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Arunachal Pradesh is one of the most bio-diverse and forested states in India. The state is home to 26 tribal groups and 110 sub-tribes. Traditionally, hunting has been a major part of the tribal communities in Arunachal Pradesh. Hunting is conducted majorly for food, recreation, games, trophies collection and for religious beliefs in the area. In this study, we aimed to collect baseline data on hunting rates and the reasons for hunting through primary surveys conducted in 4 major villages of West Siang district in Arunachal Pradesh. The sampling sites also coincided with the proposed locations for the construction of five future hydroelectric power projects in Arunachal Pradesh. We found a total of 34 trophies/hides in the study area with average hunting rates of 0.68 animal/household/annum and 0.97 animal/active hunter/annum. Sus scrofa cristatus (Wild Boar) was the most hunted species, followed by Naemorhedus sp. (Goral) and Ursus thibetanus (Black Bear). Among the most hunted species, 5 belonged to the 'Vulnerable' category of IUCN. Our findings also revealed that if the proposed Environment Management Plans (EMPs) of the 5 hydroelectric power projects were properly implemented, a total of 2000 jobs could be provided to the 2243 families in this study area. This has the potential to alleviate hunting pressures in the area. Besides, the EMPs of all the major hydroelectric power projects have provisions for community awareness and community education programmes. We propose that together with the state governments and non-governmental organizations, the hydroelectric project developers can play a very constructive role in decreasing hunting pressures and mitigating biodiversity losses in Northeast India. [ABSTRACT FROM AUTHOR]

In this study, we investigated the role of glutamate delta 1 receptor (GluD1) in oligodendrocyte progenitor cell (OPC)-mediated myelination during basal (development) and pathophysiological (cuprizone-induced demyelination) conditions. Initially, we sought to determine the expression pattern of GluD1 in OPCs and found a significant colocalization of GluD1 puncta with neuron-glial antigen 2 (NG2, OPC marker) in the motor cortex and dorsal striatum. Importantly, we found that the ablation of GluD1 led to an increase in the number of myelin-associated glycoprotein (MAG+) cells in the corpus callosum and motor cortex at P40 without affecting the number of NG2+ OPCs, suggesting that GluD1 loss selectively facilitates OPC differentiation rather than proliferation. Further, deletion of GluD1 enhanced myelination in the corpus callosum and motor cortex, as indicated by increased myelin basic protein (MBP) staining at P40, suggesting that GluD1 may play an essential role in the developmental regulation of myelination during the critical window period. In contrast, in cuprizone-induced demyelination, we observed reduced MBP staining in the corpus callosum of GluD1 KO mice. Furthermore, cuprizone-fed GluD1 KO mice showed more robust motor deficits. Collectively, our results demonstrate that GluD1 plays a critical role in OPC regulation and myelination in normal and demyelinating conditions. [ABSTRACT FROM AUTHOR]

Building organizational capacity is critical for hospitals participating in payment models such as bundled payments and accountable care organizations, particularly "co-participant" hospitals with experience in both models. This study used a national survey of American Hospital Association member hospitals with bundled payment experience, with (co-participant hospitals) or without (bundled payment hospitals) accountable care organization experience. Questions examined capacity in 4 domains: performance feedback, postacute care provider utilization, care management, and health information technology. Of 424 hospitals, 38% responded. Both co-participant and bundled payment hospitals reported high capacity for performance feedback and risk stratification and predictive risk assessment using health information technology systems. The hospital groups did not differ in care management capacity, but bundled payment hospitals reported higher postacute care provider utilization capacity. Experience with multiple payment models may prompt hospitals to make different investments or adopt different strategies than hospitals with experience in a single model. [ABSTRACT FROM AUTHOR]

Recently published national data demonstrate inadequate and worsening control of high blood pressure (HBP) in the United States, outcomes that likely have been made even worse by the coronavirus disease 2019 (COVID-19) pandemic. This major public health crisis exposes shortcomings of the US health care delivery system and creates an urgent opportunity to reduce mortality, major cardiovascular events, and costs for 115 million Americans. Ending this crisis will require a more coherent and systemic change to traditional patterns of care. The authors present an evidence-based Blueprint for Change for comprehensive health delivery system redesign based on current national clinical practice guidelines and quality measures. This innovative model includes a systems-based approach to ensuring proper BP measurement, assessment of cardiovascular risk, effective patient-centered team-based care, addressing social determinants of health, and shared decision-making. The authors also propose building on current national quality improvement initiatives designed to better control HBP. [ABSTRACT FROM AUTHOR]

