Independent Living Program, Vol. 2, 2007

The Iowa Department for the Blind is the state agency that serves Iowans with vision loss. Services are free, confidential and available statewide. "There are no limitations to what you can do with training and a positive attitude." (All quotes in this newsletter are from former training participants). At the Iowa Department for the Blind, we believe in a positive approach to blindness. Vision loss alone should not prevent anyone from being independent. For this reason, we offer a wide variety of opportunities to obtain the skills necessary for independence.

Independent Living Program, Vol. 2

Quarterly newsletter from Commission for the Blind.

Impact and cost of a 2-week community-based screening and awareness program for diabetes and cardiovascular risk factors in a Swiss canton.

BACKGROUND: Community-based diabetes screening programs can help sensitize the population and identify new cases. However, the impact of such programs is rarely assessed in high-income countries, where concurrent health information and screening opportunities are common place. INTERVENTION AND METHODS: A 2-week screening and awareness campaign was organized as part of a new diabetes program in the canton of Vaud (population of 697,000) in Switzerland. Screening was performed without appointment in 190 out of 244 pharmacies in the canton at the subsidized cost of 10 Swiss Francs per participant. Screening included questions on risk behaviors, measurement of body mass index, blood pressure, blood cholesterol, random blood glucose (RBG), and A1c if RBG was >/=7.0 mmol/L. A mass media campaign promoting physical activity and a healthy diet was channeled through several media, eg, 165 spots on radio, billboards in 250 public places, flyers in 360 public transport vehicles, and a dozen articles in several newspapers. A telephone survey in a representative sample of the population of the canton was performed after the campaign to evaluate the program. RESULTS: A total of 4222 participants (0.76% of all persons aged >/=18 years) underwent the screening program (median age: 53 years, 63% females). Among participants not treated for diabetes, 3.7% had RBG >/= 7.8 mmol/L and 1.8% had both RBG >/= 7.0 mmol/L and A1c >/= 6.5. Untreated blood pressure >/=140/90 mmHg and/or untreated cholesterol >/=5.2 mmol/L were found in 50.5% of participants. One or several treated or untreated modifiable risk factors were found in 78% of participants. The telephone survey showed that 53% of all adults in the canton were sensitized by the campaign. Excluding fees paid by the participants, the program incurred a cost of CHF 330,600. CONCLUSION: A community-based screening program had low efficiency for detecting new cases of diabetes, but it identified large numbers of persons with elevated other cardiovascular risk factors. Our findings suggest the convenience of A1c for mass screening of diabetes, the usefulness of extending diabetes screening to other cardiovascular risk factors, and the importance of a robust background communication campaign.

Independent Living Program, Vol. 2, 2008

The Iowa Department for the Blind is the state agency that serves Iowans with vision loss. Services are free, confidential and available statewide. "There are no limitations to what you can do with training and a positive attitude." (All quotes in this newsletter are from former training participants). At the Iowa Department for the Blind, we believe in a positive approach to blindness. Vision loss alone should not prevent anyone from being independent. For this reason, we offer a wide variety of opportunities to obtain the skills necessary for independence.

Broadening the horizon--level 2.5 of the HUPO-PSI format for molecular interactions.

BACKGROUND: Molecular interaction Information is a key resource in modern biomedical research. Publicly available data have previously been provided in a broad array of diverse formats, making access to this very difficult. The publication and wide implementation of the Human Proteome Organisation Proteomics Standards Initiative Molecular Interactions (HUPO PSI-MI) format in 2004 was a major step towards the establishment of a single, unified format by which molecular interactions should be presented, but focused purely on protein-protein interactions. RESULTS: The HUPO-PSI has further developed the PSI-MI XML schema to enable the description of interactions between a wider range of molecular types, for example nucleic acids, chemical entities, and molecular complexes. Extensive details about each supported molecular interaction can now be captured, including the biological role of each molecule within that interaction, detailed description of interacting domains, and the kinetic parameters of the interaction. The format is supported by data management and analysis tools and has been adopted by major interaction data providers. Additionally, a simpler, tab-delimited format MITAB2.5 has been developed for the benefit of users who require only minimal information in an easy to access configuration. CONCLUSION: The PSI-MI XML2.5 and MITAB2.5 formats have been jointly developed by interaction data producers and providers from both the academic and commercial sector, and are already widely implemented and well supported by an active development community. PSI-MI XML2.5 enables the description of highly detailed molecular interaction data and facilitates data exchange between databases and users without loss of information. MITAB2.5 is a simpler format appropriate for fast Perl parsing or loading into Microsoft Excel.

