Background
Public health nursing (PHN) is an essential component of baccalaureate nursing education. In order to build PHN competencies, universities must design and operationalize meaningful ...clinical activities addressing community and population health. Currently, there is a paucity of literature delineating best practices for promoting competency in PHN.
Aims
The purpose of this manuscript is to describe a PHN‐student health fair program as a means for meeting undergraduate PHN curricular standards, and to report results of an evaluation conducted examining its effectiveness in improving community member's health knowledge.
Methods
Health fairs were held at community agencies that served the homeless or victims of intimate partner violence. A total of 113 community members that attended a health fair were assessed at baseline and immediate posttest using open‐ended questionnaires. The design of the health fairs included a community assessment, intervention, and evaluation flow that followed the nursing process.
Results
We report that results from participants surveyed indicated that PHN‐student delivered health fairs improved health knowledge among community members in this sample (p = .000).
Conclusion
Health fairs conducted by PHN students appear to be promising community health promotion and disease prevention interventions that can serve as an effective strategy for teaching PHN student competencies and facilitating engagement with the community.
Context:
Experimental evidence supports a relevance of vitamin D (VitD) for reproduction; however, data in humans are sparse and inconsistent.
Objective:
To assess the relationship of VitD status ...with ovulation induction (OI) outcomes in women with polycystic ovary syndrome (PCOS).
Design:
A retrospective cohort.
Setting:
Secondary analysis of randomized controlled trial data.
Participants:
Participants in the Pregnancy in PCOS I (PPCOS I) randomized controlled trial (n = 540) met the National Institutes of Health diagnostic criteria for PCOS.
Interventions:
Serum 25OHD levels were measured in stored sera.
Main Outcome Measures:
Primary, live birth (LB); secondary, ovulation and pregnancy loss after OI.
Results:
Likelihood for LB was reduced by 44% for women if the 25OHD level was < 30 ng/mL (<75 nmol/L; odds ratio OR, 0.58 0.35–0.92). Progressive improvement in the odds for LB was noted at thresholds of ≥38 ng/mL (≥95 nmol/L; OR, 1.42 1.08–1.8), ≥40 ng/mL (≥100 nmol/L; OR, 1.51 1.05–2.17), and ≥45 ng/mL (≥112.5 nmol/L; OR, 4.46 1.27–15.72). On adjusted analyses, VitD status was an independent predictor of LB and ovulation after OI.
Conclusions:
In women with PCOS, serum 25OHD was an independent predictor of measures of reproductive success after OI. Our data identify reproductive thresholds for serum 25OHD that are higher than recommended for the nonpregnant population.
Stored sera from a RCT (Pregnancy in Polycystic Ovary Syndrome I) were assayed for 25OHD; vitamin D status was identified as an independent predictor of live birth following ovulation induction in women with PCOS.
Pacific salmon exposed to sublethal concentrations of organophosphate pesticides (OP) have impaired olfactory function that can lead to loss of behaviors that are essential for survival. These ...exposures often involve mixtures and can occur at levels below those which inhibit acetylcholinesterase (AChE). In this study, juvenile Coho salmon were exposed for 24 h to either 0.1, 0.5, or 2.5 ppb chlorpyrifos (CPF), 2, 10, or 50 ppb malathion (MAL), or binary mixtures of 0.1 CPF:2 ppb MAL, 0.5 CPF:10 ppb MAL, or 2.5 CPF:10 ppb MAL to mimic single and binary environmental exposures. Microarray analysis of olfactory rosettes from pesticide-exposed salmon revealed differentially expressed genes involved in nervous system function and signaling, aryl hydrocarbon receptor signaling, xenobiotic metabolism, and mitochondrial dysfunction. Coho exposed to OP mixtures exhibited a more pronounced loss in detection of a predatory olfactory cue relative to those exposed to single compounds, whereas respirometry experiments demonstrated that exposure to OPs, individually and in mixtures, reduced maximum respiratory capacity of olfactory rosette mitochondria. The observed molecular, biochemical, and behavioral effects occurred largely in the absence of effects on brain AChE. In summary, our results provide new insights associated with the sublethal neurotoxic effects of OP mixtures relevant to environmental exposures involving molecular and cellular pathways of injury to the salmon olfactory system that underlie neurobehavioral injury.
Abstract
Classifying images using supervised machine learning (ML) relies on labeled training data—classes or text descriptions, for example, associated with each image. Data‐driven models are only ...as good as the data used for training, and this points to the importance of high‐quality labeled data for developing a ML model that has predictive skill. Labeling data is typically a time‐consuming, manual process. Here, we investigate the process of labeling data, with a specific focus on coastal aerial imagery captured in the wake of hurricanes that affected the Atlantic and Gulf Coasts of the United States. The imagery data set is a rich observational record of storm impacts and coastal change, but the imagery requires labeling to render that information accessible. We created an online interface that served labelers a stream of images and a fixed set of questions. A total of 1,600 images were labeled by at least two or as many as seven coastal scientists. We used the resulting data set to investigate interrater agreement: the extent to which labelers labeled each image similarly. Interrater agreement scores, assessed with percent agreement and Krippendorff's alpha, are higher when the questions posed to labelers are relatively simple, when the labelers are provided with a user manual, and when images are smaller. Experiments in interrater agreement point toward the benefit of multiple labelers for understanding the uncertainty in labeling data for machine learning research.
