bluuebunny/crossref_metadata_2025 huggingface dataset:
Nonmotorized Site Selection Methods for Continuous and Short-Duration Volume Counting
Authors: Jackson Kristy N. , Stolz Elizabeth , Cunningham Christopher
Published: December 2015

This paper outlines the process for selecting sites to perform counts on transportation facilities in the context of establishing a nonmotorized traffic volume counting program. Many agencies are well practiced in collecting motor vehicle traffic counts and estimating annual average daily traffic volumes for motor vehicles on the basis of knowledge founded on years of research and experience. Selecting sites is one component of developing a consistent system for quantifying nonmotorized travel so bicycle and pedestrian volumes can ultimately feed into tools to measure existing trends and model future increases in nonmotorized trips at site, corridor, and regional levels. The outcome of collecting count data can ultimately assist in evaluating facility usage over time, better inform the project prioritization process, and provide evidence to support nonmotorized facility inclusion through Complete Streets planning and improve planning for active transportation. This paper outlines the goals of a nonmotorized traffic monitoring program and objectives of the site selection process. From the experience of a pilot project conducted by the North Carolina Department of Transportation, the site selection method details the following components: gathering potential sites, conducting a site visit, gathering additional data needed to inform the decision-making process, and ultimately selecting sites and developing an equipment inventory.
Validation of Bicycle Counts from Pneumatic Tube Counters in Mixed Traffic Flows
Authors: Brosnan Martin , Petesch Michael , Pieper Jason , Schumacher Scott , Lindsey Greg
Published: December 2015

FHWA and other public agencies encourage monitoring of nonmotorized traffic volumes and are collaborating with researchers in projects to test monitoring technologies and develop nonmotorized monitoring programs. This paper reports findings from research in Minnesota to validate the use of commercially available pneumatic tube counters to count bicycles in mixed traffic flows on urban roadways. Pneumatic tube counters and video cameras were installed in different configurations at two locations on arterial roadways with different traffic volumes. Bicycle counts from the tube counters were compared with manual counts from video to determine both percentage error and absolute error rates. Researchers matched time stamps from the counters and video and inspected discrepancies to determine causes of error. Calibration equations to adjust for systematic counter error were estimated by regressing hourly manual counts on hourly automated counts. The tube counters generally under-counted bicycles: error rates for the observation periods ranged from 6% to 57% depending on the location, configuration of deployment, type of device, and classification algorithm. Absolute error rates were substantially higher. Inspection of video indicated most false negatives (i.e., undercounts) were caused by occlusion. Calibration equations generally had moderate to very good fit ( R2 values from .82 to .92). Agencies can adapt standard, commercially available pneumatic tube counters to collect bicycle counts in mixed traffic flows; but depending on the site, traffic volumes, configuration, and deployment, error rates may be high. The practicability of using tube counters to count bicycles in mixed traffic flows depends on the applications and the relative need for accuracy in measurement.
Bicycle Sharing and Public Transit
Authors: Ma Ting , Liu Chao , Erdoğan Sevgi
Published: December 2015

Bicycle-sharing programs have emerged around the world. Theoretically, the effect of bicycle sharing on more conventional transit modes can take a substitute or complementary form. On one hand, bicycle sharing could substitute for conventional transit as a convenient and sustainable travel option. On the other hand, bicycle sharing may complement such transit by seamlessly connecting transit stations with origins and destinations and thus increase accessibility. However, the questions of how and to what extent bicycle-sharing programs affect public transit ridership remain to be answered, despite the attempts of a few empirical and quantitative studies. This study examined the impact of the Capital Bikeshare (CaBi) program on Metrorail's ridership in Washington, D.C. When CaBi trips were mapped, it was observed that Metrorail stations had been important origins and destinations for CaBi trips. Six of seven CaBi stations producing more than 500 trips were located close to Metrorail stations. This study conducted a regression analysis and found that public transit rider-ship was positively associated with CaBi ridership at the station level. A 10% increase in annual CaBi ridership contributed to a 2.8% increase in average daily Metrorail ridership. On the basis of these results, policy implications and recommendations are discussed.
Doctor Patient Communication: A Review
Authors: Begum Tahmina
Published: December 2015

Communication between patients and health professionals is seen as the core clinical function in building a therapeutic doctor-patient relationship, which is the heart and art of the medicine. Patients satisfaction is strongly influenced by the quality of the communication that occurs. Effective communication is the basis of mutual understanding and trust. This paper aims to raise awareness on the important issues involved in doctor-patient and inter-professional communication among the medical professionals.J Bangladesh Coll Phys Surg 2014; 32: 84-88
Percutaneous Pulmonary Valve Implantation (PPVI) with Melody®: First Ever Case Report in South Asia
Authors: Fatema Nurun Nahar , Hossain Md Rabiul
Published: December 2015

