. Piezosurgery technique improves quality of patient's life in form of decrease of postoperative pain, trismus, and swelling. Furthermore, it enhances bone quality within the extraction socket and bone quantity along the distal aspect of the mandibular second molar. PMID:27597866

In vivo determination of multiple indices of periodontal inflammation by optical spectroscopy

PubMed Central

Liu, KZ; Xiang, XM; Man, A; Sowa, MG; Cholakis, N; Ghiabi, E; Singer, DL; Scott, DA

2008-01-01

Background and Objective Visible – near infrared (optical) spectroscopy can be used to measure regional tissue hemodynamics and edema and, therefore, may represent an ideal tool with which to non-invasively study periodontal inflammation. The study objective was to evaluate the ability of optical spectroscopy to simultaneously determine multiple inflammatory indices (tissue oxygenation, total tissue hemoglobin, deoxyhemoglobin, oxygenated hemoglobin, and tissue edema) in periodontal tissues in vivo. Material and Methods Spectra were obtained, processed, and evaluated from healthy, gingivitis, and periodontitis sites (n = 133) using a portable optical – near infrared spectrometer. A modified Beer-Lambert unmixing model that incorporates a nonparametric scattering loss function was used to determine the relative contribution of each inflammatory component to the overall spectrum. Results Optical spectroscopy was harnessed to successfully generate complex inflammatory profiles in periodontal tissues. Tissue oxygenation at periodontitis sites was significantly decreased (p<0.05) compared to gingivitis and healthy controls. This is largely due to an increase in deoxyhemoglobin in the periodontitis sites compared to healthy (p<0.01) and gingivitis (p=0.05) sites. Tissue water content per se showed no significant difference between the sites but a water index associated with tissue electrolyte levels and temperature differed was significantly between periodontitis sites when compared to both healthy and gingivitis sites (p<0.03). Conclusion This study establishes that optical spectroscopy can simultaneously determine multiple inflammatory indices directly in the periodontal tissues in vivo. Visible - near infrared spectroscopy has the potential to be developed into a simple, reagent-free, user friendly, chair-side, site-specific, diagnostic and prognostic test for periodontitis. PMID:18973538

Efficacy of dexpanthenol in skin protection against irritation: a double-blind, placebo-controlled study.

PubMed

Biro, Kathrin; Thaçi, Diamant; Ochsendorf, Falk R; Kaufmann, Roland; Boehncke, Wolf-Henning

2003-08-01

Dexpanthenol is popular in treating various dermatoses and in skin care, but few controlled clinical trials have been performed. We investigated the efficacy of dexpanthenol in skin protection against irritation in a randomized, prospective, double-blind, placebo-controlled study. 25 healthy volunteers (age 18-45 years) were treated for the inner aspect of both forearms with either Bepanthol Handbalsam containing 5% dexpanthenol or placebo x2 daily for 26 days. From day 15-22, sodium lauryl sulfate (SLS) 2% was applied to these areas x2 daily. Documentation comprised sebumetry, corneometry, pH value and clinical appearance (photographs). 21 volunteers completed the study, 3 were excluded because of non-compliance and 1 experienced a non-study-related, severe, adverse event. Only corneometry yielded a statistically significant difference, with decreased values following SLS challenge at the placebo sites (P < 0.05). Intraindividual comparisons showed superior results at the dexpanthenol-treated sites in 11 cases and in only 1 case at the placebo site. 6 volunteers experienced an irritant contact dermatitis, with more severe symptoms at the placebo site in 5 cases. In conclusion, dexpanthenol exhibits protective effects against skin irritation. The initiation of a study to evaluate the efficacy of dexpanthenol in preventing irritant occupational contact dermatitis under real workplace conditions is validated.

Empirically Based Composite Fracture Prediction Model From the Global Longitudinal Study of Osteoporosis in Postmenopausal Women (GLOW)

PubMed Central

Compston, Juliet E.; Chapurlat, Roland D.; Pfeilschifter, Johannes; Cooper, Cyrus; Hosmer, David W.; Adachi, Jonathan D.; Anderson, Frederick A.; Díez-Pérez, Adolfo; Greenspan, Susan L.; Netelenbos, J. Coen; Nieves, Jeri W.; Rossini, Maurizio; Watts, Nelson B.; Hooven, Frederick H.; LaCroix, Andrea Z.; March, Lyn; Roux, Christian; Saag, Kenneth G.; Siris, Ethel S.; Silverman, Stuart; Gehlbach, Stephen H.

2014-01-01

Context: Several fracture prediction models that combine fractures at different sites into a composite outcome are in current use. However, to the extent individual fracture sites have differing risk factor profiles, model discrimination is impaired. Objective: The objective of the study was to improve model discrimination by developing a 5-year composite fracture prediction model for fracture sites that display similar risk profiles. Design: This was a prospective, observational cohort study. Setting: The study was conducted at primary care practices in 10 countries. Patients: Women aged 55 years or older participated in the study. Intervention: Self-administered questionnaires collected data on patient characteristics, fracture risk factors, and previous fractures. Main Outcome Measure: The main outcome is time to first clinical fracture of hip, pelvis, upper leg, clavicle, or spine, each of which exhibits a strong association with advanced age. Results: Of four composite fracture models considered, model discrimination (c index) is highest for an age-related fracture model (c index of 0.75, 47 066 women), and lowest for Fracture Risk Assessment Tool (FRAX) major fracture and a 10-site model (c indices of 0.67 and 0.65). The unadjusted increase in fracture risk for an additional 10 years of age ranges from 80% to 180% for the individual bones in the age-associated model. Five other fracture sites not considered for the age-associated model (upper arm/shoulder, rib, wrist, lower leg, and ankle) have age associations for an additional 10 years of age from a 10% decrease to a 60% increase. Conclusions: After examining results for 10 different bone fracture sites, advanced age appeared the single best possibility for uniting several different sites, resulting in an empirically based composite fracture risk model. PMID:24423345

Using Formative Research to Develop Environmental and Ecological Interventions to Address Overweight and Obesity

PubMed Central

Wilson, Mark G.; Goetzel, Ron Z.; Ozminkowski, Ronald J.; DeJoy, Dave M.; Della, Lindsay; Roemer, Enid Chung; Schneider, Jennifer; Tully, Karen J.; White, John M.; Baase, Catherine M.

2010-01-01

Objective This paper presents the formative research phase of a large multi-site intervention study conducted to inform the feasibility of introducing environmental and ecological interventions. Methods Using mixed methods that included an environmental assessment, climate survey, leadership focus groups and interviews, and archival data, information was collected on employee health and job factors, the physical environment, social-organizational environment, and current health programs. Results Results show that 83% of employees at the study sites were overweight or obese. Leadership was very supportive of health initiatives and felt integrating the strategies into organizational operations would increase their likelihood of success. Environmental assessment scores ranged from 47 to 19 on a 100 point scale. Health services personnel tended to view the organizational climate for health more positively than site leadership (mean of 3.6 vs 3.0 respectively). Conclusions Intervention strategies chosen included increasing healthy food choices in vending, cafeterias, and company meetings, providing a walking path, targeting messages, developing site goals, training leaders, and establishing leaders at the work group level. PMID:18073340

Determinant quantum Monte Carlo study of d -wave pairing in the plaquette Hubbard hamiltonian

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ying, T.; Mondaini, R.; Sun, X. D.

2014-08-13

We used the determinant Quantum Monte Carlo (DQMC) to determine the pairing and magnetic response for a Hubbard model built up from four-site clusters - a two-dimensional square lattice consisting of elemental 2x2 plaquettes with hopping t and on-site repulsion U coupled by an interplaquette hopping t' ≤ t. Superconductivity in this geometry has previously been studied by a variety of analytic and numeric methods, with differing conclusions concerning whether the pairing correlations and transition temperature are raised near half-filling by the inhomogeneous hopping or not. For U/t = 4, DQMC indicates an optimal t'/t ≈ 0.4 at which themore » pairing vertex is most attractive. We also found that optimal t'/t increases with U/t. We then contrast our results for this plaquette model with a Hamiltonian which instead involves a regular pattern of site energies whose large site energy limit is the three band CuO 2 model; we show that there the inhomogeneity rapidly, and monotonically, suppresses pairing.« less

Use of Gastrointestinal Anastomosis Stapler for Harvest of Gracilis Muscle and Securing It in the Face for Facial Reanimation: A Novel Technique

PubMed Central

Shridharani, Sachin M.; Stapleton, Sahael M.; Redett, Richard J.; Magarakis, Michael; Rosson, Gedge D.

2010-01-01

Background: The primary objective of this study is to report a novel technique that uses the gastrointestinal anastomosis (GIA) stapler for harvesting and securing the gracilis muscle in facial reanimation surgery. Methods: We conducted a retrospective chart review with 18 consecutive patients who underwent gracilis muscle flap transfer with or without the use of a GIA stapler. Results: Of 11 operations with the GIA stapler, one patient developed a hematoma (donor site) and another required drainage of an abscess (recipient site). Of 8 operations without the use of the stapler, one patient had total flap failure and three required drainage of an abscess (2 recipient sites and 1 donor site). These differences trended toward improvement but were not statistically different. Conclusions: The use of the GIA stapler is a fast, safe technique. Larger studies are, however, warranted to further examine this novel approach in order to test precisely what factors of increased efficiency occur, the amount of suture pull-through, and overall tension capable of being applied to the secured staple line. PMID:20396379

Shared worlds: multi-sited ethnography and nursing research.

PubMed

Molloy, Luke; Walker, Kim; Lakeman, Richard

2017-03-22

Background Ethnography, originally developed for the study of supposedly small-scale societies, is now faced with an increasingly mobile, changing and globalised world. Cultural identities can exist without reference to a specific location and extend beyond regional and national boundaries. It is therefore no longer imperative that the sole object of the ethnographer's practice should be a geographically bounded site. Aim To present a critical methodological review of multi-sited ethnography. Discussion Understanding that it can no longer be taken with any certainty that location alone determines culture, multi-sited ethnography provides a method of contextualising multi-sited social phenomena. The method enables researchers to examine social phenomena that are simultaneously produced in different locations. It has been used to undertake cultural analysis of diverse areas such as organ trafficking, global organisations, technologies and anorexia. Conclusion The authors contend that multi-sited ethnography is particularly suited to nursing research as it provides researchers with an ethnographic method that is more relevant to the interconnected world of health and healthcare services. Implications for practice Multi-sited ethnography provides nurse researchers with an approach to cultural analysis in areas such as the social determinants of health, healthcare services and the effects of health policies across multiple locations.

Effects of Site Visits on Innovation Adoption.

ERIC Educational Resources Information Center

Fleischer, Mitchell

An attempt to increase adoption of the Community Lodge program through the use of a site visit was investigated. The sample of 24 state mental hospitals agreed to have a workshop about the Lodge. At the conclusion of the workshop, 12 of the hospitals were told they would have the opportunity to send one staff member on an expense-paid site visit,…

Trajectories of body mass index and waist circumference in four Peruvian settings at different level of urbanisation: the CRONICAS Cohort Study

PubMed Central

Carrillo-Larco, Rodrigo M; Gilman, Robert H; Checkley, William; Smeeth, Liam; Casas, Juan P

2018-01-01

Background Studies have reported the incidence/risk of becoming obese, but few have described the trajectories of body mass index (BMI) and waist circumference (WC) over time, especially in low/middle-income countries. We assessed the trajectories of BMI and WC according to sex in four sites in Peru. Methods Data from the population-based CRONICAS Cohort Study were analysed. We fitted a population-averaged model by using generalised estimating equations. The outcomes of interest, with three data points over time, were BMI and WC. The exposure variable was the factorial interaction between time and study site. Results At baseline mean age was 55.7 years (SD: 12.7) and 51.6% were women. Mean follow-up time was 2.5 years (SD: 0.4). Over time and across sites, BMI and WC increased linearly. The less urbanised sites showed a faster increase than more urbanised sites, and this was also observed after sex stratification. Overall, the fastest increase was found for WC compared with BMI. Compared with Lima, the fastest increase in WC was in rural Puno (coefficient=0.73, P<0.001), followed by urban Puno (coefficient=0.59, P=0.001) and Tumbes (coefficient=0.22, P=0.088). Conclusions There was a linear increase in BMI and WC across study sites, with the greatest increase in less urbanised areas. The ongoing urbanisation process, common to Peru and other low/middle-income countries, is accompanied by different trajectories of increasing obesity-related markers. PMID:29472520

Identification of S-glutathionylation sites in species-specific proteins by incorporating five sequence-derived features into the general pseudo-amino acid composition.

PubMed

Zhao, Xiaowei; Ning, Qiao; Ai, Meiyue; Chai, Haiting; Yang, Guifu

2016-06-07

As a selective and reversible protein post-translational modification, S-glutathionylation generates mixed disulfides between glutathione (GSH) and cysteine residues, and plays an important role in regulating protein activity, stability, and redox regulation. To fully understand S-glutathionylation mechanisms, identification of substrates and specific S-Glutathionylated sites is crucial. Experimental identification of S-glutathionylated sites is labor-intensive and time consuming, so establishing an effective computational method is much desirable due to their convenient and fast speed. Therefore, in this study, a new bioinformatics tool named SSGlu (Species-Specific identification of Protein S-glutathionylation Sites) was developed to identify species-specific protein S-glutathionylated sites, utilizing support vector machines that combine multiple sequence-derived features with a two-step feature selection. By 5-fold cross validation, the performance of SSGlu was measured with an AUC of 0.8105 and 0.8041 for Homo sapiens and Mus musculus, respectively. Additionally, SSGlu was compared with the existing methods, and the higher MCC and AUC of SSGlu demonstrated that SSGlu was very promising to predict S-glutathionylated sites. Furthermore, a site-specific analysis showed that S-glutathionylation intimately correlated with the features derived from its surrounding sites. The conclusions derived from this study might help to understand more of the S-glutathionylation mechanism and guide the related experimental validation. For public access, SSGlu is freely accessible at http://59.73.198.144:8080/SSGlu/. Copyright © 2016 Elsevier Ltd. All rights reserved.

Laser assisted periodontal treatment: from bactericidal effect to local modification of the host response

NASA Astrophysics Data System (ADS)

Ciurescu, Codruţa.; Teslaru, Silvia; Zetu, Liviu; Ciurescu, Daniel

2016-03-01

The aim of the present short-term study is to investigate efficiency of laser therapy as adjunct to conventional periodontal therapy in patients with chronic periodontitis. Methods. The study protocol included 44 patients (20 males, 24 females; age 45-60) with moderate and advanced chronic periodontitis, recruited in Private Clinic Krondent (Brasov, Romania). The patients were randomly assigned in two groups, one group (test-sites group, 22 patients) treated by ultrasonic scaling and root planning followed by laser therapy (940 nm diode laser and 2780 nm Er:Cr:YAG laser) and second group (control-sites group, 22 patients) treated only by ultrasonic scaling and root planning. All patients were submitted to initial evaluation, recording of bleeding on probing (BOP) and probing of pockets depth (PPD), oral hygiene instruction and motivation. Indices BOP and PPD for the assessed periodontal sites were also recorded at 8 weeks, 16 weeks and 24 weeks after treatment. Results. Periodontal inflammatory parameters PPD (PPD>=4mm) were significantly lower in test-sites group as compared with control-sites group at 2 months (82% vs. 90%), 4 months (42% vs. 62%), and 6 months (11% vs. 30%).Periodontal parameters BOP were lower among patients in control-sites group and test-sites group at 2 months (38% vs. 32%), and significantly lower in test-sites group at 4 months (42% vs.26%), and 6 months (44% vs. 24%). Conclusions. The additional use of laser therapy increases significantly the efficiency of periodontal treatment comparing with conventional periodontal therapy.

Heavy Metals in the Atmosphere over the Northern Coast of Eurasia: Interannual Variations in Winter and Summer

NASA Astrophysics Data System (ADS)

Vinogradova, A. A.; Ivanova, Yu. A.

2017-12-01

Interannual variations in the level of anthropogenic contamination of the surface air in the northern areas of Russia are studied, which are related to a change in the direction of air mass transport. The transport of air and heavy metals to four sites located on territories of nature reserves on the coast of the Arctic Ocean (from the Kola Peninsula to a delta of the Lena River) in winter (January) and summer (July) is analyzed for 2000-2013. Indices of atmospheric circulation and data on the emission of pollutants into the atmosphere in cities and regions of Russia are involved in the analysis. Concentrations of seven heavy metals in the surface air are evaluated in the Arctic regions under study and their interannual, spatial, and seasonal variations are discussed. A strong interannual variability of atmospheric circulation differently influences the variations in the atmosphere contamination with different anthropogenic heavy metals in various areas of the north of Russia. The concentration ratios of heavy metals under study are different for each site in different years. The interannual and seasonal variations in the contamination level have maximum values for heavy metals arriving from most distant sources. Thus, the results of measuring the content of anthropogenic contaminants in the air of reference areas during one season or even one year should not serve a basis for longterm conclusions and forecasts. It would be also unjustified to make general conclusions on the contamination level of the environment from observation results for only one contaminant and/or only at a single site.

The Globalization of Pediatric Research: An Analysis of Clinical Trials Completed for Pediatric Exclusivity

PubMed Central

Pasquali, Sara K.; Burstein, Danielle S.; Benjamin, Daniel K.; Smith, P. Brian; Li, Jennifer S.

2010-01-01

Background Recent studies have examined the globalization of clinical research. These studies focused on adult trials, and the globalization of pediatric research has not been examined to date. We evaluated the setting of published studies conducted under the US Pediatric Exclusivity Program, which provides economic incentives to pharmaceutical companies to conduct drug studies in children. Methods Published studies containing the main results of trials conducted from 1998–2007 under the Pediatric Exclusivity Provision were included. Data were extracted from each study and described, including the therapeutic area of drug studied, number of patients enrolled, number of sites, and location where the study was conducted, if reported. Results Overall, 174 trials were included (sample size 8–27,065 patients); 9% did not report any information regarding the location or number of sites where the study was conducted. Of those that did report this information, 65% were conducted in at least one country outside the US, and 11% did not have any sites in the US. Fifty-four different countries were represented and 38% of trials enrolled patients in at least one site located in a developing/transition country, including more than one third of infectious disease, cardiovascular, and allergy/immunology trials. Conclusions The majority of published pediatric trials conducted under the Pediatric Exclusivity Provision included sites outside of the US, and over a third of trials enrolled patients in developing/transition countries. While there are many potential benefits to the globalization of pediatric research, this trend also raises certain scientific and ethical concerns which require further evaluation. PMID:20732941

SeedVicious: Analysis of microRNA target and near-target sites.

PubMed

Marco, Antonio

2018-01-01

Here I describe seedVicious, a versatile microRNA target site prediction software that can be easily fitted into annotation pipelines and run over custom datasets. SeedVicious finds microRNA canonical sites plus other, less efficient, target sites. Among other novel features, seedVicious can compute evolutionary gains/losses of target sites using maximum parsimony, and also detect near-target sites, which have one nucleotide different from a canonical site. Near-target sites are important to study population variation in microRNA regulation. Some analyses suggest that near-target sites may also be functional sites, although there is no conclusive evidence for that, and they may actually be target alleles segregating in a population. SeedVicious does not aim to outperform but to complement existing microRNA prediction tools. For instance, the precision of TargetScan is almost doubled (from 11% to ~20%) when we filter predictions by the distance between target sites using this program. Interestingly, two adjacent canonical target sites are more likely to be present in bona fide target transcripts than pairs of target sites at slightly longer distances. The software is written in Perl and runs on 64-bit Unix computers (Linux and MacOS X). Users with no computing experience can also run the program in a dedicated web-server by uploading custom data, or browse pre-computed predictions. SeedVicious and its associated web-server and database (SeedBank) are distributed under the GPL/GNU license.

The Decision to Access Patient Information from a Social Media Site: What Would You Do?

PubMed Central

Jent, Jason F.; Eaton, Cyd K.; Merrick, Melissa T.; Englebert, Nicole E.; Dandes, Susan K.; Chapman, Ana V.; Hershorin, Eugene R.

2011-01-01

Purpose The current study examined the prevalence with which healthcare providers use a social media site account (e.g., Facebook), the extent to which they utilize social media sites in clinical practice, and their decision-making process after accessing patient information from a social media site. Methods Pediatric faculty and trainees from a medical school campus were provided a social media site history form and seven fictional social media site adolescent profile vignettes that depicted concerning information. Participants were instructed to rate their personal use and beliefs about social media sites and to report how they would respond if they obtained concerning information about an adolescent patient from their public social media site profile. Results Healthcare providers generally believed it not to be an invasion of privacy to conduct an Internet/social media site search of someone they know. A small percentage of trainees reported a personal history of conducting an Internet search (18%) or a social media site search (14%) for a patient. However, no faculty endorsed a history of conducting searches for patients. Faculty and trainees also differed in how they would respond to concerning social media site adolescent profile information. Conclusions The findings that trainees are conducting Internet/social media site searches of patients and that faculty and trainees differ in how they would respond to concerning profile information suggest the need for specific guidelines regarding the role of social media sites in clinical practice. Practice, policy, and training implications are discussed. PMID:21939873

A framework for evaluating e-health: Systematic review of studies assessing the quality of health information and services for patients on the Internet

PubMed Central

Eysenbach, Gunther

2000-01-01

Context A recent concern and topic of many publications in the last three years has been the quality of health information and services for the public on the Internet. Objectives To identify and summarize studies published in the peer-reviewed literature evaluating the quality of information and services for consumers on the Internet, including information published on web sites, information on newsgroups and mailing lists and other venues such as email contacts with doctors, as well as studies evaluating the quality of ehealth services such as cyberdoctors and cyberpharmacies. Data Sources MEDLINE and PREMEDLINE (1966 - May 2000), Science Citation Index (1992-May 2000), Social Sciences Citation Index (1992- May 2000), Arts and Humanities Citation Index (1992-May 2000) and a personal bibliographic database. Study Selection We included empirical studies where investigators searched the Internet systematically for specific health information or clearly define a set of specific services to be included, evaluated the quality of information or services found, and reported quantitative data. Data Extraction Study characteristics, medical domain, search strategies used, quality criteria and methodology of quality assessment, results (number of sites rated as sufficient pertaining to a quality), quality and rigor of study methodology and reporting. Data Synthesis A total of 41 studies met the inclusion criteria, dealing either with content of websites, information on e-commerce sites, quality of online-care or community venues. A) Content: 29 evaluated information on websites, of those 5 evaluated information on websites from the field of pediatrics, 3 from oncology, 3 pharmacology information, 2 nutrition information, 4 general clinical information and 12 specific information from other clinical disciplines. Studies varied widely in methodology, quality and results. Among the 29 studies dealing with quality of health information on websites, one study evaluated the authority of source, 19 studies checked sites for presence or absences of technical criteria (such as disclosure of sponsorship, authorship, presence of references or last update), three evaluated readability, 20 evaluated the accuracy of information, and 12 content completeness. B) E-Commerce: Three studies dealt with drug information on e-commerce sites. To evaluate the quality authors extracted prices, checked for completeness of online-history taking and/or information provided on the site e.g. pertaining to contraindications or the presence/absence of disclaimers and/or liability waivers. Only one of these three studies actually used the service by ordering drugs, allowing to evaluate quality of online-advice, qualification of cyberdocs, delivery time, reasons for non-delivery. C) Care: Five studies dealt with the quality of online consultations, of them one dealt with advice given by ordinary physicians in response to a unsolicited fictionous patient request, two evaluated the responses of cyberdocs soliciting patient requests, and two evaluated advice given in response to a request for an online prescription directed to drug e-commerce sites. D) Community: Seven studies evaluated messages on mailing lists or usenet newsgroups. Two studies collected messages from a venue and evaluated them for accuracy, two studies posted a "test" message on a newsgroup and evaluated the accuracy of responses. In three studies authors used the cumulative impact factor of the published research of the mailing list contributors as an indicator for the qualification of the authors and thus as quality indicator of the mailing list. Of the 23 studies evaluating accuracy and/or completeness of information provided on websites, 10 used guidelines as gold standard (all of the to extract a-priori criteria), five used peer-reviewed literature (all to compare information a posteriori), two used textbooks, one used consensus among the raters and three used the personal experience or opinion of the author. All three studies which compared information against personal opinion came to a positive conclusion regarding the accuracy of information, while all of the more rigorous studies comparing information against guidelines concluded that much of the information found on the web were of low quality. In two cases it was not reported where the gold standard comes from. 9 studies used more than one rater to assess a website, 6 of them provided some sort of information on inter-observer variability. Conclusions Methodology, results and conclusions of investigators vary widely. There is a wide variability even regarding the evaluation of formal criteria such as authorship and references. Differences in study conclusions regarding the quality of Internet information are likely a result of difference in study rigor, evaluation criteria and topic chosen. All but five studies concluded that quality is a problem on the Internet. The rigor of these five studies coming to a more positive conclusion as expressed in a "assessment quality score" was significantly inferior to the remaining studies. Although there were two comparative studies of the quality of information on the Internet compared with information found outside of the Internet, there is little evidence that health information found on the Internet is worse than health information in traditional media. A conceptual and methodological framework is presented for describing, comparing, and analyzing the structure and quality of e-health, based on Donabedians quality measures of structure, process and outcome.

Smokeless Tobacco Use and Periodontal Health in a Rural Male Population

PubMed Central

Chu, Yong H.; Tatakis, Dimitris N.

2010-01-01

Background Despite the reported effects of smokeless tobacco (ST) on the periodontium and high prevalence of ST use in rural populations and in men, studies on this specific topic are limited. The purpose of this cross-sectional investigation is to evaluate the periodontal health status of male ST users from a rural population. Methods Adult male residents of two rural Appalachian Ohio counties and daily ST users, with a unilateral mandibular oral ST keratosis lesion, were recruited. Subjects completed a questionnaire and received oral examination. Teeth present, ST keratosis lesion, plaque and gingival index, probing depth (PD), recession depth (RD), and attachment level were recorded. Statistical analysis compared ST-site mandibular teeth (teeth adjacent to the subject’s unilateral ST keratosis lesion) to NST-site teeth (contralateral corresponding teeth). Results This study includes 73 ST users. Recession prevalence is much greater in ST-site quadrants (36%) compared to NST-site quadrants (18%; P <0.001). Twice as many teeth had recession on ST-site (approximately 20%) than NST-site (approximately 10%; P = 0.0001). Average buccal RD on ST-site teeth did not differ from that on the NST-site teeth (P = 0.0875). Although average buccal attachment loss is greater on ST-site teeth (P = 0.016), the mean difference is <0.5 mm. When stratified by years of ST use, subjects using ST for 10 to 18 years exhibit the most differences between ST and NST sites, whereas subjects using ST for <10 years show no differences. Conclusion The results indicate that greater gingival recession prevalence and extent are associated with ST placement site in rural male ST users. PMID:20350155

A retrospective tiered environmental assessment of the Mount Storm Wind Energy Facility, West Virginia,USA

DOE Office of Scientific and Technical Information (OSTI.GOV)

Efroymson, Rebecca Ann; Day, Robin; Strickland, M. Dale

Bird and bat fatalities from wind energy projects are an environmental and public concern, with post-construction fatalities sometimes differing from predictions. Siting facilities in this context can be a challenge. In March 2012 the U.S. Fish and Wildlife Service (USFWS) released Land-based Wind Energy Guidelines to assess collision fatalities and other potential impacts to species of concern and their habitats to aid in siting and management. The Guidelines recommend a tiered approach for assessing risk to wildlife, including a preliminary site evaluation that may evaluate alternative sites, a site characterization, field studies to document wildlife and habitat and to predictmore » project impacts, post construction studies to estimate impacts, and other post construction studies. We applied the tiered assessment framework to a case study site, the Mount Storm Wind Energy Facility in Grant County, West Virginia, USA, to demonstrate the use of the USFWS assessment approach, to indicate how the use of a tiered assessment framework might have altered outputs of wildlife assessments previously undertaken for the case study site, and to assess benefits of a tiered ecological assessment framework for siting wind energy facilities. The conclusions of this tiered assessment for birds are similar to those of previous environmental assessments for Mount Storm. This assessment found risk to individual migratory tree-roosting bats that was not emphasized in previous preconstruction assessments. Differences compared to previous environmental assessments are more related to knowledge accrued in the past 10 years rather than to the tiered structure of the Guidelines. Benefits of the tiered assessment framework include good communication among stakeholders, clear decision points, a standard assessment trajectory, narrowing the list of species of concern, improving study protocols, promoting consideration of population-level effects, promoting adaptive management through post-construction assessment and mitigation, and sharing information that can be used in other assessments.« less

Cost Analysis of Integrating the PrePex Medical Device into a Voluntary Medical Male Circumcision Program in Zimbabwe

PubMed Central

Hatzold, Karin; Reed, Jason; Edgil, Dianna; Jaramillo, Juan; Castor, Delivette; Forsythe, Steven; Xaba, Sinokuthemba; Mugurungi, Owen

2014-01-01

Background Fourteen African countries are scaling up voluntary medical male circumcision (VMMC) for HIV prevention. Several devices that might offer alternatives to the three WHO-approved surgical VMMC procedures have been evaluated for use in adults. One such device is PrePex, which was prequalified by the WHO in May 2013. We utilized data from one of the PrePex field studies undertaken in Zimbabwe to identify cost considerations for introducing PrePex into the existing surgical circumcision program. Methods and Findings We evaluated the cost drivers and overall unit cost of VMMC at a site providing surgical VMMC as a routine service (“routine surgery site”) and at a site that had added PrePex VMMC procedures to routine surgical VMMC as part of a research study (“mixed study site”). We examined the main cost drivers and modeled hypothetical scenarios with varying ratios of surgical to PrePex circumcisions, different levels of site utilization, and a range of device prices. The unit costs per VMMC for the routine surgery and mixed study sites were $56 and $61, respectively. The two greatest contributors to unit price at both sites were consumables and staff. In the hypothetical scenarios, the unit cost increased as site utilization decreased, as the ratio of PrePex to surgical VMMC increased, and as device price increased. Conclusions VMMC unit costs for routine surgery and mixed study sites were similar. Low service utilization was projected to result in the greatest increases in unit price. Countries that wish to incorporate PrePex into their circumcision programs should plan to maximize staff utilization and ensure that sites function at maximum capacity to achieve the lowest unit cost. Further costing studies will be necessary once routine implementation of PrePex-based circumcision is established. PMID:24801515

Rapid Assessment and Response Studies of Injection Drug Use: Knowledge Gain, Capacity Building, and Intervention Development in a Multisite Study

PubMed Central

Stimson, Gerry V.; Fitch, Chris; Jarlais, Don Des; Poznyak, Vladimir; Perlis, Theresa; Oppenheimer, Edna; Rhodes, Tim

2006-01-01

Objectives. We evaluated the World Health Organization’s rapid assessment and response (RAR) method of assessing injection drug use and its associated health problems, focusing on knowledge gain, capacity building, and whether RAR leads to the development of interventions reducing the health effects of injection drug use. Methods. Data were derived from RAR studies conducted in Beijing, China; Bogotá, Colombia; Greater Rosario, Argentina; Hanoi, Vietnam; Kharkiv, Ukraine; Minsk, Belarus; Nairobi, Kenya; Penang, Malaysia; St. Petersburg, Russia; and Tehran, Iran. Results. Substantial gains in knowledge and response capacity were reported at all of the study sites. Before RAR initiation, prevention and intervention programs had been absent or inadequate at most of the sites. The RARs resulted in many new or modified interventions; 7 sites reported 24 health-related interventions that were subsequently developed and influenced by the RARs. Conclusions. RARs, which require relatively little external funding, appear to be effective in linking assessment to development of appropriate interventions. The present results add to the evidence that rapid assessment is an important public health tool. PMID:16380578

Assessing children's ultraviolet radiation exposure: the potential usefulness of a colorimeter.

PubMed Central

Eckhardt, L; Mayer, J A; Creech, L; Johnston, M R; Lui, K J; Sallis, J F; Elder, J P

1996-01-01

OBJECTIVES: This study evaluated the colorimeter as an objective measure of children's ultraviolet (UV) radiation exposure. METHODS: Fifty-eight children, ages 6 to 9 years, attended two summer measurement sessions, with 46 attending a subsequent winter session. RESULTS: Comparisons between summer sessions for the L* scale showed that only the upper arm significantly changed in the tanner direction, while b* scale values indicated significant tanning for all body sites. All exposed body sites changed significantly in the less tan direction between summer and winter measurements. CONCLUSIONS: Using colorimeters to objectively measure children's UV exposure has potential applications for skin cancer prevention programs. PMID:9003142

Evaluation of Six Split-thickness Skin Graft Donor-site Dressing Materials in a Swine Model

PubMed Central

Masella, Pamela C.; Balent, Eric M.; Carlson, Terri L.; Lee, Karen W.

2013-01-01

Background: Numerous dressings for split-thickness skin graft donor sites are commercially available with no conclusive evidence-based consensus regarding the optimal dressing choice. This study was conducted to identify which of 5 commonly used materials promotes wound healing most effectively for use on split-thickness donor sites in comparison with our standard dressing, Xeroform (petrolatum gauze). Methods: Twenty-four partial-thickness wounds were created on the backs of 4 pigs using a dermatome. Wounds (n = 4 per dressing type per pig) were treated with Xeroform, Opsite (polyurethane film), Kaltostat ( calcium sodium alginate), DuoDERM (hydrocolloid), Aquacel (hydrofiber), and Mepilex (silicone foam). Full-thickness skin samples were excised at 3 or 5 days and evaluated histologically for reepithelialization and inflammation. Comparisons also included incidence of infection, ease of use, and cost analyses. Results: DuoDERM elicited the greatest percent reepithelialization (81%) and Mepilex the lowest (33%) after 3 days (P = 0.004). All dressings demonstrated complete reepithelialization except Mepilex (85%) at 5 days. There were no infections and inflammation was mild among all treatments. Mepilex was easiest to use, whereas Aquacel, Kaltostat, and Opsite were most difficult (P = 0.03). Xeroform was most cost-effective and Aquacel most expensive. Combined scoring revealed DuoDERM = Xeroform > Opsite = Mepilex > Kaltostat > Aquacel. Conclusions: DuoDERM and Xeroform were most effective overall. DuoDERM tended to outperform all dressings in reepithelialization at 3 days, while Xeroform was least expensive, easy to use, and demonstrated rapid reepithelialization. These findings suggest that Xeroform may be preferred for use on large donor-site areas. DuoDERM may be more appropriate for small donor sites when healing time is a priority. PMID:25289278

Towards identifying the next generation of superfund and hazardous waste site contaminants

USGS Publications Warehouse

Ela, Wendell P.; Sedlak, David L.; Barlaz, Morton A.; Henry, Heather F.; Muir, Derek C.G.; Swackhamer, Deborah L.; Weber, Eric J.; Arnold, Robert G.; Ferguson, P. Lee; Field, Jennifer A.; Furlong, Edward T.; Giesy, John P.; Halden, Rolf U.; Henry, Tala; Hites, Ronald A.; Hornbuckle, Keri C.; Howard, Philip H.; Luthy, Richard G.; Meyer, Anita K.; Saez, A. Eduardo; vom Saal, Frederick S.; Vulpe, Chris D.; Wiesner, Mark R.

2011-01-01

Conclusions A need exists for a carefully considered and orchestrated expansion of programmatic and research efforts to identify, evaluate, and manage CECs of hazardous waste site relevance, including developing an evolving list of priority CECs, intensifying the identification and monitoring of likely sites of present or future accumulation of CECs, and implementing efforts that focus on a holistic approach to prevention.

Social media use among patients and caregivers: a scoping review

PubMed Central

Hamm, Michele P; Chisholm, Annabritt; Shulhan, Jocelyn; Milne, Andrea; Scott, Shannon D; Given, Lisa M; Hartling, Lisa

2013-01-01

Objective To map the state of the existing literature evaluating the use of social media in patient and caregiver populations. Design Scoping review. Data sources Medline, CENTRAL, ERIC, PubMed, CINAHL Plus Full Text, Academic Search Complete, Alt Health Watch, Health Source, Communication and Mass Media Complete, Web of Knowledge and ProQuest (2000–2012). Study selection Studies reporting primary research on the use of social media (collaborative projects, blogs/microblogs, content communities, social networking sites, virtual worlds) by patients or caregivers. Data extraction Two reviewers screened studies for eligibility; one reviewer extracted data from relevant studies and a second performed verification for accuracy and completeness on a 10% sample. Data were analysed to describe which social media tools are being used, by whom, for what purpose and how they are being evaluated. Results Two hundred eighty-four studies were included. Discussion forums were highly prevalent and constitute 66.6% of the sample. Social networking sites (14.8%) and blogs/microblogs (14.1%) were the next most commonly used tools. The intended purpose of the tool was to facilitate self-care in 77.1% of studies. While there were clusters of studies that focused on similar conditions (eg, lifestyle/weight loss (12.7%), cancer (11.3%)), there were no patterns in the objectives or tools used. A large proportion of the studies were descriptive (42.3%); however, there were also 48 (16.9%) randomised controlled trials (RCTs). Among the RCTs, 35.4% reported statistically significant results favouring the social media intervention being evaluated; however, 72.9% presented positive conclusions regarding the use of social media. Conclusions There is an extensive body of literature examining the use of social media in patient and caregiver populations. Much of this work is descriptive; however, with such widespread use, evaluations of effectiveness are required. In studies that have examined effectiveness, positive conclusions are often reported, despite non-significant findings. PMID:23667163

A randomized trial comparing concise and standard consent forms in the START trial

PubMed Central

Touloumi, Giota; Walker, A. Sarah; Smolskis, Mary; Sharma, Shweta; Babiker, Abdel G.; Pantazis, Nikos; Tavel, Jorge; Florence, Eric; Sanchez, Adriana; Hudson, Fleur; Papadopoulos, Antonios; Emanuel, Ezekiel; Clewett, Megan; Munroe, David; Denning, Eileen

2017-01-01

Background Improving the effectiveness and efficiency of research informed consent is a high priority. Some express concern about longer, more complex, written consent forms creating barriers to participant understanding. A recent meta-analysis concluded that randomized comparisons were needed. Methods We conducted a cluster-randomized non-inferiority comparison of a standard versus concise consent form within a multinational trial studying the timing of starting antiretroviral therapy in HIV+ adults (START). Interested sites were randomized to standard or concise consent forms for all individuals signing START consent. Participants completed a survey measuring comprehension of study information and satisfaction with the consent process. Site personnel reported usual site consent practices. The primary outcome was comprehension of the purpose of randomization (pre-specified 7.5% non-inferiority margin). Results 77 sites (2429 participants) were randomly allocated to use standard consent and 77 sites (2000 participants) concise consent, for an evaluable cohort of 4229. Site and participant characteristics were similar for the two groups. The concise consent was non-inferior to the standard consent on comprehension of randomization (80.2% versus 82%, site adjusted difference: 0.75% (95% CI -3.8%, +5.2%)); and the two groups did not differ significantly on total comprehension score, satisfaction, or voluntariness (p>0.1). Certain independent factors, such as education, influenced comprehension and satisfaction but not differences between consent groups. Conclusions An easier to read, more concise consent form neither hindered nor improved comprehension of study information nor satisfaction with the consent process among a large number of participants. This supports continued efforts to make consent forms more efficient. Trial registration Informed consent substudy was registered as part of START study in clinicaltrials.gov #NCT00867048, and EudraCT # 2008-006439-12 PMID:28445471

Topology of the membrane protein LamB by epitope tagging and a comparison with the X-ray model.

PubMed

Newton, S M; Klebba, P E; Michel, V; Hofnung, M; Charbit, A

1996-06-01

We previously developed a genetic approach to study, with a single antibody, the topology of the outer membrane protein LamB, an Escherichia coli porin with specificity towards maltodextrins and a receptor for bacteriophage lambda. Our initial procedure consisted of inserting at random the same reporter epitope (the C3 neutralization epitope from poliovirus) into permissive sites of LamB (i.e., sites which tolerate insertions without deleterious effects on the protein activities or the cell). A specific monoclonal antibody was then used to examine the position of the inserted epitope with respect to the protein and the membrane. In the present work, we set up a site-directed procedure to insert the C3 epitope at new sites in order to distinguish between two-dimensional folding models. This allowed us to identify two new surface loops of LamB and to predict another periplasmic exposed region. The results obtained by random and directed epitope tagging are analyzed in light of the recently published X-ray structure of the LamB protein. Study of 23 hybrid LamB-C3 proteins led to the direct identification of five of the nine external loops (L4, L5, L6, L7, and L9) and led to the prediction of four periplasmic loops (I1, I4, I5, and I8) of LamB. Nine of the hybrid proteins did not lead to topological conclusions, and none led to the wrong predictions or conclusions. The comparison indicates that parts of models based on secondary structure predictions alone are not reliable and points to the importance of experimental data in the establishment of outer membrane protein topological models. The advantages and limitations of genetic foreign epitope insertion for the study of integral membrane proteins are discussed.

Occupancy modeling reveals territory-level effects of nest boxes on the presence, colonization, and persistence of a declining raptor in a fruit-growing region.

PubMed

Shave, Megan E; Lindell, Catherine A

2017-01-01

Nest boxes for predators in agricultural regions are an easily implemented tool to improve local habitat quality with potential benefits for both conservation and agriculture. The potential for nest boxes to increase raptor populations in agricultural regions is of particular interest given their positions as top predators. This study examined the effects of cherry orchard nest boxes on the local breeding population of a declining species, the American Kestrel (Falco sparverius), in a fruit-growing region of Michigan. During the 2013-2016 study, we added a total of 23 new nest boxes in addition to 24 intact boxes installed previously; kestrels used up to 100% of our new boxes each season. We conducted temporally-replicated surveys along four roadside transects divided into 1.6 km × 500 m sites. We developed a multi-season occupancy model under a Bayesian framework and found that nest boxes had strong positive effects on first-year site occupancy, site colonization, and site persistence probabilities. The estimated number of occupied sites increased between 2013 and 2016, which correlated with the increase in number of sites with boxes. Kestrel detections decreased with survey date but were not affected by time of day or activity at the boxes themselves. These results indicate that nest boxes determined the presence of kestrels at our study sites and support the conclusion that the local kestrel population is likely limited by nest site availability. Furthermore, our results are highly relevant to the farmers on whose properties the boxes were installed, for we can conclude that installing a nest box in an orchard resulted in a high probability of kestrels occupying that orchard or the areas adjacent to it.

Landscape genetics of high mountain frog metapopulations

USGS Publications Warehouse

Murphy, M.A.; Dezzani, R.; Pilliod, D.S.; Storfer, A.

2010-01-01

Explaining functional connectivity among occupied habitats is crucial for understanding metapopulation dynamics and species ecology. Landscape genetics has primarily focused on elucidating how ecological features between observations influence gene flow. Functional connectivity, however, may be the result of both these between-site (landscape resistance) landscape characteristics and at-site (patch quality) landscape processes that can be captured using network based models. We test hypotheses of functional connectivity that include both between-site and at-site landscape processes in metapopulations of Columbia spotted frogs (Rana luteiventris) by employing a novel justification of gravity models for landscape genetics (eight microsatellite loci, 37 sites, n = 441). Primarily used in transportation and economic geography, gravity models are a unique approach as flow (e.g. gene flow) is explained as a function of three basic components: distance between sites, production/attraction (e.g. at-site landscape process) and resistance (e.g. between-site landscape process). The study system contains a network of nutrient poor high mountain lakes where we hypothesized a short growing season and complex topography between sites limit R. luteiventris gene flow. In addition, we hypothesized production of offspring is limited by breeding site characteristics such as the introduction of predatory fish and inherent site productivity. We found that R. luteiventris connectivity was negatively correlated with distance between sites, presence of predatory fish (at-site) and topographic complexity (between-site). Conversely, site productivity (as measured by heat load index, at-site) and growing season (as measured by frost-free period between-sites) were positively correlated with gene flow. The negative effect of predation and positive effect of site productivity, in concert with bottleneck tests, support the presence of source-sink dynamics. In conclusion, gravity models provide a powerful new modelling approach for examining a wide range of both basic and applied questions in landscape genetics.

Improving safety climate through a communication and recognition program for construction: a mixed-methods study

PubMed Central

Sparer, Emily H; Catalano, Paul J; Herrick, Robert F; Dennerlein, Jack T

2016-01-01

Objectives This study aimed to evaluate the efficacy of a safety communication and recognition program (B-SAFE), designed to encourage improvement of physical working conditions and hazard reduction in construction. Methods A matched pair cluster randomized controlled trial was conducted on eight worksites (four received the B-SAFE intervention, four served as control sites) for approximately five months per site. Pre- and post-exposure worker surveys were collected at all sites (N=615, pre-exposure response rate of 74%, post-exposure response rate of 88%). Multi-level mixed-effect regression models evaluated the effect of B-SAFE on safety climate as assessed from surveys. Focus groups (N=6–8 workers/site) were conducted following data collection. Transcripts were coded and analyzed for thematic content using Atlas.ti (version 6). Results The mean safety climate score at intervention sites, as measured on a 0–50 point scale, increased 0.5 points (1%) between pre- and post-B-SAFE exposure, compared to control sites that decreased 0.8 points (1.6%). The intervention effect size was 1.64 (3.28%) (P-value=0.01) when adjusted for month the worker started on-site, total length of time on-site, as well as individual characteristics (trade, title, age, and race/ethnicity). At intervention sites, workers noted increased levels of safety awareness, communication, and teamwork compared to control sites. Conclusions B-SAFE led to many positive changes, including an improvement in safety climate, awareness, teambuilding, and communication. B-SAFE was a simple intervention that engaged workers through effective communication infrastructures and had a significant, positive effect on worksite safety. PMID:27158914

Comparison of the efficacy of chlorhexidine varnish and chip in the treatment of chronic periodontitis

PubMed Central

Jagadish Pai, B. S.; Rajan, Smitha Anitha; Srinivas, M.; Padma, R.; Suragimath, Girish; Walvekar, Amit; Goel, Saakshi; Kamath, Vinesh

2013-01-01

Background: The purpose of this study was to clinically evaluate the benefits of sub gingival chlorhexidine (CHX) varnish and biodegradable CHX chip application used as an adjunct to scaling and root planning (SRP) as combined therapy and also to compare the effect of combined therapy with SRP alone. Materials and Methods: Fifteen patients with at least three sites with a probing pocket depth (PPD) of 5-8 mm were considered. Following baseline evaluation, all three sites were subjected for SRP. After completing SRP, each site was randomly subjected for CHX varnish, CHX chip application and the 3rd site was left without any medication as a control. Clinical parameters such as sulcus bleeding index, plaque index, bleeding on probing (BOP), PPD, and clinical attachment level (CAL) were recorded at baseline, 1 month and 3 months post-operatively. Results: All three groups presented with an improvement in clinical parameters compared to baseline. The mean reduction in PPD was 2.4 mm in SRP sites, 2.5 mm in SRP + CHX varnish sites and 2.8 mm in SRP + CHX chip sites. The mean gain in CAL was 2.4 mm in SRP sites, 2.3 mm in SRP + CHX varnish sites and 2.8 mm SRP + CHX chip sites. Interpretation and Conclusion: The present study indicated that application of CHX varnish and placement of CHX chip as an adjunct to SRP produced a clinically significant reduction in the PPD, BOP and a gain in CAL at 30th day and 90th day from baseline when compared to SRP alone. The results though were not statistically significant. PMID:24015002

The mycobiota of the production environments of traditional Norwegian salted and dried mutton (pinnekjøtt).

PubMed

Schirmer, Bjørn C T; Wiik-Nielsen, Jannicke; Skaar, Ida

2018-07-02

In 2013, mould growth on Norwegian ready-to-sell pinnekjøtt (dried and cured lamb ribs) lead to the withdrawal of 200 tons of the product. The aim of this study was to identify the mycobiota at two Norwegian production sites and determine which species present the highest risk for reduced product quality and safety. A total of 485 samples from 2014, 2015 and 2016 were analysed for Penicillium and Aspergillus species. Both production sites showed a persistent mycobiota that remained stable over three seasons. Samples from site A were dominated by P. solitum while samples from site B were equally dominated by P. solitum, P. brevicompactum/bialowiezense and P. nordicum. The presence of P. nordicum was concentrated in one area of the production site where long-time stored hams were produced, but P. nordicum was also found sporadically in other parts of the site. Product samples taken from products with visible mould growth were at both sites dominated by P. solitum, highlighting its importance for product quality. P. nordicum was found frequently in the long-time stored hams, indicating a food safety risk of these products. However, P. nordicum was rarely isolated from pinnekjøtt. Aspergillus spp. were isolated from both sites at all samplings; however, there were no Aspergillus isolated from products, and no sites were repeatedly tested positive for identical species, indicating that Aspergillus is not a part of the persistent mycobiota, but enters the site sporadically. In conclusion, the study showed that a stable mycobiota consisting of few Penicillium species dominated the products and production environments of pinnekjøtt. Copyright © 2018 Elsevier B.V. All rights reserved.

Maternal and newborn outcomes in Pakistan compared to other low and middle income countries in the Global Network’s Maternal Newborn Health Registry: an active, community-based, pregnancy surveillance mechanism

PubMed Central

2015-01-01

Background Despite global improvements in maternal and newborn health (MNH), maternal, fetal and newborn mortality rates in Pakistan remain stagnant. Using data from the Global Network’s Maternal Newborn Health Registry (MNHR) the objective of this study is to compare the rates of maternal mortality, stillbirth and newborn mortality and levels of putative risk factors between the Pakistani site and those in other countries. Methods Using data collected through a multi-site, prospective, ongoing, active surveillance system to track pregnancies and births in communities in discrete geographical areas in seven sites across six countries including Pakistan, India, Kenya, Zambia, Guatemala and Argentina from 2010 to 2013, the study compared MNH outcomes and risk factors. The MNHR captures more than 60,000 deliveries annually across all sites with over 10,000 of them in Thatta, Pakistan. Results The Pakistan site had a maternal mortality ratio almost three times that of the other sites (313/100,000 vs 116/100,000). Stillbirth (56.5 vs 22.9/1000 births), neonatal mortality (50.0 vs 20.7/1000 livebirths) and perinatal mortality rates (95.2/1000 vs 39.0/1000 births) in Thatta, Pakistan were more than twice those of the other sites. The Pakistani site is the only one in the Global Network where maternal mortality increased (from 231/100,000 to 353/100,000) over the study period and fetal and neonatal outcomes remained stagnant. The Pakistan site lags behind other sites in maternal education, high parity, and appropriate antenatal and postnatal care. However, facility delivery and skilled birth attendance rates were less prominently different between the Pakistani site and other sites, with the exception of India. The difference in the fetal and neonatal outcomes between the Pakistani site and the other sites was most pronounced amongst normal birth weight babies. Conclusions The increase in maternal mortality and the stagnation of fetal and neonatal outcomes from 2010 to 2013 indicates that current levels of antenatal and newborn care interventions in Thatta, Pakistan are insufficient to protect against poor maternal and neonatal outcomes. Delivery care in the Pakistani site, while appearing quantitatively equivalent to the care in sites in Africa, is less effective in saving the lives of women and their newborns. By the metrics available from this study, the quality of obstetric and neonatal care in the site in Pakistan is poor. Trial registration The study is registered at clinicaltrials.gov [NCT01073475]. PMID:26062610

Evaluating multicenter DTI data in Huntington's disease on site specific effects: An ex post facto approach☆

PubMed Central

Müller, Hans-Peter; Grön, Georg; Sprengelmeyer, Reiner; Kassubek, Jan; Ludolph, Albert C.; Hobbs, Nicola; Cole, James; Roos, Raymund A.C.; Duerr, Alexandra; Tabrizi, Sarah J.; Landwehrmeyer, G. Bernhard; Süssmuth, Sigurd D.

2013-01-01

Purpose Assessment of the feasibility to average diffusion tensor imaging (DTI) metrics of MRI data acquired in the course of a multicenter study. Materials and methods Sixty-one early stage Huntington's disease patients and forty healthy controls were studied using four different MR scanners at four European sites with acquisition protocols as close as possible to a given standard protocol. The potential and feasibility of averaging data acquired at different sites was evaluated quantitatively by region-of-interest (ROI) based statistical comparisons of coefficients of variation (CV) across centers, as well as by testing for significant group-by-center differences on averaged fractional anisotropy (FA) values between patients and controls. In addition, a whole-brain based statistical between-group comparison was performed using FA maps. Results The ex post facto statistical evaluation of CV and FA-values in a priori defined ROIs showed no differences between sites above chance indicating that data were not systematically biased by center specific factors. Conclusion Averaging FA-maps from DTI data acquired at different study sites and different MR scanner types does not appear to be systematically biased. A suitable recipe for testing on the possibility to pool multicenter DTI data is provided to permit averaging of DTI-derived metrics to differentiate patients from healthy controls at a larger scale. PMID:24179771

Restoration of areas degraded by alluvial sand mining: use of soil microbiological activity and plant biomass growth to assess evolution of restored riparian vegetation.

PubMed

Venson, Graziela R; Marenzi, Rosemeri C; Almeida, Tito César M; Deschamps-Schmidt, Alexandre; Testolin, Renan C; Rörig, Leonardo R; Radetski, Claudemir M

2017-03-01

River or alluvial sand mining is causing a variety of environmental problems in the Itajaí-açú river basin in Santa Catarina State (south of Brazil). When this type of commercial activity degrades areas around rivers, environmental restoration programs need to be executed. In this context, the aim of this study was to assess the evolution of a restored riparian forest based on data on the soil microbial activity and plant biomass growth. A reference site and three sites with soil degradation were studied over a 3-year period. Five campaigns were performed to determine the hydrolysis of the soil enzyme fluorescein diacetate (FDA), and the biomass productivity was determined at the end of the studied period. The variation in the enzyme activity for the different campaigns at each site was low, but this parameter did differ significantly according to the site. Well-managed sites showed the highest biomass productivity, and this, in turn, showed a strong positive correlation with soil enzyme activity. In conclusion, soil enzyme activity could form the basis for monitoring and the early prediction of the success of vegetal restoration programs, since responses at the higher level of biological organization take longer, inhibiting the assessment of the project within an acceptable time frame.

Enzymatic evaluation of gingival crevicular fluid in cleft palate patients during orthodontic treatment: A clinico-biochemical study

PubMed Central

Kulal, Rithesh; Thomas, Biju; Ravi, M. S.; Shetty, Suchetha

2013-01-01

Background: Therapeutic goal in patients with cleft lip and palate is esthetics and long-term health of the stomatognathic system. Patients with cleft lip and palate routinely require extensive and prolonged orthodontic treatment. The osseous structures are absent or poorly developed in the osseous clefts and may be traumatized in the course of orthodontic therapy; hence require constant monitoring during orthodontic treatment. The aim of the study was to evaluate the tissue response of cleft palate patients by quantitative analysis of enzyme activity during orthodontic treatment and assess any difference in the tissue response with that of noncleft patients undergoing orthodontic treatment. Materials and Methods: 20 patients requiring orthodontic treatment agedbetween 15 to 25 years were included to participate in the studyof which ten were cleft palate patients (group I) and ten noncleft patients (group II). The GCF samples were collected at incisor and molar sites during orthodontic treatment on days as per the study design in both the groups. The GCF enzymatic levels were estimated and compared. Results: Both groups showed significant increased enzyme activity at the incisor site compared to molar site corresponding to the phases of tooth movement. Conclusion: There was significant difference in enzyme activity between the incisor adjacent to the cleft site and molar site. There was no difference in the tissue response between cleft palate patients and noncleft patients during orthodontic treatment. PMID:24049331

Site-specificity of abnormal excision: the mechanism of formation of a specialized transducing bacteriophage lambda plac5.

PubMed Central

Shpakovski, G V; Berlin, Y A

1984-01-01

Molecular mechanism of the specialized transducing bacteriophage lambda plac5 formation has been studied. Phage-bacterial DNA junctions in lambda plac5 DNA are localized and primary structure of regions of the abnormal excisional recombination leading to the phage formation is elucidated; the crossover region proved to be comparable with the central part of attP and attB sites (the core and the adjacent tetranucleotide) in length and degree of homology. Bacterial insert in lambda plac5 DNA is shown to end immediately after Z-Y spacer, the DNA not containing lacY gene segments. The data obtained led to the conclusion of site-specific (homologous) character of abnormal excision upon formation of lambda transducing bacteriophages. Possible mechanisms of the excision are discussed. Images PMID:6091038

Epigenome-wide cross-tissue predictive modeling and comparison of cord blood and placental methylation in a birth cohort

PubMed Central

De Carli, Margherita M; Baccarelli, Andrea A; Trevisi, Letizia; Pantic, Ivan; Brennan, Kasey JM; Hacker, Michele R; Loudon, Holly; Brunst, Kelly J; Wright, Robert O; Wright, Rosalind J; Just, Allan C

2017-01-01

Aim: We compared predictive modeling approaches to estimate placental methylation using cord blood methylation. Materials & methods: We performed locus-specific methylation prediction using both linear regression and support vector machine models with 174 matched pairs of 450k arrays. Results: At most CpG sites, both approaches gave poor predictions in spite of a misleading improvement in array-wide correlation. CpG islands and gene promoters, but not enhancers, were the genomic contexts where the correlation between measured and predicted placental methylation levels achieved higher values. We provide a list of 714 sites where both models achieved an R2 ≥0.75. Conclusion: The present study indicates the need for caution in interpreting cross-tissue predictions. Few methylation sites can be predicted between cord blood and placenta. PMID:28234020

Comparisons between two biochemical markers in evaluating periodontal disease severity: a cross-sectional study

PubMed Central

2014-01-01

Background The purpose of this study was to compare two biochemical markers, which have been previously used to determine the degrees of alveolar bone destruction, in evaluating periodontal disease severity. Methods The WF6 epitope of chondroitin sulfate (CS) and the alkaline phosphatase (ALP) levels were determined in gingival crevicular fluid (GCF) samples collected from patients with various degrees of disease severity, including ten patients with gingivitis (50 gingivitis sites) and 33 patients with chronic periodontitis (including gingivitis, slight, moderate, and severe periodontitis sites; n = 50 each), as well as from ten healthy volunteers (50 healthy sites) by Periopaper strips. The levels of CS and ALP were measured by an ELISA and a fluorometric assay, respectively. Results The results demonstrated low levels of CS and ALP in non-destructive and slightly destructive periodontitis sites, whereas significantly high levels of these two biomolecules were shown in moderately and severely destructive sites (p < 0.05). Although a significant difference in CS levels was found between moderate and severe periodontitis sites, no difference in ALP levels was found. Stronger correlations were found between CS levels and periodontal parameters, including probing depth, loss of clinical attachment levels, gingival index and plaque index, than between ALP levels and these parameters. Conclusions It is suggested that the CS level is a better diagnostic marker than the ALP level for evaluating distinct severity of chronic periodontitis. PMID:25174345

Attrition of Canadian Internet pharmacy websites: what are the implications?

PubMed Central

Veronin, Michael A; Clancy, Kristen M

2013-01-01

Background The unavailability of Internet pharmacy websites may impact a consumer’s drug purchases and health care. Objective To address the issue of attrition, a defined set of Canadian Internet pharmacy websites was examined at three separate time intervals. Methods In February to March 2006, 117 distinct, fully functional “Canadian Internet pharmacy” websites were located using the advanced search options of Google and the uniform resource locator (URL) for each website was recorded. To determine website attrition, each of the 117 websites obtained and recorded from the previous study was revisited at two later periods of time within a 4-year period. Results After approximately 4 years and 5 months, only 59 (50.4%) sites were found in the original state. Thirty-four sites (29.1%) had moved to a new URL address and were not functioning as the original Internet pharmacy. For 24 sites (20.5%) the viewer was redirected to another Canadian Internet pharmacy site. Conclusion Of concern for patients if Internet pharmacy sites were suddenly inaccessible would be the disruption of continuity of care. PMID:23983491

Onset of mandible and tibia osteoradionecrosis – a comparative pilot study in the rat

PubMed Central

Damek-Poprawa, Monika; Both, Stefan; Wright, Alexander C.; Maity, Amit; Akintoye, Sunday O.

2012-01-01

Objectives Osteoradionecrosis (ORN) is common in the jaws following radiotherapy. We hypothesized that mandible is more susceptible to ORN than tibia based on site-disparity in hypoxic-hypocellular-hypovascular tissue breakdown. Study Design Twelve rats received 50 Gy irradiation to mandible or tibia; 4 of 12 rats further received minor surgical trauma to the irradiated sites. Structural and cellular skeletal changes were assessed with computer tomography, histology and immunostaining. Results Mandible developed ORN with 70% mean bone loss 10 weeks post-irradiation (p < 0.05) while tibia was structurally and radiological intact for 20 weeks post-irradiation. Hypocellularity, hypoxia and oxidative stress were higher in irradiated mandible (p < 0.001) than tibia (p < 0.01) but vascular damage was similar at both skeletal sites. Combined effects of radiation and minor trauma promoted mandibular alveolar bone loss and tibial fracture Conclusion ORN has a more rapid onset in mandible relative to tibia in the rat PMID:23254371

Digital Accessible Knowledge and well-inventoried sites for birds in Mexico: baseline sites for measuring faunistic change

PubMed Central

Navarro-Sigüenza, Adolfo G.; Martínez-Meyer, Enrique

2016-01-01

Background Faunal change is a basic and fundamental element in ecology, biogeography, and conservation biology, yet vanishingly few detailed studies have documented such changes rigorously over decadal time scales. This study responds to that gap in knowledge, providing a detailed analysis of Digital Accessible Knowledge of the birds of Mexico, designed to marshal DAK to identify sites that were sampled and inventoried rigorously prior to the beginning of major global climate change (1980). Methods We accumulated DAK records for Mexican birds from all relevant online biodiversity data portals. After extensive cleaning steps, we calculated completeness indices for each 0.05° pixel across the country; we also detected ‘hotspots’ of sampling, and calculated completeness indices for these broader areas as well. Sites were designated as well-sampled if they had completeness indices above 80% and >200 associated DAK records. Results We identified 100 individual pixels and 20 broader ‘hotspots’ of sampling that were demonstrably well-inventoried prior to 1980. These sites are catalogued and documented to promote and enable resurvey efforts that can document events of avifaunal change (and non-change) across the country on decadal time scales. Conclusions Development of repeated surveys for many sites across Mexico, and particularly for sites for which historical surveys document their avifaunas prior to major climate change processes, would pay rich rewards in information about distributional dynamics of Mexican birds. PMID:27651986

The Binding of Silibinin, the Main Constituent of Silymarin, to Site I on Human Serum Albumin.

PubMed

Yamasaki, Keishi; Sato, Hiroki; Minagoshi, Saori; Kyubun, Karin; Anraku, Makoto; Miyamura, Shigeyuki; Watanabe, Hiroshi; Taguchi, Kazuaki; Seo, Hakaru; Maruyama, Toru; Otagiri, Masaki

2017-01-01

Silibinin is the main constituent of silymarin, an extract from the seeds of milk thistle (Silybum marianum). Because silibinin has many pharmacological activities, extending its clinical use in the treatment of a wider variety of diseases would be desirable. In this study, we report on the binding of silibinin to plasma proteins, an issue that has not previously been extensively studied. The findings indicated that silibinin mainly binds to human serum albumin (HSA). Mutual displacement experiments using ligands that primarily bind to sites I and II clearly revealed that silibinin binds tightly and selectively to site I (subsites Ia and/or Ic) of HSA, which is located in subdomain IIA. Thermodynamic analyses suggested that hydrogen bonding and van der Waals interactions are major contributors to silibinin-HSA interactions. Furthermore, the binding of silibinin to HSA was found to be decreased with increasing ionic strength and detergent concentration of the media, suggesting that electrostatic and hydrophobic interactions are involved in the binding. Trp214 and Arg218 were identified as being involved in the binding of silibinin to site I, based on binding experiments using chemically modified- and mutant-HSAs. In conclusion, the available evidence indicates that silibinin binds to the region close to Trp214 and Arg218 in site I of HSA with assistance by multiple forces and can displace site I drugs (e.g., warfarin or iodipamide), but not site II drugs (e.g., ibuprofen).

High variation in clonal vs. sexual reproduction in populations of the wild strawberry, Fragaria virginiana (Rosaceae)

PubMed Central

Wilk, John A.; Kramer, Andrea T.; Ashley, Mary V.

2009-01-01

Background and Aims Many plants reproduce both clonally and sexually, and the balance between the two modes of reproduction will vary among populations. Clonal reproduction was characterized in three populations of the wild strawberry, Fragaria virginiana, to determine the extent that reproductive mode varied locally between sites. The study sites were fragmented woodlands in Cook County, Illinois, USA. Methods A total of 95 strawberry ramets were sampled from the three sites via transects. Ramets were mapped and genotyped at five variable microsatellite loci. The variability at these five loci was sufficient to assign plants to clones with high confidence, and the spatial pattern of genets was mapped at each site. Key Results A total of 27 distinct multilocus genotypes were identified. Of these, 18 genotypes were detected only once, with the remaining nine detected in multiple ramets. The largest clone was identified in 16 ramets. No genets were shared between sites, and each site exhibited markedly different clonal and sexual recruitment patterns, ranging from two non-overlapping and widespread genets to 19 distinct genets. Only one flowering genet was female; the remainder were hermaphrodites. Conclusions Local population history or fine-scale ecological differences can result in dramatically different reproductive patterns at small spatial scales. This finding may be fairly widespread among clonal plant species, and studies that aim to characterize reproductive modes in species capable of asexual reproduction need to evaluate reproductive modes in multiple populations and sites. PMID:19797422

77 FR 48550 - Technicolor Creative Services, Post Production Feature Mastering Division Including On-Site...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-14

... Services, Post Production Feature Mastering Division Including On-Site Leased Workers From Ajilon... Services, Post Production Feature Mastering Division, Hollywood, California (subject firm). The worker... the workers meet the eligibility requirements of the Trade Act of 1974. Conclusion After careful...

Detection of Influenza A viruses at migratory bird stopover sites in Michigan, USA.

PubMed

Lickfett, Todd M; Clark, Erica; Gehring, Thomas M; Alm, Elizabeth W

2018-01-01

Introduction: Influenza A viruses have the potential to cause devastating illness in humans and domestic poultry. Wild birds are the natural reservoirs of Influenza A viruses and migratory birds are implicated in their global dissemination. High concentrations of this virus are excreted in the faeces of infected birds and faecal contamination of shared aquatic habitats can lead to indirect transmission among birds via the faecal-oral route. The role of migratory birds in the spread of avian influenza has led to large-scale surveillance efforts of circulating avian influenza viruses through direct sampling of live and dead wild birds. Environmental monitoring of bird habitats using molecular detection methods may provide additional information on the persistence of influenza virus at migratory stopover sites distributed across large spatial scales. Materials and methods: In the current study, faecal and water samples were collected at migratory stopover sites and evaluated for Influenza A by real-time quantitative reverse transcriptase PCR. Results and Discussion: This study found that Influenza A was detected at 53% of the evaluated stopover sites, and 7% and 4.8% of the faecal and water samples, respectively, tested positive for Influenza A virus. Conclusion: Environmental monitoring detected Influenza A at stopover sites used by migratory birds.

A Bioinformatics Approach to the Identification of Variants Associated with Type 1 and Type 2 Diabetes Mellitus that Reside in Functionally Validated miRNAs Binding Sites.

PubMed

Ghaedi, Hamid; Bastami, Milad; Jahani, Mohammad Mehdi; Alipoor, Behnam; Tabasinezhad, Maryam; Ghaderi, Omar; Nariman-Saleh-Fam, Ziba; Mirfakhraie, Reza; Movafagh, Abolfazl; Omrani, Mir Davood; Masotti, Andrea

2016-06-01

The present work is aimed at finding variants associated with Type 1 and Type 2 diabetes mellitus (DM) that reside in functionally validated miRNAs binding sites and that can have a functional role in determining diabetes and related pathologies. Using bioinformatics analyses we obtained a database of validated polymorphic miRNA binding sites which has been intersected with genes related to DM or to variants associated and/or in linkage disequilibrium (LD) with it and is reported in genome-wide association studies (GWAS). The workflow we followed allowed us to find variants associated with DM that also reside in functional miRNA binding sites. These data have been demonstrated to have a functional role by impairing the functions of genes implicated in biological processes linked to DM. In conclusion, our work emphasized the importance of SNPs located in miRNA binding sites. The results discussed in this work may constitute the basis of further works aimed at finding functional candidates and variants affecting protein structure and function, transcription factor binding sites, and non-coding epigenetic variants, contributing to widen the knowledge about the pathogenesis of this important disease.

Positive evolution of the glycoprotein (GP) gene is related to transmission of the Ebola virus.

PubMed

Jing, Y X; Wang, L N; Wu, X M; Song, C X

2016-03-28

Ebola hemorrhagic fever is a fatal disease caused by the negative-strand RNA of the Ebola virus. A high-intensity outbreak of this fever was reported in West Africa last year; however, there is currently no definitive treatment strategy available for this disease. In this study, we analyzed the molecular evolutionary history and attempted to determine the positive selection sites in the Ebola genes using multiple-genomic sequences of the various Ebola virus subtypes, in order to gain greater clarity into the evolution of the virus and its various subtypes. Only the glycoprotein (GP) gene was positively selected among the 8 Ebola genes, with the other genes remaining in the purification stage. The positive selection sites in the GP gene were identified by a random-site model; these sites were found to be located in the mucin-like region, which is associated with transmembrane protein binding. Additionally, different branches of the phylogenetic tree displayed different positive sites, which in turn was responsible for differences in the cell adhesion ability of the virus. In conclusion, the pattern of positive sites in the GP gene is associated with the epidemiology and prevalence of Ebola in different areas.

Analysis of factors associated with development of Bacille Calmette-Guérin inoculation site change in patients with Kawasaki disease.

PubMed

Araki, Tooru; Kodera, Aya; Kitada, Kunimi; Fujiwara, Michimasa; Muraoka, Michiko; Abe, Yoshiko; Ikeda, Masanori; Tsukahara, Hirokazu

2018-04-01

Objective The present study was performed to identify factors associated with a Bacille Calmette-Guérin (BCG) inoculation site change in patients with Kawasaki disease (KD). Methods Among patients who had received BCG vaccination and treatment for KD at our hospital from 2005 through 2016, 177 patients born in 2005 through 2016 were enrolled. The patients were divided into those with (n = 83, change group) and without (n = 94, no-change group) a BCG site change, and the patient demographics, clinical severity, blood examination results, and echocardiographic findings were compared between the two groups. Results The change group was younger at onset and had a shorter interval from vaccination to onset. A BCG site change was observed in patients who developed the onset of KD symptoms from 31 to 806 days after BCG vaccination. Multivariate analysis showed that the interval from vaccination was closely and positively associated with the BCG site change (hazard ratio = 0.995, 95% confidence interval = 0.993-0.997). Conclusion A BCG site change in patients with KD is most closely associated with the interval from BCG vaccination to onset.

SDM-Assist software to design site-directed mutagenesis primers introducing “silent” restriction sites

PubMed Central

2013-01-01

Background Over the past decades site-directed mutagenesis (SDM) has become an indispensable tool for biological structure-function studies. In principle, SDM uses modified primer pairs in a PCR reaction to introduce a mutation in a cDNA insert. DpnI digestion of the reaction mixture is used to eliminate template copies before amplification in E. coli; however, this process is inefficient resulting in un-mutated clones which can only be distinguished from mutant clones by sequencing. Results We have developed a program – ‘SDM-Assist’ which creates SDM primers adding a specific identifier: through additional silent mutations a restriction site is included or a previous one removed which allows for highly efficient identification of ‘mutated clones’ by a simple restriction digest. Conclusions The direct identification of SDM clones will save time and money for researchers. SDM-Assist also scores the primers based on factors such as Tm, GC content and secondary structure allowing for simplified selection of optimal primer pairs. PMID:23522286

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Tingting; Chang, Chin -Yuan; Lohman, Jeremy R.

Comparative analysis of the enediyne biosynthetic gene clusters revealed sets of conserved genes serving as outstanding candidates for the enediyne core. Here we report the crystal structures of SgcJ and its homologue NCS-Orf16, together with gene inactivation and site-directed mutagenesis studies, to gain insight into enediyne core biosynthesis. Gene inactivation in vivo establishes that SgcJ is required for C-1027 production in Streptomyces globisporus. SgcJ and NCS-Orf16 share a common structure with the nuclear transport factor 2-like superfamily of proteins, featuring a putative substrate binding or catalytic active site. Site-directed mutagenesis of the conserved residues lining this site allowed us tomore » propose that SgcJ and its homologues may play a catalytic role in transforming the linear polyene intermediate, along with other enediyne polyketide synthase-associated enzymes, into an enzyme-sequestered enediyne core intermediate. In conclusion, these findings will help formulate hypotheses and design experiments to ascertain the function of SgcJ and its homologues in nine-membered enediyne core biosynthesis.« less

Mercury in Nelson's Sparrow Subspecies at Breeding Sites

PubMed Central

Winder, Virginia L.; Emslie, Steven D.

2012-01-01

Background Mercury is a persistent, biomagnifying contaminant that can cause negative effects on ecosystems. Marshes are often areas of relatively high mercury methylation and bioaccumulation. Nelson's Sparrows (Ammodramus nelsoni) use marsh habitats year-round and have been documented to exhibit tissue mercury concentrations that exceed negative effects thresholds. We sought to further characterize the potential risk of Nelson's Sparrows to mercury exposure by sampling individuals from sites within the range of each of its subspecies. Methodology/Principal Findings From 2009 to 2011, we captured adult Nelson's Sparrows at sites within the breeding range of each subspecies (A. n. nelsoni: Grand Forks and Upham, North Dakota; A. n. alterus: Moosonee, Ontario; and A. n. subvirgatus: Grand Manan Island, New Brunswick) and sampled breast feathers, the first primary feather (P1), and blood for total mercury analysis. Mean blood mercury in nelsoni individuals captured near Grand Forks ranged from 0.84±0.37 to 1.65±1.02 SD ppm among years, between 2.0 and 4.9 times as high as concentrations at the other sites (P<0.01). Breast feather mercury did not vary among sites within a given sampling year (site means ranged from 0.98±0.69 to 2.71±2.93 ppm). Mean P1 mercury in alterus (2.96±1.84 ppm fw) was significantly lower than in any other sampled population (5.25±2.24–6.77±3.51 ppm; P≤0.03). Conclusions/Significance Our study further characterized mercury in Nelson's Sparrows near Grand Forks; we documented localized and potentially harmful mercury concentrations, indicating that this area may represent a biological mercury hotspot. This finding warrants further research to determine if wildlife populations of conservation or recreational interest in this area may be experiencing negative effects due to mercury exposure. We present preliminary conclusions about the risk of each sampled population to mercury exposure. PMID:22384194

A Randomized Placebo-Controlled Trial of Citalopram for Anxiety Disorders Following Traumatic Brain Injury

DTIC Science & Technology

2005-04-01

WRAMC and all other sites in the multi-center study have been trained to use our electronic data capture system. Recent literature on Escitalopram , the...Disorder (GAD). Based on the merits of three placebo- controlled studies, Forest Laboratories announced the FDA approval of Escitalopram for the treatment...therefore there are no conclusions that can be made at this time. References: Davidson JR, Bose A, Korotzer A, Hongije Z. Escitalopram in the

The nature of the exchange coupling between high-spin Fe(III) heme o3 and CuBII in Escherichia coli quinol oxidase, cytochrome bo3: MCD and EPR studies.

PubMed

Cheesman, Myles R; Oganesyan, Vasily S; Watmough, Nicholas J; Butler, Clive S; Thomson, Andrew J

2004-04-07

Fully oxidized cytochrome bo3 from Escherichia coli has been studied in its oxidized and several ligand-bound forms using electron paramagnetic resonance (EPR) and magnetic circular dichroism (MCD) spectroscopies. In each form, the spin-coupled high-spin Fe(III) heme o3 and CuB(II) ion at the active site give rise to similar fast-relaxing broad features in the dual-mode X-band EPR spectra. Simulations of dual-mode spectra are presented which show that this EPR can arise only from a dinuclear site in which the metal ions are weakly coupled by an anisotropic exchange interaction of J 1 cm-1. A variable-temperature and magnetic field (VTVF) MCD study is also presented for the cytochrome bo3 fluoride and azide derivatives. New methods are used to extract the contribution to the MCD of the spin-coupled active site in the presence of strong transitions from low-spin Fe(III) heme b. Analysis of the MCD data, independent of the EPR study, also shows that the spin-coupling within the active site is weak with J approximately 1 cm-1. These conclusions overturn a long-held view that such EPR signals in bovine cytochrome c oxidase arise from an S' = 2 ground state resulting from strong exchange coupling (J > 10(2) cm-1) within the active site.

The role of economics in the QUERI program: QUERI Series

PubMed Central

Smith, Mark W; Barnett, Paul G

2008-01-01

Background The United States (U.S.) Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) has implemented economic analyses in single-site and multi-site clinical trials. To date, no one has reviewed whether the QUERI Centers are taking an optimal approach to doing so. Consistent with the continuous learning culture of the QUERI Program, this paper provides such a reflection. Methods We present a case study of QUERI as an example of how economic considerations can and should be integrated into implementation research within both single and multi-site studies. We review theoretical and applied cost research in implementation studies outside and within VA. We also present a critique of the use of economic research within the QUERI program. Results Economic evaluation is a key element of implementation research. QUERI has contributed many developments in the field of implementation but has only recently begun multi-site implementation trials across multiple regions within the national VA healthcare system. These trials are unusual in their emphasis on developing detailed costs of implementation, as well as in the use of business case analyses (budget impact analyses). Conclusion Economics appears to play an important role in QUERI implementation studies, only after implementation has reached the stage of multi-site trials. Economic analysis could better inform the choice of which clinical best practices to implement and the choice of implementation interventions to employ. QUERI economics also would benefit from research on costing methods and development of widely accepted international standards for implementation economics. PMID:18430199

Health technology assessment: Off-site sterilization

PubMed Central

Dehnavieh, Reza; Mirshekari, Nadia; Ghasemi, Sara; Goudarzi, Reza; Haghdoost, AliAkbar; Mehrolhassani, Mohammad Hossain; Moshkani, Zahra; Noori Hekmat, Somayeh

2016-01-01

Background: Every year millions of dollars are expended to equip and maintain the hospital sterilization centers, and our country is not an exception of this matter. According to this, it is important to use more effective technologies and methods in health system in order to reach more effectiveness and saving in costs. This study was conducted with the aim of evaluating the technology of regional sterilization centers. Methods: This study was done in four steps. At the first step, safety and effectiveness of technology was studied via systematic study of evidence. The next step was done to evaluate the economical aspect of off-site sterilization technology using gathered data from systematic review of the texts which were related to the technology and costs of off-site and in-site hospital sterilization. Third step was conducted to collect experiences of using technology in some selected hospitals around the world. And in the last step different aspects of acceptance and use of this technology in Iran were evaluated. Results: Review of the selected articles indicated that efficacy and effectiveness of this technology is Confirmed. The results also showed that using this method is not economical in Iran. Conclusion: According to the revealed evidences and also cost analysis, due to shortage of necessary substructures and economical aspect, installing the off-site sterilization health technology in hospitals is not possible currently. But this method can be used to provide sterilization services for clinics and outpatients centers. PMID:27390714

The Utility of Geographical Information Systems (GIS) in Systems-Oriented Obesity Intervention Projects: The Selection of Comparable Study Sites for a Quasi-Experimental Intervention Design—TX CORD

PubMed Central

Byars, Allison; Byrd-Williams, Courtney; Sharma, Shreela V.; Durand, Casey; Hoelscher, Deanna M.; Butte, Nancy F.; Kelder, Steven H.