Outreach, including patient navigation, has been shown to increase the uptake of colorectal cancer (CRC) screening in underserved populations. This analysis evaluates the cost-effectiveness of triennial multi-target stool DNA (mt-sDNA) versus outreach, with or without a mailed annual fecal immunochemical test (FIT), in a Medicaid population. A microsimulation model estimated the incremental cost-effectiveness ratio using quality-adjusted life years (QALY), direct costs, and clinical outcomes in a cohort of Medicaid beneficiaries aged 50–64 years, over a lifetime time horizon. The base case model explored scenarios of either 100% adherence or real-world reported adherence (51.3% for mt-sDNA, 21.1% for outreach with FIT and 12.3% for outreach without FIT) with or without real-world adherence for follow-up colonoscopy (66.7% for all). Costs and outcomes were discounted at 3.0%. At 100% adherence to both screening tests and follow-up colonoscopy, mt-sDNA costed more and was less effective compared with outreach with or without FIT. When real-world adherence rates were considered for screening strategies (with 100% adherence for follow-up colonoscopy), mt-sDNA resulted in the greatest reduction in incidence and mortality from CRC (41.5% and 45.8%, respectively) compared with outreach with or without FIT; mt-sDNA also was cost-effective versus outreach with and without FIT ($32,150/QALY and $22,707/QALY, respectively). mt-sDNA remained cost-effective versus FIT, with or without outreach, under real-world adherence rates for follow-up colonoscopy. Outreach or navigation interventions, with associated real-world adherence rates to screening tests, should be considered when evaluating the cost-effectiveness of CRC screening strategies in underserved populations. [ABSTRACT FROM AUTHOR]

Rethinking Community Benefit Programs - A New Vision for Hospital Investment in Community Health Over the past decade, hospitals have been tasked with a growing responsibility to address the social determinants of health. This requires (1) policy reforms that incentivize investments in community health, (2)hospital-community partnerships, and (3) a renewed focus on the "investment" in community investment. [Extracted from the article]

Background and Aims: Opioid substitution treatment is used in many countries as an effective harm minimization strategy. There is a need for more information about patient safety incidents and the resulting harm relating to this treatment. We aimed to characterize patient safety incidents involving opioid substitution treatment with methadone or buprenorphine in community‐based care by: (i) identifying the sources and nature of harm and (ii) describing and interpreting themes to identify priorities to focus future improvement work. Design Mixed‐methods study examining patient safety incident reports involving opioid substitution treatment with either methadone or buprenorphine in community‐based care. Setting: Data submitted between 2005 and 2015 from the National Reporting and Learning System (NRLS), a national repository of patient safety incident reports from across England and Wales. Participants: A total of 2284 reports were identified involving patients receiving community‐based opioid substitution treatment. Measurements Incident type, contributory factors, incident outcome and severity of harm. Analysis involved data coding, processing and iterative generation of data summaries using descriptive statistical and thematic analysis. Findings Most risks of harm from opioid substitution treatment came from failure in one of four processes of care delivery: prescribing opioid substitution (n = 151); supervised dispensing (n = 248); non‐supervised dispensing (n = 318); and monitoring and communication (n = 1544). Most incidents resulting in harm involved supervised or non‐supervised dispensing (n = 91 of 127, 72%). Staff‐ (e.g. slips during task execution, not following protocols) and organization‐related (e.g. poor working conditions or poor continuity of care between services) contributory factors were identified for more than half of incidents. Conclusions: Risks of harm in delivering opioid substitute treatment in England and Wales appear to arise out of failures in four processes: prescribing opioid substitution, supervised dispensing, non‐supervised dispensing and monitoring and communication. [ABSTRACT FROM AUTHOR]

Objective: We aim to identify contemporary noise exposures and hearing protection use among U.S. children in a large, population-based study.Methods: Cross-sectional analysis of the 2014 National Health Interview Series was performed. Results from in-person interviews of families with children under 18 years of age in all 50 states were queried. Potentially harmful exposures to loud sounds and patterns of hearing protection use in the last 12 months were analyzed after representative sample weights were applied.Results: Among 73.4 million children, 18.4% (9.1 ± 0.4 million) (boys: 23.2%, girls: 13.5%; P < 0.001) were exposed to firearms noise, and 28.2% (20.7 ± 0.6 million) (boys: 30.5%, girls: 25.8%; P < 0.001) to firecrackers and other explosive sounds. Exposure to recreational "very-loud" noise exposure was more common (7.9%; 5.8 ± 0.3 million), consisting of music players (46.5%), fireworks (44.8%), lawnmowers (42.6%), and firearms (32.5%). However, only 17.1% of boys and 15.6% of girls, totaling 16.4% of all children, always used hearing protection during noise exposures.Conclusion: Children in the United States are commonly exposed to firearms and recreational loud noises. Hearing protection is infrequently used, and gender disparities in patterns of exposure and use of hearing protection are prevalent. Those children and families at risk should be identified via public health initiatives and appropriately counseled by healthcare providers.Level Of Evidence: NA Laryngoscope, 130:541-545, 2020. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: The Aerodigestive Program (the Aero Program) at Children's Hospital Colorado is a multidisciplinary program focused on airway, digestive, and lung disorders in complex children, involving collaboration between gastroenterology, pulmonology, anesthesiology, and otolaryngology in clinic and operating room. These programs have proliferated as institutions focus on providing greater care coordination and family satisfaction. However, few cost, charge, and satisfaction data exist to support these resource-intensive programs. The goal of this study was to investigate the value of combined triple endoscopy delivered by the Aero Program through analysis of institutional charges, direct costs, operating room efficiency metrics, and parent satisfaction.Study Design: Program evaluation.Methods: Finance, satisfaction, efficiency, and quality-of-care metrics were evaluated within and outside of the Aero Program through retrospective queries of electronic health records, administrative databases, and parent surveys at our institution.Results: Mean anesthesia time in the Aero Program was 54 minutes (49-60; 95% confidence interval), which was significantly less (P < .0001) than the estimated 89 minutes of having the three procedures done separately. Average charges and average direct costs for triple endoscopy were 38.8% and 41.9% less than the sum of the averages for separate procedures, respectively. Parent satisfaction was high for the Aero Program care.Conclusions: As organizations move toward greater coordination of care for complex patients, multidisciplinary programs must demonstrate their value by delivering cost-effective care. Aerodigestive programs have the potential to provide satisfying care that is less costly to the organization, insurer, and family. These programs represent a step in the evolution toward higher value care and value-based payment methodology.Level Of Evidence: 4 Laryngoscope, 130:521-525, 2020. [ABSTRACT FROM AUTHOR]

