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Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women

  • Seo, Munseok;Langabeer, James
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.4
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    • pp.181-187
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    • 2018
  • Objectives: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. Methods: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. Results: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. Conclusions: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

Distally Based Sural Artery Adipofascial Flap based on a Single Sural Nerve Branch: Anatomy and Clinical Applications

  • Mok, Wan Loong James;Por, Yong Chen;Tan, Bien Keem
    • Archives of Plastic Surgery
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    • v.41 no.6
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    • pp.709-715
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    • 2014
  • Background The distally based sural artery flap is a reliable, local reconstructive option for small soft tissue defects of the distal third of the leg. The purpose of this study is to describe an adipofascial flap based on a single sural nerve branch without sacrificing the entire sural nerve, thereby preserving sensibility of the lateral foot. Methods The posterior aspect of the lower limb was dissected in 15 cadaveric limbs. Four patients with soft tissue defects over the tendo-achilles and ankle underwent reconstruction using the adipofascial flap, which incorporated the distal peroneal perforator, short saphenous vein, and a single branch of the sural nerve. Results From the anatomical study, the distal peroneal perforator was situated at an average of 6.2 cm (2.5-12 cm) from the distal tip of the lateral malleolus. The medial and lateral sural nerve branches ran subfascially and pierced the muscle fascia 16 cm (14-19 cm) proximal to the lateral malleolus to enter the subcutaneous plane. They merged 1-2 cm distal to the subcutaneous entry point to form the common sural nerve at a mean distance of 14.5 cm (11.5-18 cm) proximal to the lateral malleolus. This merging point determined the pivot point of the flap. In the clinical cases, all patients reported near complete recovery of sensation over the lateral foot six months after surgery. All donor sites healed well with a full range of motion over the foot and ankle. Conclusions The distally based sural artery adipofascial flap allowed for minimal sensory loss, a good range of motion, an aesthetically acceptable outcome and can be performed by a single surgeon in under 2 hours.

Molecular Variation in the Paragonimus heterotremus Complex in Thailand and Myanmar

  • Sanpool, Oranuch;Intapan, Pewpan M.;Thanchomnang, Tongjit;Janwan, Penchom;Nawa, Yukifumi;Blair, David;Maleewong, Wanchai
    • Parasites, Hosts and Diseases
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    • v.51 no.6
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    • pp.677-681
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    • 2013
  • Paragonimiasis is an important food-borne parasitic zoonosis caused by infection with lung flukes of the genus Paragonimus. Of the 7 members of the genus known in Thailand until recently, only P. heterotremus has been confirmed as causing human disease. An 8th species, P. pseudoheterotremus, has recently been proposed from Thailand, and has been found in humans. Molecular data place this species as a sister species to P. heterotremus, and it is likely that P. pseudoheterotremus is not specifically distinct from P. heterotremus. In this study, we collected metacercariae of both nominal species (identification based on metacercarial morphology) from freshwater crabs from Phetchabun Province in northern Thailand, Saraburi Province in central Thailand, and Surat Thani Province in southern Thailand. In addition, we purchased freshwater crabs imported from Myanmar at Myawaddy Province, western Thailand, close to the Myanmar-Thailand border. The DNAs extracted from excysted metacercariae were PCR-amplified and sequenced for ITS2 and cox1 genes. The ITS2 sequences were nearly identical among all samples (99-100%). Phylogenies inferred from all available partial cox1 sequences contained several clusters. Sequences from Indian P. heterotremus formed a sister group to sequences from P. pseudoheterotremus-type metacercariae. Sequences of P. heterotremus from Thailand, Vietnam, and China formed a separate distinct clade. One metacercaria from Phitsanulok Province was distinct from all others. There is clearly considerable genetic variation in the P. heterotremus complex in Thailand and the form referred to as P. pseudoheterotremus is widely distributed in Thailand and the Thai-Myanmar border region.

Rigorous Design of 22-nm Node 4-Terminal SOI FinFETs for Reliable Low Standby Power Operation with Semi-empirical Parameters

  • Cho, Seong-Jae;O'uchi, Shinichi;Endo, Kazuhiko;Kim, Sang-Wan;Son, Young-Hwan;Kang, In-Man;Masahara, Meishoku;Harris, James S.Jr;Park, Byung-Gook
    • JSTS:Journal of Semiconductor Technology and Science
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    • v.10 no.4
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    • pp.265-275
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    • 2010
  • In this work, reliable methodology for device design is presented. Based on this method, the underlap length has been optimized for minimizing the gateinduced drain leakage (GIDL) in a 22-nm node 4-terminal (4-T) silicon-on-insulator (SOI) fin-shaped field effect transistor (FinFET) by TCAD simulation. In order to examine the effects of underlap length on GIDL more realistically, doping profile of the source and drain (S/D) junctions, carrier lifetimes, and the parameters for a band-to-band tunneling (BTBT) model have been experimentally extracted from the devices of 90-nm channel length as well as pnjunction test element groups (TEGs). It was confirmed that the underlap length should be near 15 nm to suppress GIDL effectively for reliable low standby power (LSTP) operation.