An eleven years old boy was diagnosed as a case of Tetralogy of Fallot (TOF) with absent left pulmonary artery (LPA) since two years of age. He had history of total corrective surgery in 2007 from India. He developed severe right pulmonary artery origin stenosis, severe tricuspid and pulmonary valve regurgitation after surgery and redo surgery was performed in 2009. During redo surgery an orthotropic conduit was placed between right ventricular (RV) out flow tract and pulmonary artery. He developed significant conduit dysfunction in the form of stenosis and regurgitation in 2011 and planned for Melody® trans-catheter pulmonary valve replacement. Finally in 25th December 2012, first ever case of pulmonary valve replacement in South Asia was performed in catheterization laboratory of CMH Dhaka with technical support from a Saudi cardiac team. Patient was discharged three days after the procedure with a fully functioning Melody® valve without any stenosis or regurgitation.J Bangladesh Coll Phys Surg 2014; 32: 102-106
Pilots’ Visual Scan Patterns and Attention Distribution During the Pursuit of a Dynamic Target
Authors: Yu Chung-San , Wang Eric Min-yang , Li Wen-Chin , Braithwaite Graham , Greaves Matthew
Published: December 2015

INTRODUCTION: The current research was to investigate pilots’ visual scan patterns in order to assess attention distribution during air-to-air maneuvers.METHODS: A total of 30 qualified mission-ready fighter pilots participated in this research. Eye movement
data were collected by a portable head-mounted eye-tracking device, combined with a jet fighter simulator. To complete the task, pilots had to search for, pursue, and lock on a moving target while performing air-to-air tasks.RESULTS: There were significant differences in pilots’
saccade duration (ms) in three operating phases, including searching (M = 241, SD = 332), pursuing (M = 311, SD = 392), and lock-on (M = 191, SD = 226). Also, there were significant differences in pilots’ pupil sizes (pixel2), of which the lock-on phase was the largest (M
= 27,237, SD = 6457), followed by pursuit (M = 26,232, SD = 6070), then searching (M = 25,858, SD = 6137). Furthermore, there were significant differences between expert and novice pilots in the percentage of fixation on the head-up display (HUD), time spent looking outside the cockpit, and
the performance of situational awareness (SA).DISCUSSION: Experienced pilots have better SA performance and paid more attention to the HUD, but focused less outside the cockpit when compared with novice pilots. Furthermore, pilots with better SA performance exhibited a smaller pupil
size during the operational phase of lock on while pursuing a dynamic target. Understanding pilots’ visual scan patterns and attention distribution are beneficial to the design of interface displays in the cockpit and in developing human factors training syllabi to improve the safety
of flight operations.Yu C-S, Wang EM, Li W-C, Braithwaite G, Greaves M. Pilots’ visual scan patterns and attention distribution during the pursuit of a dynamic target. Aerosp Med Hum Perform. 2016; 87(1):40–47.
Biodynamic Hypothesis for the Frequency Tuning of Motion Sickness
Authors: Golding John F. , Gresty Michael A.
Published: December 2015

INTRODUCTION: Motion sickness is often provoked by oscillatory translational (linear) acceleration. For humans, motion frequencies around 0.2–0.3 Hz are the most provocative. A current explanation for this frequency band is that it spans a region of maximum ambiguity concerning
the interpretation of vestibular signals. Below 0.2–0.3 Hz, linear accelerations are interpreted as ‘tilt’, whereas at higher frequencies accelerations are interpreted as ‘translation’, i.e., linear motion through space. This is termed the ‘tilt-translation’
hypothesis. However, the origin of this particular frequency range is unclear. We investigated whether the differential perceptions of oscillations at different frequencies derives from the biodynamics of active self-initiated whole body motion.METHODS: Video-films were taken of
subjects running slaloms of various combinations of lengths/amplitudes to provoke a range of temporal frequencies of slalom (reciprocal of time to run a cycle).RESULTS: The usual tactic for cornering at frequencies <0.25 Hz was whole-body tilt, whereas >0.4 Hz lateropulsion
of the legs with torso erect was observed. Between these frequencies subjects showed variable tactics, mixing components of both tilt and lateropulsion.CONCLUSIONS: This uncertainty in selecting the appropriate tactic for movement control around 0.2–0.3 Hz is the possible
origin of ‘tilt-translation’ ambiguity. It also follows that externally imposed motion around these frequencies would challenge both perception and motor control, with the consequence of motion sickness.Golding JF, Gresty MA. Biodynamic hypothesis for the frequency tuning
of motion sickness. Aerosp Med Hum Perform. 2016; 87(1):65–68.
Posture and Helmet Load Influences on Neck Muscle Activation
Authors: Harrison Michael F. , Forde Kelsey A. , Albert Wayne J. , Croll James C. , Neary J. Patrick
Published: December 2015

