Concordance of Whole-Slide Imaging and Conventional Light Microscopy for Assessment of Pathologic Response Following Neoadjuvant Therapy for Lung Cancer.

Pathologic response is an endpoint in many ongoing clinical trials for neoadjuvant regimens, including immune checkpoint blockade and chemotherapy. Whole-slide scanning of glass slides generates high-resolution digital images and allows for remote review and potential measurement with image analysis tools, but concordance of pathologic response assessment on digital scans compared with that on glass slides has yet to be evaluated. Such a validation goes beyond previous concordance studies, which focused on establishing surgical pathology diagnoses, as it requires quantitative assessment of tumor, necrosis, and regression.

Overturning circulation, nutrient limitation, and warming in the Glacial North Pacific.

Although the Pacific Ocean is a major reservoir of heat and CO, and thus an important component of the global climate system, its circulation under different climatic conditions is poorly understood. Here, we present evidence that during the Last Glacial Maximum (LGM), the North Pacific was better ventilated at intermediate depths and had surface waters with lower nutrients, higher salinity, and warmer temperatures compared to today. Modeling shows that this pattern is well explained by enhanced Pacific meridional overturning circulation (PMOC), which brings warm, salty, and nutrient-poor subtropical waters to high latitudes.

Simulation-based research in emergency medicine in Canada: Priorities and perspectives.

Objective: Simulation plays an integral role in the Canadian healthcare system with applications in quality improvement, systems development, and medical education. High-quality, simulation-based research will ensure its effective use. This study sought to summarize simulation-based research activity and its facilitators and barriers, as well as establish priorities for simulation-based research in Canadian emergency medicine (EM).

Assessing whether universal coverage with insecticide-treated nets has been achieved: is the right indicator being used?

Background/methods: Insecticide-treated nets (ITNs) are the primary tool for malaria vector control in sub-Saharan Africa, and have been responsible for an estimated two-thirds of the reduction in the global burden of malaria in recent years. While the ultimate goal is high levels of ITN use to confer protection against infected mosquitoes, it is widely accepted that ITN use must be understood in the context of ITN availability. However, despite nearly a decade of universal coverage campaigns, no country has achieved a measured level of 80% of households owning 1 ITN for 2 people in a national survey.

Design, Implementation, and Evaluation of a School Insecticide-Treated Net Distribution Program in Cross River State, Nigeria.

Background: In 2013, the World Health Organization recommended distribution through schools, health facilities, community health workers, and mass campaigns to maintain coverage with insecticide-treated nets (ITNs). We piloted school distribution in 3 local government areas (LGAs) of Cross River State, Nigeria.

Methods: From January to March 2011, all 3 study sites participated in a mass ITN campaign.

Impact of a 15-month multi-channel continuous distribution pilot on ITN ownership and access in Eastern Region, Ghana.

Background: Insecticide-treated nets are a key intervention for malaria prevention. While mass distribution can rapidly scale up ITN coverage, multiple channels may be needed to sustain high levels of ITN access and ownership. In Ghana's Eastern Region, a continuous ITN distribution pilot, started in October 2012, 18-24 months after a mass campaign.

Evaluation of a continuous community-based ITN distribution pilot in Lainya County, South Sudan 2012-2013.

Background: Continuous distribution of insecticide-treated nets (ITNs) has now been accepted as one way of sustaining ITN universal coverage. Community-based channels offer an interesting means of delivering ITNs to households to sustain universal ITN coverage. The objective of this study was to provide proof of concept for this channel.

Evaluation of community-based continuous distribution of long-lasting insecticide-treated nets in Toamasina II District, Madagascar.

Background: Continuous distribution of insecticide-treated nets (ITNs) is thought to be an effective mechanism to maintain ITN ownership and access between or in the absence of mass campaigns, but evidence is limited. A community-based ITN distribution pilot was implemented and evaluated in Toamasina II District, Madagascar, to assess this new channel for continuous ITN distribution.

