Hormonal Contraceptive Use Among Active Duty Army Servicewomen. Trends and Implications for Risk of Musculoskeletal Injury.

Almost 40% of servicewomen use hormonal contraception every year, and 60% will use a contraceptive method in their military career. Rates of contraceptive use and musculoskeletal injury are higher among servicewomen as compared to civilians. Gender differences in rates of musculoskeletal injury have led investigators to question the role of sex hormones, including contraception. Recent studies suggest that hormonal contraceptives may decreased risk of anterior cruciate ligament (ACL) injury, potentially decreasing early onset osteoarthritis (OA). We utilized the Total Army Injury and Health Outcome Database, which prospectively captured demographics, clinical and pharmacy records on over 5.6 million Army soldiers since 1994. Hormonal contraceptive use was identified in the Pharmacy Data Transaction Service. The first project described changes in covariates and contraceptive use overtime. Over the ten years of follow-up, there were increases in age, education, and rank of servicewomen at entry. Among contraceptive users, rates of pill use decreased from 79.71% in 2002 to 51.67% in 2011 with increased use of the ring, implant and IUD. Contraceptive users were young, higher ranking and more likely to be nulliparous. Education varied widely by contraceptive method with injection and patch users having the lowest and ring users the highest level of education. The second and third projects examined the association of hormonal contraceptive and ACL injury or OA by survival analysis using multivariate Cox proportional hazards models. In project two, a total of 2,253 incident ACL tears were identified from medical billing codes. In our final model, current users were 15% less likely to have incident ACL injury. Project 3 identified a total of 3,943 OA cases. In the final model, ever use of contraceptive was associated with a 19% reduced risk of OA compared to never users. Strengths of our study include the evaluation of all types of contraceptive use in a large, diverse, population-based cohort. Information gathered from this study informs future studies considering hormonal contraceptives a modifiable risk factor for ACL injury and OA, informing contraceptive decision making, clinical recommendations, and injury prevention strategies for servicewomen particularly around key career events including basic training and deployment

The Inhalation Characteristics of Patients When They Use Different Dry Powder Inhalers

Background: The characteristics of each inhalation maneuver when patients use dry powder inhalers (DPIs) are important, because they control the quality of the emitted dose. Methods: We have measured the inhalation profiles of asthmatic children [CHILD; n=16, mean forced expiratory volume in 1 sec (FEV1) 79% predicted], asthmatic adults (ADULT; n=53, mean predicted FEV1 72%), and chronic obstructive pulmonary disease (COPD; n=29, mean predicted FEV1 42%) patients when they inhaled through an Aerolizer, Diskus, Turbuhaler, and Easyhaler using their “real-life” DPI inhalation technique. These are low-, medium-, medium/high-, and high-resistance DPIs, respectively. The inhalation flow against time was recorded to provide the peak inhalation flow (PIF; in L/min), the maximum pressure change (ΔP; in kPa), acceleration rates (ACCEL; in kPa/sec), time to maximum inhalation, the length of each inhalation (in sec), and the inhalation volume (IV; in liters) of each inhalation maneuver. Results: PIF, ΔP, and ACCEL values were consistent with the order of the inhaler's resistance. For each device, the inhalation characteristics were in the order ADULT>COPD>CHILD for PIF, ΔP, and ACCEL (p4 L and ΔP >4 kPa. Conclusion: The large variability of these inhalation characteristics and their range highlights that if inhalation profiles were used with compendial in vitro dose emission measurements, then the results would provide useful information about the dose patients inhale during routine use. The inhalation characteristics highlight that adults with asthma have greater inspiratory capacity than patients with COPD, whereas children with asthma have the lowest. The significance of the inhaled volume to empty doses from each device requires investigation

Demonstrating principles of spectrophotometry by constructing a simple, low-cost, functional spectrophotometer utilizing the light sensor on a smartphone

A highly simplified variation on the DIY spectrophotometer using a smartphone’s light sensor as a detector and an app to calculate and display absorbance values was constructed and tested. This simple version requires no need for electronic components or post-measurement spectral analysis. Calibration graphs constructed from two molecules that absorb light maximally at different wavelengths (430nm and 630nm) demonstrate linearity with R2 values of 0.9975 and 0.9848 respectively

