19 research outputs found

    Mapping Patient Distributions Informs Community-Oriented Primary Care in Four Community Health Centers in Central Massachusetts

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    Background Based on the philosophy that family medicine training should occur in community-based practices and hospitals, the Worcester Family Medicine Residency (WFMR) training program was structured to combine learning opportunities in an academic medical center with outpatient care training in three unique community-based practices: the Barre Family Health Center, a rural site thirty miles west of Worcester, the Family Health Center of Worcester, a federally funded community health center serving a poor and culturally diverse urban population, and the Hahnemann Family Health Center, a hospital-owned health center serving a socioeconomically diverse population in the northeast part of Worcester. The WFMR received an AAMC “Regional Medicine-Public Health Education Centers-Graduate Medical Education (RMPHEC-GME)” grant to further integrate public health training into the clinical training experience. As part of the effort, collaboration was begun between the department of Family Medicine and Community Health at UMASS Medical School, the academic home of the WFMR, and geographers at Clark University, a local resource providing expertise in mapping of data using Geographic Information Systems (GIS). Mapping Patient Distribution A series of thematic maps were generated from actual practice data on the patients being served by each residency site and also by Fitchburg Community Health Center. Faculty champions from each site attended two training sessions to learn more about the capabilities of mapping. They were then asked to lead faculty at their site in discussion to define five maps they would like to see made from their own patient data. Most sites chose a map showing the distribution of the entire patient population, some requested a map of their pediatric patients, and then the rest were designed to depict the spread of certain chronic diseases, including asthma, hypertension, coronary disease, and diabetes. Maps were generated using geocoding and point density tools in ArcGIS Desktop software. The main goal of this mapping activity was to educate physicians in training about where their patients live and facilitate discussion about environmental factors that impact health. These maps can also be used by practitioners to communicate important information to their patients about available community resources such as gyms, parks, health clinics, and supermarkets (as shown on some maps). Making Maps Available Online One element of the grant initiative was to build an online resource to aid faculty in teaching about population health concepts. This portal, the Community Health Toolkit (http://www.umassmed.edu/fmch/toolkit.aspx), provides three types of information to aid clinicians in both their teaching and their practice. The “Data on Communities” section was developed as part of the UMMS/Clark University collaboration. In total, 24 thematic maps were generated by the GIS team at Clark University and uploaded to the “Data on Communities” web section of the Community Health Toolkit. Other sections of the Community Health Toolkit include “Learning about Populations” which provides links to a variety of local, regional and national health indicators, and a “Community Resources” section which provides links to community resources for patients. The Toolkit is presented to learners along the continuum of medical education, including second year students in the Population Health Clerkship, first year residents in the Family Medicine and Community Health rotation, then used as a resource by residents as they complete presentations and research projects

    Trichoderma: A part of possible answer towards crop residue disposal

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    India is one of the leading countries in agricultural production and generate large volume of crop residue. Increasing demand for food grains due to growing population leads to generation of crop residues. Due to lack of proper disposal mechanism of crop residue, farmers burn the residue which release greenhouse gases (GHGs) into the atmosphere, and poses great threat to environment as well as human health. The residue burning causes greater carbon emission and nutrient losses which otherwise incorporated into the soil system may substantially improve the soil biodiversity. Besides several practices of crop residue management, the most feasible method for farmers is incorporation of residue into the soil with the inoculation of microbes. In soil system the ability of microbial community in degrading organic substances is well known. In the early stages of residue decomposition simple substrates like carbohydrates are degraded by bacteria, but in later stages degradation of complex constituents viz., cellulose, lignin needs microbes which are capable of secreting enzymes like cellulase, acting on complex organic substrates. In this context, cellulolytic micro organisms like Trichoderma have the potential and emerging as an important microbial inoculants to enhance the rate of decomposition as well as alleviate the effect of residue burning

    SARS-CoV-2 B.1.617.2 Delta variant replication and immune evasion

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    Abstract: The B.1.617.2 (Delta) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in the state of Maharashtra in late 2020 and spread throughout India, outcompeting pre-existing lineages including B.1.617.1 (Kappa) and B.1.1.7 (Alpha)1. In vitro, B.1.617.2 is sixfold less sensitive to serum neutralizing antibodies from recovered individuals, and eightfold less sensitive to vaccine-elicited antibodies, compared with wild-type Wuhan-1 bearing D614G. Serum neutralizing titres against B.1.617.2 were lower in ChAdOx1 vaccinees than in BNT162b2 vaccinees. B.1.617.2 spike pseudotyped viruses exhibited compromised sensitivity to monoclonal antibodies to the receptor-binding domain and the amino-terminal domain. B.1.617.2 demonstrated higher replication efficiency than B.1.1.7 in both airway organoid and human airway epithelial systems, associated with B.1.617.2 spike being in a predominantly cleaved state compared with B.1.1.7 spike. The B.1.617.2 spike protein was able to mediate highly efficient syncytium formation that was less sensitive to inhibition by neutralizing antibody, compared with that of wild-type spike. We also observed that B.1.617.2 had higher replication and spike-mediated entry than B.1.617.1, potentially explaining the B.1.617.2 dominance. In an analysis of more than 130 SARS-CoV-2-infected health care workers across three centres in India during a period of mixed lineage circulation, we observed reduced ChAdOx1 vaccine effectiveness against B.1.617.2 relative to non-B.1.617.2, with the caveat of possible residual confounding. Compromised vaccine efficacy against the highly fit and immune-evasive B.1.617.2 Delta variant warrants continued infection control measures in the post-vaccination era

