Parent-Child Tort Immunity Law in Ohio

In light of the abrupt change in Ohio concerning the parental immunity doctrine, this comment will examine the historical justifications for the doctrine, with an extended discussion of the Ohio experience with the immunity prior to its change in Kirchner. This comment also analyzes the present Ohio position, contrasting it with the approaches of other states, and cautions against the increasing use of family exclusion clauses in liability insurance policies which have the practical effect of retaining the immunity where the court has abrogated it

The hidden sensitivity of non-smooth dynamics

Switches in dynamical systems are known to exhibit wildly different behaviours depending on how they are modelled, for instance whether they occur as smooth transitions or abrupt jumps, and whether they involve delays or discrete perturbations. These differences arise be- cause because switches are sensitive to perturbation, but there is lim- ited knowledge about where this sensitivity comes from. Here we take a switch in a simple one-dimensional system, then discretize time and introduce a small delay. The resulting system is described by a piecewise-linear map with incredibly complex dynamics, and is sensi- tive to parameter changes, even if the time-steps and delays are made infinitesimally small. We show that this sensitivity reveals itself in the more versatile numerical tool of the transition count, which captures the likelihood of switching occurring at any instant in a simulation. We then us this transition count to show that sensitivity to param- eters persists in a system with two switches, and we show why this sensitivity then has large-scale dynamical effects. The use of transi- tion counts in this way may prove a versatile tool for studying more complex switching processes in general

Coherent states on spheres

We describe a family of coherent states and an associated resolution of the identity for a quantum particle whose classical configuration space is the d-dimensional sphere S^d. The coherent states are labeled by points in the associated phase space T*(S^d). These coherent states are NOT of Perelomov type but rather are constructed as the eigenvectors of suitably defined annihilation operators. We describe as well the Segal-Bargmann representation for the system, the associated unitary Segal-Bargmann transform, and a natural inversion formula. Although many of these results are in principle special cases of the results of B. Hall and M. Stenzel, we give here a substantially different description based on ideas of T. Thiemann and of K. Kowalski and J. Rembielinski. All of these results can be generalized to a system whose configuration space is an arbitrary compact symmetric space. We focus on the sphere case in order to be able to carry out the calculations in a self-contained and explicit way.Comment: Revised version. Submitted to J. Mathematical Physic

An Evaluation of Spirituality among Graduate and Professional Degree Students: Year Two

[Note: This is a continuation of a study that was introduced at the 2013 GERA Annual Meeting.] This ongoing longitudinal study is designed to measure spirituality in graduate and professional degree students utilizing validated survey instruments. Furthermore, the study investigates perceptions regarding the role of spirituality in higher education and professional practice. We hypothesize that significant relationships exist between student perceptions on spirituality and various academic, professional, and vocational outcomes. The study is being conducted at a large, private university in the southeastern United States, which seeks to enrich both the mind and spirit of students while maintaining intellectual and religious freedom. Our study measures spirituality from inter-faith and non-faith perspectives, thereby increasing applicability to a diverse population. Results from our study will be instrumental in examining the influence of an academic institution on validated measures of spirituality. Furthermore, we hope to be the first to examine, from a qualitative and quantitative perspective, the change in daily spiritual experience among students of diverse graduate and professional degree programs at a single institution. We believe our findings have the potential to stimulate constructive dialogue on the imperative to develop methods for improved teaching and learning

A Survey of Chromospheric Activity in the Solar-Type Stars in the Open Cluster M67

We present the results of a spectroscopic survey of the Ca II H & K core strengths in a sample of 60 solar-type stars that are members of the solar-age and solar-metallicity open cluster M67. We adopt the HK index, defined as the summed H+K core strengths in 0.1 nm bandpasses centered on the H and K lines, respectively, as a measure of the chromospheric activity that is present. We compare the distribution of mean HK index values for the M67 solar-type stars with the variation of this index as measured for the Sun during the contemporary solar cycle. We find that the stellar distribution in our HK index is broader than that for the solar cycle. Approximately 17% of the M67 sun-like stars exhibit average HK indices that are less than solar minimum. About 7%-12% are characterized by relatively high activity in excess of solar maximum values while 72%-80% of the solar analogs exhibit Ca II H+K strengths within the range of the modern solar cycle. The ranges given reflect uncertainties in the most representative value of the maximum in the HK index to adopt for the solar cycle variations observed during the period A.D. 1976--2004. Thus, ~ 20% - 30% of our homogeneous sample of sun-like stars have mean chromospheric H+K strengths that are outside the range of the contemporary solar cycle. Any cycle-like variability that is present in the M67 solar-type stars appears to be characterized by periods greater than ~ 6 years. Finally, we estimate a mean chromospheric age for M67 in the range of 3.8--4.3 Gyr.Comment: Accepted in The Astrophysical Journa

The comparative impact of different patient-centered medical home domains on satisfaction among individuals living with type II diabetes

