Economic Impact and Health Disparities of Firearm Injuries Treated within the Thomas Jefferson University Health System

Introduction: Firearms are a significant cause of morbidity and mortality in the United States. In 2015, firearms killed over 36,000 Americans (CDC, 2017), and in 2013 were responsible for $229 billion in healthcare and other costs (Cerdá 2016). On an average day in Philadelphia, 4 people are injured or killed by firearms (Beard 2017). This purpose of this project is to further investigate these trends in the context of the Thomas Jefferson University Health System. Objective: To date, no research exists to examine firearm violence within the Thomas Jefferson University Hospital (TJUH) System. The purpose of this study is to fill that gap by exploring the geographic distribution, demographics, and cost associated with firearm injuries at TJUH. This information could help identify high-risk patient groups, and contribute to targeted interventions, education, and policy in the future. Methods: This study is a 10-year retrospective analysis of TJUH medical records. ICD codes were used to identify patients treated between January 2008 and December 2017 for firearm-related injuries. Information such as patient zip code, age, ethnicity, insurance, and past medical history are being collected. This data is being entered into REDCap for analysis. Results: There were 505 cases of firearm injuries recorded at TJUH between January 2008 and December 2017. Data are still being collected, so final results are forthcoming. Conclusion: Firearms are a pervasive and deadly threat to public health across the United States. Data collection is ongoing, so firm conclusions cannot yet be drawn. However, there were more cases of firearm violence within the study period than were expected. This stresses the importance of quantifying and studying this problem, so we may be better informed and better prepared to address it

The Use of Wearable Technology in the Detection of Operator Fatigue

Introduction: Operator fatigue is a prevalent cause of injury and death. Many studies have proven reliable ways of determining operator fatigue through the use of engineering and technological advances including blink rate, lid lag, respiratory rate, cardiac rate, chest expansion, etc. However the implementation of these advances has yet to be utilized. This systematic literature review seeks to elucidate the need for implementation of wearable technology for those who suffer from operator fatigue. Methods: The target population includes anyone who operates a vehicle including drivers, aviation pilots, train conductors/engineers, marine pilots, operators of heavy machinery, fishermen and professional/overnight drivers. All technological and engineering interventions used in the detection of operator fatigue will be analyzed with successful detection of driver fatigue being the outcome. Data is being compiled form PubMed, Scopus, Cochrane Library and TRID. Results: We are in the process of publishing a preferred reporting items for systematic review and meta-analyses protocol (PRISMA-P). In addition, the results from each database suggest wearable technology is successful in detecting operator fatigue. Discussion: The PRISMA-P is a necessary step to provide validity for a systematic literature review to show we aren’t manipulating parameters to skew our results. Upon publishing this, we anticipate that our PRISMA P will further support the need for a systematic literature review on the use of wearable technology in the detection of operator fatigue

Evaluation of Firearm Suicide among Patients Treated across the Jefferson Enterprise

Introduction and Objective: Firearm suicide is a leading cause of mortality. This study aims to identify risk factors associated with patients who attempt suicide with a firearm. The hypothesis is that adolescents of non-Hispanic white race/ethnicity are at the highest risk of firearm suicide. Methods: Patients treated at Thomas Jefferson University Hospital between 3/1/2017 and 12/1/2020 for a self-inflicted gunshot wound and/or attempted suicide were included in the study. Patients were identified through ICD-10 codes and a clinical research software tool known as TriNetX was used to analyze incidence of suicide as well as potential risk factors such as patient demographics and past medical history. For risk factor identification and stratification, patients who attempted suicide with a firearm were compared to those who attempted suicide via other mechanisms. Results: Of the 407 patients identified as having attempted suicide, 55 attempted suicide with a firearm. In analyzing all patients that attempted suicide, the average age was 42, 49% were male, 52% were of white race/ethnicity, and 59% had a history of a mood disorder. Among those who attempted suicide with a firearm, the average age was 53, 82% were male, 78% were of white race/ethnicity, and 75% had a history of a mood disorder. Discussion: These results do not entirely support the hypothesis as the highest incidence of firearm suicide was identified in middle-aged males of white race/ethnicity with a history of a mood disorder. Risk factors identified through this study will provide clinicians with the evidence necessary to improve firearm suicide prevention strategies

