If I Could Only Make You Care

https://digitalcommons.library.umaine.edu/mmb-vp/4234/thumbnail.jp

Moon-Bird: An Indian Love Song

https://digitalcommons.library.umaine.edu/mmb-vp/4536/thumbnail.jp

You\u27re a Grand Old Bell

https://digitalcommons.library.umaine.edu/mmb-vp/5242/thumbnail.jp

The Hour That Gave Me You

https://digitalcommons.library.umaine.edu/mmb-vp/1608/thumbnail.jp

Strutural Damage Induced by Pyritic Shale

The Evangelical Hospital located in Lewisburg, Pennsylvania has experienced distress in the form of cracked floor slabs and displaced structural steel due to swelling of the underlying fill material and natural bedrock formation. The bedrock consisted of black, pyritic, calcareous shale from the Marcellus Formation of the Hamilton Group (Devonian Age). The fill materials beneath the cracked concrete floor slabs consisted of the weathered shale fragments from this formation. Although mitigating the structural distress has been attempted, the building continued to experience problems relating to the swelling of the underlying bedrock materials. The expansion of the shale could be attributed to the oxidation of the pyrite, which produced sulfuric acid. The sulfuric acid, in turn, reacted with the calcium carbonate (calcite) in the shale partings producing the mineral gypsum. Since gypsum has approximately twice the molar volume of calcite, the result is an expansion or swelling of the shale. Various laboratory tests were conducted on the shale in an attempt to simulate the swelling processes. The failures and successes of the laboratory testing have given new directions for additional research to further educate Geotechnical Engineers unfamiliar with the expansive nature of pyritic shale

Say Yes With A Sweet Red Rose

https://digitalcommons.library.umaine.edu/mmb-vp/4297/thumbnail.jp

Visit complexity, diagnostic uncertainty, and antibiotic prescribing for acute cough in primary care: a retrospective study

Background: Guidelines and performance measures recommend avoiding antibiotics for acute cough/acute bronchitis and presume visits are straightforward with simple diagnostic decision-making. We evaluated clinician-assigned diagnoses, diagnostic uncertainty, and antibiotic prescribing for acute cough visits in primary care. Methods: We conducted a retrospective analysis of acute cough visits – cough lasting ≤21 days in adults 18–64 years old without chronic lung disease – in a primary care practice from March 2011 through June 2012. Results: Of 56,301 visits, 962 (2%) were for acute cough. Clinicians diagnosed patients with 1, 2, or ≥ 3 cough-related diagnoses in 54%, 35%, and 11% of visits, respectively. The most common principal diagnoses were upper respiratory infection (46%), sinusitis (10%), acute bronchitis (9%), and pneumonia (8%). Clinicians prescribed antibiotics in 22% of all visits: 65% of visits with antibiotic-appropriate diagnoses and 4% of visits with non-antibiotic-appropriate diagnoses. Clinicians expressed diagnostic uncertainty in 16% of all visits: 43% of visits with antibiotic-appropriate diagnoses and 5% of visits with non-antibiotic-appropriate diagnoses. Clinicians expressed uncertainty more often when prescribing antibiotics than when not prescribing antibiotics (30% vs. 12%; p < 0.001). As the number of visit diagnoses increased from 1 to 2 to ≥ 3, clinicians were more likely to express diagnostic uncertainty (5%, 25%, 40%, respectively; p < 0.001) and prescribe antibiotics (16%, 25%, 41%, respectively; p < 0.001). Conclusions: Acute cough may be more complex and have more diagnostic uncertainty than guidelines and performance measures presume. Efforts to reduce antibiotic prescribing for acute cough should address diagnostic complexity and uncertainty that clinicians face

A multiwavelength campaign of active stars with intermediate rotation rates

Near-to-simultaneous ultraviolet and visual spectroscopy of two moderate nu(sin i) RS CVn systems, V815 Herculis (nu(sin i) = 27 km s(exp -1)) and LM Pegasi (nu(sin i) = 24 km s(exp -1)), are presented along with contemporaneous UBV (RI)(sub c) - band photometry. These data were used to probe inhomogeneities in the chromospheres and photospheres, and the possible relationship between them. Both systems show evidence for rotationally modulated chromospheric emission, generally varying in antiphase to the photospheric brightness. A weak flare was observed at Mg II for V815 Her. In the case of IM Peg, we use photometry and spectra to estimate temperatures, sizes, and locations of photospheric spots. Further constraints on the spot temperature is provided by TiO observations. For IM Peg, the anticorrelation between chromospheric emission and brightness is discussed in the context of a possible solar-like spot cycle