In nutrition, there are several examples of discordance between the results of observational studies and of randomized controlled trials (RCTs). To provide empirical data on how often the summary results of epidemiological studies and of RCTs are concordant, and to explore whether the probability of concordant findings is associated with quantifiable metrics of citation maps formed between studies belonging to the evidence base of the nutrient-outcome association at hand. Citation maps are an objective representation of the translational paths in each association, and may be a surrogate of the maturity of the relevant evidence base. We searched MEDLINE to identify meta-analyses of RCTs or of epidemiological studies on the association between nutrients and health outcomes. Summary findings from both research designs that were statistically significant and in the same direction were considered qualitatively concordant. We also calculated the statistical significance of the difference in the summary effects from epidemiological studies and from RCTs (a measure of quantitative concordance). For each nutrient-outcome association we defined an evidence base including all publications identifiable by MEDLINE searches on the nutrient and outcome of interest and constructed citation maps of all articles in the evidence base that were cited by the epidemiological studies or the RCTs in the meta-analyses, either directly, or through one or more intermediary papers. We then quantified the size of the graphs (number of vertices and citation relationships), and their connectivity (density of citation relationships, mean hub and authority scores, and mean number of citations made or received over the included papers). We tested for associations between these metrics and the probability that the summary results from epidemiological studies and from RCTs are concordant between them.

关键词：临床医学;流行病学;图;健康状况;地图;营养;营养;随机对照试验(相关的),统计数据

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In this program, we proposed to establish a Nanomedicine Core to train faculty and students at Howard University to pursue molecular imaging of breast cancer using nanoparticles as targeted drug delivery vehicles. This is a partnership with the Johns Hopkins University In Vivo Cellular Molecular Imaging Center and the Nanotechnology Characterization Lab at NCI-Frederick. At Howard University, this partnership involves a multidisciplinary consortium of four departments: Radiology, Radiation Oncology, Molecular Biology and Biochemistry, and Electrical Engineering. The program has two components, a research component and a broad training component. The Howard University trainees will obtain training through collaborative research and by participation in a broad based training program. Renowned experts in nanomedicine and molecular imaging will participate in the training through mentoring research, seminars, workshops, and by offering laboratory internships. This transfer of nanomedicine techniques will support ongoing, long-term breast cancer research at Howard University. The major goal is to provide faculty trainees and their students at Howard with updated nanomedicine techniques to apply to independent breast cancer research, thus enhancing their ability to educate the next generation of scientists.

关键词：乳腺癌;诊断药物输送;图像;医学研究;纳米技术;治疗;培训

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Pain treatment and management remains one of the biggest challenges to modern medicine today. A recent Centers for Disease Control and Prevention (CDC) report found that 25 percent of U.S. adults reported experiencing a full day of pain within the past 30 days and one in 10 said their pain lasted one year or more. The most common complaints were low back pain followed by migraine or severe headache and joint pain (1) Current research efforts to understand pain mechanisms have revealed a complex picture in which the biological mechanisms of pain reach beyond the nervous system to other areas and systems associated with depression, anxiety, and sleep, areas of the mind and psyche. A recent nationwide survey found that one in five Americans say their pain has resulted in major lifestyle changes in employment, residence, or personal freedom and mobility. Participants viewed the medical community as being only partially successful in helping patients manage their pain (2) New, multi-disciplinary approaches to pain management have been developed and many therapies exist, however the dominant component of these approaches continues to be prescription and over-the-counter medications. While the use of medications is necessary and often effective, it does present the risk of overreliance, misuse, and abuse. Over the last decade there have been a number of reviews highlighting not only a significant rise in prescription medication, but also a sharp climb in abuse particularly for those between the ages of 18-25.

