Journals
2009 EN
Peng Wei · P. Richard Grimm · Deann C. Settles
+3 more
Statins may confer renal protection in a variety of glomerular diseases, including diabetic nephropathy (DN). However, various glomerular lesions have different etiologies and may have different responses to statins. This study was performed to determine the differential effects of simvastatin (SMV) on glomerular pathology including mesangial expansion and podocyte injury in a mouse model of early stage type 2 diabetes mellitus (DM). Type 2 DM was induced in male C57BL/6 mice by feeding a high fat diet (HF; 45 kcal% fat). After 22 weeks, one group of HF mice was treated with SMV (HF-SMV; 7 mug/day/g BW) and another group was treated with vehicle (HF-vehicle) for 4 weeks via osmotic mini-pump. A third group served as age-matched normal diet vehicle controls (ND-vehicle; 10 kcal% fat). At the end of treatment, glomerular morphology was evaluated in a blind manner to determine the progression of DN. Body weight, blood glucose, insulin, HDL-cholesterol and triglycerides, but not LDL-cholesterol, were increased in HF mice. Over the course of treatment, the 24-hour urinary albumin excretion (UAE) was unchanged in ND-vehicle. HF mice exhibited elevated UAE, which decreased with SMV, but was unchanged with vehicle. The absolute mesangial volume and the relative mesangial volume per glomerular volume increased in HF-vehicle and remained elevated with SMV treatment. The immuno-staining of nephrin, a protein marker of the integrity of podocyte slit diaphragms, was decreased in HF-vehicle; however, the nephrin quantity of the HF-SMV group was not different from ND-vehicle. It is concluded that SMV reverses podocyte damage, but does not affect mesangial expansion in the kidneys of early stage proteinuria of type 2 DM.
Journals
2009 EN
Jinghua Sun · Rongbin Yu · Bei Zhu
+3 more
To provide a comprehensive and reliable tabulation of available data on the epidemiological characteristics and risk factors for hepatitis C virus (HCV) infection in maintenance hemodialysis (HD) patients in China, and to help inform prevention programs and guide future research.
Journals
2009 EN
Diane M. Morrison · Mary Jane Lohr · Blair Beadnell
+3 more
The current study examines the Theory of Planned Behaviour's (TPB) ability to predict marijuana use among young women who experienced a premarital pregnancy before the age of 18 years, using longitudinal data. The validity of the TPB assumption that all other variables work through TPB constructs is also tested. Indicators of four constructs that have been shown in the literature to be predictive of marijuana use-persistent environmental adversity, emotional distress, adolescent marijuana use and drug use in the social network-were tested as predictors of attitudes, norms and self-efficacy, in a structural equation modelling framework. All paths from distal predictors were through the mediating TPB constructs, in accordance with the tenets of the model. Implications of these findings for the TPB model and for understanding factors that lead to marijuana use are discussed.
Journals
2009 EN
James M. Steven
The perennial, deadly reality that is the national transplant waiting list exists despite the good intentions of Americans. Various estimates indicate that one fourth to one half of all adults have signaled their intent to be an organ donor; that's 50 to 100 million people. So what's the problem? If more than 50 million people have signed on to be donors, shouldn't that be sufficient to eliminate the national waiting list of 100,000 plus? Why are 18 people still dying every day for want of an organ? These are the questions I set out to answer after being told that my kidneys were shutting down. Four hours of dialysis 3 days a week provides a lot of time for research. After only 18 months on the transplant list, I received a new kidney on August 3, 2004. My wait was not as long as some—usually it's 3 to 5 years—but it was long enough for me to take a hard look at the mismatch between the good intentions of donors and the reality of the national transplant waiting list. What I found is that no one really knows who and where all the donors are. True, there is a patchwork of databases kept mainly by state motor vehicle departments and regional donor organizations, but a truly national database does not exist. So I decided to apply my 35 years of advertising and marketing experience to create such a list and founded The Donor Project, a nonprofit organization, to do it. If you think about it as a marketing problem, it's quite simple. We need to conduct a marketing campaign to sign up millions of people which, actuarially speaking, will yield enough deceased donors annually to eliminate the current national transplant waiting list. It is not a lot of people when you think in marketing terms. For instance, a particularly graphic video game sold over 6 million copies in the week after its release last May. The company that registered those sales—some $500 million worth—did it because it had a product people wanted, and it used tried and true marketing strategies that had people waiting in line to buy