Having a family doctor is associated with some better patient-reported outcomes of primary care consultations

<b>Background</b> Hong Kong (HK) has pluralistic primary care that is provided by a variety of doctors. The aim of our study was to assess patient-reported outcomes of primary care consultations in HK and whether having a family doctor (FD) made any difference.<p></p> <b>Methods</b> We interviewed by telephone 3148 subjects from 5174 contacted households (response rate 60.8%) randomly selected from the general population of HK about the experience of their last primary care consultations in September 2007 and April 2008. We compared the patient-reported outcomes (PRO) and patient-centered process of care in those with a FD, those with other types of regular primary care doctors (ORD) and those without any regular primary care doctor (NRD). PRO included patient enablement, global improvement in health, overall satisfaction, and likelihood of recommending their doctors to family and friends. Patient-centered process of care indicators was explanations about the illness, and address of patient’s concerns.<p></p> <b>Results</b> One thousand one hundred fifty, 746, and 1157 reported to have FD, ORD, and NRD, respectively. Over 80% of those with FD consulted their usual primary care doctors in the last consultation compared with 27% of those with NRD. Compared with subjects having ORD or NRD, subjects with FD reported being more enabled after the consultation and were more likely to recommend their doctors to family and friends. Subjects with FD and ORD were more likely than those having NRD to report a global improvement in health and satisfaction. FD group was more likely than the other two groups to report receiving an explanation on the diagnosis, nature, and expected course of the illness, and having their concerns addressed. Patient enablement was associated with explanation of diagnosis, nature, and expected course of illness, and address of patient’s concerns.<p></p> <b>Conclusion</b> People with a regular FD were more likely to feel being enabled and to experience patient-centered care in consultations

Data-driven optimization tool for the functional, economic, and environmental properties of blended cement concrete using supplementary cementitious materials

The need to produce more sustainable concrete is proving imminent given the rising environmental concerns facing the industry. Blended cement concrete, based on any of the prominent supplementary cementitious materials (SCMs) such as fly ash, ground granulated blast-furnace slag, silica fume, calcined clay and limestone powder, have proven to be the best candidates for sustainable concrete mixes. However, a reliable sustainability measure includes not only the environmental impact, but also the economic and functional ones. Within these five SCMs, their environmental, economic and functional properties are found to be conflicting at times, making a clear judgement on what would be the optimum mix not a straightforward path. A recent framework and tool for concrete sustainability assessment ECO2, sets a reliable methodology for including the functional performance of a concrete mix depending on project-based specifications. Therefore, in this study, a recently published regression model, Pre-bcc was used to predict the functional properties of a wide grid search of potentially suitable blended cement concrete mixes. Hence, an open access novel genetic algorithm tool “Opt-bcc” was developed and used to optimize the sustainability score of these mixes based on a set selection of user-defined project-specific functional criteria. The optimized mixes using the Opt-bcc model for each strength class were compared against the mix design proposed by other optimization models from the literature and were found to be at least 70% cheaper and of 30% less environmental impact.Peer ReviewedPostprint (published version

Network Topology of an Experimental Futures Exchange

Many systems of different nature exhibit scale free behaviors. Economic systems with power law distribution in the wealth is one of the examples. To better understand the working behind the complexity, we undertook an empirical study measuring the interactions between market participants. A Web server was setup to administer the exchange of futures contracts whose liquidation prices were coupled to event outcomes. After free registration, participants started trading to compete for the money prizes upon maturity of the futures contracts at the end of the experiment. The evolving `cash' flow network was reconstructed from the transactions between players. We show that the network topology is hierarchical, disassortative and scale-free with a power law exponent of 1.02+-0.09 in the degree distribution. The small-world property emerged early in the experiment while the number of participants was still small. We also show power law distributions of the net incomes and inter-transaction time intervals. Big winners and losers are associated with high degree, high betweenness centrality, low clustering coefficient and low degree-correlation. We identify communities in the network as groups of the like-minded. The distribution of the community sizes is shown to be power-law distributed with an exponent of 1.19+-0.16.Comment: 6 pages, 12 figure

Transgenic Mice Expressing a Truncated Form of the High Mobility Group I-C Protein Develop Adiposity and an Abnormally High Prevalence of Lipomas

