Letteratura scientifica selezionata sul tema "Squad 41 (New York, N.Y.)"

SUMMARYInvasive meningococcal disease (IMD) completeness of reporting has never been assessed in New York City (NYC). We conducted a capture–recapture study to assess completeness of reporting, comparing IMD reports made to the NYC Department of Health and Mental Hygiene (DOHMH) and records identified in the New York State hospital discharge database [Statewide Planning and Research Cooperative System (SPARCS)] by ICD-9 codes from 1989 to 2010. Reporting completeness estimates were calculated for the entire study period, and stratified by year, age group, clinical syndrome, and reporting system. A chart review of hospital medical records from 2008 to 2010 was conducted to validate hospital coding and to adjust completeness estimates. Overall, 2194 unique patients were identified from DOHMH (n= 1300) and SPARCS (n= 1525); 631 (29%) were present in both. Completeness of IMD reporting was 41% [95% confidence interval (CI) 40–43]. Differences in completeness were found by age, clinical syndrome, and reporting system. The chart review found 33% of hospital records from 2008 to 2010 had no documentation of IMD. Removal of those records improved completeness of reporting to 51% (95% CI 49–53). Our data showed a low concordance between what is reported to DOHMH and what is coded by hospitals as IMD. Additional guidance to clinicians on IMD reporting criteria may improve completeness of IMD reporting.

A self-administered anonymous waiting room survey was used to evaluate men’s preferences on testing, notification, and treatment for sexually transmitted infections (STIs) in a community clinic in Upper Manhattan in 2007. Sixty-seven percent of eligible men ( n = 199) participated. Most were willing to collect a urine sample at home (71%, n = 140) or at the clinic (87%, n = 171). Respondents preferred learning of a positive STI test result by phone (67%, n = 123). However, men were willing to receive results by text (65%, n = 127) or e-mail (61%, n = 121). Most (83%, n = 162) reported they would be (very) likely to take STI medication brought to them by a partner. Twenty-one percent reported previous gonorrhea or Chlamydia infection ( n = 41). Of these, 39% ( n = 16) had received medication to bring their partner, and almost all ( n = 14/16) reported their partner took the medicine. Multiple options for STI testing, notification, and treatment are recommended to maximize service use among men, including providing patient-delivered partner therapy.

SUMMARYPrisons/jails are thought to amplify the transmission ofStaphylococcus aureus(SA) particularly methicillin-resistant SA infection and colonisation. Two independently pooled cross-sectional samples of detainees being admitted or discharged from two New York State maximum-security prisons were used to explore this concept. Private interviews of participants were conducted, during which the anterior nares and oropharynx were sampled and assessed for SA colonisation. Log-binomial regression and correspondence analysis (CA) were used to evaluate the prevalence of colonisation at entry as compared with discharge. Approximately 51% of admitted (N= 404) and 41% of discharged (N= 439) female detainees were colonised with SA. Among males, 59% of those admitted (N= 427) and 49% of those discharged (N= 393) were colonised. Females had a statistically significant higher prevalence (1·26:P= 0·003) whereas males showed no significant difference (1·06;P= 0·003) in SA prevalence between entry and discharge. CA demonstrated that some strains, such asspatypes t571 and t002, might have an affinity for certain mucosal sites. Contrary to our hypothesis, the prison setting did not amplify SA transmission, and CA proved to be a useful tool in describing the population structure of strains according to time and/or mucosal site.

Abstract The Atlantic Meridional Overturning Circulation (AMOC) describes the northward flow of warm, salty water in the upper layers, and the southward flow of colder water in the deep Atlantic layers. AMOC strength estimates at 41°N latitude based on satellite sea surface height (SSH), and ARGO ocean temperature, salinity and velocity, and finally the difference in between the absolute mean sea levels (MSL) of the tide gauges of The Battery, New York, 40.7°N latitude, and Brest, 48.3°N latitude. Results suggest that the AMOC has been minimally reducing but with a positive acceleration since 2002, has been marginally increasing but with a negative acceleration since 1993, and has not been reducing but only oscillating with clear periodicities up 18 years, 27 years and about 60 years since 1856.

