Rapid Fluctuations in Earth-Currents at College

An unusual type of earth-current variation is regularly observed in the College records. The phenomena consist of more or less regular fluctuations with range from a few mv/km to more than 1000 mv/km, and periods ranging upwards from 6 seconds. The fluctuations may continue from a few minutes to several hours. They have a strong diurnal variation at College with a broad maximum at 0600 local time. The fluctuations also occur at a site about 100 km southeast of College, but are not observed at Barrow« Thus these rapid fluctuations display characteristics quite different from the previously classified magnetic and earth-current continuous pulsations, pc's, and train pulsations, pt's. Special equipment was devised to count and record the period of the fluctuations on a continuous basis. Typical rapid, fluctuation, traces.and charts showing their activity patterns are presented.This research is sponsored by the Geophysics Research Directorate, Air Force Cambridge Research Center, Air Research and Development Command under Contract No. AF 19(604)-3075 and by a grant from the National Science Foundation.Abstract -- Introduction -- Equipment : Geographic location of electrode field ; Stray electric fields ; Electrodes ; Lines ; Recorders ; Cycle counting equipment -- Records and Scaling : Rapid fluctuation records ; Rapid fluctuation at College - selected days ; Rapid fluctuation activity - February 1958 -- Diurnal variation in rapid fluctuation -- Diurnal variation in amplitude and frequency activity ; Rapid fluctuation frequency and period ; Rapid fluctuations at College and at Barrow -- Discussion : Comparison of earth-current rapid fluctuations with geomagnetic pulsations ; Comparison with other earth-current pulsation studies ; Diurnal Variation in amplitude and fluctuation frequency activity at College ; Generation of earth-current rapid fluctuation -- Summary -- Bibliography -- FiguresYe

Motivation and attitudes toward changing health (MATCH): A new patient-reported measure to inform clinical conversations.

ObjectiveTo identify and assess patient motivation to initiate or maintain behavior changes.MethodsAttitudinal statements were developed from structured patient interviews and translated into 18 survey items. Items were analyzed with exploratory factor analysis (EFA).ResultsAn EFA with 340 type 2 diabetes patients identified three areas of patient attitudes toward changing health behaviors: (1) willingness to make changes (3 items; α = 0.69), (2) perceived ability to make or maintain changes (3 items; α = 0.74), and (3) and feeling changes are worthwhile (3 items; α = 0.61). Greater perceived ability and feelings of worthwhileness were associated with positive psychosocial and behavioral management indicators. All three areas were associated with confidence and attitudes toward making a specific behavioral change (e.g., improve diet).ConclusionsMATCH is an internally consistent and valid 9-item scale that provides a profile of factors influencing motivation that can be used in clinical and research settings

When is diabetes distress clinically meaningful?: establishing cut points for the Diabetes Distress Scale.

ObjectiveTo identify the pattern of relationships between the 17-item Diabetes Distress Scale (DDS17) and diabetes variables to establish scale cut points for high distress among patients with type 2 diabetes.Research design and methodsRecruited were 506 study 1 and 392 study 2 adults with type 2 diabetes from community medical groups. Multiple regression equations associated the DDS17, a 17-item scale that yields a mean-item score, with HbA(1c), diabetes self-efficacy, diet, and physical activity. Associations also were undertaken for the two-item DDS (DDS2) screener. Analyses included control variables, linear, and quadratic (curvilinear) DDS terms.ResultsSignificant quadratic effects occurred between the DDS17 and each diabetes variable, with increases in distress associated with poorer outcomes: study 1 HbA(1c) (P < 0.02), self-efficacy (P < 0.001), diet (P < 0.001), physical activity (P < 0.04); study 2 HbA(1c) (P < 0.03), self-efficacy (P < 0.004), diet (P < 0.04), physical activity (P = NS). Substantive curvilinear associations with all four variables in both studies began at unexpectedly low levels of DDS17: the slope increased linearly between scores 1 and 2, was more muted between 2 and 3, and reached a maximum between 3 and 4. This suggested three patient subgroups: little or no distress, <2.0; moderate distress, 2.0-2.9; high distress, ≥3.0. Parallel findings occurred for the DDS2.ConclusionsIn two samples of type 2 diabetic patients we found a consistent pattern of curvilinear relationships between the DDS and HbA(1c), diabetes self-efficacy, diet, and physical activity. The shape of these relationships suggests cut points for three patient groups: little or no, moderate, and high distress

Screening for Park Access during a Primary Care Social Determinants Screen.

