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Introduction: A suspected diagnosis of cancer through an emergency department (ED) visit is associated with poor clinical outcomes. The purpose of this study was to explore the rate at which ED patients attend cancer screenings for lung, colorectal (CRC), and breast cancers based on national guidelines set forth by the United States Preventive Services Task Force (USPSTF). Methods: This was a prospective cohort study. Patients were randomly approached in the Eskenazi Hospital ED between August 2019–February 2020 and were surveyed to determine whether they would be eligible and had attended lung, CRC, and breast cancer screenings, as well as their awareness of lung cancer screening with low-dose computed tomography (LDCT). Patients who were English-speaking and ≥18 years old, and who were not critically ill or intoxicated or being seen for acute decompensated psychiatric illness were offered enrollment. Enrolled subjects were surveyed to determine eligibility for lung, colorectal, and breast cancer screenings based on guidelines set by the USPSTF. No cancer screenings were actually done during the ED visit. Results: A total of 500 patients were enrolled in this study. More participants were female (54.4%), and a majority were Black (53.0%). Most participants had both insurance (80.2%) and access to primary care (62.8%). Among the entire cohort, 63.0% identified as smokers, and 62.2% (140/225) of the 50- to 80-year-old participants qualified for lung cancer screening. No patients were screened for lung cancer in this cohort (0/225). Only 0.6% (3/500) were aware that LDCT was the preferred method for screening. Based on pack years, 35.5% (32/90) of the patients who were 40-49 years old and 6.7% (6/90) of those 30–39 years old would eventually qualify for screening. Regarding CRC screening, 43.6% (218/500) of the entire cohort was eligible. However, of those patients only 54% (118/218) had been screened. Comparatively, 77.7% (87/112) of the eligible females ha

Introduction: A suspected diagnosis of cancer through an emergency department (ED) visit is associated with poor clinical outcomes. The purpose of this study was to explore the rate at which ED patients attend cancer screenings for lung, colorectal (CRC), and breast cancers based on national guidelines set forth by the United States Preventive Services Task Force (USPSTF). Methods: This was a prospective cohort study. Patients were randomly approached in the Eskenazi Hospital ED between August 2019–February 2020 and were surveyed to determine whether they would be eligible and had attended lung, CRC, and breast cancer screenings, as well as their awareness of lung cancer screening with low-dose computed tomography (LDCT). Patients who were English-speaking and ≥18 years old, and who were not critically ill or intoxicated or being seen for acute decompensated psychiatric illness were offered enrollment. Enrolled subjects were surveyed to determine eligibility for lung, colorectal, and breast cancer screenings based on guidelines set by the USPSTF. No cancer screenings were actually done during the ED visit. Results: A total of 500 patients were enrolled in this study. More participants were female (54.4%), and a majority were Black (53.0%). Most participants had both insurance (80.2%) and access to primary care (62.8%). Among the entire cohort, 63.0% identified as smokers, and 62.2% (140/225) of the 50- to 80-year-old participants qualified for lung cancer screening. No patients were screened for lung cancer in this cohort (0/225). Only 0.6% (3/500) were aware that LDCT was the preferred method for screening. Based on pack years, 35.5% (32/90) of the patients who were 40-49 years old and 6.7% (6/90) of those 30–39 years old would eventually qualify for screening. Regarding CRC screening, 43.6% (218/500) of the entire cohort was eligible. However, of those patients only 54% (118/218) had been screened. Comparatively, 77.7% (87/112) of the eligible females ha

BackgroundYouth in the justice system (YJS) are more likely than youth who have never been arrested to have mental health and substance use problems. However, a low percentage of YJS receive SUD services during their justice system involvement. The SUD care cascade can identify potential missed opportunities for treatment for YJS. Steps along the continuum of the cascade include identification of treatment need, referral to services, and treatment engagement. To address gaps in care for YJS, we will (1) implement a learning health system (LHS) to develop, or improve upon, alliances between juvenile justice (JJ) agencies and community mental health centers (CMHC) and (2) present local cascade data during continuous quality improvement cycles within the LHS alliances.Methods/designADAPT is a hybrid Type II effectiveness implementation trial. We will collaborate with JJ and CMHCs in eight Indiana counties. Application of the EPIS (exploration, preparation, implementation, and sustainment) framework will guide the implementation of the LHS alliances. The study team will review local cascade data quarterly with the alliances to identify gaps along the continuum. The study will collect self-report survey measures longitudinally at each site regarding readiness for change, implementation climate, organizational leadership, and program sustainability. The study will use the Stages of Implementation Completion (SIC) tool to assess the process of implementation across interventions. Additionally, the study team will conduct focus groups and qualitative interviews with JJ and CMHC personnel across the intervention period to assess for impact.DiscussionFindings have the potential to increase SUD need identification, referral to services, and treatment for YJS.

