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PubMed1997

Direct medical costs unique to people with arthritis.

OBJECTIVE: We report the results of a population based analysis of all health services used and charges incurred over a one-year period among a community based cohort of persons with a diagnosis of arthritis [including both osteoarthritis (OA) and rheumatoid arthritis (RA)] compared to a similar cohort of individuals from the same community who have never had a diagnosis of arthritis (NA), to examine the attributable costs of this chronic condition. METHODS: The unique resources of the Rochester Epidemiology Project were used to assemble the arthritis prevalence cohorts and the population based control cohort. The Olmsted County Health Care Utilization and Expenditures Database was used to collect information on health services utilization and charges. RESULTS: The average direct medical charges for the RA, OA, and NA cohorts were $3,802.05, $2,654.51, and $1,387.83, respectively (age and sex adjusted, p < 0.0001 for both the RA vs NA and OA vs NA comparisons). The median charges for these 3 groups were $1,050.00, $663.55, and $232.04 for the RA, OA, and NA groups, respectively (age and sex adjusted p < 0.0001 for both the RA vs NA and OA vs NA comparisons). These analyses indicated that, compared to the NA cohort both the OA and the RA prevalence cohorts incurred statistically significantly more charges, not only for the musculoskeletal disease care, but also for the care of numerous other conditions including respiratory, cardiovascular, gastrointestinal, neurological, and psychiatric conditions; and for general medical care. Individuals with arthritis (both OA and RA) also incurred statistically significantly more charges for diagnostic and therapeutic procedures, in-hospital care, imaging studies, physician services, equipment, and laboratory studies. Use of prescription medications was statistically significantly more common in the RA and OA groups compared to NA (96.3, 96, and 83%, respectively; age and sex adjusted p = 0.006 for the OA vs NA comparison and p = 0.015 for RA vs NA). CONCLUSION: These results emphasize the importance of considering all health services utilization (rather than only disease specific use) when estimating the economic effect of a chronic illness such as arthritis.

Adult↗

PubMed2026

Metagenomics Reveals Microbial Community Shifts Associated With Contrasting Anthropogenic Impacts in Freshwater Sources of A Coastal Protected Area in Southeastern Brazil.

This study aimed to characterize freshwater microbial communities, environmental drivers, and anthropogenic impact patterns across three sites on Marambaia Island (southeastern Brazil) using metagenomics. Samples collected from freshwater sources used for human consumption were processed through concentration, nucleic acid extraction, and sequencing on the Illumina NextSeq 2000 platform. A total of 67.2 million reads were assembled into 89,230 bacterial contigs, mostly attributed to Gammaproteobacteria, Alphaproteobacteria, and Betaproteobacteria. Sites under lower anthropogenic influence exhibited higher microbial diversity, whereas impacted sites showed enrichment of opportunistic and fecal-associated genera. A heterogeneous anthropogenic impact profile was observed across sites, corroborated by the proposed Anthropogenic Impact Index (AII). Fourteen antimicrobial resistance genes conferring resistance to beta-lactams, quinolones, sulfonamides, tetracyclines, and macrolides were detected predominantly in sewage-impacted areas, indicating potential diffuse contamination. Redundancy analysis revealed that environmental variables explained 88.1% of microbial community variation, with conductivity, salinity, and turbidity as key drivers. These findings demonstrate the applicability of metagenomics as a powerful tool for assessing microbial diversity, ecological dynamics, and contamination risks in vulnerable freshwater systems.

Brazil↗

PubMedDate not supplied

Tampa General Hospital "blows the whistle on violence".

At Tampa General Hospital, the professionals in the marketing and media relations department know how to stage a press conference and to get the attention of the media. It goes to the adage when you're buying real estate: location, location, location. Once the journalists were assembled, Tampa General launched its campaign to fight street violence: "Blow the Whistle on Violence." Their timing was aided by the release of the FBI's annual Preliminary Crime Report citing Tampa as the second most dangerous city in which to live. Tampa General's news media specialist Stacey Winn reported that "the day went together just like a puzzle with all the pieces coming together." Those pieces and more are detailed in this issue's cover story on community involvement. Street crime and violence are not unique to Tampa, of course. But with so many victims ending up in Tampa General's emergency room, Winn noted that physicians and nurses felt personally responsible for contributing toward the prevention of cases ending up there. One important element in the hospital's press conference was an appearance by one of the victims of the violence they're striving to prevent. Her appearance and statement to the assembled media representatives significantly enhanced the presentation. "Blow the Whistle on Violence" was a low-cost program with a high return. The potential benefits are enormous.

