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The Odyssey of HOMER: Comparative Effectiveness Research on Medication for Opioid Use Disorder During the COVID-19 Pandemic [Special Report]

The usual challenges of conducting primary care research, including randomized trials, have been exacerbated, and new ones identified, during the COVID-19 pandemic. HOMER (Home versus Office for Medication Enhanced Recovery; subsequently, Comparing Home, Office, and Telehealth Induction for Medication Enhanced Recovery) is a pragmatic, comparative-effectiveness research trial that aims to answer a key question from patients and clinicians: What is the best setting in which to start treatment with buprenorphine for opioid use disorder for this patient at this time? In this article, we describe the difficult journey to find the answer. The HOMER study began as a randomized trial comparing treatment outcomes in patients starting treatment with buprenorphine via induction at home (unobserved) vs in the office (observed, synchronous). The study aimed to enroll 1,000 participants from 100 diverse primary care practices associated with the State Networks of Colorado Ambulatory Practices and Partners and the American Academy of Family Physicians National Research Network. The research team faced unexpected challenges related to the COVID-19 pandemic and dramatic changes in the opioid epidemic. These challenges required changes to the study design, protocol, recruitment intensity, and funding conversations, as well as patience. As this is a participatory research study, we sought, documented, and responded to practice and patient requests for adaptations. Changes included adding a third study arm using telehealth induction (observed via telephone or video, synchronous) and switching to a comprehensive cohort design to answer meaningful patient-centered research questions. Using a narrative approach based on the Greek myth of Homer, we describe here the challenges and adaptations that have provided the opportunity for HOMER to thrive and find the way home. These clinical trial strategies may apply to other studies faced with similar cultural and extreme circumstances.




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Family Medicine Obstetrics: Answering the Call [Editorials]




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Tillerson: ‘Heartbreaking’ reports of suffering in Myanmar

Secretary of State Rex Tillerson speaks at the Center for Strategic and International Studies on Wednesday.

WASHINGTON — Secretary of State Rex Tillerson is condemning reported atrocities committed against Rohingya Muslims in Myanmar, and he says those responsible — perhaps the country’s military — will be held accountable.

Tillerson says accounts of the suffering of the Rohingya are “heartbreaking” — and that if those reports are true, then “someone is going to be held to account for that.”

Tillerson — who’s set to visit South Asia next week — is urging the Myanmar government to improve humanitarian access to the population in western Rakhine state.

Amnesty International has accused Myanmar’s security forces of killing hundreds of men, women and children during a systematic campaign to expel the Rohingya. More than 580,000 refugees have fled to neighboring Bangladesh since late August.

“We really hold the military leadership accountable for what’s happening,” Tillerson said at the Center for Strategic and International Studies, a Washington think tank. “What’s most important to us is that the world can’t just stand idly by and be witness to the atrocities that are being reported in that area.”

He also called Wednesday for the U.S. and India to expand strategic ties. He pointedly criticized China, which he accused of challenging international norms needed for global stability.

He said the world needed the U.S. and India to have a strong partnership. The two nations share goals of security, free navigation, free trade and fighting terrorism in the Indo-Pacific, and serve as “the eastern and western beacons” for an international rules-based order which is increasingly under strain, he said.

Both India and China had benefited from that order, but Tillerson said India had done so while respecting rules and norms, while China had “at times” undermined them. To make his point, he alluded to China’s island building and expansive territorial claims in seas where Beijing has long-running disputes with Southeast Asian neighbors.

“China’s provocative actions in the South China Sea directly challenge the international law and norms that the United States and India both stand for,” Tillerson said in an address at the Center for Strategic and International Studies, a Washington think tank.

He added that the U.S. seeks constructive relations with China but “won’t shrink” from the challenges it poses when it “subverts the sovereignty of neighboring countries, and disadvantages the U.S. and our friends.”

U.S.-India relations have generally prospered in the past decade, in part because of their shared concerns about the rise of China. While President Donald Trump has looked to deepen cooperation with China on addressing the nuclear threat from North Korea, he’s also sought a closer relationship with India, which shares U.S. worries on Islamic extremism.

“In this period of uncertainty and angst, India needs a reliable partner on the world stage. I want to make clear: with our shared values and vision for global stability, peace and prosperity, the United States is that partner,” Tillerson said.

