Diatoms in Castor Lake (North-Central Washington, USA) – Proxies of Climate and Hydrologic Variation

This research provides a high temporal resolution (1 sample / 2-3 years) record of hydrologic variation for the last 2,000 years using a lake sediment record from Castor Lake, a closed-basin system in Washington, USA. The core was dated using 137Cs, 14C, and tephrochronology. Approximately 600 diatoms were identified and enumerated in 198 samples from a Castor Lake freeze core and Livingstone-piston core. A diatom-inference model for salinity was applied to reconstruct fossil diatom salinity. Diatom-inferred salinity for the last century tracked Palmer Drought Severity Index, indicating diatom community composition tracks effective moisture and can be used to infer past hydrologic change. The 2000-year record of salinity from Castor Lake shows that during the Medieval Climate Anomaly (800-1300 AD) Castor Lake experienced cooler, wetter conditions than during the Little Ice Age (1400-1850 AD), which is opposite to what has been reported for the US southwest. These findings are consistent with a wet Pacific Northwest and a dry southwest recorded during La Niña and cool Pacific Decadal Oscillation (PDO) phases. Although these suggest a link to sea surface temperatures, diatom-inferred salinity was only related to proxy records of the PDO for the period between 1000 and 1500 AD. This indicates that other forcing mechanisms could also be important to controlling effective moisture at Castor Lake

Republican States Bolstered Their Health Insurance Rate Review Programs Using Incentives From the Affordable Care Act.

The Affordable Care Act (ACA) included financial and regulatory incentives and goals for states to bolster their health insurance rate review programs, increase their anticipated loss ratio requirements, expand Medicaid, and establish state-based exchanges. We grouped states by political party control and compared their reactions across these policy goals. To identify changes in states rate review programs and anticipated loss ratio requirements in the individual and small group markets since the ACAs enactment, we conducted legal research and contacted each states insurance regulator. We linked rate review program changes to the Centers for Medicare and Medicaid Services (CMS) criteria for an effective rate review program. We found, of states that did not meet CMSs criteria when the ACA was enacted, most made changes to meet those criteria, including Republican-controlled states, which generally oppose the ACA. This finding is likely the result of the relatively low administrative burden associated with reviewing health insurance rates and the fact that doing so prevents federal intervention in rate review. However, Republican-controlled states were less likely than non-Republican-controlled states to increase their anticipated loss ratio requirements to align with the federal retrospective medical loss ratio requirement, expand Medicaid, and establish state-based exchanges, because of their general opposition to the ACA. We conclude that federal incentives for states to strengthen their health insurance rate review programs were more effective than the incentives for states to adopt other insurance-related policy goals of the ACA

Overcoming challenges: Going mobile with your own video models.

This is the publisher's version, also found here: http://cec.metapress.com/content/xtv27p4270444543/?p=368d1858244d4b8d957b1ecaf7e99f37&pi=

Preschool development of coloured children in Cape Town

Developmental screening was applied during infancy to a birth cohort of 1 000 coloured infants born consecutively in Cape Town. The developmental progress of a sample of 187 children randomly selected from the cohort was followed over a period of 5 years. The value of the use of developmental screening is questioned, since 4 of the children in the cohort with major handicap had been diagnosed before the first screening was carried out and a 5th child with deafness was not detected by the screening process.Developmental milestones were similar to those studies reported in the literature. At 12 months the development correlated best with family stability. Language development at 30 months was associated with mother's education and family stability and reflected a general lag in verbal skills. By 5 years there was a good correlation between development and social indicators, particularly income and mother's education

Which electronic health record system should we use? A systematic review

The UK government had intended to introduce a comprehensive EHRs system in England by 2020. These EHRs would run across primary, secondary, and social care linking data in a single digital platform. This systematic review's objectives were to identify studies that compare EHRs in terms of direct comparison between systems and evaluate them using System and Software Quality Requirements and Evaluation (SQuaRE) ISO/IEC 25010. A systematic review was performed by searching EMBASE and Ovid MEDLINE databases between 1974 and April 2021. All original studies that appraised EHR systems and their providers were included. The main outcome measures were EHR system comparison and SQuaRE's eight characteristics: functional suitability, performance efficiency, compatibility, usability, reliability, security, maintainability, and portability. A total of 724 studies were identified using the search criteria. After review of titles and abstracts, this was filtered down to 40 studies as per exclusion and inclusion criteria set out in our study selection. Seven studies compared more than one EHR. The following number of studies looked at the various aspects of the SQuaRE respectively. Nineteen studies addressed functional suitability, n=18 performance efficiency, n=12 compatibility, n=25 usability, n=6 reliability, n=2 security, n=16 maintainability, and n=13 portability. Epic was the most studied EHR system and one of the most implemented vendors in the USA market, and one of the top ten in UK. It is difficult to assess which is the most advantageous EHR system currently available when looking at them in accordance with SQuaRE's eight characteristics for software evaluation

