Synthesis of novel tetrahydroisoquinoline chiral ligands for application in asymmetric transfer hydrogenation.

Thesis (M.Sc.)-University of KwaZulu-Natal, Westville, 2010.Several tetrahydroisoquinoline (TIQ) diamine derivatives were prepared for use as ligands in asymmetric transfer hydrogenation (ATH) of acetophenone of which 17 intermediates and the eight target ligands were novel compounds. The initial design followed that of Noyori, who presented the efficiency of his monotosylated diamine in ATH. A series of eight novel secondary amine derivatives (78a-g and 88) were prepared with substituents that influenced the electronics and the sterics of and around the nitrogen donor. Ligand 71 was shown to have no activity for the ATH of acetophenone. It was apparent from experimental observations that a balance between the electronic and steric characteristics of the substituent was necessary to facilitate activity. It was found that ligand 78d possessing a benzyl group, had the greatest activity (81 % conv.). The greatest selectivity was obtained with ligand 78f (77 % ee) having a chiral phenylmethyl substituent. It was discovered in the case of the active diamine ligands that an optimised 1500 equivalents of water was required in order to demonstrate any enantioselectivity. The exact role of the water has never been ascertained, although there are many publications in which the effect of water has been examined. The most active metal precursor was also investigated and [RhCl2(Cp*)]2 was found to be the best for these TIQ diamine ligands in the specified model reactions. This work has recently been accepted for publication and has established criteria for further rational design on this system

Leptospirosis and an Animal Bite

In October 2013, leptospirosis was identified in a 20-year-old male. The male was bitten on his hand by either his canine or a skunk while breaking up a fight between the two animals. Eight days after the bite, the male developed fever, headache, drowsiness, neck pain, nausea, vomiting, diarrhea, malaise and erythematous rash. Diagnosis was confirmed by amplification of Leptospira by DNA from a urine specimen. Veterinarian serology testing of the canine for Leptospira was negative. Leptospira in a human, acquired from an animal bite is a rare occurrence

A Clostridium perfringens Outbreak Traced to Improper Cooking of Prime Rib in Rochester, New York 2011

In December 2011, the Monroe County Department of Public Health investigated a report of gastrointestinal illness from two separate parties that had dined at a restaurant on the same day. An environmental and epidemiological investigation identified 17 individuals who met the outbreak case definition. A detailed questionnaire based on the restaurant’s menu was administered to patrons from both parties and statistically analyzed. Based on this investigation, it was hypothesized that consuming the prime rib (P \u3c 0.001) was associated with becoming ill. The environmental investigation indicated that the prime rib was not cooked to a proper temperature and was held at an improper temperature before being served. A prime rib sample and three stool samples from ill patrons were collected and sent for laboratory testing. Clostridium perfringens was identified in all of the samples by the New York State Department of Health (NYSDOH) Wadsworth Laboratory. This outbreak demonstrates the importance of proper food safety techniques for restaurants to prevent illness

Compliance with a New York State 2010 HIV Testing Law: Is There Racial/Ethnic Bias in HIV Testing? Experience of Monroe County, New York, 2012

Background: While routine HIV testing in the general population is a national recommendation, actual practice may vary. Purpose: To determine risk factors associated with HIV testing after the adoption of a New York State law in 2010 mandating that healthcare providers offer HIV testing in all clinical settings. Methods.: Survey data from Monroe County, New York, were collected in 2012 for adults aged 18-64 years and analyzed in 2014. Logistic regression was used to identify risk factors independently associated with HIV testing and high-risk behavior. Results: Among adults aged 18-34 years, fewer Whites were offered HIV testing in the past year by their doctors compared with Blacks (34% vs 64%) despite having similar rates of any HIV high-risk behavior (20% overall). For adults aged 35-64 years, fewer Whites than Blacks were ever tested for HIV (42% vs 71%), offered HIV testing in past year (17% vs 40%), and reported any HIV high-risk behavior (3% vs 13%). Latinos showed intermediate levels. With logistic regression analysis, ever tested for HIV was independently associated with only race/ethnicity; offered HIV testing in the past year was associated with females, Blacks and Latinos, aged 18-34 years, and having a routine health checkup in past year; any HIV high-risk behavior was associated with only younger age. Conclusions: To improve HIV testing rates as well as compliance with state laws and national guidelines, targeted efforts should be considered that improve perceptions of risk and emphasize the value of routine HIV screening, including those directed at white adults and their health care providers

Using Smartphone Apps in STD Interviews to Find Sexual Partners

Objectives. Smartphone applications (apps) are increasingly used to facilitate casual sexual relationships, increasing the risk of sexually transmitted diseases (STDs). In STD investigations, traditional contact elicitation methods can be enhanced with smartphone technology during field interviews. Methods. In 2013, the Monroe County Department of Public Health conducted a large, multi-infection STD investigation among men who have sex with men (MSM) using both index case and cluster interviews. When patients indicated meeting sexual partners online, disease intervention specialists (DISs) had access to smartphone apps and were able to elicit partners through access to inboxes and profiles where traditional contact information was lacking. Social network mapping was used to display the extent of the investigation and the impact of access to smartphones on the investigation. Results. A total of 14 index patient interviews and two cluster interviews were conducted; 97 individuals were identified among 117 sexual dyads. On average, eight partners were elicited per interview (range: 1–31). The seven individuals who used apps to find partners had an average of three Internet partners (range: 1–5). Thirty-six individuals either had a new STD (n=7) or were previously known to be HIV-positive (n=29). Of the 117 sexual dyads, 21 (18%) originated either online (n=8) or with a smartphone app (n=13). Of those originating online or with a smartphone app, six (29%) partners were located using the smartphone and two (10%) were notified of their exposure via a website. Three of the new STD/HIV cases were among partners who met online. Conclusion. Smartphone technology used by DISs in the field improved contact elicitation and resulted in successful partner notification and case finding

