577 research outputs found

    Reply: Glucocorticoid use and skin cancers

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    Probing dark matter substructure in the gravitational lens HE0435-1223 with the WFC3 grism

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    Strong gravitational lensing provides a powerful test of Cold Dark Matter (CDM) as it enables the detection and mass measurement of low mass haloes even if they do not contain baryons. Compact lensed sources such as Active Galactic Nuclei (AGN) are particularly sensitive to perturbing subhalos, but their use as a test of CDM has been limited by the small number of systems which have significant radio emission which is extended enough avoid significant lensing by stars in the plane of the lens galaxy, and red enough to be minimally affected by differential dust extinction. Narrow-line emission is a promising alternative as it is also extended and, unlike radio, detectable in virtually all optically selected AGN lenses. We present first results from a WFC3 grism narrow-line survey of lensed quasars, for the quadruply lensed AGN HE0435-1223. Using a forward modelling pipeline which enables us to robustly account for spatial blending, we measure the [OIII] 5007 \AA~ flux ratios of the four images. We find that the [OIII] fluxes and positions are well fit by a simple smooth mass model for the main lens. Our data rule out a M600>108(107.2)MM_{600}>10^{8} (10^{7.2}) M_\odot NFW perturber projected within \sim1\farcs0 (0\farcs1) arcseconds of each of the lensed images, where M600M_{600} is the perturber mass within its central 600 pc. The non-detection is broadly consistent with the expectations of Λ\LambdaCDM for a single system. The sensitivity achieved demonstrates that powerful limits on the nature of dark matter can be obtained with the analysis of 20\sim20 narrow-line lenses.Comment: Accepted for publication in MNRAS, 15 pages, 8 figure

    Evaluation of harmful algal bloom outreach activities

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    This is the final version of the article. Available from MDPI via the link in this record.With an apparent increase of harmful algal blooms (HABs) worldwide, healthcare providers, public health personnel and coastal managers are struggling to provide scientifically-based appropriately-targeted HAB outreach and education. Since 1998, the Florida Poison Information Center-Miami, with its 24 hour/365 day/year free Aquatic Toxins Hotline (1-888-232-8635) available in several languages, has received over 25,000 HAB-related calls. As part of HAB surveillance, all possible cases of HAB-related illness among callers are reported to the Florida Health Department. This pilot study evaluated an automated call processing menu system that allows callers to access bilingual HAB information, and to speak directly with a trained Poison Information Specialist. The majority (68%) of callers reported satisfaction with the information, and many provided specific suggestions for improvement. This pilot study, the first known evaluation of use and satisfaction with HAB educational outreach materials, demonstrated that the automated system provided useful HAB-related information for the majority of callers, and decreased the routine informational call workload for the Poison Information Specialists, allowing them to focus on callers needing immediate assistance and their healthcare providers. These results will lead to improvement of this valuable HAB outreach, education and surveillance tool. Formal evaluation is recommended for future HAB outreach and educational materials.The funding for this study was provided by the Florida Department of Health and the Centers for Disease Control and Prevention (CDC) and Florida Harmful Algal Bloom Taskforce, as well as the National Science Foundation and National Institute of Environmental Health Sciences Oceans and Human Health Center at the University of Miami Rosenstiel School (NSF 0CE0432368; NIEHS 1 P50 ES12736), the former National Institute of Environmental Health Sciences Marine and Freshwater Biomedical Sciences Center at the University of Miami Rosenstiel School (NIEHS P30ES05705), and the National Institute of Environmental Health Sciences Red Tide POI (P01 ES 10594)

    Complement component 3 levels in the cerebrospinal fluid of cognitively intact elderly individuals with major depressive disorder

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    Late-life major depression (LLMD) is a risk factor for the development of mild cognitive impairment and dementia, including Alzheimer's disease (AD) and vascular dementia. Immune dysregulation and changes in innate immune responses in particular, have been implicated in the pathophysiology of both LLMD and AD. Complement system, a key component of the innate immune mechanism, is known to play an important role in synaptic plasticity and cognitive functions. However, its role in LLMD remains unknown. In the present study, we examined the levels of complement component 3 (C3, the convergence point of all complement activation pathways) in the cerebrospinal fluid (CSF) of elderly depressed subjects compared to healthy controls; as well as the relationship of CSF C3 levels with amyloid-beta (Aβ42 and Aβ40), total tau (T-tau) and phosphorylated tau (P-tau) proteins and cognition scores. CSF was obtained from 50 cognitively intact volunteers (major depression group, N = 30; comparison group, N = 20) and analyzed for levels of C3 by ELISA. C3 levels were marginally lower in the major depression group relative to the comparison group. We did not find any significant association of C3 with the AD biomarkers Aβ42 reflecting plaque pathology, P-tau related to tau pathology or the neurodegeneration biomarker T-tau. In contrast, C3 was positively correlated with CSF Aβ40, which may reflect Aβ deposition in cerebral vessel walls. We observed a negative correlation between C3 levels and Total Recall on the Buschke Selective Reminding Test (BSRT) for memory performance in the depressed subjects when controlling for education. This initial evidence on C3 status in LLMD subjects may have implications for our understanding of the pathophysiology of major depression especially in late life

