Longer Study Period Research Articles

Lamb productivity on stockpiled fescue in honeylocust and black walnut silvopastures

Trees in silvopastures can provide forage-livestock systems with multiple goods and services, including shade, shelter, and browse, but the provision of browse has received little exploration in temperate systems. Honeylocust trees (Gleditsia triacanthos) produce nutritious pods that could serve as supplemental fodder for livestock grazing stockpiled tall fescue (Schedonorus arundinaceus). This study compared lamb performance in honeylocust (cv. Millwood) and black walnut (Juglans nigra) silvopastures with productivity on open pastures during a six week winter grazing trial. Treatment pastures were rotationally stocked with three (walnut) or six (honeylocust and open) lambs per experimental unit based on forage availability. Lambs were naive to pods and did not readily consume the fodder until four weeks into the trial. Forage availability did not differ (P = 0.7580) between honeylocust silvopastures and open pastures (mean = 5090 ± 90 kg ha−1) but was greater (P < 0.0001) than forage availability in the black walnut silvopastures (3790 ± 90 kg ha−1). Average daily gains did not differ (P = 0.3763) among treatments over the six weeks of study. However, lambs within the honeylocust silvopastures began consuming pods at about week four of the study and had greater (P = 0.0251) average daily gains in the final period (0.12 ± 0.02 kg day−1) than lambs within the open pastures (0 ± 0.02 kg day−1). These data suggest that honeylocust pods may support greater lamb weight gains, but previous exposure and longer study periods may be necessary to see their nutritional benefit when grazing high quality forages.

ALDH1 and tumor infiltrating lymphocytes as predictors for neoadjuvant chemotherapy response in breast cancer

Many studies have reported that Aldehyde dehydrogenase 1 (ALDH1) and tumor-infiltrating lymphocytes (TIL) are related to breast cancer prognosis. However, the clinical significance of ALDH1 and tumor-infiltrating immune cells in breast cancer has not been fully investigated in patients who received neoadjuvant chemotherapy (NAC). We studied the significance of the expression of ALDH1 and the population of TIL for predicting the prognosis and chemotherapeutic response of patients with breast cancer who had received NAC. Forty patients who underwent NAC were enrolled in this study. ALDH1 and TIL (T cells and tumor associated macrophages) were evaluated before and after NAC. The influences of ALDH1 expression status and TIL populations on both prognosis and chemotherapeutic response were evaluated. ALDH1 positivity was related to estrogen receptor (p = 0.026) and progesterone receptor negativity (p = 0.025). Positive change of ALDH1 after NAC tended to be associated with a poor NAC response (p = 0.078). Patients with more CD8+ T cells before NAC and fewer CD68 (+) macrophages after NAC tended to have better OS, respectively (p = 0.086, p = 0.096). The chemotherapeutic response and prognosis of patients with breast cancer who received NAC are thought to be determined by the tumor microenvironment. Further research with more patients and a longer study period is needed.

The prevalence rates of medication adherence and factors influencing adherence to antiepileptic drugs in children with epilepsy: A systematic review and meta analysis

ObjectiveWe conducted a systematic review to assess antiepileptic drug (AED) adherence rates, and to identify the characteristics associated with nonadherence in children. MethodsWe searched PubMed, EMBASE, and the Cochrane Library from inception to June 2017. Observational studies addressing medication adherence or examining factors influencing AED adherence were included. ResultsWe included 22 studies, involving 3955 participants. The general quality of included studies were rated as high quality. Adherence rates were reported in 18 studies, varying between 22.1% and 96.5%. Meta analysis of 13 studies (n = 2051) revealed a pooled adherence rate assessed by objective methods of 58% (95% CI [0.46, 0.74]). Meta analysis of nine studies (n = 1217) revealed a pooled adherence rate assessed by subjective Methods of 73%, (95% CI [0.63, 0.85]). Family support, smaller family size, stable parental marriage status, support from healthcare providers and higher family socioeconomic status were associated with better medication adherence. However, contradictory results were found regarding the effects of age, the frequency of seizure, type of seizures, type of medication and the number of administered drugs. ConclusionsAdherence to AEDs is challenging for pediatric patients with epilepsy. Few factors which influence adherence can be drawn because of differing variables and results. Future prospective research should be designed with longer study periods and larger samples in naturalistic settings.

