The Cost to Successfully Apply for Level 3 Medical Home Recognition

The NCQA Patient Centered Medical Home (PCMH) recognition program provides practices an opportunity to implement Medical home activities. Understanding the costs to apply for recognition may enable practices to plan their work

An evaluation of mechanical and biophysical skin parameters at different body locations

Background Skin is the largest organ in the body, representing an important interface to monitor health and disease. However, there is significant variation in skin properties for different ages, genders and body regions due to the differences in the structure and morphology of the skin tissues. This study aimed to evaluate the use of non-invasive tools to discriminate a range of mechanical and functional skin parameters from different skin sites. Materials and methods A cohort of 15 healthy volunteers was recruited following appropriate informed consent. Four well-established CE-marked non-invasive techniques were used to measure four anatomical regions: palm, forearm, sole and lower lumbar L3, using a repeated measures design. Skin parameters included trans-epidermal water loss (TEWL), pH (acidity), erythema, stratum corneum hydration and stiffness and elasticity using Myoton Pro (skin and muscle probe). Differences between body locations for each parameter and the intra-rater reliability between days were evaluated by the same operator. Results The results indicate that parameters differed significantly between skin sites. For the Myoton skin probe, the sole recorded the highest stiffness value of 1006 N/m (SD ± 179), while the lower lumbar recorded the least value of 484 N/m (SD ± 160). The muscle indenter Myoton probe revealed the palm's highest value of 754 N/m (± 108), and the lower lumbar recorded the least value of 208 N/m (SD ± 44). TEWL values were lowest on the forearm, averaging 11 g/m2/h, and highest on the palm, averaging 41 g/m2/h. Similar skin hydration levels were recorded in three of the four sites, with the main difference being observed in the sole averaging 13 arbitrary units. Erythema values were characterised by a high degree of inter-subject variation, and no significant differences between sites or sides were observed. The Myoton Pro Skin showed excellent reliability (intra-class correlation coefficients > 0.70) for all sites with exception of one site right lower back; the Myoton pro muscle probes showed good to poor reliability (0.90–017), the corneometer showed excellent reliability (>0.75) among all the sites tested, and the TEWL showed Good to poor reliability (0.74–0.4) among sites. Conclusion The study revealed that using non-invasive methods, the biophysical properties of skin can be mapped, and significant differences in the mechanical and functional properties of skin were observed. These parameters were reliably recorded between days, providing a basis for their use in assessing and monitoring changes in the skin during health and disease

Environmental horticulture for domestic and community gardens—An integrated and applied research approach

Societal Impact Statement Daunting global challenges of climate change and biodiversity loss may seem overwhelming. However, gardeners have a secret weapon—gardens, balconies, indoor planting, yards and allotments are mini-ecosystems that offer opportunities to counter perceptions of helplessness, inadequacy and resultant inaction by using those spaces to ‘Do what we can, with what we have, where we are’. Minimising gardening ‘footprints’ to mitigate harmful impacts, whilst maximising gardening ‘handprints’ to enhance benefits, is readily achievable. With this in mind, the Royal Horticultural Society is leading research into environmental horticulture for gardens, and benefits for individual wellbeing. Summary This article presents an integrated and applied research approach to the unique and multi-disciplinary area of science referred to here as environmental horticulture. It does this by: (a) providing an institutional perspective (The Royal Horticultural Society) on a research approach for this particular area, emphasising why domestic and community gardens are important in the context of global environmental threats; (b) presenting four primary research focus areas and project examples; and (c) highlighting interdisciplinary linkages, future research needs, public engagement/knowledge sharing opportunities, and ‘Green Skills’ development in the area of environmental horticulture. Research focus areas discussed are: (1) responding to the changing climate (adaptation, mitigation and resilience solutions in gardens); (2) ‘plants for purpose’ (harnessing the potential of horticultural plant diversity, and gardening, to help regulate environmental conditions); (3) sustainability and climate risk reduction through effective and efficient resource management (reduction, re-use, recycling and repurposing); and (4) gardening and cultivated plant choice for human health and wellbeing. We argue that a key research priority is improving our understanding of the linkages and interactions between soil, water, plants, weather and people. These crucial linkages affect above and below ground processes, for both outdoor and indoor plants. They impact the effectiveness with which water and nutrient cycling takes place, the extent to which ecosystem services may be delivered, and the resultant capacity of gardens and gardening to provide environmental and human health benefits

