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•Evidence on resource use is limited to studies reporting mostly on the resource “time” and not always under real life conditions.•Administration and project management, study selection, data extraction, and critical appraisal seem to be very resource intensive, varying with the number of included studies, while protocol development, literature search, and study retrieval take less time.•Lack of experience and domain knowledge, lack of collaborative and supportive software, as well as lack of good communication and management can increase resource use during the systematic review process. We aimed to map the resource use during systematic review (SR) production and reasons why steps of the SR production are resource intensive to discover where the largest gain in improving efficiency might be possible. We conducted a scoping review. An information specialist searched multiple databases (e.g., Ovid MEDLINE, Scopus) and implemented citation-based and grey literature searching. We employed dual and independent screenings of records at the title/abstract and full-text levels and data extraction. We included 34 studies. Thirty-two reported on the resource use—mostly time; four described reasons why steps of the review process are resource intensive. Study selection, data extraction, and critical appraisal seem to be very resource intensive, while protocol development, literature search, or study retrieval take less time. Project management and administration required a large proportion of SR production time. Lack of experience, domain knowledge, use of collaborative and SR-tailored software, and good communication and management can be reasons why SR steps are resource intensive. Resource use during SR production varies widely. Areas with the largest resource use are administration and project management, study selection, data extraction, and critical appraisal of studies.

To evaluate the effectiveness of Gay and Bisexual Men's Health Retreats in addressing factors that support safer sexual behaviors among men who have sex with men (MSM), we administered a quantitative questionnaire to intervention and comparison participants and conducted two focus groups of men who received the program intervention. Quantitative results showed that the intervention had moderate impact on patterns of behavior over time. Qualitative focus group results revealed improvements in attitude towards safer sex and use of condoms, self-acceptance, and level of social support and personal networks. Our findings suggest ways to improve the effectiveness of retreats as an HIV prevention intervention for gay and bisexual men as well as highlight the continued need for HIV prevention program evaluation for MSM.

Background: Varying patterns of policy and cultural disadvantage among sexual minorities have recently been pointed to as implicated in their poorer health outcomes, relative to the heterosexual majority. We examined the precursors of internalised homonegativity (IH) within a macro-meso-micro framework, using various data sources, to help disentangle the complex influences perpetuating homonegative internalisations among European MSM. Methods: EMIS is a collaborative study across 38 countries which during summer 2010 recruited over 180,000 MSM via Internet sites. The survey included a culturally stable form of the IH scale and various beliefs and behavioural variables. Additionally, to broaden the view of macro and meso environment at the level of individual men with respect to IH, we combined country-level data from the World Economic Forum, LGB status list, and European Values Survey. Results: The analyses included 38 countries and 144,177 MSM with a valid IH score, which varied across Europe, with the highest scores found in Southeast Europe. In multivariate analyses, at the societal structure of rule-systems, higher IH was predicted by the absence of legal rights (b.37 to .42). At the meso-level, IH was predicted by cultural values regarding homosexuality (b.16). At the individual level, greater homonegative internalisation was found among those men who perceived they could not access PEP and HIV and STI testing in their country (b.21 to .22). Higher IH, in turn, was associated with not testing for HIV and STIs (b.70 to .57). Conclusion: As possibly the first multi-level study, EMIS shows that a homonegative structural and social climate appears to have pervasive effects on MSM’s evaluation of the self, and greater IH in turn affected men’s levels of HIV precautionary behaviours. In addition to the human rights aspect, the EMIS results suggest that improved affirmative policy environments will have positive health impacts on MSM populations.

