Physician Assistants’ Views of Direct-to-Consumer Advertising Effects during Patient Encounters

Purpose: Direct-to-consumer advertising (DTCA) has become an important tool for disseminating drug information that directly impacts the patients and providers in the delivery of health care. Limited research shows that DTCA has both benefits and drawbacks that impact public health. However, there is a paucity of empirical evidence of the effects of DTCA information discussed during an office visit from the perspective of physician assistants. The purpose of the study was to examine physician assistants’ general views of DTCA benefits and drawbacks, as well as the effects DTCA information discussed during patient encounters on physician assistant-patient relationship, physician assistants’ prescriptive authority and time efficiency of the visit. Methods: A cross-sectional design was used to survey physician assistants in a single U.S. Midwestern state. A random sample of 860 of the state’s 4,483 physician assistants was drawn. The final sample consisted of 161 PAs (18.72%). Of these, 149 PAs (93%) had experience with discussing DTCA during an office visit. Pearson’s chi-squared analysis, logistic regression and multinomial logistic regression analyses were used to measure the associations between the variables. Results: Of the 161 physician assistants, most thought that DTCA drove up drug costs (76%), promoted unnecessary fear of side effects (71%), and did not provide a balanced view of risks and benefits of the product (64%). Conversely, most agreed that DTCA alerted patients to new therapies (74%) and did not create a conflict between the physician assistant and supervising physician (71%). Of the 149 physician assistants who experienced discussion about DTCA during a visit, 49% reported that patients did so because they wanted a drug; 62% deemed patients’ requests inappropriate; and 74% viewed DTCA as worsening the time efficiency. Worsened efficiency was associated with the patient wanting a test, bringing a printed advertisement, and the advertisement not being relevant. Worsened physician assistant-patient relationship was associated with challenged authority. Conclusions: The study highlights the need to enhance dialogue between the physician assistant and the supervising physician about patient needs, to provide targeted DTCA educational training opportunities that sharpen communication and interpersonal skills, and to incorporate physician assistants’ perspectives in future guidelines governing DTCA

A new neutron study of the short range order inversion in Fe1−x_{1-x}Crx_x

We have performed new neutron diffuse scattering measurements in Fe$_{1-x}$Cr$_x$ solid solutions, in a concentration range 0$<$x$<$0.15, where the atomic distribution shows an inversion of the short range order. By optimizing the signal-background ratio, we obtain an accurate determination of the concentration of inversion x$_0$ =0.110(5). We determine the near neighbor atomic short range order parameters and pair potentials, which change sign at x$_0$. The experimental results are compared with previous first principle calculations and atomistic simulations.Comment: 6 pages; 6 figure

Нейротехнологии в праве и правоприменении: прошлое, настоящее и будущее

The scope of the research is the necessity for legal regulation of the use of neurotechnologies in various sectors of human activity and the possibility of their application in jurisprudence. Neurotechnology is based on advances in neuroscience that allow us to understand the structure of the brain. The advances in neuroscience are driving the rapid development of neurotechnologies and their spread in modern society. The special importance of neurotechnologies is explained by the fact that, on the one hand, they contribute to the enhancement of artificial intelligence, significantly increasing the amount of data necessary for artificial intelligence for learning, on the other hand, with the help of neurotechnologies, people can increase their capabilities, both physical and mental.The purpose of the article is to analyze the development of the application of neurotechnologies in practical use and assess the degree of necessity for the right to respond to the use of various neurodevices by people, as well as to study the risks of using solutions based on neurotechnologies in law enforcement.The methods of conducting this research include the formal logical method, historical and comparative legal methods, the method of systems analysis, the method of abstraction and the method of legal forecasting.The main scientific results. Taking into consideration the available foreign experience, the history of the use of neurotechnologies in law enforcement to the present day is systematized, the origins of the formation of neuro-law are considered. The level of neurotechnologies achieved today is assessed, the main issues that the development of neurotechnolo- gies pose to law, and the questions that arise in connection with the growing use of neurotechnologies in law enforcement in the world are listed. Analyzed the legal acts and international documents (soft law) aimed at the regulation of neurotechnology nowadays. The short-term prospects for the use of neurotechnologies in law enforcement are formulated and the related needs for changing legal regulation, in particular, the need to recognize a new group of neuro-rights for a person are highlighted.Conclusions. The further development of neurotechnologies, declared as one of the state priorities in Russia, inevitably intensifies the penetration of neurotechnologies into various sectors of public and state life, including the activities of law enforcement agencies. Therefore, it is necessary to prepare the legal basis for this already today, implementing the relevant provisions into the Constitution of the Russian Federation, criminal, civil, administrative, labor and procedural legislation.Рассматриваются основные вопросы, которые ставит перед правом развитие нейротехнологий, и вопросы, возникающие в связи с применением нейротехнологий в деятельности правоохранительных органов. Нейротехнологии относятся к быстро развивающимся технологиям, распространение которых в России заявлено в качестве одного из приоритетов. Происходит процесс внедрения нейротехнологий в образование и медицину, в производство и сферу услуг. Использование нейротехнологий на практике вызывает потребность в регулировании правом, а также способствует проникновению данных технологий в правоприменение в связи с появляющимися новыми возможностями, предоставляемыми за счет решений на основе нейротехнологий, и из-за необходимости реагировать на использование нейроустройств людьми в повседневной жизни

