Accuracy of the Drug-Dependency Checkbox on the Maine Birth Certificate for Medicaid-covered Births, 2016-2020

Introduction: The accuracy of the drug-dependency checkbox on Maine birth certificates is unknown. Our objective was to compare the drug-dependency checkbox with information on substance use disorders (SUDs) documented in Medicaid claims. Methods: Using rule-based deterministic matching, we linked Medicaid enrollment information to Maine birth-record data between 2016 and 2020 (N = 58 584). Among the linked records (n = 27 448), we identified maternal SUD diagnoses during the 280 days before through 7 days after delivery using ICD-CM-9/10 diagnosis codes. We used the following hierarchy to create mutually exclusive SUD categories: opioid use disorder (OUD), cannabis use disorder without cocaine use disorder, and other SUD disorders (alcohol, cocaine, nicotine, or other). Results: Among women enrolled in Medicaid at the time of delivery, 12% had drug dependency indicated on their birth record and 34% had at least one SUD diagnosis recorded in their Medicaid claims. Among birth records with drug dependency indicated, 56% indicated OUD, 26% indicated cannabis use disorder without cocaine use disorder, 8% indicated other SUD, and 10% indicated no SUD. Among those without drug dependency indicated, the corresponding percentages were 4% for OUD, 9% for cannabis use disorder, 14% for other SUD, and 74% for no SUD. Discussion: Although diagnoses of OUD and cannabis use disorder were more common among birth records with a checked drug-dependency checkbox, reporting of drug dependency on birth records does not appear to accurately indicate SUD during pregnancy. Conclusions: Our findings suggest that the drug-dependency checkbox on Maine birth certificates may have limited value in identifying SUD during pregnancy

Modeling interstellar amorphous solid water grains by tight-binding based methods: comparison between GFN-XTB and CCSD(T) results for water clusters

One believed path to Interstellar Complexes Organic Molecules (iCOMs) formation inside the Interstellar Medium (ISM) is through chemical recombination at the surface of amorphous solid water (ASW) mantle covering the silicate-based core of the interstellar grains. The study of these iCOMs formation and their binding energy to the ASW, using computational chemistry, depends strongly on the ASW models used, as different models may exhibit sites with different adsorbing features. ASW extended models are rare in the literature because large sizes require very large computational resources when quantum mechanical methods based on DFT are used. To circumvent this problem, we propose to use the newly developed GFN-xTB Semi-empirical Quantum Mechanical (SQM) methods from the Grimme's group. These methods are, at least, two orders of magnitude faster than conventional DFT, only require modest central memory, and in this paper we aim to benchmark their accuracy against rigorous and resource hungry quantum mechanical methods. We focused on 38 water structures studied by MP2 and CCSD(T) approaches comparing energetic and structures with three levels of GFN-xTB parametrization (GFN0, GFN1, GFN2) methods. The extremely good results obtained at the very cheap GFN-xTB level for both water cluster structures and energetic paved the way towards the modeling of very large AWS models of astrochemical interest.Comment: 9 pages, 4 figures, Submitted to LNCS (Springer) ICCSA202

Adults Using Long-term Services and Supports: Population and Service Use Trends in Maine, SFY 2014

Prepared by research staff at the University of Southern Maine\u27s Muskie School of Public Service for the Maine Office of Aging and Disability Services (the Office), this chartbook provides information on Maine adults who use long term services and supports. This is the first chartbook to reflect all the populations served by the Office: older adults; adults with physical disabilities; adults with intellectual disabilities/autism spectrum disorder or other related conditions; and adults with acquired brain injury. Long term services and supports are a vital lifeline for the thousands of Maine adults who need them, and they account for a significant portion of the state\u27s Medicaid (MaineCare) budget

The changing nature of risk and risk management: the challenge of borders, uncertainty and resilience

No abstract available

Inter-rater reliability of the Dysexecutive Questionnaire (DEX): comparative data from non-clinician respondents – all raters are not equal

Primary objective: The Dysexecutive Questionnaire (DEX) is used to obtain information about executive and emotional problems after neuropathology. The DEX is self-completed by the patient (DEX-S) and an independent rater such as a family member (DEX-I). This study examined the level of inter-rater agreement between either two or three non-clinician raters on the DEX-I in order to establish the reliability of DEX-I ratings. Methods and procedures: Family members and/or carers of 60 people with mixed neuropathology completed the DEX-I. For each patient, DEX-I ratings were obtained from either two or three raters who knew the person well prior to brain injury. Main outcomes and results: We obtained two independent-ratings for 60 patients and three independent-ratings for 36 patients. Intra-class correlations revealed that there was only a modest level of agreement for items, subscale and total DEX scores between raters for their particular family member. Several individual DEX items had low reliability and ratings for the emotion sub-scale had the lowest level of agreement. Conclusions: Independent DEX ratings completed by two or more non-clinician raters show only moderate correlation. Suggestions are made for improving the reliability of DEX-I ratings.</p

