Evaluation of the Fragility of East Bay Municipal Utility District (EBMUD) Mokelumne Aqueduct

The East Bay Municipal Utility District provides water to the eastern region of the San Francisco Bay Area. Water is delivered through the Mokelumne Aqueduct, which consists of three large diameter steel pipelines. Approximately 15 miles of the aqueducts cross the fragile Sacramento-San Joaquin Delta. A stability analysis has been conducted to evaluate how resilient the elevated aqueduct is in the Delta. Subsidence in the Delta considerably reduces the lateral support of piles. Based on previous studies, and available survey and LiDAR data, the amount of subsidence in the Delta has been predicted over time. In addition, site-specific seismic studies have been considered in order to estimate strong ground motion parameters. A series of axial single pile analyses, lateral single pile analyses, and pile group analyses have been performed to quantify the impact of ground loss due to subsidence on pile capacities along the 15-mile alignment. Results were compared with both the maximum expected lateral load at the pile cap occurring due to seismic ground motion (base shear) and the lateral capacity at the 1-inch horizontal displacement of the pile cap (threshold). Analysis shows a significant reduction in the piles’ lateral and axial capacities, caused by lack of soil shear strength. The analytical studies are presented and discussed in order to develop retrofit alternatives

Race, Ethnicity, Socioeconomic Status, and Chronic Lung Disease in the U.S.

Background: Higher socioeconomic status (SES) indicators such as educational attainment and income reduce the risk of chronic lung diseases (CLDs) such as Chronic Obstructive Pulmonary Disease (COPD), emphysema, chronic bronchitis, and asthma. Marginalization-related Diminished Returns (MDRs) refer to smaller health benefits of high SES for marginalized populations such as racial and ethnic minorities compared to the socially privileged groups such as non-Hispanic Whites. It is still unknown, however, if MDRs also apply to the effects of education and income on CLDs. Purpose: Using a nationally representative sample, the current study explored racial and ethnic variation in the associations between educational attainment and income and CLDs among American adults.Methods: In this study, we analyzed data (n = 25,659) from a nationally representative survey of American adults in 2013 and 2014. Wave one of the Population Assessment of Tobacco and Health (PATH)-Adult study was used. The independent variables were educational attainment (less than high school = 1, high school graduate = 2, and college graduate = 3) and income (living out of poverty = 1, living in poverty = 0). The dependent variable was any CLDs (i.e., COPD, emphysema, chronic bronchitis, and asthma). Age, gender, employment, and region were the covariates. Race and ethnicity were the moderators. Logistic regressions were fitted to analyze the data. Results: Individuals with higher educational attainment and those with higher income (who lived out of poverty) had lower odds of CLDs. Race and ethnicity showed statistically significant interactions with educational attainment and income, suggesting that the protective effects of high education and income on reducing odds of CLDs were smaller for Blacks and Hispanics than for non-Hispanic Whites. Conclusions: Education and income better reduce the risk of CLDs among Whites than Hispanics and Blacks. That means we should expect disproportionately higher than expected risk of CLDs in Hispanics and Blacks with high SES. Future research should test if high levels of environmental risk factors contribute to the high risk of CLDs in high income and highly educated Black and Hispanic Americans. Policy makers should not reduce health inequalities to SES gaps because disparities sustain across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems

Diffusion-Weighted MRI: The Way Forward for MRI in Myeloma?

Multiple myeloma and other plasma cell disorders infiltrate the bone marrow in different patterns. While some patients show a homogeneous distribution of the clonal plasma cells others present with focal accumulations, commonly called focal lesions. Novel imaging techniques can provide information on these infiltration patterns and, due to their low invasiveness, can be performed repeatedly and therefore be used for monitoring. Conventional magnetic resonance imaging (MRI) has a high sensitivity for bone marrow assessment but cannot safely differentiate between active and inactive lesions. Therefore, positron emission tomography, especially combined with computed tomography (PET/CT), has been more widely used, at least for the monitoring of treatment response. Comparative, but mostly retrospective studies, have shown that functional MRI techniques, namely diffusion-weighted imaging (DWI), which assesses the movement of water molecules, can evaluate tissue cellularity with high sensitivity, which challenges the dominance of PET/CT in treatment response assessment. This review will discuss the benefits and challenges of DWI and compare it to other available imaging techniques used in patients with monoclonal plasma cell disorder

