Physician Perceptions of ADHD Stimulant Diversion and Misuse

© The Author(s) 2016. Objective: The recent rise in ADHD has prompted concerns about adolescents with ADHD diverting and/or misusing stimulants. This is the first study to assess physician perceptions of the pervasiveness of these issues. Method: Questionnaires were mailed to a national sample of pediatric subspecialists. Responses were analyzed (n = 826; 18% response rate) using descriptive statistics and regression analyses. Results: In the past year, 59% of physicians suspected ≥1 patient(s) with ADHD diverted stimulants. Seventy-four percent believed ≥1 patient(s) feigned symptoms to obtain an initial ADHD diagnosis; 66% believed ≥1 patient(s) wanted stimulants to improve academic performance. Child and adolescent psychiatrists were most likely to suspect diversion and feigning symptoms. Thirty-nine percent of physicians believed diversion was at least “common.” Conclusion: Although many physicians suspected stimulant diversion and misuse, a substantial number were unaware of these issues, and subspecialist perceptions varied. These findings support the potential pervasiveness of these issues and the need for increased physician awareness

Implicit incentives for fund managers with partial information

We study the optimal asset allocation problem for a fund manager whose compensation depends on the performance of her portfolio with respect to a benchmark. The objective of the manager is to maximise the expected utility of her final wealth. The manager observes the prices but not the values of the market price of risk that drives the expected returns. Estimates of the market price of risk get more precise as more observations are available. We formulate the problem as an optimization under partial information. The particular structure of the incentives makes the objective function not concave. Therefore, we solve the problem by combining the martingale method and a concavification procedure and we obtain the optimal wealth and the investment strategy. A numerical example shows the effect of learning on the optimal strategy

Modeling vaccination rollouts, SARS-CoV-2 variants and the requirement for non-pharmaceutical interventions in Italy

Despite progress in clinical care for patients with coronavirus disease 2019 (COVID-19)1, population-wide interventions are still crucial to manage the pandemic, which has been aggravated by the emergence of new, highly transmissible variants. In this study, we combined the SIDARTHE model2, which predicts the spread of SARS-CoV-2 infections, with a new data-based model that projects new cases onto casualties and healthcare system costs. Based on the Italian case study, we outline several scenarios: mass vaccination campaigns with different paces, different transmission rates due to new variants and different enforced countermeasures, including the alternation of opening and closure phases. Our results demonstrate that non-pharmaceutical interventions (NPIs) have a higher effect on the epidemic evolution than vaccination alone, advocating for the need to keep NPIs in place during the first phase of the vaccination campaign. Our model predicts that, from April 2021 to January 2022, in a scenario with no vaccine rollout and weak NPIs (R = 1.27), as many as 298,000 deaths associated with COVID-19 could occur. However, fast vaccination rollouts could reduce mortality to as few as 51,000 deaths. Implementation of restrictive NPIs (R = 0.9) could reduce COVID-19 deaths to 30,000 without vaccinating the population and to 18,000 with a fast rollout of vaccines. We also show that, if intermittent open\u2013close strategies are adopted, implementing a closing phase first could reduce deaths (from 47,000 to 27,000 with slow vaccine rollout) and healthcare system costs, without substantive aggravation of socioeconomic losses

Initial investigation of athletes’ electrocardiograms acquired by wearable sensors during the pre-exercise phase

