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Golden, CO, United States

SRA International, Inc. is an information technology services and solutions consulting company incorporated as Systems Research and Applications Corporation in 1976 and beginning operations in 1978. Founded by Ernst Volgenau, it is headquartered in Fair Lakes, Virginia, and employs more than 5,200 people worldwide. William L. Ballhaus is the current President and Chief Executive Officer.SRA provides information technology services to clients in national security, civil government, and health care and public health. Its largest market, national security, includes the Department of Defense, Homeland Security, US Army, US Air Force, and intelligence agencies. Wikipedia.

Geller A.I.,Centers for Disease Control and Prevention | Shehab N.,Centers for Disease Control and Prevention | Lovegrove M.C.,Centers for Disease Control and Prevention | Kegler S.R.,Centers for Disease Control and Prevention | And 3 more authors.
JAMA Internal Medicine

IMPORTANCE Detailed, nationally representative data describing high-risk populations and circumstances involved in insulin-related hypoglycemia and errors (IHEs) can inform approaches to individualizing glycemic targets. OBJECTIVE To describe the US burden, rates, and characteristics of emergency department (ED) visits and emergency hospitalizations for IHEs. DESIGN, SETTING, AND PARTICIPANTS Nationally representative public health surveillance of adverse drug events among insulin-treated patients seeking ED care (National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance project) and a national household survey of insulin use (the National Health Interview Survey) were used to obtain data from January 1, 2007, through December 31, 2011. MAIN OUTCOMES AND MEASURES Estimated annual numbers and estimated annual rates of ED visits and hospitalizations for IHEs among insulin-treated patients with diabetes mellitus. RESULTS Based on 8100 National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance cases, an estimated 97 648 (95%CI, 64 410-130 887) ED visits for IHEs occurred annually; almost one-third (29.3%; 95%CI, 21.8%-36.8%) resulted in hospitalization. Severe neurologic sequelae were documented in an estimated 60.6%(95% CI, 51.3%-69.9%) of ED visits for IHEs, and blood glucose levels of 50 mg/dL (to convert to millimoles per liter, multiply by 0.0555) or less were recorded in more than half of cases (53.4%). Insulin-treated patients 80 years or older were more than twice as likely to visit the ED (rate ratio, 2.5; 95%CI, 1.5-4.3) and nearly 5 times as likely to be subsequently hospitalized (rate ratio, 4.9; 95%CI, 2.6-9.1) for IHEs than those 45 to 64 years. The most commonly identified IHE precipitants were reduced food intake and administration of the wrong insulin product. CONCLUSIONS AND RELEVANCE Rates of ED visits and subsequent hospitalizations for IHEs were highest in patients 80 years or older; the risks of hypoglycemic sequelae in this age group should be considered in decisions to prescribe and intensify insulin. Meal-planning misadventures and insulin product mix-ups are important targets for hypoglycemia prevention efforts. © 2014 American Medical Association. All rights reserved. Source

Smith L.K.,U.S. National Institutes of Health | Smith L.K.,University of North Carolina at Chapel Hill | Shah R.R.,SRA International, Inc. | Cidlowski J.A.,U.S. National Institutes of Health
Journal of Biological Chemistry

Glucocorticoids modulate immune development and function through the induction of lymphocyte apoptosis via mechanisms requiring alterations in gene expression. Recently, short, noncoding, microRNAs have been identified as key regulators of lymphocyte function; however, it is unknown whether glucocorticoids regulate noncoding microRNAs and whether this regulation contributes to lymphocyte apoptosis. We now show by both microarray and deep sequencing analysis that microRNAs are substantially repressed during glucocorticoid-induced apoptosis of primary rat thymocytes. Mechanistic studies revealed that primary microRNA transcripts were not repressed, whereas the expression of the key microRNA processing enzymes: Dicer, Drosha, and DGCR8/Pasha, were significantly reduced at both the mRNA and protein levels during glucocorticoid-induced apoptosis. To delineate the role of Dicer depletion and microRNA repression in apoptosis, we silenced Dicer expression in two human leukemic cell lines and demonstrated that Dicer depletion significantly enhanced glucocorticoid-induced apoptosis in both model systems. Finally, in vitro and in vivo overexpression of the conserved miR-17-92 polycistron, which was repressed significantly by dexamethasone treatment in both our microarray and deep sequencing studies, blunted glucocorticoid-induced apoptosis. These studies provide evidence of altered post-transcriptional microRNA expression and the repression of the microRNA bioprocessing pathway during glucocorticoid-induced apoptosis of lymphocytes, suggesting a role for microRNA processors and specific microRNAs in cell life/death decisions. Source

Foraker R.E.,Ohio State University | Rose K.M.,SRA International, Inc. | Suchindran C.M.,University of North Carolina at Chapel Hill | Chang P.P.,University of North Carolina at Chapel Hill | And 2 more authors.
Circulation: Heart Failure

