Logan Regional Hospital

A basic consideration in the evaluation of professional medical literature is being able to understand the statistical analysis presented. One of the more frequently reported statistical methods involves correlation analysis where a correlation coefficient is reported representing the degree of linear association between two variables. This article discusses the basic aspects of correlation analysis with examples given from professional journals and focuses on the interpretations and limitations of the correlation coefficient. No attention was given to the actual calculation of this statistical value.

Japanese encephalitis (JE) is an infectious disease of the central nervous system caused by Japanese encephalitis virus (JEV), a zoonotic mosquito-borne flavivirus. JEV is prevalent in much of Asia and the Western Pacific, with over 4 billion people living at risk of infection. In the absence of antiviral intervention, vaccination is the only strategy to develop long-term sustainable protection against JEV infection. Over the past half-century, a mouse brain-derived inactivated vaccine has been used internationally for active immunization. To date, however, JEV is still a clinically important, emerging, and re-emerging human pathogen of global significance. In recent years, production of the mouse brain-derived vaccine has been discontinued, but 3 new cell culture-derived vaccines are available in various parts of the world. Here we review current aspects of JEV biology, summarize the 4 types of JEV vaccine, and discuss the potential of an infectious JEV cDNA technology for future vaccine development.

The article describes some of the ongoing problems psychiatric patients encounter on a daily basis as perceived by an individual who has lived with schizophrenia for more than 25 years. Specific carefully planned coping strategies which are seen as critical to the recovery process are presented.

The influence of a physical therapy program on pain and patellar tracking was investigated clinically and radiologically with tangential views in 51 knees with lateral patellar compression syndrome. A pretest-posttest design was used to evaluate physical measurements of patellar alignment in subjects who had had patellofemoral pain for a minimum of 6 weeks. Eighty-four percent of the subjects were pain-free after an average of 8 weeks of rehabilitation or 11 physical therapy visits, with a mean quadriceps strength to total body weight ratio of 61% in women and 86% in men. The pretest-posttest difference in Merchant's congruence angle was significant at a probability of 0.0066 in the patients who were pain-free after exercise, demonstrating less lateral patellar tracking. The pretest-posttest difference in iliotibial band flexibility was significant at a probability of 0.0017, with the patients who were pain-free after exercise becoming more flexible. No significant differences were observed from before to after exercise in the patellofemoral index, Q angle, hamstring flexibility, thigh measurement, sclerotic subchondral bone, or sulcus angle. We were unable to predict which subjects would become pain-free with exercise by patellar position because the group that improved began more laterally tilted. The results of this study indicate that patellar tracking is improved with vastus medialis oblique strengthening, iliotibial band stretching, and joint mobility exercise in the majority of subjects with lateral patellar compression syndrome.

Sport hunting has provided important economic incentives for conserving large predators since the early 1970's, but wildlife managers also face substantial pressure to reduce depredation. Sport hunting is an inherently risky strategy for controlling predators as carnivore populations are difficult to monitor and some species show a propensity for infanticide that is exacerbated by removing adult males. Simulation models predict population declines from even moderate levels of hunting in infanticidal species, and harvest data suggest that African countries and U.S. states with the highest intensity of sport hunting have shown the steepest population declines in African lions and cougars over the past 25 yrs. Similar effects in African leopards may have been masked by mesopredator release owing to declines in sympatric lion populations, whereas there is no evidence of overhunting in non-infanticidal populations of American black bears. Effective conservation of these animals will require new harvest strategies and improved monitoring to counter demands for predator control by livestock producers and local communities.