The ability to silence the activity of genetically specified neurons in a temporally precise fashion would provide the opportunity to investigate the causal role of specific cell classes in neural computations, behaviours and pathologies. Here we show that members of the class of light-driven outward proton pumps can mediate powerful, safe, multiple-colour silencing of neural activity. The gene archaerhodopsin-3 (Arch)1 from Halorubrum sodomense enables near-100% silencing of neurons in the awake brain when virally expressed in the mouse cortex and illuminated with yellow light. Arch mediates currents of several hundred picoamps at low light powers, and supports neural silencing currents approaching 900 pA at light powers easily achievable in vivo. Furthermore, Arch spontaneously recovers from light-dependent inactivation, unlike light-driven chloride pumps that enter long-lasting inactive states in response to light. These properties of Arch are appropriate to mediate the optical silencing of significant brain volumes over behaviourally relevant timescales. Arch function in neurons is well tolerated because pH excursions created by Arch illumination are minimized by self-limiting mechanisms to levels comparable to those mediated by channelrhodopsins2, 3 or natural spike firing. To highlight how proton pump ecological and genomic diversity may support new innovation, we show that the blue–green light-drivable proton pump from the fungus Leptosphaeria maculans4 (Mac) can, when expressed in neurons, enable neural silencing by blue light, thus enabling alongside other developed reagents the potential for independent silencing of two neural populations by blue versus red light. Light-driven proton pumps thus represent a high-performance and extremely versatile class of ‘optogenetic’ voltage and ion modulator, which will broadly enable new neuroscientific, biological, neurological and psychiatric investigations., National Institutes of Health (U.S.) (NIH Director's New Innovator Award (DP2 OD002002-01)), National Institutes of Health (U.S.) (grant 0835878), National Science Foundation (U.S.) (grant 0848804), McGovern Institute for Brain Research at MIT (Neurotechnology Award Program), National Institutes of Health (U.S.) (NIH 1K99MH085944), Alfred P. Sloan Foundation, United States. Dept. of Defense, Dr. Gerald Burnett and Marjorie Burnett, SFN Research Award for Innovation in Neuroscience, Massachusetts Institute of Technology. Media Laboratory, Benesse Foundation, Wallace H. Coulter Foundation, Helen Hay Whitney Foundation, Brain & Behavior Research Foundation

Background Prior exposure to stress is a risk factor for developing posttraumatic stress disorder (PTSD) in response to trauma, yet the mechanisms by which this occurs are unclear. Using a rodent model of stress-based susceptibility to PTSD, we investigated the role of serotonin in this phenomenon. Methods Adult mice were exposed to repeated immobilization stress or handling, and the role of serotonin in subsequent fear learning was assessed using pharmacologic manipulation and western blot detection of serotonin receptors, measurements of serotonin, high-speed optogenetic silencing, and behavior. Results Both dorsal raphe serotonergic activity during aversive reinforcement and amygdala serotonin 2C receptor (5-HT2CR) activity during memory consolidation were necessary for stress enhancement of fear memory, but neither process affected fear memory in unstressed mice. Additionally, prior stress increased amygdala sensitivity to serotonin by promoting surface expression of 5-HT2CR without affecting tissue levels of serotonin in the amygdala. We also showed that the serotonin that drives stress enhancement of associative cued fear memory can arise from paired or unpaired footshock, an effect not predicted by theoretical models of associative learning. Conclusions Stress bolsters the consequences of aversive reinforcement, not by simply enhancing the neurobiological signals used to encode fear in unstressed animals, but rather by engaging distinct mechanistic pathways. These results reveal that predictions from classical associative learning models do not always hold for stressed animals and suggest that 5-HT2CR blockade may represent a promising therapeutic target for psychiatric disorders characterized by excessive fear responses such as that observed in PTSD., United States. Dept. of Defense. Congressionally Directed Medical Research Programs Posttraumatic Stress Disorder Program, Human Frontier Science Program (Strasbourg, France), McGovern Institute for Brain Research at MIT, McGovern Institute for Brain Research at MIT. Neurotechnology Program, Massachusetts Institute of Technology. Media Laboratory, Massachusetts Institute of Technology. Mind-Machine Project, National Alliance for Research on Schizophrenia and Depression, National Institutes of Health (U.S.) (Director's New Innovator Award 1DP2OD002002), National Institutes of Health (U.S.) (Grant 1R01DA029639), National Institutes of Health (U.S.) (Grant 1R43NS070453), National Institutes of Health (U.S.) (Grant 1RC1MH088182), Alfred P. Sloan Foundation, National Institute of Mental Health (U.S.) (R01 MH084966), United States. Army Research Laboratory, United States. Army Research Office (Grant 58076-LS-DRP)

