Dengue transmission risk maps of the continental United States

Dengue fever is a strictly human and non-human primate disease characterized by a high fever, thrombocytopenia, retro-orbital pain, and severe joint and muscle pain. Over 40% of the world population is at risk. Recent re-emergence of dengue outbreaks in Texas and Florida following the re-introduction of competent Aedes mosquito vectors in the United States have raised growing concerns about the potential for increased occurrences of dengue fever outbreaks throughout the southern United States. Current deficiencies in vector control, active surveillance and awareness among medical practitioners may contribute to a delay in recognizing and controlling a dengue virus outbreak. Previous studies have shown links between low-income census tracts, high population density, and dengue fever within the United States. Areas of low-income and high population density that correlate with the distribution of Aedes mosquitoes result in higher potential for outbreaks. In this retrospective ecologic study, nine maps were generated to model U.S. census tracts’ potential to sustain dengue virus transmission if the virus was introduced into the area. Variables in the model included presence of a competent vector in the county and census tract percent poverty and population density. Thirty states, 1,188 counties, and 34,705 census tracts were included in the analysis. Among counties with Aedes mosquito infestation, the census tracts were ranked high, medium, and low risk potential for sustained transmission of the virus. High risk census tracts were identified as areas having the vector, ≥20% poverty, and ≥500 persons per square mile. Census tracts with either ≥20% poverty or ≥500 persons per square mile and have the vector present are considered moderate risk. Census tracts that have the vector present but have <20% poverty and <500 persons per square mile are considered low risk. Furthermore, counties were characterized as moderate risk if 50% or more of the census tracts in that county were rated high or moderate risk, and high risk if 25% or greater were rated high risk. Extreme risk counties, which were primarily concentrated in Texas and Mississippi, were considered having 50% or greater of the census tracts ranked as high risk. Mapping of geographic areas with potential to sustain dengue virus transmission will support surveillance efforts and assist medical personnel in recognizing potential cases. ^

Assessing high-priority mixtures: A review of methanol as influenced by ethanol

The intent of this research was to identify the level of risk methanol posed to a fetus during an ethanol co-exposure. This investigation was prompted by the known competitive inhibition properties of ethanol and the developmental toxicity of methanol. Integrated into this research was the practicality necessitated by regulatory processes, namely: does the risk justify the expense of additional research. To this end, the scope and nature of exposures were summarized to illustrate the ubiquity of these chemicals and the potential for dual exposure. Similarly, severity of outcome was evaluated by systematically reviewing the LOAELs, NOAELs, and statistical significance contained in methanol-induced developmental studies. Results. Blood methanol levels corresponding to developmental effects in laboratory studies were found to be substantially higher than the blood methanol levels predicted in high-risk methanol-ethanol exposure scenarios. This indicates that ethanol would not likely exacerbate methanol toxicity to the point of teratogenicity; however, it is important to note that the developmental toxicity of ethanol—an established human teratogen—was not included in the evaluation. Ethanol's contribution as a developmental toxicant rather than merely as an attenuator of methanol toxicity undermines the severity of effects possible from this chemical combination. Therefore further evaluation is needed to assess the developmental toxicities following dual exposures before rendering methanol and ethanol a high-priority mixture.^

Prevalence and risk factors of asthma and work -related asthma among U.S. adults: Data from the Third National Health and Nutrition Examination Survey, 1988--1994

