Developing predictive models of health literacy.

IntroductionLow health literacy (LHL) remains a formidable barrier to improving health care quality and outcomes. Given the lack of precision of single demographic characteristics to predict health literacy, and the administrative burden and inability of existing health literacy measures to estimate health literacy at a population level, LHL is largely unaddressed in public health and clinical practice. To help overcome these limitations, we developed two models to estimate health literacy.MethodsWe analyzed data from the 2003 National Assessment of Adult Literacy (NAAL), using linear regression to predict mean health literacy scores and probit regression to predict the probability of an individual having 'above basic' proficiency. Predictors included gender, age, race/ethnicity, educational attainment, poverty status, marital status, language spoken in the home, metropolitan statistical area (MSA) and length of time in U.S.ResultsAll variables except MSA were statistically significant, with lower educational attainment being the strongest predictor. Our linear regression model and the probit model accounted for about 30% and 21% of the variance in health literacy scores, respectively, nearly twice as much as the variance accounted for by either education or poverty alone.ConclusionsMultivariable models permit a more accurate estimation of health literacy than single predictors. Further, such models can be applied to readily available administrative or census data to produce estimates of average health literacy and identify communities that would benefit most from appropriate, targeted interventions in the clinical setting to address poor quality care and outcomes related to LHL

Reduced grapevine canopy size post-flowering via mechanical trimming alters ripening and yield of 'Pinot noir'

The degree and time of canopy trimming can alter phenology, rates of increase or decrease in berry components during grape ripening, and may influence yield and its components. The objective of this study was to investigate the extent to which reducing canopy size, by mechanical trimming post-flowering, changed Vitis vinifera L. 'Pinot noir' fruit yield and composition. Vines were mechanically trimmed to three different canopy heights at fruitset: 1000 mm (100 % canopy height), 600 mm (60 % canopy height relative to the control treatment) and 300 mm (30 % canopy height relative to the control treatment). Total soluble solids concentration and content, titratable acidity, pH and fresh berry mass were measured throughout ripening, and yield and leaf area were measured at harvest.Reduced canopy size via trimming to 30 and 60 % of the control treatment height slowed total soluble solids accumulation and in some cases increased titratable acidity and increased pH. The total soluble solids-titratable acidity ratio was therefore reduced throughout ripening by these trimming treatments relative to the full canopy height. Trimming to reduce canopy size had two effects on the source-sink ratio; it reduced the source (canopy) but increased fruit yield, an important sink. Therefore, the time of trimming is an important management consideration because it can delay and slow ripening due to reduced source leaves but could potentially accentuate the delay via increasing yield (sink). This technique may represent a way to offset the acceleration of phenology and grape ripening that has been observed to occur as a result of warmer seasons

Correlative analyses of RET and RAS mutations in a phase 3 trial of cabozantinib in patients with progressive, metastatic medullary thyroid cancer

BACKGROUND: Cabozantinib significantly prolonged progression-free survival (PFS) versus a placebo in patients with progressive, metastatic medullary thyroid cancer (MTC; P <.001). An exploratory analysis of phase 3 trial data evaluated the influence of rearranged during transfection (RET) and RAS (HRAS, KRAS, and NRAS) mutations on cabozantinib clinical activity. METHODS: Patients (n = 330) were randomized to cabozantinib (140 mg/day) or a placebo. The primary endpoint was PFS. Additional outcome measures included PFS, objective response rates (ORRs), and adverse events in RET and RAS mutation subgroups. RESULTS: Among all study patients, 51.2% were RET mutation–positive (38.2% with RET M918T), 34.8% were RET mutation–unknown, and 13.9% were RET mutation–negative. Sixteen patients were RAS mutation–positive. Cabozantinib appeared to prolong PFS versus the placebo in the RET mutation–positive subgroup (hazard ratio [HR], 0.23; 95% confidence interval [CI], 0.14-0.38; P <.0001), the RET mutation–unknown subgroup (HR, 0.30; 95% CI, 0.16-0.57; P =.0001), and the RAS mutation–positive subgroup (HR, 0.15; 95% CI, 0.02-1.10; P =.0317). The RET M918T subgroup achieved the greatest observed PFS benefit from cabozantinib versus the placebo (HR, 0.15; 95% CI, 0.08-0.28; P <.0001). The ORRs for RET mutation–positive, RET mutation–negative, and RAS mutation–positive patients were 32%, 22%, and 31%, respectively. No PFS benefit was observed in patients lacking both RET and RAS mutations, although the ORR was 21%. The safety profile for all subgroups was similar to that for the overall cabozantinib arm. CONCLUSIONS: These data suggest that cabozantinib provides the greatest clinical benefit to patients with MTC who have RET M918T or RAS mutations. However, a prospective trial is needed to confirm the relation between genetic variation and the response to cabozantinib. Cancer 2016;122:3856–3864. © 2016 American Cancer Society

