A Risk-Based Model Predictive Control Approach to Adaptive Interventions in Behavioral Health

This brief examines how control engineering and risk management techniques can be applied in the field of behavioral health through their use in the design and implementation of adaptive behavioral interventions. Adaptive interventions are gaining increasing acceptance as a means to improve prevention and treatment of chronic, relapsing disorders, such as abuse of alcohol, tobacco, and other drugs, mental illness, and obesity. A risk-based model predictive control (MPC) algorithm is developed for a hypothetical intervention inspired by Fast Track, a real-life program whose long-term goal is the prevention of conduct disorders in at-risk children. The MPC-based algorithm decides on the appropriate frequency of counselor home visits, mentoring sessions, and the availability of after-school recreation activities by relying on a model that includes identifiable risks, their costs, and the cost/benefit assessment of mitigating actions. MPC is particularly suited for the problem because of its constraint-handling capabilities, and its ability to scale to interventions involving multiple tailoring variables. By systematically accounting for risks and adapting treatment components over time, an MPC approach as described in this brief can increase intervention effectiveness and adherence while reducing waste, resulting in advantages over conventional fixed treatment. A series of simulations are conducted under varying conditions to demonstrate the effectiveness of the algorithm

Improving Pediatric Nurses Knowledge about Palliative Care Services

Palliative care knowledge is important for nursing staff caring for children with life-threatening and debilitating illness because it can provide comfort-based interventions to optimize their quality of life. Nurses in pediatric settings can support the patient and family by providing education and evaluate patients who can benefit from palliative care services. If nurses do not have the palliative care education to support this comfort care process, the quality of life for children with life-threatening and debilitating illness may be affected. The purpose of this DNP project was to educate pediatric nurses about pediatric palliative care standards. The educational program resulted in a documented increase in the knowledge of pediatric nurses which addresses an identified knowledge gap about the pediatric palliative care standards of practice. The overall increase in knowledge of the 10 nurses who participated in the program was 20% when the pretest scores were compared with those of the posttest. Additional educational sessions are recommended with a goal of educating 100% of the pediatric nurses at the hospital. The result of this educational program has the potential for positive social change for nurses and children with life-threatening and debilitating illness and their families. Educating nurses about the need for children with life-threatening and debilitating illness and their families to receive palliative care may empower them with knowledge they need to initiate a communication with the palliative care team

Determinants of Survival in Malignant Pleural Mesothelioma: A Surveillance, Epidemiology, and End Results (SEER) Study of 14,228 Patients

INTRODUCTION: Left untreated, malignant pleural mesothelioma (MPM) is associated with uniformly poor prognosis. Better survival has been reported with surgery-based multimodality therapy, but to date, no trial has demonstrated survival benefit of surgery over other therapies. We evaluated whether cancer-directed surgery influenced survival independently from other predictors in a large population-based dataset. METHODS: The SEER database was explored from 1973 to 2009 to identify all cases of pathologically-proven MPM. Age, sex, race, year of diagnosis, histology stage, cancer-directed surgery, radiation, and vital status were analyzed. The association between prognostic factors and survival was estimated using Cox regression and propensity matched analysis. RESULTS: There were 14,228 patients with pathologic diagnosis of MPM. On multivariable analysis, female gender, younger age, early stage, and treatment with surgery were independent predictors of longer survival. In comparison to no treatment, surgery alone was associated with significant improvement in survival [adjusted hazard ratio (adj HR) 0.64 (0.61-0.67)], but not radiation [adj HR 1.15 (1.08-1.23)]. Surgery and radiation combined had similar survival as surgery alone [adj HR 0.69 (0.64-0.76)]. Results were similar when cases diagnosed between 1973 and 1999 were compared to cases diagnosed between 2000 and 2009. CONCLUSIONS: Despite developments in surgical and radiation techniques, the prognosis for MPM patients has not improved over the past 4 decades. Cancer-directed surgery is independently associated with better survival, suggesting that multimodal surgery-based therapy can benefit these patients. Further research in adjuvant treatment is necessary to improve prognosis in this challenging disease

