Addressing Uncertainty in TMDLS: Short Course at Arkansas Water Resources Center 2001 Annual Conference

Management of a critical natural resource like water requires information on the status of that resource. The US Environmental Protection Agency (EPA) reported in the 1998 National Water Quality Inventory that more than 291,000 miles of assessed rivers and streams and 5 million acres of lakes do not meet State water quality standards. This inventory represents a compilation of State assessments of 840,000 miles of rivers and 17.4 million acres of lakes; a 22 percent increase in river miles and 4 percent increase in lake acres over their 1996 reports. Siltation, bacteria, nutrients and metals were the leading pollutants of impaired waters, according to EPA. The sources of these pollutants were presumed to be runoff from agricultural lands and urban areas. EPA suggests that the majority of Americans-over 218 million-live within ten miles of a polluted waterbody. This seems to contradict the recent proclamations of the success of the Clean Water Act, the Nation\u27s water pollution control law. EPA also claims that, while water quality is still threatened in the US, the amount of water safe for fishing and swimming has doubled since 1972, and that the number of people served by sewage treatment plants has more than doubled

Respiratory Syncytial Virus (RSV) Induces Innate Immunity through Toll-Like Receptors and Acquired Immunity via the RSV G Protein: A Dissertation

Respiratory syncytial virus (RSV) causes a common infection that is associated with a range of respiratory illnesses from common cold-like symptoms to serious lower respiratory tract illnesses such as pneumonia and bronchiolitis. RSV is the single most important cause of serious lower respiratory tract illness in children \u3c 1 year of age. Host innate and acquired immune responses activated following RSV infection have been suspected as contributing to RSV disease. Toll-like receptors (TLRs) activate innate and acquired immunity and are candidates for playing key roles in the host immune response to RSV. Leukocytes express TLRs including TLR2, TLR6, TLR3, TLR4, and TLR7 that can potentially interact with RSV and promote immune responses following infection. Using knockout mice, we have demonstrated that TLR2 and TLR6 signaling in leukocytes can activate innate immunity against RSV by promoting TNF-α, IL-6, CCL2 (MCP-1), and CCL5 (RANTES) production. As previously noted, TLR4 also contributed to cytokine activation (71, 90). Furthermore, we demonstrated that signals generated following TLR2 and TLR6 activation were important for controlling viral replication in vivo. Additionally, TLR2 interactions with RSV promoted neutrophil migration and dendritic cell activation within the lung. Collectively, these studies indicate that TLR2 is involved in RSV recognition and subsequent innate immune activation and may play a role in modulating acquired immune responses through DCs. Despite the fact that RSV is the single most important cause of infant upper respiratory tract disease, there are no licensed vaccines available to prevent RSV disease. We have developed a virus-like particle (VLP) vaccine candidate for RSV. The VLP is composed of the NP and M proteins of Newcastle disease virus (NDV) and a chimera protein containing the cytoplasmic and transmembrane domains of the NDV HN protein and the ectodomain of the human RSV G protein (H/G). BALB/c mice immunized with 10 or 40 μg total VLP-H/G protein by intraperitoneal or intramuscular inoculation stimulated antibody responses to G protein as good as or better than comparable amounts of UV-inactivated RSV. Furthermore, VLP-H/G induced robust CTL responses in vaccinated animals. Immunization with two or even a single dose of these particles resulted in the complete protection of BALB/c mice from RSV replication in the lungs. Upon RSV challenge of VLP-H/G immunized mice, no enhanced pathology in the lungs was observed, although lungs of mice immunized in parallel with formalin-inactivated RSV (FI-RSV) showed the significant pathology that has been previously observed with FI-RSV vaccination. Thus, the VLP-H/G candidate vaccine was immunogenic in BALB/c mice and prevented replication of RSV in murine lungs with no evidence of immunopathology. These data support further development of virus-like particle vaccine candidates for RSV

An Instrument to Assess Subjective Task Value Beliefs Regarding the Decision to Pursue Postgraduate Training