Abstract Individuals with dementia may come to forensic autopsy, partly because of non-natural deaths (e.g. fall-related), and/or concerns of abuse/neglect. At the New York City Office of Chief Medical Examiner (NYC OCME), brains from such cases are submitted for neurodegenerative disease (ND) work-up. Seventy-eight sequential cases were evaluated using a recently published condensed protocol for the NIA-AA guidelines for the neuropathologic assessment of Alzheimer disease (AD), a cost-cutting innovation in diagnostic neuropathology. ND was identified in 74 (94.9%) brains; the most common were AD (n = 41 [52.5%]), primary age-related tauopathy (n = 26 [33.3%]), and Lewy body disease ([LBD], n = 25 [32.1%]). Others included age-related tau astrogliopathy, hippocampal sclerosis of aging, progressive supranuclear palsy, multiple system atrophy, amyotrophic lateral sclerosis, argyrophilic grain disease, and Creutzfeldt-Jakob disease. 26.8% of AD cases involved a non-natural, dementia-related death, versus 40.0% for LBD. Finally, 70 (89.7%) cases had chronic cerebrovascular disease, 53 (67.9%) being moderate-to-severe. We present a diverse distribution of NDs notable for a high rate of diagnoses associated with falls (e.g. LBD), a potential difference from the hospital neuropathology experience. We also report a high burden of cerebrovascular disease in demented individuals seen at the NYC OCME. Finally, we demonstrate that the aforementioned condensed protocol is applicable for a variety of ND diagnoses.

Context.—Low interobserver diagnostic agreement exists among high-grade endometrial carcinomas. Objective.—To evaluate diagnostic variability in International Federation of Gynecology and Obstetrics (FIGO) grade 3 endometrioid adenocarcinoma (G3EC) in 2 different sign-out practices. Design.—Sixty-six G3EC cases were identified from pathology archives of Wayne State University (WSU, Detroit, Michigan) (general surgical pathology sign-out) and 65 from Memorial Sloan Kettering Cancer Center (MSK, New York, New York) (gynecologic pathology focused sign-out). Each case was reviewed together by 2 gynecologic pathologists, one from each institution, and classified into the G3EC group or a reclassified group. Clinicopathologic parameters were compared. Results.—Twenty-five WSU cases (38%) were reclassified as undifferentiated (n = 2), serous (n = 4), mixed endometrioid and serous carcinomas (n = 12), and FIGO grade 2 endometrioid adenocarcinomas with focal marked nuclear atypia (n = 7). Eleven MSK cases (17%) were reclassified as undifferentiated (n = 5), serous (n = 1), mixed endometrioid and serous carcinomas (n = 4), and mixed endometrioid and clear cell carcinomas (n = 1). Agreement rate between original and review diagnosis was 83% (54 of 65) at MSK and 62% (41 of 66) at WSU (P = .01) with an overall rate of 73% (95 of 131). There were more undifferentiated carcinomas at MSK than there were at WSU (45% [5 of 11] versus 8% [2 of 25]; P = .02). There were more grade 2 endometrioid adenocarcinomas with focal, marked nuclear atypia at WSU (28%; 7 of 25) than there were at MSK (0%) (P = .03). Mixed endometrioid and serous carcinoma was the most common misclassified subtype (44%; 16 of 36). Conclusion.—Moderate interobserver variability exists in the diagnosis of G3EC with a significantly greater diagnostic agreement rate in gynecologic pathology–focused sign-out than in general sign-out practice.

