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Oluoch-Aridi J, Chelagat T, Nyikuri MM, Onyango J, Guzman D, Makanga C, Miller-Graff L, Dowd R. COVID-19 Effect on Access to Maternal Health Services in Kenya. Front Glob Womens Health 2021; 1:599267. [PMID: 34816169 PMCID: PMC8593959 DOI: 10.3389/fgwh.2020.599267] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/02/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Maternal mortality continues to be one of the biggest challenges of the health system in Kenya. Informal settlements in Kenya have been known to have higher rates of maternal mortality and also receive maternity services of varied quality. Data assessing progress on key maternal health indicators within informal settlements are also often scarce. The COVID-19 pandemic hit Kenya in March this year and so far, the impact of the pandemic on access to maternal health has not been established. This study aims to add to the body of knowledge by investigating the effects of the COVID-19 pandemic and mitigation strategies on access to health care services in informal settlements. Methods: Qualitative methods using in-depth interviews were used to assess women's experiences of maternity care during the COVID-19 era and the impact of proposed mitigation strategies such as the lockdown and the curfew. Other aspects of the maternity experience such as women's knowledge of COVID-19, their perceived risk of infection, access to health facilities, perceived quality of care were assessed. Challenges that women facing as a result of the lockdown and curfew with respect to maternal health access and quality were also assessed. Results: Our findings illustrate that there was a high awareness of the symptoms and preventative measures for COVID-19 amongst women in informal settlements. Our findings also show that women's perception of risk to themselves was high, whereas risk to family and friends, and in their neighborhood was perceived as low. Less than half of women reported reduced access due to fear of contracting Coronavirus, Deprioritization of health services, economic constraints, and psychosocial effects were reported due to the imposed lockdown and curfew. Most respondents perceived improvements in quality of care due to short-waiting times, hygiene measures, and responsive health personnel. However, this was only reported for the outpatient services and not in-patient services. Conclusion: The most important recommendation was for the Government to provide food followed by financial support and other basic amenities. This has implications for the Government's mitigation measures that are focused on public health measures and lack social safety-net approaches for the most vulnerable communities.
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Affiliation(s)
- Jackline Oluoch-Aridi
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States.,Strathmore Business School, Institute of Healthcare Management, Strathmore University, Nairobi, Kenya
| | - Tecla Chelagat
- Strathmore Business School, Institute of Healthcare Management, Strathmore University, Nairobi, Kenya
| | - Mary M Nyikuri
- Strathmore Business School, Institute of Healthcare Management, Strathmore University, Nairobi, Kenya
| | - Joseph Onyango
- Strathmore Business School, Institute of Healthcare Management, Strathmore University, Nairobi, Kenya
| | - Danice Guzman
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Cindy Makanga
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Laura Miller-Graff
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States.,Department of Psychology, The Kroc Institute of Peace Studies, University of Notre Dame, Notre Dame, IN, United States
| | - Robert Dowd
- The Ford Family Program in Human Development Studies and Solidarity, Kellogg Institute for International Studies, University of Notre Dame, Notre Dame, IN, United States
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Jinadu T, Dowd R, Bradley L, Painter E, Hughes S, Ahmad S, Khan N, Khanra D, Arya A, Selvakumar V, Spencer C, Petkar S. Observations during the COVID-19 pandemic in chronic heart failure patients with complex devices in a tertiary care cardiac centre using the HeartLogic software. Europace 2021. [PMCID: PMC8194883 DOI: 10.1093/europace/euab116.474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Funding Acknowledgements Type of funding sources: None. Introduction Decompensation of heart failure leading (HF) to hospitalisation is the single most important drain on healthcare resources when managing patients with left ventricular systolic dysfunction. Cardiac resynchronisation therapy with/without defibrillators (CRT-P/D) decreases hospitalisation due to HF and improves survival while implantable cardiac defibrillators (ICD"s) have a favourable effect on the former. Proprietary software algorithms embedded in these complex devices give an early warning to clinicians when decompensation of HF is imminent allowing preventative action to be undertaken. HeartLogic (HL) is one such new algorithm in Boston Scientific CRT-D/ICD devices using multiple sensors to track 5 physiological parameters, combining them into one composite Index, with an Alert being triggered if the Index is >16. The COVID-19 pandemic, due to multiple reasons, resulted in a significant decrease in availability of routine HF services in the United Kingdom, especially during the initial lockdown period from 23rd March to 1st July 2020. Aim To assess the impact of the COVID-19 pandemic, using HL, in patients with HF and complex devices. Materials and Methods Retrospective analysis of patients in a tertiary care cardiac centre in whom the HL software had been activated in March/April 2019 (n = 49) and comparison of those with (Group A n = 21) and without (Group B n = 28) an Alert (HLA) during the COVID-19 pandemic. Results (Table): Whole cohort n = 49. Age: 72 ± 12 years, Median: 75, Range: 36-95. 