The article focuses on the significance of health equity in improving population health and reducing health disparities. It highlights the economic impact of health inequities and provides a framework for organizations to integrate health equity into their strategies across various domains. It authors emphasize that health equity is both a moral obligation and a business imperative, with examples of how organizations are taking steps to promote health equity.

Objectives: Primary ciliary dyskinesia (PCD) is a genetic disorder characterized by abnormal respiratory cilia ultrastructure and/or function causing defective mucociliary clearance. We investigated the extent and severity of rhinosinusitis in a large cohort of children with PCD and explored associations among risk factors, including genotype and sinus disease.Study Design: Retrospective chart review.Setting: Tertiary academic children's hospital.Subjects and Methods: A review was conducted with a patient registry at the PCD Foundation Center at our institution. Demographic, imaging, clinical, and operative data were reviewed through the institutional electronic health record system.Results: Fifty-four subjects were identified with mean and median age at diagnosis of 5.2 and 4.0 years. The male:female ratio was 35%:65%. Sinus symptoms were present in 46 (85%) subjects, 22 of whom had chronic rhinosinusitis. Nineteen (35%) subjects underwent operative intervention, consisting of endoscopic sinus surgery (ESS; 16 patients) and maxillary lavage (3 patients). Nineteen subjects underwent adenoidectomy for PCD-related indications. Five sinus-related admissions in 3 subjects were noted during the study period, and no complication of rhinosinusitis occurred in the cohort. Genetic test results were available in 27 subjects, in whom 23 (85%) had biallelic mutations in a PCD gene. Demographic factors, Lund-Mackay score, and PCD genotype were not found to be predictors for ESS or hospitalization in our cohort.Conclusion: While rhinosinusitis was common in our PCD cohort, most patients did not require ESS. Since complications of rhinosinusitis were uncommon, we recommend judicious surgical management tailored to the patient's symptoms. [ABSTRACT FROM AUTHOR]

The article offers information on the development of the tiered approach to prioritize Catheter-Associated Urinary Tract Infection (CAUTI) interventions. It mentions that the application of the Grading of Recommendations Assessment, Development and Evaluation system approach for evaluating quality of evidence and determining strength of recommendations.

Health literacy is critical for cancer patients as they must understand complex procedures or treatment options. Caregivers' health literacy also plays a crucial role in caring for cancer patients. Low health literacy is associated with low adherence to medications, poor health status, and increased health care costs. There is a growing interest in the use of mobile health applications (apps) to improve health literacy. Mobile health apps can empower underserved cancer patients and their caregivers by providing features or functionalities to enhance interactive patient-provider communication and to understand medical information more readily. Despite the potentiality of improving health literacy through mobile health apps, there exist several related concerns: no equal access to mobile technology, no familiarity or knowledge of using mobile health apps, and privacy and security concerns. These elements should be taken into account for health policy making and mobile apps design and development. Importantly, mobile apps should be developed with the goal of achieving a high range of user access by considering all health literacy level and various cultural and linguistic needs. [ABSTRACT FROM AUTHOR]

