Comparing stakeholder attitudes toward white-tailed deer and rare plant management in Canaan Valley, West Virginia

Canaan Valley, West Virginia, USA provides habitat for many plants considered rare in West Virginia. The local white-tailed deer (Odocoileus virginianus Zimm.) are a popular attraction for visitors as well as resident and nonresident hunters. However, concerns exist over the impact of white-tailed deer herbivory on rare plant communities in the wetlands. We evaluated stakeholder attitudes regarding white-tailed deer management and rare plant conservation by mailing surveys to property owners in Canaan Valley and Tucker County, WV, and providing surveys to visitors at Canaan Valley State Park and National Wildlife Refuge. Individuals that had incurred crop damage were more likely to view the Canaan Valley population as overabundant while nonresident landowners placed higher values on the conservation of rare plants and plant communities in Canaan Valley. We found that hunters were more likely than nonhunters to support white-tailed deer management actions. Results of this survey may help managers to direct management and education goals toward actual rather than perceived stakeholder attitudes

Malignant Cerebral Edema following CT Myelogram Using Isovue-M 300 Intrathecal Nonionic Water-Soluble Contrast: A Case Report

Lumbar myelogram utilizing nonionic contrast is a commonly performed procedure to identify spinal pathology. Complication rates are low. Cerebral edema has been shown to occur following intrathecal injection of ionic contrast; however, no current literature has documented this complication relating to the ubiquitously used nonionic contrast medium. We report a case of a patient who developed malignant cerebral edema following a lumbar myelogram with Isovue-M 300 nonionic water-soluble intrathecal contrast. We believe this is the first reported case of cerebral edema resulting from the use of a nonionic contrast

The Effect of Simulation based Training on Medical Students’ Perceptions, Knowledge, and Skill at Baseline and 6 month Follow up

The principal goal of most simulation-based learning is enhanced clinical skill, with the desired outcome being skill retention and improved performance over time. While evide nce supports simulation based training at the clerkship, graduate, and post graduate level, the evidence supporting its long term benefit at the pre clerkship level is less well established. Using quantitative methods, this research assessed the effect of skill based clinical simulation training on all second year medical students’ enrolled in two simulation courses at the University of Michigan during the 2013 2014 academic year (n=39). Pre course, post course, and 6 month follow up questionnaires were adm inistered, and analysis of variance was used to assess change in students\u27 knowledge, self reported confidence, and competency. Students in Course 1 (n=12) completed a post course and 6 month follow up skills test, and results were compared to faculty cont rols. Differences between groups were assessed using t tests. Odds ratios were calculated.Knowledge improved from pre course to post course; the gain was retained at follow up only for students in Course 1. Students perceived the courses as improving know ledge, confidence, and skill, though scores were significantly lower at follow up. For the subset of students participating in the skills test, the time to complete central line and thoracentesis at follow up did not significantly differ from post course; however, an increase was observed for lumbar puncture. Compared to faculty, students took significantly more time to complete the central line procedure. Outcomes for needle redirects and correct sequencing were mixed, with most procedures showing no signi ficant difference between measurement periods. Assessing students’ skill and the maintenance of that skill over time using objective and empirically derived measures can be challenging. The evaluation strategy described herein could be adapted to many proc edures commonly practiced within primary care and other medical specialties. Brief exposure to clinical simulation early in medical training and prior to clerkships can have a positive and lasting effecton medical students’ knowledge, confidence, and skil l for selected procedures

Sleep to Reduce Incident Depression Effectively (STRIDE): study protocol for a randomized controlled trial comparing stepped-care cognitive-behavioral therapy for insomnia versus sleep education control to prevent major depression

BACKGROUND: Prevention of major depressive disorder (MDD) is a public health priority. Strategies targeting individuals at elevated risk for MDD may guide effective preventive care. Insomnia is a reliable precursor to depression, preceding half of all incident and relapse cases. Thus, insomnia may serve as a useful entry point for preventing MDD. Cognitive-behavioral therapy for insomnia (CBT-I) is recommended as the first-line treatment for insomnia, but widespread implementation is limited by a shortage of trained specialists. Innovative stepped-care approaches rooted in primary care can increase access to CBT-I and reduce rates of MDD. METHODS/DESIGN: We propose a large-scale stepped-care clinical trial in the primary care setting that utilizes a sequential, multiple assignment, randomized trial (SMART) design to determine the effectiveness of dCBT-I alone and in combination with clinician-led CBT-I for insomnia and the prevention of MDD incidence and relapse. Specifically, our care model uses digital CBT-I (dCBT-I) as a first-line intervention to increase care access and reduce the need for specialist resources. Our proposal also adds clinician-led CBT-I for patients who do not remit with first-line intervention and need a more personalized approach from specialty care. We will evaluate negative repetitive thinking as a potential treatment mechanism by which dCBT-I and CBT-I benefit insomnia and depression outcomes. DISCUSSION: This project will test a highly scalable model of sleep care in a large primary care system to determine the potential for wide dissemination and implementation to address the high volume of population need for safe and effective insomnia treatment and associated prevention of depression. TRIAL REGISTRATION: ClinicalTrials.gov NCT03322774. Registered on October 26, 2017

Bostonia: The Boston University Alumni Magazine. Volume 9

Founded in 1900, Bostonia magazine is Boston University's main alumni publication, which covers alumni and student life, as well as university activities, events, and programs

From Transit Hub to Major Supplier of Illicit Cigarettes to Argentina and Brazil: The Changing Role of Domestic Production and Transnational Tobacco Companies in Paraguay Between 1960 and 2003