36/49 (73.5%) males. Type of device implanted: Resonate X4 CRT-D: 28/49 (57.1%); Momentum CRT-D: 8/49 (16.3%); Resonate ICD: 13/49 (26.5%). Ischaemic aetiology of HF: 35/49 (71.4%), Total duration of HL monitoring: 632 ± 7 days (median: 632; range: 626-672). There was no difference in the age, gender, and type of device implanted between Group A and Group B. Over nearly ∼1 year of monitoring in each of the groups, Group A had more unstable HF with 10/21 (47.6%) having their first HLA during the pandemic. Multiple HLA"s, longer period in HLA and those with ischaemic aetiology of HF were higher in Group A. 17/40 (42.5%) HLA"s in Group A were within the first lockdown period (March - July). 24/28 (85.7%) patients in Group B had no HLA"s either before or during the pandemic. There was no difference in the HLA score between Groups A and B. Conclusion In this limited group of patients with a medium term follow-up, using the HeartLogic software, patients with ischaemic aetiology of HF and those with more HLA"s prior to the pandemic did worse than those who no HLA"s. First HLA"s, multiple alerts and longer duration of alerts in this group of patients suggests a lack of access to adequate HF services during the pandemic. It has implications with regard to how HF services are configured in future whenever resources are constrained.
Abstract Figure. ![]()
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Affiliation(s)
- T Jinadu
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - R Dowd
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - L Bradley
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - E Painter
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - S Hughes
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - S Ahmad
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - N Khan
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - D Khanra
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - A Arya
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - V Selvakumar
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - C Spencer
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
| | - S Petkar
- New Cross Hospital, Wolverhampton, United Kingdom of Great Britain & Northern Ireland
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Welsh J, Dowd R, Price DA. Should Target Glucose Values Be Increased to Avoid Severe Hypoglycemia? Real-World Data Say “No.”. J Endocr Soc 2021. [PMCID: PMC8090436 DOI: 10.1210/jendso/bvab048.943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Early studies such as the Diabetes Control and Complications Trial showed a strong inverse relationship between A1C and the risk of severe hypoglycemia in type 1 diabetes. This risk has historically limited insulin therapy intensification efforts, and some treatment guidelines (e.g., Rosenzweig et al., J Clin Endocrinol Metab 105:969, 2020) suggest that A1C values <7% confer an increased risk of hypoglycemia. Nowadays, real-time continuous glucose monitoring (CGM) systems can flatten and attenuate the relationship between overall glucose control and hypoglycemia (Oliver et al., Diabetes Care 43:53, 2020). The glucose management indicator (GMI) is an estimate of A1C derived from the CGM system’s mean estimated glucose value (EGV) (Bergenstal et al., Diabetes Care 41:2275, 2018). We analyzed real-world evidence of the relationship between the GMI and exposure to hypoglycemia. Data were from an anonymized convenience sample of US-based users of the G6 CGM system (Dexcom, Inc., San Diego, CA) who used a mobile device to upload EGVs in the third quarter of 2020. Only data from people who had uploaded ≥80% of possible values were included. Each person’s GMI was calculated as GMI = 3.31 + (0.02392 × mean EGV [mg/dL]). Each person’s exposure to hypoglycemia was estimated as the percentage of EGVs <70 mg/dL or <54 mg/dL (%<70 and %<54, respectively). Patients were grouped into 6 categories according to GMI values <6.5%, 6.5 to 6.9%, 7.0 to 7.4%, 7.5 to 7.9%, 8.0 to 8.4%, and ≥8.5%. Mean %<70 mg/dL and %<54 mg/dL were both inversely correlated with GMI, decreasing monotonically as the GMI category increased. GMI category, %<70, and %<54 are as follows: (<6.5%: 5.27%, 1.13%); (6.5 to 6.9%: 2.84%, 0.59%); (7.0 to 7.4%: 1.95%, 0.41%); (7.5 to 7.9%: 1.46%, 0.31%); (8.0 to 8.4%: 1.14%, 0.25%); (≥8.5%: 0.69%, 0.17%). However, in all GMI categories except for the “<6.5%” category, the extent of hypoglycemic exposure was below the consensus targets proposed by Battelino et al. (Diabetes Care 42:1593, 2019) of <4% for EGVs <70 mg/dL and <1% for EGVs <54 mg/dL. The approach of elevating A1C targets to reduce hypoglycemia risk is not supported by real-world evidence for CGM users who have GMI or A1C values ≥6.5%. CGM users can safely strive for A1C values <7.0%.
