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Interlibrary loan activity of Metropolitan Detroit's biomedical network is under continual scrutiny. Published results include a review of interlibrary loan literature, six months analyses of document flow and retrieval, and of clientele, and cost of lending and borrowing operations to both resource and hospital libraries.
Over a five-year period, much progress has been made in meeting the needs of health care personnel in the Detroit metropolitan area through library cooperation. These cooperative relationships have stimulated implementation of the following projects: (1) publications, (2) research on medical library problems, and (3) library programs at both the city and state levels.
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PURPOSE: This study evaluated the cross-border safety impact of extended drinking hours from 1:00 to 2:00 a.m., in licensed establishments in Ontario, Canada. METHODS: This study examined patterns in total and alcohol-related casualties in: (1) Windsor, Ontario, Canada compared to Detroit, Michigan, US with a 2:00 a.m. closing time, and (2) Ontario compared to Michigan for overall trends. The criterion outcome indicators were: (1) monthly motor vehicle casualties (major injuries and fatalities) for the city-regions of Windsor and Detroit and (2) Ontario and Michigan monthly motor vehicle fatalities occurring between 11:00 p.m. and 3:00 a.m. for 4 years pre- and 3 years post-policy change. In order to examine cross-border drinking consequences, data were disaggregated to assess trends of motor vehicle injury collisions involving vehicles with US licence plates and with US drivers aged 16-20 in the Windsor region; similarly trends were assessed for motor vehicle injury collisions involving vehicles with Ontario licence plates in the Detroit region. RESULTS: The Windsor region total motor vehicle casualty data showed a non-significant pre-post increase, while the Detroit region showed a statistically significant decrease for total motor vehicle casualties. In the Windsor region, a significant increase was found for alcohol-related motor vehicle casualties after the drinking hours were extended. However, the Detroit region showed a statistically significant decrease in alcohol-related motor vehicle casualties concomitant with Ontario's drinking hour extension. No similar trends were found for the province of Ontario and the state of Michigan as a whole. Moreover, a significant decrease was found for injury collisions involving vehicles with Ontario licence plates in the Detroit region but no similar pattern was found for injury collisions involving vehicles with US licence plates and with 16-20-year-old US drivers in the Windsor region. DISCUSSION: These data seem to support a cross-border impact of the Ontario extended drinking policy. A significant increase in alcohol-related motor vehicle casualties was found in the Windsor region and concomitantly, significant decreases in total and alcohol-related motor vehicle casualties were found in the Detroit region after the extended drinking hours amendment. The Ontario government's belief that the extended drinking hour policy would "reduce the number of patrons who cross the border when Ontario's bars and restaurants close" may have been realized.
We report on the research conducted by the Community Action Against Asthma (CAAA) in Detroit, Michigan, to evaluate personal and community-level exposures to particulate matter (PM) among children with asthma living in an urban environment. CAAA is a community-based participatory research collaboration among academia, health agencies, and community-based organizations. CAAA investigates the effects of environmental exposures on the residents of Detroit through a participatory process that engages participants from the affected communities in all aspects of the design and conduct of the research; disseminates the results to all parties involved; and uses the research results to design, in collaboration with all partners, interventions to reduce the identified environmental exposures. The CAAA PM exposure assessment includes four seasonal measurement campaigns each year that are conducted for a 2-week duration each season. In each seasonal measurement period, daily ambient measurements of PM2.5 and PM10 (particulate matter with a mass median aerodynamic diameter less than 2.5 microm and 10 microm, respectively) are collected at two elementary schools in the eastside and southwest communities of Detroit. Concurrently, indoor measurements of PM2.5 and PM10 are made at the schools as well as inside the homes of a subset of 20 children with asthma. Daily personal exposure measurements of PM10 are also collected for these 20 children with asthma. Results from the first five seasonal assessment periods reveal that mean personal PM10 (68.4 39.2 microg/m(3)) and indoor home PM10 (52.2 30.6 microg/m(3)) exposures are significantly greater (p < 0.05) than the outdoor PM10 