West Virginia Oral Health Initiative, Executive Summary

The West Virginia Oral Health Initiative began in 2008 and is anchored in improving the oral health status of West Virginia residents through public awareness, provider training, dental screenings, and access to dental care. The initiative began in 2008 and is anchored in improving the oral health status of West Virginia residents through public awareness, provider training, dental screenings, and access to dental care.In March 2015, leaders of the initiative and representatives of The Benedum Foundation gathered to discuss lessons learned, the road ahead, and how both parties could improve their effectiveness. What we know is that successful collaboratives are about leveraging resources, knowledge and collective will to achieve an endwith the good fortune of timing, funding and leadership urging them onward. The West Virginia Oral Health Initiative is an example of that formula. It also provides fruitful ground to examine the expansive role of The Benedum Foundation in launching this statewide effort, guiding the work, and positioning the initiative for support by other funders

Modeling of composite beams and plates for static and dynamic analysis

A rigorous theory and the corresponding computational algorithms were developed for through-the-thickness analysis of composite plates. This type of analysis is needed in order to find the elastic stiffness constants of a plate. Additionally, the analysis is used to post-process the resulting plate solution in order to find approximate three-dimensional displacement, strain, and stress distributions throughout the plate. It was decided that the variational-asymptotical method (VAM) would serve as a suitable framework in which to solve these types of problems. Work during this reporting period has progressed along two lines: (1) further evaluation of neo-classical plate theory (NCPT) as applied to shear-coupled laminates; and (2) continued modeling of plates with nonuniform thickness

Seasonal Abundance, Movement and Diversity of Fishes in an Ozark Stream

Seasonal fluctuations in fish abundance in Mud Creek occurred throughout the year at all sampling stations. At the two upper stations abundance was high and unstable during winter and early spring and decreased after heavy rainfall in mid-April. Abundance was low throughout the summer months, increasing in the fall due to large numbers of young-of-the-year. However, a different seasonal cycle occurred at the lower station which included deeper pools. Numbers were low and stable throughout the winter and early spring but high and unstable during the summer. Bigeye shiners (Notropis boops) and bluntnose minnows (Pimephales notatus) were the most mobile species marked. Populations of brook silversides (Labidesthes sicculus) remained fairly isolated, stable, and showed little mobility. Mean species diversity fluctuated during the winter, spring, and fall; diversity values were highest and most stable during summer months when high and relatively stable numbers were collected. The main difference in mean species diversity between stations was the greater stability throughout the year at the upper station

Prognostic value of the myocardial salvage index measured by T2-weighted and T1-weighted late gadolinium enhancement magnetic resonance imaging after ST-segment elevation myocardial infarction: A systematic review and meta-regression analysis

In all patients with ST-segment elevation myocardial infarction, risk stratification should be performed before discharge. The measurement of therapy efficiency with magnetic resonance imaging has been proposed as part of the risk assessment, but it has not been adopted widely. This meta-analysis was conducted to summarize published data on the prognostic value of the proportion of salvaged myocardium inside previously ischemic myocardium (myocardial salvage index) measured by T2-weighted and T1-weighted late gadolinium enhancement magnetic resonance imaging after ST-segment elevation myocardial infarction. Random and mixed effects models were used for analyzing the data of 10 studies with 2,697 patients. The pooled myocardial salvage index, calculated as the proportion of non-necrotic myocardium inside edematous myocardium measured by T2-weighted and T1-weighted late gadolinium enhancement MRI, was 43.0% (95% confidence interval: 37.4, 48.6). The pooled length of follow-up was 12.3 months (95% confidence interval: 7.0, 17.6). The pooled incidence of major cardiac events during follow-up, defined as cardiac death, nonfatal myocardial infarction, or admission for heart failure, was 10.6% (95% confidence interval: 5.7, 15.5). The applied mixed effects model showed an absolute decrease of 1.7% in the incidence of major cardiac events during follow-up (95% confidence interval: 1.6, 1.9) with every 1% of increase in the myocardial salvage index. The heterogeneity between studies was considerable (τ = 21.3). Analysis of aggregated follow-up data after ST-segment elevation myocardial infarction suggests that the myocardial salvage index measured by T2-weighted and T1-weighted late gadolinium enhancement magnetic resonance imaging provides prognostic information on the risk of major cardiac events, but considerable heterogeneity exists between studies

Fragile States, Robust Structures: Illegal Police Protection in Buenos Aires

Weakness is a quality frequently ascribed to Latin American states. This diagnosis proves faulty since it is possible to find resistant structures inside those states that perpetuate such weaknesses. This article shows that this is the case in regards to the police force of the province of Buenos Aires. Here, I will demonstrate that the police have specialized in selling a service available to criminals and criminal organizations: illegal protection. With information taken from in-depth interviews and official documents, I will show that this protection – contrary to the views of Charles Tilly and Diego Gambetta – is characterized by a temporary suspension of the rule of law.police, protection, politics, organised crime, Buenos Aires

The Bionic Radiologist: avoiding blurry pictures and providing greater insights

Radiology images and reports have long been digitalized. However, the potential of the more than 3.6 billion radiology examinations performed annually worldwide has largely gone unused in the effort to digitally transform health care. The Bionic Radiologist is a concept that combines humanity and digitalization for better health care integration of radiology. At a practical level, this concept will achieve critical goals: (1) testing decisions being made scientifically on the basis of disease probabilities and patient preferences; (2) image analysis done consistently at any time and at any site; and (3) treatment suggestions that are closely linked to imaging results and are seamlessly integrated with other information. The Bionic Radiologist will thus help avoiding missed care opportunities, will provide continuous learning in the work process, and will also allow more time for radiologists’ primary roles: interacting with patients and referring physicians. To achieve that potential, one has to cope with many implementation barriers at both the individual and institutional levels. These include: reluctance to delegate decision making, a possible decrease in image interpretation knowledge and the perception that patient safety and trust are at stake. To facilitate implementation of the Bionic Radiologist the following will be helpful: uncertainty quantifications for suggestions, shared decision making, changes in organizational culture and leadership style, maintained expertise through continuous learning systems for training, and role development of the involved experts. With the support of the Bionic Radiologist, disparities are reduced and the delivery of care is provided in a humane and personalized fashion