Bilateral abducens nerve palsy due to septic thrombophlebitis.

PurposeTo report a case of septic thrombophlebitis producing bilateral abducens nerve palsy.ObservationA 65 year-old woman with recent sinus surgery experienced the onset of horizontal diplopia during treatment for bacteremia. Computer tomography of head and a neck ultrasonography showed right internal jugular vein occlusion. Ophthalmology examination was consistent with bilateral abducens nerve palsy. She was treated with systemic antibiotics and antiplatelet therapy with resolution of the internal jugular vein occlusion. The diplopia improved over a six-months.Conclusion and importanceOur patient had Lemierre syndrome with an unusual presentation. The patient was treated for septic thrombophlebitis with a resolution of her ocular symptoms

Evaluation of patient perception towards dynamic health data sharing using blockchain based digital consent with the Dovetail digital consent application : a cross sectional exploratory study

Background New patient-centric integrated care models are enabled by the capability to exchange the patient’s data amongst stakeholders, who each specialise in different aspects of the patient’s care. This requires a robust, trusted and flexible mechanism for patients to offer consent to share their data. Furthermore, new IT technologies make it easier to give patients more control over their data, including the right to revoke consent. These characteristics challenge the traditional paper-based, single-organisation-led consent process. The Dovetail digital consent application uses a mobile application and blockchain based infrastructure to offer this capability, as part of a pilot allowing patients to have their data shared amongst digital tools, empowering patients to manage their condition within an integrated care setting. Objective To evaluate patient perceptions towards existing consent processes, and the Dovetail blockchain based digital consent application as a means to manage data sharing in the context of diabetes care. Method Patients with diabetes at a General Practitioner practice were recruited. Data were collected using focus groups and questionnaires. Thematic analysis of the focus group transcripts and descriptive statistics of the questionnaires was performed. Results There was a lack of understanding of existing consent processes in place, and many patients did not have any recollection of having previously given consent. The digital consent application received favourable feedback, with patients recognising the value of the capability offered by the application. Patients overwhelmingly favoured the digital consent application over existing practice. Conclusions Digital consent was received favourably, with patients recognising that it addresses the main limitations of the current process. Feedback on potential improvements was received. Future work includes confirmation of results in a broader demographic sample and across multiple conditions

Variational quantum Monte Carlo simulations with tensor-network states

We show that the formalism of tensor-network states, such as the matrix product states (MPS), can be used as a basis for variational quantum Monte Carlo simulations. Using a stochastic optimization method, we demonstrate the potential of this approach by explicit MPS calculations for the transverse Ising chain with up to N=256 spins at criticality, using periodic boundary conditions and D*D matrices with D up to 48. The computational cost of our scheme formally scales as ND^3, whereas standard MPS approaches and the related density matrix renromalization group method scale as ND^5 and ND^6, respectively, for periodic systems.Comment: 4+ pages, 2 figures. v2: improved data, comparisons with exact results, to appear in Phys Rev Let

Contact area of rough spheres: Large scale simulations and simple scaling laws

We use molecular simulations to study the nonadhesive and adhesive atomic-scale contact of rough spheres with radii ranging from nanometers to micrometers over more than ten orders of magnitude in applied normal load. At the lowest loads, the interfacial mechanics is governed by the contact mechanics of the first asperity that touches. The dependence of contact area on normal force becomes linear at intermediate loads and crosses over to Hertzian at the largest loads. By combining theories for the limiting cases of nominally flat rough surfaces and smooth spheres, we provide parameter-free analytical expressions for contact area over the whole range of loads. Our results establish a range of validity for common approximations that neglect curvature or roughness in modeling objects on scales from atomic force microscope tips to ball bearings.Comment: 2 figures + Supporting Materia

Unified Description of Aging and Rate Effects in Yield of Glassy Solids

The competing effects of slow structural relaxations (aging) and deformation at constant strain rate on the shear yield stress $\tau^y$ of simple model glasses are examined using molecular simulations. At long times, aging leads to a logarithmic increase in density and $\tau^y$. The yield stress also rises logarithmically with rate, but shows a sharp transition in slope at a rate that decreases with increasing age. We present a simple phenomenological model that includes both intrinsic rate dependence and the change in properties with the total age of the system at yield. As predicted by the model, all data for each temperature collapse onto a universal curve.Comment: 4 pages, 3 figure

Impact Ionization in ZnS

The impact ionization rate and its orientation dependence in k space is calculated for ZnS. The numerical results indicate a strong correlation to the band structure. The use of a q-dependent screening function for the Coulomb interaction between conduction and valence electrons is found to be essential. A simple fit formula is presented for easy calculation of the energy dependent transition rate.Comment: 9 pages LaTeX file, 3 EPS-figures (use psfig.sty), accepted for publication in PRB as brief Report (LaTeX source replaces raw-postscript file

Incentivizing Exploration with Heterogeneous Value of Money

Recently, Frazier et al. proposed a natural model for crowdsourced exploration of different a priori unknown options: a principal is interested in the long-term welfare of a population of agents who arrive one by one in a multi-armed bandit setting. However, each agent is myopic, so in order to incentivize him to explore options with better long-term prospects, the principal must offer the agent money. Frazier et al. showed that a simple class of policies called time-expanded are optimal in the worst case, and characterized their budget-reward tradeoff. The previous work assumed that all agents are equally and uniformly susceptible to financial incentives. In reality, agents may have different utility for money. We therefore extend the model of Frazier et al. to allow agents that have heterogeneous and non-linear utilities for money. The principal is informed of the agent's tradeoff via a signal that could be more or less informative. Our main result is to show that a convex program can be used to derive a signal-dependent time-expanded policy which achieves the best possible Lagrangian reward in the worst case. The worst-case guarantee is matched by so-called "Diamonds in the Rough" instances; the proof that the guarantees match is based on showing that two different convex programs have the same optimal solution for these specific instances. These results also extend to the budgeted case as in Frazier et al. We also show that the optimal policy is monotone with respect to information, i.e., the approximation ratio of the optimal policy improves as the signals become more informative.Comment: WINE 201

Coaching Stressors in a Division II Historically Black University

Recently, studies have addressed the stressful nature of the coaching profession, identifying a multitude of stressors among coaches for Division I, national, and international programs (Durand-Bush, Collins, & McNeill, 2012; Frey, 2007; Levy, Nicholls, Marchant, & Polman, 2009; Olusoga, Butt, Hays, & Maynard, 2009). The purpose of this study was to further the research by studying coaches at a Historically Black College/University (HBCU) and Division II (DII) athletic program. Participants included seven head and five assistant coaches across seven sports. All coaches were interviewed, based on a preexisting interview guide (Olusoga et al., 2009). Data were content analyzed using previously agreed upon procedures and submitted in NVivo for further examination (Côté, Salmela, Baria, & Russell, 1993). Three higher order themes termed Interpersonal, Intrapersonal, and Contextual Stressors emerged and were composed of 16 lower order themes. The most commonly cited interpersonal stressors included athletes, expectations of others, and administration. Performance outcome and lack of control were the most common intrapersonal stressors. Finally, schedule, lack of resources, and job security were the most common contextual stressors. These findings emphasize the stressful nature of the job and the need to identify means for minimizing stressors to improve the athletic experience for all involved