Baseline Assessment of Providers\u27 Perspectives on Integrating Community Health Workers into Primary Care Teams to Improve Diabetes Prevention

• Type 2 Diabetes Mellitus (T2DM) affects 11% of U.S. adults • Additional 35% considered pre-diabetic, at-risk for developing T2DM1 • Bellevue Hospital and the VA NY Harbor Hospital disproportionately affected: 2x the prevalence in the general population, and increasing2 • Only 55% of adults receive recommended preventive services3 • Panel management: each care team is responsible for preventive care, disease management, and acute care of a patient panel • Community health worker (CHW): non-clinical frontline public health professional trained in behavioral counseling, care follow-up, program referrals, and health education4-8 • Come from the community that they serve, so they can offer ongoing social support, key to successful behavior change9-12 • CHW interventions have been shown to improve diabetes outcomes and progression to diabetes13 • Lack of literature on integrating CHWs on a larger scale into a clinical care team • CHORD study: Community Health Outreach to Reduce Diabetes • Randomized controlled intervention trial to assess the efficacy of integrating CHWs into primary care teams at Bellevue and the VA to prevent T2DM in pre-diabetic patients • Present study is a baseline assessment in preparation for the CHORD studyhttps://jdc.jefferson.edu/cwicposters/1036/thumbnail.jp

Lunar Applications of Direct Contact Membrane Distillation For Regolith And Hydroponic Water Processing

Water management has always been a critical issue facing lunar missions, since its uses are as numerous as they are vital. Using ionic liquids has been proposed for the purpose of processing the metal oxides in lunar regolith into oxygen and metals. The process used dilutes the ionic liquid. Recycling the ionic liquid solution after regolith processing is essential to reduce materials required in resupply missions and to supply oxygen. Water will also be needed for lunar farms to both grow food and assist in maintaining a habitable atmosphere. The use of direct contact membrane distillation (DCMD) technology is a method of water purification that was tested for viability in both concentrating ionic liquid streams and in hydroponic salt based nutrient streams. It was found that the ability of PTFE and PVDF based polymer membranes to separate solutes from water held potential in concentrating aqueous solutions and in recovering water from aqueous solutions. This was tested using a bench scale DCMD system to perform the operation at the temperatures of 50 ℃, 65 ℃, and 80 ℃. The results were tested using UV-Visible spectroscopy to determine concentrations. Through this method, the benefits and limitations of PTFE and PVDF membranes were found when operating at various temperatures with either aqueous ionic liquid solution or simulated hydroponic nutrient solutions

Differential expression analysis for multiple conditions

As high-throughput sequencing has become common practice, the cost of sequencing large amounts of genetic data has been drastically reduced, leading to much larger data sets for analysis. One important task is to identify biological conditions that lead to unusually high or low expression of a particular gene. Packages such as DESeq implement a simple method for testing differential signal when exactly two biological conditions are possible. For more than two conditions, pairwise testing is typically used. Here the DESeq method is extended so that three or more biological conditions can be assessed simultaneously. Because the computation time grows exponentially in the number of conditions, a Monte Carlo approach provides a fast way to approximate the $p$-values for the new test. The approach is studied on both simulated data and a data set of {\em C. jejuni}, the bacteria responsible for most food poisoning in the United States

Assessing the Olympics: Preliminary Economic Analysis of a Boston 2024 Games Impacts, Opportunities and Risks

The possibility of hosting the Summer Games is sparking significant debate in our community about the potential benefits, costs, and risks associated with hosting the Olympics. With these debates in mind, the Boston Foundation (TBF) commissioned the Economic and Public Policy Research group (EPPR) at the UMass Donahue Institute (UMDI) to perform a detailed economic impact assessment of Boston's proposed 2024 Olympic bid. While the Boston 2024 proposal is a working document and should be thought of as a "proof of concept" rather than a concrete plan, there are still several components of the proposal that can be evaluated at this time. The following report contributes to the public discourse by providing a preliminary assessment of the quantitative short-term economic impacts of hosting the 2024 Summer Olympic Games in Boston. In addition, this report highlights several of the potential opportunities, challenges, and risks associated with hosting the Olympic Games that are difficult to quantifiably measure at this time, but require further attention as the Olympic bid evolves over the next couple of years

On utility-based super-replication prices of contingent claims with unbounded payoffs

Consider a financial market in which an agent trades with utility-induced restrictions on wealth. For a utility function which satisfies the condition of reasonable asymptotic elasticity at $-\infty$ we prove that the utility-based super-replication price of an unbounded (but sufficiently integrable) contingent claim is equal to the supremum of its discounted expectations under pricing measures with finite {\it loss-entropy}. For an agent whose utility function is unbounded from above, the set of pricing measures with finite loss-entropy can be slightly larger than the set of pricing measures with finite entropy. Indeed, the former set is the closure of the latter under a suitable weak topology. Central to our proof is the representation of a cone $C_U$ of utility-based super-replicable contingent claims as the polar cone to the set of finite loss-entropy pricing measures. The cone $C_U$ is defined as the closure, under a relevant weak topology, of the cone of all (sufficiently integrable) contingent claims that can be dominated by a zero-financed terminal wealth. We investigate also the natural dual of this result and show that the polar cone to $C_U$ is generated by those separating measures with finite loss-entropy. The full two-sided polarity we achieve between measures and contingent claims yields an economic justification for the use of the cone $C_U$, and an open question

Biomechanical Comparison of Wire Circlage and Rigid Plate Fixation for Median Sternotomy Closure in Human Cadaver Specimens

