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Search Results: 1 - 10 of 315055 matches for " Alexander J. Millman "
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Rapid Molecular Testing for TB to Guide Respiratory Isolation in the U.S.: A Cost-Benefit Analysis
Alexander J. Millman, David W. Dowdy, Cecily R. Miller, Robert Brownell, John Z. Metcalfe, Adithya Cattamanchi, J. Lucian Davis
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0079669
Abstract: Background Respiratory isolation of inpatients during evaluation for TB is a slow and costly process in low-burden settings. Xpert MTB/RIF (Xpert) is a novel molecular test for tuberculosis (TB) that is faster and more sensitive but substantially more expensive than smear microscopy. No previous studies have examined the costs of molecular testing as a replacement for smear microscopy in this setting. Methods We conducted an incremental cost–benefit analysis comparing the use of a single negative Xpert versus two negative sputum smears to release consecutive adult inpatients with presumed TB from respiratory isolation at an urban public hospital in the United States. We estimated all health-system costs and patient outcomes related to Xpert implementation, diagnostic evaluation, isolation, hospitalization, and treatment. We performed sensitivity and probabilistic uncertainty analyses to determine at what threshold the Xpert strategy would become cost-saving. Results Among a hypothetical cohort of 234 individuals undergoing evaluation for presumed active TB annually, 6.4% had culture-positive TB. Compared to smear microscopy, Xpert reduced isolation bed utilization from an average of 2.7 to 1.4 days per patient, leading to a 48% reduction in total annual isolation bed usage from 632 to 328 bed-days. Xpert saved an average of $2,278 (95% uncertainty range $1582–4570) per admission, or $533,520 per year, compared with smear microscopy. Conclusions Molecular testing for TB could provide substantial savings to hospitals in high-income countries by reducing respiratory isolation usage and overall length of stay.
Yeast functional genomics and cell biology: no longer in the dark
Helena Friesen, Jonathan S Millman, Brenda J Andrews
Genome Biology , 2003, DOI: 10.1186/gb-2003-4-12-352
Abstract: Despite a blackout affecting most of the North American eastern seaboard, a bright light shone on genomic research at the Cold Spring Harbor Laboratory's tenth biannual meeting on yeast cell biology. Researchers studying the budding yeast, Saccharomyces cerevisiae, have been in the luxurious position of living in a 'post-genomic' era for more than six years, since the complete genome sequence was published in 1996. Functional genomics, proteomics and bioinformatics have become routine parts of the yeast cell biologist's repertoire, and genome-wide analysis featured in many presentations. The rapid incorporation of new technologies into yeast laboratories reflects the open and interactive philosophy of the yeast community, the utility of yeast as a powerful testing ground for new genomic and proteomic concepts, and advances in integrative cell biology. We focus here on a few main themes of the meeting, with an emphasis on studies that have been particularly influenced by genome-wide approaches.The Saccharomyces Genome Database (SGD http://www.yeastgenome.org webcite), a publicly funded database encompassing the molecular biology and genetics of yeast, is an enormously valuable online resource. Its curators constantly reannotate the genome as new information becomes available. Recently, the draft genome sequences of several yeast species closely related to S. cerevisiae have been published, together with comparative genome analyses. Anand Sethuraman (Stanford University Medical School, USA) from the SGD reported that these analyses have enabled SGD to make changes to the start sites of 77 open reading frames (ORFs) and to reclassify a large number of ORFs as 'dubious'. The reannotation has provoked a revision of the current number of probable protein-coding genes in S. cerevisiae from 6,569 hypothetical ORFs to 5,749 probable ORFs. This fine-tuning of the S. cerevisiae genome should aid in the preliminary annotation of the genomes of other organisms.While some putativ
