Marcellus Shale Natural Gas Development Increased Income for Rural Pennsylvania Families, but Youth Obesity Rates Remained High

A new study finds that despite increased income due to MarcellusShale, childhood obesity in rural PA remain unchanged

Test-Retest Reliability of Postural Control Assessment on Biodex BioSway™

Background. Recent protocols for posturographic assessment of postural control and balance have included head shake test conditions to challenge the vestibular contributions of postural control in an effort to increase the diagnostic accuracy of identifying individuals with impaired balance. However, evidence is limited regarding the test-retest reliability of such assessment protocols. Purpose. The purpose of this study was twofold: to determine the test-retest reliability of postural control assessment on the Biodex Biosway™, an accessible and field expedient tool for posturographic assessment, and to determine the test-retest reliability of the Head Shake Sensory Interaction and Balance Test (HS-SIB), an adaptation of the modified Clinical Test of Sensory Interaction and Balance (mCTSIB) which adds two head shake conditions to challenge the vestibular contributions to postural control. Study Design. This was a correlational time series cohort study completed in a biomechanics laboratory. Methods. The sample consisted of nineteen healthy adults (10 females, 9 males). Sway Index, Equilibrium Score, and the area of the ellipse enclosing 95% of the anterior-posterior (AP) and medial-lateral (ML) center of gravity (COG) displacement (AREA95) are the 3 summary variables. Standard Error of Measurement (SEM) and Minimum Detectable Change (MDC) are also reported. Results. Test-retest reliability was generally poor with limited exceptions. Moderate to good reliability was observed for the more challenging stance conditions (ICC range 0.58-0.81), including those with head shake. Conclusions. Field-expedient systems, such as the Biodex BioSway™, may offer reliable posturographic testing where gold-standard methods are not available. Clinicians should be aware that less demanding test conditions have limited reliability; however, test-retest reliability of this assessment tool is improved with more challenged stance conditions and the inclusion of a head shake task

Unsupervised hyperspectral data mining and bioimaging by information entropy and self-modeling curve resolution

Unsupervised estimation of the dimensionality of hyperspectral microspectroscopy datasets containing pure and mixed spectral features, and extraction of their representative endmember spectra, remains a challenge in biochemical data mining. We report a new versatile algorithm building on semi-nonnegativity constrained self-modeling curve resolution and information entropy, to estimate the quantity of separable biochemical species from hyperspectral microspectroscopy, and extraction of their representative spectra. The algorithm is benchmarked with established methods from satellite remote sensing, spectral unmixing, and clustering. To demonstrate the widespread applicability of the developed algorithm, we collected hyperspectral datasets using spontaneous Raman, Coherent Anti-stokes Raman Scattering and Fourier Transform IR, of seven reference compounds, an oil-in-water emulsion, and tissue-engineered extracellular matrices on poly-L-lactic acid and porcine jejunum-derived small intestine submucosa scaffolds seeded with bovine chondrocytes. We show the potential of the developed algorithm by consolidating hyperspectral molecular information with sample microstructure, pertinent to fields ranging from gastrophysics to regenerative medicine

A randomized trial comparing skin antiseptic agents at Cesarean delivery

BACKGROUND: Preoperative skin antisepsis has the potential to decrease the risk of surgical-site infection. However, evidence is limited to guide the choice of antiseptic agent at cesarean delivery, which is the most common major surgical procedure among women in the United States. METHODS: In this single-center, randomized, controlled trial, we evaluated whether the use of chlorhexidine–alcohol for preoperative skin antisepsis was superior to the use of iodine–alcohol for the prevention of surgical-site infection after cesarean delivery. We randomly assigned patients undergoing cesarean delivery to skin preparation with either chlorhexidine–alcohol or iodine–alcohol. The primary outcome was superficial or deep surgical-site infection within 30 days after cesarean delivery, on the basis of definitions from the Centers for Disease Control and Prevention. RESULTS: From September 2011 through June 2015, a total of 1147 patients were enrolled; 572 patients were assigned to chlorhexidine–alcohol and 575 to iodine–alcohol. In an intention-to-treat analysis, surgical-site infection was diagnosed in 23 patients (4.0%) in the chlorhexidine–alcohol group and in 42 (7.3%) in the iodine–alcohol group (relative risk, 0.55; 95% confidence interval, 0.34 to 0.90; P = 0.02). The rate of superficial surgical-site infection was 3.0% in the chlorhexidine–alcohol group and 4.9% in the iodine–alcohol group (P = 0.10); the rate of deep infection was 1.0% and 2.4%, respectively (P = 0.07). The frequency of adverse skin reactions was similar in the two groups. CONCLUSIONS: The use of chlorhexidine–alcohol for preoperative skin antisepsis resulted in a significantly lower risk of surgical-site infection after cesarean delivery than did the use of iodine–alcohol. (Funded by the National Institutes of Health and Washington University School of Medicine in St. Louis; ClinicalTrials.gov number, NCT01472549.

