2000 Seat Belt Usage Survey, September 13, 2001

The good news is that safety belt usage on municipal road systems (city streets) increased 1.07 percent. This is encouraging since more than 45 percent of all motor vehicle crashes occur on city streets, and usage on the municipal road system has consistently been the lowest of the road systems studied. In communities where usage is good, enforcement and public education must be maintained in order to improve usage further; in communities where usage is still low, enforcement and public education must both be increased. Usage on the primary system (U.S. or state highways) rose 1.01 percent from the previous year. This is also welcome news because almost half of all fatalities (49 percent) occur on the primary road system. There was a decline in interstate belt use (-1.45 percent). Despite this decrease interstate usage is still traditionally the highest of all roadway categories presumably because the longer trips, higher travel speeds and large number of vehicles cause drivers to assume there is greater risk.

Workforce Patterns and the Prevention of Mother-to-Child Transmission of HIV Option B Cascade in Côte d'Ivoire

Thesis (Master's)--University of Washington, 2016-08

Incidência de cárie dentária em adolescentes em município do Nordeste brasileiro, 2006

NORO, Luiz Roberto Augusto et al. Incidência de cárie dentária em adolescentes em município do Nordeste brasileiro, 2006, Cadernos de Saúde Pública, Rio de Janeiro, v. 25, n. 4, p. 783-790, abr. 2009.

The response of surf-zone phytoplankton to nutrient enrichment (Cassino Beach, Brazil)

To understand the mechanisms that trigger changes in chlorophyll a and species composition in the phytoplankton of the surf-zone at Cassino Beach (RS), we performed two short nutrient-enrichment experiments (4–5 days each) during the summer and winter of 2010. Seawater was incubated under controlled conditions of temperature (summer 25± 3 °C, winter 18±1 °C), salinity (summer 28, winter 26) and irradiance (100 μmol m−2 s−1 ). Dissolved inorganic nutrients were added in various concentrations in the summer (silicate, Si; nitrate, N; phosphate, P) and winter (N, P) experiments. Samples were taken daily for cell counts and chlorophyll a analysis. In both experiments, chlorophyll a values and cell density showed a significant increase (mainly diatoms) in the treatments with nitrate addition, regardless of the proportion added. In the summer experiment, the largest chlorophyll a increase, approximately threefold (31.5 to 89.5 μg L−1 ), was observed in the NP treatment due to the growth of Asterionellopsis glacialis (Castracane) Round, Skeletonema tropicum Cleve, Thalassiosira sp. Cleve and Pseudo-nitzschia spp. Peragallo. The maximum growth was obtained in the SiNP treatment for S. tropicum (μ=0.7), Thalassiosira (μ= 1.9) and Pseudo-nitzschia (μ= 1.3) and in the SiN treatment for A. glacialis (μ= 1.0). In the winter experiment, the chlorophyll a content increased 4.2 and 5.5 times, respectively, in the N and NP treatments (maxima 38.8 μg L−1 and 31.5 μg L−1 ), where A. glacialis (μ= 1.7–1.9) and Cylindrotheca closterium (Ehrenberg) Reimann & J.C. Lewin (μ= 1.0–1.96) showed the highest amount of growth. These results indicate that nitrate is the most important nutrient controlling phytoplankton chlorophyll a at sandy Cassino Beach. However, the responses of different species to enrichment during the summer and winter indicated that other factors also played a role. A. glacialis, present during both seasons, presented the highest growth rate during the winter, whereas during the summer it was independent of nutrient enrichment but coincided with the lowest growth of S. tropicum. This finding suggested the occurrence of allelopathic interactions between these species. During the summer, multi-enrichment (SiNP) favoured the best growth of S. tropicum, Pseudo-nitzschia spp. and Thalassiosira sp. These results indicated that the phytoplankton composition and diversity in the surf zone of Cassino Beach are shaped by the availability of silicate and phosphorus as well as by the availability of nitrate.

