Medication Non-Adherence in Community Dwelling Older Adults with Dementia: An Educational Intervention for Family Caregivers

Older adults with neurocognitive disorders are at high risk for medication non-adherence, while being vulnerable to great injury from regimen deviations. Informal caregivers often aid in healthcare management for these individuals. The current study compared the efficacy of two online health education interventions designed to increase caregiver health related knowledge for use with care recipients. Women (N=35) assisting a cognitively impaired older person with medications were randomly assigned to one of two online health education conditions (1) written materials and narrative vignettes depicting actors encountering common medication challenges or (2) written materials and didactic video clips of information from medical experts. It was hypothesized that narrative group participants would show greater improvements in several domains of functioning when compared to didactic group participants. Results showed equivalent participant satisfaction between groups; caregivers did not improve differentially between condition, over time, in the domains of medication hassles, patient-provider communication, medication management adherence, or self-efficacy. There was no main effect of time on caregiver reported hassles, patient- provider communication or medication adherence. There was a significant main effect of time on caregiver self-efficacy for controlling upsetting thoughts about the caregiving situation F (1, 33) = 8.07, p \u3c .001, p = .20, achieved power = .79. Secondary analyses revealed that caregivers in the narrative vignette condition showed significant increases in overall self-efficacy for controlling upsetting thoughts, from pre-treatment (M = 62.95, SD = 33.55), to post treatment (M = 72.38, SD = 31.27), t(17) = -2.53, p =.02. Future directions include introducing a no-treatment control, inclusion of additional post-intervention assessment points to investigate intervention effects over time, and expansion of the study to include older adults in the care dyad

Nonlinear Dynamic Modeling of a Supersonic Commercial Transport Turbo-Machinery Propulsion System for Aero-Propulso-Servo-Elasticity Research

This paper covers the development of an integrated nonlinear dynamic model for a variable cycle turbofan engine, supersonic inlet, and convergent-divergent nozzle that can be integrated with an aeroelastic vehicle model to create an overall Aero-Propulso-Servo-Elastic (APSE) modeling tool. The primary focus of this study is to provide a means to capture relevant thrust dynamics of a full supersonic propulsion system by using relatively simple quasi-one dimensional computational fluid dynamics (CFD) methods that will allow for accurate control algorithm development and capture the key aspects of the thrust to feed into an APSE model. Previously, propulsion system component models have been developed and are used for this study of the fully integrated propulsion system. An overview of the methodology is presented for the modeling of each propulsion component, with a focus on its associated coupling for the overall model. To conduct APSE studies the de- scribed dynamic propulsion system model is integrated into a high fidelity CFD model of the full vehicle capable of conducting aero-elastic studies. Dynamic thrust analysis for the quasi-one dimensional dynamic propulsion system model is presented along with an initial three dimensional flow field model of the engine integrated into a supersonic commercial transport

Baker‐Polito Administration Elevates State Technology Office

Tables S5-S12. The seminal fluid peptides identified from each human individual that underwent MS/MS using the MSDaPl program. ST5 A parsimonious list of SFPs inferred from MSDaPl for human 1. ST6 A parsimonious list of SFPs inferred from MSDaPl for human 2. ST7 A parsimonious list of SFPs inferred from MSDaPl for human 3. ST8 A parsimonious list of SFPs inferred from MSDaPl for human 4. ST9 A parsimonious list of SFPs inferred from MSDaPl for human 5. ST10 A parsimonious list of SFPs inferred from MSDaPl for human 6. ST11 A parsimonious list of SFPs inferred from MSDaPl for human 7. ST12 A parsimonious list of SFPs inferred from MSDaPl for human 8. (XLS 744 kb

Brief of Scholars of the History and Original Meaning of the Fourth Amendment as Amici Curiae in Support of Petitioner, Carpenter v. United States, No. 16-402 (U.S. Aug. 14, 2017)