Milk Replacer Acidification for Free-Access Feeding: Effects on the Performance and Health of Veal Calves  [PDF]
Cynthia G. Todd, Ken E. Leslie, Suzanne T. Millman, Jan M. Sargeant, Heather Migdal, Kathleen Shore, Neil G. Anderson, Trevor J. DeVries
Open Journal of Animal Sciences (OJAS) , 2016, DOI: 10.4236/ojas.2016.63029
Abstract: Objectives of this study were to investigate the effects of milk replacer (MR) acidification for free- access feeding on pre- and post-weaning performance, morbidity and mortality of calves. Calves were randomly assigned to free-access feeding of acidified (ACID, n = 31) or non-acidified (NON, n = 31) MR, and weaned at 42 days. ACIDMR was prepared to pH 4.0 - 4.5 using formic acid. Intakes were measured daily and weights weekly. Samples of ACID and NON MR were analyzed for coliform and aerobic bacterial growth. After weaning, calves transitioned to a grain-fed veal diet, weighed every 2 weeks. At slaughter (approximately 6 months of age), lungs were evaluated for gross pathological changes and dressed carcass weights were obtained. Generalized linear mixed models were constructed to examine the effects of MR acidification. Differences by treatment group for pre- and post-weaning morbidity and mortality were tested using Pearson’s χ2 and Fisher’s exact tests. ACID calves consumed less MR than NON (10.6 vs. 11.7 L/d, P = 0.02). Acidification tended to promote earlier onset of starter ration consumption (32.0 vs. 39.5 d, hazard ratio = 1.5, P = 0.07), but did not affect average daily starter ration or water intakes across the pre-weaning period. ACID and NON calves did not differ for BW at weaning, pre- or post-weaning ADG or dressed carcass weight. ACID MR had less coliform (P < 0.001) and aerobic bacterial growth (P < 0.001) than NON MR, but odds of disease treatment and mortality did not differ. ACID calves tended to have lower odds of pulmonary lesions during post-mortem inspection than NON calves (OR = 0.3, P = 0.07). These results indicate that under free-access feeding conditions, acidification limited bacterial growth and MR intake, but there were no long-term impacts of acidification on calf performance or health. In conclusion, acidification to pH 4.0 - 4.5 will significantly reduce bacterial growth in milk fed to calves.
Regional Dissemination of a Trimethoprim-Resistance Gene Cassette via a Successful Transposable Element
Amy S. Labar, Jennifer S. Millman, Ellen Ruebush, Japheth A. Opintan, Rima A. Bishar, A. Oladipo Aboderin, Mercy J. Newman, Adebayo Lamikanra, Iruka N. Okeke
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0038142
Abstract: Background Antimicrobial resistance is a growing international problem. We observed a 50% increase in the prevalence of trimethoprim resistance among fecal Escherichia coli from healthy Nigerian students between 1998 and 2005, a trend to increase that continued in 2009. Methods and Findings A PCR-based screen revealed that 131 (43.1%) of isolates obtained in Nigeria in 2005 and 2009 carried integron-borne dfrA cassettes. In the case of 67 (51.1%) of these isolates, the cassette was a class 1-integron-borne dfrA7 gene, which has been reported at high prevalence from E. coli isolates from other parts of Africa. Complete sequencing of a 27 Kb dfrA7-bearing plasmid from one isolate located the dfrA7 gene within a Tn21-type transposon. The transposon also contained an IS26-derived bla/sul/str element, encoding resistance to β-lactams, sulphonamides and streptomycin, and mercury resistance genes. Although the plasmid backbone was only found in 12 (5.8%) of trimethoprim-resistant isolates, dfrA7 and other transposon-borne genes were detected in 14 (16.3%) and 32 (26.3%) of trimethoprim resistant isolates collected in Nigeria in 2005 and 2009, respectively. Additionally, 37 (19.3%) of trimethoprim-resistant E. coli isolates collected between 2006 and 2008 from Ghana were positive for the dfrA7 and a transposon marker, but only 4 (2.1%) harbored the plasmid backbone. Conclusions Our data point to transposition as a principal mechanism for disseminating dfrA7 among E. coli from Nigeria and Ghana. On-going intensive use of the affordable broad-spectrum antibacterials is likely to promote selective success of a highly prevalent transposable element in West Africa.