Chromosomal translocations in human lipomas frequently create fusion transcripts encoding high mobility group (HMG) I-C DNA-binding domains and C-terminal sequences from different presumed transcription factors, suggesting a potential role for HMG I-C in the development of lipomas. To evaluate the role of the HMG I-C component, the three DNA-binding domains of HMG I-C have now been expressed in transgenic mice. Despite the ubiquitous expression of the truncated HMG I-C protein, the transgenic mice develop a selective abundance of fat tissue early in life, show marked adipose tissue inflammation, and have an abnormally high incidence of lipomas. These findings demonstrate that the DNA-binding domains of HMG I-C, in the absence of a C-terminal fusion partner, are sufficient to perturb adipogenesis and predispose to lipomas. We provide data supporting the central utility of this animal model as a tool to understand the molecular mechanisms underlying the development of one of the most common kind of human benign tumors

Mars Pathfinder mission operations concepts

The Mars Pathfinder Project plans a December 1996 launch of a single spacecraft. After jettisoning a cruise stage, an entry body containing a lander and microrover will directly enter the Mars atmosphere and parachute to a hard landing near the sub-solar latitude of 15 degrees North in July 1997. Primary surface operations last for 30 days. Cost estimates for Pathfinder ground systems development and operations are not only lower in absolute dollars, but also are a lower percentage of total project costs than in past planetary missions. Operations teams will be smaller and fewer than typical flight projects. Operations scenarios have been developed early in the project and are being used to guide operations implementation and flight system design. Recovery of key engineering data from entry, descent, and landing is a top mission priority. These data will be recorded for playback after landing. Real-time tracking of a modified carrier signal through this phase can provide important insight into the spacecraft performance during entry, descent, and landing in the event recorded data is never recovered. Surface scenarios are dominated by microrover activity and lander imaging during 7 hours of the Mars day from 0700 to 1400 local solar time. Efficient uplink and downlink processes have been designed to command the lander and microrover each Mars day

Contamination of human DNA samples with mouse DNA can lead to false detection of XMRV-like sequences

<p>Abstract</p> <p>Background</p> <p>In 2006, a novel gammaretrovirus, XMRV (xenotropic murine leukemia virus-related virus), was discovered in some prostate tumors. A more recent study indicated that this infectious retrovirus can be detected in 67% of patients suffering from chronic fatigue syndrome (CFS), but only very few healthy controls (4%). However, several groups have published to date that they could not identify XMRV RNA or DNA sequences in other cohorts of CFS patients, while another group detected murine leukemia virus (MLV)-like sequences in 87% of such patients, but only 7% of healthy controls. Since there is a high degree of similarity between XMRV and abundant endogenous MLV proviruses, it is important to distinguish contaminating mouse sequences from true infections.</p> <p>Results</p> <p>DNA from the peripheral blood of 112 CFS patients and 36 healthy controls was tested for XMRV with two different PCR assays. A TaqMan qPCR assay specific for XMRV <it>pol </it>sequences was able to detect viral DNA from 2 XMRV-infected cells (~ 10-12 pg DNA) in up to 5 μg of human genomic DNA, but yielded negative results in the test of 600 ng genomic DNA from 100,000 peripheral blood cells of all samples tested. However, positive results were obtained with some of these samples, using a less specific nested PCR assay for a different XMRV sequence. DNA sequencing of the PCR products revealed a wide variety of virus-related sequences, some identical to those found in prostate cancer and CFS patients, others more closely related to known endogenous MLVs. However, all samples that tested positive for XMRV and/or MLV DNA were also positive for the highly abundant intracisternal A-type particle (IAP) long terminal repeat and most were positive for murine mitochondrial cytochrome oxidase sequences. No contamination was observed in any of the negative control samples, containing those with no DNA template, which were included in each assay.</p> <p>Conclusions</p> <p>Mouse cells contain upwards of 100 copies each of endogenous MLV DNA. Even much less than one cell's worth of DNA can yield a detectable product using highly sensitive PCR technology. It is, therefore, vital that contamination by mouse DNA be monitored with adequately sensitive assays in all samples tested.</p

Simplified methodology to evaluate the external sulfate attack in concrete structures