Tillerson said the U.S. wants to help improve India’s military capabilities, and also improve security cooperation among the region’s major democracies, which included Japan and Australia.

Tillerson said the U.S. and India were leading regional efforts on counterterrorism. He called for India’s archrival Pakistan “to take decisive action against terrorist groups based within their own borders that threaten its own people and the broader region.”

The post Tillerson: ‘Heartbreaking’ reports of suffering in Myanmar appeared first on PBS NewsHour.




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'Renowned' restructuring firm acquired by major sector player

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Sam joins us this week for some Netflix and Krill. Anna Marie has to deal with a crisis on infinite Chris. Kelley asks the question, "Bidoff: photogenic or photobombing?" And Matt has to whistle Yuji Horii down from his crazy DQ teasing.

The post RPG Cast – Episode 586: “This Podcast Is Festering” appeared first on RPGamer.





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RPG Cast – Episode 624: “Kirby Is the New Elden Ring”

Chris wants an OP fox with mods. Matt wears a turnip and marries a twelve year old. And Josh goes off to read the new J.R.R. Martin time loop book.

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Trump and the new politics of honoring war dead

Coffins of U.S. military personnel are prepared to be offloaded at Dover Air Force Base in Dover, Delaware in this undated photo by a Reuters stringer.

WASHINGTON — After her Army son died in an armored vehicle rollover in Syria in May, Sheila Murphy says, she got no call or letter from President Donald Trump, even as she waited months for his condolences, wrote to him to say “some days I don’t want to live,” and still heard nothing.

In contrast, Trump called to comfort Eddie and Aldene Lee about 10 days after their Army son was killed in an explosion while on patrol in Iraq in April. “Lovely young man,” Trump said, according to Aldene. She thought that was a beautiful word to hear about her boy, “lovely.”

Like presidents before him, Trump has made personal contact with some families of the fallen, not all. What’s different is that Trump, alone among them, has picked a political fight over who’s done better to honor the war dead and their families.

He placed himself at the top of this pantheon, boasting Tuesday that “I think I’ve called every family of someone who’s died” while past presidents didn’t place such calls.

But The Associated Press found relatives of two soldiers who died overseas during Trump’s presidency who said they never received a call or a letter from him, as well as relatives of a third who did not get a call. And proof is plentiful that Barack Obama and George W. Bush — saddled with far more combat casualties than the roughly two dozen so far under Trump, took painstaking steps to write, call or meet bereaved military families.

The subject arose because nearly two weeks passed before Trump called the families of four U.S. soldiers who were killed in Niger nearly two weeks ago. He made the calls Tuesday.

READ MORE: Trump ignites furor with claim past presidents didn’t console military families by phone

Meanwhile, Rep. Frederica Wilson said late Tuesday that Trump told the widow of a slain soldier that he “knew what he signed up for.” Early Wednesday, the president called Wilson’s version of the conversation a fabrication.

The Florida Democrat said she was in the car with Myeshia Johnson on the way to Miami International Airport to meet the body of Johnson’s husband, Sgt. La David Johnson, when Trump called. Wilson says she heard part of the conversation on speakerphone.

When asked by Miami station WPLG if she indeed heard Trump say that she answered: “Yeah, he said that. To me, that is something that you can say in a conversation, but you shouldn’t say that to a grieving widow.” She added: “That’s so insensitive.”

Trump took strong issue with that recounting early Wednesday.

“Democrat Congresswoman totally fabricated what I said to the wife of a soldier who died in action (and I have proof). Sad!” he said on Twitter.

Sgt. Johnson was among four servicemen killed in the Niger ambush.

Wilson said that she didn’t hear the entire conversation and Myeshia Johnson told her she couldn’t remember everything that was said.

The White House didn’t immediately comment.

READ MORE: Trump’s claim about predecessors, fallen troops disputed

Trump’s delay in publicly discussing the men lost at Niger did not appear to be extraordinary, judging from past examples, but his politicization of the matter is. He went so far Tuesday as to cite the death of chief of staff John Kelly’s son in Afghanistan to question whether Obama had properly honored the war dead.

Kelly was a Marine general under Obama when his Marine son Robert died in 2010. “You could ask General Kelly, did he get a call from Obama?” Trump said on Fox News radio.

Democrats and some former government officials were livid, accusing Trump of “inane cruelty” and a “sick game.”

