Evaluation of the Pathways Palliative Care Program at the Denver Hospice

As the patterns of morbidity and mortality in the United States shift toward chronic illness requiring the need for quality continuous care over extended periods of time, more research has been devoted to end-of-life care. The purpose of this study was to evaluate the Pathways palliative care program at the Denver Hospice as seen through the eyes of patient caregivers. Nine caregivers were interviewed in order to determine their perceptions of the Pathways program and a thematic analysis of their responses was performed. Results of the thematic analysis, as confirmed by a second reviewer, yielded very positive feelings towards the Pathways program (Cohen’s Kappa = 0.862). Respondents continually stated a deep sense of having a burden lifted with the knowledge that help as a phone call away and that the help would come quickly, and this peace of mind prevented the majority of the caregivers from helplessly taking their loved one to the emergency room. Overall, all nine of the caregivers were very impressed with the Pathways program, and in particular, the Pathways staff

Software for the frontiers of quantum chemistry:An overview of developments in the Q-Chem 5 package

This article summarizes technical advances contained in the fifth major release of the Q-Chem quantum chemistry program package, covering developments since 2015. A comprehensive library of exchange–correlation functionals, along with a suite of correlated many-body methods, continues to be a hallmark of the Q-Chem software. The many-body methods include novel variants of both coupled-cluster and configuration-interaction approaches along with methods based on the algebraic diagrammatic construction and variational reduced density-matrix methods. Methods highlighted in Q-Chem 5 include a suite of tools for modeling core-level spectroscopy, methods for describing metastable resonances, methods for computing vibronic spectra, the nuclear–electronic orbital method, and several different energy decomposition analysis techniques. High-performance capabilities including multithreaded parallelism and support for calculations on graphics processing units are described. Q-Chem boasts a community of well over 100 active academic developers, and the continuing evolution of the software is supported by an “open teamware” model and an increasingly modular design

A multi-year analysis of Canadian Arctic historical weather data in support of solar and wind renewable energy deployment

This work explores the importance of renewable resource temporal distribution for solar and wind energy deployment in Arctic communities to meet building and ancillary loads. An analysis of ten years of historic weather data was performed for six locations in the Canadian Arctic to assess renewable resource variation. Simulations of similar capacity solar and wind generation systems were then coupled with the historic data to compare and contrast generation potential. This analysis highlighted the importance of considering hourly, daily, monthly, and year-to-year renewable generation when deploying solar and wind to the Arctic. As many northern communities in Canada have local electricity generation and distribution systems, and no connection to the continental grid, managing grid interactions effectively is crucial to the success of deployment, integration, and operation. The results for the solar energy analysis showed high consistency of production year-to-year. The results for the wind energy analysis showed that the annual outputs have significantly less variation than the year-to-year output of individual months for all the locations under study. For the high latitude locations studied, solar energy can still provide useful electricity generation output, but the more pronounced bias of the annual output to the summer months can leave several months with little or no output. The use of additional renewable sources is crucial in beginning to transition some electricity generating capacity within Arctic communities from being solely reliant on fossil fuels

Release of cclib version 1.4

This is an archive of the source code for cclib version 1.4, orginally released on github (https://github.com/cclib/cclib/releases/tag/v1.4)

The Antidepressant Drugs Fluoxetine and Duloxetine Produce Anxiolytic-Like Effects in a Schedule-Induced Polydipsia Paradigm in Ratsenhancement of Fluoxetine\u27s Effects by the Α2 Adrenoceptor Antagonist Yohimbine

Similar to the time-course for treating depression, several weeks of administration are required for serotonin (5-HT) reuptake inhibitors to produce anxiolytic effects. Previous studies with the schedule-induced polydipsia paradigm (a putative preclinical anxiety model) have shown that repeated administration of antidepressant drugs is necessary to produce a suppression of polydipsia, which is interpreted as an anxiolytic-like effect. The present study sought to expand past findings by evaluating the selective 5-HT reuptake inhibitor (SSRI) fluoxetine and the 5-HT-norepinephrine reuptake inhibitor duloxetine in the schedule-induced polydipsia paradigm with rats. Dose combinations of the α2 adrenoceptor antagonist yohimbine with fluoxetine were also explored to determine whether α 2 adrenoceptor antagonism could enhance the anxiolytic-like effects produced by an SSRI. Fluoxetine and duloxetine significantly reduced water intake over the course of daily administrations. Daily treatment with the combination of fluoxetine and yohimbine produced a significantly greater reduction in water intake than fluoxetine alone. The present results confirmed previous findings that inhibition of 5-HT reuptake reduces water consumption in this paradigm. The results for the α 2 antagonist yohimbine (in combination with fluoxetine) also indicate that α2 adrenoceptor antagonism may significantly enhance anxiolytic-like effects of SSRIs

