Boys' and girls' clubs

"Club work is based on sound principles and has come to stay. It is supported by federal and state aid as a definite form of agricultural extension work. Boys and girls on the farm are aided in their work and every possible advantage is extended to flt them, for better living and "to improve country life." It is proper in this connection to mention that club work has received special recognition from the State Superintendent of Public Instruction. On Pages 124-126 of the last Annual School Report will be found a general statement of this movement. On Pages 122 and 124 of the last State Course of Study will b.e found the . details of some of the projects. In the first county campaign which had as an aim to acquaint patrons, pupils and teachers with the nature and purpose of Boys' and Girls' Clubs, the state superintendent took personal part and gave sanction to the work. So far as known no other state has given stronger recognition to club work than Missouri."--Page 3

On Soot Sampling: Considerations when Sampling for TEM Imaging and Differential Mobility Spectrometer

Particulate matter (PM) has been sampled from a compression ignition engine using a differential mobility spectrometer (Cambustion DMS 500) and for imaging in a transmission electron microscope (TEM) with the aim of coupling these two measuring techniques. A known issue when coupling these two methods is that a devise like the DMS samples all PM, and the TEM only soot. To help resolve this issue, a thermal denuder was designed and built to remove all volatile organic compounds (VOC) from the sample prior to entering the DMS. For TEM imaging, soot was either collected directly onto a TEM grid using the thermophoretic effect or collected onto quartz filters with the soot then transferred onto the TEM grids. The direct to grid technique did not work after the denuder due to the gas temperature being too low for the thermophoretic effect; hence the reason to collect some soot using the quartz filters. Soot was removed from the filters using an ethanol wash/sonication technique. Morphology; diameter of gyration, projected area, primary particle size and fractal dimension have been compared between the two TEM sampling techniques, with or without the denuder. Denuder effectiveness has been assessed using TGA analysis of sampled soot. Issues concerning the sampling process itself are outlined. A comparison between the TEM and the DMS results is conducted with the discrepancies between them discussed. Direct and filter sampling gave similar results as long as the sonication process and grid prep is done properly, otherwise the filter wash technique results in a number of clusters of agglomerates which distorts the post processing and morphological data

Do selective cyclo-oxygenase-2 inhibitors and traditional non-steroidal anti-inflammatory drugs increase the risk of atherothrombosis? Meta-analysis of randomised trials

Objective: To assess the effects of selective cyclo-oxygenase-2 (COX 2) inhibitors and traditional non-steroidal anti-inflammatory drugs (NSAIDs) on the risk of vascular events. Design: Meta-analysis of published and unpublished tabular data from randomised trials, with indirect estimation of the effects of traditional NSAIDs. Data sources: Medline and Embase (January 1966 to April 2005); Food and Drug Administration records; and data on file from Novartis, Pfizer, and Merck. Review methods: Eligible studies were randomised trials that included a comparison of a selective COX 2 inhibitor versus placebo or a selective COX 2 inhibitor versus a traditional NSAID, of at least four weeks' duration, with information on serious vascular events (defined as myocardial infarction, stroke, or vascular death). Individual investigators and manufacturers provided information on the number of patients randomised, numbers of vascular events, and the person time of follow-up for each randomised group. Results: In placebo comparisons, allocation to a selective COX 2 inhibitor was associated with a 42% relative increase in the incidence of serious vascular events (1.2%/year v 0.9%/year; rate ratio 1.42, 95% confidence interval 1.13 to 1.78; P = 0.003), with no significant heterogeneity among the different selective COX 2 inhibitors. This was chiefly attributable to an increased risk of myocardial infarction (0.6%/year v 0.3%/year; 1.86, 1.33 to 2.59; P = 0.0003), with little apparent difference in other vascular outcomes. Among trials of at least one year's duration (mean 2.7 years), the rate ratio for vascular events was 1.45 (1.12 to 1.89; P = 0.005). Overall, the incidence of serious vascular events was similar between a selective COX 2 inhibitor and any traditional NSAID (1.0%/year v 0.9/%year; 1.16, 0.97 to 1.38; P = 0.1). However, statistical heterogeneity (P = 0.001) was found between trials of a selective COX 2 inhibitor versus naproxen (1.57, 1.21 to 2.03) and of a selective COX 2 inhibitor versus non-naproxen NSAIDs (0.88, 0.69 to 1.12). The summary rate ratio for vascular events, compared with placebo, was 0.92 (0.67 to 1.26) for naproxen, 1.51 (0.96 to 2.37) for ibuprofen, and 1.63 (1.12 to 2.37) for diclofenac. Conclusions: Selective COX 2 inhibitors are associated with a moderate increase in the risk of vascular events, as are high dose regimens of ibuprofen and diclofenac, but high dose naproxen is not associated with such an excess

Precision reconstruction of the cold dark matter-neutrino relative velocity fromN-body simulations

