Warfarin for Prevention of Ischemic Stroke Recurrence?

There is no evidence that anticoagulation with warfarin, initiated after a non- cardioembolic ischemic stroke, significantly reduces stroke recurrence. Furthermore, anticoagulation significantly increases the risk of fatal and nonfatal hemorrhagic stroke and extracranial hemorrhage in these patients. However, warfarin clearly is indicated for patients who have embolic strokes caused by underlying conditions such as atrial fibrillation or myxoma. (Strength of recommendation: A

Statin Therapy in Patients with Type 2 Diabetes

Based on current evidence, statin therapy should be offered to all patients with type 2 diabetes who are known to have coronary artery disease. [Strength of recommendation: A] For patients older than 40 years with type 2 diabetes who are not known to have cardiovascular disease, statins are recommended if other cardiovascular risk factors are present, regardless of the initial low-density lipoprotein (LDL) level, if the patient has failed to reach the target LDL goal of less than 100 mg per dL (2.6 mmol per L) by lifestyle modification for primary prevention. [Strength of recommendation: A

Unraveling the Attitude—Acquisition Conundrum in Learning English as a Second Language (L2) in Cameroon

This study set out to unravel the attitude—acquisition conundrum exhibited by Francophone Cameroonians in the learning of English as a second language (L2). It submits that notwithstanding the widely negative attitude they hold of English and the Anglophone Cameroonians who speak the language,  this negativism seems not, more recently, to blight their quest to learn and use the English language when necessary. The paper contends that albeit that Francophone Cameroonians overtly show a disdain for the English language, they at the same time recognize its role as a window to the global world.They also recognize that even within Cameroon knowing English will give them a competitive edge into the professional schools in the country and also to the few jobs opportunities that exist

The MAC function Pelican 2.0

We present an update of the Pelican MAC function, called Pelican 2.0. Both versions have the Alred construction and are based on Rijndael. they are a factor 2.5 more efficient than CBC-MAC with Rijndael, while providing a comparable claimed security level. The difference between Pelican 2.0 and the original version is that the initial value changes from the all-zero string to another constant. The reason for this is the negative impact on security if key check values are available computed with a certain standard key check value algorithm that applies the block cipher to the zero string and takes as key check value its truncated output. The security impact of this on a number of standard MACs is studied in Cryptology ePrint Archive Report 2014/183 and the analysis carries over for Pelican

Is Care for the Dying Improving in the United States?

Background: Striking changes occurred in health care in the United States between 2000 and 2013, including growth of hospice and hospital-based palliative care teams, and changes in Medicare payment policies. Objective: The aim of this study was to compare informants' reports and ratings of the quality of end-of-life care for decedents between 2000 and 2011?2013. Methods: The study design comprised retrospective national surveys. Subjects were decedents age 65 years and older residing in the community from two time periods. Similar survey questions were asked at the two time periods. Bivariate and multivariate analyses were conducted, using appropriate survey weights to examine response differences between time periods, after adjusting for the decedent's age, race, pattern of functional decline, and the presence of a cancer diagnosis, as well as the respondent's relationship to the decedent. Results: A total of 1208 informants were interviewed; 622 in 2000 and 586 in 2011?2013. Respondents from deaths in 2011?2013 were more likely to state that their loved ones experienced an unmet need for pain management (25.2% versus 15.5% in 2000, adjusted odds ratio [AOR] 1.9, 95% confidence interval [CI] 1.1-3.3). More respondents reported that religion and spirituality were addressed in the later time period (72.4% not addressed compared with 58.3%, AOR 1.4, 95% CI 1.1-1.9). High rates of unmet need for palliation of dyspnea and anxiety/depression remained. The overall rating of quality did not improve but decreased (with 56.7% stating care was excellent in 2000 and 47.0% in the later survey, AOR 0.70, 95% CI 0.52-0.95). Conclusions: Substantial unmet needs in end-of-life care remain. Continued efforts are needed to improve the quality of end-of-life care.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140119/1/jpm.2015.0039.pd

