Patterns of accelerometer-assessed physical activity patterns in adolescents.

Presented at: 8th Biennial Childhood Obesity Conference; June 29-July 2, 2015; San Diego, CA.https://digitalrepository.unm.edu/prc-posters-presentations/1042/thumbnail.jp

Physical activity patterns of adolescents by wrist-worn Geneactiv accelerometer.

Presented at: American College of Sports Medicine Annual Meeting; May 26-30, 2015; San Diego, CA.https://digitalrepository.unm.edu/prc-posters-presentations/1046/thumbnail.jp

Multi-study analysis of learning culture, human capital and operational performance in supply chain management: The moderating role of workforce level

Purpose – The purpose of this study is to empirically evaluate the relationship between learning culture, workforce level, human capital and operational performance in two diverse supply chain populations, aircraft maintenance and logistics readiness. Design/methodology/approach – Drawing upon competence-based view of the firm and human capital theory, this paper analyzes data from two studies. Findings – The results provide support for the hypothesized model. Workforce level moderates the relationship between learning culture and human capital, and human capital partially mediates the relationship between learning culture and operational performance. Research limitations/implications – The findings have implications for behavioral supply chain management research and implications for educating and training the supply chain management workforce. While the populations represent a diverse set of logistics functions and responsibilities, the participants are all military members, which may limit generalizability. Practical implications – This study should help leaders understand the importance of learning culture and the perceived differences in its effect on human capital based upon workforce level. Originality/value – This research is among the first to investigate the role of workforce level and answers a multitude of calls for research into the human side of supply chain management

Effect of Carelink, an Internet-Based Insulin Pump Monitoring System, on Glycemic Control in Children with Type 1 Diabetes Mellitus

Objective : To determine whether use of the internet-based Carelink system improved glycemic control in children on insulin pump therapy. Research Design and Methods - We reviewed records of 146 children treated with insulin pump therapy between the years 2004-2007, and compared glycemic control and diabetes self-care measures associated with Carelink use. Forty percent of the patients resided one hour or more from our clinic. Results: Patients who used the Carelink software and website showed significant improvement in HbA1c levels following use (8.0 ± 0.1 (SE) vs 7.7 ± 0.1 (SE), p=0.002). They uploaded data from their pump and glucometer 2.2 ± 1.8 times per month over 0.8 ± 0.4 (SD) years. Patients who had no access to Carelink software and were followed in a conventional manner showed no change in HbA1c ( 8.0 ± 0.1 (SE) vs 8.1 ± 0.1 (SE), p=0.27) during the study period. These patients did not differ significantly from Carelink users in diabetes self care behaviors. Patients who had Carelink access but did not use it had a higher HbA1c level at the onset and did not change over the study period (HbA1c 8.9 ± 0.2 (SE) vs 8.9 ± 0.3 (SE), p=0.76). These patients differed significantly from Carelink users in self-care behaviors, but not in the frequency of blood glucose monitoring. Patients in a rural location benefited equally as compared to patients who lived within one hour of our clinic. Conclusions: The Carelink software program is a powerful tool that can be used by diabetes care providers and parents to manage insulin pump therapy in children and to improve glycemic control, especially in states with a large rural population

Disorders of Bulldogs under primary veterinary care in the UK in 2013

The Bulldog is a popular companion breed in the UK despite widely reported disease predispositions. This study aimed to characterise the demography, mortality and common disorders of Bulldogs under veterinary care in the UK during 2013. VetCompass collates anonymised clinical data from UK primary-care veterinary practices for epidemiological research. The clinical records of all Bulldogs available in the VetCompass study dataset were reviewed manually in detail to extract the most definitive diagnoses recorded for all disorders that existed during 2013 and for all deaths. Bulldogs comprised 1621 (0.36%) of 445,557 study dogs. Bulldogs increased from 0.35% of the 2009 birth cohort to 0.60% in 2013. Median longevity was 7.2 years, which was lower in males (6.7 years) than females (7.9 years) (P = 0.021). The most prevalent fine-level precision disorders recorded were otitis externa (n = 206, prevalence 12.7%, 95% CI: 11.1–14.4), pyoderma (142, 8.8%, 95% CI: 7.4–10.2) and overweight/obesity (141, 8.7%, 95% CI: 7.4–10.2). The most prevalent disorder groups were cutaneous (n = 463, prevalence: 28.6%, 95% CI: 26.4–30.8), ophthalmological (292, 18.0%, 95% CI: 16.2–20.0), aural (211, 13.0%, 95% CI: 11.4–14.8), enteropathy (188, 11.6%, 95% CI: 10.1–13.3) and upper respiratory tract (171, 10.5%, 95% CI: 9.1–12.1). Provision of an evidence base on the most common disorders and causes of mortality within breeds can support owners, breeders and the veterinary profession to improve health and welfare within these breed

