Utilizing Title VI As A Means to Eradicate Health Discrimination

Health disparities among people of color are persistent and detrimental to the overall wellness of these groups. Discrimination in the provision of health care services is one of the primary causes of health disparities. Title VI of the Civil Rights Act of 1964’s availability as a tool to prevent discrimination and, in turn, disparities among these groups is underdocumented. The legislative intent of Title VI and the historical context of the law have been helpful in its use outside of the health care arena to prevent discrimination. This sheds light on the ways that the law can influence the health care sector to decrease the prevalence of discrimination and improve the health of people of color. The government must make civil rights laws, policies, and procedures unambiguous; it must vigorously utilize its enforcement powers; and it must monitor the health care facilities required to adhere to the law. Additionally, beneficiaries must be educated of their rights and the processes for pursuing action when those rights have been violated. Noncompliance with civil rights laws to the detriment of an often-marginalized population is deplorable. However, Title VI provides a powerful avenue for change

Evaporation of a packet of quantized vorticity

A recent experiment has confirmed the existence of quantized turbulence in superfluid He3-B and suggested that turbulence is inhomogenous and spreads away from the region around the vibrating wire where it is created. To interpret the experiment we study numerically the diffusion of a packet of quantized vortex lines which is initially confined inside a small region of space. We find that reconnections fragment the packet into a gas of small vortex loops which fly away. We determine the time scale of the process and find that it is in order of magnitude agreement with the experiment.Comment: figure 1a,b,c and d, figure2, figure

An Inverted Repeat in the ospC Operator Is Required for Induction in Borrelia Burgdorferi

Borrelia burgdorferi, the spirochete that causes Lyme disease, differentially regulates synthesis of the outer membrane lipoprotein OspC to infect its host. OspC is required to establish infection but then repressed in the mammal to avoid clearance by the adaptive immune response. Inverted repeats (IR) upstream of the promoter have been implicated as an operator to regulate ospC expression. We molecularly dissected the distal inverted repeat (dIR) of the ospC operator by site-directed mutagenesis at its endogenous location on the circular plasmid cp26. We found that disrupting the dIR but maintaining the proximal IR prevented induction of OspC synthesis by DNA supercoiling, temperature, and pH. Moreover, the base-pairing potential of the two halves of the dIR was more important than the nucleotide sequence in controlling OspC levels. These results describe a cis-acting element essential for the expression of the virulence factor OspC

Emergency Department Clinicians’ Attitudes Toward Opioid Use Disorder and Emergency Department-initiated Buprenorphine Treatment: A Mixed-Methods Study

Introduction: Emergency department (ED) visits related to opioid use disorder (OUD) have increased nearly twofold over the last decade. Treatment with buprenorphine has been demonstrated to decrease opioid-related overdose deaths. In this study, we aimed to better understand ED clinicians’ attitudes toward the initiation of buprenorphine treatment in the ED.Methods: We performed a mixed-methods study consisting of a survey of 174 ED clinicians (attending physicians, residents, and physician assistants) and semi-structured interviews with 17 attending emergency physicians at a tertiary-care academic hospital.Results: A total of 93 ED clinicians (53% of those contacted) completed the survey. While 80% of respondents agreed that buprenorphine should be administered in the ED for patients requesting treatment, only 44% felt that they were prepared to discuss medication for addiction treatment. Compared to clinicians with fewer than five years of practice, those with greater experience were less likely to approve of ED-initiated buprenorphine. In our qualitative analysis, physicians had differing perspectives on the role that the ED should play in treating OUD. Most physicians felt that a buprenorphine-based intervention in the ED would be feasible with institutional support, including training opportunities, protocol support within the electronic health record, counseling and support staff, and a robust referral system for outpatient follow-up.Conclusion: ED clinicians’ perception of buprenorphine varied by years of practice and training level. Most ED clinicians did not feel prepared to initiate buprenorphine in the ED. Qualitative interviews identified several addressable barriers to ED-initiated buprenorphine

Polarization of superfluid turbulence

We show that normal fluid eddies in turbulent helium II polarize the tangle of quantized vortex lines present in the flow, thus inducing superfluid vorticity patterns similar to the driving normal fluid eddies. We also show that the polarization is effective over the entire inertial range. The results help explain the surprising analogies between classical and superfluid turbulence which have been observed recently.Comment: 3 figure