/ This paper presents an approach for producing aquifer sensitivity maps from three-dimensional geologic maps, called stack-unit maps. Stack-unit maps depict the succession of geologic materials to a given depth, and aquifer sensitivity maps interpret the successions according totheir ability to transmit potential contaminants. Using McHenry County, Illinois, as a case study, stack-unit maps and an aquifer sensitivity assessment were made to help land-use planners, public health officials, consultants, developers, and the public make informed decisions regarding land use. A map of aquifer sensitivity is important for planning because the county is one of the fastest growing counties in the nation, and highly vulnerable sand and gravel aquifers occur within 6 m of ground surface over 75% of its area. The aquifer sensitivity map can provide guidance to regulators seeking optimal protection of groundwater resources where these resources are particularly vulnerable. In addition, the map can be used to help officials direct waste-disposal and industrial facilities and other sensitive land-use practices to areas where the least damage is likely to occur, thereby reducing potential future liabilities. KEY WORDS: Geologic mapping; Groundwater; Aquifers; Aquifer sensitivity; Land-use planning

Insecticide-treated nets (ITNs) are one of the main interventions used for malaria control. However, these nets may also be effective against other vector borne diseases (VBDs). We conducted a systematic review and meta-analysis to estimate the efficacy of ITNs, insecticide-treated curtains (ITCs) and insecticide-treated house screening (ITS) against Chagas disease, cutaneous and visceral leishmaniasis, dengue, human African trypanosomiasis, Japanese encephalitis, lymphatic filariasis and onchocerciasis. MEDLINE, EMBASE, LILACS and Tropical Disease Bulletin databases were searched using intervention, vector- and disease-specific search terms. Cluster or individually randomised controlled trials, non-randomised trials with pre- and post-intervention data and rotational design studies were included. Analysis assessed the efficacy of ITNs, ITCs or ITS versus no intervention. Meta-analysis of clinical data was performed and percentage reduction in vector density calculated. Twenty-one studies were identified which met the inclusion criteria. Meta-analysis of clinical data could only be performed for four cutaneous leishmaniasis studies which together showed a protective efficacy of ITNs of 77% (95%CI: 39%-91%). Studies of ITC and ITS against cutaneous leishmaniasis also reported significant reductions in disease incidence. Single studies reported a high protective efficacy of ITS against dengue and ITNs against Japanese encephalitis. No studies of Chagas disease, human African trypanosomiasis or onchocerciasis were identified. There are likely to be considerable collateral benefits of ITN roll out on cutaneous leishmaniasis where this disease is co-endemic with malaria. Due to the low number of studies identified, issues with reporting of entomological outcomes, and few studies reporting clinical outcomes, it is difficult to make strong conclusions on the effect of ITNs, ITCs or ITS on other VBDs and therefore further studies be conducted. Nonetheless, it is clear that insecticide-treated materials such as ITNs have the potential to reduce pathogen transmission and morbidity from VBDs where vectors enter houses.

There have been active efforts in the U.S., Europe, and Japan on the design of a neutrino factory. This type of facility produces intense beams of neutrinos from the decay of muons in a high-energy storage ring. In the U.S., a second detailed feasibility study (FS2) for a neutrino factory was completed in 2001. Since that report was published, new ideas in bunching, cooling, and acceleration of muon beams have been developed. We have incorporated these ideas into a new facility design, which we designate as study 2B (ST2B), that should lead to significant cost savings over the FS2 design.

