Alignment of patient and primary care practice member perspectives of chronic illness care: a cross-sectional analysis

Polly H. Noel and Luci K. Leykum are with the South Texas Veterans Health Care System, 7400 Merton Minter Blvd, San Antonio, TX 78229, USA -- Polly H. Noel, Ray F. Palmer, Raquel L. Romero, Luci K. Leykum, Holly J. Lanham, and Krista W. Bowers are with the Department of Medicine, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Dr, San Antonio, TX 78229, USA -- Michael L. Parchman is with the MacColl Center for Healthcare Innovation, Group Health Research Institute, Group Health Cooperative, 1730 Minor Ave 1600, Seattle, WA 98101, USA -- Holly J. Leykum is with the The McCombs School of Business, The University of Texas at Austin, 2110 Speedway, Stop B6000, Austin, TX 78712, USA -- John E. Zeber is with the Central Texas Veterans Health Care System, 1901 S. 1st St, Temple, TX 76504, USA and Scott and White Healthcare Center for Applied Health Research, 2401 S. 31st St, Temple, TX 76508, USABackground: Little is known as to whether primary care teams’ perceptions of how well they have implemented the Chronic Care Model (CCM) corresponds with their patients’ own experience of chronic illness care. We examined the extent to which practice members’ perceptions of how well they organized to deliver care consistent with the CCM were associated with their patients’ perceptions of the chronic illness care they have received. Methods: Analysis of baseline measures from a cluster randomized controlled trial testing a practice facilitation intervention to implement the CCM in small, community-based primary care practices. All practice “members” (i.e., physician providers, non-physician providers, and staff) completed the Assessment of Chronic Illness Care (ACIC) survey and adult patients with 1 or more chronic illnesses completed the Patient Assessment of Chronic Illness Care (PACIC) questionnaire. Results: Two sets of hierarchical linear regression models accounting for nesting of practice members (N = 283) and patients (N = 1,769) within 39 practices assessed the association between practice member perspectives of CCM implementation (ACIC scores) and patients’ perspectives of CCM (PACIC). ACIC summary score was not significantly associated with PACIC summary score or most of PACIC subscale scores, but four of the ACIC subscales were consistently associated with PACIC summary score and the majority of PACIC subscale scores after controlling for patient characteristics. The magnitude of the coefficients, however, indicates that the level of association is weak. Conclusions: The ACIC and PACIC scales appear to provide complementary and relatively unique assessments of how well clinical services are aligned with the CCM. Our findings underscore the importance of assessing both patient and practice member perspectives when evaluating quality of chronic illness care.Information, Risk, and Operations Management (IROM)[email protected]

Sensor node localisation using a stereo camera rig

In this paper, we use stereo vision processing techniques to detect and localise sensors used for monitoring simulated environmental events within an experimental sensor network testbed. Our sensor nodes communicate to the camera through patterns emitted by light emitting diodes (LEDs). Ultimately, we envisage the use of very low-cost, low-power, compact microcontroller-based sensing nodes that employ LED communication rather than power hungry RF to transmit data that is gathered via existing CCTV infrastructure. To facilitate our research, we have constructed a controlled environment where nodes and cameras can be deployed and potentially hazardous chemical or physical plumes can be introduced to simulate environmental pollution events in a controlled manner. In this paper we show how 3D spatial localisation of sensors becomes a straightforward task when a stereo camera rig is used rather than a more usual 2D CCTV camera

Word matching using single closed contours for indexing handwritten historical documents

Effective indexing is crucial for providing convenient access to scanned versions of large collections of historically valuable handwritten manuscripts. Since traditional handwriting recognizers based on optical character recognition (OCR) do not perform well on historical documents, recently a holistic word recognition approach has gained in popularity as an attractive and more straightforward solution (Lavrenko et al. in proc. document Image Analysis for Libraries (DIAL’04), pp. 278–287, 2004). Such techniques attempt to recognize words based on scalar and profile-based features extracted from whole word images. In this paper, we propose a new approach to holistic word recognition for historical handwritten manuscripts based on matching word contours instead of whole images or word profiles. The new method consists of robust extraction of closed word contours and the application of an elastic contour matching technique proposed originally for general shapes (Adamek and O’Connor in IEEE Trans Circuits Syst Video Technol 5:2004). We demonstrate that multiscale contour-based descriptors can effectively capture intrinsic word features avoiding any segmentation of words into smaller subunits. Our experiments show a recognition accuracy of 83%, which considerably exceeds the performance of other systems reported in the literature

