Health Status and Hospital Utilization of Recent Immigrants to New York City

Background. This paper examines hospital utilization, estimated hospital costs, and mortality rates for U.S.-born, foreign-born, and Puerto Rican-born persons residing in New York City. Methods. We conducted a multivariate regression analysis using New York City neighborhoods as the unit of analysis. We utilized data from the Statewide Planning and Research Cooperative System data set and from the 1997 Housing and Vacancy Survey. We also examined mortality rates using 1990 death certificate data and decennial census data. Results. The foreign-born are much less likely to be hospitalized for most major categories of illness and have lower mortality rates than either U.S.-born or Puerto Rican-born New Yorkers. The life expectancy at 1 year of age of the foreign-born is 4 years longer than for U.S.-born persons and 6 years longer than Puerto Rican-born persons. We estimate that the overall cost of providing hospital-based care to the foreign-born was $611 million dollars less than the cost of providing hospital-based care to an equivalent number of U.S.-born persons in 1996. Conclusion. The foreign-born in New York City appear to be healthier and consume fewer hospital resources than U.S.-born populations. It is possible that the cost of hospital utilization would be lower still if the foreign-born population had better access to ambulatory and preventive services

Kinematic Differences Between the Front and Back Squat and Conventional and Sumo Deadlift

Differences between the front and back squat and conventional and sumo deadlift. J Strength Cond Res 33(12): 3213–3219, 2019—The average concentric velocity (ACV) of a resistance exercise movement is inversely related to the load lifted. Previous work suggests that different resistance exercises differ in ACV at the same relative load. Currently, there is limited evidence to determine whether the style of exercise (e.g., front or back squat [BS]; sumo-style or conventional-style deadlift) also affects the load-velocity profile or other kinematic variables such as the peak concentric velocity (PCV) and linear displacement (LD). The purpose of this study was to compare the kinematics (ACV, PCV, and LD) between the front squat (FS) and BS as well as between the conventional deadlift (CD) and sumo deadlift (SD). In a randomized order, 24 men and women (22 6 3 years) performed a 1 repetition maximum (1RM) protocol for the FS, BS, CD, and SD over 4 visits to the laboratory. Barbell kinematics were recorded during all submaximal and maximal repetitions performed during the 1RM protocol using the Open Barbell System. Kinematic data were pooled into categories based on the percentage of the 1RM lifted in 10% increments (e.g., 30–39% 1RM, 40–49% 1RM, etc.) and compared between exercises. Correlations between kinematic data for the FS and BS and for the CD and SD were examined at each relative load. No differences in kinematics were observed between the FS and BS at any load (p . 0.05). However, FS and BS ACV was weakly correlated (r , 0.4) at high (.80% 1RM) loads. Differences in LD were apparent between the SD and CD at all loads (30–100% 1RM) with the SD having a smaller LD compared with the CD (p , 0.05). Average concentric velocity was not different between the SD and CD at the 1RM (0.25 6 0.09 vs. 0.25 6 0.06 m·s21 ; p 5 0.962) but was different at 80–89% 1RM (0.35 6 0.08 vs. 0.40 6 0.07; p 5 0.017), 70–79% 1RM (0.41 6 0.08 vs. 0.46 6 0.06; p 5 0.026), and 40–49% 1RM (0.66 6 0.09 vs. 0.77 6 0.08; p , 0.001). In addition, SD and CD ACV values showed no relationships (p . 0.05) at any loads except at the 1RM (r 5 0.433; p , 0.05). These results suggest individual load-velocity profiles for the FS and BS as well as for the CD and SD should be used for training purposes

Factors Related to Average Concentric Velocity of Four Barbell Exercises at Various Loads

The resistance exercise load is the primarily determinant of the average concentric velocity (ACV) during a repetition. It is unknown whether individual factors such as training experience or anthropometrics also influence the ACV. Previous research has shown the ACV during the 1 repetition maximum (1RM) varies between exercises, but it is not clear whether ACV is different between exercises at various percentages of the 1RM. This information could provide practical guidelines for trainees using ACV to select training loads. Therefore, the purpose of this study was to determine whether training age, current training frequency, limb length, height, and relative strength are related to ACV at loads between 35 and 100% of the 1RM for the squat, bench press, deadlift, and overhead press. A secondary purpose was to compare the ACV values between the 4 lifts at each relative load. Fifty-one (18 women and 33 men) completed 2 testing sessions in which the squat, bench press, deadlift, and overhead press ACV were measured during a modified 1RM protocol. Average concentric velocity values were significantly different among the 4 lifts (p \u3c 0.05) at all relative loads between 35 and 100% 1RM except for 55% 1RM (p = 0.112). Generally, compared at the same relative loads, the overhead press exhibited the greatest ACV followed by the squat, bench press, and deadlift (in order). In addition, relative strength level was inversely related to ACV at maximal loads (≥95% 1RM) for the squat, bench press, and deadlift while height was positively related to ACV at moderate loads (55% 1RM) for all lifts (p \u3c 0.05). These results suggest that the load-velocity profile is unique for each of these exercises, and that velocity ranges used for exercise prescription should be specific to the exercise. A trainee\u27s relative strength and height may be a primary influence on the ACV