Rapid monitoring of anti-tuberculosis therapy using fluorescein diacetate microscopy: a simple method to determine infectiousness and screen for drug resistance

Background: Tuberculosis treatment and infection control are hampered by difficulty assessing mycobacterial viability to determine infectiousness and early treatment response. TB culture takes weeks; molecular tests are technically demanding; and acid-fast staining cannot differentiate live from dead tuberculosis. / Objectives: To develop and evaluate a simple slide-microscopy test to rapidly determine tuberculosis viability. / Methods: A protocol was optimized to stain viable but not dead tuberculosis in decontaminated sputum dried onto microscope slides and stained with the vital stain fluorescein diacetate (FDA). The reliability of this FDA slide microscopy for determining the concentration of viable tuberculosis in sputum was then compared with quantitative culture. / Results-laboratory evaluation: In untreated patients, tuberculosis auramine staining was unaffected whether sputum was fresh or had been sterilized by boiling, whereas FDA stained only un-boiled, viable tuberculosis. Quantification of viable tuberculosis by culture was reliably predicted by FDA, but not by auramine microscopy. / Results-clinical evaluation : Sequential sputums were collected from 35 patients before and after 3, 6 and 9 days of first-line tuberculosis treatment. Culture quantification of viable mycobacteria in sputum was predicted by slide microscopy with FDA (r2=0.77) but not auramine (r2=0.33). Quantification of viable tuberculosis in sputum by both quantitative culture and FDA microscopy fell 10-100 fold during the first nine days of treatment in all patients with drug-susceptible tuberculosis, whereas there was little change for patients with MDRTB. Specifically, 70% of samples from patients with drug-susceptible tuberculosis had a decline in the FDA count of viable tuberculosis of at least 0.2 logs/treatment-day, compared with none of the samples from MDRTB patients (P1 month required for culture. This simple and inexpensive technique rapidly assessed patient infectiousness on treatment, potentially guiding infection control measures. FDA staining also revealed differences in early treatment response between non-MDR and MDRTB and may allow early field screening for MDRTB and impending treatment failure

Stabilization of Deterministically Chaotic Systems by Interference and Quantum Measurements: The Ikeda Map Case

We propose a method which can effectively stabilize fixed points in the classical and quantum dynamics of a phase-sensitive chaotic system with feedback. It is based on feeding back a selected quantum sub-ensemble whose phase and amplitude stabilize the otherwise chaotic dynamics. Although the method is rather general, we apply it to realizations of the inherently chaotic Ikeda map. One suggested realization involves the Mach-Zender interferometer with Kerr nonlinearity. Another realization involves a trapped ion interacting with laser fields.Comment: RevTeX, 5 pages, two figure

Restoring Pre-Industrial CO\u3csub\u3e2\u3c/sub\u3e Levels While Achieving Sustainable Development Goals

