Endemic tuberculosis, the homeless, and public transportation: A merging of geographical information systems surveillance and the Houston Tuberculosis Initiative Surveillance project

To reach the goals established by the Institute of Medicine (IOM) and the Centers for Disease Control's (CDC) STOP TB USA, measures must be taken to curtail a future peak in Tuberculosis (TB) incidence and speed the currently stagnant rate of TB elimination. Both efforts will require, at minimum, the consideration and understanding of the third dimension of TB transmission: the location-based spread of an airborne pathogen among persons known and unknown to each other. This consideration will require an elucidation of the areas within the U.S. that have endemic TB. The Houston Tuberculosis Initiative (HTI) was a population-based active surveillance of confirmed Houston/Harris County TB cases from 1995–2004. Strengths in this dataset include the molecular characterization of laboratory confirmed cases, the collection of geographic locations (including home addresses) frequented by cases, and the HTI time period that parallels a decline in TB incidence in the United States (U.S.). The HTI dataset was used in this secondary data analysis to implement a GIS analysis of TB cases, the locations frequented by cases, and their association with risk factors associated with TB transmission. ^ This study reports, for the first time, the incidence of TB among the homeless in Houston, Texas. The homeless are an at-risk population for TB disease, yet they are also a population whose TB incidence has been unknown and unreported due to their non-enumeration. The first section of this dissertation identifies local areas in Houston with endemic TB disease. Many Houston TB cases who reported living in these endemic areas also share the TB risk factor of current or recent homelessness. Merging the 2004–2005 Houston enumeration of the homeless with historical HTI surveillance data of TB cases in Houston enabled this first-time report of TB risk among the homeless in Houston. The homeless were more likely to be US-born, belong to a genotypic cluster, and belong to a cluster of a larger size. The calculated average incidence among homeless persons was 411/100,000, compared to 9.5/100,000 among housed. These alarming rates are not driven by a co-infection but by social determinants. The unsheltered persons were hospitalized more days and required more follow-up time by staff than those who reported a steady housing situation. The homeless are a specific example of the increased targeting of prevention dollars that could occur if TB rates were reported for specific areas with known health disparities rather than as a generalized rate normalized over a diverse population. ^ It has been estimated that 27% of Houstonians use public transportation. The city layout allows bus routes to run like veins connecting even the most diverse of populations within the metropolitan area. Secondary data analysis of frequent bus use (defined as riding a route weekly) among TB cases was assessed for its relationship with known TB risk factors. The spatial distribution of genotypic clusters associated with bus use was assessed, along with the reported routes and epidemiologic-links among cases belonging to the identified clusters. ^ TB cases who reported frequent bus use were more likely to have demographic and social risk factors associated with poverty, immune suppression and health disparities. An equal proportion of bus riders and non-bus riders were cultured for Mycobacterium tuberculosis, yet 75% of bus riders were genotypically clustered, indicating recent transmission, compared to 56% of non-bus riders (OR=2.4, 95%CI(2.0, 2.8), p<0.001). Bus riders had a mean cluster size of 50.14 vs. 28.9 (p<0.001). Second order spatial analysis of clustered fingerprint 2 (n=122), a Beijing family cluster, revealed geographic clustering among cases based on their report of bus use. Univariate and multivariate analysis of routes reported by cases belonging to these clusters found that 10 of the 14 clusters were associated with use. Individual Metro routes, including one route servicing the local hospitals, were found to be risk factors for belonging to a cluster shown to be endemic in Houston. The routes themselves geographically connect the census tracts previously identified as having endemic TB. 78% (15/23) of Houston Metro routes investigated had one or more print groups reporting frequent use for every HTI study year. We present data on three specific but clonally related print groups and show that bus-use is clustered in time by route and is the only known link between cases in one of the three prints: print 22. (Abstract shortened by UMI.)^

HPV knowledge, HPV vaccine awareness and initiation among Hispanics: The role of language, information seeking, and information scanning

