Policy Options for Improving the Resilience of US Transportation Infrastructure

Despite the vulnerability of America’s aging infrastructure to costly disruptions from man-made and natural disasters, infrastructure insurance under-utilized. On average, only 30% of catastrophic losses in the past 10 years have been covered by insurance. Most infrastructure project managers have relied instead on taxpayer-funded federal aid when disaster strikes. But it doesn’t need to be this way. In this brief, Gina Tonn, Jeffrey Czajkowski, and Howard Kunreuther use technical reports and input from infrastructure managers to outline steps that policymakers can take to help maximize the use of infrastructure insurance for providing financial protection, encouraging investment in loss mitigation measures, and limiting the current reliance on taxpayer dollars.https://repository.upenn.edu/pennwhartonppi/1058/thumbnail.jp

Lyme Disease Neuroretinitis: A Case Report and Review of Immunologic Workup

Background: Lyme disease is an infection caused by a bacterial spirochete of the borrelia genus. The human vector is from a tick bite by an infected tick of the ixodes genus, commonly referred to as the deer tick or black legged tick. The incidence of Lyme disease is increasing in the United States. Once infected, Lyme disease manifestations usually depend on the stage of infection with late stage infection often causing debilitating illness.1 Case Report: Neuroborreliosis refers to borrelia, causing neurological infection and can occur as acute or late manifestation of Lyme disease. Neuroretinitis is a rare but reported manifestation of neuroborreliosis. Lyme diagnosis requires a two-step serologic test to meet CDC guidelines for Lyme confirmation.1 Testing may be negative early in disease but may turn positive as the disease progresses. Conclusion: Presented is a case where treatment decisions were made based on equivocal Lyme testing results

Characterization of s-SWCNT/PF-PD Dispersions and Networks

Single-Walled Carbon Nanotubes (SWCNTs) are being investigated for their use in a wide variety of renewable energy applications. Their unique physical properties contribute to desirable traits such as a high carrier mobility, strong optical absorption and tunable electronic band gap. Unfortunately, due to variability in certain parameters, SWCNTs are limited in their application. The major drawback is that SWCNTs are variable in size and type and typical synthetic methods are not selective. As a result, selective methods must be developed in order to sort these tubes and extract those which are desirable for a particular application. Though there are several enrichment strategies, polymer-wrapping was used to select semiconducting SWCNTs in this research. Some issues with polymer-wrapping include inability to remove polymer post-enrichment as well as difficulty re-dispersing SWCNTs post polymer removal. Polymer removal is necessary for certain applications and the presence of excess polymer in SWCNTs can decrease their efficiency. To address the first issue, a removable polymer, PF-PD was used in the dispersion making process. The second issue of re-dispersal was discovered to be specific to a particular batch of PF-PD and was combatted by altering the polymer removal step from a centrifuge run to a TFA vapor treatment. PF-PD is loosely linked by imine bonds which are degraded by the TFA and make it easier to remove. This process does require some refining, however, since a significant percentage of SWCNTs are lost during the treatment. Several other mini experiments were conducted throughout the course of this research to contribute to a better understanding of the quality of dispersions that could be made using PF-PD with unpurified SWCNTs. The results of these experiments are inconclusive but do lead to the need for further and more detailed research on SWCNTs

Changing Needs of Individuals with Disabilities in the Time of COVID-19 as Observed by a Family Navigation Program in Miami, FL

The Family Navigator Program (FNP) is designed to help families navigate the complex system of services available to people with intellectual and developmental disabilities (I/DD), chronic health conditions, mental health issues, and other special health care needs. Based at the Mailman Center for Child Development at the University of Miami, the FNP is free and available to all families in South Florida. Most families enrolled in the FNP are receiving medical services from a university clinic; however, the program also accepts referrals from outside agencies and self-referrals. The aim of this study was to investigate the needs of families enrolled in the FNP before and after March 2020, when stay-at-home orders were put in place to address the COVID-19 pandemic. One hundred forty-five families enrolled in the FNP between November 2019 and mid-March 2020 were selected as a pre-COVID sample to be compared with 197 families enrolled from mid-March to September 2020. Families were deidentified, and data on demographics and specific needs were extracted. Demographics included race and ethnicity, language, age group, zip code, and disability or medical condition. Specific needs were defined as (1) topics on which families required education and (2) resources to which families were referred. There were no statistically significant differences in demographics before and after March 2020. There was a significant increase in referrals to financial resources during COVID (OR= 3.019, 95% CI [1.445-6.308]). There were also significant changes in the number of families provided with education on the following: increases in federal and state programs (OR = 2.156, 95% CI [1.306-3.560]) and other miscellaneous topics (1.902, 95% CI [1.081-3.348]); and decreases in school systems (OR=0.531 CI, 95% [0.328-0.858]) and therapies (CI, 95% [0.345-0.825]). These differences likely reflect the economic and social toll that the pandemic has taken on families caring for individuals with IDD and special health care needs in South Florida. Families’ priorities shifted from school and therapy to economic needs. The FNP adjusted by administering services by telephone or online, rather than by in-person meetings. These data provide a snapshot of how the needs of families changed during COVID-19 in one diverse, urban community