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Abstract
Background: Optional features of continuous glucose monitoring (CGM) systems empower patients and caregivers to understand and manage diabetes in new ways. We examined associations between use of optional features, demographics, and glycemic outcomes. Methods: Retrospective cohort studies were performed with data from US-based users of the G6 CGM System (Dexcom, Inc.). For all cohorts, data included sensor glucose values (SGVs). In separate cohorts, use of alert features (for hyperglycemia, existing hypoglycemia, and impending hypoglycemia), remote data sharing feature (Share), software for retrospective pattern analysis (CLARITY), "virtual assistant" feature that announces the current SGV and trend in response to a spoken request were assessed. Descriptive statistics were used to summarize feature set utilization patterns and relate them to glycemic outcomes. Results: Most individual features were consistently adopted by high proportions of G6 users. Threshold SGVs chosen for activating hyperglycemia and hypoglycemia alerts varied with age and were higher among the youngest and oldest patients. Use of the Share feature was more common among young patients and those with type 1 diabetes. Individuals who used more of the alert and notification features had more favorable glycemic outcomes, including time in range (TIR), than those who used fewer. More extensive engagement with CLARITY notifications was associated with higher TIR. Frequent use of the virtual assistant feature was associated with higher TIR and lower mean SGV. Conclusions: Optional features of the G6 CGM system are acceptable to and appear to benefit patients who use them. Different levels of engagement suggest that demographics and personal circumstances play a role in how patients and caregivers use CGM features to help manage diabetes.
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Affiliation(s)
- Halis Kaan Akturk
- Barbara Davis Center for Diabetes, University of Colorado, Aurora, Colorado, USA
- Address correspondence to: H. Kaan Akturk, MD, Barbara Davis Center for Diabetes, University of Colorado, 1775 Aurora Ct, Aurora, CO 80045, USA
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Oluoch-Aridi J, Smith-Oka V, Milan E, Dowd R. Exploring mistreatment of women during childbirth in a peri-urban setting in Kenya: experiences and perceptions of women and healthcare providers. Reprod Health 2018; 15:209. [PMID: 30558618 PMCID: PMC6296108 DOI: 10.1186/s12978-018-0643-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 11/23/2018] [Indexed: 11/23/2022] Open
Abstract
Background In Kenya, indirectly caused maternal deaths form a significant portion of all maternal deaths within the health system. Many of these deaths are avoidable and occur during delivery and labor. Poor quality health service has been a recurring concern among women in Kenya, with women reporting interactions with healthcare workers that are often demeaning and abusive. This paper explores the experiences and perceptions of both female patients and healthcare workers regarding mistreatment during childbirth. This study aims to provide recommendations on how dignified care can be made the norm, specifically focusing on a peri-urban setting in Kenya. Methods The research was accomplished using qualitative research methods with focus group discussions and in depth interviews with women and healthcare workers. The aim was to gain a deeper understanding of the manifestations of mistreatment within the context of a peri-urban setting in Kenya. Results Female patients reported different forms of mistreatment, such as verbal abuse, physical abuse, neglect, discrimination, abandonment, poor rapport and failure of the health system to uphold professional standards. The healthcare workers described a health system that was weak and fragmented with poor policy support particularly for the new free maternity services policy leading to the mistreatment of women. Conclusion Newly formed County Governments need to provide resources for a functioning health system to ensure an enabling environment for the provision of high quality maternal health services. This process can include feedback loops with maternity clients to ensure woman-centered services. Policy makers need to strengthen oversight for the implementation of the free maternity services Community health volunteers can be trained to provide this information. Professional associations that govern the standards of quality care for healthcare workers need to address the mistreatment through retraining and norms transformation. Electronic supplementary material The online version of this article (10.1186/s12978-018-0643-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jackline Oluoch-Aridi
- Regional Research Programs Manager, The Ford Program in Human Development Studies and Solidarity, University of Notre Dame, Regional Office, East Africa, P.O. Box 49675-00100, Nairobi, Kenya.
