Efficacy of HIV/STI behavioral interventions for heterosexual African American men in the United States: a meta-analysis

This meta-analysis estimates the overall efficacy of HIV prevention interventions to reduce HIV sexual risk behaviors and sexually transmitted infections (STIs) among heterosexual African American men. A comprehensive search of the literature published during 1988–2008 yielded 44 relevant studies. Interventions significantly reduced HIV sexual risk behaviors and STIs. The stratified analysis for HIV sexual risk behaviors indicated that interventions were efficacious for studies specifically targeting African American men and men with incarceration history. In addition, interventions that had provision/referral of medical services, male facilitators, shorter follow-up periods, or emphasized the importance of protecting family and significant others were associated with reductions in HIV sexual risk behaviors. Meta-regression analyses indicated that the most robust intervention component is the provision/referral of medical services. Findings indicate that HIV interventions for heterosexual African American men might be more efficacious if they incorporated a range of health care services rather than HIV/STI-related services alone

Fingerprint identification and recognition using backpropagation neural network

Biometrics is a technology which identifies a person based on his physiology or behavioral characteristics. Fingerprint identification and recognition is a biometrics method that has been widely used in various applications because of its reliability and accuracy in the process of recognizing and verifying a person's identity. The main purpose of this paper is to develop a fingerprint identification and recognition system. The system consists of three main parts, image acquisition, processing and identification and recognition. Fingerprint images are acquired and stored in the database in the image acquisition stage. These images are then enhanced in the image processing stage by performing gray level enhancement, spatial filtering, image sharpening, edge detection, segmentation, and thinning processes. After the image has been processed, it is fed into the backpropagation neural network as input in order to train the network. After training, the neural network is ready to perform the identification and recognition operations (matching process). A neural network has been successfully developed to identify and recognize the core part of fingerprint images

Hepatitis B virus infections and risk factors among the general population in Anhui Province, China: an epidemiological study

<p>Abstract</p> <p>Background</p> <p>Hepatitis B is one of the most common infectious diseases in China. The aim of this study was to determine the prevalence of hepatitis B surface antigen (HBsAg) among the general population and the risk factors associated with HBV infection in Anhui province, China.</p> <p>Methods</p> <p>A provincial serosurvey was conducted in four cities, and selected through stratified clustering sampling. Data on demographics, immunization history, medical history, family medical history, and life history were collected, along with serum tested for HBsAg. Completed surveys were analysed from 8,875 participants.</p> <p>Results</p> <p>Overall prevalence of HBsAg was 7.44%. Using multivariate analysis, older age was a risk factor for HBsAg infection among children younger than 15 years. Among adults 15-59 years old, the risk factors were male gender, a history of surgical operations, at least one HBsAg-positive family member, and non-vaccination. For adults older than 59 years, the risk factor was a blood transfusion history.</p> <p>Conclusions</p> <p>Though Anhui province has already reached the national goal of reducing HBsAg prevalence to less than 1% among children younger than 5 years, there are still several risk factors for HBsAg infection among the older population. Immunization programs should continue to focus on adults, and interventions should be taken to reduce risk factors associated with being infected with Hepatitis B.</p

Efficacy of Structural-Level Condom Distribution Interventions: A Meta-Analysis of U.S. and International Studies, 1998–2007

This systematic review examines the overall efficacy of U.S. and international-based structural-level condom distribution interventions (SLCDIs) on HIV risk behaviors and STIs and identifies factors associated with intervention efficacy. A comprehensive literature search of studies published from January 1988 through September 2007 yielded 21 relevant studies. Significant intervention effects were found for the following outcomes: condom use, condom acquisition/condom carrying, delayed sexual initiation among youth, and reduced incident STIs. The stratified analyses for condom use indicated that interventions were efficacious for various groups (e.g., youth, adults, males, commercial sex workers, clinic populations, and populations in areas with high STI incidence). Interventions increasing the availability of or accessibility to condoms or including additional individual, small-group or community-level components along with condom distribution were shown to be efficacious in increasing condom use behaviors. This review suggests that SLCDIs provide an efficacious means of HIV/STI prevention