MRI on rotator cuff and shoulder joint pathologies

The shoulder joint is an elegant anatomic structure formed by the humerus, clavicle and the scapula; its range of motion exceeds all other joints, yet under most circumstances, it is stable. The shoulder complex comprises of three joints namely the sternoclavicular, acromioclavicular, and glenohumeral joints. The factors which aid on to this progress including age, occupation, trauma, acromion type, slope and position, acromioclavicular joint degeneration, proximal migration of the humeral head, bony spurs compressing on the tendons. The most commonly affected rotator cuff tendon being the supraspinatus. The tears are further classified as complete/full thickness and partial tears depending on the involvement of the whole or part of the tendon. Being one of the most important stabiliser of the shoulder joint, rotator cuff pathologies can cause major joint dysfunction, like stiffness, restricted/painful joint movements even to the extent of restricting daily activities our study aims to describe MRI characteristics of shoulder and rotator cuff pathologies. And to describe the distribution of rotator cuff pathologies in terms of age, gender, symptomatology and secondary changes/sequelae study, the rotator cuff abnormalities were common in the sixth and seventh decades of life. The incidence of predisposing factors for rotator cuff tears was also found to increase with age as seen in our study, type II and III acromions, acromioclavicular joint arthropathies, osteophytosis/spurs are common in the sixth and seventh decades of life. We noticed in our patients that pain followed by stiffness resulting in reduced range of movement across the shoulder joint is very common. MRI imaging was useful in effectively ruling out the other causes of shoulder pain, overall features conclude that magnetic resonance imaging is very useful in depicting rotator cuff disease diagnosis along with the predisposing factors like the acromion type and orientation, reduction in coracohumeral distance, reduced acromioclavicular distance and other associated features like effusion, bursitis and bone changes. Further research with a larger sample size for a longer study period is suggested to draw broader conclusions and to strengthen the findings of the present study.

Trend in the Age-Adjusted Incidence of Hip Fractures in South Korea: Systematic Review.

BackgroundThe incidence of hip fractures has been reported to vary geographically, and its trend has also varied widely. However, the trend in the age-adjusted incidence of hip fractures has not been well studied in Korea. After we identified eligible studies presenting multiple age-adjusted incidences of hip fractures in the Korean population in PubMed, we evaluated changes in the absolute number of occurrence and calculated the annual percentage change (APC) of age-adjusted incidences of hip fractures.MethodsWe have searched PubMed for the original and English-language literature on the incidence of hip fractures in the Korean population published since 2000. The studies presenting multiple age-adjusted incidences of hip fractures were selected. We evaluated the change in the absolute number of hip fractures and calculated the APC of age-adjusted incidences of hip fractures for each study.ResultsThree eligible articles were identified. The absolute number of hip fractures for both genders increased over time in all three studies although the operational definition of hip fracture differed from one another. The APC of the age-adjusted incidence of hip fractures was positive for women and negative for men. However, the change was not statistically significant in both genders during each study period (2001–2004, 2005–2008, and 2006–2010, respectively).ConclusionsThe age-adjusted incidence of hip fractures was stable among men and women, while the absolute number of hip fractures increased for both genders in Korea. Further studies with longer study periods on age-adjusted incidences are required to better determine the trend in the incidence of hip fractures in Korea.