concentrations (25.8 11.8 microg/m(3)). The same was also found for PM2.5 (indoor PM2.5 = 34.4 21.7 microg/m(3); outdoor PM2.5 = 15.6 8.2 microg/m(3)). In addition, significant differences (p < 0.05) in community-level exposure to both PM10 and PM2.5 are observed between the two Detroit communities (southwest PM10 = 28.9 14.4 microg/m(3)), PM2.5 = 17.0 9.3 microg/m(3); eastside PM10 = 23.8 12.1 microg/m(3), PM2.5 = 15.5 9.0 microg/m(3). The increased levels in the southwest Detroit community are likely due to the proximity to heavy industrial pollutant point sources and interstate motorways. Trace element characterization of filter samples collected over the 2-year period will allow a more complete assessment of the PM components. When combined with other project measures, including concurrent seasonal twice-daily peak expiratory flow and forced expiratory volume at 1 sec and daily asthma symptom and medication dairies for 300 children with asthma living in the two Detroit communities, these data will allow not only investigations into the sources of PM in the Detroit airshed with regard to PM exposure assessment but also the role of air pollutants in exacerbation of childhood asthma.
BACKGROUND: National and regional population-based data have demonstrated substantially worse outcome in African-American patients with breast carcinoma when compared with white patients, as well as a younger age distribution among African-American patients with breast carcinoma. The extent to which various socioeconomic, environmental, lifestyle, and genetic factors interact to account for this ethnicity-related disparity in survival is poorly understood. Greater than one-half of the inner-city population of Detroit, Michigan is African American, and greater metropolitan Detroit has been one of the contributing registries for the Surveillance, Epidemiology, and End Results (SEER) program since its inception in 1973. The impact of breast carcinoma on African Americans in the Detroit area is therefore well documented and provides significant insight into the history, epidemiology, and biology of this major public health care problem. METHODS: A review of the medical literature published over the past 20 years regarding African-American patients with breast carcinoma was performed. The pertinent findings were summarized in the context of advances made in breast carcinoma screening, treatment, and risk reduction during that period. RESULTS: The large African-American population of Detroit is a major factor contributing to the excessive breast carcinoma mortality rate reported for this city, which is one of the highest in the United States. Improvements in early detection of breast carcinoma by using screening mammography have been apparent in the earlier stage distributions of breast carcinoma observed in both white and African-American patients; however, progress has lagged substantially for the latter group. Detroit SEER registry data also have shown a younger age distribution of African-American patients with breast carcinoma and higher rates of estrogen receptor negative tumors. Finally, preliminary data from health maintenance organizations have suggested improved breast carcinoma outcome for African Americans who possess greater socioeconomic benefits, but disparities in disease stage at presentation persist. CONCLUSIONS: The diverse Detroit community is ideally suited for breast carcinoma screening programs and clinical investigations that seek to address and overcome ethnicity-related survival disparities and barriers to health care. Findings from these studies can be correlated with results from similar projects in other geographic areas.
PCBs, organochlorine pesticides and dioxins/furans in snapping turtle eggs and plasma (Chelydra serpentina) were evaluated at three Areas of Concern (AOCs) on Lake Erie and its connecting channels (St. Clair River, Detroit River, and Wheatley Harbour), as well as two inland reference sites (Algonquin Provincial Park and Tiny Marsh) in 2001-2002. Eggs from the Detroit River and Wheatley Harbour AOCs had the highest levels of p,p'-DDE (24.4 and 57.9 ng/g) and sum PCBs (928.6 and 491.0 ng/g) wet weight, respectively. Contaminant levels in eggs from St. Clair River AOC were generally higher than those from Algonquin Park, but similar to those from Tiny Marsh. Dioxins appeared highest from the Detroit River. The PCB congener pattern in eggs suggested that turtles from the Detroit River and Wheatley Harbour AOCs were exposed to Aroclor 1260. TEQs of sum PCBs in eggs from all AOCs and p,p'-DDE levels in eggs from the Wheatley Harbour and the Detroit River AOCs exceeded the Canadian Environmental Quality Guidelines. Furthermore, sum PCBs in eggs from Detroit River and Wheatley Harbour exceeded partial restriction guidelines for consumption. Although estimated PCB body burdens in muscle tissue of females were well below consumption guidelines, estimated residues in liver and adipose were above guidelines for most sites.
