The Opioid-related Syndemic in Rural Northern New England:Findings from the DISCERNNE Study

This presentation will discuss the risk and resource environment surrounding the syndemic of opioid use disorder, HCV and overdose in rural communities in the northern New England, and opportunities to prevent Scott County-like HIV outbreaks. These findings are from the Drug Injector Surveillance and Care Enhancement in Rural Northern New England (DISCERNNE) study

Activity budget and behaviour of giant otters Pteronura brasiliensis at Parken Zoo, Eskilstuna, Sweden

Modern zoos must ensure the welfare and conservation of their captive animals. For this, it is recommended to provide cognitive stimuli (‘enrichment’), good habitat management and adequate nutrition amongst other things. Assessment of animal welfare should include behavioural observation. One frequently used approach compares the activity budget of zoo animals with their wild conspecifics, carefully interpreting resulting differences. Here, this method is used for giant otters Pteronura brasiliensis on a feeding regime with three fixed feeding times during the keeper’s working day, and ice blocks containing fish suspended above the pool, thawing over time and thus releasing fish well into the night. This time-delayed food dispensing was expected to make the subjects spend a large proportion of time foraging. Nevertheless, results show a lower feeding proportion than reported in the literature for this species in the wild (27% versus 64%), likely related to the fact that zoo animals did not have to hunt live prey. The captive otters also spent less time scent-marking (1% versus 9%), possibly due to the absence of other conspecific groups in their vicinity. By contrast, there was a higher proportion of resting (34% versus 21%) and affiliative behaviours (14% versus 1%), suggesting that shifts in the activity budget between natural habitats and zoos need not always be interpreted as indicators of reduced welfare. ‘Calling family members to food’, reported in the wild, was observed repeatedly when one family member was awake and the rest were asleep at a time that fish fell from the thawing block into the pool. Extending food distribution over time, particularly into the night, might develop behaviours other than increased feeding activity as indicators of welfare in captive giant otters. Further investigations with delayed feeding methods for this and other species are needed

Opioid initiation and injection transition in rural northern New England: A mixed-methods approach

BACKGROUND: In rural northern New England, located in the northeastern United States, the overdose epidemic has accelerated with the introduction of fentanyl. Opioid initiation and transition to opioid injection have been studied in urban settings. Little is known about opioid initiation and transition to injection drug use in rural northern New England. METHODS: This mixed-methods study characterized opioid use and drug injection in 11 rural counties in Massachusetts, Vermont, and New Hampshire between 2018 and 2019. People who use drugs completed audio computer-assisted self-interview surveys on substance use and risk behaviors (n = 589) and shared personal narratives through in-depth interviews (n = 22). The objective of the current study is to describe initiation of opioid use and drug injection in rural northern New England. RESULTS: Median age of first injection was 22 years (interquartile range 18-28 years). Key themes from in-depth interviews that led to initiating drug injection included normalization of drug use in families and communities, experiencing trauma, and abrupt discontinuation of an opioid prescription. Other factors that led to a transition to injecting included lower cost, increased effect/ rush, greater availability of heroin/ fentanyl, and faster relief of withdrawal symptoms with injection. CONCLUSIONS: Trauma, normalization of drug use, over-prescribing of opioids, and abrupt discontinuation challenge people who use drugs in rural northern New England communities. Inadequate opioid tapering may increase transition to non-prescribed drug use. The extent and severity of traumatic experiences described highlights the importance of enhancing trauma-informed care in rural areas

Quantity and quality of conflict of interest policies at German medical schools - a cross sectional study and survey