Adhésion au traitement de la maladie rénale chronique chez les québécois âgés de 18 ans ou plus

Introduction La progression de la maladie rénale chronique (MRC) augmente le risque des maladies cardiovasculaires. L’hypertension, le diabète et la dyslipidémie sont à la fois des facteurs de risque et des comorbidités de la MRC. Chez les individus souffrant de MRC, la persistance et l’observance du traitement de ces facteurs de risque, i.e. le traitement antihypertenseur (TAH), le traitement hypolipémiant (THL) et le traitement antidiabétique (TAD) contribuent à réduire le risque de mortalité et de morbidité cardiovasculaires. Néanmoins, la persistance et l’observance de ces traitements restent encore peu étudiées chez les individus ayant la MRC. Objectifs: Spécifiquement pour chacun des trois traitements (TAH, THL et TAD), une étude de cohorte a été menée dans le but : 1) d’estimer la persistance à prendre le traitement un an après le début du traitement; 2) d’estimer l’observance du traitement au cours de l’année suivant le début du traitement chez les persistants; 3) d’identifier les facteurs associés à la persistance; et 4) d’identifier les facteurs associés à l’observance. Méthodologie: Nous avons utilisé les banques de données administratives de la Régie de l’assurance maladie du Québec (RAMQ) pour mener trois études de cohorte chez les personnes âgées de 18 ans ou plus. Une étude a été conduite chez les individus qui ont commencé un TAH, l’autre conduite chez les patients ayant commencé un THL et la dernière menée chez les nouveaux utilisateurs de TAD. Les individus qui poursuivaient encore leur traitement un an après son début ont été considérés persistants. Parmi les persistants, les patients qui ont eu une proportion de jours couverts (PJC) ≥ 80 % ont été considérés observants. Les facteurs associés à la persistance et ceux associés à l’observance ont été identifiés à l’aide d’une régression de Poisson modifiée. Résultats: Parmi les 7 119 patients ayant débuté un TAH, 78,8 % ont été persistants et 87,7 % des persistants ont été observants. Les individus qui étaient plus susceptibles d’être persistants se trouvaient dans le groupe des utilisateurs de monothérapie d’inhibiteurs de l’enzyme de conversion de l’angiotensine (IECA) (Rapport de prévalences (RP) : 1,20; intervalle de confiance (IC) à 95 % : 1,13-1,27), d’antagonistes du récepteur de l’angiotensine II (ARA) (1,22; 1,14-1,31), de bloquants des canaux calciques (BCC) (1,20; 1,14-1,26), de bêta-bloquants (BB) (1,16; 1,10-1,23) et de multithérapie (1,31; 1,25-1,38) (référence : monothérapie de diurétiques (DIU)). Les individus qui étaient plus susceptibles d’être observants étaient les utilisateurs de monothérapie d’IECA (1,08; 1,03-1,04), de BB (1,10; 1,05-1,15), de BCC (1,10; 1,05-1,15) et de multithérapie. Des 14 607 individus ayant débuté un THL, 80,7 % ont persisté à le prendre; de ces derniers, 88,7 % étaient observants du THL. Les patients qui étaient plus susceptibles d’être persistants étaient ceux ayant un statut socio-économique (SSE) faible (1,03; 1,01-1,06) (référence : SSE élevé) et ceux dont le traitement initial avait été prescrit par un néphrologue (1,06; 1,04-1,09) (référence : omnipraticien). Les individus qui étaient plus susceptibles d’être observants étaient ceux âgés ≥ 66 ans (référence : 18-65) (1,04; 1,01-1,07), ceux ayant un SSE faible (1,08; 1,06-1,10) et ceux qui avaient pris plus de 12 médicaments différents (référence : <7) (1,03; 1.00-1,05). Sur un total de 6 671 individus ayant débuté un TAD, 76,9 % ont persisté à prendre le traitement. Parmi les persistants, 87,9 % étaient observants. Les individus ayant un SSE faible (1,04; 1,01-1,07) (référence : SSE élevé) ou une multithérapie (1,12; 1,08-1,16) (référence : monothérapie de metformine) étaient plus susceptibles d’être persistants, tout comme ceux ayant une comorbidité dont l’hypertension artérielle (1,04; 1,01-1,07), la dyslipidémie (1,06; 1,03-1,10), l’accident vasculaire cérébral (AVC) (1,05; 1,01-1,11) ou la maladie coronarienne (1,03; 1,01-1,06). Les individus plus susceptibles d’être observants étaient ceux ayant un SSE moyen (1,03; 1,01-1,07) ou une multithérapie (1,06; 1,03-1,09). Conclusion: Peu importe le traitement initié par les individus souffrant de MRC, environ 30% des patients ne seraient pas persistants un an après le début du traitement ou observants dans l’année suivant l’initiation. Certains facteurs sont associés de façon consistante à la persistance, par exemple l’AVC, la maladie coronarienne et le nombre de visites médicales, alors que l’âge et le SSE sont associés à l’observance peu importe que le traitement initial soit un TAH, un THL ou un TAD.