Community-Institutional Relations↗

PubMed2026

Metagenome-based vertical profiling of the Gulf of Mexico highlights its uniqueness and far-reaching effects of freshwater input.

Genomic and metagenomic explorations of the oceans have identified well-structured microbial assemblages showing endemic genomic adaptations with increasing depth. However, deep water column surveys have been limited, especially of the Gulf of Mexico (GoM) basin, despite its importance for human activities. To fill this gap, we report on 19 deeply sequenced (~5 Gbp/sample) shotgun metagenomes collected along a vertical gradient, from the surface to about 2,000 m deep, at three GoM stations. Beta diversity analysis revealed strong clustering by depth, and not by station. However, a community-level pangenome style gene content analysis revealed ~54% of predicted gene sequences to be station-specific within our GoM samples. Of the 154 medium-to-high-quality MAGs recovered, 145 represent novel species compared with the NCBI genomes and Tara Oceans MAGs databases. Two of these MAGs were relatively abundant at both surface and deep samples, revealing remarkable versatility across the water column. A few MAGs of freshwater origin (~6% of total detected) were relatively abundant at 600 m deep and 270 miles from the coast at one station, revealing that the effects of freshwater input in the GoM can sometimes be far-reaching and long-lasting. Notably, 1,447/16,068 of the total COGs detected were positively (Pearson's r ≥ 0.5) or negatively (Pearson's r ≤ -0.5) correlated with depth, including beta-lactamases, dehydrogenases, and CoA-associated oxidoreductases. Taken together, our results reveal substantial novel genome and gene diversity across the GoM's water column, and testable hypotheses for some of the diversity patterns observed.IMPORTANCETo what extent microbial communities are similar between different ocean basins at similar depths, and what the impact of freshwater input by major rivers may be on these communities, remain poorly understood issues with potentially important implications for modeling and managing marine biodiversity. In this study, we performed metagenomic sequencing and recovered 154 medium-to-high-quality metagenome-assembled genomes (MAGs) from three stations in the Gulf of Mexico (GoM) and from various depths up to about 2,000 m. Comparison to MAGs recovered from other ocean basins highlighted the unique diversity harbored by the GoM, which could be driven by more substantial input from the Mississippi River and by human activities, including offshore oil drilling. The data and results provided by this study should be useful for future comparative analysis of marine biodiversity and contribute to its more complete characterization.

Metagenome↗

PubMed2003

Construction of a BAC library and generation of BAC end sequence-tagged connectors for genome sequencing of the African malaria mosquito Anopheles gambiae.

A Bacterial Artificial Chromosome (BAC) genomic DNA library of Anopheles gambiae, the major human malaria vector in sub-Saharan Africa, was constructed and characterized. This library (ND-TAM) is composed of 30,720 BAC clones in eighty 384-well plates. The estimated average insert size of the library is 133 kb, with an overall genome coverage of approximately 14-fold. The ends of approximately two-thirds of the clones in the library were sequenced, yielding 32,340 pair-mate ends. A statistical analysis (G-test) of the results of PCR screening of the library indicated a random distribution of BACs in the genome, although one gap encompassing the white locus on the X-chromosome was identified. Furthermore, combined with another previously constructed BAC library (ND-1), ~2,000 BACs have been physically mapped by polytene chromosomal in situ hybridization. These BAC end pair mates and physically mapped BACs have been useful for both the assembly of a fully sequenced A. gambiae genome and for linking the assembled sequence to the three polytene chromosomes. This ND-TAM library is now publicly available at both http://www.malaria.mr4.org/mr4pages/index.html/ and http://hbz.tamu.edu/, providing a valuable resource to the mosquito research community.

Animals↗

PubMed1983

Toward a dietary prevention of cancer.