Methods: Beginning 9 months after the December 2012 mass campaign, a community-based distribution pilot ran for an additional 9 months, from September 2013 to June 2014.

Impact of a behaviour change communication programme on net durability in eastern Uganda.

Background: The importance of net durability and the average useful life of a net is increasingly recognized as one of the critical factors that determine how often nets need to be replaced. A study to assess the effect of a net care and repair behaviour change communication (BCC) programme on net durability was conducted in one district in Eastern Uganda with a district in a neighbouring region serving as a comparison. Both districts had received LLINs in September of 2012.

Field durability of the same type of long-lasting insecticidal net varies between regions in Nigeria due to differences in household behaviour and living conditions.

Background: With the recent publication of WHO-recommended methods to estimate net survival, comparative analyses from different areas have now become possible. With this in mind, a study was undertaken in Nigeria to compare the performance of a specific long-lasting insecticidal net (LLIN) product in three socio-ecologically different areas. In addition, the objective was to assess the feasibility of a retrospective study design for durability.

Impact of a behaviour change intervention on long-lasting insecticidal net care and repair behaviour and net condition in Nasarawa State, Nigeria.

Background: While some data on net durability have been accumulating in recent years, including formative qualitative research on attitudes towards net care and repair, no data are available on how the durability of a net is influenced by behaviour of net maintenance, care and repair, and whether behavioural change interventions (BCC) could substantially impact on the average useful life of the net.

Methods: The study used an intervention-control design with before-after assessment through repeated cross-sectional household surveys with two-stage cluster sampling following Nasarawa State's December 2010 mass campaign. All campaign nets were 100-denier polyester, long-lasting insecticidal nets (LLIN).

The use of mediation analysis to assess the effects of a behaviour change communication strategy on bed net ideation and household universal coverage in Tanzania.

Background: SBCC campaigns are designed to act on cognitive, social and emotional factors at the individual or community level. The combination of these factors, referred to as 'ideation', play a role in determining behaviour by reinforcing and confirming decisions about a particular health topic. This study introduces ideation theory and mediation analysis as a way to evaluate the impact of a malaria SBCC campaign in Tanzania, to determine whether exposure to a communication programme influenced universal coverage through mediating ideational variables.

What happens to lost nets: a multi-country analysis of reasons for LLIN attrition using 14 household surveys in four countries.

Background: While significant focus has been given to net distribution, little is known about what is done with nets that leave a household, either to be used by others or when they are discarded. To better understand the magnitude of sharing LLIN between households and patterns of discarding LLIN, the present study pools data from 14 post-campaign surveys to draw larger conclusions about the fate of nets that leave households.

Methods: Data from 14 sub-national post-campaign surveys conducted in Ghana, Senegal, Nigeria (10 states), and Uganda between 2009 and 2012 were pooled.

Role of multidetector computed tomography in the diagnosis and management of patients attending the rapid access chest pain clinic, The Scottish computed tomography of the heart (SCOT-HEART) trial: study protocol for randomized controlled trial.

Background: Rapid access chest pain clinics have facilitated the early diagnosis and treatment of patients with coronary heart disease and angina. Despite this important service provision, coronary heart disease continues to be under-diagnosed and many patients are left untreated and at risk. Recent advances in imaging technology have now led to the widespread use of noninvasive computed tomography, which can be used to measure coronary artery calcium scores and perform coronary angiography in one examination.

[The choking game in adolescence, between experimentation and risk].

In the last year there was happened a series of adolescent deaths in the province of Salta that might be related to a dangerous game known as "the choking game". It has been practiced over many years in different countries around the world and consists of provoking brain hypoxia for some seconds by different techniques to obtain an instant of ecstasy and pleasure. We consider relevant that health providers know about this practice and so be able to recognize through signs and symptoms when an adolescent might be playing this game.

