AudioCOMMUNICATOR Reminder Phone Calls to Increase Attendance of Well Child Visits

Background: The American Academy of Pediatrics recommends six well child checks (WCC) between 2 to 15 months. A large pediatric clinic in Southern California has an attendance rate of 86% and a very mobile population. Reminder phone calls have been shown to improve WCC attendance. Aims of Service Change: Improve WCC attendance to \u3e90%. As an interim step, we implemented a pilot project and measured responses to AudioCOMMUNICATOR™ reminder calls. Outcome: In two months 148 calls were made, the majority,74%, went unanswered. 26% were able to schedule an appointment or discharge from the clinic. Discussion: Reminder calls provide a simple way to schedule visits or update information. This technology could be used for other health promotion activities including immunizations, school/sports physicals, developmental screenings, and ADHD follow ups. A system with e-mail and text message capabilities would provide patients and families with other options for reminders, visit scheduling, and updating information

Transportation System Vulnerability and Resilience to Extreme Weather Events and Other Natural Hazards: Report for Pilot Project — KYTC District 1

This research’s objective is to assist the Kentucky Transportation Cabinet (KYTC) in its efforts to develop strategies to address natural hazard vulnerabilities and improve the resiliency of Kentucky’s transportation infrastructure. Recent federal legislation calls for state transportation agencies to develop a risk-based asset management plan for National Highway System (NHS) assets that includes consideration of natural hazards. Similarly, the Federal Highway Administration (FHWA) calls for state transportation agencies to identify potential vulnerabilities associated with extreme weather events and climate change, and to incorporate these findings into transportation planning, design, and maintenance practices

Efectos “in vivo” de Metformina sobre las alteraciones de la microarquitectura ósea asociadas al Síndrome Metabólico inducido por fructosa en ratas

El Síndrome Metabólico (SM) se ha asociado recientemente con una disminución en la densidad mineral ósea, y con un aumento en la incidencia de fracturas osteoporóticas. Recientemente encontramos que la Metformina por vía oral en ratas, promueve la diferenciación osteogénica de células progenitoras de médula ósea e incrementa la reparación de lesiones óseas. En este trabajo evaluamos los efectos del SM inducido por Fructosa sobre la microarquitectura ósea en ratas, y la modulación de estos efectos por Metformina administrada en forma oral. Utilizamos ratas Sprague Dawley macho jóvenes: C (control sin tratamiento), C+M (100mg/kg/día Metformina en el agua de bebida), F (10 % Fructosa en el agua de bebida) y F+M (Fructosa+Metformina en el agua de bebida). Los tratamientos se continuaron por 3 semanas luego de lo cual se tomaron muestras de sangre, previas al sacrificio de los animales. Se disecaron los fémures para evaluación histomorfométrica de la microarquitectura metafisaria por tinción con Hematoxilina-Eosina (H-E). Se observó un incremento en la glucemia y trigliceridemia en el grupo F versus el C, compatible con el desarrollo de SM. El análisis de las metáfisis femorales mostró un aumento en la densidad osteocítica trabecular para el grupo C+M (118 % del control, p<0,05). El tratamiento con Fructosa sola disminuyó la densidad osteocítica (79 % del control, p<0,05), mientras que el co-tratamiento Fructosa+Metformina (grupo F+M) revirtió parcialmente este descenso (88 % del control). Similarmente, el porcentaje de hueso trabecular en la metáfisis femoral aumentó luego del tratamiento sólo con Metformina (129 % respecto del control), se redujo en las ratas tratadas con Fructosa (89 % respecto del control), y fue intermedia en el grupo F+M (94 % respecto del control). Estos resultados muestran que el SM inducido por Fructosa en ratas altera la microarquitectura metafisaria femoral; y que estos efectos deletéreos pueden ser parcialmente prevenidos por un tratamiento oral con Metformina.Several clinical studies have demonstrated that the Metabolic Syndrome (MS) is associated with a decrease in bone mineral density, and with an increased risk for non-vertebral osteoporotic fractures. We have recently found that orally administered Metformin induces osteogenic effects in rats, promoting osteoblastic differentiation of bone marrow progenitor cells and increasing the repair of bone lesions. In the present work we have evaluated the effects of Fructose-induced MS on bone micro-architecture in rats, and the possiblemodulation of these effects by orally administered Metformin. We utilized young male Sprague-Dawley rats, divided into four groups: C (non-treated controls); C+M (100 mg/kg/day of Metformin in drinking water); F (10 % of Fructose in drinking water); and F+M (Fructose+Metformin in drinking water). After three weeks of all treatments blood samples were taken, after which animals were sacrificed by cervical dislocation under anaesthesia. Femurs were then dissected for evaluation of metaphyseal micro-architecture after Haematoxilin-Eosin staining of 5 μm histological slices of decalcified bone. In particular, osteocytic density and relative trabecular volume were determined. An increase in serum glucose and triglycerides was observed in Fructose-treated rats, in accordance with the development of MS. In rats treated with Metformin alone (group C+M), the analysis of femoral metaphyses showed an increase in trabecular osteocytic density (118 % of control [group C], p<0.05). Treatment with Fructose alone (group F) significantly decreased ostecytic density (79 % of control, p<0.05), while co-treatment with Fructose and Metformin partially reverted this decrease (group F+M, 88 % of control). Similarly, the relative trabecular volume of femoral metaphysic was increased by treatment with Metformin alone (129% of control), was reduced in Fructose-treated rats (89 % of control), and tended to revert back to control values after Fructose-Metformin co-treatment (94 % of control). These results show for the first time that (a) Fructose-induced MS in rats alters their femoral metaphysis micro-architecture; and that (b) these deleterious effects can be partially prevented by orally administered Metformin