Using text messages to promote health in African-Americans: #HeartHealthyandCancerFree

ABSTRACTObjectives: African-Americans are vulnerable to both cancer and cardiovascular disease (CVD) due to intricately connected risk factors. Use of text messages is an innovative method to provide health information to reduce these risks. The aim of this study was to test the feasibility and acceptability of a text messaging intervention to reduce CVD and cancer risk factors in African-Americans.Design: We developed an intervention using text messages culturally tailored for African-Americans over age 50 who were at risk (one or more modifiable risk factors) for CVD and/or cancer. Sociodemographic data, biologic measures, cancer screening practices, and general health status were assessed. Group interviews were conducted to assess feasibility and acceptability.Results: Participants were primarily female (69%), aged 58 ± 5 years, who were married (59%) and worked full time (56%). In terms of feasibility and acceptability, themes of encouragement through text messages received and a desire for a longer study period emerged from group interviews with participants. Participants experienced significant decreases in waist circumference (41 ± 5 vs 40 ± 5, p = .002), systolic blood pressure (147 ± 25 mmHg vs 138 ± 20 mmHg, p = .009), diastolic blood pressure (87 ± 16 mmHg vs 82 ± 10 mmHg, p = .02), total cholesterol (194 ± 35 mg/dL vs 173 ± 32 mg/dL, p < .001), and low-density lipoprotein levels (100 ± 32 mg/dL vs 86 ± 29 mg/dL, p = .015). Five participants had colorectal cancer screening, two had prostate cancer screening, and four had mammograms.Conclusions: Use of text messages was widely accepted among participants. Significant CVD risk reductions and increased cancer screenings were noted. Future studies should incorporate innovative strategies such as text messaging in promoting health in vulnerable populations.

Elastoplasty: A Silicon Polymer as a New Filling Material for Kyphoplasty in Comparison to PMMA

Background: Painful vertebral compression fractures (VCF) caused by osteoporosis are a common health problem in the elderly population. If conservative treatments are unsuccessful, surgical treatments like vertebroplasty or kyphoplasty are recommended. But the use of Polymethylmethacrylat (PMMA) bone cement for augmentation surgery is associated with risks. Objectives: Evaluation of the effectiveness and safety of a newly developed silicon polymer (VK100) that can be used instead of PMMA bone cement for kyphoplasty treatments. Study Design: A retrospective study of 30 patients comparing the outcomes of kyphoplasty treatments conducted with PMMA and VK100. Setting: Clinic for Orthopedics and Trauma Surgery Bonn, Germany. Methods: Thirty patients with one to 3 VCF were treated either with balloon kyphoplasty using VK100 or balloon kyphoplasty using PMMA bone cement. Data from both groups was compared by a matched pair analysis. The medial vertebral height was measured at each examination radiologically. The patients stated their pain intensity using the Visual Analogue Scale (VAS) and the patient’s functional impairment was evaluated with the Oswestry-Disability-Index (ODI). All data were assessed before surgery, and 3 days, 3 months, 6 months, and 12 months after surgery. Intraoperative and postoperative adverse events were documented. Results: The patients’ functional impairment and pain improved significantly after surgery. The course of ODI and VAS was comparable in both treatment groups, but the improvement in the VK group was significantly ongoing until the 12 month follow-up. Vertebral height improvement was significant in both groups, but the PMMA group achieved a better absolute restoration. The vertebral height stayed constant during the follow-up in the VK group and worsened significantly in the PMMA group. There was no significant difference between groups concerning the occurrence of additional fractures; and no other types of complications or surgery-related adverse events were observed in either the PMMA group or in the VK group. Limitations: The study is only a matched pair analysis of 15 patients for each procedure and the amount of injected filling material was not recorded. Conclusion(s): The study results demonstrate that the clinical outcome of VAS and ODI of using the silicon polymer VK100 is comparable or slightly better than using PMMA. VK 100 shows a trend to minor additional fractures during the follow-up. However, height restoration is not satisfactory in comparison to PMMA, although vertebral height stayed more or less constant in the VK group. To address the augmentation success further, it would be necessary to study a larger patient group over a longer study period and to assess additional parameters such as bone density and injected amount of filling material. Key words: Vertebral compression fracture, kyphoplasty, augmentation, osteoporosis, back pain, VK 100, elastoplasty

