Search

The Valley Baseball League is a collegiate summer baseball league with 11 teams playing 42 games between June and August. Producing a schedule has proved challenging for league management, because of the odd number of teams as well as a large number of league mandates and team-specific requests. As an amateur league with limited financial resources, there is pressure to best leverage the league schedule to maximize revenue for each team. A schedule generated by mathematical programming was enthusiastically adopted for the 2020 season and significantly outperformed previous manually produced schedules.

Defensive repositioning strategies (shifts) have become more prevalent in Major League Baseball in recent years. In 2018, batters faced some form of the shift in 34% of their plate appearances (Sawchik, Travis. 2019. “Don’t Worry, MLB–Hitters Are Killing The Shift On Their Own.” FiveThirtyEight, January 17, 2019. Also available at fivethirtyeight.com/features/dont-worry-mlb-hitters-are-killing-the-shift-on-their-own/). Most teams use a shift that overloads one side of the infield and adjusts the positioning of the outfield. In this work we describe a mathematical approach to the positioning of players over the entire field of play without the limitations of traditional positions or current methods of shifting. The model uses historical data for individual batters, and it leaves open the possibility of fewer than four infielders. The model also incorporates risk penalties for positioning players too far from areas of the field in which extra-base hits are more likely. This work is meant to serve as a decision-making tool for coaches and managers to best use their defensive assets. Our simulations show that an optimal positioning with three infielders lowered predicted batting average on balls in play (BABIP) by 5.9% for right-handers and by 10.3% for left-handers on average when compared to a standard four-infielder placement of players.

Typical goals of wetland restoration efforts are to conserve, create, or enhance wetland structure, and to achieve wetland function that approaches or exceeds natural conditions. Measuring wetland establishment, condition, and resilience can be difficult, especially because monitoring wetland function has traditionally been time-intensive, costly, and often required repeat field-based surveys. Remote sensing provides novel collections of data and facilitates rapid assessments of wetland landscapes, land cover, species/habitat composition, change detection, degradation, diversity, as well as system threats and pressures. A combination of remotely collected and in situ vegetation data were used in conjunction with landscape metrics and vegetative indices. These data were used to evaluate and compare changes and trends in condition, function and resilience of restoration sites and reference wetlands in southwest Louisiana, USA. Results of this work show the restored wetlands reached structural and functional equivalency to reference wetlands after approximately three to ten years post-construction. With adequate maturity, the restored wetlands outperformed the reference wetlands, having higher percentage of land, land aggregation, aboveground vegetation productivity and floristic quality. Supplementing traditional field-based methods with remote sensing applications provided enhanced metrics for inventorying and monitoring of wetland resources, forecasting of resource condition and stability, and adaptive management strategies.

Elizabeth Blackwell's younger sister, Emily (1826–1910), was the third woman to graduate from a regular U.S. medical college in 1854. Unlike the experience of the two women who preceded her, the Chicago medical school that accepted Emily refused to allow her to complete her studies and graduate, forcing her to hastily find an alternative. There was no explanation at the time and the Chicago Tribune, which investigated the incident, could only speculate about the source of such a dishonorable act: “It is very evident there is duplicity and double dealing somewhere. Who is guilty?” Generations of historians have attributed it to Illinois Medical Society pressure against Rush Medical College, but there was no contemporary evidence of such pressure. A closer examination of Blackwell's journal and historical records suggests that Rush founder, president, and professor of surgery, Daniel Brainard engineered her dismissal. One possible motive was a misplaced romantic approach by Brainard. Rush's actions had the paradoxical result of temporarily opening the doors of the Cleveland Medical College (now Case Western Reserve) to four more women medical students.

