Decision-Oriented Multi-Outcome Modeling for Anesthesia Patients

Anesthesia drugs have impact on multiple outcomes of an anesthesia patient. Most typical outcomes include anesthesia depth, blood pressures, heart rates, etc. Traditional diagnosis and control in anesthesia focus on a one-drug-one-outcome scenario. This paper studies the problem of real-time modeling for monitoring, diagnosing, and predicting multiple outcomes of anesthesia patients. It is shown that consideration of multiple outcomes is necessary and beneficial for anesthesia managements. Due to limited real-time data, real-time modeling in multi-outcome modeling requires low-complexity model strucrtures. This paper introduces a method of decision-oriented modeling that significantly reduces the complexity of the problem. The method employs simplified and combined model functions in a Wiener structure to contain model complexity. The ideas of drug impact prediction and reachable sets are introduced for utility of the models in diagnosis, outcome prediction, and decision assistance. Clinical data are used to evaluate the effectiveness of the method

Disability and the Immigrant Health Paradox: Gender and Timing of Migration

Although research has documented better health and longer life expectancy among the foreign-born relative to their U.S.-born counterparts, the U.S. Mexican-origin immigrant population is diverse and the healthy immigrant effect likely varies by key structural and demographic factors such as gender, migration history, and duration in the United States. Using a life course framework, we use data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE 1993–2013) which includes Mexican-American individuals aged 65 and older to assess the heterogeneity in the immigrant health advantage by age of migration and gender. We find that age of migration is an important delineating factor for disability among both men and women. The healthy immigrant hypothesis is only observable among mid- and late-life migrant men for ADL disability. While among immigrant women, late-life migrants are more likely to have an IADL disability putting them at a health disadvantage. These findings illustrate that Mexican immigrants are not a homogeneous group and migrant health selectivity depends on both gender and when migrants arrived in the United States

A model of management academics' intentions to influence values

Business schools face increased criticism for failing in the teaching of management studies to nurture their students’ values. Assuming that individual academics play an important role in shaping the value-related influence of business schools, I model management academics’ intentions to influence values. The suggested model encompasses academics’ economic and social values as internal variables, as well as perceived support for attempting to influence values and academic tenure as social and structural variables. A test with empirical data from 1,254 management academics worldwide reveals that perceived external support is most relevant for explaining intentions. Moreover, academics’ social values, but not their economic ones, contribute to an explanation of their intentions to influence values. The results reveal how important it is for academics to believe that their colleagues, higher education institutions, and other stakeholders support their value-related behavioral intentions

Schools out : Adam Smith and pre-disciplinary international political economy

In this article, I argue that invocations of Adam Smith in international political economy (IPE) often reveal the influence therein of a disciplinary ontological disaggregation of economic and non-economic rationality, which I claim is obscured by the tendency to map its complex intellectual contours in terms of competing schools. I trace the origins of the disciplinary characterisation of Smith as the founder of IPE's liberal tradition to invocations of his thought by centrally important figures in the perceived Austrian, Chicago and German historical schools of economics, and reflect upon the significance to IPE of the reiteration of this portrayal by apparent members of its so-called American and British schools. I additionally contrast these interpretations to those put forward by scholars who seek to interpret IPE and Smith's contribution to it in pre-disciplinary terms, which I claim reflects a distinct ontology to that attributed to the British school of IPE with which their work is often associated. I therefore contend that reflection upon invocations of Smith's thought in IPE problematises the longstanding tendency to map its intellectual terrain in terms of competing schools, reveals that the disciplinary ontological consensus that informs this tendency impacts upon articulations of its core concerns and suggests that a pre-disciplinary approach offers an alternative lens through which such concerns might be more effectively framed

In silico design of novel probes for the atypical opioid receptor MRGPRX2

The primate-exclusive MRGPRX2 G protein-coupled receptor (GPCR) has been suggested to modulate pain and itch. Despite putative peptide and small molecule MRGPRX2 agonists, selective nanomolar potency probes have not yet been reported. To identify a MRGPRX2 probe, we first screened 5,695 small molecules and found many opioid compounds activated MRGPRX2, including (−)- and (+)-morphine, hydrocodone, sinomenine, dextromethorphan and the prodynorphin-derived peptides, dynorphin A, dynorphin B, and α- and β-neoendorphin. We used these to select for mutagenesis-validated homology models and docked almost 4 million small molecules. From this docking, we predicted ZINC-3573, which represents a potent MRGPRX2-selective agonist, showing little activity against 315 other GPCRs and 97 representative kinases, and an essentially inactive enantiomer. ZINC-3573 activates endogenous MRGPRX2 in a human mast cell line inducing degranulation and calcium release. MRGPRX2 is a unique atypical opioid-like receptor important for modulating mast cell degranulation, which can now be specifically modulated with ZINC-3573

