A study of productivity in optometric practice: Its relation to manpower and planning

A survey of all optometrists in HEW Region X was implemented to assess a number of practice characteristics . Relationships between practice characteristics and productivity were demonstrated and changing trends in these characteristics were determined. Age, years in practice, utilization of supplementary personnel, and practice mode were found to bear a direct relationship to productivity. It was shown that manpower projections must take current trends in these characteristics into account in order to be valid

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Blood neutrophil counts in HIV-infected patients with pulmonary tuberculosis: association with sputum mycobacterial load.

BACKGROUND: Increasing evidence suggests that neutrophils play a role in the host response to Mycobacterium tuberculosis. We determined whether neutrophil counts in peripheral blood are associated with tuberculosis (TB) and with mycobacterial load in sputum in HIV-infected patients. METHODOLOGY/PRINCIPAL FINDINGS: Adults enrolling in an antiretroviral treatment (ART) clinic in a Cape Town township were screened for TB regardless of symptoms. Paired sputum samples were examined using liquid culture, fluorescence microscopy, and the Xpert MTB/RIF assay. Absolute neutrophil counts (ANC) were measured in blood samples. Of 602 HIV-infected patients screened, 523 produced one or more sputum samples and had complete results available for analysis. Among these 523 patients, the median CD4 count was 169×10(9)/L (IQR, 96-232) and median ANC was 2.6×10(9)/L (IQR, 1.9-3.6). Culture-positive pulmonary tuberculosis was diagnosed in 89 patients. Patients with TB had a median ANC of 3.4×10(9)/L (IQR, 2.4-5.1) compared to 2.5×10(9)/L (IQR, 1.8-3.4) among those who were culture negative (p7.5×10(9)/L; p = 0.0005). Patients were then classified into four mutually exclusive groups with increasing sputum mycobacterial load as defined by the results of culture, Xpert MTB/RIF and sputum smear microscopy. Multivariable analyses demonstrated that increasing sputum mycobacterial load was positively associated with blood ANC ≥2.6×10(9)/L and with neutrophilia. CONCLUSIONS/SIGNIFICANCE: Increased blood neutrophil counts were independently associated with pulmonary TB and sputum mycobacterial burden in this HIV-infected patient group. This observation supports the growing body of literature regarding the potential role for neutrophils in the host response to TB

Perioperative morbidity and mortality after transmyocardial laser revascularization: incidence and risk factors for adverse events

AbstractOBJECTIVESThe purpose of this study was to describe the incidence and spectrum of perioperative cardiac and noncardiac morbidity and mortality after transmyocardial laser revascularization (TMR) and to identify predictors of these adverse clinical events.BACKGROUNDClinical studies have demonstrated the efficacy of TMR for relieving angina pectoris, although no study to date has specifically addressed the associated perioperative morbidity and mortality.METHODSBetween October 1995 and August 1997, 34 consecutive patients with end-stage coronary artery disease (CAD) underwent isolated TMR. The majority of patients (94%) had class III or IV angina pectoris, and two patients (6%) had unstable symptoms preoperatively. Patient records were reviewed for fatal and nonfatal adverse cardiac and noncardiac events.RESULTSPerioperative death occurred in two patients (5.9%) due to cardiogenic shock complicating acute myocardial infarction. Perioperative cardiac morbidity occurred in 16 patients (47.1%); noncardiac morbidity was seen in 12 patients (35.3%). Preoperative unstable angina was the only variable predictive of perioperative death (p = 0.005). Cardiac (p = 0.005) and noncardiac (p < 0.001) morbidity rates were significantly higher for the initial 15 patients undergoing the procedure. Other predictors of perioperative complications included lack of postoperative treatment with a furosemide infusion (p ≤ 0.04) and preoperative unstable angina (p = 0.05).CONCLUSIONSPerioperative mortality in patients undergoing isolated TMR is low. Transmyocardial laser revascularization patients are at higher risk for adverse perioperative cardiac and noncardiac events, likely reflecting the lack of immediate benefit from the procedure in the setting of severe CAD. These patients merit vigilant surveillance for adverse events and aggressive medical management in the perioperative period

Detection of microRNAs in color space

MotivationDeep sequencing provides inexpensive opportunities to characterize the transcriptional diversity of known genomes. The AB SOLiD technology generates millions of short sequencing reads in color-space; that is, the raw data is a sequence of colors, where each color represents 2 nt and each nucleotide is represented by two consecutive colors. This strategy is purported to have several advantages, including increased ability to distinguish sequencing errors from polymorphisms. Several programs have been developed to map short reads to genomes in color space. However, a number of previously unexplored technical issues arise when using SOLiD technology to characterize microRNAs.ResultsHere we explore these technical difficulties. First, since the sequenced reads are longer than the biological sequences, every read is expected to contain linker fragments. The color-calling error rate increases toward the 3(') end of the read such that recognizing the linker sequence for removal becomes problematic. Second, mapping in color space may lead to the loss of the first nucleotide of each read. We propose a sequential trimming and mapping approach to map small RNAs. Using our strategy, we reanalyze three published insect small RNA deep sequencing datasets and characterize 22 new microRNAs.Availability and implementationA bash shell script to perform the sequential trimming and mapping procedure, called SeqTrimMap, is available at: http://www.mirbase.org/tools/seqtrimmap/[email protected] informationSupplementary data are available at Bioinformatics online

Habitat use and behavior of the east Pacific green turtle, Chelonia mydas in an urbanized system

Green sea turtles, Chelonia mydas, are known to inhabit populated and often urbanized areas. To understand turtle habitat use and behavior within these unique habitats, seven juvenile green turtles were fitted with acoustic transmitters (September 2012 – August 2014), of which two transmitters included an accelerometer (AP transmitter). One individual fitted with an AP transmitter was tracked using a passive acoustic array in an urbanized river, the San Gabriel River, Long Beach, CA (33°45’ N, 118°05’ W). Three additional turtles in this river and three turtles (one with AP transmitter) in a restored estuary (33°44’ N, 118°03’ W) in southern California were actively tracked for two non-consecutive 24-h periods. Those fitted with AP transmitters indicated that turtles were less active at night (0.58 ± 0.56 m/s2 and 0.50 ± 0.63 m/s2) than during the day (0.86 ± 0.63 m/s2 and 0.78 ± 0.60 m/s2) at both sites. Activity data and corresponding movements of the actively tracked turtle fitted with the AP transmitter were used to infer resting periods for other tracked individuals. Turtles rested near bridge pilings and runoff outflows in the river to potentially shelter from tidal flow. Turtles used significantly larger daily areas in the urbanized river (0.046 ± 0.023 km2) where resources may be patchier and less abundant, compared to turtles in the estuary (0.024 ± 0.012 km2) where large, dense eelgrass beds are present. Based on the habitat use and behaviors of green sea turtles, it appears that some green sea turtles are able to make use of both highly developed and restored habitats and likely benefit from certain aspects of development

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