Teleneurology clinics for polyneuropathy: a pilot study.

INTRODUCTION:Polyneuropathy (PN) is a common condition with significant morbidity. We developed tele-polyneuropathy (tele-PN) clinics to improve access to neurology and increase guideline-concordant PN care. This article describes the mixed-methods evaluation of pilot tele-PN clinics at three community sites within the Greater Los Angeles VA Healthcare System. METHODS:For the first 25 patients (48 scheduled visits), we recorded the duration of the tele-PN visit and exam; the performance on three guideline-concordant care indicators (PN screening labs, opiate reduction, physical therapy for falls); and patient-satisfaction scores. We elicited comments about the tele-PN clinic from patients and the clinical team. We combined descriptive statistics with qualitative themes to determine the feasibility and acceptability of the tele-PN clinics. RESULTS:The average tele-PN encounter and exam times were 28.5 and 9.1 min, respectively. PN screening lab completion increased from 80 to 100%. Opiate freedom improved from 68 to 88%. Physical therapy for patients with recent falls increased from 58 to 100%. The tele-PN clinic was preferred for follow-up over in-person clinics in 86% of cases. Convenience was paramount to the clinic's success, saving an average of 231 min per patient in round-trip travel. The medical team's caring and collaborative spirit received high praise. While the clinic's efficiency was equal or superior to in-person care, the limited treatment options for PN and the small clinical exam space are areas for improvement. CONCLUSION:In this pilot, we were able to efficiently see and examine patients remotely, promote guideline-concordant PN care, and provide a high-satisfaction encounter

Comparing Post-Newtonian and Numerical-Relativity Precession Dynamics

Binary black-hole systems are expected to be important sources of gravitational waves for upcoming gravitational-wave detectors. If the spins are not colinear with each other or with the orbital angular momentum, these systems exhibit complicated precession dynamics that are imprinted on the gravitational waveform. We develop a new procedure to match the precession dynamics computed by post-Newtonian (PN) theory to those of numerical binary black-hole simulations in full general relativity. For numerical relativity NR) simulations lasting approximately two precession cycles, we find that the PN and NR predictions for the directions of the orbital angular momentum and the spins agree to better than $\sim 1^{\circ}$ with NR during the inspiral, increasing to $5^{\circ}$ near merger. Nutation of the orbital plane on the orbital time-scale agrees well between NR and PN, whereas nutation of the spin direction shows qualitatively different behavior in PN and NR. We also examine how the PN equations for precession and orbital-phase evolution converge with PN order, and we quantify the impact of various choices for handling partially known PN terms

Radio Planetary Nebulae in the Small Magellanic Cloud

We present ten new radio continuum (RC) detections at catalogued planetary nebula (PN) positions in the Small Magellanic Cloud (SMC): SMPS6, LIN 41, LIN 142, SMP S13, SMP S14, SMP S16, J18, SMP S18, SMP S19 and SMP S22. Additionally, six SMC radio PNe previously detected, LIN 45, SMP S11, SMPS17, LIN321, LIN339 and SMPS24 are also investigated (re-observed) here making up a population of 16 radio detections of catalogued PNe in the SMC. These 16 radio detections represent ~15 % of the total catalogued PN population in the SMC. We show that six of these objects have characteristics that suggest that they are PN mimics: LIN 41, LIN 45, SMP S11, LIN 142, LIN 321 and LIN 339. We also present our results for the surface brightness - PN radius relation ({\Sigma}-D) of the SMC radio PN population. These are consistent with previous SMC and LMC PN measurements of the ({\Sigma}-D) relation.Comment: Accepted for publication in Astrophysics and Space Scienc

