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The present study investigates the layer-specific mechanical behavior of human skin. Motivated by skin’s histology, a biphasic model is proposed which differentiates between epidermis, papillary and reticular dermis, and hypodermis. Inverse analysis of ex vivo tensile and in vivo suction experiments yields mechanical parameters for each layer and predicts a stiff reticular dermis and successively softer papillary dermis, epidermis and hypodermis. Layer-specific analysis of simulations underlines the dominating role of the reticular dermis in tensile loading. Furthermore, it shows that the observed out-of-plane deflection in ex vivo tensile tests is a direct consequence of the layered structure of skin. In in vivo suction experiments, the softer upper layers strongly influence the mechanical response, whose dissipative part is determined by interstitial fluid redistribution within the tissue. Magnetic resonance imaging-based visualization of skin deformation in suction experiments confirms the deformation pattern predicted by the multilayer model, showing a consistent decrease in dermal thickness for large probe opening diameters., Biomechanics and Modeling in Mechanobiology, 20 (3), ISSN:1617-7959, ISSN:1617-7940

Community-based telehealth programs (CTPs) allow patients to regularly monitor health at community-based facilities. Evidence from community-based telehealth programs is scarce. In this paper, we assess factors of retention—patients remaining active participants—in a CTP called the Telehealth Intervention Programs for Seniors (TIPS). We analyzed 5-years of data on social, demographic, and multiple chronic conditions among participants from 17 sites (N=1878). We modeled a stratified multivariable logistic regression to test the association between self-reported demographic factors, caregiver status, presence of multiple chronic conditions, and TIPS retention status by limited English proficient (LEP) status. Overall, 59.5% of participants (mean age: 75.8yrs, median 77yrs, SD 13.43) remained active. Significantly higher odds of retention were observed among LEP females, English-speaking diabetics, and English proficient (EP) participants without a caregiver. We discuss the impact of CTPs in the community, the role of caregiving, and recommendations for how to retain successfully recruited non-English speaking participants.

As older adult populations rise in the United States, community-based telehealth programs are gaining momentum because of their ability to provide telehealth services for community-dwelling older adults at a lower cost compared to home-based telehealth services. The success of such community-based telehealth programs heavily depends on end-user engagement and acceptance; however, few studies to date have explored these issues. We conducted an interview study with 14 active and 3 inactive participants of a community-based Telehealth Intervention Program for Seniors (TIPS) to examine older individuals' perceived benefits and barriers to participating in community-based telehealth programs as well as strategies to improve those programs. We found that older adults had a positive experience toward the use of telehealth services in a community setting, including benefits like monitoring health status and enabling socialization. There were no perceived barriers about the telehealth program. Aspects that can be improved include facilitating the management and sharing of historical physiological data, providing additional assessments of cognitive and/or mental status, supporting self-education, and enabling more comprehensive health status tracking. We conclude this paper by discussing the implications of our results to the improvement of community-based telehealth programs for low-income, vulnerable aging populations.

Chromium doped ZnSe nanocrystals were grown at low temperature using zinc acetate and sodium selenite. A capping agent was used to avoid agglomeration of particles. It was observed that the addition of the capping agent before or after chemical synthesis of ZnSe played a very important role in controlling the size of nanoparticles and to avoid agglomeration. Size of nanoparticles of ZnSe was as small as 10 nm for both doped and undoped material. In a few cases, in spite of preventative measures, clustering of particles produced large agglomerates at room temperature. Cr-ZnSe nano particles showed fluorescence at different wavelengths compared to Cr-doped bulk crystals. Cr-doped nanocrystals showed higher bandgap than PVT grown bulk Cr-ZnSe crystals. The fluorescence intensity for Cr-ZnSe nanoparticles was significantly higher compared to undoped ZnSe nanoparticles.