Sandia National Laboratories Advanced Simulation and Computing (ASC) software quality plan : ASC software quality engineering practices Version 3.0.

The purpose of the Sandia National Laboratories (SNL) Advanced Simulation and Computing (ASC) Software Quality Plan is to clearly identify the practices that are the basis for continually improving the quality of ASC software products. Quality is defined in the US Department of Energy/National Nuclear Security Agency (DOE/NNSA) Quality Criteria, Revision 10 (QC-1) as 'conformance to customer requirements and expectations'. This quality plan defines the SNL ASC Program software quality engineering (SQE) practices and provides a mapping of these practices to the SNL Corporate Process Requirement (CPR) 001.3.6; 'Corporate Software Engineering Excellence'. This plan also identifies ASC management's and the software project teams responsibilities in implementing the software quality practices and in assessing progress towards achieving their software quality goals. This SNL ASC Software Quality Plan establishes the signatories commitments to improving software products by applying cost-effective SQE practices. This plan enumerates the SQE practices that comprise the development of SNL ASC's software products and explains the project teams opportunities for tailoring and implementing the practices

Developmental expression and differentiation-related neuron-specific splicing of metastasis suppressor 1 (Mtss1) in normal and transformed cerebellar cells

Background: Mtss1 encodes an actin-binding protein, dysregulated in a variety of tumors, that interacts with sonic hedgehog/Gli signaling in epidermal cells. Given the prime importance of this pathway for cerebellar development and tumorigenesis, we assessed expression of Mtss1 in the developing murine cerebellum and human medulloblastoma specimens. Results: During development, Mtss1 is transiently expressed in granule cells, from the time point they cease to proliferate to their synaptic integration. It is also expressed by granule cell precursor-derived medulloblastomas. In the adult CNS, Mtss1 is found exclusively in cerebellar Purkinje cells. Neuronal differentiation is accompanied by a switch in Mtss1 splicing. Whereas immature granule cells express a Mtss1 variant observed also in peripheral tissues and comprising exon 12, this exon is replaced by a CNS-specific exon, 12a, in more mature granule cells and in adult Purkinje cells. Bioinformatic analysis of Mtss1 suggests that differential exon usage may affect interaction with Fyn and Src, two tyrosine kinases previously recognized as critical for cerebellar cell migration and histogenesis. Further, this approach led to the identification of two evolutionary conserved nuclear localization sequences. These overlap with the actin filament binding site of Mtss1, and one also harbors a potential PKA and PKC phosphorylation site. Conclusion: Both the pattern of expression and splicing of Mtss1 is developmentally regulated in the murine cerebellum. These findings are discussed with a view on the potential role of Mtss1 for cytoskeletal dynamics in developing and mature cerebellar neurons

Differentiating Urban Forms: A Neighborhood Typology for Understanding Urban Water Systems

With rising populations and changing climates, urban areas need water systems capable of meeting a range of social, economic and environmental sustainability objectives. Different configurations of urban growth and development also produce varying water system outcomes. In this paper we develop a multi-dimensional classification scheme that identifies distinct configurations of ‘urban forms’ in Northern Utah, USA. We identified characteristics within urban landscapes that have been linked in the scientific literature to three types of water outcomes: water demand, water budgets, and water quality. Using publicly-available data at the census block scale, we create a typology of urban neighborhoods that share distinctive combinations of natural, built, and social structures that are expected to shape water system dynamics. The resulting typology provides a conceptual and empirical basis to generate hypotheses and design studies of complex urban water systems. We illustrate the value of the typology by using data from surveys of urban residents. While our typology classifications are unique to this region, the methodology relies on publicly available data and could be replicated in other urban areas

Implementation of the national antimicrobial stewardship competencies for UK undergraduate healthcare professional education within undergraduate pharmacy programmes: a survey of UK schools of pharmacy.

