A Novel Survey Tool to Quantify the Degree and Duration of STEMI Regionalization Across California.

IntroductionCalifornia has been a global leader in regionalization efforts for time-critical medical conditions. A total of 33 local emergency medical service agencies (LEMSAs) exist, providing an organized EMS framework across the state for almost 40 years. We sought to develop a survey tool to quantify the degree and duration of ST-elevation myocardial infarction (STEMI) regionalization over the last decade in California.MethodsThe project started with the development of an 8-question survey tool via a multi-disciplinary expert consensus process. Next, the survey tool was distributed at the annual meeting of administrators and medical directors of California LEMSAs to get responses valid through December, 2014. The first scoring approach was the Total Regionalization Score (TRS) and used answers from all 8 questions. The second approach was called the Core Score, and it focused on only 4 survey questions by assuming that the designation of STEMI Receiving Centers must have occurred at the beginning of any LEMSA's regionalization effort. Scores were ranked and grouped into tertiles.ResultsAll 33 LEMSAs in California participated in this survey. The TRS ranged from 15 to 162. The Core Score range was much narrower, from 2 to 30. In comparing TRS and Core Score rankings, the top-tertiles were quite similar. More rank variation occurred between mid- and low-tertiles.ConclusionThis study evaluated the degree and duration of STEMI network regionalization from 2004 to 2014 in California, and ranked 33 LEMSAs into tertiles based upon their TRS and their Core Score. Successful application of the 8-item survey and ranking strategies across California suggests that this approach can be used to assess regionalization in other states or countries around the world

Mealybug transmission of grapevine virus A

A closterovirus morphologially and serologically very close or identical to grapevine virus A (GVA) was experimentally transmitted by adults and instars of the Pseudococcidae mealybug Pseudococcus longispinus TARGIONI TOZZETTI from grapevine of cv. Inzolia affected by leafroll and stem pitting to Nicotiana clevelandii GRAY. GVA could not be recovered from infected vines by inoculation of sap but it was mechanically transmitted from N. clevelandii to N. benthamiana DOMIN. With immunosorbent electron microscopy (ISEM) tests, the presence of GVA was ascertained in: both the above herbaceous hosts;Inzolia vines used as donor plants for mealybug transmission tests;formerly virus-free Cabernet Franc and Procupac vines that had shown leafroll symptoms following natural mealybug infestation in a greenhouse where they were grown next to diseased grapes;squashed mealybugs which had fed on infected Inzolia vines.ISEM findings were confirmed by thin sectioning. In all cases filamentous virus particles were found in phloem tissues of infected herbaceous hosts and vines. In addition, donor (Inzolia) and recipient (Cabernet Franc, Procupac and LN-33) grapevines, but not herbaceous hosts, contained isometric virus-like particles and associated cytopathic structures (vesiculated bodies). The occurrence of a mixed infection in donor vines and the apparent transmission of both types of particles to grapevine does not allow to draw conclusions on the etiological significance of GVA in relation to leafroll disease. Further trials with source plants infected with GVA alone are now under way.Übertragung des Rebenvirus A durch SchildläuseEin Closterovirus, das morphologisch und serologisch dem Rebenvirus A (GVA) sehr nahesteht oder mit diesem identisch ist, wurde durch Adulte und Larven der Schildlaus Pseudococcus longispinus TARGIONI TOZZEITI (Pseudococcidae) von an Blattrollkrankheit und Holzrunzeligkeit erkrankten Reben der Sorte Inzolia auf Nicotiana clevelandii GRAY übertragen. Durch Saftübertragung aus infizierten Reben konnte GVA nicht nachgewiesen werden; es wurde jedoch von N. clevelandii auf N. bentamiana DOMIN. mechanisch übertragen. Mittels ISEM konnte GVA nachgewiesen werden: In den beiden oben genannten krautigen Wirtsarten;in Reben der Sorte Inzolia, die als Spenderpflanzen für die Schildlaus-Übertragungsversuche verwendet worden waren;in ursprünglich virusfreien Reben der Sorten Cabernet Franc und Procupac, die Blattrollsymptome gezeigt hatten, nachdem sie in einem Gewächshaus in unmittelbarer Nähe erkrankter Reben spontan von Schildläusen befallen worden waren;in zerquetschten Schildläusen, die an infizierten lnzolia-Reben gesogen hatten.Die ISEM-Befunde wurden an Dünnschnitten bestätigt. In allen Fällen wurden im Phloemgewebe der infizierten krautigen Wirtspflanzen und Reben filamentöse Viruspartikeln gefunden. Zusätzlich enthielten die Spender( Inzolia) und Empfängerreben (Cabernet Franc, Procupac und LN-33), nicht jedoch die krautigen Wirtspflanzen, isometrische virusartige Partikeln zusammen mit cytopathologischen Strukturen (vesiculäre Körper). Wegen des Vorliegens einer Mischinfektion in den Spenderreben und der offensichtlichen Übertragung beider Partikeltypen auf die Rebe ist es nicht möglich, Rückschlüsse auf die ätiologische Bedeutung von GVA im Verhältnis zur Blattrollkrankheit zu ziehen. Weitere Versuche unter Verwendung von Virusquellen, die nur mit GVA infiziert sind, wurden aufgenommen

