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Background: Dexpanthenol-containing ointments/fluids are recommended to restore impaired nasal mucosa. To date, there are no data about the influence of dexpanthenol or formulations including dexpanthenol on ciliary beat frequency (CBF) of nasal epithelial cells. Methods: We tested the ciliary beat frequency of human nasal epithelial cells in RPMI 1640 cell solution using in vitro high-frequency video microscopy every 60 s over a period of 15 min (min). Bepanthen® solution and dexpanthenol in two clinically relevant concentrations (1.67% and 3.33%) were added to the cells. Addition of sterile water served as control group. To get a better overview, the measurements after 1 min, 5 min and 15 min were combined. Results: The CBF in the control group (n = 17) after 15 min was 7.3 ± 2.6 Hz. In comparison, the CBF after 15 min was 1.8 ± 1.0 Hz in the 3.33% Bepanthen® group (n = 17) and 3.2 ± 1.2 Hz in the 1.67% group, which was statistically significantly lower in both groups (p < 0.001). With regard to the dexpanthenol group (n = 17) a CBF of 6.0 ± 2.6 Hz with 3.33% and 6.1 ± 2.4 Hz with 1.67% dexpanthenol, was detected, which was again statistically significantly lower (p = 0.06) compared to the control group except CBF at 15 min with 1.57% (n = 17; p = 0.04). In general, the effect on CBF was less pronounced with dexpanthenol compared with Bepanthen® with a statistically significant difference between the two formulations. The results were verified by calculating an analysis of variance (ANOVA). Conclusions: Bepanthen® as an ointment, solution or inhalation is commonly used in ENT for mucosal care. Our results have shown that both substances reduce CBF in clinically relevant concentrations, although the effect was more pronounced with Bepanthen® compared to dexpanthenol solution, which could be related to additives or change of physical properties in the solution. Further research is needed to assess potential clinical relevance. [ABSTRACT FROM AUTHOR]

There is a growing need for psychologists with specialized training in geriatric mental health competencies. The Geriatric Scholars Program for Psychologists (GSP-P) was created to address this shortage within a large integrated healthcare system. In 2019, GSP-P piloted an advanced workshop designed to enhance expertise in geriatric mental health competencies among graduates of its foundational competencies core course. The workshop included 3.5 days of expert-led seminars regarding the biopsychosocial needs of older adults with chronic medical illness and was followed by completion of an individualized learning plan. This paper describes the evaluation of the course using a mixed methods with data collected prior to the workshop, immediately post-workshop, and six months post-workshop. Results indicated enthusiasm for the workshop, significant improvements in four geropsychology domains on the Pikes Peak Geropsychology Knowledge and Skill Assessment Tool, and benefit from completion of the independent learning plans. Our findings demonstrate that continued enhancement of geropsychology competencies through advanced coursework is feasible and improves knowledge and skill, particularly when combined with individualized learning plans. [ABSTRACT FROM AUTHOR]

As federal partners, the Veterans Health Administration (VA) and the Indian Health Service (IHS) agreed to share resources, such as education. The VA Geriatric Scholars Program, a workforce development program, provides one of its training programs on team-based primary care of elders to clinicians working in IHS and Tribal Health Programs. The practical impact of that training is described. A mixed methods approach was applied to the course's evaluation survey at five clinics in the Northwestern Plains, Southwest, Pacific Coast, and Alaska. Quantitative approaches assessed participants' self-reported intention to improve recognition and assessment of common geriatric syndromes. A qualitative approach applied to open-ended text responses revealed intensions to improve team-based care. Among the 51 respondents in our sample, we found significant improvements in self-reported ability to recognize previously unfamiliar potential risks to elders' health and safety, t(49) = 8.0233, p <.001, as well as increased comfort with conducting geriatric assessments and increased confidence in interprofessional team-based communication. Improvements to team-based care included enhanced clinical skills, organizational factors and the need to train additional employees. This evaluation demonstrates the value of sharing resources among federal partners and its value for participants in IHS and Tribal Health Programs. [ABSTRACT FROM AUTHOR]

Maser polarization changes during a pulsation in the CSE of an AGB star are related in a complicated way to the magnetic field structure. 43 GHz SiO maser transitions are useful for polarization study because of their relatively simple Zeeman splitting structure and their location. This work uses 3D maser simulation to investigate the effect of the magnetic field on maser polarization with different directions. The results show that linear polarization depends on the magnetic direction while circular polarization is less significant. The EVPA changes through π/2 at an angle of around 50 degrees, approximately the Van Vleck angle. The EVPA rotation result from 3D maser simulation is consistent with results from 1D simulations, and may explain the 90 degree change of the EVPA within a single cloud in the observational cases of TX Cam and R Cas. [ABSTRACT FROM AUTHOR]

There are indications that the third-known eruption of the recurrent nova T CrB is imminent, and multiwavelength observations prior to the eruption are important to characterize the system before it erupts. T CrB is known to display the SiO fundamental vibrational feature at 8  |$\, \mu$| m. When the anticipated eruption occurs, it is possible that the shock produced when the ejected material runs into the wind of the red giant in the system may be traced using SiO maser emission. We have used the 100 m Effelsberg Radio Telescope to search for 28SiO emission in the υ = 1, υ = 2, J = 1 → 0 transitions, at 43.122 GHz and 42.820 GHz, respectively, while the system is in quiescence. We find no evidence for such emission. We set stringent 3σ upper limits of 1.66 mJy on emission in the υ = 1, J = 1 → 0 transition, and 1.72 mJy in the υ = 2, J = 1 → 0 transition, respectively, for a noise bandwidth of 250 kHz. The corresponding limits for a 31.25 kHz bandwidth are 4.69 and 4.86 mJy, respectively. These upper limits improve on previous upper limits for this system by more than two orders of magnitude. [ABSTRACT FROM AUTHOR]