While there is evidence that access to nature and parks benefits pediatric health, it is unclear how low-income families living in an urban center acknowledge or prioritize access to parks.MethodsWe conducted a study about access to parks by pediatric patients in a health system serving low-income families. Adult caregivers of pediatric patients completed a survey to identify and prioritize unmet social and economic needs, including access to parks. Univariate and multivariate analyses were conducted to explore associations between lack of access to parks and sociodemographic variables. We also explored the extent to which access to parks competed with other needs.ResultsThe survey was completed by 890 caregivers; 151 (17%) identified "access to green spaces/parks/playgrounds" as an unmet need, compared to 397 (45%) who endorsed "running out of food before you had money or food stamps to buy more". Being at or below the poverty line doubled the odds ( Odds ratio 1.96, 95% CI 1.16-3.31) of lacking access to a park (reference group: above the poverty line), and lacking a high school degree nearly doubled the odds. Thirty-three of the 151 (22%) caregivers who identified access to parks as an unmet need prioritized it as one of three top unmet needs. Families who faced competing needs of housing, food, and employment insecurity were less likely to prioritize park access (p < 0.001).ConclusionClinical interventions to increase park access would benefit from an understanding of the social and economic adversity faced by patients

Habitat selection and movements of diploid and triploid grass carp in a large reservoir

Grass Carp, an herbivorous fish introduced in North America to control aquatic vegetation, has become an increasing ecological threat to aquatic ecosystems they invade. Grass Carp have the potential to cause declines and alterations in aquatic vegetation communities, which in turn can have negative impacts on native species reliant on aquatic vegetation. In the last ten years, frequent captures and observed spawning of wild fish have increased concerns of Grass Carp establishment in novel waterways. A particular concern is the potential establishment of fish in Lake Erie and its tributaries. Understanding Grass Carp habitat selection might be useful in population control by guiding harvest actions. In addition, understanding movement ecology of Grass Carp might help to predict where Grass Carp go and what cues initiate those movements. Identifying predictable movement behaviors to heavily used sites might also be useful in control efforts. In this study, I tracked Grass Carp to evaluate winter habitat selection and to determine whether using tagged (Judas) fish is effective in removing wild fish during winter. In addition, this study aimed to characterize upstream migrations into lake tributaries and determine if diploid and triploid fish exhibit similar behaviors. From 2017-2019, I tracked 86 Grass Carp tagged with acoustic transmitters in Truman Reservoir, Missouri to answer these questions. I employed Bayesian discrete choice models to determine winter habitat selection of tagged fish. Generalized linear mixed models were used to determine environmental conditions associated with upstream migrations. Tagged Grass Carp showed strong selection for shallow littoral habitats, and 75% of locations were in waters [less than or equal to] 3 m deep. Attempts to capture fish with trammel nets using the Judas method proved difficult with only 1.9 fish caught/netting attempt versus 1.2 caught/netting attempt when selecting areas with suitable Grass Carp habitat for harvest. Fish were often observed near inundated vegetation, with food material collected in 29 of the 31 guts I sampled from fish harvested during capture attempts, which is indicative of overwinter feeding. Eleven fish (6 diploid and 5 triploid) exhibited upstream migrations over the 2018 and 2019 spawning seasons on the Osage River above Truman Reservoir, with distances between 13.6 - 108.1 river km observed. Three of the ten fish in 2019 (2 diploid and 1 triploid) made two migrations and one diploid made three migrations. Upstream migrations were observed from late April to early July and were strongly associated with river temperatures between 15 - 26[degrees] C when river levels were rising at a rate > 0.9 m/ 12 h. Five lake resident fish made upstream movements into tributaries during rising river events, indicative that fish residing in the lake proper respond to cues to move upstream. Winter habitat selection suggests that efforts to reduce Grass Carp populations via harvest may be difficult in large lake systems when fish are dispersed throughout the available littoral habitat. Upstream migrations were made by both diploid and triploid fish during conditions suitable for spawning, possibly explaining a motive for these large movements. These results may need to be considered with efforts to remove Grass Carp in large lake systems and for the utilization of triploid fish in observing Grass Carp movement behavior in natural systems.Includes bibliographical reference

An online experiment to assess bias in professional medical coding.