This cross-sectional analysis of the data from the Third National Health and Nutrition Examination Survey was conducted to determine the prevalence and determinants of asthma and wheezing among US adults, and to identify the occupations and industries at high risk of developing work-related asthma and work-related wheezing. Separate logistic models were developed for physician-diagnosed asthma (MD asthma), wheezing in the previous 12 months (wheezing), work-related asthma and work-related wheezing. Major risk factors including demographic, socioeconomic, indoor air quality, allergy, and other characteristics were analyzed. The prevalence of lifetime MD asthma was 7.7% and the prevalence of wheezing was 17.2%. Mexican-Americans exhibited the lowest prevalence of MD asthma (4.8%; 95% confidence interval (CI): 4.2, 5.4) when compared to other race-ethnic groups. The prevalence of MD asthma or wheezing did not vary by gender. Multiple logistic regression analysis showed that Mexican-Americans were less likely to develop MD asthma (adjusted odds ratio (ORa) = 0.64, 95%CI: 0.45, 0.90) and wheezing (ORa = 0.55, 95%CI: 0.44, 0.69) when compared to non-Hispanic whites. Low education level, current and past smoking status, pet ownership, lifetime diagnosis of physician-diagnosed hay fever and obesity were all significantly associated with MD asthma and wheezing. No significant effect of indoor air pollutants on asthma and wheezing was observed in this study. The prevalence of work-related asthma was 3.70% (95%CI: 2.88, 4.52) and the prevalence of work-related wheezing was 11.46% (95%CI: 9.87, 13.05). The major occupations identified at risk of developing work-related asthma and wheezing were cleaners; farm and agriculture related occupations; entertainment related occupations; protective service occupations; construction; mechanics and repairers; textile; fabricators and assemblers; other transportation and material moving occupations; freight, stock and material movers; motor vehicle operators; and equipment cleaners. The population attributable risk for work-related asthma and wheeze were 26% and 27% respectively. The major industries identified at risk of work-related asthma and wheeze include entertainment related industry; agriculture, forestry and fishing; construction; electrical machinery; repair services; and lodging places. The population attributable risk for work-related asthma was 36.5% and work-related wheezing was 28.5% for industries. Asthma remains an important public health issue in the US and in the other regions of the world. ^

Framework for risk assessment for maritime transportation systems

Maritime accidents involving ships carrying passengers may pose a high risk with respect to human casualties. For effective risk mitigation, an insight into the process of risk escalation is needed. This requires a proactive approach when it comes to risk modelling for maritime transportation systems. Most of the existing models are based on historical data on maritime accidents, and thus they can be considered reactive instead of proactive. This paper introduces a systematic, transferable and proactive framework estimating the risk for maritime transportation systems, meeting the requirements stemming from the adopted formal definition of risk. The framework focuses on ship-ship collisions in the open sea, with a RoRo/Passenger ship (RoPax) being considered as the struck ship. First, it covers an identification of the events that follow a collision between two ships in the open sea, and, second, it evaluates the probabilities of these events, concluding by determining the severity of a collision. The risk framework is developed with the use of Bayesian Belief Networks and utilizes a set of analytical methods for the estimation of the risk model parameters. The model can be run with the use of GeNIe software package. Finally, a case study is presented, in which the risk framework developed here is applied to a maritime transportation system operating in the Gulf of Finland (GoF). The results obtained are compared to the historical data and available models, in which a RoPax was involved in a collision, and good agreement with the available records is found.

Exchange Rate Stabilization and IMF High Interest Rate Policy: A Critical Reconsideration Using a Dynamic Model

This paper examines whether the IMF high interest rate policy was suitable for crisis-ridden East Asian economies. Using an "overshoot" model similar to that of Dornbusch's (1976), it shows that this sort of policy might cause an unnecessary deflationary adjusting process and have no effect on containing the real depreciation of exchange rates in the long run. The study also demonstrates that Thai economic data coincides quite well with the model presented here. Finally, it points out that the high interest policy itself might provoke high risk-premium, the existence of which, in turn, justifies the policy. This means that the policy has a self-fulfilling property. In conclusion, a "one-size-fits-all" adaptation of high interest rate policy in a currency crisis is very dangerous in general, and was inappropriate for East Asia. The desirable policy would have been to let currencies depreciate and keep interest rates stable.

Evolution and treatment of vitamin B12 deficiency as a risk factor for (cognitive and functional) neurodegenerative diseases in institutionalized elderly = Evolución y tratamiento de la deficiencia de vitamina B12 como factor de riesgo de enfermedades neurodegenerativas (cognitivas y funcionales) en las personas mayores institucionalizadas.

