Type I Error Of Four Pairwise Mean Comparison Procedures Conducted As Protected And Unprotected Tests

Type I error control accuracy of four commonly used pairwise mean comparison procedures, conducted as protected or unprotected tests, is examined. If error control philosophy is experimentwise, Tukey’s HSD, as an unprotected test, is most accurate and if philosophy is per-experiment, Dunn-Bonferroni, conducted as an unprotected test, is most accurate

A Prospective Analysis of Pharmacists Integration in the Patient-Centered Medical Home: Preparing for Value-Based Care

This is an unpublished manuscript of research completed in several patient centered medical homes that provide pharmacy services; presented at the 2016 American Pharmacists Association annual meeting in Baltimore, MD.Objective: The purpose of this project was to describe pharmacy services in a patient-centered medical home to demonstrate pharmacists’ involvement in the evolving delivery of primary care. Design: This was a prospective, qualitative study. Setting and Participants: This project analyzed the work of eight pharmacists employed at a National Committee for Quality Assurance tier III patient-centered medical home associated with a large, academic medical center. Outcome Measures: The primary outcome was to identify and quantify the types of services completed by pharmacists in a patient-centered medical home. Secondary outcomes included determining the percentage of pharmacist recommendations accepted by providers and patients, the percentage of pharmacist interventions submitted for third-party reimbursement, and the average time spent per encounter. Results: Eight pharmacists (representing 4.0 full-time equivalents) facilitated 581 encounters over 20 days. Mean time spent per encounter was 20 minutes (± 19). The most common types of encounters were interdisciplinary visits (31.8%) and phone/secure portal communication (30.0%). Of 918 pharmacist recommendations made to providers, 830 (90.4%) were accepted and implemented. Of 412 pharmacist recommendations made to patients, 393 (95.4%) were verbally accepted. Thirty-nine percent of encounters were eligible for direct payor billing. Conclusion: Our data show that pharmacists working in a patient-centered medical home are effectively integrated within the evolving delivery of primary care. Consistent inclusion of pharmacy services should be readily supported in future models of health care reform

Untangling polygons and graphs

Untangling is a process in which some vertices of a planar graph are moved to obtain a straight-line plane drawing. The aim is to move as few vertices as possible. We present an algorithm that untangles the cycle graph C_n while keeping at least \Omega(n^{2/3}) vertices fixed. For any graph G, we also present an upper bound on the number of fixed vertices in the worst case. The bound is a function of the number of vertices, maximum degree and diameter of G. One of its consequences is the upper bound O((n log n)^{2/3}) for all 3-vertex-connected planar graphs.Comment: 11 pages, 3 figure

Irreducible triangulations of surfaces with boundary

A triangulation of a surface is irreducible if no edge can be contracted to produce a triangulation of the same surface. In this paper, we investigate irreducible triangulations of surfaces with boundary. We prove that the number of vertices of an irreducible triangulation of a (possibly non-orientable) surface of genus g>=0 with b>=0 boundaries is O(g+b). So far, the result was known only for surfaces without boundary (b=0). While our technique yields a worse constant in the O(.) notation, the present proof is elementary, and simpler than the previous ones in the case of surfaces without boundary

Relationships Between Neuromuscular Function and Functional Balance Performance in Firefighters

The purpose of the present study was to examine the relationships between neuromuscular function and functional balance performance in firefighters. Fifty career firefighters (35.1±7.5yr) performed isometric leg extension and flexion muscle actions to examine peak torque (PT), and absolute (aTQ) and normalized (nTQ; %PT) rapid torque variables at 50, 100, 150, and 200ms. A performance index (PI) was determined from the functional balance assessment completion time. Partial correlations were used to examine the relationship between the PI and the maximal and rapid TQ variables for each muscle and the composite value, while controlling for demographic data related to the PI. Multiple regression analyses examined the relative contributions of the maximal and rapid aTQ variables, and demographic data on the PI. After controlling for age and %BF, the majority of the later aTQ and nTQ variables (100– 200ms) and PT were associated with the PI (r=−0.501–−0.315). Age, %BF, and aTQ100 explained 42– 50% of the variance in the PI. Lower rapid strength, increased age, and poorer body composition were related to worse performance during the functional balance assessment. Strategies to improve rapid strength and %BF, especially in aging firefighters may impact dynamic balance abilities in firefighters

Polytopality and Cartesian products of graphs

We study the question of polytopality of graphs: when is a given graph the graph of a polytope? We first review the known necessary conditions for a graph to be polytopal, and we provide several families of graphs which satisfy all these conditions, but which nonetheless are not graphs of polytopes. Our main contribution concerns the polytopality of Cartesian products of non-polytopal graphs. On the one hand, we show that products of simple polytopes are the only simple polytopes whose graph is a product. On the other hand, we provide a general method to construct (non-simple) polytopal products whose factors are not polytopal.Comment: 21 pages, 10 figure

