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The aim of this study was to describe individuals seeking care for injury at a major emergency department (ED) in southern Puerto Rico in the months after Hurricane Maria on September 20, 2017.
After informed consent, we used a modified version of the Natural Disaster Morbidity Surveillance Form to determine why patients were visiting the ED during October 16, 2017–March 28, 2018. We analyzed visits where injury was reported as the primary reason for visit and whether it was hurricane-related.
Among 5 116 patients, 573 (11%) reported injury as the primary reason for a visit. Of these, 10% were hurricane-related visits. The most common types of injuries were abrasions, lacerations, and cuts (43% of all injury visits and 50% of hurricane-related visits). The most common mechanisms of injury were falls, slips, trips (268, 47%), and being hit by/or against an object (88, 15%). Most injury visits occurred during the first 3 months after the hurricane.
Surveillance after Hurricane Maria identified injury as the reason for a visit for about 1 in 10 patients visiting the ED, providing evidence on the patterns of injuries in the months following a hurricane. Public health and emergency providers can use this information to anticipate health care needs after a disaster.
The objective was to compare the performance of the updated Charlson comorbidity index (uCCI) and classical CCI (cCCI) in predicting 30-day mortality in patients with Staphylococcus aureus bacteraemia (SAB). All cases of SAB in patients aged ⩾14 years identified at the Microbiology Unit were included prospectively and followed. Comorbidity was evaluated using the cCCI and uCCI. Relevant variables associated with SAB-related mortality, along with cCCI or uCCI scores, were entered into multivariate logistic regression models. Global model fit, model calibration and predictive validity of each model were evaluated and compared. In total, 257 episodes of SAB in 239 patients were included (mean age 74 years; 65% were male). The mean cCCI and uCCI scores were 3.6 (standard deviation, 2.4) and 2.9 (2.3), respectively; 161 (63%) cases had cCCI score ⩾3 and 89 (35%) cases had uCCI score ⩾4. Sixty-five (25%) patients died within 30 days. The cCCI score was not related to mortality in any model, but uCCI score ⩾4 was an independent factor of 30-day mortality (odds ratio, 1.98; 95% confidence interval, 1.05–3.74). The uCCI is a more up-to-date, refined and parsimonious prognostic mortality score than the cCCI; it may thus serve better than the latter in the identification of patients with SAB with worse prognoses.
The Latino population in the United States is rapidly growing and faces profound health disparities; however, engagement of Latinos in biomedical research remains low. Our community-based participatory research partnership has recruited 2083 Spanish-speaking Latinos into 21 studies over 15 years. We sought to identify and describe the strategies we have used to successfully recruit and retain Spanish-speaking Latinos in research.
We abstracted and analyzed data from archived study notes, progress reports, team meeting minutes, and in-depth interviews conducted annually from community-based participatory research partnership members. We used a nominal group process to refine and prioritize strategies.
Overall, 13 recruitment strategies and 12 retention strategies emerged. These strategies relied on the creativity and perseverance of the study team and partners.
It is essential that we develop and disseminate effective recruitment and retention strategies that engage Latinos in biomedical research to reduce health disparities and promote health equity.
Carbon nanotubes (CNTs) were synthesized by Chemical Vapor Deposition (CVD) from diethyl ether, butanol, hexane and ethyl acetate. A quartz tube with a stainless steel tube catalyst core with 0.019 m diameter and 0.6 m large formed the reactor. To avoid combustion, argon was used as the carrier gas. Time process ranged 30 to 60 min. The range of CNTs synthesis temperature was 680-850 °C for different precursors. Scanning Electron Microscopy micrographs have demonstrated tangled CNTs growth in all samples, thus presenting difficult length measurement. The CNTs diameters from diethyl ether are 45-200 nm, butanol diameter range from 55-230 nm, hexane diameter range is 50-130 nm and ethyl acetate range from 100 to 300 nm. Carbon content for all samples was higher than 93 %, CNTs from butanol showed carbon concentration up to 99%. FTIR, Raman and X-Ray Spectroscopies spectra for all samples demonstrated the characteristics signals present in carbon nanotubes. This research proposes a simple, effective and innovative method to synthesize CNTs by CVD on iron stainless steel catalyst in combination with diethyl ether, ethyl acetate, butanol and hexane as precursors by applying the principles of green chemistry, sustainability and its ease to be scaled.