Microbial fuel cells for clogging assessment in constructed wetlands

Clogging in HSSF CW may result in a reduction of system's life-span or treatment efficiency. Current available techniques to assess the degree of clogging in HSSF CW are time consuming and cannot be applied on a continuous basis. Main objective of this work was to assess the potential applicability of microbial fuel cells for continuous clogging assessment in HSSF CW. To this aim, two replicates of a membrane-less microbial fuel cell (MFC) were built up and operated under laboratory conditions for five weeks. The MFC anode was gravel-based to simulate the filter media of HSSF CW. MFC were weekly loaded with sludge that had been accumulating for several years in a pilot HSSF CW treating domestic wastewater. Sludge loading ranged from ca. 20kgTS·m−3CW·year−1 at the beginning of the study period up to ca. 250kgTS·m−3CW·year−1 at the end of the study period. Sludge loading applied resulted in sludge accumulated within the MFC equivalent to a clogging degree ranging from 0.2years (ca. 0.5kgTS·m–3CW) to ca. 5years (ca. 10kgTS·m–3CW). Results showed that the electric charge was negatively correlated to the amount of sludge accumulated (degree of clogging). Electron transference (expressed as electric charge) almost ceased when accumulated sludge within the MFC was equivalent to ca. 5years of clogging (ca. 10kgTS·m–3CW). This result suggests that, although longer study periods under more realistic conditions shall be further performed, HSSF CW operated as a MFC has great potential for clogging assessment.

Age-specific genetic and antigenic variations of influenza A viruses in Hong Kong, 2013-2014.

Age-specific genetic and antigenic variations of influenza viruses have not been documented in tropical and subtropical regions. We implemented a systematic surveillance program in two tertiary hospitals in Hong Kong Island, to collect 112 A(H1N1)pdm09 and 254 A(H3N2) positive specimens from 2013 to 2014. Of these, 56 and 72 were identified as genetic variants of the WHO recommended vaccine composition strains, respectively. A subset of these genetic variants was selected for hemagglutination-inhibition (HI) tests, but none appeared to be antigenic variants of the vaccine composition strains. We also found that genetic and antigenicity variations were similar across sex and age groups of ≤18 yrs, 18 to 65 yrs, and ≥65 yrs. Our findings suggest that none of the age groups led other age groups in genetic evolution of influenza virus A strains. Future studies from different regions and longer study periods are needed to further investigate the age and sex heterogeneity of influenza viruses.

A cross-sectional study of refractive errors between medical students of Indian and Malaysian Medical Colleges, At Belagavi

Introduction: Of all the human senses, the sense of vision is used the most and so, is affected the most. Refractive errors are becoming a more problem of concern, especially Myopia has become very common problem. The epidemiology of refractive errors seen over a generation mainly influenced by environmental changes namely stress and time spent in education, where the student’s population group requires a considerable attention. Objectives: 1. To compare the prevalence of Refractive errors between medical students. 2. To study “Gender difference” in the prevalence of refractive errors. 3. To know the involvement of “Ethnicity” factor in the prevalence of refractive errors. Materials and Methods: Study consisting of 100 Indian medical students from Belagavi Institute of Medical Sciences (BIMS), Belagavi and 100 Malaysian medical students of USM-KLE, International Medical Programme (USM-KLE) Belagavi, of all the five phases, who were tested for presence of Refractive errors with the help of Snellen’s chart, Jaegers chart and confirmation by pinhole test. Result: Overall prevalence of Refractive errors was high in USM-KLE students 65% than BIMS students 54%, Female students being more affected than males in both groups in all the errors. Especially Myopia had more prevalence in USM-KLE students 65% than BIMS students 46%, Myopia with astigmatism in USM-KLE students was 14% and in BIMS students 7%. Statistical Analysis: Basic data will be presented in percentage and the association between the variables will be done by using Chi-square test. Conclusion: The prevalence of refractive errors was more in USM-KLE students than BIMS students, females being more affected than males in both groups in all the refractive errors, which could be due to ethnic variations, genetic predisposition, higher levels of education with more near work activities and longer study periods. Keywords: Refractive errors; Medical stu

Using GPS-enabled mobile phones to characterize individuals’ activity patterns for epidemiology applications