Infants developing necrotizing enterocolitis (NEC) have a different metabolomic profile compared to controls. The potential of specific metabolomics, i.e. amino acids and amino alcohols (AAA), as early diagnostic biomarkers for NEC is largely unexplored. In this multicenter prospective case–control study, longitudinally collected fecal samples from preterm infants (born <30 weeks of gestation) from 1–3 days before diagnosis of severe NEC (Bell's stage IIIA/IIIB), were analyzed by targeted high-performance liquid chromatography (HPLC). Control samples were collected from gestational and postnatal age-matched infants. Thirty-one NEC cases (15 NEC IIIA;16 NEC IIIB) with 1:1 matched controls were included. Preclinical samples of infants with NEC were characterized by five increased essential amino acids—isoleucine, leucine, methionine, phenylalanine and valine. Lysine and ethanolamine ratios were lower prior to NEC, compared to control samples. A multivariate model was rendered based on isoleucine, lysine, ethanolamine, tryptophan and ornithine, modestly discriminating cases from controls (AUC 0.67; p < 0.001). Targeted HPLC pointed to several specific AAA alterations in samples collected 1–3 days before NEC onset, compared to controls. Whether this reflects metabolic alterations and has a role in early biomarker development for NEC, has yet to be elucidated. [ABSTRACT FROM AUTHOR]

Despite poor sleep among older adults, little is known about the sleep habits of older immigrants living in the United States. The current pragmatic qualitative descriptive study explored sleep among older Korean immigrants, using a focus group with six participants and individual phone interviews with 22 Korean immigrants aged ≥60 years. Transcripts were coded to identify underlying themes. Several thematic categories were identified under six domains: daytime function, getting ready for bed, falling asleep, awakenings during sleep, going back to sleep, and seeking advice from peers. Unhealthy sleep behaviors were found during daytime and bedtime, particularly among those who were retired/unemployed or living alone. Seeking advice from peers was common but none of the advice helped participants sleep. Sleep education programs in Korean-speaking communities can be used to target those who are socially isolated and may benefit older Korean immigrants with sleep difficulties. [Research in Gerontological Nursing, 15(4), 193–202.] [ABSTRACT FROM AUTHOR]

Poor sleep is common among older adults, affecting a wide range of health outcomes. However, little is known about sleep issues among older Korean immigrants, the fastest growing Asian American subgroup in the United States. We aimed to explore multiple factors associated with sleep among this group. We analyzed cross-sectional survey data from 43 older immigrants living in two large Korean communities in Southern California. Perceived sleep quality was significantly associated with gender, living arrangement, employment status, mental health, and sleep-related beliefs (all p-values < 0.05). Living with someone and being employed for wages were significantly uniquely associated with better sleep quality, accounting for demographic and health-related factors (R2 = 51.8%, adjusted R2 = 38.7%, p = 0.002). These findings suggest a potential role of sociocultural factors on sleep. Further studies are needed to confirm these findings and to inform a sleep intervention program tailored to the characteristics of older Korean immigrants. [ABSTRACT FROM AUTHOR]

Older adults are more likely to seek mental health care through integrated care settings such as primary care. Currently, there exists a significant shortage of mental health providers trained in geropsychology and integrated care competencies. To address this need within the Veterans Health Administration, a national workforce development program was extended to include psychologists, which is called the Geriatric Scholars Program‐Psychology Track (GSP‐P). The GSP‐P has two overarching educational program aims: (1) to improve geropsychology competencies of practicing VA psychologists, particularly those working within integrated settings (e.g., primary care) and (2) enrich psychologists' abilities to enact change in their clinical settings. Ninety‐eight VA clinicians participated in the GSP‐P, which includes a multi‐day in‐person course, from 2014 to 2018. Participants completed measures assessing confidence and self‐reported knowledge in geropsychology and integrated care competencies pre‐course and 3‐months post‐completion. Two‐weeks post‐course participants responded to open‐ended survey questions regarding their perceptions of the course and potential applications of learning. Significant improvements in confidence in and knowledge of geropsychology and integrated care competencies emerged from pre‐course to 3‐months post‐completion. Qualitative findings demonstrated that participants valued the face‐to‐face, integrated multimodal educational program. Findings provided insights regarding clinicians' planned application of the knowledge acquired, such as modifying treatments for older patients. Specialized workforce programs such as the GSP‐P have a significant, positive impact on the care of older Veterans. [ABSTRACT FROM AUTHOR]

The Fall Prevention Center of Excellence designed three progressive-intensity fall prevention program models, Increasing Stability Through Evaluation and Practice (InSTEP), to reduce risk in community-dwelling older adults. Each model included physical activity, medical risk, and home safety components and was implemented as a 12-week program for small class sizes (12-15 people) in community and senior centers. Change in fall rates and fall risk factors was assessed using a battery of performance tests, self-reports of function, and fall diaries in a 3-group within-subjects (N - 200) design measured at baseline, immediately postintervention, and at 3 and 9 months postintervention. Overall, participants experienced a reduction in falls, improved self-perception of gait and balance, and improved dynamic gait function. The medium-intensity InSTEP model significantly (p = .003) reduced self-reported falls in comparison with the other models. InSTEP is a feasible model for addressing fall risk reduction in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

