Sequence stratigraphy of the Galveston South area of the Gulf of Mexico

Due to the character of the original source materials and the nature of batch digitization, quality control issues may be present in this document. Please report any quality issues you encounter to [email protected], referencing the URI of the item.Includes bibliographical references.Not availabl

Best Practices for Teaching Core Competencies to Baldrige Examiners in State Baldrige Programs

The purpose of this study was to determine the core competencies needed by state Baldrige examiners, to identify best practices in examiner training programs provided by state Baldrige organizations, and to identify best practices for teaching core competencies. A Delphi panel ranked core competencies, best practices, and best practices for teaching core competencies using a Likert-style survey. Descriptive statistics and a formula for determining consensus quantified the results. The key findings of this study were that the Baldrige Criteria for Performance Excellence continue to provide the core competencies for which examiners need to be trained to effectively evaluate and score applications and provide meaningful feedback to applicants. The best practices for teaching core competencies, however, vary according to the needs of each state organization and the expertise and teaching styles of the trainers in the various state organizations. Coaching was the one best practice upon which the panel agreed as being applicable to teaching most of the core competencies. A template for training examiners using the best practices for teaching core competencies was the outcome of this study. Recommendations include using this template to train examiners and using the actual teams, of which the examiners will be a part, for evaluating and scoring the applications from receipt of the application through the life of the application. It is recommended that the individual review of applications be eliminated. As examiners will work with the actual applications from the beginning of the process, it is recommended that the case study be eliminated as pre-work. It is also recommended that coaches work with the actual teams from the training session until the feedback report is written

Patient and physician factors associated with participation in cervical and uterine cancer trials: An NRG/GOG247 study

AbstractPurposeThe aim of this study was to identify patient and physician factors related to enrollment onto Gynecologic Oncology Group (GOG) trials.MethodsProspective study of women with primary or recurrent cancer of the uterus or cervix treated at a GOG institution from July 2010 to January 2012. Logistic regression examined probability of availability, eligibility and enrollment in a GOG trial. Odds ratios (OR) and 95% confidence intervals (CI) for significant (p<0.05) results reported.ResultsSixty institutions, 781 patients, and 150 physicians participated, 300/780 (38%) had a trial available, 290/300 had known participation status. Of these, 150 women enrolled (59.5%), 102 eligible did not enroll (35%), 38 (13%) were ineligible. Ethnicity and specialty of physician, practice type, data management availability, and patient age were significantly associated with trial availability. Patients with >4 comorbidities (OR 4.5; CI 1.7–11.8) had higher odds of trial ineligibility. Non-White patients (OR 7.9; CI 1.3–46.2) and patients of Black physicians had greater odds of enrolling (OR 56.5; CI 1.1–999.9) in a therapeutic trial. Significant patient therapeutic trial enrollment factors: belief trial may help (OR 76.9; CI 4.9–>1000), concern about care if not on trial (OR12.1; CI 2.1–71.4), pressure to enroll (OR .27; CI 0.12–.64), caregiving without pay (OR 0.13; CI .02–.84). Significant physician beliefs were: patients would not do well on standard therapy (OR 3.6; CI 1.6–8.4), and trial would not be time consuming (OR 3.3; CI 1.3–8.1).ConclusionsTrial availability, patient and physician beliefs were factors identified that if modified could improve enrollment in cancer cooperative group clinical trials

Assessing the carcinogenic potential of low-dose exposures to chemical mixtures in the environment: the challenge ahead.

