BackgroundWhile nuts are known to reduce several cardiovascular risk factors, being energy dense, they are perceived as fattening. Short-term studies have shown that nut intake does not adversely a...
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The purpose of this study was to assess the effects of interpersonal relationship on church development. The study was built on Lewin’s theory of change and Stakeholders theory by Freeman. Descriptive research design was used to determine... more
The purpose of this study was to assess the effects of interpersonal relationship on church development. The study was built on Lewin’s theory of change and Stakeholders theory by Freeman. Descriptive research design was used to determine the effects of variables. The target population was the fellowship, church leaders and members of fellowship groups in AGC churches Anaimoi sub-county, Kericho County, Kenya. Anaimoi is divided into 6 wards with each having an average of 10 AGC churches. The fellowship groups in 18 churches were used as a sample. Strata random sampling was used to select the respondents. Data was collected using structured questionnaires and interviews. The study was analysed through descriptive statistics with the help of SPSS and presented in pie charts, tables and graphs. Interpretation was made based on research objective. A pilot study was carried out by choosing one small group fellowship to determine the reliability and validity of research instruments. Cron...
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Exploring In-Hospital Outcomes of Pancreatic Cancer: A Population-Based Study Steve Serrao, MD, MPH,1 Nicole Shah, DO,1 Nishant Puri, MD,1 Medina Sahak, MPH,4 Diana Babayan, MPH,4 David Juma, MPH,4 Lauren Gerson, MD, MSc, FACG,3 Christian... more
Exploring In-Hospital Outcomes of Pancreatic Cancer: A Population-Based Study Steve Serrao, MD, MPH,1 Nicole Shah, DO,1 Nishant Puri, MD,1 Medina Sahak, MPH,4 Diana Babayan, MPH,4 David Juma, MPH,4 Lauren Gerson, MD, MSc, FACG,3 Christian Jackson, MD, FACG,2 Kendrick Che, MD1. 1. Loma Linda University Medical Center, Loma Linda, CA; 2. VA Loma Linda Healthcare System, Loma Linda, CA; 3. California Pacifi c Medical Center, San Francisco, CA; 4. Loma Linda University School of Public Health, Loma Linda, CA.
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Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Despite a recent rise in CRC screening there remains an increasing demand for colonoscopy, yet a limited supply of gastroenterologists who can meet this... more
Colorectal cancer (CRC) is the second leading cause of cancer deaths in the USA. Despite a recent rise in CRC screening there remains an increasing demand for colonoscopy, yet a limited supply of gastroenterologists who can meet this need. To determine if a mid-career general internist (GIN) could be trained to perform high-quality colonoscopes via an intensive training programme. A GIN trained 2-3 days/week, 4-5 hours/day, for 7 months with an experienced gastroenterologist. Their independent performance was then compared with that of a gastroenterology attending (GA), with and without a gastroenterology fellow (GF). The primary outcome was to compare caecal intubation rates, adenoma detection rates (ADRs), interval CRC rates and complications between the three groups. 989 patients were initially included in the study, and 818 were included in the final analysis. Caecal intubation rates were 95%, 94% and 93% for the GIN, GA+GF and GA, respectively (p=0.31). The overall polyp detect...
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Studies about environmental burdens often explore overall community risk. Increasing evidence suggests, however, differential burdens by gender and age. The purpose of the authors' research was to determine if gender-related... more
Studies about environmental burdens often explore overall community risk. Increasing evidence suggests, however, differential burdens by gender and age. The purpose of the authors' research was to determine if gender-related difference exists among children in a region plagued with poor air quality and if increased exposure to pollutants from a major goods movement rail yard influences the relationship. Using a cross-sectional study design, the authors provided respiratory screening for children at two elementary schools. Compared to females, males were at significantly greater odds of exhibiting elevated fractional exhaled nitric oxide (FeNO) but less likely to exhibit reduced lung volume. Even in an area of overall poor air quality, the authors found that male children were a vulnerable subpopulation for greater elevated FeNO, while females were at increased risk for reduced lung capacity. Understanding differential burdens in vulnerable subpopulations is critical to providing...
Research Interests: Chemistry, Environmental Health, Environmental Monitoring, Medicine, California, and 15 moreHumans, Child, Female, Male, Public Policy and Administration, Exhaled Nitric Oxide, Public health systems and services research, Sex Factors, Railroads, Cross Sectional Studies, Environmental Exposure, Air Pollutants, ENVIRONMENTAL SCIENCE AND MANAGEMENT, Air Quality Index, and Respiratory Tract Diseases
Cortical bone drilling for preparation of screw placement is common in multiple surgical fields. The heat generated while drilling may reach thresholds high enough to cause osteonecrosis. This can compromise implant stability. Orthopedic... more
Cortical bone drilling for preparation of screw placement is common in multiple surgical fields. The heat generated while drilling may reach thresholds high enough to cause osteonecrosis. This can compromise implant stability. Orthopedic drill bits are several orders more expensive than their similarly sized, publicly available industrial counterparts. We hypothesize an industrial bit will generate less heat during drilling, and the bits will not generate more heat after multiple cortical passes. We compared 4 4.0 mm orthopedic and 1 3.97 mm industrial drill bits. Three types of each bit were drilled into porcine femoral cortices 20 times. The temperature of the bone was measured with thermocouple transducers. The heat generated during the first five drill cycles for each bit was compared to the last five cycles. These data were analyzed with analysis of covariance. The industrial drill bit generated the smallest mean increase in temperature (2.8 ± 0.29°C) p<0.0001. No significan...
