Farm Resiliency Education for At-Risk Coastal Areas in the Chesapeake Bay

The Virginia Institute of Marine Science (VIMS) in collaboration with its partners, the Land Trust Alliance, Sustainable Chesapeake, and The Nature Conservancy, explored and refined questions critical for advising and guiding landowners who farm within coastal areas that are vulnerable to sea level rise and saltwater intrusion, and ultimately, loss of arable cropland in the Chesapeake Bay watershed. While the questions posed are those that agricultural experts across the coastal zones are struggling with, this effort focused on identifying the current state of the science and informational gaps; building current, best professional guidance for landowner conservation program choices; and developing a research framework for improving our understanding and building capacity to maximize, incentivize, and secure ecosystem services beyond food provision at the farm-scape scale

An Emerging Diabetes Mellitus Diagnosis Modality: HbA1c

Classically, the diagnosis of diabetes has been made using the fasting plasma glucose, random plasma glucose, or a 2-hr 75-g oral glucose tolerance test. There are many problems with the definition of diabetes based on blood glucose levels, such as the high intra-individual biological variability, variability in the collection and storage methods, and difficulty in ensuring a fasting state before measuring the blood glucose [1]. Recently, the hemoglobin A1c (HbA1c) assay has also been recommended for the diagnosis of diabetes. The HbA1c concentration is a good indicator of glycemic control over the previous 8-12 weeks; the time period is dictated by the 120-day lifespan of erythrocytes. HbA1c is used as the standard biomarker for the adequacy of glycemic management since it correlates well with both microvascular and, to a lesser extent, macrovascular complications based on

Transient pool boiling in microgravity

Transient nucleate pool boiling experiments using R113 are conducted for short times in microgravity and in earth gravity with different heater surface orientations and subcoolings. The heating surface is a transparent gold film sputtered on a quartz substrate, which simultaneously provides surface temperature measurements and permits viewing of the boiling process from beneath. For the microgravity experiments, which have uniform initial temperatures and no fluid motion, the temperature distribution in the R113 at the moment of boiling inception is known. High speed cameras with views both across and through the heating surface record the boiling spread across the heater surface, which are classified into six (6) distinct categories.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/30197/1/0000585.pd

Language impairments in the development of sign: Do they reside in a specific modality or are they modality-independent deficits?

Various theories of developmental language impairments have sought to explain these impairments in modality-specific ways – for example, that the language deficits in SLI or Down syndrome arise from impairments in auditory processing. Studies of signers with language impairments, especially those who are bilingual in a spoken language as well as a sign language, provide a unique opportunity to contrast abilities across language in two modalities (cross-modal bilingualism). The aim of the article is to examine what developmental sign language impairments can tell us about the relationship between language impairments and modality. A series of individual and small group studies are presented here illustrating language impairments in sign language users and cross-modal bilinguals, comprising Landau-Kleffner syndrome, Williams syndrome, Down syndrome, Autism and SLI. We conclude by suggesting how studies of sign language impairments can assist researchers to explore how different language impairments originate from different parts of the cognitive, linguistic and perceptual systems

Rapid, ultra low coverage copy number profiling of cell-free DNA as a precision oncology screening strategy.

Current cell-free DNA (cfDNA) next generation sequencing (NGS) precision oncology workflows are typically limited to targeted and/or disease-specific applications. In advanced cancer, disease burden and cfDNA tumor content are often elevated, yielding unique precision oncology opportunities. We sought to demonstrate the utility of a pan-cancer, rapid, inexpensive, whole genome NGS of cfDNA approach (PRINCe) as a precision oncology screening strategy via ultra-low coverage (~0.01x) tumor content determination through genome-wide copy number alteration (CNA) profiling. We applied PRINCe to a retrospective cohort of 124 cfDNA samples from 100 patients with advanced cancers, including 76 men with metastatic castration-resistant prostate cancer (mCRPC), enabling cfDNA tumor content approximation and actionable focal CNA detection, while facilitating concordance analyses between cfDNA and tissue-based NGS profiles and assessment of cfDNA alteration associations with mCRPC treatment outcomes. Therapeutically relevant focal CNAs were present in 42 (34%) cfDNA samples, including 36 of 93 (39%) mCRPC patient samples harboring AR amplification. PRINCe identified pre-treatment cfDNA CNA profiles facilitating disease monitoring. Combining PRINCe with routine targeted NGS of cfDNA enabled mutation and CNA assessment with coverages tuned to cfDNA tumor content. In mCRPC, genome-wide PRINCe cfDNA and matched tissue CNA profiles showed high concordance (median Pearson correlation = 0.87), and PRINCe detectable AR amplifications predicted reduced time on therapy, independent of therapy type (Kaplan-Meier log-rank test, chi-square = 24.9, p < 0.0001). Our screening approach enables robust, broadly applicable cfDNA-based precision oncology for patients with advanced cancer through scalable identification of therapeutically relevant CNAs and pre-/post-treatment genomic profiles, enabling cfDNA- or tissue-based precision oncology workflow optimization