Thesis: S.M., Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, 2014., Cataloged from PDF version of thesis., Includes bibliographical references., Optogenetic actuators such as Channelrhodopsin-2 (ChR2) are seven-transmembrane proteins that function as light-gated ion channels. These naturally occurring proteins are found in green algae and serve as sensory photoreceptors controlling phototaxis. Operationally, they contain the light-isomerizable chromophore all-trans-retinal that, upon absorption of a photon at or around 473nm, a conformational change to 13-cis-retinal is induced. This change opens the channel allowing cations to flow through. In the absence of light, the 13-cis-retinal relaxes back to the resting all-trans-retinal conformation and the channel closes. When an actuators packaged into a lox-containing Adeno-associated virus is used in conjunction with a mouse that expresses the Cre recombinase enzyme in a specific cell type, cell specific expression of the opsin is achieved. When used with LEDs, lasers, or specifically fabricated light delivery tools, control of very specific neural networks is realized. This thesis provides a review of optogenetics and details the development and application of a novel wireless device to optically control neural circuits and behavior., by Patrick Erin Monahan III., S.M.

Thesis: S.M., Massachusetts Institute of Technology, School of Architecture and Planning, Program in Media Arts and Sciences, 2014., Cataloged from PDF version of thesis., Includes bibliographical references., Optogenetic actuators such as Channelrhodopsin-2 (ChR2) are seven-transmembrane proteins that function as light-gated ion channels. These naturally occurring proteins are found in green algae and serve as sensory photoreceptors controlling phototaxis. Operationally, they contain the light-isomerizable chromophore all-trans-retinal that, upon absorption of a photon at or around 473nm, a conformational change to 13-cis-retinal is induced. This change opens the channel allowing cations to flow through. In the absence of light, the 13-cis-retinal relaxes back to the resting all-trans-retinal conformation and the channel closes. When an actuators packaged into a lox-containing Adeno-associated virus is used in conjunction with a mouse that expresses the Cre recombinase enzyme in a specific cell type, cell specific expression of the opsin is achieved. When used with LEDs, lasers, or specifically fabricated light delivery tools, control of very specific neural networks is realized. This thesis provides a review of optogenetics and details the development and application of a novel wireless device to optically control neural circuits and behavior., by Patrick Erin Monahan III., S.M.

Patrick O Monahan,1 Catherine A Alder,2–4 Babar A Khan,1–3 Timothy Stump,1 Malaz A Boustani1–4 1Indiana University School of Medicine, Indianapolis, IN, USA; 2Indiana University Center for Aging Research, Indianapolis, IN, USA; 3Regenstrief Institute Inc., Indianapolis, IN, USA; 4Eskenazi Health, Indianapolis, IN, USA Background: Primary care providers need an inexpensive, simple, user-friendly, easily standardized, sensitive to change, and widely available multidomain instrument to measure the cognitive, functional, and psychological symptoms of patients suffering from multiple chronic conditions. We previously validated the Caregiver Report Version of the Healthy Aging Brain Care Monitor (HABC Monitor) for measuring and monitoring the severity of symptoms through caregiver reports. The purpose of this study was to assess the reliability and validity of the Patient Self-Report Version of the HABC Monitor (Self-Report HABC Monitor).Design: Cross-sectional study.Setting: Primary care clinics affiliated with a safety net urban health care system in Indianapolis, Indiana, USA.Subjects: A total of 291 subjects aged ≥65 years with a mean age of 72.7 (standard deviation 6.2) years, 76% female, and 56% African Americans.Analysis: Psychometric validity and reliability of the Self-Report HABC Monitor.Results: Among 291 patients analyzed, the Self-Report HABC Monitor demonstrated excellent fit for the confirmatory factor analysis model (root mean square error of approximation =0.030, comparative fit index =0.974, weighted root mean square residual =0.837) and good internal consistency (0.78–0.92). Adequate convergent–divergent validity (differences between the Telephone Interview for Cognitive Status test-based cognitive function impairment versus nonimpairment groups) was demonstrated only when patients were removed from analysis if they had both cognitive function test impairment and suspiciously perfect self-report H