Determinants of patient satisfaction with ultrasound-assisted liposuction

Background: Liposuction is one of the most common aesthetic procedures and a number of options are available to practitioners in terms of surgical technique. One of those options is ultrasound-assisted liposuction (UAL), which has garnered considerable attention in the literature and from patients themselves. Because the role of ultrasound in body sculpting is continuing to increase over time, the authors believe that a comprehensive assessment of patient satisfaction after the procedure is essential. Currently, there are very few reports in the literature examining patient satisfaction with UAL, and to the authors' knowledge, no reports in the literature have successfully outlined the determinants and predictors of long-term satisfaction with the procedure. Objective: The authors examine the correlates and predictors of patient satisfaction after UAL. Methods: The authors conducted a prospective cross-sectional study on 609 consecutive patients who underwent UAL from 2002 to 2008. One hundred and sixty (54) out of 300 patients with whom the authors could make contact agreed to answer a standardized questionnaire regarding their overall satisfaction. Results: Nearly 80 of the patients were completely or mostly satisfied with UAL. Seventy-five percent reported that they had or would recommend UAL to others. Women (P =.009), patients who did not gain weight after their UAL procedure (P <.001), patients who were content with their body appearance (P <.001), patients whose dress sizes decreased after UAL (P =.001), and patients with confidence in their body (P <.001) showed statistically significant higher rates of satisfaction with UAL. Among these correlates, confidence in body (odds ratio OR = 24.4; 95% confidence interval CI: 6.8-83.3) and contentment with body appearance (OR = 5.5; 95% CI: 1.5-19.4) were found to be reliable independent predictors of patient satisfaction. Conclusion: Most patients were satisfied with UAL, but certain patient responses were more highly correlated with overall satisfaction than others and therefore can be considered predictors of long-term patient satisfaction with this procedure. The results of this study may provide plastic surgeons with valuable clues that can enhance preoperative planning and therefore enable further improvement of patients' satisfaction with UAL. © 2010 The American Society for Aesthetic Plastic Surgery, Inc

Urine macrophage migration inhibitory factor in pediatric systemic lupus erythematosus

We reported a series of ten patients with lupus nephritis (five patients in the relapse phase and five in the remission phase) and measured the macrophage migration inhibitory factor (MIF), an important pro-inflammatory cytokine with probable role in the pathogenesis of many inflammatory diseases, in their urine samples. MIF/creatinine (Cr) ratio directly correlated with disease activity and it does not have any significant difference between inactive disease and normal ones. We found that the urine MIF/Cr ratio not only differentiates active disease from inactive disease and normal ones but also correlates with the activity indices of renal pathology. © Clinical Rheumatology 2007

Measuring the Physiologic Properties of Oral Lesions Receiving Fractionated Photodynamic Therapy

Photodynamic therapy (PDT) can treat superficial, early‐stage disease with minimal damage to underlying tissues and without cumulative dose‐limiting toxicity. Treatment efficacy is affected by disease physiologic properties, but these properties are not routinely measured. We assessed diffuse reflectance spectroscopy (DRS) for the noninvasive, contact measurement of tissue hemoglobin oxygen saturation (StO2) and total hemoglobin concentration ([tHb]) in the premalignant or superficial microinvasive oral lesions of patients treated with 5‐aminolevulinic acid (ALA)‐PDT. Patients were enrolled on a Phase 1 study of ALA‐PDT that evaluated fluences of 50, 100, 150 or 200 J cm−2 delivered at 100 mW cm−2. To test the feasibility of incorporating DRS measurements within the illumination period, studies were performed in patients who received fractionated (two‐part) illumination that included a dark interval of 90–180 s. Using DRS, tissue oxygenation at different depths within the lesion could also be assessed. DRS could be performed concurrently with contact measurements of photosensitizer levels by fluorescence spectroscopy, but a separate noncontact fluorescence spectroscopy system provided continuous assessment of photobleaching during illumination to greater tissue depths. Results establish that the integration of DRS into PDT of early‐stage oral disease is feasible, and motivates further studies to evaluate its predictive and dosimetric value.Diffuse reflectance spectroscopy with a contact probe was employed as part of a fluorescence and reflectance spectroscopy system to measure the tissue hemoglobin oxygen saturation and hemoglobin content of lesions of premalignant or early microinvasive cancer of the oral cavity. Studies demonstrate the feasibility of incorporating these measurements into treatment with fractionated (two‐part) photodynamic therapy (PDT) using 5‐aminolevulinic acid. Patient‐specific differences in physiologic parameters were detectable at baseline and at times during and after PDT. Photobleaching of photosensitizer was measured by its fluorescence. Results establish the utility of rationally designed spectroscopy probes toward personalized dosimetry in PDT of oral disease.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/113767/1/php12475.pd