Shifted Symplectic Structures on Spaces of Framed Maps

This work examines the existence of shifted symplectic and Poisson structures on certain spaces of framed maps. We define n-shifted Poisson structures and coisotropic structures in terms of shifted symplectic structures and Lagrangian structures. Shifted Poisson structures are shown to have properties analogous to those of shifted symplectic structures, and reduce to ordinary Poisson structures in the classical case. Next, we examine the space Map(X,D,Y) of maps from X to Y, framed along some divisor D. These are shown to inherit a shifted symplectic or Poisson structure from Y in certain conditions. This construction is used to rederive the existence of symplectic and Poisson structures in classical examples

Branching Diagrams for Group Inclusions Induced by Field Inclusions

A Fourier transform for a finite group G is an isomorphism from the complex group algebra CG to a direct product of complex matrix algebras, which are determined beforehand by the structure of G. Given such an isomorphism, naive application of that isomorphism to an arbitrary element of CG takes time proportional to |G|2. A fast Fourier transform for some (family of) groups is an algorithm which computes the Fourier transform of a group G of the family in less than O(|G|2) time, generally O(|G| log |G|) or O(|G|(log |G|)2). I describe the construction of a fast Fourier transform for the special linear groups SL(q) with q = 2n

Exploring Therapist Engagement Using Process Consultation

Purpose Although evidence supports that highly engaged colleagues result in better patient outcomes (Lowe, 2012; Studer, Hagins, & Cochrane, 2014), little is known about the impact of engaged occupational (OT), physical (PT), and speech (ST) therapists on patient outcomes (Mueller, Prins, & deHeer, 2018; Paulsen et al., 2014). This prospective cohort study examines the effect of a voluntary OT, PT and ST workgroup has on therapist engagement and outpatient-perceived quality services. The following research questions about the impact of process consultation within a volunteer therapist workgroup were asked: a) will engagement of all therapists improve as measured by the Utrecht Work Engagement Scale (UWES)? b) will process consultation impact engagement of OT, PT, and ST equally? and c) will patient’s perception of care by OT, PT, and ST improve? Design / Intervention Thirty-three therapists were given the opportunity to participate in a workgroup to improve communication with a nursing unit; three therapists volunteered. Thirteen therapists completed baseline UWES surveys and 17 completed post-workgroup UWES surveys. Five workgroup sessions were conducted between February 1 and March 31, 2019 led by the primary investigator, applying principles of process consultation. Outcome measures Utrecht Work Engagement Scale (UWES) was given to all therapists before and after intervention to measure therapist engagement. Essential Services Survey (ESS)—facility specific tool, and the Press Ganey Inpatient Rehabilitation Facility Experience of Care Survey (IRF EOC) were used to measure client outcomes. Results UWES score increased from 5.07 to 5.17. PT UWES score increased from 4.69 to 4.85, OT UWES score increased from 5.33 to 5.35 and ST UWES score increased from 5.1 to 5.26. ESS mean scores increased from 8.3 to 9.8. IRF EOC results included only 3 patient responses per month; therefore, it was not used. Conclusion: Using process consultation to empower therapists to prioritize work initiatives and collaboratively solve identified problems appears to improve therapist engagement. The positive impact of process consultation upon therapists’ engagement offers many practical takeaways to those who manage OTs, PTs and STs. Offering therapists, the opportunity to prioritize work initiatives and interact with hospital peers to drive change appears to be an important means of improving engagement. Similar to Lowe’s study (2012) the therapists within this study had the opportunity to make improvements in the work environment, were provided clear objectives and goals for the workgroup, acted as a team, and received supervisor support. This study supports therapy managers use of workgroups to collaboratively identify and solve problems with their employees to improve patient perception of care, increase safety, lower employee turnover, and reduce absenteeism (Studer et al, 2014). Impact Employee driven workgroups using process consultation is a tool that OT managers can use to improve performance outcomes, which is particularly needed as healthcare moves toward federal value-based purchasing programs (Owens et al., 2017). These workgroups create an organizational culture that supports high-quality performance increasing engagement among therapists (Owens, Eggers, Keller, & McDonald, 2017). Lastly, engaged therapists may also lead to reduced turnover, fewer patient falls, and improved hand hygiene compliance (Studer, Hagins, & Cochrane, 2014)

Choroidal Thickness in Normal Eyes Measured Using Cirrus HD Optical Coherence Tomography

Purpose: To examine choroidal thickness and area in healthy eyes using spectral-domain optical coherence tomography (SD-OCT). Design: Retrospective, observational case series. Methods: Thirty-four eyes (34 subjects), with no retinal or choroidal disease, underwent high-definition raster scanning using SD-OCT with frame enhancement software. Choroidal thickness was measured from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at 500-μm intervals up to 2500 μm temporal and nasal to the fovea. The central 1-mm area of the choroid was also measured, along with foveal thickness of the retina. All measurements were performed by 2 independent observers. Statistical analysis was used to correlate inter-observer findings, choroidal thickness and area measurements with age, and choroidal thickness with retinal foveal thickness. Results: The 34 subjects had a mean age of 51.1 years. Reliable measurements of choroidal thickness were obtainable in 74% of eyes examined. Choroidal thickness and area measurements had strong inter-observer correlation (r = 0.92, P < .0001 and r = 0.93, P < .0001 respectively). Area had a moderate negative correlation with age (r = −0.62, P < .0001) that was comparable to the correlation between mean subfoveal choroidal thickness and age (r = −0.61, P < .0001). Retinal and choroidal thickness were found to be poorly correlated (r = −0.23, P = .18). Mean choroidal thickness showed a pattern of thinnest choroid nasally, thickening in the subfoveal region, and then thinning again temporally. Mean subfoveal choroidal thickness was found to be 272 μm (SD, ± 81 μm). Conclusions: Choroidal thickness can be measured using SD-OCT high-definition raster scans in the majority of eyes. Choroidal thickness across the macula demonstrates a thin choroid nasally, thickest subfoveally, and again thinner temporally, and a trend toward decreasing choroidal thickness with age.National Institutes of Health (U.S.) (Contract R01-EY11289-23)National Institutes of Health (U.S.) (Contract R01-EY13178-10)National Institutes of Health (U.S.) (Contract R01-EY013516-07)United States. Air Force Office of Scientific Research (FA9550-07-1-0101)United States. Air Force Office of Scientific Research (FA9550-07-1-0014

