Strengthening genetic services in primary care for Asian Americans and Pacific Islanders

The Association of Asian Pacific Community Health Organizations (AAPCHO) is a national membership organization of community health centers (CHCs) that serve medically underserved Asian Americans and Pacific Islanders (AAPIs) with limited English-speaking proficiency and low income. OBJECTIVES: In 1995, AAPCHO was funded for a 3-year national genetics training project to improve genetics training among primary care providers at CHCs and strengthen linkages with tertiary genetic centers (TGCs). Three model linkages between CHCs and TGCs were documented on the coordination of genetic services for medically underserved AAPIs. METHODS: Guidelines were developed for three CHCs to document their genetic programs and linkages with TGCs. In addition, one clinic conducted a mail survey to assess understanding of prenatal genetic counseling sessions by patients that visited the clinic during the past 2 years. RESULTS: Model linkages between CHCs and TGCs to improve cultural and linguistic accessibility for patients include formal coordination between the CHCs and TGCs for the delivery of genetic services and the provision of varying levels of genetic services at the CHC. From the patient survey, there was a 59% response rate among 70 surveys mailed to former patients. The survey results showed that while a majority of patients understood and recalled key genetic concepts, one-fifth of patients experienced difficulty understanding their genetic counseling sessions. CONCLUSION: Based on model linkages between CHCs and TGCs and the patient satisfaction survey results, the following strategies are recommended to improve accessibility of genetic services for medically underserved AAPIs: (1) genetics education should be developed for all levels of health center staff; (2) counseling should be culturally sensitive and focus on key issues that must be conveyed for appropriate informed consent; (3) genetics education should employ the use of translated audiovisual aids and brochures to improve understanding; (4) genetic services should be coordinated between CHCs and TGCs to provide culturally and linguistically competent care for medically underserved AAPIs, and (5) financial mechanisms should be available to support genetic testing of patients and their families with little or no coverage for genetic services.     

Gravitational Stability of the Interface in Water Over Steam Geothermal Reservoirs

Stability of a geothermal system is considered in a case when the water layer lies over the layer of superheated vapor in a stratum having relatively low permeability. This stratum locates between two parallel high permeable layers. Under the assumption of smallness of advective energy transfer as compared with the conductive one, the stationary distribution of the characteristics in the stratum with an interface of phase transition is obtained. The interface separates the domains occupied by water and vapor. Investigation of normal stability of the interface shows, that stable configurations in the geothermal system under consideration exist within the range of permeability values bounded by k 0.6 × 10^–15 m² from above. The most unstable configurations occur to be the quiescent states when the permeability exceeds a certain threshold. A sufficiently high value of permeability, satisfying the criterion of smallness of the advective energy transfer as compared with the conductive one makes it possible to explain the existence of a wide class of stable natural geothermal reservoirs, where the vapor layer underlies the water one.     

Assessing and predicting changes in vegetation cover associated with military land use activities using field monitoring data at Fort Hood, Texas

We assessed short-term impacts of changes in military training load on vegetative cover at Fort Hood, TX. From 1989 to 1995, permanent field transects were monitored for vegetative cover and land use disturbance using standard army monitoring methods [Land Condition Trend Analysis (LCTA)]. Land use intensity (training load) was quantified and used to develop a model to predict future vegetation cover values. We found that standard Army monitoring methods detected changes in installation resources associated with changes in training load. Increased training loads were associated with increased measures of disturbance, decreased ground cover, and decreased aerial vegetative cover. We found that the spatial pattern of disturbance and vegetation cover remained relatively constant over the study period despite large variations in overall training load. Our model used the consistency in spatial cover patterns over time and the strong relationship between training load and vegetation cover to predict the impact of future training loads on vegetation.     

Stochastic vehicle mobility forecasts using the nato reference mobility model

The NATO Reference Mobility Model (NRMM) is a comprehensive means of predicting the speeds of military vehicles in on-road, off road, and gap-crossing contexts. The model has been in service for many years and helps user communities concerned with vehicle design, wargaming, and strategic planning. Recent developments in computer hardware and software are creating an opportunity for NRMM to serve a tactical role on the battlefield. Adaptation of NRMM to this role requires that its users come to grips with the collection of digital data to describe vehicle, terrain, and scenario data in a real-time environment. This paper discusses the performance of NRMM when selected inputs and algorithms contain random components. A developmental pathway is outlined that leads from current deterministic mobility forecasts to stochastic forecasts capable of suggesting the risks taken when speed predictions must be made in the presence of data and algorithm errors. Concepts that express measures of confidence for wide-area mobility forecasts when errors are known with small-area detail are described. Several numerical examples are given.     

