ADR and the Federal Government: Not Such Strange Bedfellows after All

These remarks focus on the Federal Government\u27s use of ADR. The Department of Justice, as the nation\u27s most prolific litigator, can benefit greatly from the effective use of ADR. What factors limit its use and how it has been implemented are discussed below

Volunteer Participation in the Health eHeart Study: A Comparison with the US Population.

Direct volunteer "eCohort" recruitment can be an efficient way of recruiting large numbers of participants, but there is potential for volunteer bias. We compared self-selected participants in the Health eHeart Study to participants in the National Health And Nutrition Examination Survey (NHANES) 2013-14, a cross-sectional survey of the US population. Compared with the US population (represented by 5,769 NHANES participants), the 12,280 Health eHeart participants with complete survey data were more likely to be female (adjusted odds ratio (ORadj) = 3.1; 95% confidence interval (CI) 2.9-3.5); less likely to be Black, Hispanic, or Asian versus White/non-Hispanic (ORadj's = 0.4-0.6, p < 0.01); more likely to be college-educated (ORadj = 15.8 (13-19) versus ≤high school); more likely to have cardiovascular diseases and risk factors (ORadj's = 1.1-2.8, p < 0.05) except diabetes (ORadj = 0.8 (0.7-0.9); more likely to be in excellent general health (ORadj = 0.6 (0.5-0.8) for "Good" versus "Excellent"); and less likely to be current smokers (ORadj = 0.3 (0.3-0.4)). While most self-selection patterns held for Health eHeart users of Bluetooth blood pressure cuff technology, there were some striking differences; for example, the gender ratio was reversed (ORadj = 0.6 (0.4-0.7) for female gender). Volunteer participation in this cardiovascular health-focused eCohort was not uniform among US adults nor for different components of the study

Witness Hide-and-Seek: Why Federal Prosecutors Should Record Pretrial Interviews

This Article pays long-overdue attention to a federal appellate court\u27s warning against playing hide-and-seek with witnesses. Specifically, prosecutors should record interviews. While courtroom cameras dominate the topic of judicial transparency, cameras can play a critical role in a sleepier corner of criminal proceedings: pretrial witness interviews. The Article first tracks the history of open judicial proceedings as a tradition of our Anglo- American jurisprudence. Next, the Article identifies the normative thread running through that history. Fairness may suffer when cameras transform public proceedings into publicized proceedings. Finally, the Article argues that this same issue of fairness applies to pretrial witness interviews. While fairness provides a reason against proceedings that are overly publicized, it provides a reason for interviews that are more public. Judicial proceedings are designed to ascertain the truth; hidden off camera, witness interviews may obscure the truth. Recording witness interviews would lift those interviews on a par with other discovery aspects of a criminal proceeding and put a welcome end to games of witness hide-and-seek

Validation of a consumer-grade activity monitor for continuous daily activity monitoring in individuals with multiple sclerosis.

Background:Technological advancements of remote-monitoring used in clinical-care and research require validation of model updates. Objectives:To compare the output of a newer consumer-grade accelerometer to a previous model in people with multiple sclerosis (MS) and to the ActiGraph, a waist-worn device widely used in MS research. Methods:Thirty-one individuals with MS participated in a 7-day validation by the Fitbit Flex (Flex), Fitbit Flex-2 (Flex2) and ActiGraph GT3X. Primary outcome was step count. Valid epochs of 5-min block increments, where there was overlap of ≥1 step/min for both devices were compared and summed to give a daily total for analysis. Results:Bland-Altman plots showed no systematic difference between the Flex and Flex2; mean step-count difference of 25 more steps-per-day more recorded by Flex2 (95% confidence intervals (CI) = 2, 48; p = 0.04),interclass correlation coefficient (ICC) = 1.00. Compared to the ActiGraph, Flex2 (and Flex) tended to record more steps (808 steps-per-day more than the ActiGraph (95% CI= -2380, 765; p < 0.01), although the ICC was high (0.98) indicating that the devices were likely measuring the same kind of activity. Conclusions:Steps from Flex and Flex2 can be used interchangeably. Differences in total step count between ActiGraph and Flex devices can make cross-device comparisons of numerical step-counts challenging particularly for faster walkers