Release of cclib version 1.5

<p>This is an archive of the source code for cclib version 1.5, orginally released on github (https://github.com/cclib/cclib/releases/tag/v1.5).</p

Masse inguinale révélatrice d’une complication d’une arthroplastie totale de hanche

Résumé La bourse de l'iliopsoas est située juste en avant de l'articulation de la hanche. La communication existant parfois entre la hanche prothésée et la bourse de l'iliopsoas peut, en permettant la formation d'une masse inguinale par distension de cette bourse, être révélatrice de la complication d'une arthroplastie totale de hanche. Nous présentons cinq cas cliniques de patients porteurs d'une prothèse totale de hanche pour lesquels l'apparition d'une masse dans le trigone fémoral de Scarpa était toujours corrélée à une défaillance de l'articulation prothésée. Nous avons choisi de ne pas réséquer la masse kystique, et de ne traiter que sa cause intra-articulaire. La symptomatologie a disparu après l'intervention dans tous les cas. Il faut savoir évoquer cette pathologie rare devant la palpation d'une tuméfaction inguinale ou devant son retentissement local, notamment veino-lymphatique. L'arthro-tomodensitométrie montre la masse et ses rapports anatomiques. Les complications prothétiques sont l'infection, le descellement ou l'usure. Le bilan étiologique comprend des examens biologiques, notamment pour la détection de l'infection, et des radiographies simples de hanche. Avant la chirurgie, l'échographie Doppler est systématique recherchant une complication thromboembolique. The iliopsoas bursa is situated immediately anterior to the hip joint. Communication can develop between a hip prosthesis and the iliopsoas bursa leading to distension and formation of an inguinal mass revealing complication of total hip arthroplasty. We report five clinical cases. The five patients with a total hip arthroplasty developed a mass in the Scarpa triangle which correlated with defective prosthesis function. We chose not to dissect the cystic mass but to treat the intra-articular cause. Symptoms resolved after the intervention in all cases. This rare condition should be envisioned if an inguinal mass develops or has a functional impact, particularly on the lymphovenous circulation. Anatomic relations can be distinguished with computed tomography. Prosthetic complications include infection, loosening or wear. The work-up should include search for infection and standard x-rays of the hip joint. Before surgery, duplex Doppler should be performed systematically to search for a thromboembolic complication

Once-daily prolonged release tacrolimus in liver transplantation: Experts' literature review and recommendations

International audienceThe efficacy and safety of tacrolimus (Tac) twice daily (bid) and once a day (qd) formulations are considered to be similar. However, the available information regarding initiation of Tac qd is sparse, and practical information is lacking. On the basis of a literature review, clinical efficacy, and safety trials, French experts in the liver transplantation field were asked to highlight pharmacokinetic (PK) differences between both formulations to assess efficacy and safety of the qd formulation in the context of de novo initiation or conversion and to provide their recommendations for initiation and day-to-day management of Tac qd. The same efficacy and safety profile is found for both immediate-release and prolonged-release Tac. PK differences carry on absorption because of the difference in formulations but not on metabolism or excretion. Tac qd offers a better reproducibility in exposure than Tac bid but is associated with an increased risk of disturbed absorption in case of a change in intestinal motility. The same therapeutic drug monitoring with Tac qd and bid could be applied, based on minimal concentration (trough level; Cmin ), as there is a similar strong correlation between Cmin and the area under the curve (AUC) for both formulations. Different protocols for Tac qd initiation were described through numerous studies, except for early conversion: initiation on day 0, using 0.10 to 0.20 mg/kg/day as monotherapy, or lower dosages in case of concomitant immunosuppressant treatment or poor graft quality; early conversion from day 5 to 6 months, preferably before hospital discharge, using a 1 to 1.3 mg/kg/day schedule and with first Cmin assessment 48 hours after the conversion; and later conversion (\textgreater6 months posttransplantation) using a milligram-to-milligram dosage schedule, and with dose adjustment based on weekly Cmin measurement. Experts underline that an increase in treatment adherence was expected using Tac qd in liver recipients. In conclusion, Tac qd has the same efficacy and safety profile as Tac bid. De novo introduction or later conversion are well documented but could differ from day-to-day practice. Liver Transpl 21:1312-1321, 2015. © 2015 AASL