Optogenetics, the ability to use light to activate and silence specific neuron types within neural networks in vivo and in vitro, is revolutionizing neuroscientists' capacity to understand how defined neural circuit elements contribute to normal and pathological brain functions. Typically, awake behaving experiments are conducted by inserting an optical fiber into the brain, tethered to a remote laser, or by utilizing an implanted light-emitting diode (LED), tethered to a remote power source. A fully wireless system would enable chronic or longitudinal experiments where long duration tethering is impractical, and would also support high-throughput experimentation. However, the high power requirements of light sources (LEDs, lasers), especially in the context of the extended illumination periods often desired in experiments, precludes battery-powered approaches from being widely applicable. We have developed a headborne device weighing 2 g capable of wirelessly receiving power using a resonant RF power link and storing the energy in an adaptive supercapacitor circuit, which can algorithmically control one or more headborne LEDs via a microcontroller. The device can deliver approximately 2 W of power to the LEDs in steady state, and 4.3 W in bursts. We also present an optional radio transceiver module (1 g) which, when added to the base headborne device, enables real-time updating of light delivery protocols; dozens of devices can be controlled simultaneously from one computer. We demonstrate use of the technology to wirelessly drive cortical control of movement in mice. These devices may serve as prototypes for clinical ultra-precise neural prosthetics that use light as the modality of biological control., National Institutes of Health (U.S.) (NIH Director’s New Innovator Award (DP2OD002002)), National Institutes of Health (U.S.) (Grant 1R01DA029639), National Institutes of Health (U.S.) (Grant 1RC1MH088182), National Institutes of Health (U.S.) (Grant 1RC2DE020919), National Institutes of Health (U.S.) (Grant 1R01NS067199), National Institutes of Health (U.S.) (Grant 1R43NS070453), National Science Foundation (U.S.) (CAREER award), National Science Foundation (U.S.) (NSF Grant DMS 1042134), National Science Foundation (U.S.) (NSF Grant DMS 0848804), National Science Foundation (U.S.) (NSF Grant EFRI 0835878), Benesse Foundation, Google (Firm), Dr. Gerald Burnett and Marjorie Burnett, United States. Dept. of Defense (CDMRP PTSD Program), Massachusetts Institute of Technology, Brain & Behavior Research Foundation, Alfred P. Sloan Foundation, Society for Neuroscience, Massachusetts Institute of Technology. Media Laboratory, McGovern Institute for Brain Research at MIT, Wallace H. Coulter Foundation

Patrick O Monahan,1 Malaz A Boustani,1–3,6 Catherine Alder,2,3,6 James E Galvin,7 Anthony J Perkins,2,3 Patrick Healey,4 Azita Chehresa,5 Polly Shepard,8 Corby Bubp,8 Amie Frame,2,3 Chris Callahan1–3,61Indiana University School of Medicine, 2Indiana University Center for Aging Research, 3Regenstrief Institute Inc, 4St Vincent’s Health Network, 5Community Health Network, 6Wishard Health Services, Eskenazi Health, Indianapolis IN, 7Alzheimer Disease Center, Departments of Neurology and Psychiatry, New York University School of Medicine, New York, NY, 8Memory Clinic of Indianapolis, Indianapolis, IN, USABackground: Dementia care providers need a clinical assessment tool similar to the blood pressure cuff (sphygmomanometer) used by clinicians and patients for managing hypertension. A “blood pressure cuff” for dementia would be an inexpensive, simple, user-friendly, easily standardized, sensitive to change, and widely available multidomain instrument for providers and informal caregivers to measure severity of dementia symptoms. The purpose of this study was to assess the reliability and validity of the Healthy Aging Brain Care Monitor (HABC-Monitor) for measuring and monitoring the severity of dementia symptoms through caregiver reports.Methods: The first prototype of the HABC-Monitor was developed in collaboration with the Indianapolis Discovery Network for Dementia, which includes 200 members representing 20 disciplines from 20 local organizations, and an expert panel of 22 experts in dementia care and research. The HABC-Monitor has three patient symptom domains (cognitive, functional, behavioral/psychological) and a caregiver quality of life domain. Patients (n = 171) and their informal caregivers (n = 171) were consecutively approached and consented during, or by phone shortly following, a patient’s routine visit to their memory care provider.Results: The HABC-Monitor demonstrated good internal consistency