Chronic illnesses like type 2 diabetes are costly and difficult to treat. Patient-centered medical homes (PCMH) have the potential to improve patient satisfaction in this population. However, which domains have the most impact on patient satisfaction has not been established. The aim of this study was to assess the relative strength of association between seven PCMH domains and two measures of satisfaction. Cross-sectional data were used in this observational study collected from a random sample of adults aged 18-89 with type 2 diabetes (n=1301) seen at 4 PCMHs. The Ambulatory Care Experiences Survey instrument was used to assess all measures. Dependent variables included 2 measures of patient satisfaction: overall care and personal doctor. Independent variables included patient perceptions of implementation level of 7 PCMH domains categorized into two dimensions: administrative features of care and physician-patient interactions. Administrative features of care include organizational access, integration of care and office staff helpfulness. Physician-patient interactions include communication, comprehensive knowledge and interpersonal treatment. Analysis was conducted using linear regression. The results reveal all physician-patient interaction PCMH domains were significantly associated with both measures of satisfaction. The relationships for administrative features of care were dependent upon the satisfaction outcome being analyzed. Communication and comprehensive knowledge had the strongest association of all domains. The authors conclude variations in importance of PCMH domains on satisfaction exist. Physician-patient interaction domains are the strongest contributors to patient satisfaction and overall experience. Understanding which PCMH domains have the largest impact can inform physician practice’s efforts to improve outcomes of care

Examining the Conceptual Design Process for Future Hybrid-Electric Rotorcraft

Hybrid-electric propulsion systems introduce immense complexity and numerous design challenges not previously encountered in aircraft design. Traditional conceptual-level rotorcraft design approaches may not adequately capture the level of propulsion system detail desired for hybrid-electric vehicle conceptual design. As part of a NASA Small Business Innovative Research (SBIR) Phase II contract, Empirical Systems Aerospace (ESAero) investigated the implementation of several hybrid-electric propulsion architectures onto three rotorcraft configurations. Unique hybrid-electric variants of these configurations were compared against their conventionally-powered counterparts using typical metrics such as payload, range, and energy efficiency. The feasibility and performance of these vehicles was also investigated in the +15 and +30-year timeframes based on third-party estimations for future component performance. Using the lessons learned during this trade study, ESAero then conducted a conceptual design effort for a hybrid-electric tiltrotor demonstrator based on the XV-15. A detailed integration of the hybrid-electric propulsion system into the vehicle airframe was also performed. The hybrid-electric XV-15 concept vehicle was estimated to achieve a 10% reduction in cruise fuel consumption compared to the original NASA XV-15 at the cost of increasing the vehicle empty weight by almost 25%. The success of this design effort suggests that the design of a manned, hybrid-electric tiltrotor is technically feasible at current technology levels

Randomized trial of inhaled nitric oxide to treat acute pulmonary embolism: The iNOPE trial

BACKGROUND: The study hypothesis is that administration of inhaled nitric oxide (NO) plus oxygen to subjects with submassive pulmonary embolism (PE) will improve right ventricular (RV) systolic function and reduce RV strain and necrosis, while improving patient dyspnea, more than treatment with oxygen alone. METHODS: This article describes the rationale and protocol for a registered (NCT01939301), nearly completed phase II, 3-center, randomized, double-blind, controlled trial. Eligible patients have pulmonary imaging-proven acute PE. Subjects must be normotensive, and have RV dysfunction on echocardiography or elevated troponin or brain natriuretic peptide and no fibrinolytics. Subjects receive NO plus oxygen or placebo for 24 hours (±3 hours) with blood sampling before and after treatment, and mandatory echocardiography and high-sensitivity troponin posttreatment to assess the composite primary end point. The sample size of N=78 was predicated on 30% more NO-treated patients having a normal high-sensitivity troponin (<14 pg/mL) and a normal RV on echocardiography at 24 hours with α=.05 and β=.20. Safety was ensured by continuous spectrophotometric monitoring of percentage of methemoglobinemia and a predefined protocol to respond to emergent changes in condition. Blinding was ensured by identical tanks, software, and physical shielding of the device display and query of the clinical care team to assess blinding efficacy. RESULTS: We have enrolled 78 patients over a 31-month period. No patient has been withdrawn as a result of a safety concern, and no patient has had a serious adverse event related to NO. CONCLUSIONS: We present methods and a protocol for the first double-blinded, randomized trial of inhaled NO to treat PE

Reduction in overt and silent stroke recurrence rate following cerebral revascularization surgery in children with sickle cell disease and severe cerebral vasculopathy

Background Children with sickle cell disease (SCD) and moyamoya may benefit from indirect cerebral revascularization surgery in addition to chronic blood transfusion therapy for infarct prevention. We sought to compare overt and silent infarct recurrence rates in children with SCD undergoing revascularization. Methods This was a retrospective cohort study of all children with SCD and moyamoya treated at two children’s hospitals. Clinical events and imaging studies were reviewed. Results Twenty-seven children with SCD and confirmed moyamoya receiving chronic transfusion therapy were identified, of whom 12 underwent indirect cerebral revascularization. Two subjects had post-operative transient ischemic attacks and another had a subarachnoid blood collection, none of which caused permanent consequences. Two subjects had surgical wound infections. Among these 12 children, the rate of overt and silent infarct recurrence decreased from 13.4 infarcts/100 patient-years before revascularization to 0 infarcts/100 patient-years after revascularization (p=0.0057); the post-revascularization infarct recurrence rate was also significantly lower than the overall infarct recurrence of 8.87 infarcts/100 patient-years in 15 children without cerebral revascularization (p=0.025). Conclusion The rate of overt and silent infarct recurrence was significantly lower following indirect cerebral revascularization. A prospective study of cerebral revascularization in children with SCD is needed