Are We Insane? The Quest for Proportionality in the Discovery Rules of the Federal Rules of Civil Procedure

Atrial fibrillation is a common heart arrhythmia which is characterized by a missing or irregular contraction of the atria. The disease is a risk factor for other more serious diseases and the total medical costs in society are extensive. Therefore it would be beneficial to improve and optimize the prevention and detection of the disease.   Pulse palpation and heart auscultation can facilitate the detection of atrial fibrillation clinically, but the diagnosis is generally confirmed by an ECG examination. Today there are several algorithms that detect atrial fibrillation by analysing an ECG. A common method is to study the heart rate variability (HRV) and by different types of statistical calculations find episodes of atrial fibrillation which deviates from normal sinus rhythm.   Two algorithms for detection of atrial fibrillation have been evaluated in Matlab. One is based on the coefficient of variation and the other uses a logistic regression model. Training and testing of the algorithms were done with data from the Physionet MIT database. Several steps of signal processing were used to remove different types of noise and artefacts before the data could be used.   When testing the algorithms, the CV algorithm performed with a sensitivity of 91,38%, a specificity of 93,93% and accuracy of 92,92%, and the results of the logistic regression algorithm was a sensitivity of 97,23%, specificity of 93,79% and accuracy of 95,39%. The logistic regression algorithm performed better and was chosen for implementation in Java, where it achieved a sensitivity of 97,31%, specificity of 93,47% and accuracy of 95,25%.Förmaksflimmer är en vanlig hjärtrytmrubbning som kännetecknas av en avsaknad eller oregelbunden kontraktion av förmaken. Sjukdomen är en riskfaktor för andra allvarligare sjukdomar och de totala kostnaderna för samhället är betydande. Det skulle därför vara fördelaktigt att effektivisera och förbättra prevention samt diagnostisering av förmaksflimmer.   Kliniskt diagnostiseras förmaksflimmer med hjälp av till exempel pulspalpation och auskultation av hjärtat, men diagnosen brukar fastställas med en EKG-undersökning. Det finns idag flertalet algoritmer för att detektera arytmin genom att analysera ett EKG. En av de vanligaste metoderna är att undersöka variabiliteten av hjärtrytmen (HRV) och utföra olika sorters statistiska beräkningar som kan upptäcka episoder av förmaksflimmer som avviker från en normal sinusrytm.   I detta projekt har två metoder för att detektera förmaksflimmer utvärderats i Matlab, en baseras på beräkningar av variationskoefficienten och den andra använder sig av logistisk regression. EKG som kommer från databasen Physionet MIT används för att träna och testa modeller av algoritmerna. Innan EKG-signalen kan användas måste den behandlas för att ta bort olika typer av brus och artefakter.   Vid test av algoritmen med variationskoefficienten blev resultatet en sensitivitet på 91,38%, en specificitet på 93,93% och en noggrannhet på 92,92%. För logistisk regression blev sensitiviteten 97,23%, specificiteten 93,79% och noggrannheten 95,39%. Algoritmen med logistisk regression presterade bättre och valdes därför för att implementeras i Java, där uppnåddes en sensitivitet på 91,31%, en specificitet på 93,47% och en noggrannhet på 95,25%

Reducing Stigma-Driven Health Disparities in People Living with HIV (PLWH): A Literature Review

Introduction: Research has found that HIV-related stigma has numerous negative impacts on the lives of people living with HIV (PLWH). Although there are more resources than ever dedicated to HIV/AIDS efforts, stigma continues to be a major factor challenging the prevention and treatment of HIV today. Understanding the impacts of stigma on health outcomes and quality of life in PLWH is essential to address the global HIV epidemic and reduce health disparities. Search Strategy: We conducted a secondary meta-analysis of existing research that discussed and evaluated the impacts of HIV-related stigma and discrimination on PLWH. We searched the following databases for peerreviewed articles: EBSCO Host, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and PubMed. We also obtained reports from Centers for Disease Control (CDC), Food and Drug Administration (FDA), Office of the High Commissioner for Human Rights (OHCHR), World Health Organization (WHO), and the Joint United Nations Programme on HIV/AIDS (UNAIDS). Results: Our review of the literature revealed that HIV-related stigma is a socially constructed global phenomenon that reflects social and cultural tradition. Most current stigma-reduction interventions are designed to address individual-level stigma (symbolic stigma). While this has contributed to improvements in individual attitudes towards PLWH, interventions at the individual level alone do not address the macro-level attitudes and societal norms that influence individual ideals and behaviors. Conclusion: Findings in the literature review suggest that because of the pervasiveness of HIV-related stigma globally, addressing stigma is imperative to the HIV response. It also suggests that interventions that address stigma at the structural level and target multiple domains might have a more profound impact on HIV-related health outcomes

