Maine Research Associates

Abstract Introduction Sleep is a crucial measure of health and wellbeing. Individuals with good sleep health tend to have better physical, emotional, cognitive, and social functioning than individuals with poor sleep health. The National Sleep Foundation developed the Sleep Health Index® (SHI) in 2016 as a means to monitor the sleep health of the general population. Since its inception, the National Sleep Foundation has administered the SHI annually to a representative sample of the US population. This study reports on the 2022 SHI and examines US population trends in sleep health from 2019 through 2022. Methods The SHI is a valid, reliable measure consisting of 16 questions related to the three discrete constructs of sleep duration, sleep quality, and disordered sleep. In 2022, the SHI was administered to a nationally representative, random sample of 1,042 Americans via the probability-based Ipsos KnowledgePanel®, in which panelists complete surveys online in English or Spanish. Results have a margin of sampling error of 3.2 points. We examined sleep health trends from 2019 through 2022 and examined whether sleep health in 2022 differed from previous years. Group differences in sleep health were also investigated. Results Americans’ average SHI score in 2022 was 75 (on a 0–100 scale), which is consistent with SHI scores observed in previous years. The SHI total score was statistically highest among college graduates, Hispanic adults, and people with household incomes of $100,000+ a year and statistically lowest among those with household incomes less than $50,000. Despite stable SHI total scores, there were statistically significant declines in both average weekday sleep scores (76 in 2021 to 71 in 2022) and in sleep deficit scores (86 in 2021 to 82 in 2022), which are based on the difference between weekday sleep and the amount of sleep respondents say they need to be well-rested and feel their best. Conclusion While overall sleep health remained stable, weekday sleep duration and sleep deficit worsened considerably as pandemic-related restrictions came to an end. The sociocultural and political contexts in which sleep health occurs, as well as associated features, like mental and physical health, deserve further consideration. Support (if any)

Finding the shortest route in wireless mesh networks is an important aspect. Many techniques are used to solve this problem like dynamic programming, evolutionary algorithms, weighted-sum techniques, and others. In this paper, we use dynamic programming techniques to find the shortest path in wireless mesh networks due to their generality, reduction of complexity and facilitation of numerical computation, simplicity in incorporating constraints, and their onformity to the stochastic nature of some problems. The routing problem is a multi-objective optimization problem with some constraints such as path capacity and end-to-end delay. Single-constraint routing problems and solutions using Dijkstra, Bellman-Ford, and Floyd-Warshall algorithms are proposed in this work with a discussion on the difference between them. These algorithms find the shortest route through finding the optimal rate between two nodes in the wireless networks but with bounded end-to-end delay. The Dijkstra-based algorithm is especially favorable in terms of processing time. We also present a comparison between our proposed single-constraint Dijkstra-based routing algorithm and the mesh routing algorithm (MRA) existing in the literature to clarify the merits of the former.

Abstract All polymeric slurries that have a high concentration of filler are shear thinning. Shear thinning is an important characteristic of polymers, filled and unfilled, because it enables an increase in the throughput, shear rate in a die or an injection molding system without having to use substantially more power to increase the flow rate. Newtonian fluid-based slurries show an increase in shear thinning as the concentration of “filler” increases above the percolation threshold. As particle maximum packing concentration is approached the slurries begin to approach a perfect pseudoplastic fluid. In some cases, the shear thinning characteristics of a filled polymer do not increase substantially as the filler loading is increased. This is a quite different response than in Newtonian fluid-based slurry. Therefore, it is important to understand the materials engineering interactions that control shear thinning so that process flow models can better predict the performance of filled polymer systems. Highly filled polymers can have processing issues, including high screw shaft torque, energy consumption, die pressure and melt temperature rise. Previous theoretical developments and experimental evaluations of highly filled polymer melts showed that the rheology can be effectively described with a percolation model. In this work, capillary rheometer measurements using several low-density polyethylene resins, calcium carbonate and titanium dioxide fillers are reported using percolation theory concepts. The theoretical treatment of the rheology as a particulate percolating system with power-law behavior is used to analyze capillary rheometer data. The observed effects of resin molecular weight, filler type and size on rheology are described. Engineers that design and debottleneck polymer processes need to utilize the polymer viscosity at the minimum process shear rate to determine the smallest motor that will allow the process to run; in addition, the shear thinning characteristics of the polymer are used to indicate how much increased production may be possible with a given motor size. Thus, some examples of expected effects on melt processing are also presented.

