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Objective: This review evaluates costs and benefits associated with acquiring, implementing, and operating clinical decision support systems (CDSSs) to prevent cardiovascular disease (CVD).Materials and Methods: Methods developed for the Community Guide were used to review CDSS literature covering the period from January 1976 to October 2015. Twenty-one studies were identified for inclusion.Results: It was difficult to draw a meaningful estimate for the cost of acquiring and operating CDSSs to prevent CVD from the available studies ( n  = 12) due to considerable heterogeneity. Several studies ( n  = 11) indicated that health care costs were averted by using CDSSs but many were partial assessments that did not consider all components of health care. Four cost-benefit studies reached conflicting conclusions about the net benefit of CDSSs based on incomplete assessments of costs and benefits. Three cost-utility studies indicated inconsistent conclusions regarding cost-effectiveness based on a conservative $50,000 threshold.Discussion: Intervention costs were not negligible, but specific estimates were not derived because of the heterogeneity of implementation and reporting metrics. Expected economic benefits from averted health care cost could not be determined with confidence because many studies did not fully account for all components of health care.Conclusion: We were unable to conclude whether CDSSs for CVD prevention is either cost-beneficial or cost-effective. Several evidence gaps are identified, most prominently a lack of information about major drivers of cost and benefit, a lack of standard metrics for the cost of CDSSs, and not allowing for useful life of a CDSS that generally extends beyond one accounting period. [ABSTRACT FROM AUTHOR]

Purpose: Assess the feasibility of measuring Repetitive Head Impacts (RHI), cognition, and eye movements across a single season of high school football. Methods: Twelve players were provided an instrumented mouthguard (3200 Hz; Prevent Biometrics, Edina, MA) to evaluate RHI. Mouthguard use was assessed by total impacts and number of games/practices. Seven players also agreed to complete cognitive (ImPACT) and custom eye-tracking (500 Hz; EyeLink II) assessments pre-, mid-, and post-season. Multiple repeated measure ANOVA's were completed using standard composite scores for ImPACT and oculomotor metrics. Results: Fifty percent of players ever used their mouthguard, and substantial variability in total impacts (M = 86.5, SD = 98.0, Range = 7–277) and number of games/practices (M = 9.8, SD = 7.6, Range = 2–23) were observed among players who did use their mouthguard. Specific completion rates for the 3 cognitive and 3 eye-tracking assessments were 71% each, and 57% of players completed all 6 scheduled assessments. Repeated measures ANOVA indicated Visual Motor Speed (VMS) improved between assessments (p = 0.015). Post hoc analysis showed both VMS and Verbal Memory increased from pre- to mid-season (−5.30(95%CI, −10.47 to −0.12), p = 0.046), (−0.20(95%CI, −13.00 to −1.41), p = 0.024). Conclusions: Variability in mouthguard use and missing assessment rates represent practical challenges in prospectively measuring RHI and utilizing multiple longitudinal assessment methods in high school football players. Although ImPACT results should be interpreted cautiously, future research should consider the potential role of practice effects and/or intentionally poor pre-season effort to explain the increase in performance during the season. A larger sample size will increase the possibility of measuring the effect of RHI on assessment outcomes. [ABSTRACT FROM AUTHOR]

We present ALMA observations of the CO(1--0) and CO(3--2) line emission tracing filaments of cold molecular gas in the central galaxy of the cluster PKS 0745--191. The total molecular gas mass of 4.6 ± 0.3 × 109 M⊙, assuming a Galactic XCO factor, is divided roughly equally between three filaments each extending radially 3-5 kpc from the galaxy centre. The emission peak is located in the SE filament ~ 1 arcsec (2 kpc) from the nucleus. The velocities of the molecular clouds in the filaments are low, lying within ± 100 km s-1 of the galaxy's systemic velocity. Their full width at half-maximum (FWHM) are less than 150 km s-1, which is significantly below the stellar velocity dispersion. Although the molecular mass of each filament is comparable to a rich spiral galaxy, such low velocities show that the filaments are transient and the clouds would disperse on < 107 yr time-scales unless supported, likely by the indirect effect of magnetic fields. The velocity structure is inconsistent with a merger origin or gravitational free-fall of cooling gas in this massive central galaxy. If the molecular clouds originated in gas cooling even a few kpc from their current locations their velocities would exceed those observed. Instead, the projection of the N and SE filaments underneath X-ray cavities suggests they formed in the updraft behind bubbles buoyantly rising through the cluster atmosphere. Direct uplift of the dense gas by the radio bubbles appears to require an implausibly high coupling efficiency. The filaments are coincident with low temperature X-ray gas, bright optical line emission and dust lanes indicating that the molecular gas could have formed from lifted warmer gas that cooled in situ. [ABSTRACT FROM AUTHOR]

