• Fabrication and testing of 4.2m off-axis aspheric primary mirror of Daniel K. Inouye Solar Telescope

      Oh, Chang Jin; Lowman, Andrew E.; Smith, Greg A.; Su, Peng; Huang, Run; Su, Tianquan; Kim, Daewook; Zhao, Chunyu; Zhou, Ping; Burge, James H.; et al. (SPIE-INT SOC OPTICAL ENGINEERING, 2016-07-22)
      Daniel K. Inouye Solar Telescope (formerly known as Advanced Technology Solar Telescope) will be the largest optical solar telescope ever built to provide greatly improved image, spatial and spectral resolution and to collect sufficient light flux of Sun. To meet the requirements of the telescope the design adopted a 4m aperture off-axis parabolic primary mirror with challenging specifications of the surface quality including the surface figure, irregularity and BRDF. The mirror has been completed at the College of Optical Sciences in the University of Arizona and it meets every aspect of requirement with margin. In fact this mirror may be the smoothest large mirror ever made. This paper presents the detail fabrication process and metrology applied to the mirror from the grinding to finish, that include extremely stable hydraulic support, IR and Visible deflectometry, Interferometry and Computer Controlled fabrication process developed at the University of Arizona.
    • Fabrication of Radially Symmetric Graded Porous Silicon using a Novel Cell Design

      Zhao, Mingrui; Keswani, Manish; Univ Arizona, Mat Sci & Engn (NATURE PUBLISHING GROUP, 2016-04-22)
      A contactless method using a novel design of the experimental cell for formation of porous silicon with morphological gradient is reported. Fabricated porous silicon layers show a large distribution in porosity, pore size and depth along the radius of the samples. Symmetrical arrangements of morphology gradient were successfully formulated radially on porous films and the formation was attributed to decreasing current density radially inward on the silicon surface exposed to Triton (R) X-100 containing HF based etchant solution. Increasing the surfactant concentration increases the pore depth gradient but has a reverse effect on the pore size distribution. Interestingly, when dimethyl sulfoxide was used instead of Triton (R) X-100 in the etchant solution, no such morphological gradients were observed and a homogeneous porous film was formed.
    • Facilitated Communication, Neurodiversity, and Human Rights

      Simmons, William Paul; Boynton, Janyce; Landman, Todd; University of Arizona (Johns Hopkins University Press, 2021-02-28)
      Facilitated Communication (FC) has rightly been labeled a pseudoscience as there are no controlled studies showing its validity as a form of communication for people with severe autism or other disabilities. In controlled studies, it has been the facilitator and not the person with disabilities that is generating the communication. Spurious communications have led to numerous cases of sexual assault and false accusations of misconduct. Nev-ertheless, FC remains widely practiced and touted even by supposed experts. We argue that this controversy has important human rights implications, especially for activists attempting to amplify marginalized people’s voices by speaking for them, and raises critical questions about epistemological issues in human rights work. © 2021 by Johns Hopkins University Press.
    • A factor increasing venous contamination on bolus chase three-dimensional magnetic resonance imaging: Charcot neuroarthropathy

      Cildag, MehmetB; Ertuğrul, MustafaB; Köseoğlu, ÖmerFK; Armstrong, DavidG; Univ Arizona, Coll Med, Dept Surg (MEDKNOW PUBLICATIONS & MEDIA PVT LTD, 2018-04-05)
      Background: The study aimed to evaluate the ratio of venous contamination in diabetic cases without foot lesion, with foot lesion and with Charcot neuroarthropathy (CN). Materials and Methods: Bolus-chase three-dimensional magnetic resonance (MR) of 396 extremities of patients with diabetes mellitus was analyzed, retrospectively. Extremities were divided into three groups as follows: diabetic patients without foot ulcer or Charcot arthropathy (Group A), patients with diabetic foot ulcers (Group B) and patients with CN accompanying diabetic foot ulcers (Group C). Furthermore, amount of venous contamination classified as no venous contamination, mild venous contamination, and severe venous contamination. The relationship between venous contamination and extremity groups was investigated. Results: Severe venous contamination was seen in Group A, Group B, and Group C, 5.6%, 15.2%, and 34.1%, respectively. Statistically significant difference was seen between groups with regard to venous contamination. Conclusion: Venous contamination following bolus chase MR was higher in patients with CN.
    • Factors affecting early identification of pregnant women by community health workers in Morogoro, Tanzania