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There is an alarming supply and demand gap for geropsychology expertise within the United States. Health policy experts called for increasing geriatric mental health competencies for all mental health providers, including within Veterans Health Administration (VHA), to address this problematic gap. The VHA Geriatrics Scholar Program (GSP) Psychology Track was developed because there were no commercially available trainings in geropsychology for licensed psychologists. Developing the GSP Psychology Track was based on an evidence-based educational model for the VHA primary care workforce; and included a stepwise curriculum design, pilot implementation, and program evaluation. The educational program was pilot tested with eight VHA psychologists. Evaluation results demonstrated feasibility of implementing an innovative integrated multimodal educational program in geropsychology. Furthermore, this program was associated with reports of increased confidence in geropsychology competencies and self-reported implementation of geropsychology knowledge, indicating the potential for this educational model to improve mental health care for older Veterans. [ABSTRACT FROM AUTHOR]

Neurodegenerative disorders share the final degenerative pathway, the inflammation-induced apoptosis and/or necrosis, irrespective of their etiology, be it of acute and chronic traumatic, vascular and idiopathic origin. Although disease-modifying strategies are an unmet need in these disorders, lately, (pre)clinical studies suggested favorable effects after an intervention with bone marrow-derived stromal cells (bm-SC). Recent interventions with intrathecal transplantation of these cells in preclinical rodent models improved the functional outcome and reduced the inflammation, but not anti-inflammatory drugs. The benefit of bm-SCs was demonstrated in rats with an acute (traumatic spinal cord injury, tSCI) and in mice with a chronic [amyotrophic lateral sclerosis (ALS)-like FUS 1-358 or SOD1-G93-A mutation] neurodegenerative process. Bm-SCs, were found to modify underlying disease processes, to reduce final clinical SCI-related outcome, and to slow down ALS-like clinical progression. After double-blind interventions with bm-SC transplantations, Vehicle (placebo), and (non)steroidal anti-inflammatory drugs (Methylprednisolone, Riluzole, Celecoxib), clinical, histological and histochemical findings, serum/spinal cytokines, markers for spinal microglial activation inclusive, evidenced the cell-to-cell action of bm-SCs in both otherwise healthy and immune-deficient tSCI-rats, as well as wild-type and FUS/SOD1-transgenic ALS-like mice. The multi-pathway hypothesis of the cell-to-cell action of bmSCs, presumably using extracellular vesicles (EVs) as carriers of messages in the form of RNAs, DNA, proteins, and lipids rather than influencing a single inflammatory pathway, could be justified by the reported differences of cytokines and other chemokines in the serum and spinal tissue. The mode of action of bm-SCs is hypothesized to be associated with its dedicated adjustment of the pro-apoptotic glycogen synthase kinase-3β level towards an anti-apoptotic level whereas their multi-pathway hypothesis seems to be confirmed by the decreased levels of the pro-inflammatory interleukin (IL)-1β and tumor necrosis factor (TNF) as well as the level of the marker of activated microglia, ionized calcium binding adapter (Iba)-1 level. [ABSTRACT FROM AUTHOR]

Aims: In case of biological hazards and pandemics, personal protective equipment of rescue forces is currently manually decontaminated with harmful disinfectants, primarily peracetic acid. To overcome current drawbacks regarding supply, handling and disposal of chemicals, the use of plasma processed air (PPA) represents a promising alternative for surface decontamination on site. In this study, the sporicidal efficiency of a portable plasma system, designed for field applications, was evaluated. Methods and Results: The developed plasma device is based on a dielectric barrier discharge (DBD) and operated with ambient air as process gas. PPA from the plasma nozzle was flushed into a treatment chamber (volume: 300 l) and bacterial endospores (Bacillus subtilis and Bacillus atrophaeus) dried on different surfaces were treated under variable conditions. Reductions in spores by more than 4 log10 were found within 3 min of PPA exposure. However, the presence of endospores in agglomerates or in an organic matrix as well as the complexity of the respective surface microstructure negatively affected the inactivation efficiency. When endospores were embedded in a dried protein matrix, mechanical wiping with swabs during exposure to PPA increased the inactivation effect significantly. Gaseous ozone alone did not provide a sporicidal effect. Significant spore inactivation was only obtained when water vapour was injected into the PPA stream. Conclusion: The results show that endospores dried on surfaces can be reduced by several orders of magnitude within few minutes in a treatment chamber which is flushed with PPA from of a DBD plasma nozzle. Significance and Impact of the Study: Plasma processed air generated on site by DBD plasma nozzles could be a suitable alternative for the disinfection of various surfaces in closed rooms. [ABSTRACT FROM AUTHOR]

Background: Maternal overweight and obesity are related to several health risks in the periods before, during and after pregnancy including a higher risk of gestational diabetes mellitus, preeclampsia and preterm birth. At the same time, women's daily life quickly changes in these periods. Therefore, we hypothesize that the value of determinants of lifestyle behavior within different levels of the socio-ecological model differ accordingly and influence lifestyle behavior. These dynamics of determinants of lifestyle behavior in the periods before, during and after pregnancy are unexplored and therefore evaluated in this study. These insights are needed to offer appropriate guidance to improve lifestyle in women of childbearing age.Methods: Individual semi-structured interviews were conducted before, during or after pregnancy in 26 women with overweight or obesity living in the Netherlands. Questions covered all levels of the socio-ecological model, i.e. intrapersonal, interpersonal, institutional and environmental/societal. All interviews were transcribed and coded.Results: Determinants at all levels of the socio-ecological model were perceived as relevant by women of childbearing age. Various determinants were mentioned including knowledge of a healthy lifestyle, social support, access to customized lifestyle guidance, and distance to healthy lifestyle supporting activities. The importance women attributed to determinants differed between the periods before, during and after pregnancy. Before pregnancy, child's wellbeing as motivator for adopting a healthy lifestyle was mentioned less frequently than during and after pregnancy. Women described that the interplay and balance between determinants varied on a daily basis, and not merely per period. This was often expressed as fluctuation in energy level per day which influences their willingness to put effort in making healthy choices.Conclusions: Findings of this study confirm the importance of determinants at multiple socio-ecological levels for shaping lifestyle behavior in women of childbearing age. The findings add to current insights that the perceived importance of determinants and their interplay differ before, during and after pregnancy. They influence lifestyle behavior decisions, not only per period but even on a daily basis, in particular in this phase of life. This perspective can be helpful in optimizing lifestyle guidance for women of childbearing age in order to prevent perinatal complications. [ABSTRACT FROM AUTHOR]