2015-01-01

Abstract Background: The Texas Childhood Obesity Research Demonstration project (TX CORD) uses a systems-oriented approach to address obesity that includes individual and family interventions, community-level action, as well as environmental and policy initiatives. Given that randomization is seldom possible in community-level intervention studies, TX CORD uses a quasi-experimental design. Comparable intervention and comparison study sites are needed to address internal validity bias. Methods: TX CORD was designed to be implemented in low-income, ethnically diverse communities in Austin and Houston, Texas. A three-stage Geographical Information System (GIS) methodology was used to establish and ascertain the comparability of the intervention and comparison study sites. Census tract (stage 1) and school (stage 2) data were used to identify spatially exclusive geographic areas that were comparable. In stage 3, study sites were compared on demographic characteristics, socioeconomic status (SES), food assets, and physical activity (PA) assets. Student's t-test was used to examine significant differences between the selected sites. Results: The methodology that was used resulted in the selection of catchment areas with demographic and socioeconomic characteristics that fit the target population: ethnically diverse population; lower-median household income; and lower home ownership rates. Additionally, the intervention and comparison sites were statistically comparable on demographic and SES variables, as well as food assets and PA assets. Conclusions: This GIS approach can provide researchers, program evaluators, and policy makers with useful tools for both research and practice. Area-level information that allows for robust understanding of communities can enhance analytical procedures in community health research and offer significant contributions in terms of community assessment and engagement. PMID:25587670

Cosmetic outcome of skin adhesives versus transcutaneous sutures in laparoscopic port-site wounds: a prospective randomized controlled trial.

PubMed

Buchweitz, Olaf; Frye, Christian; Moeller, Claus Peter; Nugent, Wolfgang; Krueger, Eckart; Nugent, Andreas; Biel, Peter; Juergens, Sven

2016-06-01

In an elective laparoscopic surgery, the cosmetic outcome becomes increasingly important. We conducted a study to evaluate the cosmetic outcome 3 months after a laparoscopic procedure and compared skin adhesive (SA) versus transcutaneous suture (TS). A randomized, controlled, prospective study was conducted at a single study centre in Hamburg, Germany. Seventy-seven patients undergoing laparoscopic surgery with two lower abdominal port sites met the study requirements. It was decided randomly which port site would be closed with SA. The opposite site was closed with TS. Wounds were assessed after 7-12 days and after 3 months. Cosmetic outcome was measured by a visual analogue scale (VAS) completed by the patient, by the Hollander wound evaluation scale (HWES) and by the judgement of blinded investigators. Seventy-seven subjects were randomized. Complete data from the 3-month follow-up visit were available from 56 patients (72.7 %). The VAS scale ranged from 0 to 100 mm with "0" representing the best possible cosmetic outcome. Median satisfaction was 2 mm in the TS group and 3 mm in the SA group. The mean was high in both groups 4.6 (s = 13.1) versus 3.8 mm (s = 4.6). The outcome was neither clinically nor statistically significant. Cosmetic outcome was assessed by an investigator, and the HWES showed no difference. In regard to complications, no difference was found between SA and TS, either. In conclusion this study demonstrated that closure of laparoscopic port-site wounds leads to equivalent outcomes whether SAs or TSs are used. Complications are rare in both methods. Thus, SAs seem to be a valid alternative to sutures in laparoscopic surgery. Registration site: www.clinicaltrials.gov . NCT02179723.

Challenges, successes and patterns of enrolment in the INSIGHT Strategic Timing of AntiRetroviral Treatment (START) trial

PubMed Central

Rappoport, C; Engen, NW; Carey, C; Hudson, F; Denning, E; Sharma, S; Florence, E; Vjecha, MJ

2015-01-01

Objectives The aim of this report is to describe the challenges, successes and patterns of enrolment in the Strategic Timing of AntiRetroviral Treatment (START) study. Methods START is a collaboration of many partners with central coordination provided by the protocol team, the statistical and data management centre (SDMC), the International Network for Strategic Initiatives in Global HIV Trials (INSIGHT) network leadership, international coordinating centres and site coordinating centres. The SDMC prepared reports on study accrual, baseline characteristics and site performance that allowed monitoring of enrolment and data quality and helped to ensure the successful enrolment of this large international trial. We describe the pattern of enrolment and challenges faced during the enrolment period of the trial. Results An initial pilot phase began in April 2009 and established feasibility of accrual at 101 sites. In August 2010, funding approval for an expanded definitive phase led to the successful accrual of 4688 participants from 215 sites in 35 countries by December 2013. Challenges to accrual included regulatory delays (e.g. national/local ethics approval and drug importation approval) and logistical obstacles (e.g. execution of contracts with pharmaceutical companies, setting up of a central drug repository and translation of participant materials). The personal engagement of investigators, strong central study coordination, and frequent and transparent communication with site investigators, community members and participants were key contributing factors to this success. Conclusions Accrual into START was completed in a timely fashion despite multiple challenges. This success was attributable to the efforts of site investigators committed to maintaining study equipoise, transparent and responsive study coordination, and community involvement in problem‐solving. PMID:25711319

Determination of orthodontic tooth movement and tissue reaction following demineralized freeze-dried bone allograft grafting intervention

PubMed Central

Seifi, Massoud; Ghoraishian, Seyed Ahmad

2012-01-01

Background: Socket preservation after tooth extraction is one of the indications of bone grafting to enhance preorthodontic condition. The aim of this study is to determine the effects of socket preservation on the immediate tooth movement, alveolar ridge height preservation and orthodontic root resorption. Materials and Methods: In a split-mouth technique, twelve sites in three dogs were investigated as an experimental study. Crushed demineralized freeze-dried bone allograft (DFDBA) (CenoBone®) was used as the graft material. The defects were made by the extraction of 3rd premolar. On one side of each jaw, the defects were preserved by DFDBA and defects of the other side left opened as the control group. Simultaneously the teeth adjacent to the defects were pulled together by a NiTi coil spring. After eight weeks, the amount of (OTM), alveolar height, and root resorption were measured. Analysis of variance was used for purpose of comparison. Results: There was a slight increase in OTM at grafted sites as they were compared to the control sites (P<0.05). Also a significant bone resorption in control site and successful socket preservation in experimental site were observed. Reduction of root resorption at the augmented site was significant compared to the normal healing site (P<0.05). Conclusion: Using socket preservation, tooth movement can be immediately started without waiting for the healing of the recipient site. This can provide some advantages like enhanced rate of OTM, its approved effects on ridge preservation that reduces the chance of dehiscence and the reduction of root resorption. PMID:22623939

Evaluation of subcutaneous and alveolar implantation surgical sites in the study of the biological properties of root-end filling endodontic materials

PubMed Central

CINTRA, Luciano Tavares Angelo; BERNABÉ, Pedro Felício Estrada; de MORAES, Ivaldo Gomes; GOMES-FILHO, João Eduardo; OKAMOTO, Tetuo; CONSOLARO, Alberto; PINHEIRO, Tiago Novaes

2010-01-01

Objective The aim of this study was to compare two methodologies used in the evaluation of tissue response to root-end filling materials in rats. Material and Methods Forty rats were divided into 4 groups: in Groups I and II (control groups), empty polyethylene tubes were implanted in the extraction site and in the subcutaneous tissue, respectively; in Groups III and IV, polyethylene tubes filled with ProRoot MTA were implanted in the extraction site and in the subcutaneous tissue, respectively. The animals were killed 7 and 30 days after tube implantation, and the hemi-maxillas and the capsular subcutaneous tissue, both with the tubes, were removed. Specimens were processed and evaluated histomorphologicaly under light microscopy. The scores obtained were analyzed statistically by the Kruskal-Wallis test (p<0.05). Results There were no statistically significant differences between the implantation methods (p=0.78033, p=0.72039). It was observed that the 30-day groups presented a more mature healing process due to smaller number of inflammatory cells. Conclusion The present study showed no differences in tissue responses as far as the implantation site and the studied period were concerned. Alveolar socket implantation methodology represents an interesting method in the study of the biological properties of root-end filling endodontic materials due to the opportunity to evaluate bone tissue response. PMID:20379685

Pilot Studies of Role Behaviors in a Parent-Child Simulation Game.

ERIC Educational Resources Information Center

McFarlane, Paul T.

Two versions of a simulation game, Parent-Child, were taught to ten white and ten black inner-city males. The twenty subjects played a total of 198 rounds of the game, and the following conclusions were made with respect to the use of the Parent-Child game as a research site. (1) Inner-city fifth and sixth grade males can be taught to play…

Feasibility Study of TRISCAN Landing System.

DTIC Science & Technology

1977-10-01

as inclinometers, tiltmeters , vertical sensors , level sensors , pendulums, and gravity sensing electrolytic transducers. Of course, the common...5.0 NAVTOLAND SENSOR REQUIREMENTS 5.1 TRISCAN PERFORMANCE _ --* L 5.2 SHIPS MOTION SENSING 5.3 DATA LINK Dit.S.ia 6.0 CONCLUSIONS AND RECOMMENDATIONS...involved in enabling the pilot to fly V/STOL Aircraft onto Navy Ships and Marine Corps tactical sites. Guidance sensors have been identified as being

Marine and continental K-T boundary clays compared

NASA Technical Reports Server (NTRS)

Schmitz, B.

1988-01-01

Detailed geochemical and mineralogical studies (1 to 5) of sediments across the Cretaceous-Tertiary (K-T) boundary at Stevns Klint, Karlstrup, Nye Klov, Dania, and Kjolby Gaard in Denmark, at Limhamn in Sweden, at Caravaca in Spain, at Waipara and Woodside Creek in New Zealand, at Trinidad in Colorado, and at various sites in Montana, have induced conclusions and reflections which are given and briefly discussed.

Breast cancer: patient information needs reflected in English and German web sites.

PubMed

Weissenberger, C; Jonassen, S; Beranek-Chiu, J; Neumann, M; Müller, D; Bartelt, S; Schulz, S; Mönting, J S; Henne, K; Gitsch, G; Witucki, G

2004-10-18

Individual belief and knowledge about cancer were shown to influence coping and compliance of patients. Supposing that the Internet information both has impact on patients and reflects patients' information needs, breast cancer web sites in English and German language were evaluated to assess the information quality and were compared with each other to identify intercultural differences. Search engines returned 10 616 hits related to breast cancer. Of these, 4590 relevant hits were analysed. In all, 1888 web pages belonged to 132 English-language web sites and 2702 to 65 German-language web sites. Results showed that palliative therapy (4.5 vs 16.7%; P=0.004), alternative medicine (18.2 vs 46.2%; P<0.001), and disease-related information (prognosis, cancer aftercare, self-help groups, and epidemiology) were significantly more often found on German-language web sites. Therapy-related information (including the side effects of therapy and new studies) was significantly more often given by English-language web sites: for example, details about surgery, chemotherapy, radiotherapy, hormone therapy, immune therapy, and stem cell transplantation. In conclusion, our results have implications for patient education by physicians and may help to improve patient support by tailoring information, considering the weak points in information provision by web sites and intercultural differences in patient needs.

Genome-Wide Assessment of Differential DNA Methylation Associated with Autoantibody Production in Systemic Lupus Erythematosus.

PubMed

Chung, Sharon A; Nititham, Joanne; Elboudwarej, Emon; Quach, Hong L; Taylor, Kimberly E; Barcellos, Lisa F; Criswell, Lindsey A

2015-01-01

Systemic lupus erythematosus (SLE) is characterized by the development of autoantibodies associated with specific clinical manifestations. Previous studies have shown an association between differential DNA methylation and SLE susceptibility, but have not investigated SLE-related autoantibodies. Our goal was to determine whether DNA methylation is associated with production of clinically relevant SLE-related autoantibodies, with an emphasis on the anti-dsDNA autoantibody. In this study, we characterized the methylation status of 467,314 CpG sites in 326 women with SLE. Using a discovery and replication study design, we identified and replicated significant associations between anti-dsDNA autoantibody production and the methylation status of 16 CpG sites (pdiscovery<1.07E-07 and preplication<0.0029) in 11 genes. Associations were further investigated using multivariable regression to adjust for estimated leukocyte cell proportions and population substructure. The adjusted mean DNA methylation difference between anti-dsDNA positive and negative cases ranged from 1.2% to 19%, and the adjusted odds ratio for anti-dsDNA autoantibody production comparing the lowest and highest methylation tertiles ranged from 6.8 to 18.2. Differential methylation for these CpG sites was also associated with anti-SSA, anti-Sm, and anti-RNP autoantibody production. Overall, associated CpG sites were hypomethylated in autoantibody positive compared to autoantibody negative cases. Differential methylation of CpG sites within the major histocompatibility region was not strongly associated with autoantibody production. Genes with differentially methylated CpG sites represent multiple biologic pathways, and have not been associated with autoantibody production in genetic association studies. In conclusion, hypomethylation of CpG sites within genes from different pathways is associated with anti-dsDNA, anti-SSA, anti-Sm, and anti-RNP production in SLE, and these associations are not explained by genetic variation. Thus, studies of epigenetic mechanisms such as DNA methylation represent a complementary method to genetic association studies to identify biologic pathways that may contribute to the clinical heterogeneity of autoimmune diseases.

Plasma 25-hydroxyvitamin D concentration and subsequent risk of total and site specific cancers in Japanese population: large case-cohort study within Japan Public Health Center-based Prospective Study cohort

PubMed Central

Budhathoki, Sanjeev; Hidaka, Akihisa; Sawada, Norie; Tanaka-Mizuno, Sachiko; Kuchiba, Aya; Charvat, Hadrien; Goto, Atsushi; Kojima, Satoshi; Sudo, Natsuki; Shimazu, Taichi; Sasazuki, Shizuka; Inoue, Manami; Tsugane, Shoichiro; Iwasaki, Motoki

2018-01-01

Abstract Objective To evaluate the association between pre-diagnostic circulating vitamin D concentration and the subsequent risk of overall and site specific cancer in a large cohort study. Design Nested case-cohort study within the Japan Public Health Center-based Prospective Study cohort. Setting Nine public health centre areas across Japan. Participants 3301 incident cases of cancer and 4044 randomly selected subcohort participants. Exposure Plasma concentration of 25-hydroxyvitamin D measured by enzyme immunoassay. Participants were divided into quarters based on the sex and season specific distribution of 25-hydroxyvitamin D among subcohorts. Weighted Cox proportional hazard models were used to calculate the multivariable adjusted hazard ratios for overall and site specific cancer across categories of 25-hydroxyvitamin D concentration, with the lowest quarter as the reference. Main outcome measure Incidence of overall or site specific cancer. Results Plasma 25-hydroxyvitamin D concentration was inversely associated with the risk of total cancer, with multivariable adjusted hazard ratios for the second to fourth quarters compared with the lowest quarter of 0.81 (95% confidence interval 0.70 to 0.94), 0.75 (0.65 to 0.87), and 0.78 (0.67 to 0.91), respectively (P for trend=0.001). Among the findings for cancers at specific sites, an inverse association was found for liver cancer, with corresponding hazard ratios of 0.70 (0.44 to 1.13), 0.65 (0.40 to 1.06), and 0.45 (0.26 to 0.79) (P for trend=0.006). A sensitivity analysis showed that alternately removing cases of cancer at one specific site from total cancer cases did not substantially change the overall hazard ratios. Conclusions In this large prospective study, higher vitamin D concentration was associated with lower risk of total cancer. These findings support the hypothesis that vitamin D has protective effects against cancers at many sites. PMID:29514781

Treatment of growth failure in the absence of GH signaling: The Ecuadorian experience.

PubMed

Guevara-Aguirre, Jaime; Guevara, Alexandra; Guevara, Carolina

2018-02-01

Recombinant human insulin-like growth factor-1 (rhIGF-1) treatment studies of growth failure in absence of growth hormone (GH) signaling (GH insensitivity -GHI, Laron syndrome -LS, GH Receptor deficiency -GHRD) have taken place in many locations around the globe. Results from these trials are comparable, and slight differences reported can be attributed to specific circumstances at different research sites. rhIGF-I treatment studies of GHI in Ecuador included various trials performed on children belonging to the largest and only homogeneous cohort of subjects with this condition in the world. All trials were performed by the same team of investigators and, during study periods, subjects received similar nutritional, physical activity and medical advice. Combination of these inherent conditions most likely creates less sources of variability during the research process. Indeed, diagnosis, selection and inclusion of research subjects; methodology used; transport, storage and delivery of study drug; data collection, monitoring and auditing; data analysis, discussion of results, conclusion inferences and reporting, etc., were submitted to the same sources of error. For the above-mentioned reasons, we are hereby mainly covering conclusions derived from rhIGF-I treatment studies of Ecuadorian children whit GHRD due to homozygosity of a splice site mutation occurring at GHR gene, whose unaffected parents were both heterozygous for the same mutation. We also describe studies of rhIGF-I administration in adolescent and adult subjects with GHRD, from the same cohort and with the same genetic anomaly. Copyright © 2017 Elsevier Ltd. All rights reserved.

Considerations for Public Health Organizations Attempting to Implement a Social Media Presence: A Qualitative Study

PubMed Central

2016-01-01

Background In the past decade, social media has become an integral part of our everyday lives, but research on how this tool is used by public health workers and organizations is still developing. Budget cuts and staff reduction in county departments have required employees to take on more responsibilities. These reductions have caused a reduction in the time for training or collaborating with others in the field. To make up for the loss, many employees are seeking collaboration through social media sites but are unable to do so because state departments block these Internet sites. Objective This study sought to highlight the key considerations and decision-making process for a public health organization deciding whether to implement a social media presence for their organization. Methods Using 3 structured interviews, 15 stakeholders were questioned on their personal experience with social media, experience within the context of public health, and their thoughts on implementation for their center. Interviews were coded using constant comparative qualitative methods. Results The following themes emerged from the interviews: (1) personal experience with technology and social networking sites, (2) use of social networking sites in public health, (3) use of social networking sites in work environments, (4) social networking sites access, (5) ways the Rural South Public Health Training Center could use social networking sites, and (6) perceived outcomes of social networking site usage for the Rural South Public Health Training Center (positive and negative). Conclusions The collective voice of the center showed a positive perceived perception of social media implementation, with the benefits outweighing the risks. Despite the benefits, there is a cautious skepticism of the importance of social networking site use. PMID:27227160

Herpetological monitoring and assessment on the Trinity River, Trinity County, California—Final report

USGS Publications Warehouse

Snover, Melissa L.; Adams, Michael J.

2016-06-14

The primary goal of the Trinity River Restoration Program is to rehabilitate the fisheries on the dam-controlled Trinity River. However, maintaining and enhancing other wildlife populations through the restoration initiative is also a key objective. Foothill yellow-legged frogs (Rana boylii) and western pond turtles (Actinemys marmorata) have been identified as important herpetological species on which to focus monitoring efforts due to their status as California state-listed species of concern and potential listing on the U.S. Endangered Species List. We developed and implemented a monitoring strategy for these species specific to the Trinity River with the objectives of establishing baseline values for probabilities of site occupancy, colonization, and local extinction; identifying site characteristics that correlate with the probability of extinction; and estimating overall trends in abundance. Our 3-year study suggests that foothill yellow-legged frogs declined in the probability of site occupancy. Conversely, our results suggest that western pond turtles increased in both abundance and the probability of site occupancy. The short length of our study period makes it difficult to draw firm conclusions, but these results provide much-needed baseline data. Further monitoring and directed studies are required to assess how habitat changes and management decisions relate to the status and trend of these species over the long term.

A novel Death Defying Domain in Met entraps the active site of Caspase-3 and blocks apoptosis in hepatocytes

PubMed Central

Ma, Jihong; Zou, Chunbin; Guo, Lida; Seneviratne, Danushka S.; Tan, Xinping; Kwon, Yong-Kook; An, Jiyan; Bowser, Robert; DeFrances, Marie C.; Zarnegar, Reza

2013-01-01

Met, the transmembrane tyrosine kinase receptor for hepatocyte growth factor (HGF) is known to function as a potent anti-apoptotic mediator in normal and neoplastic cells. Herein we report that intracellular cytoplasmic tail of Met has evolved to harbor a tandem pair of Caspase-3 cleavage sites, which bait, trap and disable the active site of Caspase-3, thereby blocking the execution of apoptosis. We call this Caspase-3 cleavage motif the ‘Death Defying Domain’ (DDD). This site consists of the following sequence: DNAD-DEVD-T (where the hyphens denote caspase cleavage sites). Through functional and mechanistic studies, we show that upon DDD cleavage by Caspase-3, the resulting DEVD-T peptide acts as a competitive inhibitor and entraps the active site of Caspase-3 akin to DEVD-CHO, which is a potent, synthetic inhibitor of Caspase-3 activity. By gain and loss-of-function studies using restoration of DDD expression in DDD deficient hepatocytic cells, we found that both Caspase-3 sites in DDD are necessary for inhibition of Caspase-3 and promotion of cell survival. Employing mutagenesis studies, we show that DDD could operate independently of Met’s enzymatic activity as determined by using kinase-dead human Met mutant constructs. Studies of both human liver cancer tissues and cell lines uncovered that DDD cleavage and entrapment of Caspase-3 by DDD occur in vivo, further proving that this site has physiological and pathophysiological relevance. Conclusion Our findings show that Met can directly inhibit Caspase-3 via a novel mechanism and promote hepato-cyte survival. Results presented here will further our understanding of the mechanisms that control not only normal tissue homeostasis but also abnormal tissue growth such as cancer and degenerative diseases in which apoptotic caspases are at play. PMID:24122846

A greater number of somatic pain sites is associated with poor mental health in adolescents: a cross-sectional study

PubMed Central

2013-01-01

Background Identifying indicators of poor mental health during adolescence is a significant public health issue. Previous studies which suggested an association between the number of somatic pains and depression have mainly focused on adults or have employed samples with a narrow age range. To date, results from previous studies have been inconsistent regarding the association between somatic pain and academic impairment. Therefore, the main aims of the present study were to 1) investigate the association between the number of somatic pain sites and poor mental health using a community sample of adolescents aged 12 to 18 years and employing a simple method of assessment, and 2) examine the association between the number of somatic pain sites and perceived academic impairment. Methods Data analysis was conducted using a large cross-sectional survey of adolescents in grades 7 to 12. The one-month prevalence rates for three sites of somatic pain including head, neck and shoulders, and abdomen were examined. Poor mental health was evaluated using the General Health Questionnaire, and perceived academic impairment was measured using a self-report questionnaire. Results A total of 18,104 adolescents participated in the survey. A greater number of pain sites was associated with poor mental health, and this association was consistent across age and gender. There was no difference in effect on mental health between any of the pain sites. Although there was an association between the number of somatic pain sites and perceived academic impairment, the results suggested that the association was mediated by poor mental health. Conclusions Simple reporting methods for assessing the number of pain sites may be a feasible indicator of poor mental health in adolescents. Professionals working with adolescents should consider the possibility of poor mental health, especially when students report multiple somatic pains. PMID:23327684

The prevalence of squamous cell carcinoma in different sites of oral cavity at our Rural Health Care Centre in Loni, Maharashtra – a retrospective 10-year study

PubMed Central

Dadhich, Anuj; Saluja, Harish; Bawane, Shilpa; Sachdeva, Shivani

2017-01-01

Aim of the study Oral cancer ranks in the top three of all cancers in India and is quickly becoming a global health priority. More than 90% of oral and oropharyngeal cancers are squamous cell carcinoma. The purpose of this study was to document its incidence depending upon the involvement of different sites of oral cavity, and its variation with age and gender. Material and methods Histopathologically proven oral squamous cell carcinoma cases were collected from the department of oral and maxillofacial surgery RDC, PIMS. The cases were systematically grouped under three headings: anatomical sub-site of oral cavity, age group, and gender, which were analysed to calculate the prevalence of oral cancer. The study was undertaken after obtaining approval from the institutional Ethical Committee board. Results Among the different sites of oral cavity, the highest incidence (31.47%) of oral squamous cell carcinoma was seen for buccal mucosa in our study. The most affected age group (39.50%) were patients above 50 years old, predominantly involving males. Conclusions The population in this study were mostly from remote areas, among which a high rate of occurrence of oral cancer was encountered because the people were of low socio-economic class, had a casual attitude towards their health, high rate of tobacco consumption, and limited health care facilities. This study provides valuable data of the prevalence of oral cancer among the rural population. PMID:28947890

Structural Basis for Certain Naturally Occurring Bioflavonoids to Function as Reducing Co-Substrates of Cyclooxygenase I and II

PubMed Central

Zhu, Bao Ting

2010-01-01

Background Recent studies showed that some of the dietary bioflavonoids can strongly stimulate the catalytic activity of cyclooxygenase (COX) I and II in vitro and in vivo, presumably by facilitating enzyme re-activation. In this study, we sought to understand the structural basis of COX activation by these dietary compounds. Methodology/Principal Findings A combination of molecular modeling studies, biochemical analysis and site-directed mutagenesis assay was used as research tools. Three-dimensional quantitative structure-activity relationship analysis (QSAR/CoMFA) predicted that the ability of bioflavonoids to activate COX I and II depends heavily on their B-ring structure, a moiety known to be associated with strong antioxidant ability. Using the homology modeling and docking approaches, we identified the peroxidase active site of COX I and II as the binding site for bioflavonoids. Upon binding to this site, bioflavonoid can directly interact with hematin of the COX enzyme and facilitate the electron transfer from bioflavonoid to hematin. The docking results were verified by biochemical analysis, which reveals that when the cyclooxygenase activity of COXs is inhibited by covalent modification, myricetin can still stimulate the conversion of PGG2 to PGE2, a reaction selectively catalyzed by the peroxidase activity. Using the site-directed mutagenesis analysis, we confirmed that Q189 at the peroxidase site of COX II is essential for bioflavonoids to bind and re-activate its catalytic activity. Conclusions/Significance These findings provide the structural basis for bioflavonoids to function as high-affinity reducing co-substrates of COXs through binding to the peroxidase active site, facilitating electron transfer and enzyme re-activation. PMID:20808785

Different thresholds for detecting osteophytes and joint space narrowing exist between the site investigators and the centralized reader in a multicenter knee osteoarthritis study—data from the Osteoarthritis Initiative

PubMed Central

Guermazi, Ali; Hunter, David J.; Li, Ling; Benichou, Olivier; Eckstein, Felix; Kwoh, C. Kent; Nevitt, Michael

2011-01-01

Objective To evaluate how the reading of knee radiographs by site investigators differs from that by an expert musculoskeletal radiologist who trained and validated them in a multicenter knee osteoarthritis (OA) study. Materials and methods A subset of participants from the Osteoarthritis Initiative progression cohort was studied. Osteophytes and joint space narrowing (JSN) were evaluated using Kellgren-Lawrence (KL) and Osteoarthritis Research Society International (OARSI) grading. Radiographs were read by site investigators, who received training and validation of their competence by an expert musculoskeletal radiologist. Radiographs were re-read by this radiologist, who acted as a central reader. For KL and OARSI grading of osteophytes, discrepancies between two readings were adjudicated by another expert reader. Results Radiographs from 96 subjects (49 women) and 192 knees (138 KL grade≥2) were included. The site reading showed moderate agreement for KL grading overall (kappa=0.52) and for KL≥2 (i.e., radiographic diagnosis of “definite OA”; kappa=0.41). For OARSI grading, the site reading showed substantial agreement for lateral and medial JSN (kappa=0.65 and 0.71), but only fair agreement for osteophytes (kappa=0.37). For KL grading, the adjudicator’s reading showed substantial agreement with the centralized reading (kappa=0.62), but only slight agreement with the site reading (kappa=0.10). Conclusion Site investigators over-graded osteophytes compared to the central reader and the adjudicator. Different thresholds for scoring of JSN exist even between experts. Our results suggest that research studies using radiographic grading of OA should use a centralized reader for all grading. PMID:21479521

Health Risks to Ecological Workers on Contaminated Sites - the Department of Energy as a Case Study

PubMed Central

Burger, Joanna; Gochfeld, Michael

2016-01-01

Background At most contaminated sites the risk to workers focuses on those ‘hazardous waste workers’ directly exposed to chemicals or radionuclides, and to the elaborate approaches implemented to protecting their health and safety. Ecological workers generally are not considered. Objectives To explore the risks to the health and safety of ecological workers on sites with potential chemical and radiological exposures before, during or after remediation of contamination. To use the U.S. Department of Energy as a case study, and to develop concepts that apply generally to sites contaminated with hazardous or nuclear wastes, Methods Develop categories of ecological workers, describe their usual jobs, and provide information on the kinds of risks they face. Ecological activities include continued surveillance and monitoring work on any sites with residual contamination, subject to institutional controls and engineered barriers following closure as well as the restoration. Results The categories of ecological workers and their tasks include 1) Ecological characterization, mapping and monitoring, 2) biodiversity studies, 2) Contaminant fate and transport, 3) On-going industrial activities 4) Remediation activities (environmental management), 5) Environmental restoration, 6) Post-cleanup surveillance and monitoring, and 7) Post-closure future site activities. There are a set of functional activities that can occur with different frequencies and intensities, including visual inspection, collecting biological samples, collecting media physical samples, collecting biological debris, restoration planting, and maintaining ecosystems. Conclusions Ecological workers face different exposures and risks than other environmental cleanup workers. Many of their tasks mimic shift work with long hours leading to fatigue, and they are exposed to biological as well as chemical/radiological hazards. DOE and other entities need to examine the risks to ecological workers on site with an eye to risk reduction. PMID:27668128

Installation restoration program. Decision document for soil and groundwater at the storage area at the USMC Subleased Area, Site 3. 144th Fighter Wing, California Air National Guard, Fresno Air Terminal, California

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1996-01-01

Decision Document for IRP Site No. 3 - Storage Area at the USMC Sublease Area, California Air National Guard, 144th Fighter Wing, Fresno Air Terminal, Fresno, California. This report documents the data, conclusion, and recommendation to support a No Further Remedial Action Planned decision at Site 3 under the IRP.

Demographic and Predeparture Factors Associated With Drinking and Alcohol-Related Consequences for College Students Completing Study Abroad Experiences

PubMed Central

Pedersen, Eric R.; Skidmore, Jessica R.; Aresi, Giovanni

2014-01-01

Objective: Study abroad students are at-risk for increased and problematic drinking behavior. As few efforts have been made to examine this at-risk population, we predicted drinking and alcohol-related consequences abroad from predeparture and site-specific factors. Participants: The sample consisted of 339 students completing study abroad programs. Method: Participants filled out online measures at predeparture, abroad, and at post-return. Results: We found drinking and consequences abroad were predicted by a number of factors including demographics (e.g., younger age, male sex, Greek affiliation, White ethnicity), student factors (e.g. low GPA, major area of study), study abroad site factors (e.g., apartment living abroad, study in Europe), predeparture levels of drinking and consequences, sensation seeking, and goals related to social gathering. Conclusions: Findings can be used to inform campus policies for admission to study abroad programs as well as assist in the development of interventions targeted toward preventing risk for students during abroad experiences. PMID:24499190

Systematic Review of Quality of Patient Information on Liposuction in the Internet

PubMed Central

Zuk, Grzegorz; Eylert, Gertraud; Raptis, Dimitri Aristotle; Guggenheim, Merlin; Shafighi, Maziar

2016-01-01

Background: A large number of patients who are interested in esthetic surgery actively search the Internet, which represents nowadays the first source of information. However, the quality of information available in the Internet on liposuction is currently unknown. The aim of this study was to assess the quality of patient information on liposuction available in the Internet. Methods: The quantitative and qualitative assessment of Web sites was based on a modified Ensuring Quality Information for Patients tool (36 items). Five hundred Web sites were identified by the most popular web search engines. Results: Two hundred forty-five Web sites were assessed after duplicates and irrelevant sources were excluded. Only 72 (29%) Web sites addressed >16 items, and scores tended to be higher for professional societies, portals, patient groups, health departments, and academic centers than for Web sites developed by physicians, respectively. The Ensuring Quality Information for Patients score achieved by Web sites ranged between 8 and 29 of total 36 points, with a median value of 16 points (interquartile range, 14–18). The top 10 Web sites with the highest scores were identified. Conclusions: The quality of patient information on liposuction available in the Internet is poor, and existing Web sites show substantial shortcomings. There is an urgent need for improvement in offering superior quality information on liposuction for patients intending to undergo this procedure. PMID:27482498

Optical turbulence forecast: ready for an operational application

NASA Astrophysics Data System (ADS)

Masciadri, E.; Lascaux, F.; Turchi, A.; Fini, L.

2017-04-01

One of the main goals of the feasibility study MOSE (MOdelling ESO Sites) is to evaluate the performances of a method conceived to forecast the optical turbulence (OT) above the European Southern Observatory (ESO) sites of the Very Large Telescope (VLT) and the European Extremely Large Telescope (E-ELT) in Chile. The method implied the use of a dedicated code conceived for the OT called ASTRO-MESO-NH. In this paper, we present results we obtained at conclusion of this project concerning the performances of this method in forecasting the most relevant parameters related to the OT (CN^2, seeing ɛ, isoplanatic angle θ0 and wavefront coherence time τ0). Numerical predictions related to a very rich statistical sample of nights uniformly distributed along a solar year and belonging to different years have been compared to observations, and different statistical operators have been analysed such as the classical bias, root-mean-squared error, σ and more sophisticated statistical operators derived by the contingency tables that are able to quantify the score of success of a predictive method such as the percentage of correct detection (PC) and the probability to detect a parameter within a specific range of values (POD). The main conclusions of the study tell us that the ASTRO-MESO-NH model provides performances that are already very good to definitely guarantee a not negligible positive impact on the service mode of top-class telescopes and ELTs. A demonstrator for an automatic and operational version of the ASTRO-MESO-NH model will be soon implemented on the sites of VLT and E-ELT.

Strategies to Support Recruitment of Patients with Life-limiting illness for Research: The Palliative Care Research Cooperative Group

PubMed Central

Hanson, Laura C.; Bull, Janet; Wessell, Kathryn; Massie, Lisa; Bennett, Rachael E.; Kutner, Jean S.; Aziz, Noreen M.; Abernethy, Amy

2014-01-01

Context The Palliative Care Research Cooperative group (PCRC) is the first clinical trials cooperative for palliative care in the United States. Objectives To describe barriers and strategies for recruitment during the inaugural PCRC clinical trial. Methods The parent study was a multi-site randomized controlled trial enrolling adults with life expectancy anticipated to be 1–6 months, randomized to discontinue statins (intervention) vs. to continue on statins (control). To study recruitment best practices, we conducted semi-structured interviews with 18 site Principal Investigators (PI) and Clinical Research Coordinators (CRC), and reviewed recruitment rates. Interviews covered 3 topics – 1) successful strategies for recruitment, 2) barriers to recruitment, and 3) optimal roles of the PI and CRC. Results All eligible site PIs and CRCs completed interviews and provided data on statin protocol recruitment. The parent study completed recruitment of n=381 patients. Site enrollment ranged from 1–109 participants, with an average of 25 enrolled per site. Five major barriers included difficulty locating eligible patients, severity of illness, family and provider protectiveness, seeking patients in multiple settings, and lack of resources for recruitment activities. Five effective recruitment strategies included systematic screening of patient lists, thoughtful messaging to make research relevant, flexible protocols to accommodate patients’ needs, support from clinical champions, and the additional resources of a trials cooperative group. Conclusion The recruitment experience from the multi-site PCRC yields new insights into methods for effective recruitment to palliative care clinical trials. These results will inform training materials for the PCRC and may assist other investigators in the field. PMID:24863152

Donation return time at fixed and mobile donation sites

PubMed Central

Carey, Patricia M.; High, Patrick M.; Schlumpf, Karen S.; Johnson, Bryce R.; Mast, Alan E.; Rios, Jorge A.; Simon, Toby L.; Wilkinson, Susan L.

2013-01-01

BACKGROUND This study investigated the effect of blood donation environment, fixed or mobile with differing sponsor types, on donation return time. STUDY DESIGN AND METHODS Data from 2006 through 2009 at six US blood centers participating in the Retrovirus Epidemiology Donor Study-II (REDS-II) were used for analysis. Descriptive statistics stratified by whole blood (WB), plateletpheresis (PP), and double red blood cell (R2) donations were obtained for fixed and mobile locations, including median number of donations and median interdonation interval. A survival analysis estimated median return time at fixed and mobile sites, while controlling for censored return times, demographics, blood center, and mandatory recovery times. RESULTS Two-thirds (67.9%) of WB donations were made at mobile sites, 97.4% of PP donations were made at fixed sites, and R2 donations were equally distributed between fixed and mobile locations. For donations at fixed sites only or alternating between fixed and mobile sites, the highest median numbers of donations were nine and eight, respectively, and the shortest model-adjusted median return times (controlling for mandatory eligibility times of 56 and 112 days) were 36 and 30 days for WB and R2 donations, respectively. For PP donations, the shortest model-adjusted median return time was 23 days at a fixed location and the longest was 693 days at community locations. CONCLUSION WB, PP, and R2 donors with the shortest time between donations were associated with fixed locations and those alternating between fixed and mobile locations, even after controlling for differing mandatory recovery times for the different blood donation procedures. PMID:21745215

Prevention of EP Migratory Contamination in a Cluster Randomized Trial to Increase tPA Use in Stroke (The INSTINCT Trial)

PubMed Central

Weston, Victoria C.; Meurer, William J.; Frederiksen, Shirley M.; Fox, Allison K.; Scott, Phillip A.

2016-01-01

Objectives Cluster randomized trials (CRTs) are increasingly utilized to evaluate quality improvement interventions aimed at healthcare providers. In trials testing emergency department interventions, migration of emergency physicians (EPs) between hospitals is an important concern, as contamination may affect both internal and external validity. We hypothesized that geographically isolating emergency departments would prevent migratory contamination in a CRT designed to increase ED delivery of tPA in stroke (The INSTINCT Trial). Methods INSTINCT was a prospective, cluster randomized, controlled trial. 24 Michigan community hospitals were randomly selected in matched pairs for study. Contamination was defined at the cluster level, with substantial contamination defined a priori as >10% of EPs affected. Non-adherence, total crossover (contamination + non-adherence), migration distance and characteristics were determined. Results 307 emergency physicians were identified at all sites. Overall, 7 (2.3%) changed study sites. 1 moved between control sites, leaving 6 (2.0%) total crossovers. Of these, 2 (0.7%) moved from intervention to control (contamination) and 4 (1.3%) moved from control to intervention (non-adherence). Contamination was observed in 2 of 12 control sites, with 17% and 9% contamination of the total site EP workforce at follow-up, respectively. Average migration distance was 42 miles for all EPs moving in the study and 35 miles for EPs moving from intervention to control sites. Conclusion The mobile nature of emergency physicians should be considered in the design of quality improvement CRTs. Increased reporting of contamination in CRTs is encouraged to clarify thresholds and facilitate CRT design. PMID:25440230

Verification of chemistry reference ranges using a simple method in sub-Saharan Africa

PubMed Central

Taylor, Douglas; Mandala, Justin; Nanda, Kavita; Van Campenhout, Christel; Agingu, Walter; Madurai, Lorna; Barsch, Eva-Maria; Deese, Jennifer; Van Damme, Lut; Crucitti, Tania

2016-01-01

Background Chemistry safety assessments are interpreted by using chemistry reference ranges (CRRs). Verification of CRRs is time consuming and often requires a statistical background. Objectives We report on an easy and cost-saving method to verify CRRs. Methods Using a former method introduced by Sigma Diagnostics, three study sites in sub-Saharan Africa, Bondo, Kenya, and Pretoria and Bloemfontein, South Africa, verified the CRRs for hepatic and renal biochemistry assays performed during a clinical trial of HIV antiretroviral pre-exposure prophylaxis. The aspartate aminotransferase/alanine aminotransferase, creatinine and phosphorus results from 10 clinically-healthy participants at the screening visit were used. In the event the CRRs did not pass the verification, new CRRs had to be calculated based on 40 clinically-healthy participants. Results Within a few weeks, the study sites accomplished verification of the CRRs without additional costs. The aspartate aminotransferase reference ranges for the Bondo, Kenya site and the alanine aminotransferase reference ranges for the Pretoria, South Africa site required adjustment. The phosphorus CRR passed verification and the creatinine CRR required adjustment at every site. The newly-established CRR intervals were narrower than the CRRs used previously at these study sites due to decreases in the upper limits of the reference ranges. As a result, more toxicities were detected. Conclusion To ensure the safety of clinical trial participants, verification of CRRs should be standard practice in clinical trials conducted in settings where the CRR has not been validated for the local population. This verification method is simple, inexpensive, and can be performed by any medical laboratory. PMID:28879112

Mesothelioma incidence and asbestos exposure in Italian national priority contaminated sites.

PubMed

Binazzi, Alessandra; Marinaccio, Alessandro; Corfiati, Marisa; Bruno, Caterina; Fazzo, Lucia; Pasetto, Roberto; Pirastu, Roberta; Biggeri, Annibale; Catelan, Dolores; Comba, Pietro; Zona, Amerigo

2017-11-01

Objectives This study aimed to (i) describe mesothelioma incidence in the Italian national priority contaminated sites (NPCS) on the basis of data available from the Italian National Mesothelioma Registry (ReNaM) and (ii) profile NPCS using Bayesian rank analysis. Methods Incident cases of mesothelioma and standardized incidence ratios (SIR) were estimated for both genders in each of the 39 selected NPCS in the period 2000-2011. Age-standardized rates of Italian geographical macro areas were used to estimate expected cases. Rankings of areas were produced by a hierarchical Bayesian model. Asbestos exposure modalities were discussed for each site. Results In the study period, 2683 incident cases of mesothelioma (1998 men, 685 women) were recorded. An excess of mesothelioma incidence was confirmed in sites with a known past history of direct use of asbestos (among men) such as Balangero (SIR 197.1, 95% CI 82.0-473.6), Casale Monferrato (SIR 910.7, 95% CI 816.5-1012.8), and Broni (SIR 1288.5, 95% CI 981.9-1691.0), in sites with shipyards and harbors (eg, Trieste, La Spezia, Venice, and Leghorn), and in settings without documented direct use of asbestos. The analysis ranked the sites of Broni and Casale Monferrato (both genders) and Biancavilla (only for women) the highest. Conclusions The present study confirms that asbestos pollution is a risk for people living in polluted areas, due to not only occupational exposure in industrial settings with direct use of asbestos but also the presence of asbestos in the environment. Epidemiological surveillance of asbestos-related diseases is a fundamental tool for monitoring the health profile in NPCS.

Confronting Challenges in Intervention Research with Ethnically Diverse Older Adults: The USC Well Elderly II Trial

PubMed Central

Jackson, Jeanne; Mandel, Deborah; Blanchard, Jeanine; Carlson, Mike; Cherry, Barbara; Azen, Stanley; Chou, Chih-Ping; Jordan-Marsh, Maryalice; Forman, Todd; White, Brett; Granger, Douglas; Knight, Bob; Clark, Florence

2011-01-01

Background Community-dwelling older adults are at risk for declines in physical health, cognition, and psychosocial well-being. However, their enactment of active and health-promoting lifestyles can reduce such declines. Purpose The purpose of this article is to describe the USC Well Elderly II study, a randomized clinical trial designed to test the effectiveness of a healthy lifestyle program for elders, and document how various methodological challenges were addressed during the course of the trial. Methods In the study, 460 ethnically diverse elders recruited from a variety of sites in the urban Los Angeles area were enrolled in a randomized experiment involving a crossover design component. Within either the first or second six month phase of their study involvement, each elder received a lifestyle intervention designed to improve a variety of aging outcomes. At 4–5 time points over an 18–24 month interval, the research participants were assessed on measures of healthy activity, coping, social support, perceived control, stress-related biomarkers, perceived physical health, psychosocial well-being, and cognitive functioning to test the effectiveness of the intervention and document the process mechanisms responsible for its effects. Results The study protocol was successfully implemented, including the enrollment of study sites, the recruitment of 460 older adults, administration of the intervention, adherence to the plan for assessment, and establishment of a large computerized data base. Limitations Methodological challenges were encountered in the areas of site recruitment, participant recruitment, testing, and intervention delivery. Conclusions The completion of clinical trials involving elders from numerous local sites requires careful oversight and anticipation of threats to the study design that stem from: (a) social situations that are particular to specific study sites; and (b) physical, functional, and social challenges pertaining to the elder population. PMID:19254939

Using Ambient Noise for Investigating Cultural Heritage Sites and Evaluating Seismic Site Response

NASA Astrophysics Data System (ADS)

D'Amico, S.; Farrugia, D.; Galea, P. M.; Ruben, B. P., Sr.

2016-12-01

Recordings of ambient noise as well as use of the HVSR technique represent a common tool for evaluating seismic site response. In this study we applied such techniques to several cultural heritage sites located on the Maltese archipelago (Central Mediterranean). In particular, two of the Maltese watchtowers, built by the Knights of St. John between 1637 and 1659, were investigated together with the megalithic temple site of Mnajdra. Array data were acquired using the Micromed SoilSpy Rosina™ equipped with 4.5 Hz vertical geophones, setting the array in an L-shaped configuration. The Extended Spatial Autocorrelation (ESAC) technique was used to extract Rayleigh-wave dispersion curves. Moreover, single-station data close to the array was collected using a Tromino 3-component seismograph (www.tromino.eu), and the H/V curves were extracted. The dispersion curves and the H/V curves were jointly inverted using the Genetic Algorithm (GA) to obtain the shear-wave velocity profile. A fixed number of layers was used in the inversion and ranges for the layer thickness, P-wave and S-wave velocity, and density were specified. The obtained velocity profiles were used to compute the amplification function for the site based on the square root of the effective seismic impedance, also known as the quarter-wavelength approximation. This was used in the simulation of ground motion parameters at the site for various earthquakes using the stochastic one-dimensional site response analysis algorithm, Extended Source Simulation (EXSIM). In addition, the fundamental period and the damping ratio of the watchtowers was obtained by recording ambient vibrations. In the megalithic temples we were also able to evaluate the coverage of the soil deposits within the structure, comparing our results with previous study that used different geophysical techniques. In conclusion, this study enables us to map the seismic amplification hazard and provides primary data on the seismic risk assessment of each cultural heritage site.

A Survey of Health-Related Activities on Second Life

PubMed Central

Beard, Leslie; Wilson, Kumanan; Morra, Dante

2009-01-01

Background Increasingly, governments, health care agencies, companies, and private groups have chosen Second Life as part of their Web 2.0 communication strategies. Second Life offers unique design features for disseminating health information, training health professionals, and enabling patient education for both academic and commercial health behavior research. Objectives This study aimed to survey and categorize the range of health-related activities on Second Life; to examine the design attributes of the most innovative and popular sites; and to assess the potential utility of Second Life for the dissemination of health information and for health behavior change. Methods We used three separate search strategies to identify health-related sites on Second Life. The first used the application’s search engine, entering both generic and select illness-specific keywords, to seek out sites. The second identified sites through a comprehensive review of print, blog, and media sources discussing health activities on Second Life. We then visited each site and used a snowball method to identify other health sites until we reached saturation (no new health sites were identified). The content, user experience, and chief purpose of each site were tabulated as well as basic site information, including user traffic data and site size. Results We found a wide range of health-related activities on Second Life, and a diverse group of users, including organizations, groups, and individuals. For many users, Second Life activities are a part of their Web 2.0 communication strategy. The most common type of health-related site in our sample (n = 68) were those whose principle aim was patient education or to increase awareness about health issues. The second most common type of site were support sites, followed by training sites, and marketing sites. Finally, a few sites were purpose-built to conduct research in SL or to recruit participants for real-life research. Conclusions Studies show that behaviors from virtual worlds can translate to the real world. Our survey suggests that users are engaged in a range of health-related activities in Second Life which are potentially impacting real-life behaviors. Further research evaluating the impact of health-related activities on Second Life is warranted. PMID:19632971

Preliminary results of the scientific experiments on the Kosmos-936 biosatellite

NASA Technical Reports Server (NTRS)

1977-01-01

The scientific equipment and experiments on the Kosmos-936 biosatellite are described, including various ground controls and the lab unit for studies at the descent vehicle landing site. Preliminary results are presented of the physiological experiment with rats, biological experiments with drosophila and higher and lower plants, and radiation physics and radiobiology studies for the planning of biological protection on future space flights. The most significant conclusion from the preliminary data is that rats tolerate space flight better with an artificial force of gravity.

How Long Will I Be Blue? Prolonged Skin Staining Following Sentinel Lymph Node Biopsy Using Intradermal Patent Blue Dye

PubMed Central

Gumus, Metehan; Gumus, Hatice; Jones, Sue E; Jones, Peter A; Sever, Ali R; Weeks, Jennifer

2013-01-01

Summary Background Blue dye used for sentinel lymph node biopsy (SLNB) in breast cancer patients may cause prolonged skin discoloration at the site of injection. The aim of this study was to assess the duration of such skin discoloration. Patients and Methods 236 consecutive patients who had undergone breast conserving surgery and SLNB for breast cancer were reviewed prospectively from January 2007 to December 2009. Results Of the 236 patients, 2 had undergone bilateral surgery, and 41 had been examined in consecutive yearly reviews. Blue discoloration remained visible at the injection site after 12, 24, and > 36 months in 36.5, 23.6, and 8.6% of the patients, respectively. Conclusion The use of patent blue for identification of the sentinel lymph node in patients undergoing breast cancer surgery may result in prolonged discoloration of the skin at the injection site. PMID:24415970

Porphyromonas endodontalis in chronic periodontitis: a clinical and microbiological cross-sectional study

PubMed Central

Lombardo Bedran, Telma Blanca; Marcantonio, Rosemary Adriana C.; Spin Neto, Rubens; Alves Mayer, Marcia Pinto; Grenier, Daniel; Spolidorio, Luis Carlos; Spolidorio, Denise Palomari

2012-01-01

Background Although previous studies have shown the presence of Porphyromonas endodontalis in chronic periodontitis associated with periapical lesions, the occurrence of this pathogen in diseased periodontal sites without periapical lesions has been poorly investigated. Objective The aims of this study were to quantify P. endodontalis in patients with chronic periodontitis without periapical lesions, to evaluate the potential correlation of P. endodontalis with Porphyromonas gingivalis and Tannerella forsythia, and to evaluate the ability of periodontal treatment to reduce these pathogens. Design Patients with generalized chronic periodontitis were selected by recording clinical attachment level (CAL), probing depth (PD), and bleeding on probing (BOP). Subgingival samples from 30 diseased nonadjacent sites (CAL≥5 mm, PD between 5 and 7 mm and positive BOP) and 30 healthy nonadjacent sites (PD≤3 mm and negative BOP) were collected and subjected to microbial analysis by quantitative polymerase chain reaction (qPCR) The variables of age, PD, CAL and BOP of all individuals were analyzed using the paired t-test (GrapPad Prism5®). Data of bacteria quantification were subjected to a normality test (D'Agostino-Pearson Test). For bacterial correlation analysis, the Spearman correlation was used. Results Our results showed that diseased sites had significantly higher levels of P. endodontalis compared to healthy sites, similar to the results obtained for P. gingivalis and T. forsythia. The numbers of all bacterial species were reduced significantly after mechanical periodontal treatment. P. endodontalis was significantly correlated with the presence of T. forsythia and P. gingivalis in the diseased group. Conclusion Our results suggest that there is a high prevalence of P. endodontalis, P. gingivalis and T. forsythia in periodontitis sites and that mechanical periodontal treatment is effective at reducing the pathogens studied. PMID:22232719

Health impact of climate change on occupational health and productivity in Thailand

PubMed Central

Langkulsen, Uma; Vichit-Vadakan, Nuntavarn; Taptagaporn, Sasitorn

2010-01-01

Background The rise in global temperature is well documented. Changes in temperature lead to increases in heat exposure, which may impact health ranging from mild heat rashes to deadly heat stroke. Heat exposure can also aggravate several chronic diseases including cardiovascular and respiratory disease. Objective This study examined the relationship between climate condition and health status and productivity in two main categories of the occupational setting – where one setting involves heat generated from the industry and the other with heat in a natural setting. Design This cross-sectional study included four industrial sites (pottery industry, power plant, knife industry, and construction site) and one agricultural site in the Pathumthani and Ayutthaya provinces. Exposure data were comprised of meteorological data and heat exposure including relative humidity (RH) measured by Wet Bulb Globe Temperature (WBGT) monitor. Heat index was calculated to measure the effects of heat exposure on the study population, which consisted of 21 workers at five worksites; a questionnaire was also used to collect data on workers. Results Among the five workplaces, the outdoor WBGT was found to be highest at 34.6°C during 12:00 and 1:00 PM at the agricultural site. It was found that four out of five study sites had heat indices in the ‘extreme caution,’ where heat cramp and exhaustion may be possible and one site showed a value of 41°C that falls into the category of ‘danger,’ where sunstroke and heat exhaustion are likely and prolonged exposure may lead to heatstroke. Productivity as perceived by the workers revealed that only the construction and pottery industry workers had a loss of productivity ranged from 10 to 60 %. Conclusions Climate conditions in Thailand potentially affect both the health and productivity in occupational settings. PMID:21160553

On the use of haplotype phylogeny to detect disease susceptibility loci

PubMed Central

Bardel, Claire; Danjean, Vincent; Hugot, Jean-Pierre; Darlu, Pierre; Génin, Emmanuelle

2005-01-01

Background The cladistic approach proposed by Templeton has been presented as promising for the study of the genetic factors involved in common diseases. This approach allows the joint study of multiple markers within a gene by considering haplotypes and grouping them in nested clades. The idea is to search for clades with an excess of cases as compared to the whole sample and to identify the mutations defining these clades as potential candidate disease susceptibility sites. However, the performance of this approach for the study of the genetic factors involved in complex diseases has never been studied. Results In this paper, we propose a new method to perform such a cladistic analysis and we estimate its power through simulations. We show that under models where the susceptibility to the disease is caused by a single genetic variant, the cladistic test is neither really more powerful to detect an association nor really more efficient to localize the susceptibility site than an individual SNP testing. However, when two interacting sites are responsible for the disease, the cladistic analysis greatly improves the probability to find the two susceptibility sites. The impact of the linkage disequilibrium and of the tree characteristics on the efficiency of the cladistic analysis are also discussed. An application on a real data set concerning the CARD15 gene and Crohn disease shows that the method can successfully identify the three variant sites that are involved in the disease susceptibility. Conclusion The use of phylogenies to group haplotypes is especially interesting to pinpoint the sites that are likely to be involved in disease susceptibility among the different markers identified within a gene. PMID:15904492

Investigation of Peri-Implant Bone Healing Using Autologous Plasma Rich in Growth Factors in the Canine Mandible After 12 Weeks: A Pilot Study

PubMed Central

Birang, Reza; Tavakoli, Mohammad; Shahabouei, Mohammad; Torabi, Alireza; Dargahi, Ali; Soolari, Ahmad

2011-01-01

Introduction: Faster reconstruction of patients’ masticatory systems is the aim of modern dentistry. A number of studies have indicated that application of growth factors to the surface of a dental implant leads to accelerated and enhanced osseointegration. The objective of the present study was to investigate the effect of plasma rich in growth factors on peri-implant bone healing. Materials and Methods: For the purpose of this study, two healthy, mixed-breed canines were selected, and the premolars were extracted from both sides of the mandible. Three months after premolar removal, 12 implants, each 5 mm in diameter and 10 mm in length, were placed in osteotomy sites on both sides of the mandible. Prior to placement, plasma rich in growth factors was applied to the surfaces of six implants, while the other six were used without plasma rich in growth factors. The implants were removed after 12 weeks along with the bone surrounding the sites using a trephine bur. One mesiodistal section containing the surrounding bone from each implant block, 50 µm in diameter, was prepared for histologic and histomorphometric investigation with an optical microscope. Results: The sites with implants treated with plasma rich in growth factors showed more bone-to-implant contact compared to control sites. Also, higher values for bone trabecular thickness and bone maturity were recorded for the PRGF-treated sites than for the control sites. Conclusion: Application of plasma rich in growth factors to the surface of an implant may enhance the bone healing process as well as bone-to-implant contact, thereby helping to achieve faster osseointegration. PMID:22145011

Psychosocial Factors and Musculoskeletal Pain Among Rural Hand-woven Carpet Weavers in Iran

PubMed Central

Chaman, Reza; Aliyari, Roqayeh; Sadeghian, Farideh; Vatani Shoaa, Javad; Masoudi, Mahmood; Zahedi, Shiva; Bakhshi, Mohammad A.

2015-01-01

Background Musculoskeletal pain (MSP) is a common and disabling problem among carpet weavers and is linked to physical and psychosocial factors of work. This study aimed to determine the prevalence of MSP, its psychosocial risk factors, and association of pain in each pair of anatomical sites among carpet weavers. Methods A cross-sectional study was performed among 546 hand-woven carpet weavers in rural small-scale workshops of Iran. Data were collected by using parts of a standardized CUPID (Cultural and Psychosocial Influences on Disability) questionnaire focused on MSP in 10 body sites, including the low-back, neck, both right and left shoulders, elbows, wrists/hands, individual, physical and psychosocial risk factors. Statistical analysis was performed applying logistic regression models. Results Prevalence of MSP in at least one body site was 51.7% over the past month. The most common sites were low back and right shoulder pain 27.4% and 20.1%, respectively. A significant difference was found between the mean number of painful anatomical sites and the level of education, age, physical loading at work, time pressure, lack of support, and job dissatisfaction. In pairwise comparisons, strongest association was found between pain in each bilateral anatomical site (odds ratio = 11.6–35.3; p < 0.001). Conclusion In home-based workshops of carpet weaving, psychosocial factors and physical loading were associated with MSP. This finding is consistent with studies conducted among other jobs. Considering the preventive programs, the same amount of attention should be paid to psychosocial risk factors and physical loading. Also, further longitudinal studies are needed to investigate the relationship of psychological factors. PMID:26106511

Upper Ottawa street landfill site health study.

PubMed Central

Hertzman, C; Hayes, M; Singer, J; Highland, J

1987-01-01

This report describes the design and conduct of two sequential historical prospective morbidity surveys of workers and residents from the Upper Ottawa Street Landfill Site in Hamilton, Ontario. The workers study was carried out first and was a hypothesis-generating study. Workers and controls were administered a health questionnaire, which was followed by an assessment of recall bias through medical chart abstraction. Multiple criteria were used to identify health problems associated with landfill site exposure. Those problems with highest credibility included clusters of respiratory, skin, narcotic, and mood disorders. These formed the hypothesis base in the subsequent health study of residents living adjacent to the landfill site. In that study, the association between mood, narcotic, skin, and respiratory conditions with landfill site exposure was confirmed using the following criteria: strength of association; consistency with the workers study; risk gradient by duration of residence and proximity to the landfill; absence of evidence that less healthy people moved to the area; specificity; and the absence of recall bias. The validity of these associations were reduced by three principal problems: the high refusal rate among the control population; socioeconomic status differences between the study groups; and the fact that the conditions found in excess were imprecisely defined and potentially interchangeable with other conditions. Offsetting these problems were the multiple criteria used to assess each hypothesis, which were applied according to present rules. Evidence is presented that supports the hypothesis that vapors, fumes, or particulate matter emanating from the landfill site, as well as direct skin exposure, may have lead to the health problems found in excess. Evidence is also presented supporting the hypothesis that perception of exposure and, therefore, of risk, may explain the results of the study. However, based on the analyses performed, it is the conclusion of the authors that the adverse effects seen were more likely the result of chemical exposure than of perception of risk. PMID:3691438

Maternal Opioid Treatment: Human Experimental Research (MOTHER) – Approach, Issues, and Lessons Learned

PubMed Central

Jones, Hendrée E.; Fischer, Gabriele; Heil, Sarah H.; Kaltenbach, Karol; Martin, Peter R.; Coyle, Mara G.; Selby, Peter; Stine, Susan M.; O’Grady, Kevin E.; Arria, Amelia M.

2015-01-01

Aims The Maternal Opioid Treatment: Human Experimental Research (MOTHER) project, an eight-site randomized, double-blind, double-dummy, flexible-dosing, parallel-group clinical trial is described. This study is the most current – and single most comprehensive – research effort to investigate the safety and efficacy of maternal and prenatal exposure to methadone and buprenorphine. Methods The MOTHER study design is outlined, and its basic features are presented. Conclusions At least seven important lessons have been learned from the MOTHER study: (1) an interdisciplinary focus improves the design and methods of a randomized clinical trial; (2) multiple sites in a clinical trial present continuing challenges to the investigative team due to variations in recruitment goals, patient populations, and hospital practices that in turn differentially impact recruitment rates, treatment compliance, and attrition; (3) study design and protocols must be flexible in order to meet the unforeseen demands of both research and clinical management; (4) staff turnover needs to be addressed with a proactive focus on both hiring and training; (5) the implementation of a protocol for the treatment of a particular disorder may identify important ancillary clinical issues worthy of investigation; (6) timely tracking of data in a multi-site trial is both demanding and unforgiving; and, (7) complex multi-site trials pose unanticipated challenges that complicate the choice of statistical methods, thereby placing added demands on investigators to effectively communicate their results. PMID:23106924

Impact of urbanisation and altitude on the incidence of, and risk factors for, hypertension

PubMed Central

Bernabé-Ortiz, Antonio; Carrillo-Larco, Rodrigo M; Gilman, Robert H; Checkley, William; Smeeth, Liam; Miranda, J Jaime

2017-01-01

Background Most of the data regarding the burden of hypertension in low-income and middle-income countries comes from cross-sectional surveys instead of longitudinal studies. We estimated the incidence of, and risk factors for, hypertension in four study sites with different degree of urbanisation and altitude. Methods Data from the CRONICAS Cohort Study, conducted in urban, semiurban and rural areas in Peru, was used. An age-stratified and sex-stratified random sample of participants was taken from the most updated census available in each site. Hypertension was defined as systolic blood pressure ≥140 mm Hg, or diastolic blood pressure ≥90 mm Hg, or self-report physician diagnosis and current treatment. The exposures were study site and altitude as well as modifiable risk factors. Incidence, incidence rate ratios (IRRs), 95% CIs and population-attributable fractions (PAFs) were estimated using generalised linear models. Results Information from 3237 participants, mean age 55.8 (SD±12.7) years, 48.4% males, was analysed. Overall baseline prevalence of hypertension was 19.7% (95% CI 18.4% to 21.1%). A total of 375 new cases of hypertension were recorded, including 5266 person-years of follow-up, with an incidence of 7.12 (95% CI 6.44 to 7.88) per 100 person-years. Individuals from semiurban site were at higher risk of hypertension compared with highly urbanised areas (IRR=1.76; 95% CI 1.39 to 2.23); however, those from high-altitude sites had a reduced risk (IRR=0.74; 95% CI 0.58 to 0.95). Obesity was the leading risk factor for hypertension with a great variation according to study site with PAF ranging from 12.5% to 42.4%. Conclusions Our results suggest heterogeneity in the progression towards hypertension depending on urbanisation and site altitude. PMID:28115473

Role of basic and acidic centers of MgO and modified MgO in catalytic transfer hydrogenation of ketones studied by infrared spectroscopy

NASA Astrophysics Data System (ADS)

Szöllösi, György; Bartók, Mihály

1999-05-01

In this study our aim was to identify the active sites and the surface species responsible for deactivation of MgO during catalytic transfer hydrogenations (CTH) of ketones using alcohols as hydrogen donors. Our previous studies showed that deactivation of MgO could be prevented by previous treatment with chloromethanes. Therefore the surface species formed during the reaction were studied before and after treatment with chloroform or chloroform- d by in situ infrared spectroscopy (IR). As a result, it was concluded that the reaction requires the presence of surface basic and acidic centers. The presence of Lewis acid centers was not necessary, the reaction could proceed on weakly acidic surface Brönsted sites, as the alterations in intensity and position of the ν(OH) bands indicated. Modification with chloroform resulted also in the generation of surface OH groups with a proper acidity for the reaction. The shift in carbonyl vibrations led us to the conclusion that Lewis acid and base centers were responsible for the catalyst poisoning, so covering these acid sites by Cl - led to a stable catalyst.

The effect of preoperative stoma site marking on quality of life

PubMed Central

Cakir, Selda Karaveli; Ozbayir, Turkan

2018-01-01

Objective: The objective of the study was to determine the effect of preoperative stoma site marking on the health- related quality of life (HRQOL). Methods: A nonrandomized, quasi-experimental design was used for the study performed from June 2013 to August 2014. The study sample (n:60) included patients for whom a stoma was opened after a planned colorectal surgery. The City of Hope Quality of Life-Ostomy Questionnaire (COHQOL-OQ) was used to measure HRQOL. Results: The mean age of the participants in the experimental group was 53.5±12.83, 18(60%) had colostomies, mean BMI was 25.46 ± 4.25 and mean age of that of the control group was 58.00 ± 14.22, 19(63.3%) had colostomies, mean BMI was 25.28 ± 5.00. A comparison of the two groups indicates that the sixth-month total score of the patients in the experimental group on (COHQOL-OQ) is higher than that of the control group (p<0.05). Conclusions: The study results demonstrated that patient who underwent stoma site marking reported higher HRQOL than those who did not. PMID:29643897

Permanent Neonatal Diabetes Caused by Creation of an Ectopic Splice Site within the INS Gene

PubMed Central

Gastaldo, Elena; Harries, Lorna W.; Rubio-Cabezas, Oscar; Castaño, Luis

2012-01-01

Background The aim of this study was to characterize the genetic etiology in a patient who presented with permanent neonatal diabetes at 2 months of age. Methodology/Principal Findings Regulatory elements and coding exons 2 and 3 of the INS gene were amplified and sequenced from genomic and complementary DNA samples. A novel heterozygous INS mutation within the terminal intron of the gene was identified in the proband and her affected father. This mutation introduces an ectopic splice site leading to the insertion of 29 nucleotides from the intronic sequence into the mature mRNA, which results in a longer and abnormal transcript. Conclusions/Significance This study highlights the importance of routinely sequencing the exon-intron boundaries and the need to carry out additional studies to confirm the pathogenicity of any identified intronic genetic variants. PMID:22235272

ENGINEERING STUDY FOR THE 200 AREA EFFLUENT TREATMENT FACILITY (ETF) SECONDARY WASTE TREATMENT OF PROJECTED FUTURE WASTE FEEDS

DOE Office of Scientific and Technical Information (OSTI.GOV)

LUECK, K.J.

2004-10-18

This report documents an engineering study conducted to evaluate alternatives for treating secondary waste in the secondary treatment train (STT) of the Hanford Site 200 Area Effluent Treatment Facility (ETF). The study evaluates ETF STT treatment alternatives and recommends preferred alternatives for meeting the projected future missions of the ETF. The preferred alternative(s) will process projected future ETF influents to produce a solid waste acceptable for final disposal on the Hanford Site. The main text of this report summarizes the ETF past and projected operations, lists the assumptions about projected operations that provide the basis for the engineering evaluation, andmore » summarizes the evaluation process. The evaluation process includes identification of available modifications to the current ETF process, screens those modifications for technical viability, evaluates the technically viable alternatives, and provides conclusions and recommendations based on that evaluation.« less

Fragment length polymorphisms among independent isolates of Epstein-Barr virus from immunocompromised and normal hosts.

PubMed

Katz, B Z; Niederman, J C; Olson, B A; Miller, G

1988-02-01

DNA restriction fragment length polymorphisms of Epstein-Barr virus (EBV) DNA were used as a molecular epidemiological tool to study multiple isolates of virus from the same and different individuals. We studied 35 EBV isolates: 19 from seven immunocompromised children and 16 from seven college students with mononucleosis. Analysis of the fragment length polymorphisms in this collection of isolates permitted several conclusions. Sites of polymorphism were most often encountered in regions with repetitive DNA. Epidemiologically unrelated patients harbored viruses that could be readily distinguished; by contrast, two infants and their mothers harbored similar viruses. Isolates from different sites in the same patient were similar. Variations between different clinical isolates of EBV mimic those found between different laboratory strains of the virus. Fragment length polymorphisms thus provide a useful marker for studying transmission and pathogenesis of EBV infections.

10 CFR 709.16 - Application of Counterintelligence Evaluation Review Boards in reaching conclusions regarding CI...

Code of Federal Regulations, 2011 CFR

2011-01-01

... his/her designee) and includes representation from the appropriate line Program Managers, lab/site... site or operations office. (c) Process. When making a final recommendation under § 709.17 of this part, to a Program Manager, the Director of Intelligence and Counterintelligence shall report on the...

Digital subtraction radiographic analysis of the combination of bioabsorbable membrane and bovine morphogenetic protein pool in human periodontal infrabony defects

PubMed Central

GUIMARÃES, Maria do Carmo Machado; PASSANEZI, Euloir; SANT’ANA, Adriana Campos Passanezi; GREGHI, Sebastião Luiz Aguiar; TABA JUNIOR, Mario

2010-01-01

Objectives This study assessed the bone density gain and its relationship with the periodontal clinical parameters in a case series of a regenerative therapy procedure. Material and Methods Using a split-mouth study design, 10 pairs of infrabony defects from 15 patients were treated with a pool of bovine bone morphogenetic proteins associated with collagen membrane (test sites) or collagen membrane only (control sites). The periodontal healing was clinically and radiographically monitored for six months. Standardized presurgical and 6-month postoperative radiographs were digitized for digital subtraction analysis, which showed relative bone density gain in both groups of 0.034 ± 0.423 and 0.105 ± 0.423 in the test and control group, respectively (p>0.05). Results As regards the area size of bone density change, the influence of the therapy was detected in 2.5 mm2 in the test group and 2 mm2 in the control group (p>0.05). Additionally, no correlation was observed between the favorable clinical results and the bone density gain measured by digital subtraction radiography (p>0.05). Conclusions The findings of this study suggest that the clinical benefit of the regenerative therapy observed did not come with significant bone density gains. Long-term evaluation may lead to a different conclusions. PMID:20835573

Uranium interaction with soil minerals in the presence of co-contaminants: Case Study- subsurface sediments at or below the water table

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gartman, Brandy N.; Qafoku, Nikolla

2016-03-09

Uranium (U) contaminated subsurface systems are common on a global scale mainly because of its essential role in the production of plutonium for nuclear weapons and other nuclear energy and research activities. Studying the behavior and fate of U in these systems is challenging because of heterogeneities of different types (i.e., physical, chemical and mineralogical) and a complex network of often time-dependent hydrological, biological and chemical reactions and processes that occur sequentially or simultaneously, affecting and/or controlling U mobility. A U contaminated site, i.e., the Integrated Field Research Challenge site in Rifle, CO, USA (a former U mill site) ismore » the focus of this discussion. The overall objectives of this chapter are to 1) provide an overview of the contamination levels (U and other co-contaminants) at this field site; 2) review and discuss different aspects of mineral-U contaminant interactions in reduced and oxidized environments, and in the presence of co-contaminants; 3) present results from a systematic macroscopic, microscopic, and spectroscopic study as an example of the current research efforts and the state-of-knowledge in this important research area; and 4) offer insightful conclusive remarks and future research needs about reactions and processes that control U and other contaminants’ fate and behavior under hydraulically saturated conditions. The implications and applications presented in this chapter are valid for U contaminated sites across the world.« less

Health plan competition in local markets.

PubMed Central

Grossman, J M

2000-01-01

OBJECTIVE: To examine the structure of local health insurance markets and the strategies health plans were using to respond to competitive pressures in local markets in 1996/1997. DATA SOURCES/STUDY SETTING: Community Tracking Study site visits conducted between May 1996 and April 1997 in 12 U.S. markets selected to be nationally representative. STUDY DESIGN: In each site, 36 to 60 interviews on local health system change were conducted with healthcare industry informants representing health plans, providers, and purchasers. DATA COLLECTION/EXTRACTION METHOD: Relevant data for this article were abstracted from standardized protocols administered to multiple respondents in each site. PRINCIPAL FINDINGS: Although the competitive threat from national plans was pervasive, local plans in most sites continued to retain strong, often dominant, positions in historically concentrated markets. In all sites, in response to purchaser pressures for stable premiums and provider choice, and the threat of entry and to plans were using three strategies to increase market share and market power: (1) consolidation/geographic expansion, (2) price competition, and (3) product line/segment diversification that focused on broad networks and open-access products. In most markets, in response to the demand for provider choice, the trend was away from ownership and exclusive arrangements with providers. CONCLUSIONS: Although local plans were moving to become full-service regional players, there was uncertainty about the abilities of all plans to sustain growth strategies at the expense of margins and organizational stability, and to effectively manage care with broad networks. PMID:10778822

Virtual colleagues, virtually colleagues—physicians’ use of Twitter: a population-based observational study

PubMed Central

Brynolf, Anne; Johansson, Stefan; Appelgren, Ester; Lynoe, Niels; Edstedt Bonamy, Anna-Karin

2013-01-01

Objective To investigate potential violations of patient confidentiality or other breaches of medical ethics committed by physicians and medical students active on the social networking site Twitter. Design Population-based cross-sectional observational study. Setting The social networking site Twitter (Swedish-speaking users, n=298819). Population Physicians and medical students (Swedish-speaking users, n=237) active on the social networking site Twitter between July 2007 and March 2012. Main outcome measure Postings that reflect unprofessional behaviour and ethical breaches among physicians and medical students. Results In all, 237 Twitter accounts were established as held by physicians and medical students and a total of 13 780 tweets were analysed by content. In all, 276 (1.9%) tweets were labelled as ‘unprofessional’. Among these, 26 (0.2%) tweets written by 15 (6.3%) physicians and medical students included information that could violate patient privacy. No information on the personal ID number or names was disclosed, but parts of the patient documentation or otherwise specific indicatory information on patients were found. Unprofessional tweets were more common among users writing under a pseudonym and among medical students. Conclusions In this study of physicians and medical students on Twitter, we observed potential violations of patient privacy and other breaches of medical ethics. Our findings underline that every physician and medical student has to consider his or her presence on social networking sites. It remains to be investigated if the introduction of social networking site guidelines for medical professionals will improve awareness. PMID:23883885

Detection of selected bacterial species in intraoral sites of patients with chronic periodontitis using multiplex polymerase chain reaction

PubMed Central

ESTRELA, Cyntia Rodrigues de Araújo; PIMENTA, Fabiana Cristina; de ALENCAR, Ana Helena Gonçalves; RUIZ, Luis Fernando Naldi; ESTRELA, Carlos

2010-01-01

Objective The aim of this study was to detect the prevalence of selected bacterial species in intraoral sites of patients with chronic periodontitis (CP) using multiplex polymerase chain reaction (PCR). Methodology Samples were collected from the tongue dorsum, buccal mucosa, supragingival and subgingival plaque and saliva of 30 patients with untreated CP. Multiplex PCR was used to determine prevalence rates, which were then compared using a chi-square test. Significance level was set at p<0.05. Mean and standard deviation values were used to evaluate variations in prevalence according to site. Results The prevalence of S. mutans was 70% in saliva; 60% in samples collected from the tongue dorsum; 50% in samples collected from the buccal mucosa; 56.5% in the supragingival plaque; and 53.5% in the subgingival plaque. The prevalence of E. faecalis ranged from 3.5% to 13.5% in all intraoral microenvironment. The highest prevalence of P. gingivalis was found in subgingival plaque (53.5%), and of P. intermedia in supragingival plaque (33.5%), subgingival plaque (30%) and tongue dorsum (33.5%). The prevalence of bacteria did not vary significantly among the intraoral sites. Conclusions All studied bacteria were identified in intraoral sites. S. mutans, P. gingivalis and P. intermedia had high prevalence rates, but the prevalence of E. faecalis was low. Multiplex PCR proved to be an adequate method for epidemiological studies. PMID:20835581

Experimental warming differentially affects microbial structure and activity in two contrasted moisture sites in a Sphagnum-dominated peatland.

PubMed

Delarue, Frédéric; Buttler, Alexandre; Bragazza, Luca; Grasset, Laurent; Jassey, Vincent E J; Gogo, Sébastien; Laggoun-Défarge, Fatima

2015-04-01

Several studies on the impact of climate warming have indicated that peat decomposition/mineralization will be enhanced. Most of these studies deal with the impact of experimental warming during summer when prevalent abiotic conditions are favorable to decomposition. Here, we investigated the effect of experimental air warming by open-top chambers (OTCs) on water-extractable organic matter (WEOM), microbial biomasses and enzymatic activities in two contrasted moisture sites named Bog and Fen sites, the latter considered as the wetter ones. While no or few changes in peat temperature and water content appeared under the overall effect of OTCs, we observed that air warming smoothed water content differences and led to a decrease in mean peat temperature at the warmed Bog sites. This thermal discrepancy between the two sites led to contrasting changes in microbial structure and activities: a rise in hydrolytic activity at the warmed Bog sites and a relative enhancement of bacterial biomass at the warmed Fen sites. These features were not associated with any change in WEOM properties namely carbon and sugar contents and aromaticity, suggesting that air warming did not trigger any shift in OM decomposition. Using various tools, we show that the use of single indicators of OM decomposition can lead to fallacious conclusions. Lastly, these patterns may change seasonally as a consequence of complex interactions between groundwater level and air warming, suggesting the need to improve our knowledge using a high time-resolution approach. Copyright © 2015 Elsevier B.V. All rights reserved.

Single-site multiport combined splenectomy and cholecystectomy with conventional laparoscopic instruments: Case series and review of literature

PubMed Central

Ozemir, Ibrahim Ali; Bayraktar, Baris; Bayraktar, Onur; Tosun, Salih; Bilgic, Cagri; Demiral, Gokhan; Ozturk, Erman; Yigitbasi, Rafet; Alimoglu, Orhan

2015-01-01

Introduction Conventional laparoscopic procedures have been used for splenic diseases and concomitant gallbladder stones, frequently in patients with hereditary spherocytosis since 1990’s. The aim of this study is to evaluate the feasibility of single-site surgery with conventional instruments in combined procedures. Presentation of case series Six consecutive patients who scheduled for combined cholecystectomy and splenectomy because of hereditary spherocytosis or autoimmune hemolytic anemia were included this study. Both procedures were performed via trans-umbilical single-site multiport approach using conventional instruments. All procedures completed successfully without conversion to open surgery or conventional laparoscopic surgery. An additional trocar was required for only one patient. The mean operation time was 190 min (150–275 min). The mean blood loss was 185 ml (70–300 ml). Median postoperative hospital stay was two days. No perioperative mortality or major complications occurred in our series. Recurrent anemia, hernia formation or wound infection was not observed during the follow-up period. Discussion Nowadays, publications are arising about laparoscopic or single site surgery for combined diseases. Surgery for combined diseases has some difficulties owing to the placement of organs and position of the patient during laparoscopic surgery. Single site laparoscopic surgery has been proposed to have better cosmetic outcome, less postoperative pain, greater patient satisfaction and faster recovery compared to standard laparoscopy. Conclusion We consider that single-site multiport laparoscopic approach for combined splenectomy and cholecystectomy is a safe and feasible technique, after gaining enough experience on single site surgery. PMID:26708949

Problematic use of social networking sites among urban school going teenagers

PubMed Central

Meena, Parth Singh; Mittal, Pankaj Kumar; Solanki, Ram Kumar

2012-01-01

Background: Social networking sites like Facebook, Orkut and Twitter are virtual communities where users can create individual public profiles, interact with real-life friends and meet other people based on shared interests. An exponential rise in usage of Social Networking Sites have been seen within the last few years. Their ease of use and immediate gratification effect on users has changed the way people in general and students in particular spend their time. Young adults, particularly teenagers tended to be unaware of just how much time they really spent on social networking sites. Negative correlates of Social Networking Sites usage include the decrease in real life social community participation and academic achievement, as well as relationship problems, each of which may be indicative of potential addiction. Aims: the aim of the study was to find out whether teenagers, specially those living in cities spend too much time on social networking websites. Materials and Methods: 200 subjects, both boys and girls were included in the cross sectional study who were given a 20 item Young's internet addiction test modified for social networking sites. The responses were analyzed using chi square test and Fisher's exact test. Results: 24.74% of the students were having occasional or ‘frequency’ problems while 2.02% of them were experiencing severe problems due to excessive time spent using social networking sites. Conclusion: With the ever increasing popularity of social media, teenagers are devoting significant time to social networking on websites and are prone to get ‘addicted’ to such form of online social interaction. PMID:24250039

Site-to-site interdomain communication may mediate different loss-of-function mechanisms in a cancer-associated NQO1 polymorphism

NASA Astrophysics Data System (ADS)

Medina-Carmona, Encarnación; Neira, Jose L.; Salido, Eduardo; Fuchs, Julian E.; Palomino-Morales, Rogelio; Timson, David J.; Pey, Angel L.

