Role of technology: Podcast in influencing respondents to receive a flu shot

Background and Problem: Studies have demonstrated that flu shots are an effective method to control flu infection. However, statistics reveal that only about 68% of people get vaccinated in the U.S. every year. We wanted to develop and evaluate an intervention to increase influenza vaccination rate. [See PDF for complete abstract

The Use of Podcasts in Education

Background: The use of podcasts has emerged as an important tool for use in education. This is especially relevant in nursing schools with the shortage of nursing faculty. The use of podcasts allows the instructor to provide lectures and other course content to students. [See PDF for complete abstract

Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system.Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist’s medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM) follow-up.Adult patients with a predicted diagnosis-related group (DRG) of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85%) received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient) were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25%) receiving MTM follow-up, 26 (65%) completing a primary care visit after their first hospital discharge, and 23 (58%) receiving a home care visit.Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system

An Optical Counterpart to the Anomalous X-ray Pulsar 4U 0142+61

The energy source of the anomalous X-ray pulsars is not well understood, hence their designation as anomalous. Unlike binary X-ray pulsars, no companions are seen, so the energy cannot be supplied by accretion of matter from a companion star. The loss of rotational energy, which powers radio pulsars, is insufficient to power AXPs. Two models are generally considered: accretion from a large disk left over from the birth process, or decay of a very strong magnetic field (10^15 G) associated with a 'magnetar'. The lack of counterparts at other wavelengths has hampered progress in our understanding of these objects. Here, we present deep optical observations of the field around 4U 0142+61, which is the brightest AXP in X-rays. We find an object with peculiar optical colours at the position of the X-ray source, and argue that it is the optical counterpart. The optical emission is too faint to admit the presence of a large accretion disk, but may be consistent with magnetospheric emission from a magnetar.Comment: 16 pages, 3 figures, accepted by Nature. Press embargo until 1900 hrs London time (GMT) on 6 December 200

The Impact of HAART on the Respiratory Complications of HIV Infection: Longitudinal Trends in the MACS and WIHS Cohorts

Objective: To review the incidence of respiratory conditions and their effect on mortality in HIV-infected and uninfected individuals prior to and during the era of highly active antiretroviral therapy (HAART). Design: Two large observational cohorts of HIV-infected and HIV-uninfected men (Multicenter AIDS Cohort Study [MACS]) and women (Women's Interagency HIV Study [WIHS]), followed since 1984 and 1994, respectively. Methods: Adjusted odds or hazards ratios for incident respiratory infections or non-infectious respiratory diagnoses, respectively, in HIV-infected compared to HIV-uninfected individuals in both the pre-HAART (MACS only) and HAART eras; and adjusted Cox proportional hazard ratios for mortality in HIV-infected persons with lung disease during the HAART era. Results: Compared to HIV-uninfected participants, HIV-infected individuals had more incident respiratory infections both pre-HAART (MACS, odds ratio [adjusted-OR], 2.4; 95% confidence interval [CI], 2.2-2.7; p<0.001) and after HAART availability (MACS, adjusted-OR, 1.5; 95%CI 1.3-1.7; p<0.001; WIHS adjusted-OR, 2.2; 95%CI 1.8-2.7; p<0.001). Chronic obstructive pulmonary disease was more common in MACS HIV-infected vs. HIV-uninfected participants pre-HAART (hazard ratio [adjusted-HR] 2.9; 95%CI, 1.02-8.4; p = 0.046). After HAART availability, non-infectious lung diseases were not significantly more common in HIV-infected participants in either MACS or WIHS participants. HIV-infected participants in the HAART era with respiratory infections had an increased risk of death compared to those without infections (MACS adjusted-HR, 1.5; 95%CI, 1.3-1.7; p<0.001; WIHS adjusted-HR, 1.9; 95%CI, 1.5-2.4; p<0.001). Conclusion: HIV infection remained a significant risk for infectious respiratory diseases after the introduction of HAART, and infectious respiratory diseases were associated with an increased risk of mortality. © 2013 Gingo et al

The practical politics of sharing personal data

The focus of this paper is upon how people handle the sharing of personal data as an interactional concern. A number of ethnographic studies of domestic environments are drawn upon in order to articulate a range of circumstances under which data may be shared. In particular a distinction is made between the in situ sharing of data with others around you and the sharing of data with remote parties online. A distinction is also drawn between circumstances of purposefully sharing data in some way and circumstances where the sharing of data is incidental or even unwitting. On the basis of these studies a number of the organisational features of how people seek to manage the ways in which their data is shared are teased out. The paper then reflects upon how data sharing practices have evolved to handle the increasing presence of digital systems in people’s environments and how these relate to the ways in which people traditionally orient to the sharing of information. In conclusion a number of ways are pointed out in which the sharing of data remains problematic and there is a discussion of how systems may need to adapt to better support people’s data sharing practices in the future

Subcellular peptide localization in single identified neurons by capillary microsampling mass spectrometry

