Telehealth is a Viable Alternative for the Treatment and Assessment of Home Peritoneal Dialysis, Stroke and Chronic Care and as Such Should be Reimbursable by Medicare

Telehealth has been shown as an effective method to improve access to care for rural patients who often travel long distances for their care. Medicare reimbursement however has been restricted to care provided through synchronous communication at a Medicare approved designated site. Proposed legislation that seeks to expand the use of this proven technology will offer respite to persons requiring chronic care, frequent home peritoneal dialysis as well as expedited assessment and treatment for those experiencing stroke sign and symptoms. In addition, to the improved quality of care, the cost saving associated with reduced readmissions for this population, makes it a viable option to be supported

A Petunia homeodomain-leucine zipper protein, PhHD-Zip, plays an important role in flower senescence.

Flower senescence is initiated by developmental and environmental signals, and regulated by gene transcription. A homeodomain-leucine zipper transcription factor, PhHD-Zip, is up-regulated during petunia flower senescence. Virus-induced gene silencing of PhHD-Zip extended flower life by 20% both in unpollinated and pollinated flowers. Silencing PhHD-Zip also dramatically reduced ethylene production and the abundance of transcripts of genes involved in ethylene (ACS, ACO), and ABA (NCED) biosynthesis. Abundance of transcripts of senescence-related genes (SAG12, SAG29) was also dramatically reduced in the silenced flowers. Over-expression of PhHD-Zip accelerated petunia flower senescence. Furthermore, PhHD-Zip transcript abundance in petunia flowers was increased by application of hormones (ethylene, ABA) and abiotic stresses (dehydration, NaCl and cold). Our results suggest that PhHD-Zip plays an important role in regulating petunia flower senescence

Superfluid turbulence from quantum Kelvin wave to classical Kolmogorov cascades

A novel unitary quantum lattice gas algorithm is used to simulate quantum turbulence of a BEC described by the Gross-Pitaevskii equation on grids up to 5760^3. For the first time, an accurate power law scaling for the quantum Kelvin wave cascade is determined: k^{-3}. The incompressible kinetic energy spectrum exhibits very distinct power law spectra in 3 ranges of k-space: a classical Kolmogorov k^{-5/3} spectrum at scales much greater than the individual quantum vortex cores, and a quantum Kelvin wave cascade spectrum k^{-3} on scales of order the vortex cores. In the semiclassical regime between these two spectra there is a pronounced steeper spectral decay, with non-universal exponent. The Kelvin k^{-3} spectrum is very robust, even on small grids, while the Kolmogorov k^{-5/3} spectrum becomes more and more apparent as the grids increase from 2048^3 grids to 5760^3.Comment: 4 pages, 2 figure

An assessment of the performance of the PLUS+ tool in supporting the evaluation of Water Framework Directive compliance in Scottish standing waters

Phosphorus is one of the main causes of waterbodies in Scotland being at less than good ecological status (GES) in terms of the water framework directive (WFD). In Scotland, there are more than 8000 standing waters, defined as lakes and reservoirs that have a surface area of more than 1 hectare. Only about 330 of these are monitored routinely to assess compliance with the WFD. The export coefficient tool PLUS+ (phosphorus land use and slope) has been developed to estimate total phosphorus (TP) concentrations in the unmonitored sites; modelled values are then compared to WFD target concentrations for high, good, moderate, poor, and bad status to assess compliance. These type-specific or site-specific targets are set by the regulatory authority and form part of a suite of physical, chemical, and ecological targets that are used to assess GES, all of which must be met. During development, the PLUS+ tool was applied to 323 monitored catchments and 7471 unmonitored catchments. The efficacy of the tool was assessed against TP concentrations observed in 2014 and found to perform well in the rural catchments. 51% of standing waters had the same modelled and observed WFD class (i.e., High, Good, Moderate, Poor, Bad), and a further 40% of standing waters had a modelled WFD class that was within one class of observed water quality. The tool performed less well in catchments with larger inputs of TP from urban sources (e.g., sewage). The greatest deviations between measured and modelled classes were explained by the shortage of information on wastewater treatment works, fish farms, migratory birds, levels of uncertainty in TP measurements, and the amount of in-lake re-cycling of P. The limitations of the tool are assessed using data from six well documented case study sites and recommendations for improving the model performance are propose

Effect of investigation intensity and treatment differences on prostate cancer survivor's physical symptoms, psychological well-being and health-related quality of life: a two country cross-sectional study

