899 resultados para sample size in mirco-clinical trials
Resumo:
The goal of this study was to test the hypothesis that the aggregated state of natural marine particles constrains the sensitivity of optical beam attenuation to particle size. An instrumented bottom tripod was deployed at the 12-m node of the Martha's Vineyard Coastal Observatory to monitor particle size distributions, particle size-versus-settling-velocity relationships, and the beam attenuation coefficient (c(p)) in the bottom boundary layer in September 2007. An automated in situ filtration system on the tripod collected 24 direct estimates of suspended particulate mass (SPM) during each of five deployments. On a sampling interval of 5 min, data from a Sequoia Scientific LISST 100x Type B were merged with data from a digital floc camera to generate suspended particle volume size distributions spanning diameters from approximately 2 mu m to 4 cm. Diameter-dependent densities were calculated from size-versus-settling-velocity data, allowing conversion of the volume size distributions to mass distributions, which were used to estimate SPM every 5 min. Estimated SPM and measured c(p) from the LISST 100x were linearly correlated throughout the experiment, despite wide variations in particle size. The slope of the line, which is the ratio of c(p) to SPM, was 0.22 g m(-2). Individual estimates of c(p):SPM were between 0.2 and 0.4 g m(-2) for volumetric median particle diameters ranging from 10 to 150 mu m. The wide range of values in c(p):SPM in the literature likely results from three factors capable of producing factor-of-two variability in the ratio: particle size, particle composition, and the finite acceptance angle of commercial beam-transmissometers.
Resumo:
Aims- The goal of this study is to obtain a subjective point of view of the use, benefits, and shortcomings of the Via Christi breastfeeding Assessment Tool in a clinical setting. Methods- This case study is based on a single yet detailed interview with a lactation consultant who has utilized the Via Christi Breastfeeding Tool in a clinical setting. Findings- Advantages of the Via Christi Breastfeeding Assessment Tool include that the tool is practical and concrete, encompassing both a subjective dimension and the basic elements of breastfeeding. Shortcomings of the tool include its non-specificity in focus on the feeding technique only and excluding other factors involved with the birth and mother- baby couplet. Conclusion- The Via Christi Breastfeeding Tool serves as a good initial screening of breastfeeding, which in result leads to the recommendation of further and more extensive study of a specific mother-baby couplet breastfeeding measures if needed.
Resumo:
Background. Diarrhea and malnutrition are the leading causes of mortality for children age one to four in the Dominican Republic. Communities within the Miches watershed lack sanitation infrastructure and water purification systems, which increases the risk of exposure to water-borne pathogens. The purpose of this cross-sectional study was to analyze health information gathered through household interviews and to test water samples for the presence of diarrheagenic pathogens and antibiotic-resistant bacteria within the Miches watershed. Methods. Frequency counts and thematic analysis were used to investigate Human Health Survey responses and Fisher's exact test was used to determine correlation between water source and reported illness. Bacteria cultured from water samples were analyzed by Gram stain, real-time PCR, API® 20E biochemical identification, and for antibiotic resistance. Results. Community members reported concerns about water sources with respect to water quality, availability, and environmental contamination. Pathogenic strains of E. coli were present in the water samples. Drinking aquifer water was positively-correlated with reported stomach aches (p=0.04) while drinking from rivers or creeks was associated with the reported absence of “gripe” (cold or flu) (p=0.01). The lack of association between reported illnesses and water source for the majority of variables suggested that there were multiple vehicles of disease transmission. Antibiotic resistant bacteria were isolated from the water samples tested. Conclusions. The presence of pathogenic E. coli in water samples suggested that water is at least one route of transmission for diarrheagenic pathogens in the Miches watershed. The presence of antibiotic-resistant bacteria in the water samples may indicate the proliferation of resistance plasmids in the environment as a result of antibiotic overuse in human and animal populations and a lack of sanitation infrastructure. An intervention that targets areas of hygiene, sanitation, and water purification is recommended to limit human exposure to diarrheagenic pathogens and antibiotic-resistant organisms. ^
Resumo:
Houston, Texas maintains the appropriate climate and mosquito populations to support the circulation of dengue viruses. The city is susceptible to the introduction and subsequent local transmission of dengue virus with its proximity to dengue-endemic Mexico and the high degree of international travel routed through its airports. In 2008, a study at the University of Texas School of Public Health identified 58 suspected dengue fever cases that presented at hospitals and clinics in the Houston area. Serum or CSF samples of the 58 samples tested positive or equivocal for the presence of anti-dengue IgM antibodies (Rodriguez, 2008). Here, we present the results of an investigation aimed to describe the clinical characteristics of the 58 suspected dengue fever cases and to determine if local transmission had occurred. Data from medical record abstractions and personal telephone interviews were used to describe clinical characteristics and travel history of the suspected cases. Our analysis classified six probable dengue fever cases based on the case definition from the World Health Organization. Three of the probable cases for which we were able to obtain travel history had not recently traveled to an endemic area prior to onset of symptoms suggesting the illnesses were locally acquired in Houston. Further analysis led us to hypothesize that additional cases of dengue fever are present in our study population. Fifty-one percent of the study population was diagnosed with meningitis and/or encephalitis. Sixty percent of the individuals who received a lumbar puncture had abnormal CSF. Together these findings indicate viral infection with neurological involvement, which has been reported to occur with dengue fever. Among the individuals who received liver enzyme analysis, 54% had evidence of abnormal liver enzyme levels, a clinical sign commonly observed with dengue. Our results indicate that a suspected outbreak of dengue fever with autochthonous transmission occurred in the Houston area between 2003 and 2005. ^