We reported the expression of the homeodomain-containing transcription factor Engrailed-2 ( EN2) in prostate cancer and showed that the presence of EN2 protein in the urine was highly predictive of prostate cancer. This study aimed to determine whether patients with prostate cancer have EN2 autoantibodies, what the prevalence of these antibodies is and whether they are associated with disease stage. The spontaneous immunoglobulin ( Ig)G immune response against EN2 and for comparison the tumour antigen New York Esophageal Squamous Cell Carcinoma 1 ( NY-ESO-1), were tested by enzyme-linked immunosorbent assay ( ELISA) in three different cohorts of prostate cancer patients as well as a group of men genetically predisposed to prostate cancer. Thirty-two of 353 (9·1%) of the SUN cohort representing all stages of prostate cancer demonstrated EN2 IgG responses, 12 of 107 patients (11·2%) in the advanced prostate cancer patients showed responses, while only four of 121 patients (3·3%) with castrate-resistant prostate cancer showed EN2 autoantibodies. No significant responses were found in the predisposed group. Anti- EN2 IgG responses were significantly higher in patients with prostate cancer compared to healthy control males and similarly prevalent to anti- NY-ESO-1 responses. While EN2 autoantibodies are not a useful diagnostic or monitoring tool, EN2 immunogenicity provides the rationale to pursue studies using EN2 as an immunotherapeutic target. [ABSTRACT FROM AUTHOR]

The European Space Agency (ESA) Gaia satellite has 106 CCD image sensors which will suffer from increased charge transfer inefficiency (CTI) as a result of radiation damage. To aid the mitigation at low signal levels, the CCD design includes supplementary buried channels (SBCs, otherwise known as 'notches') within each CCD column. We present the largest published sample of Gaia CCD SBC full well capacity (FWC) laboratory measurements and simulations based on 13 devices. We find that Gaia CCDs manufactured post-2004 have SBCs with FWCs in the upper half of each CCD that are systematically smaller by two orders of magnitude (≤50 electrons) compared to those manufactured pre-2004 (thousands of electrons). Gaia's faint star (13 ≤ G ≤ 20 mag) astrometric performance predictions by Prod'homme et al. and Holl et al. use pre-2004 SBC FWCs as inputs to their simulations. However, all the CCDs already integrated on to the satellite for the 2013 launch are post-2004. SBC FWC measurements are not available for one of our five post-2004 CCDs but the fact that it meets Gaia's image location requirements suggests that it has SBC FWCs similar to pre-2004. It is too late to measure the SBC FWCs onboard the satellite and it is not possible to theoretically predict them. Gaia's faint star astrometric performance predictions depend on knowledge of the onboard SBC FWCs but as these are currently unavailable, it is not known how representative of the whole focal plane the current predictions are. Therefore, we suggest that Gaia's initial in-orbit calibrations should include measurement of the onboard SBC FWCs. We present a potential method to do this. Faint star astrometric performance predictions based on onboard SBC FWCs at the start of the mission would allow satellite operating conditions or CTI software mitigation to be further optimized to improve the scientific return of Gaia. [ABSTRACT FROM AUTHOR]

The conversion of gas into stars is a fundamental process in astrophysics and cosmology. Stars are known to form from the gravitational collapse of dense clumps in interstellar molecular clouds, and it has been proposed that the resulting star formation rate is proportional to either the amount of mass above a threshold gas surface density, or the gas volume density. These star formation prescriptions appear to hold in nearby molecular clouds in our Milky Way Galaxy's disc as well as in distant galaxies where the star formation rates are often much larger. The inner 500 pc of our Galaxy, the Central Molecular Zone (CMZ), contains the largest concentration of dense, high-surface density molecular gas in the Milky Way, providing an environment where the validity of star formation prescriptions can be tested. Here, we show that by several measures, the current star formation rate in the CMZ is an order-of-magnitude lower than the rates predicted by the currently accepted prescriptions. In particular, the region 1° < l < 3°.5, |b| < 0°.5 contains ∼107 M⊙ of dense (> several 103 cm−3) molecular gas – enough to form 1000 Orion-like clusters – but the present-day star formation rate within this gas is only equivalent to that in Orion. In addition to density, another property of molecular clouds must be included in the star formation prescription to predict the star formation rate in a given mass of molecular gas. We discuss which physical mechanisms might be responsible for suppressing star formation in the CMZ. [ABSTRACT FROM AUTHOR]

