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PubMed2005

Comparative genomics of the pennate diatom Phaeodactylum tricornutum.

Diatoms are one of the most important constituents of phytoplankton communities in aquatic environments, but in spite of this, only recently have large-scale diatom-sequencing projects been undertaken. With the genome of the centric species Thalassiosira pseudonana available since mid-2004, accumulating sequence information for a pennate model species appears a natural subsequent aim. We have generated over 12,000 expressed sequence tags (ESTs) from the pennate diatom Phaeodactylum tricornutum, and upon assembly into a nonredundant set, 5,108 sequences were obtained. Significant similarity (E < 1E-04) to entries in the GenBank nonredundant protein database, the COG profile database, and the Pfam protein domains database were detected, respectively, in 45.0%, 21.5%, and 37.1% of the nonredundant collection of sequences. This information was employed to functionally annotate the P. tricornutum nonredundant set and to create an internet-accessible queryable diatom EST database. The nonredundant collection was then compared to the putative complete proteomes of the green alga Chlamydomonas reinhardtii, the red alga Cyanidioschyzon merolae, and the centric diatom T. pseudonana. A number of intriguing differences were identified between the pennate and the centric diatoms concerning activities of relevance for general cell metabolism, e.g. genes involved in carbon-concentrating mechanisms, cytosolic acetyl-Coenzyme A production, and fructose-1,6-bisphosphate metabolism. Finally, codon usage and utilization of C and G relative to gene expression (as measured by EST redundance) were studied, and preferences for utilization of C and CpG doublets were noted among the P. tricornutum EST coding sequences.

Animals↗

PubMed2005

Integrating animal welfare into veterinary education: using an online, interactive course.

Veterinarians in the United States and abroad are faced with growing public concern for the welfare of animals, particularly those in production. To prepare veterinarians to exert the leadership expected by the public and industry, steps should be taken to provide instruction in animal welfare at veterinary colleges. The ultimate goal is to offer courses in animal welfare in a consistent manner on a global scale, utilizing existing expertise in an efficient and cost-effective manner. Given the intense curricula of veterinary schools and the scarcity of instructors trained in animal welfare, a nontraditional approach is needed to educate veterinary students in the United States and abroad in animal welfare. Michigan State University (MSU) is developing a graduate-level, online interactive course in animal welfare assessment. The course will approach the topic of animal welfare education from a holistic, multidisciplinary standpoint (encompassing ethics, economics, and behavior) and address issues important to the general public and the international community. The MSU course will draw on renowned international animal welfare experts, allowing students to receive high-quality education that would be difficult in any other circumstance. The course will bridge an important gap in the veterinary curriculum and offer a complete and congruous education in animal welfare to veterinarians worldwide. The MSU course will also serve as a model for collaboration in content assembly and course delivery, by using technology to leverage global expertise in the interests of educational equity. In addition to innovative technology, such as the use of Web-collaboration software to create the course, a variety of media that enable students to interact with the material will also be incorporated throughout the course. Thus, the course will not only utilize the Internet to provide access to high-quality material, but will also require the active participation of the student, which is needed for effective learning.

Animal Welfare↗

PubMed1995

NIDDM is the major cause of diabetic end-stage renal disease. More evidence from a tri-ethnic community.

Diabetes is the single largest cause of end-stage renal disease (ESRD) in adults in the U.S. Insulin-dependent diabetes mellitus (IDDM) has been recognized for some time as an important cause of ESRD, but non-insulin-dependent diabetes mellitus (NIDDM) has been assumed, until recently, to rarely cause ESRD. The objective of this study is to determine the incidence of treatment of diabetic ESRD by diabetic type for three ethnic/racial groups: non-Hispanic whites, African-Americans, and Mexican-Americans. A population-based incidence cohort was assembled from all dialysis centers in Bexar (San Antonio) and Dallas counties in Texas. All patients with diabetic ESRD beginning dialysis between 1 December 1987 (Bexar) or 1 December 1988 (Dallas) and 31 July 1991 were identified. All non-hispanic whites and African-Americans and a 1/2 random sample of Mexican-Americans were approached for enrollment. Individuals were confirmed to have diabetes using the World Health Organization criteria. Diabetes typing was done using a computerized historical algorithm. Age-specific and age-adjusted incidence rates were obtained by diabetic type and ethnic/racial group. NIDDM causes the majority of diabetic ESRD: 59.5% for non-Hispanic whites, 92.8% for Mexican-Americans, and 84.3% for African-Americans. Mexican-Americans and African-Americans, respectively, have 6.1 and 6.5 times higher incidence of treatment for diabetic ESRD than non-Hispanic whites. NIDDM results in more ESRD than does IDDM. Minorities (African-Americans and Mexican-Americans) are at increased risk, and programs aimed at prevention of NIDDM-related ESRD must focus on them.

