Having a Conversation About Health Care Wishes and Goals in Vermont

Research has shown that people think talking with family and friends about end-of-life care is important, but they do not actually have this conversation. The majority of adults do not have any form of advance care planning in place. In the state of Vermont if you are 18 years of age or older there is no default person to make decisions for you (such as a spouse or next of kin) in the event that you would be unable to do so, which can result in a complicated ethical dilemma. The goal of this project is to improve conversation rates between patients and their friends and families about their health care wishes and goals.https://scholarworks.uvm.edu/fmclerk/1347/thumbnail.jp

Skull Flexure from Blast Waves: A Mechanism for Brain Injury with Implications for Helmet Design

Traumatic brain injury [TBI] has become a signature injury of current military conflicts, with debilitating, costly, and long-lasting effects. Although mechanisms by which head impacts cause TBI have been well-researched, the mechanisms by which blasts cause TBI are not understood. From numerical hydrodynamic simulations, we have discovered that non-lethal blasts can induce sufficient skull flexure to generate potentially damaging loads in the brain, even without a head impact. The possibility that this mechanism may contribute to TBI has implications for injury diagnosis and armor design.Comment: version in press, Physical Review Letters; 17 pages, 5 figures (includes supplementary material

A note on tensor categories of Lie type E9E_9

We consider the problem of decomposing tensor powers of the fundamental level 1 highest weight representation $V$ of the affine Kac-Moody algebra \g(E_9). We describe an elementary algorithm for determining the decomposition of the submodule of \Vn whose irreducible direct summands have highest weights which are maximal with respect to the null-root. This decomposition is based on Littelmann's path algorithm and conforms with the uniform combinatorial behavior recently discovered by H. Wenzl for the series $E_N$, $N\not=9$.Comment: Final published versio

Lepto-mesons, Leptoquarkonium and the QCD Potential

We consider bound states of heavy leptoquark-antiquark pairs (lepto-mesons) as well as leptoquark-antileptoquark pairs (leptoquarkonium). Unlike the situation for top quarks, leptoquarks (if they exist) may live long enough for these hadrons to form. We study the spectra and decay widths of these states in the context of a nonrelativistic potential model which matches the recently calculated two-loop QCD potential at short distances to a successful phenomenological quarkonium potential at intermediate distances. We also compute the expected number of events for these states at future colliders.Comment: 12 pages, 1 figure, 3 tables, plain TeX, requires harvmac. References updated and minor clarifications made. To appear in Physics Letters

Effects of Art from the Heart on Nurse Satisfaction and Patient Well-Being

Introduction. Art programs have been shown to positively affect unit culture, quality of care, and nursing practices. Art interventions improve well-being, reduce stress, and enhance nurse-patient communication. Art from the Heart (AFTH) is an art program that provides art supplies, visual art, and patient About Me pages to patients, families and employees at University of Vermont Medical Center (UVMMC).Objective. Assess the efficacy of AFTH through nursing staff perceptions, understanding, and attitudes toward the program.Methods. Structured interviews were conducted on Baird 4, an adult inpatient ward, at UVMMC. A 19-question survey using Likert scales and short answer formats was administered to nursing staff. Questions assessed perceptions of effects of art on patient anxiety and pain, communication, and job satisfaction. Surveys were analyzed to extract major and minor themes.Results. Twenty-eight interviews were obtained and two major themes emerged: nurse satisfaction and patient well-being. Nursing staff satisfaction minor themes included improved productivity, promoting conversation, and creating a positive influence on the unit. Respondents reported that AFTH helped initiate conversations with patients (100% of respondents) and reduced workday stress (68%). The second major theme, patient well-being, included benefits to patients with dementia, providing comfort, and serving as an outlet or distraction. Utilizing AFTH improved perceived patient mood (100%), health (78.5%), and reduced patient anxiety (89.3%).Conclusions. AFTH provides positive benefits by reducing nursing staff stress and perceived patient anxiety; improving communication, perceived patient mood and health; and creating a sense of community. AFTH should be expanded to the entire 6 Community Agency: Burlington City Arts, Art from the Hearthttps://scholarworks.uvm.edu/comphp_gallery/1240/thumbnail.jp