Prevalence of vitamin B12 deficiency is very common in elderly people and can reach values as high as 40.5% of the population. It can be the result of the interaction among several factors. Vitamin B12 deficiencies have been associated with neurological, cognitive deterioration, haematological abnormalities and cardiovascular diseases that have an important influence on the health of the elderly and their quality of life. It is necessary to approach the problems arisen from the lack of data relative to them. The main objective of this thesis was to analyse the evolution of vitamin B12 status and related parameters, lipid and haematological profiles and their relationship to health risk factors, and to functional and cognitive status over one year and to determine the effect of an oral supplementation of 500 μg of cyanocobalamin for a short period of 28 days. An additional objective was to analyze the possible effects of medicine intakes on vitamin B status. Three studies were performed: a) a one year longitudinal follow-up with four measure points; b) an intervention study providing an oral liquid supplement of 500 μg of cyanocobalamin for a 28 days period; and c) analysis of the possible effect of medication intake on vitamin B status using the ATC classification of medicines. The participants for these studies were recruited from nursing homes for the elderly in the Region of Madrid. Sixty elders (mean age 84 _ 7y, 19 men and 41 women) were recruited for Study I and 64 elders (mean age 82 _ 7y, 24 men and 40 women) for Study II. For Study III, baseline data from the initially recruited participants of the first two studies were used. An informed consent was obtained from all participants or their mentors. The studies were approved by the Ethical Committee of the University of Granada. Blood samples were obtained at each examination date and were analyzed for serum cobalamin, holoTC, serum and RBC folate and total homocysteine according to laboratory standard procedures. The haematological parameters analyzed were haematocrit, haemoglobin and MCV. For the lipid profile TG, total cholesterol, LDL- and HDLcholesterol were analyzed. Anthropometric measures (BMI, skinfolds [triceps and subscapular], waist girth and waist to hip ratio), functional tests (hand grip, arm and leg strength tests, static balance) and MMSE were obtained or administered by trained personal. The vitamin B12 supplement of Study II was administered with breakfast and the medication intake was taken from the residents’ anamnesis. Data were analyzed by parametric and non-parametric statistics depending on the obtained data. Comparisons were done using the appropriate ANOVAs or non-parametric tests. Pearsons’ partial correlations with the variable “time” as control were used to define the association of the analyzed parameters. XIII The results showed that: A) Over one year, in relationship to vitamin B status, serum cobalamin decreased, serum folate and mean corpuscular volumen increased significantly and total homocysteine concentrations were stable. Regarding blood lipid profile, triglycerides increased and HDL-cholesterol decreased significantly. Regarding selected anthropometric measurements, waist circumference increased significantly. No significant changes were observed for the rest of parameters. B) Prevalence of hyperhomocysteinemia was high in the elderly studied, ranging from 60% to 90 % over the year depending on the cut-off used for the classification. LDL-cholesterol values were high, especially among women, and showed a tendency to increase over the year. Results of the balance test showed a deficiency and a tendency to decrease; this indicates that the population studied is at high risk for falls. Lower extremity muscular function was deficient and showed a tendency to decrease. A highly significant relationship was observed between the skinfold of the triceps and blood lipid profile. C) Low cobalamin concentrations correlated significantly with low MMSE scores in the elderly studied. No correlations were observed between vitamin B12 status and functional parameters. D) Regarding vitamin B12 status, holo-transcobalamin seems to be more sensitive for diagnosis; 5-10% of the elderly had a deficiency using serum cobalamin as a criterion, and 45-52% had a deficiency when using serum holotranscobalamin as a criterion. E) 500 μg of cyanocobalamin administered orally during 28 days significantly improved vitamin B12 status and significantly decreased total homocysteine concentrations in institutionalized elderly. No effect of the intervention was observed on functional and cognitive parameters. F) The relative change (%) of improvement of vitamin B12 status was higher when using serum holo-transcobalamin as a criterion than serum cobalamin. G) Antiaenemic drug intake normalized cobalamin, urologic drugs and corticosteroids serum folate, and psychoanaleptics holo-transcobalamin levels. Drugs treating pulmonary obstruction increased total homocysteine concentration significantly. H) The daily mean drug intake was 5.1. Fiftynine percent of the elderly took medication belonging to 5 or more different ATC groups. The most prevalent were psycholeptic (53%), antiacid (53%) and antithrombotic (47%) drugs.

Do the spatial characteristics of myocardial scar tissue determine the risk of ventricular arrhythmias?

Sudden cardiac death is one of the main causes of mortality in patients with structural heart disease. Although an implantable cardioverter de?brillator signi?cantly reduces the mortality rate, many patients never receive a shock. Identi?cation of high-risk patients would reduce the costs associated with this therapy and prevent the deleterious effect of inappropriate discharges. As scar tissue is the substrate of ventricular arrhythmias in patients with structural heart disease, scar characterization could allow strati?cation of the risk. The objective of this article is to review the role of scar characteristics in the pathogenesis of ventricular arrhythmias in patients with structural heart disease.