Prevalencia de ferropenia y factores de riesgo asociados en niños de 6 a 24 meses de edad en el Hospital de Girón-Azuay 2007

Se realizó un estudio transversal en el que se incluyeron 160 niños de 6 a 24 meses de edad, seleccionados aleatoriamente, en el período comprendido de abril a septiembre del 2007. Se efectuaron determinaciones de ferritina sérica mediante el método de quimioluminiscencia y Hb mediante la técnica de la cianometahemoglobina. Además a través de una encuesta se recogió la información referente a los factores de riesgo estudiados. Resultados: los principales resultados obtenidos fueron: prevalencia de ferropenia 49%, prevalencia de anemia por déficit de hierro 52.6%. Los factores de riesgo asociados a ferropenia que mostraron significancia estadística en nuestro estudio son ingesta de leche de vaca >750 ml/día RP 1.54 (IC 1.10-2.15 p=0.04) y consumo inadecuado de vegetales verdes RP 1.42 (IC 1.01-2.01 p=0.03).Conclusiones: 1. La tasa de prevalencia de ferropenia encontrada en los lactantes estudiados fue de 49%. 2. La prevalencia de anemia con ferropenia fue de 52,6%, confirmándose que la principal causa de anemia en este grupo etáreo es la carencia de hierro como se afirma a nivel mundial. 3. La determinación de ferritina sérica es una prueba útil para detectar ferropenia en etapa temprana antes del desarrollo de anemia. 4. Los factores de riesgo que mostraron asociación estadísticamente significativa con ferropenia fueron: la ingestión de leche de vaca mayor a 750 ml /día y una dieta insuficiente en vegetales verdes

Infecciones de transmisión sexual en hombres internos en prisión: riesgo de desarrollo de nuevas infecciones

Objetivo: Medir la incidencia y determinar los factores de riesgo de las infecciones de transmisión sexual (ITS) en la población del Centro Penitenciario de Daroca (Zaragoza). Método: Estudio de cohortes retrospectivo (2005-2013) para medir la incidencia de ITS y estudio transversal para estudiar los factores de riesgo. Resultados: De los 203 internos, 79 desarrollaron una ITS, 37 tenían ITS previas, el 55,2% conocimientos y el 28,9% comportamientos no favorables a la prevención de ITS. La incidencia fue de 6,5 ITS por cada 1000 internos-año. Las de mayor incidencia fueron la hepatitis B (39,7%), la infección por Ureaplasma urealyticum (19,1%), el herpes simple (16,2%) y la infección por el virus de la inmunodeficiencia humana (8,8%). El riesgo (hazard ratio [HR]) de adquirir una nueva ITS fue significativamente mayor en los internos con antecedentes de ITS previa (HR = 2,61; intervalo de confianza del 95% [IC95%]: 1,01-6,69), y en el límite de la significación para los comportamientos no preventivos (HR = 2,10; IC95%: 0,98-4,53), pero no en los conocimientos frente a ITS (HR = 1,33; IC95%: 0,58-3,07). Conclusión: Los factores de riesgo más relevantes en prisión son los comportamientos y los antecedentes de ITS. Otros factores son ser reincidente, el consumo de drogas inyectadas o estar en un programa de metadona. Los/las profesionales sanitarios y la educación por pares pueden facilitar la prevención y el control.