      Frumence, G; Goodman, M; Chebet, J J; Mosha, I; Bishanga, D; Chitama, D; Winch, P J; Killewo, J; Baqui, A H; Univ Arizona, Dept Hlth Promot Sci (BMC, 2019-07-08)
      Background: It is recommended that Antenatal Care (ANC) be initiated within the first trimester of pregnancy for essential interventions, such folic acid supplementation, to be effective. In Tanzania, only 24% of mothers attend their first ANC appointment during their first trimester. Studies have shown that women who have had contact with a health worker are more likely to attend their first antenatal care appointment earlier in pregnancy. Community health workers (CHWs) are in an opportune position to be this contact. This study explored CHW experiences with identifying women early in gestation to refer them to facility-based antenatal care services in Morogoro, Tanzania. Methods: This qualitative study employed 10 semi-structured focus group discussions, 5 with 34 CHWs and 5 with 34 recently delivered women in three districts in Morogoro, Tanzania. A thematic analytical approach was used to identify emerging themes among the CHW and RDW responses.ResultsStudy findings show CHWs play a major role in identifying pregnant women in their communities and linking them with health facilities. Lack of trust and other factors, however, affect early pregnancy identification by the CHWs. They utilize several methods to identify pregnant women, including: asking direct questions to households when collecting information on the national census, conducting frequent household visits and getting information about pregnant women from health facilities. Conclusions: We present a framework for the interaction of factors that affect CHWs' ability to identify pregnant women early in gestation. Further studies need to be conducted investigating optimal workload for CHWs, as well as reasons pregnant women might conceal their pregnancies.
    • Factors Associated with Cancer Screening Among Hopi Men

      Batai, Ken; Sanderson, Priscilla R; Hsu, Chiu-Hsieh; Joshweseoma, Lori; Russell, Dana; Joshweseoma, Lloyd; Ojeda, Jordan; Burhansstipanov, Linda; Brown, Sylvia R; Ami, Delores; et al. (SPRINGER, 2020-10-20)
      Cancer screening rates remain low among American Indian men, and cancer screening behaviors and barriers to cancer screening among American Indian men are not well understood. This study evaluated cancer screening behaviors in 102 Hopi men who were 50 years of age or older from the Hopi Survey of Cancer and Chronic Disease. Reported cancer screening frequencies were 15.7%, 45.1%, and 35.3% for fecal occult blood test (FOBT), colonoscopy, and prostate-specific antigen (PSA) test, respectively. Among men who reported having had a FOBT, 81.2% had the test more than 1 year ago. Among men who reported a colonoscopy, 60.8% had colonoscopy within the past 3 years. Similarly, among men who reported having had PSA, 72.3% had PSA within the past 3 years. "No one told me" was the most common answer for not undergoing FOBT (33.7%), colonoscopy (48.2%), and PSA (39.4%). Men who reported having had a PSA or digital rectal exam were three times as likely to also report having a FOBT or colonoscopy (odds ratio [OR] 3.19, 95% confidence interval [CI]: 1.21-8.46). Younger age (< 65) was associated with reduced odds of ever having prostate cancer screening (OR 0.28, 95% CI: 0.10-0.77). Ever having colorectal cancer screening and previous diagnosis of cancer increased odds of ever having prostate cancer screening (OR 3.15, 95% CI: 1.13-8.81 and OR 5.28, 95% CI: 1.15-24.18 respectively). This study illustrates the importance of community cancer education for men to improve cancer screening participation.
    • Factors Associated with Functional Decline in Elderly Female Breast Cancer Patients in Appalachia

