Development of a Logic Model for a Physical Activity–Based Employee Wellness Program for Mass Transit Workers

Transportation workers, who constitute a large sector of the workforce, have worksite factors that harm their health. Worksite wellness programs must target this at-risk population. Although physical activity is often a component of worksite wellness logic models, we consider it the cornerstone for improving the health of mass transit employees. Program theory was based on in-person interviews and focus groups of employees. We identified 4 short-term outcome categories, which provided a chain of responses based on the program activities that should lead to the desired end results. This logic model may have significant public health impact, because it can serve as a framework for other US mass transit districts and worksite populations that face similar barriers to wellness, including truck drivers, railroad employees, and pilots. The objective of this article is to discuss the development of a logic model for a physical activity–based mass-transit employee wellness program by describing the target population, program theory, the components of the logic model, and the process of its development

Loperamide toxicity: a case report of turning bowels and twisting points

Introduction: Loperamide is a synthetic mu-receptor agonist used for the treatment of diarrhea however it has recently been illicitly used for a euphoric high or to diminish opiate withdrawal symptoms. In case reports, loperamide abuse has been associated with varied cardiac arrhythmias, most notably ventricular tachycardia and torsades de pointes, presumably related to prolongation of the QTc. Clinical Findings: A 32-year-old male with known prior opioid use disorder presented unresponsive, found to have polymorphic ventricular tachycardia, torsades de pointes, prolonged QTc and QRS, and transient left ventricular (LV) dysfunction. Diagnosis, interventions, and outcomes: When his mental status cleared, the patient reported taking up to 40 pills of loperamide daily with the intent of alleviating opiate withdrawal symptoms. This was felt to be the cause of his QTc prolongation, leading to cardiac toxicity and subsequent dysrhythmia. Patient initially required temporary pacing wire, which was removed hospital day three. He was discharged with suboxone and duloxetine and connected with substance use disorder specialists. Conclusions: We describe a patient with cardiac toxicity associated with loperamide misuse. In the wake of the current opioid epidemic, it is possible that occurrences of loperamide toxicity will increase. It is important for physicians to understand and identify the life-threatening effects of loperamide toxicity in order for proper diagnosis and management

Phosphorus Cycling in the Red Tide Incubator Region of Monterey Bay in Response to Upwelling

This study explores the cycling of phosphorus (P) in the euphotic zone following upwelling in northeastern Monterey Bay (the Red Tide Incubator region) of coastal California, with particular emphasis on how bacteria and phytoplankton that form harmful algal blooms mediate and respond to changes in P availability. In situ measurements of nutrient concentrations, phytoplankton community composition, and cell-specific alkaline phosphatase (AP) activity (determined via enzyme-labeled fluorescence assay) were measured during three cruises. Upwelling led to a 10-fold increase in dissolved inorganic (DIP) in surface waters, reaching ∼0.5 μmol L−1. This DIP was drawn down rapidly as upwelling relaxed over a period of 1 week. Ratios of nitrate to DIP drawdown (∼5:1, calculated as the change in nitrate divided by the change in DIP) were lower than the Redfield ratio of 16:1, suggesting that luxury P uptake was occurring as phytoplankton bloomed. Dissolved organic (DOP) remained relatively constant (∼0.3 μmol L−1) before and immediately following upwelling, but doubled as upwelling relaxed, likely due to phytoplankton excretion and release during grazing. This transition from a relatively high DIP:DOP ratio to lower DIP:DOP ratio was accompanied by a decline in the abundance of diatoms, which had low AP activity, toward localized, spatially heterogeneous blooms of dinoflagellates in the genera Prorocentrum, Ceratium, Dinophysis, Alexandrium, and Scrippsiella that showed high AP activity regardless of ambient DIP levels. A nutrient addition incubation experiment showed that phytoplankton growth was primarily limited by nitrate, followed by DIP and DOP, suggesting that P regulates phytoplankton physiology and competition, but is not a limiting nutrient in this region. AP activity was observed in bacteria associated with lysed cell debris and aggregates of particulate organic material, where it may serve to facilitate P regeneration, as well as affixed to the surfaces of intact phytoplankton cells, possibly indicative of close, beneficial phytoplankton–bacteria interactions

School Self-Evaluation and Inspection for Improving U.S. Schools?

