49 research outputs found
Evaluation of a new airborne microwave remote sensing radiometer by measuring the salinity gradients across the shelf of the Great Barrier Reef lagoon
Over the last ten years, some operational airborne remote sensing systems have become available for mapping surface salinity over large areas in near real time. A new dual-polarized Polarimetric L-band Multibeam Radiometer (PLMR) has been developed to improve accuracy and precision when compared with previous instrument generations. This paper reports on the first field evaluation of the performance of the PLMR by measuring salinity gradients in the central Great Barrier Reef. Before calibration, the raw salinity values of the PLMR and conductivity-temperature-depth (CTD) differed by 3-6 psu. The calibration, which uses in situ salinity data to remove long-term drifts in the PLMR as well as environmental effects such as surface roughness and radiation from the sky and atmosphere, was carried out by equating the means of the PLMR and CTD salinity data over a subsection of the transect, after which 85% of the salinity values between the PLMR and CTD are within 0.1 psu along the complete transect. From offshore to inshore across the shelf, the PLMR shows an average cross-shelf salinity increase of about 0.4 psu and a decrease of 2 psu over the inshore 20 km at -19deg S (around Townsville) and -18deg S (around Lucinda), respectively. The average cross-shelf salinity increase was 0.3 psu for the offshore 100 km over all transects. These results are consistent with the in situ CTD results. This survey shows that PLMR provided an effective method of rapidly measuring the surface salinity in near real time when a calibration could be made
Characteristics of general practice care: What do senior citizens value? A qualitative study
<p>Abstract</p> <p>Background</p> <p>In view of the increasing number of senior citizens in our society who are likely to consult their GP with age-related health problems, it is important to identify and understand the preferences of this group in relation to the non-medical attributes of GP care. The aim of this study is to improve our understanding about preferences of this group of patients in relation to non-medical attributes of primary health care. This may help to develop strategies to improve the quality of care that senior citizens receive from their GP.</p> <p>Methods</p> <p>Semi-structured interviews (N = 13) with senior citizens (65-91 years) in a judgement sample were recorded and transcribed verbatim. The analysis was conducted according to qualitative research methodology and the frame work method.</p> <p>Results</p> <p>Continuity of care providers, i.e. GP and practice nurses, GPs' expertise, trust, free choice of GP and a kind open attitude were highly valued. Accessibility by phone did not meet the expectations of the interviewees. The interviewees had difficulties with the GP out-of-office hours services. Spontaneous home visits were appreciated by some, but rejected by others. They preferred to receive verbal information rather than collecting information from leaflets. Distance to the practice and continuity of caregiver seemed to conflict for respondents.</p> <p>Conclusions</p> <p>Preferences change in the process of ageing and growing health problems. GPs and their co-workers should be also aware of the changing needs of the elderly regarding non-medical attributes of GP care. Meeting their needs regarding non-medical attributes of primary health care is important to improve the quality of care.</p
A Preliminary Mixed-Method Investigation of Trust and Hidden Signals in Medical Consultations.
Background
Several factors influence patients' trust, and trust influences the doctor-patient relationship. Recent literature has investigated the quality of the personal relationship and its dynamics by considering the role of communication and the elements that influence trust giving in the frame of general practitioner (GP) consultations.
Objective
We analysed certain aspects of the interaction between patients and GPs to understand trust formation and maintenance by focusing on communication channels. The impact of socio-demographic variables in trust relationships was also evaluated.
Method
A cross-sectional design using concurrent mixed qualitative and quantitative research methods was employed. One hundred adults were involved in a semi-structured interview composed of both qualitative and quantitative items for descriptive and exploratory purposes. The study was conducted in six community-based departments adjacent to primary care clinics in Trento, Italy.
Results
The findings revealed that patients trusted their GP to a high extent by relying on simple signals that were based on the quality of the one-to-one communication and on behavioural and relational patterns. Patients inferred the ability of their GP by adopting simple heuristics based mainly on the so-called social \u201chonest signals\u201d rather than on content-dependent features. Furthermore, socio-demographic variables affected trust: less literate and elderly people tended to trust more.