      Singh, Raj; Ansinelli, Hayden; Katz, Heather; Jafri, Hassaan; Gress, Todd; Tirona, Maria T; Univ Arizona, Dept Radiat Oncol (CUREUS INC, 2018-05-12)
      Background Functional status has been previously shown in the elderly cancer population to predict both mortality as well as treatment tolerance. The goal of this study was to determine if there are certain subsets of the elderly breast cancer population that are at higher risk of experiencing functional decline following treatment. Methods Patient charts from the Edwards Comprehensive Cancer Center in Huntington, West Virginia, from January 2006 - January 2016 were reviewed. Relevant inclusion criteria included patients of 65 years of age and older with a new diagnosis of Stage 0-III breast cancer. Functional decline was defined as an increase of at least one point in Eastern Cooperative Oncology Group (ECOG) scores within one year of diagnosis. ECOG performance status was subjectively determined by the physician. Fisher's exact test and Pearson's Chi-squared test were initially utilized to assess potential factors associated with functional decline such as pretreatment ECOG score, age at diagnosis, stage, hormone receptor status, type of surgery received, whether radiation therapy, chemotherapy, or hormonal therapy was received, medical comorbidities, body mass index (BMI), complaints of weakness at diagnosis, and ambulatory status. Factors that were found to be significant were further assessed via multivariate logistic regressions. Results Three-hundred and fourteen patients were identified as meeting inclusion criteria. At one-year follow-up, 45 patients (14.3% of the cohort) had documented functional decline. On initial analysis, factors associated with functional decline included Stage III disease (p=0.002) and complaints of weakness at diagnosis (p=0.004). Following multivariate analysis, Stage III disease (p = 0.02), complaints of weakness at diagnosis (p = 0.04), and bilateral mastectomy (p = 0.03) were significantly associated with functional decline. Conclusion Patients who were diagnosed with Stage III breast cancer, had complaints of weakness at time of diagnosis, or had bilateral mastectomies were more likely to have a decline in functional status at one-year follow-up. Awareness of factors associated with functional decline in the elderly Appalachian population with Stage 0-III breast cancer will be useful during discussions regarding patient expectations, treatment, and goals of care. Elderly breast cancer patients for whom bilateral prophylactic mastectomies are not indicated may be better served by lumpectomy alone (based on patient age, hormone receptor status, and tumor size), lumpectomy followed by radiation therapy, or unilateral mastectomy to maximize the likelihood of functional preservation following treatment.
    • Factors associated with patient, and diagnostic delays in Chinese TB patients: a systematic review and meta-analysis

      Li, Ying; Ehiri, John; Tang, Shenglan; Li, Daikun; Bian, Yongqiao; Lin, Hui; Marshall, Caitlin; Cao, Jia; Department of Social Medicine and Health Service Management, College of Preventive Medicine, Third Military Medical University, No. 30 Gaotanyan Road, Shapingba District, Chongqing, China; Division of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Avenue, Tucson, AZ, USA; et al. (BioMed Central, 2013)
      BACKGROUND:Delay in seeking care is a major impediment to effective management of tuberculosis (TB) in China. To elucidate factors that underpin patient and diagnostic delays in TB management, we conducted a systematic review and meta-analysis of factors that are associated with delays in TB care-seeking and diagnosis in the country.METHODS:This review was prepared following standard procedures of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and checklist. Relevant studies published up to November 2012 were identified from three major international and Chinese literature databases: Medline/PubMed, EMBASE and CNKI (China National Knowledge Infrastructure).RESULTS:We included 29 studies involving 38,947 patients from 17 provinces in China. Qualitative analysis showed that key individual level determinants of delays included socio-demographic and economic factors, mostly poverty, rural residence, lack of health insurance, lower educational attainment, stigma and poor knowledge of TB. Health facility determinants included limited availability of resources to perform prompt diagnosis, lack of qualified health workers and geographical barriers.Quantitative meta-analysis indicated that living in rural areas was a risk factor for patient delays (pooled odds ratio (OR) (95% confidence interval (CI)): 1.79 (1.62, 1.98)) and diagnostic delays (pooled OR (95% CI): 1.40 (1.23, 1.59)). Female patients had higher risk of patient delay (pooled OR (95% CI): 1.94 (1.13, 3.33)). Low educational attainment (primary school and below) was also a risk factor for patient delay (pooled OR (95% CI): 2.14 (1.03, 4.47)). The practice of seeking care first from Traditional Chinese Medicine (TMC) providers was also identified as a risk factor for diagnostic delay (pooled OR (95% CI): 5.75 (3.03, 10.94)).CONCLUSION:Patient and diagnostic delays in TB care are mediated by individual and health facility factors. Population-based interventions that seek to reduce TB stigma and raise awareness about the benefits of early diagnosis and prompt treatment are needed. Policies that remove patients' financial barriers in access to TB care, and integration of the informal care sector into TB control in urban and rural settings are central factors in TB control.
    • Factors Associated With the Recurrence, Persistence, and Clearance of Asymptomatic Bacterial Vaginosis Among Young African American Women: A Repeated-Measures Latent Class Analysis

