79 research outputs found
Understanding avian egg cuticle formation in the oviduct; a study of its origin and deposition
The cuticle is a unique invisible oviduct secretion that protects avian eggs from bacterial penetration through gas exchange pores. Despite its importance, experimental evidence is lacking for where, when, and what is responsible for its deposition. By using knowledge about the ovulatory cycle and oviposition, we have manipulated cuticle deposition to obtain evidence on these key points. Cuticle deposition was measured using staining and spectrophotometry. Experimental evidence supports the location of cuticle deposition to be the shell gland pouch (uterus), not the vagina, and the time of deposition to be within the final hour before oviposition. Oviposition induced by arginine vasotocin or prostaglandin, the penultimate and ultimate factors for the induction of oviposition, produces an egg with no cuticle; therefore, these factors are not responsible for cuticle secretion. Conversely, oviposition induced by GNRH, which mimics the normal events of ovulation and oviposition, results in a normal cuticle. There is no evidence that cuticle deposition differs at the end of a clutch and, therefore, there is no evidence that the ovulatory surge of progesterone affects cuticle deposition. Overall, the results demonstrate that the cuticle is a specific secretion and is not merely an extension of the organic matrix of the shell. Cuticle deposition was found to be reduced by an environmental stressor, and there is no codependence of the deposition of pigment and cuticle. Defining the basic facts surrounding cuticle deposition will help reduce contamination of hen's eggs and increase understanding of the strategies birds use to protect their eggs
The Dawning Era of Personalized Medicine Exposes a Gap in Medical Education
Medical student Keyan Salari argues that it is crucial that medical students be trained to use and interpret patients' genetic information appropriately and responsibly
Protocol for implementation of family health history collection and decision support into primary care using a computerized family health history system
<p>Abstract</p> <p>Background</p> <p>The CDC's Family History Public Health Initiative encourages adoption and increase awareness of family health history. To meet these goals and develop a personalized medicine implementation science research agenda, the Genomedical Connection is using an implementation research (T3 research) framework to develop and integrate a self-administered computerized family history system with built-in decision support into 2 primary care clinics in North Carolina.</p> <p>Methods/Design</p> <p>The family health history system collects a three generation family history on 48 conditions and provides decision support (pedigree and tabular family history, provider recommendation report and patient summary report) for 4 pilot conditions: breast cancer, ovarian cancer, colon cancer, and thrombosis. All adult English-speaking, non-adopted, patients scheduled for well-visits are invited to complete the family health system prior to their appointment. Decision support documents are entered into the medical record and available to provider's prior to the appointment. In order to optimize integration, components were piloted by stakeholders prior to and during implementation. Primary outcomes are change in appropriate testing for hereditary thrombophilia and screening for breast cancer, colon cancer, and ovarian cancer one year after study enrollment. Secondary outcomes include implementation measures related to the benefits and burdens of the family health system and its impact on clinic workflow, patients' risk perception, and intention to change health related behaviors. Outcomes are assessed through chart review, patient surveys at baseline and follow-up, and provider surveys. Clinical validity of the decision support is calculated by comparing its recommendations to those made by a genetic counselor reviewing the same pedigree; and clinical utility is demonstrated through reclassification rates and changes in appropriate screening (the primary outcome).</p> <p>Discussion</p> <p>This study integrates a computerized family health history system within the context of a routine well-visit appointment to overcome many of the existing barriers to collection and use of family history information by primary care providers. Results of the implementation process, its acceptability to patients and providers, modifications necessary to optimize the system, and impact on clinical care can serve to guide future implementation projects for both family history and other tools of personalized medicine, such as health risk assessments.</p
Primary care physicians' use of family history for cancer risk assessment