Background  Paraguay has reportedly been a major transit hub for illicit tobacco products since the 1960s, initially to supply markets in Argentina and Brazil and, more recently, other regional markets and beyond. However, to date there has been no systematic analysis, notably independent of the tobacco industry, of this trade including the roles of domestic production and transnational tobacco companies (TTCs). This article fills that gap by detailing the history of Paraguay’s illicit cigarette trade to Brazil and Argentina of TTC products and Paraguayan production between 1960 and 2003. The effective control of illicit cigarette flows, under Article 15 of the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) and the Protocol to Eliminate the Illicit Trade in Tobacco Products, requires fuller understanding of the changing nature of the illicit trade. Methods  We systematically searched internal industry documents to understand the activities and strategies of leading TTCs in Paraguay and subregion over time. We also mapped illicit trade volume and patterns using US government and UN data on the cigarette trade involving Paraguay. We then estimated Paraguay’s cigarette production from 1989 to 2003 using tobacco leaf flows from the United Nations Commodity Trade Statistics Database (UN Comtrade). Results  We identify four phases in the illicit tobacco trade involving Paraguay: 1) Paraguay as a transit hub to smuggle BAT and PMI cigarettes from the U.S. into Argentina and Brazil (from the 1960s to the mid-1970s); 2) BAT and PMI competing in north-east Argentina (1989–1994); 3) BAT and PMI competing in southern and southern-east Brazil (mid to late 1990s); and 4) the growth in the illicit trade of Paraguayan manufactured cigarettes (from the mid- 1990s onwards). These phases suggest the illicit trade was seeded by TTCs, and that the system of supply and demand on lower priced brands they developed in the 1990s created a business opportunity for manufacturing in Paraguay. Brazil’s efforts to fight this trade, with a 150% tax on exports to Latin American countries in 1999, further prompted supply of the illicit trade to shift from TTCs to Paraguayan manufacturers. Conclusion  This paper extends evidence of the longstanding complicity of TTCs in the illicit trade to this region and the consequent growth of Paraguayan production in the 1990s. Our findings confirm the need to better understand the factors influencing how the illicit tobacco trade has changed over time, in specific regional contexts, and amid tobacco industry globalization. In Paraguay, the changing roles of TTC and domestic production have been central to shifting patterns of illicit supply and distribution since the 1960s. Important questions are raised, in turn, about TTCs efforts to participate as legitimate partners in global efforts to combat the problem, including a leading role in data gathering and analysis

Chemical Beam Epitaxy of Compound Semiconductors

Contains an introduction, reports on three research projects and a list of publications.3M Company Faculty Development GrantDefense Advanced Research Projects Agency Subcontract 216-25013Defense Advanced Research Projects Agency Subcontract 542383Joint Services Electronics Program Contract DAAL03-92-C-0001National Science Foundation Grant ECS 88-46919National Science Foundation Grant ECS 89-05909National Science Foundation Grant DMR 92-0295

Automatically Harnessing Sparse Acceleration

Sparse linear algebra is central to many scientific programs, yet compilers fail to optimize it well. High-performance libraries are available, but adoption costs are significant. Moreover, libraries tie programs into vendor-specific software and hardware ecosystems, creating non-portable code. In this paper, we develop a new approach based on our specification Language for implementers of Linear Algebra Computations (LiLAC). Rather than requiring the application developer to (re)write every program for a given library, the burden is shifted to a one-off description by the library implementer. The LiLAC-enabled compiler uses this to insert appropriate library routines without source code changes. LiLAC provides automatic data marshaling, maintaining state between calls and minimizing data transfers. Appropriate places for library insertion are detected in compiler intermediate representation, independent of source languages. We evaluated on large-scale scientific applications written in FORTRAN; standard C/C++ and FORTRAN benchmarks; and C++ graph analytics kernels. Across heterogeneous platforms, applications and data sets we show speedups of 1.1$\times$ to over 10$\times$ without user intervention.Comment: Accepted to CC 202

American Gut: An Open Platform For Citizen Science Microbiome Research

Copyright © 2018 McDonald et al. Although much work has linked the human microbiome to specific phenotypes and lifestyle variables, data from different projects have been challenging to integrate and the extent of microbial and molecular diversity in human stool remains unknown. Using standardized protocols from the Earth Microbiome Project and sample contributions from over 10,000 citizen-scientists, together with an open research network, we compare human microbiome specimens primarily from the United States, United Kingdom, and Australia to one another and to environmental samples. Our results show an unexpected range of beta-diversity in human stool microbiomes compared to environmental samples; demonstrate the utility of procedures for removing the effects of overgrowth during room-temperature shipping for revealing phenotype correlations; uncover new molecules and kinds of molecular communities in the human stool metabolome; and examine emergent associations among the microbiome, metabolome, and the diversity of plants that are consumed (rather than relying on reductive categorical variables such as veganism, which have little or no explanatory power). We also demonstrate the utility of the living data resource and cross-cohort comparison to confirm existing associations between the microbiome and psychiatric illness and to reveal the extent of microbiome change within one individual during surgery, providing a paradigm for open microbiome research and education. IMPORTANCE We show that a citizen science, self-selected cohort shipping samples through the mail at room temperature recaptures many known microbiome results from clinically collected cohorts and reveals new ones. Of particular interest is integrating n = 1 study data with the population data, showing that the extent of microbiome change after events such as surgery can exceed differences between distinct environmental biomes, and the effect of diverse plants in the diet, which we confirm with untargeted metabolomics on hundreds of samples