BackgroundMultiple studies have documented bias in medical decision making, but no studies have examined whether this bias extends to medical coding practices. Medical coding is foundational to the US health care enterprise. We evaluate whether bias based on patient characteristics influences specific coding practices of professional medical coders.MethodsThis is an online experimental study of members of a national professional medical coding organization. Participants were randomly assigned a set of six clinical scenarios reflecting common medical conditions and asked to report encounter level of service codes for these clinical scenarios. Clinical scenarios differed by patient demographics (race, age, gender, ability) or social context (food insecurity, housing security) but were otherwise identical. We estimated Ordinary Least Squares regression models to evaluate differences in outcome average visit level of service by patient demographic characteristics described in the clinical scenarios; we adjusted for coders' age, gender, race, and years of coding experience.ResultsThe final analytic sample included 586 respondents who coded at least one clinical scenario. Higher mean level of service was assigned to clinical scenarios describing seniors compared to middle-aged patients in two otherwise identical scenarios, one a patient with type II diabetes mellitus (Coef: 0.28, SE: 0.15) and the other with rheumatoid arthritis (Coef: 0.30, SE: 0.13). Charts describing women were assigned lower level of service than men in patients with asthma exacerbation (Coef: -0.25, SE: 0.13) and rheumatoid arthritis (Coef: -0.20, SE: 0.12). There were no other significant differences in mean complexity score by patient demographics or social needs.ConclusionWe found limited evidence of bias in professional medical coding practice by patient age and gender, though findings were inconsistent across medical conditions. Low levels of observed bias may reflect medical coding workflow and training practices. Future research is needed to better understand bias in coding and to identify effective and generalizable bias prevention practices

PS2 Transfer Lines

Within the scope of the LHC injector upgrade it has been proposed to replace the present injector chain by new accelerators, LINAC4, SPL and PS2, for which new transfer lines will be required. In this report the beam line properties and requirements are summarized. Then the initial optics of these beam lines and their geometry are discussed. Particular attention is given to the injection and extraction regions where several beam lines have to intersect, imposing challenging constraints on the layout. Directions for optimisation are suggested

The 4 GeV H- Beam Transfer Line from the SPL to the PS2

The proposed new CERN injector chain LINAC4, SPL, PS2 will require the construction of new beam transfer lines. A preliminary design has been performed for the 4 GeV SPL to PS2 H- transfer line. The constraints, beam parameters and geometry requirements are summarised and a possible layout proposed, together with the magnet specifications. First considerations on longitudinal beam dynamics and on beam loss limitations from H- lifetime are presented

Comparison of first-line and second-line terlipressin versus sole norepinephrine in fulminant ovine septic shock

The Surviving Sepsis Guidelines suggest the use of vasopressin in case of catecholamine-refractory septic shock. Terlipressin (TP) as a V-1-selective AVP analogue is a potential alternative, though data regarding the first-line administration in septic shock are scarce. The present study explored and compared the effects of first-line vs. second-line infusion of TP or sole norepinephrine regarding organ function, fluid and norepinephrine requirements and survival in fulminant ovine septic shock. Peritoneal sepsis was induced in 23 ewes after laparotomy and faecal withdrawal from the caecum. After onset of shock, causal and supportive sepsis therapy (antibiotics, peritoneal lavage, fluids and open-label norepinephrine) was performed in all animals. Concurrently, animals were randomized to receive 0.9% sodium chloride (control group) or TP (2 mu g.kg(-1).h(-1), first-line group) after shock onset. In the second-line TP group, TP (2 mu g.kg(-1).h(-1)) was started once norepinephrine requirements exceeded 0.5 mu g.kg(-1).min(-1). No significant differences were found between groups regarding survival, haemodynamics as well as fluid-and catecholamine-requirements. Kidney function and electron microscopic kidney injury were comparable between groups. In the present model of fulminant ovine septic shock, first-line TP infusion had no significant effect on fluid and norepinephrine requirements or organ dysfunction as compared to second-line TP infusion or placebo