The Housing Price Bubble In A Suburban Georgia Setting: Using The Hedonic Pricing Model In The New South

This study applies a hedonic pricing model to the rapidly developing suburban housing market adjacent to the Savannah Historic Landmark District in the downtown area of Savannah, Georgia. Using OLS estimation, the hedonic pricing model yields results clearly tracing out the magnitude of the time-related housing price premium in the suburban market analyzed for the years from 2005 to 2010. The results also control for internal and external housing characteristics that are capitalized into the real sales prices of the housing transactions analyzed

Differences in Drowning Rates between Rural and Non-Rural Residents of Ontario, Canada

The objective of our study was to determine if rural residence was associated with an increased risk of drowning in Ontario, Canada. We conducted a retrospective cohort study of all unintentional drowning deaths in Ontario Canada from 2004 to 2008. Age-adjusted mortality rates for males and females living in rural and non-rural areas were calculated using direct standardization, with non-rural residents as the reference population. We identified a total of 564 unintentional drowning deaths. The majority (89%) of fatal drowning victims were male, and 75% percent of victims were from non-rural area. Excluding bathtub drowning deaths, the age-adjusted drowning mortality rate was significantly higher for both males (rate ratio 2.8; 95% CI, 2.3- 3.4) and females (rate ratio 2.8; 95% CI 1.5- 5.0) from rural compared to non-rural areas. In Ontario, rural residence was associated with an increased risk of unintentional drowning

Microsystems, Space Qualified Electronics and Mobile Sensor Platforms for Harsh Environment Applications and Planetary Exploration

NASA Glenn Research Center is presently developing and applying a range of sensor and electronic technologies that can enable future planetary missions. These include space qualified instruments and electronics, high temperature sensors for Venus missions, mobile sensor platforms, and Microsystems for detection of a range of chemical species and particulates. A discussion of each technology area and its level of maturity is given. It is concluded that there is a strong need for low power devices which can be mobile and provide substantial characterization of the planetary environment where and when needed. While a given mission will require tailoring of the technology for the application, basic tools which can enable new planetary missions are being developed

Flu Vaccine and Mortality in Hypertension:A Nationwide Cohort Study

BACKGROUND: Influenza infection may increase the risk of stroke and acute myocardial infarction (AMI). Whether influenza vaccination may reduce mortality in patients with hypertension is currently unknown. METHODS AND RESULTS: We performed a nationwide cohort study including all patients with hypertension in Denmark during 9 consecutive influenza seasons in the period 2007 to 2016 who were prescribed at least 2 different classes of antihypertensive medication (renin‐angiotensin system inhibitors, diuretics, calcium antagonists, or beta‐blockers). We excluded patients who were aged 100 years, had ischemic heart disease, heart failure, chronic obstructive lung disease, cancer, or cerebrovascular disease. The exposure to influenza vaccination was assessed before each influenza season. The end points were defined as death from all‐causes, from cardiovascular causes, or from stroke or AMI. For each influenza season, patients were followed from December 1 until April 1 the next year. We included a total of 608 452 patients. The median follow‐up was 5 seasons (interquartile range, 2–8 seasons) resulting in a total follow‐up time of 975 902 person‐years. Vaccine coverage ranged from 26% to 36% during the study seasons. During follow‐up 21 571 patients died of all‐causes (3.5%), 12 270 patients died of cardiovascular causes (2.0%), and 3846 patients died of AMI/stroke (0.6%). After adjusting for confounders, vaccination was significantly associated with reduced risks of all‐cause death (HR, 0.82; P<0.001), cardiovascular death (HR, 0.84; P<0.001), and death from AMI/stroke (HR, 0.90; P=0.017). CONCLUSIONS: Influenza vaccination was significantly associated with reduced risks of death from all‐causes, cardiovascular causes, and AMI/stroke in patients with hypertension. Influenza vaccination might improve outcome in hypertension

External influences and priority-setting for anti-cancer agents: a case study of media coverage in adjuvant trastuzumab for breast cancer

<p>Abstract</p> <p>Background</p> <p>Setting priorities for the funding of new anti-cancer agents is becoming increasingly complex. The funding of adjuvant trastuzumab for breast cancer has brought this dilemma to the fore. In this paper we review external factors that may influence decision-making bodies and present a case study of media response in Ontario, Canada to adjuvant trastuzumab for breast cancer.</p> <p>Methods</p> <p>A comprehensive search of the databases of Canadian national and local newspapers and television was performed. Articles pertaining to trastuzumab in adjuvant breast cancer as well as 17 other anti-cancer drugs and indications were retrieved. The search period was from the date when individual trial results were announced to the date funding was made available in Ontario.</p> <p>Results</p> <p>During the 2.6 months between the release of the trastuzumab results to funding approval in Ontario, we identified 51 episodes of media coverage. For the 17 other drugs/indications (7 breast and 10 non-breast), the median time to funding approval was 31 months (range 14–46). Other recent major advances in oncology such as adjuvant vinorelbine/cisplatin for resected NSCLC and docetaxel for advanced prostate cancer received considerably less media attention (17 media reports for each) than trastuzumab. The median number of media reports for breast cancer drugs was 4.5 compared to 2.5 for non-breast cancer drugs (p = 0.56).</p> <p>Conclusion</p> <p>Priority-setting for novel anti-cancer agents is a complex process that tries to ensure fair use of constrained resources to fund therapies with the best evidence of clinical benefit. However, this process is subject to external factors including the influence of media, patient advocates, politicians, and industry. The data in this case study serve to illustrate the significant involvement one (or all) of these external factors may play in the debate over priority-setting.</p