INTRODUCTION: Night vision goggles (NVG) are linked to increased neck muscle activation and pain. Counterweights (NVGcw) are hypothesized to mitigate these effects. The purpose of this study was to investigate the muscular response to varying helmet loads and postures.METHODS:
Volunteering from a representative squadron were 16 male helicopter aviators (pilots, N = 9; flight engineers, N = 7). Subjects performed head movements to assume nine different postures (three directions: left, center, and right, at three different levels: down, level, and up)
with four different head loads (no helmet; helmet only; NVG; and NVGcw) in randomized order. Subjects were provided real time visual guidance and feedback while assuming the appropriate posture in a cockpit seat in a laboratory setting. Neck muscle activation was assessed with electromyography
(EMG) of four different muscle groups, bilaterally, including the sternocleidomastoid, splenius capitis, and mid and lower trapezius.RESULTS: Two- to fourfold increases in muscle activation were observed in postures to the left (down, level, and up) while subjects wore either the
NVG or NVGcw as compared to the baseline of no helmet. This was most prevalent in smaller muscle groups (i.e., the sternocleidomastoid and splenius capitis) as compared to larger muscle groups (i.e., the mid and lower trapezius).DISCUSSION: The use of NVGcw did not decrease neck
muscle activity as compared to NVG only, particularly when the head posture moved the field of view below the horizon. This suggests interventions to decrease neck muscle activity and fatigue in military helicopter aircrew using NVG should focus on task specific guidelines with respect to
countermeasures.Harrison MF, Forde KA, Albert WJ, Croll JC, Neary JP. Posture and helmet load influences on neck muscle activiation. Aerosp Med Hum Perform. 2016; 87(1):48–53.
Flexible Transmission Network Expansion Planning Considering Uncertain Renewable Generation and Load Demand Based on Hybrid Clustering Analysis
Authors: Li Yun-Hao , Wang Jian-Xue
Published: December 2015

This paper presents a flexible transmission network expansion planning (TNEP) approach considering uncertainty. A novel hybrid clustering technique, which integrates the graph partitioning method and rough fuzzy clustering, is proposed to cope with uncertain renewable generation and load demand. The proposed clustering method is capable of recognizing the actual cluster distribution of complex datasets and providing high-quality clustering results. By clustering the hourly data for renewable generation and load demand, a multi-scenario model is proposed to consider the corresponding uncertainties in TNEP. Furthermore, due to the peak distribution characteristics of renewable generation and heavy investment in transmission, the traditional TNEP, which caters to rated renewable power output, is usually uneconomic. To improve the economic efficiency, the multi-objective optimization is incorporated into the multi-scenario TNEP model, while the curtailment of renewable generation is considered as one of the optimization objectives. The solution framework applies a modified NSGA-II algorithm to obtain a set of Pareto optimal planning schemes with different levels of investment costs and renewable generation curtailments. Numerical results on the IEEE RTS-24 system demonstrated the robustness and effectiveness of the proposed approach.
Catalytic Conversion of Glucose into 5-Hydroxymethylfurfural by Hf(OTf)4 Lewis Acid in Water
Authors: Li Junjie , Ma Yubo , Wang Lei , Song Zean , Li Huiping , Wang Tianfu , Li Hongyi , Eli Wumanjiang
Published: December 2015

A series of Lewis acidic metal salts were used for glucose dehydration to 5-hydroymethylfurfural (HMF) in water. Effect of valence state, ionic radii of Lewis acidic cation, and the type of anions on the catalytic performance have been studied systematically. The experimental results showed that the valence state played an important role in determining catalytic activity and selectivity. It was found that a higher glucose conversion rate and HMF selectivity could be obtained over high valent Lewis acid salts, where the ionic radii of these Lewis acidic metal salts are usually relatively small. Analysis on the effect of the anions of Lewis acid salts on the catalytic activity and the selectivity suggested that a higher glucose conversion and HMF selectivity could be readily obtained with Cl−. Furthermore, the recyclability of high valence state Lewis acid salt was also studied, however, inferior catalytic performance was observed. The deactivation mechanism was speculated to be the fact that high valence state Lewis acid salt was comparatively easier to undergo hydrolysis to yield complicated metal aqua ions with less catalytic activity. The Lewis acidic activity could be recovered by introducing a stoichiometric amount of hydrochloric acid (HCl) to the catalytic before the reaction.
Building Selectivity for NO Sensing in a NOx Mixture with Sonochemically Prepared CuO Structures
Authors: Mullen Max , Dutta Prabir
Published: December 2015

Several technologies are available for decreasing nitrogen oxide (NOx) emissions from combustion sources, including selective catalytic reduction methods. In this process, ammonia reacts with nitric oxide (NO) and nitrogen dioxide (NO2). As the stoichiometry of the two reactions is different, electrochemical sensor systems that can distinguish between NO and NO2 in a mixture of these two gases are of interest. Since NO and NO2 can be brought to equilibrium, depending on the temperature and the surfaces that they are in contact with, the detection of NO and NO2 independently is a difficult problem and has not been solved to date. In this study, we explore a high surface area sonochemically prepared CuO as the resistive sensing medium. CuO is a poor catalyst for NOx equilibration, and requires temperatures of 500 C to bring about equilibration. Thus, at 300 C, NO and NO2 retain their levels after interaction with CuO surface. In addition, NO adsorbs more strongly on the CuO over NO2. Using these two concepts, we can detect NO with minimal interference from NO2, if the latter gas concentration does not exceed 20% in a NOx mixture over a range of 100–800 ppm. Since this range constitutes most of the range of total NOx concentrations in diesel and other lean burn engines, this sensor should find application in selective detection of NO in this combustion application. A limitation of this sensor is the interference with CO, but with combustion in excess air, this problem should be alleviated.
A Numerical Study on System Performance of Groundwater Heat Pumps
Authors: Kim Jinsang , Nam Yujin
Published: December 2015