The understanding of the surface behavior, interaction, wettability, and topographies of surfaces with fluids is very important to remove impurities from the devices and components and to develop washing fluids to clean large area surfaces. We synthesized nano particle filled composites by wet and semi-wet techniques to achieve hydrophobicity and hence the lotus effect. Nanocomposites with different composition of polymers doped with titania nanoparticles were studied to evaluate effects on wettability. Light scattering methods were used to study the absorptions and particle size. The contact angle and hydrophobic characteristics were very composition dependent in thin film composites. At certain compositions, we observed that material showed very high anisotropy in droplet shapes which diminished with loadings of nanoparticles. These composites did not show any change in hydrophobic characteristics when exposed with ultraviolet radiation.

Pluripotent stem-cell-derived cardiomyocytes (PSC-CMs) provide an unprecedented opportunity to study human heart development and disease, but they are functionally and structurally immature. Here, we induce efficient human PSC-CM (hPSC-CM) maturation through metabolic-pathway modulations. Specifically, we find that peroxisome-proliferator-associated receptor (PPAR) signaling regulates glycolysis and fatty acid oxidation (FAO) in an isoform-specific manner. While PPARalpha (PPARa) is the most active isoform in hPSC-CMs, PPARdelta (PPARd) activation efficiently upregulates the gene regulatory networks underlying FAO, increases mitochondrial and peroxisome content, enhances mitochondrial cristae formation, and augments FAO flux. PPARd activation further increases binucleation, enhances myofibril organization, and improves contractility. Transient lactate exposure, which is frequently used for hPSC-CM purification, induces an independent cardiac maturation program but, when combined with PPARd activation, still enhances oxidative metabolism. In summary, we investigate multiple metabolic modifications in hPSC-CMs and identify a role for PPARd signaling in inducing the metabolic switch from glycolysis to FAO in hPSC-CMs.

Introduction: To evaluate if the offering of Fitbit technology led to changes in cardiovascular health metrics in a cohort of older adults. Methods: A retrospective cohort study was developed in two community-embedded health monitoring sites, located in aggregate housing communities for older adults in Westchester County, NY. Participants included older adults (55 years or older) enrolled in the Telehealth Intervention Programs for Seniors (TIPS) initiative, a community-embedded remote patient monitoring initiative. Weekly blood pressure, heart rate, weight, and blood oxygenation were taken on all participants. For participants who accepted a Fitbit Zip device, a weekly step count was also collected. Results: Ninety-four TIPS participants were offered Fitbit technology. Thirty participants accepted the technology and used it for a minimum of 6 months. No significant differences in any of the regularly acquired biometrics were noted between Fitbit users and non-Fitbit users. Across all participants, regardless of Fitbit use, there was a significant decrease in systolic blood pressure (SBP) over time. Conclusions: Neither Fitbit Zip ownership or compliance to Fitbit Zip usage influenced any of the biometrics taken as part of the TIPS. However, participation in the TIPS initiative may have an overall positive effect on SBP in older adults.

Background:Chronic disease in older adults is estimated to account for 84% of annual health care spending in the United States, with many preventable costs expected to rise as the population continues to age. Introduction:Telehealth Intervention Programs for Seniors (TIPS) is a community-embedded program targeting low-income older adults, providing weekly assessment of vital signs and subjective wellness, and wrap-around aging services. Materials and Methods:TIPS recruited 765 volunteers over 55 years, who were Medicaid and/or Medicare eligible. Data were collected from 2014 to 2016 [median enrollment 343 days (105–435)] using 12 TIPS sites. This observational study evaluated the efficacy of TIPS by measuring within-subject changes in self-reported hospital visits and

There is a strong need for rad hard and high operating temperature IR detectors for space environment. Heavy metal Selenides (high Z and large density) have been investigated for more than half century for high operating temperature mid wave infrared (MWIR) applications. Most of the efforts have been devoted to make detector arrays on high-resistivity Si substrates for operating wavelengths in the 1.5 to 5.0 μm region using physical vapor transport grown poly crystalline materials. For most of the biological spectral and imaging applications, short wave infrared (SWIR) detectors have shown better performance. Recent growth materials have shown variation in morphology with slight change in growth conditions and hence variation in performance parameters such as bandgap, mobility and resistivity from sample to sample. We have performed growth and optical characterization of binary materials CdSe-PbSe to determine the suitability for IR detector. We have determined bandgap using several theoretical models for different morphologies observed during growth on silicon wafers.

