Propagation of melting cooperativity along the phosphodiester backbone of DNA

The role of the DNA phosphodiester backbone in the transfer of melting cooperativity between two helical domains was experimentally addressed with a helix-bulge-helix DNA model, in which the bulge consisted of a varying number of either conformationally flexible propanediol or conformationally constrained bicyclic anucleosidic phosphodiester backbone units. We found that structural communication between two double helical domains is transferred along the DNA backbone over the equivalent of ca. 12-20 backbone units, depending on whether there is a symmetric or asymmetric distribution of the anucleosidic units on both strands. We observed that extension of anucleosidic units on one strand only suffices to disrupt cooperativity transfer in a similar way as if extension occurs on both strands, indicating that the length of the longest anucleosidic inset determines cooperativity transfer. Furthermore, conformational rigidity of the sugar unit increases the distance of coopertivity transfer along the phosphodiester backbone. This is especially the case when the units are asymmetrically distributed in both strands

ROBREG: Stata module providing robust regression estimators

robreg provides a number of robust estimators for linear regression models. Among them are the high breakdown-point and high efficiency MM-estimator, the Huber and bisquare M-estimator, and the S-estimator, each supporting classic or robust standard errors. Furthermore, basic versions of the LMS/LQS (least median of squares) and LTS (least trimmed squares) estimators are provided. Note that the moremata package, also available from SSC, is required.

The Lord of Heaven in the Inner Chambers: Jesuits, Women, and Domestic Christianity (ca. 1580-1690)

The study focuses on gender norms and practices in Chinese Christian communities established by Jesuit missionary activity during the long seventeenth century. It analyzes how European and Chinese gender norms and practices affected each other in the context of the Sino-Western cultural contact initiated by the missionaries. The thesis consists of two parts. First, it analyzes the ways in which European Jesuits engaged with Chinese gender relations in the course of their mission in China. The study demonstrates that the Jesuits’ adoption of the Chinese scholar-gentry’s habitus entailed a partial adaptation to Confucian gender norms. The latter placed great emphasis on gender segregation and therefore discouraged direct communication between missionaries and Chinese women. This resulted in the emergence of organizational and devotional arrangements of Christian communities specific to China. Second, the study discusses Chinese Christian women's religious culture that emerged in the absence of a strong missionary presence among female devotees. It points out that Chinese Christian women created their own ritual culture and religious sociability in the domestic context, and that they actively took part in shaping Chinese Christianity as masters of domestic rituals.

Use of Complementary and Alternative Medicine in Children with Cancer: A Study at a Swiss University Hospital

Background Though complementary and alternative medicine (CAM) are frequently used by children and adolescents with cancer, there is little information on how and why they use it. This study examined prevalence and methods of CAM, the therapists who applied it, reasons for and against using CAM and its perceived effectiveness. Parent-perceived communication was also evaluated. Parents were asked if medical staff provided information on CAM to patients, if parents reported use of CAM to physicians, and what attitude they thought physicians had toward CAM. Study Design All childhood cancer patients treated at the University Children’s Hospital Bern between 2002–2011 were retrospectively surveyed about their use of CAM. Results Data was collected from 133 patients (response rate: 52%). Of those, 53% had used CAM (mostly classical homeopathy) and 25% of patients received information about CAM from medical staff. Those diagnosed more recently were more likely to be informed about CAM options. The most frequent reason for choosing CAM was that parents thought it wouldimprove the patient’s general condition. The most frequent reason for not using CAM was lack of information. Of those who used CAM, 87% perceived positive effects. Conclusions Since many pediatric oncology patients use CAM, patients’ needs should be addressed by open communication between families, treating oncologists and CAM therapists, which will allow parents to make informed and safe choices about using CAM.

