12 research outputs found
Use of viral indicators to assess public health risk to shellfish growing areas: A case study from Blaine, Washington
A hydrographic dye study of effluent from the Lighthouse Point Water Reclamation Facility in Blaine, Washington, was conducted in November 2012. Six cages filled with oysters were deployed at various locations (stations) along the anticipated path of the effluent to correlate the dye concentrations found at the cages with the indicator bacteria and viral findings in the oysters. Sampling was also conducted at the plant to assess bacteria and virus removal efficiencies through the treatment process. The study objectives were to: (1) determine the bacterial and viral conditions in the influent and effluent and removal efficiencies for a WWTP using membrane filtration (2) determine the bacterial and viral conditions that could arise in receiving waters under a short term lapse in treatment at the WWTP; (3) provide guidance to the Washington Department of Health (WA DOH) regarding the WWTP closure zone based on dilution of effluent (4) research the dilution level needed to achieve reduction in viruses to ensure the safety of shellfish harvested near WWTPs as part of FDAâs dilution guidance The proposed presentation addresses the session theme based on the following features: (1) A description of tools and methodology currently used by FDA to assess risk from wastewater outfalls to commercial shellfish growing areas, including development of an GIS application for mapping dye plumes in real time, (2) Current efforts by FDA to develop an easily quantifiable viral indicator (MS2 Coliphage) and how this indicator correlates with presence of viral pathogens such as Adenovirus and Norovirus in oysters, (3) Evaluation fecal coliform bacteria indicator to assess public health risk from viral pathogens with wastewater plants employing membrane filtration treatment, and (4) Since Blaine sits on the border between the US and Canada, the case study also highlights transborder pollution issues
The Next Generation of Space Manufacturing: Model Based and Digitally Assured
Increasing interest in affordable space has created a parallel need for low cost, rapid manufacturing of small satellites. Raytheon along with several partners has engaged in an activity that is geared around the demonstration of semi-autonomous manufacturing of small satellites. By using modern tools, processes, and techniques, Raytheon is heavily investing in a âdigitally assuredâ manufacturing and test capability. Starting with Model Based Systems Engineering (MBSE), Raytheon has successfully developed a model of the design space starting with a 6U sized cubesat. The manufacturing line will require minimal investment from outside customers; it is being designed to be as product independent as possible. Common tooling, robotic material handling, and agnostic test equipment are all hallmarks of the Raytheon manufacturing design
Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans
Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have
fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in
25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16
regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of
correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP,
while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in
Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium
(LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region.
Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant
enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the
refined data for existing association signals, we estimate that these loci now explain âŒ38.9% of the familial relative risk of PrCa,
an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of
PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent
signals within the same regio
Risk Factors, Screening, Diagnosis, and Treatment of Osteoporosis in HIV-Infected Adults in an HIV Primary Care Clinic
Background: The population of people living with HIV is aging, and with aging come emergent comorbidities, including osteoporosis, for which screening and treatment are becoming increasingly important. Osteoporosis prevalence among those living with HIV is 3 times greater than among HIV-uninfected controls.
Objective: To assess and describe osteoporosis risk factors, screening, diagnosis, and treatment for people 50 years of age or older living with HIV and receiving care at a multidisciplinary HIV primary care clinic.
Methods: A retrospective chart review of people 50 years of age or older living with HIV was conducted at the John Ruedy Clinic in Vancouver, British Columbia, between June 1, 2016, and June 1, 2019. Patients who had had fewer than 2 yearly follow-up appointments were excluded.
Results: A total of 146 patients were included in the analysis; most were male (n = 134, 92%), and the median age was 55 years. Patients had a median of 3 osteoporosis risk factors (in addition to age and HIV infection), and 145 patients had at least 1 risk factor. All screening for osteoporosis was conducted by dual-energy X-ray absorptiometry (DXA). Thirty-nine (27%) of the patients were screened with DXA, 92 (63%) were not screened, and 15 (10%) already had a diagnosis of osteoporosis. The DXA screening identified osteoporosis in an additional 10 patients and osteopenia in 22 patients. Treatments for patients with osteoporosis included bisphosphonates (n = 15, 60%) and vitamin D or calcium (or both), without any other medications (n = 4, 16%). In the overall study population, 32 (22%) of the patients were taking calcium and 46 (32%) were taking vitamin D.