2017-03-01

Disease associated genetic variations often cause intracellular enzyme inactivation, dysregulation and instability. However, allosteric communication of mutational effects to distant functional sites leading to loss-of-function remains poorly understood. We characterize here interdomain site-to-site communication by which a common cancer-associated single nucleotide polymorphism (c.C609T/p.P187S) reduces the activity and stability in vivo of NAD(P)H:quinone oxidoreductase 1 (NQO1). NQO1 is a FAD-dependent, two-domain multifunctional stress protein acting as a Phase II enzyme, activating cancer pro-drugs and stabilizing p53 and p73α oncosuppressors. We show that p.P187S causes structural and dynamic changes communicated to functional sites far from the mutated site, affecting the FAD binding site located at the N-terminal domain (NTD) and accelerating proteasomal degradation through dynamic effects on the C-terminal domain (CTD). Structural protein:protein interaction studies reveal that the cancer-associated polymorphism does not abolish the interaction with p73α, indicating that oncosuppressor destabilization largely mirrors the low intracellular stability of p.P187S. In conclusion, we show how a single disease associated amino acid change may allosterically perturb several functional sites in an oligomeric and multidomain protein. These results have important implications for the understanding of loss-of-function genetic diseases and the identification of novel structural hot spots as targets for pharmacological intervention.

Primary tumor sites in relation to ultraviolet radiation exposure and skin visibility correlate with survival in cutaneous melanoma.

PubMed

Gordon, Daniela; Hansson, Johan; Eloranta, Sandra; Gordon, Max; Gillgren, Peter; Smedby, Karin E

2017-10-01

The prognostic value of detailed anatomic site and ultraviolet radiation (UVR) exposure patterns has not been fully determined in cutaneous melanoma. Thus, we reviewed medical records for detailed site in a population-based retrospective Swedish patient cohort diagnosed with primary invasive melanoma 1976-2003 (n = 5,973). We followed the patients from date of diagnosis until death, emigration or December 31 st 2013, and evaluated melanoma-specific survival by subsite in a multivariable regression model adjusting for established prognostic factors. We found that melanoma on chronic UVR exposure sites (face, dorsum of hands; adjusted HR 0.6; CI 0.4-0.7) and moderately intermittent UVR sites (lateral arms, lower legs, dorsum of feet; HR 0.7; CI 0.6-0.8) were associated with a favorable prognosis compared with highly intermittent sites (chest, back, neck, shoulders and thighs). Further, melanoma on poorly visible skin sites upon self-examination (scalp, retroauricular area, back, posterior upper arms and thighs, buttocks, pubic area; HR 1.3; CI 1.1-1.5) had a worse prognosis than those on easily visible sites (face, chest, abdomen, anterior upper arms and thighs, lower arms and legs, dorsum of hands and feet, palms). In conclusion, highly intermittent UVR exposure sites and poor skin visibility presumably correlate with reduced melanoma survival, independent of established tumor characteristics. A limitation of the study was the lack of information on actual individual UVR exposure. © 2017 UICC.

Multimodality language mapping in patients with left-hemispheric language dominance on Wada test

PubMed Central

Kojima, Katsuaki; Brown, Erik C.; Rothermel, Robert; Carlson, Alanna; Matsuzaki, Naoyuki; Shah, Aashit; Atkinson, Marie; Mittal, Sandeep; Fuerst, Darren; Sood, Sandeep; Asano, Eishi

2012-01-01

Objective We determined the utility of electrocorticography (ECoG) and stimulation for detecting language-related sites in patients with left-hemispheric language-dominance on Wada test. Methods We studied 13 epileptic patients who underwent language mapping using event-related gamma-oscillations on ECoG and stimulation via subdural electrodes. Sites showing significant gamma-augmentation during an auditory-naming task were defined as language-related ECoG sites. Sites at which stimulation resulted in auditory perceptual changes, failure to verbalize a correct answer, or sensorimotor symptoms involving the mouth were defined as language-related stimulation sites. We determined how frequently these methods revealed language-related sites in the superior-temporal, inferior-frontal, dorsolateral-premotor, and inferior-Rolandic regions. Results Language-related sites in the superior-temporal and inferior-frontal gyri were detected by ECoG more frequently than stimulation (p < 0.05), while those in the dorsolateral-premotor and inferior-Rolandic regions were detected by both methods equally. Stimulation of language-related ECoG sites, compared to the others, more frequently elicited language symptoms (p < 0.00001). One patient developed dysphasia requiring in-patient speech therapy following resection of the dorsolateral-premotor and inferior-Rolandic regions containing language-related ECoG sites not otherwise detected by stimulation. Conclusions Language-related gamma-oscillations may serve as an alternative biomarker of underlying language function in patients with left-hemispheric language-dominance. Significance Measurement of language-related gamma-oscillations is warranted in presurgical evaluation of epileptic patients. PMID:22503906

Implementing Rapid HIV Testing With or Without Risk-Reduction Counseling in Drug Treatment Centers: Results of a Randomized Trial

PubMed Central

Feaster, Daniel J.; Gooden, Lauren; Matheson, Tim; Mandler, Raul N.; Haynes, Louise; Tross, Susan; Kyle, Tiffany; Gallup, Dianne; Kosinski, Andrzej S.; Douaihy, Antoine; Schackman, Bruce R.; Das, Moupali; Lindblad, Robert; Erickson, Sarah; Korthuis, P. Todd; Martino, Steve; Sorensen, James L.; Szapocznik, José; Walensky, Rochelle; Branson, Bernard; Colfax, Grant N.

2012-01-01

Objectives. We examined the effectiveness of risk reduction counseling and the role of on-site HIV testing in drug treatment. Methods. Between January and May 2009, we randomized 1281 HIV-negative (or status unknown) adults who reported no past-year HIV testing to (1) referral for off-site HIV testing, (2) HIV risk-reduction counseling with on-site rapid HIV testing, or (3) verbal information about testing only with on-site rapid HIV testing. Results. We defined 2 primary self-reported outcomes a priori: receipt of HIV test results and unprotected anal or vaginal intercourse episodes at 6-month follow-up. The combined on-site rapid testing participants received more HIV test results than off-site testing referral participants (P < .001; Mantel-Haenszel risk ratio = 4.52; 97.5% confidence interval [CI] = 3.57, 5.72). At 6 months, there were no significant differences in unprotected intercourse episodes between the combined on-site testing arms and the referral arm (P = .39; incidence rate ratio [IRR] = 1.04; 97.5% CI = 0.95, 1.14) or the 2 on-site testing arms (P = .81; IRR = 1.03; 97.5% CI = 0.84, 1.26). Conclusions. This study demonstrated on-site rapid HIV testing’s value in drug treatment centers and found no additional benefit from HIV sexual risk-reduction counseling. PMID:22515871

Performance of on-site Medical waste disinfection equipment in hospitals of Tabriz, Iran

PubMed Central

Taghipour, Hassan; Alizadeh, Mina; Dehghanzadeh, Reza; Farshchian, Mohammad Reza; Ganbari, Mohammad; Shakerkhatibi, Mohammad

2016-01-01

Background: The number of studies available on the performance of on-site medical waste treatment facilities is rare, to date. The aim of this study was to evaluate the performance of onsite medical waste treatment equipment in hospitals of Tabriz, Iran. Methods: A various range of the on-site medical waste disinfection equipment (autoclave, chemical disinfection, hydroclave, and dry thermal treatment) was considered to select 10 out of 22 hospitals in Tabriz to be included in the survey. The apparatus were monitored mechanically, chemically, and biologically for a six months period in all of the selected hospitals. Results: The results of the chemical monitoring (Bowie-Dick tests) indicated that 38.9% of the inspected autoclaves had operational problems in pre-vacuum, air leaks, inadequate steam penetration into the waste, and/or vacuum pump. The biological indicators revealed that about 55.55% of the samples were positive. The most of applied devices were not suitable for treating anatomical, pharmaceutical, cytotoxic, and chemical waste. Conclusion: Although on-site medical waste treating facilities have been installed in all the hospitals, the most of infectious-hazardous medical waste generated in the hospitals were deposited into a municipal solid waste landfill, without enough disinfection. The responsible authorities should stringently inspect and evaluate the operation of on-site medical waste treating equipment. An advanced off-site central facility with multi-treatment and disinfection equipment and enough capacity is recommended as an alternative. PMID:27766238

Performance of on-site Medical waste disinfection equipment in hospitals of Tabriz, Iran.

PubMed

Taghipour, Hassan; Alizadeh, Mina; Dehghanzadeh, Reza; Farshchian, Mohammad Reza; Ganbari, Mohammad; Shakerkhatibi, Mohammad

2016-01-01

Background: The number of studies available on the performance of on-site medical waste treatment facilities is rare, to date. The aim of this study was to evaluate the performance of onsite medical waste treatment equipment in hospitals of Tabriz, Iran. Methods: A various range of the on-site medical waste disinfection equipment (autoclave, chemical disinfection, hydroclave, and dry thermal treatment) was considered to select 10 out of 22 hospitals in Tabriz to be included in the survey. The apparatus were monitored mechanically, chemically, and biologically for a six months period in all of the selected hospitals. Results: The results of the chemical monitoring (Bowie-Dick tests) indicated that 38.9% of the inspected autoclaves had operational problems in pre-vacuum, air leaks, inadequate steam penetration into the waste, and/or vacuum pump. The biological indicators revealed that about 55.55% of the samples were positive. The most of applied devices were not suitable for treating anatomical, pharmaceutical, cytotoxic, and chemical waste. Conclusion: Although on-site medical waste treating facilities have been installed in all the hospitals, the most of infectious-hazardous medical waste generated in the hospitals were deposited into a municipal solid waste landfill, without enough disinfection. The responsible authorities should stringently inspect and evaluate the operation of on-site medical waste treating equipment. An advanced off-site central facility with multi-treatment and disinfection equipment and enough capacity is recommended as an alternative.

Improving data quality and supervision of antiretroviral therapy sites in Malawi: an application of Lot Quality Assurance Sampling

PubMed Central

2012-01-01

Background High quality program data is critical for managing, monitoring, and evaluating national HIV treatment programs. By 2009, the Malawi Ministry of Health had initiated more than 270,000 patients on HIV treatment at 377 sites. Quarterly supervision of these antiretroviral therapy (ART) sites ensures high quality care, but the time currently dedicated to exhaustive record review and data cleaning detracts from other critical components. The exhaustive record review is unlikely to be sustainable long term because of the resources required and increasing number of patients on ART. This study quantifies the current levels of data quality and evaluates Lot Quality Assurance Sampling (LQAS) as a tool to prioritize sites with low data quality, thus lowering costs while maintaining sufficient quality for program monitoring and patient care. Methods In January 2010, a study team joined supervision teams at 19 sites purposely selected to reflect the variety of ART sites. During the exhaustive data review, the time allocated to data cleaning and data discrepancies were documented. The team then randomly sampled 76 records from each site, recording secondary outcomes and the time required for sampling. Results At the 19 sites, only 1.2% of records had discrepancies in patient outcomes and 0.4% in treatment regimen. However, data cleaning took 28.5 hours in total, suggesting that data cleaning for all 377 ART sites would require over 350 supervision-hours quarterly. The LQAS tool accurately identified the sites with the low data quality, reduced the time for data cleaning by 70%, and allowed for reporting on secondary outcomes. Conclusions Most sites maintained high quality records. In spite of this, data cleaning required significant amounts of time with little effect on program estimates of patient outcomes. LQAS conserves resources while maintaining sufficient data quality for program assessment and management to allow for quality patient care. PMID:22776745

Simultaneous measurements of new particle formation at 1 s time resolution at a street site and a rooftop site

NASA Astrophysics Data System (ADS)

Zhu, Yujiao; Yan, Caiqing; Zhang, Renyi; Wang, Zifa; Zheng, Mei; Gao, Huiwang; Gao, Yang; Yao, Xiaohong

2017-08-01

This study is the first to use two identical Fast Mobility Particle Sizers for simultaneous measurement of particle number size distributions (PNSDs) at a street site and a rooftop site within 500 m distance in wintertime and springtime to investigate new particle formation (NPF) in Beijing. The collected datasets at 1 s time resolution allow deduction of the freshly emitted traffic particle signal from the measurements at the street site and thereby enable the evaluation of the effects on NPF in an urban atmosphere through a site-by-site comparison. The number concentrations of 8 to 20 nm newly formed particles and the apparent formation rate (FR) in the springtime were smaller at the street site than at the rooftop site. In contrast, NPF was enhanced in the wintertime at the street site with FR increased by a factor of 3 to 5, characterized by a shorter NPF time and higher new particle yields than at the rooftop site. Our results imply that the street canyon likely exerts distinct effects on NPF under warm or cold ambient temperature conditions because of on-road vehicle emissions, i.e., stronger condensation sinks that may be responsible for the reduced NPF in the springtime but efficient nucleation and partitioning of gaseous species that contribute to the enhanced NPF in the wintertime. The occurrence or absence of apparent growth for new particles with mobility diameters larger than 10 nm was also analyzed. The oxidization of biogenic organics in the presence of strong photochemical reactions is suggested to play an important role in growing new particles with diameters larger than 10 nm, but sulfuric acid is unlikely to be the main species for the apparent growth. However, the number of datasets used in this study is relatively small, and larger datasets are essential to draw a general conclusion.

Periodontal and endodontic pathology delays extraction socket healing in a canine model

PubMed Central

2017-01-01

Purpose The aim of the present exploratory study was to evaluate extraction socket healing at sites with a history of periodontal and endodontic pathology. Methods The mandibular 4th premolar teeth in 5 adult beagle dogs served as experimental units. Periodontal and endodontic lesions were induced in 1 premolar site in each animal using wire ligatures and pulpal exposure over 3 months (diseased sites). The contralateral premolar sites served as healthy controls. The mandibular 4th premolar teeth were then extracted with minimal trauma, followed by careful wound debridement. The animals were sacrificed at days 1, 7, 30, 60, and 90 post-extraction for analysis, and the healing patterns at the healthy and diseased extraction sites were compared using radiography, scanning electron microscopy, histology, and histometry. Results During the first 7 days of healing, a significant presence of inflammatory granulation tissue was noted at the diseased sites (day 1), along with a slightly accelerated rate of fibrin clot resolution on day 7. On day 30, the diseased extraction sites showed a greater percentage of persistent fibrous connective tissue, and an absence of bone marrow formation. In contrast, healthy sites showed initial signs of bone marrow formation on day 30, and subsequently a significantly greater proportion of mature bone marrow formation on both days 60 and 90. Radiographs exhibited sclerotic changes adjoining apical endodontic lesions, with scanning electron microscopy showing collapsed Volkmann canals protruding from these regions in the diseased sites. Furthermore, periodontal ligament fibers exhibited a parallel orientation to the alveolar walls of the diseased sites, in contrast to a perpendicular arrangement in the healthy sites. Conclusions Within the limitations of this study, it appears that a history of periodontal and endodontic pathology may critically affect bone formation and maturation, leading to delayed and compromised extraction socket healing. PMID:28680710

Control of Pteridium aquilinum: Meta-analysis of a Multi-site Study in the UK

PubMed Central

Stewart, Gavin; Cox, Emma; Le Duc, Mike; Pakeman, Robin; Pullin, Andrew; Marrs, Rob

2008-01-01

Background and Aims A great deal of money is spent controlling invasive weeds as part of international and national policies. It is essential that the funded treatments work across the region in which the policies operate. We argue that experiments across multiple sites are required to validate these programs as results from single sites may be misleading. Here, the control of Pteridium aquilinum (bracken) is used as a test example to address the following four questions. (1) Does the effectiveness of P. aquilinum-control treatments vary across sites? (2) Is the best treatment identified in previous research (cutting twice per year) consistent at all sites, and if not why not? (3) Is treatment performance related to P. aquilinum rhizome mass, litter cover or litter depth at the various sites? (4) Does successful P. aquilinum control influence species richness? Methods Pteridium aquilinum‐control treatments were monitored for 10 years using six replicated experiments and analysed using meta-analysis. Meta-regressions were used to explore heterogeneity between sites. Key Results The effectiveness of treatments varied between sites depending on the measure used to assess P. aquilinum performance. In general, cutting twice per year was the most successful treatment but on some sites other, less expensive treatments were as good. The effectiveness of treatments at different sites was not related to rhizome mass, but the effectiveness of most applied treatments were inversely related to post-control litter. Effective treatment was also associated with high species richness. Conclusions It is concluded that successful development of national weed control programs requires multi-site experimental approaches. Here, meta-analyses demonstrate that variation in effectiveness between sites could be explained in part by pre-specified variables. Reliance on data from a single site for policy formulation is therefore clearly dangerous. PMID:18337356

Information theory-based analysis of CYP2C19, CYP2D6 and CYP3A5 splicing mutations.

PubMed

Rogan, Peter K; Svojanovsky, Stan; Leeder, J Steven

2003-04-01

Several mutations are known or suspected to affect mRNA splicing of CYP2C19, CYP2D6 and CYP3A5 genes; however, little experimental evidence exists to support these conclusions. The present study applies mathematical models that measure changes in information content of splice sites in these genes to demonstrate the relationship between the predicted phenotypes of these variants to the corresponding genotypes. Based on information analysis, the CYP2C19*2 variant activates a new cryptic site 40 nucleotides downstream of the natural splice site. CYP2C19*7 abolishes splicing at the exon 5 donor site. The CYP2D6*4 allele similarly inactivates splicing at the acceptor site of exon 4 and activates a new cryptic site one nucleotide downstream of the natural acceptor. CYP2D6*11 inactivates the acceptor site of exon 2. The CYP3A5*3 allele activates a new cryptic site 236 nucleotides upstream of the exon 4 natural acceptor site. CYP3A5*5 inactivates the exon 5 donor site and CYP3A5*6 strengthens a site upstream of the natural donor site, resulting in skipping of exon 7. Other previously described missense and nonsense mutations at terminal codons of exons in these genes affected splicing. CYP2D6*8 and CYP2D6*14 both decrease the strength of the exon 3 donor site, producing transcripts lacking this exon. The results of information analysis are consistent with the poor metabolizer phenotypes observed in patients with these mutations, and illustrate the potential value of these mathematical models to quantitatively evaluate the functional consequences of new mutations suspected of altering mRNA splicing.

Can multidetector CT detect the site of gastrointestinal tract injury in trauma? – A retrospective study

PubMed Central

Panda, Ananya; Kumar, Atin; Gamanagatti, Shivanand; Das, Ranjita; Paliwal, Swati; Gupta, Amit; Kumar, Subodh

2017-01-01

PURPOSE We aimed to assess the performance of computed tomography (CT) in localizing site of traumatic gastrointestinal tract (GIT) injury and determine the diagnostic value of CT signs in site localization. METHODS CT scans of 97 patients with surgically proven GIT or mesenteric injuries were retrospectively reviewed by radiologists blinded to surgical findings. Diagnosis of either GIT or mesenteric injuries was made. In patients with GIT injuries, site of injury and presence of CT signs such as focal bowel wall hyperenhancement, hypoenhancement, wall discontinuity, wall thickening, extramural air, intramural air, perivisceral infiltration, and active vascular contrast leak were evaluated. RESULTS Out of 97 patients, 90 had GIT injuries (70 single site injuries and 20 multiple site injuries) and seven had isolated mesenteric injury. The overall concordance between CT and operative findings for exact site localization was 67.8% (61/90), partial concordance rate was 11.1% (10/90), and discordance rate was 21.1% (19/90). For single site localization, concordance rate was 77.1% (54/70), discordance rate was 21.4% (15/70), and partial concordance rate was 1.4% (1/70). In multiple site injury, concordance rate for all sites of injury was 35% (7/20), partial concordance rate was 45% (9/20), and discordance rate was 20% (4/20). For upper GIT injuries, wall discontinuity was the most accurate sign for localization. For small bowel injury, intramural air and hyperenhancement were the most specific signs for site localization, while for large bowel injury, wall discontinuity and hypoenhancement were the most specific signs. CONCLUSION CT performs better in diagnosing small bowel injury compared with large bowel injury. CT can well predict the presence of multiple site injury but has limited performance in exact localization of all injury sites. PMID:27924777

Role of strategic human resource management in crisis management in Australian greenfield hospital sites: a crisis management theory perspective.

PubMed

Kendrick, Madeleine Iris; Bartram, Timothy; Cavanagh, Jillian; Burgess, John

2017-11-20

Objective This study examined strategic human resource management (SHRM) activities in two case hospitals relative to their approach to greenfield site success. Methods A comparative case study analysis approach was used, with documents sourced from public, open-access sites. The theoretical framework of crisis management theory's (CMT) proactive management and open communication channels was used to examine the documents, which were annual reports addressing both hospitals' first year of performance, union publications and transcripts of relevant parliamentary inquiries. Results The hospital that effectively used CMT in its first 12 months was demonstratively more 'successful' than the hospital that reported to not have effectively used CMT. 'Success' in this project was articulated as the hospital's ability to consolidate operations, without ongoing negative media attention, after 12 months. Conclusion This study provided an identification of how the use of CMT in a hospital's greenfield stage can increase the hospital's chances of 'success'. What is known about the topic? Journal and media articles illustrated a gap in greenfield human resource management (HRM) regarding successful consolidation, especially the healthcare context. Although manufacturing firms are addressed in academic literature in a greenfield context, there is a lack of knowledge concerning successful greenfield HRM in a healthcare context. What does this paper add? This study is among the first to identify the role of CMT in successful greenfield site establishment by identifying its presence in management activities. What are the implications for practitioners? The findings of this study suggest a potential link between the implementation of CMT and greenfield site success. This could allow future greenfield healthcare sites to operate with less cost and risk. The lack of stakeholder participation in the present study limits the applicability of its findings. However, archival document analysis provides a strong foundation for future studies.

Quality assurance of research protocols conducted in the community: The National Institute on Drug Abuse Clinical Trials Network Experience

PubMed Central

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-01-01

Background: Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. Purpose: This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. Methods: The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Results: Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. Limitations: QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. Conclusions: The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed. PMID:19342468

Effects of protonation state of Asp181 and position of active site water molecules on the conformation of PTP1B.

PubMed

Ozcan, Ahmet; Olmez, Elif Ozkirimli; Alakent, Burak

2013-05-01

In protein tyrosine phosphatase 1B (PTP1B), the flexible WPD loop adopts a closed conformation (WPDclosed ) in the active state of PTP1B, bringing the catalytic Asp181 close to the active site pocket, while WPD loop is in an open conformation (WPDopen ) in the inactive state. Previous studies showed that Asp181 may be protonated at physiological pH, and ordered water molecules exist in the active site. In the current study, molecular dynamics simulations are employed at different Asp181 protonation states and initial positions of active site water molecules, and compared with the existing crystallographic data of PTP1B. In WPDclosed conformation, the active site is found to maintain its conformation only in the protonated state of Asp181 in both free and liganded states, while Asp181 is likely to be deprotonated in WPDopen conformation. When the active site water molecule network that is a part of the free WPDclosed crystal structure is disrupted, intermediate WPD loop conformations, similar to that in the PTPRR crystal structure, are sampled in the MD simulations. In liganded PTP1B, one active site water molecule is found to be important for facilitating the orientation of Cys215 and the phosphate ion, thus may play a role in the reaction. In conclusion, conformational stability of WPD loop, and possibly catalytic activity of PTP1B, is significantly affected by the protonation state of Asp181 and position of active site water molecules, showing that these aspects should be taken into consideration both in MD simulations and inhibitor design. Copyright © 2013 Wiley Periodicals, Inc.

Associations of cumulative sun exposure and phenotypic characteristics with histologic solar elastosis

PubMed Central

Thomas, Nancy E.; Kricker, Anne; From, Lynn; Busam, Klaus; Millikan, Robert C.; Ritchey, Mary E.; Armstrong, Bruce K.; Lee-Taylor, Julia; Marrett, Loraine D.; Anton-Culver, Hoda; Zanetti, Roberto; Rosso, Stefano; Gallagher, Richard P.; Dwyer, Terence; Goumas, Chris; Kanetsky, Peter A.; Begg, Colin B.; Orlow, Irene; Wilcox, Homer; Paine, Susan; Berwick, Marianne

2010-01-01

Background Solar elastosis adjacent to melanomas in histologic sections is regarded as an indicator of sun exposure although the associations of ultraviolet (UV) exposure and phenotype with solar elastosis are yet to be fully explored. Methods The study included 2,589 incident primary melanoma patients with assessment of histologic solar elastosis in the population-based Genes, Environment, and Melanoma study. Ambient erythemal UV (UVE) at places of residence and sun exposure hours, including body site-specific exposure, were collected. We examined the association of cumulative site-specific and non site-specific sun exposure hours and ambient UVE with solar elastosis in multivariable models adjusted for age, sex, center, pigmentary characteristics, nevi and, where relevant, body site. Results Solar elastosis was associated most strongly with site-specific UVE (OR for top exposure quartile, 5.20; 95% CI, 3.40-7.96; P for trend <0.001) and also with site-specific sun exposure (OR for top quartile, 5.12; 95% CI, 3.35-7.83; P for trend <0.001). Older age (OR at >70 years, 7.69; 95% CI, 5.14-11.52); P trend < 0.001) and having more than 10 back nevi (OR, 0.77; 95% CI, 0.61-0.97; P = 0.03) were independently associated with solar elastosis. Conclusion Solar elastosis had a strong association with higher site-specific UVE dose, older age and fewer nevi. Impact Solar elastosis could be a useful biomarker of lifetime site-specific UV. Future research is needed to explore whether age represents more than simple accumulation of sun exposure and the reason that people with more nevi may be less prone to solar elastosis. PMID:20802019

Intensive insulin treatment increases donor site wound protein synthesis in burn patients

PubMed Central

Tuvdendorj, Demidmaa; Zhang, Xiao-Jun; Chinkes, David L.; Aarsland, Asle; Kulp, Gabriela A.; Jeschke, Marc G.; Herndon, David N.

2013-01-01

Background In the treatment of burns, patients’ own skin is the preferred material to cover burn wounds, resulting in the need to create a donor site wound. Enhancement of healing of the donor site wound would be beneficial in burn patients. Insulin, an anabolic agent, is routinely used to treat hyperglycemia after injury. We investigated whether intensive insulin treatment (INS) increases fractional synthesis rate (FSR) of the donor site wound protein and decreases the length of hospitalization normalized for total body surface area burned (LOS/TBSA). Methods FSR of the donor site wound protein was measured in pediatric patients randomized to control (CNT) (n = 13) and INS (n = 10) treatments. Depending on the postoperative day when the tracer study was done studies were divided into “Early” (days < 5) and “Late” (days >=5) periods. Results FSR of the donor site wound protein was greater in the INS group at the “Early” period of wound healing (CNT vs. INS, 8.2±3.8 vs. 13.1±6.9 %/day, p: < 0.05); but not at the “Late” (CNT vs. INS, 19.7±4.6 vs. 16.6±4.0 %/day, p > 0.05). Despite these differences LOS/TBSA was not decreased in the INS group. Correlation analyses demonstrated that independently of the treatment regimen FSR positively correlated (p < 0.05) with time post creation of the donor site and negatively correlated (p < 0.05) with LOS/TBSA. Conclusions Insulin treatment increased FSR of the donor site wound protein in the early period of wound healing; FSR correlated with LOS/TBSA independently of the treatment regimen. PMID:21236451

What Motivates Young Adults to Talk About Physical Activity on Social Network Sites?

PubMed Central

Campo, Shelly; Yang, Jingzhen; Eckler, Petya; Snetselaar, Linda; Janz, Kathleen; Leary, Emily

2017-01-01

Background Electronic word-of-mouth on social network sites has been used successfully in marketing. In social marketing, electronic word-of-mouth about products as health behaviors has the potential to be more effective and reach more young adults than health education through traditional mass media. However, little is known about what motivates people to actively initiate electronic word-of-mouth about health behaviors on their personal pages or profiles on social network sites, thus potentially reaching all their contacts on those sites. Objective This study filled the gap by applying a marketing theoretical model to explore the factors associated with electronic word-of-mouth on social network sites about leisure-time physical activity. Methods A Web survey link was sent to undergraduate students at one of the Midwestern universities and 439 of them completed the survey. Results The average age of the 439 participants was 19 years (SD=1 year, range: 18-24). Results suggested that emotional engagement with leisure-time physical activity (ie, affective involvement in leisure-time physical activity) predicted providing relevant opinions or information on social network sites. Social network site users who perceived stronger ties with all their contacts were more likely to provide and seek leisure-time physical activity opinions and information. People who provided leisure-time physical activity opinions and information were more likely to seek opinions and information, and people who forwarded information about leisure-time physical activity were more likely to chat about it. Conclusions This study shed light on the application of the electronic word-of-mouth theoretical framework in promoting health behaviors. The findings can also guide the development of future social marketing interventions using social network sites to promote leisure-time physical activity. PMID:28642215

Amuchina 10% solution, safe antiseptic for preventing infections of exit-site of Tenckhoff catheters, in the pediatric population of a dialysis program.

PubMed

Mendoza-Guevara, L; Castro-Vazquez, F; Aguilar-Kitsu, A; Morales-Nava, A; Rodriguez-Leyva, F; Sanchez-Barbosa, J L

2007-01-01

Although, decreasing in incidence with the disconnection systems, the first complication is still peritonitis in patients with chronic renal failure and the second is infection of Tenckhoff catheter exit-site. All efforts made to diminish the frequency of exit-site infection lower the possibility of peritonitis. The pediatric population is well-known to have a major risk of infectious complications, and making easy and safe the care of the exit-site will prevent the peritonitis that follows. The aim of the study was to evaluate the efficacy of the Amuchina 10% solution vs. pH neutral soap in children with chronic renal failure, on preventing exit-site infection. There were 60 patients who were assigned randomly to one of two groups. One group used Amuchina 10% solution for the daily cleaning of the exit-site, and the other used pH neutral soap, with 14 months of follow-up. Before the study they have to be free of infection for at least 30 days. All were taught by the same nurse how to clean their exit-site. Groups were almost identical in years, sex, and time on dialysis. We had nine infections in the soap group and none in the Amuchina 10% solution group, with an OR: 17 (p = 0.004). From these nine infections, the bacteria isolated were: 4 (13%) were caused by Pseudomona aeruginosa, 1 (3.3%) by Staphylococcus aureus, coagulase-positive staphylococci in 2 (6.6%) and Serratia marcensens in 1 (3.3%). In conclusion, Amuchina 10% solution is effective in preventing infection on the exit-site, without any secondary topical reaction.

Systematic data ingratiation of clinical trial recruitment locations for geographic-based query and visualization

PubMed Central

Luo, Jake; Chen, Weiheng; Wu, Min; Weng, Chunhua

2018-01-01

Background Prior studies of clinical trial planning indicate that it is crucial to search and screen recruitment sites before starting to enroll participants. However, currently there is no systematic method developed to support clinical investigators to search candidate recruitment sites according to their interested clinical trial factors. Objective In this study, we aim at developing a new approach to integrating the location data of over one million heterogeneous recruitment sites that are stored in clinical trial documents. The integrated recruitment location data can be searched and visualized using a map-based information retrieval method. The method enables systematic search and analysis of recruitment sites across a large amount of clinical trials. Methods The location data of more than 1.4 million recruitment sites of over 183,000 clinical trials was normalized and integrated using a geocoding method. The integrated data can be used to support geographic information retrieval of recruitment sites. Additionally, the information of over 6000 clinical trial target disease conditions and close to 4000 interventions was also integrated into the system and linked to the recruitment locations. Such data integration enabled the construction of a novel map-based query system. The system will allow clinical investigators to search and visualize candidate recruitment sites for clinical trials based on target conditions and interventions. Results The evaluation results showed that the coverage of the geographic location mapping for the 1.4 million recruitment sites was 99.8%. The evaluation of 200 randomly retrieved recruitment sites showed that the correctness of geographic information mapping was 96.5%. The recruitment intensities of the top 30 countries were also retrieved and analyzed. The data analysis results indicated that the recruitment intensity varied significantly across different countries and geographic areas. Conclusion This study contributed a new data processing framework to extract and integrate the location data of heterogeneous recruitment sites from clinical trial documents. The developed system can support effective retrieval and analysis of potential recruitment sites using target clinical trial factors. PMID:29132636

Veterans Aging Cohort Study (VACS)

PubMed Central

Justice, Amy C.; Dombrowski, Elizabeth; Conigliaro, Joseph; Fultz, Shawn L.; Gibson, Deborah; Madenwald, Tamra; Goulet, Joseph; Simberkoff, Michael; Butt, Adeel A.; Rimland, David; Rodriguez-Barradas, Maria C.; Gibert, Cynthia L.; Oursler, Kris Ann K.; Brown, Sheldon; Leaf, David A.; Goetz, Matthew B.; Bryant, Kendall

2010-01-01

Background The Veterans Aging Cohort Study (VACS) is a study of human immunodeficiency virus (HIV) infected and uninfected patients seen in infectious disease and general medical clinics. VACS includes the earlier 3 and 5 site studies (VACS 3 and VACS 5) as well as the ongoing 8 site study. Objectives We sought to provide background and context for analyses based upon VACS data, including study design and rationale as well as its basic protocol and the baseline characteristics of the enrolled sample. Research Design We undertook a prospectively consented multisite observational study of veterans in care with and without HIV infection. Measures Data were derived from patient and provider self report, telephone interviews, blood and DNA samples, focus groups, and full access to the national VA “paperless” electronic medical record system. Results More than 7200 veterans have been enrolled in at least one of the studies. The 8 site study (VACS) has enrolled 2979 HIV-infected and 3019 HIV-uninfected age–race–site matched comparators and has achieved stratified enrollment targets for race/ethnicity and age and 99% of its total target enrollment as of October 30, 2005. Participants in VACS are similar to other veterans receiving care within the VA. VACS participants are older and more predominantly black than those reported by the Centers for Disease Control. Conclusions VACS has assembled a rich, in-depth, and representative sample of veterans in care with and without HIV infection to conduct longitudinal analyses of questions concerning the association between alcohol use and related comorbid and AIDS-defining conditions. PMID:16849964

Water quality impacts from on-site waste disposal systems to coastal areas through groundwater discharge

NASA Astrophysics Data System (ADS)

Harris, P. J.

1995-12-01

This report summarizes research studies linking on-site waste disposal systems (OSDS) to pathogen and nutrient concentrations in groundwater with the potential to impact coastal embayments. Few studies connect OSDS to coastal water quality. Most studies examined pathogen and nutrient impacts to groundwater and omitted estimations of contaminants discharged to surface water. The majority of studies focused on nitrogen, with little information on pathogens and even less on phosphorus. Nitrogen discharged from OSDS poses the greatest threat to water quality. Vertical distance of septic tank infiltration system from the water table, septic system design, and siting remain the key components in minimizing potential impacts from OSDS for control of both pathogens and nutrients. The most comprehensive information connecting nutrient contributions from OSDS to surface water quality was the study conducted on Buttermilk Bay in Massachusetts where 74% of nitrogen to the bay was attributed to onsite disposal systems. In conclusion, further studies on the viability and transport of pathogens and nutrients through the groundwater aquifer and across the groundwater/surface-water interface are needed. Additional research on the importance of septic system design on the availability of contaminants to groundwater as well as the minimum distance between the septic system and water table necessary to protect groundwater are also indicated.

Exploring the advantages of using social network sites (SNSs) in dental medicine organisations.

PubMed

Franco, Mário; Pais, Leonor

2017-05-08

Purpose The purpose of this paper is to deepen and contribute to knowledge of the use of social network sites (SNSs) in organisations, and more precisely, identify the advantages. Design/methodology/approach To reach this objective, a cross-section study was adopted based on application of a questionnaire, the final sample consisting of 78 dental medicine organisations in Portugal. Findings The results obtained lead to the conclusion that a great number of the organisations studied are connected to SNSs, particularly Facebook. The advantages associated with marketing tools and breaking down barriers between the organisation and the world are those highlighted most in this study. Practical implications According to the empirical evidence obtained, organisations are found to use these sites for other purposes, such as communicating with clients/patients and receiving feedback on the service provided to increase satisfaction and improve the quality of services. Originality/value The study contributes to advancing theory in the field of internet research strategic. More precisely, this study is associated with the creation of a theoretical framework that shows the advantages of using SNSs in an innovative context: dental medicine organisations. A categorisation of these advantages and some implications for theory and practice are also some contributions of this study.

Spectral measurements of direct and scattered gamma radiation at a boiling-water reactor site

NASA Astrophysics Data System (ADS)

Block, R. C.; Preiss, I. L.; Ryan, R. M.; Vargo, G. J.

1990-12-01

Quantitative surveys of direct and scattered gamma radiation emitted from the steam-power conversion systems of a boiling-water reactor and other on-site radiation sources were made using a directionally shielded HPGe gamma spectrometry system. The purpose of this study was to obtain data on the relative contributions and energy distributions of direct and scattered gamma radiation in the site environs. The principal radionuclide of concern in this study is 16N produced by the 16O(n,p) 16N reaction in the reactor coolant. Due to changes in facility operation resulting from the implementation of hydrogen water chemistry (HWC), the amount of 16N transported from the reactor to the main steam system under full power operation is excepted to increase by a factor of 1.2 to 5.0. This increase in the 16N source term in the nuclear steam must be considered in the design of new facilities to be constructed on site as well as the evaluation of existing facilities with repect to ALARA (As Low As Reasonably Achievable) dose limits in unrestricted areas. This study consisted of base-line measurements taken under normal BWR chemistry conditions in October, 1987 and a corresponding set taken under HWC conditions in July, 1988. Ground-level and elevated measurements, corresponding to second-story building height, were obtained. The primary conclusion of this study is that direct radiation from the steam-power conversion system is the predominant source of radiation in the site environs of this reactor and that air scattering (i.e. skyshine) does not appear to be significant.

Socioeconomic environment and cancer incidence: a French population-based study in Normandy

PubMed Central

2014-01-01

Background The struggle against social inequalities is a priority for many international organizations. The objective of the study was to quantify the cancer burden related to social deprivation by identifying the cancer sites linked to socioeconomic status and measuring the proportion of cases associated with social deprivation. Methods The study population comprised 68 967 cases of cancer diagnosed between 1997 and 2009 in Normandy and collected by the local registries. The social environment was assessed at an aggregated level using the European Deprivation Index (EDI). The association between incidence and socioeconomic status was assessed by a Bayesian Poisson model and the excess of cases was calculated with the Population Attributable Fraction (PAF). Results For lung, lips-mouth-pharynx and unknown primary sites, a higher incidence in deprived was observed for both sexes. The same trend was observed in males for bladder, liver, esophagus, larynx, central nervous system and gall-bladder and in females for cervix uteri. The largest part of the incidence associated with deprivation was found for cancer of gall-bladder (30.1%), lips-mouth-pharynx (26.0%), larynx (23.2%) and esophagus (19.6%) in males and for unknown primary sites (18.0%) and lips-mouth-pharynx (12.7%) in females. For prostate cancer and melanoma in males, the sites where incidence increased with affluence, the part associated with affluence was respectively 9.6% and 14.0%. Conclusions Beyond identifying cancer sites the most associated with social deprivation, this kind of study points to health care policies that could be undertaken to reduce social inequalities. PMID:24524213

Differential DNA Methylation in Relation to Age and Health Risks of Obesity.

PubMed

Mansego, María Luisa; Milagro, Fermín I; Zulet, María Ángeles; Moreno-Aliaga, María J; Martínez, José Alfredo

2015-07-24

The aim of this study was to evaluate whether genome-wide levels of DNA methylation are associated with age and the health risks of obesity (HRO); defined according to BMI categories as "Low HRO" (overweight and class 1 obesity) versus "High HRO" (class 2 and class 3 obesity). Anthropometric measurements were assessed in a subsample of 48 volunteers from the Metabolic Syndrome Reduction in Navarra (RESMENA) study and 24 women from another independent study, Effects of Lipoic Acid and Eicosapentaenoic Acid in Human Obesity (OBEPALIP study). In the pooled population; the methylation levels of 55 CpG sites were significantly associated with age after Benjamini-Hochberg correction. In addition, DNA methylation of three CpG sites located in ELOVL2; HOXC4 and PI4KB were further negatively associated with their mRNA levels. Although no differentially methylated CpG sites were identified in relation to HRO after multiple testing correction; several nominally significant CpG sites were identified in genes related to insulin signaling; energy and lipid metabolism. Moreover, statistically significant associations between BMI or mRNA levels and two HRO-related CpG sites located in GPR133 and ITGB5 are reported. As a conclusion, these findings from two Spanish cohorts add knowledge about the important role of DNA methylation in the age-related regulation of gene expression. In addition; a relevant influence of age on DNA methylation in white blood cells was found, as well as, on a trend level, novel associations between DNA methylation and obesity.

Alcohol binding in the C1 (C1A + C1B) domain of protein kinase C epsilon

PubMed Central

Pany, Satyabrata; Das, Joydip

2015-01-01

Background Alcohol regulates the expression and function of protein kinase C epsilon (PKCε). In a previous study we identified an alcohol binding site in the C1B, one of the twin C1 subdomains of PKCε. Methods In this study, we investigated alcohol binding in the entire C1 domain (combined C1A and C1B) of PKCε. Fluorescent phorbol ester, SAPD and fluorescent diacylglycerol (DAG) analog, dansyl-DAG were used to study the effect of ethanol, butanol, and octanol on the ligand binding using fluorescence resonance energy transfer (FRET). To identify alcohol binding site(s), PKCεC1 was photolabeled with 3-azibutanol and 3-azioctanol, and analyzed by mass spectrometry. The effects of alcohols and the azialcohols on PKCε were studied in NG108-15 cells. Results In the presence of alcohol, SAPD and dansyl-DAG showed different extent of FRET, indicating differential effects of alcohol on the C1A and C1B subdomains. Effects of alcohols and azialcohols on PKCε in NG108-15 cells were comparable. Azialcohols labeled Tyr-176 of C1A and Tyr-250 of C1B. Inspection of the model structure of PKCεC1 reveals that these residues are 40 Å apart from each other indicating that these residues form two different alcohol binding sites. Conclusions The present results provide evidence for the presence of multiple alcohol-binding sites on PKCε and underscore the importance of targeting this PKC isoform in developing alcohol antagonists. PMID:26210390

Cogestion and recreation site demand: a model of demand-induced quality effects

USGS Publications Warehouse

Douglas, Aaron J.; Johnson, Richard L.

1993-01-01

This analysis focuses on problems of estimating site-specific dollar benefits conferred by outdoor recreation sites in the face of congestion costs. Encounters, crowding effects and congestion costs have often been treated by natural resource economists in a piecemeal fashion. In the current paper, encounters and crowding effects are treated systematically. We emphasize the quantitative impact of congestion costs on site-specific estimates of benefits conferred by improvements in outdoor recreation sites. The principal analytic conclusion is that techniques that streamline on data requirements produce biased estimates of benefits conferred by site improvements at facilities with significant crowding effects. The principal policy recommendation is that the Federal and state agencies should collect and store information on visitation rates, encounter levels and congestion costs at various outdoor recreation sites.

Acoustics of native-American ceremonial sites in prehispanic America (Acustica en los espacios escenios rituales prehispanicos)

NASA Astrophysics Data System (ADS)

Martinez, Maria Isabel

2003-11-01

This thesis establishes a methodology that incorporates the latest procedures used in architectural acoustics for the study of open spaces of this general type, and definitions are given for the acoustic variables of interest. The ``Juego de Pelota'' (ball game) sites are the only ceremonial sites built specifically for the performance of a fertility ritual, and are ideal for the study of prehispanic architectural topographies. Analysis of the acoustic properties of such sites revealed that the topographical characteristics of the elevation profiles of these architectural structures determine the acoustic behavior of these spaces. Such profiles are classified into three basic types: (i) inclined profile, (ii) terraced profile, and (iii) mixed profile. The terraced profiles are the most efficient, and the mixed profiles are the least efficient, in regard to acoustics. The consideration of the acoustic behavior of architectural structures intended for the ``Ball Game,'' as the designs evolved over time, leads to the conclusion that acoustical sensations that contributed effectively to the characteristic mystical atmosphere of the ceremonial rituals were characteristic only of those sites constructed in the ``classical'' period. Thesis advisors: Jaime Navarro and Juan J. Sendra Copies of this thesis written in Spanish may be obtained by contacting the advisor, Jaime Navarro, E.T.S. de Arquitectura de Sevilla, Dpto. de Construcciones Arquitectonicas I, Av. Reina Mercedes, 2, 41012 Sevilla, Spain. E-mail address: jnavarro@us.es

Comparison of the historical record of earthquake hazard with seismic-hazard models for New Zealand and the continental United States

USGS Publications Warehouse

Stirling, M.; Petersen, M.

2006-01-01

We compare the historical record of earthquake hazard experienced at 78 towns and cities (sites) distributed across New Zealand and the continental United States with the hazard estimated from the national probabilistic seismic-hazard (PSH) models for the two countries. The two PSH models are constructed with similar methodologies and data. Our comparisons show a tendency for the PSH models to slightly exceed the historical hazard in New Zealand and westernmost continental United States interplate regions, but show lower hazard than that of the historical record in the continental United States intraplate region. Factors such as non-Poissonian behavior, parameterization of active fault data in the PSH calculations, and uncertainties in estimation of ground-motion levels from historical felt intensity data for the interplate regions may have led to the higher-than-historical levels of hazard at the interplate sites. In contrast, the less-than-historical hazard for the remaining continental United States (intraplate) sites may be largely due to site conditions not having been considered at the intraplate sites, and uncertainties in correlating ground-motion levels to historical felt intensities. The study also highlights the importance of evaluating PSH models at more than one region, because the conclusions reached on the basis of a solely interplate or intraplate study would be very different.

Clinical and Other Risk Indicators for Early Periodontitis in Adults

PubMed Central

Tanner, Anne C.R.; Kent, Ralph; Van Dyke, Thomas; Sonis, Steven T.; Murray, Lora A.

2005-01-01

Background Periodontal diseases affect over half the adults in the U.S., disproportionately affecting minority populations. Periodontitis can be treated in early stages, but it is not clear what features indicate, or could be risk factors for, early stages of periodontal attachment loss. This study aimed to evaluate associations between clinical and other risk indicators of early periodontitis. Methods A cross-sectional evaluation of 225 healthy and early periodontitis adults aged 20 to 40 years was performed. Clinical measurements, demographic information, and smoking histories were recorded. Analyses evaluated demographic and clinical associations with health and early periodontitis disease categories and periodontal attachment loss. Patterns of attachment loss at interproximal and buccal/lingual sites were evaluated. Results Subject age, plaque, and measures of gingivitis exhibited associations with attachment loss and probing depth. More periodontal attachment loss was detected in African-American and Hispanic subjects compared to Asian and Caucasian subjects. Smoking history was associated with attachment loss. At interproximal sites, lower molars most frequently had attachment loss, whereas at buccal/lingual sites, higher proportions of lower bicuspid teeth demonstrated attachment loss compared with other sites. Conclusions In this study of subjects with minimal attachment loss, gingival inflammation was associated with early periodontitis. Lower molar interproximal sites were frequently associated with interproximal attachment loss, whereas lower bicuspid teeth were at risk for gingival recession on buccal surfaces. PMID:15857098

Incidence of Port-Site Incisional Hernia After Single-Incision Laparoscopic Surgery

PubMed Central

Rainville, Harvey; Ikedilo, Ojinika; Vemulapali, Pratibha

2014-01-01

Background and Objectives: Single-incision laparoscopic surgery is gaining popularity among minimally invasive surgeons and is now being applied to a broad number of surgical procedures. Although this technique uses only 1 port, the diameter of the incision is larger than in standard laparoscopic surgery. The long-term incidence of port-site hernias after single-incision laparoscopic surgery has yet to be determined. Methods: All patients who underwent a single-incision laparoscopic surgical procedure from May 2008 through May 2009 were included in the study. Single-incision laparoscopic surgical operations were performed either by a multiport technique or with a 3-trocar single-incision laparoscopic surgery port. The patients were seen at 30 to 36 months' follow-up, at which time they were examined for any evidence of port-site incisional hernia. Patients found to have hernias on clinical examination underwent repairs with mesh. Results: A total of 211 patients met the criteria for inclusion in the study. The types of operations included were cholecystectomy, appendectomy, sleeve gastrectomy, gastric banding, Nissen fundoplication, colectomy, and gastrojejunostomy. We found a port-site hernia rate of 2.9% at 30 to 36 months' follow-up. Conclusion: Port-site incisional hernia after single-incision laparoscopic surgical procedures remains a major setback for patients. The true incidence remains largely unknown because most patients are asymptomatic and therefore do not seek surgical aid. PMID:24960483

Bone modelling at fresh extraction sockets: immediate implant placement versus spontaneous healing: an experimental study in the beagle dog.

PubMed

Vignoletti, Fabio; Discepoli, Nicola; Müller, Anna; de Sanctis, Massimo; Muñoz, Fernando; Sanz, Mariano

2012-01-01

The purpose of this investigation is to describe histologically the undisturbed healing of fresh extraction sockets when compared to immediate implant placement. In eight beagle dogs, after extraction of the 3P3 and 4P4, implants were inserted into the distal sockets of the premolars, while the mesial sockets were left to heal spontaneously. Each animal provided four socket sites (control) and four implant sites (test). After 6 weeks, animals were sacrificed and tissue blocks were dissected, prepared for ground sectioning. The relative vertical buccal bone resorption in relation to the lingual bone was similar in both test and control groups. At immediate implant sites, however, the absolute buccal bone loss observed was 2.32 (SD 0.36) mm, what may indicate that while an apical shift of both the buccal and lingual bone crest occurred at the implant sites, this may not happen in naturally healing sockets. The results from this investigation showed that after tooth extraction the buccal socket wall underwent bone resorption at both test and control sites. This resorption appeared to be more pronounced at the implant sites, although the limitations of the histological evaluation method utilized preclude a definite conclusion. © 2011 John Wiley & Sons A/S.

Flooding forested groundwater recharge areas modifies microbial communities from top soil to groundwater table.

PubMed

Schütz, Kirsten; Nagel, Peter; Vetter, Walter; Kandeler, Ellen; Ruess, Liliane

2009-01-01

Subsurface microorganisms are crucial for contaminant degradation and maintenance of groundwater quality. This study investigates the microbial biomass and community composition [by phospholipid fatty acids (PLFAs)], as well as physical and chemical soil characteristics at woodland flooding sites of an artificial groundwater recharge system used for drinking water production. Vertical soil profiles to c. 4 m at two watered and one nonwatered site were analyzed. The microbial biomass was equal in watered and nonwatered sites, and considerable fractions (25-42%) were located in 40-340 cm depth. The microbial community structure differed significantly between watered and nonwatered sites, predominantly below 100 cm depth. Proportions of the bacterial PLFAs 16:1omega5, 16:1omega7, cy17:0 and 18:1omega9t, and the long-chained PLFAs 22:1omega9 and 24:1omega9 were more prominent at the watered sites, whereas branched, saturated PLFAs (iso/anteiso) dominated at the nonwatered site. PLFA community indices indicated stress response (trans/cis ratio), higher nutrient availability (unsaturation index) and changes in membrane fluidity (iso/anteiso ratio) due to flooding. In conclusion, water recharge processes led to nutrient input and altered environmental conditions, which resulted in a highly active and adapted microbial community residing in the vadose zone that effectively degraded organic compounds.

Does Categorization Method Matter in Exploring Volume-Outcome Relation? A Multiple Categorization Methods Comparison in Coronary Artery Bypass Graft Surgery Surgical Site Infection.

PubMed

Yu, Tsung-Hsien; Tung, Yu-Chi; Chung, Kuo-Piao

2015-08-01

Volume-infection relation studies have been published for high-risk surgical procedures, although the conclusions remain controversial. Inconsistent results may be caused by inconsistent categorization methods, the definitions of service volume, and different statistical approaches. The purpose of this study was to examine whether a relation exists between provider volume and coronary artery bypass graft (CABG) surgical site infection (SSI) using different categorization methods. A population-based cross-sectional multi-level study was conducted. A total of 10,405 patients who received CABG surgery between 2006 and 2008 in Taiwan were recruited. The outcome of interest was surgical site infection for CABG surgery. The associations among several patient, surgeon, and hospital characteristics was examined. The definition of surgeons' and hospitals' service volume was the cumulative CABG service volumes in the previous year for each CABG operation and categorized by three types of approaches: Continuous, quartile, and k-means clustering. The results of multi-level mixed effects modeling showed that hospital volume had no association with SSI. Although the relation between surgeon volume and surgical site infection was negative, it was inconsistent among the different categorization methods. Categorization of service volume is an important issue in volume-infection study. The findings of the current study suggest that different categorization methods might influence the relation between volume and SSI. The selection of an optimal cutoff point should be taken into account for future research.

The influence of sex and trauma impact on the rupture site of the ulnar collateral ligament of the thumb

PubMed Central

Huf, Wolfgang; Rettl, Gregor; Dahm, Falko; Meznik, Alexander; Muschitz, Gabriela; Kitzinger, Hugo; Bukaty, Adam; Fialka, Christian; Vierhapper, Martin

2017-01-01

Purpose and hypothesis Although sex- and gender-specific analyses have been gaining more attention during the last years they have rarely been performed in orthopaedic literature. The primary purpose of this study was to investigate whether for injuries of the UCL the specific location of the rupture is influenced by sex. A secondary study question addressed the sex-independent effect of trauma intensity on the rupture site of the UCL. Methods This study is a retrospective analysis of all patients with either a proximal or distal bony avulsion or with a mid-substance tear or ligament avulsion of the UCL treated surgically between 1992 and 2015 at two level-I trauma centres. Trauma mechanisms leading to the UCL injury were classified into the following categories: (1) blunt trauma (i.e., strains), (2) low-velocity injuries (e.g., fall from standing height, assaults), and (3) high-velocity injuries (e.g., sports injuries, motor vehicle accidents). After reviewing the surgical records, patients were divided into three groups, depending upon the ligament rupture site: (1) mid-substance tears, (2) proximal ligament or bony avulsions and (3) distal ligament or bony avulsions. Dependencies between the specific rupture site and the explanatory variables (sex, age, and trauma intensity) were evaluated using χ2 test and logistic regression analysis. Results In total, 1582 patients (1094 males, 488 females) met the inclusion criteria. Mean age was 41 years (range: 9–90 years). Taking into account the effects of sex on trauma intensity (p<0.001) and of trauma intensity on rupture site (p<0.001), mid-substance tears occurred more frequently in women, whereas men were more prone to distal ligament or bony avulsions (p<0.001). In other words, sex and rupture site correlated due to the effects of sex on trauma intensity and of trauma intensity on rupture site, but taking into account those effects there still was a significant effect of sex on rupture site. Conclusions The results of this study demonstrate that with regression analysis both sex and trauma intensity allow to predict rupture site in UCL injuries. PMID:28738083

Source Water Identification and Chemical Typing for Nitrogen at the Kissimmee River, Pool C, Florida--Preliminary Assessment

USGS Publications Warehouse

,

2002-01-01

As part of the South Florida Water Management District's Ground Water-Surface Water Interactions Study, a project was undertaken to identify the ages and sources of water in the area of Pool C, Kissimmee River, Florida. Twenty-two water samples were collected along two transects: at a remnant river oxbows (Site D) and in the dredged part of the channel (Site C). The samples were analyzed for concentrations of fluoride and strontium, and for isotopes of oxygen, hydrogen, and nitrogen. Selected samples were analyzed for one or more additional isotopes (carbon-14, the ratio of strontium-87 to strontium-86, tritium, and tritium-helium-3). Delta nitrogen-15 values for nitrate at Site C can be explained by soil nitrogen and fertilizer sources; at Site D soil nitrogen accounts for most values, although animal wastes may explain higher values. Some of the isotopic data seem to be contradictory: carbon-14 data apparently indicate that shallow ground water is younger at Site D than at Site C, whereas strontium-87/86 ratios lead to the opposite conclusion. More detailed analysis of major ions and nutrients for all sampling points, along with flow measurements, could allow more definitive interpretation of isotope data and provide additional insight into mixing of ground water and surface water at the sites.

Genetic variation in the endangered Southwestern Willow Flycatcher

USGS Publications Warehouse

Busch, Joseph; Miller, Mark P.; Paxton, E.H.; Sogge, M.K.; Keim, Paul

2000-01-01

The Southwestern Willow Flycatcher (Empidonax traillii extimus) is an endangered Neotropical migrant that breeds in isolated remnants of dense riparian habitat in the southwestern United States. We estimated genetic variation at 20 breeding sites of the Southwestern Willow Flycatcher (290 individuals) using 38 amplified fragment length polymorphisms (AFLPs). Our results suggest that considerable genetic diversity exists within the subspecies and within local breeding sites. Statistical analyses of genetic variation revealed only slight, although significant, differentiation among breeding sites (Mantel's r = 0.0705, P < 0.0005; θ = 0.0816, 95% CI = 0.0608 to 0.1034; ΦST = 0.0458, P < 0.001). UPGMA cluster analysis of the AFLP markers indicates that extensive gene flow has occurred among breeding sites. No one site stood out as being genetically unique or isolated. Therefore, the small level of genetic structure that we detected may not be biologically significant. Ongoing field studies are consistent with this conclusion. Of the banded birds that were resighted or recaptured in Arizona during the 1996 to 1998 breeding seasons, one-third moved between breeding sites and two-thirds were philopatric. Low differentiation may be the result of historically high rangewide diversity followed by recent geographic isolation of breeding sites, although observational data indicate that gene flow is a current phenomenon. Our data suggest that breeding groups of E. t. extimus act as a metapopulation.

Electronic Cigarette Marketing Online: a Multi-Site, Multi-Product Comparison

PubMed Central

Sidhu, Anupreet K; Valente, Thomas W

2015-01-01

Background Electronic cigarette awareness and use has been increasing rapidly. E-cigarette brands have utilized social networking sites to promote their products, as the growth of the e-cigarette industry has paralleled that of Web 2.0. These online platforms are cost-effective and have unique technological features and user demographics that can be attractive for selective marketing. The popularity of multiple sites also poses a risk of exposure to social networks where e-cigarette brands might not have a presence. Objective To examine the marketing strategies of leading e-cigarette brands on multiple social networking sites, and to identify how affordances of the digital media are used to their advantage. Secondary analyses include determining if any brands are benefitting from site demographics, and exploring cross-site diffusion of marketing content through multi-site users. Methods We collected data from two e-cigarette brands from four social networking sites over approximately 2.5 years. Content analysis is used to search for themes, population targeting, marketing strategies, and cross-site spread of messages. Results Twitter appeared to be the most frequently used social networking site for interacting directly with product users. Facebook supported informational broadcasts, such as announcements regarding political legislation. E-cigarette brands also differed in their approaches to their users, from informal conversations to direct product marketing. Conclusions E-cigarette makers use different strategies to market their product and engage their users. There was no evidence of direct targeting of vulnerable populations, but the affordances of the different sites are exploited to best broadcast context-specific messages. We developed a viable method to study cross-site diffusion, although additional refinement is needed to account for how different types of digital media are used. PMID:27227129

Necessity of Surgical Site Closed Suction Drain for Pterional Craniotomy

PubMed Central

Choi, Su Yong; Yoon, Sung Min; Yoo, Chan Jong; Kim, Young Bo; Kim, Woo Kyung

2015-01-01

Objective The aim of this study was to assess the benefit of using a prophylactic surgical site closed suction drain in pterional craniotomy. Materials and Methods A retrospective review was conducted on 607 consecutive patients who underwent a pterional craniotomy for treatment of intracranial anterior circulation aneurysms over a 5-year period. Between January 2000 and December 2004, 607 patients were divided into two groups, those who had a prophylactic suction drain during closure of the surgical site (drain group, DG) and those who did not (non-drain group, NDG). Head computed tomography (CT) was taken routinely on postoperative day (POD) 1, 7, and 14. Patients' demographics, incidence of surgical site complications, and courses of surgical site healing which were evaluated radiologically by the thickness of the surgical site myocutaneous layer, were analyzed between DG and NDG. Results Patients' demographics and characteristics did not differ significantly between the two groups. The head CT showed that the degree of changes in the postoperative surgical site thickness was 148% at POD 1, 209% at POD 7, and 198% at POD 14 in DG, and 118% at POD 1, 152% at POD 7, and 158% at POD 14 in NDG compared to the preoperative value. Postoperative surgical site hematoma was 7.9% (22/274) in DG and 2.4% (8/333) in NDG. Conclusion Prophylactic use of an epidural and/or subgaleal closed suction drain does not appear to be necessary for prevention of postoperative surgical site hematoma as well as for promotion of surgical site healing in pterional craniotomy. PMID:26523255

Wind Power Curve Modeling in Simple and Complex Terrain

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bulaevskaya, V.; Wharton, S.; Irons, Z.

2015-02-09

Our previous work on wind power curve modeling using statistical models focused on a location with a moderately complex terrain in the Altamont Pass region in northern California (CA). The work described here is the follow-up to that work, but at a location with a simple terrain in northern Oklahoma (OK). The goal of the present analysis was to determine the gain in predictive ability afforded by adding information beyond the hub-height wind speed, such as wind speeds at other heights, as well as other atmospheric variables, to the power prediction model at this new location and compare the resultsmore » to those obtained at the CA site in the previous study. While we reach some of the same conclusions at both sites, many results reported for the CA site do not hold at the OK site. In particular, using the entire vertical profile of wind speeds improves the accuracy of wind power prediction relative to using the hub-height wind speed alone at both sites. However, in contrast to the CA site, the rotor equivalent wind speed (REWS) performs almost as well as the entire profile at the OK site. Another difference is that at the CA site, adding wind veer as a predictor significantly improved the power prediction accuracy. The same was true for that site when air density was added to the model separately instead of using the standard air density adjustment. At the OK site, these additional variables result in no significant benefit for the prediction accuracy.« less

Adaptation of eastern whitepine provenances to planting sites

Treesearch

Maurice E., Jr. Demeritt; Peter W. Garrett

1996-01-01

Eastern white pine provenances from the extreme limits of the natural range of this species are changing from above- and below-average stability to average stability for height growth with increasing age. The regression method is useful for evaluating the stability of provenance to planting sites. The same general conclusions are reached for the performance at...

Female Faculty Members in University Chemistry Departments: Observations and Conclusions Based on Site Visits

ERIC Educational Resources Information Center

Chapman, Sally; Dixon, Felicia F.; Foster, Natalie; Kuck, Valerie J.; McCarthy, Deborah A.; Tooney, Nancy M.; Buckner, Janine P.; Nolan, Susan A.; Marzabadi, Cecilia H.

2011-01-01

Oral interviews in focus groups and written surveys were conducted with 877 men and women, including administrators, faculty members, postdoctoral associates, and graduate students, during one-day site visits to chemistry and chemical engineering departments at 28 Ph.D.-granting institutions. This report is a preliminary review of the perceptions…

Are integrated HIV services less stigmatizing than stand-alone models of care? A comparative case study from Swaziland

PubMed Central

Church, Kathryn; Wringe, Alison; Fakudze, Phelele; Kikuvi, Joshua; Simelane, Dudu; Mayhew, Susannah H

2013-01-01

Introduction Integrating HIV with primary health services has the potential to reduce HIV-related stigma through delivering care in settings disassociated with HIV. This study investigated the relationship between integrated care and felt stigma. The study design was a comparative case study of four models of HIV care in Swaziland, ranging from fully integrated to fully stand-alone HIV care. Methods An exit survey (N=602) measured differences in felt stigma across model of care; the primary outcome “perception of HIV status exposure through clinic attendance” was analyzed using multivariable logistic regression. In-depth interviews (N=22) explored whether and how measured differences in stigma experiences were related to service integration. Results There were significant differences in perceived status exposure across models of care. After adjustment for potential confounding between sites, those at a partially integrated site and a partially stand-alone site had greater odds of perceived status exposure than those at the fully stand-alone site (aOR 3.33, 95% CI 1.98–5.60; and aOR 11.84, 95% CI 6.89–20.36, respectively). There was no difference between the fully stand-alone and the fully integrated clinic. Qualitative data suggested that many clients at HIV-only sites felt greater confidentiality knowing that those around them were positive, and support was gained from other HIV care clients. Confidentiality was maintained in various ways, even in stand-alone sites, through separate waiting areas for HIV testing and HIV treatment, and careful clinic and room labelling. Conclusions The relationship between model of care and stigma was complex, and the hypothesis that stigma is higher at stand-alone sites did not hold true in this high prevalence setting. Policy-makers should ensure that service integration does not increase stigma, in particular within partially integrated models of care. PMID:23336726

[Association between obesity and DNA methylation among the 7-16 year-old twins].

PubMed

Li, C X; Gao, Y; Gao, W J; Yu, C Q; Lyu, J; Lyu, R R; Duan, J L; Sun, Y; Guo, X H; Wang, S F; Zhou, B; Wang, G; Cao, W H; Li, L M

2018-04-10

Objective: On whole-genome scale, we tried to explore the correlation between obesity-related traits and DNA methylation sites, based on discordant monozygotic twin pairs. Methods: A total of 90 pairs of 6-17 year-old twins were recruited in Chaoyang district, Yanqing district and Fangshan district in Beijing in 2016. Information on twins was gathered through a self-designed questionnaire and results: from physical examination, including height, weight and waist circumference of the subjects under study. DNA methylation detection was chosen on the Illumina Human Methylation EPIC BeadChip. R 3.3.1 language was used to read the DNA methylation signal under quality control on samples and probes. Ebayes function of empirical Bayes paired moderated t -test was used to identify the differential methylated CpG sites (DMCs). VarFit function of empirical Bayes paired moderated Levene test was used to identify the differentially variables CpG sits (DVCs) in obese and normal groups. Results According to the obesity discordance criteria, we collected 23 pairs of twins (age range 7 to 16 years), including 12 male pairs. A total of 817 471 qualified CpG loci were included in the genome-wide correlation analysis. According to the significance level of FDR set as <0.05, no positive sites would meet this standard. When DMC CpG site cg05684382, with the smallest P value (1.26E-06) as on chromosome 12, the DVC CpG site cg26188191 with the smallest P value (6.44E-06) appeared in CMIP gene on chromosome 16. Conclusions: In this study, we analyzed the genome-wide DNA methylation and its correlation with obesity traits. After multiple testing corrections, no positive sites were found to have associated with obesity. However, results from the correlation analysis demonstrated sites cg05684382 (chr: 12) and cg26188191 (chr: 16) might have played a role in the development of obesity. This study provides a methodologic reference for the studies on discordance twins related problems.

Providers' and Administrators' Perceptions of Complementary and Integrative Health Practices Across the Veterans Health Administration

PubMed Central

Mitchinson, Allison R.; Trumble, Erika; Hinshaw, Daniel B.; Dusek, Jeffery A.

2017-01-01

Abstract Objectives: Use of complementary and integrative health (CIH) therapies is being promoted by the Veterans Health Administration (VA), but promotion may not equate to adoption. The purpose of this study was to explore whether perceptions regarding CIH at one VA medical center (VAMC) were similar to perceptions from a sample of other VAMCs. Design: This article reports a subset of qualitative findings from a mixed-methods study. Setting/Participants: Sites were recruited through a VA-wide CIH listserver. On the basis of site description (e.g., therapies offered, interest in CIH), sustained site interest, and geographic location, recorded interviews of 22 persons were conducted at 6 sites across the country. Outcome measures: Interviewees were asked the same questions as the single-site VAMC study respondents. Results: Variable access to CIH services across the VA created the need for workarounds. Multiple barriers (e.g., limited space and challenging credentialing) and facilitators (e.g., strong champion and high veteran demand) were cited. Respondents described nonpharmacologic pain control, the usefulness in treating mental health and/or post-traumatic stress disorder issues, and improvement of staff morale as additional reasons to promote CIH. Findings confirmed those from the earlier single-site VAMC phase of the study. Even the highest-performing sites reported struggling to meet veterans' demands for delivery of CIH. Conclusions: Almost half of active-duty military personnel report the use of at least one type of CIH therapy. As active-duty personnel transition to veteran status, both their physical and mental healthcare needs can potentially benefit from CIH therapies. The VA must actively support local enthusiastic CIH proponents and receive congressional support if it is to actually meet its stated goal of providing personalized, proactive, patient-driven healthcare through the promotion of comprehensive CIH services to veterans. PMID:27925776

Waiver of consent in non-interventional, observational emergency research: the PROMMTT experience

PubMed Central

Fox, Erin E.; Bulger, Eileen M.; Dickerson, Aisha S.; del Junco, Deborah J.; Klotz, Patricia; Podbielski, Jeanette; Matijevic, Nena; Brasel, Karen J.; Holcomb, John B.; Schreiber, Martin A.; Cotton, Bryan A.; Phelan, Herb A.; Cohen, Mitchell J.; Myers, John G.; Alarcon, Louis H.; Muskat, Peter; Wade, Charles E.; Rahbar, Mohammad H.

2013-01-01

Background In the PRospective Observational Multi-center Major Trauma Transfusion (PROMMTT) study, waiver of consent was utilized because previous literature reported low response rates and subsequent bias. The goal of this manuscript is to examine the rationale and tradeoffs of using waiver of consent in PROMMTT. Methods PROMMTT enrolled trauma patients receiving at least one unit of red blood cells within 6 hours after admission at ten US Level 1 Trauma Centers. Local Institutional Review Boards (IRBs) from all sites approved the study. Site 8 was required by their IRB to attempt consent, but was allowed to retain data on patients unable to be consented. Results Of 121 subjects enrolled at Site 8, 55 consents were obtained (46%) and no patient or legally-authorized representative refused to give consent. Thirty-six (30%) patients died and 6 (5%) were discharged before consent could be attempted. Consent was attempted but not possible among 24 patients (20%). Of the 10 clinical sites, six of the local IRBs approved collection of residual blood samples, one had prior approval to collect timed blood samples under a separate protocol, and three reported that their local IRBs would not approve collection of residual blood under a waiver of consent. Conclusions Waiver of consent was used in PROMMTT because of the potential adverse impact of consent refusals; however, there were no refusals. If Site 8’s IRB had required withdrawal of patients unable to consent and destruction of their data, a serious bias would likely have been introduced. Other tradeoffs included a reduction in sites participating in residual blood collection, and a smaller than expected amount of residual blood collected among sites operating under a waiver of consent. Non-interventional emergency research studies should consider these potential tradeoffs carefully before deciding whether waiver of consent would best achieve the goals of a study. Level of Evidence Prospective, Level II PMID:23778508

Childhood violence and adult chronic pain among indigenous Sami and non-Sami populations in Norway: a SAMINOR 2 questionnaire study

PubMed Central

Eriksen, Astrid M. A.; Schei, Berit; Hansen, Ketil Lenert; Sørlie, Tore; Fleten, Nils; Javo, Cecilie

2016-01-01

Background Internationally, studies have shown that childhood violence is associated with chronic pain in adulthood. However, to date, this relationship has not been examined in any indigenous population. Objective The main objectives of this study were to investigate the association between childhood violence and reported chronic pain, number of pain sites and the intensity of pain in adulthood in indigenous Sami and non-Sami adults, and to explore ethnic differences. Design The study is based on the SAMINOR 2 questionnaire study, a larger population-based, cross-sectional survey on health and living conditions in multiethnic areas with both Sami and non-Sami populations in Mid- and Northern Norway. Our study includes a total of 11,130 adult participants: 2,167 Sami respondents (19.5%) and 8,963 non-Sami respondents (80.5%). Chronic pain was estimated by reported pain located in various parts of the body. Childhood violence was measured by reported exposure of emotional, physical and/or sexual violence. Results Childhood violence was associated with adult chronic pain in several pain sites of the body regardless of ethnicity and gender. Childhood violence was also associated with increased number of chronic pain sites and higher pain intensity compared to those not exposed to childhood violence. However, among Sami men, this association was only significant for pain located in chest, hips/legs and back, and non-significant for increased number of chronic pain sites (adjusted model), and higher pain intensity. Conclusion Respondents exposed to childhood violence reported more chronic pain in several parts of the body, increased number of chronic pain sites and more intense pain in adulthood than respondents reporting no childhood violence. However, among Sami men, this association was weaker and also not significant for increased number of chronic pain sites and higher pain intensity. PMID:27802844

Effects of 980 diode laser treatment combined with scaling and root planing on periodontal pockets in chronic periodontitis patients

NASA Astrophysics Data System (ADS)

Fallah, Alireza

2010-02-01

Objective: This study compared the effect of 980 Diode laser + scaling and root planing (SRP) versus SRP alone in the treatment of chronic periodontitis. Method: 21 healthy patients with moderate periodontitis with a probing depth of at least 5mm were included in the study. A total of 42 sites were treated during 6weeks with a combination of 980 Diode laser and SRP (21 sites) or SRP alone (21 sites). The gingival index (GI), probing pocket depth (PPD) and bleeding on probing (BOP) were examined at the baseline and after 6 weeks after the start of treatment. Results: Both groups showed statistically significant improvements in GI, BOP and PPD after treatment. The results also showed significant improvement from laser+ SRP group to SRP alone group. Conclusion: The present data suggest that treatment of chronic periodontitis with either 980 Diode laser + SRP or SRP alone results in statistically significant improvements in the clinical parameters. The combination of 980 Diode laser irradiation in the gingival sulcus and SRP, was significantly better as compared to SRP alone.

A Retrospective Comparison of Conventional versus Transverse Mini-Incision Technique for Carpal Tunnel Release

PubMed Central

Gülşen, İsmail; Ak, Hakan; Evcılı, Gökhan; Balbaloglu, Özlem; Sösüncü, Enver

2013-01-01

Background. In this retrospective study, we aimed to compare the results of two surgical techniques, conventional and transverse mini-incision. Materials and Methods. 95 patients were operated between 2011 and 2012 in Bitlis State Hospital. 50 patients were operated with conventional technique and 45 of them were operated with minimal transverse incision. Postoperative complications, incision site problems, and the time of starting to use their hands in daily activities were noted. Results. 95 patients were included in the study. The mean age was 48. 87 of them were female and 8 were male. There was no problem of incision site in both of the two surgical techniques. Only in one patient, anesthesia developed in minimal incision technique. The time of starting to use their hands in daily activities was 22,2 days and 17 days in conventional and minimal incision technique, respectively. Conclusion. Two surgical techniques did not show superiority to each other in terms of postoperative complications and incision site problems except the time of starting to use their hands in daily activities. PMID:24396607

Comparison of cooling and EMLA to reduce the burning pain during capsaicin 8% patch application: a randomized, double-blind, placebo-controlled study.

PubMed

Knolle, Erich; Zadrazil, Markus; Kovacs, Gabor Geza; Medwed, Stephanie; Scharbert, Gisela; Schemper, Michael

2013-12-01

Topical capsaicin 8% was developed for the treatment of peripheral neuropathic pain. The pain reduction is associated with a reversible reduction of epidermal nerve fiber density (ENFD). During its application, topical capsaicin 8% provokes distinct pain. In a randomized, double-blind study analyzed with a block factorial analysis of variance, we tested whether cooling the skin would result in reliable prevention of the application pain without inhibiting reduction of ENFD. A capsaicin 8% patch was cut into 4 quarters and 2 each were applied for 1 hour on the anterior thighs of 12 healthy volunteers. A randomization scheme provided for 1 of the application sites of each thigh to be pretreated with EMLA and the other with placebo, whereas both application sites of 1 thigh, also randomly selected, were cooled by cool packs, resulting in a site temperature of 20°C during the entire treatment period. The maximum pain level given for the cooled sites (visual analogue scale [VAS] 1.3 ± 1.4) proved to be significantly lower than for the non-cooled sites (VAS 7.5 ± 1.9) (P < .0001). In contrast, there was no significant difference in application pain between the sites pretreated with EMLA or with placebo (VAS 4.1 ± 3.6 vs 4.8 ± 3.5, P = .1084). At all application sites, ENFD was significantly reduced by 8.0 ± 2.8 (ENF/mm ± SD, P < .0001), that is, 70%, with no significant differences between the sites with the different experimental conditions. In conclusion, cooling the skin to 20°C reliably prevents the pain from capsaicin 8% patch application, whereas EMLA does not. ENFD reduction is not inhibited by cooling. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

CpG Sites Associated with Cigarette Smoking: Analysis of Epigenome-Wide Data from the Sister Study

PubMed Central

Harlid, Sophia; Xu, Zongli; Panduri, Vijayalakshmi; Sandler, Dale P.

