Effects of Medicaid Expansion on Diabetes Related Hospital Utilization in Appalachia

The problem that we face as a nation is the increasing cases of opiate overdoses (CDC, 2019). Regulations vary across state lines regarding patient needs and prescribing regulations. The current study addresses closing the gaps in opioid use disorder. The overarching research question for this study is—How are Narcan policies related to the drug’s utilization? Other questions in this study will be explored through analysis of national claims data. The study population consist of beneficiaries who have received a prescription for Narcan in 2016. The data includes Narcan prescriptions across state lines as well as the Narcan access law. Using the MarketScan Commercial Database we look at patient claims from states that do not have a Narcan access law and states with a Narcan access law. The study included a total of 3,756,833 prescriptions for naloxone and opioids (14,210, 0.38%), naloxone only (1660, 0.04%), and opioids only (3,740,963, 99.6%) provided to privately insured individuals in 2016. In total, 7448 Naloxone prescriptions by State Policy Status were dispensed in 2016. The odds of receiving a Naloxone prescription in access law states presented 40% greater than the states without the access law in 2016. This study will add to the literature concerning the misuse of prescription and illicit opioids

Ethics of computer use: A survey of student attitudes: Working paper series--06-02

The potential for misuse of computer systems and resources has been an important issue for many years. The rapid growth in use of remote access systems, the use of the internet and distributed systems for financial and other sensitive transactions, and the expansion in the availability of products in digital form is causing ethical issues surrounding misuse of computer resources to become an increasingly serious problem. This paper surveys ethical attitudes of a set of undergraduate business majors. The survey presents sets of scenarios in which students are asked to indicate whether a particular action is ethical or unethical using a 7 level Likert scale. Alternative base scenarios have been designed to present ethical issues relating to various types of unauthorized access to computer resources. Other sets of base scenarios focus on the use of computers to illegally copy products (software and music recordings). In addition, for each base scenario, alternative sub-scenarios are presented in which the motives of the individual vary between intellectual curiosity, securing resources for personal use, profit, and malice toward the affected entity. The scenarios are designed to provide an evaluation of how the level of malicious intent in the action affects the students' perception of the degree to which the action represents a breach of ethics. Results of this survey suggest that the intent of the individual engaging in unauthorized access or illegal copying does substantially affect student perceptions of the degree to which the behavior is a violation of ethics. In general, actions undertaken for profit or malicious intent are judged to be less ethical than the same actions undertaken for intellectual curiosity or to secure resources for personal use. In addition, a very strong majority of the students surveyed believe that any active participation in downloading is unethical

NASA advanced aeronautics design solar powered remotely piloted vehicle

Environmental problems such as the depletion of the ozone layer and air pollution demand a change in traditional means of propulsion that is sensitive to the ecology. Solar powered propulsion is a favorable alternative that is both ecologically harmless as well as cost effective. Integration of solar energy into designs ranging from futuristic vehicles to heating is beneficial to society. The design and construction of a Multi-Purpose Remotely Piloted Vehicle (MPRPV) seeks to verify the feasibility of utilizing solar propulsion as a primary fuel source. This task has been a year long effort by a group of ten students, divided into five teams, each dealing with different aspects of the design. The aircraft was designed to take-off, climb to the design altitude, fly in a sustained figure-eight flight path, and cruise for approximately one hour. This mission requires flight at Reynolds numbers between 150,000 and 200,000 and demands special considerations in the aerodynamic design in order to achieve flight in this regime. Optimal performance requires a light weight configuration with both structural integrity and maximum power availability. The structure design and choice of solar cells for the propulsion was governed by the weight, efficiency, and cost considerations. The final design is a MPRPV weighting 35 N which cruises 7 m/s at the design altitude of 50 m. The configuration includes a wing composed of balsa and foam NACA 6409 airfoil sections and carbon fiber spars, a tail of similar construction, and a truss structure fuselage. The propulsion system consists of 98 10 percent efficient solar cells donated by Mobil Solar, a NiCad battery for energy storage, and a folding propeller regulated by a lightweight and efficient control system. The airfoils and propeller chosen for the design were research and tested during the design process

Characterization of neurophysiologic and neurocognitive biomarkers for use in genomic and clinical outcome studies of schizophrenia.