TERT promoter mutations are highly recurrent in SHH subgroup medulloblastoma

Telomerase reverse transcriptase (TERT) promoter mutations were recently shown to drive telomerase activity in various cancer types, including medulloblastoma. However, the clinical and biological implications of TERT mutations in medulloblastoma have not been described. Hence, we sought to describe these mutations and their impact in a subgroup-specific manner. We analyzed the TERT promoter by direct sequencing and genotyping in 466 medulloblastomas. The mutational distributions were determined according to subgroup affiliation, demographics, and clinical, prognostic, and molecular features. Integrated genomics approaches were used to identify specific somatic copy number alterations in TERT promoter-mutated and wild-type tumors. Overall, TERT promoter mutations were identified in 21 % of medulloblastomas. Strikingly, the highest frequencies of TERT mutations were observed in SHH (83 %; 55/66) and WNT (31 %; 4/13) medulloblastomas derived from adult patients. Group 3 and Group 4 harbored this alteration in <5 % of cases and showed no association wit

Cytogenetic Prognostication Within Medulloblastoma Subgroups

PURPOSE: Medulloblastoma comprises four distinct molecular subgroups: WNT, SHH, Group 3, and Group 4. Current medulloblastoma protocols stratify patients based on clinical features: patient age, metastatic stage, extent of resection, and histologic variant. Stark prognostic and genetic differences among the four subgroups suggest that subgroup-specific molecular biomarkers could improve patient prognostication. PATIENTS AND METHODS: Molecular biomarkers were identified from a discovery set of 673 medulloblastomas from 43 cities around the world. Combined risk stratification models were designed based on clinical and cytogenetic biomarkers identified by multivariable Cox proportional hazards analyses. Identified biomarkers were tested using fluorescent in situ hybridization (FISH) on a nonoverlapping medulloblastoma tissue microarray (n = 453), with subsequent validation of the risk stratification models. RESULTS: Subgroup information improves the predictive accuracy of a multivariable survival model compared with clinical biomarkers alone. Most previously published cytogenetic biomarkers are only prognostic within a single medulloblastoma subgroup. Profiling six FISH biomarkers (GLI2, MYC, chromosome 11 [chr11], chr14, 17p, and 17q) on formalin-fixed paraffin-embedded tissues, we can reliably and reproducibly identify very low-risk and very high-risk patients within SHH, Group 3, and Group 4 medulloblastomas. CONCLUSION: Combining subgroup and cytogenetic biomarkers with established clinical biomarkers substantially improves patient prognostication, even in the context of heterogeneous clinical therapies. The prognostic significance of most molecular biomarkers is restricted to a specific subgroup. We have identified a small panel of cytogenetic biomarkers that reliably identifies very high-risk and very low-risk groups of patients, making it an excellent tool for selecting patients for therapy intensification and therapy de-escalation in future clinical trials

Determinants of acceptance towards a hypothetical HIV vaccination

This study assessed various factors that may contribute to the likelihood of getting vaccinated for HIV. Three sets of determining factors were explored. Health beliefs, based on the Health Belief Model, looked at perceived susceptibility towards HIV disease, benefits to vaccination, pragmatic barriers to vaccination, fear of the vaccine causing AIDS, perceived non-membership in traditionally defined high-risk groups, and perceived stigmatization of getting HIV vaccination. A second set of factors looked at health-enhancing behaviors (e.g., exercise, seatbelt use), health-compromising behaviors (e.g., alcohol use, smoking), and sexual behaviors (e.g., use of condoms, frequency of partners). Vaccine characteristics based on their cost, efficacy level, and social saturation level, were also investigated. Five hundred fifty-one undergraduates participated in the study. Results based on multiple regression analyses indicated that among the health beliefs, perceived susceptibility, benefits to vaccination, fear of the vaccine, and nonmembership in high-risk groups were significant predictors of HIV immunization. Smoking, frequency of condom use, and prior sexual experience were significant health behavior predictors of HIV immunization. Subjects were also more likely to choose a vaccine that was free, 80% efficacious, and where the social saturation level was 90%. The results of this study suggest that people may have reservations about accepting an HIV vaccine. As HIV vaccine development proceeds, it will be important to continue addressing issues of HIV vaccine acceptance. It is hoped that this study will lay the groundwork for additional, more comprehensive studies in other populations