EDITOR’S PERSPECTIVE What We Already Know about This Topic Dantrolene effectively treats malignant hyperthermia, but there are discrepant recommendations for dantrolene availability in facilities that stock succinylcholine for airway rescue but do not use volatile anesthetics. What This Article Tells Us That Is New The authors performed an analysis of data from three databases and a systematic literature review. Providers frequently use succinylcholine, including during difficult mask ventilation. Succinylcholine given without volatile anesthetics triggered 24 malignant hyperthermia events, 13 of which were treated with dantrolene. Fourteen patients experienced substantial complications, and one died. Delayed dantrolene treatment worsened patient outcomes. Background Although dantrolene effectively treats malignant hyperthermia (MH), discrepant recommendations exist concerning dantrolene availability. Whereas Malignant Hyperthermia Association of the United States guidelines state dantrolene must be available within 10 min of the decision to treat MH wherever volatile anesthetics or succinylcholine are administered, a Society for Ambulatory Anesthesia protocol permits Class B ambulatory facilities to stock succinylcholine for airway rescue without dantrolene. The authors investigated (1) succinylcholine use rates, including for airway rescue, in anesthetizing/sedating locations; (2) whether succinylcholine without volatile anesthetics triggers MH warranting dantrolene; and (3) the relationship between dantrolene administration and MH morbidity/mortality. Methods The authors performed focused analyses of the Multicenter Perioperative Outcomes Group (2005 through 2016), North American MH Registry (2013 through 2016), and Anesthesia Closed Claims Project (1970 through 2014) databases, as well as a systematic literature review (1987 through 2017). The authors used difficult mask ventilation (grades III and IV) as a surrogate for airway rescue. MH experts judged dantrolene treatment. For MH morbidity/mortality analyses, the authors included U.S. and Canadian cases that were fulminant or scored 20 or higher on the clinical grading scale and in which volatile anesthetics or succinylcholine were given. Results Among 6,368,356 queried outcomes cases, 246,904 (3.9%) received succinylcholine without volatile agents. Succinylcholine was used in 46% (n = 710) of grade IV mask ventilation cases (median dose, 100 mg, 1.2 mg/kg). Succinylcholine without volatile anesthetics triggered 24 MH cases, 13 requiring dantrolene. Among 310 anesthetic-triggered MH cases, morbidity was 20 to 37%. Treatment delay increased complications every 10 min, reaching 100% with a 50-min delay. Overall mortality was 1 to 10%; 15 U.S. patients died, including 4 after anesthetics in freestanding facilities. Conclusions Providers use succinylcholine commonly, including during difficult mask ventilation. Succinylcholine administered without volatile anesthetics may trigger MH events requiring dantrolene. Delayed dantrolene treatment increases the likelihood of MH complications. The data reported herein support stocking dantrolene wherever succinylcholine or volatile anesthetics may be used.

The evolution of North American grasslands has traditionally thought to have been documented by the evolution of equid teeth which became higher and had more pronounced crowns as grasses became abundant. The chronology of equid hypsodonty, radiation of equids, the first documented C4 plants and the change to a C4 diet in equids is somewhat puzzling. Hypsodonty, which is the great increase in the crown height of molars and premolars, began in the early to middle Miocene for equids and was well underway by 15 million years ago. The modern distribution of C4 grasses in North America is characterized by abundant C4 grasses in regions where the growing season temperatures are high; C4 grasses are the dominant grass in the central to southern Great Plains, the Sonoran and Chihuahuan Deserts, and Florida; C3 grasses are dominant in Canada, the Pacific Northwest, and California.

There is agreement that the complex relationship between medicine and society is best described as a metaphorical social contract and that professionalism is the medical profession's contribution to this contract. Metaphors can help clarify abstract concepts, but they can also be abused if the counterfactual attributes of a metaphor become attributed to its subject. This seems to be happening with medical professionalism, which has sometimes been reduced to a contracted deliverable and a bargaining chip. The undesirable attributes of the social contract metaphor may be hindering efforts to understand and teach medical professionalism.Despite its theoretical weaknesses, the social contract metaphor has historical credibility because of its alleged association with the 1847 Code of Medical Ethics and the subsequent ascension of regular (allopathic) medicine in the early 20th century. However, the record does not support an argument that the intended purpose of the 1847 Code was to create a social contract or that one ever arose. The alternative account that a contract did arise, but physicians were poor partners, is neither satisfying nor explanatory.As now used, medicine's social contract metaphor has serious theoretical and historic weaknesses. Medical educators should remove this narrow and overworked metaphor from their discussions of professionalism. By doing this, educators and the profession in general would only lose the ability to threaten themselves with the cancellation of their social contract. In return they would open the door to a more complex and fruitful consideration of medical professionalism and medicine's relationship with society.

Seafloor networks of cables, pipelines, and other infrastructure underpin our daily lives, providing communication links, information, and energy supplies. Despite their global importance, these networks are vulnerable to damage by a number of natural seafloor hazards, including landslides, turbidity currents, fluid flow, and scour. Conventional geophysical techniques, such as high-resolution reflection seismic and side-scan sonar, are commonly employed in geohazard assessments. These conventional tools provide essential information for route planning and design; however, such surveys provide only indirect evidence of past processes and do not observe or measure the geohazard itself. As such, many numerical-based impact models lack field-scale calibration, and much uncertainty exists about the triggers, nature, and frequency of deep-water geohazards. Recent advances in technology now enable a step change in their understanding through direct monitoring. We outline some emerging monitoring tools and how they can quantify key parameters for deepwater geohazard assessment. Repeat seafloor surveys in dynamic areas show that solely relying on evidence from past deposits can lead to an under-representation of the geohazard events. Acoustic Doppler current profiling provides new insights into the structure of turbidity currents, whereas instrumented mobile sensors record the nature of movement at the base of those flows for the first time. Existing and bespoke cabled networks enable high bandwidth, low power, and distributed measurements of parameters such as strain across large areas of seafloor. These techniques provide valuable new measurements that will improve geohazard assessments and should be deployed in a complementary manner alongside conventional geophysical tools.