A1C as a Diagnostic Criteria for Diabetes in Low- and Middle-Income Settings: Evidence from Peru

OBJECTIVES: To determine the prevalence of type 2 diabetes mellitus, in three groups of Peruvian adults, using fasting glucose and glycosylated hemoglobin (A1C). METHODOLOGY/PRINCIPAL FINDINGS: This study included adults from the PERU MIGRANT Study who had fasted ≥ 8 h. Fasting glucose ≥ 126 mg/dL and A1C ≥ 6.5% were used, separately, to define diabetes. Subjects with a current diagnosis of diabetes were excluded. 964 of 988 subjects were included in this analysis. Overall, 0.9% (95%CI 0.3-1.5) and 3.5% (95%CI 2.4-4.7) had diabetes using fasting glucose and A1C criteria, respectively. Compared to those classified as having diabetes using fasting glucose, newly classified subjects with diabetes using A1C (n = 25), were older, poorer, thinner and more likely to come from rural areas. Of these, 40% (10/25) had impaired fasting glucose (IFG). CONCLUSIONS: This study shows that the use of A1C as diagnostic criteria for type 2 diabetes mellitus identifies people of different characteristics than fasting glucose. In the PERU MIGRANT population using A1C to define diabetes tripled the prevalence; the increase was more marked among poorer and rural populations. More than half the newly diagnosed people with diabetes using A1C had normal fasting glucose

Methodological framework for World Health Organization estimates of the global burden of foodborne disease

Background: The Foodborne Disease Burden Epidemiology Reference Group (FERG) was established in 2007 by the World Health Organization to estimate the global burden of foodborne diseases (FBDs). This paper describes the methodological framework developed by FERG's Computational Task Force to transform epidemiological information into FBD burden estimates. Methods and Findings: The global and regional burden of 31 FBDs was quantified, along with limited estimates for 5 other FBDs, using Disability-Adjusted Life Years in a hazard- and incidence-based approach. To accomplish this task, the following workflow was defined: outline of disease models and collection of epidemiological data; design and completion of a database template; development of an imputation model; identification of disability weights; probabilistic burden assessment; and estimating the proportion of the disease burden by each hazard that is attributable to exposure by food (i.e., source attribution). All computations were performed in R and the different functions were compiled in the R package 'FERG'. Traceability and transparency were ensured by sharing results and methods in an interactive way with all FERG members throughout the process. Conclusions: We developed a comprehensive framework for estimating the global burden of FBDs, in which methodological simplicity and transparency were key elements. All the tools developed have been made available and can be translated into a user-friendly national toolkit for studying and monitoring food safety at the local level

Deep Multiwaveband Observations of the Jets of 0208-512 and 1202-262

We present deep {\it HST, Chandra, VLA} and {\it ATCA} images of the jets of PKS 0208--512 and PKS 1202--262, which were found in a {\it Chandra} survey of a flux-limited sample of flat-spectrum radio quasars with jets (see Marshall et al., 2005). We discuss in detail their X-ray morphologies and spectra. We find optical emission from one knot in the jet of PKS 1202--262 and two regions in the jet of PKS 0208--512. The X-ray emission of both jets is most consistent with external Comptonization of cosmic microwave background photons by particles within the jet, while the optical emission is most consistent with the synchrotron process. We model the emission from the jet in this context and discuss implications for jet emission models, including magnetic field and beaming parameters.Comment: 13 pages, 11 figures, ApJ in pres

Attribution of global foodborne disease to specific foods: Findings from a World Health Organization structured expert elicitation