Accumulation, persistence and effects of indospicine residues in camels fed Indigofera plant

Indospicine (L-2-amino-6-amidinohexanoic acid) is a natural hepatotoxin found in all parts of some Indigofera plants such as I. linnaei and I. spicata. Several studies have documented a susceptibility to this hepatotoxin in different species of animals, including cattle, sheep, dogs and rats, which are associated with mild to severe liver disease after prolonged ingestion. However, there is little published data on the effects of this hepatotoxin in camels, even though Indigofera plants are known to be palatable to camels in central Australia. The secondary poisoning of dogs after prolonged dietary exposure to residual indospicine in camel muscle has raised additional food safety concerns. In this study, a feeding experiment was conducted to investigate the in vivo accumulation, excretion, distribution and histopathological effects of dietary indospicine on camels. Six young camels (2 – 4 year old), weighing 270 − 390 kg were fed daily a roughage diet consisting of Rhodes grass hay and lucerne chaff, supplemented with Indigofera and steam flaked barley. Indigofera (I. spicata) was offered at 597 mg DM/kg body weight (bw)/day designed to deliver 337 µg indospicine/kg bw/day, and fed for a period of 32 days. Blood and muscle biopsies were collected over the period of the study. Concentrations of indospicine in the plasma and muscle biopsy samples were quantitated by validated ultra-performance liquid chromatography−tandem mass spectrometry (UPLC−MS/MS). The highest concentrations in plasma (1.01 mg/L) and muscle (2.63 mg/kg fresh weight (fw)) were found at necropsy (day 33). Other tissues were also collected at necropsy and analysis showed ubiquitous distribution of indospicine, with the highest indospicine accumulation detected in the pancreas (4.86 ± 0.56 mg/kg fw) and liver (3.60 ± 1.34 mg/kg fw); followed by the muscle, heart and kidney. Histopathological examination of liver tissue showed multiple small foci of predominantly mononuclear inflammatory cells. After cessation of Indigofera intake, indospicine present in plasma in the remaining 3 camels had a longer terminal elimination half-life (18.6 days) than muscle (15.9 days), and both demonstrated mono-exponential decreases.

Purificação e caracterização parcial de uma B-D glicosidase de Artemia franciscana com ação sobre celobiose e lactose

-D-glucosidase (EC 3.2.1.21) is one of the most interesting glycosidases, especially for hydrolysis cellobiose releasing glucose, is last step degradation of cellulose. This function makes the -D-glucosidase is of great interest as a versatile industrial biocatalyst, being critical to various bio-treatment / biorefinery processes, such as bioethanol production. Hen in the report, a -D-glucosidase was extracts from protein extracted of the invertebrate marine Artemia franciscana was purified and characterized with a combination of precipitation with ammonium sulfate (0 - 30%, 30 to 50%, 50 to 80%), the fraction saturated in the range of 30 to 50% (called F-II) was applied in a molecular exclusion chromatography, in Sephacryl S-200, the fractions corresponding to the first peak of activity of -D-glucosidase were gathered and applied in a chromatography of ion exchange in Mono Q; the third peak this protein obtained chromatography, which coincides with the peak of activity of -D-glucosidase was held and applied in a gel filtration chromatography Superose 12 where the first peak protein, which has activity of -D-glucosidase was rechromatography on Superose 12. This enzyme is probably multimerica, consisting of three subunit molecular mass of 52.7 kDa (determined by SDS-PAGE) with native molecular mass of 157 kDa (determined by gel filtration chromatography on Superose 12 under the system FPLC). The enzyme was purified 44.09 times with a recovery of 1.01%. Using up p-nitrophenyl-β-D-glucopiranoside as substrate obtained a Km apparent of 0.229 mM and a Vmax of 1.109 mM.60min-1.mL-1mM. The optimum pH and optimum temperature of catalysis of the synthetic substrate were 5.0 and 45 °C, respectively. The activity of the -D-glucosidase was strongly, inhibited by silver nitrate and N- etylmaleimide, this inhibition indicates the involvement of radical sulfidrila the hydrolysis of synthetic substrate. The -D-glucosidase of Artemia franciscana presented degradativa action on celobiose, lactose and on the synthetic substrate -nitrophenyl-β-D-glucopiranoside indicating potential use of this enzyme in the industry mainly for the production of bioethanol (production of alcohol from the participating cellulose), and production hydrolysate milk (devoid of milk lactose)

Effort-reward imbalance and sedentary lifestyle: an observational study in a large occupational cohort