Due to the increased interest in preantral follicular physiology, non-invasive retrieval and morphological classification are crucial. Therefore, this study aimed: (1) to standardize a minimally invasive isolation protocol, applicable to three ruminant species; (2) to morphologically classify preantral follicles upon retrieval; and (3) to describe morphological features of freshly retrieved follicles compared with follicle characteristics using invasive methods. Bovine, caprine and ovine ovarian cortex strips were retrieved from slaughterhouse ovaries and dispersed. This suspension was filtered, centrifuged, re-suspended and transferred to a Petri dish, to which 0.025 mg/ml neutral red (NR) was added to assess the viability of the isolated follicles. Between 59 and 191 follicles per follicle class and per species were collected and classified by light microscopy, based on follicular cell morphology. Subsequently, follicle diameters were measured. The proposed isolation protocol was applicable to all three species and showed a significant, expected increase in diameter with developmental stage. With an average diameter of 37 ± 5 μm for primordial follicles, 47 ± 6.3 μm for primary follicles and 67.1 ± 13.1 μm for secondary follicles, no significant difference in diameter among the three species was observed. Bovine, caprine and ovine follicles (63, 59 and 50% respectively) were graded as viable upon retrieval. Using the same morphological characteristics as determined by invasive techniques [e.g. haematoxylin–eosin (HE) sections], cumulus cell morphology and follicle diameter could be used routinely to classify freshly retrieved follicles. Finally, we applied a mechanical, minimally invasive, follicle isolation protocol and extended it to three ruminant species, yielding viable preantral follicles without compromising further in vitro processing and allowing routine follicle characterization upon retrieval.
To test the hypothesis that cognitive impairment in older adults is associated with all-cause mortality risk and the risk increases when the degree of cognitive impairment augments; and then, if this association is confirmed, to report the population-attributable fraction (PAF) of mortality due to cognitive impairment.
A representative random community sample of individuals aged over 55 was interviewed, and 4557 subjects remaining alive at the end of the first year of follow-up were included in the analysis. Instruments used in the assessment included the Mini-Mental Status Examination (MMSE), the History and Aetiology Schedule (HAS) and the Geriatric Mental State (GMS)-AGECAT. For the standardised degree of cognitive impairment Perneczky et al's MMSE criteria were applied. Mortality information was obtained from the official population registry. Multivariate Cox proportional hazard models were used to test the association between MMSE degrees of cognitive impairment and mortality risk. We also estimated the PAF of mortality due to specific MMSE stages.
Cognitive impairment was associated with mortality risk, the risk increasing in parallel with the degree of cognitive impairment (Hazard ratio, HR: 1.18 in the ‘mild’ degree of impairment; HR: 1.29 in the ‘moderate’ degree; and HR: 2.08 in the ‘severe’ degree). The PAF of mortality due to severe cognitive impairment was 3.49%.
A gradient of increased mortality-risk associated with severity of cognitive impairment was observed. The results support the claim that routine assessment of cognitive function in older adults should be considered in clinical practice.
Recently, bimetallic nanostructures and nanoalloys have received special interest due to their promising chemical and physical properties. Specifically, Cu-Ni nanoparticles have been investigated for biomedical and catalytic applications. This work reports the synthesis of alloys and bimetallic nanoparticles of CuxNi100-x (x = 20, 40, 50, 60 and 80) by sol-gel method, and their morphological, structural and magnetic characterization. A precursor material was prepared using a standard Pechini method and then CuNi nanoparticles were obtained by calcination treatments of the precursor in H2/N2atmosphere at 600 and 700°C for 15 minutes. The resulting nanoparticles were characterized by X-ray diffraction (XRD), which reveals that this method led to the formation of CuNi substitutional nanoalloys and bimetallic nanoparticles with good cristallinity related with the calcination temperatures and Cu:Ni weight ratios. Transmission electron microscopy (TEM) shows nearly monodisperse and uniform spherical nanoparticles with sizes between 40 and 70 nm. The magnetic properties were studied using SQUID magnetometry, according with these results, the CuNi nanoparticles showed a ferromagnetic behavior, the magnetization value increases as a function of the weight percentage of Ni.