The Effects of Sequence and Delay on Crowd Work

A common approach in crowdsourcing is to break large tasks into small microtasks so that they can be parallelized across many crowd workers and so that redundant work can be more easily compared for quality control. In practice, this can re-sult in the microtasks being presented out of their natural order and often introduces delays between individual micro-tasks. In this paper, we demonstrate in a study of 338 crowd workers that non-sequential microtasks and the introduction of delays significantly decreases worker performance. We show that interruptions where a large delay occurs between two related tasks can cause up to a 102 % slowdown in com-pletion time, and interruptions where workers are asked to perform different tasks in sequence can slow down comple-tion time by 57%. We conclude with a set of design guide-lines to improve both worker performance and realized pay, and instructions for implementing these changes in existing interfaces for crowd work. Author Keywords Crowdsourcing; human computation; workflows; continuity

Real-world heart rate norms in the Health eHeart study.

Emerging technology allows patients to measure and record their heart rate (HR) remotely by photoplethysmography (PPG) using smart devices like smartphones. However, the validity and expected distribution of such measurements are unclear, making it difficult for physicians to help patients interpret real-world, remote and on-demand HR measurements. Our goal was to validate HR-PPG, measured using a smartphone app, against HR-electrocardiogram (ECG) measurements and describe out-of-clinic, real-world, HR-PPG values according to age, demographics, body mass index, physical activity level, and disease. To validate the measurements, we obtained simultaneous HR-PPG and HR-ECG in 50 consecutive patients at our cardiology clinic. We then used data from participants enrolled in the Health eHeart cohort between 1 April 2014 and 30 April 2018 to derive real-world norms of HR-PPG according to demographics and medical conditions. HR-PPG and HR-ECG were highly correlated (Intraclass correlation = 0.90). A total of 66,788 Health eHeart Study participants contributed 3,144,332 HR-PPG measurements. The mean real-world HR was 79.1 bpm ± 14.5. The 95th percentile of real-world HR was ≤110 in individuals aged 18-45, ≤100 in those aged 45-60 and ≤95 bpm in individuals older than 60 years old. In multivariable linear regression, the number of medical conditions, female gender, increasing body mass index, and being Hispanic was associated with an increased HR, whereas increasing age was associated with a reduced HR. Our study provides the largest real-world norms for remotely obtained, real-world HR according to various strata and they may help physicians interpret and engage with patients presenting such data

Grassroots Conservation: Volunteers Contribute to Threatened and Endangered Species Projects and Foster a Supportive Public

Educational programs for volunteers participating in threatened and endangered species conservation projects foster supportive attitudes in individuals who then become valuable advocates. We surveyed volunteers to assess the impact of the Tern and Plover Conservation Partnership\u27s program. This program trains volunteers to protect Interior Least Terns and Piping Plovers nesting at sand and gravel mines, lakeshore housing developments, and river sandbars. Volunteers increased their knowledge and appreciation of threatened and endangered species and conservation policy. They expressed interest in contributing to conservation policymaking and felt that they can make a difference in the recovery of legally protected species

Physical activity counseling in overweight and obese primary care patients: Outcomes of the VA-STRIDE randomized controlled trial.