Adult↗

PubMed2006

Integrating large-scale genotype and phenotype data.

With the completion of the Human Genome Project, a new emphasis is focusing on the sequence variation and the resulting phenotype. The number of data available from genomic studies addressing this relationship is rapidly growing. In order to analyze these data as a whole, they need to be integrated, aggregated and annotated in a timely manner. The Pharmacogenetics and Pharmacogenomics Knowledge Base PharmGKB; ( ) assembles and disseminates these data and their associated metadata that are needed for unambiguous identification and replication. Assembling these data in a timely manner is challenging, and the scalability of these data produce major challenges for a knowledge base such as PharmGKB. However, it is only through rapid global meta-annotation of these data that we will understand the relationship between specific genotype(s) and the related phenotype. PharmGKB has confronted these challenges, and these experiences and solutions can benefit all genome communities.

Animals↗

PubMed1995

Responding to change: the challenge of the 1990s.

In 1995, neurosurgery in the United States is facing challenges and threats never before imagined. In its attempts to respond as a relatively small specialty, the neurosurgical community can no longer afford to remain a house divided. Neurosurgical unit has now become a critical matter. In particular, our neurosurgical leadership must minimize duplication of efforts and efficiently allocate its resources. Most importantly, it must unify its energies in directing the numerous joint American Association of Neurological Surgeons/Congress of Neurological Surgeons activities, as well as serving as a direct liaison with the emerging representative assembly under the Joint Council of State Neurosurgical Societies. The unification of the neurosurgical leadership will clearly enhance our ability to deal with all of our present challenges and future changes, but more importantly it will permit our specialty to truly speak with one voice.

Humans↗

PubMed1998

Devolution. Separate ways.

Devolution will bring health policy under the democratic control of the directly elected Scottish parliament and Welsh assembly. Some fear that members of these bodies may wish to interfere in service delivery, rather than concentrating on strategy. Devolution could highlight anomalies in health spending. Many professionals fear that devolution will fragment UK-wide policy networks.

Budgets↗

PubMed2006

Age-related macular degeneration and risk for stroke.

BACKGROUND: Age-related macular degeneration (AMD) affects 7 million persons 40 years of age and older in the United States. Risk factors for the disease are similar to those for stroke. OBJECTIVE: To determine what relationship, if any, exists between AMD and incident clinical stroke. DESIGN: Prospective cohort study. SETTING: The population-based Atherosclerosis Risk in Communities Study, which was conducted in Minnesota, Maryland, Mississippi, and North Carolina. PATIENTS: 10 405 persons between 49 and 73 years of age who had no history of stroke or coronary heart disease. MEASUREMENTS: Participants had retinal photographs taken between 1993 and 1995. A standardized protocol was used to evaluate the photographs for the presence of drusen and other signs of AMD. Incident stroke events were identified and validated by reviewing case records. RESULTS: There were 498 early-stage and 10 late-stage cases of AMD in the cohort (n = 508). Over a 10-year period, 241 persons had an incident stroke event. After adjusting for age, sex, ethnicity, and site, the authors found that persons with early-stage AMD had a higher cumulative incidence of stroke than those without the disease (4.08% vs. 2.14%). The presence of early-stage AMD was associated with a higher adjusted risk for stroke (hazard ratio, 1.87 [95% CI, 1.21 to 2.88]). Further adjustment for systolic blood pressure, diabetes, cigarette smoking, and use of antihypertensive medications did not substantially alter this association (hazard ratio, 1.85 [CI, 1.19 to 2.87]). The authors found that the association between early-stage AMD and stroke varied by study site and patient ethnicity. Multivariable-adjusted hazard ratios were 3.15 and 1.07 in samples of white patients in Minnesota and Maryland, respectively; 3.77 in a sample of African-American patients in Mississippi; and 0.33 in a sample of mostly white patients (91%) in North Carolina. No site included sufficient numbers of both African-American and white patients to determine whether ethnicity contributed to the observed differences by study site. LIMITATIONS: There were few cases of late-stage AMD, and the cohort assembly method prohibited full understanding of variation by ethnicity and site. CONCLUSION: Middle-aged persons with signs of early-stage AMD have a higher risk for stroke independent of traditional stroke risk factors.

Aged↗

PubMed2006

Mapping health on the internet: a new tool for environmental justice and public health research.