An efficient method to successively introduce transgenes into a given genomic locus in the mouse

BACKGROUND: Expression of transgenes in mice requires transcriptional regulatory elements that direct expression in a chosen cell type. Unfortunately, the availability of well-characterized promoters that direct bona-fide expression of transgenes in transgenic mice is limited. Here we described a method that allows highly efficient targeting of transgenes to a preselected locus in ES cells. RESULTS: A pgk-LoxP-Neo cassette was introduced into a desired genomic locus by homologous recombination in ES cells. The pgk promoter was then removed from the targeted ES cells by Cre recombinase thereby restoring the ES cells' sensitivity to G418. We demonstrated that transgenes could be efficiently introduced into this genomic locus by reconstituting a functional Neo gene. CONCLUSION: This approach is simple and extremely efficient in facilitating the introduction of single-copy transgenes into defined genomic loci. The availability of such an approach greatly enhances the ease of using endogenous regulatory elements to control transgene expression and, in turn, expands the repertoire of elements available for transgene expression

The Economic Cost of Community-Based Interventions to Improve Breast Cancer Control among African-American Women

A number of intervention strategies to improve the rate of early stage breast cancer detection have been proposed and evaluated. Though good effectiveness data exist, policymakers and medical administrators may be reluctant to implement such interventions because of cost considerations. Few cost-effectiveness analyses have been conducted on culturally-sensitive interventions that increase mammography screening rates or reduce barriers to receiving timely diagnostic testing and treatment for African-American women. This paper discusses an innovative cost effectiveness model, funded by the National Cancer Institute, and presents microeconomic estimates the cost of twelve community-based intervention strategies designed to improve early stage breast cancer detection rates and appropriate follow-up after an abnormal mammogram among African-American women. An innovation in the estimates is to include the value of women’s time. Community-based program costs range from $47 to$161 per patient on an ongoing basis. Same day scheduling of a mammogram with or without patient transportation, public service announcements, physician education, physician audit with feedback, and same day scheduling of a biopsy cost $47-$53 per patient per year on an ongoing basis. Interventions that require fulltime personnel to maintain the program, such as patient reminder letters, theory-based education, physician reminders, and telephone counseling, are more expensive and cost approximately $54-$57 per patient on an ongoing basis. The three most expensive interventions are the mobile mammography van, lay health workers, and church based navigators, costing approximately $67-$161 per patient In conclusion, the added costs of community-based cancer control programs for vulnerable African-American women are small and have the potential to be offset by the gains in quality-adjusted life years saved as a result of detection at an earlier stage of diagnosis and improved follow-up and treatment, particularly among high-risk communities

The Work of Seduction : Intimacy and Subjectivity in the London 'Seduction Community'

This paper explores negotiations of intimate and sexual subjectivity among men involved in the London 'seduction community', a central locus within what is more properly regarded as a community-industry. Herein, heterosexual men undertake various forms of skills training and personal development in order to gain greater choice and control in their relationships with women. As an entry point to this discussion I consider the international media event that enveloped American 'pickup artist' Julien Blanc in November 2014. Shifting focus away from the cultural figure of the 'pickup artist' and onto socially located men, I attempt to complicate a dominant narrative that characterises men who participate in this community-industry as pathetic, pathological or perverse. This analysis makes use of extensive ethnographic research undertaken within the London seduction community, and examines how men who participate in this setting engage a mode of intimate and sexual subjectivity ordered by themes of management and enterprise. Ultimately I argue that the central logics of the seduction community are not dissonant from but are in fact consistent with broader reconfigurations of intimacy and sexuality taking place in the contemporary UK context

Benefits and Costs of Interventions to Improve Breast Cancer Outcomes in African American Women

Purpose Historically, African American women have experienced higher breast cancer mortality than white women, despite lower incidence. Our objective was to evaluate whether costs of increasing rates of screening or application of intensive treatment will be off-set by survival benefits for African American women. Methods We use a stochastic simulation model of the natural history of breast cancer to evaluate the incremental societal costs and benefits of status quo versus targeted biennial screening or treatment improvements among African Americans 40 years of age and older. Main outcome measures were number of mammograms, stage, all-cause mortality, and discounted costs per life year saved (LYS). Results At the current screening rate of 76%, there is little incremental benefit associated with further increasing screening, and the costs are high: $124,053 and$124,217 per LYS for lay health worker and patient reminder interventions, respectively, compared with the status quo. Using reminders would cost $51,537 per LYS if targeted to virtually unscreened women or$78,130 per LYS if targeted to women with a two-fold increase in baseline risk. If all patients received the most intensive treatment recommended, costs increase but deaths decrease, for a cost of $52,678 per LYS. Investments of up to$6,000 per breast cancer patient could be used to enhance treatment and still yield cost-effectiveness ratios of less than $75,000 per LYS. Conclusion Except in pockets of unscreened or high-risk women, further investments in interventions to increase screening are unlikely to be an efficient use of resources. Ensuring that African American women receive intensive treatment seems to be the most cost-effective approach to decreasing the disproportionate mortality experienced by this population