    Cultural Competency Observation Tool

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    This observational assessment rubric includes rating of the elements of patient centered communication defined in the Kalamazoo Consensus Statement regarding patient centered communication: These are augmented with sections that highlight factors that emerged in our observations specific to intercultural communication such as language and interpreters, nonverbal communication, mental and social issues with a large cultural overlay (mental health, pain, and disability). In addition, the tool incorporates issues specific to the medical context such as professional competence and professional regard. The rubric is also informed by the developmental model of intercultural sensitivity and Dreyfus\u27s phenomenology of skill acquisition with skill levels progressing through the stages: novice, beginner, competence, proficient, mastery

    Recreational Exposure to Low Concentrations of Microcystins During an Algal Bloom in a Small Lake

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    We measured microcystins in blood from people at risk for swallowing water or inhaling spray while swimming, water skiing, jet skiing, or boating during an algal bloom. We monitored water samples from a small lake as a Microcystis aeruginosa bloom developed. We recruited 97 people planning recreational activities in that lake and seven others who volunteered to recreate in a nearby bloom-free lake. We conducted our field study within a week of finding a 10-μg/L microcystin concentration. We analyzed water, air, and human blood samples for water quality, potential human pathogens, algal taxonomy, and microcystin concentrations. We interviewed study participants for demographic and current health symptom information. Water samples were assayed for potential respiratory viruses (adenoviruses and enteroviruses), but none were detected. We did find low concentrations of Escherichia coli, indicating fecal contamination. We found low levels of microcystins (2 μg/L to 5 μg/L) in the water and (<0.1 ng/m3) in the aerosol samples. Blood levels of microcystins for all participants were below the limit of detection (0.147μg/L). Given this low exposure level, study participants reported no symptom increases following recreational exposure to microcystins. This is the first study to report that water-based recreational activities can expose people to very low concentrations of aerosol-borne microcystins; we recently conducted another field study to assess exposures to higher concentrations of these algal toxins

    Residual sleep disturbance and risk of relapse during the continuation/maintenance phase treatment of major depressive disorder with the selective serotonin reuptake inhibitor fluoxetine

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    <p>Abstract</p> <p>Background</p> <p>Relapse of major depressive disorder (MDD) is a common clinical problem. This study was designed to determine whether residual sleep disturbance (insomnia and hypersomnia) predict risk of relapse during the continuation and maintenance treatment of MDD.</p> <p>Methods</p> <p>A total of 570 patients with MDD were treated with open-label, flexible dose fluoxetine (range 20 to 60 mg; mean dose = 45.8 mg/day; SD = 15.1) for 12 weeks. Under double blind conditions, 262 patients who achieved clinical response were randomly assigned to continue fluoxetine or to switch to placebo for 52 weeks or until relapse. Residual sleep disturbance during the baseline visit of the double-blind phase was assessed using items 4, 5, 6 (insomnia) and 22, 23, 24 (hypersomnia) of the Hamilton Depression Rating Scale (HDRS). Survival analysis was utilized to determine the effect of residual sleep disturbance on risk of relapse.</p> <p>Results</p> <p>The severities of early (<it>P </it>> 0.05), middle (<it>P </it>> 0.05), late (<it>P </it>> 0.05), or total (<it>P </it>> 0.05) residual insomnia were not found to significantly predict risk of relapse during continuation and maintenance-phase treatment. Similarly, the severities of early bedtime (<it>P </it>> 0.05), oversleeping (<it>P </it>> 0.05), napping (<it>P </it>> 0.05), or total (<it>P </it>> 0.05) residual hypersomnia were not found to significantly predict risk of relapse during continuation and maintenance-phase treatment.</p> <p>Conclusion</p> <p>The present study did not identify the severity of residual sleep disturbance among fluoxetine responders to predict risk of MDD relapse. The size of our sample may have precluded us from identifying more modest effects of residual sleep disturbance on the risk of relapse in MDD patients. Future studies are needed to further explore the relationship between residual sleep disturbance and relapse in MDD.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov Identifier: NCT00427128</p
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