Private Enterprise for Public Health: Opportunities for Business to Improve Women's and Children's Health

This guide, developed by FSG and published by the Innovation Working Group in support of the global Every Woman, Every Child effort, explores how companies can create shared value in women's and children's health. The document sets out opportunities for multiple different industries to develop new product and services, improve delivery systems and strengthen health systems that can support global efforts to save 16 million women's and children's lives between now and 2015. It particularly notes that companies need not wait for health services to "catch up" with their economic model, but rather they can work proactively to help accelerate change, by partnering with other industries, civil society and the public sector to create collective impact in a specific location. The aim of the guide is to catalyze these transformative partnerships

Symplectic 4-manifolds admit Weinstein trisections

We prove that every symplectic 4-manifold admits a trisection that is compatible with the symplectic structure in the sense that the symplectic form induces a Weinstein structure on each of the three sectors of the trisection. Along the way, we show that a (potentially singular) symplectic braided surface in $\mathbb{CP}^2$ can be symplectically isotoped into bridge position.Comment: 28 pages, 9 figures. [v2] A necessary technical hypothesis was omitted from the statement of Lemma 5.5(1) in the first version, and the proof of Theorem 5.9 has been modified to account for this hypothesi

Self-supervised learning: When is fusion of the primary and secondary sensor cue useful?

Self-supervised learning (SSL) is a reliable learning mechanism in which a robot enhances its perceptual capabilities. Typically, in SSL a trusted, primary sensor cue provides supervised training data to a secondary sensor cue. In this article, a theoretical analysis is performed on the fusion of the primary and secondary cue in a minimal model of SSL. A proof is provided that determines the specific conditions under which it is favorable to perform fusion. In short, it is favorable when (i) the prior on the target value is strong or (ii) the secondary cue is sufficiently accurate. The theoretical findings are validated with computational experiments. Subsequently, a real-world case study is performed to investigate if fusion in SSL is also beneficial when assumptions of the minimal model are not met. In particular, a flying robot learns to map pressure measurements to sonar height measurements and then fuses the two, resulting in better height estimation. Fusion is also beneficial in the opposite case, when pressure is the primary cue. The analysis and results are encouraging to study SSL fusion also for other robots and sensors

Fairview Cancer Rehab Program Outcomes and Effectiveness: a Pilot Study

BACKGROUND AND PURPOSE: One million people in the United States of America are diagnosed with cancer each year. Many cancer patients are surviving and managing residual effects of cancer, including, but not limited to pain, muscle weakness, depression, anxiety, fatigue and decreased activity tolerance. The purpose of this study is to initiate data compilation to determine the effectiveness and outcomes of the Fairview Cancer Rehabilitation program. METHODS: Participants included 7 patients with a wide variety of cancer diagnoses who were consecutively recruited from Fairview Cancer Rehabilitation program. This program included physical and/or occupational therapy targeted to each patient’s individual impairments. Outcome measures included FACIT-Fatigue, Short-Form Health Survey (SF-12), Six-Minute Walk Test (6MWT), Timed Up and Go (TUG), bilateral grip strength, Numerical Pain Rating Scale (NPRS) and a follow-up survey inquiring about current health status, activity level and pain rating. Outcome measures were administered within the first 2 physical therapy visits and re-administered at time of discharge. The follow-up survey along with the SF-12 were mailed to each participant at 2 months post discharge. Since the number of subjects included in this study was low, changes in scores were examined for trends. RESULTS: The participants ranged in age from 24 to 66 years with an average age of 51.4 ± 14.3 years. Patients participated in an average of 9.6 physical therapy visits ranging from 4-17 visits. Patients participated in an average of 3.1 occupational therapy visits, ranging from 0-12 visits. Mean FACIT-F, SF-12 physical and mental composite scores, 6MWT, TUG scores, bilateral grip strength and NPRS demonstrated impairments at initial evaluation and demonstrated improvement at post-intervention assessment. SF-12 mental composite scores and NPRS continued to improve from the post-intervention to follow-up measures. CONCLUSION: Patients with cancer and cancer survivors are living with a variety of side effects. This pilot study supports the effectiveness of Fairview Cancer Rehabilitation program in improving patient’s quality of life and functional abilities. Further research is indicated with a larger sample size and increased follow-up time.