Discovering the mass of neutrinos is a principle goal in high energy physics and cosmology. In addition to cosmological measurements based on two-point statistics, the neutrino mass can also be estimated by observations of neutrino wakes resulting from the relative motion between cold dark matter (CDM) and neutrinos. Such a detection relies on an accurate reconstruction of the CDM-neutrino relative velocity which is affected by nonlinear structure growth and galaxy bias. We investigate our ability to reconstruct this relative velocity using large N-body simulations where we evolve neutrinos as distinct particles alongside the CDM. We find that the CDM velocity power spectrum is overpredicted by linear theory whereas the neutrino velocity power spectrum is underpredicted. The magnitude of the relative velocity observed in the simulations is found to be lower than what is predicted in linear theory. Since neither the CDM nor the neutrino velocity fields are directly observable from galaxy or 21 cm surveys, we test the accuracy of a reconstruction algorithm based on halo density fields and linear theory. Assuming prior knowledge of the halo bias, we find that the reconstructed relative velocities are highly correlated with the simulated ones with correlation coefficients of 0.94, 0.93, 0.92 and 0.88 for neutrinos of mass 0.05, 0.1, 0.2 and 0.4 eV. We confirm that the relative velocity field reconstructed from large scale structure observations such as galaxy or 21 cm surveys can be accurate in direction and, with appropriate scaling, magnitude

Effectiveness and reach of a directed-population approach to improving dental health and reducing inequalities: a cross sectional study

Background Childsmile School adopts a directed-population approach to target fluoride varnish applications to 20% of the primary one (P1) population in priority schools selected on the basis of the proportion of enrolled children considered to be at increased-risk of developing dental caries. The study sought to compare the effectiveness of four different methods for identifying individuals most in need when a directed-population approach is taken. <p></p> Methods The 2008 Basic National Dental Inspection Programme (BNDIP) cross-sectional P1 Scottish epidemiological survey dataset was used to model four methods and test three definitions of increased-risk. Effectiveness was determined by the positive predictive value (PPV) and explored in relation to 1-sensitivity and 1-specificity. <p></p> Results Complete data was available on 43470 children (87% of the survey). At the Scotland level, at least half (50%) of the children targeted were at increased-risk irrespective of the method used to target or the definition of increased-risk. There was no one method across all definitions of <i>increased-risk</i> that maximised PPV. Instead, PPV was highest when the targeting method complimented the definition of <i>increased-risk</i>. There was a higher percentage of children at <i>increased-risk</i> who were not targeted (1-sensitivity) when caries experience (rather than deprivation) was used to define <i>increased-risk</i>, irrespective of the method used for targeting. Over all three definitions of <i>increased-risk</i>, there was no one method that minimised (1-sensitivity) although this was lowest when the method and definition of <i>increased-risk</i> were complimentary. The false positive rate (1-specificity) for all methods and all definitions of <i>increased-risk</i> was consistently low (<20%), again being lowest when the method and definition of <i>increased-risk</i> were complimentary. <p></p> Conclusion Developing a method to reach all (or even the vast majority) of individuals at <i>increased-risk</i> defined by either caries experience or deprivation is difficult using a directed-population approach at a group level. There is a need for a wider debate between politicians and public health experts to decide how best to reach those most at need of intervention to improve health and reduce inequalities. <p></p&gt

Effects of alteplase for acute stroke on the distribution of functional outcomes: a pooled analysis of 9 trials

Background—Thrombolytic therapy with intravenous alteplase within 4.5 hours of ischemic stroke onset increases the overall likelihood of an excellent outcome (no, or nondisabling, symptoms). Any improvement in functional outcome distribution has value, and herein we provide an assessment of the effect of alteplase on the distribution of the functional level by treatment delay, age, and stroke severity. Methods—Prespecified pooled analysis of 6756 patients from 9 randomized trials comparing alteplase versus placebo/open control. Ordinal logistic regression models assessed treatment differences after adjustment for treatment delay, age, stroke severity, and relevant interaction term(s). Results—Treatment with alteplase was beneficial for a delay in treatment extending to 4.5 hours after stroke onset, with a greater benefit with earlier treatment. Neither age nor stroke severity significantly influenced the slope of the relationship between benefit and time to treatment initiation. For the observed case mix of patients treated within 4.5 hours of stroke onset (mean 3 hours and 20 minutes), the net absolute benefit from alteplase (ie, the difference between those who would do better if given alteplase and those who would do worse) was 55 patients per 1000 treated (95% confidence interval, 13–91; P=0.004). Conclusions—Treatment with intravenous alteplase initiated within 4.5 hours of stroke onset increases the chance of achieving an improved level of function for all patients across the age spectrum, including the over 80s and across all severities of stroke studied (top versus bottom fifth means: 22 versus 4); the earlier that treatment is initiated, the greater the benefit

Randomized multicentre pilot study of sacubitril/valsartan versus irbesartan in patients with chronic kidney disease: United Kingdom Heart and Renal Protection (HARP)- III—rationale, trial design and baseline data

