B743: Primary Health Care and the Developmentally Disabled: An Analysis of the Normalization Principle in the State of Maine

At the time of publication, there existed an estimated group of 10 million American people defined as developmentally disabled. Stimulated in part by the often observed dehumanizing environment of institutional arrangement for the mentally disabled, the search for more humane treatment and management alternative has pointed in the direction of what has been termed \u27 normalization. In 1969, the Danish Mental Retardation Service defined normalization as \u27\u27 letting the mentally retarded obtain an existence as close to normal as possible. The focus of this study is on barriers to the normalization principle in the provision of primary health care to the developmentally disabled in the State of Maine. Possible barriers include attitudes toward the developmentally disabled, accessibility and quality of community based services, and lack of viable coordination mechanisms. Since 1971, the Maine Department of Mental Health and Corrections has made a concerted effort to encourage services based upon the principle of normalization. As pressures for normalization intensify, it seems warranted that those community-based structures which carry out the concept be examined as to their receptivity and the feasibility of further efforts in this direction. Although the principle of normalization has demonstrated its usefulness and potential, it is not without its limitations (Mesibov 1976). This study made no attempt to examine these limitations of the principle itself.https://digitalcommons.library.umaine.edu/aes_bulletin/1127/thumbnail.jp

Ventricular Tachycardia Precipitated by Short-long-short Sequence in a Patient with Implantable-cardioverter Defibrillator

Abrupt changes in heart rate, particularly short-long-short sequences in the ventricular cycle length (CL), might precede initiation of ventricular tachycardia/fibrillation (VT/VF). These changes may be facilitated or caused by pacing activity in patients with pacemakers or implantable-cardioverter defibrillators (ICDs). We describe a patient with two episodes of acquired VT precipitated by short-long-short sequences and diagnosed from the ICD recordings. In such cases, the knowledge of the device parameters is extremely important for a correct diagnosis and management

Assessment of changes in the national surveillance data for adult and pediatric VAE during the COVID-19 pandemic in hospitals

Background: Among US acute-care hospitals (ACHs) reporting to the NHSN, significant increases in the incidence of Ventilator-Associated Events (VAEs) were observed during the COVID-19 pandemic years in comparison with 2019. We assessed changes in the national event-level VAE data, including the incidence of specific event-types: Ventilator-Associated Condition (VAC), Infection-related Ventilator-Associated Complication (IVAC) and Possible Ventilator-Associated Pneumonia (PVAP). We also examined changes in associated pathogens, and we evaluated incidence density rates (IDRs) of pediatric VAE (PedVAE) before and during the pandemic years. Methods: We analyzed data on VAE and PedVAE reported to NHSN between 2019 through the second quarter of 2022 (2022Q2) in ACHs. Annual proportions of VAC, IVAC, or PVAP were calculated; changes versus 2019 were assessed. The 10 most common PVAP pathogens reported annually were examined, and the percentages and ranks for each were calculated. Among pediatric and neonatal locations, PedVAE IDR were calculated as the number of events per 1,000 ventilator days and were compared between the pre-pandemic and pandemic years. All comparisons were conducted using a mid-P exact test, and P<0.05 was considered statistically significant. Results: Between 1,266 - 1,357 ACHs reported VAE data each year. A total of 24,836 (2019), 37,592 (2020), and 50,362 (2021) VAEs were reported. The proportion of VAC events in 2020 (64.1%) was significantly higher than in 2019 (62.9%), while the 2020 and 2021 PVAP proportions (8.7% and 9.2%, respectively) were significantly lower than in 2019 (10.0%). The majority of VAEs were reported from the same location types annually. The top 3 PVAP pathogens reported for each year remained unchanged: Staphylococcus aureus, Pseudomonas aeruginosa, Klebsiella. However, the proportion identified as Haemophilus influenzae decreased significantly each year from 2019-2021, with the rank dropping from #5 in 2019 (6.6%) to #10 in 2021 (2.3%). Between 199 – 257 ACHs conducted PedVAE surveillance. PedVAE IDR were significantly lower in 2020 (0.8), 2021 (1.1), and the first half of 2022 (0.8) when compared to 2019 (1.3). Conclusions: This study provides a national view of specific VAEs before and during the COVID-19 pandemic. Some changes in the associated pathogens, and the proportions of VAC and PVAP, were observed. This study is the first to produce national benchmarks for PedVAE IDR. Additional ACHs conducting PedVAE surveillance in NHSN would improve the representativeness of our results