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Research Interests: Marine Biology, Geography, Biology, Coral Reefs, Life Sciences, and 15 moreSustainable Tourism, Endangered Species, Coral Reef Ecology, Tourism Impacts, Tourism, Scuba Diving, RECREATION, Sea Turtle Biology and Conservation, Fishery, Behavioural Studies, Sea Turtle, Marine Ecotourism, Critically Endangered, Marine Protected Area, and Juvenile
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Research Interests: Anesthesiology, Medicine, Linear models, California, Humans, and 15 moreFemale, Male, Infant, Artificial, Length of Stay, Clinical Sciences, Congenital, Infant Mortality, Age Factors, Blood Transfusion, Hospital Mortality, Heart Transplantation, Blood Loss, Extracorporeal Membrane Oxygenation, and Erythrocyte transfusion
Research Interests: Medicine, Logistic Regression, Humans, Internal Medicine, Hospitalization, and 15 moreFemale, Male, Length of Stay, Clinical Sciences, Aged, Middle Aged, Gastrointestinal Endoscopy, Odds ratio, Retrospective Studies, Risk Factors, Intensive Care Units, Hospital Mortality, Logistic Models, Confidence Interval, and Angiodysplasia
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The magnetic properties of TlCrX2 (X = S, Se, Te), Tl3CrS3, TlCr3S5, TlCr3Se5 and TlCr5Se5 have been investigated. TlCrS2, TlCrSe2 and Tl3CrS3 order ferromagnetically with Curie temperatures in the range 60–140 K. The other compounds are... more
The magnetic properties of TlCrX2 (X = S, Se, Te), Tl3CrS3, TlCr3S5, TlCr3Se5 and TlCr5Se5 have been investigated. TlCrS2, TlCrSe2 and Tl3CrS3 order ferromagnetically with Curie temperatures in the range 60–140 K. The other compounds are antiferromagnetics with negative paramagnetic Curie temperatures, whereas TlCrTe2 has a positive paramagnetic Curie temperature. TlCrS2 and TlCrSe2 have a hexagonal layer structure with Cr ions sandwiched between S and Se-layers which in turn are separated by the large radius Tl-layers. The shorter Cr-Cr distance in the haxagonal planes gives rise to a stronger intralayer exchange interaction and therefore to a behaviour analogous to that of a quasi-twodimensional magnet. TlCrS2 and TlCrSe2 seem to represent the extremal case in the range of ACrX2 chalcogenides with A = Cu, Ag, Na, Li, K, where with the increase of the lattice constant a in the hexagonal plane a trend towards stronger positive exchange interactions has been observed.
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Introduction: Clostridium difficile infection (CDI) represents an increasing public health problem as it is a primary cause of antibiotic-induced diarrhea and colitis. In the United States, CDI affects millions of patients each year and... more
Introduction: Clostridium difficile infection (CDI) represents an increasing public health problem as it is a primary cause of antibiotic-induced diarrhea and colitis. In the United States, CDI affects millions of patients each year and represents an annual cost of over $1 billion. A more in-depth understanding of C. difficile colonization is necessary to improve therapeutics. In C. difficile pathogenesis, antibiotic disruption of the gut microbiota provides an open niche and invading C. difficile enters a colonization phase, which includes bacterialhost interaction, mucus adhesion and toxin production. Mucus oligosaccharides serve as both a fuel source and as binding sites for a number of bacteria. Previous studies have demonstrated that C. difficile is unable to cleave terminal mucus oligosaccharides. We hypothesize that an altered gut microbiota in CDI patients cleaves terminal mucus oligosaccharides exposing/producing bacterium and toxin binding sites. Furthermore we hypothesize that cleaved oligosaccharides can be foraged by C. difficile and used for proliferation. Methods& results: CDI patients presented with increased Bacteroidetes and decreased Firmicutes stool microbiota. In addition, CDI biopsies exhibited decreased N-acetylgalactosamine and increased terminal galactose mucus oligosaccharides. Terminal galactose residues have been shown to be the toxin A binding site in animal models, but lack of terminal galactose residues in the human colon have led to the hypothesis that the toxin A receptor must be different in humans. Our data indicates that terminal galactose residues may represent the human toxin A receptor which is upregulated in CDI. No changes were observed in mucus fucose or mannose levels. CDI patients did present with decreased mucus MUC2, with no changes in MUC1. These data demonstrate a unique mucus oligosaccharide composition in CDI patients. In vitro C. difficile BAA-1870 had enhanced binding to mucus extracted from CDI patients compared to healthy patient mucus, indicating the presence of an alternative binding epitope in the mucus of CDI patients. Furthermore, C. difficile BAA-1870 grown in TYGwas able to use fucose,mannose, galactose, N-acetylgalactosamine, N-acetylglucosamine, and sialic acid oligosaccharides for growth, although growth varied depending on pH and Na.Conclusions: These data demonstrate that CDI patients exhibit an altered gut microbiota with corresponding altered mucus oligosaccharide and MUC2 composition. In vitro C. difficile is capable of using multiple oligsoaccharides for growth which may represent a factor in the colonization phase.