Lyrical Music Improves 5 km Time Trial Performance Compared to Non-Lyrical Music

This study examined the effects of lyrical music compared to non-lyrical music on 5 km running performance. Thirteen subjects with an average age of 33.5 ± 8.3 years of age ran three separate 5 km time trials. The first trial acted as a familiarization trial where no music was present, followed by either a lyrical or non-lyrical music trial in a random counterbalanced order. Trial times, RPE, HR, and questionnaire information was analyzed using paired samples t-tests, ANOVA, and multivariate regression analyses. Lyrical music showed a significant improvement over non-lyrical music improving performance time compared to non-lyrical music, on average by 36 ± 41s (p=.000). While not statistically significant, a trend showing lyrical music was faster than no music, followed by the slowest trial of non-lyrical music. No change was detected in HR, or RPE at the 3.05 km mark suggesting that at the end although subjects were working harder (indicated by the faster completion times) they do not perceive themselves to be working harder. A correlation between increased mileage and the decreased effects of music as an ergogenic aid was seen (p=.044 r=.638) which supports previous research. This study suggests that lyrical music may improve 5 km running performance compared to no lyrical music

Bayesian Conditioning, the Reflection Principle, and Quantum Decoherence

The probabilities a Bayesian agent assigns to a set of events typically change with time, for instance when the agent updates them in the light of new data. In this paper we address the question of how an agent's probabilities at different times are constrained by Dutch-book coherence. We review and attempt to clarify the argument that, although an agent is not forced by coherence to use the usual Bayesian conditioning rule to update his probabilities, coherence does require the agent's probabilities to satisfy van Fraassen's [1984] reflection principle (which entails a related constraint pointed out by Goldstein [1983]). We then exhibit the specialized assumption needed to recover Bayesian conditioning from an analogous reflection-style consideration. Bringing the argument to the context of quantum measurement theory, we show that "quantum decoherence" can be understood in purely personalist terms---quantum decoherence (as supposed in a von Neumann chain) is not a physical process at all, but an application of the reflection principle. From this point of view, the decoherence theory of Zeh, Zurek, and others as a story of quantum measurement has the plot turned exactly backward.Comment: 14 pages, written in memory of Itamar Pitowsk

Effect of Prior Anterior Superior Iliac Spine Compression Testing on Second Assessor Findings: Implications for Inter-Examiner Reliability Testing

BACKGROUND: Osteopathic physicians use palpation to diagnose sacroiliac joint somatic dysfunction (SD) -- including the Anterior Superior Iliac Spine (ASIS) Compression Test for dysfunctional side lateralization. (Literature suggests right-sided lateralization in 80% of asymptomatic individuals). Accurate, reliable tests are crucial however to diagnose SD and kappa (κ) analysis is a gold-standard to determine the degree of interexaminer reliability for tests. Few studies have examined the effect the palpatory examination has on subsequent diagnostic findings and therefore on κ-values

Inter-Examiner Reliability of an Anterior Superior Iliac Spine Compression Test used to Lateralize Pelvic Somatic Dysfunction to the Right Side or Not

BACKGROUND: Osteopathic physicians use a number of palpatory structural examinations to diagnose pelvic somatic dysfunction (SD). They may elect to use the Anterior Superior Iliac Spine (ASIS) Compression Test to lateralize the dysfunctional side. Accurate, reliable tests are crucial to neuromusculoskeletal diagnosis and this study employs the kappa (κ) analysis protocol recommended for assessing interexaminer reliability of manual medicine tests (published by the Fédération Internationale de Médecine Manuelle [FIMM]). κ-values ≥0.40 (moderate agreement) are considered to be acceptable for use in the clinical setting