Groundwater heat pumps have energy saving potential where the groundwater resources are sufficient. System Coefficients of Performance (COPs) are measurements of performance of groundwater heat pump systems. In this study, the head and power of submersible pumps, heat pump units, piping, and heat exchangers are expressed as polynomial equations, and these equations are solved numerically to determine the system performance. Regression analysis is used to find the coefficients of the polynomial equations from a catalog of performance data. The cooling and heating capacities of water-to-water heat pumps are determined using Energy Plus. Results show that system performance drops as the water level drops, and the lowest flow rates generally achieve the highest system performance. The system COPs are used to compare the system performance of various system configurations. The groundwater pumping level and temperature provide the greatest effects on the system performance of groundwater heat pumps along with the submersible pumps and heat exchangers. The effects of groundwater pumping levels, groundwater temperatures, and the heat transfer coefficient in heat exchanger on the system performance are given and compared. This analysis needs to be included in the design process of groundwater heat pump systems, possibly with analysis tools that include a wide range of performance data.
Responses of Clonal Eucalypt Plantations to N, P and K Fertilizer Application in Different Edaphoclimatic Conditions
Authors: Melo Eduardo , Gonçalves José , Rocha José , Hakamada Rodrigo , Bazani José , Wenzel Andrea , Arthur José , Borges Jarbas , Malheiros Rogério , Lemos Cristiane , Ferreira Eric , Ferraz Alexandre
Published: December 2015

Eucalypt plantations in Brazil have the highest mean productivity when compared to other producing countries, and fertilizer application is one of the main factors responsible for these productivities. Our aim was to identify appropriate rates of N, P and K in eucalypt plantations and their interactions with edaphoclimatic factors. Four trials with four rates and three nutrients (N, P and K) were set up. Each nutrient was studied separately, and the trees received sufficient rates of all of the other nutrients through fertilization, to avoid limitations not related to the desired nutrient. We assessed solid wood volume (SV), productivity gains (PG), leaf nutrient content and leaf area index (LAI) to determine the responses to fertilization. PG, regarding N, rates ranged from 104% to 127% at 60 months after planting. P fertilizer application led to gains in productivity in soils with levels of P-resin up to 5 mg·kg−1, but decreased with stand age. K fertilizer application responses increased within age in three sites. In Paulistania, responses to K application were close to zero. N and K responses were climate related. Leaf nutrient content and LAI were not able to predict the highest yields obtained.
From Fragile to Resilient Insulation: Synthesis and Characterization of Aramid-Honeycomb Reinforced Silica Aerogel Composite Materials
Authors: Schwan Marina , Rößler Matthias , Milow Barbara , Ratke Lorenz
Published: December 2015

The production of a new composite material embedding aramid honeycomb materials into nano-porous silica aerogels is studied. Our aim is to improve the poor mechanical strength of silica aerogels by aramid honeycombs without losing the amazing properties of the aerogels like little density and low thermal conductivity. The composite materials were prepared using two formulations of silica aerogels in combination with aramid honeycomb materials of different cell sizes. The silica aerogels are prepared using silicon alkoxides methyltrimethoxysilane and tetraethylorthosilicate as precursors in a two-step acid–base sol–gel process. Shortly in advance of the gelation point, the aramid honeycombs were fluted by the sol, gelation occurred and, after the aging process, the gel bodies were supercritically dried. The properties of the received composite materials are satisfying. Even the thermal conductivities and the densities are a bit higher than for pure aerogels. Most importantly, the mechanical strength is improved by a factor of 2.3 compared to aramid honeycomb materials and by a factor of 10 compared to the two silica aerogels themselves. The composite materials have a good prospective to be used as an impressive insulation material.
Geriatrics in Practice and Research—Worldwide
Authors: Lobmann Ralf
Published: December 2015

This edition marks the launch of the new “Geriatrics” open access journal. Clinical geriatrics and the associated scientific activities required in the field constitute one of the major scientific challenges in medicine in the future. [...]
Cellular Mechanisms of Action of Drug Abuse on Olfactory Neurons
Authors: Heinbockel Thomas , Wang Ze-Jun
Published: December 2015

