COLLEGE STUDENT ALCOHOL USE: USING CURRENT RESEARCH TO GUIDE PRACTICE

Alcohol abuse has been described as the biggest health problem on college campuses today.This single statement illustrates the public health relevance of addressing college student alcohol use. College student alcohol use affects everyone on a college campus, not only the student who uses or abuses alcohol. The author of this paper is currently an employee of the University of Pittsburgh's Student Health Services. As a graduate student assistant, she has facilitated the Personal Education Assistance and Referral (PEAR) program to over 250 students. The goals of this paper are to provide an understanding of background information surrounding college student alcohol use, to critically examine three major reports and two ongoing studies and to specifically elaborate on the goals created by the Surgeon General's Call to Action to Prevent and Reduce Underage Drinking. This paper concludes with recommendations consisting of prevention and intervention strategies as well as environmental changes that are evidence-based

Development of Clinical Prediction Models for Surgery and Complications in Crohn’s Disease

Background and Objective: Crohn’s disease (CD)-related complications account for a substantial proportion of IBD-related healthcare expenditure. Identifying patients at risk for complications may allow for targeted use of early therapeutic interventions to alter this natural course. The objective of this project was to develop risk prediction models of CD-related surgery and complications. Methods: Using data from the REACT cluster-randomized clinical trial (N=1898 from 41 community practices), prediction models were developed and internally validated for CD-related surgery and CD-related complications, defined as the first CD-related surgery, hospitalization or complication within 24 months. Performance of each model was assessed in terms of discrimination and calibration, as well as decision curves and net benefit analyses. Results: There were 130 (6.8%) CD-related surgeries and 504 (26.6%) CD-related complications during the 24-month follow-up period. Selected baseline predictors for predicting surgery included age, gender, disease location, HBI score, stool frequency, antimetabolite or 5-aminosalicylates use, and the presence of a fistula, abscess or abdominal mass. Selected predictors of complications included those same factors for surgery, corticosteroid and TNF-antagonist use and excluded 5-aminosalicylate use. The discrimination ability, as measured by optimism-corrected c-statistic, was 0.70 for the surgery model, and 0.62 for the complication model. Score charts and nomograms were developed to facilitate future risk score calculation. Conclusions: Risk prediction models for CD-related surgery and CD-related complications were developed using clinical trial data involving community gastroenterology practices. These models need to be externally validated before being used to guide management of CD

You Can\u27t Go Home Again: A Reluctant Return to Traditional Gender Roles in Post-Reunification Germany

As unemployment rates rapidly rose during the immediate post-reunification period of Germany, women undeniably bore the brunt of the economic downturn in East Germany. Rachel Alsop thouroughly discusses this aspect of the ambiguous nature of German reunification in her book, A Reversal of Fortunes? Women, Work and Change in East Germany. However, she does not suggest solutions to the unemployment problem. This Book Review discusses positive action law, or affirmative action law, as one solution for women trying to break out of traditional gender roles and find new jobs

Novel Mechanisms In The Sorting Of Proglucagon To The Secretory Granules Of The Regulated Secretory Pathway

The prohormone proglucagon encodes for multiple peptide hormones, including glucagon, glucagon-like peptide-1 (GLP-1), and GLP-2, produced through tissue-specific processing by prohormone convertase (PC) 1/3 and PC2. In alpha cells, PC2 yields glucagon, the major counter-regulatory hormone to insulin, which together, control glucose homeostasis. In contrast, GLP-1 and GLP2 are mainly produced in intestinal L-cells by PC1/3. GLP-1 stimulates insulin secretion following a meal, and therefore has opposing function to glucagon regulating glucose homeostasis; in contrast, GLP-2 enhances gut nutrient absorption. Efficient sorting of proglucagon to secretory granules is required for nutrient-regulated secretion. The aim of this thesis is to discover the molecular mechanisms by which proglucagon is targeted to secretory granules, which ensures that proglucagon is correctly processed to mature hormones, and is necessary for prompt physiologic response to nutrient status. In this thesis, we identify several sorting signals within the hormone domains of proglucagon that encode targeting information. Using quantitative immunofluorescence microscopy and co-localization analyses, I was able to determine the molecular nature by which glucagon and GLP-1 enter granules. Despite these two hormones sharing a large degree of structural homology, it is their particular alpha-helix structures that enable the sorting of proglucagon. Further, I provide evidence that proglucagon is first sorted to granules prior to being processed to active hormones. Furthermore, I have identified carboxypeptidase E in the mechanism by which glucagon sorts within alpha cells. Together, each hormone carries with it a unique sorting “signature” to efficiently reach its destination, and allows alpha and L-cells to tightly regulate nutrient homeostasis