This paper reports observations of a 22 GHz water maser 'superburst' in the G25.65+1.05 massive star-forming region, conducted in response to an alert from the Maser Monitoring Organisation (M2O). Very long baseline interferometry (VLBI) observations using the European VLBI Network (EVN) recorded a maser flux density of 1.2 × 104 Jy. The superburst was investipgated in the spectral, structural, and temporal domains and its cause was determined to be an increase in maser path length generated by the superposition of multiple maser emitting regions aligning in the line of sight to the observer. This conclusion was based on the location of the bursting maser in the context of the star-forming region, its complex structure, and its rapid onset and decay. [ABSTRACT FROM AUTHOR]

Objective: To determine seniors' beliefs about falls and design a fall-risk self-assessment and educational materials to promote early identification of evidence-based fall risks and encourage prevention behaviors. Methods: Focus groups with community-dwelling seniors, conducted in two phases to identify perceptions about fall risks and risk reduction and to assess face validity of the fall-risk self-assessment and acceptability of educational materials. Results: Lay perception of fall risks was in general concordance with evidence-based research. Maintaining independence and positive tone were perceived as key motivators for fall prevention. Seniors intended to use information in the educational tool to stimulate discussions about falls with health care providers. Implications: An evidence-based, educational fall-risk self-assessment acceptable to older adults can build on existing lay knowledge about fall risks and perception that falls are a relevant problem and can educate seniors about their specific risks and how to minimize them. [ABSTRACT FROM AUTHOR]

The Fall Prevention Center of Excellence designed three progressive-intensity fall prevention program models, Increasing Stability Through Evaluation and Practice (InSTEP), to reduce risk in community-dwelling older adults. Each model included physical activity, medical risk, and home safety components and was implemented as a 12-week program for small class sizes (12-15 people) in community and senior centers. Change in fall rates and fall risk factors was assessed using a battery of performance tests, self-reports of function, and fall diaries in a 3-group within-subjects (N - 200) design measured at baseline, immediately postintervention, and at 3 and 9 months postintervention. Overall, participants experienced a reduction in falls, improved self-perception of gait and balance, and improved dynamic gait function. The medium-intensity InSTEP model significantly (p = .003) reduced self-reported falls in comparison with the other models. InSTEP is a feasible model for addressing fall risk reduction in community-dwelling older adults. [ABSTRACT FROM AUTHOR]

Discusses the homogeneous nucleation rates of supercooled water measured in single levitated microdroplets. Analyzing the angle-resolved light scattering pattern of the droplets with classical Mie theory; Increase in the depolarization of the scattered light; Statistical analysis of the freezing process of individual droplets.

The most powerful flare ever registered in the Galactic water-maser source W49N has been detected in long-term monitoring data in the 616–523 transition with line frequency f = 22.235 GHz carried out on the 22-m Simeiz, 32-m Toruń, 100-m Effelsberg, and 32-m Medicina radio telescopes, beginning in September 2017 and continuing in 2018. Some stages of the flare were monitored daily. Detailed variations of the source spectral flux density with time have been obtained. At the flare maximum, the flux exceeded P ≈ 8 × 104 Jy, and this was record highest flux registered over the entire history of observations of this source. Important conclusions related to details of the mechanism for the H2O line emission have been drawn. An exponential increase in the flare flux density was detected during both the rise and decline of the flare. The data obtained indicate that the maser is unsaturated, and remained in this state up to the maximum observed flux densities. Additional support for the idea that the maser is unsaturated is the shape of the dependence of the line width on the flux. The characteristics of the variations of the spectral flux density are probably associated with a sharp increase in the density of the medium and the photon flux that led to an increase in the temperature from an initial level of 10–40 K to hundreds of Kelvins. Interferometric maps of the object during the increase in the spectral flux density of the flare have been obtained. A possible mechanism for the primary energy release in W49N is considered. [ABSTRACT FROM AUTHOR]

Powerful flares in Galactic kilomasers are closely associated with regions of intense star formation. They contribute to the elucidation of physical processes occurring in these structures. We have recorded a superpowerful flare in the high-velocity −81 km s−1 line in the Galactic maser source W49N. As a result of our monitoring at the RT-22 (Simeiz), RT-32 (Torun), RT-100 (Effelsberg), and RT-32 (Medicina) radio telescopes in the period from September 2017 to November 2018, we have obtained the shape of the spectral flux density variations in the source with time. At the peak the flux density reached P≈5 ×104 Jy. The flare has a double pattern and different durations of its components. The pattern of spectral flux density variations for the first flare with a considerably shorter duration is apparently related to a sharp increase in the density of the medium and the photon flux and to a significant rise in the temperature to hundreds of kelvins. We propose a mechanism of primary energy release related to the existence of close massive multiple systems in star-forming regions. A powerful gravitational perturbation at the system's periastron can lead to a partial ejection of the envelope of the central massive star in a direction close to the major axis of the ellipse of the companion's orbit. This explains the significant asymmetry of high-velocity lines in W49N. The ejected envelope is an energy source more significant than the stellar wind and can explain the giant flares in the object. Further comprehensive studies in this direction, including monitoring VLBI studies, are needed to confirm this assumption. [ABSTRACT FROM AUTHOR]