Implementation of a module for risk of ozone impacts assessment to vegetation in the integrated assessment modelling system for the Iberian peninsula. Evaluation for wheat and holm oak

A module to estimate risks of ozone damage to vegetation has been implemented in the Integrated Assessment Modelling system for the Iberian Peninsula. It was applied to compute three different indexes for wheat and Holm oak; daylight AOT40 (cumulative ozone concentration over 40 ppb), cumulative ozone exposure index according to the Directive 2008/50/EC (AOT40-D) and PODY (Phytotoxic Ozone Dose over a given threshold of Y nmol m−2 s−1). The use of these indexes led to remarkable differences in spatial patterns of relative ozone risks on vegetation. Ozone critical levels were exceeded in most of the modelling domain and soil moisture content was found to have a significant impact on the results. According to the outputs of the model, daylight AOT40 constitutes a more conservative index than the AOT40-D. Additionally, flux-based estimations indicate high risk areas in Portugal for both wheat and Holm oak that are not identified by AOT-based methods.

Las Redes de Petri Interpretadas en el Diagnóstico de Fallos de Sistemas Híbridos. Aplicación a un Helicóptero no Tripulado

La seguridad y fiabilidad de los procesos industriales son la principal preocupación de los ingenieros encargados de las plantas industriales. Por lo tanto, desde un punto de vista económico, el objetivo principal es reducir el costo del mantenimiento, el tiempo de inactividad y las pérdidas causadas por los fallos. Por otra parte, la seguridad de los operadores, que afecta a los aspectos sociales y económicos, es el factor más relevante a considerar en cualquier sistema Debido a esto, el diagnóstico de fallos se ha convertido en un foco importante de interés para los investigadores de todo el mundo e ingenieros en la industria. Los principales trabajos enfocados en detección de fallos se basan en modelos de los procesos. Existen diferentes técnicas para el modelado de procesos industriales tales como máquinas de estado, árboles de decisión y Redes de Petri (RdP). Por lo tanto, esta tesis se centra en el modelado de procesos utilizando redes de petri interpretadas. Redes de Petri es una herramienta usada en el modelado gráfico y matemático con la habilidad para describir información de los sistemas de una manera concurrente, paralela, asincrona, distribuida y no determinística o estocástica. RdP son también una herramienta de comunicación visual gráfica útil como lo son las cartas de flujo o diagramas de bloques. Adicionalmente, las marcas de las RdP simulan la dinámica y concurrencia de los sistemas. Finalmente, ellas tienen la capacidad de definir ecuaciones de estado específicas, ecuaciones algebraicas y otros modelos que representan el comportamiento común de los sistemas. Entre los diferentes tipos de redes de petri (Interpretadas, Coloreadas, etc.), este trabajo de investigación trata con redes de petri interpretadas principalmente debido a características tales como sincronización, lugares temporizados, aparte de su capacidad para procesamiento de datos. Esta investigación comienza con el proceso para diseñar y construir el modelo y diagnosticador para detectar fallos definitivos, posteriormente, la dinámica temporal fue adicionada para detectar fallos intermitentes. Dos procesos industriales, concretamente un HVAC (Calefacción, Ventilación y Aire Acondicionado) y un Proceso de Envasado de Líquidos fueron usados como banco de pruebas para implementar la herramienta de diagnóstico de fallos (FD) creada. Finalmente, su capacidad de diagnóstico fue ampliada en orden a detectar fallos en sistemas híbridos. Finalmente, un pequeño helicóptero no tripulado fue elegido como ejemplo de sistema donde la seguridad es un desafío, y las técnicas de detección de fallos desarrolladas en esta tesis llevan a ser una herramienta valorada, desde que los accidentes de las aeronaves no tripuladas (UAVs) envuelven un alto costo económico y son la principal razón para introducir restricciones de volar sobre áreas pobladas. Así, este trabajo introduce un proceso sistemático para construir un Diagnosticador de Fallos del sistema mencionado basado en RdR Esta novedosa herramienta es capaz de detectar fallos definitivos e intermitentes. El trabajo realizado es discutido desde un punto de vista teórico y práctico. El procedimiento comienza con la división del sistema en subsistemas para seguido integrar en una RdP diagnosticadora global que es capaz de monitorear el sistema completo y mostrar las variables críticas al operador en orden a determinar la salud del UAV, para de esta manera prevenir accidentes. Un Sistema de Adquisición de Datos (DAQ) ha sido también diseñado para recoger datos durante los vuelos y alimentar la RdP diagnosticadora. Vuelos reales realizados bajo condiciones normales y de fallo han sido requeridos para llevar a cabo la