Generating families of surface triangulations. The case of punctured surfaces with inner degree at least 4

We present two versions of a method for generating all triangulations of any punctured surface in each of these two families: (1) triangulations with inner vertices of degree at least 4 and boundary vertices of degree at least 3 and (2) triangulations with all vertices of degree at least 4. The method is based on a series of reversible operations, termed reductions, which lead to a minimal set of triangulations in each family. Throughout the process the triangulations remain within the corresponding family. Moreover, for the family (1) these operations reduce to the well-known edge contractions and removals of octahedra. The main results are proved by an exhaustive analysis of all possible local configurations which admit a reduction.Comment: This work has been partially supported by PAI FQM-164; PAI FQM-189; MTM 2010-2044

Monterey County Behavioral Health - Transition To Integrated Care

The rate of clients discharging from acute mental health services in Monterey County is low. According to Monterey County Behavioral Health Services Act (2017), “the demand for services has greatly increased with the ACCESS programs serving 90% more individuals in the past two years [2015-2016], and a 168% increase in the last 5 years [2011-2016].” The increase in demand for services has impacted staff psychiatrist and social workers in providing quality treatment services. The Monterey County Behavioral Health Bureau (MCBH), a division of Monterey County Health Department, has identified clients who’ve shown improvement in their mental health recovery and are eligible for lower level of care treatment. In collaboration with the agency, the “Transition to Integrated Care” project was developed with the objective to transition stable clients to their Primary Care Physicians (PCP). This process is a way of rewarding clients for their recovery and increasing access for client’s who need higher level of care. For clients who are not eligible for lower level of care, they are being referred to Adult System of Care (ASOC) where the client remains with their current psychiatrist and additional case management services are provided by a Psychiatric Social Worker. At the end of the transition process, clients are invited to participate in an evaluation survey that measures areas of the transition process. It is recommended that the agency continue to use the evaluation tool to gather data and improve the continuity of care for future transitions

Attention: A view suggested by systemic and cybernetic consideration

This thesis was submitted for the degree of Doctor of Philosophy and awarded by Brunel University.Current views and models about attention regard man as a 'transmitter channel' and try to characterise the properties of that 'odd channel'. Another characteristic of the current views is that attention is regarded as a specific mental operation in a person which can be described, irrespective of the purposes of the subject. By contrast we examine attention as an activity at the service of the purposes of the person. Attention is examined as an activity by means of which the field of consciousness is structured around the 'object of attention'. This object of attention is not a specific 'stimulus' but a system in the sense of General System Theory. Hence, the approach is mainly holistic in character. Activity is looked upon as an INTERTRAFFIC between the person and his relation with the world. And where there is relatedness, information theory, in a cybernetic sense, can be used. The approach developed benefits of the advantages from previous models allowing also for a better explanation of the limitation present in the cognitive realm without appeal to some 'filter mechanism' in the physiological structure of a person.Consejo de Desarrollo Cientifico y Humanistico U. C. V. Caraca

Effect of Metallic Waste Addition on the Physical and Mechanical Properties of Cement-Based Mortars

© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).This paper investigates the influence of the type and amount of recycled metallic waste on the physical and mechanical properties of cement-based mortars. The physical and mechanical properties of cement mortars, containing four different amounts of metallic waste (ranged 4 to 16% by cement weight), were evaluated by measuring the bulk density, total porosity, flexural and compressive resistance, and dynamic elastic modulus by ultrasonic tests. All the properties were measured on test specimens under two curing ages: 7 and 28 days. Additionally, the morphological properties and elemental composition of the cement and metallic waste were evaluated by using Scanning Electron Microscopy (SEM), energy dispersive X-ray spectroscopy (EDXS), and X-ray fluorescence (XRF). Main results showed that the addition of metallic waste reduced the bulk density and increased the porosity of the cement-based mortars. Furthermore, it was observed that flexural and compressive strength proportionally increased with the metallic waste addition. Likewise, it was proven that elastic modulus, obtained by compressive and ultrasonic tests, increases with the metallic waste amount. Finally, based on a probability analysis, it was confirmed that the addition of metallic waste did not present a significant effect on the mechanical performance of the cement-based mortars.Peer reviewedFinal Published versio

Fracture in Phenolic Impregnated Carbon Ablator

The thermal protection materials used for spacecraft heat shields are subjected to various thermal-mechanical loads during an atmospheric entry which can threaten the structural integrity of the system. This paper discusses the development of a novel technique to understand the failure mechanisms inside thermal protection materials. The focus of research is Phenolic Impregnated Carbon Ablator (PICA). It has successfully flown on the Stardust spacecraft and is the TPS material chosen for the Mars Science Laboratory (MSL) and Dragon spacecraft. Although PICA has good thermal properties, structurally, it is a weak material. In order to thoroughly understand failure in PICA, fracture tests were performed on FiberForm* (precursor of PICA), virgin and charred PICA materials. Several samples of these materials were tested to investigate failure mechanisms at a microstructural scale. Stress-strain data were obtained simultaneously to estimate the fracture toughness. It was found that cracks initiated and grew in the FiberForm when a critical stress limit was reached such that the carbon fibers separated from the binder. However, both for virgin and charred PICA, crack initiation and growth occurred in the matrix (phenolic) phase. Both virgin and charred PICA showed greater strength values compared to FiberForm coupons, confirming that the presence of the porous matrix helps in absorbing the fracture energy

