608 research outputs found

    The effect of offering different numbers of colorectal cancer screening test options in a decision aid: a pilot randomized trial

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    BACKGROUND: Decision aids can improve decision making processes, but the amount and type of information that they should attempt to communicate is controversial. We sought to compare, in a pilot randomized trial, two colorectal cancer (CRC) screening decision aids that differed in the number of screening options presented. METHODS: Adults ages 48–75 not currently up to date with screening were recruited from the community and randomized to view one of two versions of our previously tested CRC screening decision aid. The first version included five screening options: fecal occult blood test (FOBT), sigmoidoscopy, a combination of FOBT and sigmoidoscopy, colonoscopy, and barium enema. The second discussed only the two most frequently selected screening options, FOBT and colonoscopy. Main outcomes were differences in screening interest and test preferences between groups after decision aid viewing. Patient test preference was elicited first without any associated out-of-pocket costs (OPC), and then with the following costs: FOBT-10,sigmoidoscopy10, sigmoidoscopy-50, barium enema-50,andcolonoscopy50, and colonoscopy-200. RESULTS: 62 adults participated: 25 viewed the 5-option decision aid, and 37 viewed the 2-option version. Mean age was 54 (range 48–72), 58% were women, 71% were White, 24% African-American; 58% had completed at least a 4-year college degree. Comparing participants that viewed the 5-option version with participants who viewed the 2-option version, there were no differences in screening interest after viewing (1.8 vs. 1.9, t-test p = 0.76). Those viewing the 2-option version were somewhat more likely to choose colonoscopy than those viewing the 5-option version when no out of pocket costs were assumed (68% vs. 46%, p = 0.11), but not when such costs were imposed (41% vs. 42%, p = 1.00). CONCLUSION: The number of screening options available does not appear to have a large effect on interest in colorectal cancer screening. The effect of offering differing numbers of options may affect test choice when out-of-pocket costs are not considered

    Multi‐century stasis in C3 and C4 grass distributions across the contiguous United States since the industrial revolution

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    AimsUnderstanding the functional response of ecosystems to past global change is crucial to predicting performance in future environments. One sensitive and functionally significant attribute of grassland ecosystems is the percentage of species that use the C4 versus C3 photosynthetic pathway. Grasses using C3 and C4 pathways are expected to have different responses to many aspects of anthropogenic environmental change that have followed the industrial revolution, including increases in temperature and atmospheric CO2, changes to land management and fire regimes, precipitation seasonality, and nitrogen deposition. In spite of dramatic environmental changes over the past 300 years, it is unknown if the C4 grass percentage in grasslands has shifted.LocationContiguous United States of America.MethodsHere, we used stable carbon isotope data (i.e. δ13C) from 30 years of soil samples, as well as herbivore tissues that date to 1739 CE, to reconstruct coarse‐grain C3 and C4 grass composition in North American grassland sites to compare with modern vegetation. We spatially resampled these three datasets to a shared 100‐km grid, allowing comparison of δ13C values at a resolution and extent common for climate model outputs and biogeographical studies.ResultsAt this spatial grain, the bison tissue proxy was superior to the soil proxy because the soils reflect integration of local carbon inputs, whereas bison sample vegetation across landscapes. Bison isotope values indicate that historical grassland photosynthetic‐type composition was similar to modern vegetation.Main conclusionsDespite major environmental change, comparing modern plot vegetation data to three centuries of bison δ13C data revealed that the biogeographical distribution of C3 and C4 grasses has not changed significantly since the 1700s. This is particularly surprising given the expected CO2 fertilization of C3 grasses. Our findings highlight the critical importance of capturing the full range of physiological, ecological and demographical processes in biosphere models predicting future climates and ecosystems.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/139065/1/jbi13061.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/139065/2/jbi13061_am.pd

    Mitigation of Shallow Groundwater Nitrate in a Poorly Drained Riparian Area and Adjacent Cropland

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    Riparian ecosystems, through their unique position in the agricultural landscape and ability to influence nutrient cycles, can potentially reduce NO3 loading to surface and ground waters. The purpose of this study was to determine the fate of NO3 in shallow groundwater moving along a lateral flowpath from a grass seed cropping system through an undisturbed mixed-species herbaceous riparian area. Soil A (30–45 cm) and C horizon (135–150 cm) NO3, dissolved oxygen, and nitrous oxide concentrations were significantly higher in the cropping system than the adjacent riparian area. Nitrate concentrations in both horizons of the riparian soil were consistently at or below 0.05 mg NL-1 while cropping system concentrations ranged from 1 to 12 mg N L-1. Chloride data suggested that NO3 dilution occurred from recharge by precipitation. However, a sharp decrease in NO3/Cl ratios as water moved into the riparian area indicated that additional dilution of NO3 concentrations was unlikely. Riparian area A horizon soil water had higher dissolved organic carbon than the cropping system and when the riparian soil became saturated, available electron acceptors (O2, NO3) were rapidly reduced. Dissolved inorganic carbon was significantly higher in the riparian area than the cropping system for both horizons indicating high biological activity. Carbon limitation in the cropping system may have led to microbial respiration using primarily O2 and to a lesser degree NO3. Within 6 m of the riparian/cropping system transition, NO3 was virtually undetectable

    The DEEP3 Galaxy Redshift Survey: The Impact of Environment on the Size Evolution of Massive Early-type Galaxies at Intermediate Redshift

