The geographic factors in the distribution of the population of Germany

Thesis (M.A.)--Boston University, 193

Assessing Information Literacy Instruction in Selected English Classes At Tennessee State University

In this study, the Brown-Daniel Library located at Tennessee State University (TSU) provided information literacy/bibliographic instruction (IL/BI) to six selected English 1010 classes with a total of 119 students in the spring semester of 2010. Students were administered an online pretest prior to the instructor’s presentation, and administered the same test as a posttest following the lecture. All classes were held on days that allotted one hour and twenty minutes which gave the library faculty time to administer both tests. Students were also asked to evaluate instruction using a Likert-style measure called Library Orientation Survey. All results were electronically submitted to the investigators for analyses

Screening Colposcopy: Evaluation of a Novel Method For Cervical Cancer Screening in Low Resource Settings

Background: Strategies to decrease the burden of cervical cancer in developed countries are often difficult to implement in low resource settings, which has stimulated researchers and others to search for novel approaches for screening. Colposcopy offers some advantages that might make it a reasonable strategy as a standalone screen and treat protocol in communities where the incidence of disease is high. To date, results for the screening accuracy of colposcopy as a screening tool have varied widely from low to high sensitivity and specificity in different studies. Methods: In this study, I analyzed cross sectional data from the medical records of 2,094 self referred women in a community cervical screening program in Haiti. The patients included in the final analyses received some combination of Pap smear, colposcopy and/or cervical biopsy, which allowed me to compare these techniques. The final study populations included 198 women who had both Pap smear and cervical biopsy, and 221 patients who had both colposcopy and cervical biopsy. The main outcome measure (cancer and precancer diagnoses) were operationalized as mild dysplasia or worse lesions on cervical biopsy. Diagnostic accuracy was determined by calculating the sensitivity, specificity, positive predictive values, and negative predictive values with 95% confidence intervals using cervical biopsy as the gold standard. Results: The prevalence of dysplasia or cancer on biopsy for the study populations was 41.9%-48.0%% while prevalence detected by Pap was 30.8%. Prevalence in the study populations detected by colposcopy was 66.7%-70.1%. Pap smear had a sensitivity of 68.7% (CI 57.6-78.4) and specificity was 96.5% (CI 91.0-99.0) using biopsy as the gold standard. The sensitivity for colposcopy was 96.2% (CI 91.0-99.0) compared to biopsy, and a specificity of Sp 53.9% (CI 44.0-63.0). Conclusion: Colposcopy identifies a population that includes most ofthe dysplasia at a price of including many false positives, placing the screened population at a significant risk of over treatment. Therefore, colposcopy is a reasonable screening strategy if the disease prevalence is high in the population of interest and the co-morbidity from over treatment is low.Master of Public Healt

The Search for High-Impact Diagnostic and Management Tools for Low-and Middle-Income Countries: A Self-Powered Low-Cost Blood Pressure Measurement Device Powered by a Solid-State Vibration Energy Harvester

The World Health Organization has established recommendations for blood pressure measurement devices for use in low-resource venues, setting the triple A expectations of Accuracy, Affordability, and Availability. Because of issues related to training and assessment of proficiency, the pendulum has swung away from manual blood pressure devices and auscultatory techniques towards automatic oscillometric devices. As a result of power challenges in the developing world, there has also been a push towards semiautomatic devices that are not dependent on external power sources or batteries. Beyond solar solutions, disruptive technology related to solid-state vibrational energy harvesting may be the next iterative solution to attain the ultimate goal of a self-powered low-cost validated device that is simple to use and reliable

Texas Broilers

Weekly report of the Texas Crop and Livestock Reporting Service on broiler chick numbers in Texas and compared with other states. It includes compiled statistics across six consecutive weeks, from the week ending May 24 to the week ending June 28, during 1985 and 1986 for broiler eggs set, chicks hatched, and chicks placed

