BACKGROUND & AIMS: A community-based household survey was utilized to assess the relationship between thermometer use, home treatment and utilization of health care services. Using a cross-sectional design, the study surveyed 688 low income Mexican origin mothers of children between the ages of 8 and 16 months in San Diego County. Mothers were asked how they determine that their child has fever and how often they use a thermometer. Nearly 40% of low income Mexican mothers interviewed in San Diego county never used a thermometer for determining childhood fever. Approximately two-thirds (64.7%) relied either primarily or exclusively on embodied methods such as visual observation or touch to determine fever in their child. A multivariate logistic regression analysis determined that low education and a separated or divorced marital status decreased the odds of thermometer use, whereas regular contact with the health care system doubled the likelihood of thermometer use. Mothers who relied on embodied methods were more likely to use over-the-counter medications than those who relied on thermometers; however, no significant differences were found between groups using other methods of home treatment. Fever determination modalities can be used to screen for lack of access to care and to provide for other health care needs in a culturally appropriate manner. While clinicians' expectations may include parental experience with temperature taking, current pediatric literature questions the need for home-based thermometer use. Possible alternatives to the traditional rectal thermometer might include digital thermometers and color coded thermometer strips.

背景与目标： 利用基于社区的家庭调查来评估温度计使用，家庭治疗和医疗服务利用之间的关系。该研究使用横断面设计对圣地亚哥县的688名墨西哥裔低收入母亲进行了调查，这些母亲年龄在8至16个月之间。询问母亲如何确定孩子发烧以及使用温度计的频率。在圣地亚哥县接受采访的近40％的低收入墨西哥母亲从未使用温度计来确定儿童发烧。大约三分之二（64.7％）的儿童主要或完全依靠视觉观察或触觉等具体方法来确定孩子的发烧情况。多元逻辑回归分析确定，受教育程度低和婚姻状况分离或离婚会降低使用温度计的几率，而与卫生保健系统的定期接触会使使用温度计的可能性加倍。与那些依靠体温计的母亲相比，那些依靠具体方法的母亲更有可能使用非处方药。但是，使用其他家庭治疗方法的组之间没有发现显着差异。发烧确定方式可用于筛查缺乏护理的机会，并以适合文化的方式提供其他医疗保健需求。尽管临床医生的期望可能包括父母的体温测量经验，但目前的儿科文献对家用温度计的使用提出了质疑。传统直肠温度计的可能替代品可能包括数字温度计和带有色码的温度计条。

BACKGROUND & AIMS: :Viruses cause significant mortality of marine microorganisms; however, their role in shaping the composition of microbial assemblages has not been fully elucidated. Because viruses may form lysogenic relationships with their hosts, temperate viruses may influence bacterial assemblage structures through direct lysis of hosts when induced by environmental stimuli or by homoimmunity (i.e., immunity to closely related viruses). We investigated the components of bacterioplankton assemblages that bore prophage using the lysogenic induction agent mitomycin C. Seawater was collected at two locations (the San Pedro Ocean Time Series Station and in the Santa Barbara Channel) in the Southern California Borderland and amended with mitomycin C. After 24-h incubation, the community structure of bacterioplankton was compared with unamended controls using automated rRNA intergenic spacer analysis. The addition of mitomycin C to seawater had effects on the community structure of bacterioplankton, stimulating detectable overall diversity and richness of fingerprints and causing the assemblages within incubations to become different to control assemblages. Most negatively impacted operational taxonomic units (OTU) in mitomycin C-amended incubations individually comprised a large fraction of total amplified DNA in initial seawater (5.3-23.3% of amplified DNA fluorescence) fingerprints, and data suggest that these include organisms putatively classified as members of the gamma-Proteobacteria, SAR11 cluster, and Synechococcus groups. The stimulation of assemblage richness by induction of lysogens, and the reduction in the contribution to total DNA of common OTU (and concomitant increase in rare OTU), suggests that temperate phage have the potential to strongly influence the diversity of bacterioplankton assemblages. Because lysogenic OTU may also be resistant to closely related lytic (i.e., free-living) viruses, the impact of lytic virioplankton on assemblages may only be pronounced transiently or when conditions causing lysogenic induction arise.