A mass-loaded coating includes a predetermined mass of powdered lead which is mixed preferably in a ratio of 3:1 with a liquid polyurethane primer. When painted onto the surface of a disc or plate, the coating mass-loads the disc and lowers the resonant frequency of the disc without significantly increasing the physical dimensions of the disc. Thicker consistency adhesives, such as spreadable paste adhesives or thick putty-like adhesives may be substituted for mass-loading objects having irregular surface textures or complex shapes., Supersedes PAT-APPL-08 127 178-93, AD-D016095.

A submarine buoyant cable antenna having positive buoyancy comprising a communications antenna electronics package encased in a polymer composition the polymer composition comprising from about 80 percent to about 85 percent by weight of a room temperature curable thermosetting polymer having a viscosity before curing in the range of from about 700 to about 900 centipoise, and from about 15 percent to about 20 percent by weight of microballoons of a size ranging from about 20 to about 100 microns in diameter, the specific gravity of the composition being in the range of from about 0.51 to about 0.65 grams per cubic centimeter to provide the positive buoyancy., Supersedes PAT-APPL-605 779-96.

There is presented a sonic apparatus for degassing liquids. The apparatus includes a vessel for recciving and releasably retaining an open-top container and adapted to be closed with the container therein, transducer suspension structure positioned in the vessel, an ultrasonic transducer suspended from tbe structure and disposed in the container spaced from the walls and bottom of the container and beneath the surface of a liquid contained therein. The apparatus further includes a signal generated outside of the vessel for transmitting power to the transducer, and a vacuum pump for maintaining the vessel interior at a vacuum. (AN), Supersedes PAT-APPL-069 817-93, AD-D015 833.

A radially-polarized piezoelectric cylindrical transducer is provided. The transducer has an electrically conductive end cap affixed with a conductive epoxy to one end of a piezoelectric body and a second cap affixed to the other end. The piezoelectric body comprises a layer of piezoelectric material located between an inner and an outer electrode. The outer electrode has an electrode gap which electrically insulates the end cap from the outer electrode. The unit is electrically conductive and permits the attachment of two electrical leads to its exterior, one to the first end cap and the other to the outer electrode of the piezoelectric body, Supersedes PAT-APPL-892 056-92.

Hydrophone transducer elements are mechanically isolated from one another in vibration by suspending them in a urethane matrix molded into a cylindrical shape. A metal ring is mechanically locked in an annular slot defined by the cylindrical shaped matrix. The ring is used to mechanically support the assembly for towing. The transducer elements are electrically connected to one another and to an electrical cable independently of this mechanical support.

Sufficient data currently exist to propose a shear-wave velocity model for the near-surface deposits in southwestern British Columbia. This model has been developed in order to estimate shear-wave velocity profiles where such data are lacking but where the stratigraphy is known, primarily for seismic microzonation mapping. In general, Pleistocene deposits that have been overridden by glaciers have shear-wave velocities greater than 400 m/sec. Consequently, little amplification of ground motion due to soil conditions would be expected in these deposits. However, Late Pleistocene deltaic and glaciomarine deposits that have not been overridden by glaciers, and Holocene deltaic, alluvial, and lacustrine, shoreline and organic deposits have average shear-wave velocities between 75 and 330 m/sec. Where sufficiently thick, these deposits are susceptible to moderate to high amplification of ground motion. In these Late Pleistocene and Holocene deposits, average shear-wave velocity increases with grain size. The data presented here are preliminary, and additional data are required for a reliable characterization of some environments