An Asymptotic Preserving Maxwell Solver Resulting in the Darwin Limit of Electrodynamics

In plasma simulations, where the speed of light divided by a characteristic length is at a much higher frequency than other relevant parameters in the underlying system, such as the plasma frequency, implicit methods begin to play an important role in generating efficient solutions in these multi-scale problems. Under conditions of scale separation, one can rescale Maxwell's equations in such a way as to give a magneto static limit known as the Darwin approximation of electromagnetics. In this work, we present a new approach to solve Maxwell's equations based on a Method of Lines Transpose (MOL$^T$) formulation, combined with a fast summation method with computational complexity $O(N\log{N})$, where $N$ is the number of grid points (particles). Under appropriate scaling, we show that the proposed schemes result in asymptotic preserving methods that can recover the Darwin limit of electrodynamics

ATD-2 Integrated Arrival/Departure/Surface (IADS) System Specification - Phase 2

The purpose of this document is to capture the core capabilities developed in ATD-2 Phase 2

The Veterans Affairs Neuropathy Scale: A Reliable, Remote Polyneuropathy Exam.

Introduction: Polyneuropathy (PN) complaints are common, prompting many referrals for neurologic evaluation. To improve access of PN care in distant community clinics, we developed a telemedicine service (patient-clinician interactions using real-time videoconference technology) for PN. The primary goal of this study was to construct a remote exam for PN that is feasible, reliable, and concordant with in-person assessments for use in our tele-PN clinics. Methods: To construct the VA Neuropathy Scale (VANS), we searched the literature for existing, validated PN assessments. From these assessments, we selected a parsimonious set of exam elements based on literature-reported sensitivity and specificity of PN detection, with modifications as necessary for our teleneurology setting (i.e., a technician examination under the direction of a neurologist). We recruited 28 participants with varying degrees of PN to undergo VANS testing under 5 scenarios. The 5 scenarios differed by mode of VANS grading (in-person vs. telemedicine) and by the in-person examiner type (neurologist vs. technician) in telemedicine scenarios. We analyzed concordance between the VANS and a person's medical chart-derived PN status by modeling the receiver operating characteristic (ROC) curve. We analyzed reliability of the VANS by mixed effects regression and computing the intraclass correlation coefficient (ICC) of scores across the 5 scenarios. Results: The VA Neuropathy Scale (VANS) tests balance, gait, reflexes, foot inspection, vibration, and pinprick. Possible scores range from 0 to 50 (worst). From the ROC curve, a cutoff of >2 points on the VANS sets the sensitivity and specificity of detecting PN at 98 and 91%, respectively. There is a small (1.3 points) but statistically significant difference in VANS scoring between in-person and telemedicine grading scenarios. For telemedicine grading scenarios, there is no difference in VANS scores between neurologist and technician examinations. The ICC is 0.89 across all scenarios. Discussion: The VANS, informed by existing PN instruments, is a promising clinical assessment tool for diagnosing and monitoring the severity of PN in telemedicine settings. This pilot study indicates acceptable concordance and reliability of the VANS with in-person examinations

Communities of care: public donations, development assistance, and independent philanthropy in the Wa State of Myanmar

If there are any charitable, philanthropic, or welfare-state activities in the de-facto states of insurgent armies, they are generally interpreted in terms of utilitarian motives and the self-legitimation of military elites and their business associates. However, development and philanthropy in the Wa State of Myanmar have more extensive purposes. We argue that a framing of care rather than of governance allows for ethnographic attention to emerging social relations and subject positions – “our people”, “the vulnerable”, and “the poor”. In this article we describe “communities of care” by analysing public donations, development assistance and independent philanthropy in the Wa State as categories of care that each follow a different moral logic, respond to different needs, and connect different actors and recipients. Zooming in on the ways in which communities of care re-produce moral subjectivities and political authority allows a re-imagining of everyday politics in the de-facto states of armed groups, no longer wedded to notions of control, legitimacy, and “rebel governance”

Drug-eluting stents: current issues

Early stent thrombosis occurs in about 1% to 1.5% of patients with drug-eluting stents, very similar to the rate with bare-metal stents. Late stent thrombosis is more of a concern with drug-eluting stents, with an incidence of at least 0.35%. I would urge caution if you feel you have to stop antiplatelet therapy in patients with drug-eluting stents. While neointima formation peaks at 6 months and then may actually regress with bare-metal stents, it continues to grow with drug-eluting stents--although this process appears to plateau by 4 years with sirolimus. With the others, we have to wait and see. We still don't know the best drug-eluting stent. Trials are under way to compare stents with surgery, and the future brings the arrival of a number of exciting new devices and approaches that are now entering clinical trials

Understanding Help Seeking for Chronic Joint Pain:Implications for Providing Supported Self-Management

Osteoarthritis-related joint pain is prevalent and potentially disabling. United Kingdom clinical guidelines suggest that patients should be supported to self-manage in primary care settings. However, the processes and mechanisms that influence patient consultation decisions for joint pain are not comprehensively understood. We recruited participants (N = 22) from an existing longitudinal survey to take part in in-depth interviews and a diary study. We found that consultation decisions and illness actions were ongoing social processes. The need for and benefits of consulting were weighed against the value of consuming the time of a professional who was considered an expert. We suggest that how general practitioners manage consultations influences patient actions and is part of a broader process of defining the utility and moral worth of consulting. Recognizing these factors will improve self-management support and consultation outcomes