Evaluation of an internet-based physical activity intervention: a preliminary investigation.

The Internet has the potential for delivering innovative, interactive physical activity (PA) interventions to large numbers of people. This study was designed to test the efficacy of an Internet intervention that consisted of a Web site plus 12 weekly e-mail tip sheets, compared with a waiting list control group. The Internet intervention was theory based and emphasized clear, graphical presentation of PA information.

User attitudes toward a physical activity promotion website.

Background: The goal of the present study was to examine participants' perceptions of a theory-driven, physical activity promotion website.

Methods: Participants in the present study were individuals in the website condition of a randomized trial designed to test the efficacy of the website. At 1 month, participants were surveyed regarding their self-report of barriers, frequency of use, and helpfulness of the website.

Behavioral epidemiology: a systematic framework to classify phases of research on health promotion and disease prevention.

Although the term "behavioral epidemiology" has been used in the literature since the late 1970s, it has not been clearly defined. A behavioral epidemiology framework is proposed to specify a systematic sequence of studies on health-related behaviors, leading to evidence-based interventions directed at populations. The phase are: 1--establish links between behaviors and health; 2--develop measures of the behavior; 3--identify influences on the behavior; 4--evaluate interventions to change the behavior; 5--translate research into practice.

Computer use and physical inactivity in young adults: public health perils and potentials of new information technologies.

Physical inactivity contributes to premature mortality and morbidity and increasing prevalences of overweight and obesity in industrialized countries. Computer use is an increasingly common sedentary behaviour, potentially displacing physical activity. Physical activity and computer use were examined in 697 young adults (18-30 years).

Age-related differences in physical activity levels of young adults.

Purpose: To examine age-related differences in the physical activity behaviors of young adults.

Methods: We examined rates of participation in vigorous- and moderate-intensity leisure-time activity and walking, as well as an index of physical activity sufficient for health benefits in three Australian cross-sectional samples, for the age ranges of 18--19, 20--24, and 25--29 yr. Data were collected in 1991, 1996, and 1997/8.

Environmental determinants of physical activity and sedentary behavior.

Environmental changes are expected to lead to decreased time in sedentary behavior and to increased levels of physical activity in populations. Past research has emphasized psychosocial determinants of physical activity. Progress in the field will require more focus on understanding sedentary behaviors and the role of environmental determinants.

Interactive health communication in preventive medicine: internet-based strategies in teaching and research.

Interactive health communication using Internet technologies is expanding the range and flexibility of intervention and teaching options available in preventive medicine and the health sciences. Advantages of interactive health communication include the enhanced convenience, novelty, and appeal of computer-mediated communication; its flexibility and interactivity; and automated processing. We outline some of these fundamental aspects of computer-mediated communication as it applies to preventive medicine.

Failure to maintain the benefits of home-based intervention in adolescents with poorly controlled type 1 diabetes.

Objective: To determine whether a 6-month home-based intervention program in adolescents with poorly controlled diabetes improves metabolic control and whether benefits are maintained after the intervention.

Research Design And Methods: Adolescents with a mean HbA1c of > 9.0% over the preceding 12 months received either routine care in a diabetes clinic and an ambulatory intervention for 6 months (n = 37) or routine care only (n = 32).

VSG gene control and infectivity strategy of metacyclic stage Trypanosoma brucei.

As the metacyclic trypanosome stage develops in the tsetse fly salivary glands, it initiates expression of variant surface glycoproteins (VSGs) and does so by each cell activating, at random, one from a small subset of metacyclic VSG (M-VSG) genes. Whereas differential activation of individual VSG genes in the bloodstream occurs as a function of time, to evade waves of antibody, it is believed that the aim in the metacyclic stage is simultaneously to generate population diversity. M-VSG genes are activated in their telomeric loci and belong to monocistronic transcription units, unlike all other known trypanosome protein-coding genes, which appear to be transcribed polycistronically.