| | - Vania Smith-Oka
- Department of Anthropology, University of Notre Dame, 248 Corbett Family Hall, Notre Dame, IN, 46556, USA
| | - Ellyn Milan
- Eck Institute for Global Health, University of Notre Dame, 120 Brownson Hall, Notre Dame, IN, 46556, USA
| | - Robert Dowd
- The Ford Program in Human Development Studies and Solidarity, Kellogg Institute of International Affairs, University of Notre Dame, 2167 Nanovic-Jenkins Hall, Notre Dame, IN, 46556, USA
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Dowd R, Barbot A, Huxlin K, Tadin D, Yoon G. Binocular function is altered by long-term exposure to interocular optical disparities in normally developed visual systems. J Vis 2017. [DOI: 10.1167/17.7.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
Personal information and personality profiles, using the Cattell 16 PF, were collected from 93 sportsmen and sportswomen. Players involved in team (volleyball) and in individual (squash) sports were represented. Athletes were at a high level of competition (those selected for training at State level) and an average level. Discriminant analysis indicated significant differences in personality characteristics between squash and volleyball players and between high- and average-level competitors. Differences on a larger number of personality dimensions as a function of type of sport were also noted when analyses were carried out on the State (high) level competitors only.
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Wootton KP, Boland MJ, Dowd R, Tan YRE, Cowie BCC, Papaphilippou Y, Taylor GN, Rassool RP. Observation of picometer vertical emittance with a vertical undulator. Phys Rev Lett 2012; 109:194801. [PMID: 23215388 DOI: 10.1103/physrevlett.109.194801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Indexed: 06/01/2023]
Abstract
Using a vertical undulator, picometer vertical electron beam emittances have been observed at the Australian Synchrotron storage ring. An APPLE-II type undulator was phased to produce a horizontal magnetic field, which creates a synchrotron radiation field that is very sensitive to the vertical electron beam emittance. The measured ratios of undulator spectral peak heights are evaluated by fitting to simulations of the apparatus. With this apparatus immediately available at most existing electron and positron storage rings, we find this to be an appropriate and novel vertical emittance diagnostic.
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Affiliation(s)
- K P Wootton
- School of Physics, The University of Melbourne, Melbourne VIC 3010, Australia.
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Chao Y, Chang P, Abe K, Abe K, Abe N, Adachi I, Aihara H, Akai K, Akatsu M, Akemoto M, Asano Y, Aso T, Aulchenko V, Aushev T, Aziz T, Bahinipati S, Bakich AM, Ban Y, Barbero M, Bay A, Bedny I, Bitenc U, Bizjak I, Blyth S, Bondar A, Bozek A, Bracko M, Brodzicka J, Browder TE, Chang MC, Chen A, Chen KF, Chen WT, Cheon BG, Chistov R, Choi SK, Choi Y, Choi YK, Chuvikov A, Cole S, Danilov M, Dash M, Dong LY, Dowd R, Dragic J, Drutskoy A, Eidelman S, Eiges V, Enari Y, Epifanov D, Everton CW, Fang F, Flanagan J, Fratina S, Fujii H, Funakoshi Y, Furukawa K, Gabyshev N, Garmash A, Gershon T, Go A, Gokhroo G, Golob B, Grosse Perdekamp M, Guler H, Guo R, Haba J, Hagner C, Handa F, Hara K, Hara T, Hastings NC, Hasuko K, Hayasaka K, Hayashii H, Hazumi M, Heenan EM, Higuchi I, Higuchi T, Hinz L, Hojo T, Hokuue