Lifestyle factors are responsible for a considerable portion of cancer incidence worldwide, but credible estimates from the World Health Organization and the International Agency for Research on Cancer (IARC) suggest that the fraction of cancers attributable to toxic environmental exposures is between 7% and 19%. To explore the hypothesis that low-dose exposures to mixtures of chemicals in the environment may be combining to contribute to environmental carcinogenesis, we reviewed 11 hallmark phenotypes of cancer, multiple priority target sites for disruption in each area and prototypical chemical disruptors for all targets, this included dose-response characterizations, evidence of low-dose effects and cross-hallmark effects for all targets and chemicals. In total, 85 examples of chemicals were reviewed for actions on key pathways/mechanisms related to carcinogenesis. Only 15% (13/85) were found to have evidence of a dose-response threshold, whereas 59% (50/85) exerted low-dose effects. No dose-response information was found for the remaining 26% (22/85). Our analysis suggests that the cumulative effects of individual (non-carcinogenic) chemicals acting on different pathways, and a variety of related systems, organs, tissues and cells could plausibly conspire to produce carcinogenic synergies. Additional basic research on carcinogenesis and research focused on low-dose effects of chemical mixtures needs to be rigorously pursued before the merits of this hypothesis can be further advanced. However, the structure of the World Health Organization International Programme on Chemical Safety 'Mode of Action' framework should be revisited as it has inherent weaknesses that are not fully aligned with our current understanding of cancer biology

Global priority areas for ecosystem restoration

Extensive ecosystem restoration is increasingly seen as being central to conserving biodiversity1 and stabilizing the climate of the Earth2. Although ambitious national and global targets have been set, global priority areas that account for spatial variation in benefits and costs have yet to be identified. Here we develop and apply a multicriteria optimization approach that identifies priority areas for restoration across all terrestrial biomes, and estimates their benefits and costs. We find that restoring 15% of converted lands in priority areas could avoid 60% of expected extinctions while sequestering 299 gigatonnes of CO2—30% of the total CO2 increase in the atmosphere since the Industrial Revolution. The inclusion of several biomes is key to achieving multiple benefits. Cost effectiveness can increase up to 13-fold when spatial allocation is optimized using our multicriteria approach, which highlights the importance of spatial planning. Our results confirm the vast potential contributions of restoration to addressing global challenges, while underscoring the necessity of pursuing these goals synergistically.Fil: Strassburg, Bernardo B. N.. Pontifícia Universidade Católica do Rio de Janeiro; Brasil. Universidade Federal do Rio de Janeiro; BrasilFil: Iribarrem, Alvaro. Pontifícia Universidade Católica do Rio de Janeiro; BrasilFil: Beyer, Hawthorne L.. The University of Queensland; Australia. University of Queensland; AustraliaFil: Cordeiro, Carlos Leandro. Pontifícia Universidade Católica do Rio de Janeiro; BrasilFil: Crouzeilles, Renato. Universidade Federal do Rio de Janeiro; Brasil. Pontifícia Universidade Católica do Rio de Janeiro; BrasilFil: Jakovac, Catarina C.. Pontifícia Universidade Católica do Rio de Janeiro; BrasilFil: Braga Junqueira, André. Pontifícia Universidade Católica do Rio de Janeiro; BrasilFil: Lacerda, Eduardo. Pontifícia Universidade Católica do Rio de Janeiro; Brasil. Universidade Federal Fluminense; BrasilFil: Latawiec, Agnieszka E.. University of East Anglia; Reino Unido. Pontifícia Universidade Católica do Rio de Janeiro; BrasilFil: Balmford, Andrew. University of Cambridge; Estados UnidosFil: Brooks, Thomas M.. University Of The Philippines Los Banos; Filipinas. Institute For Marine And Antarctic Studies; Australia. International Union For Conservation Of Nature And Natural Resources; SuizaFil: Butchart, Stuart H. M.. University of Cambridge; Estados UnidosFil: Chazdon, Robin L.. University Of The Sunshine Coast; Australia. University of Connecticut; Estados UnidosFil: Erb, Karl-Heinz. Universitat Fur Bodenkultur Wien; AustriaFil: Brancalion, Pedro. Universidade de Sao Paulo; BrasilFil: Buchanan, Graeme. Royal Society For The Protection Of Birds; Reino UnidoFil: Cooper, David. Secretariat Of The Convention On Biological Diversity; CanadáFil: Díaz, Sandra Myrna. Universidad Nacional de Córdoba; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Instituto Multidisciplinario de Biología Vegetal. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Instituto Multidisciplinario de Biología Vegetal; ArgentinaFil: Donald, Paul F.. University of Cambridge; Estados UnidosFil: Kapos, Valerie. United Nations Environment Programme World Conservation Monitoring Centre; Reino UnidoFil: Leclère, David. International Institute For Applied Systems Analysis, Laxenburg; AustriaFil: Miles, Lera. United Nations Environment Programme World Conservation Monitoring Centre; Reino UnidoFil: Obersteiner, Michael. Oxford Social Sciences Division; Reino Unido. International Institute For Applied Systems Analysis, Laxenburg; AustriaFil: Plutzar, Christoph. Universitat Fur Bodenkultur Wien; Austria. Universidad de Viena; AustriaFil: de M. Scaramuzza, Carlos Alberto. International Institute For Sustainability; BrasilFil: Scarano, Fabio R.. Universidade Federal do Rio de Janeiro; BrasilFil: Visconti, Piero. International Institute For Applied Systems Analysis, Laxenburg; Austri