Background-Among patients with heart failure (HF), early readmission or death and repeat hospitalizations may be indicators of poor disease management or more severe disease. Methods and Results-We assessed the association of neighborhood median household income (nINC) and Medicaid status with rehospitalization or death in the Atherosclerosis Risk in Communities cohort study (1987 to 2004) after an incident HF hospitalization in the context of individual socioeconomic status and evaluated the relationship for modification by demographic and comorbidity factors. We used generalized linear Poisson mixed models to estimate rehospitalization rate ratios and 95% CIs and Cox regression to estimate hazard ratios (HRs) and 95% CIs of rehospitalization or death. In models controlling for race and study community, sex, age at HF diagnosis, body mass index, hypertension, educational attainment, alcohol use, and smoking, patients with a high burden of comorbidity who were living in low-nINC areas at baseline had an elevated hazard of all-cause rehospitalization (HR, 1.40; 95% CI, 1.10 to 1.77), death (HR, 1.36; 95% CI, 1.02 to 1.80), and rehospitalization or death (HR, 1.36; 95% CI, 1.08 to 1.70) as well as increased rates of hospitalization compared to those with a high burden of comorbidity living in high-nINC areas. Medicaid recipients with a low level of comorbidity had an increased hazard of all-cause rehospitalization (HR, 1.19; 95% CI, 1.05 to 1.36) and rehospitalization or death (HR, 1.21; 95% CI, 1.07 to 1.37) and a higher rate of repeat hospitalizations compared to non-Medicaid recipients. Conclusions-Comorbidity burden appears to influence the association among nINC, Medicaid status, and rehospitalization and death in patients with HF. © 2011 American Heart Association, Inc. Source

Michaud W.R.,SRA International, Inc.
Journal of the American Water Resources Association

Does collaborative modeling improve water resource management outcomes? How does collaborative modeling improve these outcomes? Does it always work? Under what conditions is collaborative modeling most appropriate? With support from the U.S. Army Corps of Engineers' Institute for Water Resources (IWR), researchers developed an evaluation framework to help address these questions. The framework links the effects of collaborative modeling on decision-making processes with improvements in the extent to which resource management decisions, practices, and policies balance societal needs. Both practitioners' and participants' experiences suggest that under the right circumstances, collaborative modeling can generate these beneficial outcomes. Researchers developed performance measures and a survey to systematically capture these experiences and evaluate the outcomes of collaborative modeling processes. The survey can provide immediate feedback during a project to determine whether collaborative modeling is having the desired effect and whether course correction is warranted. Over the longer term, the systematic evaluation of collaborative modeling processes will help demonstrate in what ways and under what circumstances collaborative modeling is effective, inform and improve best practices, and raise awareness among water resource planners regarding the use of collaborative modeling for resource management decisions. © 2013 American Water Resources Association. Source

Wing S.,University of North Carolina at Chapel Hill | Horton R.A.,University of North Carolina at Chapel Hill | Rose K.M.,University of North Carolina at Chapel Hill | Rose K.M.,SRA International, Inc.
Environmental Health Perspectives

Background: Industrial swine operations emit odorant chemicals including ammonia, hydrogen sulfide (H2S), and volatile organic compounds. Malodor and pollutant concentrations have been associated with self-reported stress and altered mood in prior studies. Objectives: We conducted a repeated-measures study of air pollution, stress, and blood pressure in neighbors of swine operations. Methods: For approximately 2 weeks, 101 nonsmoking adult volunteers living near industrial swine operations in 16 neighborhoods in eastern North Carolina sat outdoors for 10 min twice daily at preselected times. Afterward, they reported levels of hog odor on a 9-point scale and measured their blood pressure twice using an automated oscillometric device. During the same 2- to 3-week period, we measured ambient levels of H2S and PM10 at a central location in each neighborhood. Associations between systolic and diastolic blood pressure (SBP and DBP, respectively) and pollutant measures were estimated using fixed-effects (conditional) linear regression with adjustment for time of day. Results: PM10 showed little association with blood pressure. DBP [β (SE)] increased 0.23 (0.08) mmHg per unit of reported hog odor during the 10 min outdoors and 0.12 (0.08) mmHg per 1-ppb increase of H2S concentration in the same hour. SBP increased 0.10 (0.12) mmHg per odor unit and 0.29 (0.12) mmHg per 1-ppb increase of H2S in the same hour. Reported stress was strongly associated with BP; adjustment for stress reduced the odor-DBP association, but the H2S-SBP association changed little. Conclusions: Like noise and other repetitive environmental stressors, malodors may be associated with acute blood pressure increases that could contribute to development of chronic hypertension. Source

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