An investigation of the professed characteristics and backgrounds of women in managerial positions in Guilford County, North Carolina

The primary purpose of this study was to investigate the professed characteristics and backgrounds of women in managerial positions. Two secondary purposes were (a) to determine the extent to which commonalities in perceived attributes, skills, or other characteristics existed in a selected sample of women executives; and (b) to examine the extent to which each commonality may have contributed to career success. The five high-ranking women executives were chosen from manufacturing firms which had headquarters in the Greensboro-Guilford County, North Carolina, area and which employed 1,000 or more persons. The method of gathering data was through personal interviews with each of the five women executives. The data were presented in a written case-study format

Kymatio: Scattering Transforms in Python

The wavelet scattering transform is an invariant signal representation suitable for many signal processing and machine learning applications. We present the Kymatio software package, an easy-to-use, high-performance Python implementation of the scattering transform in 1D, 2D, and 3D that is compatible with modern deep learning frameworks. All transforms may be executed on a GPU (in addition to CPU), offering a considerable speed up over CPU implementations. The package also has a small memory footprint, resulting inefficient memory usage. The source code, documentation, and examples are available undera BSD license at https://www.kymat.io

Patterns and Trends in Chlorophyll-a Concentration and Phytoplankton Phenology in the Biogeographical Regions of Southwestern Atlantic

The Southwestern Atlantic Ocean (SWA), is considered one of the most productive areas of the world, with a high abundance of ecologically and economically important fish species. Yet, the biological responses of this complex region to climate variability are still uncertain. Here, using 24 years of satellite-derived Chl-a data, we classified the SWA into 9 spatially coherent regions based on the temporal variability of Chl-a concentration, as revealed by SOM (Self-Organizing Maps) analysis. These biogeographical regions were the basis of a regional trend analysis in phytoplankton biomass, phenological indices, and environmental forcing variations. A general positive trend in phytoplankton concentration was observed, especially in the highly productive areas of the northern shelf-break, where phytoplankton biomass has increased at a rate of up to 0.42 ± 0.04 mg m−3 per decade. Significant positive trends in sea surface temperature were observed in 4 of the 9 regions (0.08–0.26 °C decade−1) and shoaling of the mixing layer depth in 5 of the 9 regions (−1.50 to −3.36 m decade−1). In addition to the generally positive trend in Chl-a, the most conspicuous change in the phytoplankton temporal patterns in the SWA is a delay in the autumn bloom (between 15 ± 3 and 24 ± 6 days decade−1, depending on the region). The observed variations in phytoplankton phenology could be attributed to climate-induced ocean warming and extended stratification period. Our results provided further evidence of the impact of climate change on these highly productive waters.Fil: Delgado, Ana Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto Argentino de Oceanografía. Universidad Nacional del Sur. Instituto Argentino de Oceanografía; Argentina. Universidad Nacional del Sur. Departamento de Geografía y Turismo; ArgentinaFil: Hernández Carrasco, Ismael. Consejo Superior de Investigaciones Científicas. Instituto Mediterráneo de Estudios Avanzados; EspañaFil: Combes, Vincent. Consejo Superior de Investigaciones Científicas. Instituto Mediterráneo de Estudios Avanzados; España. Universitat de Les Illes Balears; EspañaFil: Font Muñoz, Joan. Consejo Superior de Investigaciones Científicas. Instituto Mediterráneo de Estudios Avanzados; EspañaFil: Pratolongo, Paula Daniela. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Centro de Recursos Naturales Renovables de la Zona Semiárida. Universidad Nacional del Sur. Centro de Recursos Naturales Renovables de la Zona Semiárida; Argentina. Universidad Nacional del Sur. Departamento de Geografía y Turismo; ArgentinaFil: Basterretxea, Gotzon. Consejo Superior de Investigaciones Científicas. Instituto Mediterráneo de Estudios Avanzados; Españ

Late Transitions and Bereaved Family Member Perceptions of Quality of End‐of‐Life Care

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/146458/1/jgs15455.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/146458/2/jgs15455_am.pd