Dendrons with dodecyl ended groups joined benzyloxy moieties were attached to a cyclotriveratrylene core. The dendrimers were used in Diederich cyclopropanation reaction with the fullerene C60. The structure of the synthesized dendrimers was confirmed by 1H- and 13C-NMR, MALDI-TOF mass spectrometry and elemental analysis.
Dendrons with a porphyrin core and π-conjugated dendron branches have been synthesized and characterized. The dendrons showed an all trans configuration. Cubic non-linear optical behavior of the styryl and porphyrin-containing dendrimers was tested viaZ-Scan measurements in spin-coated film samples.
Here we present the detection of a gene cluster for Neospora caninum surface genes, similar to the Toxoplasma gondii SRS9 locus, and the cloning and characterization of the NcSRS9 gene. PCR genome walking, using NcBSR4 gene as a framework, allows the identification, upstream NcBSR4, of 2 sequences homologous to the SRS5 and the Ubiquinol-cytochrome C reductase genes and, downstream NcBSR4, of an ORF of 1191 bp coding for a 396-amino acid polypeptide with 59% similarity to the TgSRS9 antigen. A putative 39-residue signal peptide was found at the NH2-terminus followed by a hydrophilic region, and a potential site for a glycosylphosphatidylinositol anchor at the COOH-terminus. A recombinant NcSRS9 protein was produced and was recognized on a Western blot by a low proportion of sera from a panel of naturally infected cows and calves. In addition, Western blot analysis using polyclonal anti-rNcSRS9 revealed stage-specific expression of NcSRS9 in bradyzoites but not in tachyzoites, and immunohistochemistry on brain from a congenitally infected calf showed NcSRS9 recognition in bradyzoites contained in tissue cysts. However, bradyzoite-specific expression of NcSRS9 could not be proven by immunofluorescence on bradyzoites obtained in vitro and RT-PCR analysis showed no significant variations of NcSRS9 transcripts during in vitro tachyzoite-bradyzoite switch, probably due to incomplete maturity of in vitro bradyzoites. Initial characterization of NcSRS9 in this study may lead to further studies for a better understanding of N. caninum persistence.
The correlation between the structural and optical properties of Si nanocrystals embedded in SiO2 is the key factor to understand their emission mechanism. However, there is a great difficulty in imaging Si nanocrystals in SiO2 and measuring their size distribution because of the lack of contrast in electron microscopy. We have used here a new method for imaging Si nanocrystals by using high resolution electron microscopy in conjunction with conventional electron microscopy in dark field conditions. Regarding the optical properties, the band-gap energies and photoluminescence have been measured by direct and independent methods. The results have allowed experimental determination, for the first time in this material, of the experimental Stokes shift between absorption and emission as a function of crystallite size. The experimental band-gap versus size correlates well with the most accurate theoretical predictions. Moreover, the photoluminescence energy emission versus crystallite size shows a parallel behaviour to that of band-gap energy. Consequently, the experimental Stokes shift is independent of nanocrystal size and is found to be 0.26±0.03 eV. This value is almost twice the energy of the Si-O vibration (0.134 eV). These results suggest that the dominant emission of Si nanocrystals passivated with SiO2 is a fundamental transition spatially located at the Si-SiO2 interface and with the assistance of a local Si-O vibration.