it. That's what The Donor Project will do. We know we have a willing audience—those 50 or 100 million people who have already indicated their intention to be donors. We just need to create a national marketing campaign using all the bells and whistles employed by the likes of Coke, Pepsi, Nike, and Adidas to get them on our list. Our theme: “LEAVE IT. Be an organ donor.” Highlighting the campaign will be a drive to sign up potential donors on National Donor Sabbath, which is observed every year in early November. That's when the nation's 225,000 churches and synagogues focus on the importance of organ donation. We've developed a system to register potential donors at their place of worship by scanning their driver's license or photo ID—much like what is done for age verification in bars—and securing a signed consent form. The information can then be securely downloaded from the scanners and organized into a database that will be accessible to the critical links in the transplant chain—first responders, automobile communication systems like OnStar, transplant centers, and UNOS. If just a small percentage of the people who regularly attend church sign up, we will have met our goal. Just imagine the impact of such a centralized database on health care. The national transplant waiting list should be eliminated within the first few years of the promotion. Transplant center physicians will be able to estimate by region the number of organs that will be available, allowing them to more accurately predict when a transplant patient could receive a donated organ—a timeline that will be measured in weeks, not years. Valuable time will be saved when first responders can access the database at the scene of an accident and notify the transplant center that they may have a donor. People who have been denied a spot on the waiting list due to age or other medical conditions will now have the opportunity for a life-saving transplant. Excess organs will be available for research needs. Medicare could save much of the $17.8 billion it currently spends on dialysis. And there will no longer be 18 people a day dying as they wait for an organ. The groundwork has been laid over the past 4 years, and the marketing team has been assembled. The next step is fundraising. The Donor Project initially needs $600,000 to develop the marketing communications program, including broadcast, print, and online advertising, a website, direct marketing, and public relations. Then we'll need $20 million a year to execute the ongoing marketing campaign, the majority of which we hope to raise from the drug companies that provide antirejection drugs. If we're successful, the market for antirejection drugs will double from $900 million to $1.8 billion. Preliminary meetings with several pharmaceutical companies have been promising. The Donor Project will prevent the deaths of nearly 7000 people and extend the lives of more than 50,000 people every year. And, unlike other campaigns that raise money to find a cure, The Donor Project, by marrying willing donors with transplant patients, will instead be the cure.
Journals
2009 EN
Neil S. Fleming · Edmund R. Becker · Steven D. Culler
+3 more
While electronic health records (EHRs) are being widely implemented across the nation, few empirical data are currently available regarding their potential impact on financial performance and resource use. HealthTexas Provider Network is implementing a networkwide EHR, providing a unique opportunity to describe and evaluate fiscal effects. We conducted a retrospective, longitudinal observational study of financial performance related to inputs and income- and productivity-related outputs for the 33 primary care practices (July 2002-April 2006). Models for each outcome were constructed to test for a linear trend over time, adjusted for practice characteristics. F tests based on these models were used to determine the effect of each adjustor and to determine existence of a trend in each outcome. The observed staff per physician full-time equivalent (FTE) (3.6) was similar to staffing ratios reported for other primary care-only practices, while observation of 4692 work relative value units per physician FTE annually was higher than reported nationally. Significant monthly trends were identified for three of the outcome measures. During the pre-EHR baseline period, staffing ratios were equivalent to and physician productivity greater than reports available for these measures nationally or in other settings. Identification of time trends in three measures will allow these to be accounted for in the model used to evaluate the financial performance impact of EHR implementation.
Journals
2009 EN
Grace A. Levy-Clarke · Todd Goodglick · Xiaoyan Ding
+5 more
To report an unusual case of granulomatous sclerochoroiditis.
Journals
2009 EN
T. M. McClure · Dongseok Choi · Thomas Becker
+2 more
To determine if National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) scores decrease with worsening visual acuity (VA) in American Indian/Alaska Natives (Al/AN), as well as determine the other associated explanatory factors for vision-related quality of life.