Pharmacists play a key role in antimicrobial stewardship (AMS). Consensus-based national AMS competencies for undergraduate healthcare professionals in the UK reflect the increasing emphasis on competency-based healthcare professional education. However, the extent to which these are included within undergraduate pharmacy education programmes in the UK is unknown. To explore which of the AMS competencies are delivered, including when and at which level, within UK undergraduate MPharm programmes. A cross-sectional online questionnaire captured the level of study of the MPharm programme in which each competency was taught, the method of delivery and assessment of AMS education, and examples of student feedback. Ten institutions completed the survey (33% response rate). No institution reported covering all 54 AMS competencies and 5 of these were taught at half or fewer of the institutions. Key gaps were identified around taking samples, communication, outpatient parenteral antimicrobial therapy and surgical prophylaxis. The minimum time dedicated to AMS teaching differed between institutions (range 9–119 h), teaching was generally through didactic methods, and assessment was generally through knowledge recall and objective structured clinical examinations. Feedback from students suggests they find AMS and antimicrobial resistance (AMR) to be complex yet important topics. UK schools of pharmacy should utilize the competency framework to identify gaps in their AMS, AMR and infection teaching. To prepare newly qualified pharmacists to be effective at delivering AMS and prescribing antimicrobials, schools of pharmacy should utilize more simulated environments and clinical placements for education and assessment of AMS

Improved glycemic control and vascular function in overweight and obese subjects by glyoxalase 1 inducer formulation

Risk of insulin resistance, impaired glycemic control and cardiovascular disease is excessive in overweight and obese populations. We hypothesised that increasing expression of glyoxalase 1 (Glo1) – an enzyme that catalyses the metabolism of reactive metabolite and glycating agent, methylglyoxal – may improve metabolic and vascular health. Dietary bioactive compounds were screened for Glo1 inducer activity in a functional reporter assay, hits confirmed in cell culture and an optimised Glo1 inducer formulation evaluated in a randomised, placebo-controlled crossover clinical trial in 29 overweight and obese subjects. We found trans-resveratrol (tRES) and hesperetin (HESP), at concentrations achieved clinically, synergised to increase Glo1 expression. In highly overweight subjects (BMI >27.5 kg/m2), tRES-HESP co-formulation increased expression and activity of Glo1 (+ 27%. P<0.05), decreased plasma methylglyoxal (-37%, P<0.05) and total body methylglyoxal-protein glycation (-14%, P<0.01). It decreased fasting and postprandial plasma glucose (-5%, P<0.01 and – 6%, P<0.03, respectively), increased Oral Glucose Insulin Sensitivity index (+42 mlmin-1m-2, P<0.02) and improved arterial dilatation ΔFMD/ΔGTND (95%CI 0.13–2.11). In all subjects, it decreased vascular inflammation marker sICAM-1 (-10%, P<0.01). In previous clinical evaluations, tRES and HESP individually were ineffective. tRES-HESP co-formulation could be a suitable treatment for improved metabolic and vascular health in overweight and obese populations

Improving medication management in multimorbidity: development of the MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE) intervention using the Behaviour Change Wheel.

BACKGROUND: Multimorbidity, the presence of two or more chronic conditions, affects over 60 % of patients in primary care. Due to its association with polypharmacy, the development of interventions to optimise medication management in patients with multimorbidity is a priority. The Behaviour Change Wheel is a new approach for applying behavioural theory to intervention development. Here, we describe how we have used results from a review of previous research, original research of our own and the Behaviour Change Wheel to develop an intervention to improve medication management in multimorbidity by general practitioners (GPs), within the overarching UK Medical Research Council guidance on complex interventions. METHODS: Following the steps of the Behaviour Change Wheel, we sought behaviours associated with medication management in multimorbidity by conducting a systematic review and qualitative study with GPs. From the modifiable GP behaviours identified, we selected one and conducted a focused behavioural analysis to explain why GPs were or were not engaging in this behaviour. We used the behavioural analysis to determine the intervention functions, behavioural change techniques and implementation plan most likely to effect behavioural change. RESULTS: We identified numerous modifiable GP behaviours in the systematic review and qualitative study, from which active medication review (rather than passive maintaining the status quo) was chosen as the target behaviour. Behavioural analysis revealed GPs' capabilities, opportunities and motivations relating to active medication review. We combined the three intervention functions deemed most likely to effect behavioural change (enablement, environmental restructuring and incentivisation) to form the MultimorbiditY COllaborative Medication Review And DEcision Making (MY COMRADE) intervention. MY COMRADE primarily involves the technique of social support: two GPs review the medications prescribed to a complex multimorbid patient together. Four other behavioural change techniques are incorporated: restructuring the social environment, prompts/cues, action planning and self-incentives. CONCLUSIONS: This study is the first to use the Behaviour Change Wheel to develop an intervention targeting multimorbidity and confirms the usability and usefulness of the approach in a complex area of clinical care. The systematic development of the MY COMRADE intervention will facilitate a thorough evaluation of its effectiveness in the next phase of this work