The role of planets in shaping planetary nebulae

In 1997 Soker laid out a framework for understanding the formation and shaping of planetary nebulae (PN). Starting from the assumption that non-spherical PN cannot be formed by single stars, he linked PN morphologies to the binary mechanisms that may have formed them, basing these connections almost entirely on observational arguments. In light of the last decade of discovery in the field of PN, we revise this framework, which, although simplistic, can still serve as a benchmark against which to test theories of PN origin and shaping. Within the framework, we revisit the role of planets in shaping PN. Soker invoked a planetary role in shaping PN because there are not enough close binaries to shape the large fraction of non-spherical PN. In this paper we adopt a model whereby only ~20% of all 1-8 solar mass stars make a PN. This reduces the need for planetary shaping. Through a propagation of percentages argument, and starting from the assumption that planets can only shape mildly elliptical PN, we conclude, like in Soker, that ~20% of all PN were shaped via planetary and other substellar interactions but we add that this corresponds to only ~5% of all 1-8 solar mass stars. This may be in line with findings of planets around main sequence stars. PN shaping by planets is made plausible by the recent discovery of planets that have survived interactions with red giant branch (RGB) stars. Finally, we conclude that of the ~80% of 1-8 solar mass stars that do not make a PN, about one quarter do not even ascend the AGB due to interactions with stellar and substellar companions, while three quarters ascend the AGB but do not make a PN. Once these stars leave the AGB they evolve normally and can be confused with post-RGB, extreme horizontal branch stars. We propose tests to identify them.Comment: 23 pages, accepted by PAS

Equations of motion for the mass centers in a scalar theory of gravitation

A scalar theory of gravitation with a preferred reference frame (PRF) is considered, that accounts for special relativity and reduces to it if the gravitational field cancels. The gravitating system consists of a finite number of perfect-fluid bodies. An " asymptotic " post-Newtonian (PN) approximation scheme is used, allowing an explicit weak-field limit with all fields expanded. Exact mass centers are defined and their exact equations of motion are derived. The PN expansion of these equations is obtained: the zero-order equations are those of Newtonian gravity (NG), and the equations for the first-order (PN) corrections depend linearly on the PN fields. For PN corrections to the motion of the mass centers, especially in the solar system, one may assume " very-well-separated " rigidly moving bodies with spherical self-fields of the zero-order approximation. The PN corrections reduce then to a time integration and include spin effects, which might be significant. It is shown that the Newtonian masses are not correct zero-order masses for the PN calculations. An algorithm is proposed, in order to minimize the residual and to assess the velocity in the PRF.Comment: Post-Script, 32 page

Quantum Transport Characteristics of Lateral pn-Junction of Single Layer TiS3

Using density functional theory and nonequilibrium Greens functions-based methods we investigated the electronic and transport properties of monolayer TiS3 pn-junction. We constructed a lateral pn-junction in monolayer TiS3 by using Li and F adatoms. An applied bias voltage caused significant variability in the electronic and transport properties of the TiS3 pn-junction. In addition, spin dependent current-voltage characteristics of the constructed TiS3 pn-junction were analyzed. Important device characteristics were found such as negative differential resistance and rectifying diode behaviors for spin-polarized currents in the TiS3 pn-junction. These prominent conduction properties of TiS3 pn-junction offer remarkable opportunities for the design of nanoelectronic devices based on a recently synthesized single-layered material

Planetary Nebula Surveys: Past, Present and Future

In this review we cover the detection, identification and astrophysical importance of planetary nebulae (PN). The legacy of the historic Perek & Kohoutek and Acker et al. catalogues is briefly covered before highlighting the more recent but significant progress in PN discoveries in our Galaxy and the Magellanic Clouds. We place particular emphasis on the major MASH and the IPHAS catalogues, which, over the last decade alone, have essentially doubled Galactic and LMC PN numbers. We then discuss the increasing role and importance that multi-wavelength data is playing in both the detection of candidate PN and the elimination of PN mimics that have seriously biased previous PN compilations. The prospects for future surveys and current efforts and prospects for PN detections in external galaxies are briefly discussed due to their value both as cosmic distance indicators and as kinematical probes of galaxies and dark matter properties.Comment: 8 pages, 1 figure, Proceedings of the Asymmetric Planetary Nebula V Conference (Invited Review, Lake District, England, June 2010