Radical Formation in the Gas‐Phase Ozonolysis of Deprotonated Cysteine

Although the deleterious effects of ozone on the human respiratory system are well‐known, many of the precise chemical mechanisms that both cause damage and afford protection in the pulmonary epithelial lining fluid are poorly understood. As a key first step to elucidating the intrinsic reactivity of ozone with proteins, its reactions with deprotonated cysteine [Cys?H]^? are examined in the gas phase. Reaction proceeds at near the collision limit to give a rich set of products including 1) sequential oxygen atom abstraction reactions to yield cysteine sulfenate, sulfinate and sulfonate anions, and significantly 2) sulfenate radical anions formed by ejection of a hydroperoxy radical. The free‐radical pathway occurs only when both thiol and carboxylate moieties are available, implicating electron‐transfer as a key step in this reaction. This novel and facile reaction is also observed in small cys‐containing peptides indicating a possible role for this chemistry in protein ozonolysis.     

Synthesis,Structure, and Properties of SrC(NH)3, a Nitrogen‐Based Carbonate Analogue with the Trinacria Motif

Strontium guanidinate, SrC(NH)₃, the first compound with a doubly deprotonated guanidine unit, was synthesized from strontium and guanidine in liquid ammonia and characterized by X‐ray and neutron diffraction, IR spectroscopy, and density‐functional theory including harmonic phonon calculations. The compound crystallizes in the hexagonal space group P6₃/m, constitutes the nitrogen analogue of strontium carbonate, SrCO₃, and its structure follows a layered motif between Sr²⁺ ions and complex anions of the type C(NH)₃^2?; the anions adopt the peculiar trinacria shape. A comparison of theoretical phonons with experimental IR bands as well as quantum‐chemical bonding analyses yield a first insight into bonding and packing of the formerly unknown anion in the crystal.     

On the DFT Ground State of Crystalline Bromine and Iodine

We report on an erroneous ground state within common density functional theory (DFT) methods for the solid elements bromine and iodine. Phonon computations at the GGA level for both molecular crystals yield imaginary vibrational modes, erroneously indicating dynamic instability—that fact alone could easily pass as a computational artefact, but these imaginary modes lead to energetically more favorable and dynamically stable structures, made up of infinite monoatomic chains. In contrast, meta‐GGA and hybrid functionals yield the correct energetic order for bromine, while for iodine, most global hybrids do not improve the GGA result significantly. The qualitatively correct answer, in both cases, is given by the long‐range corrected hybrid LC‐ωPBE, the Minnesota functionals M06L and M06, and by periodic Hartree–Fock and MP2 theory. This poor performance of economic DFT functionals should be kept in mind, for example, during global structure optimizations of systems with significant contributions from halogen bonds.     

Laser Machined Plastic Laminates: Towards Portable Diagnostic Devices for Use in Low Resource Environments

Despite significant progress in development of bioanalytical devices cost, complexity, access to reagents and lack of infrastructure have prevented use of these technologies in resource‐limited regions. To provide a sustainable tool in the global effort to combat infectious diseases the diagnostic device must be low cost, simple to operate and read, robust, and have sensitivity and specificity comparable to laboratory analysis. In this mini‐review we describe recent work using laser machined plastic laminates to produce diagnostic devices that are capable of a wide variety of bioanalytical measurements and show great promise towards future use in low‐resource environments.     

A surface wipe sampling and LC–MS/MS method for the simultaneous detection of six antineoplastic drugs commonly handled by healthcare workers

An effective wipe sampling and LC–MS/MS method was developed to simultaneously analyze six commonly administered antineoplastic drugs in stainless steel surface. The analyzed drugs were methotrexate, paclitaxel, cyclophosphamide, 5-fluorouracil, vincristine, and oxaliplatin, a frequently prepared antineoplastic drug that has not been included among any of the published simultaneous detection methods. The established method was used to evaluate the recoveries of antineoplastic drugs on brand new and worn stainless steel surfaces by wiping the plates with a Whatman filter paper wetted with 0.5 mL of water/methanol (20:80) with 0.1 % formic acid followed by LC–MS/MS before desorbing the filter with a water/methanol (50:50) solution. A significant decrease in the recovery of all evaluated drugs was found when worn plates were used. Additionally, the inter-personnel variability on drug recoveries during wiping procedures was evaluated. Significantly higher recoveries were achieved by the personnel with more training and experience versus personnel without prior experience. Finally, a laboratory stability test was developed to assess the degradation of the antineoplastic drugs during replicated shipping conditions. With the exception of vincristine sulfate which exhibited a significant (p?<?0.05) degradation after 48 h, all evaluated drugs were stable during the first 24–48 h. However, after 144 h, an increase in the degradation of all evaluated drugs was observed, with oxaliplatin and 5-fluorouracil exhibiting the most degradation.