Carrying out a hazard assessment for offshore structures can entail the consideration of a number of different factors. Scour hazard assessments are routinely undertaken, and scour development at offshore structures should be considered a time-varying process. However, scour may take place within a morphologically dynamic environment, the combination of which will impact on the soil–structure–fluid response. This paper presents the analysis of an unique data set that shows the partial collapse of a scour hole at a large monopile foundation within a morphologically active site. The collapse suggests a slope failure mechanism, resulting in the movement of around 450 m3 of material within a period of about 75 min. The paper analyzes the processes involved regarding formation and development of the collapse.

Although dantrolene effectively treats malignant hyperthermia (MH), discrepant recommendations exist concerning dantrolene availability. Whereas Malignant Hyperthermia Association of the United States guidelines state dantrolene must be available within 10 min of the decision to treat MH wherever volatile anesthetics or succinylcholine are administered, a Society for Ambulatory Anesthesia protocol permits Class B ambulatory facilities to stock succinylcholine for airway rescue without dantrolene. The authors investigated (1) succinylcholine use rates, including for airway rescue, in anesthetizing/sedating locations; (2) whether succinylcholine without volatile anesthetics triggers MH warranting dantrolene; and (3) the relationship between dantrolene administration and MH morbidity/mortality.The authors performed focused analyses of the Multicenter Perioperative Outcomes Group (2005 through 2016), North American MH Registry (2013 through 2016), and Anesthesia Closed Claims Project (1970 through 2014) databases, as well as a systematic literature review (1987 through 2017). The authors used difficult mask ventilation (grades III and IV) as a surrogate for airway rescue. MH experts judged dantrolene treatment. For MH morbidity/mortality analyses, the authors included U.S. and Canadian cases that were fulminant or scored 20 or higher on the clinical grading scale and in which volatile anesthetics or succinylcholine were given.Among 6,368,356 queried outcomes cases, 246,904 (3.9%) received succinylcholine without volatile agents. Succinylcholine was used in 46% (n = 710) of grade IV mask ventilation cases (median dose, 100 mg, 1.2 mg/kg). Succinylcholine without volatile anesthetics triggered 24 MH cases, 13 requiring dantrolene. Among 310 anesthetic-triggered MH cases, morbidity was 20 to 37%. Treatment delay increased complications every 10 min, reaching 100% with a 50-min delay. Overall mortality was 1 to 10%; 15 U.S. patients died, including 4 after anesthetics in freestanding facilities.Providers use succinylcholine commonly, including during difficult mask ventilation. Succinylcholine administered without volatile anesthetics may trigger MH events requiring dantrolene. Delayed dantrolene treatment increases the likelihood of MH complications. The data reported herein support stocking dantrolene wherever succinylcholine or volatile anesthetics may be used.

Three photographs have helped create the collective memory of the Vietnam War. “The Burning Monk” came at a time when the United States’ involvement in Vietnam was just gaining momentum, but it put the conflict on the front pages of America’s newspapers. The “Saigon Execution” photo was made at the height of America’s military involvement, and its purported effect, especially as an anti-war text, grew to almost mythic proportions. “The Terror of War” was published as U.S. troops were being withdrawn from Vietnam, but it served as a reminder of the cost of Vietnam’s ongoing civil war — and of all wars. Each image in its own way focused attention on Vietnam, and each has lived on in the history of the war and of photojournalism.

Many subsea structures have non-uniform geometries, which extend only a finite distance above the seabed. To better understand local scour at these structures, this paper presents scour measurements from an experimental study of submerged compound piles comprised of a circular superstructure supported by a circular foundation. The experiments were conducted in the clear-water regime and considered the effect of three different ratios describing the structural geometry: (i) the overall height of the compound structure above the initial bed level to the diameter of the super-structure h 1 / D 1 ; (ii) the height of the foundation exposed above the initial bed level relative to the overall height of the superstructure h 2 / h 1 ; and (iii) the diameter of the foundation to that of the superstructure D 2 / D 1 . In all cases D 2 ≥ D 1 and h 1 ≥ h 2 ≥ 0 (i.e. the foundation and superstructure where never buried). The experimental results indicate that, if all other parameters are held constant, the non-dimensional equilibrium scour depth S 0 / D 2 increases with both h 1 / D 1 and h 2 / h 1 , and decreases as D 2 / D 1 increases. To quantitatively explain these trends the experimental results are compared with a range of existing methods to predict scour depth for non-uniform (or complex) surface piercing piles. Of these methods it is found that an effective pile height and an effective pile diameter, computed using simple geometric arguments, give good agreement. The concept of effective height is also shown to collapse time-scale measurements of the scour process convincingly across the full range of experimental results and to explain the extent and shape of the local scour hole reasonably well. Collectively, these findings suggest that the calculation of an effective height may be used to provide a reasonable first approximation to estimate the rate and extent of local scour around submerged compound structures.