G-CSF Prevents the Progression of Structural Disintegration of White Matter Tracts in Amyotrophic Lateral Sclerosis: A Pilot Trial

Background: The hematopoietic protein Granulocyte-colony stimulating factor (G-CSF) has neuroprotective and regenerative properties. The G-CSF receptor is expressed by motoneurons, and G-CSF protects cultured motoneuronal cells from apoptosis. It therefore appears as an attractive and feasible drug candidate for the treatment of amyotrophic lateral sclerosis (ALS). The current pilot study was performed to determine whether treatment with G-CSF in ALS patients is feasible.Methods: Ten patients with definite ALS were entered into a double-blind, placebo-controlled, randomized trial. Patients received either 10 mu g/kg BW G-CSF or placebo subcutaneously for the first 10 days and from day 20 to 25 of the study. Clinical outcome was assessed by changes in the ALS functional rating scale (ALSFRS), a comprehensive neuropsychological test battery, and by examining hand activities of daily living over the course of the study (100 days). The total number of adverse events (AE) and treatment-related AEs, discontinuation due to treatment-related AEs, laboratory parameters including leukocyte, erythrocyte, and platelet count, as well as vital signs were examined as safety endpoints. Furthermore, we explored potential effects of G-CSF on structural cerebral abnormalities on the basis of voxel-wise statistics of Diffusion Tensor Imaging (DTI), brain volumetry, and voxel-based morphometry.Results: Treatment was well-tolerated. No significant differences were found between groups in clinical tests and brain volumetry from baseline to day 100. However, DTI analysis revealed significant reductions of fractional anisotropy (FA) encompassing diffuse areas of the brain when patients were compared to controls. On longitudinal analysis, the placebo group showed significant greater and more widespread decline in FA than the ALS patients treated with G-CSF.Conclusions: Subcutaneous G-CSF treatment in ALS patients appears as feasible approach. Although exploratory analysis of clinical data showed no significant effect, DTI measurements suggest that the widespread and progressive microstructural neural damage in ALS can be modulated by G-CSF treatment. These findings may carry significant implications for further clinical trials on ALS using growth factors

Filicide in Austria and Finland - A register-based study on all filicide cases in Austria and Finland 1995-2005

<p>Abstract</p> <p>Background</p> <p>Filicide is the tragic crime of murdering one's own child. Previous research has found that the offending parents are commonly depressed and that suicide is often associated as an actual act or an intention. Yet, filicide is an underreported crime and previous studies have been strained with methodological problems. No comprehensive international studies on filicide have been presented in the literature until now.</p> <p>Methods</p> <p>This was a descriptive, comprehensive, register-based study of all filicides in Austria and Finland during 1995-2005. Filicide-suicide cases were also included.</p> <p>Results</p> <p>Most of the perpetrators were the biological mothers; in Austria 72%, in Finland 52%. Suicide followed filicide either as an attempt or a fulfilled act in 32% and 54% of the cases in Austria and Finland, respectively. Psychotic mood disorders were diagnosed for 10% of the living perpetrators in Austria, and 12% in Finland. Non-psychotic depression was diagnosed in 9% of surviving perpetrators in Austria, 35% in Finland.</p> <p>Conclusion</p> <p>The data from the two countries demonstrated that filicide is such a multifaceted and rare phenomenon that national data from individual countries seldom offer sufficient scope for its thorough study. Further analyses are needed to produce a complete picture of filicide.</p

Proliferation of Ty3/gypsy-like retrotransposons in hybrid sunflower taxa inferred from phylogenetic data

