Patient Safety Case Review: Inpatient Use of Recreational Opiates

Background of Case Patient with active substance use (reported snorting 8-10 bags of fentanyl/day) not initially interested in MOUD admitted to TJUH for severe sepsis due to empyema Placed on hydromorphone PCA with scheduled oxycodone for pain control and withdrawal, found to have diverted prescribed opiates and used recreational fentanyl while inpatient Project Aim Perform root cause analysis of safety event Develop solutions to prevent similar instances in future given growing opiate epidemic in Philadelphi

Premise Selection for Mathematics by Corpus Analysis and Kernel Methods

Smart premise selection is essential when using automated reasoning as a tool for large-theory formal proof development. A good method for premise selection in complex mathematical libraries is the application of machine learning to large corpora of proofs. This work develops learning-based premise selection in two ways. First, a newly available minimal dependency analysis of existing high-level formal mathematical proofs is used to build a large knowledge base of proof dependencies, providing precise data for ATP-based re-verification and for training premise selection algorithms. Second, a new machine learning algorithm for premise selection based on kernel methods is proposed and implemented. To evaluate the impact of both techniques, a benchmark consisting of 2078 large-theory mathematical problems is constructed,extending the older MPTP Challenge benchmark. The combined effect of the techniques results in a 50% improvement on the benchmark over the Vampire/SInE state-of-the-art system for automated reasoning in large theories.Comment: 26 page

Alcohol-stress interaction: possible stress alleviating prpoerties of ethanol

Stress is an inevitable part of daily life to every individual. Stress may be eustress or distress. It depends on stress exposure and individual's perception to experience the extent to which one is vulnerable. Daily stressors are unavoidable but stress coping makes an individual to tolerate stress. Many becomes the victims of alcohol drinking for the simple belief of 'tension -reduction' by the use of alcohol. Though, initially alcohol may mask few of the stress effects, its long term effects are dangerous as it may indulge in addiction behaviour. There are inconclusive reports on the interaction of stress and alcohol. There are lacunae in literature on the stress alcohol interaction especially with reference to the multi-ethnic population of the State of Sabah. Hence the objectives of the study was, to elucidate and possible stress- alcohol relationship. Whether alcohol drinking alleviates stress? Increases stress? Alcohol drinking aggravates stress? Was there any demographic, cultural factors in drinking patterns etc., Based on the previous studies, stress inventory was designed and using the DASS21 questionnaire and on its reliability and validity tests, with a voluntary consent of participants study questionnaires were introduced. Subjects of both sex 18-45 years of age were included. Exclusion criteria were chronic drinkers and those on medications for chronic diseases. The data was analysed by Structural Equation Modelling (SPSS AMOS ver 23, 2015). Results of the study revealed that, there is an association between stress and alcohol drinking. Level of stress is a major factor that is associated with level of drinking, cause of drinking among the study group. Drinking also increased the level of stress and there is interdependency between stress - alcohol drinking - stresses. In conclusion, present study confirms that, alcohol drinking does not alleviate the stress experience; on the contrary drinking alcohol increases the stress experience. It is a vicious cycle; stress experience leads to alcohol drinking, in turn alcohol drinking further increases the stress. Family and cultural drinking is one of the factors that promote alcohol drinking

A Computational Approach for Designing Tiger Corridors in India

Wildlife corridors are components of landscapes, which facilitate the movement of organisms and processes between intact habitat areas, and thus provide connectivity between the habitats within the landscapes. Corridors are thus regions within a given landscape that connect fragmented habitat patches within the landscape. The major concern of designing corridors as a conservation strategy is primarily to counter, and to the extent possible, mitigate the effects of habitat fragmentation and loss on the biodiversity of the landscape, as well as support continuance of land use for essential local and global economic activities in the region of reference. In this paper, we use game theory, graph theory, membership functions and chain code algorithm to model and design a set of wildlife corridors with tiger (Panthera tigris tigris) as the focal species. We identify the parameters which would affect the tiger population in a landscape complex and using the presence of these identified parameters construct a graph using the habitat patches supporting tiger presence in the landscape complex as vertices and the possible paths between them as edges. The passage of tigers through the possible paths have been modelled as an Assurance game, with tigers as an individual player. The game is played recursively as the tiger passes through each grid considered for the model. The iteration causes the tiger to choose the most suitable path signifying the emergence of adaptability. As a formal explanation of the game, we model this interaction of tiger with the parameters as deterministic finite automata, whose transition function is obtained by the game payoff.Comment: 12 pages, 5 figures, 6 tables, NGCT conference 201

