African American Adults’ Experiences with the Health Care System: In Their Own Words

African Americans suffer a disproportionate burden of death and illness from a number of different chronic diseases. Inequalities in health care practices and poor patient and provider communication between African American patients and health care professionals contribute to these disparities. We describe findings from focus groups with 79 urban African Americans in which the participants discussed their interactions with the healthcare system as well as beliefs and opinions of the healthcare system and professionals. Analysis revealed five major themes: (1) historical and contextual foundations; (2) interpersonal experiences with physicians and other health care workers; (3) discrimination; (4) trust, opinions and attitudes, and (5) improving health care experiences. These findings indicate that perceptions of discrimination and racism were prevalent among African Americans in this study, and that the expectation of a negative interaction is a barrier to seeking care. Authors discuss prevention and public health implications of these findings and make recommendations for health care practitioners

Fighting Wildfire with Prescribed Fire in the Southern Great Plains, USA: Liability, Regulatory and Social Factors

Elevated fuel loads together with hotter and drier climatic conditions are expected to produce more frequent catastrophic wildfires in rangelands. This has led to calls for more prescribed fire to reduce fuel loads. However, perceptions that prescribed fire presents substantial legal liability risks hinder its use by landowners. Here we present research findings about the perceptions of landowners, county commissioners and district court judges regarding prescribed fire in the Southern Great Plains. The extent of liability incorporated in legal statutes pertaining to prescribed fire can affect the use of this land management tool, and the enactment of burn bans by county officials can prevent the use of prescribed fire during conditions under which invasive volatile woody plants are most effectively controlled by fire. In states with gross negligence standards for applying prescribed fire landowners burn more than in states with simple negligence standards. The findings highlight several foci for increasing the use of fire to better manage volatile woody plants. These include reformulating legal statutes affecting the use of prescribed fire; better informing county officials about the wildfire mitigation benefits of prescribed fire to reduce volatile fuels; and the widespread establishment of prescribed burning associations to provide training, equipment and labour for land managers to apply prescribed fire safely

Differing severities of acute exacerbations of idiopathic pulmonary fibrosis (IPF): Insights from the INPULSIS\uae trials

Background: Given the broad definition of an acute exacerbation of IPF, it is likely that acute exacerbations are heterogeneous in their aetiology, severity and clinical course. We used pooled data from the INPULSIS\uae trials of nintedanib versus placebo to investigate whether acute exacerbations reported as serious adverse events were associated with higher mortality than those reported as non-serious adverse events and to assess the effect of nintedanib on these types of events. Methods: Adverse events considered by an investigator to be an acute exacerbation were adjudicated as a confirmed acute exacerbation, suspected acute exacerbation, or not an acute exacerbation. Time to first investigator-reported acute exacerbation or confirmed/suspected acute exacerbation reported as a serious adverse event or non-serious adverse event over the 52-week treatment period was assessed post-hoc. Deaths were assessed based on data collected over the 52-week treatment period. Results: Of 63 patients who had 651 investigator-reported acute exacerbation, 48 (76.2%) had a first acute exacerbation reported as a serious adverse event. Thirty-six (3.4%) patients had 651 confirmed/suspected acute exacerbation, of whom 31 had a first event reported as a serious adverse event. Investigator-reported acute exacerbations reported as serious adverse events occurred in 23 patients in the nintedanib group and 26 in the placebo group. Confirmed/suspected acute exacerbations reported as serious adverse events occurred in 10 and 21 patients in these groups, respectively. Nintedanib significantly reduced the risk of a first acute exacerbation reported as a serious adverse event (HR 0.57 [95% CI: 0.32, 0.99]; p = 0.0476) and the risk of a first confirmed/suspected acute exacerbation reported as a serious adverse event (HR 0.30 [95% CI: 0.14, 0.64]; p = 0.0019) versus placebo. A higher proportion of patients with investigator-reported acute exacerbations reported as serious adverse events died than patients with acute exacerbations reported as non-serious adverse events (61.2% versus 7.1%). Conclusion: Different severities of acute exacerbation of IPF may exist. Acute exacerbations reported as serious adverse events in the INPULSIS\uae trials were associated with high mortality. Nintedanib significantly reduced the risk of acute exacerbations reported as serious adverse events. Trial registration: ClinicalTrials.gov NCT01335464 and NCT01335477

Digital lung auscultation: Will early diagnosis of fibrotic interstitial lung disease become a reality?

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The Past, Present, and Future of Research on Interviewer Effects

Interviewer-administered surveys are a primary method of collecting information from populations across the United States and the world. Various types of interviewer-administered surveys exist, including large-scale government surveys that monitor populations (e.g., the Current Population Survey), surveys used by the academic community to understand what people think and do (e.g., the General Social Survey), and surveys designed to gauge public opinion at a particular time point (e.g., the Gallup Daily Tracking Poll). Interviewers participate in these data collection efforts in a multitude of ways, including creating lists of housing units for sampling, persuading sampled units to participate, and administering survey questions (Morton-Williams 1993). In an increasing number of surveys, interviewers are also tasked with collecting blood, saliva, and other biomeasures, and asking survey respondents for consent to link survey data to administrative records (Sakshaug 2013). Interviewers are also used in mixed mode surveys to recruit and interview non respondents after less expensive modes like mail and web have failed (e.g., the American Community Survey and the Agricultural Resource Management Survey; de Leeuw 2005; Dillman, Smyth and Christian 2014; Olson et al. 2019). In completing these varied tasks, interviewers affect survey costs and coverage, nonresponse, measurement, and processing errors (Schaeffer, Dykema and Maynard 2010; West and Blom 2017)