Productivity and Market Integration in American Communal Dairying, 1830-1875

In our late twentieth century experience, survival of an economy seems critically dependent on well established rights to private property and a return to labor that rewards greater effort. But that need not be so. History provides examples of micro-socialist economies that internally, at least, allow for little private property for participants and a constant return to labor that is independent of effort. Some such economies may even be termed 'successful,' if success is taken to mean survival over several generations. If these communities survived without conditions that are generally thought to be necessary for success, a question worth asking is how this occurred, for we can then shed some light on what really is necessary for economic survival. Addressing this issue emphasizes the critical role of time, for even if the microsocialist economies that we study here eventually became the merest shadow of their former selves, the fact that they did flourish for so long makes them a valuable counterexample, and hence, a phenomenon in need of explanation. We consider here the dairy industry of the Shakers, which was characterized by intensive efforts to increase productivity, in part through the use of market signals, but efforts that were also limited by the ideological goals of the community. The Shakers were (and are, but since it is the historical Shakers that concern this paper, the past tense will be used) a Christian communal group. Some of their distinctive beliefs included the existence of a male and female Godhead, from which followed sexual equality, and active communication between Believers (a Shaker term for members of the sect) and denizens of the spirit world. Practices of the Society (their official name is the United Society of Believers in Christ's Second Appearing, the second appearing being in the body of their foundress, an illiterate Englishwoman named Ann Lee) included pacifism, celibacy, confession of sins to elders, and joint or communal ownership of the Society's assets. Each Shaker received the same return for his or her labor: room, board, clothing, and the experience of divine proximity in a community of like minded Believers (Stein 1992).

The meaning of informal BMT caregiving

Objectives. The aims of this qualitative descriptive exploratory study were to (1) describe informal caregiver commitment in informal caregiving; (2) describe caregiver expectations in informal caregiving; (3) describe caregiver role negotiation in informal caregiving, (4) identify other important caregiver energy sources; and (5) refine the conceptual model of Informal Caregiving Dynamics based on the study results. ^ Methods. Participants were 40 informal caregivers of blood and marrow transplant patients being treated at a comprehensive cancer center who told their caregiving stories in an audiotaped dialogue. Patients consented to have their caregivers contacted about the study and to have information collected from their medical records. To address the specific aims, the dialogues were analyzed for major elements and themes with an adaptation of the descriptive exploratory method. ^ Findings. Commitment was redefined as enduring caregiver responsibility that inspires life changes to make the patient a priority. Commitment calls caregivers to supportive presence and self-affirming loving connection with the patient. Expectation management was defined as envisioning the future and yearning to return to normal. Expectation management includes taking one day at a time, gauging behavior from past experiences with the patient, and reconciling anticipated to actual treatment twists and turns. Role negotiation was defined as appropriate pushing by the caregiver toward patient recovery and independence after getting a handle on complex care that demands shared responsibilities. Role negotiation happens as caregivers determine action with attention to patient voice and vigilantly bridge communication between patients and the health care system. Three additional energy sources of caring for self, gaining insight, and connecting with others, were identified and added to the model as underpinnings for commitment, expectation, and role negotiation respectively. ^ Discussion and implications. Methods of supporting informal caregivers that deserve investigation include consistent acknowledgment of caregiver contribution to patient care; provision of clear, present-focused information; opportunities to reconcile expectations with outcomes by developing a coherent caregiving story; and encouragement to maintain good health habits while caregiving. Patient contribution to the dynamics of caregiving warrants future research attention as does change in energy sources over time as a caregiver. ^

Electron intensity modulation for mixed-beam radiation therapy with an x-ray multi-leaf collimator

The current standard treatment for head and neck cancer at our institution uses intensity-modulated x-ray therapy (IMRT), which improves target coverage and sparing of critical structures by delivering complex fluence patterns from a variety of beam directions to conform dose distributions to the shape of the target volume. The standard treatment for breast patients is field-in-field forward-planned IMRT, with initial tangential fields and additional reduced-weight tangents with blocking to minimize hot spots. For these treatment sites, the addition of electrons has the potential of improving target coverage and sparing of critical structures due to rapid dose falloff with depth and reduced exit dose. In this work, the use of mixed-beam therapy (MBT), i.e., combined intensity-modulated electron and x-ray beams using the x-ray multi-leaf collimator (MLC), was explored. The hypothesis of this study was that addition of intensity-modulated electron beams to existing clinical IMRT plans would produce MBT plans that were superior to the original IMRT plans for at least 50% of selected head and neck and 50% of breast cases. Dose calculations for electron beams collimated by the MLC were performed with Monte Carlo methods. An automation system was created to facilitate communication between the dose calculation engine and the treatment planning system. Energy and intensity modulation of the electron beams was accomplished by dividing the electron beams into 2x2-cm2 beamlets, which were then beam-weight optimized along with intensity-modulated x-ray beams. Treatment plans were optimized to obtain equivalent target dose coverage, and then compared with the original treatment plans. MBT treatment plans were evaluated by participating physicians with respect to target coverage, normal structure dose, and overall plan quality in comparison with original clinical plans. The physician evaluations did not support the hypothesis for either site, with MBT selected as superior in 1 out of the 15 head and neck cases (p=1) and 6 out of 18 breast cases (p=0.95). While MBT was not shown to be superior to IMRT, reductions were observed in doses to critical structures distal to the target along the electron beam direction and to non-target tissues, at the expense of target coverage and dose homogeneity. ^