PURPOSE Limited data are available on the prevalence and clinical impact of Lynch syndrome (LS)–associated genomic variants in non-European ancestry populations. We identified and characterized individuals harboring LS-associated variants in the ancestrally diverse Bio Me Biobank in New York City. PATIENTS AND METHODS Exome sequence data from 30,223 adult Bio Me participants were evaluated for pathogenic, likely pathogenic, and predicted loss-of-function variants in MLH1, MSH2, MSH6, and PMS2. Survey and electronic health record data from variant-positive individuals were reviewed for personal and family cancer histories. RESULTS We identified 70 individuals (0.2%) harboring LS-associated variants in MLH1 (n = 12; 17%), MSH2 (n = 13; 19%), MSH6 (n = 16; 23%), and PMS2 (n = 29; 41%). The overall prevalence was 1 in 432, with higher prevalence among individuals of self-reported African ancestry (1 in 299) than among Hispanic/Latinx (1 in 654) or European (1 in 518) ancestries. Thirteen variant-positive individuals (19%) had a personal history, and 19 (27%) had a family history of an LS-related cancer. LS-related cancer rates were highest in individuals with MSH6 variants (31%) and lowest in those with PMS2 variants (7%). LS-associated variants were associated with increased risk of colorectal (odds ratio [OR], 5.0; P = .02) and endometrial (OR, 30.1; P = 8.5 × 10−9) cancers in Bio Me. Only 2 variant-positive individuals (3%) had a documented diagnosis of LS. CONCLUSION We found a higher prevalence of LS-associated variants among individuals of African ancestry in New York City. Although cancer risk is significantly increased among variant-positive individuals, the majority do not harbor a clinical diagnosis of LS, suggesting underrecognition of this disease.

Context: Previous studies claiming a relationship between thyroid dysfunction and poor prognosis of heart failure (HF) had a major limitation in that they included patients with different etiologies. Objective: With complete information of thyroid function profile from 458 consecutive patients with idiopathic dilated cardiomyopathy, we tested the hypothesis that thyroid status can independently influence mortality in patients with HF. Design, Patients, and Outcome Measure: The original cohort consisted of 572 consecutive patients with idiopathic dilated cardiomyopathy, and 458 patients remained at the end of follow-up. All patients took thyroid function tests and other regular examinations in hospital. The risk of mortality was evaluated based on free T3, TSH, and the whole thyroid function profile, respectively. Results: The most frequent thyroid dysfunction was subclinical hypothyroidism (n = 41), followed by subclinical hyperthyroidism (n = 35), low-T3 syndrome (n = 17), and hypothyroidism (n = 12). Logistic analysis showed log-TSH and free T3 as independent predictors of exacerbated cardiac function (New York Heart Association stages III–IV vs New York Heart Association stages I–II). During the follow-up (17 ± 8 mo), 111 cumulative deaths occurred. Hypothyroidism was the strongest predictor of mortality [hazard ratio (HR) 4.189; 95% confidence interval (CI) 2.118–8.283)], followed by low-T3 syndrome (HR 3.147; 95% CI 1.558–6.355) and subclinical hypothyroidism (HR 2.869; 95% CI 1.817–4.532). Subclinical hyperthyroidism showed no significant impact. Conclusions: We found a clear association between thyroid dysfunction and increased risk of mortality in idiopathic dilated cardiomyopathy with HF. These results suggest that monitoring thyroid function in HF patients is necessary, and further studies on the treatment of HF with thyroid dysfunction are needed.

Cercospora leaf spot (CLS), caused by Cercospora beticola, is one of the major diseases affecting productivity and profitability of beet production worldwide. Fungicides are critical for the control of this disease and one of the most commonly used products is the quinone outside inhibitor (QOI) azoxystrobin. In total, 150 C. beticola isolates were collected from two commercial processing table beet fields in Batavia, NY in 2014. The mating types of the entire population were determined, and genetic diversity of a subset of samples (n = 48) was assessed using five microsatellite loci. Sensitivity to azoxystrobin was tested using a spore germination assay. The cytochrome b gene was sequenced to check for the presence of point mutations known to confer QOI resistance in fungi. High allelic diversity (He = 0.50) and genotypic diversity (D* = 0.96), gametic equilibrium of the microsatellite loci, and equal ratios of mating types were suggestive of a mixed mode of reproduction for C. beticola. Resistance to azoxystrobin was prevalent because 41% of the isolates had values for effective concentrations reducing spore germination by 50% (EC50) > 0.2 μg/ml. The G143A mutation, known to cause QOI resistance in C. beticola, was found in isolates with EC50 values between 0.207 and 19.397 μg/ml. A single isolate with an EC50 of 0.272 μg/ml carried the F129L mutation, known to be associated with low levels of QOI resistance in fungi. This is the first report of the F129L mutation in C. beticola. The implications of these findings for the epidemiology and control of CLS in table beet fields in New York are discussed.