Trace Mineral Nutrition in Poultry and Swine

  • Richards, James D.;Zhao, Junmei;Harrell, Robert J.;Atwell, Cindy A.;Dibner, Julia J.
    • Asian-Australasian Journal of Animal Sciences
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    • v.23 no.11
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    • pp.1527-1534
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    • 2010
  • Trace minerals such as zinc, copper, and manganese are essential cofactors for hundreds of cellular enzymes and transcription factors in all animal species, and thus participate in a wide variety of biochemical processes. Immune development and response, tissue and bone development and integrity, protection against oxidative stress, and cellular growth and division are just a few examples. Deficiencies in trace minerals can lead to deficits in any of these processes, as well as reductions in growth performance. As such, most animal diets are supplemented with inorganic and/or organic forms of trace minerals. Inorganic trace minerals (ITM) such as sulfates and oxides form the bulk of trace mineral supplementation, but these forms of minerals are well known to be prone to dietary antagonisms. Feeding high-quality chelated trace minerals or other classes of organic trace minerals (OTM) can provide the animal with more bioavailable forms of the minerals. Interestingly, many, if not most, published experiments show little or no difference in the bioavailability of OTMs versus ITMs. In some cases, it appears that there truly is no difference. However, real differences in bioavailability can be masked if source comparisons are not made on the linear portion of the dose-response curve. When highly bioavailable chelated minerals are fed, they will better supply the biochemical systems of the cells of the animal, leading to a wide variety of benefits in both poultry and swine. Indeed, the use of certain chelated trace minerals has been shown to enhance mineral uptake, and improve the immune response, oxidative stress management, and tissue and bone development and strength. Furthermore, the higher bioavailability of these trace minerals allows the producer to achieve similar or improved performance, at reduced levels of trace mineral inclusion.

Threshold Voltage Control through Layer Doping of Double Gate MOSFETs

  • Joseph, Saji;George, James T.;Mathew, Vincent
    • JSTS:Journal of Semiconductor Technology and Science
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    • v.10 no.3
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    • pp.240-250
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    • 2010
  • Double Gate MOSFETs (DG MOSFETs) with doping in one or two thin layers of an otherwise intrinsic channel are simulated to obtain the transport characteristics, threshold voltage and leakage current. Two different device structures- one with doping on two layers near the top and bottom oxide layers and another with doping on a single layer at the centre- are simulated and the variation of device parameters with a change in doping concentration and doping layer thickness is studied. It is observed that an n-doped layer in the channel reduces the threshold voltage and increases the drive current, when compared with a device of undoped channel. The reduction in the threshold voltage and increase in the drain current are found to increase with the thickness and the level of doping of the layer. The leakage current is larger than that of an undoped channel, but less than that of a uniformly doped channel. For a channel with p-doped layer, the threshold voltage increases with the level of doping and the thickness of the layer, accompanied with a reduction in drain current. The devices with doped middle layers and doped gate layers show almost identical behavior, apart from the slight difference in the drive current. The doping level and the thickness of the layers can be used as a tool to adjust the threshold voltage of the device indicating the possibility of easy fabrication of ICs having FETs of different threshold voltages, and the rest of the channel, being intrinsic having high mobility, serves to maintain high drive current in comparison with a fully doped channel.

Dispersion constraints and the Hilbert transform for electromagnetic system response validation (전자기 탐사 시스템 반응의 타당성 확인을 위한 분산 관계식과 힐버트 변환)

  • Macnae, James;Springall, Ryan
    • Geophysics and Geophysical Exploration
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    • v.14 no.1
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    • pp.1-6
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    • 2011
  • As a check on calibration and drift in each discrete sub-system of a commercial frequency-domain airborne electromagnetic system, we aim to use causality constraints alone to predict in-phase from wide-band quadrature data. There are several possible applications of the prediction of in-phase response from quadrature data including: (1) quality control on base level drift, calibration and phase checks; (2) prediction and validation of noise levels in in-phase from quadrature measurements and vice versa and in future; and (3) interpolation and extrapolation of sparsely sampled data enforcing causality and better frequency-domain-time-domain transformations. In practice, using tests on both synthetic and measured Resolve helicopter-borne electromagnetic frequency domain data, in-phase data points could be predicted using a scaled Hilbert transform with a standard deviation between 40 and 80 ppm. However, relative differences between base levels between flight could be resolved to better than 1 ppm, which allows an independent quality control check on the accuracy of drift corrections.