Delays in diagnosis and referral and treatment for hematologic malignancies

The purpose of this thesis project was to identify factors that may contribute to a delay in the diagnosis, referral or treatment of the hematologic malignancies. This thesis is a secondary data analysis of both qualitative and quantitative data collected during a pilot study for a parent CDC study to determine factors related to time to diagnosis, referral, and treatment of chronic lymphocytic leukemia (CLL), chronic myelogenous leukemia (CML), multiple myeloma (MM), and myelodisplastic syndrome (MDS). To identify patterns for referral, as well as explore referral, treatment, and follow-up patterns, MDACC performed a pathways analysis, and conducted semi-structured interviews with hematologic cancer patients to help identify factors related to delays. Interviews were also conducted with primary care physicians and community hematologists/oncologists to help identify factors associated with optimal and sub-optimal patterns of diagnosis and referral. The results of these analyses suggest a set of factors that may be related to a fairly smooth and rapid trajectory to treatment, and factors that may be related to a slower, more disrupted trajectory. Factors that may be especially important to facilitating rapid treatment include the presence of cues to seek diagnosis in the patient's environment and the patient recognizing and acting upon these cues to seek immediate medical attention. Furthermore, providers who perform behaviors including recognizing cues as indicators of hematologic malignancies and conducting appropriate diagnostic testing effectively and efficiently indicate that these behaviors may also contribute to shorter times to diagnosis. In regards to referrals, direct and effective communication between providers and patients, as well between providers themselves helped facilitate speedier referrals. A patient's insurance status as well as the presence or absence of social support in his environment served as factors that may increase or decrease time to diagnosis, referral, and treatment for a hematologic malignancy. Further research is needed to define delay to diagnosis, referral and treatment in order to improve early diagnosis, referral, and treatment of hematologic malignancies.^

A qualitative and quantitative assessment of cancer patients' perceptions of barriers to treatment

This study examined barriers that cancer patients experience in obtaining treatment. The principal aim of the study was to conduct a comprehensive quantitative and qualitative assessment of barriers to cancer treatment for Texas cancer patients. The three specific aims of the study were to: (1) conduct a review and critique of published and unpublished research on barriers to cancer treatment; (2) conduct focus groups for the qualitative assessment of cancer patients' perceived barriers to cancer treatment; and (3) survey a representative sample of cancer patients regarding perceived barriers to treatment. The study was guided by the Aday and Andersen access framework of predisposing, enabling, and need determinants of care-seeking.^ To address the first specific aim, a total of 732 abstracts were examined, from which 154 articles were selected for review. Of these 154 articles, 57 that related directly to research on barriers to cancer treatment were chosen for subsequent analysis. Criteria were applied to each article to evaluate the strength of the study design, sampling and measurement procedures. The major barriers that were consistently documented to influence whether or not cancer patients sought or continued required treatment included problems with communication between the patient and provider, lack of information on side effects, the cost of treatment and associated difficulties in obtaining and maintaining insurance coverage, and the absence of formal and informal networks of social support. Access barriers were generally greater for older, minority women, and patients of lower socioeconomic status.^ To address the second specific aim, a total of eight focus groups (n = 44) were conducted across the State of Texas with cancer patients identified by the Texas Community Oncology Network, American Cancer Society, and community health centers. One important finding was that cost is the greatest hurdle that patients face. Another finding was that with the health care/insurance crisis, an increasing number of physicians are working with their patients to develop individually-tailored payment plans. For people in rural areas, travel to treatment sites is a major barrier due to the travel costs as well as work time forfeited by patients and their family members. A third major finding was the patients' family and church play important roles in providing social and emotional support for cancer patients.^ To address the third aim, a total of 910 cancer patients were surveyed during October and November, 1993. Approximately 65% of the cancer patients responded to the survey. The findings showed that the major barriers to treatment included costs of medications and diagnostic tests, transportation, lack of social support, problems understanding the written information regarding their disease as well as losing coverage or having higher premiums or copayments once they were diagnosed (particularly among blacks).^ Significant differences in reported barriers were found between racial groups. The minority respondents (i.e., blacks and Hispanics) tended to experience more barriers to treatment compared to the white respondents. More specifically, Hispanics were more likely to report transportation as a barrier to treatment than both white and blacks. Future research is needed to better understand the problems that minority cancer patients experience in receiving treatment. (Abstract shortened by UMI.) ^

