Thrust Joint Manipulation Utilization by Us Physical Therapists

Study Design: Online survey study. Objective: To determine physical therapists’ utilization of thrust joint manipulation (TJM) and their comfort level in using TJM between the cervical, thoracic, and lumbar regions of the spine. We hypothesized that physical therapists who use TJM would report regular use and comfort providing it to the thoracic and lumbar spines, but not so much for the cervical spine. Background: Recent surveys of first professional physical therapy degree programs have found that TJM to the cervical spine is not taught to the same degree as to the thoracic and lumbar spines. Methods: We developed a survey to capture the required information and had a Delphi panel of 15 expert orthopedic physical therapists reviewed it and provide constructive feedback. A revised version of the survey was sent to the same Delphi panel and consensus was obtained on the final survey instrument. The revised survey was made available to any licensed physical therapists in the USA using an online survey system, from October 2014 through June 2015. Results: Of 1014 responses collected, 1000 completed surveys were included for analysis. There were 478 (48%) males; the mean age of respondents was 39.7 ± 10.81 years (range 24 – 92); and mean years of clinical experience was 13.6 ± 10.62. A majority of respondents felt that TJM was safe and effective when applied to lumbar (90.5%) and thoracic (91.1%) spines; however, a smaller percentage (68.9%) felt that about the cervical spine. More therapists reported they would perform additional screening prior to providing TJM to the cervical spine than they would for the lumbar and thoracic spine. Therapists agreed they were less likely to provide and feel comfortable with TJM in the cervical spine compared to the thoracic and lumbar spine. Finally, therapists who are male; practice in orthopedic spine setting; are aware of manipulation clinical prediction rules; and have manual therapy certification, are more likely to use TJM and be comfortable with it in all 3 regions. Conclusion: Results indicate that respondents do not believe TJM for the cervical spine to be as safe and efficacious as that for the lumbar and thoracic spines. Further, they are more likely to perform additional screening, abstain from and do not feel comfortable performing TJM for the cervical spine. Clinical Relevance: Our research reveals there is a discrepancy between utilization of TJM at different spinal levels. This research provides an opportunity to address variability in clinical practice among physical therapists utilizing TJM

Evaluating the Roles of Rainout and Post-Condensation Processes in a Landfalling Atmospheric River with Stable Isotopes in Precipitation and Water Vapor

Atmospheric rivers (ARs), and frontal systems more broadly, tend to exhibit prominent “V” shapes in time series of stable isotopes in precipitation. Despite the magnitude and widespread nature of these “V” shapes, debate persists as to whether these shifts are driven by changes in the degree of rainout, which we determine using the Rayleigh distillation of stable isotopes, or by post-condensation processes such as below-cloud evaporation and equilibrium isotope exchange between hydrometeors and surrounding vapor. Here, we present paired precipitation and water vapor isotope time series records from the 5–7 March 2016, AR in Bodega Bay, CA. The stable isotope composition of surface vapor along with independent meteorological constraints such as temperature and relative humidity reveal that rainout and post-condensation processes dominate during different portions of the event. We find that Rayleigh distillation controls during peak AR conditions (with peak rainout of 55%) while post-condensation processes have their greatest effect during periods of decreased precipitation on the margins of the event. These results and analyses inform critical questions regarding the temporal evolution of AR events and the physical processes that control them at local scales

Steady-state Raman gain in diamond as a function of pump wavelength

The variation in the Raman gain coefficient in single-crystal diamond for pump wavelengths between 355 and 1450 nm is measured. Two techniques are used: a pump-probe approach giving an absolute measurement and a stimulated Raman oscillation threshold technique giving a relative measurement. Both approaches indicate that the Raman gain coefficient is a linear function of pump wavenumber. With the pump polarized along a direction in the crystal, the Raman gain coefficient measured by the pump-probe technique is found to vary from 7.6 +/- 0.8 for a pump wavelength of 1280 nm to 78 +/- 8 cm/GW for a pump wavelength of 355 nm. With the established dependence of the Raman gain coefficient on the pump wavelength, the Raman gain coefficient can be estimated at any pump wavelength within the spectral range from 355 up to 1450 nm

Temporal discrimination: Mechanisms and relevance to adult-onset dystonia

Temporal discrimination is the ability to determine that two sequential sensory stimuli are separated in time. For any individual, the temporal discrimination threshold (TDT) is the minimum interval at which paired sequential stimuli are perceived as being asynchronous; this can be assessed, with high test-retest and inter-rater reliability, using a simple psychophysical test. Temporal discrimination is disordered in a number of basal ganglia diseases including adult-onset dystonia, of which the two most common phenotypes are cervical dystonia and blepharospasm. The causes of adult-onset focal dystonia are unknown; genetic, epigenetic, and environmental factors are relevant. Abnormal TDTs in adult-onset dystonia are associated with structural and neurophysiological changes considered to reflect defective inhibitory interneuronal processing within a network which includes the superior colliculus, basal ganglia, and primary somatosensory cortex. It is hypothesized that abnormal temporal discrimination is a mediational endophenotype and, when present in unaffected relatives of patients with adult-onset dystonia, indicates non-manifesting gene carriage. Using the mediational endophenotype concept, etiological factors in adult-onset dystonia may be examined including (i) the role of environmental exposures in disease penetrance and expression; (ii) sexual dimorphism in sex ratios at age of onset; (iii) the pathogenesis of non-motor symptoms of adult-onset dystonia; and (iv) subcortical mechanisms in disease pathogenesis

