6,447 research outputs found

    A prospective observational study of mycophenolate mofetil treatment in progressive diffuse cutaneous systemic sclerosis of recent onset.

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    OBJECTIVE: A prospective observational study of mycophenolate mofetil (MMF) treatment in patients with diffuse progressive cutaneous systemic sclerosis (SSc) of recent onset. METHODS: Twenty-five previously untreated consecutive patients with recent-onset (\u3c 24 mo) diffuse progressive cutaneous SSc received MMF as the only disease-modifying therapy. Modified Rodnan skin score (mRSS) and affected body surface area (BSA) were compared from initiation of MMF to study end. Pulmonary function tests performed at the same institution before therapy and at study end were available in 15 patients. Histopathology and real-time PCR assessment of fibrosis-related gene expression were performed before and after treatment in skin biopsies from 3 patients. RESULTS: At 18.2 ± 8.73 months of MMF therapy (median 2000 mg/day) the mRSS decreased from 24.56 ± 8.62 to 14.52 ± 10.9 (p = 0.0004) and the affected BSA from 36% ± 16% to 14% ± 13.3% (p = 0.00001). Pulmonary function tests remained stable from initiation of MMF to the end of the study. Skin histopathology showed a remarkable reduction in accumulation of fibrotic tissue. Real-time PCR of skin biopsies demonstrated a marked decrease in expression of fibrosis-related genes. CONCLUSION: Patients with diffuse progressive cutaneous SSc of recent onset treated with MMF experienced marked improvement in skin involvement and stabilization of pulmonary function. Skin biopsies from 3 patients demonstrated histopathological improvement and decreased expression of fibrosis-related genes

    Predictors of Increases in Alcohol Problems and Alcohol Use Disorders in Offspring in the San Diego Prospective Study.

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    BackgroundThe 35-year-long San Diego Prospective Study documented 2-fold increases in alcohol problems and alcohol use disorders (AUDs) in young-adult drinking offspring compared to rates in their fathers, the original probands. The current analyses use the same interviews and questionnaires at about the same age in members of the 2 generations to explore multiple potential contributors to the generational differences in adverse alcohol outcomes.MethodsUsing data from recent offspring interviews, multiple cross-generation differences in characteristics potentially related to alcohol problems were evaluated in 3 steps: first through direct comparisons across probands and offspring at about age 30; second by backward linear regression analyses of predictors of alcohol problems within each generation; and finally third through R-based bootstrapped linear regressions of differences in alcohol problems in randomly matched probands and offspring.ResultsThe analyses across the analytical approaches revealed 3 consistent predictors of higher alcohol problems in the second generation. These included the following: (i) a more robust relationship to alcohol problems for offspring with a low level of response to alcohol; (ii) higher offspring values for alcohol expectancies; and (iii) higher offspring impulsivity.ConclusionsThe availability of data across generations offered a unique perspective for studying characteristics that may have contributed to a general finding in the literature of substantial increases in alcohol problems and AUDs in recent generations. If replicated, these results could suggest approaches to be used by parents, healthcare workers, insurance companies, and industry in their efforts to mitigate the increasing rates of alcohol problems in younger generations

    Analytic solutions to the accretion of a rotating finite cloud towards a central object - II. Schwarzschild spacetime

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    We construct a general relativistic model for the accretion flow of a rotating finite cloud of non-interacting particles infalling onto a Schwarzschild black hole. The streamlines start at a spherical shell, where boundary conditions are fixed, and are followed down to the point at which they either cross the black hole horizon or become incorporated into an equatorial thin disc. Analytic expressions for the streamlines and the velocity field are given, in terms of Jacobi elliptic functions, under the assumptions of stationarity and ballistic motion. A novel approach allows us to describe all of the possible types of orbit with a single formula. A simple numerical scheme is presented for calculating the density field. This model is the relativistic generalisation of the Newtonian one developed by Mendoza, Tejeda, Nagel, 2009 and, due to its analytic nature, it can be useful in providing a benchmark for general relativistic hydrodynamical codes and for exploring the parameter space in applications involving accretion onto black holes when the approximations of steady state and ballistic motion are reasonable ones.Comment: 12 pages, 6 figures, references and minor changes added to match version accepted for publication in MNRA

    Healing the Health Care System: Asian American Voices for Health Care Reform

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    This report presents key findings from a series of community health care discussions of Asian American community members in New York City conducted by Project CHARGE. Project CHARGE (Coalition for Health Access to Reach Greater Equity) is a New York City based collaborative of 15 organizations devoted to improving healthcare access for Asian Americans through capacity building and health policy advocacy. The top 3 concerns expressed by the 128 participants included:Regardless of insurance coverage, Asian Americans are worried about health care costs.Language barriers exist for Asian Americans even with language access laws.Few health education and outreach efforts are targeting Asian Americans.Based on these findings, Project CHARGE analyzed how particular provisions from the Patient Protection and Affordable Care Act (HR 3590) as amended by the Health Care and Education Reconciliation Act of 2010 (HR 4872) impacts the Asian American community. This report offers key recommendations which New York State do to be more effective in serving Asian Pacific American families

    Hot topics, urgent priorities, and ensuring success for racial/ethnic minority young investigators in academic pediatrics.

