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OBJECTIVES/SPECIFIC AIMS: Helping researchers assess and effectively translate innovations into healthcare improvements is a complex process (Terry et. al., 2013). The Clinical Translational Science Awards (CTSA)—supported by the National Institute of Health (NIH) under the auspices of the National Center for Advancing Translational Sciences (NCATS)— provide the resources and support needed to strengthen our nation’s clinical and translational research (CTR) enterprise. In 2008, Stanford University was awarded a CTSA from the NIH, establishing Spectrum (the Stanford Center for Clinical and Translational Research and Education). Under the Spectrum umbrella, the Byers Center for Biodesign manages the MedTech Pilot Program with the goal of translating discoveries into novel health technologies that address important unmet health needs. The MedTech Pilot Program is an innovative funding mechanism that seeks to (1) stimulate clinical translational research, (2) help promising projects bridge the gap between the bench and the patients’ bedside, and (3) encourage collaborative, transdisciplinary work. Specifically, the Pilot Program offers up to $50,000 to support projects involving medical devices and mobile technologies used for (1) therapeutic applications and (2) device-based patient-specific (or POC) diagnostic applications. This analysis of the MedTech Pilot Program will: 1) describe the Program’s structure and process; 2) highlight the intensive, hands-on mentorship and practical guidance awardees receive that enables them to more efficiently and effectively advance their projects toward patient care; and 3) characterize the progress of the 36 funded projects. METHODS/STUDY POPULATION: Key elements of the Pilot Program’s infrastructure and mentoring processes as they relate to project outcomes were identified. Additionally, outcomes data were collected from two sources: (1) annual survey of Pilot Awardees and (2) publicly available information relevant to the pilot projects. RESULTS/ANTICIPATED RESULTS: The Pilot Program’s framework and infrastructure has supported a diverse group of transdisciplinary projects. These projects were evaluated using both traditional and non-traditional metrics (e.g., patents, startups, publications). The initial investment of $1.5 million to fund 36 projects has led to over $88 million dollars in additional funding. Additionally, taking full advantage of the expertise in Silicon Valley, strong mentorship has helped advance projects along the clinical and translational path. DISCUSSION/SIGNIFICANCE OF IMPACT: The Pilot Program has benefited Stanford innovators and researchers by providing seed funding to help promising projects bridge the gap between the bench and the bedside. The intensive, hands-on mentorship, early pilot funding, and practical guidance pilot awardees receive effectively help translate their technologies into patient care.
We examined the association between dietary patterns and diabetes using the strengths of two methods: principal component analysis (PCA) to identify the eating patterns of the population and reduced rank regression (RRR) to derive a pattern that explains the variation in glycated Hb (HbA1c), homeostasis model assessment of insulin resistance (HOMA-IR) and fasting glucose.
We measured diet over a 3 d period with 24 h recalls and a household food inventory in 2006 and used it to derive PCA and RRR dietary patterns. The outcomes were measured in 2009.
Adults (n 4316) from the China Health and Nutrition Survey.
The adjusted odds ratio for diabetes prevalence (HbA1c≥6·5 %), comparing the highest dietary pattern score quartile with the lowest, was 1·26 (95 % CI 0·76, 2·08) for a modern high-wheat pattern (PCA; wheat products, fruits, eggs, milk, instant noodles and frozen dumplings), 0·76 (95 % CI 0·49, 1·17) for a traditional southern pattern (PCA; rice, meat, poultry and fish) and 2·37 (95 % CI 1·56, 3·60) for the pattern derived with RRR. By comparing the dietary pattern structures of RRR and PCA, we found that the RRR pattern was also behaviourally meaningful. It combined the deleterious effects of the modern high-wheat pattern (high intakes of wheat buns and breads, deep-fried wheat and soya milk) with the deleterious effects of consuming the opposite of the traditional southern pattern (low intakes of rice, poultry and game, fish and seafood).
Our findings suggest that using both PCA and RRR provided useful insights when studying the association of dietary patterns with diabetes.
In the present study, we aimed to identify the changes or stability in the structure of dietary patterns and tracking, trends and factors related to the adherence to these dietary patterns in China from 1991 to 2009. We analysed dietary data collected during seven waves of the China Health and Nutrition Survey and included 9253 adults with complete dietary data for three or more waves. Dietary intake assessment was carried out over a 3 d period with 24 h recalls and a household food inventory. Using factor analysis in each wave, we found that the structure of the two dietary patterns identified remained stable over the studied period. The traditional southern dietary pattern was characterised by high intakes of rice, fresh leafy vegetables, low-fat red meat, pork, organ meats, poultry and fish/seafood and low intakes of wheat flour and maize/coarse grains and the modern high-wheat dietary pattern was characterised by high intakes of wheat buns/breads, cakes/cookies/pastries, deep-fried wheat, nuts/seeds, starchy root/tuber products, fruits, eggs/egg products, soya milk, animal-based milk and instant noodles/frozen dumplings. Temporal tracking (maintenance of a relative position over time) was higher for the traditional southern dietary pattern, whereas adherence to the modern high-wheat dietary pattern had an upward trend over time. Higher income, education and urbanicity levels were positively associated with both the dietary patterns, but the association became weaker in the later years. These results suggest that even in the context of rapid economic changes in China, the way people chose to combine their foods remained relatively stable. However, the increasing popularity of the modern high-wheat dietary pattern, a pattern associated with several energy-dense foods, is a cause of concern.