<p>Abstract</p> <p>Background</p> <p>Long terminal repeat (LTR) retrotransposons are a class of mobile genetic element capable of autonomous transposition via an RNA intermediate. Their large size and proliferative ability make them important contributors to genome size evolution, especially in plants, where they can reach exceptionally high copy numbers and contribute substantially to variation in genome size even among closely related taxa. Using a phylogenetic approach, we characterize dynamics of proliferation events of <it>Ty3/gypsy</it>-like LTR retrotransposons that led to massive genomic expansion in three <it>Helianthus </it>(sunflower) species of ancient hybrid origin. The three hybrid species are independently derived from the same two parental species, offering a unique opportunity to explore patterns of retrotransposon proliferation in light of reticulate evolutionary events in this species group.</p> <p>Results</p> <p>We demonstrate that <it>Ty3/gypsy</it>-like retrotransposons exist as multiple well supported sublineages in both the parental and hybrid derivative species and that the same element sublineage served as the source lineage of proliferation in each hybrid species' genome. This inference is based on patterns of species-specific element numerical abundance within different phylogenetic sublineages as well as through signals of proliferation events present in the distributions of element divergence values. Employing methods to date paralogous sequences within a genome, proliferation events in the hybrid species' genomes are estimated to have occurred approximately 0.5 to 1 million years ago.</p> <p>Conclusion</p> <p>Proliferation of the same retrotransposon major sublineage in each hybrid species indicates that similar dynamics of element derepression and amplification likely occurred in each hybrid taxon during their formation. Temporal estimates of these proliferation events suggest an earlier origin for these hybrid species than previously supposed.</p

Search for Kaluza-Klein Graviton Emission in ppˉp\bar{p} Collisions at s=1.8\sqrt{s}=1.8 TeV using the Missing Energy Signature

We report on a search for direct Kaluza-Klein graviton production in a data sample of 84 ${pb}^{-1}$ of \ppb collisions at $\sqrt{s}$ = 1.8 TeV, recorded by the Collider Detector at Fermilab. We investigate the final state of large missing transverse energy and one or two high energy jets. We compare the data with the predictions from a $3+1+n$-dimensional Kaluza-Klein scenario in which gravity becomes strong at the TeV scale. At 95% confidence level (C.L.) for $n$=2, 4, and 6 we exclude an effective Planck scale below 1.0, 0.77, and 0.71 TeV, respectively.Comment: Submitted to PRL, 7 pages 4 figures/Revision includes 5 figure

Measurement of the average time-integrated mixing probability of b-flavored hadrons produced at the Tevatron

We have measured the number of like-sign (LS) and opposite-sign (OS) lepton pairs arising from double semileptonic decays of $b$ and $\bar{b}$-hadrons, pair-produced at the Fermilab Tevatron collider. The data samples were collected with the Collider Detector at Fermilab (CDF) during the 1992-1995 collider run by triggering on the existence of $\mu \mu$ and $e \mu$ candidates in an event. The observed ratio of LS to OS dileptons leads to a measurement of the average time-integrated mixing probability of all produced $b$-flavored hadrons which decay weakly, $\bar{\chi} = 0.152 \pm 0.007$ (stat.) $\pm 0.011$ (syst.), that is significantly larger than the world average $\bar{\chi} = 0.118 \pm 0.005$.Comment: 47 pages, 10 figures, 15 tables Submitted to Phys. Rev.

Relapse prevention for addictive behaviors

The Relapse Prevention (RP) model has been a mainstay of addictions theory and treatment since its introduction three decades ago. This paper provides an overview and update of RP for addictive behaviors with a focus on developments over the last decade (2000-2010). Major treatment outcome studies and meta-analyses are summarized, as are selected empirical findings relevant to the tenets of the RP model. Notable advances in RP in the last decade include the introduction of a reformulated cognitive-behavioral model of relapse, the application of advanced statistical methods to model relapse in large randomized trials, and the development of mindfulness-based relapse prevention. We also review the emergent literature on genetic correlates of relapse following pharmacological and behavioral treatments. The continued influence of RP is evidenced by its integration in most cognitive-behavioral substance use interventions. However, the tendency to subsume RP within other treatment modalities has posed a barrier to systematic evaluation of the RP model. Overall, RP remains an influential cognitive-behavioral framework that can inform both theoretical and clinical approaches to understanding and facilitating behavior change