Differential Effects of Race and Poverty on Ambulatory Care Sensitive Conditions

This study is a continuation of an earlier study that examined hospitalization rates for ambulatory care sensitive (ACS) conditions, as a proxy for quality of care, and found evidence of a racial disparity among African American and White Medicare beneficiaries. The current study sought to determine whether neighborhood socioeconomic status (SES) explained this disparity. Differences in rates of ACS hospitalizations by race were assessed using Cochran-Mantel Haenszel tests and Poisson regression. Unadjusted rate ratios for ACS hospitalization for African Americans vs. Whites were found to be higher in low poverty areas (rate ratio (RR)=1.13; 95% CI (1.08, 1.17)) than in high poverty areas (RR=0.97; 95% CI (0.89, 1.05)). After controlling for various indicators of area SES in multivariate analyses race differences in ACS hospitalization rates persisted. Rural neighborhoods and those with higher percent of non-high school graduates were associated with greater risk of ACS hospitalizations

The value of the follow-through derives from motor learning depending on future actions.

In ball sports, we are taught to follow through, despite the inability of events after contact or release to influence the outcome [1, 2]. Here we show that the specific motor memory active at any given moment critically depends on the movement that will be made in the near future. We demonstrate that associating a different follow-through movement with two motor skills that normally interfere [3-7] allows them to be learned simultaneously, suggesting that distinct future actions activate separate motor memories. This implies that when learning a skill, a variable follow-through would activate multiple motor memories across practice, whereas a consistent follow-through would activate a single motor memory, resulting in faster learning. We confirm this prediction and show that such follow-through effects influence adaptation over time periods associated with real-world skill learning. Overall, our results indicate that movements made in the immediate future influence the current active motor memory. This suggests that there is a critical time period both before [8] and after the current movement that determines motor memory activation and controls learning.This is the final published version. The article was originally published in Current Biology, Volume 25, Issue 3, p397–401, 2 February 2015, DOI: 10.1016/j.cub.2014.12.03

Building the Evryscope: Hardware Design and Performance

The Evryscope is a telescope array designed to open a new parameter space in optical astronomy, detecting short timescale events across extremely large sky areas simultaneously. The system consists of a 780 MPix 22-camera array with an 8150 sq. deg. field of view, 13" per pixel sampling, and the ability to detect objects down to Mg=16 in each 2 minute dark-sky exposure. The Evryscope, covering 18,400 sq.deg. with hours of high-cadence exposure time each night, is designed to find the rare events that require all-sky monitoring, including transiting exoplanets around exotic stars like white dwarfs and hot subdwarfs, stellar activity of all types within our galaxy, nearby supernovae, and other transient events such as gamma ray bursts and gravitational-wave electromagnetic counterparts. The system averages 5000 images per night with ~300,000 sources per image, and to date has taken over 3.0M images, totaling 250TB of raw data. The resulting light curve database has light curves for 9.3M targets, averaging 32,600 epochs per target through 2018. This paper summarizes the hardware and performance of the Evryscope, including the lessons learned during telescope design, electronics design, a procedure for the precision polar alignment of mounts for Evryscope-like systems, robotic control and operations, and safety and performance-optimization systems. We measure the on-sky performance of the Evryscope, discuss its data-analysis pipelines, and present some example variable star and eclipsing binary discoveries from the telescope. We also discuss new discoveries of very rare objects including 2 hot subdwarf eclipsing binaries with late M-dwarf secondaries (HW Vir systems), 2 white dwarf / hot subdwarf short-period binaries, and 4 hot subdwarf reflection binaries. We conclude with the status of our transit surveys, M-dwarf flare survey, and transient detection.Comment: 24 pages, 24 figures, accepted PAS

Stability of Core-Annular Flow with Very Small Viscosity Ratio

It is known that the stability problem for core-annular flow of very viscous crude oil and water is singular, the water annulus appears to be inviscid with boundary layers at the pipe wall and at the interface. In the present paper, this singular problem is treated by the method of matched asymptotic expansions using ∈ = m/ℝα as a small parameter. There are two cases of instability corresponding to different positions of the critical point in the annulus. One case is when the critical point is far away from the interface, the other is when the critical point is close to the interface within a distance of order ∈1/3. In both cases, the equations for the eigenvalues are derived, and the explicit forms for the neutral curves are given. The stability problem is also treated by the modified finite element code used by Hu and Joseph [J. Fluid Mech. 205, 359 ( 1989); Phys. Fluids A 1, 1659 ( 1989)], taking into account the boundary layers at the pipe wall and at the interface. The results of the two methods agree where they overlap, but the finite element technique goes further