<p>Abstract</p> <p>Background</p> <p>Family history (FH) assessment is useful in identifying and managing patients at increased risk for cancer. This study assessed reported FH quality and associations with physician perceptions.</p> <p>Methods</p> <p>Primary care physicians practicing in two northeastern U.S. states were surveyed (n = 880; 70% response rate). Outcome measures of FH quality were extent of FH taken and ascertaining age at cancer diagnosis for affected family members. Predictors of quality measured in this survey included: perceived advantages and disadvantages of collecting FH information, knowledge of management options, access to supportive resources, and confidence in ability to interpret FH.</p> <p>Results</p> <p>Reported collection of information regarding second degree blood relatives and age of diagnosis among affected relatives was low. All hypothesized predictors were associated with measures of FH quality, but not all were consistent independent predictors. Perceived advantages of taking a family history, access to supportive resources, and confidence in ability to identify and manage higher risk patients were independent predictors of both FH quality measures. Perceived disadvantages of taking a family history was independently associated one measure of FH quality. Knowledge of management options was not independently associated with either quality measure.</p> <p>Conclusions</p> <p>Modifiable perception and resource factors were independently associated with quality of FH taking in a large and diverse sample of primary care physicians. Improving FH quality for identification of high risk individuals will require multi-faceted interventions.</p
Screening Patients with a Family History of Colorectal Cancer
OBJECTIVES: To compare screening practices and beliefs in patients with and without a clinically important family history. DESIGN: We mailed a brief questionnaire asking about family history and a second, longer survey asking about knowledge of and beliefs about colorectal cancer to all respondents with a family history and a random sample of respondents without a family history of colorectal cancer. We reviewed electronic medical records for screening examinations and recording of family history. PARTICIPANTS: One thousand eight hundred seventy of 6,807 randomly selected patients ages 35–55 years who had been continuously enrolled in a large multispecialty group practice for at least 5 years. MEASUREMENTS: Recognition of increased risk, screening practices, and beliefs—all according to strength of family history and patient’s age. RESULTS: Nineteen percent of respondents reported a family history of colorectal cancer. In 11%, this history was strong enough to warrant screening before age 50 years. However, only 39% (95% CI 36, 42) of respondents under the age of 50 years said they had been asked about family history and only 45% of those with a strong family history of colorectal cancer had been screened appropriately. Forty-six percent of patients with a strong family history did not know that they should be screened at a younger age than average risk people. Medical records mentioned family history of colorectal cancer in 59% of patients reporting a family history. CONCLUSIONS: More efforts are needed to translate information about family history of colorectal cancer into the care of patients
Colorectal cancer risk assessment and screening recommendation: a community survey of healthcare providers' practice from a patient perspective
<p>Abstract</p> <p>Background</p> <p>Family history is a common risk factor for colorectal cancer (CRC), yet it is often underused to guide risk assessment and the provision of risk-appropriate CRC screening recommendation. The aim of this study was to identify from a patient perspective health care providers' current practice relating to: (i) assessment of family history of CRC; (ii) notification of "increased risk" to patients at "moderately/potentially high" familial risk; and (iii) recommendation that patients undertake CRC screening.</p> <p>Methods</p> <p>1592 persons aged 56-88 years randomly selected from the Hunter Community Study (HCS), New South Wales, Australia were mailed a questionnaire. 1117 participants (70%) returned a questionnaire.</p> <p>Results</p> <p>Thirty eight percent of respondents reported ever being asked about their family history of CRC. Ever discussing family history of CRC with a health care provider was significantly more likely to occur for persons with a higher level of education, who had ever received screening advice and with a lower physical component summary score. Fifty one percent of persons at "moderately/potentially high risk" were notified of their "increased risk" of developing CRC. Thirty one percent of persons across each level of risk had ever received CRC screening advice from a health care provider. Screening advice provision was significantly more likely to occur for persons who had ever discussed their family history of CRC with a health care provider and who were at "moderately/potentially high risk".</p> <p>Conclusions</p> <p>Effective interventions that integrate both the assessment and notification of familial risk of CRC to the wider population are needed. Systematic and cost-effective mechanisms that facilitate family history collection, risk assessment and provision of screening advice within the primary health care setting are required.</p
Regional differences in awareness and attitudes regarding genetic testing for disease risk and ancestry
