Phase compensated optical fiber links enable high accuracy atomic clocks separated by thousands of kilometers to be compared with unprecedented statistical resolution. By searching for a daily ...variation of the frequency difference between four strontium optical lattice clocks in different locations throughout Europe connected by such links, we improve upon previous tests of time dilation predicted by special relativity. We obtain a constraint on the Robertson-Mansouri-Sexl parameter |α|≲1.1×10^{-8}, quantifying a violation of time dilation, thus improving by a factor of around 2 the best known constraint obtained with Ives-Stilwell type experiments, and by 2 orders of magnitude the best constraint obtained by comparing atomic clocks. This work is the first of a new generation of tests of fundamental physics using optical clocks and fiber links. As clocks improve, and as fiber links are routinely operated, we expect that the tests initiated in this Letter will improve by orders of magnitude in the near future.
•Socially vulnerable patients may have more delays in obtaining surgical care due to poor access.•Neighborhood Social Vulnerability Index (SVI) can be used to quantify surgical outcome ...disparities.•Rates of perforated appendicitis were higher in older patients and were associated with delays in care.•However, we did not find overall that Social Vulnerability Index was associated with longer delays or higher perforation rates.
Delays in obtaining care may lead to perforated appendicitis, increasing risk of morbidity and mortality. We previously explored the role of social determinants in patients undergoing cholecystectomy, finding that emergent presentation is associated with neighborhood Social Vulnerability Index (SVI). We hypothesize that social vulnerability is associated with increased incidence of perforated appendicitis.
We retrospectively identified patients presenting to our urban, academic hospital with acute appendicitis during a 9-month timeframe (11/2019 – 7/2020). Patients were classified as perforated or non-perforated. Patient SVI was determined using geocoding at the census tract level. Because rates of perforation were higher in older patients, we performed a subset analysis of patients ≥ 40 years.
190 patients were included. Patients with perforated appendicitis (n = 48, 25%) were older and were more likely to present to a clinic versus the emergency department (P = 0.009). Perforated patients had longer delay before seeking care (56% versus 6% with > 72 hours of symptoms, P < 0.001). However, there were no differences between groups in terms of sex, race/ethnicity, insurance type, language barrier, having a primary care physician, or any of the SVI subscales. Of patients ≥ 40 years, a higher proportion were perforated (28/80, 35%) despite similar rates of delayed care. In this cohort, higher overall SVI as well as the socioeconomic status and household composition/disability subscales were associated with perforation.
Contrary to our hypothesis, while perforation was associated with delayed care in this population, we did not find overall that social vulnerability or individual social determinants accounted for this delay.
Implemented for decades as part of the 'best management practices (BMPs)' for controlling urban runoff impacts on receiving waters, stormwater management ponds (SMPs) have been increasingly viewed as ...potential habitats for urban wildlife. However, since SMPs are subject to a lot of environmental constraints, research toward assessing their ecological quality and their actual benefits as habitats for biota is needed. In this study, the sediment toxicity of eight SMPs located in Southern Ontario, Canada was assessed using the sediment quality triad (SQT) approach. Sediment samples were collected for chemical, ecotoxicological and biological analyses. An oligochaete-based index approach (Oligochaete Index of Lake Bioindication and percentage of pollution-sensitive species) was used as the biological endpoint and integrated into a weight-of-evidence approach to assessing the general sediment quality of the ponds. Our results showed that (i) heavy metals in the sediment and (ii) chloride concentrations in the sediment interstitial water caused detrimental effects on the ecological quality of the sediments in the ponds studied. The oligochaete indices applied in this study showed value as biological endpoints to be integrated into the SQT and used for setting up sediment ecological quality goals.
We report on observations of electromagnetic ion cyclotron (EMIC) waves and their interactions with injected ring current particles and high energy radiation belt electrons. The magnetic field ...experiment aboard the twin Van Allen Probes spacecraft measured EMIC waves near L = 5.5–6. Particle data from the spacecraft show that the waves were associated with particle injections. The wave activity was also observed by a ground‐based magnetometer near the spacecraft geomagnetic footprint over a more extensive temporal range. Phase space density profiles, calculated from directional differential electron flux data from Van Allen Probes, show that there was a significant energy‐dependent relativistic electron dropout over a limited L‐shell range during and after the EMIC wave activity. In addition, the NOAA spacecraft observed relativistic electron precipitation associated with the EMIC waves near the footprint of the Van Allen Probes spacecraft. The observations suggest EMIC wave‐induced relativistic electron loss in the radiation belt.
Plain Language Summary
Electromagnetic waves caused by plasma particles in the Earth's magnetic fields are known to interact with high energy particles in the Earth's radiation belts, leading to loss of the particles into the Earth's atmosphere. We report on observations of the wave phenomena and their interaction with radiation belt particles using data from NASA's twin spacecraft mission called Van Allen Probes. Particle detectors aboard the spacecraft measured the increased flux of particles, providing the source energy to generate electromagnetic waves. Such wave activity was also observed by instruments on the ground. A parameter calculated using data from various instruments aboard the spacecraft enabled us to quantitatively assess how the radiation belt electron population changes over time. This analysis reveals that the wave event caused the radiation belt electrons of certain energies to decay over a limited spatial extent. In addition, particle data from low earth orbiting spacecraft show an increase in particle flux, which appears to be associated with the wave activity. The observations suggest that the wave can contribute to loss of electrons in the radiation belts.
Key Points
A radiation belt electron dropout was observed during injection‐associated electromagnetic ion cyclotron (EMIC) waves
L‐shell and energy‐dependent electron dropout indicates EMIC‐wave induced scattering of radiation belt electrons
NOAA spacecraft data show relativistic electron precipitation during the dropout event
Objective: The objective of this study was to investigate the effectiveness of teletherapy compared to in-person couple therapy in outcomes such as couple satisfaction, sexual satisfaction, and the ...therapeutic alliance.
Method: Data from 1157 married clients seeking couple therapy were examined. Individual growth curve models were used to analyze changes in the aforementioned outcomes, with teletherapy as a predictor. The study also examined client age and clinic type as moderators.
Results: The results indicated that overall, teletherapy is as effective as in-person therapy in improving outcomes. However, there were notable differences in the development of the therapeutic alliance. The alliance improved at twice the rate in in-person therapy as in teletherapy. Clinic type was also found to be a moderator of changes in sexual satisfaction. Clients in group and private practices reported improvements in sexual satisfaction; whereas clients seen in training clinics reported decreases in sexual satisfaction.
Conclusion: The study concludes that although teletherapy may be a viable alternative to in-person couple therapy, there are nevertheless differences in the development of the therapeutic alliance that warrant care and further investigation. The setting of the therapy also plays a role in the effectiveness of therapy, although not specific to therapy modality.
Monitoring the therapeutic alliance throughout treatment can improve client outcomes and lead to improved care. The individual, couple, and family versions of the intersession alliance measure (IAM) ...were developed to facilitate routine monitoring of the expanded therapeutic alliance. Psychometric properties of the three versions of the IAM were examined using a clinical sample. Participants were drawn from clinics in the United States participating in the Marriage and Family Therapy Practice Research Network. Using this sample, results indicate that items on each version of the IAM load on one factor, are invariant across sex, and that each version has good internal consistency, test–retest reliability, and concurrent validity. The IAM‐C and IAM‐F also have good predictive validity, while the IAM‐I has more limited evidence for its predictive validity. These results suggest that the IAMs are valid and reliable measures that can facilitate the routine monitoring of the expanded therapeutic alliance in psychotherapy.
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