ADP-ribosylation factors (ARF) GTPases are activated by guanine nucleotide exchange factors (GEFs) to support cellular homeostasis. Key to understanding spatio-temporal regulation of ARF signaling is the mechanism of GEF recruitment to membranes. Small GEFs are recruited through phosphoinositide (PIP) binding by a pleckstrin homology (PH) domain downstream from the catalytic Sec7 domain (Sec7d). The large GEFs lack PH domains, and their recruitment mechanisms are poorly understood. We probed Golgi recruitment of GBF1, a GEF catalyzing ARF activation required for Golgi homeostasis. We show that the homology downstream of Sec7d-1 (HDS1) regulates Golgi recruitment of GBF1. We document that GBF1 binds phosphoinositides, preferentially PI3P, PI4P and PI(4,5)P2, and that lipid binding requires the HDS1 domain. Mutations within HDS1 that reduce GBF1 binding to specific PIPs in vitro inhibit GBF1 targeting to Golgi membranes in cells. Our data imply that HDS1 and PH domains are functionally analogous in that each uses lipid-based membrane information to regulate GEF recruitment. Lipid-based recruitment of GBF1 extends the paradigm of lipid regulation to small and large GEFs and suggests that lipid-based mechanisms evolved early during GEF diversification. [ABSTRACT FROM AUTHOR]

In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address an audience of practitioners and policy makers, mindful of the pressing health care challenges of our time, including: rising health-related expenditures, an aging population, workforce shortages, health disparities, and a backdrop of inequities rooted in social determinants that have not been adequately translated into formal policies or practices among the key stakeholders in population health. These principles are meant to empower stakeholders-whether it is the planner or the practitioner, the decision maker or the dedicated caregiver-and inform the development of practical tools, research, and education. [ABSTRACT FROM AUTHOR]

The main objective of present study is to formulate and evaluate film forming gel of Bifonazole for local drug delivery. Tenia pedis is superficial skin fungal infection mainly occurs in athlete's foot. Bifonazole is a broad spectrum imidazole antifungal used in tenia pedis and possess high resistance towards fungus. It is an effective and well tolerated treatment for superficial fungal infections. In the treatment of skin fungal infections, the antifungal agent requires to be present at the site of infection for longer period of time. Thus the formulation which provides the prolonged drug delivery is needed. Film forming gel makes transparent film on the skin and provides the delivery of Bifonazole for prolonged period of time. So, such treatment reduces duration of therapy and improves the patient compliance. Eudragit RL(PO) as a film forming polymer, HPMC K100M as a gel forming agent and Triethyl citrate as a plasticizer were selected. It was concluded that drug was compatible with all excipients from FTIR study. A 32full factorial design was used in present study for optimization considering two factors Concentration of Eudragit RL(PO) and Concentration of Triethyl citrate.% Drug diffusion and Tensile strength were taken as dependent variable. The prepared film forming gel was evaluated for all parameters including mechanical properties and % drug diffusion. The optimized batch obtained from experimental design was prepared and evaluated for all parameters. Optimized formulation showed Tensile strength 0.875 N/m2 and % Drug diffusion 96.09 at 12 hour. Stability study of optimized formulation showed that formulation was stable at accelerated Condition. [ABSTRACT FROM AUTHOR]

Objective: Mal de debarquement syndrome (MdDS) is a balance disorder that typically starts after an extended exposure to passive motion, such as a boat or plane ride. Management is typically supportive (e.g. physical therapy), and symptoms that persist beyond 6 months have been described as unlikely to remit. This study was conducted to evaluate the response of patients with MdDS to management with migraine prophylaxis, including lifestyle changes and medical therapy.Study Design: Prospective review.Setting: Ambulatory setting at a tertiary care medical center.Methods: Clinical history, detailed questionnaires, and audiograms were used to diagnose patients with MdDS. Those patients with the diagnosis of the MdDS were placed on our institutional vestibular migraine management protocol. Treatment response was assessed with a quality-of-life (QOL) survey and visual analog scale.Results: Fifteen patients were diagnosed with MdDS, with a predominance of females (73%) and a mean age of 50 ± 13 years. Eleven patients (73%) responded well to management with a vestibular migraine protocol, which included lifestyle changes, as well as pharmacotherapy with verapamil, nortriptyline, topiramate, or a combination thereof. In comparison, a retrospective control group of 17 patients demonstrated a lower rate of improvement when treated with vestibular rehabilitation and physical therapy.Conclusion: Management of MdDS as vestibular migraine can improve patients' symptoms and increase the QOL. Nearly all the patients suffering from MdDS had a personal or family history of migraine headaches or had signs or symptoms suggestive of atypical migraine.Level Of Evidence: 4 Laryngoscope, 127:1670-1675, 2017. [ABSTRACT FROM AUTHOR]

The human mitochondrial chaperonin is a macromolecular machine that catalyzes the proper folding of mitochondrial proteins and is of vital importance to all cells. This chaperonin is composed of 2 distinct proteins, Hsp60 and Hsp10, that assemble into large oligomeric complexes that mediate the folding of non-native polypeptides in an ATP dependent manner. Here, we report the bacterial expression and purification of fully assembled human Hsp60 and Hsp10 recombinant proteins and that Hsp60 forms a stable tetradecameric double-ring conformation in the absence of co-chaperonin and nucleotide. Evidence of the stable double-ring conformation is illustrated by the 15 Å resolution electron microscopy reconstruction presented here. Furthermore, our biochemical analyses reveal that the presence of a non-native substrate initiates ATP-hydrolysis within the Hsp60/10 chaperonin to commence protein folding. Collectively, these data provide insight into the architecture of the intermediates used by the human mitochondrial chaperonin along its protein folding pathway and lay a foundation for subsequent high resolution structural investigations into the conformational changes of the mitochondrial chaperonin. [ABSTRACT FROM PUBLISHER]