Preload Loss in a Spacecraft Fastener via Vibration-Induced Unwinding

Sound engineering practice requires that fasteners and bolted joints maintain preload in service. NASA recently concluded a series of vibration tests of a multicomponent structure intended to simulate an upper stage section of a launch vehicle. The stacked components were joined through six circumferentially placed bolted cup-cone-style pyrotechnic joint mechanisms designed to share spacecraft structural loads and then enable separation during ascent. Over the course of the vibration test campaign, all six bolted cup-cone mechanisms experienced some degree of preload loss with two mechanisms losing half of their original bolt preload. A subsequent forensic anomaly investigation concluded that vibration-induced unwinding of the preload nut-and-bolt assemblies occurred despite the use of safety wire and high levels of thread friction. A series of experiments were done to better understand how large, heavily preloaded fasteners could unwind. Additionally, thread friction torque was measured and the fastener locking capability of safety wire was evaluated. The friction coefficient between the clamped cup-cone components was characterized and finally a highly instrumented mechanism-level vibration test was done to reproduce the unwinding phenomenon to better understand the mechanism's behavior. The conclusion drawn was that vibration and structural forces led to relative motion (sliding) of the clamped components, resulting in self-loosening and unwinding effects on the nut-and-bolt assembly. To counter this phenomenon, more effective fastener locking methodologies were recommended and a follow-on effort was initiated to quantify the relationship between preload, component motion, and resulting unwinding forces. It is hoped that elucidation of these effects can be used to design more effective fastener locking features

Seeing double with K2: Testing re-inflation with two remarkably similar planets around red giant branch stars

Despite more than 20 years since the discovery of the first gas giant planet with an anomalously large radius, the mechanism for planet inflation remains unknown. Here, we report the discovery of EPIC228754001.01, an inflated gas giant planet found with the NASA K2 Mission, and a revised mass for another inflated planet, K2-97b. These planets reside on ~9 day orbits around host stars which recently evolved into red giants. We constrain the irradiation history of these planets using models constrained by asteroseismology and Keck/HIRES spectroscopy and radial velocity measurements. We measure planet radii of 1.31 +\- 0.11 Rjup and and 1.30 +\- 0.07 Rjup, respectively. These radii are typical for planets receiving the current irradiation, but not the former, zero age main sequence irradiation of these planets. This suggests that the current sizes of these planets are directly correlated to their current irradiation. Our precise constraints of the masses and radii of the stars and planets in these systems allow us to constrain the planetary heating efficiency of both systems as 0.03% +0.03%/-0.02%. These results are consistent with a planet re-inflation scenario, but suggest the efficiency of planet re-inflation may be lower than previously theorized. Finally, we discuss the agreement within 10% of stellar masses and radii, and planet masses, radii, and orbital periods of both systems and speculate that this may be due to selection bias in searching for planets around evolved stars.Comment: 18 pages, 15 figures, accepted to AJ. Figures 11, 12, and 13 are the key figures of the pape

EvryFlare II: Rotation Periods of the Cool Flare Stars in TESS Across Half the Southern Sky

We measure rotation periods and sinusoidal amplitudes in Evryscope light curves for 122 two-minute K5-M4 TESS targets selected for strong flaring. The Evryscope array of telescopes has observed all bright nearby stars in the South, producing two-minute cadence light curves since 2016. Long-term, high-cadence observations of rotating flare stars probe the complex relationship between stellar rotation, starspots, and superflares. We detect periods from 0.3487 to 104 d, and observe amplitudes from 0.008 to 0.216 g' mag. We find the Evryscope amplitudes are larger than those in TESS with the effect correlated to stellar mass (p-value=0.01). We compute the Rossby number (Ro), and find our sample selected for flaring has twice as many intermediate rotators (0.040.44) rotators; this may be astrophysical or a result of period-detection sensitivity. We discover 30 fast, 59 intermediate, and 33 slow rotators. We measure a median starspot coverage of 13% of the stellar hemisphere and constrain the minimum magnetic field strength consistent with our flare energies and spot coverage to be 500 G, with later-type stars exhibiting lower values than earlier-types. We observe a possible change in superflare rates at intermediate periods. However, we do not conclusively confirm the increased activity of intermediate rotators seen in previous studies. We split all rotators at Ro~0.2 into Prot10 d bins to confirm short-period rotators exhibit higher superflare rates, larger flare energies, and higher starspot coverage than do long-period rotators, at p-values of 3.2 X 10^-5, 1.0 X 10^-5, and 0.01, respectively.Comment: 16 pages, 8 figures, 3 tables. Ancillary machine-readable files included. Accepted for publication in ApJ (proofs submitted). Includes significant new material, including starspot color that depends on stellar mass, more rotation periods, potential changes in activity during spin-down, and examples of binary rotator