I have attempted to address in brief fashion the question as to whether we can recommend a dietary prevention of cancer. This same question was explored in hundreds of pages recently by the large number of advisors assembled by the National Academy of Sciences to assess the animal, cell culture, and human data with regard to diet and cancer (52). My brief assessment has resulted in recommendations to the scientific community not unlike those of the National Academy, but without their clear-cut recommendation against dietary fat. It is obvious that we need a great deal more research on the factors evaluated here, that is, fiber, ascorbic acid, retinoids, the cruciferae, nitrates, alcohol, coffee, saccharine, alpha-tocopherol, aflatoxins, selenium, and saturated and polyunsaturated fats. These factors need assessment not only as they might affect the incidence of any single cancer, but also in relationship to at least the incidence of the cancers that frequently occur in humans. The human epidemiologic inquires have barely begun. We have a few studies of cancer of the colon and of cancer of the lung, and only one or two studies of such important sites as cancer of the larynx, oropharynx, stomach, and breast. Not only have the studies of specific sites been lamentably too few, but only a small number of nutrients have been evaluated. To make matters worse, we have little notion as to the competing risk of different cancers and of other diseases associated with various nutrients. There may be factors that enhance the risk of some diseases at the same time they reduce the risk of others. It is not outside the realm of possibility that the relationship discovered to date with regard to serum cholesterol, heart disease, and cancer may continue to be replicated and may be found related to ingestion of dietary fats. If such should be the case, and the potential is there, we would need to weigh the risks associated with reducing dietary fats for cancer as well as for coronary disease. Questions will need to be answered. For example, what is the optimum level of serum cholesterol to lower the risk of heart disease and at the same time not to enhance the risk of cancer. The same may be said for the association of alcohol with the risk of coronary disease compared to the risk of cancer of the upper alimentary tract.(ABSTRACT TRUNCATED AT 400 WORDS)

Alcohol Drinking↗

PubMed1992

A model research design to determine whether public programs providing health care for the poor and uninsured are successful.

The Mississippi State Department of Health has developed an empirically-proven two stage methodology of evaluation appropriate for agencies serving individuals that are poor and/or uninsured that utilizes qualitative data drawn from surveys and interviews to formulate a plan of action to collect relevant objective data. Findings are reported as being either supported, non-supported, or fallacious, and are accompanied by recommendations for intervention when appropriate. After comments on these have been assembled and disseminated, the program is required to submit a plan of action addressing all recommendations in the report.

Community Health Services↗

PubMed1999

Reproductive health for all: a commitment towards the new millennium.

The world government community made a commitment in 1994 to make reproductive health care universally available no later than the year 2015. The commitment has been confirmed by a special session of the United Nations General Assembly in July 1999. The commitment has to be backed up by resources, and the health profession has to provide the know-how. Social action will also be needed. Progress has been made, but challenges remain.

Contraception↗

PubMed1999

Guiding principles of drug demand reduction: an international response.

BACKGROUND: The 20th century has seen the globalisation and homogenisation of substance misuse problems, blurring traditional boundaries between producer and consumer countries and forcing the international community to consider new responses to substance misuse. AIMS: To highlight the importance of the principles of illicit drug demand reduction and related activities in tackling global drug problems and to discuss the commitment made by United Nations (UN) Member States at the highest political level towards meeting the objectives set in their Declaration on the Guiding Principles. METHOD: A review of international responses to substance misuse. RESULTS: Traditionally, the focus has been on reducing the supply of controlled drugs, while maintaining adequate supplies of narcotic and psychotropic drugs for clinical and scientific purposes. However, it has become apparent that supply reduction in isolation is insufficient and demand reduction is now receiving greater emphasis--culminating in the UN General Assembly adopting the Declaration on the Guiding Principles of Demand Reduction in 1998. CONCLUSIONS: This declaration offers a genuinely holistic approach to the complexities of substance misuse. To be successful, it requires the commitment of governments at the highest level and the willing participation of small communities.

Community Participation↗

PubMed2026

MetaFX: feature extraction from whole-genome metagenomic sequencing data.

MOTIVATION: Microbial communities consist of thousands of microorganisms and viruses and have a tight connection with an environment, such as gut microbiota modulation of host body metabolism. However, the direct relationship between the presence of certain microorganism and the host state often remains unknown. Toolkits using reference-based approaches are limited to microbes present in databases. Reference-free methods often require enormous resources for metagenomic assembly or results in many poorly interpretable features based on k-mers. RESULTS: Here we present MetaFX-an open-source library for feature extraction from whole-genome metagenomic sequencing data and classification of groups of samples. Using a large volume of metagenomic samples deposited in databases, MetaFX compares samples grouped by metadata criteria (e.g. disease, treatment, etc.) and constructs genomic features distinct for certain types of communities. Features constructed based on statistical k-mer analysis and de Bruijn graphs partition. Those features are used in machine learning models for classification of novel samples. Extracted features can be visualized on de Bruijn graphs and annotated for providing biological insights. We demonstrate the utility of MetaFX by building classification models for 590 human gut samples with inflammatory bowel disease. Our results outperform the previous research disease prediction accuracy up to 17%, and improves classification results compared to taxonomic analysis by 9±10% on average. AVAILABILITY AND IMPLEMENTATION: MetaFX is a feature extraction toolkit applicable for metagenomic datasets analysis and samples classification. The source code, test data, and relevant information for MetaFX are freely accessible at https://github.com/ctlab/metafx under the MIT License. Alternatively, MetaFX can be obtained via http://doi.org/10.5281/zenodo.16949369.

