Efficacy Of Statin Therapy In The Elderly

Statins are one of the most heavily prescribed medications. The 2018 ACC/AHA guidelines support statin therapy for most older adults, but recommendations are less clear for those over 75. The literature was systematically reviewed for evidence of the efficacy of statin treatment in different patient populations. Significant evidence was found supporting a decreasing association between low-density lipoprotein cholesterol (LDL-C) and mortality as well as decreasing statin efficacy with increasing age. The consequences of unnecessary statin therapy can be severe for older adults. Improved methods for evaluating atherosclerotic cardiovascular disease (ASCVD) risk, such as using negative markers to help identify those who may not benefit from statin therapy, should be more widely employed.https://dune.une.edu/pharm_studpost/1001/thumbnail.jp

Optimal minimal measurements of mixed states

The optimal and minimal measuring strategy is obtained for a two-state system prepared in a mixed state with a probability given by any isotropic a priori distribution. We explicitly construct the specific optimal and minimal generalized measurements, which turn out to be independent of the a priori probability distribution, obtaining the best guesses for the unknown state as well as a closed expression for the maximal mean averaged fidelity. We do this for up to three copies of the unknown state in a way which leads to the generalization to any number of copies, which we then present and prove.Comment: 20 pages, no figure

Cultural Diversity Professional Development in Schools Survey

This report presents findings from the Metropolitan Educational Research Consortium (MERC) Cultural Diversity Within Schools Survey. This survey was designed for school- based professionals (i.e., teachers, instructional staff, administrators) within the MERC region. Administered in the fall of 2018, the survey collected information about experiences of professional development related to cultural diversity, attitudes toward cultural diversity within schools, perceptions of barriers and opportunities, and perspectives on the need for professional development. Section 1 of the report discusses the context for this survey effort: increased cultural diversity in our schools, increased cultural mismatch between students and teachers, and multicultural education as a promising practice. This is followed in section 2 with information about the survey development and administration process. In section 3, we present the findings from the survey in several subsections that explore group comparisons and results related to the different topics covered in the survey. In section 4, we share recommendations for policy, practice and future scholarship. These recommendations are informed by the relevant literature as well as the results of the survey. The report also includes two appendices: Appendix A presents a full version of the survey, Appendix B provides detailed tables of survey results disaggregated by school division. A third appendix, Appendix C provides technical information about the survey methodology, and is available online

Confidence Level Of Primary Care Providers In Authorizing Athletic Return-To-Play

The purpose of this study was to identify the level of confidence for primary care providers in authorizing athletic retum-to-play following sports-related injury. The Centers for Disease Control and Prevention (CDC) (as cited in Patel, Yamasaki, & Brown, 2017) reported that 2.6 million children and teens ages 0-19 years are treated annually for sports-related injuries, and 7.2 million high school students participate in sports and suffer an estimated 2 million injuries that require 500,000 doctor visits and 30,000 hospitalizations annually. Although primary care providers are providing care for musculoskeletal and concussive injuries, Benham and Geier (2016) reported that they may not have the confidence, knowledge, or skill to manage common musculoskeletal conditions in their primary care practice. Excellent provisions of such care will require providers who are safe and confident in the management and treatment of sports-related injuries to ensure high-quality patient care (Benham & Geier, 2016). Researchers distributed written surveys, and links to a survey were distributed via social media postings, email, and SurveyMonkey to qualifying participants including Doctors of Medicine (MD), Doctors of Osteopathic Medicine (DO), nurse practitioners (NP), and physician assistants (PA). Data collected indicated that only 47.6% primary care providers were confident with returning youth athletes back-to-play following a sports injury, 34.7% were confident in treating sports-related concussive injuries, and 50% were confident in treating sports-related musculoskeletal injuries. Primary care providers can use this information to expose areas for confidence improvement that can be met with continued education, in-services, and workshops. Schools of medicine and nursing can use these findings to improve musculoskeletal curricula in primary care education. Determining primary care provider confidence level in authorizing athletic retum-to-play is imperative in ensuring patient safety and access to thorough and competent care from initial injury to full resolution

Directional Charge Separation in Isolated Organic Semiconductor Crystalline Nanowires

One of the fundamental design paradigms in organic photovoltaic device engineering is based on the idea that charge separation is an extrinsically driven process requiring an interface for exciton fission. This idea has driven an enormous materials science engineering effort focused on construction of domain sizes commensurate with a nominal exciton diffusion length of order 10 nm. Here, we show that polarized optical excitation of isolated pristine crystalline nanowires of a small molecule n-type organic semiconductor, 7,8,15,16-tetraazaterrylene, generates a significant population of charge-separated polaron pairs along the π-stacking direction. Charge separation was signalled by pronounced power-law photoluminescence decay polarized along the same axis. In the transverse direction, we observed exponential decay associated with excitons localized on individual monomers. We propose that this effect derives from an intrinsic directional charge-transfer interaction that can ultimately be programmed by molecular packing geometry