Patient-centered medical home technology effects on hypertension and diabetes control

Background: Hypertension and Diabetes is a public health and economic concern in the United States. The utilization of medical home concepts increases the receipt of preventive services, however, do they also increase adherence to treatments? This study examined the effect of patient-centered medical home technologies such as the electronic health record, clinical support system, and web-based care management in improving health outcomes related to hypertension and diabetes. Methods: A systematic review of the literature used a best evidence synthesis approach to address the general question " Do patient-centered medical home technologies have an effect of diabetes and hypertension treatment?" This was followed by an evaluation of specific examples of the technologies utilized such as computer-assisted recommendations and web-based care management provided by the patient's electronic health record. Ebsco host, Ovid host, and Google Scholar were the databases used to conduct the literature search. Results: The initial search identified over 25 studies based on content and quality that implemented technology interventions to improve communication between provider and patient. After further assessing the articles for risk of bias and study design, 13 randomized controlled studies were chosen. All of the studies chosen were conducted in various primary care settings in both private practices and hospitals between the years 2000 and 2007. The sample sizes of the studies ranged from 42 to 2924 participants. The mean age for all of the studies ranged from 56 to 71 years. The percent women in the studies ranged from one to 78 percent. Over one-third of the studies did not provide the racial composition of the participants. For the seven studies that did provide information about the ethnic composition, 64% of the intervention participants were White. All of the studies utilized some type of web-based or computer-based communication to manage hypertension or diabetes care. Findings on outcomes were mixed, with nine out of 13 studies showing no significant effect on outcomes examined, and four of the studies showing significant and positive impact on health outcomes related to hypertension or diabetes Conclusion: Although the technologies improved patient and provider satisfaction, the outcomes measures such as blood pressure control and glucose control were inconclusive. Further research is needed with diverse ethnic and SES population to investigate the role of patient-centered technologies on hypertension and diabetes control. Also, further research is needed to investigate the effects of innovative medical home technologies that can be used by both patients and providers to increase quality of communication concerning adherence to treatments.^

Sida y mujer : un análisis prospectivo de las causas de la infección del VIH/SIDA en las mujeres

El presente informe es el resultado de la investigación prospectiva realizada en mujeres infectadas por VIH/SIDA como tema de tesis de Magíster Políticas Sociales y Gestión Local defendida el 25 de noviembre de 2002 en el aula magna de la Facultad de Ciencias Políticas y Sociales, UNC. El SIDA no es sólo una enfermedad biológica sino que tiene una fuerte incidencia en lo social. La intención de este trabajo es despertar la inquietud para que las personas se movilicen a trabajar en la prevención y la asistencia, buscando respuestas alternativas que le faciliten al ser humano la posibilidad de tener una vida más digna. Las estadísticas nacionales demuestran una marcada feminización de esta epidemia. Las formas que asume la sexualidad son muy variadas y están determinadas por el tiempo y lugar donde vivimos. Las mujeres sufren una falta de contención de sus parejas sexuales con escasa toma de conciencia de la posibilidad de progresión de la enfermedad si no se utilizan métodos de barrera, que está íntimamente relacionado con la falta de educación sexual, también en el varón. Como conclusión, podemos decir que el 63,9% de las mujeres no utilizan métodos anticonceptivos debido a temores y prejuicios provocados por la falta de educación sexual. El 75,3% proviene de la negativa del varón a usar preservativo y el 100 % de las mujeres, a pedir el uso del preservativo por vergüenza o miedo. Todo esto nos está demostrando el poco diálogo con sus parejas sexuales y, por parte del hombre, la no protección de la mujer como madre, compañera y miembro útil de la sociedad.