      Coudray, Makella S; Sheehan, Diana M; Li, Tan; Cook, Robert L; Schwebke, Jane; Madhivanan, Purnima; Univ Arizona, Dept Hlth Promot Sci, Mel & Enid Zuckerman Coll Publ Hlth; Univ Arizona, Coll Med, Div Infect Dis; Univ Arizona, Coll Med, Dept Family & Community Med (LIPPINCOTT WILLIAMS & WILKINS, 2020-12)
      Background Although risk factors of recurrent and persistent bacterial vaginosis (BV) have been explored in the literature, the longitudinal incidence patterns of BV remain elusive. Methods We conducted a secondary analysis of longitudinal data from a randomized clinical trial of metronidazole treatment for asymptomatic BV. Repeated-measures latent class analysis was used to identify distinct longitudinal patterns of incident BV cases. Multinomial regression analysis was used to determine the predictors of class membership. The multivariable model included age, last BV treatment, douching frequency, birth control, sexual risk behavior, and assignment to treatment arm. Results A total of 858 African American women who were asymptomatic for BV were included in the analysis. Three emergent patterns of BV for 12 months were identified by repeated-measures latent class analysis: persistent (55.9%), recurrent (30.5%), and clearance (13.5%). Participants who had douched at least once had significantly lower odds to be in the recurrent class versus the clearance class (adjusted odds ratio [adjOR], 0.55; 95% confidence interval [CI], 0.18-0.63). Women who had sex with women had significantly lower odds of belonging to the persistent class versus the clearance class (adjOR, 0.38; 95% CI, 0.22-0.68) and the recurrent class (adjOR, 0.43; 95% CI, 0.23-0.81). Those who were assigned to the treatment arm had significantly increased odds of being in the recurrent class versus the clearance class (adjOR, 1.92; 95% CI, 1.22-3.03). Women older than 21 years were significantly more likely to be in the recurrent class (adjOR, 1.88; 95% CI, 1.17-3.00) than in the clearance class. Conclusions Assessment of BV cases revealed distinct patterns of recurrence and persistence of BV, which were significantly associated with douching, being in the treatment arm, and being a woman who had sex with women.
    • Factors influencing performance by contracted non-state providers implementing a basic package of health services in Afghanistan

      Salehi, Ahmad Shah; Saljuqi, Abdul Tawab Kawa; Akseer, Nadia; Rao, Krishna; Coe, Kathryn; Univ Arizona (BMC, 2018-10-05)
      Background: In 2002 Afghanistan's Ministry of Public Health (MoPH) and its development partners initiated a new paradigm for the health sector by electing to Contract-Out (CO) the Basic Package of Health Services (BPHS) to non-state providers (NSPs). This model is generally regarded as successful, but literature is scarce that examines the motivations underlying implementation and factors influencing program success. This paper uses relevant theories and qualitative data to describe how and why contracting out delivery of primary health care services to NSPs has been effective. The main aim of this study was to assess the contextual, institutional, and contractual factors that influenced the performance of NSPs delivering the BPHS in Afghanistan. Methods: The qualitative study design involved individual in-depth interviews and focus group discussions conducted in six provinces of Afghanistan, as well as a desk review. The framework for assessing key factors of the contracting mechanism proposed by Liu et al. was utilized in the design, data collection and data analysis. Results: While some contextual factors facilitated the CO (e.g. MoPH leadership, NSP innovation and community participation), harsh geography, political interference and insecurity in some provinces had negative effects. Contractual factors, such as effective input and output management, guided health service delivery. Institutional factors were important; management capacity of contracted NSPs affects their ability to deliver outcomes. Effective human resources and pharmaceutical management were notable elements that contributed to the successful delivery of the BPHS. The contextual, contractual and institutional factors interacted with each other. Conclusion: Three sets of factors influenced the implementation of the BPHS: contextual, contractual and institutional. The MoPH should consider all of these factors when contracting out the BPHS and other functions to NSPs. Other fragile states and countries emerging from a period of conflict could learn from Afghanistan's example in contracting out primary health care services, keeping in mind that generic or universal contracting policies might not work in all geographical areas within a country or between countries.
    • Factors Influencing the Use of Biomedical Health Care by Rural Bolivian Anemic Women: Structural Barriers, Reproductive Status, Gender Roles, and Concepts of Anemia