T, Hoshi Y, Hoshina K, Hou S, Hou WS, Hsiung YB, Huang HC, Igaki T, Igarashi Y, Iijima T, Ikeda H, Imoto A, Inami K, Ishikawa A, Ishino H, Itoh K, Itoh R, Iwamoto M, Iwasaki M, Iwasaki Y, Kagan R, Kakuno H, Kamitani T, Kang JH, Kang JS, Kapusta P, Kataoka SU, Katayama N, Kawai H, Kawai H, Kawakami Y, Kawamura N, Kawasaki T, Kent N, Khan HR, Kibayashi A, Kichimi H, Kikuchi M, Kikutani E, Kim HJ, Kim HO, Kim H, Kim JH, Kim SK, Kim TH, Kinoshita K, Kobayashi S, Koiso H, Koppenburg P, Korpar S, Krizan P, Krokovny P, Kubo T, Kulasiri R, Kumar S, Kuo CC, Kurashiro H, Kurihara E, Kusaka A, Kuzmin A, Kwon YJ, Lange JS, Leder G, Lee SE, Lee SH, Lee YJ, Lesiak T, Li J, Limosani A, Lin SW, Liventsev D, MacNaughton J, Majumder G, Mandl F, Marlow D, Masuzawa M, Matsuishi T, Matsumoto H, Matsumoto S, Matsumoto T, Matyja A, Michizono S, Mikami Y, Mimashi T, Mitaroff W, Miyabayashi K, Miyabayashi Y, Miyake H, Miyata H, Mizuk R, Mohapatra D, Moloney GR, Moorhead GF, Mori T, Mueller J, Murakami A, Nagamine T, Nagasaka Y, Nakadaira T, Nakamura I, Nakamura TT, Nakano E, Nakao M, Nakayama H, Nakazawa H, Natkaniec Z, Neichi K, Nishida S, Nitoh O, Noguchi S, Nozaki T, Ogawa A, Ogawa S, Ogawa Y, Ohmi K, Ohnishi Y, Ohshima T, Ohuchi N, Oide K, Okabe T, Okuno S, Olsen SL, Onuki Y, Ostrowicz W, Ozaki H, Pakhlov P, Palka H, Park CW, Park H, Park KS, Parslow N, Peak LS, Pernicka M, Perroud JP, Peters M, Piilonen LE, Poluektov A, Ronga FJ, Root N, Rozanska M, Sagawa H, Saigo M, Saitoh S, Sakai Y, Sakamoto H, Sakaue H, Sarangi TR, Satapathy M, Sato N, Schietinger T, Schneider O, Schümann J, Schwanda C, Schwartz AJ, Seki T, Semenov S, Senyo K, Settai Y, Seuster R, Sevior ME, Shibata T, Shibuya H, Shidara T, Shwartz B, Sidorov V, Siegle V, Singh JB, Somov A, Soni N, Stamen R, Stanic S, Staric M, Sugahara R, Sugi A, Sugimura T, Sugiyama A, Sumisawa K, Sumiyoshi T, Suzuki S, Suzuki SY, Swain SK, Tajima O, Takasaki F, Tamai K, Tamura N, Tanabe K, Tanaka M, Tawada M, Taylor GN, Teramoto Y, Tian XC, Tokuda S, Tovey SN, Trabelsi K, Tsuboyama T, Tsukamoto T, Uchida K, Uehara S, Uglov T, Ueno K, Unno Y, Uno S, Ushiroda Y, Varner G, Varvell KE, Villa S, Wang CC, Wang CH, Wang JG, Wang MZ, Watanabe M, Watanabe Y, Widhalm L, Xie QL, Yabsley BD, Yamaguchi A, Yamamoto H, Yamamoto N, Yamamoto S, Yamanaka T, Yamashita Y, Yamauchi M, Yang H, Yeh P, Ying J, Yoshida K, Yoshida M, Yuan Y, Yusa Y, Yuta H, Zang SL, Zhang CC, Zhang J, Zhang LM, Zhang ZP, Zheng Y, Zhilich V, Ziegler T, Zontar D, Zürcher D. Evidence for direct CP violation in B0-->K+pi- decays. Phys Rev Lett 2004; 93:191802. [PMID: 15600826 DOI: 10.1103/physrevlett.93.191802] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2004] [Indexed: 05/24/2023]
Abstract
We report evidence for direct CP violation in the decay B0-->K+pi(-) with 253 fb(-1) of data collected with the Belle detector at the KEKB e(+)e(-) collider. Using 275x10(6) BB pairs we observe a B-->K+/-pi(-/+) signal with 2140+/-53 events. The measured CP violating asymmetry is A(CP)(K+pi(-))=-0.101+/-0.025(stat)+/-0.005(syst), corresponding to a significance of 3.9sigma including systematics. We also search for CP violation in the decays B+-->K+pi(0) and B+-->pi(+)pi(0). The measured CP violating asymmetries are A(CP)(K+pi(0))=0.04+/-0.05(stat)+/-0.02(syst) and A(CP)(pi(+)pi(0))=-0.02+/-0.10(stat)+/-0.01(syst), corresponding to the intervals -0.05<A(CP)(K+pi(0))<0.13 and -0.18<A(CP)(pi(+)pi(0))<0.14 at 90% confidence level.