Background: Over 700,000 patients per year undergo open-heart surgery. Healing complication rates can be up to 5% of patients who undergo this procedure, with a morbidity rate of 50% if mediastinitis supervenes. A secure and rigid fixation of surgically divided sternum is critical to avoid healing complications. The purpose of this study was to compare the yield load, construct stiffness, ultimate load, displacement at ultimate load, and post-yield behavior of three sternotomy closure methods (Peristernal wires or Sternalock titanium plates) when stressed in each of three directions: lateral distraction, rostro-caudal (longitudinal) shear distraction, and anterior-posterior (transverse) shear in a cadaveric model. Methods: Forty-two fresh cadaver models were divided into three test groups: group A, B, and C. A cardiothoracic surgeon divided each cadaveric sternum longitudinally and repaired peristernal wires or one of two Sternalock configurations. Tests were performed using a materials testing system that applied force at a constant displacement rate in a uniaxial direction until the construct catastrophically failed. Mechanical behavior was monitored using a 3D texture correlation system to create a real-time three-dimensional representation of strain directions. The resulting displacement pattern is analogous to a finite element contour plot of displacements, Lagrange Strain, or velocity. Statistical analysis was used to show the different mechanical properties of each closure method. Results: When loaded in lateral distraction, both Sternalock configurations surpassed the rigidity of peristernal wires by 600%. Some evidence was also found linking Sternalock with stiffer behavior in the rostro-caudal direction. Though not statistically significant, a trend was observed showing that constructs using the Sternalock also had higher yield loads, as well as, less post-yield displacement when compared to peristernal wires. Conclusions: Data gathered showed the superior performance of the Sternalock system in stiffness in both longitudinal distraction and rostro-caudal shear. Implications for use of the Sternalock system are faster healing times, lower complication rates, and success of the procedure

Deterministic Domain Wall Motion Orthogonal To Current Flow Due To Spin Orbit Torque.

Spin-polarized electrons can move a ferromagnetic domain wall through the transfer of spin angular momentum when current flows in a magnetic nanowire. Such current induced control of a domain wall is of significant interest due to its potential application for low power ultra high-density data storage. In previous reports, it has been observed that the motion of the domain wall always happens parallel to the current flow - either in the same or opposite direction depending on the specific nature of the interaction. In contrast, here we demonstrate deterministic control of a ferromagnetic domain wall orthogonal to current flow by exploiting the spin orbit torque in a perpendicularly polarized Ta/CoFeB/MgO heterostructure in presence of an in-plane magnetic field. Reversing the polarity of either the current flow or the in-plane field is found to reverse the direction of the domain wall motion. Notably, such orthogonal motion with respect to current flow is not possible from traditional spin transfer torque driven domain wall propagation even in presence of an external magnetic field. Therefore the domain wall motion happens purely due to spin orbit torque. These results represent a completely new degree of freedom in current induced control of a ferromagnetic domain wall

Optimal Mass Configurations for Lensing High-Redshift Galaxies

We investigate the gravitational lensing properties of lines of sight containing multiple cluster-scale halos, motivated by their ability to lens very high-redshift (z ~ 10) sources into detectability. We control for the total mass along the line of sight, isolating the effects of distributing the mass among multiple halos and of varying the physical properties of the halos. Our results show that multiple-halo lines of sight can increase the magnified source-plane region compared to the single cluster lenses typically targeted for lensing studies, and thus are generally better fields for detecting very high-redshift sources. The configurations that result in optimal lensing cross sections benefit from interactions between the lens potentials of the halos when they overlap somewhat on the sky, creating regions of high magnification in the source plane not present when the halos are considered individually. The effect of these interactions on the lensing cross section can even be comparable to changing the total mass of the lens from 10^15 M_sun to 3x10^15 M_sun. The gain in lensing cross section increases as the mass is split into more halos, provided that the lens potentials are projected close enough to interact with each other. A nonzero projected halo angular separation, equal halo mass ratio, and high projected halo concentration are the best mass configurations, whereas projected halo ellipticity, halo triaxiality, and the relative orientations of the halos are less important. Such high mass, multiple-halo lines of sight exist in the SDSS.Comment: Accepted for publication in ApJ; emulateapj format; 24 pages, 13 figures, 1 table; plots updated to reflect erratu

Thermochemistry of Alane Complexes for Hydrogen Storage: A Theoretical and Experimental Investigation.

Knowledge of the relative stabilities of alane (AlH(3)) complexes with electron donors is essential for identifying hydrogen storage materials for vehicular applications that can be regenerated by off-board methods; however, almost no thermodynamic data are available to make this assessment. To fill this gap, we employed the G4(MP2) method to determine heats of formation, entropies, and Gibbs free energies of formation for 38 alane complexes with NH(3-n)R(n) (R = Me, Et; n = 0-3), pyridine, pyrazine, triethylenediamine (TEDA), quinuclidine, OH(2-n)R(n) (R = Me, Et; n = 0-2), dioxane, and tetrahydrofuran (THF). Monomer, bis, and selected dimer complex geometries were considered. Using these data, we computed the thermodynamics of the key formation and dehydrogenation reactions that would occur during hydrogen delivery and alane regeneration, from which trends in complex stability were identified. These predictions were tested by synthesizing six amine-alane complexes involving trimethylamine, triethylamine, dimethylethylamine, TEDA, quinuclidine, and hexamine and obtaining upper limits of ΔG° for their formation from metallic aluminum. Combining these computational and experimental results, we establish a criterion for complex stability relevant to hydrogen storage that can be used to assess potential ligands prior to attempting synthesis of the alane complex. On the basis of this, we conclude that only a subset of the tertiary amine complexes considered and none of the ether complexes can be successfully formed by direct reaction with aluminum and regenerated in an alane-based hydrogen storage system