This paper reports the results of a randomized trial to test the effectiveness of a theoretically derived intervention designed to increase parental monitoring among Hispanic parents of middle school students. Role model story newsletters developed through the process of Intervention Mapping were mailed to half of a subsample of parents whose children participated in Students for Peace, a comprehensive violence prevention program. The results indicated that parents in the experimental condition (N = 38) who had lower social norms for monitoring at baseline reported higher norms after the intervention than the parents in the control condition (N = 39) (P = 0.009). Children of parents in the experimental group reported slightly higher levels of monitoring at follow-up across baseline values, whereas control children who reported moderate to high levels of monitoring at pre-test reported lower levels at follow-up (P = 0.04). These newsletters are a population-based strategy for intervention with parents that show some promise for comprehensive school-based interventions for youth. [ABSTRACT FROM AUTHOR]

Background: An increased risk of second primary cancers has been reported in patients who survive small-cell carcinoma of the lung. The treatment's contribution to the development of second cancers is difficult to assess, in part because the number of long-term survivors seen at any one institution is small. We designed a multi-institution study to investigate the risk among survivors of developing second primary cancers other than small-cell lung carcinoma.Methods: Demographic, smoking, and treatment information were obtained from the medical records of 611 patients who had been cancer free for more than 2 years after therapy for histologically proven small-cell lung cancer, and person-years of follow-up were cumulated. Population-based rates of cancer incidence and mortality were used to estimate the expected number of cancers or deaths. The actuarial risk of second cancers was estimated by the Kaplan-Meier method.Results: Relative to the general population, the risk of all second cancers among these patients (mostly non-small-cell cancers of the lung) was increased 3.5-fold. Second lung cancer risk was increased 13-fold among those who received chest irradiation in comparison to a sevenfold increase among nonirradiated patients. It was higher in those who continued smoking, with evidence of an interaction between chest irradiation and continued smoking (relative risk = 21). Patients treated with various forms of combination chemotherapy had comparable increases in risk (9.4- to 13-fold, overall), except for a 19-fold risk increase among those treated with alkylating agents who continued smoking.Implications: Because of their substantially increased risk, survivors should stop smoking and may consider entering trials of secondary chemoprevention. [ABSTRACT FROM AUTHOR]

The article comments on the article "Politics of Political Economists," published in the November 1959 issue of "Quarterly Journal of Economics" on the views pertaining to the generation of radical political viewpoint by quantitative economics. In the first place, statistics are desperately needed for any sort of government planning of the economic system. In a free market economy, the individual business firm has little or no need of statistics. It need only know its prices and costs. In short, statistics do not have to be developed originally for politico-economic ends; their own autonomous development, directly or indirectly, opens up new fields for interventionists to exploit. Each new statistical technique, whether it be flow of funds, inter-industry economics, or activity analysis, soon acquires its own subdivision and application in government. Another reason why statistics and political pragmatism are mutually congenial is that the very hallmark of the pragmatic approach is to begin by looking for problems or "problem areas" in the society. It appears that the economic discipline, per se, imposes a rightward shift in ideological belief.

Purpose To explore athletic trainers' self-confidence for interpreting results from concussion assessments. Methods An online survey was administered via the National Athletic Trainers' Association (NATA) membership listserv to a cross-sectional sample of 10,000 certified athletic trainers (ATCs) employed in high school and collegiate settings. The survey included: 1) ATC demographics (i.e. age, sex, years of experience); 2) ATC concussion management practices (i.e. previous concussion training, continuing education received on concussion, concussion assessments administered); and 3) a 4-point Likert scale (1=no confidence, 4=high confidence) assessing ATC self-confidence for interpreting results from concussion assessments. A total of 725 ATCs completed the survey yielding a response rate of 7.25%; 114 were excluded for missing data and 611 ATCs were included in final analyses. Sample demographics, ATC concussion management practices, and ATC self-confidence scores were examined with demographic statistics (i.e. means, standard deviations, frequencies, percentages) for 16 commonly used concussion assessments. Results The sample of ATCs (mean age 38.97±14.89 years) was predominately female (59.2%) and reported an average of 10.08±7.58 years of clinical experience. Clinical examinations (63.2%) and symptom scales (61.4%) were among the most frequent assessments with high ATC self-confidence for interpretation. Vestibular/oculomotor measures (27.2%) and computerized neurocognitive testing (26.2%) were among the most frequent assessments with low ATC self-confidence for interpretation. Conclusion Low ATC self-confidence scores for interpreting results from vestibular/oculomotor measures and computerized neurocognitive testing highlight the importance of incorporating a multi-disciplinary team approach and including sport neuropsychologists for the proper management of concussion. [ABSTRACT FROM AUTHOR]