Factors associated with pastoral community knowledge and occurrence of mycobacterial infections in human-animal interface areas of Nakasongola and Mubende districts, Uganda

<p>Abstract</p> <p>Background</p> <p>Nontuberculous mycobacteria (NTM) are emerging opportunistic pathogens whose role in human and animal disease is increasingly being recognized. Major concerns are their role as opportunistic pathogens in HIV/AIDS infections. The role of open natural water sources as source and livestock/wildlife as reservoirs of infections to man are well documented. This presents a health challenge to the pastoral systems in Africa that rely mostly on open natural water sources to meet livestock and human needs. Recent study in the pastoral areas of Uganda showed infections with same genotypes of NTM in pastoralists and their livestock. The aim of this study was to determine the environmental, animal husbandry and socio-demographic factors associated with occurrence and the pastoral community knowledge of mycobacterial infections at the human-environment-livestock/wildlife interface (HELI) areas in pastoral ecosystems of Uganda.</p> <p>Methods</p> <p>Two hundred and fifty three (253) individuals were subjected to a questionnaire survey across the study districts of Nakasongola and Mubende. Data were analyzed using descriptive statistics and multivariable logistic regression analysis.</p> <p>Results</p> <p>Humans sharing of the water sources with wild animals from the forest compared to savannah ecosystem (OR = 3.3), the tribe of herding pastoral community (OR = 7.9), number of rooms present in household (3-5 vs. 1-2 rooms) (OR = 3.3) were the socio-demographic factors that influenced the level of knowledge on mycobacterial infections among the pastoral communities. Tribe (OR = 6.4), use of spring vs. stream water for domestic use (OR = 4.5), presence of sediments in household water receptacle (OR = 2.32), non separation of water containers for drinking and domestic use (OR = 2.46), sharing of drinking water sources with wild animals (OR = 2.1), duration of involvement of >5 yrs in cattle keeping (OR = 3.7) and distance of household to animal night shelters (>20 meters) (OR = 3.8) were significant socio-demographic factors associated with the risk of occurrence of mycobacterioses among the pastoral communities in Uganda.</p> <p>Conclusion</p> <p>The socio-demographic, environmental and household related factors influence the risk of occurrence as well as pastoralists' knowledge of mycobacterial infections in the pastoral households at the human-environment-livestock/wildlife pastoral interface areas of Uganda.</p

Effect of Medicaid Expansion on Cancer Treatment and Survival Among Medicaid Beneficiaries and the Uninsured

BACKGROUND: The Affordable Care Act expanded Medicaid coverage for people with low income in the United States. Expanded insurance coverage could promote more timely access to cancer treatment, which could improve overall survival (OS), yet the long-term effects of Medicaid expansion (ME) remain unknown. We evaluated whether ME was associated with improved timely treatment initiation (TTI) and 3-year OS among patients with breast, cervical, colon, and lung cancers who were affected by the policy. METHODS: Medicaid-insured or uninsured patients aged 40-64 with stage I-III breast, cervical, colon, or non-small cell lung cancer within the National Cancer Database (NCDB). A difference-in-differences (DID) approach was used to compare changes in TTI (within 60 days) and 3-year OS between patients in ME states versus nonexpansion (NE) states before (2010-2013) and after (2015-2018) ME. Adjusted DID estimates for TTI and 3-year OS were calculated using multivariable linear regression and Cox proportional hazards regression models, respectively. RESULTS: ME was associated with a relative increase in TTI within 60 days for breast (DID = 4.6; p \u3c 0.001), cervical (DID = 5.0 p = 0.013), and colon (DID = 4.0, p = 0.008), but not lung cancer (p = 0.505). In Cox regression analysis, ME was associated with improved 3-year OS for breast (DID hazard ratio [HR] = 0.82, p = 0.009), cervical (DID-HR = 0.81, p = 0.048), and lung (DID-HR = 0.87, p = 0.003). Changes in 3-year OS for colon cancer were not statistically different between ME and NE states (DID-HR, 0.77; p = 0.075). CONCLUSIONS: Findings suggest that expanded insurance coverage can improve treatment and survival outcomes among low income and uninsured patients with cancer. As the debate surrounding ME continues nationwide, our findings serve as valuable insights to inform the development of policies aimed at fostering accessible and affordable healthcare for all

A feasibility study of space-charge neutralized ion induction linacs: Final report