Background. Among Hispanics, the HPV vaccine has the potential to eliminate disparities in cervical cancer incidence and mortality but only if optimal rates of vaccination are achieved. Media can be an important information source for increasing HPV knowledge and awareness of the vaccine. Very little is known about how media use among Hispanics affects their HPV knowledge and vaccine awareness. Even less is known about what differences exist in media use and information processing among English- and Spanish-speaking Hispanics.^ Aims. Examine the relationships between three health communication variables (media exposure, HPV-specific information scanning and seeking) and three HPV outcomes (knowledge, vaccine awareness and initiation) among English- and Spanish-speaking Hispanics.^ Methods. Cross-sectional data from a survey administered to Hispanic mothers in Dallas, Texas was used for univariate and multivariate logistic regression analyses. Sample used for analysis included 288 mothers of females aged 8-22 recruited from clinics and community events. Dependent variables of interest were HPV knowledge, HPV vaccine awareness and initiation. Independent variables were media exposure, HPV-specific information scanning and seeking. Language was tested as an effect modifier on the relationship between health communication variables and HPV outcomes.^ Results. English-speaking mothers reported more media exposure, HPV-specific information scanning and seeking than Spanish-speakers. Scanning for HPV information was associated with more HPV knowledge (OR = 4.26, 95% CI = 2.41 - 7.51), vaccine awareness (OR = 10.01, 95% CI = 5.43 - 18.47) and vaccine initiation (OR = 2.54, 95% CI = 1.09 - 5.91). Seeking HPV-specific information was associated with more knowledge (OR = 2.27, 95% CI = 1.23 - 4.16), awareness (OR = 6.60, 95% CI = 2.74 - 15.91) and initiation (OR = 4.93, 95% CI = 2.64 - 9.20). Language moderated the effect of information scanning and seeking on vaccine awareness.^ Discussion. Differences in information scanning and seeking behaviors among Hispanic subgroups have the potential to lead to disparities in vaccine awareness.^ Conclusion. Findings from this study underscore health communication differences among Hispanics and emphasize the need to target Spanish language media as well as English language media aimed at Hispanics to improve knowledge and awareness.^

Women’s experiences with the use of medical abortion in a legally restricted context: the case of Argentina

This article presents the findings of a qualitative study exploring the experiences of women living in Buenos Aires Metropolitan Area, Argentina, with the use of misoprostol for inducing an abortion. We asked women about the range of decisions they had to make, their emotions, the physical experience, strategies they needed to use, including seeking health care advice and in dealing with a clandestine medical abortion, and their overall evaluation of the experience. An in-depth interview schedule was used. The women had either used misoprostol and sought counselling or care at a public hospital (n=24) or had used misoprostol based on the advice of a local hotline, information from the internet or from other women (n=21). Four stages in the women’s experiences were identified: how the decision to terminate the pregnancy was taken, how the medication was obtained, how the tablets were used, and reflections on the outcome whether or not they sought medical advice. Safety and privacy were key in deciding to use medical abortion. Access to the medication was the main obstacle, requiring a prescription or a friendly drugstore. Correct information about the number of pills to use and dosage intervals was the least easy to obtain and caused concerns. The possibility of choosing a time of privacy and having the company of a close one was highlighted as a unique advantage of medical abortion. Efforts to improve abortion law, policy and service provision in Argentina in order to ensure the best possible conditions for use of medical abortion by women should be redoubled.

Firms' use of FTA schemes in exporting and importing : is there a two-way relationship?

In this paper, we examine the roles of firm size in the use of FTA schemes in exporting and importing. Also, it is investigated as to whether FTA users in importing (exporting) are more likely to use FTA schemes in exporting (importing). To do that, we employed a unique survey in which the detailed information on FTA use is available for Japanese affiliates in ASEAN. Our findings are summarized as follows. First, firm size matters in the use of FTA schemes only in exporting, not in importing. Second, the past experience of FTA use in exporting (importing) does not help firms use the FTA schemes in importing (exporting). Thus, it is necessary to assist firms to use FTA schemes in exporting even if they are already using FTA schemes in importing.

Combined use of gliadins and SSRs to analyse the genetic variability of the Spanish collection of cultivated diploid wheat (Triticum monococcum L. ssp. monococcum)

This work studied the combined use of gliadins and SSRs to analyse inter- and intra-accession variability of the Spanish collection of cultivated einkorn (Triticum monococcum L. ssp. monococcum) maintained at the CRF-INIA. In general, gliadin loci presented higher discrimination power than SSRs, reflecting the high variability of the gliadins. The loci on chromosome 6A were the most polymorphic with similar PIC values for both marker systems, showing that these markers are very useful for genetic variability studies in wheat. The gliadin results indicated that the Spanish einkorn collection possessed high genetic diversity, being the differentiation large between varieties and small within them. Some associations between gliadin alleles and geographical and agro-morphological data were found. Agro-morphological relations were also observed in the clusters of the SSRs dendrogram. A high concordance was found between gliadins and SSRs for genotype identification. In addition, both systems provide complementary information to resolve the different cases of intra-accession variability not detected at the agro-morphological level, and to identify separately all the genotypes analysed. The combined use of both genetic markers is an excellent tool for genetic resource evaluation in addition to agro-morphological evaluation.

