Emerging infections: getting ahead of the curve.

The early history of infectious diseases was characterized by sudden, unpredictable outbreaks, frequently of epidemic proportion. Scientific advances in the late 19th and early 20th centuries resulted in the prevention and control of many infectious diseases, particularly in industrialized nations. Despite these improvements in health, outbreaks of infectious disease continue to occur, and new infections emerge. Since 1987, the National Academy of Science's Institute of Medicine (IOM) has published three reports that have identified erosion of the public health infrastructure among the factors contributing to new and reemerging infectious diseases. In partnership with many public and private organizations in the United States and abroad, the Centers for Disease Control and Prevention (CDC) has developed a strategic plan that addresses the priorities set forth in the IOM reports and serves as a guide for CDC and its partners to combat emerging microbial threats to health. Laboratory-based surveillance, better communication networks, and improvements in the public health infrastructure are the cornerstones of the strategy. Emerging Infectious Diseases, a new periodical produced by CDC, will serve as a forum for exchange of information about incipient trends in infectious diseases, analysis of factors contributing to disease emergence, and development and implementation of prevention measures

Elasticity of Stiff Polymer Networks

We study the elasticity of a two-dimensional random network of rigid rods (``Mikado model''). The essential features incorporated into the model are the anisotropic elasticity of the rods and the random geometry of the network. We show that there are three distinct scaling regimes, characterized by two distinct length scales on the elastic backbone. In addition to a critical rigidiy percolation region and a homogeneously elastic regime we find a novel intermediate scaling regime, where elasticity is dominated by bending deformations.Comment: 4 pages, 4 figure

Moving from evidence-based medicine to evidence-based health.

While evidence-based medicine (EBM) has advanced medical practice, the health care system has been inconsistent in translating EBM into improvements in health. Disparities in health and health care play out through patients' limited ability to incorporate the advances of EBM into their daily lives. Assisting patients to self-manage their chronic conditions and paying attention to unhealthy community factors could be added to EBM to create a broader paradigm of evidence-based health. A perspective of evidence-based health may encourage physicians to consider their role in upstream efforts to combat socially patterned chronic disease

Entanglement, elasticity and viscous relaxation of actin solutions

We have investigated the viscosity and the plateau modulus of actin solutions with a magnetically driven rotating disc rheometer. For entangled solutions we observed a scaling of the plateau modulus versus concentration with a power of 7/5. The measured terminal relaxation time increases with a power 3/2 as a function of polymer length. We interpret the entanglement transition and the scaling of the plateau modulus in terms of the tube model for semiflexible polymers.Comment: 5 pages, 4 figures, published versio

Development of Improved Aerogels for Spacecraft Hypervelocity Capture

The highly successful NASA Discovery mission Stardust became the first mission to return samples to Earth from a known comet in January 2006 [1]. The samples were captured during a flyby of comet 81P/Wild2 using aerogel, a very low density, silica (SiO2)-based solid with a highly porous structure [2]. Currently, scientists around the world are studying the cometary particles returned by Stardust and reporting fascinating discoveries about the history of comets and the evolution of our solar system. Given the widely acknowledged success of the Stardust mission, additional comet sample return missions are attractive and competitive concepts for future NASA Discovery-class missions; in particular, additional comet sample return missions will allow the first laboratory studies to investigate the naturally occurring diversity among comets, a crucial scientific question for understanding not just the formation of comets but also the very nature of the early solar system. Though Stardust was highly successful, there are important lessons learned from the mission on which advances in aerogel technology can be base

Recent Incarceration, Substance Use, Overdose, and Service Use Among People Who Use Drugs in Rural Communities

Importance: Drug use and incarceration have a substantial impact on rural communities, but factors associated with the incarceration of rural people who use drugs (PWUD) have not been thoroughly investigated. Objective: To characterize associations between recent incarceration, overdose, and substance use disorder (SUD) treatment access among rural PWUD. Design, setting, and participants: For this cross-sectional study, the Rural Opioid Initiative research consortium conducted a survey in geographically diverse rural counties with high rates of overdose across 10 US states (Illinois, Wisconsin, North Carolina, Oregon, Kentucky, West Virginia, Ohio, Massachusetts, New Hampshire, and Vermont) between January 25, 2018, and March 17, 2020, asking PWUD about their substance use, substance use treatment, and interactions with the criminal legal system. Participants were recruited through respondent-driven sampling in 8 rural US regions. Respondents who were willing to recruit additional respondents from their personal networks were enrolled at syringe service programs, community support organizations, and through direct community outreach; these so-called seed respondents then recruited others. Of 3044 respondents, 2935 included participants who resided in rural communities and reported past-30-day injection of any drug or use of opioids nonmedically via any route. Data were analyzed from February 8, 2022, to September 15, 2023. Exposure: Recent incarceration was the exposure of interest, defined as a report of incarceration in jail or prison for at least 1 day in the past 6 months. Main outcomes and measures: The associations between PWUD who were recently incarcerated and main outcomes of treatment use and overdose were examined using logistic regression. Results: Of 2935 participants, 1662 (56.6%) were male, 2496 (85.0%) were White; the mean (SD) age was 36 (10) years; and in the past 30 days, 2507 (85.4%) reported opioid use and 1663 (56.7%) reported injecting drugs daily. A total of 1224 participants (41.7%) reported recent incarceration, with a median (IQR) incarceration of 15 (3-60) days in the past 6 months. Recent incarceration was associated with past-6-month overdose (adjusted odds ratio [AOR], 1.38; 95% CI, 1.12-1.70) and recent SUD treatment (AOR, 1.62; 95% CI, 1.36-1.93) but not recent medication for opioid use disorder (MOUD; AOR, 1.03; 95% CI, 0.82-1.28) or currently carrying naloxone (AOR, 1.02; 95% CI, 0.86-1.21). Conclusions and relevance: In this cross-sectional study of PWUD in rural areas, participants commonly experienced recent incarceration, which was not associated with MOUD, an effective and lifesaving treatment. The criminal legal system should implement effective SUD treatment in rural areas, including MOUD and provision of naloxone, to fully align with evidence-based SUD health care policies.</p