Comunicación bucosinusal : diagnóstico con tomografía cone beam CBCT

Existe una estrecha relación entre 10s ápices de 10s molares superiores y el seno maxilar. Cualquier maniobra quirúrgica o lesión en estas piezas dentales pueden provocar una comunicación entre el seno maxilar y la cavidad bucal. Si bien el diagnóstico de la comunicación bucosinusal es fundamentalmente clínico, en muchas ocasiones 10s signos clínicos no son evidentes ni concluyentes. El estudio con Tomografía Cone Beam CBCT en tres dimensiones otorga una visualización en tres planos del espacio de las estructuras óseas y dentoalveolares permitiendo realizar un diagnóstico preciso de la magnitud y correcta localización de las comunicaciones bucosinusales, facilitando la planificación quirúrgica al profesional y evitando complicaciones al paciente.

Sediment volume variations inferred from DGPS measurements within Bossons glacier proglacial area (Mont-Blanc massif, France)

This dataset presents Differential Global Positioning System data (DGPS) acquired within the Bossons glacier proglacial area. Bossons glacier is a rapidly retreating glacier and its proglacial area is deglaciated for ~30 years. Bossons stream is one of the outlets of the subglacial drainage system. It starts as a 800 m steep cascade reach, then flows through an area with gentler slope : the Plan des Eaux (PdE). PdE is a 300 m long, 50 m wide proglacial alluvial plain with an increasing channel mobility in the downstream direction but decreasing slope gradient and incision. As it may act a sediment trap, studying periglacial and proglacial erosion processes in the Bossons catchment requires to quantify PdE sediment volume evolution. A several meter-sized block located within Bossons proglacial area was set up as GPS base : its location was measured by one antenna (Topcon Hyper Pro) by performing 600 consecutive measurements throughout one day. A second antenna (Topcon Hyper Pro) was then used to measure XYZ location of points in the proglacial area with a ~2 m grid. Radio communication between the two antennas allowed differential calculations to be automatically carried out on field using the Topcon FC-250 hand controller. This methodology yields 3 cm XY and 1.5 cm Z uncertainties. DGPS data have been acquired through 10 campaigns from 2004 to 2014; campaigns from 2004 to 2008 cover a smaller area than those from 2010 to 2014. Digital Elevation Model (DEM) have been interpolated from DGPS data and difference between two DEMs yields deposited and eroded volume within PdE. Maps of PdE volume variation between two campaigns show that incision mainly occurs in the upper and lower sections where as deposition dominates in the middle section. Deposition, denudation and net rate (deposition rate - denudation rate) are calculated by normalizing volumes by DEM areas. Deposition dominates results with a mean net rate of 29 mm/yr. However, strong inter-annual variability exists and some years are dominated by denudation : -36 mm/yr and -100 mm/yr for 2006 and 2011, respectively. Nonetheless, oldest campaigns (2004 to 2008) were carried out on the lower part part of the alluvial plain and ruling them out to keep only complete DEM (2010 to 2014) yields a mean net rate of ~15 mm/yr. This results is coherent with field observations of both strong deposition (e.g. flood deposits) and strong erosion (e.g. 30 cm incision) evidences. Bossons glacier proglacial area is thus dynamic with year-to-year geormorphological changes but may leans toward increasing its mean elevation through a deposition dominated system.