Montelukast in the treatment of duodenal eosinophilia in children with dyspepsia: Effect on eosinophil density and activation in relation to pharmacokinetics

<p>Abstract</p> <p>Background</p> <p>We have previously demonstrated the clinical efficacy of montelukast in a randomized double-blind controlled cross-over trial in patients with dyspepsia in association with duodenal eosinophilia. The mechanism of this clinical response is unknown but could involve a decrease in eosinophil density or activation.</p> <p>Methods</p> <p>Twenty-four dyspeptic patients 8–17 years of age underwent initial blood sampling and endoscopy with biopsy. Eighteen of these patients had elevated duodenal eosinophil density and underwent repeat blood sampling and endoscopy following 21 days of therapy with montelukast (10 mg/day). The following were determined: global clinical response on a 5-point Lickert-type scale, eosinophil density utilizing H & E staining, eosinophil activation determined by degranulation indices on electron microscopy, and serum cytokine concentrations. On day 21, pharmacokinetics and duodenal mucosal drug concentrations were determined.</p> <p>Results</p> <p>Eighty-three percent of the patients had a positive clinical response to montelukast with regard to relief of pain with 50% having a complete or nearly complete clinical response. The response was unrelated to systemic drug exposure or to mucosal drug concentration. Other than a mild decrease in eosinophil density in the second portion of the duodenum, there were no significant changes in eosinophil density, eosinophil activation, or serum cytokine concentrations following treatment with montelukast. Pre-treatment TNF-α concentration was negatively correlated with clinical response.</p> <p>Conclusion</p> <p>The short-term clinical response to montelukast does not appear to result from changes in eosinophil density or activation. Whether the effect is mediated through specific mediators or non-inflammatory cells such as enteric nerves remains to be determined.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov; NCT00148603</p