The economic implications of HLA matching in cadaveric renal transplantation.

Abstract Background: The potential economic effects of the allocation of cadaveric kidneys on the basis of tissue-matching criteria are controversial. We analyzed the economic costs associated with the transplantation of cadaveric kidneys with various numbers of HLA mismatches and examined the potential economic benefits of a local, as compared with a national, system designed to minimize HLA mismatches between donor and recipient in first cadaveric renal transplantations. Methods: All data were supplied by the U.S. Renal Data System. Data on all payments made by Medicare from 1991 through 1997 for the care of recipients of a first cadaveric renal transplant were analyzed according to the number of HLA-A, B, and DR mismatches between donor and recipient and the duration of cold ischemia before transplantation. Results: Average Medicare payments for renal-transplant recipients in the three years after transplantation increased from $60,436 per patient for fully HLA-matched kidneys (those with no HLA-A, B, or DR mismatches) to$80,807 for kidneys with six HLA mismatches between donor and recipient, a difference of 34 percent (P\u3c0.001). By three years after transplantation, the average Medicare payments were $64,119 for transplantations of kidneys with less than 12 hours of cold-ischemia time and$74,997 for those with more than 36 hours (P\u3c0.001). In simulations, the assignment of cadaveric kidneys to recipients by a method that minimized HLA mismatching within a local geographic area (i.e., within one of the approximately 50 organ-procurement organizations, which cover widely varying geographic areas) produced the largest cost savings ($4,290 per patient over a period of three years) and the largest improvements in the graft-survival rate (2.3 percent) when the potential costs of longer cold-ischemia time were considered. Conclusions: Transplantation of better-matched cadaveric kidneys could have substantial economic advantages. In our simulations, HLA-based allocation of kidneys at the local level produced the largest estimated cost savings, when the duration of cold ischemia was taken into account. No additional savings were estimated to result from a national allocation program, because the additional costs of longer cold-ischemia time were greater than the advantages of optimizing HLA matching

Variables in the Southern Polar Region Evryscope 2016 Dataset

The regions around the celestial poles offer the ability to find and characterize long-term variables from ground-based observatories. We used multi-year Evryscope data to search for high-amplitude (~5% or greater) variable objects among 160,000 bright stars (Mv < 14.5) near the South Celestial Pole. We developed a machine learning based spectral classifier to identify eclipse and transit candidates with M-dwarf or K-dwarf host stars - and potential low-mass secondary stars or gas giant planets. The large amplitude transit signals from low-mass companions of smaller dwarf host stars lessens the photometric precision and systematics removal requirements necessary for detection, and increases the discoveries from long-term observations with modest light curve precision. The Evryscope is a robotic telescope array that observes the Southern sky continuously at 2-minute cadence, searching for stellar variability, transients, transits around exotic stars and other observationally challenging astrophysical variables. In this study, covering all stars 9 < Mv < 14.5, in declinations -75 to -90 deg, we recover 346 known variables and discover 303 new variables, including 168 eclipsing binaries. We characterize the discoveries and provide the amplitudes, periods, and variability type. A 1.7 Jupiter radius planet candidate with a late K-dwarf primary was found and the transit signal was verified with the PROMPT telescope network. Further followup revealed this object to be a likely grazing eclipsing binary system with nearly identical primary and secondary K5 stars. Radial velocity measurements from the Goodman Spectrograph on the 4.1 meter SOAR telescope of the likely-lowest-mass targets reveal that six of the eclipsing binary discoveries are low-mass (.06 - .37 solar mass) secondaries with K-dwarf primaries, strong candidates for precision mass-radius measurements.Comment: 32 pages, 17 figures, accepted to PAS