Improving VIX Futures Forecasts using Machine Learning Methods

The problem of forecasting market volatility is a difficult task for most fund managers. Volatility forecasts are used for risk management, alpha (risk) trading, and the reduction of trading friction. Improving the forecasts of future market volatility assists fund managers in adding or reducing risk in their portfolios as well as in increasing hedges to protect their portfolios in anticipation of a market sell-off event. Our analysis compares three existing financial models that forecast future market volatility using the Chicago Board Options Exchange Volatility Index (VIX) to six machine/deep learning supervised regression methods. This analysis determines which models provide best market volatility forecast. Using VIX futures and options data along with other technical indicators, our analysis compares multiple forecasting models for estimating the 1-month VIX futures contract (UX1) both 3 and 5-days forward. This analysis finds that machine/deep learning methods of Recurrent Neural Networks (RNN) and Long Short-Term Memory (LSTM) provide improved results over existing linear regression, principal components analysis (PCA) and ARIMA methods. Comparing estimated versus actual test data, both the RNN and LSTM methods show lower mean squared error (MSE), lower mean absolute error (MAE), higher explained variance, and higher correlation. Finally, an accuracy matrix was generated for each model, which showed RNN and LSTM had better overall accuracy due to high true positive and negative forecasts as well as much lower false positive forecasts

Experiments on the improvement of written recall in social studies.

Thesis (Ed.M.)--Boston Universit

Psychopathic Traits and Impulsivity Subtypes: An Examination of Two Complex, Multifaceted Constructs

Research has demonstrated inconsistent results regarding the relationship between impulsivity and the interpersonal and affective facets of psychopathy. Therefore, the purpose of this work was to clarify and reconcile the variable empirical findings. Generally speaking, the relationship between psychopathic traits and impulsivity was expected to differ based on the psychopathy factor and type of impulsivity under investigation. Studies 1 and 2 examined psychopathy and impulsivity in on-line and student samples, utilizing the Self-Report Psychopathy Scale and several self-report measures of impulsivity. Study 2 included laboratory-assessed behavioural impulsivity measures. Results indicated that across studies erratic lifestyle was uniquely, positively associated with all self-reported impulsivity measures, but surprisingly unrelated to laboratory-assessed behavioural impulsivity. Interpersonal manipulation was uniquely, negatively associated with lack of premeditation and non-planning, and callous affect was uniquely, negatively associated with urgency across studies. Studies 3 and 4 examined the psychopathy-impulsivity relationship in youth and on-line samples. Psychopathy was examined using the Antisocial Process Screening Device (youth) and the Self-Report Psychopathy Scale (adults). Impulsivity was approximated via preselected facets of the HEXACO-PI-R and the UPPS Impulsive behavior scale (Study 4 only). Results indicated that the impulsivity (youth) and erratic lifestyle (adults) subscales were uniquely associated with heightened impulsivity. Callous-unemotional traits in youth were also associated with higher levels of impulsivity. In adults, interpersonal manipulation and callous affect were largely unrelated to impulsivity at the multivariate level (with few exceptions). Findings demonstrated that the behavioural characteristics of psychopathy contributed to a pervasive tendency towards a variety of impulsive behaviours. This relationship was consistent across the youth, adult, on-line, and student samples. Among adults, the emotional and interpersonal psychopathy traits may be unrelated to impulsivity. Interpersonal manipulation traits may result in a slightly greater tendency to demonstrate premeditated, planned behaviour, whereas callous affect may reflect slightly lower urgency. However, callous-unemotional traits in youth do appear to be related to heightened impulsivity. Findings provide a better understanding of the psychopathy-impulsivity relationship. This is the first set of studies to utilize the HEXACO model to approximate pre-established impulsivity domains. Findings also address the issue of suppression when examining multifaceted constructs, particularly psychopathic traits

Variability in the organisation and management of hospital care for COPD exacerbations in the UK

