An American Student’s Transformed View of French Culture

The goal of this project is to compare American stereotypes of French culture to a student’s interactions with French culture during a yearlong education abroad program at Ècole de Management Strasbourg in Strasbourg, France, to see which commonly accepted stereotypes deserve to be dispelled, and explain those which may be acceptable from a more informed perspective

Non-Traumatic Urologic Emergencies in Men: A Clinical Review

Although true urologic emergencies are extremely rare, they are a vital part of any emergency physician’s (EP) knowledge base, as delays in treatment lead to permanent damage. The four urologic emergencies discussed are priapism, paraphimosis, testicular torsion, and Fournier’s gangrene. An overview is given for each, including causes, pathophysiology, diagnosis, treatment, and new developments. The focus for priapism is on diagnosis and distinguishing high-flow from low-flow forms, as the latter requires emergent treatment. For paraphimosis, we describe various methods of relieving the stricture, from manual reduction to surgery in extreme cases. For testicular torsion, the most important factor in salvaging the testicle is decreasing time to treatment. This is accomplished through experience and understanding which signs and symptoms strongly suggest it, so that time-consuming tests are avoided. Lastly, Fournier’s gangrene is potentially fatal. While aggressive medical and surgical therapy will improve chances of survival and outcome, it is vital for the emergency department (ED) physician to diagnose Fournier’s. It often presents in the elderly, immunocompromised, or those with depressed mental status. The goal of this paper is to arm EPs with information to recognize urological emergencies and intervene quickly to preserve tissue, fertility, and life

Status Review of California's Low Carbon Fuel Standard

California's Low Carbon Fuel Standard (LCFS) aims to reduce emissions of greenhouse gases (GHGs) by creating financial incentives for innovation and deployment of low carbon fuels. From 2011 through Q4 2012, there was a net excess of 1.285 million credits (metric tons of CO2e); if all available for use, the excess credits represent about half of what is needed to cover the 2013 obligation. During the period, the average fuel carbon intensity (CI) of gasoline and diesel substitutes declined. There was a rise in credit trading and credit trade prices. Feedstock-specific issues are examined

Cure kinetics characterization and monitoring of an epoxy resin using DSC, Raman spectroscopy, and DEA

The use of thick sections of fiber-reinforced polymers (FRPs) is increasing for numerous industrial applications such as wind turbine blades. In situ cure monitoring is very important to directly observe the cure process of FRPs during the manufacturing process. In this work, Raman spectroscopy and dielectric analysis (DEA) are investigated for in situ cure monitoring of an epoxy resin. The cure behavior is first characterized using differential scanning calorimetry (DSC) as a baseline comparison, and the best-fit phenomenological reaction model is determined to describe the cure behavior of the epoxy resin as well as the kinetic parameters. The relationship between Tg and degree of cure is also established. The degree of cure obtained from Raman spectroscopy and DEA under isothermal conditions is compared to that obtained from DSC. A good agreement is observed among the three methods, supporting the potential of these in situ cure monitoring methods during manufacturing. An implementation plan for in-plant monitoring is also discussed

Identification of Plastoglobules as a Site of Carotenoid Cleavage

Carotenoids play an essential role in light harvesting and protection from excess light. During chloroplast senescence carotenoids are released from their binding proteins and are eventually metabolized. Carotenoid cleavage dioxygenase 4 (CCD4) is involved in carotenoid breakdown in senescing leaf and desiccating seed, and is part of the proteome of plastoglobules (PG), which are thylakoid-associated lipid droplets. Here, we demonstrate that CCD4 is functionally active in PG. Leaves of Arabidopsis thaliana ccd4 mutants constitutively expressing CCD4 fused to yellow fluorescent protein showed strong fluorescence in PG and reduced carotenoid levels upon dark- induced senescence. Lipidome-wide analysis indicated that ß-carotene, lutein, and violaxanthin were the principle substrates of CCD4 in vivo and were cleaved in senescing chloroplasts. Moreover, carotenoids were shown to accumulate in PG of ccd4 mutant plants during senescence, indicating translocation of carotenoids to PG prior to degradation

Averting HIV Infections in New York City: A Modeling Approach Estimating the Future Impact of Additional Behavioral and Biomedical HIV Prevention Strategies