As part of the ALOHA‐93 campaign a high performance all‐sky CCD imaging system was operated at Haleakala Crater, Maui, to obtain novel information on the properties and sources of short period gravity waves over an extended height range ∼80–100 km. Sequential observations of the near infrared OH and O 2 (0,1) bands and the visible wavelength OI(557.7 nm) and Na(589.2 nm) line emissions have enabled a unique comparison of the morphology and dynamics of the wave motions and their occurrence frequency at each emission altitude to be made. Two major findings are: (a) the detection of significantly higher amounts of wave structure at OI altitudes (∼96 km) compared with that in the OH emission (∼87 km) and (b) the discovery of an unusual morphology, small‐scale wave pattern that was most conspicuous in the OI emission and essentially absent at OH heights. These data provide strong evidence for the presence of ducted wave motions in the lower thermosphere.

PURPOSE: The TAPUR Study is a phase II basket trial that aims to identify signals of antitumor activity of commercially available targeted agents in patients with advanced cancers harboring genomic alterations known to be drug targets. Results in a cohort of patients with metastatic breast cancer (mBC) with high tumor mutational burden (HTMB) treated with pembrolizumab are reported. METHODS: Patients with advanced mBC received standard doses of either 2 mg/kg or 200 mg infusions of pembrolizumab every 3 weeks. Simon's two-stage design was used with a primary study end point of disease control (DC) defined as objective response or stable disease of at least 16 weeks duration. If two or more patients in stage I achieved DC, the cohort would enroll 18 additional patients in stage II. Secondary end points include progression-free survival (PFS), overall survival, and safety. RESULTS: Twenty-eight patients were enrolled from October 2016 to July 2018. All patients' tumors had HTMB ranging from 9 to 37 mutations/megabase. DC and objective response were noted in 37% (95% CI, 21 to 50) and 21% of patients (95% CI, 8 to 41), respectively. Median PFS was 10.6 weeks (95% CI, 7.7 to 21.1); median overall survival was 30.6 weeks (95% CI, 18.3 to 103.3). No relationship was observed between PFS and tumor mutational burden. Five patients experienced ≥ 1 serious adverse event or grade 3 adverse event at least possibly related to pembrolizumab consistent with the product label. CONCLUSION: Pembrolizumab monotherapy has antitumor activity in heavily pretreated patients with mBC characterized by HTMB. Our findings support the recent US Food and Drug Administration approval of pembrolizumab for treatment of patients with unresectable or metastatic solid tumors with HTMB without alternative treatment options.

Journal Article Aldo Leopold: His Life and Work Get access Aldo Leopold: His Life and Work. By Meine Curt. (Madison: University of Wisconsin Press, 1988. xv + 638 pp. Illustrations, notes, bibliography, index. $29.50). Allen Stokes, Allen Stokes Logan, Utah Search for other works by this author on: Oxford Academic Google Scholar Alice Stokes Alice Stokes Logan, Utah Search for other works by this author on: Oxford Academic Google Scholar Western Historical Quarterly, Volume 20, Issue 3, August 1989, Pages 339–340, https://doi.org/10.2307/969548 Published: 01 August 1989

Traditionally, mouse humanization studies have used human fecal transfer to germ-free animals. This practice requires gnotobiotic facilities and is restricted to gnotobiotic mouse lines, which limits humanized mouse research. We have developed a generalizable method to humanize non germ-free mice using antibiotic treatment and human fecal transfer. The method involves depleting resident intestinal microbiota with broad-spectrum antibiotics, introducing human microbiota from frozen fecal samples by weekly gavage, and maintaining mice in HEPA-filtered microisolator cages. Pyrosequencing cecal microbiota 16S rRNA genes showed that recipient mice adopt a humanized microbiota profile analogous to their human donors, and distinct from mice treated with only antibiotics (no fecal transfer) or untreated control mice. In the humanized mice, 75% of the sequence mass was observed in their respective human donor and conversely, 68% of the donor sequence mass was recovered in the recipient mice. Principal component analyses of GC- and HPLC-separated cecal metabolites were performed to determine effects of transplanted microbiota on the metabolome. Cecal metabolite profiles of mice treated with only antibiotics (no fecal transfer) and control mice were dissimilar from each other and from humanized mice. Metabolite profiles for mice humanized from different donor samples clustered near each other, yet were sufficiently distinct that separate clusters were apparent for each donor. Also, cecal concentrations of 57 metabolites were significantly different between humanization treatments. These data demonstrate that our protocol can be used to humanize non germ-free mice and is sufficiently robust to generate metabolomic differences between mice humanized from different human donors.