The external sulfate attack is a degradation process that causes expansion and cracking in concrete structures. Due to the absence of simplified methodologies to predict the potential damage, codes specify that sulfate resistant cement should be used whenever the surrounding sulfate concentration surpasses a predefined limit. This may lead to penalizing measures as the size of the element or the mechanical properties of the concrete used are not considered. In the present work, an alternative approach is proposed. A simplified chemo-mechanical methodology is deducted to assess the potential damage in concrete elements exposed to sulfate rich environments. Equations to estimate the penetration of sulfates are derived froma numericalmodel taking into account sulfate consumption, acceleration of the penetration induced by cracking and decrease in diffusivity caused by pore filling. Failure modes associated to this phenomenon are analyzed and a set of equations to assess the risk of failure are deducted. Finally, a parametric studywith different geometries of elements and surrounding sulfate contents is performed. The results show that the criterion included in codesmight be modified depending on the characteristics of the structure.Peer ReviewedPostprint (author's final draft

Modified digital image correlation aided measurement of the transverse to longitudinal deformation ratio for polymeric macro-fibres

Considering the increasing interest of polymeric macro-fibres reinforced concrete, a simple and straightforward method to assess the fibre’s transverse to longitudinal deformation ratio (¿f) becomes a determining aspect in terms of fibre both characterization and fibre–matrix interaction optimization. A noncontact optical measurement procedure to assess this ratio (¿f) - for concrete reinforcement - by a modified 2D Digital Image Correlation method is presented in this paper. This ratio (¿f) has influence on the matrix-fibre interaction and, thus, on the post-cracking tensile response of the concrete composite. Details on the definition, implementation and validation of this measurement procedure are presented. Additionally, an experimental program on 20 selected lab grade and commercial fibres was carried out to analyse the consistency of the measurements and the influence of the fibre’s geometric characteristics (flat, curved, embossed or crimped) on the ¿f. The outcomes of this research and the experimental procedure proposed are meant to assist fibre producers on the design process of optimized fibres to be used in structural concrete.Peer ReviewedPostprint (published version

Neisseria meningitidis ST11 Complex Isolates Associated with Nongonococcal Urethritis, Indiana, USA, 2015-2016

At a clinic in Indianapolis, Indiana, USA, we observed an increase in Neisseria gonorrhoeae-negative men with suspected gonococcal urethritis who had urethral cultures positive for N. meningitidis. We describe genomes of 2 of these N. meningitidis sequence type 11 complex urethritis isolates. Clinical evidence suggests these isolates may represent an emerging urethrotropic clade

Clustering Heart Rate Dynamics Is Associated with β-Adrenergic Receptor Polymorphisms: Analysis by Information-Based Similarity Index

Background: Genetic polymorphisms in the gene encoding the β-adrenergic receptors (β -AR) have a pivotal role in the functions of the autonomic nervous system. Using heart rate variability (HRV) as an indicator of autonomic function, we present a bottom-up genotype–phenotype analysis to investigate the association between β -AR gene polymorphisms and heart rate dynamics. Methods: A total of 221 healthy Han Chinese adults (59 males and 162 females, aged 33.6610.8 years, range 19 to 63 years) were recruited and genotyped for three common β-AR polymorphisms: β$_1$-AR Ser49Gly, β$_2$-AR Arg16Gly and β$_2$-AR Gln27Glu. Each subject underwent two hours of electrocardiogram monitoring at rest. We applied an information-based similarity (IBS) index to measure the pairwise dissimilarity of heart rate dynamics among study subjects. Results: With the aid of agglomerative hierarchical cluster analysis, we categorized subjects into major clusters, which were found to have significantly different distributions of β$_2$-AR Arg16Gly genotype. Furthermore, the non-randomness index, a nonlinear HRV measure derived from the IBS method, was significantly lower in Arg16 homozygotes than in Gly16 carriers. The non-randomness index was negatively correlated with parasympathetic-related HRV variables and positively correlated with those HRV indices reflecting a sympathovagal shift toward sympathetic activity. Conclusions: We demonstrate a bottom-up categorization approach combining the IBS method and hierarchical cluster analysis to detect subgroups of subjects with HRV phenotypes associated with β-AR polymorphisms. Our results provide evidence that β$_2$-AR polymorphisms are significantly associated with the acceleration/deceleration pattern of heart rate oscillation, reflecting the underlying mode of autonomic nervous system control