BackgroundEndophenotypes are quantitative, laboratory-based measures representing intermediate links in the pathways between genetic variation and the clinical expression of a disorder. Ideal endophenotypes exhibit deficits in patients, are stable over time and across shifts in psychopathology, and are suitable for repeat testing. Unfortunately, many leading candidate endophenotypes in schizophrenia have not been fully characterized simultaneously in large cohorts of patients and controls across these properties. The objectives of this study were to characterize the extent to which widely-used neurophysiological and neurocognitive endophenotypes are: 1) associated with schizophrenia, 2) stable over time, independent of state-related changes, and 3) free of potential practice/maturation or differential attrition effects in schizophrenia patients (SZ) and nonpsychiatric comparison subjects (NCS). Stability of clinical and functional measures was also assessed.MethodsParticipants (SZ n = 341; NCS n = 205) completed a battery of neurophysiological (MMN, P3a, P50 and N100 indices, PPI, startle habituation, antisaccade), neurocognitive (WRAT-3 Reading, LNS-forward, LNS-reorder, WCST-64, CVLT-II). In addition, patients were rated on clinical symptom severity as well as functional capacity and status measures (GAF, UPSA, SOF). 223 subjects (SZ n = 163; NCS n = 58) returned for retesting after 1 year.ResultsMost neurophysiological and neurocognitive measures exhibited medium-to-large deficits in schizophrenia, moderate-to-substantial stability across the retest interval, and were independent of fluctuations in clinical status. Clinical symptoms and functional measures also exhibited substantial stability. A Longitudinal Endophenotype Ranking System (LERS) was created to rank neurophysiological and neurocognitive biomarkers according to their effect sizes across endophenotype criteria.ConclusionsThe majority of neurophysiological and neurocognitive measures exhibited deficits in patients, stability over a 1-year interval and did not demonstrate practice or time effects supporting their use as endophenotypes in neural substrate and genomic studies. These measures hold promise for informing the "gene-to-phene gap" in schizophrenia research

Improved sensitivity, accuracy and prediction provided by a high‐performance liquid chromatography screen for the isolation of phytase‐harbouring organisms from environmental samples

HPLC methods are shown to be of predictive value for classification of phytase activity of aggregate microbial communities and pure cultures. Applied in initial screens, they obviate the problems of ‘false‐positive’ detection arising from impurity of substrate and imprecision of methodologies that rely on phytate‐specific media. In doing so, they simplify selection of candidates for biotechnological applications. Combined with 16S sequencing and simple bioinformatics, they reveal diversity of the histidine phosphatase class of phytases most commonly exploited for biotechnological use. They reveal contribution of multiple inositol‐polyphosphate phosphatase (MINPP) activity to aggregate soil phytase activity, and they identity Acinetobacter spp. as harbouring this prevalent soil phytase activity. Previously, among bacteria MINPP was described exclusively as an activity of gut commensals. HPLC methods have also identified, in a facile manner, a known commercially successful histidine (acid) phosphatase enzyme. The methods described afford opportunity for isolation of phytases for biotechnological use from other environments. They reveal the position of attack on phytate by diverse histidine phosphatases, something that other methods lack

An Analysis of the Environments of FU Orionis Objects with Herschel

We present Herschel-HIFI, SPIRE, and PACS 50-670 {\mu}m imaging and spectroscopy of six FU Orionis-type objects and candidates (FU Orionis, V1735 Cyg, V1515 Cyg, V1057 Cyg, V1331 Cyg, and HBC 722), ranging in outburst date from 1936-2010, from the "FOOSH" (FU Orionis Objects Surveyed with Herschel) program, as well as ancillary results from Spitzer-IRS and the Caltech Submillimeter Observatory. In their system properties (Lbol, Tbol, line emission), we find that FUors are in a variety of evolutionary states. Additionally, some FUors have features of both Class I and II sources: warm continuum consistent with Class II sources, but rotational line emission typical of Class I, far higher than Class II sources of similar mass/luminosity. Combining several classification techniques, we find an evolutionary sequence consistent with previous mid-IR indicators. We detect [O I] in every source at luminosities consistent with Class 0/I protostars, much greater than in Class II disks. We detect transitions of 13CO (J_up of 5 to 8) around two sources (V1735 Cyg and HBC 722) but attribute them to nearby protostars. Of the remaining sources, three (FU Ori, V1515 Cyg, and V1331 Cyg) exhibit only low-lying CO, but one (V1057 Cyg) shows CO up to J = 23 - 22 and evidence for H2O and OH emission, at strengths typical of protostars rather than T Tauri stars. Rotational temperatures for "cool" CO components range from 20-81 K, for ~ 10^50 total CO molecules. We detect [C I] and [N II] primarily as diffuse emission.Comment: 31 pages, 15 figures; accepted to Ap

Supreme Court Clerks\u27 Recollections of October Term 1951, Including the Steel Seizure Cases

A roundtable panel discussion at the Chautauqua Institution. The panel brought together five lawyers who fifty-five years ago served as law clerks to Justices of the Supreme Court of the United States. The panelists discussed the Justices and some of the cases of that Supreme Court Term, including the Steel Seizure Cases,1 which came to the Supreme Court in the spring of 1952. The honored guests and panelists are five lawyers who have led high-achieving, diverse and public-spirited lives: Charles C. Hileman, Abner J. Mikva , James C.N. Paul , Neal Person Rutledge, Marshall L. Small