背景与目标： ：病毒导致海洋微生物大量死亡；然而，它们在塑造微生物组合物的组成中的作用尚未完全阐明。因为病毒可能与其宿主形成溶源性关系，所以当受到环境刺激或同种免疫力（即对紧密相关的病毒的免疫力）诱导时，温带病毒可能通过直接裂解宿主来影响细菌的组装结构。我们调查了使用溶原性诱导剂丝裂霉素C进行噬菌体繁殖的浮游细菌集合体的组成部分。在南加利福尼亚边境地区的两个地点（圣佩德罗海洋时间序列站和圣塔芭芭拉海峡）收集了海水，并用丝裂霉素C进行了修正。温育24小时后，使用自动rRNA基因间间隔子分析将浮游细菌的群落结构与未经修饰的对照进行比较。向海水中添加丝裂霉素C对浮游细菌的群落结构有影响，刺激了可检测的总体多样性和指纹的丰富性，并导致孵化过程中的组合变得与对照组合不同。在丝裂霉素C修饰的孵育中，最受负面影响的操作生物分类单位（OTU）分别包含初始海水指纹中总扩增DNA的很大一部分（占扩增DNA荧光的5.3％至23.3％），数据表明，这些微生物包括假定分类为成员的生物γ-变形杆菌，SAR11簇和Synechococcus组。通过溶菌原的刺激刺激丰富的集合体，以及减少普通OTU对总DNA的贡献（并伴随稀有OTU的增加），表明温和的噬菌体有可能强烈影响浮游细菌集合体的多样性。由于溶源性OTU也可能对紧密相关的溶菌（即自由生活）病毒具有抗性，因此溶溶性浮游生物对集合体的影响只能短暂地或在引起溶源性诱导的条件出现时才显露出来。

BACKGROUND & AIMS: :The metabolic rate (MR) of four adult California sea lions (Zalophus californianus), two males and two females, was quantified during trained submersion and stationing behavior in laboratory tanks. MR was measured, at rest and for single submersions of increasing duration (1-7 min), by measuring oxygen consumption using open-circuit, indirect calorimetry. Standard MR was measured under conditions defined for basal MR and was found to be 1.9 to 3 times that predicted for terrestrial animals of similar size. Submersion MRs were calculated from the post-submersion oxygen debt and declined to as little as 47 % of standard MR on the longest submersions. This hypometabolic response was proportional to the duration of submersion and was greatest for the maximum duration submersions. Short submersions produced MRs equivalent to measured standard MR. These data suggest that although California sea lions maintain an elevated metabolism under standard conditions, they are capable of reducing their metabolism in response to the needs of diving. Such metabolic flexibility enables sea lions to moderate their oxygen use during diving and to extend their aerobic diving capability.

背景与目标： ：在训练有素的浸没和在实验室水槽中的进驻行为期间，对四只成年加州海狮（Zalophus californianus）（两只雄性和两只雌性）的代谢率（MR）进行了定量。通过使用开路，间接量热法测量氧气消耗量，在静止状态下以及持续时间较长（1-7分钟）的单个潜水器中测量MR。在为基础MR定义的条件下测量标准MR，发现其为类似大小的陆生动物预测值的1.9到3倍。淹没MR是根据淹没后的氧含量计算得出的，在最长的淹没状态下，其下降幅度仅为标准MR的47％。该代谢不良反应与浸入持续时间成比例，对于最大持续时间浸入最大。短时浸没产生的MR等于测量的标准MR。这些数据表明，尽管加利福尼亚海狮在标准条件下仍能维持较高的新陈代谢，但它们能够响应潜水需求而降低其新陈代谢。这种新陈代谢的灵活性使海狮在潜水过程中能够适度使用氧气，并扩展其有氧潜水能力。

BACKGROUND & AIMS: :Congenital anomalies are a leading cause of infant mortality and are important contributors to subsequent morbidity. Studies suggest associations between environmental contaminants and some anomalies, although evidence is limited. We aimed to investigate whether ambient air pollutant and traffic exposures in early gestation contribute to the risk of selected congenital anomalies in the San Joaquin Valley of California, 1997-2006. Seven exposures and 5 outcomes were included for a total of 35 investigated associations. We observed increased odds of neural tube defects when comparing the highest with the lowest quartile of exposure for several pollutants after adjusting for maternal race/ethnicity, education, and multivitamin use. The adjusted odds ratio for neural tube defects among those with the highest carbon monoxide exposure was 1.9 (95% confidence interval: 1.1, 3.2) compared with those with the lowest exposure, and there was a monotonic exposure-response across quartiles. The highest quartile of nitrogen oxide exposure was associated with neural tube defects (adjusted odds ratio = 1.8, 95% confidence interval: 1.1, 2.8). The adjusted odds ratio for the highest quartile of nitrogen dioxide exposure was 1.7 (95% confidence interval: 1.1, 2.7). Ozone was associated with decreased odds of neural tube defects. Our results extend the limited body of evidence regarding air pollution exposure and adverse birth outcomes.

