Centerscope

Centerscope, formerly Scope, was published by the Boston University Medical Center "to communicate the concern of the Medical Center for the development and maintenance of improved health care in contemporary society.

Roses At Twilight

https://digitalcommons.library.umaine.edu/mmb-vp/6489/thumbnail.jp

Bankcard\u27s Revenge: A Critique of the 1984 Consumer Credit Amendments to the Bankruptcy Code

Virtually from the enactment of the Bankruptcy Code in 1978, creditors attempted to roll back what they perceived to be the Code\u27s undue bias toward bankrupts. The Code was branded a debtor\u27s paradise practically beckoning borrowers to shed their debts painlessly and needlessly. It was certainly true that the number of bankruptcy filings rose substantially during the late 1970\u27s and early 1980\u27s, and that some creditors attributed at least some of this to the Code\u27s presumed generosity. Whether the Code actually caused any of the increase in filings is, to put it mildly, controversial. Other factors, most significantly the general economic malaise of the past fifteen years, undoubtedly played a far larger role. Yet the perception that the Code was little more than a charter for deadbeats was not entirely baseless. It was, at least in theory, possible for some debtors to use the Code to shed debts which they were able to pay without hardship

Determination of possible vision changes following osteopathic cranial manipulation

Many patients and practitioners of manipulative therapies have reported anecdotal incidences of visual changes following manipulations of various kinds, from chiropractic to craniosacral therapy to osteopathic cranial manipulation. There is a general lack of research into whether these changes actually do occur and, if they do, what is their nature and extent. There are many documented case studies of these visual changes, often improvements, in the literature. These case studies inspired us to undertake this study, to try to document any visual changes following osteopathic cranial manipulation. An OD thesis by two of our predecessors at Pacific University College of Optometry researched the pertinent literature, both published and unpublished, concerning visual changes following cranial manipulation. The purpose of this study is to build upon this previous literature research by giving a series of visual tests to a group of normal subjects before osteopathic cranial manipulation and then repeating these same vision tests after the treatments to document any possible changes in an objective manner. The two optometric examiners were blinded as to what the osteopathic evaluation and treatment was for each subject to minimize prejudice in the optometric data gathering. The study showed that, at least for this group of 20 normal subjects, there was no statistically significant visual improvement following osteopathic cranial manipulation as measured by the optometric tests that were performed. However, some of the individual subjects reported subjective beneficial visual improvement. Because of this, more research is needed with a group of subjects who have had traumatic brain injury or spinal injury

Mode-routed fiber-optic add-drop filter

New elements mode-converting two-mode grating and mode-filtering two-mode coupler are disclosed and used as elements in a system for communications, add-drop filtering, and strain sensing. Methods of fabrication for these new two-mode gratings and mode-filtering two-mode couplers are also disclosed

Bostonia. Volume 3

Founded in 1900, Bostonia magazine is Boston University's main alumni publication, which covers alumni and student life, as well as university activities, events, and programs

Using evidence, expert opinion and epidemiological model to understand pathways to survival and mortality:The Pathways to Survival (PATHS) Tool

BACKGROUND: The reasons why episodes of illness can lead to fatal outcomes in affected persons in low resource settings are numerous and complex. A tool that allows policy makers to better understand those complexities could be useful to improve success of programmes that are implemented globally to reduce mortality. METHODS: We developed a “Pathways to Survival” (PATHS) tool: an epidemiological model using decision trees, available evidence and expert opinion. PATHS visualises the “architecture” of mortality in the population by following the entire population cohort over a certain period of time. It explains how initially healthy persons progress through health systems to lethal outcomes at the end of the specified time period. We developed an illustrative example based on the 136 million newborns and an estimated 907 000 deaths from newborn sepsis in the year 2008. This allowed us to develop an epidemiological model that described pathways to deaths from neonatal sepsis globally in 2010. RESULTS: The model described the “status quo’ situation in 2010 with 907 000 deaths to allow an assessment of the potential impact and feasibility of different interventions and programmes at various level of health systems in reducing this cause of mortality. A useful model should incorporate both a ‘horizontal’ and a ‘vertical’ component. The ‘horizontal’ would track the progress of all neonates globally through time, ie, their first 28 days of life, and separate them into different ‘pathways’ every time a change in their risk of dying from neonatal infection occurs because of their specific contextual circumstances. The ‘vertical’ would track their position within the health systems of their countries and separate them into different categories based on the ability of health system to intervene and reduce their risk of dying. Based on those requirements, PATHS tool was developed which is based on decision trees where different “branches” of the trees are associated with varying case-fatality rates. CONCLUSIONS: The application of the PATHS tool on the example of newborn sepsis revealed that novel diagnostic tests could save many lives, so we should continue to invest in them to improve their validity, deliverability and affordability. However, PATHS showed that investments in better diagnostics have limited impact unless they are coupled with improvements of the context. Programs for parental education improve compliance and care seeking. Promoting legislation change to empower community health workers (CHWs) to actively engage in prevention, diagnosis and care also makes a difference, as well as programs for training CHWs to use diagnostic tests and administer treatments correctly. Care-seeking behaviour can also be improved through programs of conditional cash transfers. Finally, PATHS demonstrated that improving access to primary and secondary health care for everyone is the most powerful contextual change

mHealth Series:mHealth project in Zhao County, rural China - Description of objectives, field site and methods

