Opioid Settlement Funds: Do Not Neglect Patients With Pain

The opioid crisis has escalated in the setting of the COVID-19 pandemic to new extremes and has claimed more than half a million lives in the US since 2000. Lawsuits to address the civil and criminal liability of drug companies and other groups have originated from federal, state, local, and tribal jurisdictions. When successful, there will likely be billions of dollars and significant discretion as to how these funds are spent. Several groups have produced reports with principles to address the toll of addiction using settlement funds. However, they lack actionable strategies to address the needs of patients with pain, including patients with chronic pain who are receiving long-term opioid therapy. Persons with pain should not be neglected and deserve better treatment

On-orbit assembly using superquadric potential fields

The autonomous on-orbit assembly of a large space structure is presented using a method based on superquadric artificial potential fields. The final configuration of the elements which form the structure is represented as the minimum of some attractive potential field. Each element of the structure is then considered as presenting an obstacle to the others using a superquadric potential field attached to the body axes of the element. A controller is developed which ensures that the global potential field decreases monotonically during the assembly process. An error quaternion representation is used to define both the attractive and superquadric obstacle potentials allowing the final configuration of the elements to be defined through both relative position and orientation. Through the use of superquadric potentials, a wide range of geometric objects can be represented using a common formalism, while collision avoidance can make use of both translational and rotation maneuvers to reduce total maneuver cost for the assembly process

Evaluation of a disease specific rheumatoid arthritis self-management education program, a single group repeated measures study

Background: Rheumatoid Arthritis is a progressive and disabling disease, predicted to increase in prevalence over the next 50 years. Self-management is acknowledged as an integral part in the management of chronic disease. The rheumatoid arthritis specific self-management program delivered by health professionals was developed by Arthritis Western Australia in 2006. The purpose of this study was to determine whether this program would achieve early benefits in health related outcomes, and whether these improvements would be maintained for 12 months. Methods: Individuals with rheumatoid arthritis were referred from rheumatologists. Participants with co-existing inflammatory musculoskeletal conditions were excluded. All participants completed a 6-week program. Assessments occurred at baseline (8 weeks prior to intervention), pre-intervention, post-intervention, and 6 and 12 month follow ups. Outcomes measured included pain and fatigue (numerical rating scale, 0-10), depression and anxiety (hospital anxiety and depression questionnaire), health distress, and quality of life (SF-36 version 2). Results: There were significant improvements in mean [SD] fatigue (5.7 [2.4] to 5.1 [2.6]), depression (6.3 [4.3] to 5.6 [3.9]) and SF-36 mental health (44.5 [11.1] to 46.5 [9.5]) immediately following intervention, with long term benefits for depression (6.3 [4.3] to 4.9 [3.9]), and SF-36 subscales mental health (44.5 [11.1] to 47.8 [10.9]), role emotional (41.5 [13.2] to 46.5 [11.8]), role physical (35.0 [11.0] to 40.2 [12.1]) and physical function (34.8 [11.5] to 38.6 [10.7]). Conclusion: Participants in the program recorded significant improvements in depression and mental health post-intervention, which were maintained to 12 months follow up

Digital Twinning remote laboratories for online practical learning, Production & Manufacturing Research

The COVID19 pandemic has demonstrated a need for remote learning and virtual learning applications such as virtual reality (VR) and tabletbased solutions. Creating complex learning scenarios by developers is highly time-consuming and can take over a year. It is also costly to employ teams of system analysts, developers, and 3D artists. There is a requirement to provide a simple method to enable lecturers to create their own content for their laboratory tutorials. Research has been undertaken into developing generic models to enable the semiautomatic creation of virtual learning tools for subjects that require practical interactions with the lab resources. In addition to the system for creating digital twins, a case study describing the creation of a virtual learning application for an electrical laboratory tutorial is presented, demonstrating the feasibility of this approach