SummaryPrevious smaller UK audits have demonstrated wide variation in organisation, resources, and process of care for acute chronic obstructive pulmonary disease (COPD) admissions. Smallest units appeared to do less well.UK acute hospitals supplied information on (1) resources and organisation of care, (2) clinical data on process of care and outcomes for up to 40 consecutive COPD admissions. Comparisons were made against national recommendations.Eight thousand and thirteen admissions involved 7529 patients from 233 units (93% of UK acute Trusts). Twenty-six percent of units had at most one whole-time equivalent respiratory consultant while 12% had at least four. Thirty percent patients were admitted under a respiratory specialist and 48% discharged under their care whilst 28% had no specialist input at all. Variation in care provision was wide across all hospitals but patients in smaller hospitals had less access to specialist respiratory or admission wards, pulmonary rehabilitation programs, speciality triage or an early discharge scheme. Six percent of units did not have access to NIV and 18% to invasive ventilatory support.There remains wide variation in all aspects of acute hospital COPD care in the UK, with smaller hospitals offering fewest services. Those receiving specialist input are more likely to be offered interventions of proven effect. Management guidelines alone are insufficient to address inequalities of care and a clear statement of minimum national standards for resource provision and organisation of COPD care are required. This study provides a unique insight into the current state of care for patients admitted with COPD exacerbations in the UK

Psychopathy and Aggression: Examining the Role of Empathy

Empirical research has consistently demonstrated a positive association between psychopathic traits and physical aggression (Campbell, Porter, & Santor, 2004; Gretton, Hare, & Catchpole, 2004; Raine et aI., 2006; Spain, Douglas, Poythress, & Epstein, 2004). Moreover, research has also found that the emotional/interpersonal (Factor 1) psychopathy traits tend to be more closely associated with goal oriented, proactive aggression, whereas the social deviance (Factor 2) psychopathy characteristics have been more closely linked to reactive aggression, which is perpetrated in response to threat or provocation (Flight & Forth, 2007). Blair (2004; 2005; 2006) has recently proposed the Integrated Emotions Systems Model (lES), which posits that the association between Factor 1 psychopathy traits and proactive aggression is due to amygdala dysfunction leading to failed moral socialization. Consequently, individuals who exhibit Factor 1 psychopathy traits do not experience affective empathy in response to distress cues exhibited by others, thus, preventing the inhibition of proactive aggression. The current investigation sought to test this model by examining the associations among the emotional/interpersonal (Factor 1) psychopathy traits, proactive aggression, and affective empathy. After accounting for head injury, Factor 2 psychopathy traits, reactive aggression, and cognitive empathy, it was hypothesized that 1) Factor 1 psychopathy traits would predict proactive aggression, and 2) that affective empathy is a common cause of Factor 1 psychopathy traits, proactive aggression, and of the relationship between these two constructs. This hypothesis assumed that (a) affective empathy would uniquely predict Factor 1 psychopathy traits, (b) that affective empathy would uniquely predict proactive aggression, and (c) that affective empathy would account for the relationship between Factor I psychopathy traits and proactive aggression. The total sample consisted of 137 male undergraduate students. Participants completed measures of psychopathy (SRP III; Paulhus, Hemphill, & Hare, in press), aggression (PCS; Marsee, Kimonis, & Frick, 2004; RPQ; Raine et at, 2006), dispositional cognitive and affective empathy (BES; Jolliffe & Farrington, 2006; TES; Spreng, McKinnon, Mar, & Levine, 2009), and situational cognitive and affective empathy in response to neutral and empathy eliciting video clips. Physiological indices (heart rate & electrodermal activity) of affective empathy were also obtained while participants viewed the neutral and empathy eliciting videos. Findings indicated that Factor I psychopathy traits predicted proactive aggression. In addition, results demonstrated that affective empathy predicted both Factor I psychopathy traits and proactive aggression. However, the association between affective empathy and proactive aggression appeared to be dependent on the conceptualization and measurement of affective empathy. Conversely, affective empathy did not appear to account for the relationship between Factor I psychopathy traits and proactive aggression. Overall, results demonstrated partial support for the IES model. Implications of the results, limitations of the study and future research directions are discussed