Merely superficially contingent a priori knowledge and the McKinsey paradox

Acknowledgements Thanks to Bernhard Salow, Crispin Wright, David Horst and Marco Ruffino for helpful discussion. I am also grateful to two anonymous Synthese referees for helpful comments.Peer reviewedPublisher PD

Patient Characteristics and Trends in Nontraumatic Dental Condition Visits to Emergency Departments in the United States

Objective: We examined trends and patient characteristics for non-traumatic dental condition (NTDC) visits to emergency departments (EDs), and compared them to other ED visit types, specifically non-dental ambulatory care sensitive conditions (non-dental ACSCs) and non-ambulatory care sensitive conditions (non-ACSCs) in the United States. Methods: We analyzed data from the National Hospital Ambulatory Medical Care survey (NHAMCS) for 1997 to 2007. We performed descriptive statistics and used a multivariate multinomial logistic regression to examine the odds of one of the three visit types occurring at an ED. All analyses were adjusted for the survey design. Results: NTDC visits accounted for 1.4% of all ED visits with a 4% annual rate of increase (from 1.0% in 1997 to 1.7% in 2007). Self-pay patients (32%) and Medicaid enrollees (27%) were over-represented among NTDC visits compared to non-dental ACSC and non-ACSC visits (P \u3c 0.0001). Females consistently accounted for over 50% of all types of ED visits examined. Compared to whites, Hispanics had significantly lower odds of an NDTC visit versus other visit types (P \u3c 0.0001). Blacks had significantly lower odds of making NDTC visits when compared to non-dental ACSC visits only (P \u3c 0.0001). Compared to private insurance enrollees, Medicaid and self-pay patients had 2–3 times the odds of making NTDC visits compared to other visit types. Conclusion: Nationally, NTDC visits to emergency departments increased over time. Medicaid and self-pay patients had significantly higher odds of making NDTC visits

Plastron respiration using commercial fabrics

A variety of insect and arachnid species are able to remain submerged in water indefinitely using plastron respiration. A plastron is a surface-retained film of air produced by surface morphology that acts as an oxygen-carbon dioxide exchange surface. Many highly water repellent and hydrophobic surfaces when placed in water exhibit a silvery sheen which is characteristic of a plastron. In this article, the hydrophobicity of a range of commercially available water repellent fabrics and polymer membranes is investigated, and how the surface of the materials mimics this mechanism of underwater respiration is demonstrated allowing direct extraction of oxygen from oxygenated water. The coverage of the surface with the plastron air layer was measured using confocal microscopy. A zinc/oxygen cell is used to consume oxygen within containers constructed from the different membranes, and the oxygen consumed by the cell is compared to the change in oxygen concentration as measured by an oxygen probe. By comparing the membranes to an air-tight reference sample, it was found that the membranes facilitated oxygen transfer from the water into the container, with the most successful membrane showing a 1.90:1 ratio between the cell oxygen consumption and the change in concentration within the container

MEDICATION USE AND FALLS IN OLDER ADULTS: A PHARMACOEPIDEMIOLOGIC APPROACH

More than one-third of community-dwelling older adults fall each year. Falling is classified as a geriatric syndrome which has multiple contributing factors and an interaction between chronic predisposing diseases and impairments and acute precipitating insults. One potentially modifiable risk factor is medication use. While previous research has been conducted on medication-related falls, there are several gaps remaining in the literature, including the lack evidence on dose-response relationships across wide ranges of medication classes and falls as well as the frequent inability to address confounding by indication. Therefore, the overall purpose of this project was to determine—in a large, representative sample of community-dwelling older adults—associations between antihypertensive, anticholinergic, and antidepressant use and recurrent falls. First, we found no increased risk of recurrent falls in antihypertensive users compared to non-users, or those taking higher doses or for longer durations. Only those using a loop diuretic were found to have a modest increased risk of recurrent falls. In conclusion, antihypertensive use overall was not associated with recurrent falls after adjusting for important confounders. Loop diuretic use may be associated with recurrent falls and needs further study. Second, we found no statistically significant increased risk of recurrent falls in anticholinergic users, or those taking higher doses or for longer durations. In conclusion, increased point estimates suggest an association of anticholinergic use with recurrent falls, but the associations did not reach statistical significance. Future studies are needed to examine other measures of anticholinergic burden, and their associations with other outcomes such as cognitive function. Third, we found a statistically significant increased risk of recurrent falls in antidepressant users. An increased risk was also seen among those taking SSRIs, those with short duration of use, and those taking moderate doses. Among those with a history of falls/fracture at baseline, we found an increase in risk for any antidepressant use, but no increased risk was found in those without a history of falls/fracture. Taken together, the findings from this proposal will provide clinicians and researchers with clinically-relevant information on potential harmful outcomes associated with chronic medication therapy among older adults

In-situ high temperature spatially resolved X-ray diffraction of TiB2 up to ~3250 ˚C

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