Slow Light Propagation in a Thin Optical Fiber via Electromagnetically Induced Transparency

We propose a novel configuration that utilizes electromagnetically induced transparency (EIT) to tailor a fiber mode propagating inside a thin optical fiber and coherently control its dispersion properties to drastically reduce the group velocity of the fiber mode. The key to this proposal is: the evanescent-like field of the thin fiber strongly couples with the surrounding active medium, so that the EIT condition is met by the medium. We show how the properties of the fiber mode is modified due to the EIT medium, both numerically and analytically. We demonstrate that the group velocity of the new modified fiber mode can be drastically reduced (approximately 44 m/sec) using the coherently prepared orthohydrogen doped in a matrix of parahydrogen crystal as the EIT medium.Comment: 10 pages in two column RevTex4, 6 Figure

Intergenerational Community-Based Research and Creative Practice: Promoting Environmental Sustainability in Jinja, Uganda

This article critically reflects on the methodological approach developed for a recent project based in Jinja, Uganda, that sought to generate new forms of environmental knowledge and action utilizing diverse forms of creative intergenerational practice embedded within a broader framework of community-based participatory research. This approach provided new opportunities for intergenerational dialogue in Jinja, generated increased civic environmental engagement, and resulted in a participant-led campaign to share knowledge regarding sustainable biomass consumption. We term this approach intergenerational community-based research and creative practice. We discuss the advantages of this model while also reflecting throughout on the challenges of the approach

Equilibrium configurations of two charged masses in General Relativity

An asymptotically flat static solution of Einstein-Maxwell equations which describes the field of two non-extreme Reissner - Nordstr\"om sources in equilibrium is presented. It is expressed in terms of physical parameters of the sources (their masses, charges and separating distance). Very simple analytical forms were found for the solution as well as for the equilibrium condition which guarantees the absence of any struts on the symmetry axis. This condition shows that the equilibrium is not possible for two black holes or for two naked singularities. However, in the case when one of the sources is a black hole and another one is a naked singularity, the equilibrium is possible at some distance separating the sources. It is interesting that for appropriately chosen parameters even a Schwarzschild black hole together with a naked singularity can be "suspended" freely in the superposition of their fields.Comment: 4 pages; accepted for publication in Phys. Rev.

Environmental enrichment reduces signs of boredom in caged mink

Animals housed in impoverished cages are often labelled 'bored'. They have also been called 'apathetic' or 'depressed', particularly when profoundly inactive. However, these terms are rarely operationally defined and validated. As a negative state caused by under-stimulation, boredom should increase interest in stimuli of all kinds. Apathy (lack of interest), by contrast, should manifest as decreased interest in all stimuli, while anhedonia (loss of pleasure, a depressive symptom) should specifically decrease interest in normally rewarding stimuli. We tested the hypotheses that mink, a model carnivore, experience more boredom, depression-like apathy, or anhedonia in non-enriched (NE) cages than in complex, enriched (E) cages. We exposed 29 subjects (13 E, 16 NE) to ten stimuli categorized a priori as aversive (e.g. air puffs), rewarding (e.g. evoking chasing) or ambiguous/neutral (e.g. candles). Interest in stimuli was assessed via latencies to contact, contact durations, and durations oriented to stimuli. NE mink contacted all stimuli faster (P = 0.003) than E mink, and spent longer oriented to/in contact with them, albeit only significantly so for ambiguous ones (treatment*type P<0.013). With stimulus category removed from statistical models, interest in all stimuli was consistently higher among NE mink (P<0.0001 for all measures). NE mink also consumed more food rewards (P = 0.037). Finally, we investigated whether lying down while awake and stereotypic behaviour (both increased by NE housing) predicted these responses. Lying awake positively co-varied with certain measures of increased exploration. In contrast, stereotypic 'scrabbling' or locomotion (e.g. pacing) did not. Overall, NE mink showed no evidence of apathy or depression, but instead a heightened investigation of diverse stimuli consistent with boredom. This state was potentially indicated by spending much time lying still but awake (although this result requires replication). Boredom can thus be operationalized and assessed empirically in non-human animals. It can also be reduced by environmental enrichment