In this paper, local scour around a subsea structure supported by a skirted mudmat foundation is explored experimentally. For simplicity the structure is represented as a submerged circular cylinder founded on a concentric circular mudmat. The experiments are conducted in the clear-water regime and various geometries are considered by varying the height of the submerged cylinder relative to its diameter h 1 / D 1 , and the diameter of the mudmat relative to the submerged cylinder D 2 / D 1 . The experimental results indicate that the scour process can be categorized into two modes depending on geometry: Mode 1, in which local scour develops immediately at the upstream side of the mudmat; and Mode 2, in which local scour initiates at the downstream side of the mudmat and propagates upstream. For each mode, the rate of scour reduces as the mudmat becomes relatively large (i.e. as D 2 / D 1 increases). This reduction is most significant if the mudmat size is sufficient to swap the mode of scour from Mode 1 to Mode 2. The reduction in scour rate, however, does not coincide with a reduction in maximum scour depth. Instead, the relative scour depth of the superstructure S / D 1 increases as the mudmat becomes larger (i.e. as D 2 / D 1 increases). This trend is quantitatively explained by considering the effective aspect ratio of the combined mudmat and superstructure. Collectively, the results of the present study provide insight into the inherent scour protection provided by a skirted mudmat foundation.

Single-wall carbon nanotube (SWCNT) films are ideal components for thin, flexible, and durable electronic devices. Here, we use a variety of processing approaches to fabricate SWCNT-silicon heterojunctions from both unsorted and chirality-enriched SWCNTs. Through measured structure/processing/property relationships, we quantify the influence of SWCNT purity, alignment and residual doping on device performance and diode characteristics. Our results show that mixed-type unaligned SWCNTs processed in super-acid solvents can achieve state-of-the-art performance. The devices perform comparably to those fabricated from type or chiral-purified SWCNTs, despite what appear to be significant deviations from ideal diode behavior. Our results clarify a direct route for processing nanotube-silicon heterojunctions while providing additional insight into the underlying nature of these devices.

Although there has been significant recent progress in improving performance, the precise classification of nanotube–silicon heterojunctions remains ambiguous. Here, we use type, chirality, and length-purified single-walled carbon nanotubes to clarify the nature of these devices. Our junctions are assembled from freestanding nanotube sheets that show remarkable stability in response to repeated crumpling and folding during fluid processing, making the films well suited to flexible platforms. Despite modest ideality factors, the best diodes meet or exceed state-of-the-art characteristics, but with a surprising dependence on sample type. The data further suggest that these devices can be simultaneously categorized as either Schottky or p–n junctions, and we use scaling arguments to model the behavior over a broad range of sheet resistance and film thickness in a manner that highlights the critical role of nanotube midgap states. Our results demonstrate how band gap engineering can optimize these devices whi...

Offshore gravity base foundations (GBFs) are often designed with complex geometries. Such structures interact with local hydrodynamics, creating an adverse pressure gradient that is responsible for flow and scour phenomena, including the bed shear stress amplification. In this study, a method is presented for predicting clear-water scour around cylindrical structures with nonuniform geometries under the force of a unidirectional current. The interaction of the flow field with the sediment around these complex structures is described in terms of nondimensional parameters that characterize the similitude of water-sediment movement. The paper presents insights into the influence the streamwise depth-averaged Euler number has on the equilibrium scour around uniform and nonuniform cylindrical structures. Here, the Euler number is based on the depth-averaged streamwise pressure gradient (calculated using potential flow theory), the mean flow velocity, and the fluid density. Following a dimensional analysis, the controlling parameters were found to be the Euler number, pile Reynolds number, Froude number, sediment mobility number, and nondimensional flow depth. Based on this finding, a new scour-prediction equation was developed. This new method shows good agreement with the database of scour depths acquired in this study (R2=0.91)(R2=0.91). Measurements of the equilibrium scour depth around nonuniform cylindrical structures were used to show the importance of the Euler number in the scour process. Finally, the importance of the remaining nondimensional quantities with respect to scour was also investigated in this study.

