Exploring Meaningful Patient Engagement in ADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness).

BackgroundGenuine patient engagement can improve research relevance, impact and is required for studies using the National Patient-Centered Clinical Research Network including major multicenter research projects. It is unclear, however, how best to integrate patients into governance of such projects.MethodsADAPTABLE (Aspirin Dosing: A Patient-centric Trial Assessing Benefits and Long-term Effectiveness) is the first major multicenter research project to be conducted in National Patient-Centered Clinical Research Network. Here, we provide a description of how we implemented patient engagement in ADAPTABLE thus far, including a description of committee structures and composition, first-hand patient testimonials, specific contributions, and lessons learned during the planning and early implementation of ADAPTABLE.ResultsWe recruited 1 patient leader from 6 of the 7 enrolling networks to serve on a Patient Review Board for ADAPTABLE, supported the Board with an experienced patient engagement team including an "investigator-advocate" not otherwise involved in the trial, and facilitated bidirectional communication between the Board and ADAPTABLE Coordinating Center. The Board has reviewed and provided substantial input on the informed consent procedure, recruitment materials, patient portal design, and study policy including compensation of participants. Although it was "too late" for some suggested modifications, most modifications suggested by the patient leaders have been implemented, and they are enthusiastic about the study and their role. The patient leaders also attend Steering and Executive Committee calls; these experiences have been somewhat less productive.ConclusionsWith adequate support, a cadre of committed patient leaders can provide substantial value to design and implementation of a major multicenter clinical trial

How do hydrochlorothiazide and chlorthalidone compare for treating hypertension?

Q. How do hydrochlorothiazide and chlorthalidone compare for treating hypertension? A. Both medications reduce theincidence of cardiovascular events in patients with hypertension, but chlorthalidone may confer additional cardiovascular risk reduction (strength of recommendation [SOR]: B, conflicting network meta-analysis and cohort studies). (No head-to-head studies of hydrochlorothiazide [HCTZ] and chlorthalidone have been done.) Serious hypokalemia and hyponatremia can occur with either medication; it is unclear if the rates of these adverse effects are the same at equivalent doses. Patients taking chlorthalidone are less likely to need a second antihypertensive medication but more likely to be nonadherent than patients taking HCTZ (SOR: B, cohort studies)

Vehicle-Level System Impact of Boundary Layer Ingestion for the NASA D8 Concept Aircraft

The purpose of this study was to evaluate the vehicle-level impact of a boundary layer ingestion (BLI) propulsion system on a commercial transport aircraft concept. The NASA D8 (ND8) aircraft was chosen as the BLI concept aircraft to be studied. A power balance methodology developed by the Massachusetts Institute of Technology was adapted for use with the existing NASA sizing and performance tools to model the fuel consumption impact of BLI on the ND8. A key assumption for the BLI impact assessment was a 3.5% efficiency penalty associated with designing a fan for and operating in the distorted flow caused by BLI. The ND8 was compared to several other ND8-like aircraft that did not utilize BLI in order to determine the fuel consumption benefit attributable to BLI. Analytically turning off BLI on the ND8 without accounting for the physical requirements of redirecting the boundary layer or resizing the aircraft to meet the performance constraints resulted in a 2.8% increase in block fuel consumption to fly the design mission. When this non-physical aircraft was resized to meet the performance constraints, the block fuel consumption was 4.0% greater than the baseline ND8. The ND8 was also compared to an ND8-like aircraft with conventionally podded engines under the wing. This configuration had a 5.6% increase in block fuel consumption compared to the baseline ND8. This result is more reflective of the real world impact if BLI is not an available technology for the ND8 design. The BLI benefit results presented for this study should not be applied to other aircraft that have a propulsion-airframe integration design or BLI implementation different from the ND8

Let\u27s Talk Protecting Endangered Species

The Trump Administration recently changed Endangered Species Act regulations affecting how species are removed from endangered status and streamlining permits for the oil and gas and ranching industries. Environmentalists say the rules weaken protections. How could the new rules change industry and conservation in New Mexico

Validation and justification of the phylum name Cryptomycota phyl. nov.

The recently proposed new phylum name Cryptomycota phyl. nov. is validly published in order to facilitate its use in future discussions of the ecology, biology, and phylogenetic relationships of the constituent organisms. This name is preferred over the previously tentatively proposed “Rozellida” as new data suggest that the life-style and morphology of Rozella is not representative of the large radiation to which it and other Cryptomycota belong. Furthermore, taxa at higher ranks such as phylum are considered better not based on individual names of included genera, but rather on some special characteristics – in this case the cryptic nature of this group and that they were initially revealed by molecular methods rather than morphological discovery. If the group were later viewed as a member of a different kingdom, the name should be retained to indicate its fungal affinities, as is the practice for other fungal-like protist groups

Effect of Feeding Different Types of Byproducts and Concentrations Throughout a Beef Growing System on Ground Beef Color and Lipid Oxidation