Near-infrared spectroscopy study of tourniquet-induced forearm ischaemia in patients with coronary artery disease

Near-Infrared Spectroscopy (NIR) can be employed to monitor local changes in haemodynamics and oxygenation of human tissues. A preliminary study has been performed in order to evaluate the NIRS transmittance response to induced forearm ischaemia in patients with coronary artery disease (CAD). The population consists in 40 patients with cardiovascular risk factors and angiographically documented CAD, compared to a group of 13 normal subjects. By inflating and subsequently deflating a cuff placed around the patient arm, an ischaemia has been induced and released, and the patients have been observed until recovery of the basal conditions. A custom LAIRS spectrometer (IRIS) has been used to collect the backscattered light intensities from the patient forearm throughout the ischaemic and the recovery phase. The time dependence of the near-infrared transmittance on the control group is consistent with the available literature. On the contrary, the magnitude and dynamics of the NIRS signal on the CAD patients show deviations from the documented normal behavior, which can be tentatively attributed to abnormal vessel stiffness. These preliminary results, while validating the performance of the IRIS spectrometer, are strongly conducive towards the applicability of the NIRS technique to ischaemia analysis and to endothelial dysfunction characterization in CAD patients with cardiovascular risk factors.Publisher PD

A single-magnet nonlinear piezoelectric converter for enhanced energy harvesting from random vibrations

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Triclorosilane-mediated stereoselective synthesis of beta-amino esters and their conversion to highly enantiomerically enriched beta-lactams

A highly stereoselective trichlorosilane-mediated reduction of N-benzyl enamines was developed; the combination of a low cost, easy to make metal-free catalyst and an inexpensive chiral auxiliary allowed to perform the reaction on substrates with different structural features often with total control of the stereoselectivity. By easy deprotection through hydrogenolysis followed by conversion of \u3b2-aminoester to 2-azetidinones, the synthesis of enantiomerically pure \u3b2-lactams (>98% e.e.) was successfully accomplished

Portable instrument for in-vivo infrared oxymetry using spread-spectrum modulation

Near Infrared Spectroscopy (NIRS) can be employed to monitor noninvasively and continuously local changes in hemodynamics and oxygenation of human tissues. A portable NIRS research-grade acquisition system, dedicated to measurements during muscular exercise, is presented. The instrument is able to control up to eight LED sources and two detectors. A digital correlation technique, implemented on a single-chip RISC microcontroller, performs source-to-detector multiplexing. Such algorithm is highly optimized for computational efficiency and ambient noise rejection. Software-configurable input stages allow for flexibility in instrument setup. As a result of the specific correlation technique employed, the instrument is compact, lightweight and efficient. Clinical tests on oxygen consumption show excellent performance

Portable instrument for in-vivo infrared oxymetry using spread-spectrum modulation

Near Infrared Spectroscopy (NIRS) can be employed to monitor noninvasively and continuously local changes in hemodynamics and oxygenation of human tissues. A portable NIRS research-grade acquisition system, dedicated to measurements during muscular exercise, is presented. The instrument is able to control up to eight LED sources and two detectors. A digital correlation technique, implemented on a single-chip RISC microcontroller, performs source-to-detector multiplexing. Such algorithm is highly optimized for computational efficiency and ambient noise rejection. Software-configurable input stages allow for flexibility in instrument setup. As a result of the specific correlation technique employed, the instrument is compact, lightweight and efficient. Clinical tests on oxygen consumption show excellent performance