Observation of coherent many-body Rabi oscillations

A two-level quantum system coherently driven by a resonant electromagnetic field oscillates sinusoidally between the two levels at frequency $\Omega$ which is proportional to the field amplitude [1]. This phenomenon, known as the Rabi oscillation, has been at the heart of atomic, molecular and optical physics since the seminal work of its namesake and coauthors [2]. Notably, Rabi oscillations in isolated single atoms or dilute gases form the basis for metrological applications such as atomic clocks and precision measurements of physical constants [3]. Both inhomogeneous distribution of coupling strength to the field and interactions between individual atoms reduce the visibility of the oscillation and may even suppress it completely. A remarkable transformation takes place in the limit where only a single excitation can be present in the sample due to either initial conditions or atomic interactions: there arises a collective, many-body Rabi oscillation at a frequency $N^0.5\Omega$ involving all N >> 1 atoms in the sample [4]. This is true even for inhomogeneous atom-field coupling distributions, where single-atom Rabi oscillations may be invisible. When one of the two levels is a strongly interacting Rydberg level, many-body Rabi oscillations emerge as a consequence of the Rydberg excitation blockade. Lukin and coauthors outlined an approach to quantum information processing based on this effect [5]. Here we report initial observations of coherent many-body Rabi oscillations between the ground level and a Rydberg level using several hundred cold rubidium atoms. The strongly pronounced oscillations indicate a nearly complete excitation blockade of the entire mesoscopic ensemble by a single excited atom. The results pave the way towards quantum computation and simulation using ensembles of atoms

Tearing Out the Income Tax by the (Grass)Roots

Landscapes are increasingly fragmented, and conservation programs have started to look at network approaches for maintaining populations at a larger scale. We present an agent-based model of predator–prey dynamics where the agents (i.e. the individuals of either the predator or prey population) are able to move between different patches in a landscaped network. We then analyze population level and coexistence probability given node-centrality measures that characterize specific patches. We show that both predator and prey species benefit from living in globally well-connected patches (i.e. with high closeness centrality). However, the maximum number of prey species is reached, on average, at lower closeness centrality levels than for predator species. Hence, prey species benefit from constraints imposed on species movement in fragmented landscapes since they can reproduce with a lesser risk of predation, and their need for using anti-predatory strategies decreases.authorCount :

PAD4-Mediated Neutrophil Extracellular Trap Formation Is Not Required for Immunity against Influenza Infection

During an inflammatory response, neutrophils migrate to the site of infection where they can kill invading pathogens by phagocytosis, secretion of anti-microbicidal mediators or the release of neutrophil extracellular traps (NETs). NETs are specialized anti-microbial structures comprised of decondensed chromatin decorated with microbicidal agents. Increased amount of NETs have been found in patients suffering from the chronic lung inflammatory disease cystic fibrosis, correlating with increased severity of pulmonary obstruction. Furthermore, acute lung inflammation during influenza A infection is characterized by a massive influx of neutrophils into the lung. The role of NETs during virus-mediated lung inflammation is unknown. Peptidylarginine deiminase 4 (PAD4)-mediated deimination of histone H3 and H4 is required for NET formation. Therefore, we generated a PAD4-deficient mouse strain that has a striking inability to form NETs. These mice were infected with influenza A/WSN, and the disease was monitored at the level of leukocytic lung infiltration, lung pathology, viral replication, weight loss and mortality. PAD4 KO fared comparable to WT mice in all the parameters tested, but they displayed slight but statistically different weight loss kinetics during infection that was not reflected in enhanced survival. Overall, we conclude that PAD4-mediated NET formation is dispensable in a mouse model of influenza A infection

Multi-Depot and Multi-School Bus Scheduling Problem with School Bell Time Optimization

69A43551747123The school bus transportation system is responsible for transporting students to and from schools safely and promptly. This research aims to optimize the school bus schedules and the school bell times simultaneously for improving the efficiency of the school bus system operation. The authors consider the school bus scheduling problem in a multi-depot multi-school bus system and incorporate the bell time optimization to make bus operations more efficient. The authors propose four different methods, including one exact method and three heuristic methods, to solve the Multi-depot and Multi-school Bus Scheduling Problem with School Bell Time Optimization (MDSBSPTW)