Sensitivity and identifiability of hydraulic and geophysical parameters from streaming potential signals in unsaturated porous media

Fluid flow in a charged porous medium generates electric potentials called streaming potential (SP). The SP signal is related to both hydraulic and electrical properties of the soil. In this work, global sensitivity analysis (GSA) and parameter estimation procedures are performed to assess the influence of hydraulic and geophysical parameters on the SP signals and to investigate the identifiability of these parameters from SP measurements. Both procedures are applied to a synthetic column experiment involving a falling head infiltration phase followed by a drainage phase.GSA is used through variance-based sensitivity indices, calculated using sparse polynomial chaos expansion (PCE). To allow high PCE orders, we use an efficient sparse PCE algorithm which selects the best sparse PCE from a given data set using the Kashyap information criterion (KIC). Parameter identifiability is performed using two approaches: the Bayesian approach based on the Markov chain Monte Carlo (MCMC) method and the first-order approximation (FOA) approach based on the Levenberg–Marquardt algorithm. The comparison between both approaches allows us to check whether FOA can provide a reliable estimation of parameters and associated uncertainties for the highly nonlinear hydrogeophysical problem investigated.GSA results show that in short time periods, the saturated hydraulic conductivity (Ks) and the voltage coupling coefficient at saturation Csat are the most influential parameters, whereas in long time periods, the residual water content (θs), the Mualem–van Genuchten parameter n and the Archie saturation exponent na become influential, with strong interactions between them. The Mualem–van Genuchten parameter α has a very weak influence on the SP signals during the whole experiment.Results of parameter estimation show that although the studied problem is highly nonlinear, when several SP data collected at different altitudes inside the column are used to calibrate the model, all hydraulic (Ks, θs, α, n) and geophysical parameters (na, Csat) can be reasonably estimated from the SP measurements. Further, in this case, the FOA approach provides accurate estimations of both mean parameter values and uncertainty regions. Conversely, when the number of SP measurements used for the calibration is strongly reduced, the FOA approach yields accurate mean parameter values (in agreement with MCMC results) but inaccurate and even unphysical confidence intervals for parameters with large uncertainty regions.</p

Re-establishment of VWF-dependent Weibel-Palade bodies in VWD endothelial cells

Type 3 von Willebrand disease (VWD) is a severe hemorrhagic defect in humans. We now identify the homozygous mutation in the Chapel Hill strain of canine type 3 VWD that results in premature termination of von Willebrand factor (VWF) protein synthesis. We cultured endothelium from VWD and normal dogs to study intracellular VWF trafficking and Weibel-Palade body formation. Weibel-Palade bodies could not be identified in the canine VWD aortic endothelial cells (VWD-AECs) by P-selectin, VWFpp, or VWF immunostaining and confocal microscopy. We demonstrate the reestablishment of Weibel-Palade bodies that recruit endogenous P-selectin by expressing wild-type VWF in VWD-AECs. Expression of mutant VWF proteins confirmed that VWF multimerization is not necessary for Weibel-Palade body creation. Although the VWF propeptide is required for the formation of Weibel-Palade bodies, it cannot independently induce the formation of the granule. These VWF-null endothelial cells provide a unique opportunity to examine the biogenesis of Weibel-Palade bodies in endothelium from a canine model of type 3 VWD

A global method for coupling transport with chemistry in heterogeneous porous media

Modeling reactive transport in porous media, using a local chemical equilibrium assumption, leads to a system of advection-diffusion PDE's coupled with algebraic equations. When solving this coupled system, the algebraic equations have to be solved at each grid point for each chemical species and at each time step. This leads to a coupled non-linear system. In this paper a global solution approach that enables to keep the software codes for transport and chemistry distinct is proposed. The method applies the Newton-Krylov framework to the formulation for reactive transport used in operator splitting. The method is formulated in terms of total mobile and total fixed concentrations and uses the chemical solver as a black box, as it only requires that on be able to solve chemical equilibrium problems (and compute derivatives), without having to know the solution method. An additional advantage of the Newton-Krylov method is that the Jacobian is only needed as an operator in a Jacobian matrix times vector product. The proposed method is tested on the MoMaS reactive transport benchmark.Comment: Computational Geosciences (2009) http://www.springerlink.com/content/933p55085742m203/?p=db14bb8c399b49979ba8389a3cae1b0f&pi=1