GIScience 2016 Short Paper Proceedings Using GPS-enabled mobile phones to characterize individuals’ activity patterns for epidemiology applications E.-H. Yoo and Y.-S. Eum University of Buffalo, SUNY, Buffalo, NY, USA Email: {eunhye, yeum}@buffalo.edu Abstract We assessed the potential of global positioning system (GPS)-equipped mobile phones for health-related studies. We demonstrated the use of GPS data as a means of collecting individuals’ activity patterns for personal exposure assessments and public health surveillance. The widespread use of mobile phones has enabled investigators to conduct exposure studies and to detect infectious disease at the individual level on a massive scale. However, still substantial uncertainties are present in converting raw GPS data into relevant information. To address these issues, we proposed three algorithms for pre-processing and classification of raw GPS data, and demonstrated their applications to real world data in a case study. 1. Introduction Exposure models typically impose unrealistic assumptions such that subjects within a neighborhood are equally exposed to air pollution and/or most individuals spend their time at their residences. Similarly, a lack of understanding of human movement, which is an important component of disease transmission, has been considered as an obstacle to develop effective national communicable disease control programs. In exposure modelling, some improvements have been achieved by adopting a microenvironment (ME) approach where individuals’ time spent at MEs, such as outdoors, residence, and workplace, was explicitly taken into account. However, collecting the information on individuals’ time-activity patterns has been cost-, time-, and labor-intensive with limited reliability and accuracy. Comparably, aggregated data have limited efforts to reconstruct the complex and dynamic nature of real- world contact networks, which plays a critical role of contact network in an outbreak of dangerous infectious disease. The emergence of lightweight, low-cost, and accurate GPS devices has provided a promising tool for objectively assessing the geographic positions of the environmental context in which health-related behaviors take place (Schipperijn et al. 2014). GPS technology enabled investigators to capture daily trajectories of individuals with higher temporal resolution at increasing locational precision (Gerharz et al. 2013, Dias & Tchepel 2014), although the use of GPS data in health research is not without challenges. As reviewed by Krenn et al. (2011), the positional accuracy of GPS data collected in real world is often unacceptable in health studies, especially, over longer study periods. The data quality of GPS traces depends on the amount of data lost from signal drop-outs, loss of device battery power, and poor adherence of participants to following the specific research protocol. Despite the advancement in GPS technology, signal acquisition is still affected by the presence of tall buildings and significant uncertainties associated with the processing and classifying raw data are present. In this study we focus on the GPS data collected from a mobile phone with and without data connection. Our primary goal is to identify major MEs associated with health-related activities using GPS data. First we developed and applied a “selective resampler” to raw GPS data for pre-processing. Using the processed data, we identify significant places and travel modes using the two automated classification schemes.

Upper Echelon Theory Revisited: The Relationship between CEO Personal Characteristics and Financial Leverage Decision

From the upper echelons perspective, we investigate the financial leverage decision of publicly listed companies in Bursa Malaysia for the period from 2002 to 2011. Using pooled OLS and fixed-effect regressions, we examine the impacts of CEO personal characteristics on financial leverage. Our measures of CEO personal characteristics such as CEO overconfidence based on CEO profile photo, CEO age, and CEO prior experience are significantly and negatively related to leverage. However, CEO education level and CEO tenure are significantly and positively related to leverage. Furthermore, we partition our sample of companies based on CEO age and CEO education level. In the CEO-age group, we find that female CEOs are greater risk takers as compared to male CEOs in Malaysia. With respect to CEO education level, we show that younger CEOs, female CEOs, and longer-serving CEOs are risk takers and more aggressive. This paper contributes to the debate of the UET as well as determinants of leverage decision from several dimensions. First, this is the first study that investigates the impacts of CEO personal characteristics on financial leverage of Malaysian firms. Second, we make the first attempt by classifying CEO certain characteristic (age and educational level) into groups to make a further comparison on the impact of CEO personal characteristics on financial leverage. Third, this study uses a larger data sample and a longer study period than the previous studies in the literature. Fourth, the paper also makes a methodological contribution. This study employs different methods (pooled OLS regression and fixed effects panel regression) for the analysis. It is hoped that the result of this paper can fill the gap of the literature on the relationship between CEO personal characteristics and financial leverage as explained by Upper Echelon Theory.