This paper examines the prospects for integrating Internet platform GIS or 'web-GIS' into environmental justice and related public health research. Specifically, we document the development of a web-GIS created for investigating relationships between health, air quality and socioeconomic factors in Hamilton, Canada. After development of the web-GIS site, we assembled a focus group of public health professionals to test functionality and render opinions about the potential of the site and geographic information in their program implementation. Results show overwhelming support for the further integration of GIS into public health practice. The results also underscore the potential of web-GIS to alleviate concerns of cost and data availability that often limit the use of GIS in community debates centred on environmental justice issues.

Air Pollution↗

PubMed2005

Analysis of local perspectives on sustainable forest management: an Indonesian case studyThis study was funded through a collaborative project between the University of Illinois and the Center for International Forestry Research (CIFOR). The ideas contained herein are solely of the authors and do not necessarily reflect official views of CIFOR.

Despite widespread acceptance of sustainability as the ultimate goal of forest management, perspectives about its meaning, significance, and relevant indicators may still differ. This paper examines local perspectives on sustainability, and evaluates their similarities and differences. A systematic procedure based on criteria of proximity, pre-existing rights, dependency, knowledge of forest management, forestry spirit, daily activity, and legal rights was used to identify a small group of relevant stakeholders representing different groups, institutions, and organizations. Using participatory action research (PAR), stakeholders were asked to identify relevant indicators of sustainable forest management. The indicators identified by each stakeholder were then compared to a consolidated list assembled by field facilitators with respect to whether relevant indicators are present or not. Based on the resulting presence/absence matrix, a statistical tool called the simple matching coefficient was used to estimate the similarity measures among the stakeholders' perspectives. In addition, cluster analysis was used to classify groups of stakeholders depending on their similarities to each other. Finally, hypotheses related to the 'closeness' of perspectives among local communities, non-governmental organizations, a timber company, and government organizations, as revealed by their selection of indicators, were tested. Results show that: (a) local communities have different perceptions in terms of what they consider to be important indicators compared to the NGOs, (b) there are significantly different perceptions between the government and the timber companies, and (c) there are also different perceptions between urban and field-based personnel of the same organization.

Cluster Analysis↗

PubMed2026

Deciphering the effects of sulfonamide antibiotics on denitrification from a metagenomic perspective: Inhibition of nitrite reduction and succession patterns of functional microorganisms.

Limited research has thoroughly elucidated the impact mechanisms of antibiotics on the denitrification process at the genomic and gene levels, which has hindered the optimization and development of nitrogen removal technology for antibiotic-containing swine wastewater. Lab-scale sequencing batch reactors were constructed in this study to treat synthetic wastewater containing different sulfonamides and nitrate. Investigations were carried out on denitrification performance, microbial community diversity, denitrifier succession patterns, and functional gene distribution. The stress of sulfonamides inhibited the nitrite reduction process, transforming complete denitrification into partial denitrification and causing significant nitrite accumulation. The average nitrogen removal efficiency in the treatment groups decreased from 81.0% ± 2.2-40.1% ± 6.1%. Alicycliphilus and Thauera were identified as the key taxa, accounting for 32.2% and 16.9% of all potential denitrifying bacteria, respectively. Although metagenome-assembled genomes (MAGs) from Thauera were enriched with genes encoding nitrate reductases (nap, nar) and nitrite reductases (nir), this genus preferentially utilized nitrate as an electron acceptor, resulting in the preferential nitrate reduction and subsequent nitrite accumulation. In contrast, Alicycliphilus MAGs developed tolerance to the sulfonamides stress during later stages, with concomitant enrichment of associated functional genes. They replaced Thauera to reemerge as the dominant group, thereby restoring complete denitrification. This study provides new insights into the regulatory mechanisms governing complete versus partial denitrification in nitrogen removal from antibiotic-containing wastewater.

Denitrifier succession↗

PubMed2006

Editorial: Global elimination of lymphatic filariasis: fact or fantasy?

In 1997, the World Health Assembly resolved to eliminate lymphatic filariasis as a public health problem by the year 2020. By the end of 2004, almost half of the 83 endemic countries had initiated national programmes, providing mass drug administration to an at risk population of approximately 435 million. This remarkable achievement is the result of an enormous amount of technical, financial and political support from public and private sectors at the community, national, regional and global level. As the global programme to eliminate lymphatic filariasis enters its second quarter of operations, there are substantial opportunities to be taken and critical challenges to be addressed. These are the focus of this editorial.

Delivery of Health Care, Integrated↗

PubMed2000

Applying a prediction rule to identify low-risk patients with community-acquired pneumonia.

