Controlling the second-harmonic in a phase matched negative-index metamaterial

Nonlinear metamaterials (NLMMs) have been predicted to support new and exciting domains in the manipulation of light, including novel phase matching schemes for wave mixing. Most notable is the so-called nonlinear-optical mirror, in which a nonlinear negative-index medium emits the generated frequency towards the source of the pump. For the first time, we experimentally demonstrate the nonlinear-optical mirror effect in a bulk negative-index NLMM, along with two other novel phase matching configurations, utilizing periodic poling to switch between the three phase matching domains.Comment: 5 pages, 7 figure

Malignant Hyperthermia

Abstract: There are many issues that healthcare professionals face in the evolving world of medicine. One of these is the development of a disease process known as Malignant Hyperthermia (MH). This condition is precipitated by frequently used anesthetic agents such as volatile gases and depolarizing muscle relaxants. The onset of MH is sudden and can be life-threatening, therefore, diligent monitoring of patients is essential in early recognition and treatment of MH. The purpose of this poster is to provide in -depth knowledge about MH. This includes the pathophysiology of the disease, signs and symptoms, treatment options, and implications MH has on nursing and anesthesia staff. While no specific case studies were included in the poster, several can be found in the references provided

Advisers, Brokers, and Online Platforms: How a Uniform Fiduciary Duty Will Better Serve Investors

The differences between Investment Advisers and Brokers have long confused retail investors. Despite different governing statutes, many investors are still left wondering as to which services each provides and to which legal standard they are subject. Adding to this problem has been the rise of online and mobile platforms for investing that offer many of the same services and compensation structures as Advisers and Brokers, yet subject investors to a third distinct level of legal protection. This Note identifies the problems inherent in the current system and explores several possible solutions that could reduce consumer confusion and potential investor harm with minimal impact on market efficiency. In the end, this Note identifies the need for new legislation governing all financial advisers, which creates a unified fiduciary standard across all three forms of financial adviser as the optimal solution. This Note illustrates the precedent for such an extension of fiduciary obligations as well as how this standard must be tailored to best balance the interests of both investors and financial advisers

Understanding patient choices for attending sexually transmitted infection testing services: a qualitative study

Objectives: To establish which aspects of sexually transmitted infection (STI) testing services are important to STI testing service users. Methods: 10 focus groups consisting of previous or existing users of STI testing services were conducted in community settings in the south east of England. Groups were quota sampled based on age, gender and sexual orientation. Data were analysed using Framework Analysis. Results: 65 respondents (58% men) participated. Perceived expertise of staff was the key reason for attendance at genitourinary medicine services rather than general practice. Although some respondents voiced a willingness to test for STIs within general practice, the apparent limited range of tests available in general practice and the perceived lack of expertise around sexual health appeared to discourage attendance at general practice. The decision of where to test for STIs was also influenced by past experience of testing, existing relationships with general practice, method of receiving test results and whether the patient had other medical conditions such as HIV. Conclusions: No one type of STI testing service is suitable for all patients. This is recognised by policymakers, and it now requires commissioners and providers to make services outside of genitourinary medicine clinics more acceptable and attractive to patients, in particular to address the perceived lack of expertise and limited range of STIs tests available at alternative testing sites

Solar Eclipses in Ancient China

Chinese astrology began in the Shang Dynasty. (1226 BCE to 1161 BCE) The Chinese culture believed that solar eclipses were caused by a mythical dragon devouring the sun. It was also believed that eclipses in general told the future of the emperor. Due to this, predicting solar eclipses was deemed of the highest importance; so much so, that two astrologers were once beheaded because they failed to predict a solar eclipse. Astrologers not wanting to be beheaded used many methods and tools in order to try and accurately predict solar eclipses

Proposal of a Clinical Practice Guideline for a Non-Pharmacologic Music Listening Complementary Pain Therapy