Background Pontocerebellar hypoplasia (PCH) represents a group of neurodegenerative disorders with prenatal onset. Eight subtypes have been described thus far (PCH1-8) based on clinical and genetic features. Common characteristics include hypoplasia and atrophy of the cerebellum, variable pontine atrophy, and severe mental and motor impairments. PCH1 is distinctly characterized by the combination with degeneration of spinal motor neurons. Recently, mutations in the exosome component 3 gene ( EXOSC3 ) have been identified in approximately half of the patients with PCH subtype 1. Methods We selected a cohort of 99 PCH patients (90 families) tested negative for mutations in the TSEN genes, RARS2 , VRK1 and CASK . Patients in this cohort were referred with a tentative diagnose PCH type 1, 2, 4, 7 or unclassified PCH. Genetic analysis of the EXOSC3 gene was performed using Sanger sequencing. Clinical data, MR images and autopsy reports of patients positive for EXOSC3 mutations were analyzed. Results EXOSC3 mutations were found in twelve families with PCH subtype 1, and were not found in patients with other PCH subtypes. Identified mutations included a large deletion, nonsense and missense mutations. Examination of clinical data reveals a prolonged disease course in patients with a homozygous p.D132A mutation. MRI shows variable pontine hypoplasia in EXOSC3 mediated PCH, where the pons is largely preserved in patients with a homozygous p.D132A mutation, but attenuated in patients with other mutations. Additionally, bilateral cerebellar cysts were found in patients compound heterozygous for a p.D132A mutation and a nonsense allele. Conclusions EXOSC3 mediated PCH shows clear genotype-phenotype correlations. A homozygous p.D132A mutation leads to PCH with possible survival into early puberty, and preservation of the pons. Compound heterozygosity for a p.D132A mutation and a nonsense or p.Y109N allele, a homozygous p.G31A mutation or a p.G135E mutation causes a more rapidly progressive course leading to death in infancy and attenuation of the ventral pons. Our findings imply a clear correlation between genetic mutation and clinical outcome in EXOSC3 mediated PCH, including variable involvement of the pons.

To the Editor: The results of the National Lung Screening Trial (NLST) (Aug. 4 issue) 1 showed a relative reduction in lung-cancer mortality of 20% in former and current heavy smokers who underwent screening with low-dose computed tomography (CT), as compared with radiographic screening. The other main causes of morbidity and mortality in heavy smokers are ischemic heart disease and chronic obstructive lung disease (COPD). Both these diseases are underdiagnosed and lack specific screening programs. Thus, the use of CT in this context offers a unique opportunity to screen for these two important conditions. For example, the detection of coronary-artery calcification . . .

External leg compression (ELC) may increase cardiac output (CO) in fluid-responsive patients like passive leg raising (PLR). We compared the hemodynamic effects of two methods of ELC and PLR measured by thermodilution (COtd), pressure curve analysis Modelflow™ (COmf) and ultra-sound HemoSonic™ (COhs), to evaluate the method with the greatest hemodynamic effect and the most accurate less invasive method to measure that effect. We compared hemodynamic effects of two different ELC methods (circular, A (n = 16), vs. wide, B (n = 13), bandages inflated to 30 cm H 2 O for 15 min) with PLR prior to each ELC method, in 29 post-operative cardiac surgical patients. Hemodynamic responses were measured with COtd, COmf and COhs. PLR A increased COtd from 6.1 ± 1.7 to 6.3 ± 1.8 L·min −1 ( P  = 0.016), and increased COhs from 4.9 ± 1.5 to 5.3 ± 1.6 L·min −1 ( P  = 0.001), but did not increase COmf. ELC A increased COtd from 6.4 ± 1.8 to 6.7 ± 1.9 L·min −1 ( P  = 0.001) and COmf from 6.9 ± 1.7 to 7.1 ± 1.8 L·min −1 ( P  = 0.021), but did not increase COhs. ELC A increased COtd and COmf as in PLR A. PLR B increased COtd from 5.4 ± 1.3 to 5.8 ± 1.4 L·min −1 ( P  < 0.001), and COhs from 5.0 ± 1.0 to 5.4 ± 1.0 L·min −1 ( P  = 0.013), but not COmf. ELC B increased COtd from 5.2 ± 1.2 to 5.4 ± 1.1 L·min −1 ( P  = 0.003), but less than during PLR B ( P  = 0.012), while COmf and COhs did not change. Bland–Altman and polar plots showed lower limits of agreement with changes in COtd for COmf than for COhs. The circular leg compression increases CO more than bandage compression, and is able to increase CO as in PLR. The less invasive Modelflow™ can detect these changes reasonably well.