Ultra-relativistic geometrical shock dynamics and vorticity

Geometrical shock dynamics, also called CCW theory, yields approximate equations for shock propagation in which only the conditions at the shock appear explicitly; the post-shock flow is presumed approximately uniform and enters implicitly via a Riemann invariant. The nonrelativistic theory, formulated by G. B. Whitham and others, matches many experimental results surprisingly well. Motivated by astrophysical applications, we adapt the theory to ultra-relativistic shocks advancing into an ideal fluid whose pressure is negligible ahead of the shock, but one third of its proper energy density behind the shock. Exact results are recovered for some self-similar cylindrical and spherical shocks with power-law pre-shock density profiles. Comparison is made with numerical solutions of the full hydrodynamic equations. We review relativistic vorticity and circulation. In an ultrarelativistic ideal fluid, circulation can be defined so that it changes only at shocks, notwithstanding entropy gradients in smooth parts of the flow.Comment: 12 pages, 2 figure

Experimental assessment of presumed filtered density function models

Measured filtered density functions (FDFs) as well as assumed beta distribution model of mixture fraction and “subgrid” scale (SGS) scalar variance, used typically in large eddy simulations, were studied by analysing experimental data, obtained from two-dimensional planar, laser induced fluorescence measurements in isothermal swirling turbulent flows at a constant Reynolds number of 29 000 for different swirl numbers (0.3, 0.58, and 1.07)

Safe Opioid Prescribing at Discharge

Safe Opioid Prescribing at Discharge Taylor Goodman, PharmD; Elva Van Devender, PharmD; Luetta Jones, PharmD; Courtney Barber Background/Purpose: The opioid epidemic has led to devastating consequences, especially in Oregon, with an average of five Oregonians dying each week from opioid overdose. Opioid prescriptions at discharge are correlated with future continued opioid use. United States providers prescribe more opioids both inpatient and at discharge than other countries, and Oregon providers wrote more opioid prescriptions per person than the national average. Oversupplying prescription opioids can lead to reservoirs of unused medication, creating opportunities for non-medical use and overdose. Pharmacy interventions have shown significant improvement in safe opioid prescribing practices at hospital discharge. However, inpatient discharges still represent a major source of high-volume opioid prescriptions. The purpose of this study is to evaluate hospital discharge opioid prescriptions and to assess the impact of data sharing and education on subsequent discharge prescribing practices. Methods: This was a retrospective review of discharge opioid prescriptions for adult hospitalist patients discharged from two, large, tertiary hospitals during July 2018, September 2019, and either February 2020 or February 18th thru March 18th, 2020 depending on the location. Eligible patients’ data elements including discharge opioid, quantity of opioid tablets (QTY), morphine milligram equivalence (MME), concomitant benzodiazepine prescription, ordering provider, and ordering department were evaluated for pre and post intervention implementation analysis. Data was collected through a review of orders in the electronic health record (EHR). Further investigation into charts was completed for necessary additional information if needed. The primary outcome is hospitalist group opioid discharge prescribing practices pre and post multiple interventions (EHR changes to default quantity on new orders, addition of MME daily calculation and provider education) and provider education alone presented on either January 21st or February 11th, 2020. Secondary outcomes include department and individual provider prescribing practices. This study has been approved by the institutional review board. Results: At Hospital A, both the average quantity of tablets and MME per discharge decreased post EHR and education interventions, then increased (25.8 to 23 to 25 and 198.3 to 177.5 to 195.6 respectively) post education only intervention. At Hospital B, a similar trend in both the average quantity of tablets and MME per discharge post interventions (34.9 to 23.3 to 25.8 and 303.5 to 191 to 212 respectively) was seen. The percentage of(62% to 62.7% to 67.5% at Hospital A and 50.6% to 70.2% to 66.5% at Hospital B). Conclusion: Results comparison prior to intervention (2018) to post intervention (2019 and 2020) indicate that it was effective in promoting safer prescribing practices however education/data sharing only intervention may be more effective when combined with more system orientated interventions. While longer term monitoring and individual provider follow up is needed to elicit the true impact of provider education and data sharing intervention, future efforts should combine multiple interventions. These should target the individual via continued education/data sharing and system processes via workflow adjustments such as encouraging utilizing new opioid orders upon discharge. Targeting specific service lines could help identify more opportunities to promote safer prescribing practices going forward.https://digitalcommons.psjhealth.org/pharmacy_PGY1/1001/thumbnail.jp

After interaction

Interaction turns on the outmoded idea that there is a natural separation between people and things. Technologies have always been about producing dense, interconnected relationships of humans and non-humans. Seeing design as performing expansive networks of relations opens up possibilities beyond the human-computer interactions. The relations go much deeper than any discrete interactions between user and machine. Extensive investigations have also demonstrated how cognitive capacities can extend beyond the individual's mind and into the interactions between people

Getting antimalarials on target: impact of national roll-out of malaria rapid diagnostic tests on health facility treatment in three regions of Tanzania.