背景与目标： ：先天性异常是婴儿死亡的主要原因，并且是随后发病的重要原因。研究表明，尽管证据有限，但环境污染物与某些异常之间存在关联。我们的目的是调查1997-2006年加利福尼亚州圣华金河谷的环境空气污染物和妊娠早期的交通暴露是否会导致某些先天性异常的风险。总共35个被调查的协会包括7次暴露和5个结果。在调整了母体种族/民族，教育程度和多种维生素使用量后，比较几种污染物的最高和最低四分位数的暴露量，我们观察到了神经管缺陷的几率增加。一氧化碳暴露最高者的神经管缺陷校正比值比为最低暴露者，其调整后的优势比为1.9（95％置信区间：1.1、3.2），四分位数之间存在单调的暴露响应。氮氧化物暴露的最高四分位数与神经管缺陷有关（调整的优势比= 1.8、95％置信区间：1.1、2.8）。二氧化氮暴露的最高四分位数的调整后优势比为1.7（95％置信区间：1.1、2.7）。臭氧与神经管缺损几率降低有关。我们的结果扩展了有关空气污染暴露和不良出生结局的有限证据。

BACKGROUND & AIMS: BACKGROUND:Electric scooters are popular in Southern California due to their ease of use, affordability, and availability. The objective of this study was to characterize how hospital admissions and outcomes varied due to electric scooter injury among Southern California trauma centers. STUDY DESIGN:Trauma registry data from 9 urban trauma centers were queried for patients sustaining injury while operating an electric scooter from January to December 2018. Data collection included patient demographics, diagnoses, interventions, and outcomes. RESULTS:During the 1-year study period, 87 patients required trauma surgeon care due to scooter-related injury, with a mean age of 35.1 years; 71.3% were male with 20.7% and 17.2% of patients requiring ICU admission and a surgical intervention, respectively. One (1.1%) patient died. The head and face were most commonly injured, followed by the extremities. Helmet use was uncommon (71.3%). High variability in patient volume was noted, with 2 centers considered high-incidence and the remaining low-incidence. CONCLUSIONS:Injuries from electric scooter crashes are primarily to the head, face, and extremities, with approximately 1 in 5 patients requiring ICU admission and/or a surgical intervention. There is significant variation in patient volume among Southern California trauma centers that could affect the delivery of care with the abrupt introduction of this technology. Targeted public health interventions and policies might better address community use of the electric scooter.

背景与目标： 背景：电动踏板车因其易于使用，价格合理和实用性而在南加州颇受欢迎。这项研究的目的是描述南加州创伤中心因电动踏板车受伤而导致的住院收治和结局如何变化。
研究设计：从9个城市创伤中心的创伤登记数据中查询了从2018年1月至2018年12月在操作电动踏板车时受伤的患者。数据收集包括患者的人口统计学，诊断，干预和结果。
结果：在为期1年的研究期内，有87例由于踏板车相关伤害而需要创伤外科医生的护理，平均年龄为35.1岁。男性占71.3％，分别需要入ICU和手术干预的患者占20.7％和17.2％。一名（1.1％）患者死亡。头部和面部最常见，其次是四肢。使用头盔的情况很少见（占71.3％）。注意到患者数量的高变异性，其中两个中心被认为是高发病率，其余的被认为是低发病率。
结论：电动踏板车碰撞造成的伤害主要是头部，面部和四肢，约有五分之一的患者需要入住ICU和/或进行外科手术。在南加州创伤中心之间，患者数量存在显着差异，这可能会在突然引入该技术的情况下影响护理的提供。有针对性的公共卫生干预措施和政策可能会更好地解决社区对电动踏板车的使用。

BACKGROUND & AIMS: :Whisker touch is an active sensory system. Previous studies in Pinnipeds have adopted relatively stationary tasks to judge tactile sensitivity, which may not accurately promote natural whisker movements and behaviours. This study developed a novel feeding task, termed fish sweeping to encourage whisker movements. Head and whisker movements were tracked from video footage in Harbor seal (Phoca vitulina), California sea lion (Zalophus californianus) and Pacific walrus (Odobenus rosmarus divergens). All species oriented their head towards the moving fish target and moved their whiskers during the task. Some species also engaged in whisker control behaviours, including head-turning asymmetry in the Pacific walrus, and contact-induced asymmetry in the Pacific walrus and California sea lion: behaviours that have only previously been observed in terrestrial mammals. This study confirms that Pinnipeds should be thought of as whisker specialists, and that whisker control (movement and positioning) is an important aspect of touch sensing in these animals, especially in sea lions and walruses. That the California sea lion controls whisker movement in relation to an object, and also had large values of whisker amplitude, spread and asymmetry, suggests that California sea lions are a promising model with which to further explore active touch sensing.