A new scale to measure family members' perception of community health care services for persons with Huntington disease

Huntington Disease (HD) is a progressive genetic brain disease leading to disruptive cognitive, behavioral, and physical impairments. Persons with the condition and their caregivers need appropriate and accessible health care services to help them manage the disease adequately. The purpose of this study was to evaluate the psychometric properties of a new scale that measures family members' perception of community health care services (CHCS) for persons with HD

Discovery of novel reductive elimination pathway for 10-hydroxywarfarin

Coumadin (R/S-warfarin) anticoagulant therapy is highly efficacious in preventing the formation of blood clots; however, significant inter-individual variations in response risks over or under dosing resulting in adverse bleeding events or ineffective therapy, respectively. Levels of pharmacologically active forms of the drug and metabolites depend on a diversity of metabolic pathways. Cytochromes P450 play a major role in oxidizing R- and S-warfarin to 6-, 7-, 8-, 10-, and 4\u27-hydroxywarfarin, and warfarin alcohols form through a minor metabolic pathway involving reduction at the C11 position. We hypothesized that due to structural similarities with warfarin, hydroxywarfarins undergo reduction, possibly impacting their pharmacological activity and elimination. We modeled reduction reactions and carried out experimental steady-state reactions with human liver cytosol for conversion o

Pregnancy and neonatal outcomes of COVID-19: co-reporting of common outcomes from PAN-COVID and AAP SONPM registries

OBJECTIVE: Few large cohort studies have reported data on maternal, fetal, perinatal and neonatal outcomes associated with SARS-CoV-2 infection in pregnancy. We report the outcome of infected pregnancies from a collaboration formed early during the pandemic between the investigators of two registries, the UK and global Pregnancy and Neonatal outcomes in COVID-19 (PAN-COVID) study and the US American Academy of Pediatrics Section on Neonatal Perinatal Medicine (AAP SONPM) National Perinatal COVID-19 Registry. METHODS: This was an analysis of data from the PAN-COVID registry (January 1st to July 25th 2020), which includes pregnancies with suspected or confirmed maternal SARS-CoV-2 infection at any stage in pregnancy, and the AAP SONPM National Perinatal COVID-19 registry (April 4th to August 8th 2020), which includes pregnancies with positive maternal testing for SARS-CoV-2 from 14 days before delivery to 3 days after delivery. The registries collected data on maternal, fetal, perinatal and neonatal outcomes. The PAN-COVID results are presented both overall for pregnancies with suspected or confirmed SARS-CoV-2 infection and separately in those with confirmed infection. RESULTS: We report on 4005 pregnant women with suspected or confirmed SARS-CoV-2 infection (1606 from PAN-COVID and 2399 from AAP SONPM). For obstetric outcomes, in PAN-COVID overall, those with confirmed infection in PAN-COVID and AAP SONPM, respectively, maternal death occurred in 0.5%, 0.5% and 0.2% of cases, early neonatal death in 0.2%, 0.3% and 0.3% of cases and stillbirth in 0.5%, 0.6% and 0.4% of cases. Delivery was pre-term (<37 weeks' gestation) in 12.0% of all women in PAN-COVID, in 16.2% of those women with confirmed infection in PAN-COVID and in 15.7% of women in AAP SONPM. Extremely preterm delivery (< 27 weeks' gestation) occurred in 0.5% of cases in PAN-COVID and 0.3% in AAP SONPM. Neonatal SARS-CoV-2 infection was reported in 0.8% of all deliveries in PAN-COVID, in 2.0% in those with confirmed infection in PAN-COVID and in 1.8% in AAP SONPM; the proportions of neonates tested were 9.5%, 20.7% and 87.2%, respectively. The rates of a SGA neonate were 8.2% in PAN-COVID overall, 9.7% in those with confirmed infection and 9.6% in AAP SONPM. Mean gestational age adjusted birth-weight z-scores were -0.03 in PAN-COVID and -0.18 in AAP SONPM. CONCLUSIONS: The findings from the UK and US registries of pregnancies with SARS-CoV-2 infection were remarkably concordant. Preterm delivery affected a higher proportion of women than expected based on historical and contemporaneous national data. The proportions of pregnancies affected by stillbirth, a small for gestational age infant or early neonatal death were comparable to those in historical and contemporaneous UK and US data. Although maternal death was uncommon, the rate was higher than expected based on UK and US population data, which is likely explained by under-ascertainment of women affected by milder or asymptomatic infection in pregnancy in the PAN-COVID study although not in the AAP SONPM study. The data presented support strong guidance for enhanced precautions to prevent SARS-CoV-2 infection in pregnancy, particularly in the context of increased risks of preterm delivery and maternal mortality, and for priority vaccination of women planning pregnancy. This article is protected by copyright. All rights reserved