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Affiliation(s)
- Y Chao
- Department of Physics, National Taiwan University, Taipei
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Dragic J, Gershon T, Abe K, Abe K, Abe T, Aihara H, Asano Y, Aulchenko V, Aushev T, Aziz T, Bakich AM, Banas E, Bay A, Bedny I, Bitenc U, Bizjak I, Blyth S, Bondar A, Bozek A, Bracko M, Browder TE, Chang P, Chao Y, Cheon BG, Chistov R, Choi SK, Choi Y, Chuvikov A, Cole S, Dong LY, Dowd R, Eidelman S, Eiges V, Enari Y, Epifanov D, Fratina S, Gabyshev N, Gokhroo G, Golob B, Gordon A, Haba J, Hastings NC, Hayashii H, Hazumi M, Higuchi T, Hinz L, Hokuue T, Hoshi Y, Hou WS, Hsiung YB, Iijima T, Inami K, Ishikawa A, Itoh R, Iwasaki H, Iwasaki M, Kang JH, Kang JS, Kawai H, Kawasaki T, Khan HR, Kichimi H, Kim HJ, Kim JH, Kim SK, Koppenburg P, Korpar S, Krokovny P, Kulasiri R, Kumar S, Kuzmin A, Kwon YJ, Lee SE, Lee SH, Lesiak T, Li J, Limosani A, Lin SW, MacNaughton J, Majumder G, Mandl F, Matsumoto T, Matyja A, Mitaroff W, Miyake H, Miyata H, Mohapatra D, Moloney GR, Nagamine T, Nagasaka Y, Nakadaira T, Nakano E, Nakao M, Nakazawa H, Natkaniec Z, Nishida S, Nitoh O, Nozaki T, Ogawa S, Ohshima T, Okabe T, Okuno S, Olsen SL, Ostrowicz W, Ozaki H, Park CW, Park H, Parslow N, Peak LS, Piilonen LE, Poluektov A, Ronga FJ, Rozanska M, Sagawa H, Sakai Y, Sarangi TR, Schneider O, Schümann J, Schwartz AJ, Semenov S, Senyo K, Sevior ME, Shibuya H, Shwartz B, Sidorov V, Singh JB, Somov A, Soni N, Stamen R, Stanic S, Staric M, Sumisawa K, Tajima O, Tamai K, Tamura N, Tanaka M, Taylor GN, Teramoto Y, Tomura T, Tsuboyama T, Tsukamoto T, Uehara S, Uglov T, Ueno K, Unno Y, Uno S, Varner G, Varvell KE, Villa S, Wang CC, Wang CH, Wang MZ, Watanabe M, Watanabe Y, Yabsley BD, Yamada Y, Yamaguchi A, Yamamoto H, Yamashita Y, Yamauchi M, Yang H, Ying J, Zhang J, Zhang ZP, Zhilich V, Zontar D. Evidence for B0-->rho0pi0. Phys Rev Lett 2004; 93:131802. [PMID: 15524704 DOI: 10.1103/physrevlett.93.131802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2004] [Indexed: 05/24/2023]
Abstract
We present the first evidence of the decay B0-->rho(0)pi(0), using 140 fb(-1) of data collected at the Upsilon(4S) resonance with the Belle detector at the KEKB asymmetric e(+)e(-) collider. We detect 15.1+/-4.8 signal events with a significance of 3.5 standard deviations and measure the branching fraction to be B(B0-->rho(0)pi(0))=(5.1+/-1.6(stat)+/-0.9(syst))x10(-6).