Evaluación geoecológica de los paisajes del Departamento Minas (Provincia de Neuquén), para el estudio de la degradación de la tierra

Las sociedades en su afán de aprovechar los recursos naturales que la tierra le provee, han ido transformando permanentemente el medio que habitamos, generando una crisis ambiental que es tema de preocupación y permanente discusión en organismos, foros y conferencias relacionados con el cuidado y protección del medio ambiente. En las regiones áridas y semiáridas uno de los problemas ambientales más comunes es la degradación de tierras por efecto del sobrepastoreo. La tercera parte de la superficie terrestre del planeta es árida y semiárida y en ella los procesos de desertización se han intensificado en los últimos decenios. Según la Convención de las Naciones Unidas de lucha contra la Desertificación (CNULD), este problema amenaza al 40 por ciento aproximadamente, de la masa terrestre de nuestro planeta. Más de 1000 millones de personas en alrededor de 100 países están afectadas directamente por la desertificación o corren peligro de estarlo (CNULD, 2003), estimándose que "la pérdida de ingresos en las áreas afectadas alcanza a unos 42.000 millones de dólares". Argentina en general y la Patagonia en particular, no son ajenas a esta situación. La Secretaría de Recursos Naturales y Medio Ambiente Humano (1996), calcula que aproximadamente el 75 por ciento de nuestro territorio nacional se encuentra afectado por crecientes condiciones de aridez y en la Patagonia, el 90 por ciento de la superficie (unos 780.000 km2) presenta signos de degradación. De esta superficie, un 30 por ciento, está bajo procesos erosivos eólicos e hídricos severos o graves con tendencia a agravarse. Teniendo en cuenta esta situación, esta tesis tiene como propósito aplicar las concepciones metodológicas de la geoecología de los paisajes en el Departamento Minas (Provincia de Neuquén), con vistas a estudiar la estructura y funcionamiento de los paisajes, herramienta fundamental para comprender el fenómeno de la degradación de la tierra. El objetivo central de este trabajo consiste en estudiar la degradación de los paisajes de este lugar a partir de los preceptos de la geoecología, con apoyo de los Sistemas de Información Geográfica y la teledetección, estableciendo índices diagnósticos que reflejen la interacción e interdependencia entre los componentes naturales y sociales del paisaje. El estudio de los paisajes brinda la posibilidad de integrar transdisciplinariamente los conocimientos y percepciones de la diversidad geoecológica y socioeconómica desde una perspectiva dinámica. Mediante este análisis se puede arribar al conocimiento de las formas de ocupación y conservación de los recursos naturales procurando la protección de la oferta ecológica a largo plazo. El paisaje geográfico o geosistema se concibe como "un sistema espacio-temporal, complejo y abierto, que se origina y evoluciona justamente en la interfase naturaleza-sociedad, en un constante estado de intercambio de energía, materia e información, donde su estructura, funcionamiento, dinámica y evolución reflejan la interacción entre los componentes naturales (abióticos y bióticos), técnico-económicos y socio-culturales (Mateo, J. 1991; Salinas. E. 1991y 1997). Se trata de una formación socio-natural que constituye una categoría científica y como tal, será adoptada en este trabajo.

Climas motivacionales, liderazgo y cohesión grupal en contexto deportivo universitario

Objetivos: Conocer las interacciones entrenador-atleta y comprender las practicas de liderazgo, de generación de climas motivacionales y de comunicación entre líderes deportivos y jugadores. Metodología: Metodología de cohorte mixto. Se realizó correlación de variables cuantitativas y se analizaron las experiencias y los sentidos del contexto deportivo con una aproximación cualitativa. Se aplicaron a 31 deportistas universitarios los instrumentos: Clima Motivacional Percibido en el Deporte (PMCSQ-2), Clima en el Deporte (SCQ) y Orientación al Ego y a la Tarea en el Deporte. Para profundizar la información obtenida, se realizaron entrevistas semi-estructuradas a 6 deportistas y 2 entrenadores universitarios. RESULTADOS: Que el deportista sienta confianza en su entrenador se encuentra asociado a que se sienta comprendido y aceptado por él. Que el entrenador genere un clima motivacional orientado hacia el ego está relacionado con que los deportistas tengan orientaciones de meta ego. Los entrenadores utilizan dos estilos de liderazgo opuestos: liderazgo democrático (entrenamientos) y liderazgo autocrático (competiciones) Conclusiones: Cuando el atleta confía en la persona que lo dirige deportivamente, presenta mayor satisfacción deportiva. También, que el entrenador fomente un ambiente de comparación social propicia que los deportistas rivalicen con compañeros de equipo y basen su rendimiento en resultados deportivos obtenidos