2014-01-01

Background: Smoking increases the risk of many diseases, and it is also linked to blood DNA methylation changes that may be important in disease etiology. Objectives: We sought to identify novel CpG sites associated with cigarette smoking. Methods: We used two epigenome-wide data sets from the Sister Study to identify and confirm CpG sites associated with smoking. One included 908 women with methylation measurements at 27,578 CpG sites using the HumanMethylation27 BeadChip; the other included 200 women with methylation measurements for 473,844 CpG sites using the HumanMethylation450 BeadChip. Significant CpGs from the second data set that were not included in the 27K assay were validated by pyrosequencing in a subset of 476 samples from the first data set. Results: Our study successfully confirmed smoking associations for 9 previously established CpGs and identified 2 potentially novel CpGs: cg26764244 in GNG12 (p = 9.0 × 10–10) and cg22335340 in PTPN6 (p = 2.9 × 10–05). We also found strong evidence of an association between smoking status and cg02657160 in CPOX (p = 7.3 × 10–7), which has not been previously reported. All 12 CpGs were undermethylated in current smokers and showed an increasing percentage of methylation in former and never-smokers. Conclusions: We identified 2 potentially novel smoking related CpG sites, and provided independent replication of 10 previously reported CpGs sites related to smoking, one of which is situated in the gene CPOX. The corresponding enzyme is involved in heme biosynthesis, and smoking is known to increase heme production. Our study extends the evidence base for smoking-related changes in DNA methylation. Citation: Harlid S, Xu Z, Panduri V, Sandler DP, Taylor JA. 2014. CpG sites associated with cigarette smoking: analysis of epigenome-wide data from the Sister Study. Environ Health Perspect 122:673–678; http://dx.doi.org/10.1289/ehp.1307480 PMID:24704585

A Rigidifying Salt-Bridge Favors the Activity of Thermophilic Enzyme at High Temperatures at the Expense of Low-Temperature Activity

PubMed Central

Lam, Sonia Y.; Yeung, Rachel C. Y.; Yu, Tsz-Ha; Sze, Kong-Hung; Wong, Kam-Bo

2011-01-01

Background Thermophilic enzymes are often less active than their mesophilic homologues at low temperatures. One hypothesis to explain this observation is that the extra stabilizing interactions increase the rigidity of thermophilic enzymes and hence reduce their activity. Here we employed a thermophilic acylphosphatase from Pyrococcus horikoshii and its homologous mesophilic acylphosphatase from human as a model to study how local rigidity of an active-site residue affects the enzymatic activity. Methods and Findings Acylphosphatases have a unique structural feature that its conserved active-site arginine residue forms a salt-bridge with the C-terminal carboxyl group only in thermophilic acylphosphatases, but not in mesophilic acylphosphatases. We perturbed the local rigidity of this active-site residue by removing the salt-bridge in the thermophilic acylphosphatase and by introducing the salt-bridge in the mesophilic homologue. The mutagenesis design was confirmed by x-ray crystallography. Removing the salt-bridge in the thermophilic enzyme lowered the activation energy that decreased the activation enthalpy and entropy. Conversely, the introduction of the salt-bridge to the mesophilic homologue increased the activation energy and resulted in increases in both activation enthalpy and entropy. Revealed by molecular dynamics simulations, the unrestrained arginine residue can populate more rotamer conformations, and the loss of this conformational freedom upon the formation of transition state justified the observed reduction in activation entropy. Conclusions Our results support the conclusion that restricting the active-site flexibility entropically favors the enzymatic activity at high temperatures. However, the accompanying enthalpy-entropy compensation leads to a stronger temperature-dependency of the enzymatic activity, which explains the less active nature of the thermophilic enzymes at low temperatures. PMID:21423654

A 5 Year Study of Carbon Fluxes from a Restored English Blanket Bog

NASA Astrophysics Data System (ADS)

Worrall, F.; Dixon, S.; Evans, M.

2014-12-01

This study aimed to measure the effects of ecological restoration on blanket peat water table depths, DOC concentrations and CO2 fluxes. In April 2003 the Bleaklow Plateau, an extensive area of deep blanket peat in the Peak District National Park, northern England, was devegetated by a wildfire. As a result the area was selected for large scale restoration. In this study we considered a 5-year study of four restored sites in comparison to both an unrestored, bare peat control and to vegetated control that did not require restoration. Results suggested that sites with revegetation alongside slope stabilisation had the highest rates of photosynthesis and were the largest net (daylight hours) sinks of CO2. Bare sites were the largest net sources of CO2 and had the deepest water table depths. Sites with gully wall stabilisation were between 5-8 times more likely to be net CO2 sinks than the bare sites. Revegetation without gully flow blocking using plastic dams did not have a large effect on water table depths in and around the gullies investigated whereas a blocked gully had water table depths comparable to a naturally revegetating gully. A ten centimetre lowering in water table depth decreased the probability of observing a net CO2 sink, on a given site, by up to 30%. With respect to DOC the study showed that the average soil porewater DOC concentration on the restored sites rose significantly over the 5 year study representing a 34% increase relative to the vegetated control and an 11% increase relative to the unrestored, bare control. Soil pore water concentrations were not significantly different from surface runoff DOC concentrations and therefore restoration as conducted by this study would have contributed to water quality deterioration in the catchment. The most important conclusion of this research was that restoration interventions were apparently effective at increasing the likelihood of net CO2 sink behaviour and raising water tables on degraded, climatically marginal blanket bog. However, had water table restoration been conducted alongside revegetation then a significant decline in DOC concentrations could have also been realised.

Crystal structure of SgcJ, an NTF2-like superfamily protein involved in biosynthesis of the nine-membered enediyne antitumor antibiotic C-1027

DOE PAGES

Huang, Tingting; Chang, Chin -Yuan; Lohman, Jeremy R.; ...

2016-10-01

Comparative analysis of the enediyne biosynthetic gene clusters revealed sets of conserved genes serving as outstanding candidates for the enediyne core. Here we report the crystal structures of SgcJ and its homologue NCS-Orf16, together with gene inactivation and site-directed mutagenesis studies, to gain insight into enediyne core biosynthesis. Gene inactivation in vivo establishes that SgcJ is required for C-1027 production in Streptomyces globisporus. SgcJ and NCS-Orf16 share a common structure with the nuclear transport factor 2-like superfamily of proteins, featuring a putative substrate binding or catalytic active site. Site-directed mutagenesis of the conserved residues lining this site allowed us tomore » propose that SgcJ and its homologues may play a catalytic role in transforming the linear polyene intermediate, along with other enediyne polyketide synthase-associated enzymes, into an enzyme-sequestered enediyne core intermediate. In conclusion, these findings will help formulate hypotheses and design experiments to ascertain the function of SgcJ and its homologues in nine-membered enediyne core biosynthesis.« less

Housing Retention in Single-Site Housing First for Chronically Homeless Individuals With Severe Alcohol Problems

PubMed Central

Malone, Daniel K.; Clifasefi, Seema L.

2013-01-01

Objectives. We studied housing retention and its predictors in the single-site Housing First model. Methods. Participants (n = 111) were chronically homeless people with severe alcohol problems who lived in a single-site Housing First program and participated in a larger nonrandomized controlled trial (2005–2008) conducted in Seattle, Washington. At baseline, participants responded to self-report questionnaires assessing demographic, illness burden, alcohol and other drug use, and psychiatric variables. Housing status was recorded over 2 years. Results. Participants were interested in housing, although a sizable minority did not believe they would be able to maintain abstinence-based housing. Only 23% of participants returned to homelessness during the 2-year follow-up. Commonly cited risk factors—alcohol and other drug use, illness burden, psychiatric symptoms, and homelessness history—did not predict resumed homelessness. Active drinkers were more likely to stay in this housing project than nondrinkers. Conclusions. We found that single-site Housing First programming fills a gap in housing options for chronically homeless people with severe alcohol problems. PMID:24148063

A Randomized Controlled Trial of a Tailored Interactive Computer-Delivered Intervention to Promote Colorectal Cancer Screening: Sometimes More is Just the Same

PubMed Central

Bartholomew, Leona K.; McQueen, Amy; Bettencourt, Judy L.; Greisinger, Anthony; Coan, Sharon P.; Lairson, David; Chan, Wenyaw; Hawley, S. T.; Myers, R. E.

2012-01-01

Background There have been few studies of tailored interventions to promote colorectal cancer (CRC) screening. Purpose We conducted a randomized trial of a tailored, interactive intervention to increase CRC screening. Methods Patients 50–70 years completed a baseline survey, were randomized to one of three groups, and attended a wellness exam after being exposed to a tailored intervention about CRC screening (tailored group), a public web site about CRC screening (web site group), or no intervention (survey-only group). The primary outcome was completion of any recommended CRC screening by 6 months. Results There was no statistically significant difference in screening by 6 months: 30%, 31%, and 28% of the survey-only, web site, and tailored groups were screened. Exposure to the tailored intervention was associated with increased knowledge and CRC screening self-efficacy at 2 weeks and 6 months. Family history, prior screening, stage of change, and physician recommendation moderated the intervention effects. Conclusions A tailored intervention was not more effective at increasing screening than a public web site or only being surveyed. PMID:21271365

Antibody Light-Chain-Restricted Recognition of the Site of Immune Pressure in the RV144 HIV-1 Vaccine Trial Is Phylogenetically Conserved

DOE PAGES

Wiehe, Kevin; Easterhoff, David; Luo, Kan; ...

2014-11-29

In HIV-1, the ability to mount antibody responses to conserved, neutralizing epitopes is critical for protection. Here we have studied the light chain usage of human and rhesus macaque antibodies targeted to a dominant region of the HIV-1 envelope second variable (V2) region involving lysine (K) 169, the site of immune pressure in the RV144 vaccine efficacy trial. We found that humans and rhesus macaques used orthologous lambda variable gene segments encoding a glutamic acid-aspartic acid (ED) motif for K169 recognition. Structure determination of an unmutated ancestor antibody demonstrated that the V2 binding site was preconfigured for ED motif-mediated recognitionmore » prior to maturation. Thus, light chain usage for recognition of the site of immune pressure in the RV144 trial is highly conserved across species. In conclusion, these data indicate that the HIV-1 K169-recognizing ED motif has persisted over the diversification between rhesus macaques and humans, suggesting an evolutionary advantage of this antibody recognition mode.« less

Antibody Light-Chain-Restricted Recognition of the Site of Immune Pressure in the RV144 HIV-1 Vaccine Trial Is Phylogenetically Conserved

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wiehe, Kevin; Easterhoff, David; Luo, Kan

In HIV-1, the ability to mount antibody responses to conserved, neutralizing epitopes is critical for protection. Here we have studied the light chain usage of human and rhesus macaque antibodies targeted to a dominant region of the HIV-1 envelope second variable (V2) region involving lysine (K) 169, the site of immune pressure in the RV144 vaccine efficacy trial. We found that humans and rhesus macaques used orthologous lambda variable gene segments encoding a glutamic acid-aspartic acid (ED) motif for K169 recognition. Structure determination of an unmutated ancestor antibody demonstrated that the V2 binding site was preconfigured for ED motif-mediated recognitionmore » prior to maturation. Thus, light chain usage for recognition of the site of immune pressure in the RV144 trial is highly conserved across species. In conclusion, these data indicate that the HIV-1 K169-recognizing ED motif has persisted over the diversification between rhesus macaques and humans, suggesting an evolutionary advantage of this antibody recognition mode.« less

Honey Dressing Accelerates Split-Thickness Skin Graft Donor Site Healing.

PubMed

Subrahmanyam, M

2015-12-01

The management of the donor site after harvesting a skin graft is an important issue, as patients often report more discomfort at the donor site than at the recipient site. There is, however, a plethora of dressings available for the treatment and management of donor sites, yet, there is no widely accepted method established for these partial thickness wounds. Honey has been found to be useful in the treatment of burns and other wounds, split-thickness skin graft donor sites are like partial thickness burn wounds and honey's healing effect on burn wound can also be expected on these types of wounds. Therefore, this study was undertaken to evaluate the effect of honey on skin graft donor sites. From 2002 to 2004, 100 patients who have undergone skin grafting for various reasons formed the material of the randomized study divided into two groups of 50 each in honey-treated group and Vaseline gauze-treated group. Graft donor site area ranged from 30 to 48 cm(2), mean 32.6 cm(2). In the group treated with honey, 90 % of the patients had nil or only moderate pain, whereas in the group treated with Vaseline gauze,88 % had nil or mild pain (p > 0.001, not significant). There were no allergic reactions in any of the patients in either group. On opening of the dressing on the 7th day, epithelialization has occurred in 48 patients as compared to 39 in group 2, i.e., donor sites treated with Vaseline gauze (p < 0.05, statistically significant). By the 10th day, all the wounds healed in honey-treated group, whereas 76 % of wounds healed in Vaseline gauze-treated group (p < 0.05). At 1 month follow-up, the results were comparable in both groups, with regard to patient satisfaction. In conclusion, honey-impregnated gauze causes less pain and heals donor sites wounds faster with good cosmetic result.

An evaluation of information on the internet about a new device: the cervical artificial disc replacement.

PubMed

Qureshi, Sheeraz A; Koehler, Steven M; Lin, James D; Bird, Justin; Garcia, Ryan M; Hecht, Andrew C

2012-05-01

Cross-sectional survey. The objective of this study was to investigate the authorship, content, and quality of information available to the public on the Internet pertaining to the cervical artificial disc replacement device. The Internet is widely used by patients as an educational tool for health care information. In addition, the Internet is used as a medium for direct-to-consumer marketing. Increasing interest in cervical artificial disc replacement has led to the emergence of numerous Web sites offering information about this procedure. It is thought that patients can be influenced by information found on the Internet. A cross section of Web sites accessible to the general public was surveyed. Three commonly used search engines were used to locate 150 (50/search engine) Web sites providing information about the cervical artificial disc replacement. Each Web site was evaluated with regard to authorship and content. Fifty-three percent of the Web sites reviewed were authorized by a private physician group, 4% by an academic physician group, 13% by industry, 16% were news reports, and 14% were not otherwise categorized. Sixty-five percent of Web sites offered a mechanism for direct contact and 19% provided clear patient eligibility criteria. Benefits were expressed in 80% of Web sites, whereas associated risks were described in 35% or less. European experiences were noted in 17% of Web sites, whereas only 9% of Web sites detailed the current US experience. CONCLUSION.: The results of this study demonstrate that much of the content of the Internet-derived information pertaining to the cervical artificial disc replacement is for marketing purposes and may not represent unbiased information. Until we can confirm the content on a Web site to be accurate, patients should be cautioned when using the Internet as a source for health care information related to cervical disc replacement.

Standardization of Clinical Assessment and Sample Collection Across All PERCH Study Sites

PubMed Central

Prosperi, Christine; Baggett, Henry C.; Brooks, W. Abdullah; Deloria Knoll, Maria; Hammitt, Laura L.; Howie, Stephen R. C.; Kotloff, Karen L.; Levine, Orin S.; Madhi, Shabir A.; Murdoch, David R.; O’Brien, Katherine L.; Thea, Donald M.; Awori, Juliet O.; Bunthi, Charatdao; DeLuca, Andrea N.; Driscoll, Amanda J.; Ebruke, Bernard E.; Goswami, Doli; Hidgon, Melissa M.; Karron, Ruth A.; Kazungu, Sidi; Kourouma, Nana; Mackenzie, Grant; Moore, David P.; Mudau, Azwifari; Mwale, Magdalene; Nahar, Kamrun; Park, Daniel E.; Piralam, Barameht; Seidenberg, Phil; Sylla, Mamadou; Feikin, Daniel R.; Scott, J. Anthony G.; O’Brien, Katherine L.; Levine, Orin S.; Knoll, Maria Deloria; Feikin, Daniel R.; DeLuca, Andrea N.; Driscoll, Amanda J.; Fancourt, Nicholas; Fu, Wei; Hammitt, Laura L.; Higdon, Melissa M.; Kagucia, E. Wangeci; Karron, Ruth A.; Li, Mengying; Park, Daniel E.; Prosperi, Christine; Wu, Zhenke; Zeger, Scott L.; Watson, Nora L.; Crawley, Jane; Murdoch, David R.; Brooks, W. Abdullah; Endtz, Hubert P.; Zaman, Khalequ; Goswami, Doli; Hossain, Lokman; Jahan, Yasmin; Ashraf, Hasan; Howie, Stephen R. C.; Ebruke, Bernard E.; Antonio, Martin; McLellan, Jessica; Machuka, Eunice; Shamsul, Arifin; Zaman, Syed M.A.; Mackenzie, Grant; Scott, J. Anthony G.; Awori, Juliet O.; Morpeth, Susan C.; Kamau, Alice; Kazungu, Sidi; Kotloff, Karen L.; Tapia, Milagritos D.; Sow, Samba O.; Sylla, Mamadou; Tamboura, Boubou; Onwuchekwa, Uma; Kourouma, Nana; Toure, Aliou; Madhi, Shabir A.; Moore, David P.; Adrian, Peter V.; Baillie, Vicky L.; Kuwanda, Locadiah; Mudau, Azwifarwi; Groome, Michelle J.; Baggett, Henry C.; Thamthitiwat, Somsak; Maloney, Susan A.; Bunthi, Charatdao; Rhodes, Julia; Sawatwong, Pongpun; Akarasewi, Pasakorn; Thea, Donald M.; Mwananyanda, Lawrence; Chipeta, James; Seidenberg, Phil; Mwansa, James; wa Somwe, Somwe; Kwenda, Geoffrey

2017-01-01

Abstract Background. Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these problems, a program of clinical standardization was embedded in the Pneumonia Etiology Research for Child Health (PERCH) study. Methods. Between March 2011 and August 2013, standardized training on the PERCH case definition, clinical procedures, and collection of laboratory specimens was delivered to 331 clinical staff at 9 study sites in 7 countries (The Gambia, Kenya, Mali, South Africa, Zambia, Thailand, and Bangladesh), through 32 on-site courses and a training website. Staff competency was assessed throughout 24 months of enrollment with multiple-choice question (MCQ) examinations, a video quiz, and checklist evaluations of practical skills. Results. MCQ evaluation was confined to 158 clinical staff members who enrolled PERCH cases and controls, with scores obtained for >86% of eligible staff at each time-point. Median scores after baseline training were ≥80%, and improved by 10 percentage points with refresher training, with no significant intersite differences. Percentage agreement with the clinical trainer on the presence or absence of clinical signs on video clips was high (≥89%), with interobserver concordance being substantial to high (AC1 statistic, 0.62–0.82) for 5 of 6 signs assessed. Staff attained median scores of >90% in checklist evaluations of practical skills. Conclusions. Satisfactory clinical standardization was achieved within and across all PERCH sites, providing reassurance that any etiological or clinical differences observed across the study sites are true differences, and not attributable to differences in application of the clinical case definition, interpretation of clinical signs, or in techniques used for clinical measurements or specimen collection. PMID:28575355

Identifying and collecting pertinent medical records for centralized abstraction in a multi-center randomized clinical trial: The model used by the American College of Radiology arm of the National Lung Screening Trial

PubMed Central

Gareen, Ilana F.; Sicks, JoRean; Adams, Amanda; Moline, Denise; Coffman-Kadish, Nancy

2012-01-01

Background In clinical trials and epidemiologic studies, information on medical care utilization and health outcomes is often obtained from medical records. For multi-center studies, this information may be gathered by personnel at individual sites or by staff at a central coordinating center. We describe the process used to develop a HIPAA-compliant centralized process to collect medical record information for a large multi-center cancer screening trial. Methods The framework used to select, request, and track medical records incorporated a participant questionnaire with unique identifiers for each medical provider. De-identified information from the questionnaires was sent to the coordinating center indexed by these identifiers. The central coordinating center selected specific medical providers for abstraction and notified sites using these identifiers. The site personnel then linked the identifiers with medical provider information. Staff at the sites collected medical records and provided them for central abstraction. Results Medical records were successfully obtained and abstracted to ascertain information on outcomes and health care utilization in a study with over 18,000 study participants. Collection of records required for outcomes related to positive screening examinations and lung cancer diagnosis exceeded 90%. Collection of records for all aims was 87.32%. Conclusions We designed a successful centralized medical record abstraction process that may be generalized to other research settings, including observational studies. The coordinating center received no identifying data. The process satisfied requirements imposed by the Health Insurance Portability and Accountability Act and concerns of site institutional review boards with respect to protected health information. PMID:22982342

The blind men meet the elephant at the dam: Alternative spatial and taxonomic components reveal different insights about how low-head dams impact fish biodiversity

USGS Publications Warehouse

Fencl, Jane S.; Mather, Martha E.; Smith, Joseph M.; Hitchman, Sean M.

2017-01-01

Dams are ubiquitous environmental impacts that threaten aquatic ecosystems. The ability to compare across research studies is essential to conserve the native biodiversity that is impacted by the millions of low‐head dams that currently fragment streams and rivers. Here, we identify a previously unaddressed obstacle that impedes this generalization. Specifically, divergent spatial and taxonomic approaches that result from different conceptualizations of the dam‐biodiversity problem can produce conflicting science‐based conclusions about the same dam impact. In this research, using the same dammed and undammed sites, we evaluated the scientific generality of different conceptualizations of the dam‐biodiversity problem. We compared two different but commonly used spatial approaches—(1) above dam–below dam vs. (2) undammed–dammed comparisons—and 11 different, commonly used taxonomic approaches (three assemblage summaries, eight guilds). Sites above the dam structure had less diverse fish assemblages than sites below dams, whereas sites below the dam structure were similar to undammed sites. Thus, spatial approach 1 detected a large dam effect and spatial approach 2 detected a small dam effect. Similarly, some taxonomic responses (species richness, diversity, abundance, and number of guilds) detected large dam effects; other responses detected small (riffle specialist guild) or no dam effects (pool generalists). In summary, our results showed that how the problem was framed altered scientific conclusions and created different dam realities. The metaphor of how individual blind men disagree about the structure of an elephant, based on examinations of different body parts, reinforces the need for a coordinated, holistic perspective on dam research. Although no single approach is adequate for all problems, identifying the form, consequences of, and relationships among different research conceptualizations will set the stage for future syntheses of dam‐biodiversity research to advance science‐based conservation.

Study of the oxidative half-reaction catalyzed by a non-heme ferrous catalytic center by means of structural and computational methodologies

NASA Astrophysics Data System (ADS)

Cicero, Giancarlo; Carbonera, Chiara; Valegård, Karin; Hajdu, Janos; Andersson, Inger; Ranghino, Graziella

Deacetoxycephalosporin C synthase (DAOCS) is a mononuclear ferrous enzyme that catalyzes the expansion of the five-membered thiazolidine ring of the penicillin nucleus into the six-membered dihydrothiazine ring of the cephalosporins. In the first half-reaction with dioxygen and 2-oxoglutarate, a reactive iron-oxygen species is produced that can subsequently react with the penicillin substrate to yield the cephalosporin. We describe quantum mechanical calculations of the first part of the reaction based on the high-resolution structures of the active site of DAOCS and its complexes with ligands. These studies are aimed at understanding how the reactive species can be produced and contained in the active site of the enzyme. The results demonstrate the priming of the active site by the co-substrate for oxygen binding and hint to the presence of a stable iron-peroxo intermediate in equilibrium with a more reactive ferryl species and the formation of CO2 as a leaving group by decarboxylation of 2-oxoglutarate. A conclusion from these studies is that substitution of CO2 by the penicillin substrate triggers the oxidation reaction in a booby-trap-like mechanism.

Health diplomacy the adaptation of global health interventions to local needs in sub-Saharan Africa and Thailand: Evaluating findings from Project Accept (HPTN 043)

PubMed Central

2012-01-01

Background Study-based global health interventions, especially those that are conducted on an international or multi-site basis, frequently require site-specific adaptations in order to (1) respond to socio-cultural differences in risk determinants, (2) to make interventions more relevant to target population needs, and (3) in recognition of ‘global health diplomacy' issues. We report on the adaptations development, approval and implementation process from the Project Accept voluntary counseling and testing, community mobilization and post-test support services intervention. Methods We reviewed all relevant documentation collected during the study intervention period (e.g. monthly progress reports; bi-annual steering committee presentations) and conducted a series of semi-structured interviews with project directors and between 12 and 23 field staff at each study site in South Africa, Zimbabwe, Thailand and Tanzania during 2009. Respondents were asked to describe (1) the adaptations development and approval process and (2) the most successful site-specific adaptations from the perspective of facilitating intervention implementation. Results Across sites, proposed adaptations were identified by field staff and submitted to project directors for review on a formally planned basis. The cross-site intervention sub-committee then ensured fidelity to the study protocol before approval. Successfully-implemented adaptations included: intervention delivery adaptations (e.g. development of tailored counseling messages for immigrant labour groups in South Africa) political, environmental and infrastructural adaptations (e.g. use of local community centers as VCT venues in Zimbabwe); religious adaptations (e.g. dividing clients by gender in Muslim areas of Tanzania); economic adaptations (e.g. co-provision of income generating skills classes in Zimbabwe); epidemiological adaptations (e.g. provision of ‘youth-friendly’ services in South Africa, Zimbabwe and Tanzania), and social adaptations (e.g. modification of terminology to local dialects in Thailand: and adjustment of service delivery schedules to suit seasonal and daily work schedules across sites). Conclusions Adaptation selection, development and approval during multi-site global health research studies should be a planned process that maintains fidelity to the study protocol. The successful implementation of appropriate site-specific adaptations may have important implications for intervention implementation, from both a service uptake and a global health diplomacy perspective. PMID:22716131

Status of volcanism studies for the Yucca Mountain Site Characterization Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crowe, B.; Perry, F.; Murrell, M.

1995-02-01

Chapter 1 introduces the volcanism issue for the Yucca Mountain site and provides the reader with an overview of the organization, content, and significant conclusions of this report. The risk of future basaltic volcanism is the primary topic of concern including both events that intersect a potential repository and events that occur near or within the waste isolation system of a repository. Chapter 2 describes the volcanic history of the Yucca Mountain region (YMR) and emphasizes the Pliocene and Quaternary volcanic record, the interval of primary concern for volcanic risk assessment. The Lathrop Wells volcanic center is described in detailmore » because it is the youngest basalt center in the YMR. Chapter 3 describes the tectonic setting of the YMR and presents and assesses the significance of multiple alternative tectonic models. Geophysical data are described for the YMR and are used as an aid to understand the distribution of basaltic volcanic centers. Chapter 4 discusses the petrologic and geochemical features of basaltic volcanism in the YMR, the southern Great Basin and the Basin and Range province. The long time of activity and characteristic small volume of the Postcaldera basalt of the YMR result in one of the lowest eruptive rates in a volcanic field in the southwest United States. Chapter 5 summarizes current concepts of the segregation, ascent, and eruption of basalt magma. Chapter 6 summarizes the history of volcanism studies (1979 through early 1994), including work for the Yucca Mountain Site Characterization Project and overview studies by the state of Nevada and the Nuclear Regulatory Commission. Chapter 7 summarizes probabilistic volcanic hazard assessment using a three-part conditional probability model. Chapter 8 describes remaining volcanism work judged to be needed to complete characterization studies for the YMR. Chapter 9 summarizes the conclusions of this volcanism status report.« less

Solubility and partitioning of Ar in anorthite, diopside, forsterite, spinel, and synthetic basaltic liquids

NASA Technical Reports Server (NTRS)

Broadhurst, C. Leigh; Drake, Michael J.; Hagee, Bryan E.; Bernatowicz, Thomas J.

1990-01-01

The solubility and partitioning of Ar in natural anorthite, diopside, forsterite, spinel, and synthetic iron-free basaltic melts was investigated using a new technique that obviates the postquenching phase separation. It was found that the solubility of Ar in the minerals was surprisingly high. Moreover, the solubility of Ar in different samples of a particular mineral run in the same experiment varied more than the solubility in the same sample run in different experiments, suggesting that noble gases are held in lattice vacancy defects. Moreover, the results of TEM imaging revealed no anomalous microstructures, while EXAFS studies of some samples showed that Kr has no preferred site in the lattices, supporting the defect siting conclusion.

[THE FEATURES OF PHARMACOKINETICS ANTIBIOTIC CEFTRIAXONE WITH INTRAVENOUS WAY THAT ARE DEPOSITED IN AUTOLOGOUS ERYTHROCYTES AND LEUKOCYTES OF RABBIT].

PubMed

Yussifov, Z; Lokhvitskii, S; Gulyaev, A

2016-11-01

In the experiment on 18 rabbits Сeftriaxone pharmacokinetics after intravenous injection of the medication deposited in autologous erythrocytes and leukocytes were studied. The features of the pharmacokinetics when administered Сeftriaxone in erythrocytes ghost and leukocytes as compared to traditional intravenous drug administration have been determined.It is discussed the possibility of antibiotics transport in the surgical site of infection via cellular carriers in the article. We do the comparative analysis of the main pharmacokinetic parameters of Ceftriaxone in experimental conditions of leukocyte, erythrocyte transport and intravenous way. Based on these results the authors come to the conclusion about the benefits of leukocyte antibiotic transport to the site of surgical infection.

Cefoperazone Prevents the Inactivation of α1-Antitrypsin by Activated Neutrophils

PubMed Central

Dallegri, Franco; Dapino, Patrizia; Arduino, Nicoletta; Bertolotto, Maria; Ottonello, Luciano

1999-01-01

At sites of neutrophilic inflammation, tissue injury by neutrophil elastase is favored by phagocyte-induced hypochlorous acid-dependent inactivation of the natural elastase inhibitor α1-antitrypsin. In the present study, cefoperazone prevented α1-antitrypsin inactivation by neutrophils and reduced the recovery of hypochlorous acid from these cells. Moreover, the antibiotic reduced the free elastase activity in a neutrophil suspension supplemented with α1-antitrypsin without affecting the cells’ ability to release elastase. These data suggest that the drug inactivates hypochlorous acid before its reaction with α1-antitrypsin, thereby permitting the antiprotease-mediated blockade of released elastase. In conclusion, cefoperazone appears to have the potential for limiting elastase-antielastase imbalances, attenuating the related tissue injury at sites of inflammation. PMID:10471586

High prevalence of daily and multi-site pain – a cross-sectional population-based study among 3000 Danish adolescents

PubMed Central

2013-01-01

Background Daily pain and multi-site pain are both associated with reduction in work ability and health-related quality of life (HRQoL) among adults. However, no population-based studies have yet investigated the prevalence of daily and multi-site pain among adolescents and how these are associated with respondent characteristics. The purpose of this study was to investigate the prevalence of self-reported daily and multi-site pain among adolescents aged 12–19 years and associations of almost daily pain and multi-site pain with respondent characteristics (sex, age, body mass index, HRQoL and sports participation). Methods A population-based cross-sectional study was conducted among 4,007 adolescents aged 12–19 years in Denmark. Adolescents answered an online questionnaire during physical education lessons. The questionnaire contained a mannequin divided into 12 regions on which the respondents indicated their current pain sites and pain frequency (rarely, monthly, weekly, more than once per week, almost daily pain), characteristics, sports participation and HRQoL measured by the EuroQoL 5D. Multivariate regression was used to calculate the odds ratio for the association between almost daily pain, multi-site pain and respondent characteristics. Results The response rate was 73.7%. A total of 2,953 adolescents (62% females) answered the questionnaire. 33.3% reported multi-site pain (pain in >1 region) while 19.8% reported almost daily pain. 61% reported current pain in at least one region with knee and back pain being the most common sites. Female sex (OR: 1.35-1.44) and a high level of sports participation (OR: 1.51-2.09) were associated with increased odds of having almost daily pain and multi-site pain. Better EQ-5D score was associated with decreased odds of having almost daily pain or multi-site pain (OR: 0.92-0.94). Conclusion In this population-based cohort of school-attending Danish adolescents, nearly two out of three reported current pain and, on average, one out of three reported pain in more than one body region. Female sex, and high level of sports participation were associated with increased odds of having almost daily pain and multi-site pain. The study highlights an important health issue that calls for investigations to improve our understanding of adolescent pain and our capacity to prevent and treat this condition. PMID:24252440

High prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infections in anal and pharyngeal sites among a community-based sample of men who have sex with men and transgender women in Lima, Peru

PubMed Central

Leon, Segundo R; Segura, Eddy R; Konda, Kelika A; Flores, Juan A; Silva-Santisteban, Alfonso; Galea, Jerome T; Coates, Thomas J; Klausner, Jeffrey D; Caceres, Carlos F

2016-01-01

Objectives This study aimed to characterise the epidemiology of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections among men who have sex with men (MSM) and transgender women (TW) in Lima, Peru. Setting Cross-sectional study in Lima, Peru. Participants We recruited a group of 510 MSM and 208 TW for a subsequent community-based randomised controlled trial. The presence of CT and NG were evaluated using Aptima Combo2 in pharyngeal and anal swabs. We also explored correlates of these infections. Primary and secondary outcome measures: Study end points included overall prevalence of C. trachomatis and N. gonorrhoeae in anal and pharyngeal sites. Results Overall prevalence of CT was 19% (95% CI 16.1% to 22.1%) and 4.8% (95% CI 3.3% to 6.6%) in anal and pharyngeal sites, respectively, while prevalence of NG was 9.6% (95% CI 7.5% to 12.0%) and 6.5% (95% CI 4.8% to 8.5%) in anal and pharyngeal sites, respectively. Conclusions The prevalence of each infection declined significantly among participants older than 34 years (p<0.05). Efforts towards prevention and treatment of extraurogenital chlamydial and gonococcal infections in high-risk populations like MSM and TW in Lima, Peru, are warranted. Trial registration number NCT00670163; Results. PMID:26739719

Online Tonsillectomy Resources: Are Parents Getting Consistent and Readable Recommendations?

PubMed

Wozney, Lori; Chorney, Jill; Huguet, Anna; Song, Jin Soo; Boss, Emily F; Hong, Paul

2017-05-01

Objective Parents frequently refer to information on the Internet to confirm or broaden their understanding of surgical procedures and to research postoperative care practices. Our study evaluated the readability, comprehensiveness, and consistency around online recommendations directed at parents of children undergoing tonsillectomy. Study Design A cross-sectional study design was employed. Setting Thirty English-language Internet websites. Subjects and Methods Three validated measures of readability were applied and content analysis was employed to evaluate the comprehensiveness of information in domains of perioperative education. Frequency effect sizes and percentile ranks were calculated to measure dispersion of recommendations across sites. Results The mean readability level of all sites was above a grade 10 level with fewer than half of the sites (n = 14, 47%) scoring at or below the eight-grade level. Provided information was often incomplete with a noted lack of psychosocial support and skills-training recommendations. Content analysis showed 67 unique recommendations spanning the full perioperative period. Most recommendations had low consensus, being reported in 5 or fewer sites (frequency effect size <16%). Conclusion Many online parent-focused resources do not meet readability recommendations, portray incomplete education about perioperative care and expectations, and provide recommendations with low levels of consensus. Up-to-date mapping of the research evidence around recommendations is needed as well as improved efforts to make online information easier to read.

Environmental impact assessment of Gonabad municipal waste landfill site using Leopold Matrix

PubMed Central

Sajjadi, Seyed Ali; Aliakbari, Zohreh; Matlabi, Mohammad; Biglari, Hamed; Rasouli, Seyedeh Samira

2017-01-01

Introduction An environmental impact assessment (EIA) before embarking on any project is a useful tool to reduce the potential effects of each project, including landfill, if possible. The main objective of this study was to assess the environmental impact of the current municipal solid waste disposal site of Gonabad by using the Iranian Leopold matrix method. Methods This cross-sectional study was conducted to assess the environmental impacts of a landfill site in Gonabad in 2015 by an Iranian matrix (modified Leopold matrix). This study was conducted based on field visits of the landfill, and collected information from various sources and analyzing and comparing between five available options, including the continuation of the current disposal practices, construction of new sanitary landfills, recycling plans, composting, and incineration plants was examined. The best option was proposed to replace the existing landfill. Results The current approach has a score of 2.35, the construction of new sanitary landfill has a score of 1.59, a score of 1.57 for the compost plant, and recycling and incineration plant, respectively, have scores of 1.68 and 2.3. Conclusion Results showed that continuation of the current method of disposal, due to severe environmental damage and health problems, is rejected. A compost plant with the lowest negative score is the best option for the waste disposal site of Gonabad City and has priority over the other four options. PMID:28465797

Internet Use, Browsing, and the Urban Poor: Implications for Cancer Control

PubMed Central

2013-01-01

Background Despite the growing penetration of the Internet, little is known about the usage and browsing patterns of those in poverty. We report on a randomized controlled trial that sheds light on the Internet use and browsing patterns among the urban poor. Methods The data come from 312 participants in Boston, Massachusetts, from Click to Connect, a study that examined the impact of an intervention that provided computers, Internet, and training to people from lower socioeconomic position (SEP). Data were gathered through pre- and posttest surveys and Internet use tracking software that generated approximately 13 million network activity files and more than 5.5 million records. Results Internet use increased among Intervention participants, with most of their time spent on social and participatory media sites or Internet portals. Differential patterns of use by gender and race/ethnicity were observed. Purposive searching for health information was low among all participants. Most of the visits to health-related sites were to local hospitals’ sites suggesting the influence of possible preexisting relationships and trust. Social networking sites were frequently visited, with three sites enjoying similar popularity among all groups. Conclusions Our data show that the availability of Internet can lead to significant increase in its use among low SEP groups. Low SEP members used the Internet for participation and engagement, but the sites visited differed by group. Harnessing the power of social networking sites and shareware sites may be a way to increase access to health information. PMID:24395992

Amnion and Chorion Allografts in Combination with Coronally Advanced Flap in the Treatment of Gingival Recession: A Clinical Study

PubMed Central

Chakraborthy, Sonali; Sambashivaiah, Savita; Bilchodmath, Shivaprasad

2015-01-01

Background Guided tissue regeneration (GTR) based root coverage using different allograft membranes has been utilized to correct gingival recession defects with promising results. Amnion and chorion allograft membranes of alternative origin derived from human placental tissue has been advocated in the treatment of gingival recession. However, chorion membrane has been used in combination with amnion membrane no study has compared these allograft membranes in the treatment of gingival recession. Therefore, the purpose of this study was to clinically evaluate and compare the efficacy of amnion membrane and chorion membrane in combination with coronally advanced flap in the treatment of gingival recessions. Materials and Methods Twelve systemically healthy patients having at least 2 bilateral Miller’s Class I or Class II gingival recession were recruited and coronally advanced flap was performed with amnion membrane or chorion membrane. Clinical parameters such as gingival Index, plaque index, length of the recession, width of the recession, width of keratinized gingiva, relative attachment level were evaluated at baseline, 3 and 6 months post-surgery. Results The mean decrease in length of recession (LR) for Chorion site was 2.00±1.54mm and amnion site was 1.58±1.14mm. The gain in attachment level for amnion site was 2.17±1.53mm and for chorion site was 1.58±1.22mm. The total mean percentage of root coverage was 34% for chorion site and 22% for amnion site. Conclusion Both amnion membrane and chorion membrane has shown to be versatile allograft material to be used in the treatment of root coverage. PMID:26501023

Invasion and Colonisation of a Tropical Stream by an Exotic Loricariid Fish: Indices of Gradual Displacement of the Native Common Pleco (Hypostomus punctatus) by the Red Fin Dwarf Pleco (Parotocinclus maculicauda) over Fifteen Years

PubMed Central

Mazzoni, Rosana; Costa da Silva, Raquel; Pinto, Míriam Plaza

2015-01-01

The introduction of invasive species represents a major threat to the integrity of stream-dwelling fish populations worldwide, and this issue is receiving increasing attention from scientists, in particular because of potential impact on biodiversity. In this study, we analysed the dispersal of an exotic loricariid fish the red fin dwarf pleco (Parotocinclus maculicauda) in a stream of the Atlantic Forest biome in coastal south-eastern Brazil and evaluated the effects of this invasion on the native loricariid common pleco (Hypostomus punctatus). Specimens were collected at eight sites located along the course of the stream over a 15-year period. The distribution and density of the two species were determined by the Successive Removal Method. The introduction of P. maculicauda occurred in the medium sector of the stream, and during the course of the study, the species dispersed to new sites further upstream. By the end of the study, it was found at all points upstream from the original site. Hypostomus punctatus was registered at all sample sites both before and after the introduction of P. maculicauda, but its density decreased at all upstream sites after the arrival of the exotic species. Our analysis shows that colonisation by P. maculicauda seems to have a negative effect on H. punctatus densities. The maintenance of H. punctatus densities at the sites not colonised by P. maculicauda reinforces the conclusion that the colonisation of the stream by the exotic species had deleterious effects on the density of the resident H. punctatus populations, either by direct or indirect action. PMID:26440412

Relationship between the components of on-site training and emotional intelligence in the librarians of Isfahan University of Medical Sciences and Isfahan University with moderating role of personality characteristics

PubMed Central

Sayadi, Saeed; Safdarian, Ali; Khayeri, Behnaz

2015-01-01

Introduction: Training the man power is an inevitable necessity that the organizations need in order to survive and develop in today changing world. Aims: The aim of the present study is to identify the relationship between the components of on-site training and emotional intelligence in librarians of Isfahan University of Medical Sciences and Isfahan University with moderating role of personality characteristics. Settings and Design: Descriptive correlation method was used in the present study. The statistical population of the study was all of the 157 librarians of Isfahan University of Medical Sciences and Isfahan University from whom the appointed individuals were selected through random sampling method. Subjects and Methods: The research tools included the researcher-made questionnaire of investigating the effectiveness of on-site training system and two other standard questionnaires of Shrink emotional intelligence, and NEO personality questionnaire, which all of them had the needed reliability and validity. Statistical Analysis: The descriptive indices (distribution and mean) and also the inferential methods (Pearson correlation, regression analysis and analysis of variance) were used through applying version 20 of SPSS software to analyze the obtained data. Results: There was a significant relationship with certainty level of 95% between the components of on-site training with emotional intelligence in those who obtained low grades in the features of being extrovert and between the individual aspects of on-site training with emotional intelligence in those who got higher grades in the characteristic of being extrovert. Conclusion: The emotional intelligence is a promotable skill and considering the existence of a significant relationship between some components of emotional intelligence and on-site training, these skills can be institutionalized through conducting mentioned educational courses. PMID:27462631

Quantification of carious pathogens in the interdental microbiota of young caries-free adults

PubMed Central

Inquimbert, Camille; Tramini, Paul; Molinari, Nicolas; Carrouel, Florence

2017-01-01

Background The majority of caries lesions in adults occur on the proximal tooth surfaces of the posterior teeth. A comprehensive study of the composition of the oral microbiota is fundamental for a better understanding of the etiology of interdental caries. Methods Twenty-five caries-free subjects (20–35 years old) were enrolled in the study. The interdental biofilm of four interdental sites were collected. The real-time polymerase chain reaction (PCR) methodology were used to quantify (i) the following bacteria: Streptococcus spp., Streptococcus mutans, Lactobacillus spp., Enterococcus spp., and Enterococcus faecalis; (ii) the fungus Candida albicans; and (iii) total bacteria. Results Streptococcus spp. was the most abundant species, followed by Lactobacillus spp. and Enterococcus spp. Streptococcus spp. and Lactobacillus spp. were detected at all tested sites and Enterococcus spp. at 99% of sites. S. mutans was detected at only 28% of the tested sites and C. albicans was detected at 11% of sites. E. faecalis was never detected. In 54.5% of the biofilm inhabited by C. albicans, S. mutans was present. Moreover, 28% of the ID sites co-expressed S. mutans and Lactobacillus spp. The studied pathogens were organized into two correlated groups of species. Strikingly, the fungus C. albicans and the bacteria Enterococcus spp. cluster together, whereas Streptococcus spp., S. mutans and Lactobacillus spp. form one distinct cluster. Conclusion The interdental biofilm of young caries-free adults is comprised of pathogens that are able to induce interproximal caries. That several of these pathogens are implicated in heart disease or other systemic diseases is an argument for the disruption of interdental biofilms using daily oral hygiene. PMID:29016613

An ex vivo human aqueous humor-concentration comparison of two commercial bromfenac formulations

PubMed Central

Walters, Thomas R; Smyth-Medina, Robert J; Cockrum, Paul C

2018-01-01

Purpose The purpose of this study was to quantify the concentration of bromfenac in the aqueous humor utilizing high-performance liquid chromatography mass spectrometry between two commercial nonsteroidal anti-inflammatory drugs, using aqueous humor concentrations to characterize pharmacokinetic proportional differences between 0.075% bromfenac ophthalmic solution in DuraSite (BromSite®) and 0.09% bromfenac ophthalmic solution (Bromday®). Methods In this multicenter, randomized, double-masked, two-arm, parallel-group, comparative, Phase II clinical trial, subjects were assigned to receive bromfenac in DuraSite or bromfenac ophthalmic solution in a 1:1 ratio. One drop of the masked test article was instilled into the study eye once a day for 2 days prior to and 3 hours prior (last instillation) to the subject’s cataract surgery. Aqueous humor samples were collected upon initial cataract incision for analysis of bromfenac levels. The primary end point was aqueous humor concentration of bromfenac at Day 3, at the initiation of cataract surgery. Aqueous humor samples were collected and analyzed for bromfenac levels. Results A total of 60 subjects completed the study, 30 in each group. The mean bromfenac aqueous humor concentration in subjects who received bromfenac in DuraSite was more than twice (49.33±41.87 ng/mL, P=0.004) that of subjects who received bromfenac ophthalmic solution (23.65±16.31 ng/mL) after three doses. Conclusion Mean bromfenac aqueous humor concentration in subjects receiving the DuraSite-containing bromfenac in DuraSite (0.075%) was significantly higher compared to subjects receiving bromfenac ophthalmic solution (0.09%) after 3 days of dosing. PMID:29849449

A spectroscopic study of phenylbutazone and aspirin bound to serum albumin in rheumatoid diseases

NASA Astrophysics Data System (ADS)

Maciążek-Jurczyk, M.; Sułkowska, A.; Bojko, B.; Równicka-Zubik, J.; Sułkowski, W. W.

2011-11-01

Interaction of phenylbutazone (PBZ) and aspirin (ASA), two drugs recommended in rheumatoid diseases (RDs), when binding to human (HSA) and bovine (BSA) serum albumins, has been studied by quenching of fluorescence and proton nuclear magnetic resonance ( 1HNMR) techniques. On the basis of spectrofluorescence measurements high affinity binding sites of PBZ and ASA on albumin as well as their interaction within the binding sites were described. A low affinity binding site has been studied by proton nuclear magnetic resonance spectroscopy. Using fluorescence spectroscopy the location of binding site in serum albumin (SA) for PBZ and ASA was found. Association constants Ka were determined for binary (i.e. PBZ-SA and ASA-SA) and ternary complexes (i.e. PBZ-[ASA]-SA and ASA-[PBZ]-SA). PBZ and ASA change the affinity of each other to the binding site in serum albumin (SA). The presence of ASA causes the increase of association constants KaI of PBZ-SA complex. Similarly, PBZ influences KaI of ASA-SA complex. This phenomenon shows that the strength of binding and the stability of the complexes increase in the presence of the second drug. The decrease of KaII values suggests that the competition between PBZ and ASA in binding to serum albumin in the second class of binding sites occurs. The analysis of 1HNMR spectral parameters i.e. changes of chemical shifts and relaxation times of the drug indicate that the presence of ASA weakens the interaction of PBZ with albumin. Similarly PBZ weakens the interaction of ASA with albumin. This conclusion points to the necessity of using a monitoring therapy owning to the possible increase of uncontrolled toxic effects.

Aquatic environmental assessment of Lake Balaton in the light of physical-chemical water parameters.

PubMed

Sebestyén, Vitkor; Németh, József; Juzsakova, Tatjana; Domokos, Endre; Kovács, Zsófia; Rédey, Ákos

2017-11-01

One of the issues of the Hungarian Water Management Strategy is the improvement and upgrading of the water of Lake Balaton. The Water Framework Directive (WFD) specifies and sets forth the achievement of the good ecological status. However, the assessment of the water quality of the lake as a complex system requires a comprehensive monitoring and evaluation procedure. Measurements were carried out around the Lake Balaton at ten different locations/sites and 13 physical-chemical parameters were monitored at each measurement site.For the interpretation of the water chemistry parameters the Aquatic Environmental Assessment (AEA) method devised by authors was used for the water body of the Lake Balaton. The AEA method can be used for all types of the water bodies since it is flexible and using individual weighting procedure for the water chemistry parameters comprehensive information can be obtain. The AEA method was compared with existing EIA methods according to a predefined criterion system and proved to be the most suitable tool for evaluating the environmental impacts in our study.On the basis of the results it can be concluded that the status of the quality of studied area on the Lake Balaton can be categorized as proper quality (from the outcome of the ten measurement sites this conclusion was reached at seven sites).

In Situ Evaluation of Crop Productivity and Bioaccumulation of Heavy Metals in Paddy Soils after Remediation of Metal-Contaminated Soils.

PubMed

Kim, Shin Woong; Chae, Yooeun; Moon, Jongmin; Kim, Dokyung; Cui, Rongxue; An, Gyeonghyeon; Jeong, Seung-Woo; An, Youn-Joo

2017-02-15

Soils contaminated with heavy metals have been reused for agricultural, building, and industrial uses following remediation. This study assesses plant growth and bioaccumulation of heavy metals following remediation of industrially contaminated soil. The soil was collected from a field site near a nonferrous smelter and was subjected to laboratory- and field-scale studies. Soil from the contaminated site was remediated by washing with acid or mixed with soil taken from a distant uncontaminated site. The activities of various soil exoenzymes, the rate of plant growth, and the bioaccumulations of six heavy metals were measured to assess the efficacy of these bioremediation techniques. Growth of rice (Oryza sativa) was unaffected in acid-washed soil or the amended soil compared to untreated soil from the contaminated site. The levels of heavy metals in the rice kernels remained within safe limits in treated and untreated soils. Rice, sorghum (Sorghum bicolor), and wheat (Triticum aestivum) cultivated in the same soils in the laboratory showed similar growth rates. Soil exoenzyme activities and crop productivity were not affected by soil treatment in field experiments. In conclusion, treatment of industrially contaminated soil by acid washing or amendment did not adversely affect plant productivity or lead to increased bioaccumulation of heavy metals in rice.

Integrating a Suicide Prevention Program into the Primary Health Care Network: A Field Trial Study in Iran

PubMed Central

Malakouti, Seyed Kazem; Nojomi, Marzieh; Poshtmashadi, Marjan; Hakim Shooshtari, Mitra; Mansouri Moghadam, Fariba; Rahimi-Movaghar, Afarin; Afghah, Susan; Bolhari, Jafar; Bazargan-Hejazi, Shahrzad

2015-01-01

Objective. To describe and evaluate the feasibility of integrating a suicide prevention program with Primary Health Care services and evaluate if such system can improve screening and identification of depressive disorder, reduce number of suicide attempters, and lower rate of suicide completion. Methodology. This was a quasi-experimental trial in which one community was exposed to the intervention versus the control community with no such exposure. The study sites were two counties in Western Iran. The intervention protocol called for primary care and suicide prevention collaboration at different levels of care. The outcome variables were the number of suicides committed, the number of documented suicide attempts, and the number of identified depressed cases. Results. We identified a higher prevalence of depressive disorders in the intervention site versus the control site (χ 2 = 14.8, P < 0.001). We also found a reduction in the rate of suicide completion in the intervention region compared to the control, but a higher prevalence of suicide attempts in both the intervention and the control sites. Conclusion. Integrating a suicide prevention program with the Primary Health Care network enhanced depression and suicide surveillance capacity and subsequently reduced the number of suicides, especially in rural areas. PMID:25648221

Center variation in the delivery of indicated late preterm births

PubMed Central

Aliaga, Sofia; Zhang, Jun; Long, D. Leann; Herring, Amy H.; Laughon, Matthew; Boggess, Kim; Reddy, Uma M.; Grantz, Katherine Laughon

2016-01-01

Objective Evidence for optimal timing of delivery for some pregnancy complications at late preterm gestation is limited. The purpose of this study was to identify center variation of indicated late preterm births. Study design Analysis of singleton late preterm and term births from a large U.S. retrospective obstetrical cohort. Births associated with spontaneous preterm labor, major congenital anomalies, chorioamnionitis, and emergency cesarean were excluded. We used modified Poisson fixed effects logistic regression with interaction terms to assess center variation of indicated late preterm births associated with four medical/obstetric comorbidities after adjusting for socio-demographics, co-morbidities, and hospital/provider characteristics. Results We identified 150,055 births from 16 hospitals; 9218 were indicated late preterm births. We found wide variation of indicated late preterm births across hospitals. The extent of center variation was greater for births associated with preterm premature rupture of membranes (RR across sites: 0.45 – 3.05), hypertensive disorders of pregnancy (RR across sites: 0.36 – 1.27), and placenta previa/abruption (RR across sites: 0.48 – 1.82). We found less center variation for births associated with diabetes (RR across sites: 0.65 – 1.39). Conclusion Practice variation in the management of indicated late preterm deliveries might be a source of preventable late preterm birth. PMID:27120474

Application of remote sensor data to geologic analysis of the Bonanza test site, Colorado

NASA Technical Reports Server (NTRS)

Lee, K. (Compiler)

1972-01-01

A variety of remote sensor data has aided geologic mapping in central Colorado. This report summarizes the application of sensor data to both regional and local geologic mapping and presents some conclusions on the practical use of remote sensing for solving geologic mapping problems. It is emphasized that this study was not conducted primarily to test or evaluate remote sensing systems or data, but, rather, to apply sensor data as an accessory tool for geologic mapping. The remote sensor data used were acquired by the NASA Earth Observations Aircraft Program. Conclusions reached on the utility of the various sensor data and interpretation techniques for geologic mapping were by-products of attempts to use them.

An evaluation of the behaviour-change techniques used on Canadian cancer centre Web sites to support physical activity behaviour for breast cancer survivors

PubMed Central

Sylvester, B.D.; Zammit, K.; Fong, A.J.; Sabiston, C.M.

2017-01-01

Background Cancer centre Web sites can be a useful tool for distributing information about the benefits of physical activity for breast cancer (bca) survivors, and they hold potential for supporting health behaviour change. However, the extent to which cancer centre Web sites use evidence-based behaviour change techniques to foster physical activity behaviour among bca survivors is currently unknown. The aim of our study was to evaluate the presentation of behaviour-change techniques on Canadian cancer centre Web sites to promote physical activity behaviour for bca survivors. Methods All Canadian cancer centre Web sites (n = 39) were evaluated by two raters using the Coventry, Aberdeen, and London–Refined (calo-re) taxonomy of behaviour change techniques and the eEurope 2002 Quality Criteria for Health Related Websites. Descriptive statistics were calculated. Results The most common behaviour change techniques used on Web sites were providing information about consequences in general (80%), suggesting goal-setting behaviour (56%), and planning social support or social change (46%). Overall, Canadian cancer centre Web sites presented an average of M = 6.31 behaviour change techniques (of 40 that were coded) to help bca survivors increase their physical activity behaviour. Evidence of quality factors ranged from 90% (sites that provided evidence of readability) to 0% (sites that provided an editorial policy). Conclusions Our results provide preliminary evidence that, of 40 behaviour-change techniques that were coded, fewer than 20% were used to promote physical activity behaviour to bca survivors on cancer centre Web sites, and that the most effective techniques were inconsistently used. On cancer centre Web sites, health promotion specialists could focus on emphasizing knowledge mobilization efforts using available research into behaviour-change techniques to help bca survivors increase their physical activity. PMID:29270056

The Effect of Top-Level Domains and Advertisements on Health Web Site Credibility

PubMed Central

Wang, Zuoming; Loh, Tracy

2004-01-01

Background Concerns over health information on the Internet have generated efforts to enhance credibility markers; yet how users actually assess the credibility of online health information is largely unknown. Objective This study set out to (1) establish a parsimonious and valid questionnaire instrument to measure credibility of Internet health information by drawing on various previous measures of source, news, and other credibility scales; and (2) to identify the effects of Web-site domains and advertising on credibility perceptions. Methods Respondents (N = 156) examined one of 12 Web-site mock-ups and completed credibility scales in a 3 x 2 x 2 between-subjects experimental design. Factor analysis and validity checks were used for item reduction, and analysis of variance was employed for hypothesis testing of Web-site features' effects. Results In an attempt to construct a credibility instrument, three dimensions of credibility (safety, trustworthiness, and dynamism) were retained, reflecting traditional credibility sub-themes, but composed of items from disparate sources. When testing the effect of the presence or absence of advertising on a Web site on credibility, we found that this depends on the site's domain, with a trend for advertisements having deleterious effects on the credibility of sites with .org domain, but positive effects on sites with .com or .edu domains. Conclusions Health-information Web-site providers should select domains purposefully when they can, especially if they must accept on-site advertising. Credibility perceptions may not be invariant or stable, but rather are sensitive to topic and context. Future research may employ these findings in order to compare other forms of health-information delivery to optimal Web-site features. PMID:15471750

Governance for clinical decision support: case studies and recommended practices from leading institutions

PubMed Central

Sittig, Dean F; Ash, Joan S; Bates, David W; Feblowitz, Joshua; Fraser, Greg; Maviglia, Saverio M; McMullen, Carmit; Nichol, W Paul; Pang, Justine E; Starmer, Jack; Middleton, Blackford

2011-01-01

Objective Clinical decision support (CDS) is a powerful tool for improving healthcare quality and ensuring patient safety; however, effective implementation of CDS requires effective clinical and technical governance structures. The authors sought to determine the range and variety of these governance structures and identify a set of recommended practices through observational study. Design Three site visits were conducted at institutions across the USA to learn about CDS capabilities and processes from clinical, technical, and organizational perspectives. Based on the results of these visits, written questionnaires were sent to the three institutions visited and two additional sites. Together, these five organizations encompass a variety of academic and community hospitals as well as small and large ambulatory practices. These organizations use both commercially available and internally developed clinical information systems. Measurements Characteristics of clinical information systems and CDS systems used at each site as well as governance structures and content management approaches were identified through extensive field interviews and follow-up surveys. Results Six recommended practices were identified in the area of governance, and four were identified in the area of content management. Key similarities and differences between the organizations studied were also highlighted. Conclusion Each of the five sites studied contributed to the recommended practices presented in this paper for CDS governance. Since these strategies appear to be useful at a diverse range of institutions, they should be considered by any future implementers of decision support. PMID:21252052

Assessing the Validity of Self-Rated Health with the Short Physical Performance Battery: A Cross-Sectional Analysis of the International Mobility in Aging Study

PubMed Central

Belanger, Emmanuelle; Zunzunegui, Maria–Victoria; Phillips, Susan; Ylli, Alban; Guralnik, Jack

2016-01-01

Objective The aim of this study was to explore the validity of self-rated health across different populations of older adults, when compared to the Short Physical Performance Battery. Design Cross-sectional analysis of the International Mobility in Aging Study. Setting Five locations: Saint-Hyacinthe and Kingston (Canada), Tirana (Albania), Manizales (Colombia), and Natal (Brazil). Participants Older adults between 65 and 74 years old (n = 1,995). Methods The Short Physical Performance Battery (SPPB) was used to measure physical performance. Self-rated health was assessed with one single five-point question. Linear trends between SPPB scores and self-rated health were tested separately for men and women at each of the five international study sites. Poor physical performance (independent variable) (SPPB less than 8) was used in logistic regression models of self-rated health (dependent variable), adjusting for potential covariates. All analyses were stratified by gender and site of origin. Results A significant linear association was found between the mean scores of the Short Physical Performance Battery and ordinal categories of self-rated health across research sites and gender groups. After extensive control for objective physical and mental health indicators and socio-demographic variables, these graded associations became non-significant in some research sites. Conclusion These findings further confirm the validity of SRH as a measure of overall health status in older adults. PMID:27089219

Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never Events.

PubMed

Hempel, Susanne; Maggard-Gibbons, Melinda; Nguyen, David K; Dawes, Aaron J; Miake-Lye, Isomi; Beroes, Jessica M; Booth, Marika J; Miles, Jeremy N V; Shanman, Roberta; Shekelle, Paul G

2015-08-01

Serious, preventable surgical events, termed never events, continue to occur despite considerable patient safety efforts. To examine the incidence and root causes of and interventions to prevent wrong-site surgery, retained surgical items, and surgical fires in the era after the implementation of the Universal Protocol in 2004. We searched 9 electronic databases for entries from 2004 through June 30, 2014, screened references, and consulted experts. Two independent reviewers identified relevant publications in June 2014. One reviewer used a standardized form to extract data and a second reviewer checked the data. Strength of evidence was established by the review team. Data extraction was completed in January 2015. Incidence of wrong-site surgery, retained surgical items, and surgical fires. We found 138 empirical studies that met our inclusion criteria. Incidence estimates for wrong-site surgery in US settings varied by data source and procedure (median estimate, 0.09 events per 10,000 surgical procedures). The median estimate for retained surgical items was 1.32 events per 10,000 procedures, but estimates varied by item and procedure. The per-procedure surgical fire incidence is unknown. A frequently reported root cause was inadequate communication. Methodologic challenges associated with investigating changes in rare events limit the conclusions of 78 intervention evaluations. Limited evidence supported the Universal Protocol (5 studies), education (4 studies), and team training (4 studies) interventions to prevent wrong-site surgery. Limited evidence exists to prevent retained surgical items by using data-matrix-coded sponge-counting systems (5 pertinent studies). Evidence for preventing surgical fires was insufficient, and intervention effects were not estimable. Current estimates for wrong-site surgery and retained surgical items are 1 event per 100,000 and 1 event per 10,000 procedures, respectively, but the precision is uncertain, and the per-procedure prevalence of surgical fires is not known. Root-cause analyses suggest the need for improved communication. Despite promising approaches and global Universal Protocol evaluations, empirical evidence for interventions is limited.

Increasing Efficiency of Recruitment in Early Parkinson’s Disease Trials: A Case Study Examination of the STEADY-PD III Trial

PubMed Central

Berk, Sarah; Greco, Brittany L.; Biglan, Kevin; Kopil, Catherine M.; Holloway, Robert G.; Meunier, Claire; Simuni, Tanya

2017-01-01

Background: Challenges in clinical trial recruitment threaten the successful development of improved therapies. This is particularly true in Parkinson’s disease (PD) studies of disease modification where the population of interest is difficult to find and study design is more complex. Objective: This paper seeks to understand how STEADY PD III, a National Institute of Neurological Disorders and Stroke (NINDS) funded phase 3 trial evaluating the efficacy of isradipine as a disease modifying agent for PD, was able to recruit their full target population 6 months ahead of schedule. Methods: STEADY PD III aimed to enroll 336 individuals with early stage idiopathic PD within 18 months using 57 sites across the United States and Canada. The study included a 10% NIH minority recruitment goal. Eligible participants agreed to be followed for up to 36 months, complete 12 in-person visits and 4 telephone visits. A Recruitment Committee of key stakeholders was critical in the development of a comprehensive recruitment strategy involving: multi-modal outreach, protocol modifications and comprehensive site selection and activation. Efforts to increase site-specific minority recruitment strategies were encouraged through additional funding. Results: A total of 336 individuals, including 34 minorities, were enrolled within 12 months – 6 months ahead of the projected timeline. Quantitative analysis of recruitment activity questionnaires found that of the sites that completed them (n = 54), (20.4%) met goals, (24.1%) exceeded goals, and (55.6%) fell below projected goals. Referral sources completed at time of screening indicate top four study referral sources as: site personnel (53.8%); neurologists (24%); Fox Trial Finder (10.2%); and communications from The Michael J. Fox Foundation (3.9%). Conclusions: STEADY PD III serves as an important example of methods that can be used to increase clinical trial recruitment. This research highlights a continued need to improve site infrastructure and dedicate more resources to increased participation of minorities in clinical research. PMID:29103052

[Current status of illegal trade in pharmaceutical products on Internet auction sites in Japan and responses of site administrators to such transactions].

PubMed

Ohtani, Hisakazu; Imaoka, Ayuko; Akiyoshi, Takeshi

2015-01-01

In Japan, it is illegal to sell pharmaceuticals on Internet auction sites, although a considerable number of pharmaceuticals are listed on such sites. We investigated the current situation regarding the illegal trade in pharmaceuticals on Japanese Internet auction sites and the responses of site administrators to such transactions. We searched for pharmaceuticals and "gray" items that were suspected of being pharmaceuticals on Yahoo-oku! (Yahoo! Auctions, Japan) over a 37-day period and then submitted violation reports indicating that selling pharmaceuticals is illegal or that the description of an item was insufficient. The reports were directed to the site administrators and forwarded to the sellers. One hundred and six pharmaceutical products and 34 gray items were identified during the study period. After the submission of the violation reports, only 28 of the pharmaceutical products and one of the gray items were deleted by the administrator, while 18 of the pharmaceutical products and 7 of the gray items were withdrawn by their sellers. However, 41 pharmaceuticals and 20 gray items were sold. Most of the gray items were listed using characteristic terms or abbreviations without photographic images. More than 70% of the identified pharmaceuticals had a contraindication(s) other than hypersensitivity. In conclusion, the illegal trade in pharmaceuticals on Internet auction sites remains a serious problem in Japan, and the responses of site administrators to such transactions are inadequate. The government and pharmaceutical industry may have to take measures such as providing public and administrative guidance to stop the illegal trade in pharmaceuticals on the Internet.

Thyroid Disease and Surgery in CHEER: The Nation’s Otolaryngology-Head and Neck Surgery Practice Based Network

PubMed Central

Parham, Kourosh; Chapurin, Nikita; Schulz, Kris; Shin, Jennifer J.; Pynnonen, Melissa A.; Witsell, David L.; Langman, Alan; Nguyen-Huynh, Anh; Ryan, Sheila E.; Vambutas, Andrea; Wolfley, Anne; Roberts, Rhonda; Lee, Walter T.

2017-01-01

Objectives 1) Describe thyroid-related diagnoses and procedures in CHEER across academic and community sites. 2) Compare management of malignant thyroid disease across these sites, and 3) Provide practice based data related to flexible laryngoscopy vocal fold assessment before and after thyroid surgery based on AAO-HNSF Clinical Practice Guidelines. Study Design Review of retrospective data collection (RDC) database of the CHEER network using ICD-9 and CPT codes related to thyroid conditions. Setting Multisite practice based network. Subjects and Methods There were 3,807 thyroid patients (1,392 malignant; 2,415 benign) with 10,160 unique visits identified from 1 year of patient data in the RDC. Analysis was performed for identified cohort of patients using demographics, site characteristics and diagnostic and procedural distribution. Results Mean number of patients with thyroid disease per site was 238 (range 23–715). In community practices, 19% of patients with thyroid disease had cancer versus 45% in the academic setting (p<0.001). While academic sites manage more cancer patients, community sites are also surgically treating thyroid cancer, and performed more procedures per cancer patient (4.2 vs. 3.5, p<0.001). Vocal fold function was assessed by flexible laryngoscopy in 34.0% of pre-operative patients and in 3.7% post-operatively. Conclusion This is the first overview of malignant and benign thyroid disease through CHEER. It shows how the RDC can be used alone and with national guidelines to inform of clinical practice patterns in academic and community sites. This demonstrates the potential for future thyroid related studies utilizing the Otolaryngology-H&N Surgery’s practice-based research network. PMID:27371622

Management of Chronic Periodontitis Using Subgingival Irrigation of Ozonized Water: A Clinical and Microbiological Study

PubMed Central

Mathew, Jayan Jacob; Ambooken, Majo; Kachappilly, Arun Jose; PK, Ajithkumar; Johny, Thomas; VK, Linith; Samuel, Anju

2015-01-01

Introduction Adjunctive use of professional subgingival irrigation with scaling and root planing (SRP) has been found to be beneficial in eradicating the residual microorganisms in the pocket. Objective To evaluate the effect of ozonized water subgingival irrigation on microbiologic parameters and clinical parameters namely Gingival index, probing pocket depth, and clinical attachment level. Materials and Methods Thirty chronic periodontitis patients with probing pocket depth ≥6mm on at least one tooth on contra lateral sides of opposite arches were included in the study. The test sites were subjected to ozonized water subgingival irrigation with subgingival irrigation device fitted with a modified subgingival tip. Control sites were subjected to scaling and root planing only. The following clinical parameters were recorded initially and after 4 weeks at the test sites and control sites. Plaque Index, Gingival Index, probing pocket depth, clinical attachment level. Microbiologic sampling was done for the test at the baseline, after scaling, immediately after ozonized water subgingival irrigation and after 4 weeks. In control sites microbiologic sampling was done at the baseline, after scaling and after 4 weeks. The following observations were made after 4 weeks. The results were statistically analysed using independent t-test and paired t-test. Result Test sites showed a greater reduction in pocket depth and gain in clinical attachment compared to control sites. The total anaerobic counts were significantly reduced by ozonized water subgingival irrigation along with SRP compared to SRP alone. Conclusion Ozonized water subgingival irrigation can improve the clinical and microbiological parameters in patients with chronic periodontitis when used as an adjunct to scaling and root planing. PMID:26436042

A Medical Consultation Service on Facebook: Descriptive Analysis of Questions Answered

PubMed Central

2014-01-01

Background Social media is used increasingly by the general public to access health information. However, a lack of models for health information distribution limits the presence of publicly funded services on social media sites. Objective The goal of the study was to present a model for delivering child health information to parents through a social media site. Methods A Facebook site was launched for 11 months based on a question-and-answer service produced by a pediatrician and open to Facebook users over 18 years old. If the answer did not include a further referral to a health care service provider, the question was considered comprehensively answered. The site was funded by a pharmaceutical company, and it included an advertisement of a pharmaceutical product for children’s fever and pain. Results During the study, 768 questions were submitted: an average of 69.8 (SD 31.7) per month. There were 245,533 independent Facebook users on the site, with an average of 727.0 (SD 2280.6) per day. Infections were the most common theme in questions (355/768, 46.2%). Questions were more likely to be comprehensively answered if they were related to infections (279/355, 78.6%) than questions related to non-infectious symptoms (265/423, 64.2%, P=.003). Conclusions On this site aimed at parents of small children, personalized answers were an effective way of delivering information. The service is likely to have reduced the need for further contacts with a health care service provider in more than half of the cases. The site could serve as a model for publicly funded health information distribution. PMID:25189182

Morphological and molecular diversity of arbuscular mycorrhizal fungi in revegetated iron-mining site has the same magnitude of adjacent pristine ecosystems.

PubMed

Vieira, Caroline Krug; Marascalchi, Matheus Nicoletti; Rodrigues, Arthur Vinicius; de Armas, Rafael Dutra; Stürmer, Sidney Luiz

2018-05-01

Arbuscular mycorrhizal fungi (AMF) are important during revegetation of mining sites, but few studies compared AMF community in revegetated sites with pristine adjacent ecosystems. The aim of this study was to assess AMF species richness in a revegetated iron-mining site and adjacent ecosystems and to relate AMF occurrence to soil chemical parameters. Soil samples were collected in dry and rainy seasons in a revegetated iron-mining site (RA) and compared with pristine ecosystems of forest (FL), canga (NG), and Cerrado (CE). AMF species were identified by spore morphology from field and trap cultures and by LSU rDNA sequencing using Illumina. A total of 62 AMF species were recovered, pertaining to 18 genera and nine families of Glomeromycota. The largest number of species and families were detected in RA, and Acaulospora mellea and Glomus sp1 were the most frequent species. Species belonging to Glomeraceae and Acaulosporaceae accounted for 42%-48% of total species richness. Total number of spores and mycorrhizal inoculum potential tended to be higher in the dry than in the rainy season, except in RA. Sequences of uncultured Glomerales were dominant in all sites and seasons and five species were detected exclusively by DNA-based identification. Redundancy analysis evidenced soil pH, organic matter, aluminum, and iron as main factors influencing AMF presence. In conclusion, revegetation of the iron-mining site seems to be effective in maintaining a diverse AMF community and different approaches are complementary to reveal AMF species, despite the larger number of species being identified by traditional identification of field spores. Copyright © 2017. Published by Elsevier B.V.

How Does Salinity Shape Bacterial and Fungal Microbiomes of Alnus glutinosa Roots?

PubMed Central

Thiem, Dominika; Gołębiewski, Marcin; Hulisz, Piotr; Piernik, Agnieszka; Hrynkiewicz, Katarzyna

2018-01-01

Black alder (Alnus glutinosa Gaertn.) belongs to dual mycorrhizal trees, forming ectomycorrhizal (EM) and arbuscular (AM) root structures, as well as represents actinorrhizal plants that associate with nitrogen-fixing actinomycete Frankia sp. We hypothesized that the unique ternary structure of symbionts can influence community structure of other plant-associated microorganisms (bacterial and fungal endophytes), particularly under seasonally changing salinity in A. glutinosa roots. In our study we analyzed black alder root bacterial and fungal microbiome present at two forest test sites (saline and non-saline) in two different seasons (spring and fall). The dominant type of root microsymbionts of alder were ectomycorrhizal fungi, whose distribution depended on site (salinity): Tomentella, Lactarius, and Phialocephala were more abundant at the saline site. Mortierella and Naucoria (representatives of saprotrophs or endophytes) displayed the opposite tendency. Arbuscular mycorrhizal fungi belonged to Glomeromycota (orders Paraglomales and Glomales), however, they represented less than 1% of all identified fungi. Bacterial community structure depended on test site but not on season. Sequences affiliated with Rhodanobacter, Granulicella, and Sphingomonas dominated at the saline site, while Bradyrhizobium and Rhizobium were more abundant at the non-saline site. Moreover, genus Frankia was observed only at the saline site. In conclusion, bacterial and fungal community structure of alder root microsymbionts and endophytes depends on five soil chemical parameters: salinity, phosphorus, pH, saturation percentage (SP) as well as total organic carbon (TOC), and seasonality does not appear to be an important factor shaping microbial communities. Ectomycorrhizal fungi are the most abundant symbionts of mature alders growing in saline soils. However, specific distribution of nitrogen-fixing Frankia (forming root nodules) and association of arbuscular fungi at early stages of plant development should be taken into account in further studies. PMID:29720967

How Does Salinity Shape Bacterial and Fungal Microbiomes of Alnus glutinosa Roots?

PubMed

Thiem, Dominika; Gołębiewski, Marcin; Hulisz, Piotr; Piernik, Agnieszka; Hrynkiewicz, Katarzyna

2018-01-01

Black alder ( Alnus glutinosa Gaertn.) belongs to dual mycorrhizal trees, forming ectomycorrhizal (EM) and arbuscular (AM) root structures, as well as represents actinorrhizal plants that associate with nitrogen-fixing actinomycete Frankia sp. We hypothesized that the unique ternary structure of symbionts can influence community structure of other plant-associated microorganisms (bacterial and fungal endophytes), particularly under seasonally changing salinity in A. glutinosa roots. In our study we analyzed black alder root bacterial and fungal microbiome present at two forest test sites (saline and non-saline) in two different seasons (spring and fall). The dominant type of root microsymbionts of alder were ectomycorrhizal fungi, whose distribution depended on site (salinity): Tomentella , Lactarius , and Phialocephala were more abundant at the saline site. Mortierella and Naucoria (representatives of saprotrophs or endophytes) displayed the opposite tendency. Arbuscular mycorrhizal fungi belonged to Glomeromycota (orders Paraglomales and Glomales), however, they represented less than 1% of all identified fungi. Bacterial community structure depended on test site but not on season. Sequences affiliated with Rhodanobacter , Granulicella , and Sphingomonas dominated at the saline site, while Bradyrhizobium and Rhizobium were more abundant at the non-saline site. Moreover, genus Frankia was observed only at the saline site. In conclusion, bacterial and fungal community structure of alder root microsymbionts and endophytes depends on five soil chemical parameters: salinity, phosphorus, pH, saturation percentage (SP) as well as total organic carbon (TOC), and seasonality does not appear to be an important factor shaping microbial communities. Ectomycorrhizal fungi are the most abundant symbionts of mature alders growing in saline soils. However, specific distribution of nitrogen-fixing Frankia (forming root nodules) and association of arbuscular fungi at early stages of plant development should be taken into account in further studies.

Adapting the Content of Cancer Web Sites to the Information Needs of Patients: Reliability and Readability

PubMed Central

Bermúdez-Tamayo, Clara; Pernett, Jaime Jiménez; Garcia-Gutierrez, Jose Francisco; Cózar-Olmo, José Manuel; Valero-Aguilera, Beatriz

2013-01-01

Abstract Background: People who use the Internet to research health topics do not usually find all the information they need and do not trust what they read. This study was designed to assess the reliability, accessibility, readability, and popularity of cancer Web sites in Spanish and to analyze the suitability of Web site content in accordance with the specific information needs of cancer patients. Materials and Methods: This was a two-phase, cross-sectional, descriptive study. The first phase involved data gathering through online searches and direct observation. The second phase involved individual structured interviews with 169 patients with breast, prostate, bladder, and kidney cancer. Spearman rank correlations were calculated between variables. Results: Most sites belonged to nonprofit organizations, followed by universities or medical centers (14%). Thirty-one percent of the Web sites had quality seals, 59% provided details of authorship, 62% provided references to bibliographic sources, 38% identified their funding sources, and 54% showed the date of their last update. Twenty-one percent of the Web sites did not meet the minimum accessibility criteria. With regard to readability, 24% of the texts were considered to be “quite difficult.” Patients' information needs vary depending on the type of cancer they have, although all patients want to know about the likelihood of a cure, survival rates, the side effects, and risks of treatment. Conclusions: The health information on cancer available on the Internet in Spanish is not very reliable, accessible, or readable and is not necessarily the information that breast, kidney, prostate, and bladder cancer patients require. The content of cancer Web sites needs to be assessed according to the information needs of patients. PMID:24073899

Pattern similarity study of functional sites in protein sequences: lysozymes and cystatins

PubMed Central

Nakai, Shuryo; Li-Chan, Eunice CY; Dou, Jinglie

2005-01-01

Background Although it is generally agreed that topography is more conserved than sequences, proteins sharing the same fold can have different functions, while there are protein families with low sequence similarity. An alternative method for profile analysis of characteristic conserved positions of the motifs within the 3D structures may be needed for functional annotation of protein sequences. Using the approach of quantitative structure-activity relationships (QSAR), we have proposed a new algorithm for postulating functional mechanisms on the basis of pattern similarity and average of property values of side-chains in segments within sequences. This approach was used to search for functional sites of proteins belonging to the lysozyme and cystatin families. Results Hydrophobicity and β-turn propensity of reference segments with 3–7 residues were used for the homology similarity search (HSS) for active sites. Hydrogen bonding was used as the side-chain property for searching the binding sites of lysozymes. The profiles of similarity constants and average values of these parameters as functions of their positions in the sequences could identify both active and substrate binding sites of the lysozyme of Streptomyces coelicolor, which has been reported as a new fold enzyme (Cellosyl). The same approach was successfully applied to cystatins, especially for postulating the mechanisms of amyloidosis of human cystatin C as well as human lysozyme. Conclusion Pattern similarity and average index values of structure-related properties of side chains in short segments of three residues or longer were, for the first time, successfully applied for predicting functional sites in sequences. This new approach may be applicable to studying functional sites in un-annotated proteins, for which complete 3D structures are not yet available. PMID:15904486

Drinking Water in California Child Care Sites Before and After 2011–2012 Beverage Policy

PubMed Central

Yoshida, Sallie; Sharma, Sushma; Patel, Anisha; Vitale, Elyse Homel; Hecht, Ken

2015-01-01

Introduction Drinking water is promoted to improve beverage nutrition and reduce the prevalence of obesity. The aims of this study were to identify how water was provided to young children in child care and to determine the extent to which water access changed after a federal and state child care beverage policy was instituted in 2011 and 2012 in California. Methods Two independent cross-sectional samples of licensed child care providers completed a self-administered survey in 2008 (n = 429) and 2012 (n = 435). Logistic regression was used to analyze data for differences between 2008 and 2012 survey responses, after adjustment for correlations among the measurements in each of 6 child care categories sampled. Results A significantly larger percentage of sites in 2012 than in 2008 always served water at the table with meals or snacks (47.0% vs 28.0%, P = .001). A significantly larger percentage of child care sites in 2012 than in 2008 made water easily and visibly available for children to self-serve both indoors (77.9% vs 69.0%, P = .02) and outside (78.0% vs 69.0%, P = .03). Sites that participated in the federal Child and Adult Care Food Program had greater access to water indoors and outside than sites not in the program. In 2012 most (76.1%) child care providers reported no barriers to serving water to children. Factors most frequently cited to facilitate serving water were information for families (39.0% of sites), beverage policy (37.0%), and lessons for children (37.9%). Conclusion Water provision in California child care improved significantly between samples of sites studied in 2008 and 2012, but room for improvement remains after policy implementation. Additional training for child care providers and parents should be considered. PMID:26043304

Time-resolved absorbance changes induced by fast acidification of bacteriorhodopsin in vesicle systems.

