Genometric analyses of the organization of circular chromosomes: a universal pressure determines the direction of ribosomal RNA genes transcription relative to chromosome replication.

Selective pressures related to gene function and chromosomal architecture are acting on genome sequences and can be revealed, for instance, by appropriate genometric methods. Cumulative nucleotide skew analyses, i.e., GC, TA, and ORF orientation skews, predict the location of the origin of DNA replication for 88 out of 100 completely sequenced bacterial chromosomes. These methods appear fully reliable for proteobacteria, Gram-positives, and spirochetes as well as for euryarchaeotes. Based on this genome architecture information, coorientation analyses reveal that in prokaryotes, ribosomal RNA (rRNA) genes encoding the small and large ribosomal subunits are all transcribed in the same direction as DNA replication; that is, they are located along the leading strand. This result offers a simple and reliable method for circumscribing the region containing the origin of the DNA replication and reveals a strong selective pressure acting on the orientation of rRNA genes similar to the weaker one acting on the orientation of ORFs. Rate of coorientation of transfer RNA (tRNA) genes with DNA replication appears to be taxon-specific. Analyzing nucleotide biases such as GC and TA skews of genes and plotting one against the other reveals a taxonomic clusterization of species. All ribosomal RNA genes are enriched in Gs and depleted in Cs, the only so far known exception being the rRNA genes of deuterostomian mitochondria. However, this exception can be explained by the fact that in the chromosome of the human mitochondrion, the model of the deuterostomian organelle genome, DNA replication, and rRNA transcription proceed in opposite directions. A general rule is deduced from prokaryotic and mitochondrial genomes: ribosomal RNA genes that are transcribed in the same direction as the DNA replication are enriched in Gs, and those transcribed in the opposite direction are depleted in Gs.

Social and medical vulnerability factors of emergency department frequent users in a universal health insurance system.

OBJECTIVES: The objectives were to identify the social and medical factors associated with emergency department (ED) frequent use and to determine if frequent users were more likely to have a combination of these factors in a universal health insurance system. METHODS: This was a retrospective chart review case-control study comparing randomized samples of frequent users and nonfrequent users at the Lausanne University Hospital, Switzerland. The authors defined frequent users as patients with four or more ED visits within the previous 12 months. Adult patients who visited the ED between April 2008 and March 2009 (study period) were included, and patients leaving the ED without medical discharge were excluded. For each patient, the first ED electronic record within the study period was considered for data extraction. Along with basic demographics, variables of interest included social (employment or housing status) and medical (ED primary diagnosis) characteristics. Significant social and medical factors were used to construct a logistic regression model, to determine factors associated with frequent ED use. In addition, comparison of the combination of social and medical factors was examined. RESULTS: A total of 359 of 1,591 frequent and 360 of 34,263 nonfrequent users were selected. Frequent users accounted for less than a 20th of all ED patients (4.4%), but for 12.1% of all visits (5,813 of 48,117), with a maximum of 73 ED visits. No difference in terms of age or sex occurred, but more frequent users had a nationality other than Swiss or European (n = 117 [32.6%] vs. n = 83 [23.1%], p = 0.003). Adjusted multivariate analysis showed that social and specific medical vulnerability factors most increased the risk of frequent ED use: being under guardianship (adjusted odds ratio [OR] = 15.8; 95% confidence interval [CI] = 1.7 to 147.3), living closer to the ED (adjusted OR = 4.6; 95% CI = 2.8 to 7.6), being uninsured (adjusted OR = 2.5; 95% CI = 1.1 to 5.8), being unemployed or dependent on government welfare (adjusted OR = 2.1; 95% CI = 1.3 to 3.4), the number of psychiatric hospitalizations (adjusted OR = 4.6; 95% CI = 1.5 to 14.1), and the use of five or more clinical departments over 12 months (adjusted OR = 4.5; 95% CI = 2.5 to 8.1). Having two of four social factors increased the odds of frequent ED use (adjusted = OR 5.4; 95% CI = 2.9 to 9.9), and similar results were found for medical factors (adjusted OR = 7.9; 95% CI = 4.6 to 13.4). A combination of social and medical factors was markedly associated with ED frequent use, as frequent users were 10 times more likely to have three of them (on a total of eight factors; 95% CI = 5.1 to 19.6). CONCLUSIONS: Frequent users accounted for a moderate proportion of visits at the Lausanne ED. Social and medical vulnerability factors were associated with frequent ED use. In addition, frequent users were more likely to have both social and medical vulnerabilities than were other patients. Case management strategies might address the vulnerability factors of frequent users to prevent inequities in health care and related costs.