Conclusions: Many patients aged 50 years or older and receiving HIV care at the John Ruedy Clinic had or were at risk for osteoporosis. An opportunity exists to increase screening and treatment of these individuals. A multidisciplinary team may be crucial in achieving this goal.
RĂSUMĂ
Contexte : La population des personnes vivant avec le VIH vieillit et, avec le vieillissement, des comorbiditĂ©s Ă©mergent, dont lâostĂ©oporose, pour laquelle le dĂ©pistage et le traitement sont de plus en plus importants. La prĂ©valence de lâostĂ©oporose chez les personnes vivant avec le VIH est 3 fois plus Ă©levĂ©e que chez les tĂ©moins non infectĂ©s.
Objectif : Ăvaluer et dĂ©crire les facteurs de risque, le dĂ©pistage, le diagnostic et le traitement de lâostĂ©oporose chez les personnes dâau moins 50 ans vivant avec le VIH et qui reçoivent des soins dans une clinique pluridisciplinaire de soins primaires pour le VIH.
MĂ©thodes : Un examen rĂ©trospectif des dossiers des personnes dâau moins 50 ans vivant avec le VIH a Ă©tĂ© effectuĂ© Ă la clinique John Ruedy Ă Vancouver (Colombie-Britannique) entre le 1er juin 2016 et le 1er juin 2019. Les patients qui avaient eu moins de 2 rendez-vous de suivi annuels ont Ă©tĂ© exclus de lâĂ©tude.
RĂ©sultats : Au total, 146 patients ont Ă©tĂ© inclus dans lâanalyse; la plupart Ă©taient des hommes (n = 134, 92 %) et lâĂąge mĂ©dian Ă©tait de 55 ans. Les patients avaient une mĂ©diane de 3 facteurs de risque dâostĂ©oporose (en plus de lâĂąge et de lâinfection par le VIH), et 145 patients avaient au moins 1 facteur de risque. Tous les dĂ©pistages de lâostĂ©oporose ont Ă©tĂ© rĂ©alisĂ©s par absorption biphotonique Ă rayons X (DXA). Trente-neuf patients (27 %) ont Ă©tĂ© dĂ©pistĂ©s par DXA, 92 (63 %) ne lâont pas Ă©tĂ© et 15 (10 %) avaient dĂ©jĂ un diagnostic dâostĂ©oporose. Le dĂ©pistage par DXA a permis dâidentifier lâostĂ©oporose chez 10 patients supplĂ©mentaires et lâostĂ©opĂ©nie chez 22 patients. Le traitement des patients atteints dâostĂ©oporose comprenait des bisphosphonates (n = 15, 60 %) et de la vitamine D ou du calcium (ou les deux) sans autre mĂ©dicament (n = 4, 16 %). Dans la population gĂ©nĂ©rale de lâĂ©tude, 32 patients (22 %) prenaient du calcium et 46 (32 %) prenaient de la vitamine D.
Conclusions : De nombreux patients dâau moins 50 ans recevant des soins pour le VIH Ă la clinique John Ruedy prĂ©sentaient un risque dâostĂ©oporose ou lâavaient dĂ©jĂ dĂ©veloppĂ©e. Il est possible dâaccroĂźtre leur dĂ©pistage et leur traitement, et une Ă©quipe multidisciplinaire peut ĂȘtre cruciale pour atteindre cet objectif
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Risk factors and outcomes in transfusion-associated circulatory overload.