Applications for high current (> 1 kA) ion beams are increasing. They include hardening of material surfaces, transmutation of radioactive waste, cancer treatment, and possibly driving fusion reactions to create energy. The space-charge of ions limits the current that can be accelerated in a conventional ion linear accelerator (linac). Furthermore, the accelerating electric field must be kept low enough to avoid the generation and acceleration of counter-streaming electrons. These limitations have resulted in ion accelerator designs that employ long beam lines and would be expensive to build. Space-charge neutralization and magnetic insulation of the acceleration gaps could substantially reduce these two limitations, but at the expense of increasing the complexity of the beam physics. We present theory and experiments to determine the degree of charge-neutralization that can be achieved in various environments found in ion accelerators. Our results suggest that, for high current applications, space-charge neutralization could be used to improve on the conventional ion accelerator technology. There are two basic magnetic field geometries that can be used to insulate the accelerating gaps, a radial field or a cusp field. We will present studies related to both of these geometries. We shall also present numerical simulations of {open_quotes}multicusp{close_quotes} accelerator that would deliver potassium ions at 400 MeV with a total beam power of approximately 40 TW. Such an accelerator could be used to drive fusion

Effect of Medicaid expansion on cancer treatment and survival among Medicaid beneficiaries and the uninsured

BackgroundThe Affordable Care Act expanded Medicaid coverage for people with low income in the United States. Expanded insurance coverage could promote more timely access to cancer treatment, which could improve overall survival (OS), yet the long-term effects of Medicaid expansion (ME) remain unknown. We evaluated whether ME was associated with improved timely treatment initiation (TTI) and 3-year OS among patients with breast, cervical, colon, and lung cancers who were affected by the policy.MethodsMedicaid-insured or uninsured patients aged 40-64 with stage I-III breast, cervical, colon, or non-small cell lung cancer within the National Cancer Database (NCDB). A difference-in-differences (DID) approach was used to compare changes in TTI (within 60 days) and 3-year OS between patients in ME states versus nonexpansion (NE) states before (2010-2013) and after (2015-2018) ME. Adjusted DID estimates for TTI and 3-year OS were calculated using multivariable linear regression and Cox proportional hazards regression models, respectively.ResultsME was associated with a relative increase in TTI within 60 days for breast (DID = 4.6; p &lt; 0.001), cervical (DID = 5.0 p = 0.013), and colon (DID = 4.0, p = 0.008), but not lung cancer (p = 0.505). In Cox regression analysis, ME was associated with improved 3-year OS for breast (DID hazard ratio [HR] = 0.82, p = 0.009), cervical (DID-HR = 0.81, p = 0.048), and lung (DID-HR = 0.87, p = 0.003). Changes in 3-year OS for colon cancer were not statistically different between ME and NE states (DID-HR, 0.77; p = 0.075).ConclusionsFindings suggest that expanded insurance coverage can improve treatment and survival outcomes among low income and uninsured patients with cancer. As the debate surrounding ME continues nationwide, our findings serve as valuable insights to inform the development of policies aimed at fostering accessible and affordable healthcare for all

RAM simulation model for SPH/RSV systems

The US Army`s Project Manager, Crusader is sponsoring the development of technologies that apply to the Self-Propelled Howitzer (SPH), formerly the Advanced Field Artillery System (AFAS), and Resupply Vehicle (RSV), formerly the Future Armored Resupply Vehicle (FARV), weapon system. Oak Ridge National Laboratory (ORNL) is currently performing developmental work in support of the SPH/PSV Crusader system. Supportive analyses of reliability, availability, and maintainability (RAM) aspects were also performed for the SPH/RSV effort. During FY 1994 and FY 1995 OPNL conducted a feasibility study to demonstrate the application of simulation modeling for RAM analysis of the Crusader system. Following completion of the feasibility study, a full-scale RAM simulation model of the Crusader system was developed for both the SPH and PSV. This report provides documentation for the simulation model as well as instructions in the proper execution and utilization of the model for the conduct of RAM analyses

Medicaid Expansion and Postoperative Mortality in Women with Gynecologic Cancer: A Difference-in-Difference Analysis

BACKGROUND: The association between Medicaid expansion and postoperative mortality after surgery for gynecologic cancer is unknown. Our objective was to compare 30- and 90-day postoperative mortality after gynecologic cancer surgery before and after 2014 in states that did and did not expand Medicaid. METHODS: We searched the National Cancer Database for women aged 40-64 years old between 2010 and 2016 who underwent surgery for a primary gynecologic malignancy. We used pre/post and quasi-experimental difference-in-difference (DID) multivariable logistic regressions to evaluate mortality pre-2014 (2010-2013) and post-2014 (2014-2016) for states that did and did not expand Medicaid in January 2014. We completed univariable logistic regressions for covariates of interest. RESULTS: Among 169,731 women, 30-day postoperative mortality in expansion states after 2014 significantly decreased for endometrial cancer (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.26-0.67) and ovarian cancer (OR 0.67, 95% CI 0.46-0.99) and increased for cervical cancer (OR 3.82, 95% CI 1.12-13.01). Compared with non-expansion states, expansion states had improved 30-day postoperative mortality for endometrial cancer after 2014 (DID OR 0.54, 95% CI 0.31-0.96). Univariable analysis demonstrated improved 30-day postoperative mortality for Black women with endometrial cancer in expansion states (DID OR 0.22, 95% CI 0.05-0.95). There was improved 90-day postoperative mortality for endometrial cancer in expansion states (OR 0.66, 95% CI 0.50-0.85), and improved 90-day postoperative mortality for Midwestern women with ovarian cancer in expansion states on univariable analysis (DID OR 0.48, 95% CI 0.26-0.91). CONCLUSIONS: State Medicaid legislation was associated with improved postoperative survival in women with endometrial cancer and subgroups of women with endometrial and ovarian cancer