P33 Is test of cure necessary after doxycycline therapy for rectalchlamydia trachomatisinfection?

<h3>Background/introduction</h3> We reported a significantly higher treatment failure rate with azithromycin for the treatment of rectal <i>Chlamydia trachomatis</i> (CT) when compared to doxycycline (26.2% vs. 0%, p = 0.0025). One-week 100 mg doxycycline twice daily was subsequently recommended as the local first-line treatment for rectal CT. <h3>Aim(s)/objectives</h3> To re-evaluate the efficacy of doxycycline therapy in the treatment of rectal CT. <h3>Methods</h3> Data was retrospectively collected on all patients diagnosed with rectal CT from 1^st October 2010 to 1^st October 2013 at a large, inner city sexual health clinic. Information was collected on gender, concurrent sexually transmitted infection (STI), treatment received, adherence to antibiotic, risk of re-infection and 4-week test of cure (TOC). Assessment of risk of re-infection included completion of telephone follow-up, verification of contact tracing of regular partners and absence of unprotected sexual intercourse. <h3>Results</h3> 959 patients were diagnosed with rectal CT during the study period. 660 (68.8%) patients received doxycycline therapy in line with local treatment protocol. TOC was performed in 473 (71.7%) patients, of which 22 (4.7%) were positive. Risk of re-infection was excluded in 5 cases (22.7%) and considered possible treatment failures. <h3>Discussion/conclusion</h3> The treatment failure rate of doxycycline for rectal CT identified in this study is similar to that reported with azithromycin and is contradictory to our previous findings. The longer study period with larger study population may explain this result. These findings suggest that TOC following treatment of rectal CT is necessary and would not support preferential use of doxycycline over azithromycin.

Determinants of Neonatal seizure among newborns attending a tertiary care Hospital

Introduction: Neonatal seizure is an important cause of childhood mortality and morbidity. The prevalence of neonatal seizure is 2-3 /1000 live births in term and 10-15 /1000 preterm deliveries in our country. Proper neonatal care is crucial. Different study results representing the risk factors for neonatal seizure are directly and indirectly related. Objectives: The study was carried out to determine the factors influencing neonatal seizure among the patients attending a tertiary care hospital. Methods: A cross- sectional study was carried out to find out the factors of neonatal seizure where face to face interview was taken to 50 purposively selected respondents who were attending a tertiary care hospital during spring season. All the data were entered into a personal computer and thoroughly checked for any possible errors and then processed and analyzed by statistical Package for Social Science (SPSS) version 17 and MS office 2007. Results: Among the total respondents mostly were of &lt;25 years (Mean±Sd, 23.16 ±3.919) of age. 36% had primary level education and 32% were illiterate. The mean monthly family income was 11392.0 ±11551.81 BDT. Respondents by pregnancy related complications were mostly of Pre-Eclamptic Toxemias (PET) in 22% cases and anaemia in 24% cases. Gestational age of the respondents was mainly &gt;37weeks.The study also reported that antenatal care by doctors was taken in 64% cases. Among the delivery related factors, most of the deliveries took place at home (64%). Among the neonatal factors weight &lt;2kg was found in 34% cases and 2.1-2.4 kg in 56% cases respectively. 85 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Study also reported that the causes of seizures were Peri-natal Asphyxia (PNA) (12%) and LBW (11%). Respondents by onset of seizure were mostly within 24 hours (44%), common types of seizure were subtle (50%) and duration of seizures was found to be less than 5 min in (64%) cases. The study also revealed the association between the causes and types of seizure; the result showed that 60% of subtle type of seizure was associated with Infant of Diabetic Mother (IDM) followed by focal type (40%). PNA was associated with 58% of subtle type of seizure. Our result was found statistically insignificant (p&gt;0.05). Association of onset of seizure and birth weight of the neonates also revealed insignificant (p&gt;0.05) result. This can be explained by small sample size and short duration of study. On the other hand other studies reported significant (p&lt;0.05) results as they had larger sample size and longer study period. Conclusion: Maternal factors, neonatal factors and delivery related factors are related to neonatal seizure. Further studies involving larger sample size is recommended. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22931 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