Single cell mass spectrometry (MS) is uniquely positioned for the sequencing and identification of peptides in rare cells. Small peptides can take on different roles in subcellular compartments. Whereas some peptides serve as neurotransmitters in the cytoplasm, they can also function as transcription factors in the nucleus. Thus, there is a need to analyze the subcellular peptide compositions in identified single cells. Here, we apply capillary microsampling MS with ion mobility separation for the sequencing of peptides in single neurons of the mollusk Lymnaea stagnalis, and the analysis of peptide distributions between the cytoplasm and nucleus of identified single neurons that are known to express cardioactive Phe-Met-Arg-Phe amide-like (FMRFamide-like) neuropeptides. Nuclei and cytoplasm of Type 1 and Type 2 F group (Fgp) neurons were analyzed for neuropeptides cleaved from the protein precursors encoded by alternative splicing products of the FMRFamide gene. Relative abundances of nine neuropeptides were determined in the cytoplasm. The nuclei contained six of these peptides at different abundances. Enabled by its relative enrichment in Fgp neurons, a new 28-residue neuropeptide was sequenced by tandem MS

Radiogenic and muon-induced backgrounds in the LUX dark matter detector

The Large Underground Xenon (LUX) dark matter experiment aims to detect rare low-energy interactions from Weakly Interacting Massive Particles (WIMPs). The radiogenic backgrounds in the LUX detector have been measured and compared with Monte Carlo simulation. Measurements of LUX high-energy data have provided direct constraints on all background sources contributing to the background model. The expected background rate from the background model for the 85.3 day WIMP search run is (2.6±0.2stat±0.4sys)×10-3 events keVee-1kg-1day-1 in a 118 kg fiducial volume. The observed background rate is (3.6±0.4stat)×10-3 events keVee-1kg-1day-1 , consistent with model projections. The expectation for the radiogenic background in a subsequent one-year run is presented

Multi-messenger observations of a binary neutron star merger

On 2017 August 17 a binary neutron star coalescence candidate (later designated GW170817) with merger time 12:41:04 UTC was observed through gravitational waves by the Advanced LIGO and Advanced Virgo detectors. The Fermi Gamma-ray Burst Monitor independently detected a gamma-ray burst (GRB 170817A) with a time delay of ~1.7 s with respect to the merger time. From the gravitational-wave signal, the source was initially localized to a sky region of 31 deg2 at a luminosity distance of 40+8-8 Mpc and with component masses consistent with neutron stars. The component masses were later measured to be in the range 0.86 to 2.26 Mo. An extensive observing campaign was launched across the electromagnetic spectrum leading to the discovery of a bright optical transient (SSS17a, now with the IAU identification of AT 2017gfo) in NGC 4993 (at ~40 Mpc) less than 11 hours after the merger by the One- Meter, Two Hemisphere (1M2H) team using the 1 m Swope Telescope. The optical transient was independently detected by multiple teams within an hour. Subsequent observations targeted the object and its environment. Early ultraviolet observations revealed a blue transient that faded within 48 hours. Optical and infrared observations showed a redward evolution over ~10 days. Following early non-detections, X-ray and radio emission were discovered at the transient’s position ~9 and ~16 days, respectively, after the merger. Both the X-ray and radio emission likely arise from a physical process that is distinct from the one that generates the UV/optical/near-infrared emission. No ultra-high-energy gamma-rays and no neutrino candidates consistent with the source were found in follow-up searches. These observations support the hypothesis that GW170817 was produced by the merger of two neutron stars in NGC4993 followed by a short gamma-ray burst (GRB 170817A) and a kilonova/macronova powered by the radioactive decay of r-process nuclei synthesized in the ejecta

A novel colorectal cancer test combining microsatellite instability and BRAF/RAS analysis: Clinical validation and impact on Lynch syndrome screening

Background: Lynch syndrome (LS) is under-diagnosed. UK National Institute for Health and Care Excellence guidelines recommend multistep molecular testing of all colorectal cancers (CRCs) to screen for LS. However, the complexity of the pathway has resulted in limited improvement in diagnosis.Methods: One-step multiplex PCR was used to generate sequencing-ready amplicons from 14 microsatellite instability (MSI) markers and 22 BRAF, KRAS, and NRAS mutation hotspots. MSI and BRAF/RAS variants were detected using amplicon-sequencing and automated analysis. The assay was clinically validated and deployed into service in northern England, followed by regional and local audits to assess its impact.Results: MSI analysis achieved 99.1% sensitivity and 99.2% specificity and was reproducible (r = 0.995). Mutation hotspot analysis had 100% sensitivity, 99.9% specificity, and was reproducible (r = 0.998). Assay-use in service in 2022-2023 increased CRC testing (97.2% (2466/2536) versus 28.6% (601/2104)), halved turnaround times, and identified more CRC patients at-risk of LS (5.5% (139/2536) versus 2.9% (61/2104)) compared to 2019-2020 when a multi-test pathway was used.Conclusion: A novel amplicon-sequencing assay of CRCs, including all biomarkers for LS screening and anti-EGFR therapy, achieved &gt;95% testing rate. Adoption of this low cost, scalable, and fully automatable test will complement on-going, national initiatives to improve LS screening