Mobile health (mHealth) is being recognized as an innovative approach to deliver health care in an accessible, portable and cost effective manner. Despite the numerous benefits associated with the use of mobile devices, there are major concerns with mhealth in the area of privacy and security. These aspects need to be considered at every stage of design and development of mHealth devices and applications which need to be developed by security-trained, trusted manufacturers who should be accountable to minimize damages in the healthcare industry. It is also crucial for users and/or organizations to be more cautious and responsible to use mobile devices. Major stakeholders, including those in the user׳s community (patients and providers), vendors and developers, and policy makers need to come together to survey the landscape, identify the issues, and develop policies, regulations, safeguards and industry standards. [ABSTRACT FROM AUTHOR]

Objective To examine the relationship between the prescribed target dose and the dose to healthy neurovascular structures in patients with vestibular schwannomas treated with stereotactic radiosurgery (SRS). Study Design Case series with chart review. Setting SRS center from 2011 to 2013. Subjects Twenty patients with vestibular schwannomas treated at the center from 2011 to 2013. Methods Twenty patients with vestibular schwannomas were included. The average radiation dose delivered to healthy neurovascular structures (eg, carotid artery, basilar artery, facial nerve, trigeminal nerve, and cochlea) was analyzed. Results Twenty patients with vestibular schwannomas who were treated with fused computed tomography/magnetic resonance imaging-guided SRS were included in the study. The prescribed dose ranged from 10.58 to 17.40 Gy over 1 to 3 hypofractions to cover 95% of the target tumor volume. The mean dose to the carotid artery was 5.66 Gy (95% confidence interval [CI], 4.53-6.80 Gy), anterior inferior cerebellar artery was 8.70 Gy (95% CI, 4.54-12.86 Gy), intratemporal facial nerve was 3.76 Gy (95% CI, 3.04-4.08 Gy), trigeminal nerve was 5.21 Gy (95% CI, 3.31-7.11 Gy), and the cochlea was 8.70 Gy (95% CI, 7.81-9.59 Gy). Conclusions SRS for certain vestibular schwannomas can expose the anterior inferior cerebellar artery (AICA) and carotid artery to radiation doses that can potentially initiate atherosclerotic processes. The higher doses to the AICA and carotid artery correlated with increasing tumor volume. The dose delivered to other structures such as the cochlea and intratemporal facial nerve appears to be lower and much less likely to cause immediate complications when shielded. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Quantify the relationships between tinnitus, and anxiety and depression among adults.Study Design: Cross-sectional analysis of a national health survey.Methods: Adult respondents in the 2007 Integrated Health Interview Series tinnitus module were analyzed. Data for tinnitus symptoms and severity and reported anxiety and depression symptoms were extracted. Associations between tinnitus problems and anxiety, depression, lost workdays, days of alcohol consumption, and mean hours of sleep were assessed.Results: Among 21.4 ± 0.69 million adult tinnitus sufferers, 26.1% reported problems with anxiety in the preceding 12 months, whereas only 9.2% of those without tinnitus reported an anxiety problem (P < .001). Similarly, 25.6% of respondents with tinnitus reported problems with depression, whereas only 9.1% of those without tinnitus reported depression symptoms (P < .001). Those reporting tinnitus symptoms as a "big" or "very big" problem were more likely to concurrently report anxiety (odds ratio [OR]: 5.7; 95% CI: 4.0-8.1; P < .001) and depression (OR: 4.8; 95% CI: 3.5-6.7; P < .001) symptoms. Tinnitus sufferers reported significantly fewer mean hours of sleep per night (7.00 vs. 7.21; P < .001) and greater mean days of work missed (6.94 vs. 3.79, P < .001) compared to those who did not report tinnitus. Mean days of alcohol consumption between the two groups were not significantly different.Conclusions: Tinnitus symptoms are closely associated with anxiety, depression, shorter sleep duration, and greater workdays missed. These comorbidities and sequelae should be recognized and addressed to optimally manage patients with chronic and bothersome tinnitus.Level Of Evidence: 4 Laryngoscope, 2016 127:466-469, 2017. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: Permanent facial nerve injury is a difficult challenge for both patients and physicians given its potential for debilitating functional, cosmetic, and psychological sequelae. Although current surgical interventions have provided considerable advancements in facial nerve rehabilitation, they often fail to fully address all impairments. We aim to introduce an alternative approach to facial nerve rehabilitation.Study Design: Acute experiments in animals with normal facial function.Methods: The study included three anesthetized cats. Four facial muscles (levator auris longus, orbicularis oculi, nasalis, and orbicularis oris) were monitored with a standard electromyographic (EMG) facial nerve monitoring system with needle electrodes. The main trunk of the facial nerve was exposed, and a 16-channel penetrating electrode array was placed into the nerve. Electrical current pulses were delivered to each stimulating electrode individually. Elicited EMG voltage outputs were recorded for each muscle.Results: Stimulation through individual channels selectively activated restricted nerve populations, resulting in selective contraction of individual muscles. Increasing stimulation current levels resulted in increasing EMG voltage responses. Typically, selective activation of two or more distinct muscles was successfully achieved via a single placement of the multi-channel electrode array by selection of appropriate stimulation channels.Conclusion: We have established in the animal model the ability of a penetrating electrode array to selectively stimulate restricted fiber populations within the facial nerve and to selectively elicit contractions in specific muscles and regions of the face. These results show promise for the development of a facial nerve implant system.Level Of Evidence: N/A.Laryngoscope, 2016 127:460-465, 2017. [ABSTRACT FROM AUTHOR]