PubMed Central

Druckmann, S; Ottolenghi, M; Korenstein, R

1985-01-01

The direction of the accessibility to protons of the binding site in bacteriorhodopsin is of primary importance in elucidating the proton-pump mechanism. The problem is approached via the pH-dependent equilibrium bR560 in equilibrium bR605 in vesicles with preferentially oriented purple membranes. Fast acidification (stopped-flow) experiments with inside-out, monomeric, bR vesicles were carried out with and without a buffer enclosed in the vesicle interior. The results, showing a buffer-induced delay in the formation of bR605, indicate that the binding site is accessible to protons from the inside of the vesicles. We arrive at this conclusion also by working with inside-out trimeric vesicles in the presence and in the absence of H+ (and K+) ionophores. The results suggest that in Halobacterium halobium, the binding site and thus the retinal Schiff base are exposed to the outside of the cell. This conclusion is consistent with a pumping mechanism based on a light-induced pK change. PMID:3978185

Entanglement entropy and fidelity susceptibility in the one-dimensional spin-1 XXZ chains with alternating single-site anisotropy.

PubMed

Ren, Jie; Liu, Guang-Hua; You, Wen-Long

2015-03-18

We study the fidelity susceptibility in an antiferromagnetic spin-1 XXZ chain numerically. By using the density-matrix renormalization group method, the effects of the alternating single-site anisotropy D on fidelity susceptibility are investigated. Its relation with the quantum phase transition is analyzed. It is found that the quantum phase transition from the Haldane spin liquid to periodic Néel spin solid can be well characterized by the fidelity. Finite size scaling of fidelity susceptibility shows a power-law divergence at criticality, which indicates the quantum phase transition is of second order. The results are confirmed by the second derivative of the ground-state energy. We also study the relationship between the entanglement entropy, the Schmidt gap and quantum phase transitions. Conclusions drawn from these quantum information observables agree well with each other.

Solution of naturally-ocurring glasses in the geological environment

NASA Technical Reports Server (NTRS)

Glass, B. P.

1982-01-01

As part of a study to investigate the feasibility of putting nuclear wastes in glass containers and burying them on land or dumping them in the ocean, the amount of solution experience by naturally occurring glasses from two land sites and thirty-four deep sea sites was studied. The glasses are microtektites from three strewn fields and from the Zhamanshin impact crater. The microtektites range in age from 0.7 to 35 m.y. and have a wide range in composition. The weight percent SiO2, for example, ranges from 44.8 to 81.7. Although several criteria for determining the amount of solution were considered, most of the conclusions are based on two criteria: (1) width of cracks, and (2) elevation of silica rich inclusions above the adjacent microtektite surface. All the measurements were made on scanning electron microscope photomicrographs of the microtektites.

Examining Primary Healthcare Performance through a Triple Aim Lens

PubMed Central

Ryan, Bridget L.; Brown, Judith Belle; Glazier, Richard H.; Hutchison, Brian

2016-01-01

Purpose: This study sought to apply a Triple Aim framework to the measurement and evaluation of primary healthcare (PHC) team performance. Methods: Triple Aim components were populated with 10 dimensions derived from survey and health administrative data for 17 Family Health Teams (FHTs) in Ontario, Canada. Bivariate analyses and rankings of sites examined the relationships among dimensions and among Triple Aim components. Results: Readily available measures to fully populate the Triple Aim framework were lacking in FHTs. Within sites, there was little consistency in performance across the Triple Aim components (health, patient experience and cost). Conclusions: More and better measures are needed that can be readily used to examine the Triple Aim performance in PHC teams. FHTs, in this study, are partially achieving Triple Aim goals; however, there was a lack of consistency in performance. It is essential to collect appropriate measures and attend to performance across all components of the Triple Aim. PMID:27027790

Structure-Based Design of Inhibitors Targeting PrfA, the Master Virulence Regulator of Listeria monocytogenes.

PubMed

Kulén, Martina; Lindgren, Marie; Hansen, Sabine; Cairns, Andrew G; Grundström, Christin; Begum, Afshan; van der Lingen, Ingeborg; Brännström, Kristoffer; Hall, Michael; Sauer, Uwe H; Johansson, Jörgen; Sauer-Eriksson, A Elisabeth; Almqvist, Fredrik

2018-05-10

Listeria monocytogenes is a bacterial pathogen that controls much of its virulence through the transcriptional regulator PrfA. In this study, we describe structure-guided design and synthesis of a set of PrfA inhibitors based on ring-fused 2-pyridone heterocycles. Our most effective compound decreased virulence factor expression, reduced bacterial uptake into eukaryotic cells, and improved survival of chicken embryos infected with L. monocytogenes compared to previously identified compounds. Crystal structures identified an intraprotein "tunnel" as the main inhibitor binding site (A I ), where the compounds participate in an extensive hydrophobic network that restricts the protein's ability to form functional DNA-binding helix-turn-helix (HTH) motifs. Our studies also revealed a hitherto unsuspected structural plasticity of the HTH motif. In conclusion, we have designed 2-pyridone analogues that function as site-A I selective PrfA inhibitors with potent antivirulence properties.

Health Care Delivery Practices in Huntington’s Disease Specialty Clinics: An International Survey

PubMed Central

Frich, Jan C.; Rae, Daniela; Roxburgh, Richard; Miedzybrodzka, Zofia H.; Edmondson, Mary; Pope, Erika Bjorklund; Goodman, LaVonne; Haddad, Monica S.; Giuliano, Joe; Nelson, Eugene C.; Guttman, Mark; Nance, Martha

2016-01-01

Background: Little is known about the organization of clinical services for Huntington’s disease (HD). Objective: To describe how health care services are organized and delivered in HD-clinics taking part in or eligible for the Enroll-HD study. Methods: In 2014, a 69-item survey was administered to sites taking part in or eligible for the Enroll-HD study. Results: Of 231 sites surveyed, 121 (52.2%) sites in Europe, North America, Latin America, and Oceania responded. Most sites in the sample serve large populations, with 61.1% serving more than 1.5 million people, and a further 33% serving >500,000. Almost all (86.0%) centers see patients from outside their region. The majority of centers (59.7%) follow 50–199 patients, 21.9% care for more than 200. Most centers provide care in all stages of HD, and nearly all review pre-symptomatic cases. Multidisciplinary case reviews are offered in 54.5% of sites, with outreach clinics offered by 48.1%. Videoconferencing and telemedicine are used by 23.6%. Separate consultations for caregivers are offered in more than half of the centers. Most centers (70.4%) report following published guidelines or local care pathways for HD. Conclusions: Most centers serve a large population and use a multidisciplinary approach. The survey gives insight into factors underpinning HD service delivery globally. There is a need for more in-depth studies of clinical practice to understand how services are organized and how such features may be associated with quality of care. PMID:27372053

Surgical Site Infiltration for Abdominal Surgery: A Novel Neuroanatomical-based Approach

PubMed Central

Janis, Jeffrey E.; Haas, Eric M.; Ramshaw, Bruce J.; Nihira, Mikio A.; Dunkin, Brian J.

2016-01-01

Background: Provision of optimal postoperative analgesia should facilitate postoperative ambulation and rehabilitation. An optimal multimodal analgesia technique would include the use of nonopioid analgesics, including local/regional analgesic techniques such as surgical site local anesthetic infiltration. This article presents a novel approach to surgical site infiltration techniques for abdominal surgery based upon neuroanatomy. Methods: Literature searches were conducted for studies reporting the neuroanatomical sources of pain after abdominal surgery. Also, studies identified by preceding search were reviewed for relevant publications and manually retrieved. Results: Based on neuroanatomy, an optimal surgical site infiltration technique would consist of systematic, extensive, meticulous administration of local anesthetic into the peritoneum (or preperitoneum), subfascial, and subdermal tissue planes. The volume of local anesthetic would depend on the size of the incision such that 1 to 1.5 mL is injected every 1 to 2 cm of surgical incision per layer. It is best to infiltrate with a 22-gauge, 1.5-inch needle. The needle is inserted approximately 0.5 to 1 cm into the tissue plane, and local anesthetic solution is injected while slowly withdrawing the needle, which should reduce the risk of intravascular injection. Conclusions: Meticulous, systematic, and extensive surgical site local anesthetic infiltration in the various tissue planes including the peritoneal, musculofascial, and subdermal tissues, where pain foci originate, provides excellent postoperative pain relief. This approach should be combined with use of other nonopioid analgesics with opioids reserved for rescue. Further well-designed studies are necessary to assess the analgesic efficacy of the proposed infiltration technique. PMID:28293525

Evaluation of the Effect of Modafinil on Cognitive Functions in Patients with Idiopathic Hypersomnia with P300

PubMed Central

Yaman, Mehmet; Karakaya, Fatıma; Aydin, Tuğçe; Mayda, Hasan; Güzel, Hail İbrahim; Kayaalp, Dilek

2015-01-01

Background Modafinil is a well-tolerated psychostimulant drug with low addictive potential that is used to treat patients with narcolepsy and other excessive sleepiness. Whereas favorable effects of modafinil on cognitive functions have been shown in a large number of studies, there are very few reports presenting the effects of modafinil electrophysiologically. The aim of this study was to investigate the effects of modafinil on auditory P300 latency and amplitude electrophysiologically. Material/Methods Eighteen patients (age range: 16–48 years) with a diagnosis of idiopathic hypersomnia (IH) were included in the present study. As a standard treatment, 200 mg/day modafinil was administered to each patient. The P300 auditory test was performed for each patient before and at the end of 1 week of modafinil treatment. Results After 1 week of modafinil treatment, mean P300 latencies (at all electrode sites) were significantly lower than the latencies before the treatment (P values for Fz, Cz and Pz recording sites were 0.039, 0.002, and 0.004, respectively). An increase in the P300 amplitudes was detected only at the Fz recording site, but not at Cz or Pz recording sites (P values for Fz, Cz, and Pz recording sites were 0.014, 0.100, and 0.05, respectively). Conclusions One week of modafinil treatment improved the cognitive performance, alertness, and executive functions in IH patients. Our electrophysiologically obtained findings provide further confirmation for previous reports in which modafinil has been shown to exert favorable effects on cognitive performance, alertness, and executive functions. PMID:26116438

Isoprenoid emission variation of Norway spruce across a European latitudinal transect

NASA Astrophysics Data System (ADS)

van Meeningen, Ylva; Wang, Min; Karlsson, Tomas; Seifert, Ana; Schurgers, Guy; Rinnan, Riikka; Holst, Thomas

2017-12-01

Norway spruce (Picea abies) is one of the dominant tree species in the European boreal zone with the capacity to grow over large areas within Europe. It is an important emitter of biogenic volatile organic compounds (BVOCs), which can act as precursors of photochemical smog and ozone and contribute to the formation and growth of secondary organic aerosols (SOA) in the atmosphere. Isoprenoid emissions were measured from Norway spruce trees at seven different sites, distributed from Ljubljana in Slovenia to Piikkiö in Finland. Four of the sites were part of a network of genetically identical spruce trees and contained two separate provenances. The remaining three sites were part of other networks which have been used to conduct studies in the European boreal zone. There were minimal differences in the standardized emission rates between sites and across latitudes. The emission profile differed between provenances and sites, but there were not any distinct patterns which could be connected to a change in latitude. By using genetically identical trees and comparing the emission rates between sites and with genetically different trees, it was observed that the emission patterns were mostly influenced by genetics. But in order to confirm this possible stability of the relative emission profile based on genetics, more studies need to be performed. The effects of branch height, season and variation between years on observed emission pattern variations were also investigated. There were indications of potential influences of all three factors. However, due to different experimental setups between measurement campaigns, it is difficult to draw any robust conclusions.

Ultrasonographic evaluation of the canine urinary bladder following cystotomy for treatment of urolithiasis.

PubMed

Mariano, Abigail D; Penninck, Dominique G; Sutherland-Smith, James; Kudej, Raymond K

2018-05-01

OBJECTIVE To describe the ultrasonographic appearance of the urinary bladder incision site in dogs that underwent cystotomy for treatment of urolithiasis. DESIGN Prospective, longitudinal study. ANIMALS 18 client-owned dogs. PROCEDURES Dogs underwent urinary bladder ultrasonography at baseline (≤ 1 day before surgery) and at 1 day and approximately 2, 6, and 12 weeks after cystotomy for urocystolith removal. A baseline ratio between ventral (cystotomy site) and corresponding dorsal midline wall thickness was calculated and used to account for measurement variations attributable to bladder distension at subsequent visits. Patient signalment, weight, medications administered, urocystolith composition, and culture results were recorded. Clinical signs, reoccurrence of hyperechoic foci, and suture visualization were recorded at follow-up examinations. Variables were evaluated for association with cystotomy site thickening and resolution of thickening. RESULTS Median wall thickness at the ventral aspect of the bladder was significantly greater than that of the corresponding dorsal aspect at baseline. Cystotomy site thickening peaked 1 day after surgery and decreased at subsequent visits in a linear manner. Twelve weeks after surgery, 5 of 10 clinically normal dogs evaluated had persistent cystotomy site thickening. Eleven of 18 dogs had reoccurrence of hyperechoic foci within the bladder at some time during the study (median time to first detection, 17 days after surgery). CONCLUSIONS AND CLINICAL RELEVANCE Persistent cystotomy site thickening can be present up to 3 months after cystotomy for urolithiasis in dogs without lower urinary tract signs. Reoccurrence of hyperechoic foci in the bladder, although subclinical, was detected earlier and at a higher rate than anticipated.

Microbial Profiles and Detection Techniques in Peri-Implant Diseases: a Systematic Review

PubMed Central

Padial-Molina, Miguel; López-Martínez, Jesús; O’Valle, Francisco

2016-01-01

ABSTRACT Objectives To describe the microbial profiles of peri-implant diseases and the main detection methods. Material and Methods A literature search was performed in MEDLINE via PubMed database to identify studies on microbial composition of peri-implant surfaces in humans published in the last 5 years. Studies had to have clear implant status definition for health, peri-implant mucositis and/or peri-implantitis and specifically study microbial composition of the peri-implant sulcus. Results A total of 194 studies were screened and 47 included. Peri-implant sites are reported to be different microbial ecosystems compared to periodontal sites. However, differences between periodontal and peri-implant health and disease are not consistent across all studies, possibly due to the bias introduced by the microbial detection technique. New methods non species-oriented are being used to find ‘unexpected’ microbiota not previously described in these scenarios. Conclusions Microbial profile of peri-implant diseases usually includes classic periodontopathogens. However, correlation between studies is difficult, particularly because of the use of different detection methods. New metagenomic techniques should be promoted for future studies to avoid detection bias. PMID:27833735

Adolescents’ use of purpose built shade in secondary schools: cluster randomised controlled trial

PubMed Central

White, Vanessa; Wakefield, Melanie A; Jamsen, Kris M; White, Victoria; Livingston, Patricia M; English, Dallas R; Simpson, Julie A

2009-01-01

Objective To examine whether students use or avoid newly shaded areas created by shade sails installed at schools. Design Cluster randomised controlled trial with secondary schools as the unit of randomisation. Setting 51 secondary schools with limited available shade, in Australia, assessed over two spring and summer terms. Participants Students outside at lunch times. Intervention Purpose built shade sails were installed in winter 2005 at full sun study sites to increase available shade for students in the school grounds. Main outcome measure Mean number of students using the primary study sites during weekly observations at lunch time. Results Over the study period the mean change in students using the primary study site from pre-test to post-test was 2.63 (95% confidence interval 0.87 to 4.39) students in intervention schools and −0.03 (−1.16 to 1.09) students in control schools. The difference in mean change between groups was 2.67 (0.65 to 4.68) students (P=0.011). Conclusions Students used rather than avoided newly shaded areas provided by purpose built shade sails at secondary schools in this trial, suggesting a practical means of reducing adolescents’ exposure to ultraviolet radiation. Trial registration Exempt. PMID:19223344

Which came first, people or pollution? A review of theory and evidence from longitudinal environmental justice studies

NASA Astrophysics Data System (ADS)

Mohai, Paul; Saha, Robin

2015-12-01

A considerable number of quantitative analyses have been conducted in the past several decades that demonstrate the existence of racial and socioeconomic disparities in the distribution of a wide variety of environmental hazards. The vast majority of these have been cross-sectional, snapshot studies employing data on hazardous facilities and population characteristics at only one point in time. Although some limited hypotheses can be tested with cross-sectional data, fully understanding how present-day disparities come about requires longitudinal analyses that examine the demographic characteristics of sites at the time of facility siting and track demographic changes after siting. Relatively few such studies exist and those that do exist have often led to confusing and contradictory findings. In this paper we review the theoretical arguments, methods, findings, and conclusions drawn from existing longitudinal environmental justice studies. Our goal is to make sense of this literature and to identify the direction future research should take in order to resolve confusion and arrive at a clearer understanding of the processes and contributory factors by which present-day racial and socioeconomic disparities in the distribution of environmental hazards have come about. Such understandings also serve as an important step in identifying appropriate and effective societal responses to ameliorate environmental disparities.

Instagram addiction and the Big Five of personality: The mediating role of self-liking.

PubMed

Kircaburun, Kagan; Griffiths, Mark D

2018-03-01

Background and aims Recent research has suggested that social networking site use can be addictive. Although extensive research has been carried out on potential addiction to social networking sites, such as Facebook, Twitter, YouTube, and Tinder, only one very small study has previously examined potential addiction to Instagram. Consequently, the objectives of this study were to examine the relationships between personality, self-liking, daily Internet use, and Instagram addiction, as well as exploring the mediating role of self-liking between personality and Instagram addiction using path analysis. Methods A total of 752 university students completed a self-report survey, including the Instagram Addiction Scale (IAS), the Big Five Inventory (BFI), and the Self-Liking Scale. Results Results indicated that agreeableness, conscientiousness, and self-liking were negatively associated with Instagram addiction, whereas daily Internet use was positively associated with Instagram addiction. The results also showed that self-liking partially mediated the relationship of Instagram addiction with agreeableness and fully mediated the relationship between Instagram addiction with conscientiousness. Discussion and conclusions This study contributes to the small body of literature that has examined the relationship between personality and social networking site addiction and is one of only two studies to examine the addictive use of Instagram and the underlying factors related to it.

Fundamental Importance of Reference Glucose Analyzer Accuracy for Evaluating the Performance of Blood Glucose Monitoring Systems (BGMSs)

PubMed Central

Bailey, Timothy S.; Klaff, Leslie J.; Wallace, Jane F.; Greene, Carmine; Pardo, Scott; Harrison, Bern; Simmons, David A.

2016-01-01

Background: As blood glucose monitoring system (BGMS) accuracy is based on comparison of BGMS and laboratory reference glucose analyzer results, reference instrument accuracy is important to discriminate small differences between BGMS and reference glucose analyzer results. Here, we demonstrate the important role of reference glucose analyzer accuracy in BGMS accuracy evaluations. Methods: Two clinical studies assessed the performance of a new BGMS, using different reference instrument procedures. BGMS and YSI analyzer results were compared for fingertip blood that was obtained by untrained subjects’ self-testing and study staff testing, respectively. YSI analyzer accuracy was monitored using traceable serum controls. Results: In study 1 (N = 136), 94.1% of BGMS results were within International Organization for Standardization (ISO) 15197:2013 accuracy criteria; YSI analyzer serum control results showed a negative bias (−0.64% to −2.48%) at the first site and a positive bias (3.36% to 6.91%) at the other site. In study 2 (N = 329), 97.8% of BGMS results were within accuracy criteria; serum controls showed minimal bias (<0.92%) at both sites. Conclusions: These findings suggest that the ability to demonstrate that a BGMS meets accuracy guidelines is influenced by reference instrument accuracy. PMID:26902794

Incidence of childhood leukaemia and non-Hodgkin's lymphoma in the vicinity of nuclear sites in Scotland, 1968-93.

PubMed Central

Sharp, L; Black, R J; Harkness, E F; McKinney, P A

1996-01-01

OBJECTIVES: The primary aims were to investigate the incidence of leukaemia and non-Hodgkin's lymphoma in children resident near seven nuclear sites in Scotland and to determine whether there was any evidence of a gradient in risk with distance of residence from a nuclear site. A secondary aim was to assess the power of statistical tests for increased risk of disease near a point source when applied in the context of census data for Scotland. METHODS: The study data set comprised 1287 cases of leukaemia and non-Hodgkin's lymphoma diagnosed in children aged under 15 years in the period 1968-93, validated for accuracy and completeness. A study zone around each nuclear site was constructed from enumeration districts within 25 km. Expected numbers were calculated, adjusting for sex, age, and indices of deprivation and urban-rural residence. Six statistical tests were evaluated. Stone's maximum likelihood ratio (unconditional application) was applied as the main test for general increased incidence across a study zone. The linear risk score based on enumeration districts (conditional application) was used as a secondary test for declining risk with distance from each site. RESULTS: More cases were observed (O) than expected (E) in the study zones around Rosyth naval base (O/E 1.02), Chapelcross electricity generating station (O/E 1.08), and Dounreay reprocessing plant (O/E 1.99). The maximum likelihood ratio test reached significance only for Dounreay (P = 0.030). The linear risk score test did not indicate a trend in risk with distance from any of the seven sites, including Dounreay. CONCLUSIONS: There was no evidence of a generally increased risk of childhood leukaemia and non-Hodgkin's lymphoma around nuclear sites in Scotland, nor any evidence of a trend of decreasing risk with distance from any of the sites. There was a significant excess risk in the zone around Dounreay, which was only partially accounted for by the sociodemographic characteristics of the area. The statistical power of tests for localised increased risk of disease around a point source should be assessed in each new setting in which they are applied. PMID:8994402

Neighborhood Environments and Objectively Measured Physical Activity in 11 Countries

PubMed Central

Cerin, Ester; Cain, Kelli L; Conway, Terry L; Dyck, Delfien Van; Hinckson, Erica; Schipperijn, Jasper; Bourdeaudhuij, Ilse De; Owen, Neville; Davey, Rachel C; Hino, Adriano Akira Ferreira; Mitáš, Josef; Orzanco-Garralda, Rosario; Salvo, Deborah; Sarmiento, Olga L; Christiansen, Lars B; Macfarlane, Duncan J; Schofield, Grant; Sallis, James F

2014-01-01

Purpose Environmental changes are potentially effective population-level physical activity (PA) promotion strategies. However, robust multi-site evidence to guide international action for developing activity-supportive environments is lacking. We estimated pooled associations of perceived environmental attributes with objectively-measured PA outcomes; between-site differences in such associations; and, the extent to which perceived environmental attributes explain between-site differences in PA. Methods This was a cross-sectional study conducted in 16 cities located in Belgium, Brazil, Colombia, Czech Republic, Denmark, China, Mexico, New Zealand, Spain, United Kingdom, and USA. Participants were 6,968 adults residing in administrative units stratified by socio-economic status and transport-related walkability. Predictors were 10 perceived neighborhood environmental attributes. Outcome measures were accelerometry-assessed weekly minutes of moderate-to-vigorous PA (MVPA) and meeting the PA guidelines for cancer/weight gain prevention (420 min/week of MVPA). Results Most perceived neighborhood attributes were positively associated with the PA outcomes in the pooled, site-adjusted, single-predictor models. Associations were generalizable across geographical locations. Aesthetics and land use mix – access were significant predictors of both PA outcomes in the fully-adjusted models. Environmental attributes accounted for within-site variability in MVPA corresponding to a 3 min/d or 21 min/week standard deviation. Large between-site differences in PA outcomes were observed: 15.9% to 16.8% of these differences were explained by perceived environmental attributes. All neighborhood attributes were associated with between-site differences in the total effects of the perceived environment on PA outcomes. Conclusions Residents’ perceptions of neighborhood attributes that facilitate walking were positively associated with objectively-measured MVPA and meeting the guidelines for cancer/weight gain prevention at the within- and between-site levels. Associations were similar across study sites, lending support for international recommendations for designing PA-friendly built environments. PMID:24781892

A magnetotelluric study of the sensitivity of an area to seismoelectric signals

USGS Publications Warehouse

Balasis, G.; Bedrosian, P.A.; Eftaxias, K.

2005-01-01

During recent years, efforts at better understanding the physical properties of precursory ultra-low frequency pre-seismic electric signals (SES) have been intensified. Experiments show that SES cannot be observed at all points of the Earth's surface but only at certain so-called sensitive sites. Moreover, a sensitive site is capable of collecting SES from only a restricted number of seismic areas (selectivity effect). Tberefore the installation of a permanent station appropriate for SES collection should necessarily be preceded by a pilot study over a broad area and for a long duration. In short, a number of temporary stations are installed and, after the occurrence of several significant earthquakes (EQs) from a given seismic area, the most appropriate (if any) of these temporary stations, in the sense that they happen to collect SES, can be selected as permanent. Such a long experiment constitutes a serious disadvantage in identifying a site as SES sensitive. However, the SES sensitivity of a site should be related to the geoelectric structure of the area that hosts the site as well as the regional geoelectric structure between the station and the seismic focal area. Thus, knowledge of the local and regional geoelectric structure can dramatically reduce the time involved in identifying SES sites. hi this paper the magnetotelluric method is used to investigate the conductivity structure of an area where a permanent SES station is in operation. Although general conclusions cannot be drawn, the area surrounding an SES site near Ioannina, Greece is characterized by: (1) major faults in the vicinity; (2) highly resistive structure flanked by abrupt conductivity contrasts associated with large-scale geologic contacts, and (3) local inhomogeneities in conductivity structure. The above results are consistent with the fact that electric field amplitudes from remotely-generated signals should be appreciably stronger at such sites when compared to neighboring sites. European Geosciences Union ?? 2005 Author(s). This work is licensed under a Creative Commons License.

Breckinridge Project, initial effort. Report VII, Volume II. Environmental baseline report

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

Ashland Synthetic Fuels, Inc. (ASFI) and Airco Energy Company, Inc. (AECI) have recently formed the Breckinridge Project and are currently conducting a process and economic feasibility study of a commercial scale facility to produce synthetic liquid fuels from coal. The coal conversion process to be used is the H-COAL process, which is in the pilot plant testing stage under the auspices of the US Department of Energy at the H-COAL Pilot Plant Project near Catlettsburg, Kentucky. The preliminary plans for the commercial plant are for a 18,140 metric ton/day (24,000 ton/day) nominal coal assumption capacity utilizing the abundant high sulfurmore » Western Kentucky coals. The Western Kentucky area offers a source of the coal along with adequate water, power, labor, transportation and other factors critical to the successful siting of a plant. Various studies by federal and state governments, as well as private industry, have reached similar conclusions regarding the suitability of such plant sites in western Kentucky. Of the many individual sites evaluated, a site in Breckinridge County, Kentucky, approximately 4 kilometers (2.5 miles) west of the town of Stephensport, has been identified as the plant location. Actions have been taken to obtain options to insure that this site will be available when needed. This report contains an overview of the regional setting and results of the baseline environmental studies. These studies include collection of data on ambient air and water quality, sound, aquatic and terrestrial biology and geology. This report contains the following chapters; introduction, review of significant findings, ambient air quality monitoring, sound, aquatic ecology, vegetation, wildlife, geology, soils, surface water, and ground water.« less

Genome-wide DNA Methylation Profiling of CpG Islands in Hypospadias

PubMed Central

Choudhry, Shweta; Deshpande, Archana; Qiao, Liang; Beckman, Kenneth; Sen, Saunak; Baskin, Laurence S.

2013-01-01

Purpose Hypospadias is one of the most frequent genital malformations in the male newborn, and results from abnormal penile and urethral development. The etiology of hypospadias remains largely unknown despite intensive investigations. Fetal androgens have a crucial role in genital differentiation. Recent studies have suggested that molecular mechanisms that underlie the effects of androgens on the fetus may involve disruption of epigenetic programming of gene expression during development. We assessed whether epigenetic modification of DNA methylation is associated with hypospadias in a case-control study of 12 hypospadias and 8 control subjects. Materials and Methods Genome-wide DNA methylation profiling was performed on the study subjects using the Illumina Infinium® HumanMethylation450 Bead-Chip, which enables the direct investigation of methylation status of more than 485,000 individual CpG sites throughout the genome. The methylation level at each CpG site was compared between cases and controls using the t test and logistic regression. Results We identified 14 CpG sites that were associated with hypospadias with p <0.00001. These CpG sites were in or near the SCARB1, MYBPH, SORBS1, LAMA4, HOXD11, MYO1D, EGFL7, C10orf41, LMAN1L and SULF1 genes. Two CpG sites in SCARB1 and MYBPH genes remained statistically significant after correction for multiple testing (p = 2.61×10−09, pcorrected = 0.008; p = 3.06×10−08, pcorrected = 0.02, respectively). Conclusions To our knowledge this is the first study to investigate hypospadias using a unique and novel epigenetic approach. Our findings suggest DNA methylation patterns are useful in identifying new genes such as SCARB1 and MYBPH that may be involved in the etiology of hypospadias. PMID:22906644

Angiographic Validation of the American College of Cardiology Foundation–The Society of Thoracic Surgeons Collaboration on the Comparative Effectiveness of Revascularization Strategies Study

PubMed Central

Chakrabarti, Anjan K.; Grau-Sepulveda, Maria V.; O’Brien, Sean; Abueg, Cassandra; Ponirakis, Angelo; Delong, Elizabeth; Peterson, Eric; Klein, Lloyd W.; Garratt, Kirk N.; Weintraub, William S.; Gibson, C. Michael

2017-01-01

Background The goal of this study was to compare angiographic interpretation of coronary arteriograms by sites in community practice versus those made by a centralized angiographic core laboratory. Methods and Results The study population consisted of 2013 American College of Cardiology–National Cardiovascular Data Registry (ACC–NCDR) records with 2- and 3- vessel coronary disease from 54 sites in 2004 to 2007. The primary analysis compared Registry (NCDR)-defined 2- and 3-vessel disease versus those from an angiographic core laboratory analysis. Vessel-level kappa coefficients suggested moderate agreement between NCDR and core laboratory analysis, ranging from kappa=0.39 (95% confidence intervals, 0.32–0.45) for the left anterior descending artery to kappa=0.59 (95% confidence intervals, 0.55–0.64) for the right coronary artery. Overall, 6.3% (n=127 out of 2013) of those patients identified with multivessel disease at NCDR sites had had 0- or 1-vessel disease by core laboratory reading. There was no directional bias with regard to overcall, that is, 12.3% of cases read as 3-vessel disease by the sites were read as <3-vessel disease by the core laboratory, and 13.9% of core laboratory 3-vessel cases were read as <3-vessel by the sites. For a subset of patients with left main coronary disease, registry overcall was not linked to increased rates of mortality or myocardial infarction. Conclusions There was only modest agreement between angiographic readings in clinical practice and those from an independent core laboratory. Further study will be needed because the implications for patient management are uncertain. PMID:24496239

Assessment of the Effects of Holding Time and Temperature on Escherichia coli Densities in Surface Water Samples

PubMed Central

Pope, Misty L.; Bussen, Michelle; Feige, Mary Ann; Shadix, Lois; Gonder, Sharon; Rodgers, Crystal; Chambers, Yildiz; Pulz, Jessica; Miller, Ken; Connell, Kevin; Standridge, Jon

2003-01-01

Escherichia coli is a routinely used microbiological indicator of water quality. To determine whether holding time and storage conditions had an effect on E. coli densities in surface water, studies were conducted in three phases, encompassing 24 sites across the United States and four commonly used monitoring methods. During all three phases of the study, E. coli samples were analyzed at time 0 and at 8, 24, 30, and 48 h after sample collection. During phase 1, when 4°C samples were evaluated by Colilert or by placing a membrane onto mFC medium followed by transfer to nutrient agar containing 4-methylumbelliferyl-β-d-glucuronide (mFC/NA-MUG), three of four sites showed no significant differences throughout the 48-h study. During phase 2, five of seven sites showed no significant difference between time 0 and 24 h by membrane filtration (mFC/NA-MUG). When evaluated by the Colilert method, five of seven sites showed no significant difference in E. coli density between time 0 and 48 h. During phase 3, 8 of 13 sites showed no significant differences in E. coli densities between time 0 and the 48-h holding time, regardless of method. Based on the results of these studies, it appears that if samples are held below 10°C and are not allowed to freeze, most surface water E. coli samples analyzed by commonly used methods beyond 8 h after sample collection can generate E. coli data comparable to those generated within 8 h of sample collection. Notwithstanding this conclusion, E. coli samples collected from surface waters should always be analyzed as soon as possible. PMID:14532081

Ecohealth System Dynamic Model as a Planning Tool for the Reduction of Breeding Sites

NASA Astrophysics Data System (ADS)

Respati, T.; Raksanagara, A.; Djuhaeni, H.; Sofyan, A.; Shandriasti, A.

2017-03-01

Dengue is still one of major health problem in Indonesia. Dengue transmission is influenced by dengue prevention and eradication program, community participation, housing environment and climate. The complexity of the disease coupled with limited resources necessitates different approach for prevention methods that include factors contribute to the transmission. One way to prevent the dengue transmission is by reducing the mosquito’s breeding sites. Four factors suspected to influence breeding sites are dengue prevention and eradication program, community participation, housing environment, and weather condition. In order to have an effective program in reducing the breeding site it is needed to have a model which can predict existence of the breeding sites while the four factors under study are controlled. The objective of this study is to develop an Ecohealth model using system dynamic as a planning tool for the reduction of breeding sites to prevent dengue transmission with regard to dengue prevention and eradication program, community participation, housing environment, and weather condition. The methodology is a mixed method study using sequential exploratory design. The study comprised of 3 stages: first a qualitative study to 14 respondents using in-depth interview and 6 respondents for focus group discussion. The results from the first stage was used to develop entomology and household survey questionnaires for second stage conducted in 2036 households across 12 sub districts in Bandung City. Ecohealth system dynamic model was developed using data from first and second stages. Analyses used are thematic analysis for qualitative data; spatial, generalized estimating equation (GEE) and structural equation modeling for quantitative data; also average mean error (AME) and average variance error (AVE) for dynamic system model validation. System dynamic model showed that the most effective approach to eliminate breeding places was by ensuring the availability of basic sanitation for all houses. Weather factors such as precipitation can be compensated with the eradication of breeding sites activities which is conducted as scheduled and at the same time for the whole areas. Conclusion of this study is that dengue prevention and eradication program, community participation, and housing environment contributed to breeding places elimination influenced the existence of the breeding sites. The availability of basic sanitation and breeding places eradication program done timely and collectively are the most effective approach to eradicate breeding sites. Ecohealth dynamic system model can be used as a tool for the planning of breeding sites eradication program to prevent disease transmissions at city level.

Improving Web Searches: Case Study of Quit-Smoking Web Sites for Teenagers

PubMed Central

Skinner, Harvey

2003-01-01

Background The Web has become an important and influential source of health information. With the vast number of Web sites on the Internet, users often resort to popular search sites when searching for information. However, little is known about the characteristics of Web sites returned by simple Web searches for information about smoking cessation for teenagers. Objective To determine the characteristics of Web sites retrieved by search engines about smoking cessation for teenagers and how information quality correlates with the search ranking. Methods The top 30 sites returned by 4 popular search sites in response to the search terms "teen quit smoking" were examined. The information relevance and quality characteristics of these sites were evaluated by 2 raters. Objective site characteristics were obtained using a page-analysis Web site. Results Only 14 of the 30 Web sites are of direct relevance to smoking cessation for teenagers. The readability of about two-thirds of the 14 sites is below an eighth-grade school level and they ranked significantly higher (Kendall rank correlation, tau = -0.39, P= .05) in search-site results than sites with readability above or equal to that grade level. Sites that ranked higher were significantly associated with the presence of e-mail address for contact (tau = -0.46, P= .01), annotated hyperlinks to external sites (tau = -0.39, P= .04), and the presence of meta description tag (tau = -0.48, P= .002). The median link density (number of external sites that have a link to that site) of the Web pages was 6 and the maximum was 735. A higher link density was significantly associated with a higher rank (tau = -0.58, P= .02). Conclusions Using simple search terms on popular search sites to look for information on smoking cessation for teenagers resulted in less than half of the sites being of direct relevance. To improve search efficiency, users could supplement results obtained from simple Web searches with human-maintained Web directories and learn to refine their searches with more advanced search syntax. PMID:14713656

Operation BUSTER. Project 2.2. Thermal and Blast Effects on Idealized Forest Fuels

DTIC Science & Technology

1952-04-29

outside the test area . Naturally occurring fuels at the test site mm brush, grass clumps, and Joshua bark — ware studied before the tests and...oharrad« Conclusions based on results and observations from Operation BDSBRt 1. Under fire weather oonditionsi/ in a forest area , atomic ex...following atomic explosions over forest areas * 5* Bomb-induced conreotion does not produce surface winds follow« lag blastHTind effects and need not be

H.E.A.L.T.H.: Efficacy of an Internet/Population-Based Behavioral Weight Management Program for the U.S. Army

PubMed Central

Stewart, Tiffany; Han, Hongmei; Allen, H. Raymond; Bathalon, COL Gaston; Ryan, Donna H.; Newton, Robert L.; Williamson, Donald A.

2011-01-01

Background A significant number of soldiers exceed the maximum allowable weight standards or have body weights approaching the maximum allowable weight standards. This mandates development of scalable approaches to improve compliance with military weight standards. Methods We developed an intervention that included two components: (1) an Internet-based weight management program (Web site) and (2) a promotion program designed to promote and sustain usage of the Web site. The Web site remained online for 37 months, with the Web site promotion program ending after 25 months. Results Soldiers’ demographics were as follows: mean age, 32 years; body mass index (BMI), 28 kg/m2; 31% female; and 58% Caucasian. Civilian demographics were as follows: mean age, 38 years; BMI, 30 kg/m2; 84% female; and 55% Caucasian. Results indicated that 2417 soldiers and 2147 civilians (N = 4564) registered on the Web site. In the first 25 months (phase 1) of the study, new participants enrolled on the Web site at a rate of 88 (soldiers) and 80 (civilians) per month. After the promotion program was removed (phase 2), new participants enrolled at a rate of 18 (soldiers) and 13 (civilians) per month. Utilization of the Web site was associated with self-reported weight loss (p < .0001). Participants who utilized the Web site more frequently lost more weight (p < .0001). Participants reported satisfaction with the Web site. Conclusions The Web site and accompanying promotion program, when implemented at a military base, received satisfactory ratings and benefited a subset of participants in promoting weight loss. This justifies further examination of effectiveness in a randomized trial setting. PMID:21303642

Aerosol impacts on visible light extinction in the atmosphere of Mexico City.

PubMed

Eidels-Dubovoi, Silvia

2002-03-27

Eleven diurnal aerosol visible light absorption and scattering patterns were obtained from measurements done with an aethalometer and an integrating nephelometer during 28 February-10 March 1997 at two different sites in the Mexico City basin. Both measurement sites, the Merced site affected by regional and urban-scale aerosol and the Pedregal site dominated by regional-scale aerosol, showed a variety of diurnal light absorption and scattering patterns. For the majority of the 11 studied days, the highest absorption peaks appeared in the early morning, 07.00-09.30 h while those of scattering appeared later, 09.30-11.00 h. The earlier absorption peaks could be attributed to the elevated elemental carbon vehicular emissions during the heavy traffic hours whereas the later scattering peaks could be attributed to secondary aerosols formed photochemically in the atmosphere. During the period examined, the Pedregal site exhibited on the average a lower aerosol scattering and a higher aerosol absorption contribution to the total aerosol visible light extinction and a better visibility than that of the Merced site. Hence, the impact of aerosol absorption on the visibility degradation due to aerosols was greater at the less hazy Pedregal site. The overall 11-day aerosol visibility average of 20.9 km found at La Merced site, was only 9.4 km lower than that of 30.3 km found at the Pedregal site. This small aerosol visibility difference, of the order of the standard deviation, led to the conclusion that besides the regional-scale aerosol impact, the urban-scale aerosol impact on aerosol visible light extinction is very similar at La Merced and Pedregal sites.

Earthquakes: Recurrence and Interoccurrence Times

NASA Astrophysics Data System (ADS)

Abaimov, S. G.; Turcotte, D. L.; Shcherbakov, R.; Rundle, J. B.; Yakovlev, G.; Goltz, C.; Newman, W. I.

2008-04-01

The purpose of this paper is to discuss the statistical distributions of recurrence times of earthquakes. Recurrence times are the time intervals between successive earthquakes at a specified location on a specified fault. Although a number of statistical distributions have been proposed for recurrence times, we argue in favor of the Weibull distribution. The Weibull distribution is the only distribution that has a scale-invariant hazard function. We consider three sets of characteristic earthquakes on the San Andreas fault: (1) The Parkfield earthquakes, (2) the sequence of earthquakes identified by paleoseismic studies at the Wrightwood site, and (3) an example of a sequence of micro-repeating earthquakes at a site near San Juan Bautista. In each case we make a comparison with the applicable Weibull distribution. The number of earthquakes in each of these sequences is too small to make definitive conclusions. To overcome this difficulty we consider a sequence of earthquakes obtained from a one million year “Virtual California” simulation of San Andreas earthquakes. Very good agreement with a Weibull distribution is found. We also obtain recurrence statistics for two other model studies. The first is a modified forest-fire model and the second is a slider-block model. In both cases good agreements with Weibull distributions are obtained. Our conclusion is that the Weibull distribution is the preferred distribution for estimating the risk of future earthquakes on the San Andreas fault and elsewhere.

Institutionalizing evidence-based practice: an organizational case study using a model of strategic change

PubMed Central

2009-01-01

Background There is a general expectation within healthcare that organizations should use evidence-based practice (EBP) as an approach to improving the quality of care. However, challenges exist regarding how to make EBP a reality, particularly at an organizational level and as a routine, sustained aspect of professional practice. Methods A mixed method explanatory case study was conducted to study context; i.e., in terms of the presence or absence of multiple, inter-related contextual elements and associated strategic approaches required for integrated, routine use of EBP ('institutionalization'). The Pettigrew et al. Content, Context, and Process model was used as the theoretical framework. Two sites in the US were purposively sampled to provide contrasting cases: i.e., a 'role model' site, widely recognized as demonstrating capacity to successfully implement and sustain EBP to a greater degree than others; and a 'beginner' site, self-perceived as early in the journey towards institutionalization. Results The two sites were clearly different in terms of their organizational context, level of EBP activity, and degree of institutionalization. For example, the role model site had a pervasive, integrated presence of EBP versus a sporadic, isolated presence in the beginner site. Within the inner context of the role model site, there was also a combination of the Pettigrew and colleagues' receptive elements that, together, appeared to enhance its ability to effectively implement EBP-related change at multiple levels. In contrast, the beginner site, which had been involved for a few years in EBP-related efforts, had primarily non-receptive conditions in several contextual elements and a fairly low overall level of EBP receptivity. The beginner site thus appeared, at the time of data collection, to lack an integrated context to either support or facilitate the institutionalization of EBP. Conclusion Our findings provide evidence of some of the key contextual elements that may require attention if institutionalization of EBP is to be realized. They also suggest the need for an integrated set of receptive contextual elements to achieve EBP institutionalization; and they further support the importance of specific interactions among these elements, including ways in which leadership affects other contextual elements positively or negatively. PMID:19948064

Characterization of CD22 Expression in Acute Lymphoblastic Leukemia

PubMed Central

Shah, Nirali N.; Stetler-Stevenson, Maryalice; Yuan, Constance M.; Richards, Kelly; Delbrook, Cindy; Kreitman, Robert J.; Pastan, Ira; Wayne, Alan S.

2015-01-01

Background CD22 is a B-lineage differentiation antigen that has emerged as a leading therapeutic target in acute lymphoblastic leukemia (ALL). Procedure Properties of CD22 expression relevant to therapeutic targeting were characterized in primary samples obtained from children and young adults with relapsed and chemotherapy refractory B-precursor (pre-B) ALL. Results CD22 expression was demonstrated in all subjects (n=163) with detection on at least 90% of blasts in 155 cases. Median antigen site density of surface CD22 was 3,470 sites/cell (range 349 – 19,653, n=160). Blasts from patients with known 11q23 (MLL) rearrangement had lower site density (median 1,590 sites/cell, range 349-3,624, n=20 versus 3,853 sites/cell, range 451-19,653, n=140; p=<0.0001) and 6 of 21 cases had sub-populations of blasts lacking CD22 expression (22% – 82% CD22+). CD22 expression was maintained in serial studies of 73 subjects, including those treated with anti-CD22 targeted therapy. The levels of soluble CD22 in blood and marrow by ELISA were low and not expected to influence the pharmacokinetics of anti-CD22 directed agents. Conclusions These characteristics make CD22 an excellent potential therapeutic target in patients with relapsed and chemotherapy-refractory ALL, although cases with MLL rearrangement require close study to exclude the presence of a CD22-negative blast population. PMID:25728039

Combined Benzoporphyrin Derivative Monoacid Ring A Photodynamic Therapy and Pulsed Dye Laser for Port Wine Stain Birthmarks

PubMed Central

Tournas, Joshua A.; Lai, Jennifer; Truitt, Anne; Huang, Y.C.; Osann, Kathryn E.; Choi, Bernard; Kelly, Kristen M.

2009-01-01

Background Pulsed dye laser (PDL) is a commonly utilized treatment for port wine stain birthmarks (PWS) in the United States; however, results are variable and few patients achieve complete removal. Photodynamic therapy (PDT) is commonly used in China, but treatment associated photosensitivity lasts several weeks and scarring may occur. We propose an alternative treatment option, combined PDT+PDL and performed a proof-of-concept preliminary clinical trial. Methods Subjects with non-facial PWS were studied. Each subject had four test sites: control, PDL alone, PDT alone (benzoporphyrin derivative monoacid ring A photosensitizer with 576 nm light), and PDT+PDL. Radiant exposure time for PDT was increased in increments of 15 J/cm2. Authors evaluated photographs and chromametric measurements before and 12 weeks post-treatment. Results No serious adverse events were reported; epidermal changes were mild and self-limited. No clinical blanching was noted in control or PDT-alone sites. At PDT radiant exposures of 15 and 30 J/cm2, equivalent purpura and blanching was observed at PDL and PDT+PDL sites. At PDT radiant exposures over 30 J/cm2, greater purpura was noted at PDT+PDL sites as compared to PDL alone. Starting at 75 J/cm2, improved blanching was noted at PDT+PDL sites. Conclusions Preliminary results indicate that PDT+PDL is safe and may offer improved PWS treatment efficacy. Additional studies are warranted. PMID:19932451

Breast as an unusual site of metastasis- series of 3 cases and review of literature.

PubMed

Hebbar, Ashwin K; Shashidhar, K; S, Krishna Murthy; Kumar, Veerendra; Arjunan, Ravi

2014-09-01

Background and objectives Metastasis to the breast from extra mammary sites is uncommon with an incidence ranging from 1.2 to 2 % in clinical reports. Approximately 300 cases of breast metastasis from extra mammary sites have been reported, mostly in small series or as a single case report. Gastrointestinal adenocarcinoma metastasising to the breast is also very rare and only 30 cases have been reported in the literature. Metastatic deposits within the breast may be difficult to distinguish from primary breast carcinoma. Radiological features and immunohistochemistry especially for steroid hormone receptors (ER/PR) and expression of gross cystic disease fluid protein (GCDFP) and presence of other immunohistochemistry protein factors in breast metastasis which are specific to primary site may be helpful in differentiating these two conditions. Materials and methods In this series of 3 cases of breast as an unusual site of metastasis, we present different cases of adenocarcinoma of stomach, sigmoid colon and kidney with metastasis to the breast and discuss the differential diagnosis and management plans. Conclusion In conclusion, secondary tumors to the breast are rare and thus differentiating primary tumors from metastatic breast carcinoma is important for rational and optimum therapy and avoidance of unnecessary radical surgery. Palpable breast lump without typical radiological signs of primary breast carcinoma in patients with known primary should be suspected of representing metastasis.

Volumetric Analysis of Gingival Crevicular Fluid and Peri-Implant Sulcus Fluid in Healthy and Diseased Sites: A Cross-Sectional Split-Mouth Pilot Study

PubMed Central

Bevilacqua, Lorenzo; De Biasi, Matteo; Lorenzon, Maria Giulia; Frattini, Costanza; Angerame, Daniele

2016-01-01

Background: Researchers have recently drawn attention to the analysis of gingival crevicular fluid (GCF) and peri-implant sulcus fluid (PISF) for the implementation of the diagnosis of periodontal and peri-implant disease. Nevertheless, the measurements of volume and biomarkers concentration can be critically biased when data collected from studies with parallel group design are compared, given the technical difficulties, methodological variables, as well as the variability of crevicular fluid characteristics among different individuals. Objective: The aim of the present study was to assess the GCF and PISF volumes in healthy and diseased sites belonging to the same patient. Method: Ten patients presenting a periodontally healthy tooth, a tooth with periodontitis, an implant with healthy peri-implant tissues and an implant with peri-implantitis were enrolled. Samples of GCF and PISF were collected from each site of interest and their volume measured with a Periotron 8000 device. Non-parametric statistical analysis was performed to test the significance of the differences in GCF and PISF volumes between i) sites of teeth and dental implants with the same condition of health or disease and ii) healthy and diseased sites of both teeth and dental implants subgroups. The correlation between probing pocket depth (PPD) and fluid production was also tested (p<0.05). Results: Healthy periodontal and peri-implant tissues produced comparable amounts of fluid that was significantly lower than in diseased sites (p<0.05). In the presence of diagnosed disease, the volumes of GCF and PISF were similar, too. The correlation between PPD and fluid production was significant only in healthy sites (PPD/GCF, ρ=0.890, p<0.001; PPD/PISF, ρ=0.810; p<0.005). Conclusion: The periodontal and peri-implant tissues behaved similarly in terms of fluid production in condition of both health and active disease. PMID:27335614

Cost Effectiveness of On-site versus Off-site Depression Collaborative Care in Rural Federally Qualified Health Centers

PubMed Central

Pyne, Jeffrey M.; Fortney, John C.; Mouden, Sip; Lu, Liya; Hudson, Teresa J; Mittal, Dinesh

2018-01-01

Objective Collaborative care for depression is effective and cost-effective in primary care settings. However, there is minimal evidence to inform the choice of on-site versus off-site models. This study examined the cost-effectiveness of on-site practice-based collaborative care (PBCC) versus off-site telemedicine-based collaborative care (TBCC) for depression in Federally Qualified Health Centers (FQHCs). Methods Multi-site randomized pragmatic comparative cost-effectiveness trial. 19,285 patients were screened for depression, 14.8% (n=2,863) screened positive (PHQ9 ≥10) and 364 were enrolled. Telephone interview data were collected at baseline, 6-, 12-, and 18-months. Base case analysis used Arkansas FQHC healthcare costs and secondary analysis used national cost estimates. Effectiveness measures were depression-free days and quality-adjusted life years (QALYs) derived from depression-free days, Medical Outcomes Study SF-12, and Quality of Well Being scale (QWB). Nonparametric bootstrap with replacement methods were used to generate an empirical joint distribution of incremental costs and QALYs and acceptability curves. Results Mean base case FQHC incremental cost-effectiveness ratio (ICER) using depression-free days was $10.78/depression-free day. Mean base case ICERs using QALYs ranged from $14,754/QALY (depression-free day QALY) to $37,261/QALY (QWB QALY). Mean secondary national ICER using depression-free days was $8.43/depression-free day and using QALYs ranged from $11,532/QALY (depression-free day QALY) to $29,234/QALY (QWB QALY). Conclusions These results support the cost-effectiveness of the TBCC intervention in medically underserved primary care settings. Results can inform the decision about whether to insource (make) or outsource (buy) depression care management in the FQHC setting within the current context of Patient-Centered Medical Home, value-based purchasing, and potential bundled payments for depression care. The www.clinicaltrials.gov # for this study is NCT00439452. PMID:25686811

Factors influencing integration of TB services in general hospitals in two regions of China: a qualitative study

PubMed Central

2012-01-01

Background In the majority of China, the Centre for Disease Control (CDC) at the county level provides both clinical and public health care for TB cases, with hospitals and other health facilities referring suspected TB cases to the CDC. In recent years, an integrated model has emerged, where the CDC remains the basic management unit for TB control, while a general hospital is designated to provide clinical care for TB patients. This study aims to explore the factors that influence the integration of TB services in general hospitals and generate knowledge to aid the scale-up of integration of TB services in China. Methods This study adopted a qualitative approach using interviews from sites in East and West China. Analysis was conducted using a thematic framework approach. Results The more prosperous site in East China was more coordinated and thus had a better method of resource allocation and more patient-orientated service, compared with the poorer site in the West. The development of public health organizations appeared to influence how effectively integration occurred. An understanding from staff that hospitals had better capacity to treat TB patients than CDCs was a strong rationale for integration. However, the economic and political interests might act as a barrier to effective integration. Both sites shared the same challenges of attracting and retaining a skilled workforce for the TB services. The role of the health bureau was more directive in the Western site, while a more participatory and collaborative approach was adopted in the Eastern site. Conclusion The process of integration identifies similarities and differences between sites in more affluent East China and poorer West China. Integration of TB services in the hospitals needs to address the challenges of stakeholder motivations and resource allocation. Effective inter-organizational collaboration could help to improve the efficiency and quality of TB service. Key words: TB control, service delivery, integration, hospitals, China. PMID:22276746

Tailoring Care to Vulnerable Populations by Incorporating Social Determinants of Health: the Veterans Health Administration’s “Homeless Patient Aligned Care Team” Program

PubMed Central

Johnson, Erin E.; Aiello, Riccardo; Kane, Vincent; Pape, Lisa

2016-01-01

Introduction Although the clinical consequences of homelessness are well described, less is known about the role for health care systems in improving clinical and social outcomes for the homeless. We described the national implementation of a “homeless medical home” initiative in the Veterans Health Administration (VHA) and correlated patient health outcomes with characteristics of high-performing sites. Methods We conducted an observational study of 33 VHA facilities with homeless medical homes and patient- aligned care teams that served more than 14,000 patients. We correlated site-specific health care performance data for the 3,543 homeless veterans enrolled in the program from October 2013 through March 2014, including those receiving ambulatory or acute health care services during the 6 months prior to enrollment in our study and 6 months post-enrollment with corresponding survey data on the Homeless Patient Aligned Care Team (H-PACT) program implementation. We defined high performance as high rates of ambulatory care and reduced use of acute care services. Results More than 96% of VHA patients enrolled in these programs were concurrently receiving VHA homeless services. Of the 33 sites studied, 82% provided hygiene care (on-site showers, hygiene kits, and laundry), 76% provided transportation, and 55% had an on-site clothes pantry; 42% had a food pantry and provided on-site meals or other food assistance. Six-month patterns of acute-care use pre-enrollment and post-enrollment for 3,543 consecutively enrolled patients showed a 19.0% reduction in emergency department use and a 34.7% reduction in hospitalizations. Three features were significantly associated with high performance: 1) higher staffing ratios than other sites, 1) integration of social supports and social services into clinical care, and 3) outreach to and integration with community agencies. Conclusion Integrating social determinants of health into clinical care can be effective for high-risk homeless veterans. PMID:27032987

Scaffold-Based Delivery of Autologous Mesenchymal Stem Cells for Mandibular Distraction Osteogenesis: Preliminary Studies in a Porcine Model

PubMed Central

Sun, Zongyang; Tee, Boon Ching; Kennedy, Kelly S.; Kennedy, Patrick M.; Kim, Do-Gyoon; Mallery, Susan R.; Fields, Henry W.

2013-01-01

Purpose Bone regeneration through distraction osteogenesis (DO) is promising but remarkably slow. To accelerate it, autologous mesenchymal stem cells have been directly injected to the distraction site in a few recent studies. Compared to direct injection, a scaffold-based method can provide earlier cell delivery with potentially better controlled cell distribution and retention. This pilot project investigated a scaffold-based cell-delivery approach in a porcine mandibular DO model. Materials and Methods Eleven adolescent domestic pigs were used for two major sets of studies. The in-vitro set established methodologies to: aspirate bone marrow from the tibia; isolate, characterize and expand bone marrow-derived mesenchymal stem cells (BM-MSCs); enhance BM-MSC osteogenic differentiation using FGF-2; and confirm cell integration with a gelatin-based Gelfoam scaffold. The in-vivo set transplanted autologous stem cells into the mandibular distraction sites using Gelfoam scaffolds; completed a standard DO-course and assessed bone regeneration by macroscopic, radiographic and histological methods. Repeated-measure ANOVAs and t-tests were used for statistical analyses. Results From aspirated bone marrow, multi-potent, heterogeneous BM-MSCs purified from hematopoietic stem cell contamination were obtained. FGF-2 significantly enhanced pig BM-MSC osteogenic differentiation and proliferation, with 5 ng/ml determined as the optimal dosage. Pig BM-MSCs integrated readily with Gelfoam and maintained viability and proliferative ability. After integration with Gelfoam scaffolds, 2.4–5.8×107 autologous BM-MSCs (undifferentiated or differentiated) were transplanted to each experimental DO site. Among 8 evaluable DO sites included in the final analyses, the experimental DO sites demonstrated less interfragmentary mobility, more advanced gap obliteration, higher mineral content and faster mineral apposition than the control sites, and all transplanted scaffolds were completely degraded. Conclusion It is technically feasible and biologically sound to deliver autologous BM-MSCs to the distraction site immediately after osteotomy using a Gelfoam scaffold to enhance mandibular DO. PMID:24040314

Characterization of the interaction between furosemide and bovine serum albumin

NASA Astrophysics Data System (ADS)

Zhou, Neng; Liang, Yi-Zeng; Wang, Ping

2008-01-01

The interaction of furosemide (FU), one kind of potent diuretic, with bovine serum albumin (BSA) has been investigated at physiological acidity (pH 7.40) by fluorescent technique. Displacement experiment with site markers and Synchronous fluorescence clearly reveal that there are non-specific binding sites of FU with BSA. This conclusion was supported by the binding studies in the presence of the hydrophobic probe 1-anilinonaphthalene-8-sulfonic acid (ANS) and in different ionic strength. The binding sites number n and binding constant K were measured. The thermodynamic parameters Δ H°, Δ G°, Δ S° at different temperatures were calculated. The effects of other four diuretics, some common metal ions and bioactive components from herbal medicine on the binding are also considered. The results show only bumetanide has strong effect on FU's binding. Moreover, several data processing methods presently used were evaluated with Data of the same set. Quite different results were obtained from these methods suggesting more attention should be paid to the data processing methods.

Cholorhexidine, octenidine or povidone iodine for catheter related infections: A randomized controlled trial

PubMed Central

Bilir, Ayten; Yelken, Birgül; Erkan, Ayse

2013-01-01

Background: Protection of the catheter site by antimicrobial agents is one of the most important factors in the prevention of infection. Povidone iodine and chlorhexidine gluconate are the most common used agents for dressing. The purpose of this study was to compare the effects of povidone iodine, chlorhexidine gluconate and octenidine hydrochloride in preventing catheter related infections. Materials and Methods: Patients were randomized to receive; 4% chlorhexidine gluconate, 10% povidone iodine or octenidine hydrochlorodine for cutaneous antisepsis. Cultures were taken at the site surrounding catheter insertion and at the catheter hub after removal to help identify the source of microorganisms. Results: Catheter related sepsis was 10.5% in the povidone iodine and octenidine hydrochlorodine groups. Catheter related colonization was 26.3% in povidone iodine group and 21.5% in octenidine hydrochlorodine group. Conclusion: 4% chlorhexidine or octenidine hydrochlorodine for cutaneous disinfection before insertion of an intravascular device and for post-insertion site care can reduce the catheter related colonization. PMID:24250702

The allosteric citalopram binding site differentially interferes with neuronal firing rate and SERT trafficking in serotonergic neurons.

PubMed

Matthäus, Friederike; Haddjeri, Nasser; Sánchez, Connie; Martí, Yasmina; Bahri, Senda; Rovera, Renaud; Schloss, Patrick; Lau, Thorsten

2016-11-01

Citalopram is a clinically applied selective serotonin re-uptake inhibitor for antidepressant pharmacotherapy. It consists of two enantiomers, S-citalopram (escitalopram) and R-citalopram, of which escitalopram exerts the antidepressant therapeutic effect and has been shown to be one of the most efficient antidepressants, while R-citalopram antagonizes escitalopram via an unknown molecular mechanism that may depend on binding to a low-affinity allosteric binding site of the serotonin transporter. However, the precise mechanism of antidepressant regulation of the serotonin transporter by citalopram enantiomers still remains elusive. Here we investigate escitalopram׳s acute effect on (1) serotonergic neuronal firing in transgenic mice that express the human serotonin transporter without and with a mutation that disables the allosteric binding site, and (2) regulation of the serotonin transporter׳s cell surface localization in stem cell-derived serotonergic neurons. Our results demonstrate that escitalopram inhibited neuronal firing less potently in the mouse line featuring a mutation that abolishes the function of the allosteric binding site and induced serotonin transporter internalization independently of the allosteric binding site mechanism. Furthermore, citalopram enantiomers dose-dependently induced serotonin transporter internalization. In conclusion, this study provides new insight into antidepressant effects exerted by citalopram enantiomers in presence and absence of a functional allosteric binding site. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

Prospective, double-blinded, randomised controlled trial assessing the effect of an Octenidine-based hydrogel on bacterial colonisation and epithelialization of skin graft wounds in burn patients

PubMed Central

W, Eisenbeiß; F, Siemers; G, Amtsberg; P, Hinz; B, Hartmann; T, Kohlmann; A, Ekkernkamp; U, Albrecht; O, Assadian; A, Kramer

2012-01-01

Background: Moist wound treatment improves healing of skin graft donor site wounds. Microbial colonised wounds represent an increased risk of wound infection; while antimicrobially active, topical antiseptics may impair epithelialization. Objectives: The aim of this prospective randomised controlled clinical trial was to examine the influence of an Octenidine-dihydrochloride (OCT) hydrogel on bacterial colonisation and epithelialization of skin graft donor sites. Methods: The study was designed as a randomised, double-blinded, controlled clinical trial. Skin graft donor sites from a total of 61 patients were covered either with 0.05% OCT (n=31) or an OCT-free placebo wound hydrogel (n=30). Potential interaction with wound healing was assessed by measuring the time until 100% re-epithelialization. In addition, microbial wound colonisation was quantitatively determined in all skin graft donor sites. Results: There was no statistically significant difference in the time for complete epithelialization of skin graft donor sites in the OCT and the placebo group (7.3±0.2 vs. 6.9±0.2 days; p=0.236). Microbial wound colonisation was significantly lower in the OCT group than in the placebo group (p=0.014). Conclusions: The OCT-based hydrogel showed no delay in wound epithelialization and demonstrated a significantly lower bacterial colonisation of skin graft donor site wounds. PMID:23071904

Commonness and ecology, but not bigger brains, predict urban living in birds.

PubMed

Dale, Svein; Lifjeld, Jan T; Rowe, Melissah

2015-04-11

Several life history and ecological variables have been reported to affect the likelihood of species becoming urbanized. Recently, studies have also focused on the role of brain size in explaining ability to adapt to urban environments. In contrast, however, little is known about the effect of colonization pressure from surrounding areas, which may confound conclusions about what makes a species urban. We recorded presence/absence data for birds in 93 urban sites in Oslo (Norway) and compared these with species lists generated from 137 forest and 51 farmland sites surrounding Oslo which may represent source populations for colonization. We found that the frequency (proportion of sites where present) of a species within the city was strongly and positively associated with its frequency in sites surrounding the city, as were both species breeding habitat and nest site location. In contrast, there were generally no significant effects of relative brain mass or migration on urban occupancy. Furthermore, analyses of previously published data showed that urban density of birds in six other European cities was also positively and significantly associated with density in areas outside cities, whereas relative brain mass showed no such relationship. These results suggest that urban bird communities are primarily determined by how frequently species occurred in the surrounding landscapes and by features of ecology (i.e. breeding habitat and nest site location), whereas species' relative brain mass had no significant effects.

Does site of buccal mucosa graft for bulbar urethra stricture affect outcome? A comparative analysis of ventral, dorso-lateral and dorsal buccal mucosa graft augmentation urethroplasty

PubMed Central

Pathak, Hemant R.; Jain, Tarunkumar Prakash; Bhujbal, Sachin A.; Meshram, Kunal R.; Gadekar, Chetan; Parab, Sandesh

2017-01-01

Objective To compare long- term outcomes of buccal mucosa graft (BMG) augmentation urethroplasty for long segment bulbar urethral strictures done by placing the graft ventrally, dorso-laterally and dorsally. Material and methods We conducted a single institution retrospective study on 112 who underwent BMG augmentation urethroplasty for non-traumatic bulbar urethral strictures between January 2005 to December 2014. The cases were divided into three groups based on the site of placement of BMG graft i.e. (a) Ventral (n=44), (b) Dorso-lateral (n=48) and (c) Dorsal (n=20). Follow-up period was from one year to five years. Patients with failed outcomes underwent urethroscopy or retrograde urethrogram to note the site of recurrence of stricture. Results Out of 112 cases 91 (81%) were successful and 21 (19%) failed. The success rates for ventral, dorso-lateral and dorsal BMG augmentation procedures were 89%, 79% and 70%, respectively (p=0.18). Among 21 failed cases, 12 cases (57%) had stricture at proximal anastomotic site, 4 cases (19%) at graft and 5 cases (24%) at distal anastomotic site (p=0.01). Conclusion The overall success rate for BMG augmentation urethroplasty is equal for all techniques. Ventral onlay urethroplasty provides better exposure of proximal anastomotic site thus it is associated with minimum proximal anastomotic site recurrence rates. Patients with extensive spongiofibrosis and long segment strictures had higher rates of failure. PMID:28861310

Structural and Kinetic Analyses of Macrophage Migration Inhibitory Factor Active Site Interactions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Crichlow, G.; Lubetsky, J; Leng, L

Macrophage migration inhibitory factor (MIF) is a secreted protein expressed in numerous cell types that counters the antiinflammatory effects of glucocorticoids and has been implicated in sepsis, cancer, and certain autoimmune diseases. Interestingly, the structure of MIF contains a catalytic site resembling the tautomerase/isomerase sites of microbial enzymes. While bona fide physiological substrates remain unknown, model substrates have been identified. Selected compounds that bind in the tautomerase active site also inhibit biological functions of MIF. It had previously been shown that the acetaminophen metabolite, N-acetyl-p-benzoquinone imine (NAPQI), covalently binds to the active site of MIF. In this study, kinetic datamore » indicate that NAPQI inhibits MIF both covalently and noncovalently. The structure of MIF cocrystallized with NAPQI reveals that the NAPQI has undergone a chemical alteration forming an acetaminophen dimer (bi-APAP) and binds noncovalently to MIF at the mouth of the active site. We also find that the commonly used protease inhibitor, phenylmethylsulfonyl fluoride (PMSF), forms a covalent complex with MIF and inhibits the tautomerase activity. Crystallographic analysis reveals the formation of a stable, novel covalent bond for PMSF between the catalytic nitrogen of the N-terminal proline and the sulfur of PMSF with complete, well-defined electron density in all three active sites of the MIF homotrimer. Conclusions are drawn from the structures of these two MIF-inhibitor complexes regarding the design of novel compounds that may provide more potent reversible and irreversible inhibition of MIF.« less

A framework to spatially cluster air pollution monitoring sites in US based on the PM2.5 composition

PubMed Central

Austin, Elena; Coull, Brent A.; Zanobetti, Antonella; Koutrakis, Petros

2013-01-01

Background Heterogeneity in the response to PM2.5 is hypothesized to be related to differences in particle composition across monitoring sites which reflect differences in source types as well as climatic and topographic conditions impacting different geographic locations. Identifying spatial patterns in particle composition is a multivariate problem that requires novel methodologies. Objectives Use cluster analysis methods to identify spatial patterns in PM2.5 composition. Verify that the resulting clusters are distinct and informative. Methods 109 monitoring sites with 75% reported speciation data during the period 2003–2008 were selected. These sites were categorized based on their average PM2.5 composition over the study period using k-means cluster analysis. The obtained clusters were validated and characterized based on their physico-chemical characteristics, geographic locations, emissions profiles, population density and proximity to major emission sources. Results Overall 31 clusters were identified. These include 21 clusters with 2 or more sites which were further grouped into 4 main types using hierarchical clustering. The resulting groupings are chemically meaningful and represent broad differences in emissions. The remaining clusters, encompassing single sites, were characterized based on their particle composition and geographic location. Conclusions The framework presented here provides a novel tool which can be used to identify and further classify sites based on their PM2.5 composition. The solution presented is fairly robust and yielded groupings that were meaningful in the context of air-pollution research. PMID:23850585

Do highly cited clinicians get more citations when being present at social networking sites?

PubMed Central

Ramezani-Pakpour-Langeroudi, Fatemeh; Okhovati, Maryam; Talebian, Ali

2018-01-01

BACKGROUND AND AIMS: The advent of social networking sites has facilitated the dissemination of scientific research. This article aims to investigate the presence of Iranian highly cited clinicians in social networking sites. MATERIALS AND METHODS: This is a scientometrics study. Essential Science Indicator (ESI) was searched for Iranian highly cited papers in clinical medicine during November–December 2015. Then, the authors of the papers were checked and a list of authors was obtained. In the second phase, the authors’ names were searched in the selected social networking sites (ResearchGate [RG], Academia, Mendeley, LinkedIn). The total citations and h-index in Scopus were also gathered. RESULTS: Fifty-five highly cited papers were retrieved. A total of 107 authors participated in writing these papers. RG was the most popular (64.5%) and LinkedIn and Academia were in 2nd and 3rd places. None of the authors of highly cited papers were subscribed to Mendeley. A positive direct relationship was observed between visibility at social networking sites with citation and h-index rate. A significant relationship was observed between the RG score, citations, reads indicators in RG, and citation numbers and there was a significant relationship between the number of document indicator in Academia and the citation numbers. CONCLUSION: It seems putting the papers in social networking sites can influence the citation rate. We recommend all scientists to be present at social networking sites to have better chance of visibility and also citation. PMID:29629379

Jumping to (fatal) conclusions? An analysis of video film on a social networking web site of recreational jumping from height into water.

PubMed

Moran, Kevin

2014-01-01

In high-income countries, death as a consequence of recreational jumping into water from height has not been well investigated partly because it traditionally has been a covert activity within youth culture. An observational study of video recordings posted on the YouTube web site was used to gather data on the nature of jumping activity in New Zealand and Australia. An analytical framework was developed to identify site- participant- social characteristics (10 variables) and online feedback (4 variables). Of the 389 videos recorded in New Zealand (n = 210) and Australia (n = 179), 929 jumpers were observed, and rivers were the most frequently reported site of jumping activity (New Zealand 47%; Australia 35%). One fifth (20%) of the jumps in New Zealand and one third (33%) in Australia were from heights estimated to be more than 12 m. The YouTube website portraying jumps from height were visited almost half a million times (495,686 hits). Ways of reducing recreational jumping risk via targeted education interventions may be best directed at young male adults. Use of social network sites to foster safe behaviours may be an effective way to educate young people of the inherent risks of jumping from height into water.

Deletion of loop fragment adjacent to active site diminishes the stability and activity of exo-inulinase.

PubMed

Arjomand, Maryam Rezaei; Habibi-Rezaei, Mehran; Ahmadian, Gholamreza; Hassanzadeh, Malihe; Karkhane, Ali Asghar; Asadifar, Mandana; Amanlou, Massoud

2016-11-01

Inulinases are classified as hydrolases and widely used in the food and medical industries. Here, we report the deletion of a six-membered adjacent active site loop fragment ( 74 YGSDVT 79 sequence) from third Ω-loop of the exo-inulinase containing aspartate residue from Aspergillus niger to study its structural and functional importance. Site-directed mutagenesis was used to create the mutant of the exo-inulinase (Δ6SL). To investigate the stability of the region spanning this loop, MD simulations were performed 80ns for 20-85 residues. Molecular docking was performed to compare the interactions in the active sites of enzymes with fructose as a ligand. Accordingly, the functional thermostability of the exo-inulinase was significantly decreased upon loop fragment deletion. Evaluation of the kinetics parameters (V max , K m , k cat and, k cat /K m ) and activation energy (E a ) of the catalysis of enzymes indicated the importance of the deleted sequence on the catalytic performance of the enzyme. In conclusion, six-membered adjacent active site loop fragment not only plays a crucial role in the stability of the enzyme, but also it involves in the enzyme catalysis through lowering the activation energy of the catalysis and effective improving the catalytic performance. Copyright © 2016. Published by Elsevier B.V.

Non-uniformly functionalized titanium carbide-based MXenes as an anchoring material for Li-S batteries: A first-principles calculation

NASA Astrophysics Data System (ADS)

Sim, Eun Seob; Chung, Yong-Chae

2018-03-01

In this study, the influence of the non-uniform surface of F- and O-functionalized Ti2C on the anchoring behavior of lithium polysulfide (LiPS) is investigated using density functional theory. In order to consider the non-uniform surface, the substitutional, vacancy, and S-trapped sites of F- and O-functionalized Ti2C are designed. The anchoring behavior is investigated considering the adsorption energy of LiPS, reactivity between Li atoms and the substrate, and the reduction state of the S atoms. On the F-substitutional site of the O-functionalized surface, it is confirmed that the suppressing mechanism changes from the neutralization of S atoms to the anchoring of LiPS. However, too strong of an interaction between Ti atoms exposed at the vacancy site and S atoms induces trapping of the S atom at the vacancies of both F- and O-functionalized surfaces. As a result of the trapping of the S atom, the use of active material decreases. In addition, the S-trapped site originated from the vacancy site does not affect the suppressing mechanism. In conclusion, to optimize the Ti2C-based MXene as an anchoring material for Li-S batteries, the preparation process should be focused on eliminating the vacancy of functional groups.

Phytoscreening and phytoextraction of heavy metals at Danish polluted sites using willow and poplar trees.

PubMed

Algreen, Mette; Trapp, Stefan; Rein, Arno

2014-01-01

The main purpose of this study was to determine typical concentrations of heavy metals (HM) in wood from willows and poplars, in order to test the feasibility of phytoscreening and phytoextraction of HM. Samples were taken from one strongly, one moderately, and one slightly polluted site and from three reference sites. Wood from both tree species had similar background concentrations at 0.5 mg kg(-1) for cadmium (Cd), 1.6 mg kg(-1) for copper (Cu), 0.3 mg kg(-1) for nickel (Ni), and 25 mg kg(-1) for zinc (Zn). Concentrations of chromium (Cr) and lead (Pb) were below or close to detection limit. Concentrations in wood from the highly polluted site were significantly elevated, compared to references, in particular for willow. The conclusion from these results is that tree coring could be used successfully to identify strongly heavy metal-polluted soil for Cd, Cu, Ni, Zn, and that willow trees were superior to poplars, except when screening for Ni. Phytoextraction of HMs was quantified from measured concentration in wood at the most polluted site. Extraction efficiencies were best for willows and Cd, but below 0.5% over 10 years, and below 1‰ in 10 years for all other HMs.

Occupational Therapy for Patients With Acute Lung Injury: Factors Associated With Time to First Intervention in the Intensive Care Unit

PubMed Central

Dinglas, Victor D.; Colantuoni, Elizabeth; Ciesla, Nancy; Mendez-Tellez, Pedro A.; Shanholtz, Carl

2013-01-01

OBJECTIVE. Very early occupational therapy intervention in the intensive care unit (ICU) improves patients’ physical recovery. We evaluated the association of patient, ICU, and hospital factors with time to first occupational therapy intervention in ICU patients with acute lung injury (ALI). METHOD. We conducted a prospective cohort study of 514 consecutive patients with ALI from 11 ICUs in three hospitals in Baltimore, MD. RESULTS. Only 30% of patients ever received occupational therapy during their ICU stay. Worse organ failure, continuous hemodialysis, and uninterrupted continuous infusion of sedation were independently associated with delayed occupational therapy initiation, and hospital study site and admission to a trauma ICU were independently associated with earlier occupational therapy. CONCLUSION. Severity of illness and ICU practices for sedation administration were associated with delayed occupational therapy. Both hospital study site and type of ICU were independently associated with timing of occupational therapy, indicating modifiable environmental factors for promoting early occupational therapy in the ICU. PMID:23597694

Integration of Myeloblastosis Associated Virus proviral sequences occurs in the vicinity of genes encoding signaling proteins and regulators of cell proliferation

PubMed Central

Li, Chang Long; Coullin, Philippe; Bernheim, Alain; Joliot, Véronique; Auffray, Charles; Zoroob, Rima; Perbal, Bernard

2006-01-01

Aims Myeloblastosis Associated Virus type 1 (N) [MAV 1(N)] induces specifically nephroblastomas in 8–10 weeks when injected to newborn chicken. The MAV-induced nephroblastomas constitute a unique animal model of the pediatric Wilms' tumor. We have made use of three independent nephroblastomas that represent increasing tumor grades, to identify the host DNA regions in which MAV proviral sequences were integrated. METHODS Cellular sequences localized next to MAV-integration sites in the tumor DNAs were used to screen a Bacterial Artificial Chromosomes (BACs) library and isolate BACs containing about 150 kilobases of normal DNA corresponding to MAV integration regions (MIRs). These BACs were mapped on the chicken chromosomes by Fluorescent In Situ Hybridization (FISH) and used for molecular studies. Results The different MAV integration sites that were conserved after tumor cell selection identify genes involved in the control of cell signaling and proliferation. Syntenic fragments in human DNA contain genes whose products have been involved in normal and pathological kidney development, and several oncogenes responsible for tumorigenesis in human. Conclusion The identification of putative target genes for MAV provides important clues for the understanding of the MAV pathogenic potential. These studies identified ADAMTS1 as a gene upregulated in MAV-induced nephroblastoma and established that ccn3/nov is not a preferential site of integration for MAV as previously thought. The present results support our hypothesis that the highly efficient and specific MAV-induced tumorigenesis results from the alteration of multiple target genes in differentiating blastemal cells, some of which are required for the progression to highly aggressive stages. This study reinforces our previous conclusions that the MAV-induced nephroblastoma constitutes an excellent model in which to characterize new potential oncogenes and tumor suppressors involved in the establishment and maintenance of tumors. PMID:16403231

Vulnerability Assessments and Resilience Planning at Federal Facilities. Preliminary Synthesis of Project

DOE Office of Scientific and Technical Information (OSTI.GOV)

Moss, R. H.; Blohm, A. J.; Delgado, A.