Background: As many as 65% of post-surgical patients experience moderate to severe pain. Post-surgical pain is associated with a variety of negative physical and psychological consequences for patients. Currently, medical treatments for postoperative pain rely heavily on pharmaceuticals which can cause adverse side effects. Opioid analgesics, most notably, cause hypoventilation, apnea, and in some cases, dependence and addiction. In 2017, in response to state and national opioid prescription reduction programs, The Joint Commission (TJC) began requiring healthcare institutions to provide patients with non-pharmacologic pain treatment modalities. These pain treatment modalities, also known as complementary therapies, include music listening interventions, which have been shown to safely decrease pain in postoperative patients. The analgesic benefits of music have been measured in numerous controlled trials and meta-analyses. Problem: The culmination of over 30 stakeholder reports and direct observations by the project team revealed that a midwestern level-1 trauma medical center has been unable to meet TJC’s requirement to provide postoperative patients with the required non-pharmacologic pain therapies. This inspired a policy search at the healthcare facility of interest which revealed that no policy currently exists that dictates the provision of non-pharmacologic complementary therapy to patients. Purpose: The ultimate purpose of this project is to identify, adapt, and recommend an evidence-based clinical practice guideline for a postoperative music listening intervention to meet TJC’s requirement for the provision of non-pharmacologic pain treatment modalities at the healthcare facility of interest. Project leaders gathered valuable data and developed recommendations for the leadership groups which have the authority to mitigate, monitor, and sustain non-pharmacological modalities such as music listening at the healthcare facility of interest. Methods: The following objectives and methods are framed using the Plan-Do-Check-Act (PDCA) cycle, also known as the Deming cycle. 1) The project team has reviewed and synthesized evidence from the literature, hospital policy, and TJC accreditation requirements for hospitals to aid in the identification of a guideline for non-pharmacologic complementary pain therapy for patients. The planning phase also included a SWOT analysis discussion with stakeholders and personnel directly caring for patients in the PACU. 2) Members of the project team identified and modified an evidence-based clinical practice guideline from current literature incorporating feedback from the SWOT analysis for future proposal to the healthcare facility of interest. 3) The project team then collaborated with and incorporated feedback on proposed clinical practice guideline from preoperative and PACU leadership, nurses, and other stakeholders involved in the care of postoperative patients. 4) Lastly, the project team presented project findings and the modified evidence-based guideline recommendations to key stakeholders. Implications: This scholarly project can serve as a beginning point towards improving post-surgical patient pain and the medical center’s compliance with TJC requirement for healthcare facilities to provide non-pharmacologic pain treatment modalities by recommending an evidence-based clinical practice guideline for a music listening intervention in the PACU. This project is significant because it can assist the healthcare facility of interest in complying with TJC requirements. The findings of the scholarly project can also assist other departments within the healthcare system in implementing non-pharmacological pain therapy, specifically music listening interventions

Dynamic Unstructured Bargaining with Private Information: Theory, Experiment, and Outcome Prediction via Machine Learning

We study dynamic unstructured bargaining with deadlines and one-sided private information about the amount available to share (the “pie size”). Using mechanism design theory, we show that given the players’ incentives, the equilibrium incidence of bargaining failures (“strikes”) should increase with the pie size, and we derive a condition under which strikes are efficient. In our setting, no equilibrium satisfies both equality and efficiency in all pie sizes. We derive two equilibria that resolve the trade-off between equality and efficiency by favoring either equality or efficiency. Using a novel experimental paradigm, we confirm that strike incidence is decreasing in the pie size. Subjects reach equal splits in small pie games (in which strikes are efficient), while most payoffs are close to either the efficient or the equal equilibrium prediction, when the pie is large. We employ a machine learning approach to show that bargaining process features recorded early in the game improve out-of-sample prediction of disagreements at the deadline. The process feature predictions are as accurate as predictions from pie sizes only, and adding process and pie data together improves predictions even more

Assessing user preferences for sexually transmitted infection testing services: a discrete choice experiment

Objective: To assess user preferences for different aspects of sexually transmitted infection (STI) testing services. Design: A discrete choice experiment. Setting: 14 centres offering tests for STIs in East Sussex, England. Participants: People testing for STIs. Main outcome measure: (Adjusted) ORs in relation to preferred service characteristics. Results: 3358 questionnaires were returned; mean age 26 (SD 9.4) years. 70% (2366) were recruited from genitourinary medicine (GUM) clinics. The analysis suggested that the most important characteristics to users were whether 'staff had specialist STI knowledge' compared with 'staff without it' (OR 2.55; 95% CI 2.47 to 2.63) and whether 'tests for all STIs' were offered rather than 'some' (OR 2.19; 95% CI 2.12 to 2.25). They remained the most important two service characteristics despite stratifying the analysis by variables such as age and sex. Staff levels of expertise were viewed as particularly important by people attending CASH centres, women and non-men who have sex with men. A 'text or call to a mobile phone' and 'dropping in and waiting' were generally the preferred methods of results reporting and appointment system, respectively. Conclusions: This study suggests that people testing for STIs place particular importance on testing for all infections rather than some and staff with specialist STI knowledge. Thus, targets based purely on waiting up to 48 h for an appointment are misguided from a user perspectiv