Obtaining and examining cell site location records to find a person is a “search” in any normal sense of the word — a search of documents and a search for a person and her personal effects. It is therefore a “search” within the meaning of the Fourth Amendment in that it constitutes “examining,” “exploring,” “looking through,” “inquiring,” “seeking,” or “trying to find.” Nothing about the text of the Fourth Amendment, or the historical backdrop against which it was adopted, suggests that “search” should be construed more narrowly as, for example, intrusions upon subjectively manifested expectations of privacy that society is prepared to recognize as reasonable.Entrusting government agents with unfettered discretion to conduct searches using cell site location information undermines Fourth Amendment rights. The Amendment guarantees “[t]he right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches.” The Framers chose that language deliberately. It reflected the insecurity they suffered at the hands of “writs of assistance,” a form of general warrant that granted state agents broad discretion to search wherever they pleased. Such arbitrary power was “unreasonable” to the Framers, being “against the reason of the common law,” and it was intolerable because of its oppressive impact on “the people” as a whole. As emphasized in one of the seminal English cases that inspired the Amendment, this kind of general power to search was “totally subversive of the liberty of the subject.” James Otis’s famous speech denouncing a colonial writ of assistance similarly condemned those writs as “the worst instrument of arbitrary power,” placing “the liberty of every man in the hands of every petty officer.” Thus, although those who drafted and ratified the Fourth Amendment could not have anticipated cellphone technology, they would have recognized the dangers inherent in any state claim of unlimited authority to conduct searches for evidence of criminal activity. Cell site location information provides insight into where we go and what we do. Because this information is constantly generated and can be retrieved by the government long after the activities it memorializes have taken place, unfettered government access to cell site location information raises the specter of general searches and undermines the security of “the people.

Molecular diagnosis in recessive pediatric neurogenetic disease can help reduce disease recurrence in families.

BackgroundThe causes for thousands of individually rare recessive diseases have been discovered since the adoption of next generation sequencing (NGS). Following the molecular diagnosis in older children in a family, parents could use this information to opt for fetal genotyping in subsequent pregnancies, which could inform decisions about elective termination of pregnancy. The use of NGS diagnostic sequencing in families has not been demonstrated to yield benefit in subsequent pregnancies to reduce recurrence. Here we evaluated whether genetic diagnosis in older children in families supports reduction in recurrence of recessive neurogenetic disease.MethodsRetrospective study involving families with a child with a recessive pediatric brain disease (rPBD) that underwent NGS-based molecular diagnosis. Prenatal molecular testing was offered to couples in which a molecular diagnosis was made, to help couples seeking to prevent recurrence. With this information, families made decisions about elective termination. Pregnancies that were carried to term were assessed for the health of child and mother, and compared with historic recurrence risk of recessive disease.ResultsBetween 2010 and 2016, 1172 families presented with a child a likely rPBD, 526 families received a molecular diagnosis, 91 families returned to the clinic with 101 subsequent pregnancies, and 84 opted for fetal genotyping. Sixty tested negative for recurrence for the biallelic mutation in the fetus, and all, except for one spontaneous abortion, carried to term, and were unaffected at follow-up. Of 24 that genotyped positive for the biallelic mutation, 16 were electively terminated, and 8 were carried to term and showed features of disease similar to that of the older affected sibling(s). Among the 101 pregnancies, disease recurrence in living offspring deviated from the expected 25% to the observed 12% ([95% CI 0·04 to 0·20], p = 0·011).ConclusionsMolecular diagnosis in an older child, coupled with prenatal fetal genotyping in subsequent pregnancies and genetic counselling, allows families to make informed decisions to reduce recessive neurogenetic disease recurrence

A Prospective Controlled Study of Magnetic Resonance Imaging of the Brain in Gay Men and Parenteral Drug Users with Human Immunodeficiency Virus Infection