Cannabinoids (Δ9-tetrahydrocannabinol) are the active ingredient of marijuana (cannabis) which is the most commonly abused illicit drug in the USA. In addition to being known and used as recreational drugs, cannabinoids are produced endogenously by neurons in the brain (endocannabinoids) and serve as important signaling molecules in the nervous system and the rest of the body. Cannabinoids have been implicated in bodily processes both in health and disease. Recent pharmacological and physiological experiments have described novel aspects of classic brain signaling mechanisms or revealed unknown mechanisms of cellular communication involving the endocannabinoid system. While several forms of signaling have been described for endocannabinoids, the most distinguishing feature of endocannabinoids is their ability to act as retrograde messengers in neural circuits. Neurons in the main olfactory bulb express high levels of cannabinoid receptors. Here, we describe the cellular mechanisms and function of this novel brain signaling system in regulating neural activity at synapses in olfactory circuits. Results from basic research have the potential to provide the groundwork for translating the neurobiology of drug abuse to the realm of the pharmacotherapeutic treatment of addiction, specifically marijuana substance use disorder.
African American Women: Surviving Breast Cancer Mortality against the Highest Odds
Authors: White-Means Shelley , Rice Muriel , Dapremont Jill , Davis Barbara , Martin Judy
Published: December 2015

Among the country’s 25 largest cities, the breast cancer mortality disparity is highest in Memphis, Tennessee, where African American women are twice as likely to die from breast cancer as White women. This qualitative study of African-American breast cancer survivors explores experiences during and post treatment that contributed to their beating the high odds of mortality. Using a semi-structured interview guide, a focus group session was held in 2012 with 10 breast cancer survivors. Thematic analysis and a deductive a priori template of codes were used to analyze the data. Five main themes were identified: family history, breast/body awareness and preparedness to manage a breast cancer event, diagnosis experience and reaction to the diagnosis, family reactions, and impact on life. Prayer and family support were central to coping, and survivors voiced a cultural acceptance of racial disparities in health outcomes. They reported lack of provider sensitivity regarding pain, financial difficulties, negative responses from family/friends, and resiliency strategies for coping with physical and mental limitations. Our research suggested that a patient-centered approach of demystifying breast cancer (both in patient-provider communication and in community settings) would impact how women cope with breast cancer and respond to information about its diagnosis.
“That’s True Love:” Lived Experiences of Puerto Rican Perinatally HIV-Infected Youth within Their Families’ Context
Authors: Silva-Suárez Georgina , Bastida Elena , Rabionet Silvia , Beck-Sagué Consuelo , Febo Irma , Zorrilla Carmen
Published: December 2015

The burden of HIV affects not only HIV-infected patients but also their families and caregivers. It is also known that family support is crucial for people living with HIV. A qualitative study was conducted to explore the life experiences, within the family context, of perinatally HIV-infected (pHIV-I) youth in Puerto Rico. Twenty in-depth interviews were performed and audio-recorded. Within the family context, study participants experienced acceptance, love and support but also stigma and discrimination. They reported that family is an essential component in their lives and treatment. Losing one or both parents at a young age was considered more difficult than having HIV. Most participants who lost their parents lived with other family members. This was a challenging situation for both pHIV-I youth and their caregivers. Participants described their healthcare providers as part of their families and would like to keep in touch as they transition to adult care. Despite the challenges, participants expressed a desire to have children. Services targeted to this population should stress social support, incorporate family members into the medical process, provide special guidance and support while transitioning to adult care, and provide them with the latest information regarding HIV and reproductive options.
Ethnic Differences in Maternal Adipokines during Normal Pregnancy
Authors: Chen Xinhua , Scholl Theresa
Published: December 2015

Two adipokines (adiponectin and resistin) have opposite relations with insulin resistance and inflammation. Our major focus was to determine whether there were detectable ethnic differences in maternal adipokines during pregnancy. We also explored the correlation of the adipokines with maternal glucose homeostasis, blood pressure and anthropometric parameters. Pregnant women (n = 1634) were from a large prospective cohort study in Camden NJ (African-American 36.8%; Hispanic 47.6%; Caucasian 15.6%). Serum adiponectin and resistin were measured at entry (week 16.8) and the 3rd trimester (week 30.7) using the Luminex xMapTechnology. Significant differences were observed among ethnic groups, controlling for confounding variables. African American women were exceptional in that they had decreased adiponectin and increased resistin throughout the course of pregnancy (p < 0.05 to p < 0.0001) and a greater than two fold risk of simultaneously exhibiting low adiponectin (lowest tertile) and high resistin (highest tertile) compared to Caucasians and/or Hispanics. The cohort as a whole and each ethnic group showed similar negative correlations between adiponectin, and glucose homeostasis, blood pressure and anthropometric parameters but there was lesser correspondence with resistin. Our data underscore the need for further research on ethnic variation in adipokines and other physiologic biomarkers during complicated and uncomplicated pregnancy.
Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research
Authors: Oyana Tonny , Matthews-Juarez Patricia , Cormier Stephania , Xu Xiaoran , Juarez Paul
Published: December 2015