We present a computer simulation of the problem of competitive crystal growth of one-dimensional and two-dimensional single crystals restricted to a two-dimensional space. Two similar competition indexes ξ and χ accounting for the degree of preferred orientation developped during the growth process are defined and we show that they varies linearly with the film thickness. The existence of a clear formal similarity between ξ and χ indexes defined in the direct space with a textural index τ defined in the reciprocal space permits the identification of a competitive growth process by X-ray diffraction.
The fraction of soluble and insoluble fiber was determinate by AOAC International official method for dietary fiber in four varieties of Bamboo called Guadua Angustifolia Kunth. The elastic modulus of the four bamboo varieties was determined using an universal machine INSTROM 4401 based on the ASTM standard method D-143. Finally, the fiber content and the mechanical behavior were correlated using the Pearson coefficient calculated by statistical package STATGRAPHICS 5.1 The fiber content is the main factor responsible for the bamboo mechanical properties. The results show that the all fiber content into the bamboo culms is related with the mechanical behavior. These results confirm that the Guadua Bamboo is a natural composite material with aligned fibers embedded in a matrix formed by soluble fiber.
The behavioral consequences of pregnancy in goats were studied to test the hypothesis that pregnant females on rangeland select a diet richer in nutrients once the demands of gestation increase, and that nutrient content in goat diets changes with the grazing season. A total of 12 mature mixed breed goats either pregnant (n = 6) or non-pregnant (n = 6) were used during the dry period (February to May). Dietary samples obtained from the oral cavity of grazing goats (restrained with a short light rope permanently tightened around their neck) were used for chemical analyses. Across months, pregnant goats selected diets higher (P < 0.01) in crude protein (CP) than non-pregnant goats; this nutrient did not meet the requirements of late gestating goats. Pregnant goats made use of less (P < 0.01) fibrous feeds than non-pregnant goats. In order to cope with changing nutrient demands for pregnancy, goats adjusted their diet by increasing the selection of plants with 32% higher calcium content compared to forages selected by non-pregnant goats. The physiological state of goats did not alter the levels of phosphorus (P), magnesium (Mg) and sodium (Na) in their diets; these minerals were adequate to meet the demands of pregnancy. There were no effects of physiological state on concentrations of copper (Cu), zinc (Zn), manganese (Mn) and iron (Fe) in the goat diets during the dry season, with levels adequate for sustainability of pregnancy. Pregnant goats did not seek forages lower in tannins, alkaloids, saponins and terpenes. It was concluded that to cope with increasing pregnancy costs, goats adjusted their diets increasing selection of forages or plant parts with high nutritional value to maximize their net nutrient budget.
Background: Aphasia, one of the core symptoms of cortical dementia, is routinely evaluated using graded naming tests like the Boston Naming Test (BNT). However, the application of this 60-item test is time-consuming and shortened versions have been devised for screening. The hypothesis of this research is that a specifically designed shortened version of the BNT could replace the original 60-item BNT as part of a mini-battery for screening for dementia. The objective of this study was to design a short version of the BNT for a rural population in Galicia (Spain).
Methods: A clinic group of 102 patients including 43 with dementia was recruited along with 78 healthy volunteers. The clinic and control groups were scored on the Spanish version of the Mini-mental State Examination (MMSE) and BNT. In addition, the clinic group was tested with standard neuropsychological instruments and underwent brain investigations and routine neurological examination. BNT items with specificity and sensitivity above 0.5 were selected to compose a short battery of 11 pictures named BNTOu11. ANOVA and mean comparisons were made for MMSE and BNT versions. Receiver operating characteristics (ROC) curves and internal consistency were calculated.
Results: Areas under ROC curves (AUC) did not show statistically significant differences; therefore BNTOu11's AUC (0.814) was similar to the 60-item BNT versions (0.785 and 0.779), to the short versions from Argentina (0.772) and Andalusia (0.799) and to the Spanish MMSE (0.866). BNTOu11 had higher internal consistency than the other short versions.
Conclusions: BNTOu11 is a useful and time-saving method as part of a battery for screening for dementia in a psychogeriatric outpatient unit.