Disaster-Related Resilience as Ability and Process: A Concept Guiding the Analysis of Response Behavior before, during and after Extreme Events  [PDF]
Janos J. Bogardi, Alexander Fekete
American Journal of Climate Change (AJCC) , 2018, DOI: 10.4236/ajcc.2018.71006
Abstract: Extreme weather and climate events research needs concepts to analytically capture processes that describe how extreme they are: depth of impact but mainly also temporal aspects such as length, speed and quality of recovery. This paper analyses resilience as a concept to provide these dimensions. The use of the term resilience proliferates in many contexts and disciplines. Interpretations may overlap or even contradict each other. This paper seeks to make a case for a more nuanced understanding of resilience, including the use of “qualifier adjectives” to emphasize differences. Starting from the original etymological meaning of resilience as “bouncing back” the paper aims an innovative (re)conceptualization to facilitate the practical use of resilience in disaster risk management. It is recommended to distinguish between resilience as ability, being a hazard independent pre-disposition for recovery, and resilience as a process, describing different bouncing back and bouncing forward mechanisms inherent in the different recovery phases. This proposed distinction would enable the assessment of recovery abilities before calamities occur and hence could serve as guide to disaster preparedness programmes. The suggested analysis of resilience as a process would open opportunities to use the concept describing preemptive resilience response (presilience), recovery as bouncing back towards a state preceding the hazard event, as well as progressive resilience (prosilience) as bouncing forward and transition of the disaster recovery phase into adaptation and further development.
Light Meter for Measuring Photosynthetically Active Radiation  [PDF]
Alexander Kutschera, Jacob J. Lamb
American Journal of Plant Sciences (AJPS) , 2018, DOI: 10.4236/ajps.2018.912175
Abstract: Measurement of photosynthetically active radiation (PAR) incident on photosynthetic organisms is a crucial measurement for understanding how organisms respond to various light conditions, and for calculating electron flow through the photosynthetic machinery. Measurements of PAR are typically performed in the region of the electromagnetic spectrum between 400 - 700 nm, which is the region of radiation that is responsible for promoting photosynthesis. Typically, to ensure that the sensor measures in this range, the implementation of long- and short-pass filters is required. Although this allows the exclusion of radiation outside of the PAR region, such filters can be expensive. Additionally, the implementation of autonomous PAR measurements requires costly commercial instruments. Here, a straight-forward, inexpensive apparatus has been designed and constructed using a sensor that can distinguish between red, green, blue and white light. The constructed apparatus was able to perform comparably to a commercial PAR sensor. Furthermore, the implementation of the device to measure PAR intensity over a three-day period shows how the apparatus can be implemented for use as a constant light monitor.
The Hadronic Transitions $Upsilon(2S)\to Upsilon(1S)$
J. Alexander
Physics , 1998, DOI: 10.1103/PhysRevD.58.052004
Abstract: Using a data sample of $\Upsilon(2S)$ events collected with the CLEO II detector at the Cornell Electron Storage Ring, we have investigated the hadronic transitions between the $\Upsilon(2S)$ and the $\Upsilon(1S)$. The charged dipion transition $\Upsilon(2S)\to \Upsilon(1S)\pi^+\pi^-$ was studied using two different analysis techniques. Selecting events in which $\Upsilon(1S)$ decays into a $\mu\mu$ or $ee$ lepton pair(``exclusive'' analysis), we measured the branching fraction of B=0.189+-0.004+-0.009, while using a method allowing $\Upsilon(1S)$ to decay into anything (``inclusive'' analysis) we found B=0.0196+-0.002+-0.010. The appropriate average of the two measurements gives B=0.0192+-0.002+-0.010. Combining the exclusive and inclusive results we derive the $\Upsilon(1S)$ leptonic branching ratios B_{ee}=0.0229+-0.0008+-0.0011 and B_{\mu\mu}=0.0249+-0.0008+-0.0013 We also studied $\Upsilon(2S)\to \Upsilon(1S)\pi^0\pi^0$ and obtained the branching fraction of B=0.092+-0.006+-0.007. Parameters of the $\pi\pi$ system (dipion invariant mass spectra, angular distributions) were analyzed and found to be consistent with current theoretical models. Lastly, we searched for the $\eta$ and single $\pi^0$ transitions and obtained the upper limits of 0.0028 and 0.0011 respectively.
