Disparities in Hospital Services Utilization Among Patients with Mental Health Issues: A Statewide Example Examining Insurance Status and Race Factors from 1999-2010

There exist many disconnects between the mental and general health care sectors. However, a goal of the Affordable Care Act (ACA) of 2010 is to change this by improving insurance access and the intersection of mental and general health care. As insurance status intersects with race, the present study examines how race, insurance status, and hospital mental health services utilization differ across groups within the state of New Jersey. The present study aims to determine trends in hospital mental health care utilization by insurance status and race from 1999 to 2010. The rate of self-pay for mental health disorders in the Black population was significantly higher than the rate for Whites and Asians during this period. However, though Asian mental health utilization increased the most over the 11-year period, the Asian population had the slowest growth in self-pay rates. ANOVA tests demonstrated significant differences in the rate of self-pay mental health cases between race groups (

Cell viscoelasticity is linked to fluctuations in cell biomass distributions.

The viscoelastic properties of mammalian cells can vary with biological state, such as during the epithelial-to-mesenchymal (EMT) transition in cancer, and therefore may serve as a useful physical biomarker. To characterize stiffness, conventional techniques use cell contact or invasive probes and as a result are low throughput, labor intensive, and limited by probe placement. Here, we show that measurements of biomass fluctuations in cells using quantitative phase imaging (QPI) provides a probe-free, contact-free method for quantifying changes in cell viscoelasticity. In particular, QPI measurements reveal a characteristic underdamped response of changes in cell biomass distributions versus time. The effective stiffness and viscosity values extracted from these oscillations in cell biomass distributions correlate with effective cell stiffness and viscosity measured by atomic force microscopy (AFM). This result is consistent for multiple cell lines with varying degrees of cytoskeleton disruption and during the EMT. Overall, our study demonstrates that QPI can reproducibly quantify cell viscoelasticity

Evaluation of specialty fibers and waveguides for ultrashort laser pulse propagation

Ultrashort pulse lasers have become invaluable tools in many areas of science and technology. Optical waveguide or fiber delivery of ultrashort pulses would benefit numerous applications that require remote location of the laser or for addressing areas of low accessibility such as minimally invasive surgical procedures, multiphoton excitation microscopy, laser micromachining and high bandwidth telecommunications. However, the extremely high peak power and bandwidth associated with ultrashort pulses are prohibitive for most conventional waveguides that guide light in solid dielectric cores, the main drawbacks being dispersion, nonlinear effects, and damage via optical breakdown. The purpose of this study is to investigate the significant obstacles involved with implementing optical waveguides or fibers capable of delivering ultrashort pulses.In recent years, specialty fibers such as large mode-area (LMA) photonic crystal and photonic bandgap fibers have been developed, which exhibit remarkable properties such as single-mode guidance that is independent of core size and guidance in an air core respectively. In this thesis, two early prototypes of each of these fibers are investigated for their ability to deliver ultrashort pulses. Another specialty fiber, silver coated hollow silica waveguide, which was originally developed for delivery of infrared light from CO2 and Er:YAG lasers is shown to be a good candidate for single-mode delivery of gigawatt peak power pulses with minimal pulse distortion.Another potential fiber is comprised of multiple evanescently-coupled single-mode cores. This so-called multi-core fiber has demonstrated increased power handling in fiber lasers and amplifiers and was selected as a candidate for delivery of ultrashort pulses due to its scalable large mode-area and increased nonlinear threshold. A design for multi-core fibers is proposed that allows tailoring of the supermode distribution to obtain equal power distribution among all cores, thereby maximizing power handling. The design is analyzed numerically using a Scattering Matrix Method (SMM) and coupled-mode analysis. Experimental verification of the proposed supermode tailoring method is achieved with femtosecond pulse direct-written waveguide arrays in soda-lime glass and high-purity fused silica. Experimental results of direct-written waveguide arrays are in excellent agreement with SMM and coupled-mode simulations and verify the ability to tailor supermodes in these structures by controlling a single variable during fabrication

Respiration rate and volume measurements using wearable strain sensors.

Current methods for continuous respiration monitoring such as respiratory inductive or optoelectronic plethysmography are limited to clinical or research settings; most wearable systems reported only measures respiration rate. Here we introduce a wearable sensor capable of simultaneously measuring both respiration rate and volume with high fidelity. Our disposable respiration sensor with a Band-Aid© like formfactor can measure both respiration rate and volume by simply measuring the local strain of the ribcage and abdomen during breathing. We demonstrate that both metrics are highly correlated to measurements from a medical grade continuous spirometer on participants at rest. Additionally, we also show that the system is capable of detecting respiration under various ambulatory conditions. Because these low-powered piezo-resistive sensors can be integrated with wireless Bluetooth units, they can be useful in monitoring patients with chronic respiratory diseases in everyday settings

Visual Diagnosis: Pearling: a case study

We present the case of a patient who attempted to perform a type of body modification known as "pearling" or "genital beading" while in prison. This patient unfortunately caused severe trauma to his penis, requiring surgical intervention. Photographs of the traumatic injuries are presented

Usage of Tranexamic Acid for Treatment of Subdural Hematomas.

The collection of blood in the subdural layer within the cranium is classified as a subdural hematoma. Prevalence of subdural hematomas is most common among older populations with the current standard of treatment being invasive surgical evacuation for patients presenting with acute subdural hematomas with a midline shift greater than 5 mm on computed tomography (CT).Tranexamic acid (TXA) has been identified as an alternative, non-invasive option to treat patients presenting with subdural hematoma who are not suitable for surgical intervention. The presenting case involves a 90-year-old female who arrived with a code stroke with the chief complaint of right lower extremity weakness. A stroke series CT panel revealed a left frontal multiloculated subdural hematoma, measuring 130 mL with mass effect and a midline shift of 7 mm. The patient was recommended a craniotomy for hematoma evacuation or access to hospice for comfort care. A second opinion resulted in the administration of TXA. After the full completion of a TXA course, the patient achieved baseline mobility. The final measurements revealed a final hematoma volume of 10 mL and a midline shift of less than 2 mm. Current literature, as well as the case described, has begun demonstrating the efficacy of the usage of TXA in the reabsorption of subdural hematomas and should encourage further exploration into society guidelines for the usage of TXA as a non-invasive alternative to treat subdural hematomas