This study examines the quality of life in Crete, Nebraska, with the specific purpose of identifying the factors that play the largest role in determining residential satisfaction. The survey asks a number of questions pertaining to different aspects of living in Crete. The survey is adapted from a survey previously used for a similar study in Schuyler, Nebraska. Focus groups are used to identify key issues in Crete and make adjustments to the questionnaire. Cronbach's alpha is used to test the reliability of the topical variables, and index variables are created, which are used in the subsequent analysis. Using residential satisfaction as the dependent variable, stepwise multiple linear regressions are performed independently for the total population, the new arrivals, and the long-time resident groups. The findings of this study indicate that stressors and sociocultural issues are the significant contributors to the overall community's residential satisfaction.

Background. Chronic disease management requires the ability to link patient records across multiple interactions with the health sector. South Africa's National Health Laboratory Service (NHLS) conducts all routine laboratory monitoring for the country's national public sector HIV program. However, the absence of a validated patient identifier has limited the potential of the NHLS database for epidemiological research, policy evaluation, and longitudinal patient care. We developed and validated a record linkage algorithm, creating a unique patient identifier and enabling analysis of the NHLS database as a national HIV cohort. To our knowledge, this is the first national HIV cohort in any low-or middle-income country. Methods.We linked data on all CD4 counts, HIV viral loads (VL), and ART workup laboratory tests from 2004-2016. Each NHLS laboratory test result is associated with a name, sex, date of birth (DOB), gender, and facility. However, due to typographical and other errors and patient mobility between facilities, different patient specimens may be associated with different sets of identifying information. We developed a graph-based probabilistic record linkage algorithm and used it to construct a unique identifier for all patients with laboratory results in the national HIV program. We used standard probabilistic linkage methods with Jaro-Winkler string comparisons and weights informed by response frequency. We also used graph concepts to guide the linkage in Results. As of December 2016, the NHLS database contained 117 million patient specimens with a CD4, VL, or other laboratory test used in HIV care. These specimens had 63 million unique combinations of patient identifying information. From these data, our matching algorithm identified 11.6 million unique HIV patients who had at least one CD4 count or VL result. These patients 70.9 million total specimens, with a median of 3 specimens per patient (IQR 1 to 8). Sensitivity and PPV of the algorithm were estimated to be 93.7% and 98.6% in manually-matched data, compared to 64.1% and 100.0% for the existing NHLS identifier. We estimated that in 2016 there were 3.35 million patients on ART and virologically monitored, similar to the National Department of Health estimate of 3.50 million. Conclusion.We constructed a South African National HIV Cohort by applying novel graph-based probabilistic record linkage techniques to routinely collected laboratory data, with high sensitivity and positive predictive value. Information on graph structure can guide record linkage in large populations when identifying data are limited.

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Protein kinase C (PKC) inhibitors decrease alpha1(I) collagen mRNA in stellate cells exposed to 200 micromol/liter of acetaldehyde. The purpose of these studies was to determine whether PKC activation plays a role in transcriptional activation of the alpha2(I) collagen gene. Cultured stellate cells were exposed to 200 micromol/liter of acetaldehyde. PKC, inositol triphosphate, diacylglycerol (DAG), and intracellular free calcium (Ca2+i) were measured. Alpha1(I) and alpha2(I) collagen messages were determined by reverse transcriptase-polymerase chain reaction. Activation of the alpha2(I) collagen promoter was determined in transiently transfected stellate cells. Acetaldehyde exposure enhanced PKC activity translocation to the particulate fraction at 20 min. Acetaldehyde did not increase Ca2+i, or inositol triphosphate but increased DAG levels at 20 min and 3 hr. Acetaldehyde increased both the alpha1(I) and alpha2(I) collagen messages in stellate cells. Calphostin C, a specific PKC inhibitor, which blocks DAG binding, eliminated both activation of the alpha2(I) collagen promoter by acetaldehyde and mRNA production by reverse transcriptase-polymerase chain reaction analysis. Similarly, D609, an inhibitor of DAG production, also inhibited alpha2(I) collagen gene expression. This study shows that collagen production by acetaldehyde is mediated by a calcium-independent PKC mechanism.

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