背景与目标： ：Whisker touch是一个主动的感觉系统。先前在Pinnipeds进行的研究已经采用相对固定的任务来判断触觉敏感性，这可能无法准确地促进自然的晶须运动和行为。这项研究提出了一种新颖的喂养任务，称为扫鱼以鼓励晶须运动。从海豹（Phoca vitulina），加利福尼亚海狮（Zalophus californianus）和太平洋海象（Odobenus rosmarus divergens）的录像中跟踪头部和晶须的运动。在执行任务期间，所有物种的头都朝向移动的鱼目标，并移动了其胡须。一些物种还参与晶须控制行为，包括太平洋海象中的转头不对称性，以及太平洋海象和加利福尼亚海狮中的接触性不对称性：以前仅在陆生哺乳动物中观察到过这种行为。这项研究证实，应将Pinnipeds视为晶须专家，并且晶须控制（运动和定位）是这些动物（尤其是海狮和海象）触摸感应的重要方面。加州海狮控制着相对于物体的晶须运动，并且晶须振幅，传播和不对称性值也很大，这表明加州海狮是一个有前途的模型，可以用来进一步探索主动式触摸感应。

BACKGROUND & AIMS: :Many human diseases are caused by pathogens that produce exotoxins. The genes that encode these exotoxins are frequently encoded by mobile DNA elements such as plasmids or phage. Mobile DNA elements can move exotoxin genes among microbial hosts, converting avirulent bacteria into pathogens. Phage and bacteria from water, soil, and sediment environments represent a potential reservoir of phage- and plasmid-encoded exotoxin genes. The genes encoding exotoxins that are the causes of cholera, diphtheria, enterohemorrhagic diarrhea, and Staphylococcus aureus food poisoning were found in soil, sediment, and water samples by standard PCR assays from locations where the human diseases are uncommon or nonexistent. On average, at least one of the target exotoxin genes was detected in approximately 15% of the more than 300 environmental samples tested. The results of standard PCR assays were confirmed by quantitative PCR (QPCR) and Southern dot blot analyses. Agreement between the results of the standard PCR and QPCR ranged from 63% to 84%; and the agreement between standard PCR and Southern dot blots ranged from 50% to 66%. Both the cholera and shiga exotoxin genes were also found in the free phage DNA fraction. The results indicate that phage-encoded exotoxin genes are widespread and mobile in terrestrial and aquatic environments.

背景与目标： ：许多人类疾病是由产生外毒素的病原体引起的。编码这些外毒素的基因通常由可移动的DNA元件（如质粒或噬菌体）编码。可移动的DNA元素可以在微生物宿主之间移动外毒素基因，从而将无毒细菌转化为病原体。来自水，土壤和沉积物环境的噬菌体和细菌代表着噬菌体和质粒编码的外毒素基因的潜在库。通过标准PCR检测在人类疾病不常见或不存在的地方的土壤，沉积物和水样中发现了编码霍乱，白喉，肠出血性腹泻和金黄色葡萄球菌食物中毒的外毒素编码基因。平均而言，在所测试的300多个环境样本中，大约有15％检测到了目标外毒素基因中的至少一种。通过定量PCR（QPCR）和Southern点印迹分析证实了标准PCR测定的结果。标准PCR和QPCR结果之间的一致性介于63％至84％之间；标准PCR和Southern点印迹的一致性介于50％至66％之间。在游离噬菌体DNA部分中也发现了霍乱和志贺外毒素基因。结果表明，噬菌体编码的外毒素基因在陆地和水生环境中广泛存在并且可以移动。

