Integrating Sleep Promotion Education into Acute Care Orthopedics Occupational Therapy Practice: A Case Series Study

Background: The occupation of sleep is frequently under-addressed by occupational therapists with their clients. This may be in part because of a lack of general training on addressing this occupational domain or a lack of education about the basics of sleep. The domain of sleep has been in the Occupational Therapy Practice Framework since 2008. However, it remains unclear how to address the domain of sleep in occupational therapy practice. Therefore, the purpose of this case series is to describe the practical application of sleep promotion education. Methods: A practicing occupational therapist with sleep training provided sleep promotion education to five clients following an orthopedic surgery in an acute care setting. A client interview was performed to gather sleep concerns and inform specific content of the sleep promotion education. The clients were asked their motivation, satisfaction, and likelihood to use the education. Results: A detailed description of each client and how the education was tailored is provided in conjunction with the occupational therapist response to concerns. Overall, the clients reported that sleep promotion education was useful, satisfying, and that they were likely to use the education. Conclusions: This case series describes the practical application of sleep promotion education in occupational therapy practice in an acute care setting

Analytical uncertainty propagation for multi-period stochastic optimal power flow

The increase in renewable energy sources (RESs), like wind or solar power, results in growing uncertainty also in transmission grids. This affects grid stability through fluctuating energy supply and an increased probability of overloaded lines. One key strategy to cope with this uncertainty is the use of distributed energy storage systems (ESSs). In order to securely operate power systems containing renewables and use storage, optimization models are needed that both handle uncertainty and apply ESSs. This paper introduces a compact dynamic stochastic chance-constrained DC optimal power flow (CC-OPF) model, that minimizes generation costs and includes distributed ESSs. Assuming Gaussian uncertainty, we use affine policies to obtain a tractable, analytically exact reformulation as a second-order cone problem (SOCP). We test the new model on five different IEEE networks with varying sizes of 5, 39, 57, 118 and 300 nodes and include complexity analysis. The results show that the model is computationally efficient and robust with respect to constraint violation risk. The distributed energy storage system leads to more stable operation with flattened generation profiles. Storage absorbed RES uncertainty, and reduced generation cost

Breast Cancer Diagnosed During Pregnancy

Background: Pregnancy-associated breast cancers are cancers diagnosed during pregnancy or within 1 year of delivery. It is rare, occurring in 2.5-7.5/100,000, but these numbers continue to rise as maternal age increases. As a result, prospective studies evaluating diagnosis and treatment are limited. Case Description: Patient is a P1G0 35 yo woman who presented with a new breast mass at 26 wga. Diagnostic workup including core biopsy revealed invasive ductal carcinoma, ER 70%, PR 40%, her-2 negative. After multidisciplinary discussion with the breast team and the patient’s obstetrician, the patient underwent mastectomy with sentinel node biopsy at 28 wga. Pathology showed a 1.9 cm tumor with 5 negative sentinel nodes. Genomic evaluation of her tumor using 21-gene recurrence score revealed significant risk of distant recurrence without chemotherapy. Patient will initiate chemotherapy after delivery. Conclusion: The treatment regimen should be as close to standard of care as possible for a non-pregnant woman with the same cancer. Diagnostic workup should include ultrasound and possible mammogram with shielding of the fetus. Core biopsy can provide definitive diagnosis. Surgery is the mainstay of treatment during pregnancy, and decisions regarding breast conservation are dependent on gestational age at presentation. Adjuvant treatments can be performed with modifications and avoidance of radiotherapy during pregnancy. Decisions regarding treatment require multidisciplinary input between the oncology and obstetric teams to provide effective care with minimal toxicity to the fetus. Clinical Significance: Physiological changes of the breast during pregnancy make diagnosis of new breast cancer difficult. Furthermore, lack of diagnostic suspicion delays diagnosis. Further research is needed to determine the best diagnostic and therapeutic methods to ensure the best prognosis for mother and baby as the prevalence of breast cancer during pregnancy continues to rise

Sleep quality in the chronic stage of concussion is associated with poorer recovery: A systematic review