Increasing the conditionality of welfare benefits is a growing trend in many developed countries, particularly in relation to some groups who may be perceived as undeserving of state support. Problem drug users (PDUs) are one such group, and in the UK most PDUs do not work and a high proportion claim benefits. Facilitating the movement of these individuals into employment is a policy aim, because it is believed to improve the circumstances of drug users (and promote future abstinence) and because moving all groups off benefits and into work is a primary purpose of recent welfare reforms. Yet little is known about the interactions of PDUs with the UK benefits system or how recent moves to increase the conditionality of benefits are likely to affect this vulnerable group. This paper begins to address this gap by exploring the perceptions that PDUs and relevant frontline staff have of drug users’ interactions with the welfare system and the factors affecting their prospects for employment. The findings suggest some aspects of recent welfare reforms, notably the simplification of benefits, may help PDUs interact with the system. However, the data also reinforce claims that the increased use of sanctions is unlikely to succeed in improving employment rates amongst this group without intensive support and demand-side interventions.
Substituted β-diketonate complexes of barium have limited volatility even at reduced pressures. The addition of nitrogen Lewis bases to the CVD carrier gas allows barium β-diketonates, even those with no reported volatility, to be transported in the vapor phase at temperatures as low as 70°C (atmospheric pressure) with no decomposition. No increase in volatility is observed, however, for barium carboxylate complexes.
Efficient thin-film polycrystalline-silicon (pc-Si) solar cells on foreign substrates could lower the price of photovoltaic electricity. Aluminum-induced crystallization (AIC) of amorphous silicon followed by epitaxial thickening at high temperatures seems a good way to obtain efficient pc-Si solar cells. Due to its transparency and low cost, glass is well suited as substrate for pc-Si cells. However, most glass substrates do not withstand temperatures around 1000°C that are needed for high-temperature epitaxial growth. In this paper we investigate the use of experimental transparent glass-ceramics with high strain-point temperatures as substrates for pc-Si solar cells. AIC seed layers made on these substrates showed in-plane grain sizes up to 16 μm. Columnar growth was observed on these seed layers during high-temperature epitaxy. First pc-Si solar cells made on glass-ceramic substrates in substrate configuration showed efficiencies up to 4.5%, fill factors up to 75% and open-circuit voltage (Voc) values up to 536 mV. This is the highest Voc reported for pc-Si solar cells on glass and the best cell efficiency reported for cells made by AIC on glass.
Agricultural practices, other than herbicide use, can affect the rate of evolution of herbicide resistance in weeds. This study examined associations of farm management practices with the occurrence of herbicide (acetyl-CoA carboxylase or acetolactate synthase inhibitor)-resistant weeds, based upon a multi-year (2001 to 2003) random survey of 370 fields/growers from the Canadian Prairies. Herbicide-resistant weeds occurred in one-quarter of the surveyed fields. The primary herbicide-resistant weed species was wild oat, with lesser occurrence of green foxtail, kochia, common chickweed, spiny sowthistle, and redroot pigweed. The risk of weed resistance was greatest in fields with cereal-based rotations and least in fields with forage crops, fallow, or where three or more crop types were grown. Weed resistance risk also was greatest in conservation-tillage systems and particularly low soil disturbance no-tillage, possibly due to greater herbicide use or weed seed bank turnover. Large farms (> 400 ha) had a greater risk of weed resistance than smaller farms, although the reason for this association was unclear. The results of this study identify cropping system diversity as the foundation of proactive weed resistance management.
Weed resistance monitoring has been routinely conducted in the Northern Great Plains of Canada (Prairies) since the mid-1990s. Most recently, random surveys were conducted in Alberta in 2001, Manitoba in 2002, and Saskatchewan in 2003 totaling nearly 800 fields. In addition, nearly 1,300 weed seed samples were submitted by growers across the Prairies between 1996 and 2006 for resistance testing. Collected or submitted samples were screened for group 1 [acetyl-CoA carboxylase (ACCase) inhibitor] and/or group 2 [acetolactate synthase (ALS) inhibitor] resistance. Twenty percent of 565 sampled fields had an herbicide-resistant (HR) wild oat biotype. Most populations exhibited broad cross-resistance across various classes of group 1 or group 2 herbicides. In Manitoba, 22% of 59 fields had group 1–HR green foxtail. Group 2–HR biotypes of kochia were documented in Saskatchewan, common chickweed and spiny sowthistle in Alberta, and green foxtail and redroot pigweed in Manitoba. Across the Prairies, HR weeds are estimated to occur in fields covering an area of nearly 5 million ha. Of 1,067 wild oat seed samples submitted by growers and industry for testing between 1996 and 2006, 725 were group 1 HR, 34 group 2 HR, and 55 groups 1 and 2 HR. Of 80 submitted green foxtail samples, 26 were confirmed group 1 HR; most populations originated from southern Manitoba where the weed is most abundant. Similar to the field surveys, various group 2–HR biotypes were confirmed among submitted samples: kochia, wild mustard, field pennycress, Galium spp., common chickweed, and common hempnettle. Information from grower questionnaires indicates patterns of herbicide usage are related to location, changing with cropping system. Two herbicide modes of action most prone to select resistance, groups 1 and 2, continue to be widely and repeatedly used. There is little evidence that growers are aware of the level of resistance within their fields, but a majority have adopted herbicide rotations to proactively or reactively manage HR weeds.