2015-08-15

U.S. government agencies are now directed to assess the vulnerability of their operations and facilities to climate change and to develop adaptation plans to increase their resilience. Specific guidance on methods is still evolving based on the many different available frameworks. Agencies have been experimenting with these frameworks and approaches. This technical paper synthesizes lessons and insights from a series of research case studies conducted by the investigators at facilities of the U.S. Department of Energy and the Department of Defense. The purpose of the paper is to solicit comments and feedback from interested program managers and analysts before finalmore » conclusions are published. The paper describes the characteristics of a systematic process for prioritizing needs for adaptation planning at individual facilities and examines requirements and methods needed. It then suggests a framework of steps for vulnerability assessments at Federal facilities and elaborates on three sets of methods required for assessments, regardless of the detailed framework used. In a concluding section, the paper suggests a roadmap to further develop methods to support agencies in preparing for climate change. The case studies point to several preliminary conclusions; (1) Vulnerability assessments are needed to translate potential changes in climate exposure to estimates of impacts and evaluation of their significance for operations and mission attainment, in other words into information that is related to and useful in ongoing planning, management, and decision-making processes; (2) To increase the relevance and utility of vulnerability assessments to site personnel, the assessment process needs to emphasize the characteristics of the site infrastructure, not just climate change; (3) A multi-tiered framework that includes screening, vulnerability assessments at the most vulnerable installations, and adaptation design will efficiently target high-risk sites and infrastructure; (4) Vulnerability assessments can be connected to efforts to improve facility resilience to motivate participation; and (5) Efficient, scalable methods for vulnerability assessment can be developed, but additional case studies and evaluation are required.« less

Reconstruction of Past Climatic Variability

DTIC Science & Technology

1976-03-01

Research Projects Agency/IPT 1400 Wilson Boulevard 7$ 10 . PROGRAM ELEMENT, PROJECT, TASK AREA S WORK UNIT NUMBERS 62706E AO 2221-3 Mr WCPOWT...Conclusions " II. INTRODUCTION 8 III. COLLECTIONS 10 A. North American Temperate Sites 10 B. North American Arctic Sites 10 C. European...Work Time Required to Collect and Process a ^ ^ 200- to 400-Year Ring-Width Chronology Statistics for 10 Tree-Ring Chronologies

The Moral and Ethical Implications of Precision-Guided Munitions

DTIC Science & Technology

2007-03-01

are available electronically at the Air University Research Web site http://research .maxwell.af.mil and the AU Press Web site http...aupress.maxwell.af.mil. Disclaimer Opinions, conclusions, and recommendations expressed or implied within are solely those of the author and do not necessarily...munitions and their relationship with the just-war tradition. The thesis is straightforward. There are moral, social, and political dilemmas

Computer analysis of protein functional sites projection on exon structure of genes in Metazoa

PubMed Central

2015-01-01

Background Study of the relationship between the structural and functional organization of proteins and their coding genes is necessary for an understanding of the evolution of molecular systems and can provide new knowledge for many applications for designing proteins with improved medical and biological properties. It is well known that the functional properties of proteins are determined by their functional sites. Functional sites are usually represented by a small number of amino acid residues that are distantly located from each other in the amino acid sequence. They are highly conserved within their functional group and vary significantly in structure between such groups. According to this facts analysis of the general properties of the structural organization of the functional sites at the protein level and, at the level of exon-intron structure of the coding gene is still an actual problem. Results One approach to this analysis is the projection of amino acid residue positions of the functional sites along with the exon boundaries to the gene structure. In this paper, we examined the discontinuity of the functional sites in the exon-intron structure of genes and the distribution of lengths and phases of the functional site encoding exons in vertebrate genes. We have shown that the DNA fragments coding the functional sites were in the same exons, or in close exons. The observed tendency to cluster the exons that code functional sites which could be considered as the unit of protein evolution. We studied the characteristics of the structure of the exon boundaries that code, and do not code, functional sites in 11 Metazoa species. This is accompanied by a reduced frequency of intercodon gaps (phase 0) in exons encoding the amino acid residue functional site, which may be evidence of the existence of evolutionary limitations to the exon shuffling. Conclusions These results characterize the features of the coding exon-intron structure that affect the functionality of the encoded protein and allow a better understanding of the emergence of biological diversity. PMID:26693737

Workflow in Clinical Trial Sites & Its Association with Near Miss Events for Data Quality: Ethnographic, Workflow & Systems Simulation

PubMed Central

Araujo de Carvalho, Elias Cesar; Batilana, Adelia Portero; Claudino, Wederson; Lima Reis, Luiz Fernando; Schmerling, Rafael A.; Shah, Jatin; Pietrobon, Ricardo

2012-01-01

Background With the exponential expansion of clinical trials conducted in (Brazil, Russia, India, and China) and VISTA (Vietnam, Indonesia, South Africa, Turkey, and Argentina) countries, corresponding gains in cost and enrolment efficiency quickly outpace the consonant metrics in traditional countries in North America and European Union. However, questions still remain regarding the quality of data being collected in these countries. We used ethnographic, mapping and computer simulation studies to identify/address areas of threat to near miss events for data quality in two cancer trial sites in Brazil. Methodology/Principal Findings Two sites in Sao Paolo and Rio Janeiro were evaluated using ethnographic observations of workflow during subject enrolment and data collection. Emerging themes related to threats to near miss events for data quality were derived from observations. They were then transformed into workflows using UML-AD and modeled using System Dynamics. 139 tasks were observed and mapped through the ethnographic study. The UML-AD detected four major activities in the workflow evaluation of potential research subjects prior to signature of informed consent, visit to obtain subject́s informed consent, regular data collection sessions following study protocol and closure of study protocol for a given project. Field observations pointed to three major emerging themes: (a) lack of standardized process for data registration at source document, (b) multiplicity of data repositories and (c) scarcity of decision support systems at the point of research intervention. Simulation with policy model demonstrates a reduction of the rework problem. Conclusions/Significance Patterns of threats to data quality at the two sites were similar to the threats reported in the literature for American sites. The clinical trial site managers need to reorganize staff workflow by using information technology more efficiently, establish new standard procedures and manage professionals to reduce near miss events and save time/cost. Clinical trial sponsors should improve relevant support systems. PMID:22768105

Uptake of Workplace HIV Counselling and Testing: A Cluster-Randomised Trial in Zimbabwe

PubMed Central

Corbett, Elizabeth L; Dauya, Ethel; Matambo, Ronnie; Cheung, Yin Bun; Makamure, Beauty; Bassett, Mary T; Chandiwana, Steven; Munyati, Shungu; Mason, Peter R; Butterworth, Anthony E; Godfrey-Faussett, Peter; Hayes, Richard J

2006-01-01

Background HIV counselling and testing is a key component of both HIV care and HIV prevention, but uptake is currently low. We investigated the impact of rapid HIV testing at the workplace on uptake of voluntary counselling and testing (VCT). Methods and Findings The study was a cluster-randomised trial of two VCT strategies, with business occupational health clinics as the unit of randomisation. VCT was directly offered to all employees, followed by 2 y of open access to VCT and basic HIV care. Businesses were randomised to either on-site rapid HIV testing at their occupational clinic (11 businesses) or to vouchers for off-site VCT at a chain of free-standing centres also using rapid tests (11 businesses). Baseline anonymised HIV serology was requested from all employees. HIV prevalence was 19.8% and 18.4%, respectively, at businesses randomised to on-site and off-site VCT. In total, 1,957 of 3,950 employees at clinics randomised to on-site testing had VCT (mean uptake by site 51.1%) compared to 586 of 3,532 employees taking vouchers at clinics randomised to off-site testing (mean uptake by site 19.2%). The risk ratio for on-site VCT compared to voucher uptake was 2.8 (95% confidence interval 1.8 to 3.8) after adjustment for potential confounders. Only 125 employees (mean uptake by site 4.3%) reported using their voucher, so that the true adjusted risk ratio for on-site compared to off-site VCT may have been as high as 12.5 (95% confidence interval 8.2 to 16.8). Conclusions High-impact VCT strategies are urgently needed to maximise HIV prevention and access to care in Africa. VCT at the workplace offers the potential for high uptake when offered on-site and linked to basic HIV care. Convenience and accessibility appear to have critical roles in the acceptability of community-based VCT. PMID:16796402

Motif types, motif locations and base composition patterns around the RNA polyadenylation site in microorganisms, plants and animals

PubMed Central

2014-01-01

Background The polyadenylation of RNA is critical for gene functioning, but the conserved sequence motifs (often called signal or signature motifs), motif locations and abundances, and base composition patterns around mRNA polyadenylation [poly(A)] sites are still uncharacterized in most species. The evolutionary tendency for poly(A) site selection is still largely unknown. Results We analyzed the poly(A) site regions of 31 species or phyla. Different groups of species showed different poly(A) signal motifs: UUACUU at the poly(A) site in the parasite Trypanosoma cruzi; UGUAAC (approximately 13 bases upstream of the site) in the alga Chlamydomonas reinhardtii; UGUUUG (or UGUUUGUU) at mainly the fourth base downstream of the poly(A) site in the parasite Blastocystis hominis; and AAUAAA at approximately 16 bases and approximately 19 bases upstream of the poly(A) site in animals and plants, respectively. Polyadenylation signal motifs are usually several hundred times more abundant around poly(A) sites than in whole genomes. These predominant motifs usually had very specific locations, whether upstream of, at, or downstream of poly(A) sites, depending on the species or phylum. The poly(A) site was usually an adenosine (A) in all analyzed species except for B. hominis, and there was weak A predominance in C. reinhardtii. Fungi, animals, plants, and the protist Phytophthora infestans shared a general base abundance pattern (or base composition pattern) of “U-rich—A-rich—U-rich—Poly(A) site—U-rich regions”, or U-A-U-A-U for short, with some variation for each kingdom or subkingdom. Conclusion This study identified the poly(A) signal motifs, motif locations, and base composition patterns around mRNA poly(A) sites in protists, fungi, plants, and animals and provided insight into poly(A) site evolution. PMID:25052519

Incorporating ToxCast and Tox21 Datasets to Rank Biological Activity of Chemicals at Superfund Sites in North Carolina

PubMed Central

Tilley, Sloane K.; Reif, David M.; Fry, Rebecca C.

2017-01-01

Background The Superfund program of the Environmental Protection Agency (EPA) was established in 1980 to address public health concerns posed by toxic substances released into the environment in the United States. Forty-two of the 1328 hazardous waste sites that remain on the Superfund National Priority List are located in the state of North Carolina. Methods We set out to develop a database that contained information on both the prevalence and biological activity of chemicals present at Superfund sites in North Carolina. A chemical characterization tool, the Toxicological Priority Index (ToxPi), was used to rank the biological activity of these chemicals based on their predicted bioavailability, documented associations with biological pathways, and activity in in vitro assays of the ToxCast and Tox21 programs. Results The ten most prevalent chemicals found at North Carolina Superfund sites were chromium, trichloroethene, lead, tetrachloroethene, arsenic, benzene, manganese, 1,2-dichloroethane, nickel, and barium. For all chemicals found at North Carolina Superfund sites, ToxPi analysis was used to rank their biological activity. Through this data integration, residual pesticides and organic solvents were identified to be some of the most highly-ranking predicted bioactive chemicals. This study provides a novel methodology for creating state or regional databases of Superfund sites. Conclusions These data represent a novel integrated profile of the most prevalent chemicals at North Carolina Superfund sites. This information, and the associated methodology, is useful to toxicologists, risk assessors, and the communities living in close proximity to these sites. PMID:28153528

Insulator function and topological domain border strength scale with architectural protein occupancy

PubMed Central

2014-01-01

Background Chromosome conformation capture studies suggest that eukaryotic genomes are organized into structures called topologically associating domains. The borders of these domains are highly enriched for architectural proteins with characterized roles in insulator function. However, a majority of architectural protein binding sites localize within topological domains, suggesting sites associated with domain borders represent a functionally different subclass of these regulatory elements. How topologically associating domains are established and what differentiates border-associated from non-border architectural protein binding sites remain unanswered questions. Results By mapping the genome-wide target sites for several Drosophila architectural proteins, including previously uncharacterized profiles for TFIIIC and SMC-containing condensin complexes, we uncover an extensive pattern of colocalization in which architectural proteins establish dense clusters at the borders of topological domains. Reporter-based enhancer-blocking insulator activity as well as endogenous domain border strength scale with the occupancy level of architectural protein binding sites, suggesting co-binding by architectural proteins underlies the functional potential of these loci. Analyses in mouse and human stem cells suggest that clustering of architectural proteins is a general feature of genome organization, and conserved architectural protein binding sites may underlie the tissue-invariant nature of topologically associating domains observed in mammals. Conclusions We identify a spectrum of architectural protein occupancy that scales with the topological structure of chromosomes and the regulatory potential of these elements. Whereas high occupancy architectural protein binding sites associate with robust partitioning of topologically associating domains and robust insulator function, low occupancy sites appear reserved for gene-specific regulation within topological domains. PMID:24981874

A systematic review of the quality of homeopathic clinical trials

PubMed Central

Jonas, Wayne B; Anderson, Rachel L; Crawford, Cindy C; Lyons, John S

2001-01-01

Background While a number of reviews of homeopathic clinical trials have been done, all have used methods dependent on allopathic diagnostic classifications foreign to homeopathic practice. In addition, no review has used established and validated quality criteria allowing direct comparison of the allopathic and homeopathic literature. Methods In a systematic review, we compared the quality of clinical-trial research in homeopathy to a sample of research on conventional therapies using a validated and system-neutral approach. All clinical trials on homeopathic treatments with parallel treatment groups published between 1945–1995 in English were selected. All were evaluated with an established set of 33 validity criteria previously validated on a broad range of health interventions across differing medical systems. Criteria covered statistical conclusion, internal, construct and external validity. Reliability of criteria application is greater than 0.95. Results 59 studies met the inclusion criteria. Of these, 79% were from peer-reviewed journals, 29% used a placebo control, 51% used random assignment, and 86% failed to consider potentially confounding variables. The main validity problems were in measurement where 96% did not report the proportion of subjects screened, and 64% did not report attrition rate. 17% of subjects dropped out in studies where this was reported. There was practically no replication of or overlap in the conditions studied and most studies were relatively small and done at a single-site. Compared to research on conventional therapies the overall quality of studies in homeopathy was worse and only slightly improved in more recent years. Conclusions Clinical homeopathic research is clearly in its infancy with most studies using poor sampling and measurement techniques, few subjects, single sites and no replication. Many of these problems are correctable even within a "holistic" paradigm given sufficient research expertise, support and methods. PMID:11801202

Conclusions for mammography screening after 25-year follow-up of the Canadian National Breast Cancer Screening Study (CNBSS).

PubMed

Heywang-Köbrunner, S H; Schreer, I; Hacker, A; Noftz, M R; Katalinic, A

2016-02-01

Twenty-five-year follow-up data of the Canadian National Breast Cancer Screening Study (CNBSS) indicated no mortality reduction. What conclusions should be drawn? After conducting a systematic literature search and narrative analysis, we wish to recapitulate important details of this study, which may have been neglected: Sixty-eight percent of all included cancers were palpable, a situation that does not allow testing the value of early detection. Randomisation was performed at the sites after palpation, while blinding was not guaranteed. In the first round, this "randomisation" assigned 19/24 late stage cancers to the mammography group and only five to the control group, supporting the suspicion of severe errors in the randomisation process. The responsible physicist rated mammography quality as "far below state of the art of that time". Radiological advisors resigned during the study due to unacceptable image quality, training, and medical quality assurance. Each described problem may strongly influence the results between study and control groups. Twenty-five years of follow-up cannot heal these fundamental problems. This study is inappropriate for evidence-based conclusions. The technology and quality assurance of the diagnostic chain is shown to be contrary to today's screening programmes, and the results of the CNBSS are not applicable to them. • The evidence base of the Canadian study (CNBSS) has to be questioned.• Severe flaws in the randomization process and test methods occurred. • Problems were criticized during and after conclusion of the trial by experts.• The results are not applicable to quality-assured screening programs. • The evidence base of this study must be re-analyzed.

Develop and test fuel cell powered on-site integrated total energy systems. Phase 3: Full-scale power plant development

NASA Technical Reports Server (NTRS)

1983-01-01

Satisfactory performance is reported for the first three 12-cell sub-stacks of the 5 kW stack rebuild. Early general conclusions are presented from an economic study. Results are reported on a successful 700-hour test of a 3-cell stack in the full-sized configuration (0.33m x 0.56m). Construction of a 5 kW equivalent methanol/steam reformer based on a commercial shell-and-tube heat exchanger was completed. Several test runs are summarized. Preliminary conclusions are presented on the technical and economic aspects of fuel cell/HVAC interaction. Physical data are presented on several dense graphite materials which are candidates for gas-distribution plates. Performance of a new cathode catalyst is reported.

U.S. Geological survey program on toxic waste--ground-water contamination; proceedings of the Second technical meeting, Cape Cod, Massachusetts, October 21-25, 1985

USGS Publications Warehouse

Ragone, S.E.

1988-01-01

This study characterizes the clay minerals in sediments associated with a plume of creosote-contaminated groundwater. The plume of contaminated groundwater near Pensacola, FL, is in shallow, permeable, Miocene to Holocene quartz sand and flows southward toward Pensacola Bay. Clay-size fractions were separated from 41 cores, chiefly split-spoon samples at 13 drill sites. The most striking feature of the chemical analyses of the clay fractions from uncontaminated site 2 and contaminated sites 4,5,6, and 7 is the variability of iron oxide (species in some samples as Fe2O3); total iron oxide abundance is lowest (2.5%) in uncontaminated sample 2-40, but is > 4.5% (4.5 to 8.5%) in the remaining assemblages. One feature suggesting interaction between the indigenous clays and the waste plume is the presence of nontronite-rich smectite. Nontronite commonly has been identified as the product of hydrothermal alteration and deep-sea weathering of submarine basalts; it is not a common constituent of Cenozoic Gulf Coast sediments. At the Pensacola site, relatively abundant nontronitic smectite is confined to contaminated sands or associated muds; it is least abundant or absent in sands and muds peripheral to the waste plume. The geochemistry of the waste plume, its substantial dissolved, (chiefly ferrous iron), mildly acidic (pH 5-6), and low redox composition, provides an environment similar to that previously determined for the low-temperature synthesis of nontronite. Data from clay-size fractions confirm conclusions that neoformed pyrite in some grain coatings occurs in an assemblage with excess iron over that required in the pyrite. Continuing studies to evaluate these tentative conclusions include: (1) chemical analysis of clay fractions from remaining sites to further examine the apparent relation between iron content and abundance of nontronitic smectite; (2) clay separation and analysis, and pore fluid extraction (squeezing or ultracentrifugation) and analysis from a continuous core through the mud lens to determine pore fluid composition (presence or absence of waste fluid), and character of associated clay minerals; and (3) clay separation and analysis in both permeable sands and the intervening mud lens that are clearly outside the limits of the waste plume to further document the effects of the plume. (See also W90-00022) (Lantz-PTT)

e-Ana and e-Mia: A Content Analysis of Pro–Eating Disorder Web Sites

PubMed Central

Schenk, Summer; Wilson, Jenny L.; Peebles, Rebecka

2010-01-01

Objectives. The Internet offers Web sites that describe, endorse, and support eating disorders. We examined the features of pro–eating disorder Web sites and the messages to which users may be exposed. Methods. We conducted a systematic content analysis of 180 active Web sites, noting site logistics, site accessories, “thinspiration” material (images and prose intended to inspire weight loss), tips and tricks, recovery, themes, and perceived harm. Results. Practically all (91%) of the Web sites were open to the public, and most (79%) had interactive features. A large majority (84%) offered pro-anorexia content, and 64% provided pro-bulimia content. Few sites focused on eating disorders as a lifestyle choice. Thinspiration material appeared on 85% of the sites, and 83% provided overt suggestions on how to engage in eating-disordered behaviors. Thirty-eight percent of the sites included recovery-oriented information or links. Common themes were success, control, perfection, and solidarity. Conclusions. Pro–eating disorder Web sites present graphic material to encourage, support, and motivate site users to continue their efforts with anorexia and bulimia. Continued monitoring will offer a valuable foundation to build a better understanding of the effects of these sites on their users. PMID:20558807

Cancer incidence and mortality in Chukotka, 1997–2010

PubMed Central

Dudarev, Alexey A.; Chupakhin, Valery S.; Odland, Jon Øyvind

2013-01-01

Objectives The general aim was to assess cancer incidence and mortality among the general population of Chukotka in 1997–2010 and to compare it with the population of Russia. Methods Cancer data were abstracted from the annual statistical reports of the P.A. Hertzen Research Institute of Oncology in Moscow. The annual number and percent of cases, crude and age-standardized cancer incidence (ASIR) and mortality (ASMR) rates per 100,000 among men and women in the Chukotka Autonomous Okrug were determined for the period 1997–2010 for incidence and 1999–2010 for mortality. Two years’ data were aggregated to generate temporal trends during the period. In age-standardization, the Segi-Doll world standard population used by the International Agency for Research on Cancer was used. Results The higher incidence and mortality rate of cancer (all sites combined) among men compared to women, which was observed in Russia nationally, was reflected also in Chukotka, although the difference between men and women was not statistically significant. Overall, the patterns of cancer sites are similar between Chukotka and Russia, with cancer of the lung/trachea/bronchus and stomach occupying the top ranks among men. Oesophageal cancer is common in Chukotka but not in Russia, whereas prostate cancer is common in Russia but not in Chukotka. Among women, breast cancer is either the commonest or second commonest cancer in terms of incidence or mortality in both Chukotka and Russia. Cancer of the lung/trachea/bronchi ranks higher in Chukotka than in Russia. The rate of cancer incidence and mortality for all sites combined during the 13-year period was relatively stable in Russia. Dividing the period into two halves, an increase among both men and women was observed in Chukotka for all sites combined, and also for colorectal cancer. Conclusions This paper presents previously unavailable cancer epidemiological data on Chukotka. They provide a basis for comparative studies across circumpolar regions and countries. With its small population, cancer rates in Chukotka tend to be highly unstable and fluctuate widely from year to year. Even when aggregated over a decade or more, only broad conclusions regarding patterns and trends can be made regarding some of the commonest cancer sites, or with all sites combined. Chukotka experienced substantial social and economic dislocations during the period under study, which could conceivably affect risk factor distribution and the quality of medical care. PMID:23518507

DOE Office of Scientific and Technical Information (OSTI.GOV)

Matthews, Patrick K.

This Corrective Action Decision Document/Closure Report presents information supporting the closure of Corrective Action Unit (CAU) 550: Smoky Contamination Area, Nevada National Security Site, Nevada. CAU 550 includes 19 corrective action sites (CASs), which consist of one weapons-related atmospheric test (Smoky), three safety experiments (Ceres, Oberon, Titania), and 15 debris sites (Table ES-1). The CASs were sorted into the following study groups based on release potential and technical similarities: • Study Group 1, Atmospheric Test • Study Group 2, Safety Experiments • Study Group 3, Washes • Study Group 4, Debris The purpose of this document is to provide justificationmore » and documentation supporting the conclusion that no further corrective action is needed for CAU 550 based on implementation of the corrective actions listed in Table ES-1. Corrective action investigation (CAI) activities were performed between August 2012 and October 2013 as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 550: Smoky Contamination Area; and in accordance with the Soils Activity Quality Assurance Plan. The approach for the CAI was to investigate and make data quality objective (DQO) decisions based on the types of releases present. The purpose of the CAI was to fulfill data needs as defined during the DQO process. The CAU 550 dataset of investigation results was evaluated based on a data quality assessment. This assessment demonstrated the dataset is complete and acceptable for use in fulfilling the DQO data needs.« less

Changing Brain Networks Through Non-invasive Neuromodulation

PubMed Central

To, Wing Ting; De Ridder, Dirk; Hart Jr., John; Vanneste, Sven

2018-01-01

Background/Objective: Non-invasive neuromodulation techniques, such as repetitive Transcranial Magnetic Stimulation (rTMS) and transcranial Direct Current Stimulation (tDCS), have increasingly been investigated for their potential as treatments for neurological and psychiatric disorders. Despite widespread dissemination of these techniques, the underlying therapeutic mechanisms and the ideal stimulation site for a given disorder remain unknown. Increasing evidence support the possibility of non-invasive neuromodulation affecting a brain network rather than just the local stimulation target. In this article, we present evidence in a clinical setting to support the idea that non-invasive neuromodulation changes brain networks. Method: This article addresses the idea that non-invasive neuromodulation modulates brain networks, rather than just the local stimulation target, using neuromodulation studies in tinnitus and major depression as examples. We present studies that support this hypothesis from different perspectives. Main Results/Conclusion: Studies stimulating the same brain region, such as the dorsolateral prefrontal cortex (DLPFC), have shown to be effective for several disorders and studies using different stimulation sites for the same disorder have shown similar results. These findings, as well as results from studies investigating brain network connectivity on both macro and micro levels, suggest that non-invasive neuromodulation affects a brain network rather than just the local stimulation site targeted. We propose that non-invasive neuromodulation should be approached from a network perspective and emphasize the therapeutic potential of this approach through the modulation of targeted brain networks. PMID:29706876

Changing Brain Networks Through Non-invasive Neuromodulation.

PubMed

To, Wing Ting; De Ridder, Dirk; Hart, John; Vanneste, Sven

2018-01-01

Background/Objective : Non-invasive neuromodulation techniques, such as repetitive Transcranial Magnetic Stimulation (rTMS) and transcranial Direct Current Stimulation (tDCS), have increasingly been investigated for their potential as treatments for neurological and psychiatric disorders. Despite widespread dissemination of these techniques, the underlying therapeutic mechanisms and the ideal stimulation site for a given disorder remain unknown. Increasing evidence support the possibility of non-invasive neuromodulation affecting a brain network rather than just the local stimulation target. In this article, we present evidence in a clinical setting to support the idea that non-invasive neuromodulation changes brain networks. Method : This article addresses the idea that non-invasive neuromodulation modulates brain networks, rather than just the local stimulation target, using neuromodulation studies in tinnitus and major depression as examples. We present studies that support this hypothesis from different perspectives. Main Results/Conclusion : Studies stimulating the same brain region, such as the dorsolateral prefrontal cortex (DLPFC), have shown to be effective for several disorders and studies using different stimulation sites for the same disorder have shown similar results. These findings, as well as results from studies investigating brain network connectivity on both macro and micro levels, suggest that non-invasive neuromodulation affects a brain network rather than just the local stimulation site targeted. We propose that non-invasive neuromodulation should be approached from a network perspective and emphasize the therapeutic potential of this approach through the modulation of targeted brain networks.

Treatment and survival in a population-based sample of patients diagnosed with gastroesophageal adenocarcinoma

PubMed Central

Cronin-Fenton, Deirdre P; Mooney, Margaret M; Clegg, Limin X; Harlan, Linda C

2008-01-01

AIM: To examine the extent of use of specific therapies in clinical practice, and their relationship to therapies validated in clinical trials. METHODS: The US National Cancer Institutes’ Patterns of Care study was used to examine therapies and survival of patients diagnosed in 2001 with histologically-confirmed gastroesophageal adenocarcinoma (n = 1356). The study re-abstracted data and verified therapy with treating physicians for a population-based stratified random sample. RESULTS: Approximately 62% of patients had stomach adenocarcinoma (SAC), while 22% had gastric-cardia adenocarcinoma (GCA), and 16% lower esophageal adenocarcinoma (EAC). Stage IV/unstaged esophageal cancer patients were most likely and stage I-III stomach cancer patients least likely to receive chemotherapy as all or part of their therapy; gastric-cardia patients received chemotherapy at a rate between these two. In multivariable analysis by anatomic site, patients 70 years and older were significantly less likely than younger patients to receive chemotherapy alone or chemoradiation for all three anatomic sites. Among esophageal and stomach cancer patients, receipt of chemotherapy was associated with lower mortality; but no association was found among gastric-cardia patients. CONCLUSION: This study highlights the relatively low use of clinical trials-validated anti-cancer therapies in community practice. Use of chemotherapy-based treatment was associated with lower mortality, dependent on anatomic site. Findings suggest that physicians treat lower esophageal and SAC as two distinct entities, while gastric-cardia patients receive a mix of the treatment strategies employed for the two other sites. PMID:18506920

Donor-Site Morbidity After DIEAP Flap Breast Reconstruction—A 2-Year Postoperative Computed Tomography Comparison

PubMed Central

Bosse, Gerhard; Mynarek, Georg Karl; Berg, Thomas; Tindholdt, Tyge Tind; Tønseth, Kim Alexander

2017-01-01

Background: The study was undertaken to provide a more complete picture of donor-site morbidity following the deep inferior epigastric artery perforator (DIEAP) flap harvest in breast reconstruction. Most studies evaluating this subject have been performed using ultrasonography. Computed tomography (CT) might provide valuable information. Methods: In 14 patients who were reconstructed with a DIEAP flap, donor-site morbidity was assessed by comparing routine preoperative CT abdomen with CT abdomen performed 2 years postoperatively. The anteroposterior diameter and transverse diameter (TD) of the rectus muscle were measured bilaterally within 4 standardized zones. Diastasis recti abdominis (DRA) was measured in the same zones. The abdominal wall was assessed for hernias, bulging, and seromas. Results: The operated rectus muscle had a significantly increased anteroposterior diameter in 2 zones and decreased TD in 1 zone compared with preoperative measurements. Comparing the operated and nonoperated rectus muscles, the former had a significantly decreased TD in 1 zone. Supraumbilical DRA was significantly decreased with surgery, whereas infraumbilical DRA was significantly increased. No new hernias or bulging were found. Two patients had seroma formation in the abdominal wall. Conclusions: Symmetry of the 2 hemiabdomens is well preserved after DIEAP flap harvest; however, significant changes to the rectus muscles and DRA were observed. Hernia formation does not seem to be a postoperative complication of importance. The study indicates that DIEAP flaps result in limited donor-site morbidity, which for most patients does not outweigh the benefits of free perforator flap breast reconstruction. PMID:28831346

Characteristics of antibiotic prophylaxis and risk of surgical site infections in open colectomies

PubMed Central

Poeran, Jashvant; Wasserman, Isaac; Zubizarreta, Nicole; Mazumdar, Madhu

2016-01-01

Background Despite numerous trials assessing optimal antibiotic prophylaxis strategies for colorectal surgery, few studies have assessed real-world practice on a national scale with respect to risk of surgical site infections. Objective Using a large, national claims database we aimed to describe 1) current use of prophylactic antibiotics (type and duration) and 2) associations with surgical site infection after open colectomies. Design Retrospective study using the Premier Perspective database. Setting Patient hospitalizations nationwide from January 2006 to December 2013. Patients 90,725 patients that underwent an open colectomy in 445 different hospitals. Main Outcome Measures Multilevel multivariable logistic regressions measured associations between surgical site infection and 1) type of antibiotic used and 2) duration (day of surgery only, day of surgery and the day after, >1 day after surgery). Results Overall surgical site infection prevalence was 5.2% (n=4,750). Most patients (41.8%) received cefoxitin for prophylaxis; other choices were ertapenem (18.2%), cefotetan (10.3%), metronidazole+cefazolin (9.9%), ampicillin+sulbactam (7.6%), while 12.2% received other antibiotics. Distribution of prophylaxis duration was: 51.6%, 28.5%, and 19.9% for days 0, 0+1, and 1+, respectively. Compared to cefoxitin, lower odds for surgical site infection were observed for ampicillin+sulbactam (odds ratio 0.71; 95% confidence interval 0.63–0.82), ertapenem (odds ratio 0.65; 95% confidence interval 0.58–0.71) and metronidazole+cefazolin (odds ratio 0.56; 95% confidence interval 0.49–0.64), and “other” (odds ratio 0.81; 95% confidence interval 0.73–0.90); duration was not significantly associated with altered odds for surgical site infection. Sensitivity analyses supported the main findings. Limitations Lack of detailed clinical information in the billing dataset used. Conclusions In this national study assessing real-world use of prophylactic antibiotics in open colectomies, type of antibiotic used appeared to be associated with up to 44% decreased odds for surgical site infections. While there are numerous trials on optimal prophylactic strategies, studies that particularly focus on factors that influence the choice of prophylactic antibiotic might provide insights into ways of reducing the burden of surgical site infections in colorectal surgeries. PMID:27384091

Neurobehavioral effects of arsenic exposure among secondary school children in the Kandal Province, Cambodia

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vibol, Sao; Faculty of Agricultural Technology and Management, Royal University of Agriculture, Phnom Penh; Hashim, Jamal Hisham, E-mail: jamalhas@hotmail.com

The research was carried out at 3 study sites with varying groundwater arsenic (As) levels in the Kandal Province of Cambodia. Kampong Kong Commune was chosen as a highly contaminated site (300–500 μg/L), Svay Romiet Commune was chosen as a moderately contaminated site (50–300 μg/L) and Anlong Romiet Commune was chosen as a control site. Neurobehavioral tests on the 3 exposure groups were conducted using a modified WHO neurobehavioral core test battery. Seven neurobehavioral tests including digit symbol, digit span, Santa Ana manual dexterity, Benton visual retention, pursuit aiming, trail making and simple reaction time were applied. Children's hair samplesmore » were also collected to investigate the influence of hair As levels on the neurobehavioral test scores. The results from the inductively coupled plasma-mass spectrometry (ICP-MS) analyses of hair samples showed that hair As levels at the 3 study sites were significantly different (p<0.001), whereby hair samples from the highly contaminated site (n=157) had a median hair As level of 0.93 μg/g, while the moderately contaminated site (n=151) had a median hair As level of 0.22 μg/g, and the control site (n=214) had a median hair As level of 0.08 μg/g. There were significant differences among the 3 study sites for all the neurobehavioral tests scores, except for digit span (backward) test. Multiple linear regression clearly shows a positive significant influence of hair As levels on all the neurobehavioral test scores, except for digit span (backward) test, after controlling for hair lead (Pb), manganese (Mn) and cadmium (Cd). Children with high hair As levels experienced 1.57–4.67 times greater risk of having lower neurobehavioral test scores compared to those with low hair As levels, after adjusting for hair Pb, Mn and Cd levels and BMI status. In conclusion, arsenic-exposed school children from the Kandal Province of Cambodia with a median hair As level of 0.93 µg/g among those from the highly contaminated study site, showed clear evidence of neurobehavioral effects. - Highlights: • We measured the level of arsenic concentration in school secondary school children's hair. • As contamination in groundwater is the major source effect on the neurobehavioral performance of school children. • School children in highly and moderately contaminated sites are at risk of As exposure.« less

Involvement of two classes of binding sites in the interactions of cyclophilin B with peripheral blood T-lymphocytes.

PubMed

Denys, A; Allain, F; Carpentier, M; Spik, G

1998-12-15

Cyclophilin B (CyPB) is a cyclosporin A (CsA)-binding protein, mainly associated with the secretory pathway, and is released in biological fluids. We recently reported that CyPB specifically binds to T-lymphocytes and promotes enhanced incorporation of CsA. The interactions with cellular binding sites involved, at least in part, the specific N-terminal extension of the protein. In this study, we intended to specify further the nature of the CyPB-binding sites on peripheral blood T-lymphocytes. We first provide evidence that the CyPB binding to heparin-Sepharose is prevented by soluble sulphated glycosaminoglycans (GAG), raising the interesting possibility that such interactions may occur on the T-cell surface. We then characterized CyPB binding to T-cell surface GAG and found that these interactions involved the N-terminal extension of CyPB, but not its conserved CsA-binding domain. In addition, we determined the presence of a second CyPB binding site, which we termed a type I site, in contrast with type II for GAG interactions. The two binding sites exhibit a similar affinity but the expression of the type I site was 3-fold lower. The conclusion that CyPB binding to the type I site is distinct from the interactions with GAG was based on the findings that it was (1) resistant to NaCl wash and GAG-degrading enzyme treatments, (2) reduced in the presence of CsA or cyclophilin C, and (3) unmodified in the presence of either the N-terminal peptide of CyPB or protamine. Finally, we showed that the type I binding sites were involved in an endocytosis process, supporting the hypothesis that they may correspond to a functional receptor for CyPB.

Skinfold Thickness at 8 Common Cryotherapy Sites in Various Athletic Populations

PubMed Central

Jutte, Lisa S.; Hawkins, Jeremy; Miller, Kevin C.; Long, Blaine C.; Knight, Kenneth L.

2012-01-01

Context: Researchers have observed slower cooling rates in thigh muscle with greater overlying adipose tissue, suggesting that cryotherapy duration should be based on the adipose thickness of the treatment site. Skinfold data do not exist for other common cryotherapy sites, and no one has reported how those skinfolds might vary because of physical activity level or sex. Objective: To determine the variability in skinfold thickness among common cryotherapy sites relative to sex and activity level (National Collegiate Athletic Association Division I athletes, recreationally active college athletes). Design: Descriptive laboratory study. Setting: Field. Patients or Other Participants: Three hundred eighty-nine college students participated; 196 Division I athletes (157 men, 39 women) were recruited during preseason physicals, and 193 recreationally active college athletes (108 men, 85 women) were recruited from physical education classes. Intervention(s): Three skinfold measurements to within 1 mm were taken at 8 sites (inferior angle of the scapula, middle deltoid, ulnar groove, midforearm, midthigh, medial collateral ligament, midcalf, and anterior talofibular ligament [ATF]) using Lange skinfold calipers. Main Outcome Measure(s): Skinfold thickness in millimeters. Results: We noted interactions among sex, activity level, and skinfold site. Male athletes had smaller skinfold measurements than female athletes at all sites except the ATF, scapula, and ulnar groove (F7,2702 = 69.85, P < .001). Skinfold measurements were greater for recreationally active athletes than their Division I counterparts at all sites except the ATF, deltoid, and ulnar groove (F7,2702 = 30.79, P < .001). Thigh skinfold measurements of recreationally active female athletes were the largest, and their ATF skinfolds were the smallest. Conclusions: Skinfold thickness at common cryotherapy treatment sites varied based on level of physical activity and sex. Therefore, clinicians should measure skinfold thickness to determine an appropriate cryotherapy duration. PMID:22488282

Post-analysis report on Chesapeake Bay data processing. [spectral analysis and recognition computer signature extension

NASA Technical Reports Server (NTRS)

Thomson, F.

1972-01-01

The additional processing performed on data collected over the Rhode River Test Site and Forestry Site in November 1970 is reported. The techniques and procedures used to obtain the processed results are described. Thermal data collected over three approximately parallel lines of the site were contoured, and the results color coded, for the purpose of delineating important scene constituents and to identify trees attacked by pine bark beetles. Contouring work and histogram preparation are reviewed and the important conclusions from the spectral analysis and recognition computer (SPARC) signature extension work are summarized. The SPARC setup and processing records are presented and recommendations are made for future data collection over the site.

Productivity of tree swallows (Tachycineta bicolor) exposed to PCBs at the Kalamazoo River superfund site.

PubMed

Neigh, Arianne M; Zwiernik, Matthew J; MacCarroll, Monica A; Newsted, John L; Blankenship, Alan L; Jones, Paul D; Kay, Denise P; Giesy, John P

2006-03-01

A 123-km stretch of the Kalamazoo River in Michigan, was designated a Superfund site in 1990 due to historical releases of effluent containing polychlorinated biphenyl (PCB)-contaminated paper waste. Risk to bird species in the river ecosystem was evaluated using the tree swallow (Tachycineta bicolor) as a monitor for possible effects due to PCB exposure at two nesting locations, one in the Superfund site and one in an upstream reference location that is less contaminated with PCBs. In 2 of the 3 years of the study, clutch size at the contaminated location was 3.7 +/- 1.4 and 4.8 +/- 0.73 eggs per nest (mean +/- SD), which was significantly less than the clutch size at the reference location (5.0 +/- 1.1 and 5.3 +/- 1.1 eggs per nest). However, there were no statistically significant differences in fledging success, predicted brood size, predicted number of fledglings, or growth of nestlings between the Kalamazoo River Superfund site and an upstream reference location with lesser concentrations of PCBs in the sediments and riparian soils. Productivity and hatching success comparisons between these same sites were also not significantly different; however, the power of these conclusions was less (p < .10). The reduction in clutch size at the co-contaminated location could not be attributed to PCBs due to a number of confounding factors, including Co-cocontaminants, habitat structure, and food availability. Other reproductive parameters were not significantly impaired, and the size of the newly established colony at the Kalamazoo River Superfund site continued to grow over the period of the study. These site-specific observations, combined with multiple lines of evidence approach that considered results reported for the effects of both total PCBs and 2,3,7,8 tetrachlorodibenzo-p-dioxin equivalents (TEQ) on tree swallows at other locations, suggest that there were no significant population-level effects of PCBs on tree swallows at the Kalamazoo River Superfund site.

Nitric oxide synthase inhibition attenuates cutaneous vasodilation during the post-menopausal hot flash

PubMed Central

Hubing, Kimberly A.; Wingo, Jonathan E.; Brothers, R. Matthew; Coso, Juan Del; Low, David A.; Crandall, Craig G.

2010-01-01

Objective The purpose of this study was to test the hypothesis that local inhibition of nitric oxide and prostaglandin synthesis attenuates cutaneous vasodilator responses during post-menopausal hot flashes. Methods Four microdialysis membranes were inserted into forearm skin (dorsal surface) of 8 post-menopausal women (mean ± SD, 51±7 y). Ringers solution (control), 10mM Ketorolac (Keto) to inhibit prostaglandin synthesis, 10mM NG-L-arginine methyl ester (L-NAME) to inhibit nitric oxide synthase, and a combination of 10mM Keto + 10mM L-NAME were each infused at the separate sites. Skin blood flow at each site was indexed using laser-Doppler flowmetry. Cutaneous vascular conductance (CVC) was calculated as laser-Doppler flux/mean arterial blood pressure and was expressed as a percentage of the maximal calculated CVC (CVCmax) obtained following infusion of 50mM sodium nitropruside at all sites at the end of the study. Data from 13 hot flashes were analyzed. Results At the control site, the mean ± SD peak increase in CVC was 15.5±6% CVCmax units. This value was not different relative to the peak increase in CVC at the Keto site (13.0±5 % CVCmax units, P = 0.09). However, the peak increase in CVC during the flash was attenuated at the L-NAME and L-NAME + Keto sites (7.4±4 % CVCmax units and 8.7±7 % CVCmax units, respectively) relative to both the control and the Keto sites (P<0.05 for both comparisons). There were no significant differences in the peak increases in sweat rate between any of the sites (P = 0.24). Conclusions These data demonstrate that cutaneous vasodilation during a hot flash has a nitric oxide component. Increases in CVC despite the inhibition of prostaglandin synthesis suggest prostaglandins do not contribute to cutaneous vasodilation during a hot flash. PMID:20505548

Internet Usage by Low-Literacy Adults Seeking Health Information: An Observational Analysis

PubMed Central

Birru, Mehret S; Monaco, Valerie M; Charles, Lonelyss; Drew, Hadiya; Njie, Valerie; Bierria, Timothy; Detlefsen, Ellen

2004-01-01

Background Adults with low literacy may encounter informational obstacles on the Internet when searching for health information, in part because most health Web sites require at least a high-school reading proficiency for optimal access. Objective The purpose of this study was to 1) determine how low-literacy adults independently access and evaluate health information on the Internet, 2) identify challenges and areas of proficiency in the Internet-searching skills of low-literacy adults. Methods Subjects (n=8) were enrolled in a reading assistance program at Bidwell Training Center in Pittsburgh, PA, and read at a 3rd to 8th grade level. Subjects conducted self-directed Internet searches for designated health topics while utilizing a think-aloud protocol. Subjects' keystrokes and comments were recorded using Camtasia Studio screen-capture software. The search terms used to find health information, the amount of time spent on each Web site, the number of Web sites accessed, the reading level of Web sites accessed, and the responses of subjects to questionnaires were assessed. Results Subjects collectively answered 8 out of 24 questions correctly. Seven out of 8 subjects selected "sponsored sites"-paid Web advertisements-over search engine-generated links when answering health questions. On average, subjects accessed health Web sites written at or above a 10th grade reading level. Standard methodologies used for measuring health literacy and for promoting subjects to verbalize responses to Web-site form and content had limited utility in this population. Conclusion This study demonstrates that Web health information requires a reading level that prohibits optimal access by some low-literacy adults. These results highlight the low-literacy adult population as a potential audience for Web health information, and indicate some areas of difficulty that these individuals face when using the Internet and health Web sites to find information on specific health topics. PMID:15471751

The Prevalence, Correlates, Detection and Control of Diabetes among Older People in Low and Middle Income Countries. A 10/66 Dementia Research Group Population-Based Survey

PubMed Central

Salas, Aquiles; Acosta, Daisy; Ferri, Cleusa P.; Guerra, Mariella; Huang, Yueqin; Jacob, K. S.; Jimenez-Velazquez, Ivonne Z.; Llibre Rodriguez, Juan J.; Sosa, Ana L.; Uwakwe, Richard; Williams, Joseph D.; Jotheeswaran, A. T.; Liu, Zhaorui; Lopez Medina, A. M.; Salinas-Contreras, Rosa Maria; Prince, Martin J.

2016-01-01

Background Little is known of the epidemiology of diabetes among older people in low and middle income countries. We aimed to study and compare prevalence, social patterning, correlates, detection, treatment and control of diabetes among older people in Latin America, India, China and Nigeria. Methods Cross-sectional surveys in 13 catchment area sites in nine countries. Diagnosed diabetes was assessed in all sites through self-reported diagnosis. Undiagnosed diabetes was assessed in seven Latin American sites through fasting blood samples (glucose > = 7mmol/L). Results Total diabetes prevalence in catchment sites in Cuba (prevalence 24.2%, SMR 116), Puerto Rico (43.4%, 197), and urban (27.0%, 125), and rural Mexico (23.7%, 111) already exceeds that in the USA, while that in Venezuela (20.9%, 100) is similar. Diagnosed diabetes prevalence varied very widely, between low prevalences in sites in rural China (0.9%), rural India (6.6%) and Nigeria (6.0%). and 32.1% in Puerto Rico, explained mainly by access to health services. Treatment coverage varied substantially between sites. Diabetes control (40 to 61% of those diagnosed) was modest in the Latin American sites where this was studied. Diabetes was independently associated with less education, but more assets. Hypertension, central obesity and hypertriglyceridaemia, but not hypercholesterolaemia were consistently associated with total diabetes. Conclusions Diabetes prevalence is already high in most sites. Identifying undiagnosed cases is essential to quantify population burden, particularly in least developed settings where diagnosis is uncommon. Metabolic risk factors and associated lifestyles may play an important part in aetiology, but this requires confirmation with longitudinal data. Given the high prevalence among older people, more population research is indicated to quantify the impact of diabetes, and to monitor the effect of prevention and health system strengthening on prevalence, treatment and control. PMID:26913752

Risk of adverse birth outcomes in populations living near landfill sites

PubMed Central

Elliott, Paul; Briggs, David; Morris, Sara; de Hoogh, Cornelis; Hurt, Christopher; Jensen, Tina Kold; Maitland, Ian; Richardson, Sylvia; Wakefield, Jon; Jarup, Lars

2001-01-01

Objective To investigate the risk of adverse birth outcomes associated with residence near landfill sites in Great Britain. Design Geographical study of risks of adverse birth outcomes in populations living within 2 km of 9565 landfill sites operational at some time between 1982 and 1997 (from a total of 19 196 sites) compared with those living further away. Setting Great Britain. Subjects Over 8.2 million live births, 43 471 stillbirths, and 124 597 congenital anomalies (including terminations). Main outcome measures All congenital anomalies combined, some specific anomalies, and prevalence of low and very low birth weight (<2500 g and <1500 g). Results For all anomalies combined, relative risk of residence near landfill sites (all waste types) was 0.92 (99% confidence interval 0.907 to 0.923) unadjusted, and 1.01 (1.005 to 1.023) adjusted for confounders. Adjusted risks were 1.05 (1.01 to 1.10) for neural tube defects, 0.96 (0.93 to 0.99) for cardiovascular defects, 1.07 (1.04 to 1.10) for hypospadias and epispadias (with no excess of surgical correction), 1.08 (1.01 to 1.15) for abdominal wall defects, 1.19 (1.05 to 1.34) for surgical correction of gastroschisis and exomphalos, and 1.05 (1.047 to 1.055) and 1.04 (1.03 to 1.05) for low and very low birth weight respectively. There was no excess risk of stillbirth. Findings for special (hazardous) waste sites did not differ systematically from those for non-special sites. For some specific anomalies, higher risks were found in the period before opening compared with after opening of a landfill site, especially hospital admissions for abdominal wall defects. Conclusions We found small excess risks of congenital anomalies and low and very low birth weight in populations living near landfill sites. No causal mechanisms are available to explain these findings, and alternative explanations include data artefacts and residual confounding. Further studies are needed to help differentiate between the various possibilities. What is already known on this topicVarious studies have found excess risks of certain congenital anomalies and low birth weight near landfill sitesRisks up to two to three times higher have been reportedThese studies have been difficult to interpret because of problems of exposure classification, small sample size, confounding, and reporting biasWhat this study addsSome 80% of the British population lives within 2 km of known landfill sites in Great BritainBy including all landfill sites in the country, we avoided the problem of selective reporting, and maximised statistical powerAlthough we found excess risks of congenital anomalies and low birth weight near landfill sites in Great Britain, they were smaller than in some other studiesFurther work is needed to differentiate potential data artefacts and confounding effects from possible causal associations with landfill PMID:11509424

Changes of the peri-implant soft tissue thickness after grafting with a collagen matrix

PubMed Central

Zafiropoulos, Gregory-George; Deli, Giorgio; Hoffmann, Oliver; John, Gordon

2016-01-01

Background: The aim of this study was to determine the treatment outcome of the use of a porcine monolayer collagen matrix (mCM) to increase soft-tissue volume as a part of implant site development. Materials and Methods: Implants were placed in single sites in 27 patients. In the test group, mCM was used for soft-tissue augmentation. No graft was placed in the control group. Soft-tissue thickness (STTh) was measured at the time of surgery (T0) and 6 months postoperatively (T1) at two sites (STTh 1, 1 mm below the gingival margin; STTh 2, 3 mm below the mucogingival margin). Results: Significant increases (P < 0.001) in STTh (STTh 1 = 1.06 mm, 117%; STTh 2 = 0.89 mm, 81%) were observed in the test group. Biopsy results showed angiogenesis and mature connective tissue covered by keratinized epithelium. Conclusions: Within the limitations of this study, it could be concluded that mCM leads to a significant increase of peri-implant soft-tissue thickness, with good histological integration and replacement by soft tissue and may serve as an alternative to connective tissue grafting. PMID:28298828

A Cross-site Qualitative Study of Physician Order Entry

PubMed Central

Ash, Joan S.; Gorman, Paul N.; Lavelle, Mary; Payne, Thomas H.; Massaro, Thomas A.; Frantz, Gerri L.; Lyman, Jason A.

2003-01-01

Objective: To describe the perceptions of diverse professionals involved in computerized physician order entry (POE) at sites where POE has been successfully implemented and to identify differences between teaching and nonteaching hospitals. Design: A multidisciplinary team used observation, focus groups, and interviews with clinical, administrative, and information technology staff to gather data at three sites. Field notes and transcripts were coded using an inductive approach to identify patterns and themes in the data. Measurements: Patterns and themes concerning perceptions of POE were identified. Results: Four high-level themes were identified: (1) organizational issues such as collaboration, pride, culture, power, politics, and control; (2) clinical and professional issues involving adaptation to local practices, preferences, and policies; (3) technical/implementation issues, including usability, time, training and support; and (4) issues related to the organization of information and knowledge, such as system rigidity and integration. Relevant differences between teaching and nonteaching hospitals include extent of collaboration, staff longevity, and organizational missions. Conclusion: An organizational culture characterized by collaboration and trust and an ongoing process that includes active clinician engagement in adaptation of the technology were important elements in successful implementation of physician order entry at the institutions that we studied. PMID:12595408

The relationship between the target effective site concentration of rocuronium and the degree of recovery from neuromuscular blockade in elderly patients

PubMed Central

Fan, Xiaochong; Ma, Minyu; Li, Zhisong; Gong, Shengkai; Zhang, Wei; Wen, Yuanyuan

2015-01-01

Objective: To study the relationship between the target effective site concentration (Ce) of rocuronium and the degree of recovery from neuromuscular blockade in elderly patients. Methods: 50 elderly patients (ASA grade II) scheduled for selective surgical procedure under general anaesthesia were randomly divided into two groups, A and B, with 25 cases in each group. The Ce of rocuronium for intubation was 3 μg·ml-1 in both groups, and the Ce during operation were 0.8 and 1.0 μg·ml-1 in group A and B, respectively. When target controlled infusion of rocuronium was stopped, without the administration of reversal agents for neuromuscular blockade, the relationship between Ce and the first twitch height (T1) was studied by regression analysis. Results: There was a significant linear relationship between Ce and T1, and there was no statistical difference in regression coefficient and interception between group A and B (P>0.05). Conclusion: The degree of recovery from neuromuscular blockade could be judged by the target effective site concentration of rocuronium at the time of reversal from neuromuscular blockade in the elderly patients. PMID:26629159

Seasonal and Spatial Dynamics of the Primary Vector of Plasmodium knowlesi within a Major Transmission Focus in Sabah, Malaysia

PubMed Central

Wong, Meng L.; Chua, Tock H.; Leong, Cherng S.; Khaw, Loke T.; Fornace, Kimberly; Wan-Sulaiman, Wan-Yusoff; William, Timothy; Drakeley, Chris; Ferguson, Heather M.; Vythilingam, Indra

2015-01-01

Background The simian malaria parasite Plasmodium knowlesi is emerging as a public health problem in Southeast Asia, particularly in Malaysian Borneo where it now accounts for the greatest burden of malaria cases and deaths. Control is hindered by limited understanding of the ecology of potential vector species. Methodology/Principal Findings We conducted a one year longitudinal study of P. knowlesi vectors in three sites within an endemic area of Sabah, Malaysia. All mosquitoes were captured using human landing catch. Anopheles mosquitoes were dissected to determine, oocyst, sporozoites and parous rate. Anopheles balabacensis is confirmed as the primary vector of. P. knowlesi (using nested PCR) in Sabah for the first time. Vector densities were significantly higher and more seasonally variable in the village than forest or small scale farming site. However An. balabacensis survival and P. knowlesi infection rates were highest in forest and small scale farm sites. Anopheles balabacensis mostly bites humans outdoors in the early evening between 1800 to 2000hrs. Conclusions/Significance This study indicates transmission is unlikely to be prevented by bednets. This combined with its high vectorial capacity poses a threat to malaria elimination programmes within the region. PMID:26448052

The capsaicin cough reflex in eczema patients with respiratory symptoms elicited by perfume.

PubMed

Elberling, Jesper; Dirksen, Asger; Johansen, Jeanne Duus; Mosbech, Holger

2006-03-01

Respiratory symptoms elicited by perfume are common in the population but have unclear pathophysiology. Increased capsaicin cough responsiveness has been associated with the symptoms, but it is unknown whether the site of the symptoms in the airways influences this association. The aim of this study was to investigate the association between the site of airway symptoms elicited by perfume and cough responsiveness to bronchial challenge with capsaicin. 21 eczema patients with respiratory symptoms elicited by perfume were compared with 21 healthy volunteers in a sex- and age-matched case control study. The participants completed a symptom questionnaire and underwent a bronchial challenge with capsaicin. Lower, but not upper, respiratory symptoms elicited by perfume were associated with increased capsaicin cough responsiveness. Having severe symptoms to perfume (n=11) did not relate to the site of the symptoms in the airways and was not associated with increased capsaicin cough responsiveness. In conclusion, respiratory symptoms elicited by perfume may reflect local hyperreactivity related to defensive reflexes in the airways, and measurements of the capsaicin cough reflex are relevant when patients with lower respiratory symptoms related to environmental perfume exposures are investigated.

Lactate Dehydrogenase Activity in Gingival Crevicular Fluid as a Marker in Orthodontic Tooth Movement

PubMed Central

Alfaqeeh, Sarah A; Anil, Sukumaran

2011-01-01

Objectives: This study aims at analyzing the changes in gingival crevicular fluid (GCF) lactate dehydrogenase (LDH) activity during orthodontic movement. Methods: Twenty patients all requiring first premolar extractions were selected and treated with conventional straight wire mechanotherapy. Canine retraction was done using 125 g Nitinol closed coil springs. The maxillary canine on one side served as the experimental site while the contralateral canine served as the control. GCF was collected from the canines before initiation of retraction, then 1 hour after initiating canine retraction, followed by 1 day, 7 days, 14 days and 21 days. GCF LDH levels were estimated and compared with the control site. Results The results revealed significantly higher LDH levels on the 7th, 14th and 21st day at the sites where orthodontic force had been applied. The levels also showed a significant increase from 0 hour to the 21st day. Peak levels were seen on 14th and 21st day following initiation of retraction. Conclusions: The study showed that LDH could be successfully estimated in the GCF and its increased levels could indicate active tooth movement, which could aid the clinician in monitoring active orthodontic tooth movement. PMID:21760863

Effect of Genital Sampling Site on the Detection and Quantification of Ureaplasma Species with Quantitative Polymerase Chain Reaction during Pregnancy.

PubMed

Faron, Gilles; Vancutsem, Ellen; Naessens, Anne; Buyl, Ronald; Gucciardo, Leonardo; Foulon, Walter

2017-01-01

Objective . This study aimed to compare the qualitative and quantitative reproducibility of quantitative PCR (qPCR) for Ureaplasma species (Ureaplasma spp.) throughout pregnancy and according to the genital sampling site. Study Design . Between 5 and 14 weeks of gestation (T1), vaginal, fornix, and two cervical samples were taken. Sampling was repeated during the 2nd (T2) and 3rd (T3) trimester in randomly selected T1 positive and negative women. Qualitative and quantitative reproducibility were evaluated using, respectively, Cohen's kappa ( κ ) and interclass correlation coefficients (ICC) and repeated measures ANOVA on the log-transformed mean number of DNA copies for each sampling site. Results . During T1, 51/127 women were positive for U. parvum and 8 for U. urealyticum (4 patients for both). Sampling was repeated for 44/55 women at T2 and/or T3; 43 (97.7%) remained positive at the three timepoints. κ ranged between 0.83 and 0.95 and the ICC for cervical samples was 0.86. Conclusions . Colonization by Ureaplasma spp. seems to be very constant during pregnancy and vaginal samples have the highest detection rate.

Factors Associated with Mobility Outcomes in a National Spina Bifida Patient Registry

PubMed Central

Dicianno, Brad E.; Karmarkar, Amol; Houtrow, Amy; Crytzer, Theresa M.; Cushanick, Katelyn M.; McCoy, Andrew; Wilson, Pamela; Chinarian, James; Neufeld, Jacob; Smith, Kathryn; Collins, Diane M.

2017-01-01

Objective To provide descriptive data on ambulatory ability and muscle strength in a large cohort of individuals with spina bifida enrolled in a National Spina Bifida Patient Registry (NSBPR) and to investigate factors associated with ambulatory status. Design Cross-sectional analysis of data from a multi-site patient registry Results Descriptive analysis of mobility variables for 2604 individuals with spina bifida age 5 and above are presented from 19 sites in the United States. Analysis of a subset of NSBPR data from 380 individuals from three sites accompanied by data from a specialized spina bifida electronic medical record revealed that those with no history of a shunt, lower motor level, and no history of hip or knee contracture release surgery were more likely to be ambulatory at the community level than at the household or wheelchair level. Conclusion This study is the first to examine factors associated with ambulatory status in a large sample of individuals with myelomeningocele and non-myelomeningocele subtypes of SB. Results of this study delineate the breadth of strength and functional abilities within the different age groups and subtypes of SB. The results may inform clinicians of the characteristics of those with varying ambulatory abilities. PMID:26488146

Prevalence of overweight in children with bone fractures: a case control study

PubMed Central

2012-01-01

Background Children's fractures have been enlisted among orthopaedics complaints of childhood obesity. Unhealthy lifestyle behaviours may contribute to increased risk. This study described the prevalence of overweight/obesity in children and adolescents reporting a recent fracture in relation to gender, dynamic of trauma, and site of fracture. Methods Four-hundred-forty-nine children and adolescents with fracture and 130 fracture-free controls were recruited from a large children’s hospital. The interaction between overweight and gender, dynamic of trauma, site of fracture was explored. Sports participation, television viewing, and calcium intake were also investigated. Results Overweight/obesity rate was increased in girls with fracture either at the upper or the lower limb (p= 0.004), while it was increased only in boys with fracture at the lower limb (p <0.02). Overweight/obesity rate did not differ between groups with low or moderate trauma. TV viewing ≥ 2 hrs was more frequent in children with fractures than controls (61.5% vs 34.5%, p =0.015) in the overweight/obese group. Conclusions The increased prevalence of overweight/obesity in children with fractures is related to gender and site of fracture. Higher levels of sedentary behaviours characterize overweight children reporting fractures. PMID:23088687

Site selection for managed aquifer recharge using fuzzy rules: integrating geographical information system (GIS) tools and multi-criteria decision making

NASA Astrophysics Data System (ADS)

Malekmohammadi, Bahram; Ramezani Mehrian, Majid; Jafari, Hamid Reza

2012-11-01

One of the most important water-resources management strategies for arid lands is managed aquifer recharge (MAR). In establishing a MAR scheme, site selection is the prime prerequisite that can be assisted by geographic information system (GIS) tools. One of the most important uncertainties in the site-selection process using GIS is finite ranges or intervals resulting from data classification. In order to reduce these uncertainties, a novel method has been developed involving the integration of multi-criteria decision making (MCDM), GIS, and a fuzzy inference system (FIS). The Shemil-Ashkara plain in the Hormozgan Province of Iran was selected as the case study; slope, geology, groundwater depth, potential for runoff, land use, and groundwater electrical conductivity have been considered as site-selection factors. By defining fuzzy membership functions for the input layers and the output layer, and by constructing fuzzy rules, a FIS has been developed. Comparison of the results produced by the proposed method and the traditional simple additive weighted (SAW) method shows that the proposed method yields more precise results. In conclusion, fuzzy-set theory can be an effective method to overcome associated uncertainties in classification of geographic information data.

Detecting Malaria Hotspots: A Comparison of Rapid Diagnostic Test, Microscopy, and Polymerase Chain Reaction

PubMed Central

Mogeni, Polycarp; Williams, Thomas N; Omedo, Irene; Kimani, Domtila; Ngoi, Joyce M; Mwacharo, Jedida; Morter, Richard; Nyundo, Christopher; Wambua, Juliana; Nyangweso, George; Kapulu, Melissa; Fegan, Gregory; Bejon, Philip

2017-01-01

Abstract Background Malaria control strategies need to respond to geographical hotspots of transmission. Detection of hotspots depends on the sensitivity of the diagnostic tool used. Methods We conducted cross-sectional surveys in 3 sites within Kilifi County, Kenya, that had variable transmission intensities. Rapid diagnostic test (RDT), microscopy, and polymerase chain reaction (PCR) were used to detect asymptomatic parasitemia, and hotspots were detected using the spatial scan statistic. Results Eight thousand five hundred eighty-one study participants were surveyed in 3 sites. There were statistically significant malaria hotspots by RDT, microscopy, and PCR for all sites except by microscopy in 1 low transmission site. Pooled data analysis of hotspots by PCR overlapped with hotspots by microscopy at a moderate setting but not at 2 lower transmission settings. However, variations in degree of overlap were noted when data were analyzed by year. Hotspots by RDT were predictive of PCR/microscopy at the moderate setting, but not at the 2 low transmission settings. We observed long-term stability of hotspots by PCR and microscopy but not RDT. Conclusion Malaria control programs may consider PCR testing to guide asymptomatic malaria hotspot detection once the prevalence of infection falls. PMID:28973672

Modeling Ca2+ Feedback on a Single Inositol 1,4,5-Trisphosphate Receptor and Its Modulation by Ca2+ Buffers

PubMed Central

Shuai, Jianwei; Pearson, John E.; Parker, Ian

2008-01-01

The inositol 1,4,5-trisphosphate receptor/channel (IP3R) is a major regulator of intracellular Ca2+ signaling, and liberates Ca2+ ions from the endoplasmic reticulum in response to binding at cytosolic sites for both IP3 and Ca2+. Although the steady-state gating properties of the IP3R have been extensively studied and modeled under conditions of fixed [IP3] and [Ca2+], little is known about how Ca2+ flux through a channel may modulate the gating of that same channel by feedback onto activating and inhibitory Ca2+ binding sites. We thus simulated the dynamics of Ca2+ self-feedback on monomeric and tetrameric IP3R models. A major conclusion is that self-activation depends crucially on stationary cytosolic Ca2+ buffers that slow the collapse of the local [Ca2+] microdomain after closure. This promotes burst-like reopenings by the rebinding of Ca2+ to the activating site; whereas inhibitory actions are substantially independent of stationary buffers but are strongly dependent on the location of the inhibitory Ca2+ binding site on the IP3R in relation to the channel pore. PMID:18641077

Effects of Payment Changes on Trends in Post-Acute Care

PubMed Central

Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

2009-01-01

Objective To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Data Sources Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. Study Design We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. Data Extraction Methods A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Principal Findings Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Conclusions Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites. PMID:19490159

Does predator management enhance survival of reintroduced black-footed ferrets?

USGS Publications Warehouse

Breck, Stewart W.; Biggins, Dean E.; Livieri, Travis M.; Matchett, Marc R.; Kopcso, Valerie

2006-01-01

Predation on black-footed ferrets (Mustela nigripes) is a potential problem at reintroduction sites, causing up to 95 percent of the documented mortality of ferrets. Strategies to reduce mortality due to predation can focus on preconditioning ferrets prior to reintroduction and/or managing predators of ferrets. Biologists have tried three general strategies to control predators at reintroduction sites: (1) selective removal of individual predators, (2) nonselective removal of coyotes (Canis latrans), and (3) electric fences to exclude coyotes from release sites. We conducted a post hoc review of data from releases during 1994–2003 at 11 sites in South Dakota and Montana to address whether or not predator management has benefited reintroduced black-footed ferrets. Limited evidence indicates that (1) individual great horned owls (Bubo virginianus) can cause significant ferret mortality and that identifying and removing these individuals can be beneficial, (2) lethal control of coyotes may have inverse effects on ferret survival, and (3) electric fencing does not enhance short- or long-term survival of reintroduced ferrets. The data are confounded by a variety of factors, making conclusions tenuous. Well designed studies are needed to properly address the effectiveness of predator management for enhancing ferret survival.

Work-site cardiovascular risk reduction: a randomized trial of health risk assessment, education, counseling, and incentives.

PubMed Central

Gomel, M; Oldenburg, B; Simpson, J M; Owen, N

1993-01-01

OBJECTIVES. This study reports an efficacy trial of four work-site health promotion programs. It was predicted that strategies making use of behavioral counseling would produce a greater reduction in cardiovascular disease risk factors than screening and educational strategies. METHODS. Twenty-eight work sites were randomly allocated to a health risk assessment, risk factor education, behavioral counseling, or behavioral counseling plus incentives intervention. Participants were assessed before the intervention and at 3, 6, and 12 months. RESULTS. Compared with the average of the health risk assessment and risk factor education conditions, there were significantly higher validated continuous smoking cessation rates and smaller increases in body mass index and estimated percentage of body fat in the two behavioral counseling conditions. The behavioral counseling condition was associated with a greater reduction in mean blood pressure than was the behavioral counseling plus incentives condition. On average among all groups, there was a short-term increase in aerobic capacity followed by a return to baseline levels. CONCLUSIONS. Work-site interventions that use behavioral approaches can produce lasting changes in some cardiovascular risk factors and, if implemented routinely, can have a significant public health impact. PMID:8362997

The Impact of Green Stormwater Infrastructure Installation on Surrounding Health and Safety

PubMed Central

Low, Sarah C.; Henning, Jason; Branas, Charles C.

2015-01-01

Objectives. We investigated the health and safety effects of urban green stormwater infrastructure (GSI) installments. Methods. We conducted a difference-in-differences analysis of the effects of GSI installments on health (e.g., blood pressure, cholesterol and stress levels) and safety (e.g., felonies, nuisance and property crimes, narcotics crimes) outcomes from 2000 to 2012 in Philadelphia, Pennsylvania. We used mixed-effects regression models to compare differences in pre- and posttreatment measures of outcomes for treatment sites (n = 52) and randomly chosen, matched control sites (n = 186) within multiple geographic extents surrounding GSI sites. Results. Regression-adjusted models showed consistent and statistically significant reductions in narcotics possession (18%–27% less) within 16th-mile, quarter-mile, half-mile (P < .001), and eighth-mile (P < .01) distances from treatment sites and at the census tract level (P < .01). Narcotics manufacture and burglaries were also significantly reduced at multiple scales. Nonsignificant reductions in homicides, assaults, thefts, public drunkenness, and narcotics sales were associated with GSI installation in at least 1 geographic extent. Conclusions. Health and safety considerations should be included in future assessments of GSI programs. Subsequent studies should assess mechanisms of this association. PMID:25602887

Computational Fluid Dynamics Simulations of Hemodynamics in Plaque Erosion

PubMed Central

Campbell, Ian C.; Timmins, Lucas H.; Giddens, Don P.; Virmani, Renu; Veneziani, Alessandro; Rab, S. Tanveer; Samady, Habib; McDaniel, Michael C.; Finn, Aloke V.; Taylor, W. Robert; Oshinski, John N.

2013-01-01

Purpose We investigated whether local hemodynamics were associated with sites of plaque erosion and hypothesized that patients with plaque erosion have locally elevated WSS magnitude in regions where erosion has occurred. Methods We generated 3D, patient-specific models of coronary arteries from biplane angiographic images in 3 human patients with plaque erosion diagnosed by optical coherence tomography (OCT). Using computational fluid dynamics, we simulated pulsatile blood flow and calculated both wall shear stress (WSS) and oscillatory shear index (OSI). We also investigated anatomic features of plaque erosion sites by examining branching and local curvature in x-ray angiograms of barium-perfused autopsy hearts. Results Neither high nor low magnitudes of mean WSS were associated with sites of plaque erosion. OSI and local curvature were also not associated with erosion. Anatomically, 8 of 13 hearts had a nearby bifurcation upstream of the site of plaque erosion. Conclusions This study provides preliminary evidence that neither hemodynamics nor anatomy are predictors of plaque erosion, based upon a very unique dataset. Our sample sizes are small, but this dataset suggests that high magnitudes of wall shear stress, one potential mechanism for inducing plaque erosion, are not necessary for erosion to occur. PMID:24223678

Implant Dentistry: Monitoring of Bacteria Along the Transmucosal Passage of the Healing Screw in Absence of Functional Load

PubMed Central

MEYNARDI, F.; PASQUALINI, M.E.; ROSSI, F.; DAL CARLO, L.; NARDONE, M.; BAGGI, L.

2016-01-01

SUMMARY Purpose To assess the changes in bacterial profile along the transmucosal path of healing screws placed immediately after insertion of two-piece endosseus implants during the 4-month osseointegration phase, in absence of functional load. Materials and methods Two site-specific samples were collected at the peri-implant mucosa of the healing screws of 80 two-piece implants, for a total of 640 samples. Implants placement was performed following a single protocol with flapless technique, in order to limit bacterial contamination of the surgical site. Identical healing screws (5 mm diameter/4 mm height) were used for each of the 80 implants. During the 4 months of the study, the patients followed a standard oral care regimen with no special hygiene maneuvers at the collection sites. Results The present research documents that during the 4-month period prior to application of function load the bacterial profile of all sites exhibited a clear prevalence of cocci at the interface between implant neck and osteoalveolar crest margin. Conclusions A potentially pathogenic bacterial flora developed only along the peri-implant transmucosal path. PMID:28280528

Ames Laboratory site environmental report, calendar year 1988

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mathison, L.K.

1989-05-01

The summarized data and conclusions from the Ames Laboratory environmental monitoring program are presented in this Annual Site Environmental Report. Ames Laboratory is located on the campus of Iowa State University (ISU) and occupies several buildings owned by the Department of Energy. A study is being conducted to identify environmental sampling methods which can characterize and separate the impact of Ames Laboratory's campus activities and that of ISU. This will enable the Laboratory to determine what possible impact it's operations may be having to the environment, if any. Two Pollution Abatement projects were begun in 1988. They were: removal ofmore » thorium contaminated soil resulting from a historical release of thorium at the Laboratory, to the Ames, Iowa Water Pollution Control (sewage) Plant and demolition of a small Blockhouse'' constructed of concrete block which had been used for low level radioactive waste handling. The contaminated soil has been removed and transported to Hanford, WA for disposal. A final site radiological survey for thorium is pending. In addition, contaminated debris was transported to Hanford, WA for disposal and a final site survey is pending. 7 refs., 4 figs., 1 tab.« less

Healing of donor site in bone-tendon-bone ACL reconstruction accelerated with plasma rich in growth factors: a randomized clinical trial.

PubMed

Seijas, Roberto; Rius, Marta; Ares, Oscar; García-Balletbó, Montserrat; Serra, Iván; Cugat, Ramón

2015-04-01

To determine whether the use of plasma rich in growth factors accelerates healing of the donor site in bone-tendon-bone anterior cruciate ligament (ACL) reconstruction (patellar graft). The use of the patellar graft presents post-operative problems such as anterior knee pain, which limits its use and leads to preference being taken for alternative grafts. A double-blind, randomized, clinical trial was performed comparing two groups of patients who underwent ACL reconstruction using patellar tendon graft and comparing the use of plasma rich in growth factors at the donor site after graft harvest in terms of local regeneration by ultrasound assessment. The plasma rich in growth factors group shows earlier donor site regeneration in comparison with the control group (2 months earlier), with significant differences in the first 4 months of the follow-up. The application of plasma rich in growth factors shows accelerated tissue regeneration processes with respect to the control group. This fact, together with the previously published with similar conclusions, can create a knowledge basis in order to set out new recovery guidelines following ACL reconstruction. Therapeutic study, Level I.

Single-Site Laparoscopic Management of a Large Adnexal Mass

PubMed Central

Scribner, Dennis R.; Weiss, Patrice M.

2013-01-01

Introduction: Single-site laparoscopy is gaining acceptance in many surgical fields including gynecology. The purpose of this report is to demonstrate the technique and outcome for removing a large adnexal mass through a single site. Case Description: A 41-y-old female was referred to gynecology oncology for increased abdominal girth for 3 mo. An ultrasound confirmed a benign-appearing, 37-cm left adnexal mass. The mass was removed through a single-site laparoscopic incision with the aid of drainage and a morcellator. The operating time was 84 min. The patient was discharged 2 h and 35 min later with full return to normal activity in 5 d. Conclusion: Large, benign-appearing adnexal masses can be managed safely with superior cosmetic results using single-site laparoscopy. PMID:23925036

Comparative evaluation of diode laser ablation and surgical stripping technique for gingival depigmentation: A clinical and immunohistochemical study

PubMed Central

Bakutra, Gaurav; Shankarapillai, Rajesh; Mathur, Lalit; Manohar, Balaji

2017-01-01

Introduction: There are various treatment modalities to remove the black patches of melanin pigmentation. The aim of the study is to clinically compare the diode laser ablation and surgical stripping technique for gingival depigmentation and to evaluate their effect on the histological changes in melanocyte activity. Materials and Methods: A total of 40 sites of 20 patients with bilateral melanin hyperpigmentation were treated with the surgical stripping and diode laser ablation technique. Change in Hedin index score, change in area of pigmentation using image analyzing software, pain perception, patient preference of treatment were recorded. All 40 sites were selected for immunohistochemical analysis using HMB-45 immunohistochemical marker. Results: At 12 months post-operative visit, in all sites, repigmentation was observed with different grades of Hedin index. Paired t-test, analysis of variance, and Chi-square tests were used for statistical analysis. Repigmentation in surgical stripping is significantly lesser compared to laser ablation. Lesser numbers of melanocytes were found on immunohistological examination at 12 months postoperatively. Comparison for patient preference and pain indices give statistically significant values for diode laser techniques. Conclusion: Gingival hyperpigmentation is effectively managed by diode laser ablation technique and surgical stripping method. In this study, surgical stripping technique found to be better compared to diode laser ablation. PMID:28539864

Microenvironment Tracker (MicroTrac) | Science Inventory ...

EPA Pesticide Factsheets

Epidemiologic studies have shown associations between air pollution concentrations measured at central-site ambient monitors and adverse health outcomes. Using central-site concentrations as exposure surrogates, however, can lead to exposure errors due to time spent in various indoor and outdoor microenvironments (ME) with pollutant concentrations that can be substantially different from central-site concentrations. These exposure errors can introduce bias and incorrect confidence intervals in health effect estimates, which diminish the power of such studies to establish correct conclusions about the exposure and health effects association. The significance of this issue was highlighted in the National Research Council (NRC) Report “Research Priorities for Airborne Particulate Matter”, which recommends that EPA address exposure error in health studies. To address this limitation, we developed MicroTrac, an automated classification model that estimates time of day and duration spent in eight ME (indoors and outdoors at home, work, school; inside vehicles; other locations) from personal global positioning system (GPS) data and geocoded boundaries of buildings (e.g., home, work, school). MicroTrac has several innovative design features: (1) using GPS signal quality to account for GPS signal loss inside certain buildings, (2) spatial buffering of building boundaries to account for the spatial inaccuracy of the GPS device, and (3) temporal buffering of GPS positi

Effects of soluble and particulate Cr(VI) on genome-wide DNA methylation in human B lymphoblastoid cells.

PubMed

Lou, Jianlin; Wang, Yu; Chen, Junqiang; Ju, Li; Yu, Min; Jiang, Zhaoqiang; Feng, Lingfang; Jin, Lingzhi; Zhang, Xing

2015-10-01

Several previous studies highlighted the potential epigenetic effects of Cr(VI), especially DNA methylation. However, few studies have compared the effects of Cr(VI) on DNA methylation profiles between soluble and particulate chromate in vitro. Accordingly, Illumina Infinium Human Methylation 450K BeadChip array was used to analyze DNA methylation profiles of human B lymphoblastoid cells exposed to potassium dichromate or lead chromate, and the cell viability was also studied. Array based DNA methylation analysis showed that the impacts of Cr(VI) on DNA methylation were limited, only about 40 differentially methylated CpG sites, with an overlap of 15CpG sites, were induced by both potassium dichromate and lead chromate. The results of mRNA expression showed that after Cr(VI) treatment, mRNA expression changes of four genes (TBL1Y, FZD5, IKZF2, and KIAA1949) were consistent with their DNA methylation alteration, but DNA methylation changes of other six genes did not correlate with mRNA expression. In conclusion, both of soluble and particulate Cr(VI) could induce a small amount of differentially methylated sites in human B lymphoblastoid cells, and the correlations between DNA methylation changes and mRNA expression varied between different genes. Copyright © 2015 Elsevier B.V. All rights reserved.

A Pilot Study of Open Venous Revascularization using Expandable PTFE Stent Grafts in a Porcine (Sus scrofa) Model

DTIC Science & Technology

2017-05-23

expandable stent -grafts that are designed to expand within a vessel to cover an injury or open a blockage. Methods: 3 Yorkshire cross swine were...expandable PTFE stent graft was deployed into the vessel in an open direct fashion. The swine were awoken and allowed to ambulate. At 72 hours, conduit...hours, all stents were patent on venography. Conclusion: Direct site endovascular repair of venous injuries utilizing expandable PTFE stent grafts is a

Potential anti-cholinesterase and β-site amyloid precursor protein cleaving enzyme 1 inhibitory activities of cornuside and gallotannins from Cornus officinalis fruits.