STUDY OBJECTIVES: To study the validity of a recently developed community-acquired pneumonia (CAP) severity prediction rule in estimating mortality, to determine its utility in decision making regarding hospitalization, and to assess factors influencing this decision. DESIGN: Retrospective chart review. SETTING: Two sites of the University Health Network, the Toronto General and Toronto Western Hospitals, tertiary-care teaching institutions with a sizable primary-care and secondary-care source of referrals, and a total of 900 beds. PATIENTS: Consecutive patients with CAP admitted between February and June 1996. MEASUREMENTS AND RESULTS: A single trained medical records extractor assembled data to compare our population to that used in developing the CAP prediction rule, in terms of mortality and to assess reasons for hospitalization. Two hundred fifty-five eligible patients were admitted, and 244 charts (96%) were available. Our patients tended to be older, with nearly four times as many residents of chronic care institutions (39% compared with 10%), and had a higher risk class distribution than the published cohort. Risk class-specific mortality was similar in four of five classes. Of the 71 patients in the low-risk classes, 67 had additional reasons for admission; 18 of which were psychosocial (homelessness, substance abuse, or inadequate home supports). CONCLUSIONS: The CAP severity prediction rule estimates mortality well. Admission of low-risk patients was linked to psychosocial and other medical reasons not captured by this rule. The rule can be very useful in assessing the need for hospitalization; however, there remains a significant percentage of patients with a low severity score who may require hospitalization for psychosocial and economic considerations.

Adult↗

PubMed2005

Rationales for home safety promotion in the Iranian primary healthcare system: results from a pilot study.

OBJECTIVE: To analyse the prerequisites for a nationwide primary healthcare (PHC) home safety promotion programme in Iran. BACKGROUND: Injury is a major public health problem throughout the world, currently accounting for one-seventh of all premature deaths and disabilities. Within 20 years, it is estimated that the proportion will increase to one-fifth. The present healthcare system in Iran was started in 1979, with a major focus on easy access to services and prevention. The system is based on the 'health house', which is run by community health workers. A survey shows that 36% of injuries occur in the home environment. A pilot phase of the Home Safety Promotion Programme was initiated in 1994, and included safety checking at home for fences, kitchens, drugs and poisons, heaters, electricity, and stairs and ladders. The pilot study covered 478,551 households out of the 12 million (approximately) in Iran. Sixty-nine supervisors were involved individually, assembled into eight focus groups. RESULTS: Household safety increased by 10-20% over the 4 years of the study. The frequency of home visits changed from annual to seasonal, since all participants agreed that there were seasonal differences in safety problems. The supervisors showed a high level of knowledge of injury as a public health problem, and also positive attitudes towards doing something about safety on the basis of a PHC scheme. The role of a surveillance system was highlighted, and it was suggested that such a system should be added to the programme. DISCUSSION AND CONCLUSION: Based on our preliminary findings, there were reasons to obtain a policy decision concerning a national programme for safety promotion before extending the pilot scheme to the whole country. A national safety programme was decided upon following completion of the pilot study. It includes a home-related-injury surveillance system that is mandatory in rural areas and voluntary in some cities.

Accidents, Home↗

PubMed2001

Incidence of four adverse outcomes in the elderly population: implications for home care policy and research.

The cost-effective allocation of home care resources requires knowledge of the incidence of institutionalization, hospitalization, functional impairment, and mortality. We therefore assembled a database containing 176 rates abstracted from 71 longitudinal studies published between 1985 and 1998 that examine one or more of these outcomes in the 65 and over population in the United States. Where possible we calculate median values for the estimated annual rate of each outcome for different types of studies-nationally representative, sub-national probability, and convenience sample-and specific subgroups-community residents, hospital admissions and discharges, and nursing home admissions and discharges. We find comparatively low rates of institutionalization and mortality, relatively high rates of hospitalization and functional impairment, similar rates for national and sub-national probability samples, and rates from convenience samples, which greatly exceed probability-based rates. While the rates for institutionalization, hospitalization and mortality are quite stable, the rates for functional impairment display considerably more variability. We conclude by discussing the implications of our findings for researchers and policymakers.

Activities of Daily Living↗

PubMed2004

Cost savings and effectiveness of outpatient treatment with low molecular weight heparin of deep vein thrombosis in a community hospital.