A grant from the One-University Open Access Fund at the University of Kansas was used to defray the author's publication fees in this Open Access journal. The Open Access Fund, administered by librarians from the KU, KU Law, and KUMC libraries, is made possible by contributions from the offices of KU Provost, KU Vice Chancellor for Research & Graduate Studies, and KUMC Vice Chancellor for Research. For more information about the Open Access Fund, please see http://library.kumc.edu/authors-fund.xml.Background Recovery from a concussion varies based on a multitude of factors. One such factor is sleep disturbances. In our prior review, it was observed that in the acute phase, sleep disturbances are predictive of poor outcomes following a concussion. The literature gap remains on how sleep in the chronic phase of recovery affects outcomes. Objective To examine the association between sleep quality during the chronic stage of concussion and post-concussion outcomes. Literature Survey: Literature searches were performed during 1 July to 1 August 2019 in selected databases along with searching grey literature. Out of the 733 results, 702 references were reviewed after duplicate removal. Methods Three reviewers independently reviewed and consented on abstracts meeting eligibility criteria (n = 35). The full-text articles were assessed independently by two reviewers. Consensus was achieved, leaving four articles. Relevant data from each study was extracted using a standard data-extraction table. Quality appraisal was conducted to assess potential bias and the quality of articles. Results One study included children (18–60 months) and three studies included adolescents and/or adults (ranging 12–35 years). The association between sleep and cognition (two studies), physical activity (one study), and emotion symptoms (one study) was examined. Sleep quality was associated with decreased cognition and emotional symptoms, but not with meeting physical activity guidelines six months post-concussion injury. Conclusions The heterogeneity in age of participants and outcomes across studies and limited number of included studies made interpretations difficult. Future studies may consider if addressing sleep quality following concussion will improve outcomes

Новий словник епітетів української мови

У статті йдеться про засади створення «Нового словника епітетів української мови» (автори С. П. Бибик, С. Я. Єрмоленко, В. І. Єрмоленко). Словник значно доповнено за рахунок нових заголовкових слів та збільшення кількості узгоджених означень до всіх заголовкових слів. Розширено сполучуваність заголовкових іменників із прикметниковими словам. Нова структура словникової статті виокремлює епітети, що вживаються в структурі порівняння, а також епітети у структурі метафори

Adversarial Scrutiny of Evidentiary Statistical Software

The U.S. criminal legal system increasingly relies on software output to convict and incarcerate people. In a large number of cases each year, the government makes these consequential decisions based on evidence from statistical software -- such as probabilistic genotyping, environmental audio detection, and toolmark analysis tools -- that defense counsel cannot fully cross-examine or scrutinize. This undermines the commitments of the adversarial criminal legal system, which relies on the defense's ability to probe and test the prosecution's case to safeguard individual rights. Responding to this need to adversarially scrutinize output from such software, we propose robust adversarial testing as an audit framework to examine the validity of evidentiary statistical software. We define and operationalize this notion of robust adversarial testing for defense use by drawing on a large body of recent work in robust machine learning and algorithmic fairness. We demonstrate how this framework both standardizes the process for scrutinizing such tools and empowers defense lawyers to examine their validity for instances most relevant to the case at hand. We further discuss existing structural and institutional challenges within the U.S. criminal legal system that may create barriers for implementing this and other such audit frameworks and close with a discussion on policy changes that could help address these concerns.Comment: Typos corrected, appendix B remove

Postfledging Survival, Movements, and Dispersal of Ring Ouzels (Turdus torquatus)

We thank Invercauld Estate for cooperation with access to Glen Clunie. S. Redpath, J. Wilson, and S. Roos provided valuable comments on the manuscript. This study was funded by the Royal Society for the Protection of Birds, Scottish Natural Heritage, and the Cairngorms National Park Authority. J.L.L. was supported by the Natural Environment Research Council.Peer reviewedPublisher PD

Interfacial and Foaming Properties of Tailor-Made Glycolipids—Influence of the Hydrophilic Head Group and Functional Groups in the Hydrophobic Tail

Glycolipids are a class of biodegradable surfactants less harmful to the environment than petrochemically derived surfactants. Here we discuss interfacial properties, foam stability, characterized in terms of transient foam height, gas volume fraction and bubble diameter as well as texture of seven enzymatically synthesized surfactants for the first time. Glycolipids consisting of different head groups, namely glucose, sorbitol, glucuronic acid and sorbose, combined with different C10 acyl chains, namely decanoate, dec-9-enoate and 4-methyl-nonanoate are compared. Equilibrium interfacial tension values vary between 24.3 and 29.6 mN/m, critical micelle concentration varies between 0.7 and 3.0 mM. In both cases highest values were found for the surfactants with unsaturated or branched tail groups. Interfacial elasticity and viscosity, however, were significantly reduced in these cases. Head and tail group both affect foam stability. Foams from glycolipids with sorbose and glucuronic acid derived head groups showed higher stability than those from surfactants with glucose head group, sorbitol provided lowest foam stability. We attribute this to different head group hydration also showing up in the time to reach equilibrium interfacial adsorption. Unsaturated tail groups reduced whereas branching enhanced foam stability compared to the systems with linear, saturated tail. Moreover, the tail group strongly influences foam texture. Glycolipids with unsaturated tail groups produced foams quickly collapsing even at smallest shear loads, whereas the branched tail group yielded a higher modulus than the linear tails. Normalized shear moduli for the systems with different head groups varied in a narrow range, with the highest value found for decylglucuronat