New Trends in Cyber Threats, Recognizing and Fighting Persistent Threats

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Risk factors and medical resource utilization of respiratory syncytial virus, human metapneumovirus, and influenza-related hospitalizations in adults—a global study during the 2017–2019 epidemic seasons (hospitalized acute respiratory tract infection [HARTI] study)

Background: Respiratory syncytial virus (RSV), human metapneumovirus (hMPV), and influenza are respiratory pathogens leading to hospitalization in adults. Our understanding of the disease burden is limited to data from single-center or 1-season studies in elderly patients. The HARTI study allows comparison of risk factors for progression to severe disease and medical resources utilization (MRU) during and post-hospitalization in adults diagnosed with influenza, RSV, or hMPV. Methods: This was a prospective global study in adults hospitalized with acute respiratory tract infection (40 centers, 12 countries). Participants with influenza, RSV, or hMPV were enrolled in a substudy and followed for up to 3 months postdischarge. Results: Overall, 366 influenza, 238 RSV, and 100 hMPV-infected participants enrolled in the substudy. RSV participants were older and had greater frequency of risk factors and longer duration of symptoms before hospitalization than influenza participants. The RSV and hMPV groups received more bronchodilators, corticosteroids, and oxygen supplementation. No significant differences in intensive care unit admissions or complications were observed. Readmission occurred in 20%-33% of patients within 3 months postdischarge, with the highest rates for RSV and hMPV. In-hospital death occurred in 2.5% of RSV, 1.6% of influenza, and 2% of hMPV participants. In multivariate analyses, length of stay was independently associated with country, renal disease, and increased age; probability of receiving supplemental oxygen was associated with pathogen (hMPV \u3e RSV \u3e influenza), abnormal chest x-ray, and increased age. Conclusions: Although influenza is more frequent, the HARTI study demonstrates greater frequency of underlying risk factors and MRU for RSV and hMPV vs influenza in hospitalized adults, indicating a need for effective interventions

Establishing the Scope and Methodological Approach to Out-of-hospital Outcomes and Effectiveness Research

: Outcomes research offers out-of-hospital medicine a valuable methodology for studying the effectiveness of services provided in the out-of hospital setting. A clear understanding of the history and constructs of outcomes research is necessary for its integration into emergency medical services research. This report describes the conceptual framework of outcomes research and key methodological considerations for the successful implementation of out-of-hospital outcomes research. Illustrations of the specific applications of outcomes research and implications to existing methodologies are given, as well as suggestions for improved interdisciplinary research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75033/1/j.aem.2004.04.014.pd

Risk Adjustment and Outcome Measures for Out-of-hospital Respiratory Distress

: The purpose of the Emergency Medical Services Outcomes Project (EMSOP) is to develop a foundation and framework for out-of-hospital outcomes research. In prior work, this group delineated the priority conditions, described conceptual models, suggested core and risk adjustment measures potentially useful to emergency medical services research, and summarized out-of-hospital pain measurement. In this fifth article in the EMSOP series, the authors recommend specific risk-adjustment measures and outcome measures for use in out-of-hospital research on patients presenting with respiratory distress. The methodology included systematic literature searches and a structured review by an expert panel. The EMSOP group recommends use of pulse oximetry, peak expiratory flow rate, and the visual analog dyspnea scale as potential risk-adjustment measures and outcome measures for out-of-hospital research in patients with respiratory distress. Furthermore, using mortality as an outcome measure is also recommended. Future research is needed to alleviate the paucity of validated tools for out-of-hospital outcomes research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73779/1/j.aem.2004.03.010.pd

Sheep Models of F508del and G542X Cystic Fibrosis Mutations Show Cellular Responses to Human Therapeutics

Cystic Fibrosis (CF) is a genetic disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. The F508del and G542X are the most common mutations found in US patients, accounting for 86.4% and 4.6% of all mutations, respectively. The F508del causes deletion of the phenylalanine residue at position 508 and is associated with impaired CFTR protein folding. The G542X is a nonsense mutation that introduces a stop codon into the mRNA, thus preventing normal CFTR protein synthesis. Here, we describe the generation of CFTRF508del/F508del and CFTRG542X/G542X lambs using CRISPR/Cas9 and somatic cell nuclear transfer (SCNT). First, we introduced either F508del or G542X mutations into sheep fetal fibroblasts that were subsequently used as nuclear donors for SCNT. The newborn CF lambs develop pathology similar to CFTR−/− sheep and CF patients. Moreover, tracheal epithelial cells from the CFTRF508del/F508del lambs responded to a human CFTR (hCFTR) potentiator and correctors, and those from CFTRG542X/G542X lambs showed modest restoration of CFTR function following inhibition of nonsense-mediated decay (NMD) and aminoglycoside antibiotic treatments. Thus, the phenotype and electrophysiology of these novel models represent an important advance for testing new CF therapeutics and gene therapy to improve the health of patients with this life-limiting disorder