Objective: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. Methods: We identified counties in the 48 contiguous USA where observed low birthweight (LBW) rates were higher than expected during a five-year study period. The identification was conducted using a retrospective space-time analysis scan for statistically significant clusters with high or low rates by a Discrete Poisson Model. Results: We observed statistically significant associations of LBW rate with a set of predictive variables. However, in one of the two spatiotemporal models we discovered LBW to be associated with five predictive variables (teen birth rate, adult obesity, uninsured adults, physically unhealthy days, and percent of adults who smoke) in two counties situated in Alabama after adjusting for location changes. Counties with higher than expected LBW rates were similarly associated with two environmental variables (ozone and fine particulate matter). Conclusions: The county-level predictive measures of LBW offer new insights into spatiotemporal patterns relative to key contributory factors. An external framework provides a promising place-based approach for identifying “hotspots” with implications for designing targeted interventions and control measures to reduce and eliminate health disparities.
Genistein and Glyceollin Effects on ABCC2 (MRP2) and ABCG2 (BCRP) in Caco-2 Cells
Authors: Schexnayder Chandler , Stratford Robert
Published: December 2015

The goal of the present study was to determine the effects of glyceollins on intestinal ABCC2 (ATP Binding Cassette C2, multidrug resistance protein 2, MRP2) and ABCG2 (ATP Binding Cassette G2, breast cancer resistance protein, BCRP) function using the Caco-2 cell intestinal epithelial cell model. Glyceollins are soy-derived phytoestrogens that demonstrate anti-proliferative activity in several sources of cancer cells. 5 (and 6)-carboxy-2′,7′-dichloroflourescein (CDF) was used as a prototypical MRP2 substrate; whereas BODIPY-prazosin provided an indication of BCRP function. Comparison studies were conducted with genistein. Glyceollins were shown to inhibit MRP2-mediated CDF transport, with activity similar to the MRP2 inhibitor, MK-571. They also demonstrated concentration-dependent inhibition BCRP-mediated efflux of BODIPY-prazosin, with a potency similar to that of the recognized BCRP inhibitor, Ko143. In contrast, genistein did not appear to alter MRP2 activity and even provided a modest increase in BCRP efflux of BODIPY-prazosin. In particular, glyceollin inhibition of these two important intestinal efflux transporters suggests the potential for glyceollin to alter the absorption of other phytochemicals with which it might be co-administered as a dietary supplement, as well as alteration of the absorption of pharmaceuticals that may be administered concomitantly.
Health Policy Training: A Review of the Literature
Authors: Heiman Harry , Smith L. , McKool Marissa , Mitchell Denise , Roth Bayer Carey
Published: December 2015

The context within which health care and public health systems operate is framed by health policies. There is growing consensus about the need for increased health policy leadership and a health professional workforce prepared to assume these leadership roles. At the same time, there is strong evidence supporting the need for a broader policy lens and the need to intentionally target health disparities. We reviewed the published literature between 1983 and 2013 regarding health policy training. From 5124 articles identified, 33 met inclusion criteria. Articles varied across common themes including target audience, goal(s), health policy definition, and core curricular content. The majority of articles were directed to medical or nursing audiences. Most articles framed health policy as health care policy and only a small number adopted a broader health in all policies definition. Few articles specifically addressed vulnerable populations or health disparities. The need for more rigorous research and evaluation to inform health policy training is compelling. Providing health professionals with the knowledge and skills to engage and take leadership roles in health policy will require training programs to move beyond their limited health care-oriented health policy framework to adopt a broader health and health equity in all policies approach.
Barriers for Compliance to Breast, Colorectal, and Cervical Screening Cancer Tests among Hispanic Patients
Authors: Miranda-Diaz Christine , Betancourt Elba , Ruiz-Candelaria Yelitza , Hunter-Mellado Robert
Published: December 2015

Hispanics are less likely to undergo screening tests for colorectal cancer and cervical cancer than non-Hispanic whites. Compliance with mammography, fecal occult blood testing (FOBT), colonoscopy, and cervical smears (PAP) and barriers for compliance were studied. A descriptive study was performed with 194 ambulatory patients while they attended routine medical visits. Women are more likely than men to undergo a colonoscopy. Conversely, FOBT was most likely reported by men. Reasons for compliance with FOBT differed by gender. Men were most likely to avoid FOBT due to lack of knowledge whereas women reported that physicians do not recommend the procedure. Both men and women reported that lack of physician’s recommendation was their primary reason for not undergoing a colonoscopy. Men tend to report lack of knowledge about colonoscopy procedure. A higher mammogram utilization rate was reported by women older than 40 years. PAP smears were reported by 74% of women older than 21 years. The major reasons for avoiding mammography and PAP tests were having a busy schedule, fear, and feeling uncomfortable during the procedure. In a multivariate regression analysis, occupational status was found to be a predictor for compliance with FOBT and colonoscopy.
Building Collaborative Health Promotion Partnerships: The Jackson Heart Study
Authors: Addison Clifton , Campbell Jenkins Brenda , Odom Darcel , Fortenberry Marty , Wilson Gregory , Young Lavon , Antoine-LaVigne Donna
Published: December 2015