The U.S. test-based accountability model holds schools and teachers accountable for student outcomes with little attention to school improvement processes. The authors look at an approach used in several European counties, which entails more school-centered accountability efforts, such as school self-evaluation followed by inspection (SSE/I) to examine school quality. SSE/I is a complex policy instrument with mixed consequences and many research questions still to be answered. Moreover, accountability models from other countries cannot be naively imported to the U.S. given the vital distinctions in sociopolitical contexts. That being said, a look at some of the purposes or principles behind SSE/I—especially its emphasis on quality improvement—can nevertheless inform efforts to redesign and improve the U.S. accountability model. The purpose of this brief is to take just such a look at this model. Despite those necessary cautions, the researchers suggest that SSE/I’s underlying purposes and principles, in particular its focus on quality improvement, can help inform the redesign and improvement of the U.S. approach

Smartphone-Based Microscope for Pathogen Detection

Vibrio cholerae is a water and food borne bacteria that causes cholera, a severe acute diarrheal disease, when ingested and when left untreated, can cause patient death within hours. Currently there is a lack of both sensitive and rapid portable detection technologies of V. cholerae for testing water and food samples. Combining nucleic acid amplification and particle diffusometry present an alternative detection method for V. cholerae in under 30 minutes, but the process requires an expensive laboratory microscope. In this work, we develop a smartphone-based microscope to detect V. cholerae DNA in environmental water samples using particle diffusometry. A modular iPhone case is designed with a detachable cartridge and an integrated ball lens to image a microfluidic sample slide. This sample slide is essential for performing the DNA amplification assay and contains the microparticles necessary for imaging and particle diffusometry measurements. The ball lenses to image these particles have diameters of 1.0, 0.79, and 0.5 millimeters and are tested in conjunction with the iPhone 6 camera to determine optimal magnification and focal length. We demonstrate the ability to detect the Brownian motion of 1.0 micrometer particles using a 0.5 millimeter ball lens with brightfield imaging. This field-portable imaging platform provides the capability to perform rapid detection of V. cholerae in the field, and in the future, can be applied toward detecting other diseases at the point of care

The Most Massive Galaxies at 3.0<z<4.0 in the NEWFIRM Medium-Band Survey: Properties and Improved Constraints on the Stellar Mass Function

[Abridged] We use the NEWFIRM Medium-Band Survey (NMBS) to characterize the properties of a mass-complete sample of 14 galaxies at 3.0<z<4.0 with M_star>2.5x10^11 Msun, and to derive more accurate measurements of the high-mass end of the stellar mass function (SMF) of galaxies at z=3.5, with significantly reduced contributions from photometric redshift errors and cosmic variance to the total error budget of the SMF. The typical very massive galaxy at z=3.5 is red and faint in the observer's optical, with median r=26.1, and rest-frame U-V=1.6. About 60% of the sample have optical colors satisfying either the U- or the B-dropout color criteria, although ~50% of these galaxies have r>25.5. About 30% of the sample has SFRs from SED modeling consistent with zero. However, >80% of the sample is detected at 24 micron, with total infrared luminosities in the range (0.5-4.0)x10^13 Lsun. This implies the presence of either dust-enshrouded starburst activity (with SFRs of 600-4300 Msun/yr) and/or highly-obscured active galactic nuclei (AGN). The contribution of galaxies with M_star>2.5x10^11 Msun to the total stellar mass budget at z=3.5 is ~8%. We find an evolution by a factor of 2-7 and 3-22 from z~5 and z~6, respectively, to z=3.5. The previously found disagreement at the high-mass end between observed and model-predicted SMFs is now significant at the 3sigma level. However, systematic uncertainties dominate the total error budget, with errors up to a factor of ~8 in the densities, bringing the observed SMF in marginal agreement with the predicted SMF. Additional systematic uncertainties on the high-mass end could be introduced by either 1) the intense star-formation and/or the very common AGN activities as inferred from the MIPS 24 micron detections, and/or 2) contamination by a significant population of massive, old, and dusty galaxies at z~2.6.Comment: 20 pages, 11 figures. Accepted in ApJ. Minor changes to colors of figures to match accepted versio