© 2020 by the authors. Unless humanity achieves United Nations Sustainable Development Goals (SDGs) by 2030 and restores the relatively stable climate of pre-industrial CO2 levels (as early as 2140), species extinctions, starvation, drought/floods, and violence will exacerbate mass migrations. This paper presents conceptual designs and techno-economic analyses to calculate sustainable limits for growing high-protein seafood and macroalgae-for-biofuel. We review the availability of wet solid waste and outline the mass balance of carbon and plant nutrients passing through a hydrothermal liquefaction process. The paper reviews the availability of dry solid waste and dry biomass for bioenergy with CO2 capture and storage (BECCS) while generating Allam Cycle electricity. Sufficient wet-waste biomass supports quickly building hydrothermal liquefaction facilities. Macroalgae-for-biofuel technology can be developed and straightforwardly implemented on SDG-achieving high protein seafood infrastructure. The analyses indicate a potential for (1) 0.5 billion tonnes/yr of seafood; (2) 20 million barrels/day of biofuel from solid waste; (3) more biocrude oil from macroalgae than current fossil oil; and (4) sequestration of 28 to 38 billion tonnes/yr of bio-CO2. Carbon dioxide removal (CDR) costs are between 25–33% of those for BECCS with pre-2019 technology or the projected cost of air-capture CDR

Subtle changes in the flavour and texture of a drink enhance expectations of satiety

Background: The consumption of liquid calories has been implicated in the development of obesity and weight gain. Energy-containing drinks are often reported to have a weak satiety value: one explanation for this is that because of their fluid texture they are not expected to have much nutritional value. It is important to consider what features of these drinks can be manipulated to enhance their expected satiety value. Two studies investigated the perception of subtle changes in a drink’s viscosity, and the extent to which thick texture and creamy flavour contribute to the generation of satiety expectations. Participants in the first study rated the sensory characteristics of 16 fruit yogurt drinks of increasing viscosity. In study two, a new set of participants evaluated eight versions of the fruit yogurt drink, which varied in thick texture, creamy flavour and energy content, for sensory and hedonic characteristics and satiety expectations. Results: In study one, participants were able to perceive small changes in drink viscosity that were strongly related to the actual viscosity of the drinks. In study two, the thick versions of the drink were expected to be more filling and have a greater expected satiety value, independent of the drink’s actual energy content. A creamy flavour enhanced the extent to which the drink was expected to be filling, but did not affect its expected satiety. Conclusions: These results indicate that subtle manipulations of texture and creamy flavour can increase expectations that a fruit yogurt drink will be filling and suppress hunger, irrespective of the drink’s energy content. A thicker texture enhanced expectations of satiety to a greater extent than a creamier flavour, and may be one way to improve the anticipated satiating value of energy-containing beverages

Accessible Content and Accessibility Experiences: The Interplay of Declarative and Experiential Information in Judgment

Recall tasks render 2 distinct sources of information available: the recalled content and the experienced ease or difficulty with which it can be brought to mind. Because retrieving many pieces of information is more difficult than retrieving only a few, reliance on accessible content and subjective accessibility experiences leads to opposite judgmental outcomes. People are likely to base judgments on accessibility experiences when they adopt a heuristic processing strategy and the informational value of the experience is not called into question. When the experience is considered nondiagnostic, or when a systematic processing strategy is adopted, people rely on accessible content. Implications for the operation of the availability heuristic and the emergence of knowledge accessibility effects are discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68686/2/10.1207_s15327957pspr0202_2.pd

Measurement of the Lifetime Difference Between B_s Mass Eigenstates

We present measurements of the lifetimes and polarization amplitudes for B_s --> J/psi phi and B_d --> J/psi K*0 decays. Lifetimes of the heavy (H) and light (L) mass eigenstates in the B_s system are separately measured for the first time by determining the relative contributions of amplitudes with definite CP as a function of the decay time. Using 203 +/- 15 B_s decays, we obtain tau_L = (1.05 +{0.16}/-{0.13} +/- 0.02) ps and tau_H = (2.07 +{0.58}/-{0.46} +/- 0.03) ps. Expressed in terms of the difference DeltaGamma_s and average Gamma_s, of the decay rates of the two eigenstates, the results are DeltaGamma_s/Gamma_s = (65 +{25}/-{33} +/- 1)%, and DeltaGamma_s = (0.47 +{0.19}/-{0.24} +/- 0.01) inverse ps.Comment: 8 pages, 3 figures, 2 tables; as published in Physical Review Letters on 16 March 2005; revisions are for length and typesetting only, no changes in results or conclusion

Risk Factors for Post-ERCP Pancreatitis: A Prospective Multicenter Study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75082/1/j.1572-0241.2006.00380.x.pd