Objectives: To assess the quantity and evaluate the quality of policies and curricula focusing on conflicts of interests (COI) at medical schools across Germany. Design: Cross-sectional study, survey of medical schools, standardised web search. Setting: Medical schools, Germany. Participants: 38 German medical schools. Interventions: We collected relevant COI policies, including teaching activities, by conducting a search of the websites of all 38 German medical schools using standardised keywords for COI policies and teaching. Further, we surveyed all medical schools’ dean’s offices. Finally, we adapted a scoring system for results we obtained with 13 categories based on prior similar studies. Main outcomes and measures: Presence or absence of COI-related policies, including teaching activities at medical school. The secondary outcome was the achieved score on a scale from 0 to 26, with high scores representing restrictive policies and sufficient teaching activities. Results: We identified relevant policies for one medical school via the web search. The response rate of the deans’ survey was 16 of 38 (42.1%). In total, we identified COI-related policies for 2 of 38 (5.3%) German medical schools, yet no policy was sufficient to address all COI-related categories that were assessed in this study. The maximum score achieved was 12 of 26. 36 (94.7%) schools scored 0. No medical school reported curricular teaching on COI. Conclusions: Our results indicate a low level of action by medical schools to protect students from undue commercial influence. No participating dean was aware of any curriculum or instruction on COI at the respective school and only two schools had policies in place. The German Medical Students Association and international counterparts have called for a stronger focus on COI in the classroom. We conclude that for German medical schools, there is still a long way to go

Additive-Subtractive Process Chain for Highly Functional Polymer Components

Additive manufacturing processes offer the possibility of producing components without using tools. Especially in mobility, new technologies are needed to make geometrically complex, functionally integrated and highly precise components. The fused filament fabrication (FFF) process is an additive manufacturing technique that offers easy handling and a large range of materials. However, the FFF process has a considerable shortcoming in dimensional accuracy. A process hybridization consisting of additive and subtractive steps was developed to eliminate this shortcoming. Applying subtractive work steps enables the precise integration of inserts and, thus, the production of highly functional polymer components. For this purpose, suitable demonstrators are derived from an example of a stator of a double-sided axial flux machine and the manufacturing process with the different working steps (additive & subtractive) is demonstrated. The focus is on increasing the dimensional accuracy and more precise integration of the inserts with the help of subtractive steps. Furthermore, non-planar overprinting during the additive manufacturing steps was investigated. The advantages of the combination of subtractive processing and non-planar printing were concluded

Incidence and Severity of Lymphoedema following Limb Salvage of Extremity Soft Tissue Sarcoma

Background and Purpose. Lymphoedema is a serious complication following limb salvage for extremity soft tissue sarcomas (STSs) for which little is known. We aimed to evaluate its incidence, its, severity and its associated risk factors. Material and Method. Patient and tumor characteristics, treatment modalities and complications and functional outcomes (MSTS 1987, TESS), and lymphoedema severity (Stern) were all collected from prospective databases. Charts were retrospectively abstracted for BMI and comorbidities. Results. There were 289 patients (158 males). Mean age was 53 (16–88). Followup ranged between 12 and 60 months with an average of 35 and a median of 36 months. Mean BMI was 27.4 (15.8–52.1). 72% had lower extremity tumors and 38% upper extremity. Mean tumor size was 8.1 cm (1.0–35.6 cm). 27% had no adjuvant radiation, 62% had 50 Gy, and 11% received 66 Gy. The incidence of lymphoedema was 28.8% (206 none, 58 mild, 22 moderate, 3 severe, and 0 very severe). Mean MSTS score was 32 (11–35) and TESS was 89.4 (32.4–100). Radiation dose was significantly correlated with tumor size > 5 cm (P = 0.0001) and TESS score (P = 0.001), but not MSTS score (P = 0.090). Only tumor size > 5 cm and depth were found to be independent predictors of significant lymphoedema. Conclusion. Nine percent of STS patients in our cohort developed significant (grade ≥ 2) lymphoedema. Tumor size > 5 cm and deep tumors were associated with an increased occurrence of lymphoedema but not radiation dosage

Computational Aerodynamics of Low Reynolds Number Plunging, Pitching and Flexible Wings for MAV Applications

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/76136/1/AIAA-2008-523-190.pd

Axions In String Theory

In the context of string theory, axions appear to provide the most plausible solution of the strong CP problem. However, as has been known for a long time, in many string-based models, the axion coupling parameter F_a is several orders of magnitude higher than the standard cosmological bounds. We re-examine this problem in a variety of models, showing that F_a is close to the GUT scale or above in many models that have GUT-like phenomenology, as well as some that do not. On the other hand, in some models with Standard Model gauge fields supported on vanishing cycles, it is possible for F_a to be well below the GUT scale.Comment: 62 pages, v2; references, acknowledgements and minor corrections adde