Varying the Time Delay of an Action Potential Elicited with a Neural-Electronic Stimulator

There have been various theoretical and experimental studies presented in the literature that focus on interfacing neurons with discrete electronic devices such as transistors. It has also been demonstrated experimentally that neural-electronic devices can be used to elicit action potentials in a target neuron in close proximity to the neural-electronic stimulator. The time delay between stimulus and the onset of the neural action potential can be varied by varying the pulse amplitude and width generated by the neural-electronic stimulator (transistor)

Health Care Reform: Why Not Best Practices?

The passage of the Affordable Care Act (“ACA” or “Obamacare”) in 2010 promises to bring about significant changes in the way that health care is provided and paid for in the United States of America (USA). Supporters of ACA point to a 2000 WHO study of worldwide health care systems in which the USA ranked 37th as justification for proposed changes, and many of them have expressed a preference for ultimately implementing a single-payer or single-provider system (such as currently exists in Canada or the United Kingdom). Detractors, who generally label the act Obamacare, have expressed concerns about whether the act can achieve its stated objectives, whether it represents a negative step instead of a positive one, and whether the ultimate goal of a single-payer or single-provider system is desirable one or even an achievable one. In the context of the ongoing debate over health care in the USA, this paper reviews the WHO study and subsequent comparative analyses of world health care systems to address the following questions:Does the USA really have the 37th best health care system in the world?Does either a “single-payer” health care system or a “single-provider” health care system offer prospects for significant improvement?What model or models for delivery of health care services represent “best practices” and how can and should they be emulated?

The Emergence of Behavioral Addiction in DSM-5

The release of the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has sparked continuous debate about the structure, organization, and inclusion or exclusion of mental disorders. The term addiction made its first appearance in the manual with the category of Substance-Related and Addictive Disorders, after much anticipation from mental health professionals. With the emergence of behavioral (process) addictions in the diagnostic manual such as gambling disorder, it is likely that other mental disorders with similar features will follow suit. Speculation about other behaviors that could potentially be addictive includes Internet use, sex, shopping, exercise, and compulsive eating, among others. The goal of the current review is twofold: to explain the concept of behavioral addictions, including a focus on gambling and Internet gaming disorders, and to discuss how the emergence of process addictions may influence the work of human services practitioners. Clinical implications within the human services profession are also discussed

Distance Supervision in Human Services

As the use of technology increases, there are more opportunities for students and human service professionals to participate in education and supervision remotely. Distance supervision has become increasingly popular in the field of human services, providing educators and practitioners with new methods of professional communication. However, the use of technology in supervision also poses unique challenges for human service professionals and requires additional ethical considerations. The following will address the above points as well as review both asynchronous and synchronous delivery methods for distance learning supervision and their utility for providing supervision in the field of human services

Impact of the SPOP Mutant Subtype on the Interpretation of Clinical Parameters in Prostate Cancer.

Purpose: Molecular characterization of prostate cancer, including The Cancer Genome Atlas, has revealed distinct subtypes with underlying genomic alterations. One of these core subtypes, SPOP (speckle-type POZ protein) mutant prostate cancer, has previously only been identifiable via DNA sequencing, which has made the impact on prognosis and routinely used risk stratification parameters unclear. Methods: We have developed a novel gene expression signature, classifier (Subclass Predictor Based on Transcriptional Data), and decision tree to predict the SPOP mutant subclass from RNA gene expression data and classify common prostate cancer molecular subtypes. We then validated and further interrogated the association of prostate cancer molecular subtypes with pathologic and clinical outcomes in retrospective and prospective cohorts of 8,158 patients. Results: The subclass predictor based on transcriptional data model showed high sensitivity and specificity in multiple cohorts across both RNA sequencing and microarray gene expression platforms. We predicted approximately 8% to 9% of cases to be SPOP mutant from both retrospective and prospective cohorts. We found that the SPOP mutant subclass was associated with lower frequency of positive margins, extraprostatic extension, and seminal vesicle invasion at prostatectomy; however, SPOP mutant cancers were associated with higher pretreatment serum prostate-specific antigen (PSA). The association between SPOP mutant status and higher PSA level was validated in three independent cohorts. Despite high pretreatment PSA, the SPOP mutant subtype was associated with a favorable prognosis with improved metastasis-free survival, particularly in patients with high-risk preoperative PSA levels. Conclusion: Using a novel gene expression model and a decision tree algorithm to define prostate cancer molecular subclasses, we found that the SPOP mutant subclass is associated with higher preoperative PSA, less adverse pathologic features, and favorable prognosis. These findings suggest a paradigm in which the interpretation of common risk stratification parameters, particularly PSA, may be influenced by the underlying molecular subtype of prostate cancer

A Randomized Trial Examining Preoperative Sedative Medication and Post-operative Sleep in Children

Study Objective Midazolam has been found to have beneficial effects on anxiety in children in the preoperative setting. Prior studies have examined various postoperative behaviors of children, but little research has examined the effects of preoperative use of midazolam with postoperative sleep. The purpose of this investigation was to compare postoperative sleep in children as a function of preoperative sedative medication use. Design This study was a 2-group randomized controlled trial. Setting Participants were recruited from Yale-New Haven Children\u27s Hospital. Patients Participants included a convenience sample of 70 children between the ages of 3 to 12 years undergoing ambulatory tonsillectomy and adenoidectomy. Interventions Children were randomly assigned to 1 of 2 groups: a control group who received preoperative acetaminophen only (n = 32) and an experimental group who received both acetaminophen and midazolam preoperatively (n = 38). Measurements Parents completed measures of postoperative behavioral recovery and a subset of children wore actigraphs to examine objective sleep data. Main Results Children who received midazolam experienced similar sleep changes compared to children in the control group. The actigraph data revealed that children who received midazolam were awake significantly less during the night compared to the control group (P= .01). Conclusion Children who received midazolam before surgery had similar postoperative sleep changes compared to children who did not receive midazolam. Further understanding of the postoperative behavioral effects of midazolam on children will help guide healthcare providers in their practice

Quark Masses: An Environmental Impact Statement

We investigate worlds that lie on a slice through the parameter space of the Standard Model over which quark masses vary. We allow as many as three quarks to participate in nuclei, while fixing the mass of the electron and the average mass of the lightest baryon flavor multiplet. We classify as "congenial" worlds that satisfy the environmental constraint that the quark masses allow for stable nuclei with charges one, six, and eight, making organic chemistry possible. Whether a congenial world actually produces observers depends on a multitude of historical contingencies, beginning with primordial nucleosynthesis, which we do not explore. Such constraints may be independently superimposed on our results. Environmental constraints such as the ones we study may be combined with information about the a priori distribution of quark masses over the landscape of possible universes to determine whether the measured values of the quark masses are determined environmentally, but our analysis is independent of such an anthropic approach. We estimate baryon masses as functions of quark masses and nuclear masses as functions of baryon masses. We check for the stability of nuclei against fission, strong particle emission, and weak nucleon emission. For two light quarks with charges 2/3 and -1/3, we find a band of congeniality roughly 29 MeV wide in their mass difference. We also find another, less robust region of congeniality with one light, charge -1/3 quark, and two heavier, approximately degenerate charge -1/3 and 2/3 quarks. No other assignment of light quark charges yields congenial worlds with two baryons participating in nuclei. We identify and discuss the region in quark-mass space where nuclei would be made from three or more baryon species.Comment: 40 pages, 16 figures (in color), 4 tables. See paper for a more detailed abstract. v4: Cleaning up minor typo