BACKGROUND: Transfusion-associated circulatory overload is characterized by new respiratory distress and hydrostatic pulmonary edema within 6 hours after blood transfusion, but its risk factors and outcomes are poorly characterized. METHODS: Using a case control design, we enrolled 83 patients with severe transfusion-associated circulatory overload identified by active surveillance for hypoxemia and 163 transfused controls at the University of California, San Francisco (UCSF) and Mayo Clinic (Rochester, Minn) hospitals. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression, and survival and length of stay were analyzed using proportional hazard models. RESULTS: Transfusion-associated circulatory overload was associated with chronic renal failure (OR 27.0; 95% CI, 5.2-143), a past history of heart failure (OR 6.6; 95% CI, 2.1-21), hemorrhagic shock (OR 113; 95% CI, 14.1-903), number of blood products transfused (OR 1.11 per unit; 95% CI, 1.01-1.22), and fluid balance per hour (OR 9.4 per liter; 95% CI, 3.1-28). Patients with transfusion-associated circulatory overload had significantly increased in-hospital mortality (hazard ratio 3.20; 95% CI, 1.23-8.10) after controlling for Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score, and longer hospital and intensive care unit lengths of stay. CONCLUSIONS: The risk of transfusion-associated circulatory overload increases with the number of blood products administered and a positive fluid balance, and in patients with pre-existing heart failure and chronic renal failure. These data, if replicated, could be used to construct predictive algorithms for transfusion-associated circulatory overload, and subsequent modifications of transfusion practice might prevent morbidity and mortality associated with this complication
Risk factors and outcomes in transfusion-associated circulatory overload.
BackgroundTransfusion-associated circulatory overload is characterized by new respiratory distress and hydrostatic pulmonary edema within 6 hours after blood transfusion, but its risk factors and outcomes are poorly characterized.MethodsUsing a case control design, we enrolled 83 patients with severe transfusion-associated circulatory overload identified by active surveillance for hypoxemia and 163 transfused controls at the University of California, San Francisco (UCSF) and Mayo Clinic (Rochester, Minn) hospitals. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression, and survival and length of stay were analyzed using proportional hazard models.ResultsTransfusion-associated circulatory overload was associated with chronic renal failure (OR 27.0; 95% CI, 5.2-143), a past history of heart failure (OR 6.6; 95% CI, 2.1-21), hemorrhagic shock (OR 113; 95% CI, 14.1-903), number of blood products transfused (OR 1.11 per unit; 95% CI, 1.01-1.22), and fluid balance per hour (OR 9.4 per liter; 95% CI, 3.1-28). Patients with transfusion-associated circulatory overload had significantly increased in-hospital mortality (hazard ratio 3.20; 95% CI, 1.23-8.10) after controlling for Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score, and longer hospital and intensive care unit lengths of stay.ConclusionsThe risk of transfusion-associated circulatory overload increases with the number of blood products administered and a positive fluid balance, and in patients with pre-existing heart failure and chronic renal failure. These data, if replicated, could be used to construct predictive algorithms for transfusion-associated circulatory overload, and subsequent modifications of transfusion practice might prevent morbidity and mortality associated with this complication
Recommended from our members
Risk factors and outcomes in transfusion-associated circulatory overload.
BackgroundTransfusion-associated circulatory overload is characterized by new respiratory distress and hydrostatic pulmonary edema within 6 hours after blood transfusion, but its risk factors and outcomes are poorly characterized.MethodsUsing a case control design, we enrolled 83 patients with severe transfusion-associated circulatory overload identified by active surveillance for hypoxemia and 163 transfused controls at the University of California, San Francisco (UCSF) and Mayo Clinic (Rochester, Minn) hospitals. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression, and survival and length of stay were analyzed using proportional hazard models.ResultsTransfusion-associated circulatory overload was associated with chronic renal failure (OR 27.0; 95% CI, 5.2-143), a past history of heart failure (OR 6.6; 95% CI, 2.1-21), hemorrhagic shock (OR 113; 95% CI, 14.1-903), number of blood products transfused (OR 1.11 per unit; 95% CI, 1.01-1.22), and fluid balance per hour (OR 9.4 per liter; 95% CI, 3.1-28). Patients with transfusion-associated circulatory overload had significantly increased in-hospital mortality (hazard ratio 3.20; 95% CI, 1.23-8.10) after controlling for Acute Physiology and Chronic Health Evaluation-II (APACHE-II) score, and longer hospital and intensive care unit lengths of stay.ConclusionsThe risk of transfusion-associated circulatory overload increases with the number of blood products administered and a positive fluid balance, and in patients with pre-existing heart failure and chronic renal failure. These data, if replicated, could be used to construct predictive algorithms for transfusion-associated circulatory overload, and subsequent modifications of transfusion practice might prevent morbidity and mortality associated with this complication