Objectives. To develop and validate an instrument to assess subjective ratings of the perceived value of various postgraduate training paths followed using expectancy-value as a theoretical framework; and to explore differences in value beliefs across type of postgraduate training pursued and type of pharmacy training completed prior to postgraduate training. Methods. A survey instrument was developed to sample 4 theoretical domains of subjective task value: intrinsic value, attainment value, utility value, and perceived cost. Retrospective self-report methodology was employed to examine respondents’ (N=1,148) subjective task value beliefs specific to their highest level of postgraduate training completed. Exploratory and confirmatory factor analytic techniques were used to evaluate and validate value belief constructs. Results. Intrinsic, attainment, utility, cost, and financial value constructs resulted from exploratory factor analysis. Cross-validation resulted in a 26-item instrument that demonstrated good model fit. Differences in value beliefs were noted across type of postgraduate training pursued and pharmacy training characteristics. Conclusions. The Postgraduate Training Value Instrument demonstrated evidence of reliability and construct validity. The survey instrument can be used to assess value beliefs regarding multiple postgraduate training options in pharmacy and potentially inform targeted recruiting of individuals to those paths best matching their own value beliefs

Continental shelf seafloor mapping, benthic habitat surveys, and reef fish assessments in the eastern Gulf of Mexico

In April 2010, The Deepwater Horizon (DWH) oil spill originated in the deep sea 1,500 m below the ocean surface at the edge of the continental shelf off Louisiana. Surface and sub-surface dispersal of the oil eventually encompassed an area of over 200,000 km2. Impacts of DWH on biota of the Gulf of Mexico were severe, wide-spread, and are ongoing even a decade after the spill. Because of its offshore origin, the spill caused injury to many resources on the continental shelf, including important reef fish species (e.g., snappers and groupers, etc.) and protected species including sea turtles. Habitats which these species occupy were oiled which resulted in the loss of key supporting plant and animal species. Because so little of the offshore habitat of reef fish species and sea turtles was mapped and characterized prior to the spill, restoration efforts aimed at improving degraded habitats and strengthening species populations proved difficult. This project was specifically developed to discover additional, high conservation value, habitats of reef fishes and sea turtles on the continental shelf of the Gulf of Mexico off Florida (the West Florida Shelf, WFS). The goal of the project was to map such habitats and quantify the density and biodiversity of species occupying them, and to facilitate additional conservation management decisions to enhance their long-term sustainability. The project resulted in mapping and classifying and characterizing 2,350 km2 of heretofore unmapped habitats, the development of new methods to extrapolate habitat types from a sub-sample from video surveys, and new technologies to automate the counting and identification of fish species and habitat features using artificial intelligence. Project personnel have presented these materials to the competent management authorities responsible for fish and sea turtle management. Here we provide technical detail on the methods, procedures and findings from this project.Funded by the National Fish and Wildlife Foundation (NFWF) Gulf Environmental Benefit Fund (2015 - 2020

Collapsible Pushdown Parity Games

International audienceThis paper studies a large class of two-player perfect-information turn-based parity games on infinite graphs, namely those generated by collapsible pushdown automata. The main motivation for studying these games comes from the connections from collapsible pushdown automata and higher-order recursion schemes, both models being equi-expressive for generating infinite trees. Our main result is to establish the decidability of such games and to provide an effective representation of the winning region as well as of a winning strategy. Thus, the results obtained here provide all necessary tools for an in-depth study of logical properties of trees generated by collapsible pushdown automata/recursion schemes

Pharmaceutical systematics: Description and preliminary investigation of an alternative method for structuring drug information

Objectives: To identify the 30 most common adverse drug events or reactions (ADE/ADRs) within the top 200 medications: (1) by raw incidence, (2) weighted by prescription volume, (3) and weighted by retail dollars. Methods: The Pharmacy Times Top 200 Medications (as ranked by prescription volume) was utilized to identify the top 200 medications in 2008. The ADE/ADRs for each medication were obtained from Facts and Comparisons, Micromedex, and Lexi-Comp and entered into a database. These ADE/ADRs were compiled and summed, identifying the number of times each appeared. These then were ranked to identify the 30 most common ADE/ADRs. The actual prescription volume and total retail dollars for each medication were obtained and listed next to each medication's ADE/ADR. The incidence of each ADE/ADR then was weighted by actual prescription volume and retail dollars to determine the top 30 most common ADE/ADRs. Results: Initial evaluation resulted in 9829 individual ADE/ADRs and summed into 1477 distinct ADE/ADRs, after adjusting for interchangeable terminology. Examples of the 30 most common ADE/ADRs (raw incidence) included: dizziness/vertigo, headache, nausea, vomiting, and diarrhea/loose stools. The list remained the same after weighting by actual prescription volume. After weighting by retail dollars, the order of ADE/ADRs changed slightly. Conclusion: Knowledge of ADE/ADRs is important for pharmacists in all healthcare settings. Consolidating ADE/ADRs for medications may enable pharmacists to recall the most common side effects and aid in earlier identification of ADE/ADRs, which may positively impact patient safety across practice settings. Type: Original Researc