The Three Pillars of Sustainability Framework: Approaches for Laws and Governance  [PDF]
William Henry Clune, Alexander J. B. Zehnder
Journal of Environmental Protection (JEP) , 2018, DOI: 10.4236/jep.2018.93015
Abstract: The three pillars of sustainability framework is a multidisciplinary implementation and solutions oriented approach that recognizes most successful and scalable sustainability solutions require the presence of, and are driven by, all three pillars simultaneously: 1) technology and innovation; 2) laws and governance; and 3) economics and financial incentives. The three pillars framework is strategic because it often reveals or describes specific and feasible changes that advance sustainability solutions within markets and institutional settings. The section on technology discusses the crucial role that technology plays in creating new ways for doing more in our rapidly urbanizing communities by using less resources and energy inputs. The section on economics discusses problems with current conceptions of economic welfare that measure growth (flow) rather than the asset base (wealth), and explores possibilities for integrated and multidisciplinary analysis for coupled economic and social systems. The section on laws and governance considers the role of legal frameworks related to incentives, regulatory baselines, and in public policy formation, including influences and feedback effects from social norms, changing culture, and sustainability education. Technological development and engaging economic markets are at the center of our best and most rapidly deployable sustainability solutions. In that context, a specific focus is given throughout the discussion sections to the key role of laws and governance in supporting relevant, effective, and sustainable technological and economic development, as well as to highlight the crucial (often final) steps the law plays in successfully implementing new sustainability projects. As the discussions and examples (taken from Asia, the US, and Europe) demonstrate, the three pillars framework is flexible and useful in a number of contexts, as a solutions template, as an integrated planning approach, as a decision making guide, and for determining project priorities.
Health services research doctoral core competencies
Christopher B Forrest, Diane P Martin, Erin Holve, Anne Millman
BMC Health Services Research , 2009, DOI: 10.1186/1472-6963-9-107
Abstract: Health services research (HSR) is a scientific field that examines the structures, functions, policies, and outcomes of health services delivered to individuals and populations[1]. Its purview is global and involves investigation into all service sectors that affect health, not just the medical care system. Given the field's 40 year history, it is now appropriate to propose a common set of educational competencies. Elucidating the knowledge base and skills needed to be a successful health services researcher will aid in defining the field's professional identity.In the 1995 Institute of Medicine report, Health Services Research: Training and Workforce Issues [2], four elements of HSR training were emphasized: its multi-disciplinary approach; inclusion of basic and applied research; use of conceptual and theoretical relationships within and between health systems; and, research done on both populations and individuals. Although the report did not specify the core skills or knowledge sets that are common to HSR professionals, it did suggest that "a single educational path is neither practical nor desirable" and HSR programs should offer a range of training opportunities.HSR incorporates a wide range of disciplines, notably biomedicine, economics, epidemiology, informatics, management sciences, political science, psychology, sociology, and statistics. Application of these disciplines to problems confronting health systems requires a workforce with a diverse skill set. The field has specific journals, professional societies, employers, sponsors, and training programs; however, the competencies common to all doctoral-trained HSR professionals have not been well-defined.Graduates of HSR training programs pursue a wide variety of careers in academia, research, healthcare delivery, and policy analysis. Despite the success of these graduates, they complete their respective training programs unsure what it means to be a health services researcher, how they are distinguished f
ROTHKO or TESCO
Chantal Lacourarie,Ian Millman,Marie-Annick Mattioli
Recherche et Pratiques Pédagogiques en Langues de Spécialité : Cahiers de l'APLIUT , 2011, DOI: 10.4000/apliut.151
Abstract: IntroductionCette fiche pédagogique décrit et analyse une activité réalisée dans le cadre du module Apprendre et Travailler Autrement défini dans les Programmes Pédagogiques Nationaux (PPN) comme permettant d’ approfondir de manière autonome ou tutorée les connaissances acquises .Il s’agit, d’une part, de la réalisation d’un voyage pédagogique à Londres entre le 5 et le 7 décembre 2008 ; nous souhaitions faire ou refaire découvrir Londres à nos étudiants, qu’ils visitent et prennent des...
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