Despite the progress in scour research over the last three decades, seabed scour development in cohesive and nonuniform soils is still an area of great uncertainty and remains a challenge for designing structurally efficient and effective foundations in the offshore marine environment. The uncertainty is made greater by the timescale required for scouring and effects, such as sediment abrasion, pile installation impacts, and operationally and environmentally induced dynamic motions. The rapid growth in offshore wind, particularly in European waters, has led to a requirement for estimates for scour development in such soils. This becomes very pertinent for large-volume serial installation of foundations, such as those required for offshore wind farm developments, given that there is a limit to the amount of detailed geotechnical information that can be collected as part of a project, and soil erosion testing is not standard. There is a reliance in geotechnical data, such as undrained shear strength, derived from cone penetration tests, supplemented with borehole data collected at a limited number of locations across the wind farm site combined with laboratory analysis of soil samples. This paper reviews the present evidence from both field and laboratory measurements of scour potential and looks at possible approaches for determining scour magnitude in cohesive soils including hydraulic and mechanical effects.

Aridification is often considered a major driver of long-term ecological change and hominin evolution in eastern Africa during the Plio-Pleistocene; however, this hypothesis remains inadequately tested owing to difficulties in reconstructing terrestrial paleoclimate. We present a revised aridity index for quantifying water deficit (WD) in terrestrial environments using tooth enamel δ18O values, and use this approach to address paleoaridity over the past 4.4 million years in eastern Africa. We find no long-term trend in WD, consistent with other terrestrial climate indicators in the Omo-Turkana Basin, and no relationship between paleoaridity and herbivore paleodiet structure among fossil collections meeting the criteria for WD estimation. Thus, we suggest that changes in the abundance of C4 grass and grazing herbivores in eastern Africa during the Pliocene and Pleistocene may have been decoupled from aridity. As in modern African ecosystems, other factors, such as rainfall seasonality or ecological interactions among plants and mammals, may be important for understanding the evolution of C4 grass- and grazer-dominated biomes.

[ILLUSTRATION OMITTED] The Civil War was a little more than a year old in the first days of September 1862, and Confederate general Robert E. Lee knew the South could not win a prolonged struggle against the manpower and industrial might of the Union. He hoped for a decisive victory that would lift the South's spirits, weaken the North's will to fight, and bring European recognition of the Confederacy--and, with that recognition, a halt to the war. Lee planned to invade Maryland, strike Pennsylvania, and ultimately move on Washington, D.C. Union commander George McClellan marched his army across the Potomac from Washington to meet Lee's challenge. The two armies arrived on either side of Antietam Creek in northern Maryland on the afternoon of September 15. Lee's Army of Northern Virginia numbered about 40,000 men. McClellan's Army of the Potomac totaled more than twice that number, about 87,000. A skirmish occurred on the afternoon of September 16, but it was a prelude to the climactic battle, which commenced at dawn on September 17,1862. (1) More than 6,000 Union and Confederate soldiers died that day in the farm fields outside Sharpsburg, making it the single bloodiest day in American military history. More soldiers died that day than died in combat in all other wars fought by America in the nineteenth century combined: the War of 1812, the Mexican-American War, the Spanish-American War, and the Indian wars. Beyond the statistics was the indescribable carnage. "Words are inadequate to portray the scene," wrote one soldier. Another, in charge of a burial party, described the dead "in every state of mutilation, sans arms, sans legs, heads, and intestines, and in greater number than on any field we have seen before." It was said that a person could walk a mile or more atop the bodies without touching ground. (2) An estimated 5,000 people watched the fighting from a hill a safe distance away. Edwin Forbes of Frank Leslie's Illustrated Newspaper reported that the battle took place on open ground and was fully visible from the hillside, which was "black with spectators." "No battle of the war, I think, was witnessed by so many people," he reported. It is possible the photographers Alexander Gardner and James F. Gibson were among them. The two men, employees of Mathew Brady, had been following the Union army for about two weeks, primarily photographing soldiers in their camps. When exactly they arrived at Antietam is uncertain, but they were on the field with their equipment the day after the battle; no other American battlefield had been photographed so soon after the fighting. The pair exposed seventy glass negatives within five days of the battle. Their images include landmarks of the field, hastily dug graves, and the corpses of horses and men. A union surgeon described bodies "stretched along, in one straight line, ready for interment, at least a thousand blackened bloated corpses with blood and gas protruding from every orifice, and maggots holding high carnival over their heads." (3) Gardner and Gibson's photographs were the first of dead soldiers on American soil. They would be displayed in Brady's New York studio a few weeks later, presenting the public with a previously unseen, shocking aspect of war. That the two men had managed to take photographs at all under the conditions was a technological and psychological feat. "But it is not the technical expertise that is ultimately Gardner's accomplishment," wrote his biographer Mark Katz. "[R]ather it is in extending the power of the photographic image in affecting public awareness. The photographic coverage of the Civil War by Gardner and others sent authentic images of the horrors of the battlefield directly to the public for the first time." This, Katz contended, was "the birth of photojournalism as we now know it." (4) The American public already thirsted for visual news of the war, and illustrated newspapers did their best to supply it, but Gardner's photographs, because they could not be reproduced in print, remained accessible only to a limited number of people. …