Background Recently the World Health Organization, Foodborne Disease Burden Epidemiology Reference Group (FERG) estimated that 31 foodborne diseases (FBDs) resulted in over 600 million illnesses and 420,000 deaths worldwide in 2010. Knowing the relative role importance of different foods as exposure routes for key hazards is critical to preventing illness. This study reports the findings of a structured expert elicitation providing globally comparable food source attribution estimates for 11 major FBDs in each of 14 world subregions. Methods and findings We used Cooke’s Classical Model to elicit and aggregate judgments of 73 international experts. Judgments were elicited from each expert individually and aggregated using both equal and performance weights. Performance weighted results are reported as they increased the informativeness of estimates, while retaining accuracy. We report measures of central tendency and uncertainty bounds on food source attribution estimate. For some pathogens we see relatively consistent food source attribution estimates across subregions of the world; for others there is substantial regional variation. For example, for non-typhoidal salmonellosis, pork was of minor importance compared to eggs and poultry meat in the American and African subregions, whereas in the European and Western Pacific subregions the importance of these three food sources were quite similar. Our regional results broadly agree with estimates from earlier European and North American food source attribution research. As in prior food source attribution research, we find relatively wide uncertainty bounds around our median estimates. Conclusions We present the first worldwide estimates of the proportion of specific foodborne diseases attributable to specific food exposure routes. While we find substantial uncertainty around central tendency estimates, we believe these estimates provide the best currently available basis on which to link FBDs and specific foods in many parts of the world, providing guidance for policy actions to control FBDs.This study was commissioned and paid for by the World Health Organization (WHO). Aspinall & Associates and Gibb Epidemiology Consulting LLC provided support in the form of salaries for authors [WA, HJG], but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ sectio

Modes of exercise training for intermittent claudication

Background According to international guidelines and literature, all patients with intermittent claudication should receive an initial treatment of cardiovascular risk modification, lifestyle coaching, and supervised exercise therapy. In the literature, supervised exercise therapy often consists of treadmill or track walking. However, alternative modes of exercise therapy have been described and yielded similar results to walking. This raises the following question: which exercise mode produces the most favourable results? This is the first update of the original review published in 2014.ObjectivesTo assess the effects of alternative modes of supervised exercise therapy compared to traditional walking exercise in patients with intermittent claudication.Search methodsThe Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase and CINAHL databases and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 4 March 2019. We also undertook reference checking, citation searching and contact with study authors to identify additional studies. No language restriction was applied.Selection criteriaWe included parallel-group randomised controlled trials comparing alternative modes of exercise training or combinations of exercise modes with a control group of supervised walking exercise in patients with clinically determined intermittent claudication. The supervised walking programme needed to be supervised at least twice a week for a consecutive six weeks of training.Data collection and analysisTwo review authors independently selected studies, extracted data, and assessed the risk of bias for each study. As we included studies with different treadmill test protocols and different measuring units (metres, minutes, or seconds), the standardised mean difference (SMD) approach was used for summary statistics of mean walking distance (MWD) and pain-free walking distance (PFVVD). Summary estimates were obtained for all outcome measures using a random-effects model. We used the GRADE approach to assess the certainty of the evidence.Main results For this update, five additional studies were included, making a total of 10 studies that randomised a total of 527 participants with intermittent claudication (IC). The alternative modes of exercise therapy included cycling, lower-extremity resistance training, upper-arm ergometry, Nordic walking, and combinations of exercise modes. Besides randomised controlled trials, two quasi-randomised trials were included.Overall risk of bias in included studies varied from high to low. According to GRADE criteria, the certainty of the evidence was downgraded to low, due to the relatively small sample sizes, clinical inconsistency, and inclusion of three studies with risk of bias concerns. Overall, comparing alternative exercise modes versus walking showed no clear differences for MVVD at 12 weeks (standardised mean difference (SMD)-0.01, 950/o confidence interval (CI)-0.29 to 0.27; P = 0.95; 6 studies; 274 participants; low-certainty evidence); or at the end of training (SMD-0.11, 95% CI-0.33 to 0.11; P = 0.32; 9 studies; 412 participants; low-certainty evidence). Similarly, no clear differences were detected in PFWD at 12 weeks (SMD-0.01, 950/o CI-0.26 to 0.25; P= 0.97; 5 studies; 249 participants; low-certainty evidence); or at the end of training (SMD-0.06, 95% CI-0.30 to 0.17; P = 0.59; 8 studies, 382 participants; low-certainty evidence). Four studies reported on health-related quality of life (HR-QoL) and three studies reported on functional impairment. As the studies used different measurements, meta-analysis was only possible for the walking impairment questionnaire (WIQ) distance score, which demonstrated little or no difference between groups (MD-5.52, 95% CI-17A1 to 6.36; P = 0.36; 2 studies; 96 participants; low-certainty evidence).Authors' conclusionsThis review found no clear difference between alternative exercise modes and supervised walking exercise in improving the maximum and pain-free walking distance in patients with intermittent claudication. The certainty of this evidence was judged to be low, due to clinical inconsistency, small sample size and risk of bias concerns. The findings of this review indicate that alternative exercise modes may be useful when supervised walking exercise is not an option. More RCTs with adequate methodological quality and sufficient power are needed to provide solid evidence for comparisons between each alternative exercise mode and the current standard of supervised treadmill walking. Future RCTs should investigate outcome measures on walking behaviour, physical activity, cardiovascular risk, and HRQoL, using standardised testing methods and reporting of outcomes to allow meaningful comparison across studies.</p