Journals
2009 EN
Nathan C. Sanders · Steven B. Chin
Phonological distance can be measured computationally using formally specified algorithms. This work investigates two such measures, one developed by Nerbonne and Heeringa (1997) based on Levenshtein distance (Levenshtein, 1965) and the other an adaptation of Dunning's (1994) language classifier that uses maximum likelihood distance. These two measures are compared against naïve transcriptions of the speech of pediatric cochlear implant users. The new measure, maximum likelihood distance, correlates highly with Levenshtein distance and naïve transcriptions; results from this corpus are easier to obtain since cochlear implant speech has a lower intelligibility than the usually high intelligibility of the speech of a different dialect.
Journals
2009 EN
Andrew P. Bayliss · Debra Griffiths · Steven P. Tipper
When we see someone change their direction of gaze, we spontaneously follow their eyes because we expect people to look at interesting objects. Bayliss and Tipper (2006) examined the consequences of observing this expectancy being either confirmed or violated by faces producing reliable or unreliable gaze cues. Participants viewed different faces that would consistently look at the target, or consistently look away from the target: The faces that consistently looked towards targets were subsequently chosen as being more trustworthy than the faces that consistently looked away from targets. The current work demonstrates that these gaze contingency effects are only detected when faces create a positive social context by smiling, but not in the negative context when all the faces held angry or neutral expressions. These data suggest that implicit processing of the reward contingencies associated with gaze cues relies on a positive emotional expression to maintain expectations of a favourable outcome of joint attention episodes.
Journals
2009 FR
Steven K. Firth · Kevin J. Lomas · Andrew Wright
The Community Domestic Energy Model (CDEM) has been developed to explore potential routes to reduce carbon dioxide (CO2) emissions and the model is used to predict the CO2 emissions of the existing English housing stock. The average dwelling CO2 emissions are estimated as 5827 kgCO2 per year, of which space heating accounts for 53%, water heating for 20%, cooking for 5%, and lights and appliance for 22%. Local sensitivity analysis is undertaken for dwellings of different age and type to investigate the effect on predicted emissions of uncertainty in the model's inputs. High normalized sensitivity coefficients were calculated for parameters that affect the space heating energy use. The effects of the input uncertainties were linear and superposable, so the impact of multiple uncertainties could be easily determined. The results show that the accumulated impact on national CO2 emissions of the underperformance of energy-efficiency measures could be very large. Quality control of the complete energy system in new and refurbished dwellings is essential if national CO2 targets are to be met. Quality control needs to prioritize detached dwellings because their emissions are both the greatest and the most sensitive to all energy-efficiency measures. The work demonstrates that the uncertainty in the predictions of stock models can be large; a failure to acknowledge this can lead to a false sense of their reliability. Le Modèle d'Energie Domestique Communautaire (CDEM) a été développé afin d'explorer les voies possibles pour réduire les émissions de dioxyde de carbone (CO2) et ce modèle est utilisé pour prévoir les émissions de CO2 du parc bâti anglais existant. Les émissions de CO2 d'un logement moyen sont estimées à 5827 kg de CO2 par an, le chauffage des volumes en représentant 53%, le chauffage de l'eau 20%, la cuisine 5%, et l'éclairage et les appareils électroménagers 22%. L'analyse de la sensibilité locale est entreprise pour des logements d'âges et de types différents afin d'étudier l'incidence sur les émissions prévues de l'incertitude des données entrantes du modèle. Des coefficients de sensibilité normalisée élevés ont été calculés pour les paramètres qui affectent l'utilisation d'énergie pour le chauffage des volumes. Les effets des incertitudes des données entrantes étaient linéaires et superposables, de sorte qu'il a été possible de déterminer facilement l'incidence des multiples incertitudes. Les résultats montrent que les effets cumulés sur les émissions nationales de CO2 d'une performance inférieure aux attentes des mesures de rendement énergétique pouvaient être très importants. Le contrôle qualité de l'ensemble du système d'énergie dans les logements neufs et réhabilités est essentiel si l'on veut que les objectifs nationaux de CO2 soient atteints. Il est nécessaire que le contrôle qualité se donne pour priorité les logements individuels parce que ce sont leurs émissions qui sont à la fois les plus importantes et les plus sensibles à toutes les mesures de rendement énergétique. Ces travaux démontrent que l'incertitude dans les prévisions des modèles de parc de logements peut être importante; une incapacité à reconnaître cela peut conduire à une fausse impression quant à leur fiabilité. Mots clés: parc bâti modèle carbone émissions de dioxyde de carbone (CO2) domestique rendement énergétique modèle énergétique, logement