Recently there is a big thrust on bio-inspired sensors and there has been a large rise in the investment and expectations for nanotechnology to meet these goals. For in situ sensor development materials deposition on substrate is essential part of device development. Physical vapor deposition (PVD), chemical vapor deposition (CVD) and molecular organic vapor deposition methods have developed for growth of semiconductor bulk and thin film growth with some modifications have been used for these materials. Oxides and other elements of the VI group such as sulfides and selenides are key components in the skins of many species. Growth of ordered structures containing these elements have been achieved by using PVD method. This paper describes effect of growth parameters during PVD growth on the quality of materials. Growth kinetics and mechanism will be discussed for the vertical and horizontal growth reactors. Since most of the efficient materials systems are multinary and in many cases non-congruent, PVD provides a pathway to grow materials below melting temperature.

The ways people connect, interact, share, and communicate have changed due to recent developments in information technology. These developments, categorized as social media, have captured the attention of business executives, technologists, and education professionals alike, and have altered many business models. Additionally, the concept of social media impacts numerous sub-disciplines within business and has become an important issue with operational, tactical, and strategic considerations. Despite this interest, many business schools do not have courses involving social media technologies and applications. In those that do, the placement and focus of the course varies considerably. This article provides motivation and insight into the process of developing an approach for effectively teaching social media use in business. Additionally, it offers implementation examples of courses taught at three major universities. The article concludes with lessons-learned that will give instructors practical guidance and ensure that social media courses taught in a business school provide students with a solid basis for integrating social media into business practice.

Carbon-11- and fluorine-18-labeled choline derivatives have been introduced as promising tracers for prostate cancer imaging. However, due to limited specificity and sensitivity, there is a need for new tracers with higher sensitivity and specificity for diagnosing prostate cancer to improve tracer uptake and enhance imaging contrast. The aim of this study was to compare the properties of [11C]choline ([11C]CHO) with S(+)-β-methyl-[11C]choline ([11C]SMC) as tracer for prostate cancer imaging in a human prostate tumor mouse xenograft model by small-animal positron emission tomography/X-ray computed tomography (PET/CT). We carried out a dual-tracer small-animal PET/CT study comparing [11C]CHO and [11C]SMC. The androgen-independent human prostate tumor cell line PC3 was implanted subcutaneously in the flanks of Naval Medical Research Institute (NMRI) (nu/nu) mice (n = 11). Mice—6 weeks post-xenograft implantation—were injected with 37 MBq [11C]CHO via the tail vein. On a separate day, the mice were injected with 37 MBq [11C]SMC. Dynamic imaging was performed for 60 min with the Inveon animal PET/CT scanner (Siemens Medical Solutions) on two separate days (randomizing the sequence of the tracers). The dynamic PET images were acquired in list mode. Regions of interest (5 × 5 × 5 mm) were placed in transaxial slices in tumor, muscle (thigh), liver, kidney, and blood. Image analysis was performed calculating tumor to muscle (T/M) ratios based on summed images as well as dynamic data. For [11C]SMC, the mean T/M ratio was 2.24 ± 0.56 while the corresponding mean [11C]CHO T/M ratio was 1.35 ± 0.28. The T/M ratio for [11C]SMC was significant higher compared to [11C]CHO (p

Pace University's Doctor of Professional Studies in Computing program, a fusion of academic and professional cultures, started as a venture into largely uncharted educational territory. One part of the mission was, and remains, a one hundred percent student retention rate, with each student successfully defending a dissertation with original research in three years. Yet, throughout, the students retain full-time employment as high-level computing and IT professionals. Another part of the mission is to provide breadth and currency across the computing disciplines (specifically, computer science, information systems, and telecommunications) as well as depth in annually selected areas of emerging technology. This is in a context in which entering students have master's degrees and generally at least five years of professional experience in diverse computing-related areas and therefore lack a common foundational background. As a new program at the University and in the country, penetrating assessments have been conducted each semester. This report describes the assessments, the anticipated and unanticipated challenges, and the steps that have made the evolutionary development of this program successful.