Allostatic Load Markers as Predictors of Melanoma Outcomes

https://openworks.mdanderson.org/sumexp23/1046/thumbnail.jp

Psychosocial and environmental determinants of child cognitive development in rural south africa and tanzania: findings from the mal-ed cohort

Background Approximately 66% of children under the age of 5 in Sub-Saharan African countries do not reach their full cognitive potential, the highest percentage in the world. Because the majority of studies investigating child cognitive development have been conducted in high-income countries (HICs), there is limited knowledge regarding the determinants of child development in low- and middle-income countries (LMICs). Methods This analysis includes 401 mother-child dyads from the South Africa and Tanzania sites of the Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) longitudinal birth cohort study. We investigated the effect of psychosocial and environmental determinants on child cognitive development measured by the Wechsler Preschool Primary Scales of Intelligence (WPPSI) at 5 years of age using multivariable linear regression. Results Socioeconomic status was most strongly associated with child cognitive development (WPSSI Score Difference (SD):14.27, 95% CI:1.96, 26.59). Modest associations between the organization of the home environment and its opportunities for cognitive stimulation and child cognitive development were also found (SD: 3.08, 95% CI: 0.65, 5.52 and SD: 3.18, 95% CI: 0.59, 5.76, respectively). Conclusion This study shows a stronger association with child cognitive development at 5 years of age for socioeconomic status compared to more proximal measures of psychosocial and environmental determinants. A better understanding of the role of these factors is needed to inform interventions aiming to alleviate the burden of compromised cognitive development for children in LMICs.publishedVersio

Hospitalization rates in patients switched from oral anti-psychotics to aripiprazole once-monthly: final efficacy analysis

Abstract Objective: To compare hospitalization rates in patients with schizophrenia treated prospectively with aripiprazole once-monthly 400 mg (AOM 400; an extended-release injectable suspension) vs the same patients\u27 retrospective rates with their prior oral anti-psychotic therapy. Research design and methods: Multi-center, open-label, mirror-image, naturalistic study in a community setting in North America. Patients who required a change in treatment and/or would benefit from long-acting injectable anti-psychotic therapy were treated prospectively for 6 months with AOM 400. Retrospective data on hospitalization rates were obtained. Clinical trial registration: ClinicalTrials.gov: NCT01432444. Main outcome measures: The proportion of patients with \u3e/=1 psychiatric inpatient hospitalization with oral anti-psychotic therapy examined retrospectively (months -4 to -1 before oral conversion) and after switching to AOM 400 (months 4-6 after initiating AOM 400). Results: Psychiatric hospitalization rates were significantly lower when patients were treated with AOM 400 compared with oral anti-psychotic therapy both in the 3-month primary efficacy sample (2.7% [n = 9/336] vs 27.1% [n = 91/336], respectively; p \u3c 0.0001) and in the total sample (6-month prospective rate: 8.8% [n = 38/433] vs 6-month retrospective rate: 38.1% [n = 165/433]; p \u3c 0.0001). Discontinuations due to adverse events (AEs) during cross-titration were lower in patients cross-titrated on oral aripiprazole for \u3e1 and(2.9% [n = 7/239]) compared with patients cross-titrated fo

The Great Debate at 'Immunotherapy Bridge', Naples, December 5, 2019

As part of the 2019 Immunotherapy Bridge congress (December 4–5, Naples, Italy), the Great Debate session featured counterpoint views from leading experts on six topical issues in immunotherapy today. These were the use of chimeric antigen receptor T cell therapy in solid tumors, whether the Immunoscore should be more widely used in clinical practice, whether antibody-dependent cellular cytotoxicity is important in the mode of action of anticytotoxic T-lymphocyte-associated protein 4 antibodies, whether the brain is immunologically unique or just another organ, the role of microbiome versus nutrition in affecting responses to immunotherapy, and whether chemotherapy is immunostimulatory or immunosuppressive. Discussion of these important topics are summarized in this report