Analgesic prescribing trends in a national sample of older veterans with osteoarthritis: 2012-2017

Few investigations examine patterns of opioid and nonopioid analgesic prescribing and concurrent pain intensity ratings before and after institution of safer prescribing programs such as the October 2013 Veterans Health Administration system-wide Opioid Safety Initiative (OSI) implementation. We conducted a quasi-experimental pre–post observational study of all older U.S. veterans (≥50 years old) with osteoarthritis of the knee or hip. All associated outpatient analgesic prescriptions and outpatient pain intensity ratings from January 1, 2012 to December 31, 2016, were analyzed with segmented regression of interrupted time series. Standardized monthly rates for each analgesic class (total, opioid, nonsteroidal anti-inflammatory drug, acetaminophen, and other study analgesics) were analyzed with segmented negative binomial regression models with overall slope, step, and slope change. Similarly, segmented linear regression was used to analyze pain intensity ratings and percentage of those reporting pain. All models were additionally adjusted for age, sex, and race. Before OSI implementation, total analgesic prescriptions showed a steady rise, abruptly decreasing to a flat trajectory after OSI implementation. This trend was primarily due to a decrease in opioid prescribing after OSI. Total prescribing after OSI implementation was partially compensated by continuing increased prescribing of other study analgesics as well as a significant rise in acetaminophen prescriptions (post-OSI). No changes in nonsteroidal anti-inflammatory drug prescribing were seen. A small rise in the percentage of those reporting pain but not mean pain intensity ratings continued over the study period with no changes associated with OSI. Changes in analgesic prescribing trends were not paralleled by changes in reported pain intensity for older veterans with osteoarthritis

The oral microbiome of denture wearers is influenced by natural dentition

Objectives: The composition of dental plaque has been well defined, whereas currently there is limited understanding of the composition of denture plaque and how it directly influences denture related stomatitis (DS). The aims of this study were to compare the microbiomes of denture wearers, and to understand the implications of these towards inter-kingdom and host-pathogen interactions within the oral cavity. Methods: Swab samples were obtained from 123 participants wearing either a complete or partial denture; the bacterial composition of each sample was determined using bar-coded illumina MiSeq sequencing of the bacterial hypervariable V4 region of 16S rDNA. Sequencing data processing was undertaken using QIIME, clustered in Operational Taxonomic Units (OTUs) and assigned to taxonomy. The dentures were sonicated to remove the microbial flora residing on the prosthesis, sonicate was then cultured using diagnostic colorex Candida media. Samples of unstimulated saliva were obtained and antimicrobial peptides (AMP) levels were measured by ELISA. Results: We have shown that dental and denture plaques are significantly distinct both in composition and diversity and that the oral microbiome composition of a denture wearer is variable and is influenced by the location within the mouth. Dentures and mucosa were predominantly made up of Bacilli and Actinobacteria. Moreover, the presence of natural teeth has a significant impact on the overall microbial composition, when compared to the fully edentulous. Furthermore, increasing levels of Candida spp. positively correlate with Lactobacillus spp. AMPs were quantified, though showed no specific correlations. Conclusions: This is the first study to provide a detailed understanding of the oral microbiome of denture wearers and has provided evidence that DS development is more complex than simply a candidal infection. Both fungal and bacterial kingdoms clearly play a role in defining the progression of DS, though we were unable to show a defined role for AMPs

Lay belief in biopolitics and political prejudice

Building on psychological research linking essentialist beliefs about human differences with prejudice, we test whether lay belief in the biological basis of political ideology is associated with political intolerance and social avoidance. In two studies of American adults (Study 1: N 1⁄4 288, Study 2: N 1⁄4 164), we find that belief in the biological basis of political views is associated with greater intolerance and social avoidance of ideologically dissimilar others. The association is substantively large and robust to demographic, religious, and political control variables. These findings stand in contrast to some theoretical expectations that biological attributions for political ideology are associated with tolerance. We conclude that biological lay theories are especially likely to be correlated with prejudice in the political arena, where social identities tend to be salient and linked to intergroup competition and animosity

Tapping Environmental History to Recreate America’s Colonial Hydrology

To properly remediate, improve, or predict how hydrological systems behave, it is vital to establish their histories. However, modern-style records, assembled from instrumental data and remote sensing platforms, hardly exist back more than a few decades. As centuries of data is preferable given multidecadal fluxes of both meteorology/climatology and demographics, building such a history requires resources traditionally considered only useful in the social sciences and humanities. In this Feature, Pastore et al. discuss how they have undertaken the synthesis of historical records and modern techniques to understand the hydrology of the Northeastern U.S. from Colonial times to modern day. Such approaches could aid studies in other regions that may require heavier reliance on qualitative narratives. Further, a better insight as to how historical changes unfolded could provide a “past is prologue” methodology to increase the accuracy of predictive environmental models