Kinetics of Aluminization and Homogenization in Wrought H-X750 Nickel-Base Superalloy

In sub-millimeter sheets of wrought H-X750 Nickel-base superalloy, aluminum-rich coatings are bonded to matrix with a vapor phase aluminization process. If an appropriate amount of aluminum is bonded to matrix with homogenization treatment, the resulting diffusion couple will diffuse into coherent (g/g’) heterogeneous phases creating matrix that is both precipitation and solid solution strengthened. The diffusional mechanisms for solid solution mass transport involved with the growth and dispersion of bonded aluminum-rich coatings in the aluminization process only differ from the no external mass flow homogenization process with annealing treatment in that the boundary conditions are different. In each case these forces that activate diffusion at the macroscopic level are connected to the activation energies of random walks of atoms on a wide scale at the angstrom level. An overview of wrought Nickel-base superalloy is presented. Starting with thin sheets the alloy will be aluminized and homogenized. The research from this study will determine the parameters for the movement of the phase boundaries, mass transport, and the time variant concentration fields for both the aluminization and homogenization processes. This is predictable for both single dimension fluxes assuming the interdiffusivities and fluxes at the phase boundaries are known. Because mass-transport is related to the movement of the phase boundaries through density, an investigation into the less dense aluminum-rich coatings and resultant matrix is also included

Assessing the capacity of unoccupied aerial systems Structure-from-Motion (UAS-SfM) for monitoring forest and fuel attributes in California, USA for improved fire hazard land management

Forest wildfires in California, USA historically played a beneficial ecological role in shaping landscape heterogeneity and driving ecological diversity. However, exacerbated by climate change and the expansion of the wilderness urban interface, over a century of federal wildfire suppression policies has given rise to elevated fuel loads in forests throughout the state such that half of California’s forestlands now require restoration. The successful application of fuels reduction treatments on such a broad landscape scale depends highly upon targeting management efforts using accurate maps of fuel loading. This thesis, therefore, seeks to support these efforts through the development and assessment of an area-based machine learning modelling approach to predicting canopy fuel loads using data from unoccupied aerial system Structure-from-Motion (UAS-SfM). This thesis is comprised of four studies. In the first study, I aimed to provide context for assessing the development of future fuels mapping methods. In this study, I conducted fuzzy cognitive mapping (FCM) with land managers to capture their decision-making around fire hazard mitigation and the role of information in these processes. From the FCM results, priority setting emerged as the most significant driver of management outcomes. While information consistently contributed to decision-making, and priority setting specifically, little agreement existed between interviewees on what information sources they utilize. However, they consistently identified accessibility and timeliness as the critical criteria for determining the utility of an information source. In the second study, I developed a workflow for UAS-SfM data processing in the complex mixed forests of California and applied these data to monitoring the long-term impacts from a significant fire event. From this workflow, canopy metrics extracted from the UAS-SfM point cloud demonstrated strong relationships with airborne lidar (ALS) for the upper canopy with diminishing agreement at lower heights. In the fire impact testing, while upper canopy structure only exhibited minor changes with burn severity, spectral data from UAS-SfM captured significant persistent declines in vegetation health as measured by NDVI. In the third study, I conducted area-based machine learning modelling of canopy fuel loads at sites across California using UAS-SfM predictors. These models performed well for the vertical fuel parameters of canopy base height (CBH), mean canopy height, and biomass, but displayed lower accuracy for the horizontal fuel parameters of leaf area index (LAI), canopy bulk density (CBD), and canopy cover. Variable selection proved consistent within each fuel parameter group, with the models for the vertical fuel parameters utilizing predictors related to the structure of the UAS-SfM data and predictors from the multispectral data and spectral indices for the horizontal parameters. In the final study, I extended this area-based modelling approach to other remote sensing technologies, specifically terrestrial laser scanning (TLS), handheld mobile laser scanning (HMLS), and PlanetScope satellite spectral. This study sought to determine the greatest achievable performance of machine learning modelling of canopy fuels to provide context for the accuracies obtained from more accessible methods such as UAS-SfM. While TLS provided the highest accuracy across all parameters, UAS-SfM performance consistently came within 10% of TLS. Likewise, only 5% difference existed for any fuel parameter between the multispectral UAS-SfM data and the spectral data obtained from PlanetScope. Together, these results demonstrate the utility of UAS-SfM as a potential mapping technology of forest fuel canopy loads. Further work should focus on removing the remaining technical barriers for the implementation of this technique in order to render it fully operationalizable in land management decision-making