BACKGROUND & AIMS: :Young men who have sex with men (YMSM) are at alarming risk for HIV acquisition, demonstrating the highest rates of incident infection of any age-risk group. GRINDR is a global positioning service-based social networking application popular with YMSM for sexual partnering. To assess the characteristics of YMSM who use GRINDR, we conducted a computer-assisted self-interview-based survey of 375 YMSM using GRINDR in metropolitan Los Angeles, recruited using the GRINDR platform. The median age was 25 (interquartile range, 22-27) years old, 42.4 % caucasian, 6.4 % African American, 33.6 % Latino, and 14.1 % Asian/Pacific Islander. Participants reported high rates of sexual partnering and unprotected anal intercourse (UAI). The majority (70 %) of those reporting unprotected anal intercourse reported low perception of HIV-acquisition risk. Of the participants, 83.1 % reported HIV testing within the past 12 months; 4.3 % had never been HIV tested. Of the participants, 4.5 % reported HIV-positive serostatus; 51.7 % indicated that they would be interested in participating in a future HIV prevention trial. Latinos were more likely than either caucasians or African Americans to endorse trial participation interest (odds ratio, 1.9; 95 % confidence interval [1.1-3.3]). HIV-positive test results were associated with increased number of anal sex partners in the past 3 months (adjusted odds ratio (AOR), 1.53 [0.97-2.40]), inconsistent inquiry about partners' serostatus (AOR, 3.63 [1.37-9.64]), reporting the purpose for GRINDR use including "friendship" (AOR, 0.17 [0.03-1.06), and meeting a sexual partner in a bookstore in the past 3 months (AOR, 33.84 [0.99-1152]). Men recruited via GRINDR were high risk for HIV acquisition or transmission and interested in clinical trial participation, suggesting potential for this method to be used for recruitment of YMSM to HIV prevention trials.

背景与目标： ：与男性发生性关系的年轻人（YMSM）感染艾滋病毒的危险性令人震惊，这表明在任何年龄风险组中，事件感染率最高。 GRINDR是一种基于全球定位服务的社交网络应用程序，在YMSM中很受欢迎，用于进行性伴侣。为了评估使用GRINDR的YMSM的特征，我们使用GRINDR平台招募了在洛杉矶大都市使用GRINDR进行的基于计算机辅助自我访谈的375 YMSM调查。中位年龄为25岁（四分位数范围为22-27岁），白种人为42.4％，非洲裔美国人为6.4％，拉丁美洲人为33.6％，亚洲/太平洋岛民为14.1％。参与者报告说，性伴侣和无保护的肛门性交（UAI）的发生率很高。报告无保护的肛门性交的人中的大多数（70％）报告对艾滋病毒感染风险的认识较低。在参与者中，有83.1％的人在过去12个月内报告了HIV检测; 4.3％的人从未接受过HIV检测。在参与者中，有4.5％的人报告HIV阳性血清状况; 51.7％的人表示他们有兴趣参加未来的HIV预防试验。与白种人或非裔美国人相比，拉丁美洲人更有可能认可试验参与者的兴趣（优势比为1.9； 95％的置信区间[1.1-3.3]）。 HIV阳性测试结果与过去3个月中肛交伴侣的数量增加相关（调整比值比（AOR），1.53 [0.97-2.40]），对伴侣血清状况的询问不一致（AOR，3.63 [1.37-9.64]） ），报告使用GRINDR的目的，包括“友谊”（AOR，0.17 [0.03-1.06]），并在过去3个月内在书店里结识性伴侣（AOR，33.84 [0.99-1152]）。通过GRINDR招募的男性对HIV的获取或传播具有很高的风险，并且对临床试验的参与感兴趣，这表明该方法可能被用于招募YMSM参加HIV预防试验。

BACKGROUND & AIMS: :Ecstasy (3,4-methylenedioxymethamphetamine [MDMA]) is an illegal synthetic amphetamine used as a stimulant and hallucinogen. On January 4, 2010, the Los Angeles County (LAC) Department of Public Health (DPH) learned of six MDMA-related emergency department (ED) visits and one death, all linked to a New Year's Eve event attended by approximately 45,000 persons. LAC DPH conducted an investigation to search for additional MDMA-related ED visits, characterize the cases, and determine whether drug contamination was involved. This report summarizes the results of the investigation, which determined that 18 patients visited EDs in LAC for MDMA-related illness within 12 hours of the rave. All were aged 16-34 years, and nine were female. In addition to using MDMA, 10 of the 18 had used alcohol, and five had used other drugs. Three patients were admitted to the hospital, including one to intensive care. A tablet obtained from one of the patients contained MDMA and caffeine, without known toxic contaminants. The cluster of apparent ecstasy overdoses occurred in the context of likely increasing MDMA use in the county during 2005-2009, as indicated by increased identification of MDMA-containing forensic specimens and a large increase in LAC residents entering drug treatment programs for MDMA. Collaboration between public health, police, fire, and emergency medical service (EMS) officials on a comprehensive prevention strategy might reduce the number of overdoses at similar events.