A 17 yr old female with a congenital bleeding disorder was found to suffer from dysfibrinogenemia. Whole blood and plasma coagulation times were delayed and thrombelastograms were grossly abnormal. Clottability of plasma fibrinogen by addition of thrombin was not demonstrated during the 30 min test period. Fibrinogen was revealed by turbidometric and immunologic techniques. Other coagulation factors were present in normal amounts and prothrombin activation was normal. Patient's plasma inhibited thrombin clotting times of normal plasma and purified normal fibrinogen. Fibrinolysis was not detected. The plasma fibrinogen migrated normally on paper and cellulose acetate electrophoresis, but on immunoelectrophoresis it displayed a faster mobility than normal fibrinogen. On immunodiffusion the antigenic determinants were similar to those of normal fibrinogen. The patient's fibrinogen-antifibrinogen precipitins required longer to appear and the resultant precipitin was broader and hazier than those elicited with normal fibrinogen. These findings suggest the presence of two discrete populations of fibrinogen molecules. Investigation of the family of the patient suggested that the defect has an autosomal dominant pattern of heredity. Immunologic comparisons of our patient's plasma and of her relatives with plasma of patients with "Fibrinogen Baltimore" and "Fibrinogen Cleveland" revealed certain differences in immunoelectrophoretic mobility as well as in immunodiffusion. In keeping with the nomenclatures of abnormal fibrinogens in the literature, we propose the term "Fibrinogen Detroit" for this fibrinogen.Physicochemical properties of "Fibrinogen Detroit" were investigated also and compared with those of normal fibrinogen. Purified normal fibrinogen (clottability 96.7%) and "Fibrinogen Detroit" revealed homogeneity when studied by ultracentrifugation and immunoelectrophoresis. Native and cleaved "Fibrinogen Detroit" had the same sedimentation constants and molecular weights as the normal. In fresh samples. 3 moles of free SH groups/mole of fibrinogen were titrated in both. Determination of the amino acid composition revealed a decreased content of lysine, glucosamine, and galactosamine in abnormal fibrinogen. Total carbohydrates, protein-bound hexoses, sialic acid, and hexosamine were decreased in the abnormal fibrinogen. In an investigation with Doctors Blombäck a specific molecular defect was revealed in the N-terminal disulfide knot of the alpha (A) chain in which the arginine at the 19th position was replaced by serine. It is believed that the substitution of a strongly basic amino acid with a neutral hydroxy acid may result in considerable conformational changes in the N-terminal disulfide knot of fibrinogen which might affect the "active site" for polymerization. The lower carbohydrate content observed in "Fibrinogen Detroit" may have been the result of a change in primary and tertiary structure of the protein.
