Psychologists and Medications in the Era of Interprofessional Care: Collaboration is Less Problematic and Costly Than Prescribing

Increasing emphasis on interprofessionalism and teamwork in healthcare renders psychologists’ collaborations critical and invites reexamination of psychologists’ roles related to medications. The Collaboration Level outlined by the APA’s Ad Hoc Task Force is more achievable and in synch with health reform than prescription privileges (RxP). RxP remains controversial due to training and safety concerns, lacking support from health professionals, psychologists, and consumers. Differences in educational preparation of psychologists relative to prescribing professionals are discussed. Enactment of only three of 170 RxP initiatives reveals RxP to be a costly, ineffectual agenda. Alternatives (e.g., integrated care, collaboration, telehealth) increase access without risks associated with lesser medical knowledge. Concerns about RxP and the movement toward team-based care warrant reconsideration of the profession’s objectives regarding psychopharmacology

INDOT Pavement Preservation: Crack Sealing/Filling

This crack sealing/filling presentation will cover why and how it\u27s done, along with what are the best types of sealants to use in this climate for crack sealing versus crack filling. Also, basics on the equipment (melters, routers, hot air lances) used will be covered

Union

The colored engraving depicts Abraham Lincoln (reworked over John Calhoun) and other statesmen: Winfield Scott, Lewis Cass, Henry Clay, Daniel Webster, Millard Fillmore, Howell Cobb of Georgia, James McDowell, Thomas Hart Benton of Missouri, John M. Clayton of Delaware, Thomas Corwin, James Buchanan, Stephen A. Douglas, John J. Crittenden, Sam Houston of Texas, Henry Foote of Mississippi, Willie P. Mangum of North Carolina, W. R. King of Alabama, Daniel S. Dickinson of New York, John McLean of Ohio, John Bell of Tennessee, and John C. Fremont of Californiahttps://scholarsjunction.msstate.edu/fvw-prints/1019/thumbnail.jp

Vertical Heating Structures Associated with the MJO as Characterized by TRMM Estimates, ECMWF Reanalyses, and Forecasts: A Case Study during 1998/99 Winter

The Madden–Julian oscillation (MJO) is a fundamental mode of the tropical atmosphere variability that exerts significant influence on global climate and weather systems. Current global circulation models, unfortunately, are incapable of robustly representing this form of variability. Meanwhile, a well-accepted and comprehensive theory for the MJO is still elusive. To help address this challenge, recent emphasis has been placed on characterizing the vertical structures of the MJO. In this study, the authors analyze vertical heating structures by utilizing recently updated heating estimates based on the Tropical Rainfall Measuring Mission (TRMM) from two different latent heating estimates and one radiative heating estimate. Heating structures from two different versions of the European Centre for Medium-Range Weather Forecasts (ECMWF) reanalyses/forecasts are also examined. Because of the limited period of available datasets at the time of this study, the authors focus on the winter season from October 1998 to March 1999. The results suggest that diabatic heating associated with the MJO convection in the ECMWF outputs exhibits much stronger amplitude and deeper structures than that in the TRMM estimates over the equatorial eastern Indian Ocean and western Pacific. Further analysis illustrates that this difference might be due to stronger convective and weaker stratiform components in the ECMWF estimates relative to the TRMM estimates, with the latter suggesting a comparable contribution by the stratiform and convective counterparts in contributing to the total rain rate. Based on the TRMM estimates, it is also illustrated that the stratiform fraction of total rain rate varies with the evolution of the MJO. Stratiform rain ratio over the Indian Ocean is found to be 5% above (below) average for the disturbed (suppressed) phase of the MJO. The results are discussed with respect to whether these heating estimates provide enough convergent information to have implications on theories of the MJO and whether they can help validate global weather and climate models

Interference of Asfotase alfa in immunoassays employing alkaline phosphatase technology