Immunizations with pneumococcal surface protein A and pneumolysin are protective against pneumonia in a murine model of pulmonary infection with Streptococcus pneumoniae

Intranasal infection of mice with certain strains of capsular group 19 Streptococcus pneumoniae can result in focal pneumonia in the absence of bacteremia. Using this model of murine pneumonia, we demonstrated that immunization with recombinant forms of either pneumococcal surface protein A (PspA) or PdB (a genetically detoxified derivative of pneumolysin) elicited significant protection against focal pulmonary infection. This may be the first demonstration that a proposed vaccine antigen can protect against pneumococcal pneumonia. The best protection was obtained by immunizing mice with a mixture of PspA and PdB, indicating that the protection elicited by these antigens can complement each other. This result is in agreement with previous studies that used pneumococcal sepsis and nasal colonization models and demonstrate that the best protein vaccines for prevention of infection may be those that include more than one protection-eliciting pneumococcal protein.David E. Briles, Susan K. Hollingshead, James C. Paton, Edwin W. Ades, Lea Novak, Frederik W. van Ginkel, and William H. Benjamin, Jr

Immunizations with pneumococcal surface protein A and pneumolysin are protective against pneumonia in a murine model of pulmonary infection with Streptococcus pneumoniae

Intranasal infection of mice with certain strains of capsular group 19 Streptococcus pneumoniae can result in focal pneumonia in the absence of bacteremia. Using this model of murine pneumonia, we demonstrated that immunization with recombinant forms of either pneumococcal surface protein A (PspA) or PdB (a genetically detoxified derivative of pneumolysin) elicited significant protection against focal pulmonary infection. This may be the first demonstration that a proposed vaccine antigen can protect against pneumococcal pneumonia. The best protection was obtained by immunizing mice with a mixture of PspA and PdB, indicating that the protection elicited by these antigens can complement each other. This result is in agreement with previous studies that used pneumococcal sepsis and nasal colonization models and demonstrate that the best protein vaccines for prevention of infection may be those that include more than one protection-eliciting pneumococcal protein.David E. Briles, Susan K. Hollingshead, James C. Paton, Edwin W. Ades, Lea Novak, Frederik W. van Ginkel, and William H. Benjamin, Jr

Distinct Roles for Aryl Hydrocarbon Receptor Nuclear Translocator and Ah Receptor in Estrogen-Mediated Signaling in Human Cancer Cell Lines

The activated AHR/ARNT complex (AHRC) regulates the expression of target genes upon exposure to environmental contaminants such as 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Importantly, evidence has shown that TCDD represses estrogen receptor (ER) target gene activation through the AHRC. Our data indicates that AHR and ARNT act independently from each other at non-dioxin response element sites. Therefore, we sought to determine the specific functions of AHR and ARNT in estrogen-dependent signaling in human MCF7 breast cancer and human ECC-1 endometrial carcinoma cells. Knockdown of AHR with siRNA abrogates dioxin-inducible repression of estrogen-dependent gene transcription. Intriguingly, knockdown of ARNT does not effect TCDD-mediated repression of estrogen-regulated transcription, suggesting that AHR represses ER function independently of ARNT. This theory is supported by the ability of the selective AHR modulator 3′,4′-dimethoxy-α-naphthoflavone (DiMNF) to repress estrogen-inducible transcription. Furthermore, basal and estrogen-activated transcription of the genes encoding cathepsin-D and pS2 are down-regulated in MCF7 cells but up-regulated in ECC-1 cells in response to loss of ARNT. These responses are mirrored at the protein level with cathepsin-D. Furthermore, knock-down of ARNT led to opposite but corresponding changes in estrogen-stimulated proliferation in both MCF7 and ECC-1 cells. We have obtained experimental evidence demonstrating a dioxin-dependent repressor function for AHR and a dioxin-independent co-activator/co-repressor function for ARNT in estrogen signalling. These results provide us with further insight into the mechanisms of transcription factor crosstalk and putative therapeutic targets in estrogen-positive cancers