This study explores the use of mobile health applications (mHealth apps) on smartphones or tablets for health-seeking behavior among US adults. Data was obtained from cycle 4 of the 4th edition of the Health Information National Trends Survey (HINTS 4). Weighted multivariate logistic regression models examined predictors of 1) having mHealth apps, 2) usefulness of mHealth apps in achieving health behavior goals, 3) helpfulness in medical care decision-making, and 4) asking a physician new questions or seeking a second opinion. Using the Andersen Model of health services utilization, independent variables of interest were grouped under predisposing factors (age, gender, race, ethnicity, and marital status), enabling factors (education, employment, income, regular provider, health insurance, and rural/urban location of residence), and need factors (general health, confidence in their ability to take care of health, Body Mass Index, smoking status, and number of comorbidities). In a national sample of adults who had smartphones or tablets, 36 % had mHealth apps on their devices. Among those with apps, 60 % reported the usefulness of mHealth apps in achieving health behavior goals, 35 % reported their helpfulness for medical care decision-making, and 38 % reported their usefulness in asking their physicians new questions or seeking a second opinion. The multivariate models revealed that respondents were more likely to have mHealth apps if they had more education, health insurance, were confident in their ability to take good care of themselves, or had comorbidities, and were less likely to have them if they were older, had higher income, or lived in rural areas. In terms of usefulness of mHealth apps, those who were older and had higher income were less likely to report their usefulness in achieving health behavior goals. Those who were older, African American, and had confidence in their ability to take care of their health were more likely to respond that the mHealth apps were helpful in making a medical care decision and asking their physicians new questions or for a second opinion. Potentially, mHealth apps may reduce the burden on primary care, reduce costs, and improve the quality of care. However, several personal-level factors were associated with having mHealth apps and their perceived helpfulness among their users, indicating a multidimensional digital divide in the population of US adults. [ABSTRACT FROM AUTHOR]

Conservation efforts globally are skewed toward terrestrial ecosystems. To date, conservation of aquatic ecosystems, in particular fish fauna, is largely neglected. We provide a country-wide assessment of Indian river ecosystems in order to identify and prioritize areas for protection and restoration of freshwater fish fauna. Using various biodiversity and anthropogenic attributes, coupled with tools of ecological modeling, we delineated areas for fish fauna conservation and restoration in the 20 major river basins of India. To do this, we used prioritization analyses and reserve selection algorithms to derive conservation value index (CVI) and vulnerability index (VI) of the river basins. CVI was estimated using endemicity, rarity, conservation value, and taxonomic singularity, while VI was estimated using a disturbance index derived from percent geographic area of the basin under human settlements, human population density, predominant land use, and total number of exotic fish species in each basin. The two indices, CVI and VI, were converted into geo-referenced maps, and each map was super-imposed onto species richness and forest cover maps, respectively. After superimposition, areas with high CVI and low VI shade intensities were delineated for conservation, while areas with high CVI and high VI shade intensities were demarcated for restoration. In view of the importance of freshwater fish for human livelihoods and consumption, and ecosystems of India's rivers, we call for urgent attention to the conservation of their fish fauna along with restoration of their degraded habitats. [ABSTRACT FROM AUTHOR]

Members of the large Sec7 domain- containing Arf guanine nucleotide exchange factor (GEF) family have been shown to dimerize through their NH2-terminal dimerization and cyclophilin binding (DCB) and homology upstream of Sec7 (HUS) domains. However, the importance of dimerization in GEF localization and function has not been assessed. We generated a GBF1 mutant (91/130) in which two residues required for oligomerization (K91 and E130 within the DCB domain) were replaced with A and assessed the effects of these mutations on GBF1 localization and cellular functions. We show that 91/130 is compromised in oligomerization but that it targets to the Golgi in a manner indistinguishable from wild-type GBF1 and that it rapidly exchanges between the cytosolic and membrane-bound pools. The 91/130 mutant appears active as it integrates within the functional network at the Golgi, supports Arf activation and COPI recruitment, and sustains Golgi homeostasis and cargo secretion when provided as a sole copy of functional GBF1 in cells. In addition, like wild-type GBF1, the 91/130 mutant supports poliovirus RNA replication, a process requiring GBF1 but believed to be independent of GBF1 catalytic activity. However, oligomerization appears to stabilize GBF1 in cells, and the 91/130 mutant is degraded faster than the wild-type GBF1. Our data support a model in which oligomerization is not a key regulator of GBF1 activity but impacts its function by regulating the cellular levels of GBF1. [ABSTRACT FROM AUTHOR]