Context. Magnetohydrodynamical simulations show that the magnetic field can drive molecular outflows during the formation of massive protostars. The best probe to observationally measure both the morphology and the strength of this magnetic field at scales of 10–100 au is maser polarization. Aims. We measure the direction of magnetic fields at milliarcsecond resolution around a sample of massive star-forming regions to determine whether there is a relation between the orientation of the magnetic field and of the outflows. In addition, by estimating the magnetic field strength via the Zeeman splitting measurements, the role of magnetic field in the dynamics of the massive star-forming region is investigated. Methods. We selected a flux-limited sample of 31 massive star-forming regions to perform a statistical analysis of the magnetic field properties with respect to the molecular outflows characteristics. We report the linearly and circularly polarized emission of 6.7 GHz CH3OH masers towards seven massive star-forming regions of the total sample with the European VLBI Network. The sources are: G23.44−0.18, G25.83−0.18, G25.71−0.04, G28.31−0.39, G28.83−0.25, G29.96−0.02, and G43.80−0.13. Results. We identified a total of 219 CH3OH maser features, 47 and 2 of which showed linearly and circularly polarized emission, respectively. We measured well-ordered linear polarization vectors around all the massive young stellar objects and Zeeman splitting towards G25.71−0.04 and G28.83−0.25. Thanks to recent theoretical results, we were able to provide lower limits to the magnetic field strength from our Zeeman splitting measurements. Conclusions. We further confirm (based on ∼80% of the total flux-limited sample) that the magnetic field on scales of 10–100 au is preferentially oriented along the outflow axes. The estimated magnetic field strength of |B||| > 61 mG and >21 mG towards G25.71−0.04 and G28.83−0.25, respectively, indicates that it dominates the dynamics of the gas in both regions. [ABSTRACT FROM AUTHOR]

We present the results from the Australian Long Baseline Array (LBA) observations of the ground- and excited-state OH masers (1.7- and 6.0-GHz lines) at high spatial and velocity resolution towards the high-mass star-forming region G351.417 |$+$| 0.645. We obtained accurate spatial gradient magnetic fields from 21 and 23 Zeeman pairs at ground and excited states, respectively, providing magnetic field measurements between −6.4 and +4.4 mG. In addition, we verify the reliability of magnetic field strengths measured from previous lower resolution observations. We found that OH maser features at 1665- and 6035-MHz reveal the same trend of a reversal of magnetic field which we attribute, based on recent infrared observations to cloud fragmentation. In comparison with previous LBA observations 11 yr prior, we identify several matched Zeeman pairs. We found no significant changes of magnetic field strengths, directions, or radial velocities from the matched Zeeman pairs between these two epochs (although there were small internal proper motions). This implies quite stable physical conditions in this region. Moreover, we also analysed the physical conditions from the coincidence of OH maser features from different transitions based on current OH maser models. [ABSTRACT FROM AUTHOR]

The Rural Interdisciplinary Team Training Program (RITT) is a team-based educational component of the Veterans Health Administration (VHA) Office of Rural Health Geriatric Scholars Program. It is a workforce development program to enhance the geriatrics knowledge and skills of VA primary care clinicians and staff caring for older veterans in rural communities. The RITT workshop, accredited for 6.5 hours, is interactive and multi-modal with didactic mini-lectures, interactive case discussions and role play demonstrations of assessments. Clinic teams also develop and implement a small quality improvement project based on common challenges faced by older persons. This report is an evaluation of the effect of the RITT Program on geriatrics knowledge and team development as well as success in developing and implementing the quality improvement projects in 80 VHA rural outpatient clinics in 38 states. [ABSTRACT FROM AUTHOR]

Process planning for assembly requires a computerized representation and analysis of assembled products. In order to recommend a good sequence of assembly operations, the process planner needs to generate all such feasible sequences. This paper presents a methodology to consistently generate all feasible assembly sequences with consideration for the various combinations of subassembly operations. The methodology is demonstrated on a real product. A practical method to reduce the number of feasible combinations generated is also demonstrated. [ABSTRACT FROM AUTHOR]

The part-period balancing lot-sizing algorithm is modified to use fuzzy data for the single-stage lot-sizing problem. Triangular fuzzy numbers are used to represent uncertainty in the master production schedule. This paper shows that uncertain demand can he easily incorporated into the pan-period balancing lot-sizing algorithm and that a fuzzy master production schedule can be used to determine production lot sizes. A detailed example is presented to illustrate the techniques. [ABSTRACT FROM AUTHOR]

Highlights the use of high-resolution triple-crystal x-ray diffractometry to investigate long-range order in single-crystal (100)-oriented metastable (Gallium Antimony)[sub1-x])Germanium[sub2])[subx] alloys. Diagram of the multitarget radio-frequency sputtering system used for crystal growth; Key feature in allowing the growth of single-phase metastable alloys; Determination of an order parameter from x-ray diffraction measurements.