Predicting USMLE Step 2 Scores Using Results from the NBME Shelf Exams

Background In February of 2020 the sponsors of the USMLE examinations, which includes the NBME and the Federation of State Medical Boards (FSMB) decided to change the scoring system of the USMLE Step 1 from a three-digit numeric score to a Pass/Fail outcome1. The basis of this change was made to “address concerns about Step 1 scores impacting student well-being and medical education”2. Historically, the three-digit numeric score from Step 1 has been one of the top determining factors for admission into residency3. This change will cause a shift in the priority of objective and subjective factors about applicants that residency program directors use to assess medical students. The purpose of this study is to further assess the correlation between core clerkship NBME Shelf exam scores with performance on the USMLE Step 2. Predicting performance on the USMLE Step 2 is of more importance now that the Step 1 scoring system was changed to a Pass/Fail outcome. We expect that the scores on the NBME shelf exams will be correlated to the overall performance on USMLE Step 2, further supporting the conclusions of the previous study by Zahn et al4. Methods Data containing students’ performance on the USMLE Step 2 and NBME Shelf exams was obtained from Blackboard and One45. In order to protect student confidentiality, data will be de-identified at the point of collection by supervising faculty. From the clerkship assessment score (professionalism, clinical knowledge, shelf exam, etc.) each component will be standardized and converted into a z-score. The NBME Shelf Exams and USMLE Step 2 score will also be converted into a standardized z-score. Standardized USMLE Step 2 T-scores will be substituted in place of NBME Shelf T-scores and final grading computation will analyze the frequency of each grade type (Honors, High Pass, Pass, Fail). Linear regression will be used to determine the correlation between USLME Step 2 scores and performance on the Clerkship Shelf Exams. To assess the effect size of the regression equation, a squared correlation coefficient (R2) will be computed between scores of the USLME Step 2 and NBME Shelf Exams. Results Data collection complete after update to IRB research proposal was approved. Data analysis underway with preliminary results expected in early Spring 2021. Conclusion Further analysis of the data is required for proper conclusions to be drawn

Managing Food Quality Risk in Global Supply Chain: A Risk Management Framework

Today, the food sector is one of the sectors most vulnerable to intentional contamination by debilitating agents [1]. Some cases of contaminated food have indicated that product quality risk is one of the vulnerabilities in the global supply chain. A series of company scandals, affecting reputation and causing the recall of products and increasing costs have hit the food industry. The obvious problem is that even a minor incident in one part of the chain can have disastrous effects on other parts of the supply chain. Thus, risks are transmitted through the chain. Even though the dangers from members in the supply chain are small, the cumulative effect becomes significant. The aim of this study is to propose an integrated supply chain risk management framework for practitioners that can provide directions for how to evaluate food quality risk in the global supply chain. For validating the proposed model in‐depth, a case study is conducted on a food SME distributor in Central America. The case study investigates how product quality risks are handled according to the proposed framework

Desarrollo de un sistema de cálculo independiente en braquiterapia HDR para una unidad microSelectron®