关键词：针灸;Ci(互补和综合);整体方法;药物;军事医学;流动性;神经系统;疼痛;疼痛管理;患者;风险;睡眠(生理学);调查;治疗

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The purpose of the report is to update what is currently known about the resiliency, coping, and compassion fatigue of Army and Civilian Nurses, LPNs, and Medics who treat wounded Soldiers and whether these factors can be improved over a sustained period of time. The study was a longitudinal, correlational, cohort, pilot study formulated to examine the impact of CPSP training on resiliency, coping and compassion fatigue over time (prior to CPSP training and 30-days post-training) in a population of Army and Civilian Nurses, LPNs, and Medics at Womack Army Medical Center (WAMC) at Fort Bragg, NC. A prospective cohort pilot study was implemented to investigate the long-term effects of resiliency training (CPSP) on Army and Civilian Nurses, LPNs, and Medics (n = 93) over two time points at Womack Army Medical Center. A convenience sample of 120 Army and Civilian Nurses, LPNs, and Medics attending CPSP training at WAMC between February 2013 and June 2013 was planned for the study. The sample size sought was 120, factoring in outliers (2) and a 30attrition rate, obtaining questionnaires from 81 participants.

关键词：保健提供者支持计划(CPSP);同情;应对;疲劳;医疗保险;医疗服务;军事医学;军事人员;护士;弹性;培训;创伤和损伤

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This publication presents national estimates of drug-related visits to hospital emergency departments (EDs) for the calendar year 2011, based on data from the Drug Abuse Warning Network (DAWN). Also presented are comparisons of 2011 estimates with those for 2004, 2009, and 2010. DAWN is a public health surveillance system that monitors drug-related ED visits for the Nation and for selected metropolitan areas. The Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS), is the agency responsible for DAWN. SAMHSA is required to collect data on drug-related ED visits under Section 505 of the Public Health Service Act. DAWN relies on a nationally representative sample of general, non-Federal hospitals operating 24-hour EDs, with oversampling of hospitals in selected metropolitan areas. In each participating hospital, ED medical records are reviewed retrospectively to find the ED visits that involved recent drug use. All types of drugsillegal drugs, prescription drugs, over-the-counter pharmaceuticals (e.g., dietary supplements, cough medicine), and substances inhaled for their psychoactive effectsare included. Alcohol is considered an illicit drug when consumed by patients aged 20 or younger. For patients aged 21 or older, though, alcohol is reported only when it is used in conjunction with other drugs. Marked findings of this report are (a) a 29 percent increase in the number of drug-related ED visits involving illicit drugs in the short term between 2009 and 2011; (b) simultaneous, short-term increases in the involvement of both illicit and licit stimulant-like drugs; and (c) some indications that the pace of increases in pharmaceutical involvement is slowing down.

关键词：不利影响;酗酒,自杀未遂;图表(图);解毒;药物滥用;紧急医疗服务;急诊室

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An index to Federal Aviation Administration Office of Aerospace Medicine Reports (1964-2012) and Civil Aeromedical Institute Reports (1961- 1963) is presented for those engaged in aviation medicine and related activities. The index lists all FAA aerospace medicine technical reports published from 1961 through 2012: chronologically, alphabetically by author, and alphabetically by subject.

关键词：航空航天医学;人因工程学;报告;研究报告

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Arguments appear almost daily in the media that biofuels will increase our domestic supply of transportation fuel, end our dependence on foreign oil, reduce military vulnerabilities on the battlefield, and improve national security. Biofuels are further touted to reduce fuel price volatility, polluting emissions, and greenhouse gases (GHG), and stimulate the economy. The promise and curse of biofuels is that they are limited by the energy that living organisms harvest from the sun and suffer a fatal 'catch-22': uncultivated biofuel yields are far too small, diffuse, and infrequent to displace any meaningful fraction of U.S. primary energy needs, and boosting yields through cultivation consumes more energy than it adds to the biomass. Furthermore, the harvested biomass requires large amounts of additional energy to convert it into the compact, energy-rich, liquid hydrocarbon form required for compatibility with the nation's fuel infrastructure, transportation sector, and especially the military. The energy content of the final-product biofuel compared to the energy required to produce it proves to be a very poor investment, especially compared to other alternatives. In many cases, there is net loss of energy. The United States cannot achieve energy security through biofuels, and even the attempt is ironically achieving effects contrary to 'clean' and 'green' environmental goals and actively threatening global security. This article focuses on cultivated biomass converted into liquid transportation fuel. The overall approach is an analysis of alternatives comparing three distinct biofuels methodologies with conventional petroleum fuel to assess their relative costs and benefits. The article provides evidence that pursuit of biofuels creates irreversible harm to the environment, increases greenhouse gas emissions, undermines food security, and promotes abuse of human rights. The article concludes with specific recommendations for policy and action.