Purpose: MP 29-02, which contains fluticasone propionate and azelastine hydrochloride, is used as a topical nasal application for the treatment of seasonal and perennial allergic rhinitis. Although a multitude of data is available on the clinical symptom reduction and treatment safety of MP 29-02, the effect of MP 29-02 on ciliary beat frequency (CBF) has not been evaluated thus far.Methods: MP 29-02-containing solution was applied at concentrations of 2.5, 5, 10, and 20% to 14 healthy subjects, and nasal ciliated epithelial cells were then visualized using a phase-contrast microscope. CBF was measured after the application of MP 29-02. For a comparison, fluticasone propionate was used. CBF measurements were then performed for 15 min at 22 °C. Ringer’s solution was applied as a negative control.Results: MP 29-02 significantly reduced CBF at all the tested concentrations compared with that of the control group within the observation time. At a 2.5% concentration, MP 29-02 significantly reduced CBF from 6.81 Hz (SD ± 1.35 Hz) at baseline to 4.88 Hz (SD ± 1.52 Hz, p < 0.001) after 15 min. In contrast, for fluticasone propionate, a significant reduction was observed only with the 20% concentration after 5, 10, and 15 min.Conclusions: MP 29-09 significantly reduced CB, with an almost linear relationship between the MP 29-09 concentration and reduction in CBF. For fluticasone propionate, a significant reduction of CBF was observed only at the highest analyzed concentration. The findings have implications for the long-term use of the MP 29-02. Yet, further clinical studies are needed to confirm these results in vivo, especially in patients with seasonal or perennial allergic rhinits. [ABSTRACT FROM AUTHOR]

Background/Objectives: Home‐based primary care (HBPC) is a comprehensive, interdisciplinary program to meet the medical needs of community‐dwelling populations needing long‐term care (LTC). The U.S. Department of Veterans Affairs (VA) expanded its HBPC program to underserved rural communities, including American Indian reservations, providing a “natural laboratory” to study change in access to VA LTC benefits and utilization outcomes for rural populations that typically face challenges in accessing LTC medical support. Design: Pretest‐Posttest quasi‐experimental approach with interrupted time‐series design using linked VA, Medicare, and Indian Health Service (IHS) records. Setting: American Indian reservations and non‐Indian communities in rural HBPC catchment areas. Participants: 376 veterans (88 IHS beneficiaries, 288 non‐IHS beneficiaries) with a HBPC length of stay of 12 months or longer. Measurements: Baseline demographic and health characteristics, activities of daily living (ADL), previous VA enrollment, and hospital admissions and emergency department (ED) visits as a function of time, accounting for IHS beneficiary and functional statuses. Results: For HBPC users, VA enrollment increased by 22%. At baseline, 30% of IHS and non‐IHS beneficiaries had 2 or more ADLs impairments; IHS populations were younger (P < .001) and had more diagnosed chronic diseases (P = .007). Overall, hospital admissions decreased by 0.10 (95% confidence interval (CI) = −0.14 to −0.05) and ED visits decreased by 0.13 (95% CI = −0.19 to −0.07) in the 90 days after HBPC admission (Ps < .001) and these decreases were maintained over 1 year follow‐up. Before HBPC, probability of hospital admission was 12% lower for IHS than non‐IHS beneficiaries (P = .02). Conclusion: Introducing HBPC to rural areas increased access to LTC and enrollment for healthcare benefits, with equitable outcomes in IHS and non‐IHS populations. [ABSTRACT FROM AUTHOR]

Background: Microglial cell-associated neuroinflammation is considered as a potential contributor to the pathophysiology of sporadic amyotrophic lateral sclerosis. However, the specific role of microglia in the disease pathogenesis remains to be elucidated.Methods: We studied the activation profiles of the microglial cultures exposed to the cerebrospinal fluid from these patients which recapitulates the neurodegeneration seen in sporadic amyotrophic lateral sclerosis. This was done by investigating the morphological and functional changes including the expression levels of prostaglandin E2 (PGE2), cyclooxygenase-2 (COX-2), TNF-α, IL-6, IFN-γ, IL-10, inducible nitric oxide synthase (iNOS), arginase, and trophic factors. We also studied the effect of chitotriosidase, the inflammatory protein found upregulated in the cerebrospinal fluid from amyotrophic lateral sclerosis patients, on these cultures.Results: We report that the cerebrospinal fluid from amyotrophic lateral sclerosis patients could induce an early and potent response in the form of microglial activation, skewed primarily towards a pro-inflammatory profile. It was seen in the form of upregulation of the pro-inflammatory cytokines and factors including IL-6, TNF-α, iNOS, COX-2, and PGE2. Concomitantly, a downregulation of beneficial trophic factors and anti-inflammatory markers including VEGF, glial cell line-derived neurotrophic factor, and IFN-γ was seen. In addition, chitotriosidase-1 appeared to act specifically via the microglial cells.Conclusion: Our findings demonstrate that the cerebrospinal fluid from amyotrophic lateral sclerosis patients holds enough cues to induce microglial inflammatory processes as an early event, which may contribute to the neurodegeneration seen in the sporadic amyotrophic lateral sclerosis. These findings highlight the dynamic role of microglial cells in the pathogenesis of the disease, thus suggesting the need for a multidimensional and temporally guarded therapeutic approach targeting the inflammatory pathways for its treatment. [ABSTRACT FROM AUTHOR]

Background: Veterans Health Affairs (VA) home-based primary care (HBPC) is an evidence-based interdisciplinary approach to non-institutional long-term care that was developed in urban settings to provide longitudinal care for vulnerable older patients. Under the authority of a Memorandum of Understanding between VA and Indian Health Service (IHS) to improve access to healthcare, 14 VA medical centers (VAMC) independently initiated plans to expand HBPC programs to rural American Indian reservations and 12 VAMC successfully implemented programs. The purpose of this study is to describe barriers and facilitators to implementation in rural Native communities with the aim of informing planners and policy-makers for future program expansions.Methods: A qualitative comparative case study approach was used, treating each of the 14 VAMC as a case. Using the Consolidated Framework for Implementation Research (CFIR) to inform an open-ended interview guide, telephone interviews (n = 37) were conducted with HBPC staff and clinicians and local/regional managers, who participated or oversaw implementation. The interviews were transcribed, coded, and then analyzed using CFIR domains and constructs to describe and compare experiences and to identify facilitators, barriers, and adaptations that emerged in common across VAMC and HBPC programs.Results: There was considerable variation in local contexts across VAMC. Nevertheless, implementation was typically facilitated by key individuals who were able to build trust and faith in VA healthcare among American Indian communities. Policy promoted clinical collaboration but collaborations generally occurred on an ad hoc basis between VA and IHS clinicians to optimize patient resources. All programs required some adaptations to address barriers in rural areas, such as distances, caseloads, or delays in hiring additional clinicians. VA funding opportunities facilitated expansion and sustainment of these programs.Conclusions: Since program expansion is a responsibility of the HBPC program director, there is little sharing of lessons learned across VA facilities. Opportunities for shared learning would benefit federal healthcare organizations to expand other medical services to additional American Indian communities and other rural and underserved communities, as well as to coordinate with other healthcare organizations. The CFIR structure was an effective analytic tool to compare programs addressing multiple inner and outer settings. [ABSTRACT FROM AUTHOR]