Golden mahseer, Tor putitora Hamilton, one of the largest freshwater fish of the Indian sub-continent, inhabits mainly Himalayan rivers in the foothills. Among numerous freshwater fishes of the sub-continent, Golden mahseer is the most striking due to its large size, attractive golden colour, sustenance and sporting values. Tor putitora is known by various common names such as king mahseer, mighty mahseer and the tiger of water. Being a migratory fish, Golden mahseer undertakes periodic upstream migration during pre-monsoon and monsoon seasons from large rivers and higher order streams in the foothills to lower order streams for spawning. In recent years, conservationists, anglers and commercial fishermen have expressed concern over the declining populations of Golden mahseer due to indiscriminate fishing of brooders and juveniles besides the adverse effects of dams. Despite its ecological and economic importance, specific conservation measures by way of protective legal provisos are lacking for Golden mahseer in India. In view of its physical features, ecology and vulnerable conservation status, there is an exigent need to promote the Golden mahseer as a flagship conservation species of the Himalayan rivers. In view of the recent reports of unprecedented river regulation projects on the Himalayan rivers and need to draw global attention of conservationists, we review various aspects of ecology, life history, interesting features, traits and threats associated with the reduced chances of survival of Golden mahseer. [ABSTRACT FROM AUTHOR]

Evidence suggests that the current growth in value-based payment models may unintentionally worsen health care disparities by disadvantaging hospitals caring for socially at-risk populations. To address this tension, value-based payment models should adopt a disparities-sensitive frame shift to integrate measures of equity into hospitals' financial calculus, incentivizing hospitals to tackle the disparities challenge without losing sight of quality. [ABSTRACT FROM AUTHOR]

The article deals with FoodBorne Chicago, launched by Chicago Department of Public Health (CDPH) and civic partners on March 23, 2013, tasked to promote food safety improvement in Chicago, Illinois by identifying and responding to complaints on possible foodborne illnesses on online social networking Twitter. Topics discussed include submission of 193 complaints of possible foodborne illness, inspection of 133 restaurants, and Twitter messages tracked through supervised learning algorithm.

Glutamate delta-1 (GluD1) receptors are expressed throughout the forebrain during development with high levels in the hippocampus during adulthood. We have recently shown that deletion of GluD1 receptor results in aberrant emotional and social behaviors such as hyperaggression and depression-like behaviors and social interaction deficits. Additionally, abnormal expression of synaptic proteins was observed in amygdala and prefrontal cortex of GluD1 knockout mice (GluD1 KO). However the role of GluD1 in learning and memory paradigms remains unknown. In the present study we evaluated GluD1 KO in learning and memory tests. In the eight-arm radial maze GluD1 KO mice committed fewer working memory errors compared to wildtype mice but had normal reference memory. Enhanced working memory in GluD1 KO was also evident by greater percent alternation in the spontaneous Y-maze test. No difference was observed in object recognition memory in the GluD1 KO mice. In the Morris water maze test GluD1 KO mice showed no difference in acquisition but had longer latency to find the platform in the reversal learning task. GluD1 KO mice showed a deficit in contextual and cue fear conditioning but had normal latent inhibition. The deficit in contextual fear conditioning was reversed by D-Cycloserine (DCS) treatment. GluD1 KO mice were also found to be more sensitive to foot-shock compared to wildtype. We further studied molecular changes in the hippocampus, where we found lower levels of GluA1, GluA2 and GluK2 subunits while a contrasting higher level of GluN2B in GluD1 KO. Additionally, we found higher postsynaptic density protein 95 (PSD95) and lower glutamate decarboxylase 67 (GAD67) expression in GluD1 KO. We propose that GluD1 is crucial for normal functioning of synapses and absence of GluD1 leads to specific abnormalities in learning and memory. These findings provide novel insights into the role of GluD1 receptors in the central nervous system. [ABSTRACT FROM AUTHOR]