Performance of GloFAS Flood Forecasts using proxy data in Uganda

Capabilities to forecast fluvial flooding are not equality spread across the globe and forecasting systems are especially limited in flood-prone low-income countries (Revilla Romero et al., 2014). The availability of higher spatial and temporal resolution remote sensing data and the increase in post processing technology have opened opportunities for fluvial forecasting at a continental and global scale (Emerton et al., 2016a) (Revilla-Romero et al., 2015). This means flood forecasts are available for regions where previously there were no forecasting capabilities. The availability of flood forecasts for flood-prone low-income countries does not directly lead to action being taken in case of flooding. The forecast based financing program of the Red Cross Climate Centre enables early action to be taken using probabilistic forecast information, with the aim of reducing the impacts of flooding (Coughlan de Perez et al 2015). The program uses a combination of forecast models including the Global Flood Awareness System (GLoFAS) and is active in multiple location including Tongo, Peru and Uganda. There are many factors at play to create an effective early warning system, including the performance of the forecast. Analysing the performance of forecasts is essential for the further improvement and development of an effective early warning system. However, in low-income countries with a low data availability this is a major challenge. This poster shows the performance of the GloFAS forecast using proxy flood event data in the North East of Uganda and poses the question: “How can the performance of forecasts be analysed when data is limited and uncertain?”

Estimating flood forecast performance using inundation data in Soroti, Uganda

This work explores the question “How can data on flood extents derived from Earth Observations (EO) be used to assess the performance of a global flood forecasting model in the ungauged catchment of the Okere and Okok Rivers in Uganda?”. The Global Flood Awareness System (GloFAS), jointly developed by the European Commission and the European Centre for Medium-Range Weather Forecasts (ECMWF), is a global hydrological forecast and monitoring system. In many parts of sub-Saharan Africa the performance of GloFAS has not been assessed. GloFAS is being used in some parts of Uganda to forecast floods. Recently Africa Risk Capacity has been developing a pan-African flood model for use in underpinning parametric flood insurance. The African Flood Extent Depiction Model (AFED) is a daily depiction of temporarily flooded areas everywhere in Africa over the past 20 years. The AFED uses satellite remote sensing from microwave sensors to map floods. The AFED data set was used to assess the performance of GloFAS for two rivers in Uganda. The AFED flood data consists of a flooded fraction per pixel which ranges from 0 to 1. This is not directly comparable to the river discharges produced by the GloFAS flood forecasting model. In order to compare both datasets and assess GloFAS’s performance, the following steps were taken: Extracting the flooded fraction of the Okok and Okere Rivers. Five methods were explored: Flooded fraction of the most downstream pixel; Catchment average flooded fraction for all non-zero pixels; Maximum flooded fraction in catchment; Number of pixels that are non-zero in the catchment; Sum of flooded fraction of all the pixels in the catchment. Comparing the recorded floods derived from newspaper articles with the EO data to establish if the AFED captures the flooding of the Okok and Okere Rivers. Establishing the range of the flood fraction that signifies flooding in recorded events. Extracting flood events using the peaks of the AFED data and the range of flooding from step 3. Assessing the performance of GloFAS and calculating its skill scores using this extended flood events. Results show that AFED data successfully identifies flooding for the two rivers and can be used to assess GloFAS’s performance

Transduction by Phi Bb-1, a Bacteriophage of Borrelia Burgdorferi

We previously described a bacteriophage of the Lyme disease agent Borrelia burgdorferi designated phi BB-1. This phage packages the host complement of the 32-kb circular plasmids (cp32s), a group of homologous molecules found throughout the genus Borrelia. To demonstrate the ability of phi BB-1 to package and transduce DNA, a kanamycin resistance cassette was inserted into a cloned fragment of phage DNA, and the resulting construct was transformed into B. burgdorferi CA-11.2A cells. The kan cassette recombined into a resident cp32 and was stably maintained. The cp32 containing the kan cassette was packaged by phi BB-1 released from this B. burgdorferi strain. phi BB-1 has been used to transduce this antibiotic resistance marker into naive CA-11.2A cells, as well as two other strains of B. burgdorferi. This is the first direct evidence of a mechanism for lateral gene transfer in B. burgdorferi

Decay of quantised vorticity by sound emission

It is thought that in a quantum fluid sound generation is the ultimate sink of turbulent kinetic energy in the absence of any other dissipation mechanism near absolute zero. We show that a suitably trapped Bose-Einstein condensate provides a model system to study the sound emitted by accelerating vortices in a controlled way.Comment: 6 pages, 3 figure