Objectives: To investigate the association between effort-reward imbalance (ERI) at work and sedentary lifestyle. Methods: Cross-sectional data from the ongoing Finnish Public Sector Study related to 30 433 women and 7718 men aged 17-64 were used (n = 35 918 after exclusion of participants with missing values in covariates). From the responses to a questionnaire, an aggregated mean score for ERI in a work unit was assigned to each participant. The outcome was sedentary lifestyle defined as <2.00 metabolic equivalent task (MET) hours/day. Logistic regression with generalized estimating equations was used as an analysis method to include both individual and work unit level predictors in the models. Adjustments were made for age, marital status, occupational status, job contract, smoking, and heavy drinking. Results: Twenty five percent of women and 27% of men had a sedentary lifestyle. High individual level ERI was associated with a higher likelihood of sedentary lifestyle both among women (odds ratio (OR) = 1.08, 95% CI 1.01 to 1.16) and men (OR = 1.17, 95% CI 1.02 to 1.33). These associations were not explained by relevant confounders and they were also independent of work unit level job strain measured as a ratio of job demands and control. Conclusions: A mismatch between high occupational effort spent and low reward received in turn seems to be associated with an elevated risk of sedentary lifestyle, although this association is relatively weak.

Telmisartan to prevent recurrent stroke and cardiovascular events

Background Prolonged lowering of blood pressure after a stroke reduces the risk of recurrent stroke. In addition, inhibition of the renin–angiotensin system in high-risk patients reduces the rate of subsequent cardiovascular events, including stroke. However, the effect of lowering of blood pressure with a renin–angiotensin system inhibitor soon after a stroke has not been clearly established. We evaluated the effects of therapy with an angiotensin-receptor blocker, telmisartan, initiated early after a stroke. Methods In a multicenter trial involving 20,332 patients who recently had an ischemic stroke, we randomly assigned 10,146 to receive telmisartan (80 mg daily) and 10,186 to receive placebo. The primary outcome was recurrent stroke. Secondary outcomes were major cardiovascular events (death from cardiovascular causes, recurrent stroke, myocardial infarction, or new or worsening heart failure) and new-onset diabetes. Results The median interval from stroke to randomization was 15 days. During a mean followup of 2.5 years, the mean blood pressure was 3.8/2.0 mm Hg lower in the telmisartan group than in the placebo group. A total of 880 patients (8.7%) in the telmisartan group and 934 patients (9.2%) in the placebo group had a subsequent stroke (hazard ratio in the telmisartan group, 0.95; 95% confidence interval [CI], 0.86 to 1.04; P = 0.23). Major cardiovascular events occurred in 1367 patients (13.5%) in the telmisartan group and 1463 patients (14.4%) in the placebo group (hazard ratio, 0.94; 95% CI, 0.87 to 1.01; P = 0.11). New-onset diabetes occurred in 1.7% of the telmisartan group and 2.1% of the placebo group (hazard ratio, 0.82; 95% CI, 0.65 to 1.04; P = 0.10). Conclusions Therapy with telmisartan initiated soon after an ischemic stroke and continued for 2.5 years did not significantly lower the rate of recurrent stroke, major cardiovascular events, or diabetes. (ClinicalTrials.gov number, NCT00153062.)

Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke

Background Recurrent stroke is a frequent, disabling event after ischemic stroke. This study compared the efficacy and safety of two antiplatelet regimens — aspirin plus extendedrelease dipyridamole (ASA–ERDP) versus clopidogrel. Methods In this double-blind, 2-by-2 factorial trial, we randomly assigned patients to receive 25 mg of aspirin plus 200 mg of extended-release dipyridamole twice daily or to receive 75 mg of clopidogrel daily. The primary outcome was first recurrence of stroke. The secondary outcome was a composite of stroke, myocardial infarction, or death from vascular causes. Sequential statistical testing of noninferiority (margin of 1.075), followed by superiority testing, was planned. Results A total of 20,332 patients were followed for a mean of 2.5 years. Recurrent stroke occurred in 916 patients (9.0%) receiving ASA–ERDP and in 898 patients (8.8%) receiving clopidogrel (hazard ratio, 1.01; 95% confidence interval [CI], 0.92 to 1.11). The secondary outcome occurred in 1333 patients (13.1%) in each group (hazard ratio for ASA–ERDP, 0.99; 95% CI, 0.92 to 1.07). There were more major hemorrhagic events among ASA–ERDP recipients (419 [4.1%]) than among clopidogrel recipients (365 [3.6%]) (hazard ratio, 1.15; 95% CI, 1.00 to 1.32), including intracranial hemorrhage (hazard ratio, 1.42; 95% CI, 1.11 to 1.83). The net risk of recurrent stroke or major hemorrhagic event was similar in the two groups (1194 ASA–ERDP recipients [11.7%], vs. 1156 clopidogrel recipients [11.4%]; hazard ratio, 1.03; 95% CI, 0.95 to 1.11). Conclusions The trial did not meet the predefined criteria for noninferiority but showed similar rates of recurrent stroke with ASA–ERDP and with clopidogrel. There is no evidence that either of the two treatments was superior to the other in the prevention of recurrent stroke. (ClinicalTrials.gov number, NCT00153062.)