The cost-effectiveness of treating hypertension at the patient's place of work was compared in a randomized controlled trial with care delivered in a community. The average total cost per patient for worksite care in this 12-month study was not significantly different from that for regular care ($242.86 +/- 6.94 vs $211.34 +/- 18.66, mean +/- SEM). The worksite health system cost was significantly more expensive ($197.36 +/- 4.99 vs $129.33 +/- 13.34, p less than 0.001) but the patient cost was significantly less ($45.40 +/- 3.23 vs $82.00 +/- 6.20, p less than 0.01). The mean reduction in diastolic blood pressure (BP) at the year-end assessment was significantly greater in the worksite group (12.1 +/- 0.6 vs 6.5 +/- 0.6 mm Hg, p less than 0.001). The incremental cost-effectiveness ratio of $5.63 per mm Hg for worksite care was less than the base cost-effectiveness ratio of $32.51 per mm Hg for regular care, indicating that the worksite program was substantially more cost-effective. Our findings support health policies that favor allocating resources to work-based hypertension treatment programs for the target group identified in this study.

Ski2-like RNA helicases are large multidomain proteins involved in a variety of RNA processing and degradation events. Recent structures of Mtr4, Ski2 and Brr2 provide our first view of these intricate helicases. Here we review these structures, which reveal a conserved ring-like architecture that extends beyond the canonical RecA domains to include a winged helix and ratchet domain. Comparison of apo- and RNA-bound Mtr4 structures suggests a role for the winged helix domain as a molecular hub that coordinates RNA interacting events throughout the helicase. Unique accessory domains provide expanded diversity and functionality to each Ski2-like family member. A common theme is the integration of Ski2-like RNA helicases into larger protein assemblies. We describe the central role of Mtr4 and Ski2 in formation of complexes that activate RNA decay by the eukaryotic exosome. The current structures provide clues into what promises to be a fascinating view of these dynamic assemblies.

Soft tissue fixation to bone is a basic technique of orthopaedic surgery for which a multitude of devices have been developed. A new class of orthopaedic devices termed "suture anchors" has been developed to secure soft tissues to bone using suture material. The suture anchor is designed to allow quick and secure fixation without the need for extensive exposure. This device was tested using in vitro and in vivo models and found to be comparable with standard transosseous and two-pronged stable techniques. This device should prove useful in allowing the versatility of suture fixation of soft tissues to bone without the technical requirements of constructing transosseous suture tunnels.

Streamflow disaggregation is used to preserve statistical attributes of time series across multiple sites and timescales. Several algorithms for spatial disaggregation and for disaggregation of annual to monthly flows are available. However, the disaggregation of monthly to daily or weekly to daily flows remains a challenge. A new algorithm is presented for simultaneously disaggregating monthly flows at a number of sites and daily flows at an index site to daily flows at a number of sites on a drainage network. The continuity of flow in time across months at each site as well as the intersite flow pattern are preserved. The disaggregated daily flows at the multiple sites are conditioned on the spatial (across site) pattern of monthly flows at the respective sites. The probability distribution of the vector of disaggregated flows conditional on the multisite monthly flows is approximated nonparametrically using the k nearest neighbors of the monthly spatial flow pattern. A constrained optimization problem is solved to adaptively estimate the disaggregated flows in space and time for each such neighborhood. An application to data from a tributary of the Colorado River is used to illustrate the modeling process.