Creating the Metaverse: Consequences for Economy, Society, and Law

Objective: to define the degree of influence of such developing technological field as metaverse on various spheres of society and to identify the need for reaction on the part of law.Methods: the key method used for the research is the systemic-structural method, which allows establishing connections between various elements of the society as a complex system, analyzing the regularities generated by the spreading influence of metaverse prototypes in one sphere on other ones. Additional methods used are formal-logical, comparative-legal methods, as well as the methods of legal modeling and forecasting.Results: the practical implementation of the metaverse concept will open new opportunities for people, but will be accompanied by drastic changes in the economic subsystem of the society, in particular, the multifold growth of the share of virtual economy and structural changes in employment. The changes will also occur in the social subsystem: the social links and the education models will transform, new personal demands will occur. Changes in the economic and social spheres will entail the need to adapt law to them, in order to preserve the effective legal regulation of social relations. Also, it should be noted that the metaverse will increase the capabilities of not only people but also the artificial intelligence, for which virtual environment is actually the “natural” one. Legal norms must provide protection of a human under the increased virtual component in people’s lives, accompanied by intellectualization of the environment.Scientific novelty: the author has systematically analyzed the changes taking place in various spheres of the modern society in connection with the development of the technological field of metaverses; highlighted the key issues arising due to the said development and requiring legal solution both at the constitutional level and at the level of sector legislation; and proposed the necessary changes in legal regulation.Practical significance: the research materials can be used when preparing proposals on changes and amendments in the current legislation, as well as in pedagogical activity, in particular, for implementation of educational courses or modules related to law under digital transformation of the society

Future of the Artificial Intelligence: Object of Law or Legal Personality?

Objective: to reveal the problems associated with legal regulation of public relations, in which artificial intelligence systems are used, and to rationally comprehend the possibility of endowing such systems with a legal subject status, which is being discussed by legal scientists.Methods: the methodological basis of the research are the general scientific methods of analysis and synthesis, analogy, abstraction and classification. Among the legal methods primarily applied in the work are formal-legal, comparative-legal and systemic-structural methods, as well as the methods of law interpretation and legal modeling.Results: the authors present a review of the state of artificial intelligence development and its introduction into practice by the time of the research. Legal framework in this sphere is considered; the key current concepts of endowing artificial intelligence with a legal personality (individual, collective and gradient legal personality of artificial intelligence) are reviewed. Each approach is assessed; conclusions are made as to the most preferable amendments in the current legislation, which ceases to correspond to the reality. The growing inconsistency is due to the accelerated development of artificial intelligence and its spreading in various sectors of economy, social sphere, and in the nearest future – in public management. All this testifies to the increased risk of a break between legal matter and the changing social reality.Scientific novelty: scientific approaches are classified which endow artificial intelligence with a legal personality. Within each approach, the key moments are identified, the use of which will allow in the future creating legal constructs based on combinations, avoiding extremes and observing the balance between the interests of all parties. The optimal variant to define the legal status of artificial intelligence might be to include intellectual systems into a list of civil rights objects, but differentiating the legal regulation of artificial intelligence as an object of law and an “electronic agent” as a quasi subject of law. The demarcation line should be drawn depending on the functional differences between intellectual systems, while not only a robot but also a virtual intellectual system can be considered an “electronic agent”.Practical significance: the research materials can be used when preparing proposals for making amendments and additions to the current legislation, as well as when elaborating academic course and writing tutorials on the topics related to regulation of using artificial intelligence

Flood Vulnerability Assessment of Urban Traditional Buildings in Kuala Lumpur, Malaysia

Flood hazard is increasing in frequency and magnitude in Southeast Asia major metropolitan areas due to the effects of fast urban development and changes in climate, threatening people's properties and life. Typically, flood management actions are mostly focused on large scale defenses, such as river embankments or discharge channels or tunnels. However, these are difficult to implement in historic centres without disturbing their heritage value, and might not provide sufficient mitigation in these areas. Therefore urban heritage buildings may be particularly exposed to flood events, even when they were originally designed and built with intrinsic resilient measures, based on the local knowledge of the natural environment and its threats at the time. Their attractiveness, cultural and economic values, means that they can represent a proportionally high contribution to losses of any event. Hence it is worth to pursue more localised, tailored, mitigation measures. Vulnerability assessment studies are essential to inform the feasibility and development of such strategies. In the present paper we propose a multi-level methodology to assess the flood vulnerability of residential buildings in an area of Kuala Lumpur Malaysia characterised by traditional timber housing. The multi-scale flood vulnerability model is based on a wide range of parameters, covering building specific parameters, neighbourhood conditions and catchment area condition. Parameters for 163 buildings were measured in detail by a field surveys integrated with Google Street View. The vulnerability model is combined with high resolution fluvial and pluvial flood maps providing likely water depths for a range of different flood return periods. The obtained vulnerability index shows ability to reflect different exposure by different building types and their relative locations. The study provides evidence that results obtained for a small district can be scaled up at city level, to inform both generic and specific protection strategies. The paper discusses these in relation to a scenario event of 0.1 % Annual Exceedance Probability (AEP), based on hydrological and hydraulic models developed for the Disaster Resilient Cities Project