Divergent Human Cortical Regions for Processing Distinct Acoustic-Semantic Categories of Natural Sounds: Animal Action Sounds vs. Vocalizations

A major gap in our understanding of natural sound processing is knowledge of where or how in a cortical hierarchy differential processing leads to categorical perception at a semantic level. Here, using functional magnetic resonance imaging (fMRI) we sought to determine if and where cortical pathways in humans might diverge for processing action sounds vs. vocalizations as distinct acoustic-semantic categories of real-world sound when matched for duration and intensity. This was tested by using relatively less semantically complex natural sounds produced by non-conspecific animals rather than humans. Our results revealed a striking double-dissociation of activated networks bilaterally. This included a previously well described pathway preferential for processing vocalization signals directed laterally from functionally defined primary auditory cortices to the anterior superior temporal gyri, and a less well-described pathway preferential for processing animal action sounds directed medially to the posterior insulae. We additionally found that some of these regions and associated cortical networks showed parametric sensitivity to high-order quantifiable acoustic signal attributes and/or to perceptual features of the natural stimuli, such as the degree of perceived recognition or intentional understanding. Overall, these results supported a neurobiological theoretical framework for how the mammalian brain may be fundamentally organized to process acoustically and acoustic-semantically distinct categories of ethologically valid, real-world sounds

A simple flip of an obstetrics clerkship lecture focusing on interactive learning

Abstract Objective: To determine the value of interactive learning after a low-tech flip of a traditional lecture during an obstetrics and gynecology clerkship. Design: All third-year medical students completed a flipped learning experience between May 2014 and April 2016. Central to the change was replacement of a mid-clerkship lecture ("late term and prolonged gestation") with interactive learning at seven stations by student pairs (one each on separate obstetrics and gynecology services). Before class, students electronically received a handout that described learning objectives, subject background, and interactive stations. The stations featured manipulative models, instruments, data, and images involving prenatal care, fetal growth and testing, and labor and delivery decision-making. Results: The flipped model was easily executed with proper preparation. The 178 consecutive students completed the two mandated surveys. The median score given by students about the same instructor's effectiveness increased from 4.0 (previous two years) to 4.4 (on a 5-point scale). Compared with traditional lectures by other clerkship faculty, the flipped classroom was judged by students to be easier for understanding and more interactive. Students perceived being more responsible for learning with better recall and application to practice. Conclusions: A low-tech approach to the flipped classroom was easily executed with favorable responses from students about interactive learning

Crystal Structure of the Sodium Cobaltate Deuterate Superconductor NaxCoO2o4xD2O (x=1/3)

Neutron and x-ray powder diffraction have been used to investigate the crystal structures of a sample of the newly-discovered superconducting sodium cobaltate deuterate compound with composition Na0.31(3)CoO2o1.25(2)D2O and its anhydrous parent compound Na0.61(1)CoO2. The deuterate superconducting compound is formed by coordinating four D2O molecules (two above and two below) to each Na ion in a way that gives Na-O distances nearly equal to those in the parent compound. One deuteron of the D2O molecule is hydrogen bonded to an oxygen atom in the CoO2 plane and the oxygen atom and the second deuteron of each D2O molecule lie approximately in a plane between the Na layer and the CoO2 layers. This coordination of Na by four D2O molecules leads to ordering of the Na ions and D2O molecules. The sample studied here, which has Tc=4.5 K, has a refined composition of Na0.31(3)CoO2o1.25(2)D2O, in agreement with the expected 1:4 ratio of Na to D2O. These results show that the optimal superconducting composition should be viewed as a specific hydrated compound, not a solid solution of Na and D2O (H2O) in NaxCoO2oyD2O. Studies of physical properties vs. Na or D2O composition should be viewed with caution until it is verified that the compound remains in the same phase over the composition range of the study.Comment: 22 pages, 8 figure