Effective field theory analysis of the self-interacting chameleon

We analyse the phenomenology of a self-interacting scalar field in the context of the chameleon scenario originally proposed by Khoury and Weltman. In the absence of self-interactions, this type of scalar field can mediate long range interactions and simultaneously evade constraints from violation of the weak equivalence principle. By applying to such a scalar field the effective field theory method proposed for Einstein gravity by Goldberger and Rothstein, we give a thorough perturbative evaluation of the importance of non-derivative self-interactions in determining the strength of the chameleon mediated force in the case of orbital motion. The self-interactions are potentially dangerous as they can change the long range behaviour of the field. Nevertheless, we show that they do not lead to any dramatic phenomenological consequence with respect to the linear case and solar system constraints are fulfilled.Comment: 15 pages, 2 figures. Final version accepted for publication on General Relativity and Gravitatio

Probability distribution of arrival times in quantum mechanics

In a previous paper [V. Delgado and J. G. Muga, Phys. Rev. A 56, 3425 (1997)] we introduced a self-adjoint operator $\hat {{\cal T}}(X)$ whose eigenstates can be used to define consistently a probability distribution of the time of arrival at a given spatial point. In the present work we show that the probability distribution previously proposed can be well understood on classical grounds in the sense that it is given by the expectation value of a certain positive definite operator $\hat J^{(+)}(X)$ which is nothing but a straightforward quantum version of the modulus of the classical current. For quantum states highly localized in momentum space about a certain momentum $p_0 \neq 0$, the expectation value of $\hat J^{(+)}(X)$ becomes indistinguishable from the quantum probability current. This fact may provide a justification for the common practice of using the latter quantity as a probability distribution of arrival times.Comment: 21 pages, LaTeX, no figures; A Note added; To be published in Phys. Rev.

Quantum probability distribution of arrival times and probability current density

This paper compares the proposal made in previous papers for a quantum probability distribution of the time of arrival at a certain point with the corresponding proposal based on the probability current density. Quantitative differences between the two formulations are examined analytically and numerically with the aim of establishing conditions under which the proposals might be tested by experiment. It is found that quantum regime conditions produce the biggest differences between the formulations which are otherwise near indistinguishable. These results indicate that in order to discriminate conclusively among the different alternatives, the corresponding experimental test should be performed in the quantum regime and with sufficiently high resolution so as to resolve small quantum efects.Comment: 21 pages, 7 figures, LaTeX; Revised version to appear in Phys. Rev. A (many small changes

Acute Trauma Factor Associations With Suicidality Across the First 5 Years After Traumatic Brain Injury

AbstractObjectiveTo determine whether severity of head and extracranial injuries (ECI) is associated with suicidal ideation (SI) or suicide attempt (SA) after traumatic brain injury (TBI).DesignFactors associated with SI and SA were assessed in this inception cohort study using data collected 1, 2, and 5 years post-TBI from the National Trauma Data Bank and Traumatic Brain Injury Model Systems (TBIMS) databases.SettingLevel I trauma centers, inpatient rehabilitation centers, and the community.ParticipantsParticipants with TBI from 15 TBIMS Centers with linked National Trauma Data Bank trauma data (N=3575).InterventionsNot applicable.Main Outcome MeasuresSI was measured via the Patient Health Questionnaire 9 (question 9). SA in the last year was assessed via interview. ECI was measured by the Injury Severity Scale (nonhead) and categorized as none, mild, moderate, or severe.ResultsThere were 293 (8.2%) participants who had SI without SA and 109 (3.0%) who had SA at least once in the first 5 years postinjury. Random effects logit modeling showed a higher likelihood of SI when ECI was severe (odds ratio=2.73; 95% confidence interval, 1.55–4.82; P=.001). Drug use at time of injury was also associated with SI (odds ratio=1.69; 95% confidence interval, 1.11–2.86; P=.015). Severity of ECI was not associated with SA.ConclusionsSevere ECI carried a nearly 3-fold increase in the odds of SI after TBI, but it was not related to SA. Head injury severity and less severe ECI were not associated with SI or SA. These findings warrant additional work to identify factors associated with severe ECI that make individuals more susceptible to SI after TBI

Plankton lattices and the role of chaos in plankton patchiness

Spatiotemporal and interspecies irregularities in planktonic populations have been widely observed. Much research into the drivers of such plankton patches has been initiated over the past few decades but only recently have the dynamics of the interacting patches themselves been considered. We take a coupled lattice approach to model continuous-in-time plankton patch dynamics, as opposed to the more common continuum type reaction-diffusion-advection model, because it potentially offers a broader scope of application and numerical study with relative ease. We show that nonsynchronous plankton patch dynamics (the discrete analog of spatiotemporal irregularity) arise quite naturally for patches whose underlying dynamics are chaotic. However, we also observe that for parameters in a neighborhood of the chaotic regime, smooth generalized synchronization of nonidentical patches is more readily supported which reduces the incidence of distinct patchiness. We demonstrate that simply associating the coupling strength with measurements of (effective) turbulent diffusivity results in a realistic critical length of the order of 100 km, above which one would expect to observe unsynchronized behavior. It is likely that this estimate of critical length may be reduced by a more exact interpretation of coupling in turbulent flows