The 8th International Conference on Scour and Erosion (ICSE 2016) was organised by HR Wallingford, Oxfordshire, UK and held at the Mathematical Institute, Andrew Wiles Building, The University of Oxford from 12 to 15 September 2016. Contributions were received across eight principal themes: internal erosion, sediment transport, grain scale to continuum scale, advanced numerical modelling of scour and erosion, terrestrial scour and erosion, river and estuarine erosion including scour around structures, coastal and offshore scour and erosion and, management of scour/erosion and sediment (including hazard management and sedimentation in dams and reservoirs). The conference included four keynote lectures from world leading academics and practitioners cutting across the themes of scour and erosion, together with 132 peer-reviewed papers from 34 countries.

This paper explores the possibility of opportunistic cognitive radio based offloading for infotainment services in future autonomous vehicles. With the goal of a truly intelligent vehicle, research into the potential of vehicular communications intends to facilitate a wide range of services from safety aspects such as collision prevention to in-car information and entertainment (infotainment) services. With such a broad remit, future vehicles will likely have to rely on multiple communication technologies to successfully service their needs. In this paper we identify the benefits of offloading to WiFi via Drive-thru Internet in vehicular applications but note the damaging handover overheads introduced by such schemes. Instead we propose a method of opportunistic access based on Beacon Interval Whitetime to macro-cellular WiFi access points as a means of sustaining an active connection whilst moving through an urban environment. This will reduce the inefficiencies of successive handovers and enable increased volumes of content to be delivered to the vehicle. We perform an empirical study of the potential for offloading in a representative urban environment and find periods of upto 100 ms per second are available for opportunistic use throughout the test. Additionally we find semi-deterministic opportunities for cognitive access occur following 35% of beacons observed on a WiFi channel.

We present experiments that systematically examine how the addition of physically cohesive clay to sand affects scour evolution around a monopile in a current. Repeated centreline transects are used to show the changes in scour depth and excavated material over time. Combined with 3D plots of the final equilibrium morphology, the results conclusively prove that clay content causes a progressive reduction in the equilibrium depth, excavated area and that timescales of scour increase with clay content. Winnowing of clay particles from the sand matrix is a pre-requisite for scour and differences in clay content influence the rate and extent of winnowing, ultimately controlling equilibrium scour morphology. The strong linear relationships between clay content and equilibrium scour parameters offers a simple index on which to modify existing scour prediction methods. It follows that improved predictions of scour development can reduce manufacturing costs and related logistical expenses of structure operations in fluvial, coastal or offshore environments.

Many offshore foundations are composed of non-uniform cylindrical geometries such as cones and different diameter composite cylinders. However, little is known about how these types of structure respond with regards to scour under the forcing of a unidirectional current. The present paper describes a series of laboratory experiments that have been performed to examine the effect that the geometry of a marine structure has on the evolution and equilibrium depth of scour under different hydrodynamic conditions. It was found that the hydrodynamic scour response of the non-uniform cylindrical structures is fundamentally different to that of a uniform cylinder.

Offshore Gravity Base Foundations (GBFs) are often designed with non-uniform cylindrical geometries. Such structures interact with the local hydrodynamics which amplify the adverse dynamic pressure gradient, which is responsible for all flow and scour phenomena including the bed shear stress amplification. In this study a method for predicting the effect non-uniform cylindrical structure geometries have on local scour around offshore structures under the forcing of a unidirectional current is presented. The interaction of the flow field with the sediment around these complex structures is described in terms of non-dimensional parameters that characterize the similitude of water-sediment movement. The paper presents insights in the influence a form of the Euler number has on the equilibrium scour around uniform and non-uniform cylindrical structures. Here the Euler number is defined as the depth averaged pressure gradient (calculated using potential flow theory) divided by the product of the square of mean flow velocity and the fluid density. The insights are confirmed through a series of experiments where the equilibrium scour was monitored for different types of structures and flow conditions. The results of this study show that the Euler number is a more appropriate parameter for describing the scour potential of a structure compared to using the equivalent pile diameter. The experimental data show that an increasing Euler number yields an increase in the non-dimensional equilibrium scour. The results of this study also suggest that an increase in the water depth yields a decrease in the equilibrium scour depth for the conical, cylindrical base structures and truncated cylinders and an increase in the equilibrium scour depth for the uniform cylinders which can also be explained in terms of changes in the Euler number. Finally, the Buckingham π theorem in conjunction with the experimental data was used to derive a simple shape correction factor that could be used to determine the scour depth of a non-uniform cylindrical structure based on the equilibrium scour produced for the same flow conditions by a uniform cylinder.