Conclusions
This study is unique in attempting to explore the role of simple signals in trust relationships within medical consultation: people shape trust and give meaning to their relationships through a powerful channel of communication that orbits not around words but around social relations. The findings have implications for both clinicians and researchers. For doctors, these results suggest a way of thinking about encounters with patients. For researchers, the findings underline the importance of analysing some new key factors around trust for future investigations in medical practice and education
Miz1 Is a Critical Repressor of cdkn1a during Skin Tumorigenesis
The transcription factor Miz1 forms repressive DNA-binding complexes with the Myc, Gfi-1 and Bcl-6 oncoproteins. Known target genes of these complexes encode the cyclin-dependent kinase inhibitors (CKIs) cdkn2b (p15Ink4), cdkn1a (p21Cip1), and cdkn1c (p57Kip2). Whether Miz1-mediated repression is important for control of cell proliferation in vivo and for tumor formation is unknown. Here we show that deletion of the Miz1 POZ domain, which is critical for Miz1 function, restrains the development of skin tumors in a model of chemically-induced, Ras-dependent tumorigenesis. While the stem cell compartment appears unaffected, interfollicular keratinocytes lacking functional Miz1 exhibit a reduced proliferation and an accelerated differentiation of the epidermis in response to the tumor promoter 12-O-tetradecanoylphorbol-13-acetate (TPA). Tumorigenesis, proliferation and normal differentiation are restored in animals lacking cdkn1a, but not in those lacking cdkn2b. Our data demonstrate that Miz1-mediated attenuation of cell cycle arrest pathways via repression of cdkn1a has a critical role during tumorigenesis in the skin
Distinct Merkel Cell Polyomavirus Molecular Features in Tumour and Non Tumour Specimens from Patients with Merkel Cell Carcinoma
Merkel Cell Polyomavirus (MCPyV) is associated with Merkel Cell carcinoma (MCC), a rare, aggressive skin cancer with neuroendocrine features. The causal role of MCPyV is highly suggested by monoclonal integration of its genome and expression of the viral large T (LT) antigen in MCC cells. We investigated and characterized MCPyV molecular features in MCC, respiratory, urine and blood samples from 33 patients by quantitative PCR, sequencing and detection of integrated viral DNA. We examined associations between either MCPyV viral load in primary MCC or MCPyV DNAemia and survival. Results were interpreted with respect to the viral molecular signature in each compartment. Patients with MCC containing more than 1 viral genome copy per cell had a longer period in complete remission than patients with less than 1 copy per cell (34 vs 10 months, P = 0.037). Peripheral blood mononuclear cells (PBMC) contained MCPyV more frequently in patients sampled with disease than in patients in complete remission (60% vs 11%, P = 0.00083). Moreover, the detection of MCPyV in at least one PBMC sample during follow-up was associated with a shorter overall survival (P = 0.003). Sequencing of viral DNA from MCC and non MCC samples characterized common single nucleotide polymorphisms defining 8 patient specific strains. However, specific molecular signatures truncating MCPyV LT were observed in 8/12 MCC cases but not in respiratory and urinary samples from 15 patients. New integration sites were identified in 4 MCC cases. Finally, mutated-integrated forms of MCPyV were detected in PBMC of two patients with disseminated MCC disease, indicating circulation of metastatic cells. We conclude that MCPyV molecular features in primary MCC tumour and PBMC may help to predict the course of the disease
CIViCdb 2022: evolution of an open-access cancer variant interpretation knowledgebase
CIViC (Clinical Interpretation of Variants in Cancer; civicdb.org) is a crowd-sourced, public domain knowledgebase composed of literature-derived evidence characterizing the clinical utility of cancer variants. As clinical sequencing becomes more prevalent in cancer management, the need for cancer variant interpretation has grown beyond the capability of any single institution. CIViC contains peer-reviewed, published literature curated and expertly-moderated into structured data units (Evidence Items) that can be accessed globally and in real time, reducing barriers to clinical variant knowledge sharing. We have extended CIViC’s functionality to support emergent variant interpretation guidelines, increase interoperability with other variant resources, and promote widespread dissemination of structured curated data. To support the full breadth of variant interpretation from basic to translational, including integration of somatic and germline variant knowledge and inference of drug response, we have enabled curation of three new Evidence Types (Predisposing, Oncogenic and Functional). The growing CIViC knowledgebase has over 300 contributors and distributes clinically-relevant cancer variant data currently representing &gt;3200 variants in &gt;470 genes from &gt;3100 publications