      Bedwell, Rebecca M.; Spielvogel, Hilde; Bellido, Diva; Vitzthum, Virginia J.; Univ Arizona, Sch Anthropol (PUBLIC LIBRARY SCIENCE, 2017-01-26)
      The persistently high prevalence of anemia in rural highland Bolivia argues for targeted iron supplementation. We evaluated the cultural, structural and behavioral factors that may facilitate or impede an anemic woman's decision to secure this biomedical treatment from a rural Bolivian health center. Methods Non-pregnant women from a rural town and its surrounding region were tested for anemia. During phase 1 ( n = 181), anemic women received a written recommendation for low-cost purchase of iron pills at the nearest health center. They were subsequently interviewed on their actions and experiences. Results Estimated anemia prevalence among these non-pregnant women was 50% higher than the national average. Despite holding conceptualizations of anemia generally aligned with biomedical concepts, only 40% of anemic women attempted to obtain iron supplements from the health center. Town residents were about twice as likely to attempt to purchase pills as outside-town residents. Town women who were concurrently breastfeeding and menstruating, considered anemia most serious for women, and considered family health the shared responsibility of spouses were most likely to decide to purchase iron pills. Age, education, or native language did not negatively influence this health care behavior. Conclusions Securing iron supplements involves individual trade-offs in the allocation of time, cost and effort. Nonetheless, suitably tailored programs can potentially harness local perceptions in the service of reducing anemia. Because of their comparatively high motivation to obtain iron supplements, targeting concurrently breastfeeding and menstruating women could have a positive cascade effect such that these women continue attending to their iron needs once they stop breastfeeding and if they become pregnant again. Because a sense of shared responsibility for family health appears to encourage women to attend to their own health, programs for women could involve their spouses. Complementing centralized availability, biomedical and traditional healers could distribute iron supplements on rotating visits to outlying areas and/or at highly attended weekly markets.
    • Factors influencing U.S. canine heartworm (Dirofilaria immitis) prevalence

      Wang, Dongmei; Bowman, Dwight; Brown, Heidi; Harrington, Laura; Kaufman, Phillip; McKay, Tanja; Nelson, Charles; Sharp, Julia; Lund, Robert; Department of Mathematical Sciences, Clemson University, Clemson, SC 29634-0975, USA; et al. (BioMed Central, 2014)
      BACKGROUND:This paper examines the individual factors that influence prevalence rates of canine heartworm in the contiguous United States. A data set provided by the Companion Animal Parasite Council, which contains county-by-county results of over nine million heartworm tests conducted during 2011 and 2012, is analyzed for predictive structure. The goal is to identify the factors that are important in predicting high canine heartworm prevalence rates.METHODS:The factors considered in this study are those envisioned to impact whether a dog is likely to have heartworm. The factors include climate conditions (annual temperature, precipitation, and relative humidity), socio-economic conditions (population density, household income), local topography (surface water and forestation coverage, elevation), and vector presence (several mosquito species). A baseline heartworm prevalence map is constructed using estimated proportions of positive tests in each county of the United States. A smoothing algorithm is employed to remove localized small-scale variation and highlight large-scale structures of the prevalence rates. Logistic regression is used to identify significant factors for predicting heartworm prevalence.RESULTS:All of the examined factors have power in predicting heartworm prevalence, including median household income, annual temperature, county elevation, and presence of the mosquitoes Aedes trivittatus, Aedes sierrensis and Culex quinquefasciatus. Interactions among factors also exist.CONCLUSIONS:The factors identified are significant in predicting heartworm prevalence. The factor list is likely incomplete due to data deficiencies. For example, coyotes and feral dogs are known reservoirs of heartworm infection. Unfortunately, no complete data of their populations were available. The regression model considered is currently being explored to forecast future values of heartworm prevalence.
    • Factors Related to Physician Clinical Decision-Making for African-American and Hispanic Patients: a Qualitative Meta-Synthesis.