背景与目标： 迷魂药（3,4-亚甲二氧基甲基苯丙胺[MDMA]）是用作刺激剂和迷幻剂的非法合成苯丙胺。 2010年1月4日，洛杉矶县（LAC）公共卫生部门（DPH）获悉，与MDMA相关的急诊部门（ED）进行了6次访问和1次死亡，所有这些都与除夕活动有关，约有45,000人参加。 LAC DPH进行了一项调查，以寻找与MDMA相关的其他ED访问，确定病例特征，并确定是否涉及药物污染。该报告总结了调查的结果，该调查确定了18位患者在狂欢后12小时内就LAC中的MDMA相关疾病访问了ED。年龄均在16-34岁之间，其中9人为女性。除了使用摇头丸之外，18个中的10个还使用了酒精，另外5个使用了其他药物。三名患者入院，其中一名接受重症监护。从一名患者中获得的片剂含有MDMA和咖啡因，没有已知的有毒污染物。在2005-2009年期间，该县明显使用过量摇头丸的情况发生了，如对含MDMA的法医标本的识别增加以及进入MDMA药物治疗计划的LAC居民的大量增加所表明的。公共卫生，警察，消防和紧急医疗服务（EMS）官员之间在全面预防策略上的合作可能会减少类似事件中药物过量的数量。

BACKGROUND & AIMS: :In Britain matters of clinical judgement and practice rarely become the subject of political action and are usually not covered by legislation, but rather by 'guidelines' and well-meaning persuasion. In California, however, where the medical and dental professions are not trusted to put their own house in order, everything is covered by legislation and becomes the subject of intense political lobbying. The giving of general anaesthesia by dentists has been tightly governed since 1980 but the legislature has only just come to grips with the question of conscious sedation.

背景与目标： ：在英国，临床判断和实践问题很少成为政治行为的主题，通常不在立法范围之内，而是在“指南”和善意的说服范围之内。但是，在加利福尼亚州，那里不信任医学和牙科专业人士整理自己的房屋，而这一切都受到立法的限制，并成为激烈的政治游说的对象。自1980年以来，牙医对全身麻醉的使用一直受到严格的管理，但是立法机关才刚刚解决了自觉镇静的问题。

BACKGROUND & AIMS: BACKGROUND:Large-scale cancer epidemiology cohorts (CEC) have successfully collected, analyzed, and shared patient-reported data for years. CECs increasingly need to make their data more findable, accessible, interoperable, and reusable, or FAIR. How CECs should approach this transformation is unclear. METHODS:The California Teachers Study (CTS) is an observational CEC of 133,477 participants followed since 1995-1996. In 2014, we began updating our data storage, management, analysis, and sharing strategy. With the San Diego Supercomputer Center, we deployed a new infrastructure based on a data warehouse to integrate and manage data and a secure and shared workspace with documentation, software, and analytic tools that facilitate collaboration and accelerate analyses. RESULTS:Our new CTS infrastructure includes a data warehouse and data marts, which are focused subsets from the data warehouse designed for efficiency. The secure CTS workspace utilizes a remote desktop service that operates within a Health Insurance Portability and Accountability Act (HIPAA)- and Federal Information Security Management Act (FISMA)-compliant platform. Our infrastructure offers broad access to CTS data, includes statistical analysis and data visualization software and tools, flexibly manages other key data activities (e.g., cleaning, updates, and data sharing), and will continue to evolve to advance FAIR principles. CONCLUSIONS:Our scalable infrastructure provides the security, authorization, data model, metadata, and analytic tools needed to manage, share, and analyze CTS data in ways that are consistent with the NCI's Cancer Research Data Commons Framework. IMPACT:The CTS's implementation of new infrastructure in an ongoing CEC demonstrates how population sciences can explore and embrace new cloud-based and analytics infrastructure to accelerate cancer research and translation.See all articles in this CEBP Focus section, "Modernizing Population Science."