On the Definition of Cyber-Physical Resilience in Power Systems

In recent years, advanced sensors, intelligent automation, communication networks, and information technologies have been integrated into the electric grid to enhance its performance and efficiency. Integrating these new technologies has resulted in more interconnections and interdependencies between the physical and cyber components of the grid. Natural disasters and man-made perturbations have begun to threaten grid integrity more often. Urban infrastructure networks are highly reliant on the electric grid and consequently, the vulnerability of infrastructure networks to electric grid outages is becoming a major global concern. In order to minimize the economic, social, and political impacts of power system outages, the grid must be resilient. The concept of a power system cyber-physical resilience centers around maintaining system states at a stable level in the presence of disturbances. Resilience is a multidimensional property of the electric grid, it requires managing disturbances originating from physical component failures, cyber component malfunctions, and human attacks. In the electric grid community, there is not a clear and universally accepted definition of cyber-physical resilience. This paper focuses on the definition of resilience for the electric grid and reviews key concepts related to system resilience. This paper aims to advance the field not only by adding cyber-physical resilience concepts to power systems vocabulary, but also by proposing a new way of thinking about grid operation with unexpected disturbances and hazards and leveraging distributed energy resources.Comment: 20 pages. This is a modified versio

Enhancing legacy in palliative care: study protocol for a randomized controlled trial of Dignity Therapy focused on positive outcomes.

BackgroundDignity Therapy is a brief psychotherapy that can enhance a sense of legacy while addressing the emotional and existential needs of patients receiving hospice or palliative care. In Dignity Therapy, patients create a formalized "legacy" document that records their most cherished memories, their lessons learned in life, as well as their hopes and dreams for loved ones in the future. To date, this treatment has been studied for its impact on mitigating distress within hospice and palliative care populations and has provided mixed results. This study will instead focus on whether Dignity Therapy enhances positive outcomes in this population.Methods/designIn this study, 90 patients with cancer receiving hospice or palliative care will complete a mixed-methods randomized controlled trial of Dignity Therapy (n = 45) versus Supportive Attention (n = 45). The patients will be enrolled in the study for 3 weeks, receiving a total of six study visits. The primary outcomes examine whether the treatment will quantitatively increase levels of positive affect and a sense of life closure. Secondary outcomes focus on gratitude, hope, life satisfaction, meaning in life, resilience, and self-efficacy. Using a fixed, embedded dataset design, this study will additionally use qualitative interviews to explore patients' perceptions regarding the use of positive outcome measures and whether these outcomes are appropriately matched to their experiences in therapy.DiscussionDignity Therapy has shown mixed results when evaluating its impact on distress, although no other study to date has solely focused on the potential positive aspects of this treatment. This study is novel in its use of mixed methods assessments to focus on positive outcomes, and will provide valuable information about patients' direct experiences in this area.Trial registrationISRCTN91389194

An Exploratory Model of Shared Decision-Making in Women\u27s Reproductive Health in Indiana: A Cross-Sectional Study

Ecological approaches to shared decision-making (SDM) are underexplored in women’s reproductive health. The purpose was to identify ecological factors important to women in contraceptive and prenatal care SDM. In this cross-sectional study, women (18-45 years) living in Indiana who had sought reproductive healthcare completed an online survey (N=432). Multiple linear regression was utilized to identify predictors of SDM. Furthermore, exploratory factor analysis, confirmatory factor analysis, and structural equation modeling were conducted to explore ecological factors associated with SDM in contraception and prenatal care. Healthcare professional type was associated with decreased contraceptive SDM scores, but not prenatal care SDM scores. Access, social support, and patient-healthcare professional relationship demonstrated good global fit in confirmatory factor analysis. Path coefficients suggested significant relationships between these ecological factors and contraceptive and prenatal care SDM scores. Additionally, the ecological factors demonstrated good global fit for contraceptive and prenatal care SDM. Social support had a significant, strong, and inverse relationship with both contraceptive and prenatal care SDM in the models. Findings further SDM work by moving beyond option discussion and toward increased attention to women’s contexts and relationships. Taking a holistic approach to SDM and the patient experience ensures that women’s multi-faceted needs, influences, and preferences are met across healthcare settings

