Willingness to share personal health record data for care improvement and public health: A survey of experienced personal health record users

Background: Data stored in personally controlled health records (PCHRs) may hold value for clinicians and public health entities, if patients and their families will share them. We sought to characterize consumer willingness and unwillingness (reticence) to share PCHR data across health topics, and with different stakeholders, to advance understanding of this issue. Methods: Cross-sectional 2009 Web survey of repeat PCHR users who were patients over 18 years old or parents of patients, to assess willingness to share their PCHR data with an-out-of-hospital provider to support care, and the state/local public health authority to support monitoring; the odds of reticence to share PCHR information about ten exemplary health topics were estimated using a repeated measures approach. Results: Of 261 respondents (56% response rate), more reported they would share all information with the state/local public health authority (63.3%) than with an out-of-hospital provider (54.1%) (OR 1.5, 95% CI 1.1, 1.9; p = .005); few would not share any information with these parties (respectively, 7.9% and 5.2%). For public health sharing, reticence was higher for most topics compared to contagious illness (ORs 4.9 to 1.4, all p-values < .05), and reflected concern about anonymity (47.2%), government insensitivity (41.5%), discrimination (24%). For provider sharing, reticence was higher for all topics compared to contagious illness (ORs 6.3 to 1.5, all p-values < .05), and reflected concern for relevance (52%), disclosure to insurance (47.6%) and/or family (20.5%). Conclusions: Pediatric patients and their families are often willing to share electronic health information to support health improvement, but remain cautious. Robust trust models for PCHR sharing are needed

Academic and Business Leaders Agree: Six Skills Essential for Effective Management

This study surveyed 632 business and public education mid-level managers to ascertain both the importance of and their confidence in using six research-based management competencies. Both groups rated the six as equally or highly valuable; however, educational managers valued conflict resolution more than business counterparts. The education group reported less confidence using their skills in problem solving, conflict resolution, and strategic planning. While both groups perceived most of the six competencies as equally valuable, the two groups did not feel similarly confident using the skills. Participants’ ratings of skill-importance did not predict their level of confidence using the skills

Inhibition of VEGF and Angiopoietin-2 to Reduce Brain Metastases of Breast Cancer Burden

For metastases in the central nervous system, angiogenesis enhances metastatic potential and promotes progression. Primary factors which drive vessel growth are vascular endothelial growth factor (VEGF) and angiopoietin-2. Preclinical models show inhibition of either factor reduces metastases spread and inhibits growth. This work sets out to answer two questions in a preclinical mouse model. First, whether the combined inhibition of VEGF and angiopoietin-2, reduces passive permeability and limits drug uptake into brain metastases; and second, whether this inhibition reduces metastases burden in brain. We observed combinatorial inhibition of VEGF and angiopoietin-2, decreased (p \u3c 0.05) angiogenesis and vascular branching in an aortic ring assay and decreased (p \u3c 0.05) endothelial wound closure times. Using a brain metastases of breast cancer model (induced by intracardiac injections of brain seeking MDA-MB-231Br cells or 4T1Br cells), we observed, similar to VEGF, angiopoetin-2 expression correlates to increased angiogenesis (p \u3c 0.05) and increased lesion permeability. To determine efficacy, animals were administered bevacizumab plus L1-10 (angiopoietin inhibitor) twice per week until neurological symptoms developed. Lesion permeability significantly decreased by ∼50% (p \u3c 0.05) compared to untreated lesions, but remained ∼25% greater (p \u3c 0.0%) than brain. In subsequent experiments, animals were administered similar regimens but sacrificed on day 32. The number of metastatic lesions developed was significantly (p \u3c 0.001) reduced in the bevacizumab group (56%) and combination group (86%). Lesions’ size was reduced in bevacizumab treated lesions (∼67%) and bevacizumab and L1-10 treated lesions (∼78%) developing area \u3c 0.5 mm2. In summary, combinatorial inhibition of VEGF and angiopoietin reduces lesion permeability and brain metastatic burden

TWAM: A Certifying Abstract Machine for Logic Programs

Type-preserving (or typed) compilation uses typing derivations to certify correctness properties of compilation. We have designed and implemented a type-preserving compiler for a simply-typed dialect of Prolog we call T-Prolog. The crux of our approach is a new certifying abstract machine which we call the Typed Warren Abstract Machine (TWAM). The TWAM has a dependent type system strong enough to specify the semantics of a logic program in the logical framework LF. We present a soundness metatheorem which constitutes a partial correctness guarantee: well-typed programs implement the logic program specified by their type. This metatheorem justifies our design and implementation of a certifying compiler from T-Prolog to TWAM.Comment: 41 pages, under submission to ACM Transactions on Computational Logi

Shedding Light on Avian Influenza H4N6 Infection in Mallards: Modes of Transmission and Implications for Surveillance