Infrared Diagnostics for the Extended 12 micron Sample of Seyferts

We present an analysis of Spitzer IRS spectroscopy of 83 active galaxies from the extended 12 micron sample. We find rank correlations between several tracers of star formation which suggest that (1) the PAH feature is a reliable tracer of star formation, (2) there is a significant contribution to the heating of the cool dust by stars, (3) the H$_2$ emission is also primarily excited by star formation. The 55-90 vs. 20-30 spectral index plot is also a diagnostic of the relative contribution of Starburst to AGN. We see there is a large change in spectral index across the sample. Thus, the contribution to the IR spectrum from the AGN and starburst components can be comparable in magnitude but the relative contribution also varies widely across the sample. We find rank correlations between several AGN tracers. We search for correlations between AGN and Starburst tracers and we conclude that the AGN and Starburst tracers are not correlated. This is consistent with our conclusion that the relative strength of the AGN and Starburst components varies widely across the sample. Thus, there is no simple link between AGN fueling and Black Hole Growth and star formation in these galaxies. The distribution of Sil 10 micron and 18 micron strengths is consistent with the clumpy torus models of Sirocky et al. We find a rank correlation between the [NeV] 14 micron line and the 6.7 micron continuum which may be due to an extended component of hot dust. The Sy 2s with a Hidden Broad Line Region (HBLR) have a higher ratio of AGN to Starburst contribution to the SED than Sy 2s without an HBLR. This may contribute to the detection of the HBLR in polarized light. The Sy 2s with an HBLR are more similar to the Sy 1s than they are to the Sy 2s without an HBLR

Familial ATTR amyloidosis: microalbuminuria as a predictor of symptomatic disease and clinical nephropathy

Familial ATTR amyloidosis: microalbuminuria as a predictor of symptomatic disease and clinical nephropathy. Lobato L, Beirão I, Silva M, Bravo F, Silvestre F, Guimarães S, Sousa A, Noël LH, Sequeiros J. SourceDepartment of Nephrology and Centro de Estudos de Paramiloidose, Hospital Geral de Santo António and Institute for Molecular and Cell Biology, Porto, Portugal. [email protected] Abstract BACKGROUND: Portuguese type familial amyloid polyneuropathy (FAP) is a neuropathic amyloidosis caused by a mutant transthyretin (TTR). Varying degrees of renal involvement have been reported. Our aim was to assess the value of microalbuminuria (MA) for predicting clinical neurological disease and overt nephropathy in TTR-related amyloidosis. METHODS: All subjects had the TTR Val30Met mutation, and were recruited between 1993 and 1999. We have prospectively evaluated 22 asymptomatic gene carriers (7 male, 15 female; mean age 41.6+/-9.6 years) and 32 patients with neuropathy (14 male, 18 female; 36.8+/-8.8 years, on average, 33.0+/-9.3 years at the onset of neuropathy). We measured urinary albumin excretion every year, if asymptomatic, or every 6 months if already affected. Kidney biopsies were performed in patients with normal urinary albumin excretion, MA, and overt nephropathy, respectively. RESULTS: In asymptomatic carriers, persistent MA was detected in eight (36%) subjects. The presence of MA in asymptomatic gene carriers, compared with those having normal urinary albumin excretion, conferred a 4.8-fold risk of developing neuropathy, usually within the subsequent 3 years. Once neurological signs appeared, nephropathy, manifested as MA, progressed to overt nephropathy in one-half of subjects. In patients with neuropathy, 24 (75%) had MA during follow-up: evolution towards clinical renal disease occurred in 14 (58%) and renal failure occurred in five (21%), always after a course of MA. Proteinuria or renal failure without prior persistent MA were never observed in the present patient cohort. Histopathological evaluation did not reveal glomerular lesions other than amyloid deposits to explain abnormal urinary albumin excretion. The amount of mesangial and vascular-pole amyloid deposits was correlated with the degree of albuminuria. CONCLUSIONS: Microalbuminuria represents the first stage of clinical TTR amyloid nephropathy and is premonitory of neuropathy. Its presence identifies a subgroup of patients who are more prone to develop overt nephropathy. Screening of MA may be important to assess disease onset and to recommend liver transplantation in individuals at risk

Evaluation of Load Velocity Profiles with Varying Warm-up Sets and Relative Intensities