    Application of Virtual Globes in Education

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    The advent of virtual globes and online mapping has generated interest in spatial representations of data among many non-geographic communities, including educators and researchers who have very little to no expertise in geospatial technologies. In this article, we give a state-of-the-art survey of existing virtual globes and review the existing teaching applications related to them. We focus on the four most popular virtual globes (Google Earth; NASA World Wind; Microsoft Virtual Earth Earth; and Skyline Globe), illustrating their various applications and comparing their capabilities, with a particular emphasis on educational aspects. We also explain the distinction between the virtual globes and various online mapping applications, such as Google Maps mash-ups. © 2008 The Authors Journal Compilation © 2008 Blackwell Publishing Ltd

    Concrete Evidence & Geographically Weighted Regression: A Regional Analysis of Wealth and the Land Cover in Massachusetts

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    Several studies indicate that there is a positive relationship between green vegetation land cover and wealthy socio-economic conditions in urban areas. The purpose of this research is to test for and explore spatial variation in the relationship between socio-economic and green vegetation land cover across urban, suburban, and rural areas, using geographically weighted regression (GWR). The analysis was conducted at the census block group level for Massachusetts, using Census 2000 data and impervious surface data at 1-m resolution. To explore regional variations in the relationship, four scenarios were generated by regressing each of the following socio-economic variables - median household income, percentage of poverty, percentage of minority population, and median home value - against two environmental variables - percent of impervious surface and population density. GWR results show that there is a considerable spatial variation in the character and the strength of the relationship for each model. There are two main conclusions in this study. First, the impervious surface is generally a strong predictor of the level of wealth as measured by four variables included in the analysis, at the scale of census block group; however, the strength of the relationship varies geographically. Second, GWR, not ordinary least squares technique, should be used for regional scale spatial analysis because it is able to account for local effects and shows geographical variation in the strength of the relationship. © 2009 Elsevier Ltd. All rights reserved

    Examining the Impact of Environmental Factors on Quality of Life Across Massachusetts

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    Several studies indicate that there are significant relationships among quality of life, green vegetation, and socioeconomic conditions, particularly in urban environments. The purpose of this research is twofold: (1) to compare two weighting and aggregation techniques, data envelopment analysis (DEA) and principal components analysis (PCA), in the development of a socioeconomic index; and (2) to test for and explore spatial variation in the relationship between socioeconomic index and environmental variables using geographically weighted regression (GWR). The analysis was conducted at the census block group level in Massachusetts. First, DEA and PCA were used to generate two separate socioeconomic indexes. Second, the relationship between these indexes and environmental variables including percentage impervious surface, percentage industrial land use, percentage land used for waste, and traffic density was modeled using ordinary least squares (OLS) regression and GWR. The GWR models explained more variance in the relationship than the OLS models and indicated that there is considerable spatial variation in the character and the strength of this relationship. The results of the GWR analyses were similar between the models generated using DEA- and PCA-derived indexes, indicating that the results were corroborative. The study concludes that the environmental variables are generally a strong predictor of the socioeconomic conditions at the scale of census block group; however, there is substantial geographical variation in the strength and the character of this relationship. The results of this study also suggest that various weighting and aggregation methods should be tested in every study that uses or creates composite indicators. © 2013 Copyright Taylor and Francis Group, LLC

    A review of accuracy assessment for object-based image analysis: From per-pixel to per-polygon approaches

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    Object-based image analysis (OBIA) has gained widespread popularity for creating maps from remotely sensed data. Researchers routinely claim that OBIA procedures outperform pixel-based procedures; however, it is not immediately obvious how to evaluate the degree to which an OBIA map compares to reference information in a manner that accounts for the fact that the OBIA map consists of objects that vary in size and shape. Our study reviews 209 journal articles concerning OBIA published between 2003 and 2017. We focus on the three stages of accuracy assessment: (1) sampling design, (2) response design and (3) accuracy analysis. First, we report the literature\u27s overall characteristics concerning OBIA accuracy assessment. Simple random sampling was the most used method among probability sampling strategies, slightly more than stratified sampling. Office interpreted remotely sensed data was the dominant reference source. The literature reported accuracies ranging from 42% to 96%, with an average of 85%. A third of the articles failed to give sufficient information concerning accuracy methodology such as sampling scheme and sample size. We found few studies that focused specifically on the accuracy of the segmentation. Second, we identify a recent increase of OBIA articles in using per-polygon approaches compared to per-pixel approaches for accuracy assessment. We clarify the impacts of the per-pixel versus the per-polygon approaches respectively on sampling, response design and accuracy analysis. Our review defines the technical and methodological needs in the current per-polygon approaches, such as polygon-based sampling, analysis of mixed polygons, matching of mapped with reference polygons and assessment of segmentation accuracy. Our review summarizes and discusses the current issues in object-based accuracy assessment to provide guidance for improved accuracy assessments for OBIA
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