Tumor suppressor p53 functions as a transcriptional factor that regulates the cell cycle and apoptosis. A mutated p53 gene can result in decreased sequence-specific DNA binding and transcriptional activity of the p53 protein. In this study, we examined the regulatory role of the extracellular matrix components in p53 expression and nuclear localization in a Detroit 562 cell line derived from a pharyngeal carcinoma. When cultured on a polystyrene surface, type I collagen gel, or Matrigel containing basement membrane components, Detroit 562 cells showed a distinct response to extracellular matrix components morphologically. As shown by Western blotting, Detroit 562 cells cultured on Matrigel displayed an increased expression of p53 protein as well as an elevated nuclear p53 level, as compared with the cells cultured on the polystyrene surface or type I collagen gel. When cultured on Matrigel, nuclear p53-positive cells were exclusively localized to the outer surface layer of the cell clusters, whereas most of the inner cells showed no p53 expression. In Detroit 562 cell clusters on Matrigel, proliferative activities, as evaluated by proliferationcell nuclear antigen staining and bromo-deoxyuridine incorporation assay, were evenly distributed; virtually no apoptotic cells, as evaluated by the fluorescence TUNEL assay, were detected in the cell clusters, suggesting that the peculiar localization of nuclear p53-positive cells was not directly related to cell proliferation or apoptosis. These results indicate that p53 expression and its localization in Detroit cells were modulated by extracellular matrix signals, particularly by the basement membrane components in Matrigel.
Sediment from the upper Detroit and lower Rouge Rivers in southeastern Michigan, USA, were analyzed to examine the distribution of polychlorinated naphthalenes (PCNs), biphenyls (PCBs), dibenzo-p-dioxins (PCDDs), and dibenzofurans (PCDFs) as well as polycyclic aromatic hydrocarbons (PAHs) and alkylphenolic compounds such as butylphenol, octylphenol, and nonylphenol (NP). Sediments from a non-point source location in Lake Michigan were also analyzed for target compounds. Concentrations of target compounds in the upper Detroit and lower Rouge Rivers varied considerably among locations, and notable spatial variation existed. Concentrations of PCNs and PCDDs/PCDFs in sediments from the upper Detroit and lower Rouge Rivers ranged from 0.08 to 187 ng/g and 69 to 1420 pg/g dry weight, respectively. Total PCBs, PAHs, and NP concentrations ranged from 8 to 25,000, 17 to 44,000, and < 10 to 60,000 ng/g dry weight, respectively. Concentrations of all target compounds except PCNs were significantly correlated with total organic carbon content of sediments. Similarly, concentrations of PCBs, PCDDs, and PCDFs were significantly correlated with each other. The distribution of organic contaminants in the upper reaches of the Detroit River and lower Rouge River suggested the presence of localized, but multiple, sources of contamination for each compound class. Conners Creek combined sewer overflow has been identified as one of the potential sources for the upper Detroit River, where the highest concentrations PCBs and PCDDs/PCDFs were found. Polycyclic aromatic hydrocarbon and NP concentrations were consistently high in sediment from the lower Rouge River. Analysis of data from selected locations suggested that PCNs contributed a greater proportion of the dioxin-like activity than PCBs and PCDDs/PCDFs contributed.
Arson, the second leading cause of residential fire-associated deaths in the United States, accounts for approximately 700 deaths annually, destroys homes, and destabilizes neighborhoods. In Detroit, Michigan (1990 population: 1,027,974), arson accounted for nearly half (46.3%) of all fire-related deaths since 1984. During the late 1970s, pre-Halloween pranks traditionally associated in some parts of the United States with the night of October 30 turned destructive in Detroit, with hundreds of fires set throughout the city. By 1984, October 30 became known as "Devil's Night" and had evolved to 3 consecutive nights of arson on October 29-31; in that year, a record 810 fires were reported. In 1985, Detroit began a citywide intervention campaign against arson and vandalism during the 3-day Halloween period using data from an ongoing fire surveillance system maintained by the Detroit Fire Department (DFD) to target areas at high risk for arson. This report describes the intervention implemented by the city of Detroit from 1985 through 1996 and the impact of the intervention in preventing Halloween arson; approximately 34,000 volunteers participated in 1996, and the number of fires during this 3-day period decreased to the average number of fires for any other 3-day period during the remainder of the year.