Sub-100 ps monolithic diamond Raman laser emitting at 573 nm

We report a compact and efficient picosecond diamond Raman laser at 573 nm wavelength. The laser consists of a 0.5 mm thick single-crystal synthetic diamond coated to form a plane–plane laser resonator, and pumped at 532 nm by a frequency-doubled Q-switched microchip laser system. The pump delivers 85 ps pulses at 100 kHz repetition rate at a maximum average power of ~500 mW. We demonstrate 1st Stokes emission from the diamond Raman laser with maximum power of 175 mW, corresponding to a conversion efficiency of 47% and a pulse duration of 71 ps. Substantial pulse shortening is obtained by proper adjustment of the pump spot diameter on the diamond sample. A minimum pulse duration of 39 ps is reported for a conversion efficiency of 36% and 150 mW output power. The simplicity of the architecture makes the system highly appealing as a yellow picosecond laser source

Contrasting local and long-range-transported warm ice-nucleating particles during an atmospheric river in coastal California, USA

Ice-nucleating particles (INPs) have been found to influence the amount, phase and efficiency of precipitation from winter storms, including atmospheric rivers.Warm INPs, those that initiate freezing at temperatures warmer than -10°C, are thought to be particularly impactful because they can create primary ice in mixed-phase clouds, enhancing precipitation efficiency. The dominant sources of warm INPs during atmospheric rivers, the role of meteorology in modulating transport and injection of warm INPs into atmospheric river clouds, and the impact of warm INPs on mixed-phase cloud properties are not well-understood. In this case study, time-resolved precipitation samples were collected during an atmospheric river in northern California, USA, during winter 2016. Precipitation samples were collected at two sites, one coastal and one inland, which are separated by about 35 km. The sites are sufficiently close that air mass sources during this storm were almost identical, but the inland site was exposed to terrestrial sources of warm INPs while the coastal site was not. Warm INPs were more numerous in precipitation at the inland site by an order of magnitude. Using FLEXPART (FLEXible PARTicle dispersion model) dispersion modeling and radar-derived cloud vertical structure, we detected influence from terrestrial INP sources at the inland site but did not find clear evidence of marine warm INPs at either site.We episodically detected warm INPs from long-range-transported sources at both sites. By extending the FLEXPART modeling using a meteorological reanalysis, we demonstrate that long-range-transported warm INPs were observed only when the upper tropospheric jet provided transport to cloud tops. Using radar-derived hydrometeor classifications, we demonstrate that hydrometeors over the terrestrially influenced inland site were more likely to be in the ice phase for cloud temperatures between 0 and -10°C. We thus conclude that terrestrial and long-rangetransported aerosol were important sources of warm INPs during this atmospheric river. Meteorological details such as transport mechanism and cloud structure were important in determining (i) warm INP source and injection temperature and (ii) ultimately the impact of warm INPs on mixed-phase cloud properties

Hyperinflation in Venezuela: How to Address the Problem

Massive amounts of hyperinflation have been ravaging Venezuela for years. Forbes reported that the annual inflation rate for Venezuela in 2018 was 80,000%. To put this in perspective, an inflation rate this high doubles prices nearly every two weeks. Inflation rates this high haven’t been seen since Zimbabwe in the 2000s and Germany in the 1920s. Venezuela’s high inflation levels are due to the sum total effect of relying too heavily on imports for basic goods, depending on oil as its main export, inefficient government industries, and governmental corruption. While this would have been enough to warrent a thesis on its own, there is more to the story of hyperinflation in Venezuela. Beneath the current economic crisis is a political power struggle. On one side is the current President Nicolas Maduro, head of the United Socialist Party of Venezuela. Challenging him is the interim President of the National Assembly Juan Guaido, from the Popular Will party. To complicate matters further, the United States officially recognized Guaido as the legitimate president of Venezuela. The intersectionality of econoimcs and politics is what intrigued me about Venezuela’s situation. As I started research, I learned that the easiest method for fighting hyperinflation, dollarization, is politically unavailable to President Maduro. Doing so would be seen as a sign of defeat for the leader who has spent so much time denouncing the United States. From here, I started to expand my search for other ways in which Venezuela might be able to fix its economy. In my thesis, I aim to detail what hyperinflation is, where it has occurred in the past, and the solutions those countries employed to get their economies back on track. I will then explore how Venezuela got to the point it is today in regards to their inflation rate and how the solutions previously examined might be successful or unsuccessful. With increasing tensions between the U.S. and Venezuela, it will be interesting to examine how the unique political situation of Venezuela affects the options for remedying the hyperinflation of the country. I will analyze both the economic as well as the political viability of any and all proposed solutions to the Venezuelan situation.Humanitie