Aim: The aim of this study is to support large-scale prevention programs fighting sport-related sudden cardiac death by providing a set of electrocardiographic features representing a starting point in the development of normal reference values for the pre-exercise phase. Background: In people with underlying, often unknown, cardiovascular abnormalities, increased cardiovascular load during exercise can trigger sport-related sudden cardiac death. Prevention remains the only weapon to contrast sport-related sudden cardiac death. So far, no reference values have been proposed for electrocardiograms of athletes acquired with wearable sensors in the pre-exercise phase, consisting of the few minutes immediately before the beginning of the training session. Objective: To perform an initial investigation of athletes’ electrocardiograms acquired by wearable sensors during the pre-exercise phase. Methods: The analyzed electrocardiograms, acquired through BioHarness 3.0 by Zephyr, belong to 51 athletes (Sport Database and Cycling Database of the Cardiovascular Bioengineering Lab of the Università Politecnica delle Marche, Italy). Preliminary values consist of interquartile ranges of six electrocardiographic features which are heart rate, heart-rate variability, QRS duration, ST level, QT interval, and corrected QT interval. Results: For athletes 35 years old or younger, preliminary values were [72;91]bpm, [26;47]ms, [85;104]ms, [-0.08;0.08]mm, [326;364]ms and [378;422]ms, respectively. For athletes older than 35 years old, preliminary values were [71;94]bpm, [16;65]ms, [85;100]ms, [-0.11;0.07]mm, [330;368]ms and [394;414]ms, respectively. Conclusion: Availability of preliminary reference values could help identify those athletes who, due to electrocardiographic features out of normal ranges, are more likely to develop cardiac complications that may lead to sport-related sudden cardiac death

Genome-Wide Quantitative Identification of DNA Differentially Methylated Sites in Arabidopsis Seedlings Growing at Different Water Potential

BackgroundIn eukaryotes, the combinatorial usage of cis-regulatory elements enables the assembly of composite genetic switches to integrate multifarious, convergent signals within a single promoter. Plants as sessile organisms, incapable of seeking for optimal conditions, rely on the use of this resource to adapt to changing environments. Emerging evidence suggests that the transcriptional responses of plants to stress are associated with epigenetic processes that govern chromatin accessibility. However, the extent at which specific chromatin modifications contribute to gene regulation has not been assessed.Methodology/Principal FindingsIn the present work, we combined methyl-sensitive-cut counting and RNA-seq to follow the transcriptional and epigenetic response of plants to simulated drought. Comprehensive genome wide evidence supports the notion that the methylome is widely reactive to water potential. The predominant changes in methylomes were loci in the promoters of genes encoding for proteins suited to cope with the environmental challenge.Conclusion/SignificanceThese selective changes in the methylome with corresponding changes in gene transcription suggest drought sets in motion an instructive mechanism guiding epigenetic machinery toward specific effectors genes

The wiring diagram for plant G signaling

Like electronic circuits, the modular arrangement of cell-signaling networks decides how inputs produce outputs. Animal heterotrimeric guanine nucleotide binding proteins (G-proteins) operate as switches in the circuits that signal between extracellular agonists and intracellular effectors. There still is no biochemical evidence for a receptor or its agonist in the plant G-protein pathways. Plant G-proteins deviate in many important ways from the animal paradigm. This review covers important discoveries from the last two years that enlighten these differences and ends describing alternative wiring diagrams for the plant signaling circuits regulated by G-proteins. We propose that plant G-proteins are integrated in the signaling circuits as variable resistor rather than switches, controlling the flux of information in response to the cell’s metabolic state

Gα modulates salt-induced cellular senescence and cell division in rice and maize

Highlight textThis work reveals two distinct functions of Gα in NaCl stress in rice and maize: attenuation of leaf senescence caused by sodium toxicity in leaves, and cell cycle regulation by osmotic/ionic stress.The plant G-protein network, comprising Gα, Gβ, and Gγ core subunits, regulates development, senses sugar, and mediates biotic and abiotic stress responses. Here, we report G-protein signalling in the salt stress response using two crop models, rice and maize. Loss-of-function mutations in the corresponding genes encoding the Gα subunit attenuate growth inhibition and cellular senescence caused by sodium chloride (NaCl). Gα null mutations conferred reduced leaf senescence, chlorophyll degradation, and cytoplasm electrolyte leakage under NaCl stress. Sodium accumulated in both wild-type and Gα-mutant shoots to the same levels, suggesting that Gα signalling controls cell death in leaves rather than sodium exclusion in roots. Growth inhibition is probably initiated by osmotic change around root cells, because KCl and MgSO4 also suppressed seedling growth equally as well as NaCl. NaCl lowered rates of cell division and elongation in the wild-type leaf sheath to the level of the Gα-null mutants; however there was no NaCl-induced decrease in cell division in the Gα mutant, implying that the osmotic phase of salt stress suppresses cell proliferation through the inhibition of Gα-coupled signalling. These results reveal two distinct functions of Gα in NaCl stress in these grasses: attenuation of leaf senescence caused by sodium toxicity in leaves, and cell cycle regulation by osmotic/ionic stress