Resumo:
Background. There is currently a push to increase the number of minorities in cancer clinical trials in an effort to reduce cancer health disparities. Overcoming barriers to clinical trial research for minorities is necessary if we are to achieve the goals of Healthy People 2010. To understand the unexpectedly high rate of attrition in the A NULIFE study, the research team examined the perceived barriers to participation among minority women. The purpose of this study was to determine if either personal or study-related factors influenced healthy pre-menopausal women aged 25-45 years to terminate their participation in the A NULIFE Study. We hypothesized that personal factors were the driving forces for attrition rates in the prevention trial.^ Methods. The target population consisted of eligible women who consented to the A NULIFE study but withdrew prior to being randomized (N= 46), as well as eligible women who completed the informed consent process for the A NULIFE study and withdrew after randomization (N= 42). Examination of attrition rates in this study occurred at a time point when 10 out of 12 participant groups had completed the A NULIFE study. Data involving the 2 groups that were actively engaged in study activities were not used in this analysis. A survey instrument was designed to query the personal and study-related factors that were believed to have contributed to the decision to terminate participation in the A NULIFE study.^ Results. Overall, the highest ranked personal reason that influenced withdrawal from the study was being “too busy” with other obligations. The second highest ranked factor for withdrawal was work obligations. Whereas, more than half of all participants agreed that they were well-informed about the study and considered the study personnel to be approachable, 54% of participants would have been inclined to remain in the study if it were located at a local community center.^ Conclusions. Time commitment was likely a major factor for withdrawal from the A NULIFE study. Future investigators should implement trials within participant communities where possible. Also, focus group settings may provide detailed insight into factors that contribute to the attrition of minorities in cancer clinical trials.^
Resumo:
Monsoon climate is an important component of the global climatic system. A comprehensive understanding of its variability over glacial-interglacial time scales as well as of its effects on the continent and in the ocean is required to decipher links between climate, continental weathering and productivity. A detailed multiproxy study, including bulk and clay mineralogy, grain-size analysis, phosphorus geochemistry (SEDEX extraction), organic matter characterization, and nitrogen stable isotopes, was carried out on samples from ODP Sites 1143 and 1144 (Leg 184, South China Sea), covering the past 140 000 years. We tentatively reconstruct the complex sedimentation and climatic history of the region during the last glacial-interglacial cycle, when sea-level variations, linked to the growth and melting of ice caps, interact with monsoon variability. During interglacial periods of high sea level, summer monsoon was strong, and humid and warm climate characterized the adjacent continent and islands. Clay minerals bear signals of chemical weathering during these intervals. High calcite and reactive phosphorus mass accumulation rates (MARs) indicate high productivity, especially in the southern region of the basin. During glacial intervals, strong winter monsoon provided enhanced detrital input from the continent, as indicated by high detrital MAR. Glacial low sea level resulted in erosion of sediments from the exposed Sunda shelf to the south, and clay mineral variations indicate that warm and humid conditions still prevailed in the southern tropical areas. Enhanced supply of nutrients from the continent, both by river and eolian input, maintained high primary productivity. Reduced circulation during these periods possibly induced active remobilization of nutrients, such as phosphorus, from the sediments. Intense and short cold periods recorded during glacial and interglacial stages correlate with loess records in China and marine climatic records in the North Atlantic, confirming a teleconnection between low- and high-latitude climate variability.
Resumo:
Ocean acidification results from an increase in the concentrations of atmospheric carbon dioxide (CO2) impacts on marine calcifying species, which is predicted to become more pronounced in the future. By the end of this century, atmospheric pCO2 levels will have doubled relative to the pre-industrial levels of 280 ppm. However, the effects of pre-industrial pCO2 levels on marine organisms remain largely unknown. In this study, we investigated the effects of pre-industrial pCO2 conditions on the size of the pluteus larvae of sea urchins, which are known to be vulnerable to ocean acidification. The larval size of Hemicentrotus pulcherrimus significantly increased when reared at pre-industrial pCO2 level relative to the present one, and the size of Anthocidaris crassispina larvae decreased as the pCO2 levels increased from the pre-industrial level to the near future ones after 3 days' exposure. In this study, it is suggested that echinoid larvae responded to pre-industrial pCO2 levels. Ocean acidification may be affecting some sensitive marine calcifiers even at the present pCO2 level.