Building Collaborative Health Promotion Partnerships: The Jackson Heart Study. Background: Building a collaborative health promotion partnership that effectively employs principles of community-based participatory research (CBPR) involves many dimensions. To ensure that changes would be long-lasting, it is imperative that partnerships be configured to include groups of diverse community representatives who can develop a vision for long-term change. This project sought to enumerate processes used by the Jackson Heart Study (JHS) Community Outreach Center (CORC) to create strong, viable partnerships that produce lasting change. Methods: JHS CORC joined with community representatives to initiate programs that evolved into comprehensive strategies for addressing health disparities and the high prevalence of cardiovascular disease (CVD). This collaboration was made possible by first promoting an understanding of the need for combined effort, the desire to interact with other community partners, and the vision to establish an effective governance structure. Results: The partnership between JHS CORC and the community has empowered and inspired community members to provide leadership to other health promotion projects. Conclusion: Academic institutions must reach out to local community groups and together address local health issues that affect the community. When a community understands the need for change to respond to negative health conditions, formalizing this type of collaboration is a step in the right direction.
Depression, a Hidden Mental Health Disparity in an Asian Indian Immigrant Community
Authors: Roberts Lisa , Mann Semran , Montgomery Susanne
Published: December 2015

Cultural influences are deeply rooted, and continue to affect the lives of Asian-Indian (AI) immigrants living in Western culture. Emerging literature suggests the powerful nature of traditions and culture on the lives, mental and physical health of AI immigrants, particularly women. The purpose of this study was to explore depression among AI women in Central California (CC). This mixed-methods research was conducted in collaboration with the CC Punjabi community and the support of local religious leaders. All interviews were conducted in Punjabi and English. Whenever possible we utilized validated scales aligned with emerging themes from the qualitative data, which also provided contextualization to survey responses. In all we conducted 11 key informant interviews, four focus groups (n = 47) and a rigorously developed anonymous survey (n = 350). Social dynamics and traditional expectations including gendered roles significantly affected mental health among women participants. Subgroups along the lines of language choice (Punjabi vs. English) experience and report depression differently in part due to the highly stigmatized nature of mental health issues in this model minority community. The findings of this study highlight the importance of utilizing mixed methods to access hard to reach populations regarding sensitive topics such as mental health.
Characterizing the HIV/AIDS Epidemic in the United States and China
Authors: Huang Ming-Bo , Ye Li , Liang Bing-Yu , Ning Chuan-Yi , Roth William , Jiang Jun-Jun , Huang Jie-Gang , Zhou Bo , Zang Ning , Powell Michael , Liang Hao , Bond Vincent
Published: December 2015

The HIV/AIDS data from the national surveillance systems of China and the United States from 1985 to 2014 were compared to characterize the HIV/AIDS epidemic in both countries. The current estimated national HIV prevalence rate in China and the United States are 0.0598% and 0.348%, respectively. In the United States, the annual number of new HIV infections has remained relatively stable (~50,000 each year) and has shown a downward trend in recent years. The Chinese national HIV prevalence is still low, and new HIV infections have been contained at a low level (50,000–100,000 each year). However, the epidemic has showed an increasing trend since 2012. By risk group, in both countries, men who have sex with men (MSM), heterosexual sex, and injection drug use (IDU) are the most common modes of transmission of new HIV infections. However, in the United States, MSM is the dominant transmission route, accounting for >60% of new infections; whereas in China, heterosexual sex has now become the dominant route, also accounting for >60% of new infections. A rapid increase in the proportion of HIV cases that were attributed to MSM and an obvious decrease in the proportion of HIV cases attributed to IDU in China in recent years imply that the China’s epidemic is still evolving, to some extent, copying what was experienced in the United States. By age group, the proportions of HIV cases that were attributed to the age group 25–59 were comparable between the two countries. However, the United States had a higher proportion of cases that were attributed to age groups 15–19 and 20–24 than China, indicating that youth account for more infections in the United States. One other fact worth noting: in China there is a significant increase in the number of HIV new infections in individuals over 50 years of age, which results in much higher proportion of cases that were attributed to age groups 60–64 and over 65 in China than those in the United States. By race/ethnicity, in the United States, Blacks/African Americans continue to experience the most severe HIV burden, followed by Hispanics/Latinos. In China, no official data on race/ethnicity disparities are currently available. Thus, region, risk group, age are important factors in the HIV epidemics in both countries.
A Multidisciplinary Intervention Utilizing Virtual Communication Tools to Reduce Health Disparities: A Pilot Randomized Controlled Trial
Authors: Emerson John , Welch Madelyn , Rossman Whitney , Carek Stephen , Ludden Thomas , Templin Megan , Moore Charity , Tapp Hazel , Dulin Michael , McWilliams Andrew
Published: December 2015