The Therapeutic Effects of Bevacizumab in Patients with Polypoidal Choroidal Vasculopathy

A proper description of the biosynthesis of fungal β-lactam antibiotics requires detailed knowledge of the cell biology of the producing organisms. This involves a delineation of the compartmentalization of the biosynthetic pathways, and of the consequential transport steps across the cell-boundary plasma membrane and across organellar membranes. Of the enzymes of the penicillin biosynthetic pathway in Penicillium chrysogenum and Aspergillus nidulans, δ-(L-α-aminoadipyl)-L-cysteinyl-D-valine synthetase (ACVS) and isopenicillin N synthase (IPNS) probably have a cytosolic location. Acyl-coenzyme A:isopenicillin N acyltransferase (IAT) is located in microbodies. Of the two enzymes that may be involved in activation of the side chain, acetyl-coenzyme A synthetase (ACS) is located in the cytosol, and phenylacetyl-coenzyme A ligase (PCL) is probably located in the microbody. All enzymes of the cephalosporin biosynthesis pathway in Cephalosporium acremonium probably have a cytosolic location. The vacuole may play an ancillary role in the supply of precursor amino acids, and in the storage of intermediates. The distribution of precursors, intermediates, end- and side-products, the transport of nutrients, precursors, intermediates and products across the plasma membrane, and the transport of small solutes across organellar membranes, is discussed. The relevance of compartmentalization is considered against the background of recent biotechnological innovations of fungal β-lactam biosynthesis pathways.

Optical coherence tomography-based consensus definition for lamellar macular hole.

BackgroundA consensus on an optical coherence tomography definition of lamellar macular hole (LMH) and similar conditions is needed.MethodsThe panel reviewed relevant peer-reviewed literature to reach an accord on LMH definition and to differentiate LMH from other similar conditions.ResultsThe panel reached a consensus on the definition of three clinical entities: LMH, epiretinal membrane (ERM) foveoschisis and macular pseudohole (MPH). LMH definition is based on three mandatory criteria and three optional anatomical features. The three mandatory criteria are the presence of irregular foveal contour, the presence of a foveal cavity with undermined edges and the apparent loss of foveal tissue. Optional anatomical features include the presence of epiretinal proliferation, the presence of a central foveal bump and the disruption of the ellipsoid zone. ERM foveoschisis definition is based on two mandatory criteria: the presence of ERM and the presence of schisis at the level of Henle's fibre layer. Three optional anatomical features can also be present: the presence of microcystoid spaces in the inner nuclear layer (INL), an increase of retinal thickness and the presence of retinal wrinkling. MPH definition is based on three mandatory criteria and two optional anatomical features. Mandatory criteria include the presence of a foveal sparing ERM, the presence of a steepened foveal profile and an increased central retinal thickness. Optional anatomical features are the presence of microcystoid spaces in the INL and a normal retinal thickness.ConclusionsThe use of the proposed definitions may provide uniform language for clinicians and future research

A consensus definition for lamellar macular hole

Background: A consensus on an optical coherence tomography (OCT) definition of lamellar macular hole (LMH) and similar conditions is needed. Methods: The panel reviewed relevant peer-reviewed literature to reach a consensus on LMH definition and to differentiate LMH from other similar conditions. Results: The panel reached a consensus on the definition of 3 clinical entities: LMH, epiretinal membrane (ERM) foveoschisis and macular pseudohole (MPH). LMH definition is based on 3 mandatory criteria and 3 optional anatomical features. The 3 mandatory criteria are the presence of irregular foveal contour, the presence of a foveal cavity with undermined edges, and the apparent loss of foveal tissue. Optional anatomical features include the presence of epiretinal proliferation, the presence of a foveal bump and the disruption of the ellipsoid line. ERM foveoschisis definition is based on 2 mandatory criteria: the presence of ERM and the presence of schisis at the level of Henle’s fiber layer. Three optional anatomical features can also be present: the presence of microcystoid spaces in the inner nuclear layer (INL), an increase of retinal thickness, and the presence of retinal wrinkling. MPH definition is based on 3 mandatory criteria and 2 optional anatomical features. Mandatory criteria include the presence of a foveal sparing ERM, the presence of a steepened foveal profile and an increased central retinal thickness. Optional anatomical features are the presence of microcystoid spaces in the INL and a normal retinal thickness. Conclusions: The use of the proposed definitions may provide uniform language for clinicians and future research