Microscopic Analysis and Quality Assessment of Induced Sputum From Children With Pneumonia in the PERCH Study.

BACKGROUND.: It is standard practice for laboratories to assess the cellular quality of expectorated sputum specimens to check that they originated from the lower respiratory tract. The presence of low numbers of squamous epithelial cells (SECs) and high numbers of polymorphonuclear (PMN) cells are regarded as indicative of a lower respiratory tract specimen. However, these quality ratings have never been evaluated for induced sputum specimens from children with suspected pneumonia. METHODS.: We evaluated induced sputum Gram stain smears and cultures from hospitalized children aged 1-59 months enrolled in a large study of community-acquired pneumonia. We hypothesized that a specimen representative of the lower respiratory tract will contain smaller quantities of oropharyngeal flora and be more likely to have a predominance of potential pathogens compared to a specimen containing mainly saliva. The prevalence of potential pathogens cultured from induced sputum specimens and quantity of oropharyngeal flora were compared for different quantities of SECs and PMNs. RESULTS.: Of 3772 induced sputum specimens, 2608 (69%) had 25 PMNs per LPF, measures traditionally associated with specimens from the lower respiratory tract in adults. Using isolation of low quantities of oropharyngeal flora and higher prevalence of potential pathogens as markers of higher quality, 25 PMNs per LPF) was the microscopic variable most associated with high quality of induced sputum. CONCLUSIONS.: Quantity of SECs may be a useful quality measure of induced sputum from young children with pneumonia

Avoid or Embrace? Practice Effects in Alzheimer's Disease Prevention Trials

Demonstrating a slowing in the rate of cognitive decline is a common outcome measure in clinical trials in Alzheimer’s disease (AD). Selection of cognitive endpoints typically includes modeling candidate outcome measures in the many, richly phenotyped observational cohort studies available. An important part of choosing cognitive endpoints is a consideration of improvements in performance due to repeated cognitive testing (termed “practice effects”). As primary and secondary AD prevention trials are comprised predominantly of cognitively unimpaired participants, practice effects may be substantial and may have considerable impact on detecting cognitive change. The extent to which practice effects in AD prevention trials are similar to those from observational studies and how these potential differences impact trials is unknown. In the current study, we analyzed data from the recently completed DIAN-TU-001 clinical trial (TU) and the associated DIAN-Observational (OBS) study. Results indicated that asymptomatic mutation carriers in the TU exhibited persistent practice effects on several key outcomes spanning the entire trial duration. Critically, these practice related improvements were larger on certain tests in the TU relative to matched participants from the OBS study. Our results suggest that the magnitude of practice effects may not be captured by modeling potential endpoints in observational studies where assessments are typically less frequent and drug expectancy effects are absent. Using alternate instrument forms (represented in our study by computerized tasks) may partly mitigate practice effects in clinical trials but incorporating practice effects as outcomes may also be viable. Thus, investigators must carefully consider practice effects (either by minimizing them or modeling them directly) when designing cognitive endpoint AD prevention trials by utilizing trial data with similar assessment frequencies