Compositional and Mineralogical Effects on Ice Nucleation Activity of Volcanic Ash

Volcanic ash produced during explosive eruptions may serve as ice nuclei in the atmosphere, contributing to the occurrence of volcanic lightning due to tribocharging from ice&ndash;ice or ice&ndash;ash collisions. Here, different ash samples were tested using deposition-mode and immersion-mode ice nucleation experiments. Results show that bulk composition and mineral abundance have no measurable effect on depositional freezing at the temperatures tested, as all samples have similar ice saturation ratios. In the immersion mode, there is a strong positive correlation between K₂O content and ice nucleation site density at &minus;25 &deg;C and a strong negative correlation between MnO and TiO₂ content at temperatures from &minus;35 to &minus;30 &deg;C. The most efficient sample in the immersion mode has the highest surface area, smallest average grain size, highest K₂O content, and lowest MnO content. These results indicate that although ash abundance&mdash;which creates more available surface area for nucleation&mdash;has a significant effect on immersion-mode freezing, composition may also contribute. Consequently, highly explosive eruptions of compositionally evolved magmas create the necessary parameters to promote ice nucleation on grain surfaces, which permits tribocharging due to ice&ndash;ice or ice&ndash;ash collisions, and contribute to the frequent occurrence of volcanic lightning within the eruptive column and plume during these events.</p

24 New Citizen Science Light Curves of WASP-12b and Updated Ephemeris by Combining with ETD and ExoClock Datasets

NASA citizen scientists from all over the world have used EXOplanet Transit Interpretation Code (EXOTIC) to reduce 71 sets of time-series images of WASP-12 taken by the 6-inch telescope operated by the Centre of Astrophysics | Harvard & Smithsonian MicroObservatory. Of these sets, 24 result in clean Transit light curves of the WASP-12b which are uploaded to the NASA Exoplanet Watch website. We use priors from the NASA Exoplanet Archive to calculate the ephemeris of the planet and combine it with ETD (Exoplanet Transit Database) and ExoClock observations. Combining the Exoplanet Watch, ETD, and Exoclock datasets gives an updated ephemeris for the WASP-12b system of 2454508.97872 +/- 0.00003 with an orbital period of 1.0914196 +/- 1.7325322e-08 days which can be used to inform future space telescope observations

The Role of Public Health in Addressing Racial and Ethnic Disparities in Mental Health and Mental Illness

Racial/ethnic minority populations are underserved in the American mental health care system. Disparity in treatment between whites and African Americans has increased substantially since the 1990s. Racial/ethnic minorities may be disproportionately affected by limited English proficiency, remote geographic settings, stigma, fragmented services, cost, comorbidity of mental illness and chronic diseases, cultural understanding of health care services, and incarceration. We present a model that illustrates how social determinants of health, interventions, and outcomes interact to affect mental health and mental illness. Public health approaches to these concerns include preventive strategies and federal agency collaborations that optimize the resilience of racial/ethnic minorities. We recommend strategies such as enhanced surveillance, research, evidence-based practice, and public policies that set standards for tracking and reducing disparities

Detection of Pathogenic Mycobacteria Based on Functionalized Quantum Dots Coupled with Immunomagnetic Separation

Mycobacteria have always proven difficult to identify due to their low growth rate and fastidious nature. Therefore molecular biology and more recently nanotechnology, have been exploited from early on for the detection of these pathogens. Here we present the first stage of development of an assay incorporating cadmium selenide quantum dots (QDs) for the detection of mycobacterial surface antigens. The principle of the assay is the separation of bacterial cells using magnetic beads coupled with genus-specific polyclonal antibodies and monoclonal antibodies for heparin-binding hemagglutinin. These complexes are then tagged with anti-mouse biotinylated antibody and finally streptavidin-conjugated QDs which leads to the detection of a fluorescent signal. For the evaluation of performance, the method under study was applied on Mycobacterium bovis BCG and Mycobacterium tuberculosis (positive controls), as well as E. coli and Salmonella spp. that constituted the negative controls. The direct observation of the latter category of samples did not reveal fluorescence as opposed to the mycobacteria mentioned above. The minimum detection limit of the assay was defined to 104 bacteria/ml, which could be further decreased by a 1 log when fluorescence was measured with a spectrofluorometer. The method described here can be easily adjusted for any other protein target of either the pathogen or the host, and once fully developed it will be directly applicable on clinical samples