HIPAA-Phobia Hampers Efforts To Track And Contain COVID-19

The Health Insurance Portability and Accountability Act (HIPAA), enacted by the US Congress 1996, laudably protects medical privacy in healthcare settings. However, this federal law has created a culture of fear that limits current efforts to address the COVID-19 pandemic. Healthcare providers, who are covered by HIPAA, may be reluctant to disclose information about outbreak clusters for fear of violating the law. Healthcare organizations, who are also covered by the law, still rely on fax machines to avoid violating HIPAA’s data security requirements. And the scrupulous rule-following in healthcare has given independent life to a HIPAA boogeyman. Thus, officials who are not covered by the law (e.g. schools) withhold or deter the release of valuable information—even when HIPAA does not apply to them. The Executive has taken some action to relax HIPAA in these unprecedented times and should take further action, along with Congress, to balance privacy rights with the need for greater transparency in the fight against COVID-19.https://scholarship.law.slu.edu/lawjournalonline/1055/thumbnail.jp

A comparison of Noether charge and Euclidean methods for Computing the Entropy of Stationary Black Holes

The entropy of stationary black holes has recently been calculated by a number of different approaches. Here we compare the Noether charge approach (defined for any diffeomorphism invariant Lagrangian theory) with various Euclidean methods, specifically, (i) the microcanonical ensemble approach of Brown and York, (ii) the closely related approach of Ba\~nados, Teitelboim, and Zanelli which ultimately expresses black hole entropy in terms of the Hilbert action surface term, (iii) another formula of Ba\~nados, Teitelboim and Zanelli (also used by Susskind and Uglum) which views black hole entropy as conjugate to a conical deficit angle, and (iv) the pair creation approach of Garfinkle, Giddings, and Strominger. All of these approaches have a more restrictive domain of applicability than the Noether charge approach. Specifically, approaches (i) and (ii) appear to be restricted to a class of theories satisfying certain properties listed in section 2; approach (iii) appears to require the Lagrangian density to be linear in the curvature; and approach (iv) requires the existence of suitable instanton solutions. However, we show that within their domains of applicability, all of these approaches yield results in agreement with the Noether charge approach. In the course of our analysis, we generalize the definition of Brown and York's quasilocal energy to a much more general class of diffeomorphism invariant, Lagrangian theories of gravity. In an appendix, we show that in an arbitrary diffeomorphism invariant theory of gravity, the ``volume term" in the ``off-shell" Hamiltonian associated with a time evolution vector field $t^a$ always can be expressed as the spatial integral of $t^a {\cal C}_a$, where ${\cal C}_a = 0$ are the constraints associated with the diffeomorphism invariance.Comment: 29 pages (double-spaced) late

No hair for spherical black holes: charged and nonminimally coupled scalar field with self--interaction

We prove three theorems in general relativity which rule out classical scalar hair of static, spherically symmetric, possibly electrically charged black holes. We first generalize Bekenstein's no--hair theorem for a multiplet of minimally coupled real scalar fields with not necessarily quadratic action to the case of a charged black hole. We then use a conformal map of the geometry to convert the problem of a charged (or neutral) black hole with hair in the form of a neutral self--interacting scalar field nonminimally coupled to gravity to the preceding problem, thus establishing a no--hair theorem for the cases with nonminimal coupling parameter $\xi<0$ or $\xi\geq {1\over 2}$. The proof also makes use of a causality requirement on the field configuration. Finally, from the required behavior of the fields at the horizon and infinity we exclude hair of a charged black hole in the form of a charged self--interacting scalar field nonminimally coupled to gravity for any $\xi$.Comment: 30 pages, RevTeX. Sec.IV corrected, simplified and shortened. Corrections to Sec.IIA between Eqs. 2.7 and Eq.2.1. First two paragraphs of Sec. VC new. To appear Phys. Rev. D, Oct. 15, 199

On the dynamics of Extrasolar Planetary Systems under dissipation. Migration of planets

We study the dynamics of planetary systems with two planets moving in the same plane, when frictional forces act on the two planets, in addition to the gravitational forces. The model of the general three-body problem is used. Different laws of friction are considered. The topology of the phase space is essential in understanding the evolution of the system. The topology is determined by the families of stable and unstable periodic orbits, both symmetric and non symmetric. It is along the stable families, or close to them, that the planets migrate when dissipative forces act. At the critical points where the stability along the family changes, there is a bifurcation of a new family of stable periodic orbits and the migration process changes route and follows the new stable family up to large eccentricities or to a chaotic region. We consider both resonant and non resonant planetary systems. The 2/1, 3/1 and 3/2 resonances are studied. The migration to larger or smaller eccentricities depends on the particular law of friction. Also, in some cases the semimajor axes increase and in other cases they are stabilized. For particular laws of friction and for special values of the parameters of the frictional forces, it is possible to have partially stationary solutions, where the eccentricities and the semimajor axes are fixed.Comment: Accepted in Celestial Mechanics and Dynamical Astronom