Family doctors' problems and motivating factors in management of depression

BACKGROUND: Depression is a frequent psychiatric disorder, and depressive patient may be more problematic for the family doctors (FD) than a patient suffering from a somatic disease. Treatment of patients with depressive disorders is a relatively new task for Estonian FDs. The aim of our study was to find out the family doctors' attitudes to depression related problems, their readiness, motivating factors and problems in the treatment of depressive patients as well as the existence of relevant knowledge. METHODS: In 2002, altogether 500 FDs in Estonia were invited to take part in a tailor-made questionnaire survey, of which 205 agreed to participate. RESULTS: Of the respondents 185(90%) considered management of depressive patients and their treatment to be the task of FDs. One hundred and eighty FDs (88%) were themselves ready to deal with depressed patients, and 200(98%) of them actually treated such patients. Commitment to the interests of the patients, better cooperation with successfully treated patients, the patients' higher confidence in FDs and disappearance of somatic complaints during the treatment of depression were the motivating factors for FDs. FDs listed several important problems interfering with their work with depressive patients: limited time for one patient, patients' attitudes towards the diagnosis of depression, doctors' difficulties to change the underlying causes of depression, discontinuation of the treatment due to high expenses and length. Although 115(56%) respondents maintained that they had sufficient knowledge for diagnostics and treatment of depression, 181(88%) were of the opinion that they needed additional training. CONCLUSION: FDs are ready to manage patients who might suffer from depression and are motivated by good doctor-patient relationship. However, majority of them feel that they need additional training

Cigarette smokers' intention to quit smoking in Dire Dawa town Ethiopia: an assessment using the Transtheoretical Model

<p>Abstract</p> <p>Background</p> <p>Cessation of smoking reduces morbidity and mortality related to tobacco smoking. It is essential to explore the intention of individuals to quit smoking to design effective interventions. The objective of this study was to assess cigarette smokers' intention to quit smoking in Dire Dawa town using the Transtheoretical model.</p> <p>Methods</p> <p>From February 15 to 19, 2009, we conducted a community based cross-sectional study among 384 current cigarette smokers in Dire Dawa town east Ethiopia. Data was collected by trained personnel using a pretested structured questionnaire. The data was analyzed using SPSS version 16.0.</p> <p>Results</p> <p>Two hundred and nineteen (57%) smokers in the study area had the intention to quit cigarette smoking within the next six months and all the process of change had an increasing trend across the stages. Based on the Fragestrom test of nicotine dependence of cigarette, 35 (9.1%), 69 (18%) and 48(12.5%) were very high, high and medium dependent on nicotine respectively. For the majority 247(64.3%) of the respondents, the mean score of cons of smoking outweighs the pros score (negative decisional balance). Only 66(17.2%) had high self efficacy not to smoke in places and situations that can aggravate smoking.</p> <p>Conclusions</p> <p>Majority of the smokers had the intention to quit smoking. All the process of change had an increasing trend across the stages. Those who had no intention to quit smoking had high level of dependence on nicotine and low self efficacy. The pros of smoking were decreasing while the cons were increasing across the stages. Stage based interventions should be done to move the smokers from their current stage to an advanced stages of quitting cigarette smoking.</p

Fabrication of Double Shell Targets with a Glass Inner Capsule Supported by SiO2 Aerogel for Shots on the Omega Laser in 2006

Indirectly driven double shell implosions are being investigated as a possible noncryogenic path to ignition on the National Ignition Facility. Lawrence Livermore National Laboratory has made several technological advances that have produced double shell targets that represent a significant improvement to previously fielded targets. The inner capsule is supported inside the ablator shell by SiO{sub 2} aerogel with a nominal density of 50 mg/cm{sup 3}. The aerogel is cast around the inner capsule and then machined concentric to it. The seamless sphere of aerogel containing the embedded capsule is then assembled between the two halves of the ablator shell. The concentricity between the two shells has been improved to less than 1.5 {micro}m. The ablator shell consists of two hemispherical shells that mate at a step joint that incorporates a gap with a nominal thickness of 0.1 {micro}m. Using a new flexure-based tool holder that precisely positions the diamond cutting tool on the diamond turning machine, step discontinuities on the inner surface of the ablator of less than 0.5 {micro}m have been achieved. New methods have been used to comprehensively characterize each of the targets using high-resolution x-ray imaging systems

The Legacy of the U. S. Public Health Service Study of Untreated Syphilis in African American Men at Tuskegee on the Affordable Care Act and Health Care Reform Fifteen Years after President Clinton's Apology

http://dx.doi.org/10.1080/10508422.2012.73080