Effect of the 3K background radiation on ultrahigh energy cosmic rays

In this work we re-examine the opacity of the cosmic background radiation to the propagation of extremely high energy cosmic rays. We use the continuous energy loss approximation to provide spectral modification factors for several hypothesized cosmic ray sources. Earlier problems with this approximation are resolved including the effects of resonances other than the $\Delta$.Comment: 13 pages revtex, 3 figures. To appear in Phys. Rev.

Global transpiration data from sap flow measurements: The SAPFLUXNET database

Plant transpiration links physiological responses of vegetation to water supply and demand with hydrological, energy, and carbon budgets at the land-atmosphere interface. However, despite being the main land evaporative flux at the global scale, transpiration and its response to environmental drivers are currently not well constrained by observations. Here we introduce the first global compilation of whole-plant transpiration data from sap flow measurements (SAPFLUXNET, https://sapfluxnet.creaf.cat/, last access: 8 June 2021). We harmonized and quality-controlled individual datasets supplied by contributors worldwide in a semi-automatic data workflow implemented in the R programming language. Datasets include sub-daily time series of sap flow and hydrometeorological drivers for one or more growing seasons, as well as metadata on the stand characteristics, plant attributes, and technical details of the measurements. SAPFLUXNET contains 202 globally distributed datasets with sap flow time series for 2714 plants, mostly trees, of 174 species. SAPFLUXNET has a broad bioclimatic coverage, with woodland/shrubland and temperate forest biomes especially well represented (80% of the datasets). The measurements cover a wide variety of stand structural characteristics and plant sizes. The datasets encompass the period between 1995 and 2018, with 50% of the datasets being at least 3 years long. Accompanying radiation and vapour pressure deficit data are available for most of the datasets, while on-site soil water content is available for 56% of the datasets. Many datasets contain data for species that make up 90% or more of the total stand basal area, allowing the estimation of stand transpiration in diverse ecological settings. SAPFLUXNET adds to existing plant trait datasets, ecosystem flux networks, and remote sensing products to help increase our understanding of plant water use, plant responses to drought, and ecohydrological processes. SAPFLUXNET version 0.1.5 is freely available from the Zenodo repository (10.5281/zenodo.3971689; Poyatos et al., 2020a). The "sapfluxnetr"R package-designed to access, visualize, and process SAPFLUXNET data-is available from CRAN. © 2021 Rafael Poyatos et al.This research was supported by the Minis-terio de Economía y Competitividad (grant no. CGL2014-55883-JIN), the Ministerio de Ciencia e Innovación (grant no. RTI2018-095297-J-I00), the Ministerio de Ciencia e Innovación (grant no. CAS16/00207), the Agència de Gestió d’Ajuts Universitaris i de Recerca (grant no. SGR1001), the Alexander von Humboldt-Stiftung (Humboldt Research Fellowship for Experienced Researchers (RP)), and the Institució Catalana de Recerca i Estudis Avançats (Academia Award (JMV)). Víctor Flo was supported by the doctoral fellowship FPU15/03939 (MECD, Spain)

Hypersurface-Invariant Approach to Cosmological Perturbations

Using Hamilton-Jacobi theory, we develop a formalism for solving semi-classical cosmological perturbations which does not require an explicit choice of time-hypersurface. The Hamilton-Jacobi equation for gravity interacting with matter (either a scalar or dust field) is solved by making an Ansatz which includes all terms quadratic in the spatial curvature. Gravitational radiation and scalar perturbations are treated on an equal footing. Our technique encompasses linear perturbation theory and it also describes some mild nonlinear effects. As a concrete example of the method, we compute the galaxy-galaxy correlation function as well as large-angle microwave background fluctuations for power-law inflation, and we compare with recent observations.Comment: 51 pages, Latex 2.09 ALBERTA THY/20-94, DAMTP R94/25 To appear in Phys. Rev.