Leveraging Epidemiology to Improve Risk Assessment.

The field of environmental public health is at an important crossroad. Our current biomonitoring efforts document widespread exposure to a host of chemicals for which toxicity information is lacking. At the same time, advances in the fields of genomics, proteomics, metabolomics, genetics and epigenetics are yielding volumes of data at a rapid pace. Our ability to detect chemicals in biological and environmental media has far outpaced our ability to interpret their health relevance, and as a result, the environmental risk paradigm, in its current state, is antiquated and ill-equipped to make the best use of these new data. In light of new scientific developments and the pressing need to characterize the public health burdens of chemicals, it is imperative to reinvigorate the use of environmental epidemiology in chemical risk assessment. Two case studies of chemical assessments from the Environmental Protection Agency Integrated Risk Information System database are presented to illustrate opportunities where epidemiologic data could have been used in place of experimental animal data in dose-response assessment, or where different approaches, techniques, or studies could have been employed to better utilize existing epidemiologic evidence. Based on the case studies and what can be learned from recent scientific advances and improved approaches to utilizing human data for dose-response estimation, recommendations are provided for the disciplines of epidemiology and risk assessment for enhancing the role of epidemiologic data in hazard identification and dose-response assessment

The Impact of Simulation Sequencing on Perceived Clinical Decision Making

An emerging nursing education trend is to utilize simulated learning experiences as a means to optimize competency and decision making skills. The purpose of this study was to examine differences in students\u27 perception of clinical decision making and clinical decision making-related self-confidence and anxiety based on the sequence (order) in which they participated in a block of simulated versus hospital-based learning experiences. A quasi-experimental crossover design was used. Between and within group differences were found relative to self-confidence with the decision making process. When comparing groups, at baseline the simulation followed by hospital group had significantly higher self-confidence scores, however, at 14-weeks both groups were not significantly different. Significant within group differences were found in the simulation followed by hospital group only, demonstrating a significant decrease in clinical decision making related anxiety across the semester. Finally, there were no significant difference in; perceived clinical decision making within or between the groups at the two measurement points. Preliminary findings suggest that simulated learning experiences can be offered with alternating sequences without impacting the process, anxiety or confidence with clinical decision making. This study provides beginning evidence to guide curriculum development and allow flexibility based on student needs and available resources

The pressure-amorphized state in zirconium tungstate: a precursor to decomposition

In contrast to widely accepted view that pressure-induced amorphization arises due to kinetic hindrance of equilibrium phase transitions, here we provide evidence that the metastable pressure-amorphized state in zirconium tungstate is a precursor to decomposition of the compound into a mixture of simple oxides. This is from the volume collapse ΔV across amorphization, which is obtained for the first time by measuring linear dimensions of irreversibly amorphized samples during their recovery to the original cubic phase upon isochronal annealing up to 1000 K. The anomalously large ΔV of 25.7 ± 1.2% being the same as that expected for the decomposition indicates that this amorphous state is probably a precursor to kinetically hindered decomposition. A P–T diagram of the compound is also proposed

Charge injection, electroluminescence, and ageing of an epoxy resin in high divergent fields

[INTRODUCTION]Most experimental studies of electrical ageing have concentrated on semi-crystalline polymers such as those used in cable insulation and capacitors (see for example [1]). Theoretical models [2-4] for electrical ageing have been developed on the basis of these studies. The consensus is that ageing involves the formation of low-density regions, though the mechanisms responsible are disputed. For example, bond scission by high-energy electrons [2,5], and mechanical deformation have both been suggested. Both of these mechanisms are related to charge injection and the subsequent formation of high local fields. The semi-crystalline polymers studied so far have similar chemistries and almost identical morphologies. They tend, therefore, to show many similarities in, for example, the size of the energy barriers for the ageing reaction, critical ageing levels, and field dependence of ageing [4]. These similarities make it difficult to discriminate between mechanisms. Epoxy resins, however, are network polymers with a different molecular chemistry to that of the semi-crystalline polymers and are thus ideal to evaluate the proposed ageing mechanisms. We have therefore studied an epoxy resin (CY1301) under both uniform field and high divergent field conditions. Uniform field conditions were used to gain baseline characteristics for the properties of the unaged epoxy resin, and also for the effects of electrical ageing in low fields. Studies in high divergent fields were made using an electrode arrangement adapted from that of [6]. A number of wires set approximately 0.5mm apart were embedded, parallel to the flat faces, in thin (290 m ) flat samples. The radius of the wires ranged from 5 m (gold plated tungsten) to 25 m (tungsten). Relatively small voltages applied to the wires (5 kV DC) therefore produced local fields up to 170 kV/mm depending upon the wire radius chosen. These field levels are high enough to inject space-charge [6] without leading to instantaneous failure. This geometry, therefore, may both inject charge and simulate local stress enhancements arising from charge accumulation. The number of wires is large (30) so that the volume affected is big enough to allow changes on ageing to be detectable

The Infrared Telescope Facility (IRTF) spectral library: spectral diagnostics for cool stars