Metagenomics↗

PubMedDate not supplied

The NIA cDNA project in mouse stem cells and early embryos.

A catalog of mouse genes expressed in early embryos, embryonic and adult stem cells was assembled, including 250000 ESTs, representing approximately 39000 unique transcripts. The cDNA libraries, enriched in full-length clones, were condensed into the NIA 15 and 7.4K clone sets, freely distributed to the research community, providing a standard platform for expression studies using microarrays. They are essential tools for studying mammalian development and stem cell biology, and to provide hints about the differential nature of embryonic and adult stem cells.

Animals↗

PubMed2000

The filarial genome project: analysis of the nuclear, mitochondrial and endosymbiont genomes of Brugia malayi.

The Filarial Genome Project (FGP) was initiated in 1994 under the auspices of the World Health Organisation. Brugia malayi was chosen as the model organism due to the availability of all life cycle stages for the construction of cDNA libraries. To date, over 20000 cDNA clones have been partially sequenced and submitted to the EST database (dbEST). These ESTs define approximately 7000 new Brugia genes. Analysis of the EST dataset provides useful information on the expression pattern of the most abundantly expressed Brugia genes. Some highly expressed genes have been identified that are expressed in all stages of the parasite's life cycle, while other highly expressed genes appear to be stage-specific. To elucidate the structure of the Brugia genome and to provide a basis for comparison to the Caenorhabditis elegans genome, the FGP is also constructing a physical map of the Brugia chromosomes and is sequencing genomic BAC clones. In addition to the nuclear genome, B. malayi possesses two other genomes: the mitochondrial genome and the genome of a bacterial endosymbiont. Eighty percent of the mitochondrial genome of B. malayi has been sequenced and is being compared to mitochondrial sequences of other nematodes. The bacterial endosymbiont genome found in B. malayi is closely related to the Wolbachia group of rickettsia-like bacteria that infects many insect species. A set of overlapping BAC clones is being assembled to cover the entire bacterial genome. Currently, half of the bacterial genome has been assembled into four contigs. A consortium has been established to sequence the entire genome of the Brugia endosymbiont. The sequence and mapping data provided by the FGP is being utilised by the nematode research community to develop a better understanding of the biology of filarial parasites and to identify new vaccine candidates and drug targets to aid the elimination of human filariasis.

Animals↗

PubMed2003

Development and maturation of Escherichia coli K-12 biofilms.

The development and maturation of E. coli biofilms in flow-chambers was investigated. We found that the presence of transfer constitutive IncF plasmids induced biofilm development forming structures resembling those reported for Pseudomonas aeruginosa. The development occurred in a step-wise process: (i). attachment of cells to the substratum, (ii). clonal growth and microcolony formation, and (iii). differentiation into expanding structures rising 70-100 microm into the water phase. The first two steps were the same in the plasmid-carrying and plasmid-free strains, whereas the third step only occurred in conjugation pilus proficient plasmid-carrying strains. The final shapes of the expanding structures in the mature biofilm seem to be determined by the pilus configuration, as various mutants affected in the processing and activity of the transfer pili displayed differently structured biofilms. We further provide evidence that flagella, type 1 fimbriae, curli and Ag43 are all dispensable for the observed biofilm maturation. In addition, our results indicate that cell-to-cell signalling mediated by autoinducer 2 (AI-2) is not required for differentiation of E. coli within a biofilm community. We suggest on the basis of these results that E. coli K-12 biofilm development and maturation is dependent on cell-cell adhesion factors, which may act as inducers of self-assembly processes that result in differently structured biofilms depending on the adhesive properties on the cell surface.

Bacterial Adhesion↗

PubMed1997

Turning wheels for youth.

Reconditioned bicycles donated from Japan to family planning associations (FPAs) in the West Indies and the Caribbean are being used to assist the promotion of reproductive health/family planning services at the grass roots. The FPAs of St. Vincent, Belize, Grenada, and St. Lucia, respectively, received 75 bicycles each with spare parts in mid-1996. The bicycles were donated through the Municipal Coordinating Committee for Overseas Bicycle Assistance, an association of Japanese local governments and JOICFP. A low-cost, non-fuel means of transport, the bicycles are a convenient means for mobilizing grass-roots health agents and motivators. The St. Lucia Planned Parenthood Association distributed the bicycles to field workers conducting educational activities on sexual and reproductive health, home visits, group activities and counseling throughout the island. Peer counselors are also using the bicycles to assist with peer educational activities in schools, home visits and for other social activities. The Grenada Planned Parenthood Association is utilizing the bicycles to assist with youth activities. The bicycles are mobilizing key personnel of the Under Twenty Clubs (UTCs) who assemble youths in weekly meetings, and peer educators who provide counseling to their peers on sexuality and personal development. The bicycles donated to the Belize Family Life Association have bolstered the activities of the community workers who provide community outreach services, organize community meetings, and conduct educational sessions. The bicycles also support peer education activities by helping youths reach out to their peers to recruit them for the education program and to distribute educational materials.