Aim: To investigate effects on men's health and well-being of higher prostate cancer (PCa) investigation and treatment levels in similar populations.Participants PCa survivors in Ireland where the Republic of Ireland (RoI) has a 50% higher PCa incidence than Northern Ireland (NI).Method: A cross-sectional postal questionnaire was sent to PCa survivors 2–18 years post-treatment, seeking information about current physical effects of treatment, health-related quality of life (HRQoL; EORTC QLQ-C30; EQ-5D-5L) and psychological well-being (21 question version of the Depression, Anxiety and Stress Scale, DASS-21). Outcomes in RoI and NI survivors were compared, stratifying into ‘late disease’ (stage III/IV and any Gleason grade (GG) at diagnosis) and ‘early disease’ (stage I/II and GG 2–7). Responses were weighted by age, jurisdiction and time since diagnosis. Between-country differences were investigated using multivariate logistic and linear regression.Results: 3348 men responded (RoI n=2567; NI n=781; reflecting population sizes, response rate 54%). RoI responders were younger; less often had comorbidities (45% vs 38%); were more likely to present asymptomatically (66%; 41%) or with early disease (56%; 35%); and less often currently used androgen deprivation therapy (ADT; 2%; 28%). Current prevalence of incontinence (16%) and impotence (56% early disease, 67% late disease) did not differ between RoI and NI. In early disease, only current bowel problems (RoI 12%; NI 21%) differed significantly in multivariate analysis. In late disease, NI men reported significantly higher levels of gynaecomastia (23% vs 9%) and hot flashes(41% vs 19%), but when ADT users were analysed separately, differences disappeared. For HRQoL, in multivariate analysis, only pain (early disease: RoI 11.1, NI 19.4) and financial difficulties (late disease: RoI 10.4, NI 7.9) differed significantly between countries. There were no significant between-country differences in DASS-21 or index ED-5D-5L score.Conclusions: Treatment side effects were commonly reported and increased PCa detection in RoI has left more men with these side effects. We recommended that men be offered a PSA test only after informed discussion

Effect of investigation intensity and treatment differences on prostate cancer survivor's physical symptoms, psychological well-being and health-related quality of life: a two country cross-sectional study

Aim: To investigate effects on men's health and well-being of higher prostate cancer (PCa) investigation and treatment levels in similar populations. Participants: PCa survivors in Ireland where the Republic of Ireland (RoI) has a 50% higher PCa incidence than Northern Ireland (NI). Method: A cross-sectional postal questionnaire was sent to PCa survivors 2–18 years post-treatment, seeking information about current physical effects of treatment, health-related quality of life (HRQoL; EORTC QLQ-C30; EQ-5D-5L) and psychological well-being (21 question version of the Depression, Anxiety and Stress Scale, DASS-21). Outcomes in RoI and NI survivors were compared, stratifying into ‘late disease’ (stage III/IV and any Gleason grade (GG) at diagnosis) and ‘early disease’ (stage I/II and GG 2–7). Responses were weighted by age, jurisdiction and time since diagnosis. Between-country differences were investigated using multivariate logistic and linear regression. Results: 3348 men responded (RoI n=2567; NI n=781; reflecting population sizes, response rate 54%). RoI responders were younger; less often had comorbidities (45% vs 38%); were more likely to present asymptomatically (66%; 41%) or with early disease (56%; 35%); and less often currently used androgen deprivation therapy (ADT; 2%; 28%). Current prevalence of incontinence (16%) and impotence (56% early disease, 67% late disease) did not differ between RoI and NI. In early disease, only current bowel problems (RoI 12%; NI 21%) differed significantly in multivariate analysis. In late disease, NI men reported significantly higher levels of gynaecomastia (23% vs 9%) and hot flashes(41% vs 19%), but when ADT users were analysed separately, differences disappeared. For HRQoL, in multivariate analysis, only pain (early disease: RoI 11.1, NI 19.4) and financial difficulties (late disease: RoI 10.4, NI 7.9) differed significantly between countries. There were no significant between-country differences in DASS-21 or index ED-5D-5L score. Conclusions: Treatment side effects were commonly reported and increased PCa detection in RoI has left more men with these side effects. We recommended that men be offered a PSA test only after informed discussion

Rebecca Fillyaw MS Thesis Data for Publication in the Journal Sustainability

By combatting erosion and increasing habitat, mangrove living shorelines are an effective alternative to hard-armoring in tropical and subtropical areas. An experimental red mangrove living shoreline was deployed within Mosquito Lagoon, Florida, using a factorial design to test the impact of mangrove age, breakwater presence, and mangrove placement on mangrove survival within the first year of deployment. Mixed mangrove age treatments were included to identify if seedling (11-month-old) survival could be enhanced by the presence of transitional (23-month-old) and adult (35 to 47-month-old) mangroves. Environmental factors were monitored to detect possible causes of mangrove mortalities. Approximately half (50.6%) of mangroves died, and of those, 90.7% occurred within the annual high-water season, and 88.9% showed signs of flooding stress. Planting seedlings haphazardly among older mangroves did not attenuate enough wave energy to significantly increase seedling survival. Breakwaters alleviated stress through the reduction of water velocity and wave height, increasing the odds of survival by 197% and 437% when mangroves were planted in the landward and seaward rows, respectively. Compared to seedlings, deployment of adult mangroves increased survival odds by 1,087%. Collectively, our results indicate that sites with a high-water season should utilize a breakwater structure and mangroves with a woody stem

The Vector Population Monitoring Tool (VPMT): High-Throughput DNA-Based Diagnostics for the Monitoring of Mosquito Vector Populations

Regular monitoring of mosquito vector populations is an integral component of most vector control programmes. Contemporary data on mosquito species composition, infection status, and resistance to insecticides are a prerequisite for effective intervention. For this purpose we, with funding from the Innovative Vector Control Consortium (IVCC), have developed a suite of high-throughput assays based on a single “closed-tube” platform that collectively comprise the “Vector Population Monitoring Tool” (VPMT). The VPMT can be used to screen mosquito disease vector populations for a number of traits including Anopheles gambiae s.l. and Anopheles funestus species identification, detection of infection with Plasmodium parasites, and identification of insecticide resistance mechanisms. In this paper we focus on the Anopheles-specific assays that comprise the VPMT and include details of a new assay for resistance todieldrin Rdl detection. The application of these tools, general and specific guidelines on their use based on field testing in Africa, and plans for further development are discussed