Effects of organism preparation in metallothionein and metal analysis in marine invertebrates for biomonitoring marine pollution

Metallothionein (MT) is established as a potentially useful biomarker for monitoring aquatic pollution. This paper addresses widespread inconsistencies in storage conditions, tissue type selection and pre-treatment of samples before MT and metal analysis in biomarker studies. This variation hampers comparability and so the widespread implementation of this monitoring approach. Actively sampled Mytilus edulis in Southampton Water, UK were exposed to different storage temperatures, a variety of tissue types were analysed, and various pre-treatments of transportation on ice, transportation in seawater, depuration, and rapid dissection in the field were examined. Storage temperatures of −20°C were found to be adequate for periods of at least ten weeks, as MT was not reduced by protein degradation compared with samples kept at −80°C. Whole tissue and digestive gland concentrations of MT and metals were significantly positively correlated and directly relatable. MT in the digestive gland appeared to be more responsive to metals than in whole tissue, where it may be diluted, masking MT responses. However, longer study periods may suffer the effects of mass changes to the digestive gland, which alters MT concentration, and it may therefore be advisable to measure whole tissue. Depuration and transportation in seawater reduced both MT and metal concentrations in the digestive gland, and few correlations between MT and metals were identified for these treatments. It is therefore recommended that: i) samples are transported to the laboratory on ice and dissected as soon as possible thereafter, ii) depuration should not be used when examining MT response to metal exposure until further research clarifying its utility is reported, iii) either whole tissue or the digestive gland can be used to measure MT, though whole tissue may be preferable on long-term studies, and iv) organisms can be stored at −20°C before analysis for up to ten weeks. These practices can be applied to future biomonitoring studies and will improve the comparability and repeatability of using MT as a biomarker.

Quality of Disease Management and Risk of Mortality in English Primary Care Practices.

To investigate whether better management of chronic conditions by family practices reduces mortality risk. Two random samples of 5 million patients registered with over 8,000 English family practices followed up for 4 years (2004/5-2007/8). Measures of the quality of disease management for 10 conditions were constructed for each family practice for each year. The outcome measure was an indicator taking the value 1 if the patient died during a specified year, 0 otherwise. Cross-section and multilevel panel data multiple logistic regressions were estimated. Covariates included age, gender, morbidity, hospitalizations, attributed socio-economic characteristics, and local health care supply measures. Although a composite measure of the quality of disease management for all 10 conditions was significantly associated with lower mortality, only the quality of stroke care was significant when all 10 quality measures were entered in the regression. The panel data results suggest that a 1 percent improvement in the quality of stroke care could reduce the annual number of deaths in England by 782 [95 percent CI: 423, 1140]. A longer study period may be necessary to detect any mortality impact of better management of other conditions.

Observer bias and subsampling efficiencies for estimating the number of migrating fish in rivers using Dual-frequency IDentification SONar (DIDSON)

Fixed-location, side-looking, multibeam, sonar techniques offer a practical approach to estimate the numbers of migrating fish in rivers that are too large or occluded for traditional sampling methods, such as weir trapping, visual observation techniques, and netting. While this technology has been used to enumerate salmonid escapement in coastal river systems of western North America, little use and evaluation has occurred in inland waters such as the Great Lakes, where rivers and runs of fish are considerably smaller than those along the Pacific coast. We use a “Dual-frequency IDentification SONar” (“DIDSON”) imaging sonar system to investigate the error and variability among nine people performing fish counts. There was no significant difference found among observers’ estimates of fish abundance per DIDSON file; however, the total count of all fish differed from the benchmark value by as much as 26%. Post-processing simple fish counts from DIDSON raw data is labour-intensive and costly. Three subsampling methods of fish passage estimations were developed and evaluated for their accuracy and precision for daily and seasonal time frames. The random and systematic subsampling methods had similar seasonal and daily accuracy and precision with few exceptions. Automation-assisted counting was much more accurate and efficient for seasonal estimates. A ratio of approximately 2:1 was found for the automated to manual fish counts and this varied little among years. The DIDSON multibeam sonar unit is useful in estimating potamodromous fish migrations for large tributaries of the Great Lakes. DIDSON image processing costs can be minimized through suitable subsampling approaches. The automation-assisted method is the most cost-effective means of estimating moderate levels of fish passage over longer study periods. Multiple individuals can be used interchangeably for the manual post-processing of DIDSON data.