Background:New York City (NYC) remains an epicenter of the HIV epidemic in the United States. Given the variety of evidence-based HIV prevention strategies available and the significant resources required to implement each of them, comparative studies are needed to identify how to maximize the number of HIV cases prevented most economically.Methods:A new model of HIV disease transmission was developed integrating information from a previously validated micro-simulation HIV disease progression model. Specification and parameterization of the model and its inputs, including the intervention portfolio, intervention effects and costs were conducted through a collaborative process between the academic modeling team and the NYC Department of Health and Mental Hygiene. The model projects the impact of different prevention strategies, or portfolios of prevention strategies, on the HIV epidemic in NYC.Results:Ten unique interventions were able to provide a prevention benefit at an annual program cost of less than $360,000, the threshold for consideration as a cost-saving intervention (because of offsets by future HIV treatment costs averted). An optimized portfolio of these specific interventions could result in up to a 34$106,378; the total cost was in excess of $2 billion (over the 20 year period, or approximately$100 million per year, on average). The cost-savings of prevented infections was estimated at more than $5 billion (or approximately$250 million per year, on average).Conclusions:Optimal implementation of a portfolio of evidence-based interventions can have a substantial, favorable impact on the ongoing HIV epidemic in NYC and provide future cost-saving despite significant initial costs. © 2013 Kessler et al

Concordance of self- and informant-rated depressive symptoms in nursing home residents with Dementia: cross-sectional findings

Background: Depression is highly prevalent in nursing home residents living with moderate to severe dementia. However, assessing depressive symptoms in residents with dementia can be challenging and may vary by rater perspective. We aimed to investigate the concordance of, and factors associated with self- and informant-rated depressive symptoms in nursing home residents with dementia. Methods: Cross-sectional data was collected from N= 162 nursing home residents with dementia (age: 53-100; 74% women). Self-ratings were assessed with the Geriatric Depression Scale, while the depression and anxiety items of the Neuropsychiatric Inventory were used for informant-ratings. Cohen's Kappa was calculated to determine the concordance of both measures and of each with antidepressant medication. Multivariate associations with sociodemographic variables, self- and informant-rated quality of life, dementia stage, neuropsychiatric symptoms, functional status and antidepressant medication were analysed with linear mixed models and generalized estimating equations. Results: Concordance between self- and single item informant-rated depressive symptoms was minimal (Cohen's Kappa = .22, p= .02). No concordance was found for self-reported depressive symptoms and the combined informant-rated depression-anxiety score. Self-reported depression was negatively associated with self-rated quality of life (beta=-.32; 95%CI: -.45 to -.19, p< .001), informant-rated quality of life (beta=-.25; 95%CI: -.43 to -.07, p= .005) and functional status (beta=-.16; 95%CI: -.32 to -.01, p= .04), whilst single item informant-rated depression revealed negative associations with informant-rated quality of life (beta =-.32; 95%CI: -.52 to .13, p=.001) and dementia stage (beta=-.31; 95%CI: -.52 to -.10, p = .004). The combined informant-rated depression-anxiety score showed negative associations with self-rated quality of life (beta=-.12; 95%CI: -.22 to -.03, p = .01) and dementia stage (beta = -.37; 95%CI: -.67 to -.07, p= .02) and a positive association with neuropsychiatric symptoms (beta = .30; 95%CI: .10 to .51, p= .004). No concordance was found with antidepressant medication. Conclusions: In line with our expectations, low agreement and unique association patterns were found for both measures. These findings indicate that both instruments address different aspects of depression and underline the need for comprehensive approaches when it comes to detecting signs of clinically relevant depressive symptoms in dementia

Averting HIV Infections in New York City: A Modeling Approach Estimating the Future Impact of Additional Behavioral and Biomedical HIV Prevention Strategies

Background: New York City (NYC) remains an epicenter of the HIV epidemic in the United States. Given the variety of evidence-based HIV prevention strategies available and the significant resources required to implement each of them, comparative studies are needed to identify how to maximize the number of HIV cases prevented most economically. Methods: A new model of HIV disease transmission was developed integrating information from a previously validated micro-simulation HIV disease progression model. Specification and parameterization of the model and its inputs, including the intervention portfolio, intervention effects and costs were conducted through a collaborative process between the academic modeling team and the NYC Department of Health and Mental Hygiene. The model projects the impact of different prevention strategies, or portfolios of prevention strategies, on the HIV epidemic in NYC. Results: Ten unique interventions were able to provide a prevention benefit at an annual program cost of less than$360,000, the threshold for consideration as a cost-saving intervention (because of offsets by future HIV treatment costs averted). An optimized portfolio of these specific interventions could result in up to a 34$106,378; the total cost was in excess of $2 billion (over the 20 year period, or approximately$100 million per year, on average). The cost-savings of prevented infections was estimated at more than $5 billion (or approximately$250 million per year, on average). Conclusions: Optimal implementation of a portfolio of evidence-based interventions can have a substantial, favorable impact on the ongoing HIV epidemic in NYC and provide future cost-saving despite significant initial costs