Packing problems, such as how densely objects can fill a volume, are among the most ancient and persistent problems in mathematics and science. For equal spheres, it has only recently been proved that the face-centered cubic lattice has the highest possible packing fraction \batchmode \documentclass[fleqn,10pt,legalpaper]{article} \usepackage{amssymb} \usepackage{amsfonts} \usepackage{amsmath} \pagestyle{empty} \begin{document} \({\varphi}={\pi}{/}\sqrt{18}{\approx}0.74\) \end{document} . It is also well known that certain random (amorphous) jammed packings have φ ≈ 0.64. Here, we show experimentally and with a new simulation algorithm that ellipsoids can randomly pack more densely—up to φ= 0.68 to 0.71for spheroids with an aspect ratio close to that of M&M's Candies—and even approach φ ≈ 0.74 for ellipsoids with other aspect ratios. We suggest that the higher density is directly related to the higher number of degrees of freedom per particle and thus the larger number of particle contacts required to mechanically stabilize the packing. We measured the number of contacts per particle Z ≈ 10 for our spheroids, as compared to Z ≈ 6 for spheres. Our results have implications for a broad range of scientific disciplines, including the properties of granular media and ceramics, glass formation, and discrete geometry.

Late nephrology referral, before initiation of dialysis treatment, is associated with adverse outcome.To investigate the implications of late nephrology referral on mortality among dialysis patients in Israel.We retrospectively analyzed 200 incident dialysis patients. Patients were defined as late referrals if they started dialysis less than 3 months after their first nephrology consultation. Survival rates and risk factors for mortality were analyzedThe early referral (ER) group comprised 118 patients (59%) and the late referral (LR) group 82 patients (41%). The mortality rate was 44.5% (53 patients) in the ER and 68% (n = 56) in the LR group. The 4 year survival rate was 41.1% in the ER and 18.7% in the LR group (P0.0001). The mortality rate increased with late nephrology referral (HR 1.873, 95% CI 1.133-3.094), with age (HR 1.043 for each year, 95% CI 1.018-1.068), with diabetes (HR 2.399, CI 1.369-4.202), and with serum albumin level (HR 0.359 for an increase of each 1 g/dl, 95% CI 0.242-0.533). The median survival time was higher for the ER group in women, in patients younger than 70, and in diabetic patients. A trend for longer survival time was found in non-diabetic patients. Survival time was not increased in early referred patients older than 70 and in male patients.Late nephrology referral is associated with an overall higher mortality rate in dialysis patients. The survival advantage of early referral may have a different significance in specific subgroups. The timing of nephrology referral should be considered as a modifiable risk factor for mortality in patients with end-stage renal disease.

In registration trials, triple therapy with telaprevir (TVR), pegylated interferon (Peg-IFN), and ribavirin (RBV) achieved sustained virological response (SVR) rates between 64% and 75%, but the clinical effectiveness and economic burdens of this treatment in real-world practice remain to be determined. Records of 147 patients who initiated TVR-based triple therapy at the Mount Sinai Medical Center (May-December 2011) were reviewed. Direct medical costs for pretreatment, on-treatment, and posttreatment care were calculated using data from Medicare reimbursement databases, RED Book, and the Healthcare Cost and Utilization Project database. Costs are presented in 2012 U.S. dollars. SVR (undetectable hepatitis C virus [HCV] RNA 24 weeks after the end of treatment) was determined on an intention-to-treat basis. Cost per SVR was calculated by dividing the median cost by the SVR rate. Median age of the 147 patients was 56 years (interquartile range [IQR] = 51-61), 68% were male, 19% were black, 11% had human immunodeficiency virus/HCV coinfection, 36% had advanced fibrosis/cirrhosis (FIB-4 scores ≥3.25), and 44% achieved an SVR. The total cost of care was $11.56 million. Median cost of care was $83,721 per patient (IQR = $66,652-$98,102). The median cost per SVR was $189,338 (IQR = $150,735-$221,860). Total costs were TVR (61%), IFN (24%), RBV (4%), adverse event management (8%), professional fees (2%), and laboratory tests (1%).TVR and Peg-IFN accounted for 85% of costs. Pharmaceutical prices and the low (44%) SVR rate, in this real-world study, were major contributors to the high cost per SVR.