The effect of bathymetry interaction with waves and sea currents on the loading and thrust of a tidal turbine

This paper reports work undertaken to advance analytical methods used to evaluate the influence of bathymetry on wave- current interactions with tidal turbines. The model takes in to account the wave transformation due to a sudden depth change in the sea level. The functions developed provide solutions for wave transformation by changes in bathymetry to find how this change effects the torque and thrust exerted over a tidal turbine. Costal site data for the west coast of the US, from the US DoE, has been used to access the robustness of these analytical methods. The high resolution data sets used have monitored wave, sea and climatic conditions over a period of 8 years

Body weight impact of the sugar- sweetened beverages tax in Mexican children: A modeling study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156213/3/ijpo12636_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156213/2/ijpo12636-sup-0001-supinfo.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156213/1/ijpo12636.pd

Self-assembled cation transporters made from lipophilic 8-phenyl-2'-deoxyguanosine derivatives

We have previously reported that 8-phenyl-2'-deoxyguanosine derivatives (8PhGs) are able to extract metal cations from an aqueous phase into an organic phase. Herein, we report on the ability of 8PhGs to transport metal cations across a bulk lipophilic liquid membrane. The experiments were performed using lithium, sodium, potassium and strontium picrate salts with the parent lipophilic Gi, two isomeric 8PhG derivatives, cis-dicyclohexano-18-crown-6 (DC18C6) and [222] cryptand as reference compounds. The relative amounts of the picrate salts were measured by UV spectroscopy in both the source phase and the receiving phase over a period of 24h. The results show that the transport efficiency of the self-assembled ionophores formed by 8PhGs is either similar or superior to that of DC18C6, and in all but one case higher than the parent compound Gi. The varying efficiencies between the derivatives can be attributed to the stability (kinetic and thermodynamic) and the different molecularities of the supramolecules formed by these 8PhGs. The ease of the synthesis of 8PhGs, their anion-independent assembly and the fact that the transport efficiency can be modulated as a function of the structure of the 8PhGs bode well for the use of such compounds in the development of novel antimicrobial agents and cation-sensing devices. © 2010 Taylor & Francis

SEROPREVALENCE OF LEPTOSPIROSIS IN ALPACAS FROM QUIMSACHATA, PUNO

El objetivo del presente estudio fue determinar la seroprevalencia de leptospirosis en alpacas durante la época de lluvias (enero-marzo) en la localidad Quimsachata, Puno. Se analizaron 344 sueros de alpacas de una estación experimental del Instituto Nacional de Investigación y Extensión Agraria, mediante la prueba de microaglutinación. Se evaluó, además, la asociación de las variables sexo y edad con la reacción a la prueba. El 44.8 ± 5.3% de los animales fueron serorreactores. Los serovares detectados fueron pomona (43.6%), icterohaemorrhagiae (9.9%), y canicola (1.5%), no encontrándose ningún reactor a hardjo. No se encontró ningún suero positivo en tuis; mientras que en adultos no se encontró diferencia significativa entre sexos. Los altos títulos hallados para pomona e icterohaemorrhagiae en estos animales sugieren una infección activa durante la época de lluvia.The objective of this study was to estimate the prevalence of leptospirosis in alpacas reared in the locality of Quimsachata, Puno during the rainy season (January-March). Serum samples (n=344) of alpacas from the experimental station of the Instituto Nacional de Investigación y Extensión Agraria (INIA) were analyzed using the microaglutination test. The association of age and sex with test results was also evaluated. The overall seroprevalence was 44.8 ± 5.3%. The detected serovars were pomona (43.6%), icterohaemorrhagiae (9.9%), canicola (1.5%), and none for hardjo. Positive samples in young animals («tuis») were nil, whereas in adult animals no statistical differences was found due to sex. The high antibody titres in pomona and icterohaemorrhagiae suggested an active infection during the rainy period