Triclosan (5-chloro-2-(2,4-dichlorophenoxy)phenol) is an antimicroibial disinfectant agent used in a wide array of consumer products. An analytical method based on solid-phase extraction (SPE) followed by reverse phase, liquid chromatography coupled with electrospray ionization (negative)-tandem quadrupole mass spectrometry (LC-ESI(-)-MS/MS; in the multiple reaction monitoring (MRM) mode) was developed, optimized and validated for the determination of triclosan in wastewater/sewage treatment plant (WSTP) effluent and surface waters from the upper Detroit River (Canada). The mean recoveries (+/-%RSD) of triclosan and the internal standard 2'-HO-tribromodiphenyl ether (2'-HO-BDE-28) spiked to surface water and WSTP effluent samples ranged similarly from 104+/-8% and 91+/-10%, respectively, and method limits of quantification were in the low ppb/high ppt range. However, ESI(-) enhancement was found for both analytes due to sample matrix effects, as indicated by % process efficiencies (a measure of ESI(-) enhancement/suppression), which were in the 111-128% range. We report the first known assessment of triclosan in the Detroit River watershed of the Great Lakes, which preliminarily examined the presence and UV-treatment effects on triclosan in effluent from the major WSTP serving the City of Windsor, Ontario, Canada, and fate in surface waters of the upper Detroit River. Triclosan in WSTP effluent decreased 22% after final UV treatment to a mean concentration of 63 ng/L. Concentrations were further reduced to 4 and 8 ng/L (a >90% reduction) in surface water samples from sites downstream on the Canadian shoreline of the Detroit River, which was due to dilution. Two hydroxylated tribrominated diphenyl ethers, which are structurally similar to triclosan, were also detected in WSTP effluent and surface water samples.
Polybrominated diphenyl ethers (PBDEs) were identified in fish collected from the Detroit River, MI and Des Plaines Rivers, IL. In the Detroit River fish, carp and large mouth bass, the congener patterns were dominated by the 2,2',4,4'-tetrabromo (BDE-47) congener, however, in Des Plaines River carp the dominant isomers were the heptabromo congeners BDE-181 and BDE-183 and lesser amounts of another heptabromo congener, BDE-190, and two hexabromo congeners, BDE-154 and BDE-153. Three possible sources exist for these less-commonly identified PBDE congeners: (a) waste discharge from manufacturing or discarded products near the river, (b) public owned treatment work (POTW) effluents which constitute more than 75% of the flow in the Des Plaines River, (c) or formation of these congeners by debromination of in-place deposits of decabromodiphenyl ether. Average concentration totals (sum of concentrations for seven of the dominant PBDE congeners) were similar on a wet weight bases for the carp (5.39 ng/g wet weight) and large mouth bass (5.25 ng/g) in the Detroit River samples; however, the bass were significantly higher, p = 0.01, when compared on a lipid basis (bass--163 ng/g vs. carp--40.5 ng/g lipid weight). Some of the PBDE congeners were positively correlated with increasing lipid levels in both fish species. Average total PBDE concentrations in the carp from the Des Plaines River (12.48 ng/g wet weight) were significantly higher, p = 0.01, than in carp from the Detroit River. The residues were isolated using standard organochlorine methods for fish and analyzed using gas chromatography/mass spectrometry-negative chemical ionization methods.
It has been clearly established that substance abuse treatment works (De Leon 1988). Thus, activities which increase the proportion of indigent clients in Detroit who actually get into treatment and activities which help indigent clients stay in treatment are likely to significantly improve treatment outcomes. The Target Cities projects in general and the Detroit Target Cities project in particular represent some of the few efforts currently underway to determine intervention activities which significantly improve treatment outcomes for indigent substance abusing clients. Subsequent evaluation has shown that the proportion of clients referred by the CDRS who were actually admitted into a treatment program increased significantly after full implementation of the Detroit Target Cities screening and pretreatment case management activities. Furthermore, the average time between referral by the CDRS and admission into a treatment program decreased significantly (Tucker 1997). Evaluation of the Detroit Target Cities jail-based substance abuse treatment program also showed a significant increase in the proportion of clients who remained drug free after full implementation of the program (Tucker 1998).