      Breathett, Khadijah; Jones, Jacqueline; Lum, Hillary D; Koonkongsatian, Dawn; Jones, Christine D; Sanghvi, Urvi; Hoffecker, Lilian; McEwen, Marylyn; Daugherty, Stacie L; Blair, Irene V; et al. (SPRINGER INTERNATIONAL PUBLISHING AG, 2018-03-05)
      Clinical decision-making may have a role in racial and ethnic disparities in healthcare but has not been evaluated systematically. The purpose of this study was to synthesize qualitative studies that explore various aspects of how a patient's African-American race or Hispanic ethnicity may factor into physician clinical decision-making. Using Ovid MEDLINE, Embase, and Cochrane Library, we identified 13 manuscripts that met inclusion criteria of usage of qualitative methods; addressed US physician clinical decision-making factors when caring for African-American, Hispanic, or Caucasian patients; and published between 2000 and 2017. We derived six fundamental themes that detail the role of patient race and ethnicity on physician decision-making, including importance of race, patient-level issues, system-level issues, bias and racism, patient values, and communication. In conclusion, a non-hierarchical system of intertwining themes influenced clinical decision-making among racial and ethnic minority patients. Future study should systematically intervene upon each theme in order to promote equitable clinical decision-making among diverse racial/ethnic patients.
    • Factors that Influence the Effectiveness of Sanitation Programs

      Fernandez-Haddad, Marilu; Ingram, Maia; College of Public Health, University of Arizona (Frontiers, 2015-09-01)
      Local governments in both Mexico and the U.S. spend considerable money on public services, which do not always bring the expected results. For instance, a large part of the public budget is destined to solve social and health problems, such as public sanitation. Government has attacked the problem by providing public sanitation infrastructure (such as garbage and recycling receptacles) and by using social ad campaigns. However, these efforts do not always affect the habits of residents and bring the desired changes in city sanitation. This article presents a case study that used a participatory method to address an innovative city sanitation effort: The Clean City Program in Puebla, Mexico. This program adopted social marketing techniques, a discipline born in the 70s when the principles and practices developed to sell products and services started to be applied to sell ideas, attitudes, or behaviors. Social marketing programs have been adopted by governments to change attitudes and behavior in areas such as public services. The article first describes the context and strategies of the program, which included the use of the promotora model to engage community members. The researchers then make use of qualitative data gathered throughout program planning and implementation to evaluate the impact of the social marketing programs and its effectiveness. The article analyzes social, educational, economic, demographic, and cultural factors that influence the effectiveness of sanitation programs and presents recommendations for strategies to engage community members in community sanitation programs.
    • FADS genetic and metabolomic analyses identify the ∆5 desaturase (FADS1) step as a critical control point in the formation of biologically important lipids

      Reynolds, Lindsay M; Dutta, Rahul; Seeds, Michael C; Lake, Kirsten N; Hallmark, Brian; Mathias, Rasika A; Howard, Timothy D; Chilton, Floyd H; Univ Arizona, Dept Nutr Sci; Univ Arizona, BIO5 Inst (NATURE RESEARCH, 2020-09-28)
      Humans have undergone intense evolutionary selection to optimize their capacity to generate necessary quantities of long chain (LC-) polyunsaturated fatty acid (PUFA)-containing lipids. To better understand the impact of genetic variation within a locus of three FADS genes (FADS1, FADS2, and FADS3) on a diverse family of lipids, we examined the associations of 247 lipid metabolites (including four major classes of LC-PUFA-containing molecules and signaling molecules) with common and low-frequency genetic variants located within the FADS locus. Genetic variation in the FADS locus was strongly associated (p < 1.2 × 10-8) with 52 LC-PUFA-containing lipids and signaling molecules, including free fatty acids, phospholipids, lyso-phospholipids, and an endocannabinoid. Notably, the majority (80%) of FADS-associated lipids were not significantly associated with genetic variants outside of this FADS locus. These findings highlight the central role genetic variation at the FADS locus plays in regulating levels of physiologically critical LC-PUFA-containing lipids that participate in innate immunity, energy homeostasis, and brain development/function.
    • Faecal glucocorticoid metabolite profiles in diademed sifakas increase during seasonal fruit scarcity with interactive effects of age/sex class and habitat degradation