Spectroscopic Discovery of the Broad-Lined Type Ic Supernova 2010bh Associated with the Low-Redshift GRB 100316D

We present the spectroscopic discovery of a broad-lined Type Ic supernova (SN 2010bh) associated with the nearby long-duration gamma-ray burst (GRB) 100316D. At z = 0.0593, this is the third-nearest GRB-SN. Nightly optical spectra obtained with the Magellan telescopes during the first week after explosion reveal the gradual emergence of very broad spectral features superposed on a blue continuum. The supernova features are typical of broad-lined SNe Ic and are generally consistent with previous supernovae associated with low-redshift GRBs. However, the inferred velocities of SN 2010bh at 21 days after explosion are a factor of ~2 times larger than those of the prototypical SN 1998bw at similar epochs, with v ~ 26,000 km/s, indicating a larger explosion energy or a different ejecta structure. A near-infrared spectrum taken 13.8 days after explosion shows no strong evidence for He I at 1.083 microns, implying that the progenitor was largely stripped of its helium envelope. The host galaxy is of low luminosity (M_R ~ -18.5 mag) and low metallicity (Z < 0.4 Z_solar), similar to the hosts of other low-redshift GRB-SNe.Comment: 6 pages, 4 figures, 1 table, submitted to ApJ Letter

ERK/MAPK Signaling Drives Overexpression of the Rac-GEF, PREX1, in BRAF- and NRAS-Mutant Melanoma

Recently we identified that PREX1 overexpression is critical for metastatic but not tumorigenic growth in a mouse model of NRAS-driven melanoma. In addition, a PREX1 gene signature correlated with and was dependent on ERK mitogen-activated protein kinase (MAPK) activation in human melanoma cell lines. In the current study, the underlying mechanism of PREX1 overexpression in human melanoma was assessed. PREX1 protein levels were increased in melanoma tumor tissues and cell lines compared with benign nevi and normal melanocytes, respectively. Suppression of PREX1 by siRNA impaired invasion but not proliferation in vitro. PREX1-dependent invasion was attributable to PREX1-mediated activation of the small GTPase RAC1 but not the related small GTPase CDC42. Pharmacologic inhibition of ERK signaling reduced PREX1 gene transcription and additionally regulated PREX1 protein stability. This ERK-dependent upregulation of PREX1 in melanoma, due to both increased gene transcription and protein stability, contrasts with the mechanisms identified in breast and prostate cancers, where PREX1 overexpression was driven by gene amplification and HDAC-mediated gene transcription, respectively. Thus, although PREX1 expression is aberrantly upregulated and regulates RAC1 activity and invasion in these three different tumor types, the mechanisms of its upregulation are distinct and context-dependent

Focus Group Evidence: Implications for Design and Analysis

In evaluation and applied social research, focus groups may be used to gather different kinds of evidence (e.g., opinion, tacit knowledge). In this article, we argue that making focus group design choices explicitly in relation to the type of evidence required would enhance the empirical value and rigor associated with focus group utilization. We offer a descriptive framework to highlight contrasting design characteristics and the type of evidence they generate. We present examples of focus groups from education and healthcare evaluations to illustrate the relationship between focus group evidence, design, and how focus groups are conducted. To enhance the credibility of focus group evidence and maximize potential learning from this popular qualitative data collection method, we offer a set of questions to guide evaluators reflection and decision making about focus group design and implementation.Ope