PubMed

Bhakta, Himanshu Kumar; Park, Chan Hum; Yokozawa, Takako; Tanaka, Takashi; Jung, Hyun Ah; Choi, Jae Sue

2017-07-01

Cholinesterase (ChE) and β-site amyloid precursor protein cleaving enzyme 1 (BACE1) inhibitors are promising agents for the treatment of Alzheimer's disease (AD). In the present study, we examined the inhibitory activity of seven compounds isolated from the fruits of Cornus officinalis, cornuside, polymeric proanthocyanidins, 1,2,3-tri-O-galloyl-β-D-glucose, 1,2,3,6-tetra-O-galloyl-β-D-glucose, tellimagrandin I, tellimagrandin II, and isoterchebin, against acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and BACE1. All of the compounds displayed concentration-dependent in vitro inhibitory activity toward the ChEs and BACE1. Among them, tellimagrandin II exhibited the best inhibitory activity toward ChEs, whereas the best BACE1 inhibitor was 1,2,3,6-tetra-O-galloyl-β-D-glucose. Isoterchebin and polymeric proanthocyanidins were also significant ChE inhibitors. The kinetic and docking studies demonstrated that all compounds interacted with both the catalytic active sites and the peripheral anionic sites of the ChEs and BACE1. Tellimagrandin II, isoterchebin, and the polymeric proanthocyanidins exhibited concentration-dependent inhibition of peroxynitrite-mediated protein tyrosine nitration. In conclusion, we identified significant ChE and BACE1 inhibitors from Corni Fructus that could have value as new multi-targeted compounds for anti-AD agents.

International longitudinal pediatric reference standards for bone mineral content.

PubMed

Baxter-Jones, Adam D G; Burrows, Melonie; Bachrach, Laura K; Lloyd, Tom; Petit, Moira; Macdonald, Heather; Mirwald, Robert L; Bailey, Don; McKay, Heather

2010-01-01

To render a diagnosis pediatricians rely upon reference standards for bone mineral density or bone mineral content, which are based on cross-sectional data from a relatively small sample of children. These standards are unable to adequately represent growth in a diverse pediatric population. Thus, the goal of this study was to develop sex and site-specific standards for BMC using longitudinal data collected from four international sites in Canada and the United States. Data from four studies were combined; Saskatchewan Paediatric Bone Mineral Accrual Study (n=251), UBC Healthy Bones Study (n=382); Penn State Young Women's Health Study (n=112) and Stanford's Bone Mineral Accretion study (n=423). Males and females (8 to 25 years) were measured for whole body (WB), total proximal femur (PF), femoral neck (FN) and lumbar spine (LS) BMC (g). Data were analyzed using random effects models. Bland-Altman was used to investigate agreement between predicted and actual data. Age, height, weight and ethnicity independently predicted BMC accrual across sites (P<0.05). Compared to White males, Asian males had 31.8 (6.8) g less WB BMC accrual; Hispanic 75.4 (28.2) g less BMC accrual; Blacks 82.8 (26.3) g more BMC accrual with confounders of age, height and weight controlled. We report similar findings for the PF and FN. Models for females for all sites were similar with age, height and weight as independent significant predictors of BMC accrual (P<0.05). We provide a tool to calculate a child's BMC Z-score, accounting for age, size, sex and ethnicity. In conclusion, when interpreting BMC in pediatrics we recommend standards that are sex, age, size and ethnic specific. Copyright (c) 2009 Elsevier Inc. All rights reserved.

International Longitudinal Paediatric Reference Standards for Bone Mineral Content

PubMed Central

Baxter-Jones, Adam DG; McKay, Heather; Burrows, Melonie; Bachrach, Laura K; Lloyd, Tom; Petit, Moira; Macdonald, Heather; Mirwald, Robert L; Bailey, Don

2014-01-01

To render a diagnosis pediatricians rely upon reference standards for bone mineral density or bone mineral content, which are based on cross-sectional data from a relatively small sample of children. These standards are unable to adequately represent growth in a diverse pediatric population. Thus, the goal of this study was to develop sex and site specific standards for BMC using longitudinal data collected from four international sites in Canada and the United States. Data from four studies were combined; Saskatchewan Paediatric Bone Mineral Accrual Study (n=251), UBC Healthy Bones Study (n=382); Penn State Young Women’s Health Study (n=112) and Stanford’s Bone Mineral Accretion study (n=423). Males and females (8 to 25 years) were measured for whole body (WB), total proximal femur (PF), femoral neck (FN) and lumbar spine (LS) BMC (g). Data were analyzed using random effects models. Bland-Altman was used to investigate agreement in predicted and actual data. Age, height, weight and ethnicity independently predicted BMC accrual across sites (P <0.05). Compared to White males, Asian males had 31.8 (6.8) g less WB BMC accrual; Hispanic 75.4 (28.2) g less BMC accrual; Blacks 82.8 (26.3) g more BMC accrual with confounders of age, height and weight controlled. Similar findings were found for PF and FN. Female models for all sites were similar with age, height and weight all independent significant predictors of BMC accrual (P <0.05). We provide a tool to calculate a child’s BMC Z-score, accounting for age, size, sex and ethnicity. In conclusion, when interpreting BMC in paediatrics we recommend standards that are sex, age, size and ethnic specific. PMID:19854308

Environmental exposure to pesticides and cancer risk in multiple human organ systems.

PubMed

Parrón, Tesifón; Requena, Mar; Hernández, Antonio F; Alarcón, Raquel

2014-10-15

There is growing evidence on the association between long-term exposure to pesticides in occupational settings and an elevated rate of chronic diseases, including different types of cancer. However, data on non-occupational exposures are scarce to draw any conclusion. The objective of this study was to investigate the putative associations of environmental pesticide exposures in the general population with several cancer sites and to discuss potential carcinogenic mechanisms by which pesticides develop cancer. A population-based case-control study was conducted among people residing in 10 Health districts from Andalusia (South Spain) to estimate the risk of cancer at different sites. Health districts were categorized into areas of high and low environmental pesticide exposure based on two quantitative criteria: number of hectares devoted to intensive agriculture and pesticide sales per capita. The study population consisted of 34,205 cancer cases and 1,832,969 age and health district matched controls. Data were collected by computerized hospital records (minimum dataset) between 1998 and 2005. Prevalence rates and the risk of cancer at most organ sites were significantly higher in districts with greater pesticide use related to those with lower pesticide use. Conditional logistic regression analyses showed that the population living in areas with high pesticide use had an increased risk of cancer at all sites studied (odds ratios between 1.15 and 3.45) with the exception of Hodgkin's disease and non-Hodgkin lymphoma. The results of this study support and extend previous evidence from occupational studies indicating that environmental exposure to pesticides may be a risk factor for different types of cancer at the level of the general population. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Development of a Comprehensive Database System for Safety Analyst

PubMed Central

Paz, Alexander; Veeramisti, Naveen; Khanal, Indira; Baker, Justin

2015-01-01

This study addressed barriers associated with the use of Safety Analyst, a state-of-the-art tool that has been developed to assist during the entire Traffic Safety Management process but that is not widely used due to a number of challenges as described in this paper. As part of this study, a comprehensive database system and tools to provide data to multiple traffic safety applications, with a focus on Safety Analyst, were developed. A number of data management tools were developed to extract, collect, transform, integrate, and load the data. The system includes consistency-checking capabilities to ensure the adequate insertion and update of data into the database. This system focused on data from roadways, ramps, intersections, and traffic characteristics for Safety Analyst. To test the proposed system and tools, data from Clark County, which is the largest county in Nevada and includes the cities of Las Vegas, Henderson, Boulder City, and North Las Vegas, was used. The database and Safety Analyst together help identify the sites with the potential for safety improvements. Specifically, this study examined the results from two case studies. The first case study, which identified sites having a potential for safety improvements with respect to fatal and all injury crashes, included all roadway elements and used default and calibrated Safety Performance Functions (SPFs). The second case study identified sites having a potential for safety improvements with respect to fatal and all injury crashes, specifically regarding intersections; it used default and calibrated SPFs as well. Conclusions were developed for the calibration of safety performance functions and the classification of site subtypes. Guidelines were provided about the selection of a particular network screening type or performance measure for network screening. PMID:26167531

Implementation of a Novel Adherence Monitoring Strategy in a Phase III, Blinded, Placebo-Controlled, HIV-1 Prevention Clinical Trial.

PubMed

Husnik, Marla J; Brown, Elizabeth R; Marzinke, Mark; Livant, Edward; Palanee-Phillips, Thesla; Hendrix, Craig W; Matovu Kiweewa, Flavia; Nair, Gonasagrie; Soto-Torres, Lydia E; Schwartz, Katie; Hillier, Sharon L; Baeten, Jared M

2017-11-01

Placebo-controlled HIV-1 prevention trials of pre-exposure prophylaxis (PrEP) have not generally used concurrent measurement of adherence because of the potential risk of unblinding. However, several pre-exposure prophylaxis trials for HIV-1 prevention among women failed to show effectiveness because of low product adherence. Evaluation of product adherence objectively during a study provides the opportunity for strengthening adherence activities at sites having low adherence. During MTN-020/ASPIRE, a phase III, placebo-controlled trial of the dapivirine intravaginal ring, we implemented an adherence monitoring system. Monitoring began in quarter 1 (Q1) 2013 and continued through the conclusion of the trial. Blood plasma was collected quarterly and tested for dapivirine concentrations while maintaining blinding among study team members involved in participant management. Dapivirine concentrations >95 pg/mL, reflecting >8 hours of continuous use, were assessed as signaling product use. Study leadership monitored results on a monthly basis and provided feedback to site investigators. Experiences were shared across sites to motivate staff and counsel participants to strive toward higher adherence levels. An upward trend in adherence was observed (P < 0.0001); the proportion of samples from subjects in the active arm with dapivirine >95 pg/mL increased from 63% in Q1 2013 to 84% by Q1 2015. Ongoing drug level testing as a marker of adherence in MTN-020/ASPIRE demonstrates the feasibility of real-time adherence monitoring while maintaining study blinding at the level of participants, sites, and study leadership. This approach is novel for large-scale effectiveness studies for HIV-1 prevention.

mHealth Series: mHealth project in Zhao County, rural China – Description of objectives, field site and methods

PubMed Central

van Velthoven, Michelle Helena; Li, Ye; Wang, Wei; Du, Xiaozhen; Wu, Qiong; Chen, Li; Majeed, Azeem; Rudan, Igor; Zhang, Yanfeng; Car, Josip

2013-01-01

Background We set up a collaboration between researchers in China and the UK that aimed to explore the use of mHealth in China. This is the first paper in a series of papers on a large mHealth project part of this collaboration. This paper included the aims and objectives of the mHealth project, our field site, and the detailed methods of two studies. Field site The field site for this mHealth project was Zhao County, which lies 280 km south of Beijing in Hebei Province, China. Methods We described the methodology of two studies: (i) a mixed methods study exploring factors influencing sample size calculations for mHealth–based health surveys and (ii) a cross–over study determining validity of an mHealth text messaging data collection tool. The first study used mixed methods, both quantitative and qualitative, including: (i) two surveys with caregivers of young children, (ii) interviews with caregivers, village doctors and participants of the cross–over study, and (iii) researchers’ views. We combined data from caregivers, village doctors and researchers to provide an in–depth understanding of factors influencing sample size calculations for mHealth–based health surveys. The second study, a cross–over study, used a randomised cross–over study design to compare the traditional face–to–face survey method to the new text messaging survey method. We assessed data equivalence (intrarater agreement), the amount of information in responses, reasons for giving different responses, the response rate, characteristics of non–responders, and the error rate. Conclusions This paper described the objectives, field site and methods of a large mHealth project part of a collaboration between researchers in China and the UK. The mixed methods study evaluating factors that influence sample size calculations could help future studies with estimating reliable sample sizes. The cross–over study comparing face–to–face and text message survey data collection could help future studies with developing their mHealth tools. PMID:24363919

Effect of site level environmental variables, spatial autocorrelation and sampling intensity on arthropod communities in an ancient temperate lowland woodland area.

PubMed

Horak, Jakub

2013-01-01

The interaction of arthropods with the environment and the management of their populations is a focus of the ecological agenda. Spatial autocorrelation and under-sampling may generate bias and, when they are ignored, it is hard to determine if results can in any way be trusted. Arthropod communities were studied during two seasons and using two methods: window and panel traps, in an area of ancient temperate lowland woodland of Zebracka (Czech Republic). The composition of arthropod communities was studied focusing on four site level variables (canopy openness, diameter in the breast height and height of tree, and water distance) and finally analysed using two approaches: with and without effects of spatial autocorrelation. I found that the proportion of variance explained by space cannot be ignored (≈20% in both years). Potential bias in analyses of the response of arthropods to site level variables without including spatial co-variables is well illustrated by redundancy analyses. Inclusion of space led to more accurate results, as water distance and tree diameter were significant, showing approximately the same ratio of explained variance and direction in both seasons. Results without spatial co-variables were much more disordered and were difficult to explain. This study showed that neglecting the effects of spatial autocorrelation could lead to wrong conclusions in site level studies and, furthermore, that inclusion of space may lead to more accurate and unambiguous outcomes. Rarefactions showed that lower sampling intensity, when appropriately designed, can produce sufficient results without exploitation of the environment.

Enhancing Hispanic Participation in Mental Health Clinical Research: Development of a Spanish-speaking Depression Research Site

PubMed Central

Rivera, Vivianne Aponte; Dunlop, Boadie W.; Ramirez, Cynthia; Kelley, Mary E.; Schneider, Rebecca; Blastos, Beatriz; Larson, Jacqueline; Mercado, Flavia; Mayberg, Helen; Craighead, W. Edward

2015-01-01

Background Hispanics, particularly those with limited English proficiency, are underrepresented in psychiatric clinical research studies. We developed a bilingual and bicultural research clinic dedicated to the recruitment and treatment of Spanish-speaking subjects in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) study, a large clinical trial of treatment-naïve subjects with major depressive disorder (MDD). Methods Demographic and clinical data derived from screening evaluations of the first 1,174 subjects presenting for participation were compared between the Spanish-speaking site (N=275) and the primary English-speaking site (N=899). Reasons for ineligibility (N=888) for the PReDICT study were tallied for each site. Results Compared to English-speakers, Spanish-speakers had a lower level of education and were more likely to be female, uninsured, and have uncontrolled medical conditions. Clinically, Spanish-speakers demonstrated greater depression severity, with higher mean symptom severity scores, and a greater number of previous suicide attempts. Among the subjects who were not randomized into the PReDICT study, Spanish-speaking subjects were more likely to have an uncontrolled medical condition or refuse participation, whereas English-speaking subjects were more likely to have bipolar disorder or a non-MDD depressive disorder. Conclusion Recruitment of Hispanic subjects with MDD is feasible and may enhance efforts at signal detection, given the higher severity of depression among Spanish-speaking participants presenting for clinical trials. Specific approaches for the recruitment and retention of Spanish-speaking participants are required. PMID:23959771

Identification of potential essential fish habitats for skates based on fishers' knowledge.

PubMed

Serra-Pereira, Bárbara; Erzini, Karim; Maia, Catarina; Figueiredo, Ivone

2014-05-01

Understanding of spatio-temporal patterns of sensitive fish species such as skates (Rajidae) is essential for implementation of conservation measures. With insufficient survey data available for these species in Portuguese Continental waters, this study shows that fishery-dependent data associated with fishers' knowledge can be used to identify potential Essential Fish Habitats (EFH) for seven skate species. Sites with similar geomorphology were associated with the occurrence of juveniles and/or adults of the same group of species. For example, sites deeper than 100 m with soft sediment include predominantly adults of Raja clavata, and are the habitat for egg deposition of this species. Raja undulata and R. microocellata are the more coastal species, preferring sand or gravel habitats, while coastal areas with rocks and sand seabed are potential nursery areas for R. brachyura, R. montagui and R. clavata. The main output of this study is the identification of preferential fishing sites enclosing potential EFH for some species, associated with egg-laying and nursery grounds. The location of these areas will be considered for future seasonal closures, and studies will be conducted to evaluate the biological and socio-economic impacts of such measures. As in the past, fishermen will collaborate in the process of evaluating those impacts, since they have practical and applied knowledge that is extremely valuable for evaluating the advantages and disadvantages of such closures. In conclusion, this study is a first contribution to the understanding and identification of EFH for skate species, associated with nursery and egg deposition sites, with direct application to management.

Identification of Potential Essential Fish Habitats for Skates Based on Fishers' Knowledge

NASA Astrophysics Data System (ADS)

Serra-Pereira, Bárbara; Erzini, Karim; Maia, Catarina; Figueiredo, Ivone

2014-05-01

Understanding of spatio-temporal patterns of sensitive fish species such as skates (Rajidae) is essential for implementation of conservation measures. With insufficient survey data available for these species in Portuguese Continental waters, this study shows that fishery-dependent data associated with fishers' knowledge can be used to identify potential Essential Fish Habitats (EFH) for seven skate species. Sites with similar geomorphology were associated with the occurrence of juveniles and/or adults of the same group of species. For example, sites deeper than 100 m with soft sediment include predominantly adults of Raja clavata, and are the habitat for egg deposition of this species. Raja undulata and R. microocellata are the more coastal species, preferring sand or gravel habitats, while coastal areas with rocks and sand seabed are potential nursery areas for R. brachyura, R. montagui and R. clavata. The main output of this study is the identification of preferential fishing sites enclosing potential EFH for some species, associated with egg-laying and nursery grounds. The location of these areas will be considered for future seasonal closures, and studies will be conducted to evaluate the biological and socio-economic impacts of such measures. As in the past, fishermen will collaborate in the process of evaluating those impacts, since they have practical and applied knowledge that is extremely valuable for evaluating the advantages and disadvantages of such closures. In conclusion, this study is a first contribution to the understanding and identification of EFH for skate species, associated with nursery and egg deposition sites, with direct application to management.

Access site-related complications after transradial catheterization can be reduced with smaller sheath size and statins.

PubMed

Honda, Tsuyoshi; Fujimoto, Kazuteru; Miyao, Yuji; Koga, Hidenobu; Hirata, Yoshihiro

2012-09-01

The aim of this study was to investigate the risk factors for access site-related complications after transradial coronary angiography (CAG) or percutaneous coronary intervention (PCI). Transradial PCI has been shown to reduce access site-related bleeding complications compared with procedures performed through a femoral approach. Although previous studies focused on risk factors for access site-related complications after a transfemoral approach or transfemoral and transradial approaches, it is uncertain which factors affect vascular complications after transradial catheterization. We enrolled 500 consecutive patients who underwent transradial CAG or PCI. We determined the incidence and risk factors for access site-related complications such as radial artery occlusion and bleeding complications. Age, sheath size, the dose of heparin and the frequency of PCI (vs. CAG) were significantly greater in patients with than without bleeding complications. However, body mass index (BMI) was significantly lower in patients with than without bleeding complications. Sheath size was significantly higher and the frequency of statin use was significantly lower in patients with than without radial artery occlusion. Multiple logistic analysis revealed that sheath size [odds ratio (OR) 5.5; P < 0.05] and BMI (OR 0.86; P < 0.01) were risk factors for bleeding complications; and sheath size (OR 5.2; P < 0.05) and the lack of statin pretreatment (OR 0.50; P < 0.05) were risk factors for occlusive complications. In conclusion, these findings indicate that down-sizing of the devices used in transradial procedures might attenuate access site-related complications after transradial CAG or PCI. Statin pretreatment might also be a strategy that could prevent radial artery occlusion after transradial procedures.

Association between maternal health literacy and child vaccination in India: a cross-sectional study

PubMed Central

Johri, Mira; Subramanian, S V; Sylvestre, Marie-Pierre; Dudeja, Sakshi; Chandra, Dinesh; Koné, Georges K; Sharma, Jitendar K; Pahwa, Smriti

2015-01-01

Background Education of mothers may improve child health. We investigated whether maternal health literacy, a rapidly modifiable factor related to mother's education, was associated with children's receipt of vaccines in two underserved Indian communities. Methods Cross-sectional surveys in an urban and a rural site. We assessed health literacy using Indian child health promotion materials. The outcome was receipt of three doses of diphtheria-tetanus-pertussis (DTP3) vaccine. We used multivariate logistic regression to investigate the relationship between maternal health literacy and vaccination status independently in each site. For both sites, adjusted models considered maternal age, maternal and paternal education, child sex, birth order, household religion and wealth quintile. Rural analyses used multilevel models adjusted for service delivery characteristics. Urban analyses represented cluster characteristics through fixed effects. Results The rural analysis included 1170 women from 60 villages. The urban analysis included 670 women from nine slum clusters. In each site, crude and adjusted models revealed a positive association between maternal health literacy and DTP3. In the rural site, the adjusted OR was 1.57 (95% CI 1.11 to 2.21, p=0.010) for those with medium health literacy, and OR=1.30 (95% CI 0.89 to 1.91, p=0.172) for those with high health literacy. In the urban site, the adjusted OR was 1.10 (95% CI 0.65 to 1.88, p=0.705) for those with medium health literacy, and OR=2.06 (95% CI 1.06 to 3.99, p=0.032) for those with high health literacy. Conclusions In these study settings, maternal health literacy is independently associated with child vaccination. Initiatives targeting health literacy could improve vaccination coverage. PMID:25827469

The Enzymatic and Structural Basis for Inhibition of Echinococcus granulosus Thioredoxin Glutathione Reductase by Gold(I)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Salinas, Gustavo; Gao, Wei; Wang, Yang

Aims: New drugs are needed to treat flatworm infections that cause severe human diseases such as schistosomiasis. The unique flatworm enzyme thioredoxin glutathione reductase (TGR), structurally different from the human enzyme, is a key drug target. Structural studies of the flatworm Echinococcus granulosus TGR, free and complexed with AuI-MPO, a novel gold inhibitor, together with inhibition assays were performed. Results: AuI-MPO is a potent TGR inhibitor that achieves 75% inhibition at a 1:1 TGR:Au ratio and efficiently kills E. granulosus in vitro. The structures revealed salient insights: (i) unique monomer–monomer interactions, (ii) distinct binding sites for thioredoxin and the glutaredoxinmore » (Grx) domain, (iii) a single glutathione disulfide reduction site in the Grx domain, (iv) rotation of the Grx domain toward the Sec-containing redox active site, and (v) a single gold atom bound to Cys519 and Cys573 in the AuI-TGR complex. Structural modeling suggests that these residues are involved in the stabilization of the Sec-containing C-terminus. Consistently, Cys→Ser mutations in these residues decreased TGR activities. Mass spectroscopy confirmed these cysteines are the primary binding site. Innovation: The identification of a primary site for gold binding and the structural model provide a basis for gold compound optimization through scaffold adjustments. Conclusions: The structural study revealed that TGR functions are achieved not only through a mobile Sec-containing redox center but also by rotation of the Grx domain and distinct binding sites for Grx domain and thioredoxin. The conserved Cys519 and Cys573 residues targeted by gold assist catalysis through stabilization of the Sec-containing redox center. Antioxid. Redox Signal. 27, 1491–1504.« less

Quantitative analysis applied to contrast medium extravasation by using the computed-tomography number within the region of interest

NASA Astrophysics Data System (ADS)

Lee, Jae-Seung; Im, In-Chul; Kim, Moon-Jib; Goo, Eun-Hoe; Kim, Sun-Ju; Kim, Kwang; Kwak, Byung-Joon

2014-02-01

The present study was carried out to present a method to analyze extravasation quantitatively by measuring the computed tomography (CT) number after determining the region of interest (ROI) in the CT images obtained from patients suspected of extravasation induced by contrast medium auto-injection. To achieve this, we divided the study subjects into a group of patients who incurred extravasation and a group of patients who underwent routine scans without incurring extravasation. The CT numbers at IV sites were obtained as reference values, and CT numbers at extravasation sites and hepatic portal veins, respectively, were obtained as relative values. Thereupon, the predicted time for extravasation ( T EP ) and the predicted ratio for extravasation ( R EP ) of an extravasation site were obtained and analyzed quantitatively. In the case of extravasation induced by a dual auto-injector, the values of the CT numbers were confirmed to be lower and the extravasation site to be enlarged when compared to the extravasation induced by a single autoinjector. This is because the physiological saline introduced after the injection of the contrast agent diluted the concentration of the extravasated contrast agent. Additionally, the T EP caused by the auto-injector was about 40 seconds, and we could perform a precise quantitative assessment of the site suspected of extravasation. In conclusion, the dual auto-injection method, despite its advantage of reducing the volume of contrast agent and improving the quality of images for patients with good vascular integrity, was judged to be likely to increase the risk of extravasation and aggravate outcomes for patients with poor vascular integrity by enlarging extravasation sites.

Once Is Not Enough: Withholding Postoperative Prophylactic Antibiotics in Prosthetic Breast Reconstruction Is Associated with an Increased Risk of Infection

PubMed Central

Clayton, John L.; Bazakas, Andrea; Lee, Clara N.; Hultman, C. Scott; Halvorson, Eric G.

2014-01-01

Background There has been a trend toward limiting perioperative prophylactic antibiotics, based on research not conducted in plastic surgery patients. The authors’ university hospital instituted antibiotic prescribing guidelines based on the Surgical Care Improvement Project. An increased rate of surgical-site infections was noted in breast reconstruction patients. The authors sought to determine whether the change in antibiotic prophylaxis regimen affected rates of surgical-site infections. Methods A retrospective study compared patients undergoing breast reconstruction who received preoperative and postoperative prophylactic antibiotics with a group who received only a single dose of preoperative antibiotic. Type of reconstruction and known risk factors for implant infection were noted. Results Two hundred fifty patients were included: 116 in the pre–Surgical Care Improvement Project group and 134 in the Surgical Care Improvement Project group. The overall rate of surgical-site infections increased from 18.1 percent to 34.3 percent (p = 0.004). Infections requiring reoperation increased from 4.3 percent to 16.4 percent (p = 0.002). Multivariate logistic regression demonstrated that patients in the Surgical Care Improvement group were 4.74 times more likely to develop a surgical-site infection requiring reoperation (95 percent CI, 1.69 to 13.80). Obesity, history of radiation therapy, and reconstruction with tissue expanders were associated with increased rates of surgical-site infection requiring reoperation. Conclusions Withholding postoperative prophylactic antibiotics in prosthetic breast reconstruction is associated with an increased risk of surgical-site infection, reoperation, and thus reconstructive failure. The optimal duration of postoperative prophylactic antibiotic use is the subject of future study. PMID:22575852

Health information exchange technology on the front lines of healthcare: workflow factors and patterns of use

PubMed Central

Johnson, Kevin B; Lorenzi, Nancy M

2011-01-01

Objective The goal of this study was to develop an in-depth understanding of how a health information exchange (HIE) fits into clinical workflow at multiple clinical sites. Materials and Methods The ethnographic qualitative study was conducted over a 9-month period in six emergency departments (ED) and eight ambulatory clinics in Memphis, Tennessee, USA. Data were collected using direct observation, informal interviews during observation, and formal semi-structured interviews. The authors observed for over 180 h, during which providers used the exchange 130 times. Results HIE-related workflow was modeled for each ED site and ambulatory clinic group and substantial site-to-site workflow differences were identified. Common patterns in HIE-related workflow were also identified across all sites, leading to the development of two role-based workflow models: nurse based and physician based. The workflow elements framework was applied to the two role-based patterns. An in-depth description was developed of how providers integrated HIE into existing clinical workflow, including prompts for HIE use. Discussion Workflow differed substantially among sites, but two general role-based HIE usage models were identified. Although providers used HIE to improve continuity of patient care, patient–provider trust played a significant role. Types of information retrieved related to roles, with nurses seeking to retrieve recent hospitalization data and more open-ended usage by nurse practitioners and physicians. User and role-specific customization to accommodate differences in workflow and information needs may increase the adoption and use of HIE. Conclusion Understanding end users' perspectives towards HIE technology is crucial to the long-term success of HIE. By applying qualitative methods, an in-depth understanding of HIE usage was developed. PMID:22003156

Sensemaking, Stakeholder Discord, and Long-Term Risk Communication at a U.S. Superfund Site

PubMed Central

Hoover, Anna Goodman

2018-01-01

Introduction Risk communication can help reduce exposures to environmental contaminants, mitigate negative health outcomes, and inform community-based decisions about hazardous waste sites. While communication best practices have long guided such efforts, little research has examined unintended consequences arising from such guidelines. As rhetoric informs stakeholder sensemaking, the language used in and reinforced by these guidelines can challenge relationships and exacerbate stakeholder tensions. Objectives This study evaluates risk communication at a U.S. Superfund site to identify unintended consequences arising from current risk communication practices. Methods This qualitative case study crystallizes data spanning 6 years from three sources: 1) local newspaper coverage of site-related topics; 2) focus-group transcripts from a multi-year project designed to support future visioning of site use; and 3) published blog entries authored by a local environmental activist. Constant comparative analysis provides the study’s analytic foundation, with qualitative data analysis software QSR NVivo 8 supporting a three-step process: 1) provisional coding to identify broad topic categories within datasets, 2) coding occurrences of sensemaking constructs and emergent intra-dataset patterns, and 3) grouping related codes across datasets to examine the relationships among them. Results Existing risk communication practices at this Superfund site contribute to a dichotomous conceptualization of multiple and diverse stakeholders as members of one of only two categories: the government or the public. This conceptualization minimizes perceptions of capacity, encourages public commitment to stances aligned with a preferred group, and contributes to negative expectations that can become self-fulfilling prophecies. Conclusion Findings indicate a need to re-examine and adapt risk communication guidelines to encourage more pluralistic understanding of the stakeholder landscape. PMID:28282297

The impact of disposal of fine-grained sediments from maintenance dredging works on SPM concentration and fluid mud in and outside the harbor of Zeebrugge

NASA Astrophysics Data System (ADS)

Fettweis, Michael; Baeye, Matthias; Cardoso, Claudio; Dujardin, Arvid; Lauwaert, Brigitte; Van den Eynde, Dries; Van Hoestenberghe, Thomas; Vanlede, Joris; Van Poucke, Luc; Velez, Carlos; Martens, Chantal

2016-11-01

The amount of sediments to be dredged and disposed depends to a large part on the suspended particulate matter (SPM) concentration. Tidal, meteorological, climatological, and seasonal forcings have an influence on the horizontal and vertical distribution of the SPM in the water column and on the bed and control the inflow of fine-grained sediments towards harbors and navigation channels. About 3 million tons (dry matter) per year of mainly fine-grained sediments is dredged in the port of Zeebrugge and is disposed on a nearby disposal site. The disposed sediments are quickly resuspended and transported away from the site. The hypothesis is that a significant part of the disposed sediments recirculates back to the dredging places and that a relocation of the disposal site to another location at equal distance to the dredging area would reduce this recirculation. In order to validate the hypothesis, a 1-year field study was set up in 2013-2014. During 1 month, the dredged material was disposed at a new site. Variations in SPM concentration were related to tides, storms, seasonal changes, and human impacts. In the high-turbidity Belgian near-shore area, the natural forcings are responsible for the major variability in the SPM concentration signal, while disposal has only a smaller influence. The conclusion from the measurements is that the SPM concentration decreases after relocation of the disposal site but indicate stronger (first half of field experiment) or weaker (second half of field experiment) effects that are, however, supported by the environmental conditions. The results of the field study may have consequences on the management of disposal operations as the effectiveness of the disposal site depends on environmental conditions, which are inherently associated with chaotic behavior.

Hawaiian temples and their orientations: issues of method and interpretation

NASA Astrophysics Data System (ADS)

Ruggles, Clive L. N.

2015-08-01

In 2002 I began a collaboration with Pat Kirch (Berkeley) to survey the temple sites (heiau) in the Kahikinui and Kaupo districts of southern Maui, and study their orientations and potential astronomical significance. Our investigations of over 70 temples in the area were completed in 2011 and are due for publication in 2016. Pat Kirch will present some of our main conclusions in his keynote talk within FM2. In this paper I propose to concentrate on issues of field methodology and procedure that have wider implications for developments in method and practice within archaeoastronomy. Methodologically, temple sites in the Hawaiian Islands constitute a "halfway house" between prehistoric monuments in Europe, where the only evidence is archaeological and studies of orientations tend to follow formal, "data-driven" or statistical, approaches, and Mesoamerica, where the existence of pre-conquest written records and inscriptions and post-conquest ethnohistory relegate "alignment studies" to a secondary role. In Hawai‘i, cultural data, including oral histories recorded after conquest, provide a finer balance between historical accounts and the physical evidence. Selection issues at the Maui temple sites include distinguishing marginal temple sites from house sites and identifying the intended direction of orientation at complex structures. Initial analyses of the principal orientations identified clusterings in orientation which were interpreted as relating to different gods, and particular the war-god Ku and the god of dryland agriculture, Lono. Later, more comprehensive surveys revealed evidence of observing platforms and foresights at some of the Lono temples, suggesting that systematic observations were made of the Pleiades, known from the ethnohistory to be of particular calendrical significance. This type of alignment evidence is too subjective to be sustained on the basis of a formal analysis alone but, given the historical context, provides a more robust cultural interpretation.

A Tale of Two Health-Care Systems: Cost-Utility Analysis of Open Carpal Tunnel Release in Canada and the United States

PubMed Central

Kaur, Manraj N.; Tolliver, Tyson; Longo, Christopher J.; Naam, Nash H.; Thoma, Achilles

2017-01-01

Purpose: Canadian health care is often criticized for extended wait times, whereas the United States suffers from increased costs. The purpose of this pilot study was to determine the cost-utility of open carpal tunnel release in Canada versus the United States. Methods: A prospective cohort study evaluated patients undergoing open carpal tunnel release at an institution in Canada and the United States. All costs from a societal perspective were captured. Utility was measured using validated health-related quality of life (HRQOL) scales—the EuroQol-5D and the Michigan Hand Outcome Questionnaire. Results: Twenty-one patients at the Canadian site and 8 patients at the US site participated. Mean total costs were US $1581 ± $1965 and $2179 (range: $1421-$2741) at the Canadian and US sites, respectively. Health-related quality of life demonstrated significant improvements following surgery (P < .05). Patient utilities preoperatively and at 6 weeks and 3 months postoperatively were 0.72 ± 0.20, 0.86 ± 0.11, and 0.83 ± 0.16 at the Canadian site and 0.81 ± 0.09, 0.86 ± 0.10, and 0.86 ± 0.12 at the US site. Improvements in HRQOL directly related to surgery were not significantly different between patients in Canada and the United States. American patients, however, attained improved HRQOL sooner due to shorter wait times (27 ± 10 vs 214 ± 119 days; P < .001). The incremental cost-utility of the US system was $7758/quality-adjusted life year gained compared to the Canadian system. Sensitivity analyses confirmed that these results were robust. Conclusion: This pilot study suggests that carpal tunnel surgery is more cost-effective in the United States due to prolonged wait times in Canada. PMID:29026806

Relationships between lines of evidence of pollution in estuarine areas: Linking contaminant levels with biomarker responses in mussels and with structure of macroinvertebrate benthic communities.

PubMed

De Los Ríos, A; Echavarri-Erasun, B; Lacorte, S; Sánchez-Ávila, J; De Jonge, M; Blust, R; Orbea, A; Juanes, J A; Cajaraville, M P

2016-10-01

Data obtained in a pollution survey performed in estuarine areas were integrated using multivariate statistics. The sites selected for the study were areas affected by treated and untreated urban discharges, harbours or industrial activities as well as reference sites. Mussels were transplanted to each site and after different times of exposure, samples of water, sediments and mussels were collected. Biomarkers were analysed on mussels after 3 and 21 days of transplant whereas concentrations of contaminants were measured in water, sediments and mussels after 21 days of transplant. The structure of macroinvertebrate benthic communities was studied in sediment samples. Studied variables were organised into 5 datasets, each one constituting a line of evidence (LOE): contaminants in water, contaminants in sediments, contaminants accumulated by transplanted mussels, biomarkers in transplanted mussels and changes in the structure of macroinvertebrate benthic communities of each sampling site. Principal Component Analysis (PCA) identified the variables of each LOE best explaining variability among sites. In order to know how LOEs relate to each other, Pearson's correlations were performed. Contaminants in sediments were not correlated with the rest of LOEs. Contaminants in water were significantly correlated with contaminants and biomarkers in mussels and with structure of macroinvertebrate benthic communities. Similarly, significant correlations were found between contaminants and biomarkers in mussels and between biomarkers in mussels and structure of macroinvertebrate benthic communities. In conclusion, biomarker responses give relevant information on pollution in estuarine areas and provide a link between chemical and ecological statuses of water bodies in the context of the Water Framework Directive. Copyright © 2016 Elsevier Ltd. All rights reserved.

Medicarpin, a Natural Pterocarpan, Heals Cortical Bone Defect by Activation of Notch and Wnt Canonical Signaling Pathways

PubMed Central

Gupta, Chandra Prakash; Kureel, Jyoti; Mansoori, Mohd Nizam; Shukla, Priyanka; John, Aijaz A.; Singh, Kavita; Purohit, Dipak; Awasthi, Pallavi; Singh, Divya; Goel, Atul

2015-01-01

We evaluated the bone regeneration and healing effect of Medicarpin (med) in cortical bone defect model that heals by intramembranous ossification. For the study, female Sprague–Dawley rats were ovariectomized and rendered osteopenic. A drill hole injury was generated in mid femoral bones of all the animals. Med treatment was commenced the day after and continued for 15 days. PTH was taken as a reference standard. Fifteen days post-treatment, animals were sacrificed. Bones were collected for histomorphometry studies at the injury site by micro-computed tomography (μCT) and confocal microscopy. RNA and protein was harvested from newly generated bone. For immunohistochemistry, 5μm sections of decalcified femur bone adjoining the drill hole site were cut. By μCT analysis and calcein labeling of newly generated bone it was found that med promotes bone healing and new bone formation at the injury site and was comparable to PTH in many aspects. Med treatment led to increase in the Runx-2 and osteocalcin signals indicating expansion of osteoprogenitors at the injury site as evaluated by qPCR and immunohistochemical localization. It was observed that med promoted bone regeneration by activating canonical Wnt and notch signaling pathway. This was evident by increased transcript and protein levels of Wnt and notch signaling components in the defect region. Finally, we confirmed that med treatment leads to elevated bone healing in pre-osteoblasts by co localization of beta catenin with osteoblast marker alkaline phosphatase. In conclusion, med treatment promotes new bone regeneration and healing at the injury site by activating Wnt/canonical and notch signaling pathways. This study also forms a strong case for evaluation of med in delayed union and non-union fracture cases. PMID:26657206

Medicarpin, a Natural Pterocarpan, Heals Cortical Bone Defect by Activation of Notch and Wnt Canonical Signaling Pathways.

PubMed

Dixit, Manisha; Raghuvanshi, Ashutosh; Gupta, Chandra Prakash; Kureel, Jyoti; Mansoori, Mohd Nizam; Shukla, Priyanka; John, Aijaz A; Singh, Kavita; Purohit, Dipak; Awasthi, Pallavi; Singh, Divya; Goel, Atul

2015-01-01

We evaluated the bone regeneration and healing effect of Medicarpin (med) in cortical bone defect model that heals by intramembranous ossification. For the study, female Sprague-Dawley rats were ovariectomized and rendered osteopenic. A drill hole injury was generated in mid femoral bones of all the animals. Med treatment was commenced the day after and continued for 15 days. PTH was taken as a reference standard. Fifteen days post-treatment, animals were sacrificed. Bones were collected for histomorphometry studies at the injury site by micro-computed tomography (μCT) and confocal microscopy. RNA and protein was harvested from newly generated bone. For immunohistochemistry, 5μm sections of decalcified femur bone adjoining the drill hole site were cut. By μCT analysis and calcein labeling of newly generated bone it was found that med promotes bone healing and new bone formation at the injury site and was comparable to PTH in many aspects. Med treatment led to increase in the Runx-2 and osteocalcin signals indicating expansion of osteoprogenitors at the injury site as evaluated by qPCR and immunohistochemical localization. It was observed that med promoted bone regeneration by activating canonical Wnt and notch signaling pathway. This was evident by increased transcript and protein levels of Wnt and notch signaling components in the defect region. Finally, we confirmed that med treatment leads to elevated bone healing in pre-osteoblasts by co localization of beta catenin with osteoblast marker alkaline phosphatase. In conclusion, med treatment promotes new bone regeneration and healing at the injury site by activating Wnt/canonical and notch signaling pathways. This study also forms a strong case for evaluation of med in delayed union and non-union fracture cases.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Safira, Nabila, E-mail: safira.nabila@ymail.com; Anggraeni, Tjandra, E-mail: tjandra@sith.itb.ac.id

Several studies had shown that lead (Pb) in the environment could accumulate in bees, which in turn could affect the quality of the resulting product. In this study, forager stingless bees (Trigona sp.) and its product (propolis) collected from a stingless bees apiculture. This apiculture had two apiary sites which were distinguished by its environmental setting. Apiary site in Cilutung had a forest region environmental setting, while apiary site in Maribaya was located beside the main road. The objective of this study was to determine the extent of lead concentration in propolis originated from both apiary sites and establish themore » correlation between lead concentration in propolis and lead level in forager stingless bees. Forager bees and propolis samples were originated from 50 bees colonies (Cilutung) and 44 bees colonies (Maribaya). They were analyzed using AAS-GF (Atomic Absorption Spectrometre–Graphite Furnace) to determine the level of lead concentration. The results showed that the average level of lead in propolis originated from Cilutung (298.08±73.71 ppb) was lower than the average level of lead in forager bees which originated from Maribaya (330.64±156.34 ppb). However, these values did not show significant difference (p>0.05). There was no significant difference (p>0.05) between the average level of lead in forager bees which originated from Cilutung (118.08±30.46 ppb) and Maribaya (128.82±39.66 ppb). However, these values did not show significant difference (p>0.05). In conclusion, the average level of lead concentration in propolis in both sites had passed the maximum permission standard of lead for food in Indonesia. There was no correlation between lead concentration in propolis and forager stingless bees.« less

Analysis of lead concentration in forager stingless bees Trigona sp. (hymenoptera: Apidae) and propolis at Cilutung and Maribaya, West Java

NASA Astrophysics Data System (ADS)

Safira, Nabila; Anggraeni, Tjandra

2015-09-01

Several studies had shown that lead (Pb) in the environment could accumulate in bees, which in turn could affect the quality of the resulting product. In this study, forager stingless bees (Trigona sp.) and its product (propolis) collected from a stingless bees apiculture. This apiculture had two apiary sites which were distinguished by its environmental setting. Apiary site in Cilutung had a forest region environmental setting, while apiary site in Maribaya was located beside the main road. The objective of this study was to determine the extent of lead concentration in propolis originated from both apiary sites and establish the correlation between lead concentration in propolis and lead level in forager stingless bees. Forager bees and propolis samples were originated from 50 bees colonies (Cilutung) and 44 bees colonies (Maribaya). They were analyzed using AAS-GF (Atomic Absorption Spectrometre-Graphite Furnace) to determine the level of lead concentration. The results showed that the average level of lead in propolis originated from Cilutung (298.08±73.71 ppb) was lower than the average level of lead in forager bees which originated from Maribaya (330.64±156.34 ppb). However, these values did not show significant difference (p>0.05). There was no significant difference (p>0.05) between the average level of lead in forager bees which originated from Cilutung (118.08±30.46 ppb) and Maribaya (128.82±39.66 ppb). However, these values did not show significant difference (p>0.05). In conclusion, the average level of lead concentration in propolis in both sites had passed the maximum permission standard of lead for food in Indonesia. There was no correlation between lead concentration in propolis and forager stingless bees.

Cold-induced vasoconstriction at forearm and hand skin sites: the effect of age.

PubMed

Kingma, B R M; Frijns, A J H; Saris, W H M; van Steenhoven, A A; van Marken Lichtenbelt, W D

2010-07-01

During mild cold exposure, elderly are at risk of hypothermia. In humans, glabrous skin at the hands is well adapted as a heat exchanger. Evidence exists that elderly show equal vasoconstriction due to local cooling at the ventral forearm, yet no age effects on vasoconstriction at hand skin have been studied. Here, we tested the hypotheses that at hand sites (a) elderly show equal vasoconstriction due to local cooling and (b) elderly show reduced response to noradrenergic stimuli. Skin perfusion and mean arterial pressure were measured in 16 young adults (Y: 18-28 years) and 16 elderly (E: 68-78 years). To study the effect of local vasoconstriction mechanisms local sympathetic nerve terminals were blocked by bretylium (BR). Baseline local skin temperature was clamped at 33 degrees C. Next, local temperature was reduced to 24 degrees C. After 15 min of local cooling, noradrenaline (NA) was administered to study the effect of neural vasoconstriction mechanisms. No significant age effect was observed in vasoconstriction due to local cooling at BR sites. After NA, vasoconstriction at the forearm showed a significant age effect; however, no significant age effect was found at the hand sites. [Change in CVC (% from baseline): Forearm Y: -76 +/- 3 vs. E: -60 +/- 5 (P < 0.01), dorsal hand Y: -74 +/- 4 vs. E: -72 +/- 4 (n.s.), ventral hand Y: -80 +/- 7 vs. E: -70 +/- 11 (n.s.)]. In conclusion, in contrast to results from the ventral forearm, elderly did not show a blunted response to local cooling and noradrenaline at hand skin sites. This indicates that at hand skin the noradrenergic mechanism of vasoconstriction is maintained with age.

Associations between breakfast frequency and adiposity indicators in children from 12 countries

PubMed Central

Zakrzewski, J K; Gillison, F B; Cumming, S; Church, T S; Katzmarzyk, P T; Broyles, S T; Champagne, C M; Chaput, J-P; Denstel, K D; Fogelholm, M; Hu, G; Kuriyan, R; Kurpad, A; Lambert, E V; Maher, C; Maia, J; Matsudo, V; Mire, E F; Olds, T; Onywera, V; Sarmiento, O L; Tremblay, M S; Tudor-Locke, C; Zhao, P; Standage, M

2015-01-01

OBJECTIVES: Reports of inverse associations between breakfast frequency and indices of obesity are predominantly based on samples of children from high-income countries with limited socioeconomic diversity. Using data from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE), the present study examined associations between breakfast frequency and adiposity in a sample of 9–11-year-old children from 12 countries representing a wide range of geographic and socio-cultural variability. METHODS: Multilevel statistical models were used to examine associations between breakfast frequency (independent variable) and adiposity indicators (dependent variables: body mass index (BMI) z-score and body fat percentage (BF%)), adjusting for age, sex, and parental education in 6941 children from 12 ISCOLE study sites. Associations were also adjusted for moderate-to-vigorous physical activity, healthy and unhealthy dietary patterns and sleep time in a sub-sample (n=5710). Where interactions with site were significant, results were stratified by site. RESULTS: Adjusted mean BMI z-score and BF% for frequent breakfast consumers were 0.45 and 20.5%, respectively. Frequent breakfast consumption was associated with lower BMI z-scores compared with occasional (P<0.0001, 95% confidence intervals (CI): 0.10–0.29) and rare (P<0.0001, 95% CI: 0.18–0.46) consumption, as well as lower BF% compared with occasional (P<0.0001, 95% CI: 0.86–1.99) and rare (P<0.0001, 95% CI: 1.07–2.76). Associations with BMI z-score varied by site (breakfast by site interaction; P=0.033): associations were non-significant in three sites (Australia, Finland and Kenya), and occasional (not rare) consumption was associated with higher BMI z-scores compared with frequent consumption in three sites (Canada, Portugal and South Africa). Sub-sample analyses adjusting for additional covariates showed similar associations between breakfast and adiposity indicators, but lacked site interactions. CONCLUSIONS: In a multinational sample of children, more frequent breakfast consumption was associated with lower BMI z-scores and BF% compared with occasional and rare consumption. Associations were not consistent across all 12 countries. Further research is required to understand global differences in the observed associations. PMID:27152190

Assessing technical performance at diverse ambulatory care sites.

PubMed

Osterweis, M; Bryant, E

1978-01-01

The purpose of the large study reported here was to develop and test methods for assessing the quality of health care that would be broadly applicable to diverse ambulatory care organizations for periodic comparative review. Methodological features included the use of an age-sex stratified random sampling scheme, dependence on medical records as the source of data, a fixed study period year, use of Kessner's tracer methodology (including not only acute and chronic diseases but also screening and immunization rates as indicators), and a fixed tracer matrix at all test sites. This combination of methods proved more efficacious in estimating certain parameters for the total patient populations at each site (including utilization patterns, screening, and immunization rates) and the process of care for acute conditions than it did in examining the process of care for the selected chronic condition. It was found that the actual process of care at all three sites for the three acute conditions (streptococcal pharyngitis, urinary tract infection, and iron deficiency anemia) often differed from the expected process in terms of both diagnostic procedures and treatment. For hypertension, the chronic disease tracer, medical records were frequently a deficient data source from which to draw conclusions about the adequacy of treatment. Several aspects of the study methodology were found to be detrimental to between-site comparisons of the process of care for chronic disease management. The use of an age-sex stratified random sampling scheme resulted in the identification of too few cases of hypertension at some sites for analytic purposes, thereby necessitating supplementary sampling by diagnosis. The use of a fixed study period year resulted in an arbitrary starting point in the course of the disease. Furthermore, in light of the diverse sociodemographic characteristics of the patient populations, the use of a fixed matrix of tracer conditions for all test sites is questionable. The discussion centers on these and other problems encountered in attempting to compare technical performance within diverse ambulatory care organizations and provides some guidelines as to the utility of alternative methods for assessing the quality of health care.

Spatial Variations in Dengue Transmission in Schools in Thailand

PubMed Central

Ratanawong, Pitcha; Kittayapong, Pattamaporn; Olanratmanee, Phanthip; Wilder-Smith, Annelies; Byass, Peter; Tozan, Yesim; Dambach, Peter; Quiñonez, Carlos Alberto Montenegro; Louis, Valérie R.

2016-01-01

Background Dengue is an important neglected tropical disease, with more than half of the world’s population living in dengue endemic areas. Good understanding of dengue transmission sites is a critical factor to implement effective vector control measures. Methods A cohort of 1,811 students from 10 schools in rural, semi-rural and semi-urban Thailand participated in this study. Seroconversion data and location of participants’ residences and schools were recorded to determine spatial patterns of dengue infections. Blood samples were taken to confirm dengue infections in participants at the beginning and the end of school term. Entomological factors included a survey of adult mosquito density using a portable vacuum aspirator during the school term and a follow up survey of breeding sites of Aedes vectors in schools after the school term. Clustering analyses were performed to detect spatial aggregation of dengue infections among participants. Results A total of 57 dengue seroconversions were detected among the 1,655 participants who provided paired blood samples. Of the 57 confirmed dengue infections, 23 (40.0%) occurred in students from 6 (6.8%) of the 88 classrooms in 10 schools. Dengue infections did not show significant clustering by residential location in the study area. During the school term, a total of 66 Aedes aegypti mosquitoes were identified from the 278 mosquitoes caught in 50 classrooms of the 10 schools. In a follow-up survey of breeding sites, 484 out of 2,399 water containers surveyed (20.2%) were identified as active mosquito breeding sites. Discussion and Conclusion Our findings suggest that dengue infections were clustered among schools and among classrooms within schools. The schools studied were found to contain a large number of different types of breeding sites. Aedes vector densities in schools were correlated with dengue infections and breeding sites in those schools. Given that only a small proportion of breeding sites in the schools were subjected to vector control measures (11%), this study emphasizes the urgent need to implement vector control strategies at schools, while maintaining efforts at the household level. PMID:27669170

Computational fluid dynamics modeling and analysis for the Giant Magellan Telescope (GMT)

NASA Astrophysics Data System (ADS)

Ladd, John; Slotnick, Jeffrey; Norby, William; Bigelow, Bruce; Burgett, William

2016-08-01

The Giant Magellan Telescope (GMT) is planned for construction at a summit of Cerro Las Campanas at the Los Campanas Observatory (LCO) in Chile. GMT will be the most powerful ground-based telescope in operation in the world. Aero-thermal interactions between the site topography, enclosure, internal systems, and optics are complex. A key parameter for optical quality is the thermal gradient between the terrain and the air entering the enclosure, and how quickly that gradient can be dissipated to equilibrium. To ensure the highest quality optical performance, careful design of the telescope enclosure building, location of the enclosure on the summit, and proper venting of the airflow within the enclosure is essential to minimize the impact of velocity and temperature gradients in the air entering the enclosure. High-fidelity Reynolds-Averaged Navier Stokes (RANS) Computational Fluid Dynamics (CFD) analysis of the GMT, enclosure, and LCO terrain is performed to study (a) the impact of either an open or closed enclosure base soffit external shape design, (b) the effect of telescope/enclosure location on the mountain summit, and (c) the effect of enclosure venting patterns. Details on the geometry modeling, grid discretization, and flow solution are first described. Then selected computational results are shown to quantify the quality of the airflow entering the GMT enclosure based on soffit, site location, and venting considerations. Based on the results, conclusions are provided on GMT soffit design, site location, and enclosure venting. The current work is not used to estimate image quality but will be addressed in future analyses as described in the conclusions.

Inclusion of the female condom in a male condom-only intervention in the sex industry in China: a cross-sectional analysis of pre- and post-intervention surveys in three study sites

PubMed Central

Liao, S.; Weeks, M.R.; Wang, Y.; Li, N.; Li, F.; Zhou, Y.; Zeng, X.; Jiang, J.; He, B.; Li, J.; Dunn, J.; Zhang, Q.

2011-01-01

SUMMARY Objectives To describe female condom (FC) use, male condom (MC) use and overall levels of protected sex before, during and after FC education and promotion (using the original prototype FC) combined with MC promotion among female sex workers in three rural or small urban settings in southern China. Study design The 1-year FC intervention was conducted by local health workers through outreach to establishments where sex work is conducted. Three serial cross-sectional surveys were conducted in each study town before, during and after the intervention along with process documentation throughout the intervention period. Methods Cross-sectional data from pre-intervention (baseline) and 6-month and 12-month post-intervention surveys from three study sites are used in a descriptive comparison of the context of the sex industry, outreach in two phases of intervention, and FC adoption after the intensive intervention phase in each site. Results Approximately 75–80% of eligible women working in sex establishments, varying from 74 to 155 participants for each survey, were recruited from three study sites. After introduction and promotion of the FC along with the MC during the community public health intervention, between one-fifth and one-half of the study participants had tried the FC in the three study sites by the time of the 6-month and 12-month cross-sectional surveys. Among them, 10–30% had used the FC more than once. FC awareness increased following the intervention with much less variation across the three study sites. At baseline, 31–54% of participants across the three sites reported 100% protected sex in the last 30 days with all types of partners. At one of the sites with relatively low MC use before the intervention, the proportion of women reporting 100% protected sex in the last 30 days increased by 15%, and the proportion reporting nil protected sex in the last 30 days decreased by 13% between baseline and 12-month post-intervention surveys. More complex profiles of FC and MC use and protected sex were shown at the other two study sites, where a higher level of protection had been reached before the project started. Conclusions Different levels of FC adoption were identified after the 1-year FC promotion intervention through outreach to sex establishments. The input, output and outcomes of the intervention may be associated with women’s demographic and risk characteristics, the local capacities of intervention staff, and other contextual factors. Further analysis of these factors will help establish the role of the FC in increasing protected sex, and provide insight into how to achieve greater FC use. PMID:21513961

Brugia Rapid™ antibody responses in communities of Indonesia in relation to the results of 'transmission assessment surveys' (TAS) for the lymphatic filariasis elimination program.

PubMed

Dewi, Rita M; Tuti, Sekar; Ganefa, Sitti; Anwar, Chairiyah; Larasati, Ria; Ariyanti, Endah; Herjati, Herty; Brady, Molly

2015-10-01

The Global Programme to Eliminate Lymphatic Filariasis recommends the transmission assessment survey (TAS) as the preferred methodology for determining whether mass drug administration can be stopped in an endemic area. Because of the limited experience available globally with the use of Brugia Rapid™ tests in conducting TAS in Brugia spp. areas, we explored the relationship between the antibody test results and Brugia spp. infection as detected by microfilaremia in different epidemiological settings. The study analyzes the Brugia Rapid™ antibody responses and microfilaremia in all ages at three study sites in: i) a district which was classified as non-endemic, ii) a district which passed TAS, and iii) a district which failed TAS. Convenience sampling was done in each site, in one to three purposefully selected villages with a goal of 500 samples in each district. A total of 1543 samples were collected from residents in all three study sites. In the site which was classified as non-endemic and where MDA had not been conducted, 5 % of study participants were antibody positive, none was positive for microfilaremia, and age-specific antibody prevalence peaked at almost 8 % in the 25-34 year-old age range, with no antibody-positive results found in children under eight years of age. In the site that had passed TAS, 1 % of participants were antibody positive and none was positive for microfilaremia. In the site which failed TAS, 15 % of participants were antibody positive, 0.2 % were microfilaremic, and age-specific antibody prevalence was highest in 6-7 year olds (30 %), but above 8 % in all age levels above 8 years old. These results from districts which followed the current WHO guidance for mapping, MDA, and implementing TAS, while providing antibody profiles of treated and untreated populations under programmatic settings, support the choice of antibody prevalence in the 6- and 7-year-old age group in TAS for making stopping MDA decisions. Since only one study participant was microfilaremic, no conclusions could be drawn about the relationship between antibodies and microfilaremia and further longitudinal studies are required to understand this relationship.

Solar power satellite system definition study. Volume 1: Executive summary, phase 3

NASA Technical Reports Server (NTRS)

1980-01-01

Results of a three phase study of the Solar Power Satellite System are summarized. Various options and alternate systems were considered and the following conclusions were reached: antenna mounted solid state transmitters are potentially as cost effective as the klystron approach, althrough limited to 2500 megawatts net output; the free electron laser and optical diode laser appear most promising for laser power transmission; ground antenna siting need not be restricted to below 35 degrees of latitude; and nonrecurring cost reductions attainable by using a smaller Heavy Lift Launch Vehicle are highly attractive.

Laparoendoscopic single-site surgery varicocelectomy versus conventional laparoscopic varicocele ligation: A meta-analysis

PubMed Central

Li, Mingchao; Wang, Zhengyun

2016-01-01

Objective To perform a meta-analysis of data from available published studies comparing laparoendoscopic single-site surgery varicocelectomy (LESSV) with conventional transperitoneal laparoscopic varicocele ligation. Methods A comprehensive data search was performed in PubMed and Embase to identify randomized controlled trials and comparative studies that compared the two surgical approaches for the treatment of varicoceles. Results Six studies were included in the meta-analysis. LESSV required a significantly longer operative time than conventional laparoscopic varicocelectomy but was associated with significantly less postoperative pain at 6 h and 24 h, a shorter recovery time and greater patient satisfaction with the cosmetic outcome. There was no difference between the two surgical approaches in terms of postoperative semen quality or the incidence of complications. Conclusion These data suggest that LESSV offers a well tolerated and efficient alternative to conventional laparoscopic varicocelectomy, with less pain, a shorter recovery time and better cosmetic satisfaction. Further well-designed studies are required to confirm these findings and update the results of this meta-analysis. PMID:27688686

Population-Level Cost-Effectiveness of Implementing Evidence-Based Practices into Routine Care

PubMed Central

Fortney, John C; Pyne, Jeffrey M; Burgess, James F

2014-01-01

Objective The objective of this research was to apply a new methodology (population-level cost-effectiveness analysis) to determine the value of implementing an evidence-based practice in routine care. Data Sources/Study Setting Data are from sequentially conducted studies: a randomized controlled trial and an implementation trial of collaborative care for depression. Both trials were conducted in the same practice setting and population (primary care patients prescribed antidepressants). Study Design The study combined results from a randomized controlled trial and a pre-post-quasi-experimental implementation trial. Data Collection/Extraction Methods The randomized controlled trial collected quality-adjusted life years (QALYs) from survey and medication possession ratios (MPRs) from administrative data. The implementation trial collected MPRs and intervention costs from administrative data and implementation costs from survey. Principal Findings In the randomized controlled trial, MPRs were significantly correlated with QALYs (p = .03). In the implementation trial, patients at implementation sites had significantly higher MPRs (p = .01) than patients at control sites, and by extrapolation higher QALYs (0.00188). Total costs (implementation, intervention) were nonsignificantly higher ($63.76) at implementation sites. The incremental population-level cost-effectiveness ratio was $33,905.92/QALY (bootstrap interquartile range −$45,343.10/QALY to $99,260.90/QALY). Conclusions The methodology was feasible to operationalize and gave reasonable estimates of implementation value. PMID:25328029

Influence of disposable, concentric needle electrodes on muscle enzyme and lactate serum levels.

PubMed

Finsterer, Josef; Mittendorfer, Bettina; Neuhuber, Werner; Löscher, Wolfgang N

2002-08-01

Several studies addressed the question whether needle-EMG causes elevation of muscle enzymes [aspartate-aminotransferase, alanine-aminotransferase, lactate-dehydrogenase, creatine-phosphokinase (CPK), isoenzyme-MB, aldolase] and lactate with conflicting results. However, these studies used sterilizable needle electrodes and different protocols and methods to record EMGs and determine muscle enzymes. This study examined if muscle enzymes are elevated immediately after or 24 h following EMGs with disposable, concentric needle-electrodes, and if they are dependent on age, sex, muscle, number of investigated sites and previous CPK-elevation. In 53 subjects, 24 woman, 29 men, aged 17-88 years, muscle enzymes were determined before, immediately after and 24 h following EMG with disposable, concentric needle-electrodes. Muscle enzymes were not different before, immediately after and 24 h following the EMG. Muscle enzymes were not different between patients 60 years of age. Apart from higher CPK in men than women, muscle enzymes were not different between the genders. Apart from CPK, muscle enzymes were not different between the brachial biceps and anterior tibial muscle. Muscle enzymes were not different if 20 sites were investigated and were independent on pre-EMG CPK-levels. In conclusion this study shows that muscle enzymes do not increase immediately or 24 h following EMG with disposable, concentric needle-electrodes, irrespective of age, gender, muscle, number of investigated sites and pre-EMG CK-levels.

A multi-center field study of two point-of-care tests for circulating Wuchereria bancrofti antigenemia in Africa

PubMed Central

Chesnais, Cédric B.; Awaca-Uvon, Naomi-Pitchouna; Bolay, Fatoma K.; Boussinesq, Michel; Fischer, Peter U.; Gankpala, Lincoln; Meite, Aboulaye; Missamou, François; Pion, Sébastien D.

2017-01-01

Background The Global Programme to Eliminate Lymphatic Filariasis uses point-of-care tests for circulating filarial antigenemia (CFA) to map endemic areas and for monitoring and evaluating the success of mass drug administration (MDA) programs. We compared the performance of the reference BinaxNOW Filariasis card test (ICT, introduced in 1997) with the Alere Filariasis Test Strip (FTS, introduced in 2013) in 5 endemic study sites in Africa. Methodology The tests were compared prior to MDA in two study sites (Congo and Côte d'Ivoire) and in three sites that had received MDA (DRC and 2 sites in Liberia). Data were analyzed with regard to % positivity, % agreement, and heterogeneity. Models evaluated potential effects of age, gender, and blood microfilaria (Mf) counts in individuals and effects of endemicity and history of MDA at the village level as potential factors linked to higher sensitivity of the FTS. Lastly, we assessed relationships between CFA scores and Mf in pre- and post-MDA settings. Principal findings Paired test results were available for 3,682 individuals. Antigenemia rates were 8% and 22% higher by FTS than by ICT in pre-MDA and in post-MDA sites, respectively. FTS/ICT ratios were higher in areas with low infection rates. The probability of having microfilaremia was much higher in persons with CFA scores >1 in untreated areas. However, this was not true in post-MDA settings. Conclusions/Significance This study has provided extensive new information on the performance of the FTS compared to ICT in Africa and it has confirmed the increased sensitivity of FTS reported in prior studies. Variability in FTS/ICT was related in part to endemicity level, history of MDA, and perhaps to the medications used for MDA. These results suggest that FTS should be superior to ICT for mapping, for transmission assessment surveys, and for post-MDA surveillance. PMID:28892473

Water quality and amphibian health in the Big Bend region of the Rio Grande Basin

USGS Publications Warehouse

Sharma, Bibek; Hu, F.; Carr, J.A.; Patino, Reynaldo

2011-01-01

Male and female Rio Grande leopard frogs (Rana berlandieri) were collected in May 2005 from the main stem and tributaries of the Rio Grande in the Big Bend region of Texas. Frogs were examined for (1) incidence of testicular ovarian follicles in males; (2) thyroid epithelial cell height, a potential index of exposure to thyroid-disrupting contaminants; and (3) incidence of liver melanomacrophage aggregates, a general index of exposure to contaminants. Standard parameters of surface water quality and concentrations of selected elements, including heavy metals, were determined at each frog collection site. Heavy metals also were measured in whole-frog composite extracts. Water cadmium concentrations in most sites and chloride concentrations in the main stem exceeded federal criteria for freshwater aquatic life. Mercury was detected in frogs from the two collection sites in Terlingua Creek. There was a seventeen percent incidence of testicular ovarian follicles in male frogs. Mean thyroid epithelial cell height was greater in frogs from one of the Terlingua Creek sites (Terlingua Abajo). No differences were observed in the incidence of hepatic macrophage aggregates among sites. In conclusion, although potential cause-effect relationships between indices of habitat quality and amphibian health could not be established, the results of this study raise concerns about the general quality of the aquatic habitat and the potential long-term consequences to the aquatic biota of the Big Bend region. The presence of ovarian follicles in male frogs is noteworthy but further study is necessary to determine whether this phenomenon is natural or anthropogenically induced.

Overview of topographic effects based on experimental observations: meaning, causes and possible interpretations

NASA Astrophysics Data System (ADS)

Massa, Marco; Barani, Simone; Lovati, Sara

2014-06-01

The paper presents an extensive review of topographic effects in seismology taking into account the knowledge of 40 yr of scientific literature. An overview of topographic effects based on experimental observations and numerical modelling is presented with the aim of highlighting meaning and causes of these phenomena as well as possible correlations between site response (fundamental frequency, amplification level) and geometrical (width and shape ratio of a relief) parameters. After a thorough summary of topographic effects, the paper focuses on five Italian sites whose seismic response is potentially affected by local morphology, as already evidenced by previous studies. In this study, seismic data recorded at these sites are analysed computing directional spectral ratios both in terms of horizontal to vertical spectral ratios (HVSRs) and, wherever possible, in terms of standard spectral ratios (SSRs). The analysis lead to the conclusion that wavefield tends to be polarized along a direction perpendicular to the main axis of a topographic irregularity, direction along which ground motion amplification is maximum. The final section of the article compares and contrasts different spectral ratio techniques in order to examine their effectiveness and reliability in detecting topographic effects. The examples discussed in the paper show that site responses based on HVSRs rather than SSR measurements could lead to misinterpretation of ground response results, both as concerns the definition of the site fundamental frequency and amplification level. Results and findings of this work will be used as starting point to discuss the influence of topographic effects on ground motion prediction equations and regulations for design. These topics will be discussed in the companion article.

Polymorphisms in O-methyltransferase genes are associated with stover cell wall digestibility in European maize (Zea mays L.)

PubMed Central

2010-01-01

Background OMT (O-methyltransferase) genes are involved in lignin biosynthesis, which relates to stover cell wall digestibility. Reduced lignin content is an important determinant of both forage quality and ethanol conversion efficiency of maize stover. Results Variation in genomic sequences coding for COMT, CCoAOMT1, and CCoAOMT2 was analyzed in relation to stover cell wall digestibility for a panel of 40 European forage maize inbred lines, and re-analyzed for a panel of 34 lines from a published French study. Different methodologies for association analysis were performed and compared. Across association methodologies, a total number of 25, 12, 1, 6 COMT polymorphic sites were significantly associated with DNDF, OMD, NDF, and WSC, respectively. Association analysis for CCoAOMT1 and CCoAOMT2 identified substantially fewer polymorphic sites (3 and 2, respectively) associated with the investigated traits. Our re-analysis on the 34 lines from a published French dataset identified 14 polymorphic sites significantly associated with cell wall digestibility, two of them were consistent with our study. Promising polymorphisms putatively causally associated with variability of cell wall digestibility were inferred from the total number of significantly associated SNPs/Indels. Conclusions Several polymorphic sites for three O-methyltransferase loci were associated with stover cell wall digestibility. All three tested genes seem to be involved in controlling DNDF, in particular COMT. Thus, considerable variation among Bm3 wildtype alleles can be exploited for improving cell-wall digestibility. Target sites for functional markers were identified enabling development of efficient marker-based selection strategies. PMID:20152036

School Site Visits for Community-Based Participatory Research on Healthy Eating

PubMed Central

Patel, Anisha I.; Bogart, Laura M.; Uyeda, Kimberly E.; Martinez, Homero; Knizewski, Ritamarie; Ryan, Gery W.; Schuster, Mark A.

2010-01-01

Background School nutrition policies are gaining support as a means of addressing childhood obesity. Community-based participatory research (CBPR) offers an approach for academic and community partners to collaborate to translate obesity-related school policies into practice. Site visits, in which trained observers visit settings to collect multilevel data (e.g., observation, qualitative interviews), may complement other methods that inform health promotion efforts. This paper demonstrates the utility of site visits in the development of an intervention to implement obesity-related policies in Los Angeles Unified School District (LAUSD) middle schools. Methods In 2006, trained observers visited four LAUSD middle schools. Observers mapped cafeteria layout; observed food/beverage offerings, student consumption, waste patterns, and duration of cafeteria lines; spoke with school staff and students; and collected relevant documents. Data were examined for common themes and patterns. Results Food and beverages sold in study schools met LAUSD nutritional guidelines, and nearly all observed students had time to eat most or all of their meal. Some LAUSD policies were not implemented, including posting nutritional information for cafeteria food, marketing school meals to improve student participation in the National School Lunch Program, and serving a variety of fruits and vegetables. Cafeteria understaffing and cost were obstacles to policy implementation. Conclusions Site visits were a valuable methodology for evaluating the implementation of school district obesity-related policies and contributed to the development of a CBPR intervention to translate school food policies into practice. Future CBPR studies may consider site visits in their toolbox of formative research methods. PMID:19896033

Mortality in employees at a New Zealand agrochemical manufacturing site

PubMed Central

Burns, Carol J.; Herbison, G. Peter; Humphry, Noel F.; Bodner, Kenneth; Collins, James J.

2009-01-01

Background Previous studies at the Dow AgroSciences (Formerly Ivon Watkins-Dow) plant in New Plymouth, New Zealand, had raised concerns about the cancer risk in a subset of workers at the site with potential exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. As the plant had been involved in the synthesis and formulation of a wide range of agrochemicals and their feedstocks, we examined the mortality risk for all workers at the site. Aims To quantify the mortality hazards arising from employment at the Dow AgroSciences agrochemical production site in New Plymouth, New Zealand. Methods Workers employed between 1 January 1969 and 1 October 2003 were followed up to the end of 2004. Standardized mortality ratios (SMRs) were calculated using national mortality rates by employment duration, sex, period of hire and latency. Results A total of 1754 employees were followed during the study period and 247 deaths were observed. The all causes and all cancers SMRs were 0.97 (95% CI 0.85–1.10) and 1.01 (95% CI 0.80–1.27), respectively. Mortality due to all causes was higher for short-term workers (SMR 1.23, 95% CI 0.91–1.62) than long-term workers (SMR 0.92, 95% CI 0.80–1.06) and women had lower death rates than men. Analyses by latency and period of hire did not show any patterns consistent with an adverse impact of occupational exposures. Conclusions The mortality experience of workers at the site was similar to the rest of New Zealand. PMID:19297337

Effect-site concentration of remifentanil required to blunt haemodynamic responses during tracheal intubation: A randomized comparison between single- and double-lumen tubes.

PubMed

Kim, Tae Kyong; Hong, Deok Man; Lee, Seo Hee; Paik, Hyesun; Min, Se Hee; Seo, Jeong-Hwa; Jung, Chul-Woo; Bahk, Jae-Hyon

2018-01-01

Objective To investigate the effect-site concentration of remifentanil required to blunt haemodynamic responses during tracheal intubation with a single-lumen tube (SLT) or a double-lumen tube (DLT). Methods Patients scheduled for thoracic surgery requiring one-lung ventilation were randomly allocated to either the SLT or DLT group. All patients received a target-controlled infusion of propofol and a predetermined concentration of remifentanil. Haemodynamic parameters during intubation were recorded. The effect-site concentration of remifentanil was determined using a delayed up-and-down sequential allocation method. Results A total of 92 patients were enrolled in the study. The effective effect-site concentrations of remifentanil required to blunt haemodynamic responses in 50% of patients (EC 50 ) estimated by isotonic regression with bootstrapping was higher in the DLT than the SLT group (8.5 ng/ml [95% confidence interval (CI) 8.0-9.5 ng/ml] versus 6.5 ng/ml [95% CI 5.6-6.7 ng/ml], respectively). Similarly, the effective effect-site concentrations of remifentanil in 95% of patients in the DLT group was higher than the SLT group (9.9 ng/ml [95% CI 9.8-10.0 ng/ml] versus 7.0 ng/ml [95% CI 6.9-7.0 ng/ml], respectively). Conclusions This study demonstrated that a DLT requires a 30% higher EC 50 of remifentanil than does an SLT to blunt haemodynamic responses during tracheal intubation when combined with a target-controlled infusion of propofol. Trial registration Clinicaltrials.gov identifier: NCT01542099.

Racial Differences in DNA-Methylation of CpG Sites Within Preterm-Promoting Genes and Gene Variants.

PubMed

Salihu, H M; Das, R; Morton, L; Huang, H; Paothong, A; Wilson, R E; Aliyu, M H; Salemi, J L; Marty, P J

2016-08-01

Objective To evaluate the role DNA methylation may play in genes associated with preterm birth for higher rates of preterm births in African-American women. Methods Fetal cord blood samples from births collected at delivery and maternal demographic and medical information were used in a cross-sectional study to examine fetal DNA methylation of genes implicated in preterm birth among black and non-black infants. Allele-specific DNA methylation analysis was performed using a methylation bead array. Targeted maximum likelihood estimation was applied to examine the relationship between race and fetal DNA methylation of candidate preterm birth genes. Receiver-operating characteristic analyses were then conducted to validate the CpG site methylation marker within the two racial groups. Bootstrapping, a method of validation and replication, was employed. Results 42 CpG sites were screened within 20 candidate gene variants reported consistently in the literature as being associated with preterm birth. Of these, three CpG sites on TNFAIP8 and PON1 genes (corresponding to: cg23917399; cg07086380; and cg07404485, respectively) were significantly differentially methylated between black and non-black individuals. The three CpG sites showed lower methylation status among infants of black women. Bootstrapping validated and replicated results. Conclusion for Practice Our study identified significant differences in levels of methylation on specific genes between black and non-black individuals. Understanding the genetic/epigenetic mechanisms that lead to preterm birth may lead to enhanced prevention strategies to reduce morbidity and mortality by eventually providing a means to identify individuals with a genetic predisposition to preterm labor.

Communication Inequalities and Public Health Implications of Adult Social Networking Site Use in the United States

PubMed Central

Kontos, Emily Z.; Emmons, Karen M.; Puleo, Elaine; Viswanath, K.

2011-01-01

Background Social media, and specifically social networking sites (SNS), are emerging as an important platform for communication and health information exchange. Yet, despite the increase in popularity and use, only a limited number of empirical studies document which segments of the adult population are and are not using social networking sites and with what, if any, affect on health. Methods The purpose of this study is to identify potential communication inequalities in social networking site use among a representative sample of US adults and to examine the association between SNS-use and psychological well-being. We analyzed data from the National Cancer Institute’s 2007 Health Information National Trends Survey (HINTS). Results Thirty-five percent of online adults reported SNS-use within the past 12 months, and; there were no significant differences in SNS-use by race/ethnicity or socio-economic position. Younger age (p=.00) was the most significant predictor of SNS-use while being married (p=.02) and having a history of cancer (p=.02) were associated with a decreased odds of SNS-use. Social networking site use was significantly associated with a 0.80 (p=.00) increment in psychological distress score after controlling for other factors. Conclusion The absence of inequalities in adult SNS-use across race/ethnicity and class offers some support for the continued use of social media to promote public health efforts; however, issues such as the persisting Digital Divide and potential deleterious effects of SNS-use on psychological well-being need to be addressed. PMID:21154095

Effect of Methodological and Ecological Approaches on Heterogeneity of Nest-Site Selection of a Long-Lived Vulture

PubMed Central

Moreno-Opo, Rubén; Fernández-Olalla, Mariana; Margalida, Antoni; Arredondo, Ángel; Guil, Francisco

2012-01-01

The application of scientific-based conservation measures requires that sampling methodologies in studies modelling similar ecological aspects produce comparable results making easier their interpretation. We aimed to show how the choice of different methodological and ecological approaches can affect conclusions in nest-site selection studies along different Palearctic meta-populations of an indicator species. First, a multivariate analysis of the variables affecting nest-site selection in a breeding colony of cinereous vulture (Aegypius monachus) in central Spain was performed. Then, a meta-analysis was applied to establish how methodological and habitat-type factors determine differences and similarities in the results obtained by previous studies that have modelled the forest breeding habitat of the species. Our results revealed patterns in nesting-habitat modelling by the cinereous vulture throughout its whole range: steep and south-facing slopes, great cover of large trees and distance to human activities were generally selected. The ratio and situation of the studied plots (nests/random), the use of plots vs. polygons as sampling units and the number of years of data set determined the variability explained by the model. Moreover, a greater size of the breeding colony implied that ecological and geomorphological variables at landscape level were more influential. Additionally, human activities affected in greater proportion to colonies situated in Mediterranean forests. For the first time, a meta-analysis regarding the factors determining nest-site selection heterogeneity for a single species at broad scale was achieved. It is essential to homogenize and coordinate experimental design in modelling the selection of species' ecological requirements in order to avoid that differences in results among studies would be due to methodological heterogeneity. This would optimize best conservation and management practices for habitats and species in a global context. PMID:22413023

Electrodiagnostic Evaluation of Individuals Implanted With Extracellular Matrix for the Treatment of Volumetric Muscle Injury: Case Series

PubMed Central

Han, Nami; Yabroudi, Mohammad A.; Stearns-Reider, Kristen; Helkowski, Wendy; Sicari, Brian M.; Rubin, J. Peter; Badylak, Stephen F.; Boninger, Michael L.