Universal Design for Better Living The Essential Bathroom, May 2004

An easy-living home requires a full-sized bathroom on the main level. Family members will appreciate the extra space and guests of all ages and abilities will feel more welcome. At a minimum, you’ll need a five foot circle of open floor space for maneuvering a wheelchair between bathroom fixtures. A small powder room won’t work for guests who use walkers or wheelchairs. A shower stall—with no curb to step over—is more convenient than a tub for most guests. Make sure the doorway opening for the bathroom is at least 32 inches wide (preferably 36 inches). Universal design features, such as these, make homes better for everyone.

Universal Design for Better Living: “Where to Get Gadgets and Gizmos”, May 2004

If they don’t carry the item, ask them to order it for you. Look at discount stores, such as Target, Wal-Mart, K-Mart, or Menard’s (they are more likely to carry items with universal design features). Look at the “Gadgets and Gizmos” section of the Iowa State University Extension Web site on “Universal Design & Home Accessibility.”

The effects of a universal child benefit

I study the impact of a universal child benefit on fertility and family well-being. I exploitthe unanticipated introduction of a new, sizeable, unconditional child benefit in Spain in2007, granted to all mothers giving birth on or after July 1, 2007. The regressiondiscontinuity-type design allows for a credible identification of the causal effects. I find thatthe benefit did lead to a significant increase in fertility, as intended, part of it coming froman immediate reduction in abortions. On the unintended side, I find that families whoreceived the benefit did not increase their overall expenditure or their consumption ofdirectly child-related goods and services. Instead, eligible mothers stayed out of the laborforce significantly longer after giving birth, which in turn led to their children spending lesstime in formal child care and more time with their mother during their first year of life. Ialso find that couples who received the benefit were less likely to break up the year afterhaving the child, although this effect was only short-term. Taken together, the resultssuggest that child benefits of this kind may successfully increase fertility, as well asaffecting family well-being through their impact on maternal time at home and familystability.

Stroke initial severity and outcome relative to insurance status in a universal health care system in Switzerland.

BACKGROUND:  Socioeconomic status is thought to have a significant influence on stroke incidence, risk factors and outcome. Its influence on acute stroke severity, stroke mechanisms, and acute recanalisation treatment is less known. METHODS:  Over a 4-year period, all ischaemic stroke patients admitted within 24 h were entered prospectively in a stroke registry. Data included insurance status, demographics, risk factors, time to hospital arrival, initial stroke severity (NIHSS), etiology, use of acute treatments, short-term outcome (modified Rankin Scale, mRS). Private insured patients (PI) were compared with basic insured patients (BI). RESULTS:  Of 1062 consecutive acute ischaemic stroke patients, 203 had PI and 859 had BI. They were 585 men and 477 women. Both populations were similar in age, cardiovascular risk factors and preventive medications. The onset to admission time, thrombolysis rate, and stroke etiology according to TOAST classification were not different between PI and BI. Mean NIHSS at admission was significantly higher for BI. Good outcome (mRS ≤ 2) at 7 days and 3 months was more frequent in PI than in BI. CONCLUSION:  We found better outcome and lesser stroke severity on admission in patients with higher socioeconomic status in an acute stroke population. The reason for milder strokes in patients with better socioeconomic status in a universal health care system needs to be explained.

A universal microscope manipulator

A modified and improved model of a mechanical manipulator for observation of pinned and mounted insects is described. This device allows movement of the observed object around three perpendicular axes in the field of vision at all magnifications of stereomicroscopes. The main improvement of this new model is positioning of the guiding knobs for rotating around two of the axes next to each other, allowing faster and easier manipulation of the studied object. Thus, one of the main advantages of this device is the possibility to rotate the specimen without the need to refocus. The device enables easily reaching a precession deviation in the intersection point of axes up to 0.5 mm in the process of assembling.

Ciência e Cidadania38 Por um cidadão cabo-verdiano universal e transdisciplinar

A autonomia da Ciência e as questões de ética. A explicação científica. A Comissão de Ética em Ciência e Tecnologia (COMEST) da UNESCO e os eventuais riscos da aplicabilidade dos produtos da investigação científica e tecnológica. A Comissão Europeia e as experiências de participação pública em matérias de C&T. A aprendizagem das ciências e a cidadania. A necessidade do cidadão de hoje em ter uma educação científica que o capacite a entender o que se passa ao seu redor. O caso de Cabo Verde. Sugestões de medidas e resoluções para o melhor envolvimento do cidadão cabo-verdiano em matérias de C&T.