背景与目标： 背景：大型癌症流行病学队列（CEC）多年来已成功收集，分析和共享患者报告的数据。 CEC越来越需要使它们的数据更易于查找，访问，互操作和可重用，或称为FAIR。 CEC如何应对这种转变尚不清楚。
方法：自1995年至1996年以来，加州教师研究（CTS）是一项133,477名参与者的观察性CEC。 2014年，我们开始更新数据存储，管理，分析和共享策略。通过圣地亚哥超级计算机中心，我们部署了一个基于数据仓库的新基础架构，以集成和管理数据以及带有文档，软件和分析工具的安全且共享的工作空间，这些文件，软件和分析工具可促进协作并加速分析。
结果：我们新的CTS基础架构包括一个数据仓库和数据集市，它们是为提高效率而设计的数据仓库中的重点子集。安全的CTS工作区利用远程桌面服务，该服务在符合《健康保险可移植性和责任法案》（HIPAA）和《联邦信息安全管理法案》（FISMA）的平台内运行。我们的基础架构可广泛访问CTS数据，包括统计分析和数据可视化软件和工具，可灵活管理其他关键数据活动（例如，清理，更新和数据共享），并将继续发展以推进FAIR原则。
结论：我们的可扩展基础架构提供了以与NCI的癌症研究数据共享框架一致的方式管理，共享和分析CTS数据所需的安全性，授权，数据模型，元数据和分析工具。
影响：CTS在持续进行的CEC中对新基础设施的实施演示了人口科学如何探索和采用新的基于云的分析基础设施，以加速癌症研究和翻译。请参阅本CEBP焦点部分“现代化人口科学”中的所有文章。

BACKGROUND & AIMS: :The efficacy of the HbOC conjugate Haemophilus influenzae type b vaccine was evaluated in a study population of 61,080 infants in the Northern California Kaiser Permanente Medical Care Program. Between February, 1988, and June, 1990, the HbOC vaccine was given as part of a three-dose series at 2, 4, and 6 months of age to 20,800 infants. The study population included children with a well-care visit at a study center during the first 6 months of life. There were 25 cases of Haemophilus influenzae type b disease in the study population: 22 in unvaccinated children and 3 in children who received only one dose of HbOC vaccine. The efficacy of the full three-dose series was evaluated by several methods: a primary analysis comparing fully vaccinated children with unvaccinated children from 7 to 18 months of age; a stratified exact analysis adjusted for age and seasonality; and a case-control analysis which further adjusted for known risk factors. The efficacy of three doses of vaccine was 100% with the lower bound of the 95% confidence interval for the three analyses at 68, 71, and 64%, respectively. There were no cases of disease resulting from two doses of HbOC vaccine yielding an estimate of 100% efficacy (95% confidence interval, 47 to 100) for two doses of HbOC vaccine. However, for children who had received only one dose of HbOC vaccine, vaccine efficacy was estimated to be 26% and the possibility that one dose of HbOC vaccine had no efficacy could not be excluded.(ABSTRACT TRUNCATED AT 250 WORDS)

背景与目标： ：在北加州凯撒永久医疗计划的61,080名婴儿的研究人群中评估了HbOC缀合的b型流感嗜血杆菌流感疫苗的功效。在1988年2月至1990年6月之间，HbOC疫苗是在3、2、4和6个月大的剂量时向20,800名婴儿接种的三剂疫苗。研究对象包括在生命的头6个月内在研究中心接受过精心照顾的儿童。在研究人群中，有25例b型流感嗜血杆菌病例：未接种疫苗的儿童中有22例，仅接受一剂HbOC疫苗的儿童中有3例。完整的三剂量系列药物的疗效通过几种方法进行了评估：将完全接种疫苗的儿童与7到18个月大的未接种疫苗的儿童进行初步分析；根据年龄和季节性调整的分层精确分析；并进行病例对照分析，以进一步调整已知的危险因素。三剂疫苗的功效为100％，三种分析的95％置信区间的下限分别为68％，71％和64％。没有两例HbOC疫苗引起的疾病病例，对于两剂HbOC疫苗，估计有100％的功效（95％置信区间，47至100）。但是，对于仅接受一剂HbOC疫苗的儿童，疫苗效力估计为26％，并且不能排除一剂HbOC疫苗无效的可能性。（摘要以250字截断）

BACKGROUND & AIMS: OBJECTIVE:Long-term care (LTC) ombudsman advocate for the health, safety, welfare, and rights of residents in LTC facilities. This article examines factors associated with self-rated effectiveness of local LTC Ombudsman Programs (LTCOPs) in California and New York across the five statutorily mandated activities under the Older Americans Act: complaint investigation, resident/family education, community education, monitoring laws, and policy advocacy. METHOD:Data were collected from telephone interviews with coordinators of local LTCOPs in California and New York and from the National Ombudsman Reporting System. Analyses examined factors associated with effectiveness: program size, resource adequacy, organizational autonomy, interorganizational relationships, and program outputs. RESULTS:Resource and autonomy measures are significantly associated with different effectiveness measures in each state. Staff full-time equivalencies and coordinator hours per week in New York and the quality of training in California are significantly associated with effectiveness in most mandated activities. DISCUSSION:Findings highlight variability within and between the local LTCOPs in California and New York.