The purpose of this 2-arm randomized clinical trial was to evaluate the effectiveness of a 12-month, expert system-based, print-delivered physical activity intervention in a primary care Veteran population in Pittsburgh, Pennsylvania. Participants were not excluded for many health conditions that typically are exclusionary criteria in physical activity trials. The primary outcome measures were physical activity reported using the Community Healthy Activities Model Program for Seniors (CHAMPS) questionnaire and an accelerometer-based activity assessment at baseline, 6, and 12 months. Of the 232 Veterans enrolled in the study, 208 (89.7%) were retained at the 6-month follow-up and 203 (87.5%) were retained at 12 months. Compared to the attention control, intervention participants had significantly increased odds of meeting the U.S. recommended guideline of ≥ 150 min/week of at least moderate-intensity physical activity at 12 months for the modified CHAMPS (odds ratio [OR] = 2.86; 95% CI: 1.03-7.96; p = 0.04) but not at 6 months (OR = 1.54; 95% CI: 0.56-4.23; p = 0.40). Based on accelerometer data, intervention participants had significantly increased odds of meeting ≥ 150 min/week of moderate-equivalent physical activity at 6 months (OR = 6.26; 95% CI: 1.26-31.22; p = 0.03) and borderline significantly increased odds at 12 months (OR = 4.73; 95% CI: 0.98-22.76; p = 0.053). An expert system physical activity counseling intervention can increase or sustain the proportion of Veterans in primary care meeting current recommendations for moderate-intensity physical activity. Trial Registration Clinical trials.gov identifier: NCT00731094 URL: http://www.clinicaltrials.gov/ct2/show/NCT00731094

Randomized trial of conventional transseptal needle versus radiofrequency energy needle puncture for left atrial access (the TRAVERSE-LA study).

BackgroundTransseptal puncture is a critical step in achieving left atrial (LA) access for a variety of cardiac procedures. Although the mechanical Brockenbrough needle has historically been used for this procedure, a needle employing radiofrequency (RF) energy has more recently been approved for clinical use. We sought to investigate the comparative effectiveness of an RF versus conventional needle for transseptal LA access.Methods and resultsIn this prospective, single-blinded, controlled trial, 72 patients were randomized in a 1:1 fashion to an RF versus conventional (BRK-1) transseptal needle. In an intention-to-treat analysis, the primary outcome was time required for transseptal LA access. Secondary outcomes included failure of the assigned needle, visible plastic dilator shavings from needle introduction, and any procedural complication. The median transseptal puncture time was 68% shorter using the RF needle compared with the conventional needle (2.3 minutes [interquartile range {IQR}, 1.7 to 3.8 minutes] versus 7.3 minutes [IQR, 2.7 to 14.1 minutes], P = 0.005). Failure to achieve transseptal LA access with the assigned needle was less common using the RF versus conventional needle (0/36 [0%] versus 10/36 [27.8%], P < 0.001). Plastic shavings were grossly visible after needle advancement through the dilator and sheath in 0 (0%) RF needle cases and 12 (33.3%) conventional needle cases (P < 0.001). There were no differences in procedural complications (1/36 [2.8%] versus 1/36 [2.8%]).ConclusionsUse of an RF needle resulted in shorter time to transseptal LA access, less failure in achieving transseptal LA access, and fewer visible plastic shavings

Molecular Population Structure of Junonia

Up to 9 described species of Junonia butterflies occur in the Americas, but authorities disagree due to species similarities, geographical and seasonal variability, and possible hybridization. In dispute is whether Caribbean Junonia are conspecific with South American species. Cytochrome oxidase I (COI) barcodes, wingless (wg) sequences, and Randomly Amplified Fingerprints (RAF) were studied to reveal Junonia population structure in French Guiana, Guadeloupe, Martinique, and Argentina. Phylogenetic analysis of COI recovered 2 haplotype groups, but most Junonia species can have either haplotype, so COI barcodes are ambiguous. Analysis of nuclear wingless alleles revealed geographic patterns but did not identify Junonia species. Nuclear RAF genotyping distinguished 11 populations of Junonia arranged into 3 clusters. Gene flow occurs within clusters but is limited between clusters. One cluster included all Argentinian samples. Two clusters included samples from French Guiana, Martinique, and Guadeloupe and appear to be divided by larval host plant use (Lamiales versus Scrophulariales). Many Junonia taxa were distributed across populations, possibly reflecting patterns of genetic exchange. We had difficulty distinguishing between the Caribbean forms J. zonalis and J. neildi, but we demonstrate that Caribbean Junonia are genetically distinct from South American J. evarete and J. genoveva, supporting the taxonomic hypothesis that they are heterospecific