African-American mitochondrial DNAs often match mtDNAs found in multiple African ethnic groups

BACKGROUND: Mitochondrial DNA (mtDNA) haplotypes have become popular tools for tracing maternal ancestry, and several companies offer this service to the general public. Numerous studies have demonstrated that human mtDNA haplotypes can be used with confidence to identify the continent where the haplotype originated. Ideally, mtDNA haplotypes could also be used to identify a particular country or ethnic group from which the maternal ancestor emanated. However, the geographic distribution of mtDNA haplotypes is greatly influenced by the movement of both individuals and population groups. Consequently, common mtDNA haplotypes are shared among multiple ethnic groups. We have studied the distribution of mtDNA haplotypes among West African ethnic groups to determine how often mtDNA haplotypes can be used to reconnect Americans of African descent to a country or ethnic group of a maternal African ancestor. The nucleotide sequence of the mtDNA hypervariable segment I (HVS-I) usually provides sufficient information to assign a particular mtDNA to the proper haplogroup, and it contains most of the variation that is available to distinguish a particular mtDNA haplotype from closely related haplotypes. In this study, samples of general African-American and specific Gullah/Geechee HVS-I haplotypes were compared with two databases of HVS-I haplotypes from sub-Saharan Africa, and the incidence of perfect matches recorded for each sample. RESULTS: When two independent African-American samples were analyzed, more than half of the sampled HVS-I mtDNA haplotypes exactly matched common haplotypes that were shared among multiple African ethnic groups. Another 40% did not match any sequence in the database, and fewer than 10% were an exact match to a sequence from a single African ethnic group. Differences in the regional distribution of haplotypes were observed in the African database, and the African-American haplotypes were more likely to match haplotypes found in ethnic groups from West or West Central Africa than those found in eastern or southern Africa. Fewer than 14% of the African-American mtDNA sequences matched sequences from only West Africa or only West Central Africa. CONCLUSION: Our database of sub-Saharan mtDNA sequences includes the most common haplotypes that are shared among ethnic groups from multiple regions of Africa. These common haplotypes have been found in half of all sub-Saharan Africans. More than 60% of the remaining haplotypes differ from the common haplotypes at a single nucleotide position in the HVS-I region, and they are likely to occur at varying frequencies within sub-Saharan Africa. However, the finding that 40% of the African-American mtDNAs analyzed had no match in the database indicates that only a small fraction of the total number of African haplotypes has been identified. In addition, the finding that fewer than 10% of African-American mtDNAs matched mtDNA sequences from a single African region suggests that few African Americans might be able to trace their mtDNA lineages to a particular region of Africa, and even fewer will be able to trace their mtDNA to a single ethnic group. However, no firm conclusions should be made until a much larger database is available. It is clear, however, that when identical mtDNA haplotypes are shared among many ethnic groups from different parts of Africa, it is impossible to determine which single ethnic group was the source of a particular maternal ancestor based on the mtDNA sequence

Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review

<p>Abstract</p> <p>Background</p> <p>The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations).</p> <p>Methods</p> <p>We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes.</p> <p>Results</p> <p>Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported.</p> <p>Conclusions</p> <p>A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.</p

Computerized clinical decision support systems for drug prescribing and management: A decision-maker-researcher partnership systematic review

<p>Abstract</p> <p>Background</p> <p>Computerized clinical decision support systems (CCDSSs) for drug therapy management are designed to promote safe and effective medication use. Evidence documenting the effectiveness of CCDSSs for improving drug therapy is necessary for informed adoption decisions. The objective of this review was to systematically review randomized controlled trials assessing the effects of CCDSSs for drug therapy management on process of care and patient outcomes. We also sought to identify system and study characteristics that predicted benefit.</p> <p>Methods</p> <p>We conducted a decision-maker-researcher partnership systematic review. We updated our earlier reviews (1998, 2005) by searching MEDLINE, EMBASE, EBM Reviews, Inspec, and other databases, and consulting reference lists through January 2010. Authors of 82% of included studies confirmed or supplemented extracted data. We included only randomized controlled trials that evaluated the effect on process of care or patient outcomes of a CCDSS for drug therapy management compared to care provided without a CCDSS. A study was considered to have a positive effect (<it>i.e.</it>, CCDSS showed improvement) if at least 50% of the relevant study outcomes were statistically significantly positive.</p> <p>Results</p> <p>Sixty-five studies met our inclusion criteria, including 41 new studies since our previous review. Methodological quality was generally high and unchanged with time. CCDSSs improved process of care performance in 37 of the 59 studies assessing this type of outcome (64%, 57% of all studies). Twenty-nine trials assessed patient outcomes, of which six trials (21%, 9% of all trials) reported improvements.</p> <p>Conclusions</p> <p>CCDSSs inconsistently improved process of care measures and seldomly improved patient outcomes. Lack of clear patient benefit and lack of data on harms and costs preclude a recommendation to adopt CCDSSs for drug therapy management.</p

Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to 300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m 2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Valorisation of Biowastes for the Production of Green Materials Using Chemical Methods

With crude oil reserves dwindling, the hunt for a sustainable alternative feedstock for fuels and materials for our society continues to expand. The biorefinery concept has enjoyed both a surge in popularity and also vocal opposition to the idea of diverting food-grade land and crops for this purpose. The idea of using the inevitable wastes arising from biomass processing, particularly farming and food production, is, therefore, gaining more attention as the feedstock for the biorefinery. For the three main components of biomass—carbohydrates, lipids, and proteins—there are long-established processes for using some of these by-products. However, the recent advances in chemical technologies are expanding both the feedstocks available for processing and the products that be obtained. Herein, this review presents some of the more recent developments in processing these molecules for green materials, as well as case studies that bring these technologies and materials together into final products for applied usage