A Community-Driven Intervention for Prostate Cancer Screening in African Americans

The purpose of the study was to assess the impact of an educational intervention on prostate cancer screening behavior and knowledge. Participants were 104 African American men, 45 years and older, who had not been screened for prostate cancer with a prostate-specific antigen and/or digital rectal exam within the past year. All participants received an intervention delivered by trained lay community educators using a prostate cancer educational brochure developed in collaboration with the community, with structured interviews preintervention and 3 months postintervention. The main study outcomes included prostate-specific antigen screening rates during the 3-month interval and knowledge, barriers to screenings, and decisional conflict around screening. Compared with the 46 men who did not get screened, the 58 participants who got screened were more likely to have greater than a high school education, annual household incomes ≥$25,000, and a family history of non–prostate cancer (p \u3c .05). Average knowledge scores increased, and barriers to screening scores decreased, from preintervention to postintervention only for participants who had been screened (p \u3c .05). The results of this study demonstrate the feasibility and efficacy of an academic institution collaborating with the African American community to develop a successful prostate cancer educational intervention, an approach that can be expanded to other cancers and other chronic diseases

Modulation of Immune Checkpoints by Chemotherapy in Human Colorectal Liver Metastases.

Metastatic colorectal cancer (CRC) is a major cause of cancer-related death, and incidence is rising in younger populations (younger than 50 years). Current chemotherapies can achieve response rates above 50%, but immunotherapies have limited value for patients with microsatellite-stable (MSS) cancers. The present study investigates the impact of chemotherapy on the tumor immune microenvironment. We treat human liver metastases slices with 5-fluorouracil (5-FU) plus either irinotecan or oxaliplatin, then perform single-cell transcriptome analyses. Results from eight cases reveal two cellular subtypes with divergent responses to chemotherapy. Susceptible tumors are characterized by a stemness signature, an activated interferon pathway, and suppression of PD-1 ligands in response to 5-FU+irinotecan. Conversely, immune checkpoint TIM-3 ligands are maintained or upregulated by chemotherapy in CRC with an enterocyte-like signature, and combining chemotherapy with TIM-3 blockade leads to synergistic tumor killing. Our analyses highlight chemomodulation of the immune microenvironment and provide a framework for combined chemo-immunotherapies

May Measurement Month 2018: a pragmatic global screening campaign to raise awareness of blood pressure by the International Society of Hypertension

Aims Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140 mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk

Tumor slice culture as a biologic surrogate of human cancer.

Background: The tumor microenvironment (TME) is critical to every aspect of cancer biology. Organotypic tumor slice cultures (TSCs) preserve the original TME and have demonstrated utility in predicting drug sensitivity, but the association between clinicopathologic parameters and Methods: One hundred and eight fresh tumor specimens from liver resections at a tertiary academic center were procured and precisely cut with a Vibratome to create 250 μm × 6 mm slices. These fixed-dimension TSCs were grown on polytetrafluoroethylene inserts, and their metabolic activities were determined by a colorimetric assay. Correlation between baseline activities and clinicopathologic parameters was assessed. Tissue CEA mRNA expression was determined by RNAseq. Results: By standardizing the dimensions of a slice, we found that adjacent tumor slices have equivalent metabolic activities, while those derived from different tumors exhibit \u3e30-fold range in baseline MTS absorbances, which correlated significantly with the percentage of tumor necrosis based on histologic assessment. Extending this to individual cancers, we were able to detect intra-tumoral heterogeneity over a span of a few millimeters, which reflects differences in tumor cell density and Ki-67 positivity. For colorectal cancers, tissue CEA expression based on RNAseq of tumor slices was found to correlate with clinical response to chemotherapies. Conclusions: We report a standardized method to assess and compare human cancer growth ex vivo across a wide spectrum of tumor samples. TSC reflects the state of tumor behavior and heterogeneity, thus providing a simple approach to study of human cancers with an intact TME