The Utility of an Online Convenience Panel for Reaching Rare and Dispersed Populations

Gaps in data collection systems, as well as challenges associated with gathering data from rare and dispersed populations, render current health surveillance systems inadequate to identify and monitor efforts to reduce health disparities. Using sexual and gender minorities we investigated the utility of using a large nonprobability online panel to conduct rapid population assessments of such populations using brief surveys. Surveys of the Google Android Panel (four assessing sexual orientation and one assessing gender identity and sex assigned at birth) were conducted resulting in invitation of 53,739 application users (37,505 of whom viewed the invitation) to generate a total of 34,759 who completed screening questions indicating their sexual orientation, or gender identity and sex at birth. Where possible we make comparisons to similar data from two population-based surveys (NHIS and NESARC). We found that 99.4% to 100.0% of respondents across our Google Android panel samples completed the screening questions and 97.8% to 99.2% of those that consented to participate in our surveys indicated they were “OK” with the content of surveys that assessed sexual orientation and sex/gender. In our Google Android panel samples there was a higher percentage of sexual minority respondents than in either NHIS or NESARC with 7.4% of men and 12.4% of women reporting gay, lesbian or bisexual identities. The proportion sexual minority was 2.8 to 5.6 times higher in the Google Android panel samples than was found in the 2012 NHIS sample, for men and women, respectively. The percentage of “transgender” identified individuals in the Google sample was 0.7%, which is similar to 0.5% transgender identified through the Massachusetts BRFSS, and using a transgender status item we found that 2.0% of the overall sample fit could be classified as transgender. The Google samples sometimes more closely approximated national averages for ethnicity and race than NHIS.     

Videotaped Behavior as a Predictor of Clinical Outcome in Rhesus Macaques (Macaca mulatta)

Understanding the behavior of laboratory NHP facilitates health assessment and clinical care. We sought to characterize the behavior of critically ill rhesus macaques (Macaca mulatta) and determine whether specific behaviors or behavioral changes might facilitate the determination of prognosis and clinical endpoints. Twenty-two critically-ill subjects were videorecorded after they were removed from the outdoor breeding colony for diagnostic work-up and treatment. Subjects were categorized as survivors (n = 15) and those that were euthanized according to existing clinical endpoints (n = 7). Behavior before, during, and after cageside examination was compared between these groups with regard to the presence or absence of direct observation. This approach allowed us to determine whether these settings revealed differences between groups or masking of behaviors during direct observation. Before cageside examination, several behaviors (for example, self-grooming and anxiety behaviors) were significantly more common in surviving subjects than in euthanized subjects. Few significant differences in behavior were detectable during or after the examination. Subjects that were eventually euthanized showed more illness-related behaviors; however, not all animals requiring euthanasia showed these signs when an observer was present. Furthermore, euthanized animals spent more time in an alert posture during direct observation than at other times. Therefore, direct observation of critically ill rhesus macaques may not yield the most accurate assessment of illness severity, and using video to assess behavior may be helpful for prognosis.The assessment and recognition of pain and distress in laboratory animals is crucial to ensure welfare and high-quality research.^{6,10,12,20,23,26,28} Difficulty in identifying species-specific signs of pain and distress suggests that cageside assessment of clinical condition by an observer, as a stand-alone method, may not be an optimal method of determining prognosis in critically ill animals of some species.^10,24,26,27 The behavior of NHP, including rhesus macaques (Macaca mulatta), can be especially difficult to interpret due to their relatively stoic nature and tendency to mask clinical signs of illness in the presence of human observers.^{8,10,12,14,17} Two explanations for the tendency to mask pain, which is also observed in other species, are their status as a prey species and the need to hide weaknesses from group members.^3,17,22,23 According to the 2009 Institute for Laboratory Animal Research (ILAR) recommendations for recognizing pain and distress in nonhuman primates, “[v]iewing an animal from a distance or by video can aid in detecting subtle clinical changes.”¹² The goal of the current study was to evaluate the use of videotaped behavioral data to increase accuracy in predicting prognoses for rhesus macaques that are critically ill.A humane endpoint is defined as the earliest time at which an animal may experience unnecessary pain or distress, undue suffering, or impending death.^4,12 Both subjective and objective diagnostic criteria are currently used to define clinical and research endpoints.^{6,7,10,12,21,26,29}A myriad of diagnostics can be used for this purpose, including physical examination, cageside examination, blood assays (CBC and serum biochemistry), imaging (radiographs, ultrasound, CT, and MRI), bacterial culture and sensitivity, urinalysis, and collection of tissue samples (fine-needle aspiration and biopsy). One specific example of using clinical diagnostics to aid in the prediction of mortality in NHP involved using acid-base levels in animals with severe social trauma.¹¹ Behavioral assessment may be an important and underutilized diagnostic method for assessing pain and distress. Recent studies have evaluated the behavior, specifically facial expression, of mice to detect and assess pain.^16,19 Methods for evaluating behavior typically involve cageside examination, but assessment of behavior via videotape in the absence of an observer may also be useful.Endpoints may vary depending on species, nature of the research conducted, and assessment of degree of pain or distress. At our facility, experimental endpoints (those defined as part of a specific study) are differentiated from clinical endpoints (those determined by an animal''s health and quality of life). The veterinarian has the authority to elect euthanasia for an animal that is assessed to have reached an endpoint by either or both classifications. IACUC-approved endpoint policies have been established to aid in this decision. Criteria included in these guidelines include weight loss (excluding postpartum females and intended weight loss for obese animals), anorexia that is not responsive to treatment, diarrhea that is not responsive to treatment, and major organ failure that is not responsive to treatment. Veterinarians use cageside examination in the overall assessment of animals and to aid in the decision to euthanize.To our knowledge, the current study is the first to assess the behavior of critically ill rhesus macaques that controls for the cause of clinical presentation and to use observer presence or absence as an independent variable. To obtain information that may assist in refining clinical endpoints, we compared the behavior of critically ill rhesus macaques while an observer was absent, present, and recently present (labeled as preobservation, observation, and postobservation, respectively, in this text).We hypothesized that in comparison to in-person observation of critically ill rhesus macaques, the use of videotaping in the absence of direct observation would be more accurate in detecting differences in the behavior between those animals that eventually required euthanasia and those that did not. In addition, we hypothesized that behaviors would be suppressed (‘masked’) during direct observation, accounting for the reduced information available to the direct observer. If our hypothesis is supported, then videotaped behavior may be useful as a prognostic indicator that could be incorporated into development of clinical endpoints.     

