Coplanar interconnection module

Module for interconnecting a semiconductor array to external leads or components incorporates a metal external heat sink for cooling the array. Heat sink, extending down from the molded block that supports the array, is immersed in a liquid nitrogen bath which is designed to maintain the desired array temperature

On the locus formed by the maximum heights of projectile motion with air resistance

We present an analysis on the geometrical place formed by the set of maxima of the trajectories of a projectile launched in a media with linear drag. Such a place, the locus of apexes, is written in term of the Lambert $W$ function in polar coordinates, confirming the special role played by this function in the problem. In order to characterize the locus, a study of its curvature is presented in two parameterizations, in terms of the launch angle and in the polar one. The angles of maximum curvature are compared with other important angles in the projectile problem. As an addendum, we find that the synchronous curve in this problem is a circle as in the drag-free case.Comment: 7 pages, 6 color eps figures. Synchronous curve added. Typos and style corrected

Mifepristone Antagonization With Progesterone to Prevent Medical Abortion: A Randomized Controlled Trial.

ObjectiveTo estimate the efficacy and safety of mifepristone antagonization with high-dose oral progesterone.MethodsWe planned to enroll 40 patients in a double-blind, placebo-controlled, randomized trial. We enrolled patients at 44-63 days of gestation with ultrasound-confirmed gestational cardiac activity who were planning surgical abortion. Participants ingested mifepristone 200 mg and initiated oral progesterone 400 mg or placebo 24 hours later twice daily for 3 days, then once daily until their planned surgical abortion 14-16 days after enrollment. Follow-up visits were scheduled 3±1, 7±1, and 15±1 days after mifepristone intake with ultrasonography and blood testing for human chorionic gonadotropin and progesterone. Participants exited from the study when they had their surgical abortion or earlier for gestational cardiac activity absence, gestational sac expulsion, or medically indicated suction aspiration. We assessed the primary outcome of continued gestational cardiac activity at approximately 2 weeks (15±1 day), side effects after drug ingestion, and safety outcomes including hemorrhage and emergent treatment.ResultsWe enrolled participants from February to July 2019 and stopped enrollment after 12 patients for safety concerns. Mean gestational age was 52.5 days. Two (one per group) voluntarily discontinued 3 days after mifepristone ingestion for subjective symptoms (nausea and vomiting, bleeding). Among the remaining 10 patients (five per group), gestational cardiac activity continued for 2 weeks in four in the progesterone group and two in the placebo group. One patient in the placebo group had no gestational cardiac activity 3 days after mifepristone use. Severe hemorrhage requiring ambulance transport to hospital occurred in three patients; one received progesterone (complete expulsion, no aspiration) and two received placebo (aspiration for both, one required transfusion). We halted enrollment after the third hemorrhage. No other significant side effects were reported.ConclusionWe could not estimate the efficacy of progesterone for mifepristone antagonization due to safety concerns when mifepristone is administered without subsequent prostaglandin analogue treatment. Patients in early pregnancy who use only mifepristone may be at high risk of significant hemorrhage.Clinical trial registrationClinicalTrials.gov, NCT03774745

Determinism and inevitability

In Freedom Evolves, Dan Dennett embarks on his second book-length attempt to lay to rest the deep metaphysical concerns that many philosophers have expressed about the possibility of human freedom.One of his main objectives in the earlier chapters of the book is to make determinism appear less threatening to our prospects for free agency than it has sometimes seemed, by attempting to show that a deterministic universe would not necessarily be a universe of which it could truly be said that everything that occurs in it is inevitable. In this paper, I want to consider Dennett’s striking argument for this conclusion in some detail. I shall begin by suggesting that on its most natural interpretation, the argument is vulnerable to a serious objection. I shall then develop a second interpretation which is more promising than the first, but will argue that without placing more weight on etymological considerations than they can really bear, it can deliver, at best, only a significantly qualified version of the conclusion that Dennett is seeking. However, although I shall be arguing that his central argument fails, it is also part of the purpose of this paper to build on what I regard as some rather insightful and suggestive material which is developed by Dennett in the course of elaborating his views. His own development of these ideas is hampered, so I shall argue, by a framework for thinking about possibility that is too crude to accommodate the immense subtlety and complexity which is exhibited by the workings of the modal verb ‘can’ and its past tense form, ‘could’; and also, I believe, by the mistaken conviction, on Dennett’s part, that any naturalistically respectable solution to the problem of free will would have to be of a compatibilist stripe. I shall attempt, in the second half of the paper, to explain what seems to me to be wrong with the framework, and to make some points about the functioning of ‘can’ and ‘could’, which I believe any adequate replacement for Dennett’s framework must respect. Ironically, though, I shall argue that it is the rejection of Dennett’s own framework which holds the key to understanding how to defend the spirit (if not the letter) of his thoughts about the invulnerability of our ordinary modal thinking to alleged threats from determinism

Do actions occur inside the body?