Evidence from Strandings for Geomagnetic Sensitivity in Cetaceans

We tested the hypothesis that cetaceans use weak anomalies in the geomagnetic field as cues for orientation, navigation and/or piloting. Using the positions of 212 stranding events of live animals in the Smith sonian compilation which fall within the boundaries of the USGS East-Coast Aeromagnetic Survey, we found that there are highly significant tendencies for cetaceans to beach themselves near coastal locations with local magnetic minima. Monte-Carlo simulations confirm the significance of these effects. These results suggest that cetaceans have a magnetic sensory systemcomparable to that in other migratory and homing animals, and predict that the magnetic topography and in particular the marine magnetic lineations may play an important role in guiding long-distance migration. The ‘map’ sense of migratoryanimals may therefore be largely based on a simple strategy of following paths of local magnetic minima and avoiding magnetic gradients

Food Availability and Stomach Content of Fish Populations in Semenyih Reservoir, Malaysia

This study was done to evaluate the food availability and stomach content of fish populations in Semenyih Reservoir, Malaysia. Samples were collected at monthly intervals from November 1998 to October 1999. Fish specimens were collected from twelve stations at the shallow littoral zone of the reservoir using various sizes of gill nets for the investigation of fish species inhabiting the reservoir and for the examination of the gut content. A total of 1,469 fish were collected from the Reservoir throughout the study. Seven species belonging to seven different families were identified. Fish community consisted of Mystacoleocus marginatus C&V (sia), Hampala macrolepidota van Hasselt (sebarau) Cyclochelichthys apogon C&V (merah mata), Osteochilus hasselti C&V (terbul), Oreochromis mossambicus Peters (tilapia), Oxyleotris marmorafus Bleeker (Ketutu), and Mystus nemurus C&V (baung). Mystacoleocus marginatus was the most dominant species, comprising 64.6% of the total number of fish sampled, followed by H. macrolepidota (24.8%), C. apogon (4.2%), 0. hasseltii (2.6%), 0. mossambicus (1.4%) 0. marmoratus (1.3%), and M. nemurus (1 .I%). Composition and frequency of occurrence of food items iii have been studied. Phytoplankton, insects and zooplankton were found to be the main food items consumed of different fish species in the reservoir. While the least food items were mollusks, juvenile fish and crustaceans. Mystacoleocus marginatus, Cyclochelichthys apogon and Oreochromis mossambicus were largely omnivore at the time they were analyzed. While Hampala macrolepidota, Osteochilus hasseltii, Oxyleotris marmoratus and Mystus nemurus were highly carnivorous at the time they were analyzed. The phytoplankton community was composed of six different groups, (chlorophytes, cyanophytes, bacillariophytes, crysophytes, euglenoids and dinoflagellates) with a mean total density of 20.41 X lo4 cells ml-I. Among the six groups, chlorophytes was the most dominant with a mean density of 64,806.40 cells ml-I, followed by bacillariophytes (51,836.28 cells ml-I); cyanophytes (48,916.48 cells d l ) ; dinoflagellates (24,943.25 cells ml-I); crysophytes (1 1,387.68 cells ml-I) and euglenoids (2,189.59 cells ml-I). On the other hand, the zooplankton community consisted of three groups, namely, copepods, cladocerans and rotifers. Zooplankton was dominated by copepods with a total density of 2,701.27 organisms I", followed by rotifers (2,297.40 organisms I-') and cladocerans (7,16.47 organisms I-'). The macrobenthos of Semenyih Reservoir was composed of mollusks, annelids and chironomids, with a mean total density of 13,658.33 organisms/m2. Among these groups, mollusks were the most dominant with a mean density of 11,525.17 organisms/m2; followed by chironomids (1,599.88 organisms/m2) and annelids (533.29 organisms/m2). Physico-chemical and biological parameters of Semenyih Reservoir were also studied. Temperature, dissolved oxygen, secchi disk visibility and pH values range from 27.55-30.00 OC, 6.63-7.33 mg I-'; 50.60 - 99.80 cm; and 6.96 - 7.84, respectively. Nitrate-nitrogen, phosphate-phosphorous, silica and ammonia-nitrogen ranges from 0.09 mg 1-I to 0.15 mg I-', 2.71-5.26 mg I'', 0.2-0.3 mg I-' and 0.06 - 0.24 mg I-' respectively. One concluding sentence about the fish population, Semenyih Reservoir was a mesotrophic body of water

Lessons on Ethnic Data Disaggregation from the “Count Me In” Campaign

This article supports the need to re-evaluate current models of racial/ethnic data collection in order to accurately assess and improve efforts of inclusion for Asian American and Pacific Islander (AAPI) students. Through highlighting the efforts of students in the 2007 “Count Me In” campaign at the University of California, I argue that the campaign serves as an exemplar of AAPIs’ desire to disaggregate. Contrary to the often-referenced depiction of being a monolithic “model minority,” this article discusses the diverse experiences of the various AAPI sub-communities and the ways in which the larger label masks inequalities between AAPI sub-groups and across other communities of color. Additionally, it suggests how more precise data collection may improve recruitment efforts and how universities may be able to enhance and create new student services to address the needs of emergent AAPI ethnic communities