The objective of this trial was to evaluate the effect of feeding different concentrations of wet distillers grains during winter backgrounding and either modified wet distillers grains or Sweet Bran® during the finishing phase on ground beef color and lipid oxidation. After a 14 day aging period, ground beef patties were made and placed in a simulated retail display for seven days. There were no overall differences in lipid oxidation between treatments but was a treatment by day interaction for discoloration. Ground beef from heifers finished with modified wet distillers grains discolored at a greater extent when compared to ground beef from heifers finished with Sweet Bran

The fate of steroid estrogens: Partitioning during wastewater treatment and onto river sediments

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2010 Springer Science+Business Media B.V.The partitioning of steroid estrogens in wastewater treatment and receiving waters is likely to influence their discharge to, and persistence in, the environment. This study investigated the partitioning behaviour of steroid estrogens in both laboratory and field studies. Partitioning onto activated sludge from laboratory-scale Husmann units was rapid with equilibrium achieved after 1 h. Sorption isotherms and Kd values decreased in the order 17α-ethinyl estradiol > 17α-estradiol > estrone > estriol without a sorption limit being achieved (1/n >1). Samples from a wastewater treatment works indicated no accumulation of steroid estrogens in solids from primary or secondary biological treatment, however, a range of steroid estrogens were identified in sediment samples from the River Thames. This would indicate that partitioning in the environment may play a role in the long-term fate of estrogens, with an indication that they will be recalcitrant in anaerobic conditions.EPSR

Child stunting is associated with child, maternal, and environmental factors in Vietnam

Child stunting in Vietnam has reduced substantially since the turn of the century but has remained relatively high for several years. We analysed data on children 6–59 months (n = 85,932) from the Vietnam Nutritional Surveillance System, a nationally representative cross‐sectional survey. Multivariable Poisson regression models were used to estimate relative risk (RR) of stunting, stratified by child age and ecological region. Covariates at the child, maternal, household, and environmental levels were included based on available data and the World Health Organization conceptual framework on child stunting. Among children 6–23 months, the strongest associations with child stunting were child age in years (RR: 2.49; 95% CI [2.26, 2.73]), maternal height < 145 cm compared with ≥150 cm (RR: 2.04; 95% CI [1.85, 2.26]), living in the Northeast compared with the Southeast (RR: 2.01; 95% CI [1.69, 2.39]), no maternal education compared with a graduate education (RR: 1.77; 95% CI, [1.44, 2.16]), and birthweight < 2,500 g (RR: 1.75; 95% CI [1.55, 1.98]). For children 24–59 months, the strongest associations with child stunting were no maternal education compared with a graduate education (RR: 2.07; 95% CI [1.79, 2.40]), living in the Northeast compared with the Southeast (RR: 1.94; 95% CI [1.74, 2.16]), and maternal height < 145 cm compared with ≥150 cm (RR: 1.81; 95% CI [1.69, 1.94]). Targeted approaches that address the strongest stunting determinants among vulnerable populations are needed and discussed. Multifaceted approaches outside the health sector are also needed to reduce inequalities in socioeconomic status.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151838/1/mcn12826.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151838/2/mcn12826_am.pd

Steam reforming on transition-metal carbides from density-functional theory

A screening study of the steam reforming reaction (CH_4 + H_2O -> CO + 3H_2) on early transition-metal carbides (TMC's) is performed by means of density-functional theory calculations. The set of considered surfaces includes the alpha-Mo_2C(100) surfaces, the low-index (111) and (100) surfaces of TiC, VC, and delta-MoC, and the oxygenated alpha-Mo_2C(100) and TMC(111) surfaces. It is found that carbides provide a wide spectrum of reactivities towards the steam reforming reaction, from too reactive via suitable to too inert. The reactivity is discussed in terms of the electronic structure of the clean surfaces. Two surfaces, the delta-MoC(100) and the oxygen passivated alpha-Mo_2C(100) surfaces, are identified as promising steam reforming catalysts. These findings suggest that carbides provide a playground for reactivity tuning, comparable to the one for pure metals.Comment: 6 pages, 4 figure

Clinical-pathological study on β-APP, IL-1β, GFAP, NFL, Spectrin II, 8OHdG, TUNEL, miR-21, miR-16, miR-92 expressions to verify DAI-diagnosis, grade and prognosis

Traumatic brain injury (TBI) is one of the most important death and disability cause, involving substantial costs, also in economic terms, when considering the young age of the involved subject. Aim of this paper is to report a series of patients treated at our institutions, to verify neurological results at six months or survival; in fatal cases we searched for βAPP, GFAP, IL-1β, NFL, Spectrin II, TUNEL and miR-21, miR-16, and miR-92 expressions in brain samples, to verify DAI diagnosis and grade as strong predictor of survival and inflammatory response. Concentrations of 8OHdG as measurement of oxidative stress was performed. Immunoreaction of β-APP, IL-1β, GFAP, NFL, Spectrin II and 8OHdG were significantly increased in the TBI group with respect to control group subjects. Cell apoptosis, measured by TUNEL assay, were significantly higher in the study group than control cases. Results indicated that miR-21, miR-92 and miR-16 have a high predictive power in discriminating trauma brain cases from controls and could represent promising biomarkers as strong predictor of survival, and for the diagnosis of postmortem traumatic brain injury