Fine needle aspiration of splenic extramedullary hematopoiesis presenting as a solitary mass. A case report

BACKGROUND: Extramedullary hematopoiesis (EMH) generally occurs in patients with deficient bone marrow hematopoiesis secondary to either peripheral red cell destruction or marrow replacement. EMH is most commonly seen in the liver and spleen as a diffuse lesion. Rarely EMH presents as a solitary mass, posing a diagnostic dilemma. In asymptomatic patients without obvious evidence of hematopathology, the differential diagnosis is even more complex. Despite the several articles detailing the radiographic findings in EMH, fewer promote the utility of fine needle aspiration (FNA) in making this diagnosis. CASE: EMH presented as a discrete, 6-cm, tumorlike splenic mass, first identified on computed tomography in a patient with a history of prostate carcinoma. FNA findings suggested a diagnosis of EMH, which was confirmed by splenectomy. In searching for the cause of EMH, no evidence of either metastatic or hematologic disease was identified. The cause of EMH in this patient remains unknown. To our knowledge, this is the first case of solitary splenic EMH reported to occur in an asymptomatic patient. CONCLUSION: FNA is a useful adjunct in the evaluation of isolated splenic masses, particularly in the diagnosis of EMH, where hematopoietic precursors are readily identified cytologically. We advocate the use of FNA in the management of splenic masses. In addition, our case also suggests that EMH be included in the differential diagnosis of isolated splenic lesions, even in patients without obvious hematologic disorders.     

The Roles of Structural Order and Intermolecular Interactions in Determining Ionization Energies and Charge‐Transfer State Energies in Organic Semiconductors

The energy landscape in organic semiconducting materials greatly influences charge and exciton behavior, which are both critical to the operation of organic electronic devices. These energy landscapes can change dramatically depending on the phases of material present, including pure phases of one molecule or polymer and mixed phases exhibiting different degrees of order and composition. In this work, ultraviolet photoelectron spectroscopy measurements of ionization energies (IEs) and external quantum efficiency measurements of charge‐transfer (CT) state energies (E_CT) are applied to molecular photovoltaic material systems to characterize energy landscapes. The results show that IEs and E_CT values are highly dependent on structural order and phase composition. In the sexithiophene:C₆₀ system both the IEs of sexithiophene and C₆₀ shift by over 0.4 eV while E_CT shifts by 0.5 eV depending on molecular composition. By contrast, in the rubrene:C₆₀ system the IE of rubrene and C₆₀ vary by ≤ 0.11 eV and E_CT varies by ≤ 0.04 eV as the material composition varies. These results suggest that energy landscapes can exist whereby the binding energies of the CT states are overcome by energy offsets between charges in CT states in mixed regions and free charges in pure phases.     

INDUCTION OF SPECIFIC PROTEINS IN EUKARYOTIC ALGAE GROWN UNDER IRON-, PHOSPHORUS-, OR NITROGEN-DEFICIENT CONDITIONS1

What limits phytoplankton growth in nature? The answer is elusive because of methodological problems associated with bottle incubations and nutrient addition experiments. We are investigating the possibility that antibodies to proteins repressed by a specific nutrient can be used as probes to indicate which nutrient limits photosynthetic carbon fixation in the ocean. The diatom Phaeodactylum tricornutum Bohlin and the chlorophyte Dunaliella tertiolecta Butcher were grown in batch cultures in artificial seawater and f/2 nutrient lacking either phosphorus, iron, or nitrogen. Chlorosis was induced by nutrient limitation in both species with the exception of phosphorus-limited D. tertiolecta. The synthesis and appearance of specific proteins were followed by labeling with ¹⁴C-bicarbonate. Nutrient limitation in general leads to a decrease in the quantum efficiency of photosystem II, suggesting that deficiency of any nutrient affects the photosynthetic apparatus to some degree: however, the effect of nitrogen and iron limitation on quantum efficiency is more severe than that of phosphorus. A crude fractionation of the soluble and membrane proteins demonstrated that the large proteins induced under limitation by phosphorus and iron were associated with the membranes. However, small iron-repressible proteins were located in the soluble fraction. Isolation with anion-exchange chromatography and N-terminal sequencing of iron-repressible, 23-kDa Proteins from D. tertiolecta, P. tricornutum, and Chaetoceros gracilis revealed that these small soluble proteins have strong homology with the N-terminal sequence of flavodoxins from Azotobacter and Clostridium. The identity of the flavodoxin from D. tertiolecta was confirmed by immunodetection using antiflavodoxin raised against Chlorella. Flavodoxin was detected only under iron deprivation and was absent from nitrogen-and phosphorus-limited algae. Flavodoxin is a prime candidate for a molecular probe of iron limitation in the ocean. The requirements to confirm its utility in nature are discussed.