Approach to the use of indicators for the assessment of the environmental level of construction products

The European construction industry is supposed to consume the 40% of the natural European resources and to generate the 40% of the European solid waste. Conscious of the great damage being suffered by the environment because of construction activity, this work tries to provide the building actors with a new tool to improve the current situation. The tool proposed is a model for the comprehensive evaluation of construction products by determining their environmental level. In this research, the environmental level of a construction product has been defined as its quality of accomplishing the construction requirements needed by causing the minimum ecological impact in its surrounding environment. This information allows building actors to choose suitable materials for building needs and also for the environment, mainly in the project stage or on the building site, contributing to improve the relationship between buildings and environment. For the assessment of the environmental level of construction products, five indicators have been identified regarding their global environmental impact through the product life cycle: CO2 emissions provoked during their production, volume and toxicity of waste generated on the building site, durability and recycling capacity after their useful life. Therefore, the less environmental impact one construction product produces, the higher environmental level performs. The model has been tested in 30 construction products that include environmental criteria in their description. The results obtained will be discussed in this article. Furthermore, this model can lay down guidelines for the selection of ecoefficient construction products and the design of new eco-competitive and eco-committed ones

An example of Learning based on competences: Use of Maxima in Linear Algebra for Engineers

This paper analyzes the role of Computer Algebra Systems (CAS) in a model of learning based on competences. The proposal is an e-learning model Linear Algebra course for Engineering, which includes the use of a CAS (Maxima) and focuses on problem solving. A reference model has been taken from the Spanish Open University. The proper use of CAS is defined as an indicator of the generic ompetence: Use of Technology. Additionally, we show that using CAS could help to enhance the following generic competences: Self Learning, Planning and Organization, Communication and Writing, Mathematical and Technical Writing, Information Management and Critical Thinking.

Mutual Information and Perplexity based Clustering of Dialogue Information for Dynamic Adaptation of Language Models

We present two approaches to cluster dialogue-based information obtained by the speech understanding module and the dialogue manager of a spoken dialogue system. The purpose is to estimate a language model related to each cluster, and use them to dynamically modify the model of the speech recognizer at each dialogue turn. In the first approach we build the cluster tree using local decisions based on a Maximum Normalized Mutual Information criterion. In the second one we take global decisions, based on the optimization of the global perplexity of the combination of the cluster-related LMs. Our experiments show a relative reduction of the word error rate of 15.17%, which helps to improve the performance of the understanding and the dialogue manager modules.

Use of prediction methods for patent and trademark applications in Spain

Patent and trademark offices which run according to principles of new management have an inherent need for dependable forecasting data in planning capacity and service levels. The ability of the Spanish Office of Patents and Trademarks to carry out efficient planning of its resource needs requires the use of methods which allow it to predict the changes in the number of patent and trademark applications at different time horizons. The approach for the prediction of time series of Spanish patents and trademarks applications (1979e2009) was based on the use of different techniques of time series prediction in a short-term horizon. The methods used can be grouped into two specifics areas: regression models of trends and time series models. The results of this study show that it is possible to model the series of patents and trademarks applications with different models, especially ARIMA, with satisfactory model adjustment and relatively low error.

Mutual Information and Perplexity based Clustering of Dialogue Information for Dynamic Adaptation of Language Models

We present two approaches to cluster dialogue-based information obtained by the speech understanding module and the dialogue manager of a spoken dialogue system. The purpose is to estimate a language model related to each cluster, and use them to dynamically modify the model of the speech recognizer at each dialogue turn. In the first approach we build the cluster tree using local decisions based on a Maximum Normalized Mutual Information criterion. In the second one we take global decisions, based on the optimization of the global perplexity of the combination of the cluster-related LMs. Our experiments show a relative reduction of the word error rate of 15.17%, which helps to improve the performance of the understanding and the dialogue manager modules.