ALMA Multi-line Imaging of the Nearby Starburst Galaxy NGC 253

We present spatially resolved ($\sim$50 pc) imaging of molecular gas species in the central kiloparsec of the nearby starburst galaxy NGC 253, based on observations taken with the Atacama Large Millimeter/submillimeter Array (ALMA). A total of 50 molecular lines are detected over a 13 GHz bandwidth imaged in the 3 mm band. Unambiguous identifications are assigned for 27 lines. Based on the measured high CO/C$^{17}$O isotopic line ratio ($\gtrsim$350), we show that $^{12}$CO(1-0) has moderate optical depths. A comparison of the HCN and HCO$^{+}$ with their $^{13}$C-substituted isotopologues shows that the HCN(1-0) and HCO$^{+}$(1-0) lines have optical depths at least comparable to CO(1-0). H$^{13}$CN/H$^{13}$CO$^{+}$ (and H$^{13}$CN/HN$^{13}$C) line ratios provide tighter constraints on dense gas properties in this starburst. SiO has elevated abundances across the nucleus. HNCO has the most distinctive morphology of all the bright lines, with its global luminosity dominated by the outer parts of the central region. The dramatic variation seen in the HNCO/SiO line ratio suggests that some of the chemical signatures of shocked gas are being erased in the presence of dominating central radiation fields (traced by C$_{2}$H and CN). High density molecular gas tracers (including HCN, HCO$^+$, and CN) are detected at the base of the molecular outflow. We also detect hydrogen $\beta$ recombination lines that, like their $\alpha$ counterparts, show compact, centrally peaked morphologies, distinct from the molecular gas tracers. A number of sulfur based species are mapped (CS, SO, NS, C$_{2}$S, H$_{2}$CS and CH$_{3}$SH) and have morphologies similar to SiO.Comment: 20 pages, 10 figures, accepted to the Astrophysical Journa

High-resolution Observations of Molecular Lines in Arp 220: Kinematics, Morphology, and Limits on the Applicability of the Ammonia Thermometer

We observe Arp 220, the nearest ultra-luminous infrared galaxy, over 4 GHz in the K and Ka bands, providing constraints for the kinematics and morphology, and identifying molecular species on scales resolving both nuclei (0".6 or 230 pc). We detect multiple molecular species, including hydroxyl (OH ^2Π_(3/2)J = 9/2 F= 4-4; 5-5) in both cores, and tentatively detect H_2O(6_(15)-5_(23)) at ~21.84 GHz in both nuclei, indicating the likely presence of maser emission. The observed frequency range also contains metastable ammonia transitions from (J, K) = (1, 1)–(5, 5), as well as the (9, 9) inversion line; together, they are a well-known thermometer of dense molecular gas. Furthermore, the non-metastable (4, 2) and (10, 9), and possibly the (3, 1), lines are also detected. We apply a standard temperature analysis to Arp 220; however, the analysis is complicated in that standard local thermal equilibrium (LTE) assumptions do not hold. There are indications that a substantial fraction of ammonia could be in the non-metastable transitions, as opposed to only the metastable ones. Thus, the non-metastable transitions could be essential to constraining the temperature. We compare all of these data to ALMA observations of this source, confirming the outflow previously observed by other tracers in both nuclei

Contact-free mapping of electronic transport phenomena of polar domains in SrMnO3 films

Under the terms of the Creative Commons Attribution license.-- et al.High-resolution mapping of electronic transport phenomena plays an increasingly important role for the characterization of ferroic domains and their functionality. At present, spatially resolved electronic transport data are commonly gained from local two-point measurements, collected in line-by-line scans with a conducting nanosized probe. Here, we introduce an innovative experimental approach based on low-energy electron microscopy. As a model case, we study polar domains of varying conductance in strained SrMnO3. By a direct comparison with conductive atomic force and electrostatic force microscopy, we reveal that the applied low-energy electron-microscopy experiment can be considered as an inverse I(V) measurement, providing access to the local electronic conductance with nanoscale resolution and short data-acquisition times in the order of 10-102 ms. Low-energy electrons thus hold yet unexplored application opportunities as a minimal-invasive probe for local electronic transport phenomena, opening a promising route towards spatially resolved, high-throughput sampling at the nanoscale.We thank HZB for the allocation of synchrotron beam time and we thankfully acknowledge financial support by HZB. Research at the ETH was financed in part by the SNF (Proposal No. 200021_149192). L. M., E. L., P. A. A., and J. A. P. acknowledge financial support from Ministerio de Economía y Competitividad under Project No. MAT2014-51982-C2 and Gobierno de Aragón under Project No. E26.Peer Reviewe