Aun cuando la exactitud de los cálculos de dosis en Braquiterapia ha sido verificada en el comisionamiento y durante los tests periódicos de control de calidad, existe la posibilidad de error en la aplicación de cada tratamiento [1]. Por ello, se ha desarrollado una aplicación totalmente automatizada para recalcular la dosis absorbida que estima un TPS (“treatment planning system” - sistema de planificación de tratamiento) sobre los puntos que el Físico ha definido como de interés dosimétrico en la planificación de un tratamiento de braquiterapia HDR (“high-dose rate” - alta tasa de dosis). La unidad de tratamiento empleada fue microSelectron® Digital (HDR-v3), con TPS Oncentra® 4.3 y trabajando con fuente de 192Ir. El primer reto a vencer fue la apertura e importación del archivo DICOM (“digital imaging and Communications in medicine” - comunicaciones e imágenes digitales en medicina) de tratamiento, que normalmente esta encriptado, aspecto que fue resuelto con la ayuda del lenguaje de programación Python®; asimismo, la ecuación de tasa de dosis planteada por el tratado TG 43 [2] fue modelada en los 2 formalismos expuestos en dicha publicación, tomando en cuenta así como optimizando la recomendación de Lachaine et al. [1] para el mas elaborado de estos 2 formalismos de cálculo. Se trabajó con una base de datos de 100 planificaciones en donde se comparó la variación porcentual de lo calculado por la aplicación construida respecto del TPS. Como resultado de esta comparación se obtuvo que el 97.15% de los 1650 puntos de control analizados estaban en un margen de ±10% para el formalismo 1D, mientras que para 2D se obtuvo ±3% en el 97.03%. En conclusión, la aplicación desarrollada, bautizada como HyDRax, es aceptable para uso clínico en su variante 2D, ya que en ningún caso se violo el umbral máximo recomendado de ±20% [3].Despite the fact Brachytherapy dose calculations accuracy has been verified during commissioning procedure and quality control tests, which are done monthly and/or annually, it exists anyway the mistake possibility at each treatment [1]. According to this, a completely automated software application to recalculate the absorbed dose which a TPS (treatmentplanning system) calculates on dosimetric interest points was developed. The treatment unit is a microSelectron® Digital (HDR-v3) charged with an 192Ir source, with TPS Oncentra® 4.3. The first task to solve was to decodify and import DICOM (digital imaging and Communications in medicine) treatment file, that usually is encrypted; Python® programming language was used to achieve it. TG 43 [2] dose rate equation was completely modeled, for 1D and 2D calculation formalism, taking into account Lachaine et al.s’ [1] proposal for the second one. Database has contained 100 treatment plannings. Comparing percentage variation between calculations made by application respect to TPS, it was found that 97.15% from 1650 calculation points has fitted a window range of ±10% for 1D formalism, while for the 2D one this improved to ±3% range for 97.03% from total points. As the conclusion of this study it can be said that application developed, named as HyDRax is acceptable for clinical use at 2D modeling, because no point passes the ±20% threshold established [3].Tesi

Desarrollo del cronograma y costo del saneamiento en la zona rural con biodigestores en diez localidades de la provincia de San Miguel - Cajamarca

El desarrollo de esta tesis está enfocada principalmente en la elaboración de una propuesta de planeación de la Gestión del cronograma y costos con el uso del PMBOK sexta edición, para la construcción de una obra de saneamiento básico con biodigestores, proyecto de saneamiento localizado en la provincia de San Miguel del departamento de Cajamarca. El proyecto consiste en la construcción de 831 unidades básico de saneamiento (letrina con arrastre hidráulico con biodigestor para el tratamiento de excretas). En la parte primera se basa en describir el problema real, donde podemos precisar que no contamos con herramientas que ayuden a llevar un control de la ejecución del Proyecto desde el inicio hasta el final. Se justifica pues mediante este estudio se va a desarrollar un plan de gestión tomando como base los conocimientos PMBOK, basados principalmente en dos conocimientos (cronograma y costo), se buscará hacer comparaciones con el método del valor ganado, realización de un cronograma mediante el Microsoft Project, esta propuesta servirá para obras similares, para que así puedan tener un mejor control en la dirección de proyectos basado en el cronograma y costos. Se tiene el Objetivo principal y secundarios que se basa principalmente en desarrollar un plan de gestión del cronograma y costos en la ejecución de la obra de saneamiento con biodigestores de la zona rural de la Provincia de San Miguel. El marco teórico está desarrollado a través de los conocimientos del PMBOK. Por último, la metodología a usar será mediante el levantamiento de información en las 10 localidades donde se ejecutó la obra y análisis documental Bibliográfico sobre Project Management Institute (PMBOK). Finalmente, el proyecto nos conduce a una optimización del trabajo, sin afectar la rentabilidad del proyecto el tiempo de ejecución la obra, cumpliendo con los requisitos de buena Gestión de Proyectos.The development of this thesis is mainly focused on the elaboration of a planning proposal for the management of the schedule and costs with the use of the sixth edition PMBOK, for the construction of a basic sanitation work with biodigesters, a sanitation project located in the province from San Miguel of the department of Cajamarca. The project involves the construction of 831 basic sanitation units (latrine with hydraulic drag with biodigester for excreta treatment). In the first part it is based on describing the real problem, where we can specify that we do not have tools that help to keep track of the execution of the Project from the beginning to the end. It is justified because through this study a management plan will be developed based on PMBOK knowledge, based mainly on two knowledge (schedule and cost), it will seek to make comparisons with the method of earned value, making a schedule through Microsoft Project, this proposal will serve for similar works, so that they can have better control in the direction of projects based on the schedule and costs. The main and secondary Objective is based, which is mainly based on developing a schedule of management of the schedule and costs in the execution of the sanitation work with biodigesters in the rural area of the Province of San Miguel. The theoretical framework is developed through the knowledge of PMBOK. Finally, the methodology to be used will be through the collection of information in the 10 locations where the work was carried out and Bibliographic documentary analysis on Project Management Institute (PMBOK). Finally, the project leads us to an optimization of the work, without affecting the profitability of the project the execution time of the work, complying with the requirements of good Project Management.Tesi