Design of a training tool for improving the use of hand-held detectors in humanitarian demining

Purpose – The purpose of this paper is to introduce the design of a training tool intended to improve deminers' technique during close-in detection tasks. Design/methodology/approach – Following an introduction that highlights the impact of mines and improvised explosive devices (IEDs), and the importance of training for enhancing the safety and the efficiency of the deminers, this paper considers the utilization of a sensory tracking system to study the skill of the hand-held detector expert operators. With the compiled information, some critical performance variables can be extracted, assessed, and quantified, so that they can be used afterwards as reference values for the training task. In a second stage, the sensory tracking system is used for analysing the trainee skills. The experimentation phase aims to test the effectiveness of the elements that compose the sensory system to track the hand-held detector during the training sessions. Findings – The proposed training tool will be able to evaluate the deminers' efficiency during the scanning tasks and will provide important information for improving their competences. Originality/value – This paper highlights the need of introducing emerging technologies for enhancing the current training techniques for deminers and proposes a sensory tracking system that can be successfully utilised for evaluating trainees' performance with hand-held detectors.

Comparative study about the use of two and three-dimensional methods in surface finishing characterization

The increasing number of works related to the surface texture characterization based on 3D information, makes convenient rethinking traditional methods based on two-dimensional measurements from profiles. This work compares results between measurements obtained using two and three-dimensional methods. It uses three kinds of data sources: reference surfaces, randomly generated surfaces and measured. Preliminary results are presented. These results must be completed trying to cover a wider number of possibilities according to the manufacturing process and the measurement instrumentation since results can vary quite significantly between them.

Mapping Genetic Diversity of Cherimoya (Annona cherimola Mill.): Application of Spatial Analysis for Conservation and Use of Plant Genetic Resources.

There is a growing call for inventories that evaluate geographic patterns in diversity of plant genetic resources maintained on farm and in species' natural populations in order to enhance their use and conservation. Such evaluations are relevant for useful tropical and subtropical tree species, as many of these species are still undomesticated, or in incipient stages of domestication and local populations can offer yet-unknown traits of high value to further domestication. For many outcrossing species, such as most trees, inbreeding depression can be an issue, and genetic diversity is important to sustain local production. Diversity is also crucial for species to adapt to environmental changes. This paper explores the possibilities of incorporating molecular marker data into Geographic Information Systems (GIS) to allow visualization and better understanding of spatial patterns of genetic diversity as a key input to optimize conservation and use of plant genetic resources, based on a case study of cherimoya (Annona cherimola Mill.), a Neotropical fruit tree species. We present spatial analyses to (1) improve the understanding of spatial distribution of genetic diversity of cherimoya natural stands and cultivated trees in Ecuador, Bolivia and Peru based on microsatellite molecular markers (SSRs); and (2) formulate optimal conservation strategies by revealing priority areas for in situ conservation, and identifying existing diversity gaps in ex situ collections. We found high levels of allelic richness, locally common alleles and expected heterozygosity in cherimoya's putative centre of origin, southern Ecuador and northern Peru, whereas levels of diversity in southern Peru and especially in Bolivia were significantly lower. The application of GIS on a large microsatellite dataset allows a more detailed prioritization of areas for in situ conservation and targeted collection across the Andean distribution range of cherimoya than previous studies could do, i.e. at province and department level in Ecuador and Peru, respectively.

Hybrid City. Learning to make cities through the daily use of the internet

The concept hybrid city responds to a series of real demands of liveability in cities in an information society as it integrates the physical and the virtual in an "augmented" reality by the everyday use of ICT and virtual social network.

Combine use of Selected Schizosaccharomyces pombe and Lachancea thermotolerans Yeast Strains as an Alternative to the Traditional Malolactic Fermentation in Red Wine Production

Most red wines commercialized in the market use the malolactic fermentationprocess in order to ensure stability from a microbiological point of view. In this secondfermentation, malic acid is converted into L-lactic acid under controlled setups. Howeverthis process is not free from possible collateral effects that on some occasions produceoff-flavors, wine quality loss and human health problems. In warm viticulture regions suchas the south of Spain, the risk of suffering a deviation during the malolactic fermentationprocess increases due to the high must pH. This contributes to produce wines with highvolatile acidity and biogenic amine values. This manuscript develops a new red winemakingmethodology that consists of combining the use of two non-Saccharomyces yeast strains asan alternative to the traditional malolactic fermentation. In this method, malic acid is totallyconsumed by Schizosaccharomyces pombe, thus achieving the microbiological stabilizationobjective, while Lachancea thermotolerans produces lactic acid in order not to reduce andeven increase the acidity of wines produced from low acidity musts. This technique reducesthe risks inherent to the malolactic fermentation process when performed in warm regions.The result is more fruity wines that contain less acetic acid and biogenic amines than thetraditional controls that have undergone the classical malolactic fermentation.