Issuance of patient reminders for influenza vaccination by US-based primary care physicians during the first year of universal influenza vaccination recommendations.

To estimate the number of physician-reported influenza vaccination reminders during the 2010-2011 influenza season, the first influenza season after universal vaccination recommendations for influenza were introduced, we interviewed 493 members of the Physicians Consulting Network. Patient vaccination reminders are a highly effective means of increasing influenza vaccination; nonetheless, only one quarter of the primary care physicians interviewed issued influenza vaccination reminders during the first year of universal vaccination recommendations, highlighting the need to improve office-based promotion of influenza vaccination.

O global e o local nos processos de prescrição e realização do currículo e na promoção do conhecimento universal. O caso da Universidade de Cabo Verde

Na abordagem da problemática do currículo e do seu desenvolvimento no contexto do ensino superior, tem-se enfatizado a centralidade do conhecimento científico, com a consequente tradução do global e do local na produção científica, bem como nas prescrições e nas práxis curriculares. Entretanto, a tendência para, à escala internacional, prevalecerem lógicas hegemónicas e mercadológicas na prescrição e aferição do conhecimento válido, e a existência de gritantes assimetrias entre os países centrais e da periferia na produção científica constituem sérios desafios na promoção de uma educação e de um ensino superior pautados por perspetivas contra-hegemónicas e humanistas. No entanto, não é suficiente a denúncia do hegemonismo científico e curricular, nem mesmo a reivindicação, a nível dos discursos, quer de um maior protagonismo dos países periféricos na promoção do património mundial do conhecimento, quer de uma mais efetiva autonomia das universidades na conceção dos currículos e projetos de formação. Nesta conferência, sustenta-se que não só é possível aliar-se o global e o local nos processos de formulação das opções curriculares e dos projetos de formação, mediante a instauração de lógicas idiossincráticas, democráticas e emancipadoras na tradução do desígnio nacional de desenvolvimento dos países da periferia, como existe um vasto potencial de oportunidades de inovação, adaptação e recriação do currículo no contexto das atividades académicas, com a consequente promoção das epistemologias dos referidos países, como contribuição para a valorização do património universal do conhecimento.

Social and medical vulnerability factors of emergency department frequent users in a universal health insurance system

Objectifs - Identifier les facteurs de vulnérabilité sociaux et médicaux associés au recours multiple aux consultations des urgences. - Déterminer si les patients à recours multiple sont plus à même de combiner ces facteurs dans un système d'assurance universelle. Méthode Il s'agit d'une étude cas-contrôle rétrospective basée sur l'étude de dossiers médico-administratifs comparant des échantillons randomisés de patients à recours multiple à des patients n'appartenant pas à cette catégorie, au sein des urgences du Centre Hospitalier Universitaire Vaudois et de la Policlinique Médicale Universitaire de Lausanne. Les auteurs ont défini les patients à recours multiple comme comptabilisant au moins quatre consultations aux urgences durant les douze mois précédents. Les patients adultes (>18 ans) ayant consulté les urgences entre avril 2008 et mars 2009 (période d'étude) étaient inclus ; ceux quittant les urgences sans décharge médicale étaient exclus. Pour chaque patient, le premier dossier d'urgence informatisé inclus dans la période d'étude était sélectionné pour l'extraction des données. Outre les variables démographiques de base, les variables d'intérêt comprennent des caractéristiques sociales (emploi, type de résidence) et médicales (diagnostic principal aux urgences). Les facteurs sociaux et médicaux significatifs ont été utilisés dans la construction d'un modèle de régression logistique, afin de déterminer les facteurs associés avec le recours multiple aux urgences. De plus, la combinaison des facteurs sociaux et médicaux a été étudiée. Résultats Au total, 359/Γ591 patients à recours multiple et 360/34'263 contrôles ont été sélectionnés. Les patients à recours multiple représentaient moins d'un vingtième de tous les patients des urgences (4.4%), mais engendraient 12.1% de toutes les consultations (5'813/48'117), avec un record de 73 consultations. Aucune différence en termes d'âge ou de genre n'est apparue, mais davantage de patients à recours multiples étaient d'une nationalité autre que suisse ou européenne (n=117 [32.6%] vs n=83 [23.1%], p=0.003). L'analyse multivariée a montré que les facteurs de vulnérabilité sociaux et médicaux les plus fortement associés au recours multiple aux urgences étaient : être sous tutelle (Odds ratio [OR] ajusté = 15.8; intervalle de confiance [IC] à 95% = 1.7 à 147.3), habiter plus proche des urgences (OR ajusté = 4.6; IC95% = 2.8 à 7.6), être non assuré (OR ajusté = 2.5; IC95% = 1.1 à 5.8), être sans emploi ou dépendant de l'aide sociale (OR ajusté = 2.1; IC95% = 1.3 à 3.4), le nombre d'hospitalisations psychiatriques (OR ajusté = 4.6; IC95% = 1.5 à 14.1), ainsi que le recours à au moins cinq départements cliniques différents durant une période de douze mois (OR ajusté = 4.5; IC95% = 2.5 à 8.1). Le fait de comptabiliser deux sur quatre facteurs sociaux augmente la vraisemblance du recours multiple aux urgences (OR ajusté = 5.4; IC95% = 2.9 à 9.9) ; des résultats similaires ont été trouvés pour les facteurs médicaux (OR ajusté = 7.9; IC95% = 4.6 à 13.4). La combinaison de facteurs sociaux et médicaux est fortement associée au recours multiple aux urgences, puisque les patients à recours multiple étaient dix fois plus à même d'en comptabiliser trois d'entre eux (sur un total de huit facteurs, IC95% = 5.1 à 19.6). Conclusion Les patients à recours multiple aux urgences représentent une proportion modérée des consultations aux urgences du Centre Hospitalier Universitaire Vaudois et de la Policlinique Médicale Universitaire de Lausanne. Les facteurs de vulnérabilité sociaux et médicaux sont associés au recours multiple aux urgences. En outre, les patients à recours multiple sont plus à même de combiner les vulnérabilités sociale et médicale que les autres. Des stratégies basées sur le case management pourraient améliorer la prise en charge des patients à recours multiple avec leurs vulnérabilités afin de prévenir les inégalités dans le système de soins ainsi que les coûts relatifs.