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Affiliation(s)
- J Dragic
- University of Melbourne, Victoria
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11
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Dowd R. Role of calcium, vitamin D, and other essential nutrients in the prevention and treatment of osteoporosis. Nurs Clin North Am 2001; 36:417-31, viii. [PMID: 11532657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Calcium is an essential nutrient for the prevention and treatment of osteoporosis. Despite universal recognition of its importance, most people still do not obtain recommended amounts. Recent additions to the treatment of osteoporosis with potent bone active drugs produce an even greater need for calcium and total nutrition for restoration of lost bone. Practitioners and patients need to emphasize and appreciate the role that calcium, vitamin D, and other nutrients play in the promotion of health and in the prevention and treatment of disease.
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Affiliation(s)
- R Dowd
- Department of Medicine, Creighton University Osteoporosis Research Center, Omaha, Nebraska 68131, USA.
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Deng HW, Li J, Li JL, Dowd R, Davies KM, Johnson M, Gong G, Deng H, Recker RR. Association of estrogen receptor-alpha genotypes with body mass index in normal healthy postmenopausal Caucasian women. J Clin Endocrinol Metab 2000; 85:2748-51. [PMID: 10946876 DOI: 10.1210/jcem.85.8.6728] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Several lines of evidence suggest the importance of the estrogen receptor (ER) in determining body mass index (BMI). Our purpose was to investigate whether genetic polymorphisms at the restriction enzyme PvuII site of the ER-alpha gene locus are associated with BMI variation. Data on BMI, age, and ER-alpha genotypes were obtained from 108 healthy midwestern U.S. postmenopausal Caucasian women. The study subjects were unrelated and aged 65 yr and over (mean age +/- SD, 73.4 +/- 5.1 yr), with an average BMI of 25.25 (SD, 4.04). The ER-alpha genotypes were obtained by PCR followed by restriction enzyme PvuII digestion. We found that in our study subjects the ER-alpha genotypes are significantly associated with BMI (by ANOVA, P = 0.04), explaining about 6.2% of the BMI variation in our study sample. The allelic effects of this locus on BMI are approximately additive. In our sample, individuals of the PP and Pp genotypes have, respectively, 11.4% and 4.8% higher BMI than individuals of the pp genotype. There is a significant ER-alpha genotype by age interaction, so that in our sample PP individuals tend to gain weight with age, whereas Pp and pp individuals tend to lose weight with age. Therefore, the ER-alpha polymorphisms are associated with BMI variation in healthy postmenopausal Caucasian women aged 65 yr and over. Our result is consistent with some recent findings suggesting the potential effects of the ER on BMI. The importance of the ER-alpha genotypes in other populations and other age groups needs to be demonstrated. Although the results of the ER-alpha genotype by age interaction are obtained here from cross-sectional data, direct confirmation may come from longitudinal studies in which individuals are measured multiple times over several years. The importance of the ER-alpha genotypes on BMI should be confirmed by further studies using methods robust to the potential problem of population substructuring that may confound the conclusions of population association studies.
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Affiliation(s)
- H W Deng
- Osteoporosis Research Center and Department of Biomedical Sciences, Creighton University, Omaha, Nebraska 68131, USA.