UNLABELLED: This study was conducted at Centenary Health Centre of the Rouge Valley Health System, a community based hospital in Toronto. In January 1997, a new treatment was introduced for the management of patients with uncomplicated deep vein thrombosis (DVT). Eligible patients presenting at the ER were placed on LMWH (tinzaparin) and followed at home. Previously the patients had been hospitalized and treated with intravenous heparin until they reached a therapeutic international normalized ratio (INR). The intent of this study was to evaluate the patient outcomes and cost-savings of the new approach. METHODS: Data from all patients eligible for home care, treated in 1996 were assembled and compared with those from all eligible patients treated from April 1, 1997 to March 31, 1998. The data was collected by chart review and consisted of patient outcomes and costs during the period of heparin treatment. Costs for hospitalized patients were based on a per diem. For home care patients, the costs were itemized according to service and medication usage. All costs were calculated in 1999 Canadian dollars. RESULTS: In each one year period, 39 cases were treated. There was no serious adversity and the outcomes were compatible with what has been reported in the literature. The mean cost per patient for the 1996 hospitalized cohort was $3,266 compared to $584 for the subsequent home care cohort. The difference was statistically significant (p<0.00001). CONCLUSION: Home care with tinzaparin compared to hospital care with IV heparin resulted in a large mean saving per patient with no difference in outcome.

Adult↗

PubMed2002

Signaling complexes: junctions on the intracellular information super highway.

An enigmatic yet fundamental principle of signal transduction is that parallel signaling pathways assembled from a common repertoire of enzymes are able to propagate diverse physiological responses. A key feature of such a mechanism is that separate signaling pathways are organized into localized transduction units, each tailored to respond optimally to a particular signal. Protein-protein interactions maintained by anchoring, adapter and scaffolding proteins provide the molecular glue that holds these signal transduction units together. A major objective of the signaling community is to ascertain how signals flow through compartmentalized transduction units that contain transmembrane receptors, protein kinases, phosphatases and their substrates.

Animals↗

PubMed1994

Bicycle helmet use among schoolchildren. Impact of a community education program and a cycling fatality.

OBJECTIVE: To assess the effect of a community bicycle helmet education and subsidy program and the further effect of a bicycle rodeo on helmet ownership and use among elementary schoolchildren. The unanticipated effect of a child cyclist fatality was also measured. DESIGN: Helmet ownership and use were measured in two ways: a questionnaire was sent to all elementary schoolteachers asking about helmet ownership and use by their students; and volunteers counted the children riding their bicycles to school. SETTING: Elementary schools in the town of Goderich, population 7400, and the town of Kincardine, population 6227, both on Lake Huron in southwestern Ontario. PARTICIPANTS: More than 80% of the 1050 elementary school students in Goderich and, for comparison, more than 90% of the 1439 elementary school students in Kincardine. INTERVENTIONS: An extensive education campaign with programs, assemblies, teaching aids, speakers, and a colouring and poster contest, coupled with a discount helmet offer in October 1991. Incentives to helmet use, such as bicycle rodeos, took place in May 1992 and 1993. A child cyclist not wearing a helmet was fatally injured in September 1992. MAIN OUTCOME MEASURES: Teachers polled students on helmet use and student volunteers counted children riding bicycles and noted helmet use. RESULTS: A total of 250 helmets were purchased, and helmet use was observed to increase among 5- to 14-year-old children from 0.75% to 12.8% during 9 months. Program effect was significantly greater on younger children, and girls used helmets more often than boys did. The cycling fatality in Goderich was associated with a dramatic increase in helmet use (to more than 50%), a significantly higher rate than in Kincardine. A second subsidy and rodeo did not further increase helmet use. CONCLUSIONS: A small community with limited resources can mount a bicycle helmet education and incentive program with high exposure and participation rates by children. Despite an initial 17-fold increase in observed helmet use, more than 87% of cyclists still did not wear helmets. The cycling fatality was associated with a significant increase in helmet use.

Adolescent↗

PubMed1997

Completeness of case ascertainment in a Scottish regional cancer registry for the year 1992.

To assess completeness of case ascertainment by the Scottish Cancer Registry for the year 1992, we assembled a collection of databases containing potential registrations (excluding non-melanoma skin tumours and non-invasive neoplasms) from 14 separate sources relating to the population covered by one of the five regional registries. Apparently missed registrations were identified by linkage of these databases to cancer registration records. Their eligibility for registration was determined by reference in medical records, or when these were unavailable, by reference to the local Community Health Index (to establish residency at the time of diagnosis) in conjunction with the text of the original pathology report and/or the original death certificate. Misclassifications of site or incidence year were not regarded as missed cases. Of 517 apparently missed cancer registrations, 66 cases (3.5% of the revised total number of registrations of malignant neoplasms other than non-melanoma skin tumours for the study area in 1992) should have been registered as new independent primary malignant neoplasms, giving an overall estimate of completeness of 96.5%. The fact that so many apparently missed registrations were not eligible for registration illustrates the limitations of passive registration. Ascertainment of cases by the Scottish Cancer Registry appears to be high for most sites and compares favourably to the figures reported by registries outside Scotland.

Humans↗