To detect the earliest structural changes in the brain in human immunodeficiency virus (HIV) infection, 118 gay men and 115 parenteral drug users enrolled in a study of the natural history of HIV infection underwent magnetic resonance imaging evaluations. Routine T2-weighted and heavily T2-weighted scans for quantification of brain water were obtained, blinded to HIV serostatus. Atrophy and foci of increased signal did not correlate with any medical, immunologic, neurologic, or neuropsychologic parameters in the group as a whole, or in the gay men or parenteral drug user subgroups. Three subjects had progressive multifocal leukoencephalopathy and one had central nervous system lymphoma. In a subgroup in whom intracranial water percent was calculated, correlations were found with CD4 counts and CD4/CD8 ratios. We conclude that standard magnetic resonance imaging of the brain does not differentiate asymptomatic and mildly symptomatic HIV-positive individuals from HIV-negative individuals, regardless of risk group. However, intracranial water percent may distinguish HIV-positive from HIV-negative individuals because it correlates with raw CD4 counts and CD4/CD8 ratios

Chemical Substructure in the Milky Way Halo: A New Population of Old Stars

We report the results of a coherent study of a new class of halo stars defined on the basis of the chemical compositions of three metal-poor objects ([Fe/H] -2) that exhibit unusually low abundances of α-element (Mg, Si, Ca) and neutron-capture (Sr, Y, Ba) material. Our analyses confirm and expand on earlier reports of atypical α- and neutron-capture abundances in BD +80°245, G4-36, and CS 22966-043. We also find that the latter two stars exhibit unusual relative abundance enhancements within the iron peak (Cr, Mn, Ni, Zn), along with what may be large abundances of Ga, an element not previously reported as being observed in any metal-poor star. These results provide further evidence that chemical enrichment and star formation histories varied from region to region within the Milky Way halo. Comparing the chemical abundances of the newly identified stellar population to supernova model yields, we derive supernova ratios of Type Ia versus Type II events in the range of 0.6 (NIa/NII)New Pop 1.3. For the Sun, we derive 0.18 ± 0.01 < (NIa/NII)☉ < 0.25 ± 0.06, supernova ratios in good agreement with values found in the literature. Given the relatively low metallicity and relatively high NIa/NII ratios of the low-α stars studied here, these objects may have been born from material produced in the yields of the earliest Type Ia supernova events. We also report the results of a preliminary attempt to employ the observed chemical abundances of low-metallicity stars in the identification, and possible cosmic evolution, of Type Ia supernova progenitors, and we discuss the limitations of current model yields

Evaluating the Effect of Chemical Digestion Treatments on Polystyrene Microplastics: Recommended Updates to Chemical Digestion Protocols

Establishing the toxicity and exposure consequences of microplastics (MPs) on marine organisms relies on the nondestructive isolation of plastics from biological matrices. MPs are commonly extracted from these matrices by chemical digestion using alkali (e.g., potassium hydroxide (KOH) and sodium hydroxide (NaOH)), oxidative (e.g., hydrogen peroxide (H2O2)) and/or acidic (e.g., nitric acid (HNO3)) reagents. Although these digestion conditions can be highly effective for MP extraction, they can also react with the plastics. This can attribute an inaccurate representation of plastic contamination by altering MP visual characteristics (size, shape, color), thereby impeding identification and potentially returning erroneous numbers of ingested particles. In this study, the degradative impacts are assessed of the routinely applied digestion reagents (i) KOH, (ii) NaOH, (iii) H2O2, and (iv)HNO3 on polystyrene (PS) based MPs sized between 200 μm and 5 mm. Degradation of the PS MPs is evaluated using FT-IR, gel permeation chromatography, NMR, photoluminescence spectroscopy, and microscopy. These studies reveal HNO3 to be the most destructive for PS MPs, while the alkali and oxidative reagents result in negligible changes in plastic properties. These results are recommended to be used as a guideline to update current protocols to ensure the nondestructive treatment of MPs