Background: Studying diversity and distribution patterns of species along elevational gradients and understanding drivers behind these patterns is central to macroecology and conservation biology. A number of studies on biogeographic gradients are available for terrestrial ecosystems, but freshwater ecosystems remain largely neglected. In particular, we know very little about the species richness gradients and their drivers in the Himalaya, a global biodiversity hotspot. Methodology/Principal Findings: We collated taxonomic and distribution data of fish species from 16 freshwater Himalayan rivers and carried out empirical studies on environmental drivers and fish diversity and distribution in the Teesta river (Eastern Himalaya). We examined patterns of fish species richness along the Himalayan elevational gradients (50-3800 m) and sought to understand the drivers behind the emerging patterns. We used generalized linear models (GLM) and generalized additive models (GAM) to examine the richness patterns; GLM was used to investigate relationship between fish species richness and various environmental variables. Regression modelling involved stepwise procedures, including elimination of collinear variables, best model selection, based on the least Akaike's information criterion (AIC) and the highest percentage of deviance explained (D²). This maiden study on the Himalayan fishes revealed that total and non- endemic fish species richness monotonously decrease with increasing elevation, while endemics peaked around mid elevations (700-1500 m). The best explanatory model (synthetic model) indicated that water discharge is the best predictor of fish species richness patterns in the Himalayan rivers. Conclusions/Significance: This study, carried out along one of the longest bioclimatic elevation gradients of the world, lends support to Rapoport's elevational rule as opposed to mid domain effect hypothesis. We propose a species-discharge model and contradict species-area model in predicting fish species richness. We suggest that drivers of richness gradients in terrestrial and aquatic ecosystems are likely to be different. These studies are crucial in context of the impacts of unprecedented on-going river regulation on fish diversity and distribution in the Himalaya. [ABSTRACT FROM AUTHOR]

The delta family of ionotropic glutamate receptors consists of glutamate d1 (GluD1) and glutamate d2 (GluD2) receptors. While the role of GluD2 in the regulation of cerebellar physiology is well understood, the function of GluD1 in the central nervous system remains elusive. We demonstrate for the first time that deletion of GluD1 leads to abnormal emotional and social behaviors. We found that GluD1 knockout mice (GluD1 KO) were hyperactive, manifested lower anxiety-like behavior, depression-like behavior in a forced swim test and robust aggression in the resident-intruder test. Chronic lithium rescued the depression-like behavior in GluD1 KO. GluD1 KO mice also manifested deficits in social interaction. In the sociability test, GluD1 KO mice spent more time interacting with an inanimate object compared to a conspecific mouse. D-Cycloserine (DCS) administration was able to rescue social interaction deficits observed in GluD1 KO mice. At a molecular level synaptoneurosome preparations revealed lower GluA1 and GluA2 subunit expression in the prefrontal cortex and higher GluA1, GluK2 and PSD95 expression in the amygdala of GluD1 KO. Moreover, DCS normalized the lower GluA1 expression in prefrontal cortex of GluD1 KO. We propose that deletion of GluD1 leads to aberrant circuitry in prefrontal cortex and amygdala owing to its potential role in presynaptic differentiation and synapse formation. Furthermore, these findings are in agreement with the human genetic studies suggesting a strong association of GRID1 gene with several neuropsychiatric disorders including schizophrenia, bipolar disorder, autism spectrum disorders and major depressive disorder. [ABSTRACT FROM AUTHOR]

Measles is an acute viral respiratory illness caused by a virus of the Paramyxoviridae family. Despite being eliminated from the United States, small outbreaks across the country continue to occur. The United States experienced a record number of cases in 2014, with 668 cases seen across the country, a record since its elimination in 2000. Here, we present a case of an acute presentation of measles illness and discuss the otolaryngologic manifestation of the disease. Laryngoscope, 126:1481-1483, 2016 [ABSTRACT FROM AUTHOR]

The Academic Database Assessment Tool (ADAT) from the Joint Information Systems Committee (JISC) enables users to compile and compare journal title lists from many different suppliers. The makers claim that this tool can help identify overlap of coverage among comparable databases and platforms. This article provides an overview of the tool's major features, including limitations, and how it can be used in academic libraries to make informed collection development and management decisions regarding electronic databases. [ABSTRACT FROM AUTHOR]

Non-adherence to medical therapy is emerging as an important determinant of relapse in patients with inflammatory bowel disease (IBD). To find the prevalence of and reasons for nonadherence to medical therapy in Indian patients with IBD and its correlation with disease outcome. In this cross-sectional study, we checked for adherence to treatment in 127 patients with IBD (117 ulcerative colitis and 10 Crohn’s disease) using a questionnaire that inquired into frequency of missed doses, causes for missed doses, and its relation to relapse of disease. Of the 127 patients (mean age 42.8 years; 68 women), 103 (81%) were non-adherent to treatment, defined as taking 80% or less of the dose advised. The reasons for non-adherence (not mutually exclusive) were: forgetfulness-98 patients (77%), felt better-18 (14.2 %), high frequency of doses-13 (10.1%), no effect of medications-10 (7.87%), non-availability of medications-3 (2.3%). Non-adherent patients were three times more likely to develop a relapse as compared to those with adherence (OR 3.389, 95% CI 1.29-8.88, p=0.012). Over 80% of patients with IBD in this survey were non-adherent to medical treatment; forgetfulness was mentioned as the most common cause. Non-adherent patients were more likely to relapse. Patients need to be educated regarding the need for adherence to treatment in IBD. [ABSTRACT FROM AUTHOR]