OBJECTIVES: Parasitological confirmation of malaria prior to treatment is recommended for patients of all ages, with malaria rapid diagnostic tests (mRDTs) an important tool to target artemisinin-based combination therapies (ACTs) to patients with malaria. To evaluate the impact on case management practices of routine government implementation of mRDTs, we conducted large-scale health facility surveys in three regions of Tanzania before and after mRDT roll-out. METHODS: Febrile patients at randomly selected health facilities were interviewed about care received at the facility, and blood samples were collected for reference blood smears. Health facility staff were interviewed about their qualifications and availability of malaria diagnostics and drugs. RESULTS: The percentage of febrile patients tested for malaria at the facility increased from 15.8% in 2010 to 54.9% in 2012. ACTs were obtained by 65.8% of patients positive by reference blood smear in 2010 and by 50.2% in 2012 (P = 0.0675); no antimalarial was obtained by 57.8% of malaria-negative patients in 2010 and by 82.3% in 2012 (P < 0.0001). Overall, ACT use decreased (39.9-21.3%, P < 0.0001) and antibiotic use increased (31.2-48.5%, P < 0.0001). CONCLUSION: Roll-out of mRDTs in Tanzania dramatically improved diagnostic testing for malaria and reduced overuse of ACTs for patients without parasitemia. However, post-roll-out almost 50% of febrile patients did not receive a diagnostic test, and almost 50% of patients testing positive did not receive ACTs. Stock-outs of ACTs and mRDTs were important problems. Further investigation is needed to determine reasons for not providing ACTs to patients with malaria and potential for inappropriate antibiotic use

Planning reform, land release and the supply of housing

There is a growing interest in academic and policy circles in the relationship between land use planning policy and housing supply. Housing researchers are interested in the extent to which planning policies and practises may be exacerbating housing affordability questions, while planning academics and practitioners focus on what effect their policies actually have on the characteristics of housing supply. Policies seeking a diversity of built form are underpinned by attempts to reduce energy consumption through smaller house sizes and the design of less car dependent suburbs. Urban Growth Boundaries (UGBs) and increased net housing densities seek to slow the expansion of cities into hinterlands and reduce travel costs. The impact of UGBs on house prices is one of a number of issues that remains contested (Nelson et al 2007; Buxton and Scheurer 2007)

TMC-1C: an accreting starless core

We have mapped the starless core TMC-1C in a variety of molecular lines with the IRAM 30m telescope. High density tracers show clear signs of self-absorption and sub-sonic infall asymmetries are present in N2H+ (1-0) and DCO+ (2-1) lines. The inward velocity profile in N2H+ (1-0) is extended over a region of about 7,000 AU in radius around the dust continuum peak, which is the most extended ``infalling'' region observed in a starless core with this tracer. The kinetic temperature (~12 K) measured from C17O and C18O suggests that their emission comes from a shell outside the colder interior traced by the mm continuum dust. The C18O (2-1) excitation temperature drops from 12 K to ~10 K away from the center. This is consistent with a volume density drop of the gas traced by the C18O lines, from ~4x10^4 cm^-3 towards the dust peak to ~6x10^3 cm^-3 at a projected distance from the dust peak of 80" (or 11,000 AU). The column density implied by the gas and dust show similar N2H+ and CO depletion factors (f_D < 6). This can be explained with a simple scenario in which: (i) the TMC-1C core is embedded in a relatively dense environment (H2 ~10^4 cm^-3), where CO is mostly in the gas phase and the N2H+ abundance had time to reach equilibrium values; (ii) the surrounding material (rich in CO and N2H+) is accreting onto the dense core nucleus; (iii) TMC-1C is older than 3x10^5 yr, to account for the observed abundance of N2H+ across the core (~10^-10 w.r.t. H2); and (iv) the core nucleus is either much younger (~10^4 yr) or ``undepleted'' material from the surrounding envelope has fallen towards it in the past 10,000 yr.Comment: 29 pages, including 5 tables and 15 figure

Wild Buckwheat Is Unlikely to Pose a Risk to Buckwheat-Allergic Individuals

Buckwheat (Fagopyrum esculentum) is a commonly allergenic food especially in Asia where buckwheat is more commonly consumed. Wild buckwheat (Polygonum convolvulus, recently changed to Fallopia convolvulus) is an annual weed prevalent in grain-growing areas of the United States. Wild buckwheat is not closely related to edible buckwheat although the seeds do have some physical resemblance. A large shipment of wheat into Japan was halted by the discovery of the adventitious presence of wild buckwheat seeds over possible concerns for buckwheat-allergic consumers. However, IgE-binding was not observed to an extract of wild buckwheat using sera from 3 buckwheat-allergic individuals either by radio-allergosorbent test inhibition or by immunoblotting after protein separation by sodium dodecyl sulfate–polyacrylamide gel electrophoresis. Furthermore, the extract of wild buckwheat was not detected in a buckwheat enzyme-linked immunosorbent assay developed with antisera against common buckwheat. Thus, wild buckwheat is highly unlikely to pose any risk to buckwheat-allergic individuals. The common names of plants should not be a factor in the risk assessment for possible cross-allergenicity