Sources of land-derived runoff to a coral reef-fringed embayment identified using geochemical tracers in nearshore sediment traps

This paper is not subject to U.S. copyright. The definitive version was published in Estuarine, Coastal and Shelf Science 85 (2009): 459-471, doi:10.1016/j.ecss.2009.09.014.Geochemical tracers, including Ba, Co, Th, 7Be, 137Cs and 210Pb, and magnetic properties were used to characterize terrestrial runoff collected in nearshore time-series sediment traps in Hanalei Bay, Kauai, during flood and dry conditions in summer 2006, and to fingerprint possible runoff sources in the lower watershed. In combination, the tracers indicate that runoff during a flood in August could have come from cultivated taro fields bordering the lower reach of the river. Land-based runoff associated with summer floods may have a greater impact on coral reef communities in Hanalei Bay than in winter because sediment persists for several months. During dry periods, sediment carried by the Hanalei River appears to have been mobilized primarily by undercutting of low 7Be, low 137Cs riverbanks composed of soil weathered from tholeiitic basalt with low Ba and Co concentrations. Following a moderate rainfall event in September, high 7Be sediment carried by the Hanalei River was probably mobilized by overland flow in the upper watershed. Ba-desorption in low-salinity coastal water limited its use to a qualitative runoff tracer in nearshore sediment. 210Pb had limited usefulness as a terrestrial tracer in the nearshore due to a large dissolved oceanic source and scavenging onto resuspended bottom sediment. 210Pb-scavenging does, however, illustrate the role resuspension could play in the accumulation of particle-reactive contaminants in nearshore sediment. Co and 137Cs were not affected by desorption or geochemical scavenging and showed the greatest potential as quantitative sediment provenance indicators in material collected in nearshore sediment traps

An RND-Type Efflux System in Borrelia burgdorferi Is Involved in Virulence and Resistance to Antimicrobial Compounds

Borrelia burgdorferi is remarkable for its ability to thrive in widely different environments due to its ability to infect various organisms. In comparison to enteric Gram-negative bacteria, these spirochetes have only a few transmembrane proteins some of which are thought to play a role in solute and nutrient uptake and excretion of toxic substances. Here, we have identified an outer membrane protein, BesC, which is part of a putative export system comprising the components BesA, BesB and BesC. We show that BesC, a TolC homolog, forms channels in planar lipid bilayers and is involved in antibiotic resistance. A besC knockout was unable to establish infection in mice, signifying the importance of this outer membrane channel in the mammalian host. The biophysical properties of BesC could be explained by a model based on the channel-tunnel structure. We have also generated a structural model of the efflux apparatus showing the putative spatial orientation of BesC with respect to the AcrAB homologs BesAB. We believe that our findings will be helpful in unraveling the pathogenic mechanisms of borreliae as well as in developing novel therapeutic agents aiming to block the function of this secretion apparatus

Sodium Glucose co-Transporter 2 (SGLT2) Inhibitors for Type 2 Diabetes Mellitus: Assessing their Safety and Effectiveness using Real-world Data

Background: Sodium glucose co-transporter 2 (SGLT2) inhibitors are a new class of medications for adults with type 2 diabetes mellitus. While their efficacy has been well established, less is known about their effectiveness and safety in routine care. The three studies for this thesis include: (1) To compare the cardiovascular effectiveness of SGLT2-inhibitors compared to metformin for people with diabetes who are treatment-naive; (2) To compare the risk of fracture with SGLT2-inhibitors compared to GLP1 agonists; and (3) To identify predictors of SGLT2-related diabetic ketoacidosis using Machine Learning. Methods: All three studies utilized routinely collected data from large healthcare databases in the United States and applied the new-user cohort design. Study 1 and 2 applied propensity-score matching and a Cox proportional hazards model to estimate the hazard ratios for the primary outcome. Study 3 utilized two popular machine learning techniques: least absolute shrinkage and selection operator regression and gradient boosted trees. Results: In Study 1, the primary outcome of stroke, myocardial infarction, or heart failure occurred in 198 individuals (32 events per 1,000 person-years) newly prescribed an SGLT2, compared to 223 individuals (31 events per 1,000 person-years) among 10,549 PS-matched new-users of metformin (HR = 1.02, 95% CI: 0.84, 1.23). In Study 2, 79,964 patients initiating canagliflozin who were propensity score matched to 79,964 patients initiating a GLP1-agonist. The primary outcome of hip fracture, pelvic fracture, humeral fracture, or wrist fracture was similar for canagliflozin (2.2 events per 1,000 person-years) compared to GLP1-agonists (2.3 events per 1,000 person-years). In Study 3, 111,597 adults newly prescribed an SGLT2 were identified. The following variables had strong associations with an inpatient diagnosis of diabetic ketoacidosis: prior DKA (OR = 4.62, 95% CI 1.06 – 20.14), digoxin use (OR = 4.38, 95% CI 1.98, 8.56), and a baseline hemoglobin A1C above 10% (OR = 3.10, 95% CI 1.93,4.98). Discussion: This thesis provides timely data to understand the safety and effectiveness of SGLT2-inhibitors in routine care. This was achieved through advanced pharmacoepidemiologic methods and machine-learning techniques. With the aid of open-source statistical packages, this body of work also provides a methodologic framework for conducting similar studies.Ph.D.2021-11-13 00:00:0

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