Lead tolerance and accumulation in five willow clones were investigated using a nutrient film technique. Plants were exposed to 0, 48, 121, 169, or 241 microM Pb for 14 days. Tolerance indices (TI) and critical toxicity thresholds (EC50) were determined for five willow clones. SX61 had the highest TI values (92%) in the 48 and 121 microM Pb treatments, as well as the highest EC50 threshold values (70.5 microM for roots, 155.9 microM for aboveground tissue), indications of a high degree of tolerance to Pb. This clone also developed the highest biomass of all the clones tested. We found significant variation in willows' lead accumulation. The highest Pb content in roots (24 mg plant(-1)) and aboveground tissue (7.6 mg plant(-1)) was recorded in the 48 microM Pb treatment in SX61. Based on high biomass, TI, ECso, and Pb content in plant tissues, SX61 holds promise for phytoextraction of lead.
A randomized controlled efficacy trial targeting older adults with hypertension (age 60 and over) provided an e-health, tailored intervention with the “next generation” of the Personal Education Program (PEP-NG). Eleven primary care practices with advanced practice registered nurse (APRN) providers participated. Participants (N=160) were randomly assigned by the PEP-NG (accessed via a wireless touchscreen tablet computer) to either control (entailing data collection and four routine APRN visits) or tailored intervention (involving PEP-NG intervention and four focused APRN visits) group. Compared to patients in the control group, patients receiving the PEP-NG e-health intervention achieved significant increases in both self-medication knowledge and self-efficacy measures, with large effect sizes. Among patients not at BP targets upon entry to the study, therapy intensification in controls (increased antihypertensive dose and/or an additional antihypertensive) was significant (p=.001) with an odds ratio of 21.27 in the control compared to the intervention group. Among patients not at BP targets on visit 1, there was a significant declining linear trend in proportion of the intervention group taking NSAIDs 21–31 days/month (p=0.008). Satisfaction with the PEP-NG and the APRN provider relationship was high in both groups. These results suggest that the PEP-NG e-health intervention in primary care practices is effective in increasing knowledge and self-efficacy, as well as improving behavior regarding adverse self-medication practices among older adults with hypertension.
Risk differences and associated confidence intervals are fiequentiy the basis for statistical testing in clinical trials. Ile analysis is often complicated by the presence of measured baseline covariates related to response that may be used to improve the precision of the treatment comparison by covariate adjustment in the statistical analysis. We use a clinical trial example and supporting simulations to show that logis-Miaomiao Go, PhD Covariate-adjusted Difference in Proportions From Clinical Trials Using Logistic Regression Candidate Pjzer Inc. Groton. Connecticut; Department Risk Differences and Weightedtic regression can be used to estimate the risk difference and compare its performance to common weighted-difference methods. We also examine when a useful improvement in precision can result fiom covariate adjustment, the use of a continuous rather than categorized covariate, and the consequences of including an unpredictive covariate.
While the development of resistance to a new antibiotic is expected, the time course and degree of resistance that will develop are uncertain. Some best projections of the future extent of resistance can be highly impactful for activities, such as antimicrobial development, that require significant lead time. We focus on the surge among hospital isolates in fluoroquinolone-resistant Escherichia coli and use data on resistance and consumption to explore and quantify trends in increasing resistance and their relationship to antibiotic use from 2001 to 2007. A mixed-effects logistic regression model produced a good fit to the observed resistance rates during this period in the United States and Europe. The model contained significant effects of time, consumption, and country on developing fluoroquinolone resistance in E. coli. There was a larger projected increase in resistance for high fluoroquinolone-consuming countries projected to 2013: 45% (95% confidence interval [CI]: 38%, 53%) for high consumers vs. 33% (95% CI: 25%, 41%) for low consumers. The model was also used to obtain regional projections of resistance that can be used by local prescribers. In order to better understand and predict trends in antimicrobial resistance, it is vital to implement and expand current surveillance systems.
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