背景与目标： 目的：长期护理（LTC）监察员倡导长期护理设施中居民的健康，安全，福利和权利。本文研究了《老年人法案》规定的五项法定强制性活动中与加利福尼亚和纽约地方LTC监察员计划（LTCOP）自我评估的有效性相关的因素：投诉调查，居民/家庭教育，社区教育，监控法律和政策倡导。
方法：数据是通过与加利福尼亚和纽约当地LTCOP协调员的电话采访以及国家监察员报告系统收集的。分析与有效性相关的检查因素：计划规模，资源充足性，组织自主权，组织间关系和计划产出。
结果：资源和自治措施与每个州的不同有效性措施显着相关。在纽约，工作人员的全职当量工作量和每周的协调员时数以及加利福尼亚州的培训质量与大多数法定活动的有效性密切相关。
讨论：研究结果突出了加利福尼亚和纽约当地LTCOP内和之间的差异。

BACKGROUND & AIMS: OBJECTIVES:This study compared trends in colorectal cancer (CRC) incidence and mortality rates among Koreans in South Korea and Korean Americans and non-Hispanic whites in California between 1999 and 2009, and examined CRC screening rates and socio-demographic correlates of CRC screening in the two Korean populations. DESIGN:Age-standardized CRC incidence and mortality rates of Koreans in South Korea and Korean Americans and non-Hispanic whites in California for the years 1999-2009 were obtained from annual reports of cancer statistics and modeled using joinpoint regression. Using 2009 data from the Korean National Health and Nutrition Examination Survey and the California Health Interview Survey, we estimated and compared CRC screening rates and test modalities. We used multiple logistic regression to examine socio-demographic correlates of completion of CRC screening according to the guidelines among the two Korean populations. RESULTS:CRC incidence and mortality rates among South Koreans increased during 1999-2009 but more slowly during the late 2000s. In California, CRC incidence increased among Korean American females but decreased among non-Hispanic whites. About 37% of South Koreans and 60% of Korean Americans reported completion of CRC screening according to guidelines in 2009. Among South Koreans, married status, higher income, and private health insurance were associated with CRC screening, adjusting for other factors. Among Korean Americans, having health insurance was associated with CRC screening. CONCLUSION:Despite almost identical CRC screening guidelines in South Korea and the USA and substantially higher screening rates among Korean Americans as compared to South Koreans, disparities remain in both populations with respect to CRC statistics. Thus, efforts to promote primary and secondary prevention of CRC in both Korean populations are critically important in both countries.

背景与目标： 目的：本研究比较了1999年至2009年之间韩国人，韩国人，韩国人，韩国人和韩国的非西班牙裔白人中大肠癌（CRC）发生率和死亡率的趋势，并调查了CRC筛查率和社会人口统计学相关性。两个朝鲜族。
设计：从癌症统计数据的年度报告中获得了韩国和韩国裔美国人以及加利福尼亚州的非西班牙裔白人的年龄标准化的CRC发病率和死亡率，并使用joinpoint回归进行了建模。使用2009年韩国国家健康与营养检查调查和加州健康访问调查得出的数据，我们估算并比较了CRC筛查率和检测方式。我们根据韩国两个人群的指南，使用多元逻辑回归分析了CRC筛查完成情况的社会人口统计学相关性。
结果：韩国人的CRC发病率和死亡率在1999年至2009年期间有所增加，但在2000年代后期则更为缓慢。在加利福尼亚州，韩裔美国女性的CRC发病率上升，但非西班牙裔白人的CRC发病率下降。 2009年，大约37％的韩国人和60％的韩裔美国人根据指南完成了CRC筛查。在韩国人中，已婚的身分，较高的收入和私人健康保险与CRC筛查相关，并调整了其他因素。在韩裔美国人中，拥有健康保险与CRC筛查有关。
结论：尽管韩国和美国的CRC筛查指南几乎相同，并且韩裔美国人的筛查率比韩国人高得多，但两个人群的CRC统计数据仍存在差异。因此，在这两个国家中促进在朝鲜族人群中一级和二级预防CRC的努力至关重要。