Leaders of the top-performing accountable care organizations in the Medicare Shared Savings Program attribute the success of their organizations in large part to seven strategies: Seek action-oriented leadership. Transform primary care physician practices. Keep patients out of the emergency department. Ensure all transitions are smooth. Make effective use of available data. Share information on physician performance. Keep patients engaged.

Subsea pipeline networks with components such as Wye-pieces and Pipeline End Manifolds (PLEMs) require protection from mechanical impacts. Pipeline scour is well understood and scour at solid caissons/gravity base foundations and piled foundations has been studied (Whitehouse, 1998; Whitehouse, et al., 2011; Sumer and Fredsøe, 2002). The scouring at small subsea gravity protection structures has received less attention than those with piles (Ottesen Hansen, 1997; Fog and Krogh, 2001) and hence there is uncertainty about predicting scour at such structures (Whitehouse, et al., 2010). The design of subsea structures requires a composite assessment of scour and stability for the protected asset and the protection structure itself. A closed structure may lead to the formation of a scour footprint that is quite similar to a solid caisson or gravity base. For an open structure, the contribution to scour interaction from the different components is more difficult to assess. Large-scale mobile bed laboratory experiments evaluated scour for a surface laid pipeline, with a spur and valves, and a generic subsea protection structure with mudmats and a perimeter skirt. Bathymetry mapping was achieved with a high precision underwater laser scanner. The experiments evaluated the contributions to scour arising from the different subsea components. Sediment mobility was a key factor, with the perimeter skirt able to resist scour over part of its length when the mobility was low/moderate, whereas in a high mobility environment the skirt was completely undermined. The foundation beams were underscoured quite quickly and the eroded sediment was flushed out through the perforated mudmats, highlighting the importance of mudmat design. The scour pattern and rate was similar with or without the pipeline in place. The underscouring of the beams caused settlement and tilting of the structure, highlighting the importance of assessing scour and scour countermeasures for these types of structure. The scour assessment needs to be integrated into the structural, geotechnical and functional performance study for any structure and the new results illustrate the importance of understanding effects related to sediment mobility, the prevailing direction of currents, the design of mudmats and skirts, and the need for additional scour countermeasures.

Tragedies such as school shootings and the assault on Congresswoman Gabrielle Giffords share features that define them as acts of “rampage violence.” These types of events can lead to despair about their inevitability and unpredictability. To understand and prevent rampage violence, we need to acknowledge that current discipline-based violence research is not well suited to this specific challenge. There are numerous important, unanswered research questions that can inform policies designed to prevent rampage violence. It is time to develop alternative research approaches to reduce the risk of rampage violence. Such approaches should incorporate transdisciplinary research models; flexible, outcomes-focused organizational structures similar to those used to investigate other catastrophic events; and an expanded inventory of analytic tools.

Background Efforts to enhance physician substance abuse (SA) management skills lack tools to assess skills and training effectiveness. We sought to develop an easily administered survey to assess SA fact-based skills and clinical decision-making. Methods We prepared 60 fact-based items dealing with SA knowledge, attitudes, and behaviors (KAB) and 53 script concordance test (SCT) items assessing SA decision-making. We used expert review and standard psychometric criteria to eliminate discordant or non-contributory survey items. We tested 92 draft items in 117 physicians, including 13 with additional SA training (trained), and 17 recognized SA experts. We assessed final survey internal consistency with Cronbach's alpha and differences in scores between experts, trained physicians, and physicians without SA training (novices) with the Kruskal–Wallis test. Results Following refinement, the draft survey was reduced to 30 KAB and 33 SCT items. Alpha was 0.901 for the final 63-item survey and 0.887 and 0.797 for the KAB and SCT subscales, respectively. Novices, trained physicians, and experts scored means of 196, 213, and 261 respectively out of 315 possible points on the final survey. The KAB and SCT subscale results showed similar patterns. Score differences for the overall survey and its subscales were highly significant (p Conclusions This survey, which we have named the Physicians’ Competence in Substance Abuse Test (P-CSAT) and placed in the public domain, meets baseline criteria for reliability and validity. Future studies should determine the extent to which the P-CSAT provides consistent results in other practitioner populations and responds to SA educational efforts.