Healthcare disparities in the perioperative setting: An analysis of the National Anaesthesia Clinical Outcomes Registry

Background There are numerous studies which indicate healthcare disparities exist in the United States. Aims This study aims to investigate healthcare disparities in perioperative setting. Methods The National Anaesthesia Clinical Outcomes Registry (NACOR) was analysed for the impact of socioeconomic status and gender on perioperative adverse outcomes in elective, non-obstetrical cases. Socioeconomic status was initially divided into six income groups using Thompson & Hickey class modifications and subsequently classified into three income group classification (lower, middle, and upper). Three adverse outcomes were studied: intraoperative cardiac arrest, unplanned ICU admissions, and mortality. Results A total of 1,800,506 non-emergency, non-obstetrical cases in NACOR documented the presence or absence of an adverse outcome. In these cases, 43.42 per cent were males and 56.58 per cent were females. The incidences of adverse outcomes per 10,000 were 8.64 for unplanned ICU admissions, 7.86 for intraoperative cardiac arrest not leading to death and 2.37 for intraoperative cardiac arrest leading to death. Patients in the upper socioeconomic group had significantly fewer adverse outcomes than patients in lower group for unplanned ICU admissions (OR 0.41, 95 per cent CI 0.28-0.59), cardiac arrest not leading to death (OR 0.21; 95 per cent CI 0.13–0.33), and cardiac arrest leading to death (OR 0.41 95 per cent CI 0.21–0.79). The lower class group was found to have more intraoperative cardiac arrests not leading to death than the middle class group. There was no statistical significance between the lower and middle income groups when analysing unplanned ICU admissions and mortality. Conclusion Our study has found that healthcare disparities do exist in the perioperative setting

Healthcare Disparities in the Perioperative Setting: An Analysis of the National Anaesthesia Clinical Outcomes Registry

BackgroundThere are numerous studies which indicate healthcare disparities exist in the United States. AimsThis study aims to investigate healthcare disparities in perioperative setting.Methods The National Anaesthesia Clinical Outcomes Registry (NACOR) was analysed for the impact of socioeconomic status and gender on perioperative adverse outcomes in elective, non-obstetrical cases. Socioeconomic status was initially divided into six income groups using Thompson & Hickey class modifications and subsequently classified into three income group classification (lower, middle, and upper). Three adverse outcomes were studied: intraoperative cardiac arrest, unplanned ICU admissions, and mortality.Results A total of 1,800,506 non-emergency, non-obstetrical cases in NACOR documented the presence or absence of an adverse outcome. In these cases, 43.42 per cent were males and 56.58 per cent were females. The incidences of adverse outcomes per 10,000 were 8.64 for unplanned ICU admissions, 7.86 for intraoperative cardiac arrest not leading to death and 2.37 for intraoperative cardiac arrest leading to death. Patients in the upper socioeconomic group had significantly fewer adverse outcomes than patients in lower group for unplanned ICU admissions (OR 0.41, 95 per cent CI 0.28-0.59), cardiac arrest not leading to death (OR 0.21; 95 per cent CI 0.13–0.33), and cardiac arrest leading to death (OR 0.41 95 per cent CI 0.21–0.79). The lower class group was found to have more intraoperative cardiac arrests not leading to death than the middle class group. There was no statistical significance between the lower and middle income groups when analysing unplanned ICU admissions and mortality.ConclusionOur study has found that healthcare disparities do exist in the perioperative setting