The HPS electromagnetic calorimeter

The Heavy Photon Search experiment (HPS) is searching for a new gauge boson, the so-called “heavy photon.” Through its kinetic mixing with the Standard Model photon, this particle could decay into an electron-positron pair. It would then be detectable as a narrow peak in the invariant mass spectrum of such pairs, or, depending on its lifetime, by a decay downstream of the production target. The HPS experiment is installed in Hall-B of Jefferson Lab. This article presents the design and performance of one of the two detectors of the experiment, the electromagnetic calorimeter, during the runs performed in 2015–2016. The calorimeter's main purpose is to provide a fast trigger and reduce the copious background from electromagnetic processes through matching with a tracking detector. The detector is a homogeneous calorimeter, made of 442 lead-tungstate (PbWO4) scintillating crystals, each read out by an avalanche photodiode coupled to a custom trans-impedance amplifier

Nucleon and Nuclear Structure Through Dilepton Production

Transverse momentum distributions and generalized parton distributions provide a comprehensive framework for the three-dimensional imaging of the nucleon and the nucleus experimentally using deeply virtual semi-exclusive and exclusive processes. The advent of combined high luminosity facilities and large acceptance detector capabilities enables experimental investigation of the partonic structure of hadrons with time-like virtual probes, in complement to the rich on-going space-like virtual probe program. The merits and benefits of the dilepton production channel for nuclear structure studies are discussed within the context of the International Workshop on Nucleon and Nuclear Structure through Dilepton Production taking place at the European Center for Theoretical Studies in Nuclear Physics and Related Areas (ECT*) of Trento. Particularly, the double deeply virtual Compton scattering, the time-like Compton scattering, the deeply virtual meson production, and the Drell-Yan processes are reviewed and a strategy for high impact experimental measurements is proposed

Análisis del primer nivel de atención de la ciudad de Bahía Blanca usando SIG

El primer nivel de atención en salud, organizado en nuestro país en base a Centros de Atención Primaria de la Salud (CAPS) brinda servicios sanitarios preventivos a la sociedad en general y en especial a la población que no posee cobertura médica. Si bien la red de CAPS se diseña con un criterio de cobertura máxima, la dinámica poblacional y el crecimiento demográfico y territorial hace que los CAPS no siempre estén distribuidos de forma adecuada, es decir, su ubicación no suele ajustarse a la necesidad de la población y, por lo tanto, no se asegura la deseada equidad en el acceso. El objetivo principal de este trabajo es analizar información relevante sobre los CAPS en el partido de Bahía Blanca, mediante el estudio de la necesidad, la demanda y la oferta de servicios del primer nivel con el auxilio de un Sistema de Información Geográfico (SIG). Utilizando las herramientas de los modernos SIG se crearon mapas que permiten analizar y visualizar la distribución de los datos. Se propuso una metodología sencilla para proyectar la población del censo 2010 a la actualidad y así poder aproximar el crecimiento de la población. Se analizó información sobre la cantidad de consultas realizadas y se estimó la oferta por especialidad, teniendo en cuenta la cantidad de profesionales en el sistema y la cantidad de horas trabajadas. Mediante las distintas herramientas del SIG se calcularon diferentes indicadores de cobertura. Sobre la base de estos estudios se identifican los sectores donde se debería reforzar la Atención Primaria y la conveniencia de una redistribución de los servicios analizados.Sociedad Argentina de Informática e Investigación Operativ