Prevention beats removal: avoiding stripe artifacts from current variation in particle beam microscopy through time-resolved sensing

Accepted manuscrip

Robustness of time- resolved measurement to unknown and variable beam current in particle beam microscopy

Variations in the intensity of the incident beam can cause significant inaccuracies in microscopes that use focused beams of electrons or ions. Existing mitigation methods depend on the artifacts having characteristic spatial structures explained by the raster scan pattern and temporal correlation of the beam current variations. We show that recently introduced time-resolved measurement methods create robustness to beam current variations that improve significantly upon existing methods while not depending on separability of artifact structure from underlying image content. These advantages are illustrated through Monte Carlo simulations representative of both helium ion microscopy (higher secondary electron yield) and scanning electron microscopy (lower secondary electron yield). Notably, this demonstrates that when the beam current variation is appreciable, time-resolved measurements provide a novel benefit in particle beam microscopy that extends to low secondary electron yields.Draper Laboratory, Inc.; CCF-1815896 - National Science FoundationAccepted manuscrip

Addressing neon gas field ion source instability through online beam current estimation

CCF-1815896 - National Science Foundation; Draper Laboratory, Inc.Accepted manuscrip

Online beam current estimation in particle beam microscopy

Accepted manuscrip

Online beam current estimation in particle beam microscopy through time-resolved measurement

Draper Laboratory, Inc.; CCF-1815896 - National Science FoundationAccepted manuscrip

Robustness of time-resolved measurement to unknown and variable beam current in particle beam microscopy

Variations in the intensity of the incident beam can cause significant inaccuracies in microscopes that use focused beams of electrons or ions. Existing mitigation methods depend on the artifacts having characteristic spatial structures explained by the raster scan pattern and temporal correlation of the beam current variations. We show that recently introduced time-resolved measurement methods create robustness to beam current variations that improve significantly upon existing methods while not depending on separability of artifact structure from underlying image content. These advantages are illustrated through Monte Carlo simulations representative of both helium ion microscopy (higher secondary electron yield) and scanning electron microscopy (lower secondary electron yield). Notably, this demonstrates that when the beam current variation is appreciable, time-resolved measurements provide a novel benefit in particle beam microscopy that extends to low secondary electron yields.Accepted manuscrip

An increase in dietary n-3 fatty acids decreases a marker of bone resorption in humans

Human, animal, and in vitro research indicates a beneficial effect of appropriate amounts of omega-3 (n-3) polyunsaturated fatty acids (PUFA) on bone health. This is the first controlled feeding study in humans to evaluate the effect of dietary plant-derived n-3 PUFA on bone turnover, assessed by serum concentrations of N-telopeptides (NTx) and bone-specific alkaline phosphatase (BSAP). Subjects (n = 23) consumed each diet for 6 weeks in a randomized, 3-period crossover design: 1) Average American Diet (AAD; [34% total fat, 13% saturated fatty acids (SFA), 13% monounsaturated fatty acids (MUFA), 9% PUFA (7.7% LA, 0.8% ALA)]), 2) Linoleic Acid Diet (LA; [37% total fat, 9% SFA, 12% MUFA, 16% PUFA (12.6% LA, 3.6% ALA)]), and 3) α-Linolenic Acid Diet (ALA; [38% total fat, 8% SFA, 12% MUFA, 17% PUFA (10.5% LA, 6.5% ALA)]). Walnuts and flaxseed oil were the predominant sources of ALA. NTx levels were significantly lower following the ALA diet (13.20 ± 1.21 nM BCE), relative to the AAD (15.59 ± 1.21 nM BCE) (p < 0.05). Mean NTx level following the LA diet was 13.80 ± 1.21 nM BCE. There was no change in levels of BSAP across the three diets. Concentrations of NTx were positively correlated with the pro-inflammatory cytokine TNFα for all three diets. The results indicate that plant sources of dietary n-3 PUFA may have a protective effect on bone metabolism via a decrease in bone resorption in the presence of consistent levels of bone formation