Evidence that fin whales respond to the geomagnetic field during migration

We challenge the hypothesis that fin whales use a magnetic sense to guide migration by testing for associations between geophysical parameters and the positions where fin whales were observed over the continental shelf off the northeastern United States. Monte Carlo simulations estimated the probability that the distribution of fin whale sighting was random with respect to bottom depth, bottom slope and the intensity and gradient of the geomagnetic field. The simulations demonstrated no overall association of sighting positions with any of these four geophysical parameters. Analysis of the data by season, however, demonstrated statistically reliable associations of sighting positions with areas of low geomagnetic intensity and gradient in winter and fall, respectively, but no association of sighting positions with bathymetric parameters in any season. An attempt to focus on migrating animals by excluding those observed feeding confirmed the associations of sighting positions with low geomagnetic intensity and gradient in winter and fall, respectively, and revealed additional associations with low geomagnetic gradients in winter and spring. These results are consistent with the hypothesis that fin whales, and perhaps other mysticete species, possess a magnetic sense that they use to guide migration

PROGRAM NOTES FOR GRADUATE RECITAL: BENJAMIN’S LE TOMBEAU DE RAVEL VALSE CAPRICES, MANDAT’S ONE LINERS, SMITH’S FIVE PIECES FOR SOLO CLARINET, AND MOZART’S KEGELSTATT TRIO IN E-FLAT MAJOR, K. 498

AN ABSTRACT OF THE RESEARCH PAPER OF Kristine J. Dizon, for the Master’s of Music degree in MUSIC PERFORMANCE at Southern Illinois University Carbondale. TITLE: PROGRAM NOTES FOR GRADUATE RECITAL: BENJAMIN’S LE TOMBEAU DE RAVEL VALSE CAPRICES, MANDAT’S ONE LINERS, SMITH’S FIVE PIECES FOR SOLO CLARINET, AND MOZART’S KEGELSTATT TRIO IN E-FLAT MAJOR, K. 498 MAJOR PROFESSOR: Dr. Eric P. Mandat The purpose of this research paper is to provide scholarly program notes to accompany the graduate recital of Kristine J. Dizon, which took place on April 26, 2014. Program notes for Arthur Benjamin’s Le Tombeau de Ravel Valse Caprices (1949), Eric P. Mandat’s One Liners (2000), William O. Smith’s Five Pieces for Clarinet Solo (1959), and Wolfgang Mozart’s Kegelstatt Trio for Clarinet, Viola, and Piano, K. 498 (1786) will be provided. Each piece will be examined historically and by musical analysis

“Lift As You Climb”: A Narrative on Self-Empowerment and Student-Initiated Retention

Through a study on student-initiated retention projects, Maldonado, Buenavista, and Rhoads (2005) focused on the role of student agency and group empowerment and offered insight into how retention theory, policy, and practice may be reconsidered. This critical race counterstory will explore how my undergraduate experience was shaped by a student-initiated retention project in a way that contributed to my self-empowerment. I conclude with a discussion on empowerment’s relationship to retention and share suggestions for how student affairs educators may engage in student-centered and student–initiated programming to foster critical knowledge construction, community and identity formation, and leadership

Precision medicine and personalized breast cancer: combination pertuzumab therapy

Trastuzumab (Herceptin), a monoclonal antibody directed against the human epidermal growth-factor receptor 2 (HER2), is the poster child for antibody-based targeted therapy in breast cancer. Pertuzumab, another humanized monoclonal antibody, binds to a different domain of HER2 and prevents the formation of HER2:HER3 dimers, which is the most potent heterodimer in the HER family. The combination of trastuzumab and pertuzumab has synergistic activity, and is associated with improved clinical outcomes. The US Food and Drug Administration (FDA) approved pertuzumab in combination with trastuzumab-based chemotherapy originally as first-line therapy for metastatic HER2-positive breast cancer in 2012, and more recently as neoadjuvant therapy for localized disease in 2013. Pertuzumab is the first neoadjuvant drug to receive accelerated approval by the FDA based on pathological complete response as the primary end point. In this article, we review the mechanism of action, pharmacokinetics, clinical efficacy, safety, and current role of pertuzumab in the management of breast cancer, as well as ongoing clinical trials and future directions regarding the utility of pertuzumab as a personalized therapeutic option for HER2-positive breast cancer. In the coming years, we anticipate increased utilization of neoadjuvant trials for drug development, biomarker discovery, and validation, and envision conduct of personalized breast cancer clinics in which therapies will be routinely selected based on genetic alterations in the tumor. Regardless of the targeted therapy combinations employed based on tumor genomic profile, trastuzumab and pertuzumab will likely continue to form the backbone of the personalized regimen for HER2-positive breast cancer