Modern American populism: Analyzing the economics behind the Silent Majority, the Tea Party and Trumpism

This article researches populism, more specifically, Modern American Populism (MAP), constructed of white, rural, and economically oppressed reactionarianism, which was borne out of the political upheaval of the 1960’s Civil Rights movement. The research looks to explain the causes of populism and what leads voters to support populist movements and politicians. The research focuses on economic anxiety as the main cause but also examines an alternative theory of racial resentment. In an effort to answer the question, what causes populist movements and motivations, I apply a research approach that utilizes qualitative and quantitative methods. There is an examination of literature that defines populism, its causes and a detailed discussion of the case studies, including the 1972 election of Richard Nixon; the Tea Party election of 2010; and the 2016 election of Donald Trump. In addition, statistical data analysis was run using American National Election Studies (ANES) surveys associated with each specific case study. These case studies were chosen because they most represent forms of populist movements in modern American history. While ample qualitative evidence suggested support for the hypothesis that economic anxiety is a necessary condition for populist voting patterns that elected Nixon, the Tea Party and Trump, the statistical data only supported the hypothesis in two cases, 2010 and 2016, with 1972 coming back inconclusive. The data also suggested that both economic anxiety and racial resentment played a role in 2010 and 2016, while having no significant effect in 1972 in either case. This suggests that further research needs to be conducted into additional populist case studies, as well as an examination into the role economic anxiety and economic crises play on racial resentment and racially motivated voting behavior

The MOBILIZE Boston Study: Design and methods of a prospective cohort study of novel risk factors for falls in an older population

<p>Abstract</p> <p>Background</p> <p>Falls are the sixth leading cause of death in elderly people in the U.S. Despite progress in understanding risk factors for falls, many suspected risk factors have not been adequately studied. Putative risk factors for falls such as pain, reductions in cerebral blood flow, somatosensory deficits, and foot disorders are poorly understood, in part because they pose measurement challenges, particularly for large observational studies.</p> <p>Methods</p> <p>The MOBILIZE Boston Study (MBS), an NIA-funded Program Project, is a prospective cohort study of a unique set of risk factors for falls in seniors in the Boston area. Using a door-to-door population-based recruitment, we have enrolled 765 persons aged 70 and older. The baseline assessment was conducted in 2 segments: a 3-hour home interview followed within 4 weeks by a 3-hour clinic examination. Measures included pain, cerebral hemodynamics, and foot disorders as well as established fall risk factors. For the falls follow-up, participants return fall calendar postcards to the research center at the end of each month. Reports of falls are followed-up with a telephone interview to assess circumstances and consequences of each fall. A second assessment is performed 18 months following baseline.</p> <p>Results</p> <p>Of the 2382 who met all eligibility criteria at the door, 1616 (67.8%) agreed to participate and were referred to the research center for further screening. The primary reason for ineligibility was inability to communicate in English. Results from the first 600 participants showed that participants are largely representative of seniors in the Boston area in terms of age, sex, race and Hispanic ethnicity. The average age of study participants was 77.9 years (s.d. 5.5) and nearly two-thirds were women. The study cohort was 78% white and 17% black. Many participants (39%) reported having fallen at least once in the year before baseline.</p> <p>Conclusion</p> <p>Our results demonstrate the feasibility of conducting comprehensive assessments, including rigorous physiologic measurements, in a diverse population of older adults to study non-traditional risk factors for falls and disability. The MBS will provide an important new data resource for examining novel risk factors for falls and mobility problems in the older population.</p

Socioeconomic position and incident mobility impairment in the Cardiovascular Health Study

Background We investigated if personal socioeconomic position (SEP) factors and neighborhood characteristics were associated with incident mobility impairment in the elderly. Methods We used data from the Cardiovascular Health Study, a longitudinal, population-based examination of coronary heart disease and stroke among persons aged 65 and older in the United States. Results Among 3,684 persons without baseline mobility impairment, lower baseline SEP was associated with increased risk of incident mobility disability during the 10-year follow-up period, although the strengths of these associations varied by socioeconomic indicator and race/sex group. Conclusion Among independent-living elderly, SEP affected development of mobility impairment into later life. Particular effort should be made to prevent or delay its onset among the elderlyhttp://deepblue.lib.umich.edu/bitstream/2027.42/57781/1/Socioeconomic Position and Incident Mobility Impairment in the Cardiovascular Health Study.pd