Measuring & Mapping Mortality in the Elm City: Identifying and Addressing Health Inequities in New Haven with Years of Potential Life Lost (YPLL) and Other Health Determinants

Population health in the City of New Haven, including health care access, health outcomes, and mortality, is influenced by socioeconomic disparities. These disparities exist on both the individual and neighborhood scale, and across demographics such as age, sex, race, and ethnicity. Continued analyses to understand these disparities is imperative to elucidate public health concerns and to design and to implement appropriate initiatives and interventions. The objectives of this study were as follows: To measure the leading causes of death, average life expectancy, and premature death in New Haven using mortality data and stratifying by key variables including age, sex, race, and ethnicity, and to characterize the relationships between mortality, geographic location, and other demographic variables.https://elischolar.library.yale.edu/ysph_pbchrr/1019/thumbnail.jp

Exercise professional education, qualifications, and certifications: a content analysis of job postings in the United States

IntroductionGrowth in the field of clinical exercise science and the potential impacts on overall health and wellbeing have driven the need for qualified, clinically trained, exercise professionals. And yet, it is not well understood what specific credentials employers are seeking when hiring exercise professionals.PurposeThe purpose of the study was to examine the qualification requirements for professionals seeking employment in exercise science, exercise physiology, kinesiology or equivalent fields.MethodsSearch platforms Indeed.com and USAJobs.gov were examined within a two week period in 2022. Search terms included “Exercise Physiology”, “Exercise Science”, “Exercise Professional”, “Exercise Prescription”, “Exercise Specialist”, and “Kinesiology”.ResultsA total of n = 739 jobs were retrieved and n = 615 jobs were included: Exercise Science (n = 227), Kinesiology (n = 210), Exercise Physiology (n = 91), Exercise specialist (n = 53), and Exercise prescription (n = 32). Over 70% of the jobs analyzed required a bachelor's degree with the remainder requiring various levels of education. The primary certification required was personal trainer (n = 94), followed by strength and conditioning specialist (n = 33), clinical exercise physiologist (n = 26), group exercise (n = 17), exercise specialist (n = 10), and exercise physiologist (n = 5). Four job focus areas were determined: academic teaching and research, general fitness and worksite wellness, athletic performance and rehabilitation, clinical exercise specialist all with varying levels of degree and certification requirements.DiscussionJob postings related to exercise related professions are varied across the United States with wide-ranging education, credentialing and certification requirements. These findings indicate the timely need for outreach to employers to highlight changing credentialing requirements due to evolving accreditation standards

Outbreak of Mycobacterium chelonae Infection Associated with Tattoo Ink

Background In January 2012, on the basis of an initial report from a dermatologist, we began to investigate an outbreak of tattoo-associated Mycobacterium chelonae skin and softtissue infections in Rochester, New York. The main goals were to identify the extent, cause, and form of transmission of the outbreak and to prevent further cases of infection. Methods We analyzed data from structured interviews with the patients, histopathological testing of skin-biopsy specimens, acid-fast bacilli smears, and microbial cultures and antimicrobial susceptibility testing. We also performed DNA sequencing, pulsed-field gel electrophoresis (PFGE), cultures of the ink and ingredients used in the preparation and packaging of the ink, assessment of source water and faucets at tattoo parlors, and investigation of the ink manufacturer. Results Between October and December 2011, a persistent, raised, erythematous rash in the tattoo area developed in 19 persons (13 men and 6 women) within 3 weeks after they received a tattoo from a single artist who used premixed gray ink; the highest occurrence of tattooing and rash onset was in November (accounting for 15 and 12 patients, respectively). The average age of the patients was 35 years (range, 18 to 48). Skin-biopsy specimens, obtained from 17 patients, showed abnormalities in all 17, with M. chelonae isolated from 14 and confirmed by means of DNA sequencing. PFGE analysis showed indistinguishable patterns in 11 clinical isolates and one of three unopened bottles of premixed ink. Eighteen of the 19 patients were treated with appropriate antibiotics, and their condition improved. Conclusions The premixed ink was the common source of infection in this outbreak. These findings led to a recall by the manufacturer

Robotic Follow-Up for Human Exploration

We are studying how "robotic follow-up" can improve future planetary exploration. Robotic follow-up, which we define as augmenting human field work with subsequent robot activity, is a field exploration technique designed to increase human productivity and science return. To better understand the benefits, requirements, limitations and risks associated with this technique, we are conducting analog field tests with human and robot teams at the Haughton Crater impact structure on Devon Island, Canada. In this paper, we discuss the motivation for robotic follow-up, describe the scientific context and system design for our work, and present results and lessons learned from field testing