Democratic Sen. Tammy Duckworth of Illinois, an Iraq veteran who lost both legs when her helicopter was attacked, said: “I just wish that this commander in chief would stop using Gold Star families as pawns in whatever sick game he’s trying to play here.”

For their part, Gold Star families, which have lost members in wartime, told AP of acts of intimate kindness from Obama and Bush when those commanders in chief consoled them.

Trump initially claimed that only he among presidents made sure to call families. Obama may have done so on occasion, he said, but “other presidents did not call.”

He equivocated Tuesday as the record made plain that his characterization was false. “I don’t know,” he said of past calls. But he said his own practice was to call all families of the war dead.

But that hasn’t happened:

No White House protocol demands that presidents speak or meet with the families of Americans killed in action — an impossible task in a war’s bloodiest stages. But they often do.

Altogether some 6,900 Americans have been killed in overseas wars since the Sept. 11, 2001, attacks, the overwhelming majority under Bush and Obama.

Despite the much heavier toll on his watch — more than 800 dead each year from 2004 through 2007 — Bush wrote to all bereaved military families and met or spoke with hundreds if not thousands, said his spokesman, Freddy Ford.

Veterans groups said they had no quarrel with how presidents have recognized the fallen or their families.

“I don’t think there is any president I know of who hasn’t called families,” said Rick Weidman, co-founder and executive director of Vietnam Veterans of America. “President Obama called often and President Bush called often. They also made regular visits to Walter Reed and Bethesda Medical Center, going in the evenings and on Saturdays.”

___

Bynum reported from Savannah, Georgia. Jonathan Drew in Raleigh, North Carolina, Kristen de Groot in Philadelphia, Jennifer McDermott in Providence, Rhode Island, Michelle Price in Salt Lake City, and Hope Yen and Robert Burns in Washington contributed to this report.

The post Trump and the new politics of honoring war dead appeared first on PBS NewsHour.




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A black hole devouring a giant star gives clues to a cosmic mystery

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Inside NASA’s ambitious plan to bring the ISS crashing back to Earth

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Don't disrespect Alan Turing by reanimating him with AI

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Forums, Competitions, Challenges: Inspiring Creativity in Robotics



This is a sponsored article brought to you by Khalifa University of Science and Technology.

A total of eight intense competitions to inspire creativity and innovation along with 13 forums dedicated to diverse segments of robotics and artificial intelligence will be part of the 36th edition of the IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS 2024) in Abu Dhabi.

These competitions at the Middle East and North Africa (MENA) region’s first-ever global conference and exhibition from 14-18 October 2024 at the Abu Dhabi National Exhibition Center (ADNEC) will highlight some of the key aspects of robotics. These include physical or athletic intelligence of robots, remote robot navigation, robot manipulation, underwater robotics, perception and sensing as well as challenges for wildlife preservation.

This edition of IROS is one of the largest of its kind globally in this category because of active participation across all levels, with 5,740 authors, 16 keynote speakers, 46 workshops, 11 tutorials, as well as 28 exhibitors and 12 startups. The forums at IROS will explore the rapidly evolving role of robotics in many industry sectors as well as policy-making and regulatory areas. Several leading corporate majors, and industry professionals from across the globe are gathering for IROS 2024 which is themed “Robotics for Sustainable Development.”

“The intense robotics competitions will inspire creativity, while the products on display as well as keynotes will pave the way for more community-relevant solutions.” —Jorge Dias, IROS 2024 General Chair

Dr. Jorge Dias, IROS 2024 General Chair, said: “Such a large gathering of scientists, researchers, industry leaders and government stakeholders in Abu Dhabi for IROS 2024 also demonstrates the role of UAE in pioneering new technologies and in providing an international platform for knowledge exchange and sharing of expertise. The intense robotics competitions will inspire creativity, while the products on display as well as keynotes will pave the way for more community-relevant solutions.”

The competitions are:

In addition to these competitions, the Falcon Monitoring Challenge (FMC) will focus on advancing the field of wildlife tracking and conservation through the development of sophisticated, noninvasive monitoring systems.

Khalifa University

IROS 2024 will also include three keynote talks on ‘Robotic Competitions’ that will be moderated by Professor Lakmal Seneviratne, Director, Center for Autonomous Robotic Systems (KU-CARS), Khalifa University. The keynotes will be delivered by Professor Pedro Lima, Institute for Systems and Robotics, Instituto Superior Técnico, University of. Lisbon, Portugal; Dr. Timothy Chung, General Manager, Autonomy and Robotics, Microsoft, US; and Dr. Ubbo Visser, President of the RoboCup Federation, Director of Graduate Studies, and Associate Professor of Computer Science, University of Miami, US.

