88,240 research outputs found
Risk and Cost Assessment of Nitrate Contamination in Domestic Wells
This study combines empirical predictive and economics models to estimate the cost of remediation for domestic wells exceeding suggested treatment thresholds for nitrates. A multiple logistic regression model predicted the probability of well contamination by nitrate, and a life cycle costing methodology was used to estimate costs of nitrate contamination in groundwater in two areas of Nebraska. In south-central Nebraska, 37% of wells were estimated to be at risk of exceeding a threshold of 7.5 mg/L as N, and 17% were at risk of exceeding 10 mg/L as N, the legal limit for human consumption in the United States. In an area in northeastern Nebraska, 82% of wells were at risk of exceeding the 10 mg/L as N legal threshold. Reverse osmosis Point-of-Use (POU) treatment was the option with the lowest costs for a household (3–4 individuals), with an average of 164 total regional cost per household per year depending on the threshold for treatment. Ion exchange and distillation were the next most cost-effective options. At the community level (~10,000 individuals), a reverse osmosis Point-of-Entry (POE) treatment system was the most expensive option for a community due to high initial costs and ongoing operation and maintenance costs, whereas the biological denitrification system was least expensive due to economies of scale. This study demonstrates integrated modeling methods to assess water treatment costs over time associated with groundwater nitrate contamination, including quantification of at-risk wells, and identifies suitable options for treatment systems for rural households and communities based on their cost
Do patients who die from an alcohol-related condition ‘drift’ into areas of greater deprivation? Alcohol-related mortality and health selection theory in Scotland
Background: Health selection has been proposed to explain the patterning of alcohol-related mortality by area deprivation. This study investigated whether persons who die from alcohol-related conditions are more likely to experience social drift than those who die from other causes.
Methods: Deaths recorded in Scotland (2013, >21 years) were coded as ‘alcohol-related’ or ‘other’ and by deprivation decile of residence at death. Acute hospital admissions data from 1996 to 2012 were used to provide premortality deprivation data. χ² tests estimated the difference between observed and expected alcohol-related deaths by first Scottish Index of Multiple Deprivation (SIMD) decile and type of death. Logistic regression models were fitted using type of death as the outcome of interest and change in SIMD decile as the exposure of interest.
Results: Of 47 012 deaths, 1458 were alcohol-related. Upward and downward mobility was observed for both types of death. An estimated 31 more deaths than expected were classified ‘alcohol-related’ among cases whose deprivation score decreased, while 204 more deaths than expected were classified ‘alcohol-related’ among cases whose initial deprivation ranking was in the four most deprived deciles. Becoming more deprived and first deprivation category were both associated with increased odds of type of death being alcohol-related after adjusting for confounders.
Conclusion: This study suggests that health selection appears to contribute less to the deprivation gradient in alcohol-related mortality in Scotland than an individual’s initial area deprivation category
Positive Outcomes of HAART at 24 Months in HIV-Infected Patients in Cambodia.
OBJECTIVES: African and Asian cohort studies have demonstrated the feasibility and efficacy of HAART in resource-poor settings. The long-term virological outcome and clinico-immunological criteria of success remain important questions. We report the outcomes at 24 months of antiretroviral therapy (ART) in patients treated in a Médecins Sans Frontières/Ministry of Health programme in Cambodia. METHODS: Adults who started HAART 24 +/- 2 months ago were included. Plasma HIV-RNA levels were assessed by real-time polymerase chain reaction. Factors associated with virological failure were analysed using logistic regression. RESULTS: Of 416 patients, 59.2% were men; the median age was 33.6 years. At baseline, 95.2% were ART naive, 48.9% were at WHO stage IV, and 41.6% had a body mass index less than 18 kg/m. The median CD4 cell count was 11 cells/microl. A stavudine-lamivudine-efavirenz-containing regimen was initiated predominantly (81.0%). At follow-up (median 23.8 months), 350 (84.1%) were still on HAART, 53 (12.7%) had died, six (1.4%) were transferred, and seven (1.7%) were lost to follow-up. Estimates of survival were 85.5% at 24 months. Of 346 tested patients, 259 (74.1%) had CD4 cell counts greater than 200 cells/microl and 306 (88.4%) had viral loads of less than 400 copies/ml. Factors associated with virological failure at 24 months were non-antiretroviral naive, an insufficient CD4 cell gain of less than 350 cells/microl or a low trough plasma ART concentration. In an intention-to-treat analysis, 73.6% of patients were successfully treated. CONCLUSION: Positive results after 2 years of advanced HIV further demonstrate the efficacy of HAART in the medium term in resource-limited settings
Substantial improvements not seen in health behaviors following corner store conversions in two Latino food swamps.