Benchmarking therapeutic drug monitoring software: A systematic evaluation of available computer tools

Introduction: Therapeutic drug monitoring (TDM) aims at optimizing treatment by individualizing dosage regimen based on measurement of blood concentrations. Maintaining concentrations within a target range requires pharmacokinetic and clinical capabilities. Bayesian calculation represents a gold standard in TDM approach but requires computing assistance. In the last decades computer programs have been developed to assist clinicians in this assignment. The aim of this benchmarking was to assess and compare computer tools designed to support TDM clinical activities.¦Method: Literature and Internet search was performed to identify software. All programs were tested on common personal computer. Each program was scored against a standardized grid covering pharmacokinetic relevance, user-friendliness, computing aspects, interfacing, and storage. A weighting factor was applied to each criterion of the grid to consider its relative importance. To assess the robustness of the software, six representative clinical vignettes were also processed through all of them.¦Results: 12 software tools were identified, tested and ranked. It represents a comprehensive review of the available software's characteristics. Numbers of drugs handled vary widely and 8 programs offer the ability to the user to add its own drug model. 10 computer programs are able to compute Bayesian dosage adaptation based on a blood concentration (a posteriori adjustment) while 9 are also able to suggest a priori dosage regimen (prior to any blood concentration measurement), based on individual patient covariates, such as age, gender, weight. Among those applying Bayesian analysis, one uses the non-parametric approach. The top 2 software emerging from this benchmark are MwPharm and TCIWorks. Other programs evaluated have also a good potential but are less sophisticated (e.g. in terms of storage or report generation) or less user-friendly.¦Conclusion: Whereas 2 integrated programs are at the top of the ranked listed, such complex tools would possibly not fit all institutions, and each software tool must be regarded with respect to individual needs of hospitals or clinicians. Interest in computing tool to support therapeutic monitoring is still growing. Although developers put efforts into it the last years, there is still room for improvement, especially in terms of institutional information system interfacing, user-friendliness, capacity of data storage and report generation.

Benchmarking therapeutic drug monitoring software: A systematic evaluation of available computer tools

Objectives: Therapeutic drug monitoring (TDM) aims at optimizing treatment by individualizing dosage regimen based on blood concentrations measurement. Maintaining concentrations within a target range requires pharmacokinetic (PK) and clinical capabilities. Bayesian calculation represents a gold standard in TDM approach but requires computing assistance. The aim of this benchmarking was to assess and compare computer tools designed to support TDM clinical activities.¦Methods: Literature and Internet were searched to identify software. Each program was scored against a standardized grid covering pharmacokinetic relevance, user-friendliness, computing aspects, interfacing, and storage. A weighting factor was applied to each criterion of the grid to consider its relative importance. To assess the robustness of the software, six representative clinical vignettes were also processed through all of them.¦Results: 12 software tools were identified, tested and ranked. It represents a comprehensive review of the available software characteristics. Numbers of drugs handled vary from 2 to more than 180, and integration of different population types is available for some programs. Nevertheless, 8 programs offer the ability to add new drug models based on population PK data. 10 computer tools incorporate Bayesian computation to predict dosage regimen (individual parameters are calculated based on population PK models). All of them are able to compute Bayesian a posteriori dosage adaptation based on a blood concentration while 9 are also able to suggest a priori dosage regimen, only based on individual patient covariates. Among those applying Bayesian analysis, MM-USC*PACK uses a non-parametric approach. The top 2 programs emerging from this benchmark are MwPharm and TCIWorks. Others programs evaluated have also a good potential but are less sophisticated or less user-friendly.¦Conclusions: Whereas 2 software packages are ranked at the top of the list, such complex tools would possibly not fit all institutions, and each program must be regarded with respect to individual needs of hospitals or clinicians. Programs should be easy and fast for routine activities, including for non-experienced users. Although interest in TDM tools is growing and efforts were put into it in the last years, there is still room for improvement, especially in terms of institutional information system interfacing, user-friendliness, capability of data storage and automated report generation.