2016-01-01

Background Electrodiagnosis can reveal the nerve and muscle changes following surgical placement of an extracellular matrix (ECM) bioscaffold for treatment of volumetric muscle loss (VML). Objective The purpose of this study was to characterize nerve conduction study (NCS) and electromyography (EMG) changes following ECM bioscaffold placement in individuals with VML. The ability of presurgical NCS and EMG to be used as a tool to help identify candidates who are likely to display improvements postsurgically also was explored. Design A longitudinal case series design was used. Methods The study was conducted at the McGowan Institute for Regenerative Medicine at the University of Pittsburgh. Eight individuals with a history of chronic VML participated. The intervention was surgical placement of an ECM bioscaffold at the site of VML. The strength of the affected region was measured using a handheld dynamometer, and electrophysiologic evaluation was conducted on the affected limb with standard method of NCS and EMG. All measurements were obtained the day before surgery and repeated 6 months after surgery. Results Seven of the 8 participants had a preoperative electrodiagnosis of incomplete mononeuropathy within the site of VML. After ECM treatment, 5 of the 8 participants showed improvements in NCS amplitude or needle EMG parameters. The presence of electrical activity within the scaffold remodeling site was concomitant with clinical improvement in muscle strength. Limitations This study had a small sample size, and participants served as their own controls. The electromyographers and physical therapists performing the evaluation were not blinded. Conclusions Electrodiagnostic data provide objective evidence of physiological improvements in muscle function following ECM placement at sites of VML. Future studies are warranted to further investigate the potential of needle EMG as a predictor of successful outcomes following ECM treatment for VML. PMID:26564252

The Psychosocial Impact of Acne Vulgaris

PubMed Central

Hazarika, Neirita; Archana, M

2016-01-01

Background: Acne vulgaris causes erythematous papulopustular lesions in active stage and often leave behind residual scarring and pigmentation. Its onset in adolescence may add to the emotional and psychological challenges experienced during this period. Aims: To assess the impact of acne on the various psychosocial domains of daily life. Materials and Methods: This was a prospective, cross-sectional study done in the dermatology out-patient department of a tertiary care hospital from January to March 2015. A total of 100 consecutive, newly diagnosed patients of acne vulgaris, aged 15 years and above were included in this study. The relationship between acne vulgaris and its sequelae was analyzed with ten different domains of daily life by using dermatology life quality index (DLQI) questionnaire. Results: Females (56%), 15–20 year olds (61%), facial lesions (60%), and Grade II acne (70%) were most common. Acne scars were noted in 75% patients, whereas 79% cases had post-acne hyperpigmentation. Thirty-seven percent patients had DLQI scores of (6–10) interpreted as moderate effect on patient's life. Statistically significant correlation (P < 0.05) found were as follows: Physical symptoms with grade of acne; embarrassment with site and grade of acne; daily activities with grade of acne and post-acne pigmentation; choice of clothes with site of acne; social activities with gender, site and grade of acne; effect on work/study with grade of acne; interpersonal problems with site and post-acne pigmentation; sexual difficulties with grade of acne. Limitation: It was a hospital-based study with small sample size. Conclusion: Significant impact of acne and its sequelae was noted on emotions, daily activities, social activities, study/work, and interpersonal relationships. Assurance and counseling along with early treatment of acne vulgaris is important to reduce disease-related psychosocial sequelae and increase the efficacy of treatment. PMID:27688440

Accuracy of Marketing Claims by Providers of Stereotactic Radiation Therapy

PubMed Central

Narang, Amol K.; Lam, Edwin; Makary, Martin A.; DeWeese, Theodore L.; Pawlik, Timothy M.; Pronovost, Peter J.; Herman, Joseph M.

2013-01-01

Purpose: Direct-to-consumer advertising by industry has been criticized for encouraging overuse of unproven therapies, but advertising by health care providers has not been as carefully scrutinized. Stereotactic radiation therapy is an emerging technology that has sparked controversy regarding the marketing campaigns of some manufacturers. Given that this technology is also being heavily advertised on the Web sites of health care providers, the accuracy of providers' marketing claims should be rigorously evaluated. Methods: We reviewed the Web sites of all US hospitals and private practices that provide stereotactic radiation using two leading brands of stereotactic radiosurgery technology. Centers were identified by using data from the manufacturers. Centers without Web sites were excluded. The final study population consisted of 212 centers with online advertisements for stereotactic radiation. Web sites were evaluated for advertisements that were inconsistent with advertising guidelines provided by the American Medical Association. Results: Most centers (76%) had individual pages dedicated to the marketing of their brand of stereotactic technology that frequently contained manufacturer-authored images (50%) or text (55%). Advertising for the treatment of tumors that have not been endorsed by professional societies was present on 66% of Web sites. Centers commonly claimed improved survival (22%), disease control (20%), quality of life (17%), and toxicity (43%) with stereotactic radiation. Although 40% of Web sites championed the center's regional expertise in delivering stereotactic treatments, only 15% of Web sites provided data to support their claims. Conclusion: Provider advertisements for stereotactic radiation were prominent and aggressive. Further investigation of provider advertising, its effects on quality of care, and potential oversight mechanisms is needed. PMID:23633973

Islet grafting and imaging in a bioengineered intramuscular space†

PubMed Central

Witkowski, Piotr; Sondermeijer, Hugo; Hardy, Mark A.; Woodland, David C.; Lee, Keagan; Bhagat, Govind; Witkowski, Kajetan; See, Fiona; Rana, Abbas; Maffei, Antonella; Itescu, Silviu; Harris, Paul E.

2011-01-01

Background Since the hepatic portal system may not be the optimal site for islet transplantation, several extrahepatic sites have been studied. Here we examine an intramuscular transplantation site, bioengineered to better support islet neovascularization, engraftment, and survival, and demonstrate that at this novel site, grafted beta cell mass may be quantitated in a real time non-invasive manner by PET imaging. Methods Streptozotocin induced rats were pretreated intramuscularly with a biocompatible angiogenic scaffold received syngeneic islet transplants 2 weeks later. The recipients were monitored serially by blood glucose and glucose tolerance measurements and by PET imaging of the transplant site with [11C] dihydrotetrabenazine. Parallel histopathologic evaluation of the grafts was done using insulin staining and evaluation of microvasularity. Results Reversal of hyperglycemia by islet transplantation was most successful in recipients pretreated with bioscaffolds containing angiogenic factors as compared to those who received no bioscaffolds or bioscaffolds not treated with angiogenic factors. PET imaging with [11C] dihydrotetrabenazine, insulin staining and microvascular density patterns were consistent with islet survival, increased levels of angiogenesis, and with reversal of hyperglycemia. Conclusions Induction of increased neovascularization at an intramuscular site significantly improves islet transplant engraftment and survival compared to controls. The use of a non hepatic transplant site may avoid intrahepatic complications and permit the use of PET imaging to measure and follow transplanted beta-cell mass in real time. These findings have important implications for effective islet implantation outside of the liver, and offer promising possibilities for improving islet survival, monitoring, and even prevention of islet loss. PMID:19898201

Different properties of skin of different body sites: The root of keloid formation?

PubMed

Butzelaar, Liselotte; Niessen, Frank B; Talhout, Wendy; Schooneman, Dennis P M; Ulrich, Magda M; Beelen, Robert H J; Mink van der Molen, Aebele B

2017-09-01

The purpose of this study was to examine extracellular matrix composition, vascularization, and immune cell population of skin sites prone to keloid formation. Keloids remain a complex problem, posing esthetical as well as functional difficulties for those affected. These scars tend to develop at anatomic sites of preference. Mechanical properties of skin vary with anatomic location and depend largely on extracellular matrix composition. These differences in extracellular matrix composition, but also vascularization and resident immune cell populations might play a role in the mechanism of keloid formation. To examine this hypothesis, skin samples of several anatomic locations were taken from 24 human donors within zero to 36 hours after they had deceased. Collagen content and cross-links were determined through high-performance liquid chromatography. The expression of several genes, involved in extracellular matrix production and degradation, was measured by means of real-time PCR. (Immuno)histochemistry was performed to detect fibroblasts, collagen, elastin, blood vessels, Langerhans cells, and macrophages. Properties of skin of keloid predilections sites were compared to properties of skin from other locations (nonpredilection sites [NPS]). The results indicated that there are site specific variations in extracellular matrix properties (collagen and cross-links) as well as macrophage numbers. Moreover, predilection sites (PS) for keloid formation contain larger amounts of collagen compared to NPS, but decreased numbers of macrophages, in particular classically activated CD40 positive macrophages. In conclusion, the altered (histological, protein, and genetic) properties of skin of keloid PS may cause a predisposition for and contribute to keloid formation. © 2017 by the Wound Healing Society.

Reconnaissance investigation of petroleum products in soil and ground water at Longmire, Mount Rainier National Park, Washington, 1990

USGS Publications Warehouse

Sumioka, S.S.

1995-01-01

The removal of an underground waste-oil storage tank in Mount Rainier National Park, at Longmire, Washington, led to the discovery that soil surrounding the tank was saturated with unidentified petroleum hydrocarbons. Subsequent investigations by the National Park Service indicated that a petroleum product smelling like diesel oil was present in the unsaturated zone as far as 120 feet from the tank site. A study was conducted by the U.S. Geological Survey in cooperation with the National Park Service to determine the extent to which the petroleum hydrocarbons have affected the unsaturated zone and ground water in the Longmire area. Measurements of water levels in wells and of water-surface elevations of the Nisqually River and a wetland west of Longmire indicate that ground water does not flow from the maintenance area to the river or to the wetland. Waste oil and diesel oil were detected in soil samples from the site closest to the waste-oil storage-tank site. Diesel oil was also detected in samples from a site about 200 feet northwest of the storage-tank site. Organic compounds of undetermined origin were detected in soil samples from all of the other sites. Waste oil was not conclusively detected in any of the ground-water samples. Diesel oil was detected in water samples from the well closest to the storage tank and from a well about 200 feet west of the storage-tank site. Ground-water samples from all of the other wells contained organic compounds of undetermined origin.

Indirect MR lymphangiography of the head and neck using conventional gadolinium contrast: A pilot study in humans

DOE Office of Scientific and Technical Information (OSTI.GOV)

Loo, Billy W.; Draney, Mary T.; Sivanandan, Ranjiv

2006-10-01

Purpose: To evaluate indirect magnetic resonance lymphangiography (MR-LAG) using interstitial injection of conventional gadolinium contrast (gadoteridol and gadopentetate dimeglumine) for delineating the primary lymphatic drainage of head-and-neck sites. Methods and Materials: We performed head-and-neck MR-LAG in 5 healthy volunteers, with injection of dermal and mucosal sites. We evaluated the safety of the procedure, the patterns of enhancement categorized by injection site and nodal level, the time course of enhancement, the optimal concentration and volume of contrast, and the optimal imaging sequence. Results: The worst side effects of interstitial contrast injection were brief, mild pain and swelling at the injected sitesmore » that were self-limited. MR-LAG resulted in consistent visualization of the primary lymphatic drainage pattern specific to each injected site, which was reproducible on repeated examinations. The best enhancement was obtained with injection of small volumes (0.3-0.5 mL) of either agent diluted, imaging within 5-15 min of injection, and a three-dimensional fast spoiled gradient echo sequence with magnetization transfer. Conclusions: We found head-and-neck MR-LAG to be a safe, convenient imaging method that provides functional information about the lymphatic drainage of injected sites. Applied to head-and-neck cancer, it has the potential to identify sites at highest risk of occult metastatic spread for radiotherapy or surgical planning, and possibly to visualize micrometastases.« less

Periodontal disease severity and cancer risk in postmenopausal women: The Buffalo OsteoPerio Study

PubMed Central

Mai, Xiaodan; LaMonte, Michael J.; Hovey, Kathleen M.; Freudenheim, Jo L.; Andrews, Christopher A.; Genco, Robert J.; Wactawski-Wende, Jean

2015-01-01

Purpose Few prospective studies have reported on relationships between objective periodontal disease (PD) measures and cancer risk. This association was examined in 1,337 postmenopausal women participating in the Buffalo OsteoPerio Study. Methods Oral alveolar crestal bone height (ACH) was measured using oral radiographs. Incident cancers were adjudicated with medical records. Hazard ratios (HR) and 95% confidence intervals (CI) for associations between ACH and incident cancer outcomes were estimated using Cox proportional hazards models. Results There were 203 confirmed total incident cancer cases during follow-up (12.2±4.2 years). After adjusting for age and smoking, there were no statistically significant associations between ACH-defined PD categories and total cancer risk (mild/moderate vs. none: HR=1.33, 95%CI: 0.91–1.94; severe vs. none: HR=1.20, 95%CI: 0.77–1.86). ACH-defined PD categories were not associated with common site-specific cancers. Whole mouth mean and worst site ACH (per 1mm loss) were significantly associated with increased risk of lung (adjusted HR=1.81, 95% CI: 1.30–2.54; adjusted HR=1.34, 95% CI: 1.08–1.66, respectively), but not total or other site-specific cancer. Smoking status modified the associations between continuous ACH variables and total cancer risk; measures of PD were associated with total cancer among smokers but not never-smokers (interaction p=0.02 and p<0.01 for whole mouth mean and worst site ACH, respectively). Conclusions ACH-defined PD was associated with total cancer risk in ever but not never-smoking postmenopausal women. Whole mouth mean and worst site ACH were associated with increased lung cancer risk. However, these results need to be interpreted cautiously given the small number of lung cancer cases (n=18). Further research utilizing a larger sample is warranted to confirm the relationships among oral bone loss, site-specific cancers, and total cancer. PMID:26661782

Decreasing Abundance, Increasing Diversity and Changing Structure of the Wild Bee Community (Hymenoptera: Anthophila) along an Urbanization Gradient

PubMed Central

Fortel, Laura; Henry, Mickaël; Guilbaud, Laurent; Guirao, Anne Laure; Kuhlmann, Michael; Mouret, Hugues; Rollin, Orianne; Vaissière, Bernard E.

2014-01-01

Background Wild bees are important pollinators that have declined in diversity and abundance during the last decades. Habitat destruction and fragmentation associated with urbanization are reported as part of the main causes of this decline. Urbanization involves dramatic changes of the landscape, increasing the proportion of impervious surface while decreasing that of green areas. Few studies have investigated the effects of urbanization on bee communities. We assessed changes in the abundance, species richness, and composition of wild bee community along an urbanization gradient. Methodology/Principal Findings Over two years and on a monthly basis, bees were sampled with colored pan traps and insect nets at 24 sites located along an urbanization gradient. Landscape structure within three different radii was measured at each study site. We captured 291 wild bee species. The abundance of wild bees was negatively correlated with the proportion of impervious surface, while species richness reached a maximum at an intermediate (50%) proportion of impervious surface. The structure of the community changed along the urbanization gradient with more parasitic species in sites with an intermediate proportion of impervious surface. There were also greater numbers of cavity-nesting species and long-tongued species in sites with intermediate or higher proportion of impervious surface. However, urbanization had no effect on the occurrence of species depending on their social behavior or body size. Conclusions/Significance We found nearly a third of the wild bee fauna known from France in our study sites. Indeed, urban areas supported a diverse bee community, but sites with an intermediate level of urbanization were the most speciose ones, including greater proportion of parasitic species. The presence of a diverse array of bee species even in the most urbanized area makes these pollinators worthy of being a flagship group to raise the awareness of urban citizens about biodiversity. PMID:25118722

Personal endotoxin exposure in a panel study of school children with asthma

PubMed Central

2011-01-01

Background Endotoxin exposure has been associated with asthma exacerbations and increased asthma prevalence. However, there is little data regarding personal exposure to endotoxin in children at risk, or the relation of personal endotoxin exposure to residential or ambient airborne endotoxin. The relation between personal endotoxin and personal air pollution exposures is also unknown. Methods We characterized personal endotoxin exposures in 45 school children with asthma ages 9-18 years using 376 repeated measurements from a PM2.5 active personal exposure monitor. We also assayed endotoxin in PM2.5 samples collected from ambient regional sites (N = 97 days) and from a subset of 12 indoor and outdoor subject home sites (N = 109 and 111 days, respectively) in Riverside and Whittier, California. Endotoxin was measured using the Limulus Amoebocyte Lysate kinetic chromogenic assay. At the same time, we measured personal, home and ambient exposure to PM2.5 mass, elemental carbon (EC), and organic carbon (OC). To assess exposure relations we used both rank correlations and mixed linear regression models, adjusted for personal temperature and relative humidity. Results We found small positive correlations of personal endotoxin with personal PM2.5 EC and OC, but not personal PM2.5 mass or stationary site air pollutant measurements. Outdoor home, indoor home and ambient endotoxin were moderately to strongly correlated with each other. However, in mixed models, personal endotoxin was not associated with indoor home or outdoor home endotoxin, but was associated with ambient endotoxin. Dog and cat ownership were significantly associated with increased personal but not indoor endotoxin. Conclusions Daily fixed site measurements of endotoxin in the home environment may not predict daily personal exposure, although a larger sample size may be needed to assess this. This conclusion is relevant to short-term exposures involved in the acute exacerbation of asthma. PMID:21810249

Treatment of uncommon sites of focal primary hyperhidrosis: experience with pharmacological therapy using oxybutynin

PubMed Central

Teivelis, Marcelo Passos; Wolosker, Nelson; Krutman, Mariana; Kauffman, Paulo; de Campos, José Ribas Milanez; Puech-Leão, Pedro

2014-01-01

OBJECTIVES: Primary hyperhidrosis usually affects the hands, armpits, feet and cranio-facial region. Sweating in other areas is common in secondary hyperhidrosis (after surgery or in specific clinical conditions). Oxybutynin has provided good results and is an alternative for treating hyperhidrosis at common sites. Our aim was to evaluate the efficacy of oxybutynin as a treatment for primary sweating at uncommon sites (e.g., the back and groin). METHODS: This retrospective study analyzed 20 patients (10 females) who received oxybutynin for primary focal hyperhidrosis at uncommon sites. The subjects were evaluated to determine quality of life before beginning oxybutynin and six weeks afterward and they were assigned grades (on a scale from 0 to 10) to measure their improvement at each site of excessive sweating after six weeks and at the last consult. RESULTS: The median follow-up time with oxybutynin was 385 days (133-1526 days). The most common sites were the back (n = 7) and groin (n = 5). After six weeks, the quality of life improved in 85% of the subjects. Dry mouth was very common and was reported by 16 patients, 12 of whom reported moderate/severe dry mouth. Five patients stopped treatment (two: unbearable dry mouth, two: excessive somnolence and one: palpitations). At the last visit, 80% of patients presented with moderate/great improvement at the main sites of sweating. CONCLUSION: After six weeks, more than 80% of the patients presented with improvements in their overall quality of life and at the most important site of sweating. Side effects were common (80% reported at least one side effect) and caused 25% of the patients to discontinue treatment. Oxybutynin is effective for treating bothersome hyperhidrosis, even at atypical locations and most patients cope well with the side effects. PMID:25318092

Central Core Laboratory versus Site Interpretation of Coronary CT Angiography: Agreement and Association with Cardiovascular Events in the PROMISE Trial.

PubMed

Lu, Michael T; Meyersohn, Nandini M; Mayrhofer, Thomas; Bittner, Daniel O; Emami, Hamed; Puchner, Stefan B; Foldyna, Borek; Mueller, Martin E; Hearne, Steven; Yang, Clifford; Achenbach, Stephan; Truong, Quynh A; Ghoshhajra, Brian B; Patel, Manesh R; Ferencik, Maros; Douglas, Pamela S; Hoffmann, Udo

2018-04-01

Purpose To assess concordance and relative prognostic utility between central core laboratory and local site interpretation for significant coronary artery disease (CAD) and cardiovascular events. Materials and Methods In the Prospective Multicenter Imaging Study for Evaluation of Chest Pain (PROMISE) trial, readers at 193 North American sites interpreted coronary computed tomographic (CT) angiography as part of the clinical evaluation of stable chest pain. Readers at a central core laboratory also interpreted CT angiography blinded to clinical data, site interpretation, and outcomes. Significant CAD was defined as stenosis greater than or equal to 50%; cardiovascular events were defined as a composite of cardiovascular death or myocardial infarction. Results In 4347 patients (51.8% women; mean age ± standard deviation, 60.4 years ± 8.2), core laboratory and site interpretations were discordant in 16% (683 of 4347), most commonly because of a finding of significant CAD by site but not by core laboratory interpretation (80%, 544 of 683). Overall, core laboratory interpretation resulted in 41% fewer patients being reported as having significant CAD (14%, 595 of 4347 vs 23%, 1000 of 4347; P < .001). Over a median follow-up period of 25 months, 1.3% (57 of 4347) sustained myocardial infarction or cardiovascular death. The C statistic for future myocardial infarction or cardiovascular death was 0.61 (95% confidence interval [CI]: 0.54, 0.68) for the core laboratory and 0.63 (95% CI: 0.56, 0.70) for the sites. Conclusion Compared with interpretation by readers at 193 North American sites, standardized core laboratory interpretation classified 41% fewer patients as having significant CAD. © RSNA, 2017 Online supplemental material is available for this article. Clinical trial registration no. NCT01174550.

Port-Site Metastases and Chimney Effect of B-Ultrasound-Guided and Laparoscopically-Assisted Hyperthermic Intraperitoneal Perfusion Chemotherapy

PubMed Central

Zhang, Xiang-Liang; Gong, Yuan-Feng; Yan, Zhao-Fei; Wang, Shuai; Tang, Yun-Qiang; Cui, Shu-Zhong

2017-01-01

Purpose CO2 leakage along the trocar (chimney effect) has been proposed to be an important factor underlying port-site metastasis after laparoscopic surgery. This study aimed to test this hypothesis by comparing the incidence of port-site metastasis between B-ultrasound-guided and laparoscopically-assisted hyperthermic intraperitoneal perfusion chemotherapy (HIPPC). Materials and Methods Sixty-two patients with malignant ascites induced by gastrointestinal or ovarian cancer were divided into two groups to receive either B-ultrasound-guided or laparoscopically-assisted HIPPC. Clinical efficacy was assessed from the objective remission rate (ORR), the Karnofsky Performance Status (KPS) score, and overall survival. The incidence of port-site metastasis was compared between the two groups. Results Patients in the B-ultrasound (n=32) and laparoscopy (n=30) groups were comparable in terms of age, sex, primary disease type, volume of ascites, and free cancer cell (FCC)-positive ascites. After HIPPC, there were no significant differences between the B-ultrasound and laparoscopy groups in the KPS score change, ORR, and median survival time. The incidence of port-site metastasis after HIPPC was not significantly different between the B-ultrasound (3 of 32, 9.36%) and laparoscopy (3 of 30, 10%) groups, but significantly different among pancreatic, gastric, ovarian, and colorectal cancer (33.33, 15.79, 10.00, and 0.00%, p<0.001). Conclusion The chimney effect may not be the key reason for port-site metastasis after laparoscopy. Other factors may play a role, including the local microenvironment at the trocar site and the delivery of viable FCCs (from the tumor or malignant ascites) to the trauma site during laparoscopic surgery. PMID:28332353

The uses and abuses of Facebook: A review of Facebook addiction

PubMed Central

RYAN, TRACII; CHESTER, ANDREA; REECE, JOHN; XENOS, SOPHIA

2014-01-01

Abstract Background and aims: Recent research suggests that use of social networking sites can be addictive for some individuals. Due to the link between motivations for media use and the development of addiction, this systematic review examines Facebook-related uses and gratifications research and Facebook addiction research. Method: Searches of three large academic databases revealed 24 studies examining the uses and gratifications of Facebook, and nine studies of Facebook addiction. Results: Comparison of uses and gratifications research reveals that the most popular mo- tives for Facebook use are relationship maintenance, passing time, entertainment, and companionship. These motivations may be related to Facebook addiction through use that is habitual, excessive, or motivated by a desire for mood alteration. Examination of Facebook addiction research indicates that Facebook use can become habitual or excessive, and some addicts use the site to escape from negative moods. However, examination of Facebook addic- tion measures highlights inconsistency in the field. Discussion: There is some evidence to support the argument that uses and gratifications of Facebook are linked with Facebook addiction. Furthermore, it appears as if the social skill model of addiction may explain Facebook addiction, but inconsistency in the measurement of this condition limits the ability to provide conclusive arguments. Conclusions: This paper recommends that further research be performed to establish the links between uses and gratifications and Facebook addiction. Furthermore, in order to enhance the construct validity of Facebook addiction, researchers should take a more systematic approach to assessment. PMID:25317337

Antiquity of man in America indicated by radiometric dates on the Yuha burial site

USGS Publications Warehouse

Bischoff, J.L.; Merriam, R.; Childers, W.M.; Protsch, R.

1976-01-01

MUCH evidence suggests that man was present in the Western Hemisphere before 12,000 yr ago, but the case has remained less than conclusive 1. In some situations, the geological age of the site is reasonably well established but the association or nature of the artefacts is questionable2,3. In other cases, museum specimens of human bones dated by radiocarbon analysis of collagen lack desirable information concerning site location, geology, and stratigraphy even though the accuracy of their absolute ages seems valid4-6. We report here the results of radiometric dates of the Yuha burial site from Imperial County, California, for which the geology and stratigraphy have been documented and reported in detail7. ?? 1976 Nature Publishing Group.

Cone penetrometer comparison testing.

DOT National Transportation Integrated Search

2011-01-01

A total of 61 cone penetration tests were performed at 14 sites in the state of Wisconsin. Data : reinforced conclusions from practice in Minnesota and previously performed test programs : related to the Marquette Interchange and Mitchell interchange...

Human-specific protein isoforms produced by novel splice sites in the human genome after the human-chimpanzee divergence

PubMed Central

2012-01-01

Background Evolution of splice sites is a well-known phenomenon that results in transcript diversity during human evolution. Many novel splice sites are derived from repetitive elements and may not contribute to protein products. Here, we analyzed annotated human protein-coding exons and identified human-specific splice sites that arose after the human-chimpanzee divergence. Results We analyzed multiple alignments of the annotated human protein-coding exons and their respective orthologous mammalian genome sequences to identify 85 novel splice sites (50 splice acceptors and 35 donors) in the human genome. The novel protein-coding exons, which are expressed either constitutively or alternatively, produce novel protein isoforms by insertion, deletion, or frameshift. We found three cases in which the human-specific isoform conferred novel molecular function in the human cells: the human-specific IMUP protein isoform induces apoptosis of the trophoblast and is implicated in pre-eclampsia; the intronization of a part of SMOX gene exon produces inactive spermine oxidase; the human-specific NUB1 isoform shows reduced interaction with ubiquitin-like proteins, possibly affecting ubiquitin pathways. Conclusions Although the generation of novel protein isoforms does not equate to adaptive evolution, we propose that these cases are useful candidates for a molecular functional study to identify proteomic changes that might bring about novel phenotypes during human evolution. PMID:23148531

The Typhoid Fever Surveillance in Africa Program (TSAP): Clinical, Diagnostic, and Epidemiological Methodologies

PubMed Central

von Kalckreuth, Vera; Konings, Frank; Aaby, Peter; Adu-Sarkodie, Yaw; Ali, Mohammad; Aseffa, Abraham; Baker, Stephen; Breiman, Robert F.; Bjerregaard-Andersen, Morten; Clemens, John D.; Crump, John A.; Cruz Espinoza, Ligia Maria; Deerin, Jessica Fung; Gasmelseed, Nagla; Sow, Amy Gassama; Im, Justin; Keddy, Karen H.; Cosmas, Leonard; May, Jürgen; Meyer, Christian G.; Mintz, Eric D.; Montgomery, Joel M.; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Rakotozandrindrainy, Raphaël; Schütt-Gerowitt, Heidi; Soura, Abdramane Bassiahi; Warren, Michelle R.; Wierzba, Thomas F.; Marks, Florian

2016-01-01

Background. New immunization programs are dependent on data from surveillance networks and disease burden estimates to prioritize target areas and risk groups. Data regarding invasive Salmonella disease in sub-Saharan Africa are currently limited, thus hindering the implementation of preventive measures. The Typhoid Fever Surveillance in Africa Program (TSAP) was established by the International Vaccine Institute to obtain comparable incidence data on typhoid fever and invasive nontyphoidal Salmonella (iNTS) disease in sub-Saharan Africa through standardized surveillance in multiple countries. Methods. Standardized procedures were developed and deployed across sites for study site selection, patient enrolment, laboratory procedures, quality control and quality assurance, assessment of healthcare utilization and incidence calculations. Results. Passive surveillance for bloodstream infections among febrile patients was initiated at thirteen sentinel sites in ten countries (Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya, Madagascar, Senegal, South Africa, Sudan, and Tanzania). Each TSAP site conducted case detection using these standardized methods to isolate and identify aerobic bacteria from the bloodstream of febrile patients. Healthcare utilization surveys were conducted to adjust population denominators in incidence calculations for differing healthcare utilization patterns and improve comparability of incidence rates across sites. Conclusions. By providing standardized data on the incidence of typhoid fever and iNTS disease in sub-Saharan Africa, TSAP will provide vital input for targeted typhoid fever prevention programs. PMID:26933028

Effects of a continuous lateral turning device on pressure relief.

PubMed

Do, Nam Ho; Kim, Deog Young; Kim, Jung-Hoon; Choi, Jong Hyun; Joo, So Young; Kang, Na Kyung; Baek, Yoon Su

2016-01-01

[Purpose] The purpose of this study was to examine the pressure-relieving effects of a continuous lateral turning device on common pressure ulcer sites. [Subjects] Twenty-four healthy adults participated. [Methods] The design of our continuous lateral turning device was motivated by the need for an adequate pressure-relieving device for immobile and/or elderly people. The procedure of manual repositioning is embodied in our continuous lateral turning device. The interface pressure and time were measured, and comfort grade was evaluated during sessions of continuous lateral turning at 0°, 15°, 30°, and 45°. We quantified the pressure-relieving effect using peak pressure, mean pressure, and pressure time integration. [Results] Participants demonstrated pressure time integration values below the pressure-time threshold at 15°, 30°, and 45° at all the common pressure ulcer sites. Moreover, the most effective angles for pressure relief at the common pressure ulcer sites were 30° at the occiput, 15° at the left scapula, 45° at the right scapula, 45° at the sacrum, 15° at the right heel, and 30° at the left heel. However, angles greater than 30° induced discomfort. [Conclusion] Continuous lateral turning with our specially designed device effectively relieved the pressure of targeted sites. Moreover, the suggested angles of continuous lateral turning can be used to relieve pressure at targeted sites.

Altitude affects the reproductive performance in monoicous and dioicous bryophytes: examples from a Brazilian Atlantic rainforest

PubMed Central

Maciel-Silva, Adaíses S.; Marques Valio, Ivany F.; Rydin, Håkan

2012-01-01

Background and aims Short life cycles and trade-offs linked to breeding systems make bryophytes good models for the study of plant reproductive strategies. Our aim was to test if differences in sexual reproductive performance of bryophytes in tropical rainforests are driven by the breeding system of the species (monoicous or dioicous) or are mainly affected by the habitat. Methodology The reproductive performance (sexual branches, gametangia (sex organs), fertilization and sporophyte production) of 11 species was repeatedly monitored and analysed from populations at sea-level and montane sites of a Brazilian Atlantic rainforest over 15 months. Principal results Monoicous species had the highest reproductive performance, particularly for sexual branches, fertilized gametangia and sporophyte production. Species at the sea-level site produced more sexual branches and had more female-biased sex ratios of gametangia than species in the montane site. Fertilizations were more frequent at the montane site, but sporophyte frequency was similar between the two sites. Fertilization tended to occur mostly in the periods of heavy rain (October to December). Conclusions Breeding system is not the only major influence on the reproductive performance of bryophytes. We show that habitat is also an important factor determining life-history differentiation. Female-biased sex ratios and low rates of fertilization are seen to be compensated for by high production of reproductive structures at the initial phases of the reproductive cycle. PMID:22822422

Structural study of the Fox-1 RRM protein hydration reveals a role for key water molecules in RRM-RNA recognition

PubMed Central

Blatter, Markus; Cléry, Antoine; Damberger, Fred F.

2017-01-01

Abstract The Fox-1 RNA recognition motif (RRM) domain is an important member of the RRM protein family. We report a 1.8 Å X-ray structure of the free Fox-1 containing six distinct monomers. We use this and the nuclear magnetic resonance (NMR) structure of the Fox-1 protein/RNA complex for molecular dynamics (MD) analyses of the structured hydration. The individual monomers of the X-ray structure show diverse hydration patterns, however, MD excellently reproduces the most occupied hydration sites. Simulations of the protein/RNA complex show hydration consistent with the isolated protein complemented by hydration sites specific to the protein/RNA interface. MD predicts intricate hydration sites with water-binding times extending up to hundreds of nanoseconds. We characterize two of them using NMR spectroscopy, RNA binding with switchSENSE and free-energy calculations of mutant proteins. Both hydration sites are experimentally confirmed and their abolishment reduces the binding free-energy. A quantitative agreement between theory and experiment is achieved for the S155A substitution but not for the S122A mutant. The S155 hydration site is evolutionarily conserved within the RRM domains. In conclusion, MD is an effective tool for predicting and interpreting the hydration patterns of protein/RNA complexes. Hydration is not easily detectable in NMR experiments but can affect stability of protein/RNA complexes. PMID:28505313

Absorption, distribution, metabolism and excretion of loxoprofen after dermal application of loxoprofen gel to rats.

PubMed

Sawamura, Ryoko; Kazui, Miho; Kurihara, Atsushi; Izumi, Takashi

2014-11-01

1. Loxoprofen (LX), is a prodrug of the pharmacologically active form, trans-alcohol metabolite (trans-OH form), which shows very potent analgesic effect. In this study, the pharmacokinetics and metabolism of [(14)C]LX-derived radioactivity after dermal application of [(14)C]LX gel (LX-G) to rats were evaluated. 2. The area under concentration-time curve (AUC0-∞) of radioactivity in the plasma after the dermal application was 13.6% of that of the oral administration (p < 0.05). 3. After the dermal application, the radioactivity remained in the skin and skeletal muscle at the treated site for 168 h, whereas the AUC0-168 h of the radioactivity concentration in every tissue examined except the treated site was statistically lower than that after the oral administration (p < 0.05). 4. The trans-OH form was observed at high levels in the treated skin site at 0.5 h. Metabolite profiles in plasma, non-treated skin site and urine after the dermal application were comparable with those after the oral administration. 5. Renal excretion was the main route of elimination after the dermal application. 6. In conclusion, compared to the oral administration, the dermal application of [(14)C]LX-G showed lower systemic and tissue exposure with higher exposure in the therapeutic target site. The radioactivity revealed similar metabolite profiles in both administration routes.

Direction, site and the muzzle target distance of bullet in the head and neck at close range as an indication of suicide or homicide.

PubMed

Suwanjutha, T

1988-05-01

Direction, site and muzzle target distance can indicate suicide or homicide. This conclusion can be drawn from autopsies of 57 cases of suicide and 68 cases of homicide by handgun fired at close range to the head and neck together with going to the crimescene in some cases. This study was carried out in Bangkok during the period from January 1983 to January 1986. In order to determine whether it was suicide or homicide, the path of the bullet, the site, the muzzle target distance must be considered. The angle of the bullet would be either elevated (from below upward), horizontal or an angle of depression (from above downward). For suicide, the direction of the bullet should be at an angle of elevation in the majority of cases. The position of the handgun in relation to the head in suicide was most often in tight contact and near contact. For homicide, the direction of the bullet should be horizontal in most cases. The bullet was at close range in the majority of the cases. There are 8 common sites for suicide and homicide and 10 different sites in the case of homicide which are at neck, left cheek, left aural region, lip, left occipital area orbit, chin, left eyebrow, submental and nose.

Identification of E-cadherin signature motifs functioning as cleavage sites for Helicobacter pylori HtrA

NASA Astrophysics Data System (ADS)

Schmidt, Thomas P.; Perna, Anna M.; Fugmann, Tim; Böhm, Manja; Jan Hiss; Haller, Sarah; Götz, Camilla; Tegtmeyer, Nicole; Hoy, Benjamin; Rau, Tilman T.; Neri, Dario; Backert, Steffen; Schneider, Gisbert; Wessler, Silja

2016-03-01

The cell adhesion protein and tumour suppressor E-cadherin exhibits important functions in the prevention of gastric cancer. As a class-I carcinogen, Helicobacter pylori (H. pylori) has developed a unique strategy to interfere with E-cadherin functions. In previous studies, we have demonstrated that H. pylori secretes the protease high temperature requirement A (HtrA) which cleaves off the E-cadherin ectodomain (NTF) on epithelial cells. This opens cell-to-cell junctions, allowing bacterial transmigration across the polarised epithelium. Here, we investigated the molecular mechanism of the HtrA-E-cadherin interaction and identified E-cadherin cleavage sites for HtrA. Mass-spectrometry-based proteomics and Edman degradation revealed three signature motifs containing the [VITA]-[VITA]-x-x-D-[DN] sequence pattern, which were preferentially cleaved by HtrA. Based on these sites, we developed a substrate-derived peptide inhibitor that selectively bound and inhibited HtrA, thereby blocking transmigration of H. pylori. The discovery of HtrA-targeted signature sites might further explain why we detected a stable 90 kDa NTF fragment during H. pylori infection, but also additional E-cadherin fragments ranging from 105 kDa to 48 kDa in in vitro cleavage experiments. In conclusion, HtrA targets E-cadherin signature sites that are accessible in in vitro reactions, but might be partially masked on epithelial cells through functional homophilic E-cadherin interactions.

Site-specific cancer risk in the Baltic cohort of Chernobyl cleanup workers, 1986–2007

PubMed Central

Rahu, Kaja; Hakulinen, Timo; Smailyte, Giedre; Stengrevics, Aivars; Auvinen, Anssi; Inskip, Peter D.; Boice, John D.; Rahu, Mati

2013-01-01

Objective To assess site-specific cancer risk in the Baltic cohort of Chernobyl cleanup workers 1986–2007. Methods The Baltic cohort includes 17,040 men from Estonia, Latvia and Lithuania who participated in the environmental cleanup after the accident at the Chernobyl Nuclear Power Station in 1986–1991, and who were followed for cancer incidence until the end of 2007. Cancer cases diagnosed in the cohort and in the male population of each country were identified from the respective national cancer registers. The proportional incidence ratio (PIR) with 95% confidence interval (CI) was used to estimate the site-specific cancer risk in the cohort. For comparison and as it was possible, the site-specific standardized incidence ratio (SIR) was calculated for the Estonian sub-cohort, which was not feasible for the other countries. Results Overall, 756 cancer cases were reported during 1986–2007. A higher proportion of thyroid cancers in relation to the male population was found (PIR=2.76; 95%CI 1.63–4.36), especially among those who started their mission shortly after the accident, in April–May 1986 (PIR=6.38; 95% CI 2.34–13.89). Also, an excess of oesophageal cancers was noted (PIR=1.52; 95% CI 1.06–2.11). No increased PIRs for leukaemia or radiation-related cancer sites combined were observed. PIRs and SIRs for the Estonian sub-cohort demonstrated the same site-specific cancer risk pattern. Conclusion Consistent evidence of an increase in radiation-related cancers in the Baltic cohort was not observed with the possible exception of thyroid cancer, where conclusions are hampered by known medical examination including thyroid screening among cleanup workers. PMID:23683549

Laser removal of graffiti from Pink Morelia Quarry

NASA Astrophysics Data System (ADS)

Penide, J.; Quintero, F.; Riveiro, A.; Sánchez-Castillo, A.; Comesaña, R.; del Val, J.; Lusquiños, F.; Pou, J.

2013-11-01

Morelia is an important city sited in Mexico. Its historical center reflects most of their culture and history, especially of the colonial period; in fact, it was appointed World Heritage Site by UNESCO. Sadly, there is a serious problem with graffiti in Morelia and its historical center is the worst affected since its delicate charming is definitely damaged. Hitherto, the conventional methods employed to remove graffiti from Pink Morelia Quarry (the most used building stone in Morelia) are quite aggressive to the appearance of the monuments, so actually, they are not a very good solution. In this work, we performed a study on the removal of graffiti from Pink Morelia Quarry by high power diode laser. We carried out an extensive experimental study looking for the optimal processing parameters, and compared a single-pass with a multi-pass method. Indeed, we achieved an effective cleaning without producing serious side effects in the stone. In conclusion, the multi-pass method emitting in continuous wave was revealed as the more effective operating modes to remove the graffiti.

Clinical effectiveness of late maxillary protraction in cleft lip and palate: a methods paper

PubMed Central

Lee, MK; Lane, C; Azeredo, F; Landsberger, M; Kapadia, H; Sheller, B; Yen, SL

2017-01-01

Objectives A prospective parallel cohort trial was conducted to compare outcomes of patients treated with maxillary protraction vs. LeFort 1 maxillary advancement surgery. Setting and Sample Population The primary site for the clinical trial is Children’s Hospital Los Angeles; the satellite test site is Seattle Children’s Hospital. All patients have isolated cleft lip and palate and a skeletal Class III malocclusion. Material & Methods A total of 50 patients, ages 11–14 will be recruited for the maxillary protraction cohort. The maxillary surgery cohort consists of 50 patients, ages 16–21, who will undergo LeFort 1 maxillary advancement surgery. Patients with additional medical or cognitive handicaps were excluded from the study. Results Current recruitment of patients is on track to complete the study within the proposed recruitment period. Conclusion This observational trial is collecting information that will examine dental, skeletal, financial, and quality of life issues from both research cohorts. PMID:28643931

Epidemiology and Antimicrobial Resistance of International Travel-Associated Campylobacter Infections in the United States, 2005–2011

PubMed Central

Palmer, Amanda; Wymore, Katie; Clogher, Paula; Oosmanally, Nadine; Robinson, Trisha; Lathrop, Sarah; Karr, Jillian; Hatch, Julie; Dunn, John; Ryan, Patricia; Blythe, David

2014-01-01

Objectives. The objective of this study was to determine the role international travel plays in US Campylobacter epidemiology and antimicrobial resistance. Methods. In this study, epidemiological and antimicrobial resistance data, encompassing the years 2005 to 2011, from 10 sites participating in the Foodborne Diseases Active Surveillance Network were linked. The 10 sites are represented by 7 states that conducted surveillance on a statewide level, and 3 states which conducted county-level surveillance. Cases of Campylobacter among persons with history of international travel in the week prior to illness were compared with cases among individuals with no international travel. Results. Approximately 18% of Campylobacter infections were estimated to be associated with international travel, and 60% of international travel-associated infections had a quinolone-resistant Campylobacter isolate. Conclusions. We confirm that international travel plays a significant role in campylobacteriosis diagnosed in the United States. Recognizing this is important to both medical management decisions and understanding burden and attribution estimates of US campylobacteriosis and antibiotic-resistant campylobacteriosis. PMID:24832415

Narcissism and Social Networking Behavior: A Meta-Analysis.

PubMed

Gnambs, Timo; Appel, Markus

2018-04-01

The increasing popularity of social networking sites (SNS) such as Facebook and Twitter has given rise to speculations that the intensity of using these platforms is associated with narcissistic tendencies. However, recent research on this issue has been all but conclusive. We present a three-level, random effects meta-analysis including 289 effect sizes from 57 studies (total N = 25,631) on the association between trait narcissism and social networking behavior. The meta-analysis identified a small to moderate effect of ρ = .17 (τ = .11), 95% CI [.13, .21], for grandiose narcissism that replicated across different social networking platforms, respondent characteristics, and time. Moderator analyses revealed pronounced cultural differences, with stronger associations in power-distant cultures. Moreover, social networking behaviors geared toward self-presentation and the number of SNS friends exhibited stronger effects than usage durations. Overall, the study not only supported but also refined the notion of a relationship between engaging in social networking sites and narcissistic personality traits. © 2017 Wiley Periodicals, Inc.

Anophelism in a Former Malaria Area of Northeastern Spain

PubMed Central

Bueno-Marí, Rubén; Jiménez-Peydró, Ricardo

2013-01-01

Background: A field study on diversity and distribution of anophelines currently present in a past endemic malaria area of Spain was carried out in order to identify possible risk areas of local disease transmission. Methods: Multiple larval sites were sampled from June to October of 2011 in the Region of Somontano de Barbastro (Northeastern Spain). The sampling effort was fixed at 10 minutes which included the active search for larvae in each biotope visited. Results: A total of 237 larval specimens belonging to four Anopheles species (Anopheles atroparvus, An. claviger, An. maculipennis and An. petragnani) were collected and identified. Conclusions: Malaria receptivity in the study area is high, especially in the area of Cinca river valley, due to the abundance of breeding sites of An. atroparvus very close to human settlements. Although current socio-economic conditions in Spain reduce possibilities of re-emergence of malaria transmission, it is evident that certain entomological and epidemiological vigilance must be maintained and even increased in the context of current processes of climate change and globalization. PMID:24409440

The retrospective annual surgical incidence of cystic echinococcosis in Sivas, Turkey.

PubMed

Gonlugur, U; Ozcelik, S; Gonlugur, T E; Arici, S; Celiksoz, A; Elagoz, S; Cevit, R

2009-06-01

Cystic echinococcosis is an important public health problem in our region. The aim of this study was to assess the surgical incidence of cystic echinococcosis in Sivas, Turkey. A retrospective follow-up study was carried out between 1997 and 2004. The mean age of 124 men (39.2%) and 192 women was 36.4 years. The liver was the primary site of cyst development (76.6%), followed by the lungs (19.9%), the spleen (5.4%), the kidneys (3.5%) and the peritoneal cavity (3.2%). Mean annual surgical incidence was 6.4 per 100,000 inhabitants for a 7-year period. The most common site of recurrence was the liver. Hepatic cysts were more frequently infected than pulmonary cysts (P < 0.05). In those patients with an infected cyst, the mean circulating eosinophil level was significantly lower than in those without. Rupture and infection were more common in men (P < 0.01). In conclusion, serious structural, legislative, surveillance, prevention and control measures for echinooccus should be undertaken in our region.

G4 motifs affect origin positioning and efficiency in two vertebrate replicators

PubMed Central

Valton, Anne-Laure; Hassan-Zadeh, Vahideh; Lema, Ingrid; Boggetto, Nicole; Alberti, Patrizia; Saintomé, Carole; Riou, Jean-François; Prioleau, Marie-Noëlle

2014-01-01

DNA replication ensures the accurate duplication of the genome at each cell cycle. It begins at specific sites called replication origins. Genome-wide studies in vertebrates have recently identified a consensus G-rich motif potentially able to form G-quadruplexes (G4) in most replication origins. However, there is no experimental evidence to demonstrate that G4 are actually required for replication initiation. We show here, with two model origins, that G4 motifs are required for replication initiation. Two G4 motifs cooperate in one of our model origins. The other contains only one critical G4, and its orientation determines the precise position of the replication start site. Point mutations affecting the stability of this G4 in vitro also impair origin function. Finally, this G4 is not sufficient for origin activity and must cooperate with a 200-bp cis-regulatory element. In conclusion, our study strongly supports the predicted essential role of G4 in replication initiation. PMID:24521668

Biological role and structural mechanism of twinfilin–capping protein interaction

PubMed Central

Falck, Sandra; Paavilainen, Ville O; Wear, Martin A; Grossmann, J Günter; Cooper, John A; Lappalainen, Pekka

2004-01-01

Twinfilin and capping protein (CP) are highly conserved actin-binding proteins that regulate cytoskeletal dynamics in organisms from yeast to mammals. Twinfilin binds actin monomer, while CP binds the barbed end of the actin filament. Remarkably, twinfilin and CP also bind directly to each other, but the mechanism and role of this interaction in actin dynamics are not defined. Here, we found that the binding of twinfilin to CP does not affect the binding of either protein to actin. Furthermore, site-directed mutagenesis studies revealed that the CP-binding site resides in the conserved C-terminal tail region of twinfilin. The solution structure of the twinfilin–CP complex supports these conclusions. In vivo, twinfilin's binding to both CP and actin monomer was found to be necessary for twinfilin's role in actin assembly dynamics, based on genetic studies with mutants that have defined biochemical functions. Our results support a novel model for how sequential interactions between actin monomers, twinfilin, CP, and actin filaments promote cytoskeletal dynamics. PMID:15282541

Evaluation of moxifloxacin-hydroxyapatite composite graft in the regeneration of intrabony defects: A clinical, radiographic, and microbiological study

PubMed Central

Nagarjuna Reddy, Y. V.; Deepika, P. C.; Venkatesh, M. P.; Rajeshwari, K. G.

2016-01-01

Background: The formation of new connective periodontal attachment is contingent upon the elimination or marked reduction of pathogens at the treated periodontal site. An anti-microbial agent, i.e. moxifloxacin has been incorporated into the bone graft to control infection and facilitate healing during and after periodontal therapy. Materials and Methods: By purposive sampling, 15 patients with at least two contralateral vertical defect sites were selected. The selected sites in each individual were divided randomly into test and control sites according to split-mouth design. Test site received moxifloxacin-hydroxyapatite composite graft and control site received hydroxyapatite-placebo gel composite graft. Probing depth (PD) and Clinical attachment level (CAL) were assessed at baseline, 3, 6, 9, and 12 months. Bone probing depth (BPD) and hard tissue parameters such as amount of defect fill, percentage of defect fill, and changes in alveolar crest were assessed at baseline, 6, and 12 months. Changes in subgingival microflora were also assessed by culturing the subgingival plaque samples at baseline and at 3-month follow-up. The clinical, radiographic, and microbiological data obtained were subjected to statistical analysis using descriptive statistics, paired sample t-test, independent t-test, and contingency test. Results: On intragroup comparison at test and control sites, there was a significant improvement in all clinical and radiographic parameters. However, on intergroup comparison of the same, there was no statistically significant difference between test and control sites at any interval. Although test sites showed slightly higher amount of bone fill, it was not statistically significant. There was a significant reduction in the counts of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis at both sites from baseline to 3 months. In addition, there was a significant reduction at test sites as compared to control sites at 3-month follow-up (P = 0.003 and P = 0.013). Conclusion: The reduction in microbial counts found in test sites at 3-month follow-up could not bring similar significant improvements in the clinical and radiographic parameters though the test sites showed slightly higher bone fill. PMID:27630501

Risk-adapted monitoring is not inferior to extensive on-site monitoring: Results of the ADAMON cluster-randomised study.

PubMed

Brosteanu, Oana; Schwarz, Gabriele; Houben, Peggy; Paulus, Ursula; Strenge-Hesse, Anke; Zettelmeyer, Ulrike; Schneider, Anja; Hasenclever, Dirk

2017-12-01

Background According to Good Clinical Practice, clinical trials must protect rights and safety of patients and make sure that the trial results are valid and interpretable. Monitoring on-site has an important role in achieving these objectives; it controls trial conduct at trial sites and informs the sponsor on systematic problems. In the past, extensive on-site monitoring with a particular focus on formal source data verification often lost sight of systematic problems in study procedures that endanger Good Clinical Practice objectives. ADAMON is a prospective, stratified, cluster-randomised, controlled study comparing extensive on-site monitoring with risk-adapted monitoring according to a previously published approach. Methods In all, 213 sites from 11 academic trials were cluster-randomised between extensive on-site monitoring (104) and risk-adapted monitoring (109). Independent post-trial audits using structured manuals were performed to determine the frequency of major Good Clinical Practice findings at the patient level. The primary outcome measure is the proportion of audited patients with at least one major audit finding. Analysis relies on logistic regression incorporating trial and monitoring arm as fixed effects and site as random effect. The hypothesis was that risk-adapted monitoring is non-inferior to extensive on-site monitoring with a non-inferiority margin of 0.60 (logit scale). Results Average number of monitoring visits and time spent on-site was 2.1 and 2.7 times higher in extensive on-site monitoring than in risk-adapted monitoring, respectively. A total of 156 (extensive on-site monitoring: 76; risk-adapted monitoring: 80) sites were audited. In 996 of 1618 audited patients, a total of 2456 major audit findings were documented. Depending on the trial, findings were identified in 18%-99% of the audited patients, with no marked monitoring effect in any of the trials. The estimated monitoring effect is -0.04 on the logit scale with two-sided 95% confidence interval (-0.40; 0.33), demonstrating that risk-adapted monitoring is non-inferior to extensive on-site monitoring. At most, extensive on-site monitoring could reduce the frequency of major Good Clinical Practice findings by 8.2% compared with risk-adapted monitoring. Conclusion Compared with risk-adapted monitoring, the potential benefit of extensive on-site monitoring is small relative to overall finding rates, although risk-adapted monitoring requires less than 50% of extensive on-site monitoring resources. Clusters of findings within trials suggest that complicated, overly specific or not properly justified protocol requirements contributed to the overall frequency of findings. Risk-adapted monitoring in only a sample of patients appears sufficient to identify systematic problems in the conduct of clinical trials. Risk-adapted monitoring has a part to play in quality control. However, no monitoring strategy can remedy defects in quality of design. Monitoring should be embedded in a comprehensive quality management approach covering the entire trial lifecycle.

Risk-adapted monitoring is not inferior to extensive on-site monitoring: Results of the ADAMON cluster-randomised study

PubMed Central

Brosteanu, Oana; Schwarz, Gabriele; Houben, Peggy; Paulus, Ursula; Strenge-Hesse, Anke; Zettelmeyer, Ulrike; Schneider, Anja; Hasenclever, Dirk

2017-01-01

Background According to Good Clinical Practice, clinical trials must protect rights and safety of patients and make sure that the trial results are valid and interpretable. Monitoring on-site has an important role in achieving these objectives; it controls trial conduct at trial sites and informs the sponsor on systematic problems. In the past, extensive on-site monitoring with a particular focus on formal source data verification often lost sight of systematic problems in study procedures that endanger Good Clinical Practice objectives. ADAMON is a prospective, stratified, cluster-randomised, controlled study comparing extensive on-site monitoring with risk-adapted monitoring according to a previously published approach. Methods In all, 213 sites from 11 academic trials were cluster-randomised between extensive on-site monitoring (104) and risk-adapted monitoring (109). Independent post-trial audits using structured manuals were performed to determine the frequency of major Good Clinical Practice findings at the patient level. The primary outcome measure is the proportion of audited patients with at least one major audit finding. Analysis relies on logistic regression incorporating trial and monitoring arm as fixed effects and site as random effect. The hypothesis was that risk-adapted monitoring is non-inferior to extensive on-site monitoring with a non-inferiority margin of 0.60 (logit scale). Results Average number of monitoring visits and time spent on-site was 2.1 and 2.7 times higher in extensive on-site monitoring than in risk-adapted monitoring, respectively. A total of 156 (extensive on-site monitoring: 76; risk-adapted monitoring: 80) sites were audited. In 996 of 1618 audited patients, a total of 2456 major audit findings were documented. Depending on the trial, findings were identified in 18%–99% of the audited patients, with no marked monitoring effect in any of the trials. The estimated monitoring effect is −0.04 on the logit scale with two-sided 95% confidence interval (−0.40; 0.33), demonstrating that risk-adapted monitoring is non-inferior to extensive on-site monitoring. At most, extensive on-site monitoring could reduce the frequency of major Good Clinical Practice findings by 8.2% compared with risk-adapted monitoring. Conclusion Compared with risk-adapted monitoring, the potential benefit of extensive on-site monitoring is small relative to overall finding rates, although risk-adapted monitoring requires less than 50% of extensive on-site monitoring resources. Clusters of findings within trials suggest that complicated, overly specific or not properly justified protocol requirements contributed to the overall frequency of findings. Risk-adapted monitoring in only a sample of patients appears sufficient to identify systematic problems in the conduct of clinical trials. Risk-adapted monitoring has a part to play in quality control. However, no monitoring strategy can remedy defects in quality of design. Monitoring should be embedded in a comprehensive quality management approach covering the entire trial lifecycle. PMID:28786330

Remedial Investigation of Hanford Site Releases to the Columbia River - 13603

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lerch, J.A.; Hulstrom, L.C.; Sands, J.P.

2013-07-01

In south-central Washington State, the Columbia River flows through the U.S. Department of Energy Hanford Site. A primary objective of the Hanford Site cleanup mission is protection of the Columbia River, through remediation of contaminated soil and groundwater that resulted from its weapons production mission. Within the Columbia River system, surface water, sediment, and biota samples related to potential Hanford Site hazardous substance releases have been collected since the start of Hanford operations. The impacts from release of Hanford Site radioactive substances to the Columbia River in areas upstream, within, and downstream of the Hanford Site boundary have been previouslymore » investigated as mandated by the U.S. Department of Energy requirements under the Atomic Energy Act. The Remedial Investigation Work Plan for Hanford Site Releases to the Columbia River [1] was issued in 2008 to initiate assessment of the impacts under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 [2]. The work plan established a phased approach to characterize contaminants, assess current risks, and determine whether or not there is a need for any cleanup actions. Field investigation activities over a 120-mile stretch of the Columbia River began in October 2008 and were completed in 2010. Sampled media included surface water, pore water, surface and core sediment, island soil, and fish (carp, walleye, whitefish, sucker, small-mouth bass, and sturgeon). Information and sample results from the field investigation were used to characterize current conditions within the Columbia River and assess whether current conditions posed a risk to ecological or human receptors that would merit additional study or response actions under CERCLA. The human health and ecological risk assessments are documented in reports that were published in 2012 [3, 4]. Conclusions from the risk assessment reports are being summarized and integrated with remedial investigation/feasibility study (RI/FS) reports developed for upland areas, riparian areas, and groundwater in the Hanford Site River Corridor. The RI/FS reports will evaluate the impacts to soil, groundwater, and river sediments and lead to proposed cleanup actions and records of decision to address releases from the Hanford Site reactor operations. (authors)« less

Chiropractic wellness on the web: the content and quality of information related to wellness and primary prevention on the Internet

PubMed Central

2011-01-01

Background The Internet has become a common source of information for patients wishing to learn about health information. Previous studies found information related to back pain poor and often contradictory to current guidelines. Wellness has become a common topic in the field of chiropractic and accrediting agencies have standards on delivery of wellness-based content in college curricula as well as directives for clinical applications. The purpose of this study was to evaluate the quality of the information on the Internet using the terms "chiropractic wellness," or "wellness chiropractic". Methods Five commonly used search engines were selected and the first 10 sites found using the strategy above were evaluated by two raters. Demographic assessments of the sites were made along with whether they were Health on the Net Foundation (HON) certified, contained standard wellness content, mentioned any Healthy People Focus Areas, and other chiropractic topics. Kappa statistics compared inter-rater agreement. Results Potential patients appeared to be the audience 87% of the time and a private doctor of chiropractic appeared to be the typical site owner. The sites usually promoted the provider. No sites displayed HON certification logo nor did any appear to meet the HON certification criteria. Twenty-six sites (55%) promoted regular physical activity in some manner and 18 (38%) had information on health risks of tobacco. Four (9%) had mental health or stress-reduction content but none had information supportive of vaccination. Some had information contradictory to common public health measures. Conclusions Patients searching the Internet for chiropractic wellness information will often find useless information that will not help them maintain health or become well. Most simply market the chiropractic practice or allow for a patients to provide personal information in exchange for more 'wellness' information. More research should be done on how providers determine site content, pay any attention to the details on their sites, or agree with content as some appear to be prefabricated sites. Website content could be enhanced by sharing of information from reputable sources like US Centers for Disease Control, the National Institutes of Health and other authoritative sources. HON certification should also be sought. PMID:21288336

Primer on the Implementation of a Pharmacy Intranet Site to Improve Department Communication

PubMed Central

Hale, Holly J.

2013-01-01

Purpose: The purpose of the article is to describe the experience of selecting, developing, and implementing a pharmacy department intranet site with commentary regarding application to other institutions. Clinical practitioners and supporting staff need an effective, efficient, organized, and user-friendly communication tool to utilize and relay information required to optimize patient care. Summary: To create a functional and user-friendly department intranet site, department leadership and staff should be involved in the process from selection of product through implementation. A product that supports both document storage management and communication delivery and has the capability to be customized to provide varied levels of site access is desirable. The designation of an intranet site owner/developer within the department will facilitate purposeful site design and site maintenance execution. A well-designed and up-to-date site along with formal end-user training are essential for staff adoption and continued utilization. Conclusion: Development of a department intranet site requires a considerable time investment by several members of the department. The implementation of an intranet site can be an important step toward achieving improved communications. Staff utilization of this resource is key to its success. PMID:24421523

Discordance Between Preoperative and Postoperative Bladder Cancer Location: Implications for Partial-Bladder Radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goldsmith, Benjamin; Tucker, Kai; Conway, Robert Greg

2013-03-01

Purpose: There is strong interest in partial-bladder radiation whether as a boost or definitive therapy to limit long-term toxicity. It is unclear that a standard preoperative examination can accurately identify all sites of disease within the bladder. The purpose of this study was to determine the correlation between preoperative localization of bladder tumors with postoperative findings to facilitate partial-bladder radiation techniques when appropriate. Methods and Materials: We examined patients with clinically staged T1-T4 invasive transitional cell carcinoma (TCC) or TCC with variant histology with no history of radiation or partial cystectomy undergoing radical cystectomy. Patients were scored as “under-detected” ifmore » a bladder site was involved with invasive disease (≥T1) at the time of cystectomy, but not identified preoperatively. Patients were additionally scored as “widely under-detected” if they had postoperative lesions that were not identified preoperatively in a given site, nor in any adjacent site. Rates of under-detected and widely under-detected lesions, as well as univariate and multivariate association between clinical variables and under-detection, were evaluated using logistic regression. Results: Among 222 patients, 96% (213/222) had at least 1 area of discordance. Fifty-eight percent of patients were under-detected in at least 1 location, whereas 12% were widely under-detected. Among 24 patients with a single site of disease on preoperative evaluation, 21/24 (88%) had at least 1 under-detected lesion and 14/24 (58%) were widely under-detected. On multivariate analysis, only solitary site of preoperative disease was associated with increased levels of under-detection of invasive disease (OR = 4.161, 95% CI, 1.368-12.657). Conclusion: Our study shows a stark discordance between preoperative and postoperative localization of bladder tumors. From a clinical perspective, incomplete localization of all sites of disease within the bladder may lead to marginal misses when a partial-bladder technique is used.« less

‘It's trying to manage the work’: a qualitative evaluation of recruitment processes within a UK multicentre trial

PubMed Central

Skea, Zoë Christina; Treweek, Shaun; Gillies, Katie

2017-01-01

Objectives To explore trial site staff's perceptions regarding barriers and facilitators to local recruitment. Design Qualitative semi-structured interviews with a range of trial site staff from four trial sites in the UK. Interviews were analysed thematically to identify common themes across sites, barriers that could be addressed and facilitators that could be shared with other sites. Participants 11 members of staff from four trial sites: clinical grant Co-applicant (n=1); Principal Investigators (n=3); Consultant Urologist (n=1); Research Nurses (n=5); Research Assistant (n=1). Setting Embedded within an ongoing randomised controlled trial (the TISU trial). TISU is a UK multicentre trial comparing therapeutic interventions for ureteric stones. Results Our study draws attention to the initial and ongoing burden of trial work that is involved throughout the duration of a clinical trial. In terms of building and sustaining a research culture, trial staff described the ongoing work of engagement that was required to ensure that clinical staff were both educated and motivated to help with the process of identifying and screening potential participants. Having adequate and sufficient organisational and staffing resources was highlighted as being a necessary prerequisite to successful recruitment both in terms of accessing potentially eligible patients and being able to maximise recruitment after patient identification. The nature of the research study design can also potentially generate challenging communicative work for recruiting staff which can prove particularly problematic. Conclusions Our paper adds to existing research highlighting the importance of the hidden and complex work that is involved in clinical trial recruitment. Those designing and supporting the operationalisation of clinical trials must recognise and support the mitigation of this ‘work’. While much of the work is likely to be contextually sensitive at the level of local sites and for individual trials, some aspects are ubiquitous issues for delivery of trials more generally. Trial registration number ISRCTN No 92289221; Pre-results. PMID:28801422

Does Prebiopsy, Nonsterile Ultrasonography Gel Affect Biopsy-Site Asepsis?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gurel, Kamil; Karabay, Oguz; Gurel, Safiye

2008-01-15

Purpose. The purpose of this study was to determine the extent to which the use of nonsterile gel, prior to antiseptic procedures in ultrasonography (US)-guided percutaneous biopsies, results in contamination of the biopsy site. Materials and Methods. Patients referred for US-guided percutaneous biopsies were included in this study. Transmission material used for US evaluation before biopsy-site antiseptic procedures were performed was either nonsterile gel or sterile saline. Patients were randomly assigned to two groups: nonsterile gel (n = 30) and sterile saline (n = 30). Before the transmission material was used and after antiseptic procedures were performed, microbial swabs ofmore » a 10-cm{sup 2}-diameter area were obtained at the biopsy site. Swabs were also obtained from the gel, saline, and povidine-iodine. Inoculated specimen plates were incubated at 37{sup o}C under aerobic conditions, and the numbers of colony-forming units recorded. Nominal logistic regression analysis was used to calculate the odds of postantisepsis bacterial growth (after antiseptic procedures were performed) based on group, gender, coincidental disease (diabetes, chronic renal failure, and malignancy), biopsy-site location (head and neck or breast and abdomen), and local factors (skin fold, skin tag, and hair). Results. The following odds ratios (adjusted for the other variables) and their 95% confidence intervals were calculated: (1) group (2.9 [0.8-11.1]; p = 0.10); (2) gender (1.2 [0.3-5.2]; p = 0.78); (3) coincidental disease (7.6 [0.9-166.7]; p = 0.09); (4) biopsy site location (6.2 [1.4-31.3]; p = 0.02); and (5) local factors (7.0 [1.6-36.0]; p = 0.01). No bacterial growth occurred with swabs obtained from gel, povidine-iodine, or saline. Conclusion. We conclude that nonsterile gel used prior to percutaneous biopsy does not affect biopsy-site asepsis.« less

Students' perception of the learning environment in a distributed medical programme

PubMed Central

Veerapen, Kiran; McAleer, Sean

2010-01-01

Background The learning environment of a medical school has a significant impact on students' achievements and learning outcomes. The importance of equitable learning environments across programme sites is implicit in distributed undergraduate medical programmes being developed and implemented. Purpose To study the learning environment and its equity across two classes and three geographically separate sites of a distributed medical programme at the University of British Columbia Medical School that commenced in 2004. Method The validated Dundee Ready Educational Environment Survey was sent to all students in their 2nd and 3rd year (classes graduating in 2009 and 2008) of the programme. The domains of the learning environment surveyed were: students' perceptions of learning, students' perceptions of teachers, students' academic self-perceptions, students' perceptions of the atmosphere, and students' social self-perceptions. Mean scores, frequency distribution of responses, and inter- and intrasite differences were calculated. Results The perception of the global learning environment at all sites was more positive than negative. It was characterised by a strongly positive perception of teachers. The work load and emphasis on factual learning were perceived negatively. Intersite differences within domains of the learning environment were more evident in the pioneer class (2008) of the programme. Intersite differences consistent across classes were largely related to on-site support for students. Conclusions Shared strengths and weaknesses in the learning environment at UBC sites were evident in areas that were managed by the parent institution, such as the attributes of shared faculty and curriculum. A greater divergence in the perception of the learning environment was found in domains dependent on local arrangements and social factors that are less amenable to central regulation. This study underlines the need for ongoing comparative evaluation of the learning environment at the distributed sites and interaction between leaders of these sites. PMID:20922033

Improving the healthcare response to domestic violence and abuse in sexual health clinics: feasibility study of a training, support and referral intervention

PubMed Central

Sohal, Alex Hardip; Pathak, Neha; Blake, Sarah; Apea, Vanessa; Berry, Judith; Bailey, Jayne; Griffiths, Chris; Feder, Gene

2018-01-01

Objectives Sexual health and gynaecological problems are the most consistent and largest physical health differences between abused and non-abused female populations. Sexual health services are well placed to identify and support patients experiencing domestic violence and abuse (DVA). Most sexual health professionals have had minimal DVA training despite English National Institute for Health and Care Excellence recommendations. We sought to determine the feasibility of an evidence-based complex DVA training intervention in female sexual health walk-in services (IRIS ADViSE: Identification and Referral to Improve Safety whilst Assessing Domestic Violence in Sexual Health Environments). Methods An adaptive mixed method pilot study in the female walk-in service of two sexual health clinics. Following implementation and evaluation at site 1, the intervention was refined before implementation at site 2. The intervention comprised electronic prompts, multidisciplinary training sessions, clinic materials and simple referral pathways to IRIS ADViSE advocate-educators (AEs). The pilot lasted 7 weeks at site 1 and 12 weeks at site 2. Feasibility outcomes were to assign a supportive DVA clinical lead, an IRIS ADViSE AE employed by a local DVA service provider, adapt electronic records, develop local referral pathways, assess whether enquiry, identification and referral rates were measurable. Results Both sites achieved all feasibility outcomes: appointing a supportive DVA clinical lead and IRIS ADViSE AE, establishing links with a local DVA provider, adapting electronic records, developing local referral pathways and rates of enquiry, identification and referral were found to be measurable. Site 1: 10% enquiry rate (n=267), 4% identification rate (n=16) and eight AE referrals. Site 2: 61% enquiry rate (n=1090), a 7% identification rate (n=79) and eight AE referrals. Conclusions IRIS ADViSE can be successfully developed and implemented in sexual health clinics. It fulfils the unmet need for DVA training. Longer-term evaluation is recommended. PMID:28724743

Environmental assessment: Davis Canyon site, Utah

DOE Office of Scientific and Technical Information (OSTI.GOV)

none,

1986-05-01

In February 1983, the US Department of Energy (DOE) identified the Davis Canyon site in Utah as one of the nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. To determine their suitability, the Davis Canyon site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. These evaluations were reported in draft environmental assessments (EAs), which were issued for public review and comment. After considering the comments received on the draft EAs, the DOEmore » prepared the final EA. The Davis Canyon site is in the Paradox Basin, which is one of five distinct geohydrologic settings considering for the first repository. This setting contains one other potentially acceptable site -- the Lavender Canyon site. Although the Lavender Canyon site is suitable for site characterization, the DOE has concluded that the Davis Canyon site is the preferred site in the Paradox Basin. On the basis of the evaluations reported in this EA, the DOE has found that the Davis Canyon site is not disqualified under the guidelines. Furthermore, the DOE has found that the site is suitable for site characterization because the evidence does not support a conclusion that the site will not be able to meet each of the qualifying conditions specified in the guidelines. On the basis of these findings, the DOE is nominating the Davis Canyon site as one of five sites suitable for characterization.« less

Information Architecture of Web-Based Interventions to Improve Health Outcomes: Systematic Review

PubMed Central

Grenen, Emily; Surla, Stacy; Schwarz, Mary; Cole-Lewis, Heather

2018-01-01

Background The rise in usage of and access to new technologies in recent years has led to a growth in digital health behavior change interventions. As the shift to digital platforms continues to grow, it is increasingly important to consider how the field of information architecture (IA) can inform the development of digital health interventions. IA is the way in which digital content is organized and displayed, which strongly impacts users’ ability to find and use content. While many information architecture best practices exist, there is a lack of empirical evidence on the role it plays in influencing behavior change and health outcomes. Objective Our aim was to conduct a systematic review synthesizing the existing literature on website information architecture and its effect on health outcomes, behavioral outcomes, and website engagement. Methods To identify all existing information architecture and health behavior literature, we searched articles published in English in the following databases (no date restrictions imposed): ACM Digital Library, CINAHL, Cochrane Library, Google Scholar, Ebsco, and PubMed. The search terms used included information terms (eg, information architecture, interaction design, persuasive design), behavior terms (eg, health behavior, behavioral intervention, ehealth), and health terms (eg, smoking, physical activity, diabetes). The search results were reviewed to determine if they met the inclusion and exclusion criteria created to identify empirical research that studied the effect of IA on health outcomes, behavioral outcomes, or website engagement. Articles that met inclusion criteria were assessed for study quality. Then, data from the articles were extracted using a priori categories established by 3 reviewers. However, the limited health outcome data gathered from the studies precluded a meta-analysis. Results The initial literature search yielded 685 results, which was narrowed down to three publications that examined the effect of information architecture on health outcomes, behavioral outcomes, or website engagement. One publication studied the isolated impact of information architecture on outcomes of interest (ie, website use and engagement; health-related knowledge, attitudes, and beliefs; and health behaviors), while the other two publications studied the impact of information architecture, website features (eg, interactivity, email prompts, and forums), and tailored content on these outcomes. The paper that investigated IA exclusively found that a tunnel IA improved site engagement and behavior knowledge, but it decreased users’ perceived efficiency. The first study that did not isolate IA found that the enhanced site condition improved site usage but not the amount of content viewed. The second study that did not isolate IA found that a tailored site condition improved site usage, behavior knowledge, and some behavior outcomes. Conclusions No clear conclusion can be made about the relationship between IA and health outcomes, given limited evidence in the peer-reviewed literature connecting IA to behavioral outcomes and website engagement. Only one study reviewed solely manipulated IA, and we therefore recommend improving the scientific evidence base such that additional empirical studies investigate the impact of IA in isolation. Moreover, information from the gray literature and expert opinion might be identified and added to the evidence base, in order to lay the groundwork for hypothesis generation to improve empirical evidence on information architecture and health and behavior outcomes. PMID:29563076

Environmental assessment: Reference repository location, Hanford site, Washington

DOE Office of Scientific and Technical Information (OSTI.GOV)

none,

1986-05-01

In February 1983, the US Department of Energy (DOE) identified a reference repository location at the Hanford Site in Washington as one of the nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. The site is in the Columbia Plateau, which is one of five distinct geohydrologic settings considered for the first repository. To determine their suitability, the Hanford Site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE's General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. These evaluations were reported inmore » draft environmental assessments (EAs), which were issued for public review and comment. After considering the comments received on the draft EAs, the DOE prepared the final EAs. On the basis of the evaluations reported in this EA, the DOE has found that the Hanford site is not disqualified under the guidelines. The DOE has also found that it is suitable for site characterization because the evidence does not support a conclusion that the site will not be able to meet each of the qualifying conditions specified in the guidelines. On the basis of these findings, the DOE is nominating the Hanford site as one of five sites suitable for characterization.« less

Environmental assessment: Yucca Mountain site, Nevada research and development area, Nevada; Volume 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1986-05-01

In February 1983, the US Department of Energy (DOE) identified the Yucca Mountain site in Nevada as one of nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high- level radioactive waste. The site is in the Great Basin, which is one of five distinct geohydrologic settings considered for the first repository. To determine their suitability, the Yucca Mountain site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE`s General Guideline for the Recommendation of Sites for the Nuclear Waste Repositories. These evaluations were reported in draft environmental assessmentsmore » (EA), which were issued for public review and comment. After considering the comments received on the draft EAs, the DOE prepared the final EAs. On the basis of the evaluations reported in this EA, the DOE found that the Yucca Mountain site is not disqualified under the guidelines. The DOE has also found that it is suitable for site characterization because the evidence does not support a conclusion that the site will not be able to meet each of the qualifying conditions specified in the guidelines. On the basis of these findings, the DOE is nominating the Yucca Mountain site as of five sites suitable for characterization.« less

Environmental assessment: Yucca Mountain site, Nevada research and development area, Nevada; Volume 3

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1986-05-01

In February 1983, the US Department of Energy (DOE) identified the Yucca Mountain site in Nevada as one of nine potentially acceptable sites for a mined geologic repository for spent nuclear fuel and high-level radioactive waste. The site is in the Great Basin, which is one of five distinct geohydrologic settings considered for the first repository. To determine their suitability, the Yucca Mountain site and the eight other potentially acceptable sites have been evaluated in accordance with the DOE`s General Guidelines for the Recommendation of Sites for the Nuclear Waste Repositories. These evaluations were reported in draft environmental assessments (EAs),more » which were issued for public review and comment. After considering the comments received on the draft EAs, the DOE prepared the final EAs. On the basis of the evaluations reported in this EA, the DOE has found that the Yucca Mountain site is not disqualified under the guidelines. The DOE has also found that it is suitable for site characterization because the evidence does not support a conclusion that the site will not be able to meet each of the qualifying conditions specified in the guidelines. On the basis of these findings, the DOE is nominating the Yucca Mountain site as one of five sites suitable for characterization.« less

Transcatheter Arterial Embolization of Intramuscular Active Hemorrhage with N-Butyl Cyanoacrylate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yoo, Dong Hyun; Jae, Hwan Jun, E-mail: jhj@radiol.snu.ac.kr; Kim, Hyo-Cheol

Purpose: This study was designed to evaluate the clinical efficacy and safety of transcatheter arterial embolization (TAE) with n-butyl cyanoacrylate (NBCA) for intramuscular active hemorrhage of varied etiologies and anatomic sites. Methods: Eighteen patients who demonstrated hematoma with pseudoaneurysm and/or active extravasation of contrast media underwent TAE with NBCA. Etiologies of hematoma included trauma, postoperative complication, and coagulopathy (due to underlying disease or anticoagulation therapy). Sites of embolization included chest wall, abdomen wall, retroperitoneum, and extremity. TAE was performed by using 1:3 to 1:5 mixtures of NBCA and iodized oil, either solely (n = 15) or in combination with microcoilmore » (n = 3). The technical and clinical success rate, procedure-related complications, and clinical outcomes were evaluated. Results: The technical and clinical success rates were 100% and 83% (15/18), respectively. Two patients expired while admitted due to other comorbidities. One patient expired due to recurrent bleeding at another site. There were no serious complications relating to the embolization procedure. Conclusions: TAE with NBCA is effective and safe treatment modality for intramuscular active hemorrhage.« less

Integration of High-Risk Human Papillomavirus into Cellular Cancer-Related Genes in Head and Neck Cancer Cell Lines

PubMed Central

Walline, Heather M; Komarck, Christine M; McHugh, Jonathan B; Tang, Alice L; Owen, John H; Teh, Bin T; McKean, Erin; Glover, Thomas; Graham, Martin P; Prince, Mark E; Chepeha, Douglas B; Chinn, Steven B; Ferris, Robert L; Gollin, Susanne M; Hoffmann, Thomas K; Bier, Henning; Brakenhoff, Ruud; Bradford, Carol R; Carey, Thomas E

2017-01-01

Background HPV-positive oropharyngeal cancer is generally associated with excellent response to therapy, but some HPV-positive tumors progress despite aggressive therapy. This study evaluates viral oncogene expression and viral integration sites in HPV16 and HPV18-positive squamous carcinoma cell lines. Methods E6-E7 alternate transcripts were assessed by RT-PCR. Detection of integrated papillomavirus sequences (DIPS-PCR) and sequencing identified viral insertion sites and affected host genes. Cellular gene expression was assessed across viral integration sites. Results All HPV-positive cell lines expressed alternate HPVE6/E7 splicing indicative of active viral oncogenesis. HPV integration occurred within cancer-related genes TP63, DCC, JAK1, TERT, ATR, ETV6, PGR, PTPRN2, and TMEM237 in 8 HNSCC lines but UM-SCC-105 and UM-GCC-1 had only intergenic integration. Conclusions HPV integration into cancer-related genes occurred in 7/9 HPV-positive cell lines and of these six were from tumors that progressed. HPV integration into cancer-related genes may be a secondary carcinogenic driver in HPV-driven tumors. PMID:28236344

Evaluating clinical periodontal measures as surrogates for bacterial exposure: The Oral Infections and Vascular Disease Epidemiology Study (INVEST)

PubMed Central

2010-01-01

Background Epidemiologic studies of periodontal infection as a risk factor for cardiovascular disease often use clinical periodontal measures as a surrogate for the underlying bacterial exposure of interest. There are currently no methodological studies evaluating which clinical periodontal measures best reflect the levels of subgingival bacterial colonization in population-based settings. We investigated the characteristics of clinical periodontal definitions that were most representative of exposure to bacterial species that are believed to be either markers, or themselves etiologic, of periodontal disease. Methods 706 men and women aged ≥ 55 years, residing in northern Manhattan were enrolled. Using DNA-DNA checkerboard hybridization in subgingival biofilms, standardized values for Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola and Tannerella forsythia were averaged within mouth and summed to define "bacterial burden". Correlations of bacterial burden with clinical periodontal constructs defined by the severity and extent of attachment loss (AL), pocket depth (PD) and bleeding on probing (BOP) were assessed. Results Clinical periodontal constructs demonstrating the highest correlations with bacterial burden were: i) percent of sites with BOP (r = 0.62); ii) percent of sites with PD ≥ 3 mm (r = 0.61); and iii) number of sites with BOP (r = 0.59). Increasing PD or AL severity thresholds consistently attenuated correlations, i.e., the correlation of bacterial burden with the percent of sites with PD ≥ 8 mm was only r = 0.16. Conclusions Clinical exposure definitions of periodontal disease should incorporate relatively shallow pockets to best reflect whole mouth exposure to bacterial burden. PMID:20056008