RVU : Relative Value Unit CF : Conversion Factor GPCI : Geographic Practice Cost Index CMS : Centers for Medicare and Medicaid Services MP : malpractice RBRVS : Resource-Based Relative Value Scale CPT : Current Procedural Terminology SGR : Sustainable Growth Rate To understand the

Obesity has reached epidemic proportions in the USA and is a particular threat to those with coronary disease. Motivational interviewing (MI) is a client-centered, directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence about altering behavior. This study examined the efficacy of MI compared to nutritional counseling for weight loss in a small sample of obese cardiac patients. Participants were assigned to either MI or to nutrition counseling and followed up over 3 months. Trained undergraduate students delivered the MI intervention. There were significant reductions in weight in women in the MI intervention, but not in men. The results suggest that MI may be effective for obese female cardiac patients, in particular, even when delivered by nonprofessional interviewers. Limitations of the study include a small sample size, nonrandomized assignment to conditions, and attrition over time.

Current drugs for induction and maintenance of sedation in mechanically ventilated patients in the intensive care unit have limitations. Fospropofol, a prodrug of propofol, has not been studied as a sedative in the ICU setting. In this randomized, open-label pilot study, patients received 1 of 3 regimens with a goal of maintaining a Ramsay Sedation Score of 2 to 5: (1) fospropofol IV infusion with a bolus and increased infusion rate for agitation events (infusion/bolus); (2) fospropofol IV infusion with an increased infusion rate for agitation events (infusion only); or (3) propofol IV infusion with an increased infusion rate for agitation events. Sixty patients received study drug and were included in the safety and efficacy analyses. Because incidence rates for adverse events were similar between fospropofol groups, and because the study was not powered to determine significant differences between treatment groups for safety variables, adverse events for both fospropofol groups were combined. In the fospropofol groups, 28 out of 38 patients (74%) experienced treatment-emergent adverse events in comparison with 14 out of 22 patients (64%) in the propofol group. The most common treatment-emergent adverse events with fospropofol were procedural pain (21.1%) and nausea (13.2%). Two patients (1 each in the fospropofol infusion/bolus and the propofol groups) experienced hypotension during the study as a potential sedation-related adverse event. Mean plasma formate levels were not significantly different among groups. Patients in all 3 treatment groups maintained Ramsay Sedation Scores of 2 to 5 for >90% of the time they were sedated. This pilot study suggests that fospropofol, administered in either an infusion/bolus or infusion-only regimen, is tolerable and effective for short-term induction and maintenance of sedation in mechanically ventilated intensive care unit patients.

Attainment of blood pressure (BP) goals in patients with diabetes is critical both to reduce the risk of cardiovascular events and to delay the progression of renal disease. While therapeutic guidelines advise initial therapy with an angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, monotherapy with these agents may not be sufficient to attain target BP. The ADHT (Amlodipine Diabetic Hypertension Efficacy Response Evaluation Trial) evaluated the efficacy and safety of adding amlodipine to the treatment regimen of patients with hypertension and diabetes who were already receiving either quinapril or losartan as monotherapy. ADHT was a double-blind, double-dummy, 22-week trial conducted in the US. After a washout period of 7-13 days, patients (aged 30-75 y) with hypertension and diabetes were randomized to receive quinapril 20 mg/day plus placebo or losartan 50 mg/day plus placebo for 4 weeks, titrated to 40 mg or 100 mg (if required), respectively, for an additional 4 weeks to achieve their BP goals (<130/80 mm Hg). At week 8, either amlodipine 5 mg/day or placebo was added for an additional 12 weeks, with titration to 10 mg at week 14 if the BP goal was not achieved. Efficacy of add-on therapy was evaluated in 411 patients (amlodipine 211, placebo 200). BP goal was reached by 27.5% of patients when amlodipine was added to quinapril or losartan monotherapy, compared with 12.5% when placebo was added (OR 2.73; 95% CI 1.61 to 4.64; p < 0.001). When added to quinapril or losartan monotherapy, amlodipine reduced BP by 8.1/5.4 mm Hg, compared with a 1.6/0.7 mm Hg decrease with add-on placebo (p < 0.001). Amlodipine, quinapril, and losartan were well tolerated. Amlodipine is safe and effective when added to quinapril or losartan monotherapy to help lower BP toward therapeutic targets in patients with hypertension and diabetes.

The Indian Ocean tsunami of 26 December 2004 shows poignantly that catastrophic tsunamis are too infrequent for their hazard to be characterized by historical records alone. Long‐term geologic records provide opportunities to assess tsunami hazards more fully. Telltale deposits left by tsunamis help assess water depth and velocity of past inundations, estimate source locations, and aid in understanding how tsunamis affect the ecology and geomorphology of coastlines. Dated deposits allow estimates of times and recurrence intervals of past tsunamis. Such information guides mitigation efforts and may reduce losses from future tsunamis.