Utilização de métodos de representação espacial para cálculo do fator topográfico na equação universal de perda de solo revisada em bacias hidrográficas

Métodos de representação espacial para o cálculo do fator topográfico (LS) da Equação Universal de Perda de Solo Revisada (RUSLE) têm sido utilizados para estimar a erosão do solo e a produção de sedimentos em bacias hidrográficas. Esses procedimentos baseiam-se nas equações tradicionalmente empregadas para determinação do fator LS e em informações que caracterizam a forma das vertentes derivadas do modelo numérico de elevação (MNE). Neste estudo foram analisados dois métodos de representação espacial utilizados no cálculo do fator LS em modelos matemáticos de erosão e produção de sedimentos em bacias hidrográficas. A análise foi realizada em quatro bacias rurais de relevo movimentado. Os valores de LS obtidos pelos métodos de representação espacial foram comparados entre si e com valores de LS determinados pelo método tradicional com levantamento em campo. Resultados mostraram que os valores de LS gerados pelos métodos de representação espacial apresentam diferenças significativas entre si, sendo dependentes do procedimento de cálculo e do método utilizado para determinar a direção de fluxo no MNE. Também foi verificado que os valores numéricos do fator LS determinados pelos métodos de representação espacial apresentam diferenças em relação àqueles estimados pelo método tradicional.

Calibração e validação da equação universal de perda de solos modificada (MUSLE) utilizando dados hidrossedimentológicos locais

Modelos hidrossedimentológicos são úteis na análise ambiental de bacias hidrográficas não monitoradas. Entretanto, para que as suas predições sejam confiáveis, é necessário que os modelos sejam adequadamente calibrados e validados para as condições locais. O objetivo do presente trabalho foi calibrar o coeficiente a da MUSLE para as condições da bacia do ribeirão Pipiripau, usando dados hidrossedimentológicos locais, bem como validar a equação calibrada, com uma série de dados diferente da usada na calibração. O coeficiente a da MUSLE foi calibrado por meio do ajuste entre os valores observados e calculados de aporte de sedimento de eventos individuais, correspondentes ao período entre 1999 e 2005, usando dados hidrológicos (Q e q p) observados. Para validação do modelo calibrado, a série usada correspondeu aos anos de 1998 e 2006-2009 (N.A.: dados corretos, ver p. 12), onde apenas os dados pluviométricos locais e os fatores CN, K, L, S, C e P da bacia, previamente obtidos, foram usados. Os resultados indicam que a MUSLE calibrada apresenta melhor acurácia na estimativa do aporte de sedimento total anual (R² = 0,68 e E = 0,61) do que em nível mensal (R² = 0,44 e E = 0,43). Como o coeficiente de ajuste a da MUSLE foi proporcional ao volume de precipitação pluvial anual, este poderá ser usado para melhorar as predições do modelo.