Nonthermal disinfection technologies are gaining increasing interest in the field of minimally processed food in order to improve the microbial safety or to extend the shelf life. Especially fresh-cut produce or meat and fish products are vulnerable to microbial spoilage, but, due to their sensitivity, they require gentle preservation measures. The application of intense light pulses of a broad spectral range comprising ultraviolet, visible and near infrared irradiation is currently investigated as a potentially suitable technology to reduce microbial loads on different food surfaces or in beverages. Considerable research has been performed within the last two decades, in which the impact of various process parameters or microbial responses as well as the suitability of pulsed light (PL) for food applications has been examined. This review summarizes the outcome of the latest studies dealing with the treatment of various foods including the impact of PL on food properties as well as recent findings about the microbicidal action and relevant process parameters. [ABSTRACT FROM AUTHOR]

Purpose: The mandibular canal contributes to the development and growth of the mandible, as it acts as a conduit for the growing inferior alveolar neurovascular structures. A clear understanding of the canal's pathway is, therefore, important in interpreting the growth pattern of the inferior alveolar neurovascular bundle. This study investigated the position of the mandibular canal within the body of the mandible and its general dimensions within a pediatric collection of mandibles. Methods: The sample included 45 mandibles and was subdivided into three: group 1 (30 gestational weeks to birth), group 2 (birth to 12 months), and group 3 (1 to 4 years). Mandibles were scanned using a Nikon XTH 225L micro-CT unit. Scanning conditions ranged between 85 kV/83 µA and 100 kV/100 µA. Measurements included: the maximum width and height of the mandibular canal and distances between the mandibular canal and the relevant surfaces of the mandible. Data analysis included an ANOVA, MANOVA, and principal component analysis. Results: The mandibular canal increased significantly in size from 30 gestational weeks to 12 months relative to the deciduous molar crypts. Postnatally, the mandibular canal increased significantly in height at the level of the second deciduous molar crypt. The canal lies closer to the buccal surface in the region of the first and second deciduous molar teeth. Conclusion: The consistency in the positioning of the mandibular canal within the body of the mandible may assist in predicting the occurrence of aberrant growth patterns, particularly during the initial stages of growth. [ABSTRACT FROM AUTHOR]

Mupirocin is used worldwide for topical treatment of infected skin lesions, impetigo, and especially for nasal decolonization of patients with carriage of Staphylococci, including methicillin-resistant Staphylococcus aureus. Nevertheless, data regarding the effects of mupirocin on the nasal mucosa, in particular on ciliary beat frequency (CBF), is lacking to date. We tested the CBF of ciliated nasal epithelial cells under the influence of Mupirocin-calcium dissolved in tert-butyl alcohol (TBA) containing media in different concentrations comparable to clinical use. Ringer's lactate solution and TBA served as negative control. Cells were visualized with a phase contrast microscope, and the CBF was measured with the SAVA system's region of interest method. Mupirocin-calcium dissolved in TBA led to a statistically significant time- and concentration-dependent decrease in CBF compared to the negative control. TBA addition without mupirocin also led to a significant decrease in CBF, although to a lesser extent than mupirocin/TBA. In conclusion, CBF of human nasal epithelia is significantly reduced by mupirocin-calcium-containing solutions in therapeutic concentrations. Due to our results in this study, mupirocin as a nasal decolonization agent should be used only with care, with a strictly set medical indication, and additional care measures should be considered. [ABSTRACT FROM AUTHOR]

Objective: To determine if the combined effects of patient-level (demographic and clinical characteristics) and organizational-level (structure and strategies to improve access) factors are uniformly associated with utilization of Indian Health Service (IHS) and/or Veterans Health Administration (VHA) by American Indian and Alaska Native (AIAN) Veterans to inform policy which promotes dual use.Methods: We estimated correlates and compared two separate multilevel logistic regression models of VHA-IHS dual versus IHS-only and VHA-IHS dual versus VHA-only in a sample of 18,892 AIAN Veterans receiving care at 201 VHA and IHS facilities during FY02 and FY03. Demographic, diagnostic, eligibility, and utilization data were drawn from administrative records. A survey of VHA and IHS facilities defined availability of services and strategies to enhance access to healthcare for AIAN Veterans.Results: Facility level strategies that are generally associated with enhancing access to healthcare (e.g., population-based services and programs, transportation or co-location) were not significant factors associated with dual use. In both models the common variable of dual use was related to medical need, defined as the number of diagnoses per patient. Other significant demographic, medical need and organizational factors operated in opposing manners. For instance, age increased the likelihood of dual use versus IHS-only but decreased the likelihood of dual use versus VHA-only.Conclusions: Efforts to enhance access through population-based and consumer-driven strategies may add value but be less important to utilization than availability of healthcare resources needed by this population. Sharing health records and co-management strategies would improve quality of care while policies allow and promote dual use. [ABSTRACT FROM AUTHOR]