GI Bleeding in the Elderly

Purpose: To determine the risk factors contributing to and etiologies of gastrointestinal bleeding in an elderly patient population seen by Southwest Gastroenterology (SWGA) providers. Methods: This study reviews charts of patients with GI bleeding from documented sources between 1/1999 and 3/2006. The cases are gathered retrospectively from the clinical records of SWGA, a 12-person private, single specialty gastroenterology group serving community hospitals. Etiology and risk factors for GI hemorrhages are recorded in an elderly population, defined as patients age 55 and older. Results: GI hemorrhages are identified in 105 patients. The majority (83, 79%) of hemorrhages are upper GI bleeds (UGIB) comparing to 22 (21%) lower GI bleeds (LGIB). In the UGIB group, the most common etiology of bleed is gastric ulcer (29%). We also found 72% of UGIB patients on prescribed anticoagulation medications, including anti-platelet agents or non-steroidal anti-inflammatory drugs (NSAIDs). 20% of these patients are also positive for H. Pylori. Thirty patients in the UGIB group smoke or consume alcohol heavily (consuming more than 3 drinks per day for men and two drinks per day for women) while 2 patients smoke or consume alcohol in the LGIB group. Previous bleeds are common in both groups with 39 (41%) in UGIB and 9 (47%) in LGIB. Co-morbidity is the most common risk factor with 20 (91%) in LGIB and 73 (88%) in UGIB. In the peptic ulcer disease (PUD) bleeds, the majority (77%) are taking NSAIDs, while in the non-PUD bleeds, only 38% are currently on NSAIDs. Overall, there are 2 mortalities resulting from cardiovascular complications of GI bleeding. Conclusion: The etiologies of GI bleeds in this population are comparable to other studies in the literature. The ratio of UGIB to LGIB in this elderly population is also similar to that reported in the literature. The risk factors shown to be most correlated to bleeding are co-morbidities, previous episodes of bleeding, anticoagulation, NSAID use, smoking and alcohol use. NSAID use is significant in PUD bleed patients. This study reinforces that increased knowledge of etiology, incidence and contributing factors of GI bleeding are necessary for physicians to efficiently treat GI bleeds in the elderly population

The analysis of relapse-free survival curves: implications for evaluating intensive systemic adjuvant treatment regimens for breast cancer

Results of adjuvant dose intensification studies in patients with localised breast cancer have raised questions regarding the clinical usefulness of this treatment strategy. Here, we develop and fit a natural history model for the time to clinical tumour recurrence as a function of the number of involved lymph nodes, and derive plausible predictions of the effects of dose intensification under various conditions. The time to tumour recurrence is assumed to depend on the residual postoperative micrometastatic burden of tumour, the fractional reduction of residual tumour burden (RTB) by treatment, and the rate of regrowth of the RTB to a clinically detectable size. It is assumed that a proportion of micrometastatic tumours are unresponsive to adjuvant chemotherapy even at maximal dose intensity. Data fitted included the San Antonio Cancer Institute (SACI) database of untreated patients, and CALGB #9082, a study comparing a highly intensive and moderately intensity adjuvant regimen in patients with 10+ positive axillary nodes. The proportion of tumours unresponsive to maximally intensive adjuvant treatment is estimated to be 48% (29–67%). The estimated log kill for intermediate-dose therapy from CALGB #9082 was 6.5 logs, compared with 9 logs or greater for high-dose therapy. The model is consistent with a modest but nonnegligible advantage of dose intensification compared with standard therapies in patients with sensitive tumours who have 10+ positive axillary nodes, and suggests that much of this clinical benefit could be achieved using intermediate levels of treatment intensification. The model further suggests that, in patients with fewer than 10 involved axillary nodes, any advantage of treatment intensification over standard therapy would be much reduced, because in patients with smaller tumour burdens of sensitive tumour, a larger proportion of cures achievable with intensified therapy could be achieved as well with standard therapy