The coupling between mechanical flexibility and electronic performance is evaluated for thin films of metallic and semiconducting single-wall carbon nanotubes (SWCNTs) deposited on compliant supports. Percolated networks of type-purified SWCNTs are assembled as thin conducting coatings on elastic polymer substrates, and the sheet resistance is measured as a function of compression and cyclic strain through impedance spectroscopy. The wrinkling topography, microstructure and transparency of the films are independently characterized using optical microscopy, electron microscopy, and optical absorption spectroscopy. Thin films made from metallic SWCNTs show better durability as flexible transparent conductive coatings, which we attribute to a combination of superior mechanical performance and higher interfacial conductivity.

Summary •While studies of modern plants indicate negative responses to low [CO2] that occurred during the last glacial period, studies with glacial plant material that incorporate evolutionary responses are rare. In this study, physiological responses to changing [CO2] were compared between glacial (La Brea tar pits) and modern Juniperus trees from southern California. •Carbon isotopes were measured on annual rings of glacial and modern Juniperus. The intercellular : atmospheric [CO2] ratio (ci/ca) and intercellular [CO2] (ci) were then calculated on an annual basis and compared through geologic time. •Juniperus showed constant mean ci/ca between the last glacial period and modern times, spanning 50 000 yr. Interannual variation in physiology was greatly dampened during the last glacial period relative to the present, indicating constraints of low [CO2] that reduced responses to other climatic factors. Furthermore, glacial Juniperus exhibited low ci that rarely occurs in modern trees, further suggesting limiting [CO2] in glacial plants. •This study provides some of the first direct evidence that glacial plants remained near their lower carbon limit until the beginning of the glacial–interglacial transition. Our results also suggest that environmental factors that dominate carbon-uptake physiology vary across geologic time, resulting in major alterations in physiological response patterns through time.

This paper analyses scour at offshore foundations, with special reference to gravity base foundations which are used in a range of applications including oil and gas production, wind farm foundations and subsea infrastructure protection, such as concrete covers to pipelines. Two published empirical methods available for evaluating scour are reviewed and compared with laboratory and field data. The methods that are presented are reasonable for first-order assessment although they do not represent the inclusion of skirts. In a vigorous scour environment the foundation is liable to be undermined and scour protection will be required. A flow chart for a scour management plan is proposed to integrate scour considerations into the life cycle management of the gravity base foundations and some improvements that can be made to the predictive capabilities are outlined.

In this paper, we address the efficient utilization of a wireless sensor network (WSN) to improve the overall data throughput and to cut down the cost of running it. Sensor nodes closest to the sink node expend more energy as they send more routing messages, which decreases their life and introduces dead spots. Having dead spots will lead to the eventual isolation of the sink nodes from the network. We attempt to solve this problem by distributing multiple sink nodes. This will enable us to utilize the network at its maximal capacity as the sensor nodes start to die off. By adding multiple sink nodes, we will switch between them and choose the one that will yield optimal network coverage after the initial sink node is no longer viable to service or cannot service the network optimally. However, at any point of time, there will be only one active sink node. We will explore in three ways. First, we use a single sink node (with no switching) until it is isolated from the network. Second, we use a combination of highest percentage of network coverage combined with the highest areas of node density on the network to derive the optimal use of the network. We call this the Cluster Algorithm for Sink Selection (CASS). Finally, we try to keep the network optimal by switching to the sink node that is farthest from the current sink (assuming to gain the maximum network reach). We will analyze and discuss our findings with respect to the data through put and life of the network.

Purpose: Little is known about the skin cancer detection skills of advanced practice nurses (APNs). This systematic review of published literature seeks to describe (a) barriers to APNs’ performance of skin examination, (b) APNs’ ability to recognize suspicious skin lesions, and (c) APNs’ skin cancer detection training activities. Data sources: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guided the literature search (OVID Medline, Web of Science, and CINAHL databases) and interpretation of findings. Of the 136 articles meeting criteria for selection, 12 pertaining to the purpose were selected for further review. Conclusions: Barriers to skin examination by APNs have been infrequently and inconsistently measured. Limited time to conduct skin examination is the most consistent barrier. APNs’ ability to recognize and refer suspicious and benign lesions is inconsistent, but shows improvement after training. Few skin cancer training programs are available for APNs. Implications: Larger and more rigorously designed studies are needed to better determine APNs’ barriers and facilitators to skin cancer assessment and their ability to recognize and appropriately refer potentially malignant skin lesions with a high level of sensitivity and specificity. Training to increase these skills needs to be targeted to APNs and occur at a much higher volume than current efforts.