Accelerator mass spectrometry dated pollen, plant-macrofossil, and charcoal records from Sutherland Pond (41°23′29″N, 74°02′16″W), located in the Black Rock Forest, provide a detailed account of forest history during the late-glacial – Holocene transition in the Hudson Highlands, lower Hudson Valley, southeastern New York. Pollen assemblages dating more than 12 600 radiocarbon years before present (years BP) are dominated by herbaceous and shrub types (Salix, Betula, Alnus, Ericaceae, Cyperaceae, Gramineae, and Tubuliflorae), with some arboreal types (Pinus and Picea), apparently representing an open landscape possibly with scattered trees. At 12 600 years BP increased organic deposition and pollen influx and the first occurrence of macrofossils indicate dramatic environmental change. Mixed assemblages of boreal and temperate taxa (Picea, Abies, Betula papyrifera, Quercus, Ostrya – Carpinus, and Fraxinus) are evident from 12 600 to 11 200 years BP. Low charcoal influx suggests that fire was a minor component of early woodland development beginning around 12 600 years BP. A Picea–Abies–Alnus assemblage, suggesting a cool climatic episode, dominates between 11 200 and 10 120 years BP, with rapid onset and termination each occurring within 150 years. Fire activity is also low during this colder interval. Warmer conditions, reestablished by 10 120 years BP, are inferred from expansion of Pinus strobus and increasing Quercus and Ostrya–Carpinus, followed by replacement of B. papyrifera by Betula populifolia and increased charcoal influx. Key words: late glacial, pollen, plant macrofossils, fire, accelerator mass spectrometry radiocarbon dating, New York.

Abstract William Bullitt served as US Ambassador to the Soviet Union (1933–36) and France (1936–41). His book has three noteworthy features. “(1) It is a standard work for followers of the anti-Red crusade. It describes the insatiable tyranny and aggrandizement of Russia as continuous from Ivan the Terrible to Stalin, from the Oprichina to the N. K.V.D., from the conquest of Kazan in 1552 to the occupation of Persian Azerbaijan in 1945–46. (2) It uncompromisingly criticizes Roosevelt’s War-time diplomacy and his failure to coax Stalin into good-neighbourliness. (3) It sketches a policy of a Defence League of Democratic States to resist Soviet aggression and prepare a federal organization of the world, which foreshadows the Truman doctrine and the Marshall plan.” The book may “leave unsatisfied even those who agree that the Soviet regime is a detestable tyranny, and that appeasement is contemptible folly.” It exhibits “too much of the egocentric illusion here to give the truest perspective in which to see the Russo-Occidental conflict, and the deepest grounds on which to understand and condemn the Stalinist despotism.” Moreover, the book “isolates and emphasizes” Roosevelt’s diplomacy, notably “the naive optimism with which Roosevelt approached Stalin, repeating Chamberlain’s approach to Hitler.” Roosevelt may have “paid too high a price to keep Russia in the war, but Mr. Bullitt scarcely recognizes that the price paid secured goods punctually delivered and of surpassing quality.”