Relationship between hyperacute blood pressure and outcome after ischemic stroke: data from the VISTA Collaboration

Background and Purpose—High blood pressure (BP) is associated independently with poor outcome after acute ischemic stroke, although in most analyses “baseline” BP was measured 24 hours or more postictus, and not during the hyperacute period. Methods—Analyses included 1722 patients in hyperacute trials (recruitment 8 hours) from the Virtual Stroke International Stroke Trial Archive (VISTA) Collaboration. Data on BP at enrolment and after 1, 2, 16, 24, 48, and 72 hours, neurological impairment at 7 days (NIHSS), and functional outcome at 90 days (modified Rankin scale) were assessed using logistic regression models, adjusted for confounding variables; results are for 10-mm Hg change in BP. Results—Mean time to enrolment was 3.7 hours (range 1.0 to 7.9). High systolic BP (SBP) was significantly associated with increased neurological impairment (odds ratio, OR 1.06, 95% confidence interval, 95% CI 1.01 to 1.12), and poor functional outcome; odds ratios for both increased with later BP measurements made at up to 24 hours poststroke. Smaller (versus larger) declines in SBP over the first 24 hours were significantly associated with poor NIHSS scores (OR 1.16, 95% CI 1.05 to 1.27) and functional outcome (OR 1.23, 95% CI 1.13 to 1.34). A large variability in SBP was also associated with poor functional outcome. Conclusions—High SBP and large variability in SBP in the hyperacute stages of ischemic stroke are associated with increased neurological impairment and poor functional outcome, as are small falls in SBP over the first 24 hours.

Preparación y caracterización de películas delgadas de Cu3BiS3 con potencial aplicación en celdas solares

Propósito y Método de Estudio: El despliegue a gran escala de la energía fotovoltaica se está convirtiendo cada vez en un aspecto más importante. Las tecnologías actuales que utilizan elementos raros como el indio y el galio es improbable que sean capaces de satisfacer la creciente demanda de celdas solares de película delgada. Las películas de Cu3BiS3 formadas por depósito por baño químico exhiben alta absorbancia óptica en la región visible y una conductividad de tipo “p”. Contribuciones y Conclusiones: Se depositaron películas delgadas de Cu3BiS3 sobre sustratos de vidrio por el método de CBD aplicando tratamiento térmico durante 1.5 h a vacío a capas de Bi2S3-CuS. Los espesores logrados fueron desde 170 nm hasta 450 nm. El análisis por difracción de rayos X confirmó la formación del material Cu3BiS3. Las películas con espesor de 170 nm presentan bajos %T y %R, estos porcentajes disminuyen al aumentar el espesor de la película a 450 nm. Se obtuvieron valores de Eg = 1.65 y 1.0 eV para las películas de 170 y 450 nm, respectivamente. Así mismo fue calculada la conductividad del material obteniendo valores de 2.58 y 1.01 (Ω-cm)-1. Se logró la incorporación del material Cu3BiS3 en estructuras de celdas solares obteniendo adherencia sobre las capas anteriores. Las celdas solares desarrolladas presentaron valores de Jsc= 0.26 y 0.02 (mA/cm2) y V = 130 y 1.45 mV para las películas de 170 y 450 nm respectivamente.