PREVALENCE OF BOVINE LEPTOSPIROSIS AT TWO LOCALITIES IN PUNO DURING THE DRY SEASON AND DETERMINATION OF RISK FACTORS

La leptospirosis es una enfermedad zoonótica causada por una espiroqueta del género Leptospira, de distribución mundial que tiene gran impacto económico por las importantes pérdidas que ocasiona en la ganadería, sobre todo en la reproducción y la producción láctea, ya que tiene potencial abortivo y es causante de mortalidad neonatal, además de disminuir o anular la producción de leche. El objetivo del presente trabajo fue determinar la prevalencia de leptospirosis en bovinos en dos predios del departamento de Puno, Perú (Estación Experimental de ILLPA- INIA y Ganadería Cárdenas en la localidad de Mañazo), y su asociación con la época del año y las edad. Se recolectaron 116 muestras de sangre del total de animales de ambos predios, en la época seca. Los sueros se evaluaron mediante la Prueba de Aglutinación Microscópica (MAT) para la detección de anticuerpos, empleándose una batería de cuatro serovares (canicola, icterohaemorrhagiae, pomona y hardjo). Se obtuvo una prevalencia total de 2.6%, del cual 1.3% correspondió a animales de ILLPA-INIA y 5.3% a los animales de Mañazo. El serovar icterohaemorrhagiae fue el único prevalente con un nivel de anticuerpos de 1:200. Estos resultados sugieren una prevalencia baja de Leptospira sp en la época de seca en la zona estudiada.Leptospirosis is a disease caused by a spirochet of the genus Leptospira. It is aworld-wide zoonotic disease with a great economic impact because of the importantlosses that causes to livestock farmers, especially in terms of reproduction performanceand milk yield loses. The objective of the study was to estimate the prevalence ofleptospirosis in bovines in two farms in the department of Puno, Peru: the ILLPA-INIAExperimental Station and Cardenas farm at Mañazo and its association with season andage. One hundred and sixteen serum samples collected during the dry season wereevaluated. Blood samples were collected to all animals in both farms. The MicroscopicAgglutination Test (MAT) was used for the detection of antibodies through a set of fourserovars (canicola, icterohaemorrhagiae, pomona, and hardjo). The total prevalencewas 2.6% while 1.3% corresponded to animals at ILLPA-INIA and 5.3% to animals atMañazo. The icterohaemorrhagiae was the only prevalent serovar and the level ofantibodies was 1:200. The results suggested a low prevalence of Leptospira sp. in thedry season in the area of study

Aplicación móvil para monitoreo del arrecife mesoamericano

ITESO, A.C

Congenital hereditary endothelial dystrophy caused by SLC4A11 mutations progresses to Harboyan syndrome.

Purpose: Homozygous mutations in SLC4A11 cause 2 rare recessive conditions: congenital hereditary endothelial dystrophy (CHED), affecting the cornea alone, and Harboyan syndrome consisting of corneal dystrophy and sensorineural hearing loss. In addition, adult-onset Fuchs endothelial corneal dystrophy (FECD) is associated with dominant mutations in SLC4A11. In this report, we investigate whether patients with CHED go on to develop hearing loss and whether their parents, who are carriers of an SLC4A11 mutation, show signs of having FECD. Methods: Patients with CHED were screened for mutations in the SLC4A11 gene and underwent audiometric testing. The patients and their parents underwent a clinical examination and specular microscopy. Results: Molecular analyses confirmed SLC4A11 mutations in 4 affected individuals from 3 families. All the patients were found to have varying degrees of sensorineural hearing loss at a higher frequency range. Guttate lesions were seen in 2 of the 4 parents who were available for examination. Conclusions: Our observations suggest that CHED caused by homozygous SLC4A11 mutations progresses to Harboyan syndrome, but the severity of this may vary considerably. Patients with CHED should therefore be monitored for progressive hearing loss. We could not determine conclusively whether the parents of the patients with CHED were at increased risk of developing late-onset FECD