Guidelines for the diagnosis, prevention and treatment of osteoporosis, 2012

La osteoporosis es una patología en constante crecimiento y que afecta a más de 200 millones de personas a nivel mundial. Las recomendaciones presentes son guías para el diagnóstico, la prevención y tratamiento pero no normas para las decisiones clínicas en pacientes individuales. El médico debe adaptarlas a situaciones y pacientes deferentes, incorporando factores personales que trascienden los límites de estas guías y hacen al saber y al arte del médico. Como todo conocimiento médico científico deben ser revisadas y actualizadas periódicamente a medida que se adquieran nuevas, mejores y más efectivas herramientas diagnósticas y terapéuticas.Osteoporosis is a constantly growing disease which affects over 200 million people worldwide. The present recommendations are guidelines for its diagnosis, prevention and treatment, but they do not constitute standards for clinical decisions in individual patients. The physician must adapt them to individual patients and special situations, incorporating personal factors that transcend the limits of these guidelines and are dependent on the knowledge and art of the physician. These guidelines should be reviewed and updated periodically as new, better and more effective diagnostic and therapeutic tools become available.Fil: Schurman, Leon. Grupo de Investigación en Osteopatías y Metabolismo Mineral; ArgentinaFil: Bagur, Alicia. Centro de Osteopatías Médicas; ArgentinaFil: Claus Hermberg, Heraldo. Hospital Alemán; ArgentinaFil: Messina, Osvaldo D.. Ministerio de Defensa. Ejercito Argentino. Hospital Militar Central Cirujano Mayor "Cosme Argerich"; ArgentinaFil: Negri, Armando L.. Universidad del Salvador; ArgentinaFil: Sánchez, Ariel. Centro de Endocrinología; ArgentinaFil: González, Claudio. Centro de Educación Médica e Investigaciones Clínicas; ArgentinaFil: Diehl, María. Hospital Italiano de Buenos Aires; ArgentinaFil: Rey, Paula. Universidad del Salvador; ArgentinaFil: Gamba, Julieta. Ministerio de Defensa. Ejercito Argentino. Hospital Militar Central Cirujano Mayor "Cosme Argerich"; ArgentinaFil: Chiarpenello, Javier. Universidad Nacional de Rosario; ArgentinaFil: Moggia, María Susana. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Mastaglia, Silvina Rosana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Inmunología, Genética y Metabolismo; Argentin

Chemical characteristics of brown carbon in atmospheric particles at a suburban site near Guangzhou, China

Light-absorbing organic carbon (or brown carbon, BrC) in atmospheric particles has received much attention for its potential role in global radiative forcing. While a number of field measurement campaigns have differentiated light absorption by black carbon (BC) and BrC, the chemical characteristics of BrC are not well understood. In this study, we present co-located real-time light absorption and chemical composition measurements of atmospheric particles to explore the relationship between the chemical and optical characteristics of BrC at a suburban site downwind of Guangzhou, China, from November to December 2014. BrC and BC contributions to light absorption were estimated using measurements from a seven-wavelength aethalometer, while the chemical composition of non-refractory PM1 was measured with a high-resolution time-of-flight aerosol mass spectrometer (HR-ToF-AMS). Using the absorption Ångström exponent (AAE) method, we estimated that BrC contributed 23.6&thinsp;% to the total aerosol absorption at 370&thinsp;nm, 18.1&thinsp;% at 470&thinsp;nm, 10.7&thinsp;% at 520&thinsp;nm, 10.7&thinsp;% at 590&thinsp;nm, and 10.5&thinsp;% at 660&thinsp;nm. Biomass burning organic aerosol (BBOA) has the highest mass absorption coefficient among sources of organic aerosols. Its contribution to total brown carbon absorption coefficient decreased but that of low-volatility oxygenated organic aerosol (LVOOA) increased with increasing wavelength, suggesting the need for wavelength-dependent light absorption analysis for BrC in association with its chemical makeup. Clear correlations of N-containing ion fragments with absorption coefficient were observed. These correlations also depended on their degrees of unsaturation/cyclization and oxygenation. While the current study relates light absorption by BrC to ion fragments, more detailed chemical characterization is warranted to constrain this relationship.</p

Natural disturbance impacts on trade-offs and co-benefits of forest biodiversity and carbon

With accelerating environmental change, understanding forest disturbance impacts on trade-offs between biodiversity and carbon dynamics is of high socio-economic importance. Most studies, however, have assessed immediate or short-term effects of disturbance, while long-term impacts remain poorly understood. Using a tree-ring-based approach, we analysed the effect of 250 years of disturbances on present-day biodiversity indicators and carbon dynamics in primary forests. Disturbance legacies spanning centuries shaped contemporary forest co-benefits and trade-offs, with contrasting, local-scale effects. Disturbances enhanced carbon sequestration, reaching maximum rates within a comparatively narrow post-disturbance window (up to 50 years). Concurrently, disturbance diminished aboveground carbon storage, which gradually returned to peak levels over centuries. Temporal patterns in biodiversity potential were bimodal; the first maximum coincided with the short-term post-disturbance carbon sequestration peak, and the second occurred during periods of maximum carbon storage in complex old-growth forest. Despite fluctuating local-scale trade-offs, forest biodiversity and carbon storage remained stable across the broader study region, and our data support a positive relationship between carbon stocks and biodiversity potential. These findings underscore the interdependencies of forest processes, and highlight the necessity of large-scale conservation programmes to effectively promote both biodiversity and long-term carbon storage, particularly given the accelerating global biodiversity and climate crises