The paper offers a critical examination of Jennifer Hornsby's view that actions are internal to the body. It focuses on three of Hornsby's central claims: (P) many actions are bodily movements (in a special sense of the word “movement”) (Q) all actions are tryings; and (R) all actions occur inside the body. It is argued, contra Hornsby, that we may accept (P) and (Q) without accepting also the implausible (R). Two arguments are first offered in favour of the thesis (Contrary-R): that no actions occur inside the body. Three of Hornsby's arguments in favour of R are then examined. It is argued that we need to make a distinction between the causes and the causings of bodily movements (in the ordinary sense of the word “movement”) and that actions ought to be identified with the latter rather than the former. This distinction is then used to show how Hornsby's arguments for (R) may be resisted

Coordination Implications of Software Coupling in Open Source Projects

The effect of software coupling on the quality of software has been studied quite widely since the seminal paper on software modularity by Parnas [1]. However, the effect of the increase in software coupling on the coordination of the developers has not been researched as much. In commercial software development environments there normally are coordination mechanisms in place to manage the coordination requirements due to software dependencies. But, in the case of Open Source software such coordination mechanisms are harder to implement, as the developers tend to rely solely on electronic means of communication. Hence, an understanding of the changing coordination requirements is essential to the management of an Open Source project. In this paper we study the effect of changes in software coupling on the coordination requirements in a case study of a popular Open Source project called JBoss

Practice transformations to optimize the delivery of HIV primary care in community healthcare settings in the United States: A program implementation study.

BackgroundThe United States HIV care workforce is shrinking, which could complicate service delivery to people living with HIV (PLWH). In this study, we examined the impact of practice transformations, defined as efficiencies in structures and delivery of care, on demonstration project sites within the Workforce Capacity Building Initiative, a Health Resources and Services Administration (HRSA) Ryan White HIV/AIDS Program Special Projects of National Significance (SPNS).Methods and findingsData were collected at 14 demonstration project sites in 7 states and the District of Columbia. Organizational assessments were completed at sites once before and 4 times after implementation. They captured 3 transformation approaches: maximizing the HIV care workforce (efforts to increase the number of existing healthcare workforce members involved in the care of PLWH), share-the-care (team-based care giving more responsibility to midlevel providers and staff), and enhancing client engagement in primary HIV care to reduce emergency and inpatient care (e.g., care coordination). We also obtained Ryan White HIV/AIDS Program Services Reports (RSRs) from sites for calendar years (CYs) 2014-2016, corresponding to before, during, and after transformation. The RSR include data on client retention in HIV care, prescription of antiretroviral therapy (ART), and viral suppression. We used generalized estimating equation (GEE) models to analyze changes among sites implementing each practice transformation approach. The demonstration projects had a mean of 18.5 prescribing providers (SD = 23.5). They reported data on more than 13,500 clients per year (mean = 969/site, SD = 1,351). Demographic characteristics remained similar over time. In 2014, a majority of clients were male (71% versus 28% female and 0.2% transgender), with a mean age of 47 (interquartile range [IQR] 37-54). Racial/ethnic characteristics (48% African American, 31% Hispanic/Latino, 14% white) and HIV risk varied (31% men who have sex with men; 31% heterosexual men and women; 7% injection drug use). A substantial minority was on Medicaid (41%). Across sites, there was significant uptake in practices consistent with maximizing the HIV care workforce (18% increase, p < 0.001), share-the-care (25% increase, p < 0.001), and facilitating patient engagement in HIV primary care (13% increase, p < 0.001). There were also significant improvements over time in retention in HIV care (adjusted odds ratio [aOR] = 1.03; 95% confidence interval [CI] 1.02-1.04; p < 0.001), ART prescription levels (aOR = 1.01; 95% CI 1.00-1.01; p < 0.001), and viral suppression (aOR = 1.03; 95% CI 1.02-1.04; p < 0.001). All outcomes improved at sites that implemented transformations to maximize the HIV care workforce or improve client engagement. At sites that implemented share-the-care practices, only retention in care and viral suppression outcomes improved. Study limitations included use of demonstration project sites funded by the Ryan White HIV/AIDS Program (RWHAP), which tend to have better HIV outcomes than other US clinics; varying practice transformation designs; lack of a true control condition; and a potential Hawthorne effect because site teams were aware of the evaluation.ConclusionsIn this study, we found that practice transformations are a potential strategy for addressing anticipated workforce challenges among those providing care to PLWH. They hold the promise of optimizing the use of personnel and ensuring the delivery of care to all in need while potentially enhancing HIV care continuum outcomes