      Tecot, Stacey R; Irwin, Mitchell T; Raharison, Jean-Luc; Univ Arizona, Sch Anthropol; Univ Arizona, Sch Anthropol, Lab Evolutionary Endocrinol Primates (OXFORD UNIV PRESS, 2019-02-06)
      We measured faecal glucocorticoid metabolites (GCs) in Critically Endangered diademed sifaka to understand how food availability, nutritional intake and habitat disturbance impact stress physiology. GCs elevated with food scarcity and correlated negatively with feeding time. Attenuated GCs in fragmented forest groups suggest a downregulated response to a chronically poor environment. Abstract Glucocorticoids are metabolic byproducts of animals' physiological responses to ecological or social challenges and are thought to represent an adaptive response allowing beneficial responses to short-term challenges. Glucocorticoid metabolites (GCs) can be assayed non-invasively through faeces and therefore can be a useful tool to gauge the health of populations experiencing natural and/or anthropogenic stressors. However, the response of GCs to anthropogenic stressors varies, with both higher and lower GC levels reported. Here, we describe variation in GC secretion within eight diademed sifaka (Propithecus diadema) groups across 1 year. These groups span a gradient of anthropogenic habitat disturbance, including groups in continuous forest (CONT') and disturbed fragments (FRAG'), and indicators of health suggest that FRAG groups are negatively impacted by habitat disturbance. We monitored phenology, used focal animal follows to quantify diet and collected faeces (n = 547) from which we quantified GC content using enzyme immunoassay. All groups showed elevated lean-season GCs, but with a single, brief peak. GCs were inversely correlated with feeding time. No overall effect of habitat (CONT vs. FRAG) was found, but the lean-season peak was significantly higher in CONT groups. There was a significant season*age-sex interaction; adult females had an attenuated lean-season response compared with groupmates. The observed lean-season challenge' is consistent with previous lemur studies, as well as mammals in general. Low and largely invariable GC levels in FRAG, within the context of observed health and nutritional declines, suggest that FRAG groups employ a strategy whereby the adrenal response to stressors is downregulated. More research is needed to contextualize our observations of GC variation and health on an individual level, both in terms of corroborating evidence for ecological and social stressors, and longer-term quantification of reproductive success and fitness.
    • Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications

      Mosier, Jarrod M; Sakles, John C; Whitmore, Sage P; Hypes, Cameron D; Hallett, Danielle K; Hawbaker, Katharine E; Snyder, Linda S; Bloom, John W; Department of Emergency Medicine, University of Arizona (Springer, 2015-03-06)
      Background: Noninvasive positive-pressure ventilation (NIPPV) use has increased in the treatment of patients with respiratory failure. However, despite decreasing the need for intubation in some patients, there are no data regarding the risk of intubation-related complications associated with delayed intubation in adult patients who fail NIPPV. The objective of this study is to evaluate the odds of a composite complication of intubation following failed NIPPV compared to patients intubated primarily in the medical intensive care unit (ICU). Methods: This is a single-center retrospective cohort study of 235 patients intubated between 1 January 2012 and 30 June 2013 in a medical ICU of a university medical center. A total of 125 patients were intubated after failing NIPPV, 110 patients were intubated without a trial of NIPPV. Intubation-related data were collected prospectively through a continuous quality improvement (CQI) program and retrospectively extracted from the medical record on all patients intubated on the medical ICU. A propensity adjustment for the factors expected to affect the decision to initially use NIPPV was used, and the adjusted multivariate regression analysis was performed to evaluate the odds of a composite complication (desaturation, hypotension, or aspiration) with intubation following failed NIPPV versus primary intubation. Results: A propensity-adjusted multivariate regression analysis revealed that the odds of a composite complication of intubation in patients who fail NIPPV was 2.20 (CI 1.14 to 4.25), when corrected for the presence of pneumonia or acute respiratory distress syndrome (ARDS), and adjusted for factors known to increase complications of intubation (total attempts and operator experience). When a composite complication occurred, the unadjusted odds of death in the ICU were 1.79 (95% CI 1.03 to 3.12). Conclusions: After controlling for potential confounders, this propensity-adjusted analysis demonstrates an increased odds of a composite complication with intubation following failed NIPPV. Further, the presence of a composite complication during intubation is associated with an increased odds of death in the ICU.
    • Failure to achieve first attempt success at intubation using video laryngoscopy is associated with increased complications