Background: Wild mallards (Anas platyrhychos) are considered one of the primary reservoir species for avian influenza viruses (AIV). Because AIV circulating in wild birds pose an indirect threat to agriculture and human health, understanding the ecology of AIV and developing risk assessments and surveillance systems for prevention of disease is critical. Methodology/Principal Findings: In this study, mallards were experimentally infected with an H4N6 subtype of AIV by oral inoculation or contact with an H4N6 contaminated water source. Cloacal swabs, oropharyngeal swabs, fecal samples, and water samples were collected daily and tested by real-time RT-PCR (RRT-PCR) for estimation of viral shedding. Fecal samples had significantly higher virus concentrations than oropharyngeal or cloacal swabs and 6 month old ducks shed significantly more viral RNA than 3 month old ducks regardless of sample type. Use of a water source contaminated by AIV infected mallards, was sufficient to transmit virus to naïve mallards, which shed AIV at higher or similar levels as orally-inoculated ducks. Conclusions: Bodies of water could serve as a transmission pathway for AIV in waterfowl. For AIV surveillance purposes, water samples and fecal samples appear to be excellent alternatives or additions to cloacal and oropharyngeal swabbing. Furthermore, duck age (even within hatch-year birds) may be important when interpreting viral shedding results from experimental infections or surveillance. Differential shedding among hatch-year mallards could affect prevalence estimates, modeling of AIV spread, and subsequent risk assessments

Intercropping Promotes the Ability of Legume and Cereal to Facilitate Phosphorus and Nitrogen Acquisition through Root- Induced Processes

Intercropping of cereal and legume can improve the use of resources for crop growth compared to cropping system. An increase in soil phosphorus (P) and nitrogen (N) acquisition by root-induced biochemical changes of intercropped species has been reported as key processes of facilitation and complementarily between both intercropping legumes and cereals. Indeed, the functional facilitation prevails over interspecific competition under nutrients limiting for crop growth. Results showed that P availability significantly increased in the rhizosphere of both species, especially in intercropping under the P-deficient soil conditions. This increase was associated with high efficiency efficiency in use of rhizobial, plant growth and resource use efficiency as indicated by higher land equivalent ratio (LER) and N nutrition index. In addition, the rhizosphere P availability and nodule biomass were positively correlated (r2 = 0.71**, and r2 = 0.62**) in the intercropped common bean grown at P-deficient soil. The increased P availability presumably improved biomass and yield in intercropping, although it mainly enhanced intercropped maize grain yield. Exploiting belowground parameters in a legume-cereal intercropping is likely necessary to maximize rhizosphere-interspecific interactions as a strategy to improve the symbiotic rhizobial efficiency and microbial activities, as a result of root-induced pH and N availability changes under low P soils

Flame retarding polyamide 11 with exfoliated vermiculite nanoflakes

Polyamide 11‐based bionanocomposites were prepared by melt compounding with 10 wt% clays of different chemistry and morphology. This included vermiculite nanoflakes obtained by consecutive thermal and ultrasonic exfoliation in both neat and organo‐modified form. The mechanical reinforcement‐ and flame‐retardant performance of the vermiculite clays were compared to organo‐modified montmorillonite (Cloisite 30B) and needle‐shaped sepiolite (Pangel S9). Electron microscope investigations revealed different structures and dispersion levels of the clay nanoparticles in the polymer matrix. Tensile tests showed that the addition of clays led to considerable improvements in Young's modulus without compromising the elongation at break. Compared to the neat polymer, all clays reduced the peak heat release rate and the smoke production rate in cone calorimeter testing. Surprisingly, the needle‐shaped sepiolite clay and the two vermiculites outperformed the montmorillonite organoclay in the fire testing even though it featured the highest degree of exfoliation in the polymer matrix.The Deutsche Forschungsgemeinschaft (DFG) through Grant AN 212/18-1 and from the National Research Foundation (NRF) via the South African/Algeria research partnership program under Grant 87453.https://onlinelibrary.wiley.com/journal/154826342019-10-01hj2019Chemical Engineerin

Current Status and Perspectives of Protease Inhibitors and Their Combination with Nanosized Drug Delivery Systems for Targeted Cancer Therapy

Abstract: In cancer treatments, many natural and synthetic products have been examined; among them, protease inhibitors are promising candidates for anti-cancer agents. Since dysregulated proteolytic activities can contribute to tumor development and metastasis, antagonization of proteases with tailored inhibitors is an encouraging approach. Although adverse effects of early designs of these inhibitors disappeared after the introduction of next-generation agents, most of the proposed inhibitors did not pass the early stages of clinical trials due to their nonspecific toxicity and lack of pharmacological effects. Therefore, new applications that modulate proteases more specifically and serve their programmed way of administration are highly appreciated. In this context, nanosized drug delivery systems have attracted much attention because preliminary studies have demonstrated that the therapeutic capacity of inhibitors has been improved significantly with encapsulated formulation as compared to their free forms. Here, we address this issue and discuss the current application and future clinical prospects of this potential combination towards targeted protease-based cancer therapy