Objectives: To analyse grey matter changes in early stages of Huntington's disease using magnetic resonance imaging (MRI) and the technique of voxel based morphometry (VBM).Methods: Forty four patients with a molecularly confirmed clinical diagnosis of Huntington's disease based on the presence of motor signs were included in the study. Patients were clinically rated using the Unified Huntington's Disease Rating Scale; all were in early clinical stages of the disease (that is, Shoulson stages I and II). High resolution volume rendering MRI scans (MP-RAGE) were acquired. MRI data were volumetrically analysed in comparison to an age matched normal database by VBM, using statistical parametric mapping (SPM99).Results: In Huntington's disease, robust regional decreases in grey matter density (p<0.001, corrected for multiple comparisons)-that is, atrophy-were found bilaterally in striatal areas as well as in the hypothalamus and the opercular cortex, and unilaterally in the right paracentral lobule. The topography of striatal changes corresponded to the dorso-ventral gradient of neuronal loss described in neuropathological studies. Stratification according to clinical severity showed a more widespread involvement extending into the ventral aspects of the striatum in the group of more severely affected patients.Conclusions: The topography of cerebral volume changes associated with Huntington's disease can be mapped using VBM. It can be shown that cerebral grey matter changes co-vary with clinical severity and CAG repeat length. [ABSTRACT FROM AUTHOR]

The Veterans Affairs Geriatric Scholars Program ( GSP) is a continuing professional development program to integrate geriatrics into the clinical practices of primary care providers and select associated health professions that support primary care teams. GSP uses a blended program educational format, and the minimal requirements are to attend an intensive course in geriatrics, participate in an interactive workshop on quality improvement ( QI), and initiate a local QI project to demonstrate application of new knowledge to benefit older veterans. Using a retrospective post/pre survey design, the effect of GSP on clinical practices and behaviors and variation of that effect on clinicians working in rural and nonrural settings were evaluated. Significant improvement was found in the frequency of using evidence-based brief standardized assessments, clinical decision-making, and standards of care. Significant subgroup differences were observed in peer-to-peer information sharing between rural and nonrural clinicians. Overall, 77% of the sample reported greater job satisfaction after participating in GSP. The program is a successful model for advancing postgraduate education in geriatrics and a model that might be replicated to increase access to quality health care, particularly in rural areas. [ABSTRACT FROM AUTHOR]

Aims The objective of this study was a comprehensive characterization of physiological changes of Salmonella enterica induced by intense broad spectrum pulsed light (PL). After exposing the bacteria to this nonthermal decontamination technology on a gel surface, multiple viability parameters beyond culturability were assessed. Methods and Results By applying flow cytometry, a luciferin-luciferase bioluminescence assay and a microplate assay to measure the current redox activity, the impact of pulsed light on the membrane potential, membrane integrity, esterase activity, efflux pump activity, expression of the green fluorescent protein (GFP), respiration activity and ATP-content of Salm. enterica ATCC BAA-1045 was determined. These culture-independent methods for assessing the bacterial activity were compared to the ability to grow on tryptic soy agar. It is shown that this strain is rather sensitive to PL considering colony count reductions, while on the other hand unculturable bacteria still exhibit significant cellular energetic functions. However, this residual activity after PL exposure significantly decreases during sample storage in buffer for 24 h. This study also shows that the GFP expression of PL-treated cells which have rendered unculturable is severely reduced. Conclusions This study reveals that although not all cellular functions of Salm. enterica are immediately shut down after PL exposure, the synthesis of new GFP is strongly reduced and affected to a similar extent as the culturability. Significance and Impact of the Study It is shown for the first time, that even there is significant bacterial activity measurable after PL exposure, it is likely that nongrowing pathogenic bacteria like Salm. enterica are unable to express proteins, which is of great importance regarding their pathogenicity. [ABSTRACT FROM AUTHOR]

The eigensystem realization algorithm (ERA) is a commonly used data-driven method for system identification and reduced-order modelling of dynamical systems. The main computational difficulty in ERA arises when the system under consideration has a large number of inputs and outputs, requiring to compute a singular value decomposition (SVD) of a large-scale dense Hankel matrix. In this work, we present an algorithm that aims to resolve this computational bottleneck via tangential interpolation. This involves projecting the original impulse response sequence onto suitably chosen directions. The resulting data-driven reduced model preserves stability and is endowed with an a priori error bound. Numerical examples demonstrate that the modified ERA algorithm with tangentially interpolated data produces accurate reduced models while, at the same time, reducing the computational cost and memory requirements significantly compared to the standard ERA. We also give an example to demonstrate the limitations of the proposed method. [ABSTRACT FROM AUTHOR]

Ultraviolet light (UV) is an important risk factor for cutaneous basal cell carcinoma, cutaneous squamous cell carcinoma and cutaneous melanoma of the skin. These cancers most commonly affect persons with fair skin and blue eyes who sunburn rather than suntan. However, each of these cancers appears to be associated with a different pattern of UV exposure and to be mediated by different intracellular molecular pathways. Some melanocortin 1 receptor (MC1R) gene variants play a direct role in the pathogenesis of cutaneous basal cell carcinoma, cutaneous squamous cell carcinoma and cutaneous melanoma apart from their role in determining a cancer-prone pigmentory phenotype (fair skin, red hair, blue eyes) through their interactions with other genes regulating immuno-inflammatory responses, DNA repair or apoptosis. In this short review we focus on the aetiological role of UV in cutaneous basal cell carcinoma, cutaneous squamous cell carcinoma and cutaneous melanoma of the skin, and on some associated biopathological events. [ABSTRACT FROM AUTHOR]