BACKGROUND: Asfotase alfa (STRENSIQ®, Alexion Pharmaceuticals, Inc.) is the only approved treatment for patients with pediatric-onset hypophosphatasia, a disease caused by a mutation in the tissue-nonspecific alkaline phosphatase (TNSALP) gene. ALP is often used as signaling system in routine immunoassays. Because asfotase alfa contains the active site of the full ALP enzyme, it can catalyze the substrate as the antibody-conjugated ALP would within an assay. Therefore, its presence in a treated patient's sample may generate false positive or false negative results. We investigated whether the presence of asfotase alfa within a sample induced interference in immunoassays that utilize ALP or alternative detection systems. METHODS: Asfotase alfa was added to samples at concentrations from 0.08-5 µg/mL and analysed on various immunoassays following manufacturer's instructions. RESULTS: Asfotase alfa was detected in all ALP assays but ALKP1 (RayBiotech). We observed no changes in normetanephrine and noradrenaline (IBL) at any asfotase alfa concentration. However, asfotase alfa notably interfered in an oxytocin (ENZO) assay in nonextracted samples. Extraction using a C18 column eliminated the interference. No interference was observed on automated analyzers using alternative detection system (COBAS fT4 and TSH; Advia Centaur FSH, fT4; Architect LH; FSH). Immulite 2000 fT4, TSH, testosterone and hCG (ALP-based) showed no interference. However, the presence of asfotase alfa resulted in a dose-dependent increase of Troponin I signal. CONCLUSION: The presence of asfotase alfa must be taken into consideration when analyzing blood samples in treated patients to avoid any risk of misinterpretation of false positive/negative results. It is essential that assays be tested for this possible interference

Advances in developing deep neural networks for finding primary vertices in proton-proton collisions at the LHC

We are studying the use of deep neural networks (DNNs) to identify and locate primary vertices (PVs) in proton-proton collisions at the LHC. Earlier work focused on finding primary vertices in simulated LHCb data using a hybrid approach that started with kernel density estimators (KDEs) derived heuristically from the ensemble of charged track parameters and predicted "target histogram" proxies, from which the actual PV positions are extracted. We have recently demonstrated that using a UNet architecture performs indistinguishably from a "flat" convolutional neural network model. We have developed an "end-to-end" tracks-to-hist DNN that predicts target histograms directly from track parameters using simulated LHCb data that provides better performance (a lower false positive rate for the same high efficiency) than the best KDE-to-hists model studied. This DNN also provides better efficiency than the default heuristic algorithm for the same low false positive rate. "Quantization" of this model, using FP16 rather than FP32 arithmetic, degrades its performance minimally. Reducing the number of UNet channels degrades performance more substantially. We have demonstrated that the KDE-to-hists algorithm developed for LHCb data can be adapted to ATLAS and ACTS data using two variations of the UNet architecture. Within ATLAS/ACTS, these algorithms have been validated against the standard vertex finder algorithm. Both variations produce PV-finding efficiencies similar to that of the standard algorithm and vertex-vertex separation resolutions that are significantly better

Prototype Software for Future Spaceflight Tested at Mars Desert Research Station

NASA scientists in MDRS Crew 49 (April 23-May 7, 2006) field tested and significantly extended a prototype monitoring and advising system that integrates power system telemetry with a voice commanding interface. A distributed, wireless network of functionally specialized agents interacted with the crew to provide alerts (e.g., impending shut-down of inverter due to low battery voltage), access md interpret historical data, and display troubleshooting procedures. In practical application during two weeks, the system generated speech over loudspeakers and headsets lo alert the crew about the need to investigate power system problems. The prototype system adapts the Brahms/Mobile Agents toolkit to receive data from the OneMeter (Brand Electronics) electric metering system deployed by Crew 47. A computer on the upper deck was connected to loudspeakers, four others were paired with wireless (Bluetooth) headsets that enabled crew members to interact with their personal agents from anywhere in the hab. Voice commands and inquiries included: 1. What is the {battery | generator} {volts | amps | volts and amps}? 2. What is the status of the {generator | inverter | battery | solar panel}? 3. What is the hab{itat} {power usage | volts | voltage | amps | volts and amps}? 4. What was the average hab{itat} {amps | volts | voltage} since {AM | PM)? 5. When did the {generator | batteries} change status? 6. Tell {me I | everyone} when{ ever} the generator goes offline. 7. Tell {me | | everyone} when the hab{itat} {amps | volts | voltage} {exceeds | drops brelow} . 8. {Send | Take | Record} {a} voice note {(for | to} } {at }. This research demonstrates the principles of design in the context of use, investigating requirements through experimental use of prototype systems in an analog setting, and use of MDRS as a research facility for designing and implementing new systems