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Abstract
Clinical trials of treatment agents impose strict and often necessary inclusion and exclusion criteria, while patients presenting to physicians for treatment frequently exhibit complicating features that would have excluded them from entry into study. To quantify the degree of discordance between ordinary patients and study subjects, a retrospective chart review was carried out of all new patients with osteoporosis seen in an academic medical center within a consecutive 40-month period, meeting clinical treatment criteria. Each patient chart was reviewed for the inclusion and exclusion criteria of four large, multicenter study protocols. There were 120 consecutive female patients seeking health care, with bone density T-scores below -2.0 and/or with one or more low-trauma fractures. The four trials would have accepted 4, 5, 25 and 8 of our 120 patients. The trial with the most liberal inclusion criteria would have taken only 21% of the total. Principal reasons for ineligibility were comorbidity, prior treatment with bone-active agents, and current therapy with glucocorticoids, anticoagulants and anticonvulsants. Some of these exclusions inevitably reflect the patient mix of a referral center; nevertheless, comorbidity and its therapy are common in the age range in which osteoporosis is prevalent and would, therefore, be expected to be present in patients in general medical practice as well. Thus a large fraction, perhaps the majority, of patients with diagnoses of osteoporosis who are candidates for treatment by their physicians, are not eligible for entry into typical treatment trials. The results of such trials may, therefore, have uncertain applicability to types of patients excluded, both for safety and for efficacy.
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Affiliation(s)
- R Dowd
- Creighton University, Osteoporosis Research Center, Omaha, Nebraska 68131, USA
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Dowd R, Cavalieri RJ. Help your patient live with osteoporosis. Am J Nurs 1999; 99:55, 57-60. [PMID: 10234326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Affiliation(s)
- R Dowd
- Creighton University Osteoporosis Research Center, Omaha, NE, USA
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Recker RR, Dowd R, Gale JR, Packard P. Patient care of osteoporosis. Clin Geriatr Med 1995; 11:625-40. [PMID: 8556691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Osteoporosis is a condition of excessive skeletal fragility that afflicts more than 25 million Americans and results in over one half million fractures per year in the United States. Evaluation of patients presenting with symptoms of osteoporosis includes measurement of serum 25 hydroxy, vitamin D, thyroxine, thyroid-stimulating hormone, serum protein electrophoresis, in addition to blood count, urinalysis, and multichannel screen. Spine and other films are indicated as necessary, and although bone density measurements are useful, they are somewhat restricted in availability. There are lifestyle measures that influence the cause as well as the treatment of osteoporosis. Symptomatic patients benefit most by interventions that include nutrition, physical fitness, calcium, and vitamin D.
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Affiliation(s)
- R R Recker
- Osteoporosis Research Center, Creighton University, Omaha, Nebraska, USA
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Abstract
High- and low-trait anxious subjects participated in a divided visual field emotional Stroop task. Subjects identified the colour of unilaterally presented threat-related, positive and neutral words. The high- and low-trait groups differed in terms of their accuracy scores but not in their reaction times. Analysis of the accuracy data revealed that the high-trait group exhibited right hemisphere interference for emotional relative to neutral trials whereas the low-trait showed right hemisphere interference for threat-related trials only. The idea that the right hemisphere is differentially specialised for the processing of emotional information was supported.
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Affiliation(s)
- A Richards
- Birkbeck College, University of London, U.K
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Tumosa CS, Dowd R. An unusual variant of blood group A. J Forensic Sci 1988; 33:1503-5. [PMID: 3204353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A blood specimen from a forensic science case appeared to violate Landsteiner's Rule. The red cells failed to react with anti-A, anti-B, or O serum while reacting strongly with Ulex europaeus lectin but not other anti-A lectins. The saliva from the person involved was found to contain both A and H blood group substances in a ratio of 4:1. The blood group was determined to be type Am.
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Affiliation(s)
- C S Tumosa
- Criminalistics Laboratory, Philadelphia Police Department, PA
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Dowd R. Regulatory focus: sludge disposal studies. Environ Sci Technol 1987; 21:746. [PMID: 19995055 DOI: 10.1021/es00162a601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Dowd R. Regulatory focus: pollution in the home. Environ Sci Technol 1987; 21:535. [PMID: 19994970 DOI: 10.1021/es00160a602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Dowd R, Tumosa CS. Erythrocyte diaphorases DIA1 and DIA2 in bloodstains. Z Rechtsmed 1983; 91:123-7. [PMID: 6689390 DOI: 10.1007/bf02098777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The ability to determine the phenotypes of erythrocyte NADH diaphorase (DIA1) was demonstrated in bloodstains, the utility of the system extending about two weeks. Electrophoretic variants representing three uncommon phenotypes (DIA1 2-1, DIA1 4-1 and DIA1 7-1) were found in five of 785 individuals tested. The NADPH diaphorase DIA2 isozymes could not be resolved sufficiently for practical use.
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