BackgroundThe effectiveness of food retail interventions is largely undetermined, yet substantial investments have been made to improve access to healthy foods in food deserts and swamps via grocery and corner store interventions. This study evaluated the effects of corner store conversions in East Los Angeles and Boyle Heights, California on perceived accessibility of healthy foods, perceptions of corner stores, store patronage, food purchasing, and eating behaviors.MethodsHousehold data (n = 1686) were collected at baseline and 12- to 24-months post-intervention among residents surrounding eight stores, three of which implemented a multi-faceted intervention and five of which were comparisons. Bivariate analyses and logistic and linear regressions were employed to assess differences in time, treatment, and the interaction between time and treatment to determine the effectiveness of this intervention.ResultsImprovements were found in perceived healthy food accessibility and perceptions of corner stores. No changes were found, however, in store patronage, purchasing, or consumption of fruits and vegetables.ConclusionsResults suggest limited effectiveness of food retail interventions on improving health behaviors. Future research should focus on other strategies to reduce community-level obesity
Serum micrornas as novel biomarkers for primary sclerosing cholangitis and cholangiocarcinoma
The diagnosis of primary sclerosing cholangitis (PSC) is difficult due to the lack of sensitive and specific biomarkers, as is the early diagnosis of cholangiocarcinoma (CC), a complication of PSC. The aim of this study was to identify specific serum miRNAs as diagnostic biomarkers for PSC and CC
Mining the Demographics of Political Sentiment from Twitter Using Learning from Label Proportions
Opinion mining and demographic attribute inference have many applications in
social science. In this paper, we propose models to infer daily joint
probabilities of multiple latent attributes from Twitter data, such as
political sentiment and demographic attributes. Since it is costly and
time-consuming to annotate data for traditional supervised classification, we
instead propose scalable Learning from Label Proportions (LLP) models for
demographic and opinion inference using U.S. Census, national and state
political polls, and Cook partisan voting index as population level data. In
LLP classification settings, the training data is divided into a set of
unlabeled bags, where only the label distribution in of each bag is known,
removing the requirement of instance-level annotations. Our proposed LLP model,
Weighted Label Regularization (WLR), provides a scalable generalization of
prior work on label regularization to support weights for samples inside bags,
which is applicable in this setting where bags are arranged hierarchically
(e.g., county-level bags are nested inside of state-level bags). We apply our
model to Twitter data collected in the year leading up to the 2016 U.S.
presidential election, producing estimates of the relationships among political
sentiment and demographics over time and place. We find that our approach
closely tracks traditional polling data stratified by demographic category,
resulting in error reductions of 28-44% over baseline approaches. We also
provide descriptive evaluations showing how the model may be used to estimate
interactions among many variables and to identify linguistic temporal
variation, capabilities which are typically not feasible using traditional
polling methods
Timeliness of Clinic Attendance is a good predictor of Virological Response and Resistance to Antiretroviral drugs in HIV-infected patients
Ensuring long-term adherence to therapy is essential for the success of HIV treatment. As access to viral load monitoring and genotyping is poor in resource-limited settings, a simple tool to monitor adherence is needed. We assessed the relationship between an indicator based on timeliness of clinic attendance and virological response and HIV drug resistance
Virulence of malaria is associated with differential expression of Plasmodium falciparum var gene subgroups in a case-control study
Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1) is a major pathogenicity factor in falciparum malaria that mediates cytoadherence. PfEMP1 is encoded by approximately 60 var genes per haploid genome. Most var genes are grouped into 3 subgroups: A, B, and C. Evidence is emerging that the specific expression of these subgroups has clinical significance. Using field samples from children from Papua New Guinea with severe, mild, and asymptomatic malaria, we compared proportions of transcripts of var groups, as determined by quantitative polymerase chain reaction. We found a significantly higher proportion of var group B transcripts in children with clinical malaria (mild and severe), whereas a large proportion of var group C transcripts was found in asymptomatic children. These data from naturally infected children clearly show that major differences exist in var gene expression between parasites causing clinical disease and those causing asymptomatic infections. Furthermore, parasites forming rosettes showed a significant up-regulation of var group A transcripts
miRNA Signatures in Sera of Patients with Active Pulmonary Tuberculosis.