configuración del diagnosticador y verificar su comportamiento. Vale la pena señalar que un alto riesgo fue asumido en la generación de fallos durante los vuelos, a pesar de eso esto permitió recoger datos básicos para desarrollar el diagnóstico de fallos, técnicas de aislamiento, protocolos de mantenimiento, modelos de comportamiento, etc. Finalmente, un resumen de la validación de resultados obtenidos durante las pruebas de vuelo es también incluido. Un extensivo uso de esta herramienta mejorará los protocolos de mantenimiento para UAVs (especialmente helicópteros) y permite establecer recomendaciones en regulaciones. El uso del diagnosticador usando redes de petri es considerado un novedoso enfoque. ABSTRACT Safety and reliability of industrial processes are the main concern of the engineers in charge of industrial plants. Thus, from an economic point of view, the main goal is to reduce the maintenance downtime cost and the losses caused by failures. Moreover, the safety of the operators, which affects to social and economic aspects, is the most relevant factor to consider in any system. Due to this, fault diagnosis has become a relevant focus of interest for worldwide researchers and engineers in the industry. The main works focused on failure detection are based on models of the processes. There are different techniques for modelling industrial processes such as state machines, decision trees and Petri Nets (PN). Thus, this Thesis is focused on modelling processes by using Interpreted Petri Nets. Petri Nets is a tool used in the graphic and mathematical modelling with ability to describe information of the systems in a concurrent, parallel, asynchronous, distributed and not deterministic or stochastic manner. PNs are also useful graphical visual communication tools as flow chart or block diagram. Additionally, the marks of the PN simulate the dynamics and concurrence of the systems. Finally, they are able to define specific state equations, algebraic equations and other models that represent the common behaviour of systems. Among the different types of PN (Interpreted, Coloured, etc.), this research work deals with the interpreted Petri Nets mainly due to features such as synchronization capabilities, timed places, apart from their capability for processing data. This Research begins with the process for designing and building the model and diagnoser to detect permanent faults, subsequently, the temporal dynamic was added for detecting intermittent faults. Two industrial processes, namely HVAC (Heating, Ventilation and Air Condition) and Liquids Packaging Process were used as testbed for implementing the Fault Diagnosis (FD) tool created. Finally, its diagnostic capability was enhanced in order to detect faults in hybrid systems. Finally, a small unmanned helicopter was chosen as example of system where safety is a challenge and fault detection techniques developed in this Thesis turn out to be a valuable tool since UAVs accidents involve high economic cost and are the main reason for setting restrictions to fly over populated areas. Thus, this work introduces a systematic process for building a Fault Diagnoser of the mentioned system based on Petri Nets. This novel tool is able to detect both intermittent and permanent faults. The work carried out is discussed from theoretical and practical point of view. The procedure begins with a division of the system into subsystems for further integration into a global PN diagnoser that is able to monitor the whole system and show critical variables to the operator in order to determine the UAV health, preventing accidents in this manner. A Data Acquisition System (DAQ) has been also designed for collecting data during the flights and feed PN Diagnoser. Real flights carried out under nominal and failure conditions have been required to perform the diagnoser setup and verify its performance. It is worth noting that a high risk was assumed in the generation of faults during the flights, nevertheless this allowed collecting basic data so as to develop fault diagnosis, isolations techniques, maintenance protocols, behaviour models, etc. Finally, a summary of the validation results obtained during real flight tests is also included. An extensive use of this tool will improve preventive maintenance protocols for UAVs (especially helicopters) and allow establishing recommendations in regulations. The use of the diagnoser by using Petri Nets is considered as novel approach.

Screening for hypercholesterolaemia in primary care: randomised controlled trial of postal questionnaire appraising risk of coronary heart disease

Objectives: To validate a self administered postal questionnaire appraising risk of coronary heart disease. To determine whether use of this questionnaire increased the percentage of people at high risk of coronary heart disease and decreased the percentage of people at low risk who had their cholesterol concentration measured.