International Journal of Exercise Science 14(4): 971-979, 2021. The purpose of this study was to determine whether the number of warm-up sets and relative intensity impacts the prediction of velocity-based one-repetition maximum (1RM) values. Twenty resistance-trained individuals (males: n = 10, females: n = 10) participated in this study. Warm-up sets consisted of subject’s bench-pressing loads at 50 (five-repetitions), 70 (three-repetitions), and 90% (one-repetition) of estimated 1RM. A maximum of four attempts were performed to determine 1RM, while recording mean concentric velocity (MCV)using a linear position transducer during warm-up and 1RM trials in order to develop load-velocity profiles. Specifically, four different velocity-based 1RM equations (EQ) were developed from the warm-up sets of 50, 70, and 90% (MCV-EQ1), 50 and 90% (MCV-EQ2), 70 and 90% (MCV-EQ3), and 50 and 70% (MCV-EQ4). Constant error (CE) for the MCV prediction equations were not statistically significant for any comparisons (CEs = 0.80 to 2.96kg, all p \u3e 0.05). Correlation coefficients between the MCV prediction methods and measured 1RM were near perfect for all comparisons (r ≥ 0.98, all p \u3c 0.001). The standard error of estimate (SEE) and 95% limits of agreement (LOAs) were lowest for MCV-EQ1 (7.86 kg and ± 15.00 kg, respectively) and slightly higher for MCV-EQ3 (9.24 kg and 17.74 kg, respectively). Nonetheless, SEEs and 95% LOAs for MCV-EQ2 (8.10 kg and ± 15.55kg, respectively) and MCV-EQ4 (8.38 kg and ± 16.08 kg, respectively) were similar as MCV-EQ1. Current study results indicated that an additional warm-up set only slightly increases the accuracy of velocity-based 1RM estimations. Furthermore, larger differences in relative intensity will help produce slightly more accurate 1RM values

Two-color, nonlocal vector solitary waves with angular momentum in nematic liquid crystals

The propagation and interaction of two solitary waves with angular momentum in bulk nematic liquid crystals, termed nematicons, have been studied in the nonlocal limit. These two spinning solitary waves are based on two different wavelengths of light and so are referred to as two-color nematicons. Under suitable boundary conditions, the two nematicons can form a bound state in which they spin about each other. This bound state is found to be stable to the emission of diffractive radiation as the nematicons evolve. In addition this bound state shows walk-off due to dispersion. Using an approximate method based on the use of suitable trial functions in an averaged Lagrangian of the two-color nematicon equations, modulation equations for the evolution of the individual nematicons are derived. These modulation equations are extended to include the diffractive radiation shed as the nematicons evolve. Excellent agreement is found between solutions of the modulation equations and full numerical solutions of the nematicon equations. The shed diffractive radiation is found to play a much lesser role in the nonlocal limit than in the local limit

The Gridded Retarding Ion Drift Sensor for the PetitSat CubeSat Mission

The Gridded Retarding Ion Drift Sensor (GRIDS) is a small sensor that will fly on the 6 U petitSat CubeSat. It is designed to measure the three-dimensional plasma drift velocity vector in the Earth’s ionosphere. The GRIDS also supplies information about the ion temperature, ion density, and the ratio of light to heavy ions present in the ionospheric plasma. It utilizes well-proven techniques that have been successfully validated by similar instruments on larger satellite missions while meeting CubeSat-compatible requirements for low mass, size, and power consumption. GRIDS performs the functions of a Retarding Potential Analyzer (RPA) and an Ion Drift Meter (IDM) by combining the features of both types of instruments in a single package. The sensor alternates RPA and IDM measurements to produce the full set of measurement parameters listed above. On the petitSat mission, GRIDS will help identify and characterize a phenomenon known as plasma blobs (or enhancements)

Carcass characteristics and beef quality of young grass-fed Angus x Salers bovines

To characterize carcass and meat attributes, such as beef eating quality in specific farming conditions, 31 young grass-fed crossbred Angus x Salers cattle in two farming systems (a mono-cattle system versus a mixed system with beef cattle and sheep) were used in this study. Three muscle cuts (striploin—m. longissimus dorsi et thoracis; bolar blade—m. triceps brachii caput longum; internal flank plate—m. obliquus internus abdominis) were used for consumer eating quality testing and striploin was used for panelist eating quality assessment, and objective measurements [Warner–Bratzler shear force (WBSF) and fatty acid (FA) and antioxidant contents]. Results indicated that the farming system had no impact on carcass characteristics or meat quality, but it tended to affect FA content, which is likely explained by between-system differences in animal maturity (assessed by ossification score). Animal gender had significant effects on three eating quality traits evaluated by untrained consumers, with higher flavor liking, overall liking, and overall meat eating quality (MQ4) scores in females than in males. Additionally, FA contents were correlated with sensory quality traits to varying extents: consumer-scored tenderness, flavor, and overall liking were mainly positively correlated with ω-3 and ω-6 polyunsaturated fatty acid (PUFA) contents, and panelist-evaluated tenderness and abnormal flavor were more positively correlated with total lipids, saturated fatty acid (SFA), and monounsaturated fatty acid (MUFA) contents. Overall, this study showed that specific grass-fed crossbred Angus x Salers cattle can produce lean meat rich in ω-3 PUFAs with a low ω-6/ω-3 ratio and with “better than average” beef eating quality