The Moderating Influence of Religion on the Behavioral Health of Formerly Incarcerated Men

Formerly incarcerated persons have been found to sustain disproportionate rates of infectious and chronic diseases that place them at elevated levels of morbidity and mortality. However, prior research has found that religiosity moderates risks for poor health outcomes. We assess the moderating influence of religiosity on non-compliance with health maintenance and risk behaviors found to be robust predictors of poor health. Findings indicated that religiosity was not significantly associated with health maintenance behaviors. However, religiosity did demonstrate a significant negative relationship with reductions in health risk behaviors including marginal reductions in prior substance dependency and significant reductions in opinions on extramarital and unprotected sex practices contrary to prior research findings of the prevalence of high sexual risk behaviors. Findings validate prior research that found this population at sustained risk for illness. However, the study demonstrated a clear inverse relationship between religion and health risk behaviors found to be prevalent among formerly incarcerated men. Results from this exploratory investigation suggest that the moderating influence of religion on high risk behaviors of formerly incarcerated men should be examined over a much longer study period with controls to tease out the unfettered influence of religion.

A Continual Reassessment Method With Cohort Size Adaptation Based on Bayesian Posterior Probabilities in Phase I Dose-Finding Studies

In phase I cancer studies, the maximum tolerated dose (MTD) is estimated by gradually increasing dose levels while accumulating safety information. Recently, Bayesian dose-finding methods such as the continual reassessment method (CRM) have gained popularity. Due to the lack of safety information, phase I studies on new drugs must start at doses low enough that efficacy is not expected but safety is certain up to an acceptable level. To reach the MTD with fewer patients, a 2-stage method has been proposed that enrolls only a single patient at each dose level until the first dose-limiting toxicity is observed. If the study drug is less toxic, it may require many cohorts to complete the study and thus may lead to a longer study period. In this paper, the authors propose a new CRM with cohort size adaptation to reduce the number of cohorts without reducing the accuracy of MTD selection. The cohort size is determined based on the Bayesian posterior probabilities computed during a study. Simulation studies show that the proposed method reduced the number of cohorts compared with the 2-stage method while still yielding a comparable probability of selecting the MTD correctly.

Change in masticatory ability with the implant restoration of second molars

Controversy exists as to whether missing second molars should be replaced to restore masticatory ability. The purpose of this study was to analyze the alteration in masticatory ability associated with the implant restoration of the second molar; the subjective effect of implant treatment on the participant was also assessed. Twenty-one individuals (13 men and 8 women) participated. Masticatory ability was recorded before the cementation of implant-supported single crowns, immediately after cementation, and 1 month after cementation. The occlusal load (Pa), the load-bearing contact area (mm(2)), and the maximum occlusal force (N) were calculated. A subjective evaluation of masticatory ability was conducted before treatment and 1 month after treatment through the use of a questionnaire to evaluate chewing difficulties and global satisfaction with treatment. The Wilcoxon signed rank test was used to analyze the difference in scores. The load-bearing contact area, maximum occlusal force, and participant satisfaction were found to increase significantly 1 month after the cementation of implant-supported single crowns. The restoration of the second molar with an implant increased both objective masticatory ability and subjective satisfaction 1 month after cementation of the implant-supported single crowns. Patients presenting with a missing second molar may benefit from replacement with implant-supported crowns. Longer study periods and larger sample populations are needed to obtain more definitive results.