Flood vulnerability and risk assessment of urban traditional buildings in a heritage district of Kuala Lumpur, Malaysia

Flood hazard is increasing in frequency and magnitude in major South East Asian metropolitan areas due to fast urban development and changes in climate, threatening people's property and life. Typically, flood management actions are mostly focused on large-scale defences, such as river embankments or discharge channels or tunnels. However, these are difficult to implement in town centres without affecting the value of their heritage districts and might not provide sufficient mitigation. Therefore, urban heritage buildings may become vulnerable to flood events, even when they were originally designed and built with intrinsic resilient measures, based on the local knowledge of the natural environment and its threats at the time. Their aesthetic and cultural and economic values mean that they can represent a proportionally high contribution to losses in any event. Hence it is worth investigating more localized, tailored mitigation measures. Vulnerability assessment studies are essential to inform the feasibility and development of such strategies. In this study we propose a multilevel methodology to assess the flood vulnerability and risk of residential buildings in an area of Kuala Lumpur, Malaysia, characterized by traditional timber housing. The multiscale flood vulnerability model is based on a wide range of parameters, covering building-specific parameters, neighbourhood conditions and catchment area conditions. The obtained vulnerability index shows the ability to reflect different exposure by different building types and their relative locations. The vulnerability model is combined with high-resolution fluvial and pluvial flood maps providing scenario events with 0.1 % annual exceedance probability (AEP). A damage function of generic applicability is developed to compute the economic losses at individual building and sample levels. The study provides evidence that results obtained for a small district can be scaled up to the city level, to inform both generic and specific protection strategies

Shell-Model Effective Operators for Muon Capture in ^{20}Ne

It has been proposed that the discrepancy between the partially-conserved axial-current prediction and the nuclear shell-model calculations of the ratio $C_P/C_A$ in the muon-capture reactions can be solved in the case of ^{28}Si by introducing effective transition operators. Recently there has been experimental interest in measuring the needed angular correlations also in ^{20}Ne. Inspired by this, we have performed a shell-model analysis employing effective transition operators in the shell-model formalism for the transition $^{20}Ne(0^+_{g.s.})+\mu^- \to ^{20}F(1^+; 1.057 MeV) + \nu_\mu$. Comparison of the calculated capture rates with existing data supports the use of effective transition operators. Based on our calculations, as soon as the experimental anisotropy data becomes available, the limits for the ratio $C_P/ C_A$ can be extracted.Comment: 9 pages, 3 figures include

Microbial communities in local and transplanted soils along a latitudinal gradient

Factors shaping community structure of soil microbiota have been intensively studied; however, the pattern in community composition and structure of soil microbiota at large geographical scales and factors regulating its metabolic activity remains poorly understood. Here, we used a field transplantation experiments to investigate the effects of substrate and climatic conditions on basal soil respiration, microbial biomass C and diversity of soil microbiota by comparing local and transplanted soils along a latitudinal gradient. Soil samples collected in April 2008 at donor site (Sokolov, Czech Republic) in Central Europe were gamma-ray sterilized and transplanted to receptor sites in Europe and the USA in May and early June 2008. Soil samples were taken in June 2009 after one year of exposure and immediately prepared for laboratory analysis. Basal soil respiration in local soils increased from 22 to 42 mg CO2-C kg-1 h-1 with latitude while basal soil respiration in transplanted soils decreased with latitude from 32 to 19 mg CO2-C kg-1 h-1. The microbial biomass C in both transplanted and local soils decreased with latitude. Content of fungal and bacterial phospholipid fatty acids increased nearly twice with latitude in local soils. Shannon diversity index of fungal community decreased from 2.5 to 1.2 along the latitudinal gradient in transplanted soils while local soils increased from 0.9 to 2.4 with latitude. Based on our results, microbial activity is driven mainly by changes of the soil substrate along latitudinal and climatic gradients while microbial biomass is driven more by global climatic factors itself. The diversity of soil microbial communities is mostly affected by latitudinal and climatic factors while community structure is mostly shaped by substrate quality

Technical design and performance of the NEMO3 detector

The development of the NEMO3 detector, which is now running in the Frejus Underground Laboratory (L.S.M. Laboratoire Souterrain de Modane), was begun more than ten years ago. The NEMO3 detector uses a tracking-calorimeter technique in order to investigate double beta decay processes for several isotopes. The technical description of the detector is followed by the presentation of its performance.Comment: Preprint submitted to Nucl. Instrum. Methods A Corresponding author: Corinne Augier ([email protected]