Aurora Volume 15

College formerly located at Olivet, Illinois and known as Olivet University, 1912-1923; Olivet College, 1923-1939, Olivet Nazarene College, 1940-1986, Olivet Nazarene University, 1986-https://digitalcommons.olivet.edu/arch_yrbks/1017/thumbnail.jp

Recommendations for Implementing Hepatitis C Virus Care in Homeless Shelters: The Stakeholder Perspective.

Compared with the general population, homeless individuals are at higher risk of hepatitis C infection (HCV) and may face unique barriers in receipt of HCV care. This study sought the perspectives of key stakeholders toward establishing a universal HCV screening, testing, and treatment protocol for individuals accessing homeless shelters. Four focus groups were conducted with homeless shelter staff, practice providers, and social service outreach workers (n = 27) in San Francisco, California, and Minneapolis, Minnesota. Focus groups evaluated key societal, system, and individual-level facilitators and barriers to HCV testing and management. Interviews were transcribed and analyzed thematically. The societal-level barriers identified were lack of insurance, high-out-of-pocket expenses, restriction of access to HCV treatment due to active drug and/or alcohol use, and excessive paperwork required for HCV treatment authorization from payers. System-level barriers included workforce constraints and limited health care infrastructure, HCV stigma, low knowledge of HCV treatment, and existing shelter policies. At the individual level, client barriers included competing priorities, behavioral health concerns, and health attitudes. Facilitators at the system level for HCV care service integration in the shelter setting included high acceptability and buy in, and linkage with social service providers. Conclusion: Despite societal, system, and individual-level barriers identified with respect to the scale-up of HCV services in homeless shelters, there was broad support from key stakeholders for increasing capacity for the provision of HCV services in shelter settings. Recommendations for the scale-up of HCV services in homeless shelter settings are discussed

Selecting Differentially Expressed Genes from Microarray Experiments

High throughput technologies, such as gene expression arrays and protein mass spectrometry, allow one to simultaneously evaluate thousands of potential biomarkers that distinguish different tissue types. Of particular interest here is cancer versus normal organ tissues. We consider statistical methods to rank genes (or proteins) in regards to differential expression between tissues. Various statistical measures are considered and we argue that two measures related to the Receiver Operating Characteristic Curve are particularly suitable for this purpose. We also propose that sampling variability in the gene rankings be quantified and suggest using the “selection probability function”, the probability distribution of rankings for each gene. This is estimated via the bootstrap. A real data set derived from gene expression arrays of 23 normal and 30 ovarian cancer tissues are analyzed. Simulation studies are also used to assess the relative performance of different statistical gene ranking measures and our quantification of sampling variability. Our approach leads naturally to a procedure for sample size calculations appropriate for exploratory studies that seek to identify differentially expressed genes

Shoreline Situation Report Accomack County, Virginia

It is the objective of this report to supply an assessment, and at least a partial integration, of those important shoreland parameters and characteristics which will aid the planners and the managers of the shorelands in making the best decisions for the utilization of this limited and very valuable resource. The report gives particular attention to the problem of shore erosion and to recommendations concerning the alleviation of the impact of this problem. In addition we have tried to include in our assessment some of the potential uses of the shoreline, particularly with respect to recreational use, since such information could be of considerable value in the way a particular segment of coast is perceived by potential users

Recommendation to Use Exact P-values in Biomarker Discovery Research

Background: In biomarker discovery studies, markers are ranked for validation using P-values. Standard P-value calculations use normal approximations that may not be valid for small P-values and small sample sizes common in discovery research. Methods: We compared exact P-values, valid by definition, with normal and logit-normal approximations in a simulated study of 40 cases and 160 controls. The key measure of biomarker performance was sensitivity at 90% specificity. Data for 3000 uninformative markers and 30 true markers were generated randomly, with 10 replications of the simulation. We also analyzed real data on 2371 antibody array markers measured in plasma from 121 cases with ER/PR positive breast cancer and 121 controls. Results: Using the same discovery criterion, the valid exact P-values lead to discovery of 24 true and 82 false biomarkers while approximate P-values yielded 15 true and 15 false biomarkers (normal approximation) and 20 true and 86 false biomarkers (logit-normal approximation). Moreover, the estimated numbers of true markers among those discovered were substantially incorrect for approximate P-values: normal estimated 0 true markers discovered but found 15; logit-normal estimated 42 but found 20. The exact method estimated 22, close to the actual number of 24 true discoveries. With real data, exact and approximate P-values ranked candidate breast cancer biomarkers very differently. Conclusions: Exact P-values should be used because they are universally valid. Approximate P-values can lead to inappropriate biomarker selection rules and incorrect conclusions. Impact: Rigorous data analysis methodology in discovery research may improve the yield of biomarkers that validate clinically

Intake of methyl-related nutrients and risk of pancreatic cancer in a population-based case-control study in Minnesota

BACKGROUND/OBJECTIVES: Folate, vitamin B6, vitamin B12, and methionine are involved in DNA synthesis and methylation and thus may modulate pancreatic cancer risk. We investigated these associations in a population-based case-control study conducted in 1994-1998. SUBJECTS/METHODS: Cases (n = 150) were identified from all hospitals in the metropolitan areas of the Twin Cities and the Mayo Clinic, Minnesota. Controls (n = 459) were selected randomly from the general population and were frequency matched to cases by age, sex, and race. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for risk of pancreatic cancer in relation to intake of nutrients considered. RESULTS: Dietary intake of folate was associated with a reduced pancreatic cancer risk [OR (95% CI) for quartile (Q) 4 vs. Q1: 0.31 (0.12-0.78)]. A composite score (range from 2 to 8), reflecting combined dietary intake of folate and vitamin B6, was also inversely associated with pancreatic cancer risk [OR (95% CI) for Q4 vs. Q1: 0.24 (0.08-0.70)]. Null associations were found for intake of vitamin B12 and methionine. CONCLUSIONS: Dietary folate intake was associated with a reduced pancreatic cancer risk, and this association became stronger when dietary intake of folate and vitamin B6 was combined in analysis

Shoreline situation report, Middlesex County, Virginia

It is the objective of this report to supply an assessment, and at least a partial integration, of those important shoreland parameters and characteristics which will aid the planners and the managers of the shorelands in making the best decisions for the utilization of this limited and very valuable resource. The report gives particular attention to the problem of shore erosion and to recommendations concerning the alleviation of the impact of this problem. In addition we \u27have tried to include in our assessment some of the potential uses of the shoreline, particularly with respect to recreational use, since such information could be of considerable value in the way a particular segment of coast is perceived by potential users