Collapsible Pushdown Automata and Recursion Schemes

International audienceWe consider recursion schemes (not assumed to be homogeneously typed, and hence not necessarily safe) and use them as generators of (possibly infinite) ranked trees. A recursion scheme is essentially a finite typed {deterministic term} rewriting system that generates, when one applies the rewriting rules ad infinitum, an infinite tree, called its value tree. A fundamental question is to provide an equivalent description of the trees generated by recursion schemes by a class of machines. In this paper we answer this open question by introducing collapsible pushdown automata (CPDA), which are an extension of deterministic (higher-order) pushdown automata. A CPDA generates a tree as follows. One considers its transition graph, unfolds it and contracts its silent transitions, which leads to an infinite tree which is finally node labelled thanks to a map from the set of control states of the CPDA to a ranked alphabet. Our contribution is to prove that these two models, higher-order recursion schemes and collapsible pushdown automata, are equi-expressive for generating infinite ranked trees. This is achieved by giving an effective transformations in both directions

Preparing for the spread of patient-reported outcomes (PROs) data collection from primary care to community pharmacy: stakeholder insights

Medication non-adherence is a significant public health problem. Patient-reported outcomes (PROs) offer a rich data source to facilitate resolution of medication non-adherence. PatientToc™ is an electronic PRO data collection software originally implemented at primary care practices in California, United States (US). Currently, the use of standardized PRO data collection systems in US community pharmacies is limited. Thus, we are conducting a two-phase evaluation of the spread and scale of PatientToc™ to US Midwestern community pharmacies. This report focuses on the first phase of the evaluation. The objective of this phase was to prepare for implementation of PatientToc™ in community pharmacies by conducting a pre-implementation developmental formative evaluation to (1) identify potential barriers, facilitators, and actionable recommendations to PatientToc™ implementation and (2) create a draft implementation toolkit

An evaluation of the spread and scale of PatientToc™ from primary care to community pharmacy practice for the collection of patient-reported outcomes: A study protocol

Background Medication non-adherence is a problem of critical importance, affecting approximately 50% of all persons taking at least one regularly scheduled prescription medication and costing the United States more than $100 billion annually. Traditional data sources for identifying and resolving medication non-adherence in community pharmacies include prescription fill histories. However, medication possession does not necessarily mean patients are taking their medications as prescribed. Patient-reported outcomes (PROs), measuring adherence challenges pertaining to both remembering and intention to take medication, offer a rich data source for pharmacists and prescribers to use to resolve medication non-adherence. PatientToc™ is a PROs collection software developed to facilitate collection of PROs data from low-literacy and non-English speaking patients in Los Angeles. Objectives This study will evaluate the spread and scale of PatientToc™ from primary care to community pharmacies for the collection and use of PROs data pertaining to medication adherence. Methods The following implementation and evaluation steps will be conducted: 1) a pre-implementation developmental formative evaluation to determine community pharmacy workflow and current practices for identifying and resolving medication non-adherence, potential barriers and facilitators to PatientToc™ implementation, and to create a draft implementation toolkit, 2) two plan-do-study-act cycles to refine an implementation toolkit for spreading and scaling implementation of PatientToc™ in community pharmacies, and 3) a comprehensive, theory-driven evaluation of the quality of care, implementation, and patient health outcomes of spreading and scaling PatientToc™ to community pharmacies. Expected impact This research will inform long-term collection and use of PROs data pertaining to medication adherence in community pharmacies