Several studies showed that assessing levels of specific circulating microRNAs (miRNAs) is a non-invasive, rapid, and accurate method for diagnosing diseases or detecting alterations in physiological conditions. We aimed to identify a serum miRNA signature to be used for the diagnosis of tuberculosis (TB). To account for variations due to the genetic makeup, we enrolled adults from two study settings in Europe and Africa. The following categories of subjects were considered: healthy (H), active pulmonary TB (PTB), active pulmonary TB, HIV co-infected (PTB/HIV), latent TB infection (LTBI), other pulmonary infections (OPI), and active extra-pulmonary TB (EPTB). Sera from 10 subjects of the same category were pooled and, after total RNA extraction, screened for miRNA levels by TaqMan low-density arrays. After identification of "relevant miRNAs", we refined the serum miRNA signature discriminating between H and PTB on individual subjects. Signatures were analyzed for their diagnostic performances using a multivariate logistic model and a Relevance Vector Machine (RVM) model. A leave-one-out-cross-validation (LOOCV) approach was adopted for assessing how both models could perform in practice. The analysis on pooled specimens identified selected miRNAs as discriminatory for the categories analyzed. On individual serum samples, we showed that 15 miRNAs serve as signature for H and PTB categories with a diagnostic accuracy of 82% (CI 70.2-90.0), and 77% (CI 64.2-85.9) in a RVM and a logistic classification model, respectively. Considering the different ethnicity, by selecting the specific signature for the European group (10 miRNAs) the diagnostic accuracy increased up to 83% (CI 68.1-92.1), and 81% (65.0-90.3), respectively. The African-specific signature (12 miRNAs) increased the diagnostic accuracy up to 95% (CI 76.4-99.1), and 100% (83.9-100.0), respectively. Serum miRNA signatures represent an interesting source of biomarkers for TB disease with the potential to discriminate between PTB and LTBI, but also among the other categories
Socioeconomic status as an effect modifier of alcohol consumption and harm: an analysis of linked cohort data
Background:
Alcohol-related mortality and morbidity are higher in socioeconomically disadvantaged populations. It is unclear if elevated harm reflects differences in consumption, reverse causation or greater risk of harm following similar consumption. We investigated whether the harmful effects differed by socioeconomic status accounting for alcohol consumption and other health-related factors.
Methods:
Alcohol consumption (weekly units and binge drinking) data (n=50,236; 429,986 person-years of follow-up) were linked to deaths, hospitalisations and prescriptions. The primary outcome was alcohol-attributable hospitalisation/death. The relationship between alcohol attributable harm and socioeconomic status was investigated for four measures (education level, social class, household income and area-based deprivation) using Cox proportional hazards models. The potential for alcohol consumption and other risk factors mediating the social patterning was explored. Downward social selection for high-risk drinkers (reverse causation) was tested by comparing change in area deprivation over time.
Findings:
Low socioeconomic status was consistently associated with markedly elevated alcohol-attributable harms, including after adjustment for weekly consumption, binge drinking, body mass index and smoking. There was evidence of effect modification: for example, relative to light drinkers living in advantaged areas, the hazard ratio for excessive drinkers was 6.75 (95% CI 5.09-8.93) in advantaged and 11.06 (95% CI 8.53-14.35) in deprived areas. We found little support for downward social selection.
Interpretation:
Disadvantaged social groups experience greater alcohol-attributable harms compared to the advantaged for given levels of alcohol consumption, even after accounting for different drinking patterns, obesity and smoking status at the individual level
- …