The Possibility and the Way to Introduce of Venture Debt to Encourage Growth of Ventures (벤처기업의 성장 촉진을 위한 벤처부채의 가능성과 도입방안)

  • Hong, Jong Soo;Na, Sumi;Park, Jaesung James
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.4
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    • pp.17-25
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    • 2020
  • Venture debt is a prominent funding tool to promote scale-up of ventures. In the growth stage, venture firms that need large-scale funding can accelerate their growth by leveraging venture debt without diluting their shares, while venture capitals can quickly recollect their investments by accelerating the growth of the ventures they invest. By supplying venture debt, banks can diversify their asset primarily concentrated on loans, and improve the return on assets. As in the case of Silicon Valley Bank, a leading venture lender, closer cooperation between the two agents is essential to supply venture debt. One is the venture capital, an equity capital supplier, and the other is the bank, a debt capital supplier. To this end, we propose "credit risk sharing venture loans" and "venture loan pooling". The former encourages banks' participation in the venture debt market where the manager of Korean Fund of Funds, KVIC and policy guarantee schemes such as KODIT and KIBO screen or partially absorbe the risks inherent in venture loans. The latter reduces the burden of banking on individual venture loans through securitization.

The use of SlAdh2 promoter as a novel fruit-specific promoter in transgenic tomato

  • Chung, Mi-Young;Naing, Aung Htay;Vrebalov, Julia;Shanmugam, Ashokraj;Lee, Do-Jin;Park, In Hwan;Kim, Chang Kil;Giovannon, James
    • Journal of Plant Biotechnology
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    • v.47 no.2
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    • pp.172-178
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    • 2020
  • Fruit-specific promoters play an important role in the improvement of traits, such as fruit quality through genetic engineering. In tomato, the development of fruit-specific promoters was previously reported, but less attention has been paid to the promoters involved in the fruit development stage. In this study, we characterized the gene expression patterns of tomato alcohol dehydrogenase 2 (SlAdh2) in various tissues of wild-type tomato (cv. Ailsa Craig). Our findings revealed that SlAdh2 expression levels were higher in the developing fruit than in the leaves, stems, and flowers. The ProSlAdh2 region, which is expressed at different stages of fruit development, was isolated from tomato genomic DNA. Following this, it was fused with a β-glucuronidase reporter gene (GUS) and introduced into wild-type tomato using Agrobacterium-mediated transformation to evaluate promoter activity in the various tissues of transgenic tomato. The ProSlAdh2:GUS promoter exhibited strong activity in the fruit and weak activity in the stems, but displayed undetectable activity in the leaves and flowers. Interestingly, the promoter was active from the appearance of the green fruit (1 cm in size) to the well-ripened stage in transgenic tomatoes, indicating its suitability for transgene expression during fruit development and ripening. Thus, our findings suggest that ProSlAdh2 may serve as a potential fruit-specific promoter for genetic-based improvement of tomato fruit quality.

Hazardous Alcohol Use in 2 Countries: A Comparison Between Alberta, Canada and Queensland, Australia

  • Sanchez-Ramirez, Diana C.;Franklin, Richard;Voaklander, Donald
    • Journal of Preventive Medicine and Public Health
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    • v.50 no.5
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    • pp.311-319
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    • 2017
  • Objectives: This article aimed to compare alcohol consumption between the populations of Queensland in Australia and Alberta in Canada. Furthermore, the associations between greater alcohol consumption and socio-demographic characteristics were explored in each population. Methods: Data from 2500 participants of the 2013 Alberta Survey and the 2013 Queensland Social Survey were analyzed. Regression analyses were used to explore the associations between alcohol risk and socio-demographic characteristics. Results: A higher rate of hazardous alcohol use was found in Queenslanders than in Albertans. In both Albertans and Queenslanders, hazardous alcohol use was associated with being between 18 and 24 years of age. Higher income, having no religion, living alone, and being born in Canada were also associated with alcohol risk in Albertans; while in Queenslanders, hazardous alcohol use was also associated with common-law marital status. In addition, hazardous alcohol use was lower among respondents with a non-Catholic or Protestant religious affiliation. Conclusions: Younger age was associated with greater hazardous alcohol use in both populations. In addition, different socio-demographic factors were associated with hazardous alcohol use in each of the populations studied. Our results allowed us to identify the socio-demographic profiles associated with hazardous alcohol use in Alberta and Queensland. These profiles constitute valuable sources of information for local health authorities and policymakers when designing suitable preventive strategies targeting hazardous alcohol use. Overall, the present study highlights the importance of analyzing the socio-demographic factors associated with alcohol consumption in population-specific contexts.