Trapped ions in optical lattices for probing oscillator chain models

We show that a chain of trapped ions embedded in microtraps generated by an optical lattice can be used to study oscillator models related to dry friction and energy transport. Numerical calculations with realistic experimental parameters demonstrate that both static and dynamic properties of the ion chain change significantly as the optical lattice power is varied. Finally, we lay out an experimental scheme to use the spin degree of freedom to probe the phase space structure and quantum critical behavior of the ion chain

Uptake Mechanism of ApoE-Modified Nanoparticles on Brain Capillary Endothelial Cells as a Blood-Brain Barrier Model

Background: The blood-brain barrier (BBB) represents an insurmountable obstacle for most drugs thus obstructing an effective treatment of many brain diseases. One solution for overcoming this barrier is a transport by binding of these drugs to surface-modified nanoparticles. Especially apolipoprotein E (ApoE) appears to play a major role in the nanoparticle-mediated drug transport across the BBB. However, at present the underlying mechanism is incompletely understood. Methodology/Principal Findings: In this study, the uptake of the ApoE-modified nanoparticles into the brain capillary endothelial cells was investigated to differentiate between active and passive uptake mechanism by flow cytometry and confocal laser scanning microscopy. Furthermore, different in vitro co-incubation experiments were performed with competing ligands of the respective receptor. Conclusions/Significance: This study confirms an active endocytotic uptake mechanism and shows the involvement of low density lipoprotein receptor family members, notably the low density lipoprotein receptor related protein, on the uptake of the ApoE-modified nanoparticles into the brain capillary endothelial cells. This knowledge of the uptake mechanism of ApoE-modified nanoparticles enables future developments to rationally create very specific and effective carriers to overcome the blood-brain barrier

Heralded single photon absorption by a single atom

The emission and absorption of single photons by single atomic particles is a fundamental limit of matter-light interaction, manifesting its quantum mechanical nature. At the same time, as a controlled process it is a key enabling tool for quantum technologies, such as quantum optical information technology [1, 2] and quantum metrology [3, 4, 5, 6]. Controlling both emission and absorption will allow implementing quantum networking scenarios [1, 7, 8, 9], where photonic communication of quantum information is interfaced with its local processing in atoms. In studies of single-photon emission, recent progress includes control of the shape, bandwidth, frequency, and polarization of single-photon sources [10, 11, 12, 13, 14, 15, 16, 17], and the demonstration of atom-photon entanglement [18, 19, 20]. Controlled absorption of a single photon by a single atom is much less investigated; proposals exist but only very preliminary steps have been taken experimentally such as detecting the attenuation and phase shift of a weak laser beam by a single atom [21, 22], and designing an optical system that covers a large fraction of the full solid angle [23, 24, 25]. Here we report the interaction of single heralded photons with a single trapped atom. We find strong correlations of the detection of a heralding photon with a change in the quantum state of the atom marking absorption of the quantum-correlated heralded photon. In coupling a single absorber with a quantum light source, our experiment demonstrates previously unexplored matter-light interaction, while opening up new avenues towards photon-atom entanglement conversion in quantum technology.Comment: 10 pages, 4 figure

Coherence of qubits based on single Ca+^+ ions

Two-level ionic systems, where quantum information is encoded in long lived states (qubits), are discussed extensively for quantum information processing. We present a collection of measurements which characterize the stability of a qubit based on the $S_{1/2}$--$D_{5/2}$ transition of single $^{40}$Ca$^+$ ions in a linear Paul trap. We find coherence times of $\simeq$1 ms, discuss the main technical limitations and outline possible improvements.Comment: Proceedings of "Trapped charged particles and fundamental interactions" submitted to Journal of Physics B (IoP

A replication study confirms the association of TNFSF4 (OX40L) polymorphisms with systemic sclerosis in a large European cohort

<p><b>Objectives</b> The aim of this study was to confirm the influence of TNFSF4 polymorphisms on systemic sclerosis (SSc) susceptibility and phenotypic features.</p> <p><b>Methods</b> A total of 8 European populations of Caucasian ancestry were included, comprising 3014 patients with SSc and 3125 healthy controls. Four genetic variants of TNFSF4 gene promoter (rs1234314, rs844644, rs844648 and rs12039904) were selected as genetic markers.</p> <p><b>Results</b> A pooled analysis revealed the association of rs1234314 and rs12039904 polymorphisms with SSc (OR 1.15, 95% CI 1.02 to 1.31; OR 1.18, 95% CI 1.08 to 1.29, respectively). Significant association of the four tested variants with patients with limited cutaneous SSc (lcSSc) was revealed (rs1234314 OR 1.22, 95% CI 1.07 to 1.38; rs844644 OR 0.91, 95% CI 0.83 to 0.99; rs844648 OR 1.10, 95% CI 1.01 to 1.20 and rs12039904 OR 1.20, 95% CI 1.09 to 1.33). Association of rs1234314, rs844648 and rs12039904 minor alleles with patients positive for anti-centromere antibodies (ACA) remained significant (OR 1.23, 95% CI 1.10 to 1.37; OR 1.12, 95% CI 1.01 to 1.25; OR 1.22, 95% CI 1.07 to 1.38, respectively). Haplotype analysis confirmed a protective haplotype associated with SSc, lcSSc and ACA positive subgroups (OR 0.88, 95% CI 0.82 to 0.96; OR 0.88, 95% CI 0.80 to 0.96; OR 0.86, 95% CI 0.77 to 0.97, respectively) and revealed a new risk haplotype associated with the same groups of patients (OR 1.14, 95% CI 1.03 to 1.26; OR 1.20, 95% CI 1.08 to 1.35; OR 1.23, 95% CI 1.07 to 1.42, respectively).</p> <p><b>Conclusions</b> The data confirm the influence of TNFSF4 polymorphisms in SSc genetic susceptibility, especially in subsets of patients positive for lcSSc and ACA.</p&gt