Bone Mass and Strength in Older Men With Type 2 Diabetes: The Osteoporotic Fractures in Men Study

The effects of type 2 diabetes mellitus (T2DM) on bone volumetric density, bone geometry, and estimates of bone strength are not well established. We used peripheral quantitative computed tomography (pQCT) to compare tibial and radial bone volumetric density (vBMD, mg/cm3), total (ToA, mm2) and cortical (CoA, mm2) bone area and estimates of bone compressive and bending strength in a subset (n = 1171) of men (≥65 years of age) who participated in the multisite Osteoporotic Fractures in Men (MrOS) study. Analysis of covariance–adjusted bone data for clinic site, age, and limb length (model 1) and further adjusted for body weight (model 2) were used to compare data between participants with (n = 190) and without (n = 981) T2DM. At both the distal tibia and radius, patients with T2DM had greater bone vBMD (+2% to +4%, model 1, p < .05) and a smaller bone area (ToA −1% to −4%, model 2, p < .05). The higher vBMD compensated for lower bone area, resulting in no differences in estimated compressive bone strength at the distal trabecular bone regions. At the mostly cortical bone midshaft sites of the radius and tibia, men with T2DM had lower ToA (−1% to −3%, p < .05), resulting in lower bone bending strength at both sites after adjusting for body weight (−2% to −5%, p < .05) despite the lack of difference in cortical vBMD at these sites. These data demonstrate that older men with T2DM have bone strength that is low relative to body weight at the cortical-rich midshaft of the radius despite no difference in cortical vBMD. © 2010 American Society for Bone and Mineral Researc

Human RECQL5β stimulates flap endonuclease 1

Human RECQL5 is a member of the RecQ helicase family which is implicated in genome maintenance. Five human members of the family have been identified; three of them, BLM, WRN and RECQL4 are associated with elevated cancer risk. RECQL1 and RECQL5 have not been linked to any human disorder yet; cells devoid of RECQL1 and RECQL5 display increased chromosomal instability. Here, we report the physical and functional interaction of the large isomer of RECQL5, RECQL5β, with the human flap endonuclease 1, FEN1, which plays a critical role in DNA replication, recombination and repair. RECQL5β dramatically stimulates the rate of FEN1 cleavage of flap DNA substrates. Moreover, we show that RECQL5β and FEN1 interact physically and co-localize in the nucleus in response to DNA damage. Our findings, together with the previous literature on WRN, BLM and RECQL4’s stimulation of FEN1, suggests that the ability of RecQ helicases to stimulate FEN1 may be a general feature of this class of enzymes. This could indicate a common role for the RecQ helicases in the processing of oxidative DNA damage

Reliability, validity and psychometric properties of the Greek translation of the Major Depression Inventory

BACKGROUND: The Major Depression Inventory (MDI) is a brief self-rating scale for the assessment of depression. It is reported to be valid because it is based on the universe of symptoms of DSM-IV and ICD-10 depression. The aim of the current preliminary study was to assess the reliability, validity and psychometric properties of the Greek translation of the MDI. METHODS: 30 depressed patients of mean age 23.41 (± 5.77) years, and 68 controls patients of mean age 25.08 (± 11.42) years, entered the study. In 18 of them, the instrument was re-applied 1–2 days later and the Translation and Back Translation made. Clinical diagnosis was reached with the use of the SCAN v.2.0 and the International Personality Disorders Examination (IPDE). The Center for Epidemiological Studies-Depression (CES-D) and the Zung Depression Rating Scale (ZDRS) were applied for cross-validation purposes. Statistical analysis included ANOVA, the Spearman Product Moment Correlation Coefficient, Principal Components Analysis and the calculation of Cronbach's α. RESULTS: Sensitivity and specificity were 0.86 and 0.94, respectively, at 26/27. Cronbach's α for the total scale was equal to 0.89. The Spearman's rho between MDI and CES-D was 0.86 and between MDI and ZDRS was 0.76. The factor analysis revealed two factors but the first accounted for 54% of variance while the second only for 9%. The test-retest reliability was excellent (Spearman's rho between 0.53 and 0.96 for individual items and 0.89 for total score). CONCLUSION: The current study provided preliminary evidence concerning the reliability and validity of the Greek translation of the MDI. Its properties are similar to those reported in the international literature, but further research is necessary