BackgroundCare recipients in care and welfare are increasingly presenting themselves with complex needs (Huber et al., 2016). An answer to this is the integrated organization of care and welfare in a way that personalized care is the measure (Topol, 2016). The reality, however, is that care and welfare are still mainly offered in a standardized, specialized and fragmented way. This imbalance between the need for care and the supply of care not only leads to under-treatment and over-treatment and thus to less (experienced) quality, but also entails the risk of mis-treatment, which means that patient safety is at stake (Berwick, 2005). It also leads to a reduction in the functioning of citizens and unnecessary healthcare cost (Olsson et al, 2009).Integrated CareIntegrated care is the by fellow human beings experienced smooth process of effective help, care and service provided by various disciplines in the zero line, the first line, the second line and the third line in healthcare and welfare, as close as possible (Ettema et al, 2018; Goodwin et al, 2015). Integrated care starts with an extensive assessment with the care recipient. Then the required care and services in the zero line, the first line, the second line and / or the third line are coordinated between different care providers. The care is then delivered to the person (fellow human) at home or as close as possible (Bruce and Parry, 2015; Evers and Paulus, 2015; Lewis, 2015; Spicer, 2015; Cringles, 2002).AimSupport societal participation, quality of live and reduce care demand and costs in people with complex care demands, through integration of healthcare and welfare servicesMethods (overview)1. Create best healthcare and welfare practices in Slovenia, Poland, Austria, Norway, UK, Finland, The Netherlands: three integrated best care practices per involved country 2. Get insight in working mechanisms of favourable outcomes (by studying the contexts, mechanisms and outcomes) to enable personalised integrated care for meeting the complex care demand of people focussed on societal participation in all integrated care best practices.3. Disclose program design features and requirements regarding finance, governance, accountability and management for European policymakers, national policy makers, regional policymakers, national umbrella organisations for healthcare and welfare, funding organisations, and managers of healthcare and welfare organisations.4. Identify needs of healthcare and welfare deliverers for creating and supporting dynamic partnerships for integrating these care services for meeting complex care demands in a personalised way for the client.5. Studying desired behaviours of healthcare and welfare professionals, managers of healthcare and welfare organisations, members of involved funding organisations and national umbrella organisations for healthcare and welfare, regional policymakers, national policy makers and European policymakersInvolved partiesAlma Mater Europaea Maribor Slovenia, Jagiellonian University Krakow Poland, University Graz Austria, Kristiania University Oslo Norway, Salford University Manchester UK, University of Applied Sciences Turku Finland, University of Applied Sciences Utrecht The Netherlands (secretary), Rotterdam Stroke Service The Netherlands, Vilans National Centre of Expertise for Long-term Care The Netherlands, NIVEL Netherlands Institute for Health Services Research, International Foundation of Integrated Care IFIC.References1. Berwick DM. The John Eisenberg Lecture: Health Services Research as a Citizen in Improvement. Health Serv Res. 2005 Apr; 40(2): 317–336.2. Bruce D, Parry B. Integrated care: a Scottish perspective. London J Prim Care (Abingdon). 2015; 7(3): 44–48.3. Cringles MC. Developing an integrated care pathway to manage cancer pain across primary, secondary and tertiary care. International Journal of Palliative Nursing. 2002 May 8;247279.4. Ettema RGA, Eastwood JG, Schrijvers G. Towards Evidence Based Integrated Care. International journal of integrated care 2018;18(s2):293. DOI: 10.5334/ijic.s22935. Evers SM, Paulus AT. Health economics and integrated care: a growing and challenging relationship. Int J Integr Care. 2015 Jun 17;15:e024.6. Goodwin N, Dixon A, Anderson G, Wodchis W. Providing integrated care for older people with complex needs: lessons from seven international case studies. King’s Fund London; 2014.7. Huber M, van Vliet M, Giezenberg M, Winkens B, Heerkens Y, Dagnelie PC, Knottnerus JA. Towards a 'patient-centred' operationalisation of the new dynamic concept of health: a mixed methods study. BMJ Open. 2016 Jan 12;6(1):e010091. doi: 10.1136/bmjopen-2015-0100918. Lewis M. Integrated care in Wales: a summary position. London J Prim Care (Abingdon). 2015; 7(3): 49–54.9. Olsson EL, Hansson E, Ekman I, Karlsson J. A cost-effectiveness study of a patient-centred integrated care pathway. 2009 65;1626–1635.10. Spicer J. Integrated care in the UK: variations on a theme? London J Prim Care (Abingdon). 2015; 7(3): 41–43.11. Topol E. (2016) The Patient Will See You Now. The Future of Medicine Is in Your Hands. New York: Basic Books.