Plain Language Summary
After hurricanes and storms, pictures taken from a plane can be used to observe how the coast was impacted. A single flight might take thousands of pictures. If a computer could automatically analyze the pictures, then a person would not need to look at them one‐by‐one. To teach a computer to analyze images, we need many pictures and many labels that describe what is visible in each picture. But where do we get those labels? Typically, a coastal scientist labels the pictures by sorting them into folders or typing codes into a spreadsheet. But does every coastal scientist label pictures the same way? Some labeling questions are easy to answer, and scientists mostly agree (“Is this image all water?”). Other labeling questions are harder to answer, and cause disagreement (“Was there damage to buildings?”). This paper is about how well scientists agree when labeling the same pictures, and how we can improve agreement among scientists. We try some experiments and offer a few ideas on how to improve agreement. We suggest writing very clear questions, using smaller images, and having a comprehensive manual. It turns out that having a manual with examples—and reading the manual!—really helps.
Key Points
We measure agreement among coastal scientists labeling the same sets of poststorm images
Coastal scientists agree more when rating landforms, less when labeling inferred processes
Iterating on questions, providing documentation, and using smaller image sizes all increase agreement
Both constitutive secretion and Ca(2+)-regulated exocytosis require the assembly of the soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE) complexes. At present, little is ...known about how the SNARE complexes mediating these two distinct pathways differ in structure. Using the Drosophila neuromuscular synapse as a model, we show that a mutation modifying a hydrophobic layer in syntaxin 1A regulates the rate of vesicle fusion. Syntaxin 1A molecules share a highly conserved threonine in the C-terminal +7 layer near the transmembrane domain. Mutation of this threonine to isoleucine results in a structural change that more closely resembles those found in syntaxins ascribed to the constitutive secretory pathway. Flies carrying the I254 mutant protein have increased levels of SNARE complexes and dramatically enhanced rate of both constitutive and evoked vesicle fusion. In contrast, overexpression of the T254 wild-type protein in neurons reduces vesicle fusion only in the I254 mutant background. These results are consistent with molecular dynamics simulations of the SNARE core complex, suggesting that T254 serves as an internal brake to dampen SNARE zippering and impede vesicle fusion, whereas I254 favors fusion by enhancing intermolecular interaction within the SNARE core complex.
The purpose of this study is to report the outcomes after closed or percutaneous reduction with percutaneous fixation of displaced proximal humeral fractures. This study included 35 patients from 3 ...institutions. Of these, 27 were followed up for a minimum of 1 year after surgery. The mean age at injury was 61 years. There were seven 2-part, eight 3-part, and twelve valgus-impacted 4-part proximal humeral fractures. All fractures were reduced and stabilized with percutaneous techniques only. The mean duration of follow-up was 35 months. All fractures healed after the index procedure. The mean pain score on a visual analog scale was 1.4. The mean American Shoulder and Elbow Surgeons and Constant scores were 83.4 and 73.9, respectively. Four patients healed with malunion, and in four, glenohumeral joint osteoarthritis developed. Fracture type, age, malunion, or osteoarthritis had no significance influence on measured outcomes. Percutaneous treatment of selected proximal humeral fractures results in predictable union and good clinical results with a low rate of complications.
Glucokinase (GK) is a key regulator of glucose homeostasis, and its small-molecule activators represent a promising opportunity for the treatment of type 2 diabetes. Several GK activators have been ...advanced into clinical trials and have demonstrated promising efficacy; however, hypoglycemia represents a key risk for this mechanism. In an effort to mitigate this hypoglycemia risk while maintaining the efficacy of the GK mechanism, we have investigated a series of amino heteroaryl phosphonate benzamides as ‘‘partial” GK activators. The structure–activity relationship studies starting from a “full GK activator” 11, which culminated in the discovery of the “partial GK activator” 31 (BMS-820132), are discussed. The synthesis and in vitro and in vivo preclinical pharmacology profiles of 31 and its pharmacokinetics (PK) are described. Based on its promising in vivo efficacy and preclinical ADME and safety profiles, 31 was advanced into human clinical trials.
This manuscript on real‐world evidence (RWE) in pulmonary hypertension (PH) incorporates the broad experience of members of the Pulmonary Vascular Research Institute's Innovative Drug Development ...Initiative Real‐World Evidence Working Group. We aim to strengthen the research community's understanding of RWE in PH to facilitate clinical research advances and ultimately improve patient care. Herein, we review real‐world data (RWD) sources, discuss challenges and opportunities when using RWD sources to study PH populations, and identify resources needed to support the generation of meaningful RWE for the global PH community.
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