Simulations of the OzDES AGN Reverberation Mapping Project

As part of the OzDES spectroscopic survey we are carrying out a large scale reverberation mapping study of $\sim$500 quasars over five years in the 30 deg$^2$ area of the Dark Energy Survey (DES) supernova fields. These quasars have redshifts ranging up to 4 and have apparent AB magnitudes between $16.8<r<22.5$ mag. The aim of the survey is to measure time lags between fluctuations in the quasar continuum and broad emission line fluxes of individual objects in order to measure black hole masses for a broad range of AGN and constrain the radius-luminosity ($R-L$) relationship. Here we investigate the expected efficiency of the OzDES reverberation mapping campaign and its possible extensions. We expect to recover lags for $\sim$35-45\% of the quasars. AGN with shorter lags and greater variability are more likely to yield a lag, and objects with lags $\lesssim$6 months or $\sim$1 year are expected be recovered the most accurately. The baseline OzDES reverberation mapping campaign is predicted to produce an unbiased measurement of the $R-L$ relationship parameters for H$\beta$, Mg II $\lambda$2798, and C IV $\lambda$1549. However, extending the baseline survey by either increasing the spectroscopic cadence, extending the survey season, or improving the emission line flux measurement accuracy will significantly improve the $R-L$ parameter constraints for all broad emission lines.Comment: Published online in MNRAS. 28 page

Development of Carbon Dioxide Removal Systems for Advanced Exploration Systems

"NASA's Advanced Exploration Systems (AES) program is pioneering new approaches for rapidly developing prototype systems, demonstrating key capabilities, and validating operational concepts for future human missions beyond Earth orbit" (NASA 2012). These forays beyond the confines of earth's gravity will place unprecedented demands on launch systems. They must not only blast out of earth's gravity well as during the Apollo moon missions, but also launch the supplies needed to sustain a crew over longer periods for exploration missions beyond earth's moon. Thus all spacecraft systems, including those for the separation of metabolic carbon dioxide and water from a crewed vehicle, must be minimized with respect to mass, power, and volume. Emphasis is also placed on system robustness both to minimize replacement parts and ensure crew safety when a quick return to earth is not possible. Current efforts are focused on improving the current state-of-the-art systems utilizing fixed beds of sorbent pellets by seeking more robust pelletized sorbents, evaluating structured sorbents, and examining alternate bed configurations to improve system efficiency and reliability. These development efforts combine testing of sub-scale systems and multi-physics computer simulations to evaluate candidate approaches, select the best performing options, and optimize the configuration of the selected approach, which is then implemented in a full-scale integrated atmosphere revitalization test. This paper describes the carbon dioxide (CO2) removal hardware design and sorbent screening and characterization effort in support of the Atmosphere Resource Recovery and Environmental Monitoring (ARREM) project within the AES program. A companion paper discusses development of atmosphere revitalization models and simulations for this project

A perpetual switching system in pulmonary capillaries

Of the 300 billion capillaries in the human lung, a small fraction meet normal oxygen requirements at rest, with the remainder forming a large reserve. The maximum oxygen demands of the acute stress response require that the reserve capillaries are rapidly recruited. To remain primed for emergencies, the normal cardiac output must be parceled throughout the capillary bed to maintain low opening pressures. The flow-distributing system requires complex switching. Because the pulmonary microcirculation contains contractile machinery, one hypothesis posits an active switching system. The opposing hypothesis is based on passive switching that requires no regulation. Both hypotheses were tested ex vivo in canine lung lobes. The lobes were perfused first with autologous blood, and capillary switching patterns were recorded by videomicroscopy. Next, the vasculature of the lobes was saline flushed, fixed by glutaraldehyde perfusion, flushed again, and then reperfused with the original, unfixed blood. Flow patterns through the same capillaries were recorded again. The 16-min-long videos were divided into 4-s increments. Each capillary segment was recorded as being perfused if at least one red blood cell crossed the entire segment. Otherwise it was recorded as unperfused. These binary measurements were made manually for each segment during every 4 s throughout the 16-min recordings of the fresh and fixed capillaries (>60,000 measurements). Unexpectedly, the switching patterns did not change after fixation. We conclude that the pulmonary capillaries can remain primed for emergencies without requiring regulation: no detectors, no feedback loops, and no effectors-a rare system in biology. NEW & NOTEWORTHY The fluctuating flow patterns of red blood cells within the pulmonary capillary networks have been assumed to be actively controlled within the pulmonary microcirculation. Here we show that the capillary flow switching patterns in the same network are the same whether the lungs are fresh or fixed. This unexpected observation can be successfully explained by a new model of pulmonary capillary flow based on chaos theory and fractal mathematics