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    BackgroundThe number of racial/ethnic minority children will exceed the number of white children in the USA by 2018. Although 38% of Americans are minorities, only 12% of pediatricians, 5% of medical-school faculty, and 3% of medical-school professors are minorities. Furthermore, only 5% of all R01 applications for National Institutes of Health grants are from African-American, Latino, and American Indian investigators. Prompted by the persistent lack of diversity in the pediatric and biomedical research workforces, the Academic Pediatric Association Research in Academic Pediatrics Initiative on Diversity (RAPID) was initiated in 2012. RAPID targets applicants who are members of an underrepresented minority group (URM), disabled, or from a socially, culturally, economically, or educationally disadvantaged background. The program, which consists of both a research project and career and leadership development activities, includes an annual career-development and leadership conference which is open to any resident, fellow, or junior faculty member from an URM, disabled, or disadvantaged background who is interested in a career in academic general pediatrics.MethodsAs part of the annual RAPID conference, a Hot Topic Session is held in which the young investigators spend several hours developing a list of hot topics on the most useful faculty and career-development issues. These hot topics are then posed in the form of six "burning questions" to the RAPID National Advisory Committee (comprised of accomplished, nationally recognized senior investigators who are seasoned mentors), the RAPID Director and Co-Director, and the keynote speaker.Results/conclusionsThe six compelling questions posed by the 10 young investigators-along with the responses of the senior conference leadership-provide a unique resource and "survival guide" for ensuring the academic success and optimal career development of young investigators in academic pediatrics from diverse backgrounds. A rich conversation ensued on the topics addressed, consisting of negotiating for protected research time, career trajectories as academic institutions move away from an emphasis on tenure-track positions, how "non-academic" products fit into career development, racism and discrimination in academic medicine and how to address them, coping with isolation as a minority faculty member, and how best to mentor the next generation of academic physicians

    Integrating new assessment strategies into mathematics classrooms: an exploratory study in Singapore primary and secondary schools

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    Educational researchers and practitioners have in recent years paid mounting attention to the importance of new assessment (or the so-called alternative assessment) strategies in Mathematics instruction to better reflect the new desired educational goals and shifted values in education. However, research is wanting in this area, particularly in Singapore's educational setting. This project seeks to investigate the influence of using new assessment strategies in Mathematics teaching and learning on students' achievements, in both the cognitive and affective domains, in our local school settings. A quasi-experimental study with about 15-20 teachers at primary and lower secondary levels will be carried out to assess the impact of using a variety of strategies (e.g., projects, journal writing, oral presentation, performance tasks, student self-assessment, classroom observation and interview, etc.) for three school semesters on students' learning. The project will also look into issues concerning how to use new assessment strategies effectively in classrooms in local schools. For this purpose, data will be collected from classroom observation, interviews with teachers and students, and questionnaire surveys. It is hoped that the project will provide research-based evidence and practical suggestions for promoting the effective use of alternative assessment in Singapore Mathematics classrooms. <br/

    Adopting Team-Based Learning for In-Service Teachers: A Case Study

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    Team-based learning (TBL) is an instructional pedagogy that has gained recent popularity due to its effectiveness in disciplines such as medicine and business. However, TBL has not been widely adopted in teacher education based on reviews of research and practitioner based literature. The purpose of this case study was to assess the implementation and effectiveness of TBL in a Singapore teaching institute with thirty in-service teachers. Quantitative and qualitative data was collected from teachers about their experience learning through TBL. Research findings revealed that 1) teachers generally perceived TBL to be a positive experience, although several areas for improvement were suggested; 2) quality of scores through TBL was high, with team scores being significantly higher than individual scores. The findings from this study have the potential to guide the design of future TBL courses in education

    Sistema de información y la gestión comercial de los trabajadores en la empresa Sodimac Perú S.A. – Huacho, 2021

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    Título de la investigación: “Sistema de información y la gestión comercial de los trabajadores en la Empresa Sodimac Perú S.A. – Huacho, 2021”, Autor: Bach. Stalin Lee Varillas Mendoza. Objetivo: Conocer el Sistema de información y su relación con la gestión comercial de los trabajadores en la Empresa Sodimac Perú S.A. – Huacho, 2021. Metodología: Se utilizó el método científico del tipo investigación fue básico y se denomina puro o fundamental. El nivel de investigación está relacionado, es decir, el investigador utiliza métodos deductivos para meditar de forma razonable para responder a las preguntas planteadas. Y tiene el soporte principal, la observación. Hipótesis: El sistema de información se relaciona significativamente con la gestión comercial de los trabajadores en la Empresa Sodimac Perú S.A. – Huacho, 2021. Población: Estuvo constituido con población de 46 trabajadores de la empresa Sodimac Huacho que fueron las unidades de observación y encuestados. Las técnicas utilizadas en este estudio fueron observaciones no estructuradas, encuestas estructuradas, literatura y cada herramienta utilizada. En cuanto a la recolección de información se establece un cuestionario, el cual contiene una pregunta para medir la variable independiente y una pregunta para medir la variable dependiente, para luego utilizar la herramienta de recolección de datos y el paquete estadístico SPSS25.0 para procesar la información estadísticamente. analizar datos. Se analizan e interpretan tablas y estadísticas, y en ellas se presentan los resultados relevantes. Bajo supuestos generales, el valor de Spearman devuelve 0,794, lo que representa una buena correlación y, finalmente llega a la conclusión general: Existe relación directa y significativamente entre el sistema de información y la gestión comercial de los trabajadores en la Empresa Sodimac Perú S.A. – Huacho, 2021
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