El Rey, que Dios guarde : se ha servido señalar ... el jueves diez y seis del corriente mes de mayo de mil ochocientos veinte y dos para la primera corrida de toros, de las concedidas por S. M. en el Real Sitio de Aranjuez

Texto del cartel: "Los diez toros de todo el dia serán: siete de la muy acreditada vacada de don Manuel Bañuelos Rodriguez, vecino de Colmenar Viejo, con divisa azul turquí; y tres de la de don Manuel de Aléas, de la propia vecindad, con á azul y blanca ... Por la mañana picarán los cuatro toros Francisco Ortiz y José Hernandez. Por la tarde lo ejecutarán á los seis restantes, Cristóbal Ortiz y Juan Marchena, Clavellino ... serán lidiados y banderilleados por las cuadrillas de á pie, al cuidado de Juan León, y José Antonio Baden ... La corrida se empezará por la mañana á las diez, y por la tarde á las cuatro ... "Año tomado de la fecha de celebración de la corridaTipografía en tinta negra sobre papel blancoTexto enmarcado con orla tipográfic

Plaza de Toros de Madrid : Beneficencia : año 1912 : Corrida Extraordinaria que á favor del Hospital Provincial de esta Corte Se verificará (si el tiempo no lo impide) el domingo 7 de Abril de 1912 ..."

Texto del cartel: "Bajo la Presidencia de la Autoridad competente se lidiarán OCHO TOROS CUATRO, con divisa encarnada y negra, de la muy acreditada ganadería de MURUBE y CUATRO, con encarnada y azul, de la no menos acreditad del Excelentísimo Sr. Conde de SANTA COLOMA[.] De la lidia de estos ocho toros están encargados los célebres matadores Antonio Fuentes, Vicente Pastor, Manuel Rodríguez (Manolete) y Rodolfo Gaona ... La Banda de música del Hospicio amenizará la fiesta ejecutando escogidas piezas musicales ...""Picadores ... José Carriles y Cipriano Moreno; Francisco Codes (Melones) y Bautista Santonja (Artillero); Manuel de la Haba (Zurito) y Rafael Márquez (Mazzantini); Manuel Fernández (Chanito) y Antonio Chaves (Camero) ..." ; Banderilleros ... José González (Gonzalito), Enrique Pérez (Perdigón) y Manuel González (Recarcao); Emilio Moreno (Morenito de Valencia), José Balbastre (Pepín de Valencia) y Ramón Arango (Aranguito); Manuel S. León (Cantimplas), Francisco González (Chiquilín), Rafael de Dios (Conejito) y Fernando Díaz (Mancheguito); Ulpiano Vega (Veguita), Antonio Ganga (El Trallero) y Elías Labrador (Pinturas). Puntilleros ... Manuel Navidad Illana, Francisco Torrijos (Pepín) y Fernando Díaz (Mancheguito) ...""SS. MM. y AA. RR. honrarán con su presencia el espectáculo""La corrida empezará á las CUATRO en punto""El servicio será de lujo, y los lidiadores lucirán sus mejores y más vistosos trajes ... La Plaza estará artística y profusamente adornada por el Excmo. Ayuntamiento, según tradicional costumbre."En el pie de imprenta: "Madrid ... R. Velasco, impresor, Marqués de Santa Ana, 11 duplicado ... Teléfono 551"Texto inserto en el grabado profusamente decorado firmado por A. Ciarán (fotograbado) y "E. Barruso 1912" (firma autógrafa)Tipografía en tinta negra estampada sobre seda amarillaCabecera con título e ilustración en la que figura en el centro escudo de la Diputación Provincial de Madrid. A ambos lados, a la izquierda, una cabeza de toro, y a la derecha, tres jóvenes en un balcón con mantilla y abanico, una de ellas. Dos personajes masculinos aparecen debajo con sombrero de ala ancha. Todos miran al torero con verónica y en actitud de torear, a sus pies, instrumentos taurinos y musicales que decoran toda la parte inferior y también el lado izquierdo del cartel. Motivos florales alternativo

Plaza de Toros de Madrid : corrida extraordinaria de Beneficencia á favor del Hospital Provincial de esta Corte para el día 28 de octubre de 1898 ...

Texto del cartel: "Orden del espectáculo [:] los inteligentes aficionados D. Antonio Fernández de Heredia y D. Rafael Rodil ... rejonearán dos toros ... Ocho toros de la renombrada ganadería del ... Sr. D. Eduardo Ibarra vecino de Sevilla con divisa azul y caña ... Espadas [:] Rafael Bejarano (Torerito), Antonio Moreno (Lagartijo), Emilio Torres (Bombita) y Domingo del Campo (Dominguín) que alternará por primera vez en esta Plaza como matador de toros ... La corrida empezará a las dos en punto"Año tomado de la fecha de celebración de la corridaReproducción fototipografía en tinta negra estampada sobre seda rojaTexto inserto en la ilustraciónCartel dibujado por V. Ordozgoiti (V. Ordozgoiti dº y lº) y fotograbado por A Ciarán ("A. Ciaran fto"). Rodean al texto, incluido en banderola, cuatro escenas diferentes enmarcadas, que representan de arriba a abajo, una habitación de hospital, el escudo de la Diputación Provincial de Madrid sostenido por dos pajes, tres damas en un palco cuyo marco es una pandereta y escena de toros bravos en el campo. Todo el conjunto figura dentro de una estructura de tipo arquitectónic

Instruccion de lo que deben practicar los pretendientes a plaza en el Real Colegio de Caballeros Cadetes del Real Cuerpo de Artilleria para lograr su admision en él

Signatura: A7Portada con grabado xilográfic