Revegetation is perhaps the most efficient and practical means of returning lands disturbed by surface mining to a productive capability. The challenge now, in the face of expanding energy concerns, is to assure that revegetation techniques adequately provide the site protection stand- ards and other requirements imposed by society. Unfortu- nately, methods for assessing the success of revegetation are not well defined, nor are uniform standards available by which that success can be achieved. Normally, the relative success of revegetation is judged on the basis of a comparison of various attributes of vegetation with a reference area. However, complete standardization of methods of sampling vegetation is not available, and probably is not desirable, because no single method can satisfy all objectives.

Purpose The purpose of this study was to examine the influence of training at different ranges of motion during the squat exercise on joint-angle specific strength adaptations. Methods Twenty eight men were randomly assigned to one of three training groups, differing only in the depth of squats (quarter squat, half squat, and full squat) performed in 16-week training intervention. Strength measures were conducted in the back squat pre-, mid-, and post-training at all three depths. Vertical jump and 40-yard sprint time were also measured. Results Individuals in the quarter and full squat training groups improved significantly more at the specific depth at which they trained when compared to the other two groups (<i>p</i> < 0.05). Jump height and sprint speed improved in all groups (<i>p</i> < 0.05); however, the quarter squat had the greatest transfer to both outcomes. Conclusions Consistently including quarter squats in workouts aimed at maximizing speed and jumping power can result in greater improvements.

Floral nectar is prone to colonization by nectar-adapted yeasts and bacteria via air-, rain-, and animal-mediated dispersal. Upon colonization, microbes can modify nectar chemical constituents that are plant-provisioned or impart their own through secretion of metabolic by-products or antibiotics into the nectar environment. Such modifications can have consequences for pollinator perception of nectar quality, as microbial metabolism can leave a distinct imprint on olfactory and gustatory cues that inform foraging decisions. Furthermore, direct interactions between pollinators and nectar microbes, as well as consumption of modified nectar, have the potential to affect pollinator health both positively and negatively. Here, we discuss and integrate recent findings from research on plant-microbe-pollinator interactions and their consequences for pollinator health. We then explore future avenues of research that could shed light on the myriad ways in which nectar microbes can affect pollinator health, including the taxonomic diversity of vertebrate and invertebrate pollinators that rely on this reward. This article is part of the theme issue 'Natural processes influencing pollinator health: from chemistry to landscapes'.

Serial venous duplex scans (VDS) were done in 507 trauma patients with at least one risk factor (RF) for venous thromboembolism (VTE) during a 2-year study period. Deep vein thrombosis (DVT) was detected in 31 (6.1%) patients. This incidence was 3.1 per cent in low (1-2 RFs), 3.4 per cent in moderate (3-5 RFs), and 7.7 per cent in high (> or =6 RFs) VTE scores (P = 0.172). Incidence was statistically different (3% vs. 7.2%, P = 0.048) on reanalyzing patients in two risk categories, low-risk (1-4 RFs) and high-risk (> or =5 RFs). Only 4 of 16 RFs had statistically higher incidence of DVT in patients with or without RFs: previous VTE (27.3% vs. 5.6%, odds ratio (OR) 6.628, P = 0.024), spinal cord injury (22.6% vs. 5%, OR 5.493, P = 0.001), pelvic fractures (11.4% vs. 5.1%, OR 2.373, P = 0.042), and head injury with a greater than two Abbreviated Injury Score (10.5% vs. 4.2%, OR 2.639, P = 0.014). On reanalyzing patients with > or =5 RFs vs. <5RFs, obesity (14.3 vs. 6.1%, P = 0.007), malignancy (5.6% vs. 0.6%, P = 0.006), coagulopathy (10.8% vs. 1.8%, P = 0.000), and previous VTE (3.2% vs. 0%, P = 0.019) were significant on univariate analysis. Patients with DVT had 3.70 +/- 1.75 RFs and a 9.61 +/- 4.93 VTE score, whereas, patients without DVT had 2.66 +/- 1.50 RFs and a 6.83 +/- 3.91 VTE score (P = 0.000). DVTs had a direct positive relationship with higher VTE scores, length of stay, and number of VDS (>1 r, P < or = 0.001). Increasing age was a weak risk factor (0.03 r, P = 0.5). First two VDS diagnosed 77 per cent of DVTs. Patients with injury severity score of > or =15 and 25 had higher DVTs compared with the ones with lower injury severity score levels (P < or = 0.05). Pulmonary embolism was silent in 63 per cent and DVTs were asymptomatic in 68 per cent.