Anthrax outbreak in a Swedish beef cattle herd - 1st case in 27 years: Case report

After 27 years with no detected cases, an outbreak of anthrax occurred in a beef cattle herd in the south of Sweden. The outbreak was unusual as it occurred in winter, in animals not exposed to meat-and-bone meal, in a non-endemic country

Understanding maternal intentions to engage in home visiting programs

Little is known as to why some parents choose to engage in voluntary home visitation services while others refuse or avoid services. To address this knowledge gap, this study tests several hypotheses about the factors that influence maternal intentions to engage in home visitation services and the link between these intentions and the receipt of a home visit. The sample consists of an ethnically diverse group of mothers identified as at-risk for parenting difficulties (N = 343). These mothers were offered home visitation services from nine home visiting programs located across six states. Regardless of service acceptance or refusal, all mothers were interviewed within 2 weeks of the service offer and 3 months later. The findings suggest that mothers who intend to use services look substantially different from those who do not state an intention to participate in home visitation. The results indicate that lower infant birth weight and greater comfort with a provider in one\u27s home are significant predictors of maternal intentions to utilize home visiting services. The study results also support the connection between intent and behavior as the expressed intention to engage in home visitation services was a key predictor of the receipt of a visit

Synthesis, Characterization, and Cyclic Stress Influenced Degradation of a Poly(Ethylene) Glycol Based Poly(Beta-Amino Ester)

Poly(beta-amino esters) are photopolymerizable and biodegradable polymers prepared by the combination of amines with diacrylates. This study aims to fundamentally understand the polymer network formed by poly(ethylene)glycol diacrylate (PEGDA) MW 700 and 3-methoxypropylamine (3MOPA) as well as to characterize the degradation response of this material with and without cyclic loading. The networks were formed by a two-step process; (1) the synthesis of amine-co-peg diacrylate macromers through a step growth reaction, followed by (2) UV initiated chain growth network formation of the diacrylated macromers. Macromer reaction chemistry was confirmed by 1H NMR measurements. UV calorimetric analysis revealed that network formation was dependent on molecular weight of the PEGDA monomer and light intensity, but not temperature in the range of 20 °C to 40 °C. The glass transition temperature of all networks was measured to be in the range of -40 °C to -30°C with a rubbery moduli ranging from 4 to 10 MPa, depending on the molecular weight of the PEGDA monomer. Partial crystallization was discovered to occur in the networks containing higher molecular weight PEGDA only in the presence of humidity and high frequency cyclic loading. Degradation studies were performed with and without applied cyclical stress, and in both cases elastic modulus decrease and mass loss occurred steadily over a 24-hour period. Increasing frequency of applied compressive stress during degradation served to slightly lower degradation rates, especially in samples cycled at high frequency, which crystallized. In all materials, applied cyclic load resulted in catastrophic fracture of the material prior to an appreciable decrease in modulus. The experiments reveal that degradation rate and failure mode can be influenced by the addition of cyclic loading and this should be considered when screening biodegradable polymers for applications that include mechanical loading.M.S.Committee Chair: Kenneth Gall; Committee Member: Johnna Temenoff; Committee Member: Rina Tannenbau

Defining a Transformational Education Model for the Engaged University

Land-grant universities and Extension programs have recently been challenged to be more effective in engaging people and communities in participatory processes that benefit the interests of those being served. The University of Wisconsin Cooperative Extension has refined and adopted a definition of Transformational Education that is now being integrated into its approaches to community-based educational program development. Significant linkages are seen between the definition and practice of Transformational Education and the Kellogg Commission\u27s (1999) recommendations for engaged universities

The role of community in facilitating service utilization

Guided by an integrated theory of parent participation, this study examines the role community characteristics play in influencing a parent\u27s decision to use voluntary child abuse prevention programs. Multiple regression techniques were used to determine if different community characteristics, such as neighborhood distress and the community\u27s ratio of caregivers to those in need of care, predict service utilization levels in a widely available home visiting program. Our findings suggest that certain community characteristics are significant predictors of the extent to which families utilize voluntary family supports over and above the proportion of variance explained by personal characteristics and program experiences. Contrary to our initial assumptions, however, new parents living in the most disorganized communities received more home visits than program participants living in more organized communities. The article concludes with recommendations on how community capacity building might be used to improve participant retention. Copyright © by The Haworth Press, Inc. All rights reserved