Religion and Spirituality in Nevada

Across the world, religion is integral to society insofar it shapes people’s thoughts, behaviors, and interactions. What exactly the term “religion” means, however, is far from clear-cut, as it continues to be a highly charged topic of discussion and debate, a subject that many hold dear and near to their hearts. There seem to be just as many ways to define religion as there are groups and denominations that claim to hold the key to the “meaning of life” and even solve humanity’s woes. For many people, the word religion evokes shared ideas of church, gatherings, worship, prayer, music, traditions, and pilgrimages. Some of these images fit in with the “mainstream” meanings of religion, at least in terms of the practices of organized and institutionalized religion recognized in the United States. For other people, religion harbors meanings that go beyond the mainstream norms and that conflict with more familiar ideas of religion and religiosity. The rich diversity of the U.S. population reflects the amalgam of conventional and unconventional religious belief systems that coexist on a day-to-day basis. For the most part, the adherents of broad types of belief systems appear to tolerate one another, at least enough to function in a civil manner under the banner of an overarching “civil religion” (Bellah, 1967). Still, the nation has its share of religious conflict, and there are many examples of believers with clashing ideas and practices who struggle to have their voices heard and defend their religious convictions. Although Americans enjoy the rights to religious freedom and diversity guaranteed by the First Amendment to the U.S. Constitution, conflicts exist over the interpretation of freedom of religion versus freedom from religion. And debates about the Christian origins of the U.S. – often fueled by a Christian majority that makes up some 80% of the U.S. population – provide plenty of fodder for the so-called “culture wars” (Hunter, 1991; Borer & Murphree, 2008; Borer & Schafer, 2011). Conflicts over competing religious belief systems and worldviews do not necessarily imply social strife. Debates about the origins and the meanings of life and how they connect to our identities may foster healthy discussions and promote tolerance and pluralism. Motivated by presumed relations to a higher power or cause, religious groups have also been at the forefront of social activism and change. Though it is not always the case, conflicts between religious groups, and between religious groups and their secular counterparts, can lead to better understandings of diverse beliefs and practices and promote the social health of a nation, a state, and a community. Thus, we start with the proposition that religious diversity is central to the social health and well-being of human collectivities

Gender Performance in Womens\u27 Mixed Martial Arts

Academic research has typically focused on men who practice Mixed Martial Arts and their expression of hyper-masculinity. There is a lack of comparative work which examines women who practice MMA as a sport. This article aims to address this oversight by exploring the meaning and importance of the sports for women. The main focus is to explore how women navigate and “perform gender” in the patriarchal subculture of MMA. Drawing on a “grounded theory” approach, semi-structured interviews, content analysis, and participant observation, I developed a preliminary model of female Mixed Martial Artist. I examine three female fighter “types” (“Feminine inclined female Fighters,” “Neutral female fighters,” and “Masculine inclined female fighters”) and explore different aspects of gender performance which helped to signify these. In my research I discovered that in MMA there is a “gender order.” Many times when the gender order is disrupted women seek to recreate it. This results in the adaptation and navigation of the three fighter types that I mentioned previously. I also found that on many occasions women “purposely perform” a gender type making it an “explicit performance.” My findings demonstrate the need to consider the range and diversity of women’s fighter types. Further research should elaborate on the process of constructing a “gender order” amongst woman as well as the sociocultural expectations of female fighters. Other research should also investigate how “gender order” applies to other social worlds such as non-combat sports and other leisure activities, work and occupations, and everyday life

Religion and Spirituality in Nevada

Across the world, religion is integral to society insofar it shapes people’s thoughts, behaviors, and interactions. What exactly the term “religion” means, however, is far from clear-cut, as it continues to be a highly charged topic of discussion and debate, a subject that many hold dear and near to their hearts

Top ten risk factors for morbidity and mortality in patients with chronic systolic heart failure and elevated heart rate: the SHIFT risk model

Aims We identified easily obtained baseline characteristics associated with outcomes in patients with chronic heart failure (HF) and elevated heart rate (HR) receiving contemporary guideline-recommended therapy in the SHIFT trial, and used them to develop a prognostic model. Methods We selected the 10 best predictors for each of four outcomes (cardiovascular death or HF hospitalisation; all-cause mortality; cardiovascular mortality; and HF hospitalisation). All variables with p &#60; 0.05 for association were entered into a forward stepwise Cox regression model. Our initial analysis excluded baseline therapies, though randomisation to ivabradine or placebo was forced into the model for the composite endpoint and HF hospitalisation. Results Increased resting HR, low ejection fraction, raised creatinine, New York Heart Association class III/IV, longer duration of HF, history of left bundle branch block, low systolic blood pressure and, for three models, age were strong predictors of all outcomes. Additional predictors were low body mass index, male gender, ischaemic HF, low total cholesterol, no history of hyperlipidaemia or dyslipidaemia and presence of atrial fibrillation/flutter. The c-statistics for the four outcomes ranged from 67.6% to 69.5%. There was no evidence for lack of fit of the models with the exception of all-cause mortality (p = 0.017). Similar results were found including baseline therapies. Conclusion The SHIFT Risk Model includes simple, readily obtainable clinical characteristics to produce important prognostic information in patients with chronic HF, systolic dysfunction, and elevated HR. This may help better calibrate management to individual patient risk.</p