Just Marriage. By Mary Lyndon Shanley, with Commentators. New
York: Oxford University Press, 2004. 116p. $45.00 cloth, $12.95 paper.
Should marriage as we know it be abolished? This is one proposed
solution to the injustices of marriage today: unjust to those excluded
from access to it, to those who might like it but cannot find a partner,
and to those who choose other forms of relationships or even consider
marriage oppressive. Or does marriage remain an institution so bound up
with social needs, such as child raising and care for dependents, that the
state cannot abdicate regulatory authority over it? Mary Lyndon Shanley
argues the latter position.
Verity Burgmann's condemnation of identity politics is unhelpful, because it is moralistic and ahistorical. Its assumptions take us back to a time before the civil rights, New Left, women's, and gay movements reinvented the Left so as to articulate their aspirations and grievances.
This paper reports 3-dimensional confocal microscopy observations on how nephrogenic aggregates form from the NCAM- and Pax2-positive caps (4–5 cells deep) of condensed metanephric mesenchyme surrounding the duct tips of the mouse kidney. Aggregates of 6–8 cells are first seen at ∼E12.5–12.75 immediately proximal to this cap, closely abutting the duct surface. As the tip advances, NCAM expression is maintained in the cap but is otherwise restricted to aggregates whose cells rapidly epithelialise, forming tubules that invade the duct epithelium. Pax2 expression studies shows how the rind of nephrogenic blastemal cells forms: as duct tips extend towards the kidney surface, the associated Pax2+ cells form patches of cells on the kidney surface. These observations revise our knowledge of the timing and process of nephron initiation.
A 9-year-old boy with dyskinetic cerebral palsy secondary to neonatal encephalopathy is described. He presented with blurring of near vision which had begun to impact on his school work. Objective assessment of accommodation showed that very little was present, although convergence was almost normal. The near-vision symptoms were completely removed and reading dramatically improved with the provision of varifocal spectacles. Varifocal lenses provide an optimal correction for far, intermediate (i.e. for computer screens), and near distances (i.e. for reading). Managing this type of patient with varifocal spectacles has not been previously reported. It is clearly very important to prescribe an optimal spectacle correction to provide clear vision to optimize learning.
The National Council of Jewish Women (NCJW) was “my only hope ” recalled a German-Jewish refugee in 1940.1 “Walter ” was one of a few thousand German-Jewish refugees from Nazism who emigrated to the United States between 1933 and 1941. Council intervention even helped a few Jews escape Europe in the years before the United States entered the war. The NCJW located refugees' relatives trapped in Europe and attempted to secure their release. In some cases, they succeeded.
Most of the NCJW's war work, however, was devoted to protecting thousands of refugees as soon as they put foot on American docks. When German-Jewish refugees first arrived in the United States, a National Council of Jewish Women social worker or volunteer was often the first person to greet them upon arrival. The NCJW helped these émigréss find a home, employment, and social services; educated them in American customs and citizenship requirements; and lobbied tirelessly for legislation to lift immigrant quotas, ease naturalization requirements, and protect aliens' legal rights.
Despite these accomplishments, this chapter suggests that NCJW members were severely hampered by their status as women, Jews, and of German origin. United States government agencies and male Jewish leadership severely restricted the Council's activities, and the NCJW nearly tore itself apart through its own internal disagreements and conflicts with other agencies.
Multipatient use and prolonged use of prefilled disposable oxygen humidifier bottles (Aquapak 301, Respiratory Care, Inc., Arlington Heights, IL) were evaluated by performing microbiologic monitoring and a cost analysis on bottles used for varying numbers of patients and lengths of time.
Humidifiers were hung for a maximum of one month. Monitoring was conducted in 6 different nursing areas. Quantitative cultures were done for aerobes and Legionella. Reusable humidifier bottles also were monitored.
Cultures were obtained from 1,311 disposable and 60 reusable humidifiers. No significant bacterial contamination was detected in the prefilled disposable oxygen humidifier units. Ten percent of the reusable bottles were contaminated by organisms associated with skin flora.
Multipatient use and increased duration of use of disposable humidifiers result in cost savings without increasing patient risk. Restricted multipatient use of prefilled disposable oxygen humidifier bottles for a period of one month is a safe and cost-efficient practice.