RSFQ Circuitry Using Intrinsic π-Phase Shifts

The latching of temporary data is essential in the rapid single flux quantum (RSFQ) electronics family. Its pulse-driven nature requires two or more stable states in almost all cells. Storage loops must be designed to have exactly two stable states for binary data representation. In conventional RSFQ such loops are constructed to have two stable states, e.g. by using asymmetric bias currents. This bistability naturally occurs when phase-shifting elements are included in the circuitry, such as pi-Josephson junctions or a pi-phase shift associated with an unconventional (d-wave) order parameter symmetry. Both approaches can be treated completely analogously, giving the same results. We have demonstrated for the first time the correct operation of a logic circuit, a toggle-flip-flop, using rings with an intrinsic pi-phase shift (pi-rings) based on hybrid high-Tc to low-Tc Josephson junctions. Because of their natural bistability these pi-rings improve the device symmetry, enhance operation margins and alleviate the need for bias current lines.\ud \u

Migraine, Personality, and Psychiatric Comorbidity

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71396/1/j.1526-4610.1995.hed3507382.x.pd

Rural Physician-Pharmacist Collaborative Practice Agreements Managing Patients in Supportive Living and Assisted Living Memory Care Facilities

Setting: Supportive living and assisted living memory care facilities in a rural West-Central Illinois county. Objectives: 1) Evaluate the impact of active pharmacist participation on patient care for residents living in supportive and assisted living facilities, 2) demonstrate feasibility and financial sustainability of rural community pharmacists providing disease state management services, 3) create processes for best practice to expand the clinical role of the community pharmacist Design: Case study. Interventions: Participating residents received disease state management services provided by a community pharmacist as outlined through collaborative practice agreements with local physicians. The disease states managed included hypertension, hyperlipidemia, diabetes mellitus, and warfarin anticoagulation therapy. The pharmacist completed an initial chart review, initial face-to-face visit, subsequent monthly chart reviews, and monthly face-to-face visits with each resident. Results: During the 6-month period of community pharmacist management, 86 face-to-face visits were completed to deliver a median of 5 visits per resident. The pharmacist identified 23 drug therapy problems with recommended solutions communicated to the resident’s primary care provider. Providers accepted 19 of these recommendations, reflecting an 82.6% acceptance rate. Conclusions: Community pharmacists can feasibly implement enhanced clinical services to assist with disease state management of supportive living and assisted living residents in collaboration with physicians. Pharmacists can provide clinical assessment, education and effective communication to optimize medication management and utilization.   Article Type: Case Stud

Услови и перспективи за развој на туризмот и социоекономските карактеристики на Општина Долнени

Општина Долнени се наоѓа во северозападниот дел на Пелагонискиот слив, на надморска височина од околу 600 метри, блиску до една од поголемите општини во Република Македонија, и е важен дел од Пелагонискиот слив, како и за Македонија во целина. Општината природно е поделена на две целини, од кои првата единица, која е рамничарска и зафаќа околу 90% од нејзината територија, вклучувајќи ја целата обработлива површина, а втората единица, од вкупната површина, е ридско-планински дел. од кои половината е покриена со пасишта, а половина со шуми. Имајќи ги предвид овие податоци, како и подготвените поглавја од овој труд, можеме да заклучиме дека општината е главен двигател на социо-економските фактори во овој регион, што истовремено укажува дека има големи изгледи за развој и унапредување на туризмот. Во овој труд подетално ќе ги разгледаме информациите за оваа општина, ќе го анализираме социјалниот, но и економскиот развој, се со цел да се утврдат перспективите за развој на туризмот во оваа општина, и колку тој туризам може да има големо значење за подобрување и унапредување на оваа општина, но и за туризмот воопшто. Ќе бидат разгледани и културните настани и традиции во ова место, и нивниот придонес во развојот на туризмот во оваа општина. Трудот завршува со заклучок од претходно споменатите и анализирани податоци за општината

Patient Experiences at Enhanced-Service Pharmacies in Iowa

Objectives: As payment systems are evolving, the role of community pharmacists has expanded from simply dispensing prescriptions to actively providing care to patients. Little is known about patients’ experiences with enhanced pharmacy services under the pay-for-performance model.  In Iowa, Wellmark implemented its Value-Based Pharmacy Program (VBPP) where pharmacists receive capitation for performance on a set of quality measurements. Therefore, the objective of this study was to evaluate the quality of services and pharmacies from patients’ perspective in VBPP. A structured interview guide developed from the service quality model was used for this study. Methods: We conducted telephone interviews with patients from 6 community pharmacies participating in VBPP between December 2017 and January 2018. Patients who were aged between 21 and 90 years, had Wellmark prescription drug coverage, were currently on at least three medications with one or more of the medications for a chronic condition and had received enhanced pharmacy services were invited for the study. The semi-structured interview transcripts were coded and analyzed using an inductive approach of thematic analysis. Results: Interviews were completed by 25 patients. Most of them were female and the average age was 59. More than half of the patients were taking at least five medications for chronic conditions. A majority of the patients received medication synchronization and immunization. A total of 13 themes across the service quality dimensions were identified. Patients thought their pharmacists were reliable, responsive, knowledgeable and trustworthy when they provided services. Pharmacy services were accessible and perceived as high quality. Privacy was not a big concern for most patients. Patients had a somewhat limited view regarding how pharmacists helped them maintain health. Conclusions: Patients’ perceptions of enhanced pharmacy services and pharmacies were generally positive while their understanding of pharmacists’ clinical role was limited.   Article Type: Original Researc

PTSD and physical comorbidity among women receiving Medicaid: Results from service-use data

Patterns of physical comorbidity among women with posttraumatic stress disorder (PTSD) were explored using Michigan Medicaid claims data. PTSD-diagnosed women (n = 2,133) were compared with 14,948 randomly selected women in three health outcome areas: ICD-9 categories of disease, chronic conditions associated with sexual assault history in previous research, and reproductive health conditions. PTSD was associated with increased risk of all categories of diseases (OR range = 1.3–4.8), endometriosis (OR = 2.7), and dyspareunia (OR = 3.4). When PTSD was not complicated by other mental health conditions, odds ratios for chronic conditions ranged from 1.9 for fibromyalgia to 4.3 for irritable bowel. Comorbidity with depression or a dissociative or borderline personality disorder raised risk in a dose–response pattern.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50659/1/20097_ftp.pd

An Experimental Investigation of Detonation Corner-Turning Using High Resolution Radiography

We have performed experiments investigating detonation corner turning over a range of high-explosives including LX-17, Composition B, LX-04 and Tritonal. The primary diagnostic utilized here was a new high-resolution x-ray system that was capable of recording a time sequence of the detonation process as it negotiated the corner of interest and propagated. For LX-17 our data detail the formation of a significant dead-zone. Although the detonation eventually turned the corner in LX-17, the dead zone persisted to late times and evidence exists that it never was consumed by either detonation or fast combustion processes. In LX-17 the detonations ability to corner-turn increases as the density is reduced. Furthermore, lowering the density decreases the size of the dead-zone and alters its shape. The other high-explosives investigated were able to turn the corner immediately with no indication of any dead-zone formation

A Comparison of Recall and Diary Food Expenditure Data

Recall food expenditure data, which is the basis of a great deal of empirical work, is believed to suffer from considerable measurement error. Diary records are believed to be more accurate. We study an unusual data set that collects recall and diary data from the same households and so allows a direct comparison of the two methods of data collection. The diary data imply measurement errors in recall food expenditure data that are substantial, and which do not have the properties of classical measurement error. However, we also present evidence that the diary measures are themselves imperfect