Identifying Overweight Risk and Intervening at the Twelve Month Well Child Exam

Childhood obesity is an epidemic that is having devastating effects on the physical and psychological health of children. The core processes of Acceptance and Commitment Therapy (ACT) are explored in this paper relative to how they can be applied as interventions in an early life obesity prevention model. While reviewing research in childhood obesity intervention models, this paper proposes a study that involves conducting behavioral health consultations with mothers whose children are at high risk for becoming overweight.

A PCR based method to detect Russula spp. in soil samples and Limodorum abortivum roots in Mediterranean environments

Aim of study. Orchidaceae has the largest number of species of any family in the plant kingdom. This family is subject to a high risk of extinction in natural environments, such as natural parks and protected areas. Recent studies have shown the prevalence of many species of orchids to be linked to fungal soil diversity, due to their myco-heterotrophic behaviour. Plant communities determine fungal soil diversity, and both generate optimal conditions for orchid development. Area of study. The work was carried out in n the two most important natural parks in Alicante (Font Roja and Sierra Mariola), in South-eastern of Spain. Material and Methods. We designed a molecular tool to monitor the presence of Russula spp. in soil and orchids roots, combined with phytosociological methods. Main results. Using a PCR-based method, we detected the presence in the soil and Limodorum abortivum orchid roots of the mycorrhizal fungi Russula spp. The species with highest coverage was Quercus rotundifolia in areas where the orchid was present. Research highlights. We present a useful tool based on PCR to detect the presence of Russula spp. in a natural environment. These results are consistent with those obtained in different studies that linked the presence of the mycorrhizal fungi Russula spp. in roots of the species Limodorum and the interaction between these fungal species and Quercus ilex trees in Mediterranean forest environments.

Multiple regulatory variants located in cell type-specific enhancers within the PKP2 locus form major risk and protective haplotypes for canine atopic dermatitis in German shepherd dogs.

BACKGROUND Canine atopic dermatitis (CAD) is a chronic inflammatory skin disease triggered by allergic reactions involving IgE antibodies directed towards environmental allergens. We previously identified a ~1.5 Mb locus on canine chromosome 27 associated with CAD in German shepherd dogs (GSDs). Fine-mapping indicated association closest to the PKP2 gene encoding plakophilin 2. RESULTS Additional genotyping and association analyses in GSDs combined with control dogs from five breeds with low-risk for CAD revealed the top SNP 27:19,086,778 (p = 1.4 × 10(-7)) and a rare ~48 kb risk haplotype overlapping the PKP2 gene and shared only with other high-risk CAD breeds. We selected altogether nine SNPs (four top-associated in GSDs and five within the ~48 kb risk haplotype) that spanned ~280 kb forming one risk haplotype carried by 35 % of the GSD cases and 10 % of the GSD controls (OR = 5.1, p = 5.9 × 10(-5)), and another haplotype present in 85 % of the GSD cases and 98 % of the GSD controls and conferring a protective effect against CAD in GSDs (OR = 0.14, p = 0.0032). Eight of these SNPs were analyzed for transcriptional regulation using reporter assays where all tested regions exerted regulatory effects on transcription in epithelial and/or immune cell lines, and seven SNPs showed allelic differences. The DNA fragment with the top-associated SNP 27:19,086,778 displayed the highest activity in keratinocytes with 11-fold induction of transcription by the risk allele versus 8-fold by the control allele (pdifference = 0.003), and also mapped close (~3 kb) to an ENCODE skin-specific enhancer region. CONCLUSIONS Our experiments indicate that multiple CAD-associated genetic variants located in cell type-specific enhancers are involved in gene regulation in different cells and tissues. No single causative variant alone, but rather multiple variants combined in a risk haplotype likely contribute to an altered expression of the PKP2 gene, and possibly nearby genes, in immune and epithelial cells, and predispose GSDs to CAD.

Erectile Dysfunction Drug Use, Risk Behavior, and Sexually Transmitted Diseases

Thesis (Master's)--University of Washington, 2016-06

Power, privilege and HIV prevalence: examination of sexual HIV-risk factors in MSM and transgender women who engage in transactional sex

Thesis (Master's)--University of Washington, 2016-06