The Prisoner Re-Entry Initiative (PRI) Grant Program Iowa Department of Correctional Services, January 2, 2007

The Iowa Department of Corrections (DOC) and the Department of Human Rights, Division of Criminal and Juvenile Justice Planning (CJJP) entered into a contract for services from January 2, 2007 to June 30, 2008 for the purposes of assisting in the evaluation component for the two-year Prison Re-Entry Initiative (PRI) grand awarded to the DOC by the U.S. Office of Justice Programs. The PRI grant period ran from July 2006 through June 2008 and included two primary components. First, all PRI participants returning to Polk County would participate in a Lifeskills curriculum offered through the Des Moines Area Community College (DMACC) at four Iowa prison institutions located at Mitchellville, Newton, Fort Dodge and Rockwell City. Second, all PRI participants returning to Polk County would be referred to The Directors Council (TDC) for cmmunity-based wrap-around services.

Field Evaluation of Compaction Monitoring Technology: Phase II Volumes 1 and 2, TR-495, 2006

This report documents an extensive field program carried out to identify the relationships between soil engineering properties, as measured by various in situ devices, and the results of machine compaction monitoring using prototype compaction monitoring technology developed by Caterpillar Inc. Primary research tasks for this study include the following: (1) experimental testing and statistical analyses to evaluate machine power in terms of the engineering properties of the compacted soil (e.g., density, strength, stiffness) and (2) recommendations for using the compaction monitoring technology in practice. The compaction monitoring technology includes sensors that monitor the power consumption used to move the compaction machine, an on-board computer and display screen, and a GPS system to map the spatial location of the machine. In situ soil density, strength, and stiffness data characterized the soil at various stages of compaction. For each test strip or test area, in situ soil properties were compared directly to machine power values to establish statistical relationships. Statistical models were developed to predict soil density, strength, and stiffness from the machine power values. Field data for multiple test strips were evaluated. The R2 correlation coefficient was generally used to assess the quality of the regressions. Strong correlations were observed between averaged machine power and field measurement data. The relationships are based on the compaction model derived from laboratory data. Correlation coefficients (R2) were consistently higher for thicker lifts than for thin lifts, indicating that the depth influencing machine power response exceeds the representative lift thickness encountered under field conditions. Caterpillar Inc. compaction monitoring technology also identified localized areas of an earthwork project with weak or poorly compacted soil. The soil properties at these locations were verified using in situ test devices. This report also documents the steps required to implement the compaction monitoring technology evaluated.

Use of Longitudinal Subdrains in the 3R Program, HR-509, Progress Report #2, 1981

The main consideration for base construction under the pavement, in the design of Iowa's interstate, was structural capacity. The material was dense graded with the aim of supporting the pavement and distributing the load as it is transferred to the underlying grade. The drainage characteristics of the base was apparently not given adequate consideration. On jointed portland cement concrete pavement, the water that is trapped immediately beneath the pavement causes severe problems. The traffic causes rapid movement of the water resulting in the hydraulic pressures or "pumping" (movement and redeposit of base fine material), further resulting in faulting between individual slabs. The objective of this evaluation is to determine if longitudinal subdrains are effective in preventing or reducing pumping, faulting and related deterioration. Results suggest that, based upon the flow from the outlets observed during periodic checks and evidence of water flow at the outlets, it appears that to date the subdrains are effective in draining the subbase and subgrade. Because of the limited data available at this time, however, the pavement condition and faulting results are inconclusive.

Extracellular deposition of matrilin-2 controls the timing of the myogenic program during muscle regeneration.

Here, we identify a role for the matrilin-2 (Matn2) extracellular matrix protein in controlling the early stages of myogenic differentiation. We observed Matn2 deposition around proliferating, differentiating and fusing myoblasts in culture and during muscle regeneration in vivo. Silencing of Matn2 delayed the expression of the Cdk inhibitor p21 and of the myogenic genes Nfix, MyoD and Myog, explaining the retarded cell cycle exit and myoblast differentiation. Rescue of Matn2 expression restored differentiation and the expression of p21 and of the myogenic genes. TGF-β1 inhibited myogenic differentiation at least in part by repressing Matn2 expression, which inhibited the onset of a positive-feedback loop whereby Matn2 and Nfix activate the expression of one another and activate myoblast differentiation. In vivo, myoblast cell cycle arrest and muscle regeneration was delayed in Matn2(-/-) relative to wild-type mice. The expression levels of Trf3 and myogenic genes were robustly reduced in Matn2(-/-) fetal limbs and in differentiating primary myoblast cultures, establishing Matn2 as a key modulator of the regulatory cascade that initiates terminal myogenic differentiation. Our data thus identify Matn2 as a crucial component of a genetic switch that modulates the onset of tissue repair.