A critique of a method to determine long-term decline of coral reef ecosystems\ud
The supposedly already-degraded state of coral reef ecosystems is sometimes claimed to be a reason why anthropogenic global warming will have a major impact on the reefs, i.e. they are already close to extinction and can easily be tipped over the edge. Recently published work by Pandolfi et al. (2003) in Science has outlined a method for measuring the decline of coral reef ecosystems throughout the world according to which the outer and inner Great Barrier Reef (GBR) are claimed to be 28% and 36% respectively, down the path towards ecological extinction. This is a highly significant claim given the important status of the GBR, so the result deserves attention and objective scrutiny. This paper sets out to scrutinise the methodology used by Pandolfi et al. (2003) under four headings: (i) the guilds are poorly weighted and focus largely on human target species, rather than species that are ecologically important to reefs; (ii) the numerical scale used to “measure” the state of the reefs is not well-founded and hence distorts the result; (iii) the analysis fails to recognize that the GBR is of relatively recent origin and therefore never existed in the pre-human/pristine cultural period as defined by PAN; and (iv) in many cases it is doubtful that the literature cited demonstrates the claimed decline in ecological state. It is concluded that the work of Pandolfi et al. (2003) cannot be used as justification that the Great Barrier Reef has lost significant resilience, or that it is particularly susceptible to global warming because of its present supposedly degraded state
Trapping of mangrove propagules due to density-driven secondary circulation in the Normanby River estuary, NE Australia
The dispersal of mangrove propagules in the Normanby River estuary is dominated by secondary estuarine circulation. On flood tides, an axial surface convergence forms midstream, generated by a density-driven circulation cell. Floating material including mangrove propagules is trapped in the convergence, and moves upstream. On ebb tides, the circulation cell reverses, and propagules move towards the banks, where water velocities are much smaller than midstream. Over a tidal cycle, a net upstream drift of propagules occurs. This displacement effect occurs throughout the tropical dry season. Buoyant propagules of Rhizophora stylosa, Bruguiera gymnorrhiza, Xylocarpus mekongensis and Heritiera littoralis have been found to be transported upstream at a speed comparable to a net average speed of 3.2 km d-1, found in a drift-drogue experiment. The propagules subsequently accumulate in large numbers in hydrodynamic traps upstream from the convergence and, more importantly, upstream from the mangrove fringe. The hydrodynamic trapping conflicts with the temporal and spatial requirements of propagules to Œfind¹ a habitat suitable for development
A predictive model for Dengue Hemorrhagic Fever epidemics
A statistical model for predicting monthly Dengue Hemorrhagic Fever (DHF) cases from the city of Makassar is developed and tested. The model uses past and present DHF cases, climate and meteorological observations as inputs. These inputs are selected using a stepwise regression method to predict future DHF cases. The model is tested independently and its skill assessed using two skill measures. Using the selected variables as inputs, the model is capable of predicting a moderately-severe epidemic at lead times of up to six months. The most important input variable in the prediction is the present number of DHF cases followed by the relative humidity three to four months previously. A prediction 1-6 months in advance is sufficient to initiate various activities to combat DHF epidemic. The model is suitable for warning and easily becomes an operational tool due to its simplicity in data requirement and computational effort