A Fast and Accurate Diagnostic Test for Severe Sepsis Using Kernel Classifiers

Severe sepsis occurs frequently in the intensive care unit (ICU) and is a leading cause of admission, mortality, and cost. Treatment guidelines recommend early intervention, however gold standard blood culture test results may return in up to 48 hours. Insulin sensitivity (SI) is known to decrease with worsening condition and inflammatory response, and could thus be used to aid clinical treatment decisions. Some glycemic control protocols are able to accurately identify SI in real-time. A biomarker for severe sepsis was developed from retrospective SI and concurrent temperature, heart rate, respiratory rate, blood pressure, and SIRS score from 36 adult patients with sepsis. Patients were identified as having sepsis based on a clinically validated sepsis score (ss) of 2 or higher (ss = 0–4 for increasing severity). Kernel density estimates were used for the development of joint probability density profiles for ss = 2 and ss < 2 data hours (213 and 5858 respectively of 6071 total hours) and for classification. From the receiver operator characteristic (ROC) curve, the optimal probability cutoff values for classification were determined for in-sample and out-of-sample estimates. A biomarker including concurrent insulin sensitivity and clinical data for the diagnosis of severe sepsis (ss = 2) achieves 69–94% sensitivity, 75–94% specificity, 0.78–0.99 AUC, 3–17 LHR+, 0.06–0.4 LHR-, 9–38% PPV, 99–100% NPV, and a diagnostic odds ratio of 7–260 for optimal probability cutoff values of 0.32 and 0.27 for in-sample and out-of-sample data, respectively. The overall result lies between these minimum and maximum error bounds. Thus, the clinical biomarker shows good to high accuracy and may provide useful information as a real-time diagnostic test for severe sepsis

Non-stoichiometry in monoclinic zirconia and amorphous zirconia

A combination of materials modelling techniques and targeted experimental investigations have identified the manner in which non-stoichiometry is accommodated within both crystalline and amorphous ZrO2. Not only is excess oxygen possible in both crystalline and amorphous ZrO2, but it is found that there is a high propensity for significant deviations – especially in the amorphous system – forming ZrO2+x. This has clear implications to the behavior and degradation of ZrO2 as a thermal barrier coating in aerospace and energy components, but also as the boundary oxide protecting zirconium alloys in aggressive environments, including within a water cooled nuclear power reactor. The behavior was highlighted through a combination of both Raman spectroscopy and associated atomic scale predictions coupled with thermodynamic analysis of the system. As excess oxygen cannot readily oxidize Zr4+ ions beyond this charge state, the additional oxygen is accommodated instead as a peroxide ion – O22-. This peroxide specie has a distinct covalent bond not expected in the stoichiometric ionic ZrO2 system that is readily observable using Raman spectroscopy. Now that excess oxygen accommodation in ZrO2 has been highlighted, an understanding of how various dopant or alloying elements can impact its behavior can be targeted to improve component reliability. The presence of amorphous phases at grain boundaries is also discussed in terms of potential super-highways for oxygen transport through the oxide system

First normal stress difference and crystallization in a dense sheared granular fluid

The first normal stress difference (${\mathcal N}_1$) and the microstructure in a dense sheared granular fluid of smooth inelastic hard-disks are probed using event-driven simulations. While the anisotropy in the second moment of fluctuation velocity, which is a Burnett-order effect, is known to be the progenitor of normal stress differences in {\it dilute} granular fluids, we show here that the collisional anisotropies are responsible for the normal stress behaviour in the {\it dense} limit. As in the elastic hard-sphere fluids, ${\mathcal N}_1$ remains {\it positive} (if the stress is defined in the {\it compressive} sense) for dilute and moderately dense flows, but becomes {\it negative} above a critical density, depending on the restitution coefficient. This sign-reversal of ${\mathcal N}_1$ occurs due to the {\it microstructural} reorganization of the particles, which can be correlated with a preferred value of the {\it average} collision angle $\theta_{av}=\pi/4 \pm \pi/2$ in the direction opposing the shear. We also report on the shear-induced {\it crystal}-formation, signalling the onset of fluid-solid coexistence in dense granular fluids. Different approaches to take into account the normal stress differences are discussed in the framework of the relaxation-type rheological models.Comment: 21 pages, 13 figure