The ischemic "steal" syndrome complicates angio-access in a growing number of hemodialysed patients. Until now, operative attempts (fistula ligation or banding) to treat this problem have met with only limited success.To assess the results of DRIL (distal revascularization-interval ligation) procedure in treating the "steal" syndrome.A retrospective review (1996-2002) was conducted of all 11 patients who underwent the DRIL procedure in two tertiary care hemodialysis units.Two patients were excluded because of inadequate medical documentation. All of the nine patients remaining suffered from overt atherosclerotic disease, six had diabetic nephropathy and four were smokers. The arteriovenous access, which led to the "steal" syndrome, was proximally located in all (antecubital in 8, thigh area in 1). "Steal" symptoms included hand pain, paraesthesia, neurologic deficits and gangrenous ulcers. DRIL was technically successful in all patients. There were no perioperative deaths. Immediate and complete relief of pain was achieved in eight of the nine patients. One patient with gangrene later required a transmetacarpal amputation. No patient required hand amputation. During follow-up (range 1-26 months) hemodialysis was continued uninterruptedly using the problematic AVA in all patients. Thrombosis occurred in the AVA in only two patients after the DRIL procedure at 9 and 24 months postoperatively, respectively. Three patient deaths were unrelated to the DRIL.In selected patients the DRIL procedure is a safe and effective way to treat the "steal" syndrome. AVA patency is not compromised by this operation. Preoperative angiography, before and after manual compression of the AVA, is crucial for the proper selection of patients who will benefit most from the DRIL procedure.

We present an automated procedure to assign CATH and SCOP classifications to proteins whose FSSP score is available. CATH classification is assigned down to the topology level, and SCOP classification is assigned to the fold level. Because the FSSP database is updated weekly, this method makes it possible to update also CATH and SCOP with the same frequency. Our predictions have a nearly perfect success rate when ambiguous cases are discarded. These ambiguous cases are intrinsic in any protein structure classification that relies on structural information alone. Hence, we introduce the "twilight zone for structure classification." We further suggest that to resolve these ambiguous cases, other criteria of classification, based also on information about sequence and function, must be used.

This paper describes the concept of an asynchronous distance-learning course and its application to an elective course, Data Communications and Networks. Goals for the asynchronous course included providing facilities and opportunities for interaction and exchange of ideas among class members, analogous to the interactions which occur in a conventional class. Implemented as a Web-based course, a discussion board and email were heavily used to support class interactions. Some experiences with the initial Web-based offering of the course are described.

STUDY DESIGN:This case report illustrates that although it is rare, a ganglion cyst can occur intraosseously in the odontoid process. OBJECTIVES:The tissue diagnosis was established by surgical resection of the cyst membrane and evacuation of the cyst content. The patient tolerated the procedure well, and the hospital course was uneventful. SUMMARY OF BACKGROUND DATA:Synovial cyst of the spine is uncommon and is usually found in the lumbar region. Its occurrence in the cervical spine is rare, and no cases in the odontoid process, to the authors' knowledge, have been reported. METHODS:This patient was evaluated initially for neck pain, which led to radiographic studies depicting the lesion. It raised the suspicion of metastatic neoplastic process, although the search for primary source proved to be negative. A biopsy was indicated. RESULTS:Surgical findings consisted of mucoid material field cavity lined by a thin membrane. The cyst was excised, and pathologic evaluation confirmed the diagnosis of synovial cyst. CONCLUSION:The correct radiographic diagnosis of this patient was not made because of lack of experience with such lesions in this location. The authors hope that this case report helps raise the awareness of clinicians in considering this diagnosis when facing similar radiographic presentation.