      Hypes, Cameron; Sakles, John; Joshi, Raj; Greenberg, Jeremy; Natt, Bhupinder; Malo, Josh; Bloom, John; Chopra, Harsharon; Mosier, Jarrod; Univ Arizona, Sect Pulm Allergy Crit Care & Sleep, Dept Med; et al. (SPRINGER-VERLAG ITALIA SRL, 2017-12)
      The purpose of this investigation was to investigate the association between first attempt success and intubation-related complications in the Intensive Care Unit after the widespread adoption of video laryngoscopy. We further sought to characterize and identify the predictors of complications that occur despite first attempt success. This was a prospective observational study of consecutive intubations performed with video laryngoscopy at an academic medical Intensive Care Unit. Operator, procedural, and complication data were collected. Multivariable logistic regression was used to examine the relationship between the intubation attempts and the occurrence of one or more complications. A total of 905 patients were intubated using a video laryngoscope. First attempt success occurred in 739 (81.7 %), whereas > 1 attempt was needed in 166 (18.3 %). One or more complications occurred in 146 (19.8 %) of those intubated on the first attempt versus 107 (64.5 %, p < 0.001) of those requiring more than one attempt. Logistic regression analysis shows that > 1 attempt is associated with 6.4 (95 % CI 4.4-9.3) times the adjusted odds of at least one complication. Pre-intubation predictors of at least one complication despite first attempt success include vomit or edema in the airway as well as the presence of hypoxemia or hypotension. There are increased odds of complications with even a second attempt at intubation in the Intensive Care Unit. Complications occur frequently despite a successful first attempt, and as such, the goal of airway management should not be simply first attempt success, but instead first attempt success without complications.
    • Failure to identify modifiers of NEBULIN-related nemaline myopathy in two pre-clinical models of the disease

      Qiu, Boyang; Ruston, Julie; Granzier, Henk; Justice, Monica J; Dowling, James J; Univ Arizona, Dept Physiol (COMPANY BIOLOGISTS LTD, 2019-09-18)
      Nemaline myopathy is a rare neuromuscular disorder that affects 1 in 50,000 live births, with prevalence as high as 1 in 20,000 in certain populations. 13 genes have been linked to nemaline myopathy (NM), all of which are associated with the thin filament of the muscle sarcomere. Of the 13 associated genes, mutations in NEBULIN (NEB) accounts for up to 50% of all cases. Currently, the disease is incompletely understood and there are no available therapeutics for patients. To address this urgent need for effective treatments for patients affected by NM, we conducted a large scale chemical screen in a zebrafish model of NEB-related NM and an N-ethyl-N-nitrosourea (ENU)-based genetic screen in a mouse model of NEB exon 55 deletion, the most common NEB mutation in NM patients. Neither screen was able to identify a candidate for therapy development, highlighting the need to transition from conventional chemical therapeutics to gene-based therapies for the treatment of NM.
    • The Faint End of the Centaurus A Satellite Luminosity Function

      Crnojević, D.; Sand, D. J.; Bennet, P.; Pasetto, S.; Spekkens, K.; Caldwell, N.; Guhathakurta, P.; McLeod, B.; Seth, A.; Simon, J. D.; et al. (IOP PUBLISHING LTD, 2019-02-10)
      The Panoramic Imaging Survey of Centaurus and Sculptor (PISCeS) is constructing a wide-field map of the resolved stellar populations in the extended halos of these two nearby, prominent galaxies. We present new Magellan/Megacam imaging of a similar to 3 deg(2) area around Centaurus A (Cen A), which filled in much of our coverage to its south, leaving a nearly complete halo map out to a projected radius of similar to 150 kpc and allowing us to identify two new resolved dwarf galaxies. We have additionally obtained deep Hubble Space Telescope (HST) optical imaging of 11 out of the 13 candidate dwarf galaxies identified around Cen A and presented in Crnojevic et al. 2016a: seven are confirmed to be satellites of Cen A, while four are found to be background galaxies. We derive accurate distances, structural parameters, luminosities, and photometric metallicities for the seven candidates confirmed by our HST/ACS imaging. We further study the stellar population along the similar to 60 kpc long (in projection) stream associated with Dw3, which likely had an initial brightness of M-V similar to -15 and shows evidence for a metallicity gradient along its length. Using the total sample of 11 dwarf satellites discovered by the PISCeS survey, as well as 13 brighter previously known satellites of Cen A, we present a revised galaxy luminosity function for the Cen A group down to a limiting magnitude of M-V similar to -8, which has a slope of -1.14 +/- 0.17, comparable to that seen in the Local Group and in other nearby groups of galaxies.