The forums at IROS 2024 will include:

Other forums include:

One of the largest and most important robotics research conferences in the world, IROS 2024 provides a platform for the international robotics community to exchange knowledge and ideas about the latest advances in intelligent robots and smart machines. A total of 3,344 paper submissions representing 60 countries, have been received from researchers and scientists across the world. China tops the list with more than 1,000 papers, the US with 777, Germany with 302, Japan with 253, and the UK and South Korea with 173 each. The UAE remains top in the Arab region with 68 papers.

One of the largest and most important robotics research conferences in the world, IROS 2024 provides a platform for the international robotics community to exchange knowledge and ideas.

For eight consecutive years since 2017, Abu Dhabi has remained first on the world’s safest cities list, according to online database Numbeo, which assessed 329 global cities for the 2024 listing. This reflects the emirate’s ongoing efforts to ensure a good quality of life for citizens and residents. With a multicultural community, Abu Dhabi is home to people from more than 200 nationalities, and draws a large number of tourists to some of the top art galleries in the city such as Louvre Abu Dhabi and the Guggenheim Abu Dhabi, as well as other destinations such as Ferrari World Abu Dhabi and Warner Bros. World™ Abu Dhabi.

Because of its listing as one of the safest cities, Abu Dhabi continues to host several international conferences and exhibitions. Abu Dhabi is set to host the UNCTAD World Investment Forum, the 13th World Trade Organization (WTO) Ministerial Conference (MC13), the 12th World Environment Education Congress in 2024, and the IUCN World Conservation Congress in 2025.

IROS 2024 is sponsored by IEEE Robotics and Automation Society, Abu Dhabi Convention and Exhibition Bureau, the Robotics Society of Japan (RSJ), the Society of Instrument and Control Engineers (SICE), the New Technology Foundation, and the IEEE Industrial Electronics Society (IES).

More information at https://iros2024-abudhabi.org/




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]]>





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The post Canada’s anti-money laundering agency hit by a cyber attack first appeared on ITBusiness.ca.




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Teens Gain Experience at IEEE’s TryEngineering Summer Institute



The future of engineering is bright, and it’s being shaped by the young minds at the TryEngineering Summer Institute (TESI), a program administered by IEEE Educational Activities. This year more than 300 students attended TESI to fuel their passion for engineering and prepare for higher education and careers. Sessions were held from 30 June through 2 August on the campuses of Rice University, the University of Pennsylvania, and the University of San Diego.

The program is an immersive experience designed for students ages 13 to 17. It offers hands-on projects, interactive workshops, field trips, and insights into the profession from practicing engineers. Participants get to stay on a college campus, providing them with a preview of university life.

Student turned instructor

One future innovator is Natalie Ghannad, who participated in the program as a student in 2022 and was a member of this year’s instructional team in Houston at Rice University. Ghannad is in her second year as an electrical engineering student at the University of San Francisco. University students join forces with science and engineering teachers at each TESI location to serve as instructors.

For many years, Ghannad wanted to follow in her mother’s footsteps and become a pediatric neurosurgeon. As a high school junior in Houston in 2022, however, she had a change of heart and decided to pursue engineering after participating in the TESI at Rice. She received a full scholarship from the IEEE Foundation TESI Scholarship Fund, supported by IEEE societies and councils.

“I really liked that it was hands-on,” Ghannad says. “From the get-go, we were introduced to 3D printers and laser cutters.”

The benefit of participating in the program, she says, was “having the opportunity to not just do the academic side of STEM but also to really get to play around, get your hands dirty, and figure out what you’re doing.”

“Looking back,” she adds, “there are so many parallels between what I’ve actually had to do as a college student, and having that knowledge from the Summer Institute has really been great.”

She was inspired to volunteer as a teaching assistant because, she says, “I know I definitely want to teach, have the opportunity to interact with kids, and also be part of the future of STEM.”

More than 90 students attended the program at Rice. They visited Space Center Houston, where former astronauts talked to them about the history of space exploration.