关键词：生物质转换;成本收益分析;环境影响;乙醇;燃料;石油产品;能量转换

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This report describes in detail one potential conversion process to hydrocarbon products by way of biological conversion of lignocellulosic-derived sugars. The pathway model leverages expertise established over time in core conversion and process integration research at NREL, while adding in new technology areas primarily for hydrocarbon production and associated processing logistics. The overarching process design converts biomass to a hydrocarbon intermediate, represented here as a free fatty acid, using dilute-acid pretreatment, enzymatic saccharification, and bioconversion. Ancillary areas--feed handling, hydrolysate conditioning, product recovery and upgrading (hydrotreating) to a final blendstock material, wastewater treatment, lignin combustion, and utilities--are also included in the design. Detailed material and energy balances and capital and operating costs for this baseline process are also documented.

关键词：生物质;木质纤维素;糖类;碳氢化合物生物转化;设计;经济分析;酶活性;液体燃料;运营成本;生产;技术评估

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In the current study, processes to produce either ethanol or a representative fatty acid ethyl ester (FAEE) via the fermentation of sugars liberated from lignocellulosic materials pretreated in acid or alkaline environments are analyzed in terms of economic and environmental metrics. Simplified process models are introduced and employed to estimate process performance, and Monte Carlo analyses were carried out to identify key sources of uncertainty and variability. We find that the near-term performance of processes to produce FAEE is significantly worse than that of ethanol production processes for all metrics considered, primarily due to poor fermentation yields and higher electricity demands for aerobic fermentation. In the longer term, the reduced cost and energy requirements of FAEE separation processes will be at least partially offset by inherent limitations in the relevant metabolic pathways that constrain the maximum yield potential of FAEE from biomass-derived sugars.

关键词：生物化学;乙醇;乙酯;柳枝稷;碱性;生物量;脂肪酸;发酵;木质材料;指标;蒙特卡罗法;生产;分离流程;糖

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The overall objective of this study was to select chemical processing equipment, install and operate that equipment to directly convert algae to biodiesel via a reaction patented by Old Dominion University (Pat. No. US 8,080,679B2). This reaction is a high temperature (250-330 degrees C) methylation reaction utilizing tetramethylammonium hydroxide (TMAH) to produce biodiesel. As originally envisioned, algal biomass could be treated with TMAH in methanol without the need to separately extract triacylglycerides (TAG). The reactor temperature allows volatilization and condensation of the methyl esters whereas the spent algae solids can be utilized as a high-value fertilizer because they are minimally charred. During the course of this work and immediately prior to commencing, we discovered that glycerol, a major by-product of the conventional transesterification reaction for biofuels, is not formed but rather three methoxylated glycerol derivatives are produced. These derivatives are high-value specialty green chemicals that strongly upgrade the economics of the process, rendering this approach as one that now values the biofuel only as a by-product, the main value products being the methoxylated glycerols. A horizontal agitated thin-film evaporator (one square foot heat transfer area) proved effective as the primary reactor facilitating the reaction and vaporization of the products, and subsequent discharge of the spent algae solids that are suitable for supplementing petrochemical-based fertilizers for agriculture. Because of the size chosen for the reactor, we encountered problems with delivery of the algal feed to the reaction zone, but envision that this problem could easily disappear upon scale-up or can be replaced economically by incorporating an extraction process. The objective for production of biodiesel from algae in quantities that could be tested could not be met, but we implemented use of soybean oil as a surrogate TAG feed to overcome this limitation.

关键词：藻类;替代燃料;农药;生物量;化学加工;柴油燃料;酯类;提取;化肥;甘油;实施;石化;弗吉尼亚州;生物柴油

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