Little is known about the lay public’s awareness and attitudes concerning genetic testing and what factors influence their perspectives. The existing literature focuses mainly on ethnic and socioeconomic differences; however, here we focus on how awareness and attitudes regarding genetic testing differ by geographical regions in the US. We compared awareness and attitudes concerning genetic testing for disease risk and ancestry among 452 adults (41% Black and 67% female) in four major US cities, Norman, OK; Cincinnati, OH; Harlem, NY; and Washington, DC; prior to their participation in genetic ancestry testing. The OK participants reported more detail about their personal ancestries (p = 0.02) and valued ancestry testing over disease testing more than all other sites (p < 0.01). The NY participants were more likely than other sites to seek genetic testing for disease (p = 0.01) and to see benefit in finding out more about one’s ancestry (p = 0.02), while the DC participants reported reading and hearing more about genetic testing for African ancestry than all other sites (p < 0.01). These site differences were not better accounted for by sex, age, education, self-reported ethnicity, religion, or previous experience with genetic testing/counseling. Regional differences in awareness and attitudes transcend traditional demographic predictors, such as ethnicity, age and education. Local sociocultural factors, more than ethnicity and socioeconomic status, may influence the public’s awareness and belief systems, particularly with respect to genetics
Soil chemistry and clay mineralogy of an alluvial chronosequence from the north Carolina Sandhills of the upper coastal plain, USA
Temporal changes in soil development were assessed on fluvial terraces of the Little River in the upper Coastal Plain of North Carolina. We examined five profiles from each of six surfaces spanning about 100,000 years. Soil-age relationships were evaluated with inter-surface clay mineral comparisons and regression of chemical properties versus previously reported optically-stimulated luminescence ages using the most developed subsoil horizon per profile. Bases to alumina (Bases/Al2 O3 ) ratios have negative correlations with age, whereas dithionite-Fe (FeD ) concentrations are positively correlated with time and differentiate floodplain (\u3c200 yr BP) from terrace (≥10 ± 2 ka) soils and T4 pedons (75 ± 10 ka) from younger (T1-T3b, 10 ± 2–55 ± 15 ka) and older (T5b, 94 ± 16 ka) profiles. Entisols develop into Ultisols with exponentially decreasing Bases/Al2 O3 ratios, reflecting rapid weatherable mineral depletion and alumina enrichment during argillic horizon development in the first 13–21 kyr of pedogenesis. Increasing FeD represents transformation and illuviation of free Fe inherited from parent sediments. Within ~80–110 kyr, a mixed clay mineral assemblage becomes dominated by kaolinite and gibbsite. Argillic horizons form by illuviation, secondary mineral transformations, and potentially, a bioturbation-translocation mechanism, in which clays distributed within generally sandy deposits are transported to surface horizons by ants and termites and later illuviated to subsoils. T5b profiles have FeD concentrations similar to, and gibbsite abundances greater than, those of pedons on 0.6–1.6 Ma terraces along Coastal Plain rivers that also drain the Appalachian Piedmont. This is likely because the greater permeability and lower weatherable mineral contents of sandy, Coastal Plain-sourced Little River alluvium favor more rapid weathering, gibbsite formation, and Fe translocation than the finer-grained, mineralogically mixed sediments of Piedmont-draining rivers. Therefore, recognizing provenance-related textural and mineralogical distinctions is crucial for evaluating regional chronosequences
Mega-meander paleochannels of the southeastern Atlantic Coastal Plain, USA
Paleodischarge estimates based on the slope-area method and channel boundaries determined from stratigraphic cross-sections indicate that large, terminal Pleistocene meandering paleochannels (“mega-meanders”) in river valleys of the southeastern Atlantic Coastal Plain of the United States represent bankfull flows that were at least double the magnitude of those on modern rivers. Correlation of radiocarbon- and luminescence-dated paleomeanders with previously reported pollen and eolian sedimentary records suggests that greater discharge was driven by seasonally wetter conditions resulting from dynamic changes to regional precipitation and runoff that occurred in association with global warming at the end of the Pleistocene. While reflecting larger channel-forming flows, the exceptionally large widths and radii of curvature of mega-meanders were nonetheless maintained by a relatively modest discharge magnitude that was between two and four times larger than modern bankfull flow and within the size range of the present two- to five-year flood. Despite their large planform, the paleochannels conveyed relatively modest bankfull discharges because a wide, shallow shape limited their cross-sectional area and hydraulic radius. Within the late Quaternary evolution of fluvial systems in the region, scrolled mega-meanders constitute a transitional meandering planform that remained influenced by large volumes of sandy bedload following the sand-bed braided channels of the late Wisconsin interval, circa 30–17 ka. In addition to greater discharge, the large planimetric dimensions of paleochannels reflect a lack of cohesive vertical accretion facies on paleomeander floodplains, a sediment regime that transported large quantities of bedload sand, and the influence of these factors on channel boundary composition, bank stability, and channel shape. Findings underscore the importance of reconstructing channel cross-sectional dimensions and slope when estimating discharge for infilled paleomeanders. This approach reduces uncertainties surrounding channel cross-sectional area, gradient, and boundary composition inherent to studies lacking subsurface data that rely upon meander geometry to retrodict discharge
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