Competition between electron-phonon attraction and weak Coulomb repulsion

The Holstein-Hubbard model is examined in the limit of infinite dimensions. Conventional folklore states that charge-density-wave (CDW) order is more strongly affected by Coulomb repulsion than superconducting order because of the pseudopotential effect. We find that both incommensurate CDW and superconducting phases are stabilized by the Coulomb repulsion, but, surprisingly, the commensurate CDW transition temperature is more robust than the superconducting transition temperature. This puzzling feature is resolved by a detailed analysis of perturbation theory.Comment: 13 pages in ReVTex including 3 encapsulated postscript files (embedded in the text). The encapsulated postscript files are compressed and uuencoded after the TeX file

Improved Dynamical Masses for Six Brown Dwarf Companions Using Hipparcos and Gaia EDR3

We present comprehensive orbital analyses and dynamical masses for the substellar companions Gl~229~B, Gl~758~B, HD~13724~B, HD~19467~B, HD~33632~Ab, and HD~72946~B. Our dynamical fits incorporate radial velocities, relative astrometry, and most importantly calibrated Hipparcos-Gaia EDR3 accelerations. For HD~33632~A and HD~72946 we perform three-body fits that account for their outer stellar companions. We present new relative astrometry of Gl~229~B with Keck/NIRC2, extending its observed baseline to 25 years. We obtain a $<$1\% mass measurement of $71.4 \pm 0.6\,M_{\rm Jup}$ for the first T dwarf Gl~229~B and a 1.2\% mass measurement of its host star ($0.579 \pm 0.007\,M_{\odot}$) that agrees with the high-mass-end of the M dwarf mass-luminosity relation. We perform a homogeneous analysis of the host stars' ages and use them, along with the companions' measured masses and luminosities, to test substellar evolutionary models. Gl~229~B is the most discrepant, as models predict that an object this massive cannot cool to such a low luminosity within a Hubble time, implying that it may be an unresolved binary. The other companions are generally consistent with models, except for HD~13724~B that has a host-star activity age 3.8$\sigma$ older than its substellar cooling age. Examining our results in context with other mass-age-luminosity benchmarks, we find no trend with spectral type but instead note that younger or lower-mass brown dwarfs are over-luminous compared to models, while older or higher-mass brown dwarfs are under-luminous. The presented mass measurements for some companions are so precise that the stellar host ages, not the masses, limit the analysis.Comment: Accepted for publication in AJ. References updated in version 2. See the journal version for the full quality figures. Figure sets and the MCMC chains (reduced to just 1000 samples however) are included with the journal version of the article, and pre-publication at https://drive.google.com/drive/folders/1_A8QYn9NyPgmGqJaY5sMHyT_wAS3uRRK?usp=sharin

Can a combination of the conformal thin-sandwich and puncture methods yield binary black hole solutions in quasi-equilibrium?

We consider combining two important methods for constructing quasi-equilibrium initial data for binary black holes: the conformal thin-sandwich formalism and the puncture method. The former seeks to enforce stationarity in the conformal three-metric and the latter attempts to avoid internal boundaries, like minimal surfaces or apparent horizons. We show that these two methods make partially conflicting requirements on the boundary conditions that determine the time slices. In particular, it does not seem possible to construct slices that are quasi-stationary and avoid physical singularities and simultaneously are connected by an everywhere positive lapse function, a condition which must obtain if internal boundaries are to be avoided. Some relaxation of these conflicting requirements may yield a soluble system, but some of the advantages that were sought in combining these approaches will be lost.Comment: 8 pages, LaTeX2e, 2 postscript figure

Initial data for Einstein's equations with superposed gravitational waves

A method is presented to construct initial data for Einstein's equations as a superposition of a gravitational wave perturbation on an arbitrary stationary background spacetime. The method combines the conformal thin sandwich formalism with linear gravitational waves, and allows detailed control over characteristics of the superposed gravitational wave like shape, location and propagation direction. It is furthermore fully covariant with respect to spatial coordinate changes and allows for very large amplitude of the gravitational wave.Comment: Version accepted by PRD; added convergence plots, expanded discussion. 9 pages, 9 figure