Approach Considerations in Aircraft with High-Lift Propeller Systems

NASA's research into distributed electric propulsion (DEP) includes the design and development of the X-57 Maxwell aircraft. This aircraft has two distinct types of DEP: wingtip propellers and high-lift propellers. This paper focuses on the unique opportunities and challenges that the high-lift propellers--i.e., the small diameter propellers distributed upstream of the wing leading edge to augment lift at low speeds--bring to the aircraft performance in approach conditions. Recent changes to the regulations related to certifying small aircraft (14 CFR x23) and these new regulations' implications on the certification of aircraft with high-lift propellers are discussed. Recommendations about control systems for high-lift propeller systems are made, and performance estimates for the X-57 aircraft with high-lift propellers operating are presented

Effect of visit-to-visit variation of heart rate and systolic blood pressure on outcomes in chronic systolic heart failure: results from the Systolic Heart Failure Treatment With the If Inhibitor Ivabradine Trial (SHIFT) trial

Background: Elevated resting heart rate (HR) and low systolic blood pressure (SBP) are related to poor outcomes in heart failure (HF). The association between visit-to-visit variation in SBP and HR and risk in HF is unknown. Methods and Results: In Systolic Heart Failure Treatment with the If inhibitor ivabradine Trial (SHIFT) patients, we evaluated relationships between mean HR, mean SBP, and visit-to-visit variations (coefficient of variation [CV]=SD/mean×100%) in SBP and HR (SBP-CV and HR-CV, respectively) and primary composite endpoint (cardiovascular mortality or HF hospitalization), its components, all-cause mortality, and all-cause hospitalization. High HR and low SBP were closely associated with risk for primary endpoint, all-cause mortality, and HF hospitalization. The highest number of primary endpoint events occurred in the highest HR tertile (38.8% vs 16.4% lowest tertile; P&lt;0.001). For HR-CV, patients at highest risk were those in the lowest tertile. Patients in the lowest thirds of mean SBP and SBP-CV had the highest risk. The combination of high HR and low HR-CV had an additive deleterious effect on risk, as did that of low SBP and low SBP-CV. Ivabradine reduced mean HR and increased HR-CV, and increased SBP and SBP-CV slightly. Conclusions: Beyond high HR and low SBP, low HR-CV and low SBP-CV are predictors of cardiovascular outcomes with additive effects on risk in HF, but with an unknown effect size. Beyond HR reduction, ivabradine increases HR-CV. Low visit-to-visit variation of HR and SBP might signal risk of cardiovascular outcomes in systolic HF. Clinical Trial Registration: URL: http://www.isrctn.com/. Unique identifier: ISRCTN70429960

Voice in Hausa

Diese Diplomarbeit versucht, die Distribution des Grade 7 Morphems in Hausa zu erklären. Die Grade 7 Markierung tritt an intransitiven Verben auf. Es besteht aus einem tonalen Muster und einem Suffix. In einem ersten Schritt wird die Frage geklärt, inwieweit es sich bei Grade 7 um ein einziges Morphem handelt, was klar bejaht werden muss. In einem zweiten Schritt werden die Hypothesen vorgestellt, die im letzten Vierteljahrhundert aufgestellt wurden, um die Distribution des Grade 7 Morphems zu erklären. Diese lassen sich in drei Kategorien einteilen: Die Annahme, dass Grade 7 Unakkusative, Passive oder Sustentative markiert. Ich zeige, dass alle drei Hypothesen nicht in der Lage sind, das Auftreten aller Grade 7 Verben sowie deren syntaktisches und semantisches Verhalten vorauszusagen. Ein Thema welches, soweit ich weiß , noch nicht in früheren Analysen des Problems Beachtung gefunden hat, ist die Variation in Grammatikalitätsurteilen. Einige Beispiele, welche in die Literatur Eingang gefunden haben, widersprechen sich klar. Ich gehe daher davon aus, dass es dialektale Variation im Gebrauch des Morphems gibt. Ich zeige in dieser Arbeit, dass es sich bei Grade 7 um einen Diathesesen-synkretismus handelt. Grade 7 markiert demnach nicht nur Resultative, sondern auch verbale Reziprokale und in manchen Varietäten auch Passive. Unter dieser Annahme bin ich in der Lage, die syntaktische Distribution und die Semantik von Grade 7 Verben zu erklären.This thesis attempts to explain the distribution of the grade 7 morpheme in Hausa. The grade 7 morpheme is a verbal affix on intransitive verbs. The affix consists of a tonal pattern and a suffix. In a first step, I elaborate on whether grade 7 constitutes a single morpheme, or multiple morphemes. I conclude that it can only be a single morpheme. In a second step, I present the hypotheses which have been put forward in the last quarter of a century to explain the distribution of grade 7 verbs. These hypotheses are categorizable into three groups: the unaccusative hypothesis, the passive hypothesis, and the sustentative hypothesis. I show that all of these hypotheses are unable to explain the distribution of grade 7 verbs, as well as their syntactic and semantic variation. I will also discuss dialectal variation in the distribution of grade 7. To my knowledge, the topic of variation in grade 7 has not been addressed so far. I will assume that contradictory grammaticality judgments reflect different varieties of Hausa. In this thesis, I show that grade 7 verbs reflect a voice syncretism. It does not only mark resultatives, but also verbal reciprocals, and in certain varieties also passives. In assuming this syncretism, I am able to explain the syntactic distribution and the semantics of grade 7 verbs