Starledger: A Business Activity Model Using SAP R/3 As A Classroom Tool To Measure Learning Outcomes

Integrating enterprise system applications within the accounting curriculum has been a major challenge for over eight years.  Enterprise systems education is surprisingly well documented within the literature of enterprise system education.  Not surprisingly, most of these papers provide a descriptive study of individual experiences of an institution of an academic unit.  This paper focuses on the use of a practice case set within the accounting curriculum of a four year liberal arts based accounting program.  The results of the integration of this practice case show the ability of enterprise software to bring textbook concepts to life and a high satisfaction level among the students using this package.&nbsp

Attention allocation in a language with post-focal prominences

Accentuation influences selective attention and the depth of semantic processing during online speech comprehension. We investigated the processing of semantically congruent and incongruent words in a language that presents cues to prosodic prominences in the region of the utterance occurring after the focussed information (the post-focal region). This language is Italian, in particular the variety spoken in Bari. In this variety, questions have a compressed, post-focal accent, whereas in statements there is a low-level pitch in this position. Using event-related potentials, we investigated the processing of congruent and incongruent target words with two prosodic realizations (focussed with accentuation, post-focal realization) and in two-sentence modalities (statement, question). Results indicate an N400 congruence effect that was modulated by position (focal, post-focal) and modality (statement, question): processing was deeper for questions in narrow focus than in post-focal position, while statements showed similar pronounced N400 effects across positions. The attenuated N400 difference for post-focal targets in questions was accompanied by a more enhanced late positivity when they were incongruent, indicating that attentional resources are allocated during updating of speech act information

Glyphosate resistance by engineering the flavoenzyme glycine oxidase.

Glycine oxidase from Bacillus subtilis is a homotetrameric flavoprotein of great potential biotechnological use because it catalyzes the oxidative deamination of various amines and D-isomer of amino acids to yield the corresponding \u3b1-keto acids, ammonia/amine, and hydrogen peroxide. Glyphosate (N-phosphonomethylglycine), a broad spectrum herbicide, is an interesting synthetic amino acid: this compound inhibits 5-enolpyruvylshikimate-3-phosphate synthase in the shikimate pathway, which is essential for the biosynthesis of aromatic amino acids in plants and certain bacteria. In recent years, transgenic crops resistant to glyphosate were mainly generated by overproducing the plant enzyme or by introducing a 5-enolpyruvylshikimate-3-phosphate synthase insensitive to this herbicide. In this work, we propose that the enzymatic oxidation of glyphosate could be an effective alternative to this important biotechnological process. To reach this goal, we used a rational design approach (together with site saturation mutagenesis) to generate a glycine oxidase variant more active on glyphosate than on the physiological substrate glycine. The glycine oxidase containing three point mutations (G51S/A54R/H244A) reaches an up to a 210-fold increase in catalytic efficiency and a 15,000-fold increase in the specificity constant (the kcat/Km ratio between glyphosate and glycine) as compared with wild-type glycine oxidase. The inspection of its three-dimensional structure shows that the \u3b12-\u3b13 loop (comprising residues 50-60 and containing two of the mutated residues) assumes a novel conformation and that the newly introduced residue Arg54 could be the key residue in stabilizing glyphosate binding and destabilizing glycine positioning in the binding site, thus increasing efficiency on the herbicide

A Cellular Automata-Based Mathematical Model for Thymocyte Development

Intrathymic T cell development is an important process necessary for the normal formation of cell-mediated immune responses. Importantly, such a process depends on interactions of developing thymocytes with cellular and extracellular elements of the thymic microenvironment. Additionally, it includes a series of oriented and tunely regulated migration events, ultimately allowing mature cells to cross endothelial barriers and leave the organ. Herein we built a cellular automata-based mathematical model for thymocyte migration and development. The rules comprised in this model take into account the main stages of thymocyte development, two-dimensional sections of the normal thymic microenvironmental network, as well as the chemokines involved in intrathymic cell migration. Parameters of our computer simulations with further adjusted to results derived from previous experimental data using sub-lethally irradiated mice, in which thymus recovery can be evaluated. The model fitted with the increasing numbers of each CD4/CD8-defined thymocyte subset. It was further validated since it fitted with the times of permanence experimentally ascertained in each CD4/CD8-defined differentiation stage. Importantly, correlations using the whole mean volume of young normal adult mice revealed that the numbers of cells generated in silico with the mathematical model fall within the range of total thymocyte numbers seen in these animals. Furthermore, simulations made with a human thymic epithelial network using the same mathematical model generated similar profiles for temporal evolution of thymocyte developmental stages. Lastly, we provided in silico evidence that the thymus architecture is important in the thymocyte development, since changes in the epithelial network result in different theoretical profiles for T cell development/migration. This model likely can be used to predict thymocyte evolution following therapeutic strategies designed for recovery of the thymus in diseases coursing with thymus involution, such as some primary immunodeficiencies, acute infections, and malnutrition