Advances in technology are likely to provide new approaches to address healthcare disparities for high-risk populations. This study explores the feasibility of a new approach to health disparities research using a multidisciplinary intervention and advanced communication technology to improve patient access to care and chronic disease management. A high-risk cohort of uninsured, poorly-controlled diabetic patients was identified then randomized pre-consent with stratification by geographic region to receive either the intervention or usual care. Prior to enrollment, participants were screened for readiness to make a behavioral change. The primary outcome was the feasibility of protocol implementation, and secondary outcomes included the use of patient-centered medical home (PCMH) services and markers of chronic disease control. The intervention included a standardized needs assessment, individualized care plan, intensive management by a multidisciplinary team, including health coach-facilitated virtual visits, and the use of a cloud-based glucose monitoring system. One-hundred twenty-seven high-risk, potentially eligible participants were randomized. Sixty-one met eligibility criteria after an in-depth review. Due to limited resources and time for the pilot, we only attempted to contact 36 participants. Of these, we successfully reached 20 (32%) by phone and conducted a readiness to change screen. Ten participants screened in as ready to change and were enrolled, while the remaining 10 were not ready to change. Eight enrolled participants completed the final three-month follow-up. Intervention feasibility was demonstrated through successful implementation of 13 out of 14 health coach-facilitated virtual visits, and 100% of participants indicated that they would recommend the intervention to a friend. Protocol feasibility was demonstrated as eight of 10 participants completed the entire study protocol. At the end of the three-month intervention, participants had a median of nine total documented contacts with PCMH providers compared to four in the control group. Three intervention and two control participants had controlled diabetes (hemoglobin A1C <9%). Multidisciplinary care that utilizes health coach-facilitated virtual visits is an intervention that could increase access to intensive primary care services in a vulnerable population. The methods tested are feasible and should be tested in a pragmatic randomized controlled trial to evaluate the impact on patient-relevant outcomes across multiple chronic diseases.
Micro RNA in Exosomes from HIV-Infected Macrophages
Authors: Roth William , Huang Ming , Addae Konadu Kateena , Powell Michael , Bond Vincent
Published: December 2015

Exosomes are small membrane-bound vesicles secreted by cells that function to shuttle RNA and proteins between cells. To examine the role of exosomal micro RNA (miRNA) during the early stage of HIV-1 infection we characterized miRNA in exosomes from HIV-infected macrophages, compared with exosomes from non-infected macrophages. Primary human monocytes from uninfected donors were differentiated to macrophages (MDM) which were either mock-infected or infected with the macrophage-tropic HIV-1 BaL strain. Exosomes were recovered from culture media and separated from virus particles by centrifugation on iodixanol density gradients. The low molecular weight RNA fraction was prepared from purified exosomes. After pre-amplification, RNA was hybridized to microarrays containing probes for 1200 miRNA species of known and unknown function. We observed 48 miRNA species in both infected and uninfected MDM exosomes. Additionally, 38 miRNAs were present in infected-cell exosomes but not uninfected-cell exosomes. Of these, 13 miRNAs were upregulated in exosomes from HIV-infected cells, including 4 miRNA species that were increased by more than 10-fold. Though numerous miRNA species have been identified in HIV-infected cells, relatively little is known about miRNA content in exosomes from these cells. In the future, we plan to investigate whether the upregulated miRNA species we identified are increased in exosomes from HIV-1-positive patients.
User-Friendly Data-Sharing Practices for Fostering Collaboration within a Research Network: Roles of a Vanguard Center for a Community-Based Study
Authors: Lee Jae , Sung Jung , Barnett M. , Norris Keith
Published: December 2015

Although various attempts have been made to build collaborative cultures for data sharing, their effectiveness is still questionable. The Jackson Heart Study (JHS) Vanguard Center (JHSVC) at the NIH-funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) may be a new concept in that the data are being shared with a research network where a plethora of scientists/researchers are working together to achieve their common goal. This study describes the current practices to share the JHS data through the mechanism of JHSVC. The JHS is the largest single-site cohort study to prospectively investigate the determinants of cardiovascular disease among African-Americans. It has adopted a formal screened access method through a formalized JHSVC mechanism, in which only a qualified scientist(s) can access the data. The role of the DCC was to help RTRN researchers explore hypothesis-driven ideas to enhance the output and impact of JHS data through customized services, such as feasibility tests, data querying, manuscript proposal development and data analyses for publication. DCC has implemented these various programs to facilitate data utility. A total of 300 investigators attended workshops and/or received training booklets. DCC provided two online and five onsite workshops and developed/distributed more than 250 copies of the booklet to help potential data users understand the structure of and access to the data. Information on data use was also provided through the RTRN website. The DCC efforts led to the production of five active manuscript proposals, seven completed publications, 11 presentations and four NIH grant proposals. These outcomes resulted from activities during the first four years; over the last couple of years, there were few new requests. Our study suggested that DCC-customized services enhanced the accessibility of JHS data and their utility by RTRN researchers and helped to achieve the principal goal of JHSVC of scientific productivity. In order to achieve long-term success, the following, but not limited to these, should be addressed in the current data sharing practices: preparation of new promotional strategies in response to changes in technology and users’ needs, collaboration with the Network statisticians, harmonization of the JHS data with the other local-based heart datasets to meet the needs of the potential users from the broader geographical areas, adoption of the RTRN comprehensive data-sharing policy to broaden the variety of research topics and implementation of an ongoing monitoring program to evaluate its success.