Efficacy profile of ivabradine in patients with heart failure plus angina pectoris

Objectives: In the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial (SHIFT), slowing of the heart rate with ivabradine reduced cardiovascular death or heart failure hospitalizations among patients with systolic chronic heart failure (CHF). Subsequently, in the Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients with Coronary Artery Disease (SIGNIFY) slowing of the heart rate in patients without CHF provided no benefit for cardiovascular death or nonfatal myocardial infarction (primary composite end point), with secondary analyses suggesting possible harm in the angina subgroup. Therefore, we examined the impact of ivabradine in the patients with CHF plus angina in SHIFT. Methods: SHIFT enrolled adults with stable, symptomatic CHF, a left ventricular ejection fraction ≤35% and a sinus rhythm with a resting heart rate ≥70 bpm. Outcomes were the SHIFT and SIGNIFY primary composite end points and their components. Results: Of 6,505 patients in SHIFT, 2,220 (34%) reported angina at randomization. Ivabradine numerically, but not significantly, reduced the SIGNIFY primary composite end point by 8, 11 and 11% in the SHIFT angina subgroup, nonangina subgroup and overall population, respectively. Ivabradine also reduced the SHIFT primary composite end point in all 3 subgroups. Conclusions: In SHIFT, ivabradine showed consistent reduction of cardiovascular outcomes in patients with CHF; similar results were seen in the subgroup of SHIFT patients with angina

Budget impact of adding ivabradine to standard of care in patients with chronic systolic heart failure in the United States

BACKGROUND: Heart failure (HF) costs $21 billion annually in direct health care costs, 80 OBJECTIVE: To estimate the budget impact of ivabradine from a U.S. commercial payer perspective. METHODS: A budget impact model estimated the per-member-per month (PMPM) impact of introducing ivabradine to existing formularies by comparing a reference scenario (SoC) and a new drug scenario (ivabradine + SoC) in hypothetical 1 million-member commercial and Medicare Advantage plans. In both scenarios, U.S. claims data were used for the reference cumulative annual rates of hospitalizations (HF, non-HF cardiovascular [CV], and non-CV), and hospitalization rates were adjusted using SHIFT data. The model controlled for mortality risk using SHIFT and U.S. life table data, and hospitalization costs were obtained from U.S. claims data: HF-related =$37,507; non-HF CV = $28,951; and non-CV =$17,904. The annualized wholesale acquisition cost of ivabradine was $4,500, with baseline use for this new drug at 2 RESULTS: Based on the approved U.S. indication, approximately 2,000 commercially insured patients from a 1 million-member commercial plan were eligible to receive ivabradine. Ivabradine resulted in a PMPM cost savings of$0.01 and $0.04 in years 1 and 3 of the core model, respectively. After including the acquisition price for ivabradine, the model showed a decrease in total costs in the commercial ($991,256 and $474,499, respectively) and Medicare populations ($13,849,262 and $4,280,291, respectively) in year 1. This decrease was driven by ivabradine’s reduction in hospitalization rates. For the core model, the estimated pharmacy-only PMPM in year 1 was$0.01 for the commercial population and $0.24 for the Medicare Advantage population. CONCLUSIONS: Adding ivabradine to SoC led to lower average annual treatment costs. The negative PMPM budget impact indicates that ivabradine is an affordable option for U.S. payers

A Method for Designing Conforming Folding Propellers

As the aviation vehicle design environment expands due to the in flux of new technologies, new methods of conceptual design and modeling are required in order to meet the customer's needs. In the case of distributed electric propulsion (DEP), the use of high-lift propellers upstream of the wing leading edge augments lift at low speeds enabling smaller wings with sufficient takeoff and landing performance. During cruise, however, these devices would normally contribute significant drag if left in a fixed or windmilling arrangement. Therefore, a design that stows the propeller blades is desirable. In this paper, we present a method for designing folding-blade configurations that conform to the nacelle surface when stowed. These folded designs maintain performance nearly identical to their straight, non-folding blade counterparts