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    Using data drawn from the DEEP2 and DEEP3 Galaxy Redshift Surveys, we investigate the relationship between the environment and the structure of galaxies residing on the red sequence at intermediate redshift. Within the massive (10 < log(M*/Msun) < 11) early-type population at 0.4 < z <1.2, we find a significant correlation between local galaxy overdensity (or environment) and galaxy size, such that early-type systems in higher-density regions tend to have larger effective radii (by ~0.5 kpc or 25% larger) than their counterparts of equal stellar mass and Sersic index in lower-density environments. This observed size-density relation is consistent with a model of galaxy formation in which the evolution of early-type systems at z < 2 is accelerated in high-density environments such as groups and clusters and in which dry, minor mergers (versus mechanisms such as quasar feedback) play a central role in the structural evolution of the massive, early-type galaxy population.Comment: 11 pages, 5 figures, 2 tables; resubmitted to MNRAS after addressing referee's comments (originally submitted to journal on August 16, 2011

    Is Residual Memory Variance a Valid Method for Quantifying Cognitive Reserve? A Longitudinal Application

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    Cognitive reserve describes the mismatch between brain integrity and cognitive performance. Older adults with high cognitive reserve are more resilient to age-related brain pathology. Traditionally, cognitive reserve is indexed indirectly via static proxy variables (e.g., years of education). More recently, cross-sectional studies have suggested that reserve can be expressed as residual variance in episodic memory performance that remains after accounting for demographic factors and brain pathology (whole brain, hippocampal, and white matter hyperintensity volumes). The present study extends these methods to a longitudinal framework in a community-based cohort of 244 older adults who underwent two comprehensive neuropsychological and structural magnetic resonance imaging sessions over 4.6 years. On average, residual memory variance decreased over time, consistent with the idea that cognitive reserve is depleted over time. Individual differences in change in residual memory variance predicted incident dementia, independent of baseline residual memory variance. Multiple-group latent difference score models revealed tighter coupling between brain and language changes among individuals with decreasing residual memory variance. These results suggest that changes in residual memory variance may capture a dynamic aspect of cognitive reserve and could be a useful way to summarize individual cognitive responses to brain changes. Change in residual memory variance among initially non-demented older adults was a better predictor of incident dementia than residual memory variance measured at one time-point

    The Advanced Camera for Surveys General Catalog: Structural Parameters for Approximately Half A Million Galaxies

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    We present the Advanced Camera for Surveys General Catalog (ACS-GC), a photometric and morphological database using publicly available data obtained with the Advanced Camera for Surveys (ACS) instrument on the Hubble Space Telescope. The goal of the ACS-GC database is to provide a large statistical sample of galaxies with reliable structural and distance measurements to probe the evolution of galaxies over a wide range of look-back times. The ACS-GC includes approximately 470,000 astronomical sources (stars + galaxies) derived from the AEGIS, COSMOS, GEMS, and GOODS surveys. Galapagos was used to construct photometric (SEXTRACTOR) and morphological (GALFIT) catalogs. The analysis assumes a single Sersic model for each object to derive quantitative structural parameters. We include publicly available redshifts from the DEEP2, COMBO-17, TKRS, PEARS, ACES, CFHTLS, and zCOSMOS surveys to supply redshifts (spectroscopic and photometric) for a considerable fraction (similar to 74%) of the imaging sample. The ACS-GC includes color postage stamps, GALFIT residual images, and photometry, structural parameters, and redshifts combined into a single catalog.NASA/ESA GO-10134, GO-09822, GO-09425.01, GO-09583.01, GO-9500NASA NAS 5-26555NSF AST00-71048NASA LTSA NNG04GC89GESO Paranal Observatory LP175.A-0839Astronom

    Promoting decision aid use in primary care using a staff member for delivery

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    To determine the feasibility and effectiveness of in-clinic decision aid distribution using a care assistant

    Idiopathic gastroparesis is associated with specific transcriptional changes in the gastric muscularis externa

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    BACKGROUND: The molecular changes that occur in the stomach that are associated with idiopathic gastroparesis are poorly described. The aim of this study was to use quantitative analysis of mRNA expression to identify changes in mRNAs encoding proteins required for the normal motility functions of the stomach. METHODS: Full-thickness stomach biopsy samples were collected from non-diabetic control subjects who exhibited no symptoms of gastroparesis and from patients with idiopathic gastroparesis. mRNA was isolated from the muscularis externa and mRNA expression levels were determined by quantitative reverse transcriptase (RT)-PCR. KEY RESULTS: Smooth muscle tissue from idiopathic gastroparesis patients had decreased expression of mRNAs encoding several contractile proteins, such as MYH11 and MYLK1. Conversely, there was no significant change in mRNAs characteristic of interstitial cells of Cajal (ICCs) such as KIT or ANO1. There was also a significant decrease in mRNA-encoding platelet-derived growth factor receptor α (PDGFRα) and its ligand PDGFB and in Heme oxygenase 1 in idiopathic gastroparesis subjects. In contrast, there was a small increase in mRNA characteristic of neurons. Although there was not an overall change in KIT expression in gastroparesis patients, KIT expression showed a significant correlation with gastric emptying whereas changes in MYLK1, ANO1 and PDGFRα showed weak correlations to the fullness/satiety subscore of patient assessment of upper gastrointestinal disorder-symptom severity index scores. CONCLUSIONS AND INFERENCES: Our findings suggest that idiopathic gastroparesis is associated with altered smooth muscle cell contractile protein expression and loss of PDGFRα+ cells without a significant change in ICCs
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