Americas↗

PubMed1997

New York governor signs ban on female genital mutilation.

On September 29, 1997, mixed-record Governor George Pataki (R) signed a bill that bans female genial mutilation (FGM) from being performed on minor females and establishes a campaign to educate the communities that traditionally use FGM about the "health risks and emotional trauma inflicted by such practices." The measure, AB 3379, which is scheduled to take effect 45 days after the signing date, passed the Assembly on July 2 by 145-0 and was approved in the Senate by 55-0. AB 3379 would only allow such a procedure to be used by a licensed medical practitioner if it is "necessary to the health of the person on whom it is performed" or it is performed "for medical purposes" associated with labor or childbirth. Individuals accused of performing FGM would be charged with a class E felony, which is punishable by up to 1 year in prison.

Americas↗

PubMed1998

Frequency and predictors of adverse events. PRiSM Psychosis Study. 3.

BACKGROUND: Community care has been criticised as a hazardous policy associated with high rates of adverse events. There is little research evidence as to the truth of this claim. METHOD: Best available evidence from public records, interviews, case notes, key workers and general practitioners was assembled to establish: (a) which of the 514 subjects initially identified as having psychotic illnesses had died during an average follow-up of 4.9 years; (b) care currently received by all 286 subjects originally selected for interview; and (c) rates of major adverse events and of admission for these 286 individuals. RESULTS: Twenty-eight natural and II unnatural deaths had occurred. Among subjects still living at the end of the follow-up, 84% were in contact with specialist mental health services and 11% only with primary care services. Rates of serious violence, imprisonment and homelessness were relatively low. Forty-one per cent had been admitted at least once during a mean follow-up of 3.2 years and 20% at least once under the Mental Health Act. After adjustment, there were no significant differences between standard and intensive care sectors. CONCLUSIONS: Rates of adverse events and 'slipping through the net' are relatively low among individuals receiving community-based services, whether intensive or standard care.

Cause of Death↗

PubMed1992

No aging in India: the uses of gerontology.

This paper develops a critique of international gerontology through an ethnography and analysis of gerontological practice in India. The central theme of Indian gerontology - that of an imminent demographic and social explosion of an aging population who will tax the country's slender resources - misrepresents available data and fails to signify the experience of most Indian old people. Narrative and deconstructive techniques are deployed to examine the language of crisis and the complex sources of this misrepresentation. Three sources are explored: local disjunctions of class and gender in India, neocolonial biases in the structure of knowledge on aging central to international discourse, and subaltern strategies within India for subverting Western and elite Indian imperatives of what it means to be old. A variety of textual, ethnographic, and historical materials are examined: Indian and American literature pertaining to the 1982 World Assembly on Aging, a series of sociological texts each entitled "Aging in India," and four contemporary Indian institutions designed to meet the needs of old people: a social service agency, a geriatric clinic, a retirement community, and an old age home.

Aged↗

PubMed2004

Emergence of non-random structure in local food webs generated from randomly structured regional webs.

Previous studies have shown that high-resolution, empirical food webs possess a non-random network structure, typically characterized by uniform or exponential degree distributions. However, the empirical food webs that have been investigated for their structural properties represent local communities that are only a subset of a larger pool of regionally coexisting species. Here, we use a simple model to investigate the effects of regional food web structure on local food webs that are assembled by two simple processes: random immigration of species from a source web (regional food web), and random extinction of species within the local web. The model shows that local webs with non-random degree distributions can arise from randomly structured source webs. A comparison of local webs assembled from randomly structured source webs with local webs assembled from source webs generated by the niche model shows that the former have higher species richness at equilibrium, but have a nonlinear response to changing extinction rates. These results imply that the network structure of regional food webs can play a significant role in the assembly and dynamics of local webs in natural ecosystems. With natural landscapes becoming increasingly fragmented, understanding such structure may be a necessary key to understanding the maintenance and stability of local species diversity.

Animals↗