Participants also were treated to presentations by guest speakers including IEEE Senior Member Phil Bautista, the founder of Bull Creek Data, a consulting company that provides technical solutions; IEEE Senior Member Christopher Sanderson, chair of the IEEE Region 5 Houston Section; and James Burroughs, a standards manager for Siemens in Atlanta. Burroughs, who spoke at all three TESI events this year, provided insight on overcoming barriers to do the important work of an engineer.

Learning about transit systems and careers

The University of Pennsylvania, in Philadelphia, hosted the East Coast TESI event this year. Students were treated to a field trip to the Southeastern Pennsylvania Transportation Association (SEPTA), one of the largest transit systems in the country. Engineers from AECOM, a global infrastructure consulting firm with offices in Philadelphia that worked closely with SEPTA on its most recent station renovation, collaborated with IEEE to host the trip.

The benefit of participating in the program was “having the opportunity to not just do the academic side of STEM but also to really get to play around, get your hands dirty, and figure out what you’re doing.” — Natalie Ghannad

Participants also heard from guest speakers including Api Appulingam, chief development officer of the Philadelphia International Airport, who told the students the inspiring story of her career.

Guest speakers from Google and Meta

Students who attended the TESI camp at the University of San Diego visited Qualcomm. Hosted by the IEEE Region 6 director, Senior Member Kathy Herring Hayashi, they learned about cutting-edge technology and toured the Qualcomm Museum.

Students also heard from guest speakers including IEEE Member Andrew Saad, an engineer at Google; Gautam Deryanni, a silicon validation engineer at Meta; Kathleen Kramer, 2025 IEEE president and a professor of electrical engineering at the University of San Diego; as well as Burroughs.

“I enjoyed the opportunity to meet new, like-minded people and enjoy fun activities in the city, as well as get a sense of the dorm and college life,” one participant said.

Hands-on projects

In addition to field trips and guest speakers, participants at each location worked on several hands-on projects highlighting the engineering design process. In the toxic popcorn challenge, the students designed a process to safely remove harmful kernels. Students tackling the bridge challenge designed and built a span out of balsa wood and glue, then tested its strength by gradually adding weight until it failed. The glider challenge gave participants the tools and knowledge to build and test their aircraft designs.

One participant applauded the hands-on activities, saying, “All of them gave me a lot of experience and helped me have a better idea of what engineering field I want to go in. I love that we got to participate in challenges and not just listen to lectures—which can be boring.”

The students also worked on a weeklong sparking solutions challenge. Small teams identified a societal problem, such as a lack of clean water or limited mobility for senior citizens, then designed a solution to address it. On the last day of camp, they pitched their prototypes to a team of IEEE members that judged the projects based on their originality and feasibility. Each student on the winning teams at each location were awarded the programmable Mech-5 robot.

Twenty-nine scholarships were awarded with funding from the IEEE Foundation. IEEE societies that donated to the cause were the IEEE Computational Intelligence Society, the IEEE Computer Society, the IEEE Electronics Packaging Society, the IEEE Industry Applications Society, the IEEE Oceanic Engineering Society, the IEEE Power & Energy Society, the IEEE Power Electronics Society, the IEEE Signal Processing Society, and the IEEE Solid-State Circuits Society.




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The Role of MES Consultants in Streamlining Manufacturing Operations

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The post The Role of MES Consultants in Streamlining Manufacturing Operations appeared first on Chart Attack.




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The Everything Guide to Securing Your Dental Health

The Importance of Dental Hygiene Dental hygiene is crucial for maintaining overall health and well-being. Poor oral health has been linked to various health problems, including heart disease, diabetes, and respiratory infections. Therefore, taking care of your teeth and gums should be a top priority in your daily routine. 1. Oral Health and Overall Well-being […]

The post The Everything Guide to Securing Your Dental Health appeared first on Chart Attack.




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Robotic Precision in Manufacturing: Achieving High Accuracy for Complex Tasks

From assembling delicate electronics to constructing safety-critical aerospace components, the margin for error has shrunk to almost nothing. To meet these rigorous standards, the manufacturing industry increasingly relies on robotic precision. Modern robotics, equipped with advanced sensors, grippers, and AI, allow manufacturers to complete intricate tasks with extraordinary accuracy. Technological Innovations Driving Robotic Precision Today’s […]

The post Robotic Precision in Manufacturing: Achieving High Accuracy for Complex Tasks appeared first on Chart Attack.