BACKGROUND: Patients with chronic kidney disease (CKD) are at risk of progression to end-stage renal disease and cardiovascular disease. Data from other populations and animal experiments suggest that neprilysin inhibition (which augments the natriuretic peptide system) may reduce these risks, but clinical trials among patients with CKD are required to test this hypothesis. METHODS: UK Heart and Renal Protection III (HARP-III) is a multicentre, double-blind, randomized controlled trial comparing sacubitril/valsartan 97/103 mg two times daily (an angiotensin receptor-neprilysin inhibitor) with irbesartan 300 mg one time daily among 414 patients with CKD. Patients ≥18 years of age with an estimated glomerular filtration rate (eGFR) of ≥45 but <60 mL/min/1.73 m2 and urine albumin:creatinine ratio (uACR) >20 mg/mmol or eGFR ≥20 but <45 mL/min/1.73 m2 (regardless of uACR) were invited to be screened. Following a 4- to 7-week pre-randomization single-blind placebo run-in phase (during which any current renin-angiotensin system inhibitors were stopped), willing and eligible participants were randomly assigned either sacubitril/valsartan or irbesartan and followed-up for 12 months. The primary aim was to compare the effects of sacubitril/valsartan and irbesartan on measured GFR after 12 months of therapy. Important secondary outcomes include effects on albuminuria, change in eGFR over time and the safety and tolerability of sacubitril/valsartan in CKD. RESULTS: Between November 2014 and January 2016, 620 patients attended a screening visit and 566 (91%) entered the pre-randomization run-in phase. Of these, 414 (73%) participants were randomized (mean age 63 years; 72% male). The mean eGFR was 34.0 mL/min/1.73 m2 and the median uACR was 58.5 mg/mmol. CONCLUSIONS: UK HARP-III will provide important information on the short-term effects of sacubitril/valsartan on renal function, tolerability and safety among patients with CKD

Transesophageal echocardiography in children: New peephole to the heart

Markers of inflammation, including plasma C-reactive protein (CRP), are associated with an increased risk of cardiovascular disease, and it has been suggested that this association is causal. However, the relationship between inflammation and cardiovascular disease has not been extensively studied in patients with chronic kidney disease. To evaluate this, we used data from the Study of Heart and Renal Protection (SHARP) to assess associations between circulating CRP and LDL cholesterol levels and the risk of vascular and non-vascular outcomes. Major vascular events were defined as nonfatal myocardial infarction, cardiac death, stroke or arterial revascularization, with an expanded outcome of vascular events of any type. Higher baseline CRP was associated with an increased risk of major vascular events (hazard ratio per 3x increase 1.28; 95% confidence interval 1.19-1.38). Higher baseline LDL cholesterol was also associated with an increased risk of major vascular events (hazard ratio per 0.6 mmol/L higher LDL cholesterol; 1.14, 1.06-1.22). Higher baseline CRP was associated with an increased risk of a range of non-vascular events (1.16, 1.12-1.21), but there was a weak inverse association between baseline LDL cholesterol and non-vascular events (0.96, 0.92-0.99). The efficacy of lowering LDL cholesterol with simvastatin/ezetimibe on major vascular events, in the randomized comparison, was similar irrespective of CRP concentration at baseline. Thus, decisions to offer statin-based therapy to patients with chronic kidney disease should continue to be guided by their absolute risk of atherosclerotic events. Estimation of such risk may include plasma biomarkers of inflammation, but there is no evidence that the relative beneficial effects of reducing LDL cholesterol depends on plasma CRP concentration

Microplastics in the Arctic: a transect through the Barents Sea

Globally, the abundance of microplastics in our oceans is increasing, including within the remote locations of the polar regions. The Barents Sea, which adjoins the Arctic Ocean, is an area of high primary productivity that, owing to the convergence of regional currents, has been mooted as a potential sixth ocean gyre that may coalesce high concentrations of plastic debris. This study aimed to explore data collected from large volume samples of sub-surface water collected from transects through the Barents Sea to quantify and characterise microplastics in this region, with a focus on potential impacts to zooplankton. Overall, the mean microplastic abundance in the Barents Sea was 0.011 microplastics m-3 (range: 0.007 – 0.015 m-3). Microplastics were found in higher abundances nearer land mass at the southern end of the transect and northwards towards the ice edge, recording 0.015 microplastics m-3 during both transect legs. Microplastics were predominantly fibrous (92.1%) and typically blue (79%) or red (17%) in colour. A range of polymers were identified including polyester (3.8%), copolymer blends (2.7%), elastomers (7.1%) and acrylics (10.6%), however semi-synthetic polymers dominated, comprising 74.4% of particles found. Higher microplastic concentrations in the northernmost transect may stem from melting sea-ice, while the higher concentrations in the southernmost transect likely derive from the long-range transport of microplastics via currents from Europe

Study protocol : the empirical investigation of methods to correct for measurement error in biobanks with dietary assessment

Peer reviewedPublisher PD