Qualitative thematic analysis of consent forms used in cancer genome sequencing

<p>Abstract</p> <p>Background</p> <p>Large-scale whole genome sequencing (WGS) studies promise to revolutionize cancer research by identifying targets for therapy and by discovering molecular biomarkers to aid early diagnosis, to better determine prognosis and to improve treatment response prediction. Such projects raise a number of ethical, legal, and social (ELS) issues that should be considered. In this study, we set out to discover how these issues are being handled across different jurisdictions.</p> <p>Methods</p> <p>We examined informed consent (IC) forms from 30 cancer genome sequencing studies to assess (1) stated purpose of sample collection, (2) scope of consent requested, (3) data sharing protocols (4) privacy protection measures, (5) described risks of participation, (6) subject re-contacting, and (7) protocol for withdrawal.</p> <p>Results</p> <p>There is a high degree of similarity in how cancer researchers engaged in WGS are protecting participant privacy. We observed a strong trend towards both using samples for additional, unspecified research and sharing data with other investigators. IC forms were varied in terms of how they discussed re-contacting participants, returning results and facilitating participant withdrawal. Contrary to expectation, there were no consistent trends that emerged over the eight year period from which forms were collected.</p> <p>Conclusion</p> <p>Examining IC forms from WGS studies elucidates how investigators are handling ELS challenges posed by this research. This information is important for ensuring that while the public benefits of research are maximized, the rights of participants are also being appropriately respected.</p

Variability in chemotherapy delivery for elderly women with advanced stage ovarian cancer and its impact on survival

Given the survival benefits of adjuvant chemotherapy for advanced ovarian cancer (OC), we examined the associations of survival with the time interval from debulking surgery to initiation of chemotherapy and with the duration of chemotherapy. Among patients ⩾65 years with stages III/IV OC diagnosed between 1991 and 2002 in the Surveillance, Epidemiology, and End Results-Medicare database, we developed regression models of predictors of the time interval from surgery to initiation of chemotherapy and of the total duration of chemotherapy. Survival was examined with Cox proportional hazards models. Among 2558 patients, 1712 (67%) initiated chemotherapy within 6 weeks of debulking surgery, while 846 (33%) began treatment >6 weeks. Older age, black race, being unmarried, and increased comorbidities were associated with delayed initiation of chemotherapy. Delay of chemotherapy was associated with an increase in mortality (hazard ratio (HR)=1.11; 95% CI, 1.0–1.2). Among 1932 patients in the duration of treatment analysis, the 1218 (63%) treated for 3–7 months had better survival than the 714 (37%) treated for ⩽3 months (HR=0.84; 95% CI, 0.75–0.94). This analysis represents one of the few studies describing treatment delivery and outcome in women with advanced OC. Delayed initiation and early discontinuation of chemotherapy were common and associated with increased mortality

Theory of Multidimensional Solitons

We review a number of topics germane to higher-dimensional solitons in Bose-Einstein condensates. For dark solitons, we discuss dark band and planar solitons; ring dark solitons and spherical shell solitons; solitary waves in restricted geometries; vortex rings and rarefaction pulses; and multi-component Bose-Einstein condensates. For bright solitons, we discuss instability, stability, and metastability; bright soliton engineering, including pulsed atom lasers; solitons in a thermal bath; soliton-soliton interactions; and bright ring solitons and quantum vortices. A thorough reference list is included.Comment: review paper, to appear as Chapter 5a in "Emergent Nonlinear Phenomena in Bose-Einstein Condensates: Theory and Experiment," edited by P. G. Kevrekidis, D. J. Frantzeskakis, and R. Carretero-Gonzalez (Springer-Verlag

The effect of horizontal and vertical furcation involvement on molar survival: A retrospective study.

BACKGROUND: Periodontal involvement of the furcation area (furcation involvement, FI) has been reported to confer molars a higher risk of tooth loss. AIMS: The aim of this retrospective analysis was to assess the effect of FI on disease progression and tooth loss in molars of patients with chronic periodontitis undergoing supportive periodontal therapy (SPT) in a UK private practice setting. MATERIALS AND METHODS: Six-hundred and thirty-three molars were analysed in 100 chronic periodontitis patients treated with active periodontal therapy (APT) and followed up in SPT for at least 5 years. Molars were treated with a combination of resective, regenerative or conservative approaches, according to the different clinical needs. RESULTS: Twenty-three molars were extracted during APT and a further 23 were lost during SPT. Multivariable analysis showed that both horizontal FI and vertical furcation component were associated with increased risk of tooth loss during SPT (OR 5.26, 95% CI: 1.46-19.03, p = .012 and OR 9.83, 95% CI: 1.83-50.11, p = .006, respectively). CONCLUSION: Attention should be placed on both horizontal and vertical FI in molars, owing to their association with tooth loss during SPT