BACKGROUND: We set up a collaboration between researchers in China and the UK that aimed to explore the use of mHealth in China. This is the first paper in a series of papers on a large mHealth project part of this collaboration. This paper included the aims and objectives of the mHealth project, our field site, and the detailed methods of two studies. FIELD SITE: The field site for this mHealth project was Zhao County, which lies 280 km south of Beijing in Hebei Province, China. METHODS: We described the methodology of two studies: (i) a mixed methods study exploring factors influencing sample size calculations for mHealth–based health surveys and (ii) a cross–over study determining validity of an mHealth text messaging data collection tool. The first study used mixed methods, both quantitative and qualitative, including: (i) two surveys with caregivers of young children, (ii) interviews with caregivers, village doctors and participants of the cross–over study, and (iii) researchers’ views. We combined data from caregivers, village doctors and researchers to provide an in–depth understanding of factors influencing sample size calculations for mHealth–based health surveys. The second study, a cross–over study, used a randomised cross–over study design to compare the traditional face–to–face survey method to the new text messaging survey method. We assessed data equivalence (intrarater agreement), the amount of information in responses, reasons for giving different responses, the response rate, characteristics of non–responders, and the error rate. CONCLUSIONS: This paper described the objectives, field site and methods of a large mHealth project part of a collaboration between researchers in China and the UK. The mixed methods study evaluating factors that influence sample size calculations could help future studies with estimating reliable sample sizes. The cross–over study comparing face–to–face and text message survey data collection could help future studies with developing their mHealth tools

Deriving mesoscopic models of collective behaviour for finite populations

Animal groups exhibit emergent properties that are a consequence of local interactions. Linking individual-level behaviour to coarse-grained descriptions of animal groups has been a question of fundamental interest. Here, we present two complementary approaches to deriving coarse-grained descriptions of collective behaviour at so-called mesoscopic scales, which account for the stochasticity arising from the finite sizes of animal groups. We construct stochastic differential equations (SDEs) for a coarse-grained variable that describes the order/consensus within a group. The first method of construction is based on van Kampen's system-size expansion of transition rates. The second method employs Gillespie's chemical Langevin equations. We apply these two methods to two microscopic models from the literature, in which organisms stochastically interact and choose between two directions/choices of foraging. These `binary-choice' models differ only in the types of interactions between individuals, with one assuming simple pair-wise interactions, and the other incorporating higher-order effects. In both cases, the derived mesoscopic SDEs have multiplicative, or state-dependent, noise. However, the different models demonstrate the contrasting effects of noise: increasing order in the pair-wise interaction model, whilst reducing order in the higher-order interaction model. Although both methods yield identical SDEs for such binary-choice, or one-dimensional, systems, the relative tractability of the chemical Langevin approach is beneficial in generalizations to higher-dimensions. In summary, this book chapter provides a pedagogical review of two complementary methods to construct mesoscopic descriptions from microscopic rules and demonstrates how resultant multiplicative noise can have counter-intuitive effects on shaping collective behaviour.Comment: Second version, 4 figures, 2 appendice

Human genomic Z-DNA segments probed by the Zα domain of ADAR1

Double-stranded DNA is a dynamic molecule that adopts different secondary structures. Experimental evidence indicates Z-DNA plays roles in DNA transactions such as transcription, chromatin remodeling and recombination. Furthermore, our computational analysis revealed that sequences with high Z-DNA forming potential at moderate levels of DNA supercoiling are enriched in human promoter regions. However, the actual distribution of Z-DNA segments in genomes of mammalian cells has been elusive due to the unstable nature of Z-DNA and lack of specific probes. Here we present a first human genome map of most stable Z-DNA segments obtained with A549 tumor cells. We used the Z-DNA binding domain, Zα, of the RNA editing enzyme ADAR1 as probe in conjunction with a novel chromatin affinity precipitation strategy. By applying stringent selection criteria, we identified 186 genomic Z-DNA hotspots. Interestingly, 46 hotspots were located in centromeres of 13 human chromosomes. There was a very strong correlation between these hotspots and high densities of single nucleotide polymorphism. Our study indicates that genetic instability and rapid evolution of human centromeres might, at least in part, be driven by Z-DNA segments. Contrary to in silico predictions, however, we found that only two of the 186 hotspots were located in promoter regions