The near-infrared (NIR) wavelength range offers some unique spectral features, and it is less prone to the extinction than the optical one. Recently, the first flux calibrated NIR library of cool stars from the NASA Infrared Telescope Facility (IRTF) have become available, and it has not been fully exploited yet. We want to develop spectroscopic diagnostics for stellar physical parameters based on features in the wavelength range 1-5 micron. In this work we test the technique in the I and K bands. The study of the Y, J, H, and L bands will be presented in the following paper. An objective method for semi-empirical definition of spectral features sensitive to various physical parameters is applied to the spectra. It is based on sensitivity map--i.e., derivative of the flux in the spectra with respect to the stellar parameters at a fixed wavelength. New optimized indices are defined and their equivalent widths (EWs) are measured. A number of sensitive features to the effective temperature and surface gravity are re-identified or newly identified clearly showing the reliability of the sensitivity map analysis. The sensitivity map allows to identify the best bandpass limits for the line and nearby continuum. It reliably predicts the trends of spectral features with respect to a given physical parameter but not their absolute strengths. Line blends are easy to recognize when blended features have different behavior with respect to some physical stellar parameter. The use of sensitivity map is therefore complementary to the use of indices. We give the EWs of the new indices measured for the IRTF star sample. This new and homogeneous set of EWs will be useful for stellar population synthesis models and can be used to get element-by-element abundances for unresolved stellar population studies in galaxies.Comment: 46 pages, 27 figures, accepted for publication on Astronomy and Astrophysic

Vascular remodeling of the mouse yolk sac requires hemodynamic force

The embryonic heart and vessels are dynamic and form and remodel while functional. Much has been learned about the genetic mechanisms underlying the development of the cardiovascular system, but we are just beginning to understand how changes in heart and vessel structure are influenced by hemodynamic forces such as shear stress. Recent work has shown that vessel remodeling in the mouse yolk sac is secondarily effected when cardiac function is reduced or absent. These findings indicate that proper circulation is required for vessel remodeling, but have not defined whether the role of circulation is to provide mechanical cues, to deliver oxygen or to circulate signaling molecules. Here, we used time-lapse confocal microscopy to determine the role of fluid-derived forces in vessel remodeling in the developing murine yolk sac. Novel methods were used to characterize flows in normal embryos and in embryos with impaired contractility (Mlc2a^(–/–)). We found abnormal plasma and erythroblast circulation in these embryos, which led us to hypothesize that the entry of erythroblasts into circulation is a key event in triggering vessel remodeling. We tested this by sequestering erythroblasts in the blood islands, thereby lowering the hematocrit and reducing shear stress, and found that vessel remodeling and the expression of eNOS (Nos3) depends on erythroblast flow. Further, we rescued remodeling defects and eNOS expression in low-hematocrit embryos by restoring the viscosity of the blood. These data show that hemodynamic force is necessary and sufficient to induce vessel remodeling in the mammalian yolk sa

A Decade Of Starspot Activity On The Eclipsing Short-Period RS Canum Venaticorum Star WY Cancri: 1988-1997

We present optical photometry of the short-period eclipsing RS CVn system WY Cancri for the years 1988–1997. For each light curve, we model the distortion waves in order to study the behavior of starspots in this system. After removing the spot effects f

Managing menopausal symptoms and associated clinical issues in breast cancer survivors

Objective: Review evidence to guide management of menopausal signs and symptoms in women after breast cancer and make recommendations accordingly. Evidence: Randomized controlled clinical trials, observational studies, evidence-based guidelines, and expert opinion from professional societies. Background: Symptoms and clinical problems associated with estrogen depletion—sleep disorders, vulvovaginal atrophy (VVA), vasomotor symptoms (VMS), mood changes, depressive symptoms, cardiovascular disease, osteopenia, and osteoporosis—confront the estimated 9.3 million breast cancer survivors globally. Recommendations: Following breast cancer, women should not generally be treated with menopausal hormone therapy or tibolone but should optimize lifestyle. Women with moderate to severe symptoms may benefit from mind–brain behavior or nonhormone, pharmacologic therapy. The selective serotonin/noradrenaline reuptake inhibitors and gabapentenoid agents improve VMS and quality of life. For osteoporosis, nonhormonal agents are available. Treatment of VVA remains an area of unmet need. Low-dose vaginal estrogen is absorbed in small amounts with blood levels remaining within the normal postmenopausal range but could potentially stimulate occult breast cancer cells, and although poorly studied, is not generally advised, particularly for those on aromatase inhibitors. Intravaginal dehydroepiandrosterone and oral ospemiphene have been approved to treat dyspareunia, but safety after breast cancer has not been established. Vaginal laser therapy is being used for VVA but efficacy from sham-controlled studies is lacking. Therapies undergoing development include lasofoxifene, neurokinin B inhibitors, stellate ganglion blockade, vaginal testosterone, and estetrol. Conclusions: Nonhormone options and therapies are available for treatment of estrogen depletion symptoms and clinical problems after a diagnosis of breast cancer. Individualization of treatment is essential

Controlled spontaneous emission

The problem of spontaneous emission is studied by a direct computer simulation of the dynamics of a combined system: atom + radiation field. The parameters of the discrete finite model, including up to 20k field oscillators, have been optimized by a comparison with the exact solution for the case when the oscillators have equidistant frequencies and equal coupling constants. Simulation of the effect of multi-pulse sequence of phase kicks and emission by a pair of atoms shows that both the frequency and the linewidth of the emitted spectrum could be controlled.Comment: 25 pages including 11 figure