Systems of algebraic equations for a high-collisionality electron-ion plasma are constructed from the general moment equations with linearized collision operators [J.-Y. Ji and E. D. Held, Phys. Plasmas 13, 102103 (2006) and J.-Y. Ji and E. D. Held, Phys. Plasmas 15, 102101 (2008)]. A systematic geometric method is invented and applied to solve the system of equations to find closure and transport relations. It is known that some closure coefficients of Braginskii [S. I. Braginskii, Reviews of Plasma Physics (Consultants Bureau, New York, 1965), Vol. 1] are in error up to 65% for some finite values of x (cyclotron frequency × electron-ion collision time) and have significant error in the large-x limit [E. M. Epperlein and M. G. Haines, Phys. Fluids 29, 1029 (1986)]. In this work, fitting formulas for electron coefficients are obtained from the 160 moment (Laguerre polynomial) solution, which converges with increasing moments for x≤100 and from the asymptotic solution for large x-values. The new fitting formulas are practically exact (less than 1% error) for arbitrary x and Z (the ion charge number, checked up to Z = 100). The ion coefficients for equal electron and ion temperatures are moderately modified by including the ion-electron collision operator. When the ion temperature is higher than the electron temperature, the ion-electron collision and the temperature change terms in the moment equations must be kept. The ion coefficient formulas from 3 moment (Laguerre polynomial) calculations, precise to less than 0.4% error from the convergent values, are explicitly written.

Diapause is a physiological arrest of development ahead of adverse environmental conditions and is a critical phase of the life cycle of many insects. In bees, diapause has been reported in species from all seven taxonomic families. However, they exhibit a variety of diapause strategies. These different strategies are of particular interest since shifts in the phase of the insect life cycle in which diapause occurs have been hypothesized to promote the evolution of sociality. Here we provide a comprehensive evaluation of this hypothesis with phylogenetic analysis and ancestral state reconstruction (ASR) of the ecological and evolutionary factors associated with diapause phase. We find that social lifestyle, latitude and voltinism are significant predictors of the life stage in which diapause occurs. ASR revealed that the most recent common ancestor of all bees likely exhibited developmental diapause and shifts to adult, reproductive, or no diapause have occurred in the ancestors of lineages in which social behaviour has evolved. These results provide fresh insight regarding the role of diapause as a prerequisite for the evolution of sociality in bees.

Statistics published by the Federal Highway Administration indicate that maintenance and rehabilitation of highway pavements in the United States requires an expenditure of over $17 billion a year. In conventional visual and manual pavement distress analysis approaches inspectors traverse roads and stop and measure distress objects when they are found. Therefore, the conventional approaches are very costly, time consuming, dangerous, labor intensive, tedious, subjective, have a high degree of variability, are unable to provide meaningful quantitative information, and almost always lead to inconsistencies in distress detail over space and across evaluations. In this paper, a new pavement distress image-enhancement algorithm and a new analysis and classification algorithm are studied. The enhancement algorithm corrects nonuniform background illumination by calculating multiplication factors that eliminate the background lighting variations. The new pavement distress classification algorithm builds a data structure storing the geometry of the skeleton obtained from the thresholded image. This data structure is pruned, simplified, and aligned, yielding a set of features for distress classification; the number of distress objects, number of branch intersections, number of loops, relative sizes of branches in each direction, etc. The experimental results demonstrate that the proposed algorithm can precisely quantify geometrical and topological parameters, quickly accept new classification rules for classification, and accurately estimate the distress severity from the thresholded image.