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We study the chaotic signatures of the geodesic dynamics of a non-spinning test particle in the effective-one-body (EOB) formalism for the inspiral process of spinning binary black holes. We first show that the second order post-Newtonian (2PN) EOB dynamics is non-integrable by demonstrating that the EOB metric does not satisfy the criterion for the existence of Carter constant. We then employ the numerical study to find the plateaus of the rotation curve, which are associated with the existence of Birkhoff islands in the Poincar\'e surface of section, signifying the chaotic dynamics in the system. Our results show the signatures of chaos for the EOB dynamics, especially in the regime of interest for which the Kerr bounds of the component black holes hold. We also find that chaotic behavior is more obvious as the spin parameter $a$ of the deformed EOB background metric increases. Our results can help to uncover the implications of dynamical chaos in gravitational wave astronomy. Finally, we also present some preliminary results due to corrections at 3PN order., Comment: 19 pages, 11 figures. Improvements and references added. Accepted for publication in Phys. Rev. D

Advancing Health Equity Through Innovations and Technology This year’s summit was unique given the COVID-19 pandemic: a major global outbreak that has imposed severe restrictions in all aspects of our life. At the outset, we were faced with three mutually exclusive options. First option was to cancel the summit in its entirety: this was the easiest and most obvious choice once the COVID-19 pandemic forced a near total lockdown all over the country with unprecedented disruptions of normal daily activities as the disease announced its thunderous touchdown on United States (US) soil. It was also the most-logical response faced with uncertainty regarding summit logistics and expected poor attendance due to the raging pandemic. Second option was to conduct a digital summit restricted to local audiences at Baylor College of Medicine: this option entailed implementing a virtual summit with attendance restricted to participants from our institution only. It sounded like a reasonable choice but that would impede the presence of diversity of topics, perspectives, insights and experiential learning opportunities, which are what render the summit exciting and worth attending. And finally, the last option was to conduct a digital unrestricted summit open to all interested audiences throughout the US. The conduct of a virtual summit open to all participants from around the country was initially considered daunting given the likelihood of amplified technical problems associated with an array of internet access differentials around the country, which would require a strong Information Technology (IT) presence throughout the sessions. Nonetheless, the attractiveness of going national with a virtual summit, despite the pandemic and logistical challenges, slowly gained converts and became the dominant choice. The response and level of participation in this first virtual summit showed an unanticipated surge despite the increase in registration fees to cover IT costs. This year, we had attendees from all regions of the US as well as from the United Kingdom. The range of topics was quite diverse encompassing health disparities in relation to cancers, nutrition, musculo-skeletal disorders, amputation rates, vaccination uptakes and COVID-19 infections. Various solutions were passionately presented to address these disparities including novel health technologies, community engagement and partnerships, improvement in health literacy and alternative therapeutics. There were no hitches despite the complex breakout sessions, and above all, attendees were satisfied and offered outstanding evaluation scores. This was definitely a summit that metamorphosed from pessimism to a triumphant success! Copyright © 2020 Salihu et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

Bacterial infections represent a major cause of mortality and morbidity in patients with cirrhosis that can alter the clinical course of compensated cirrhosis. The most common infections are spontaneous bacterial peritonitis by gram-negative organisms, urinary-tract infection, and pneumonia. In this case report, we raise the question of considering infections in the prognosis scoring in this patient group.

Here, we derive the metric for the spacetime around rotating object for the gravity action having nonlocal correction of $R\Box^{-2} R $ to the Einstein-Hilbert action. Starting with the generic stationary, axisymmetric metric, we solve the equations of motion in linearized gravity limit for the modified action including energy-momentum tensor of the rotating mass. We also derive the rotating metric from the static metric using the Demanski-Janis-Newmann algorithm. Finally, we obtain the constraint on the value of $M$ by calculating the frame dragging effect in our theory and comparing it with that of General Relativity and Gravity Probe B results, where $M$ is the mass scale of the theory., 13 pages, 3 figures

Background Joint Commission mandates that prescribers document indication for antibiotics at the time of prescribing. Antibiotic indications may offer opportunities for pharmacists to optimize dosing and frequency or provide alternative therapeutic options. We examined the impact of antibiotic indications during order entry on frequency and type of pharmacist interventions, time to order verification, and time to administration of antibiotics. Methods Number of pharmacist interventions documented in EPIC from 4/28/17 through 4/28/18 (pre-intervention) were compared with interventions from 4/29/18 through 2/28/19 (post-intervention). All pharmacist interventions involving antibiotic orders were included. For antibiotic orders involving a pharmacist intervention, data collected included antibiotic prescribed, indication for antibiotic (post-intervention only) and reason for intervention. For administered antibiotics, data collected included order time, time of arrival of order in pharmacist queue, pharmacist verification time, patient administration time. Statistical analysis involved chi-squared test (compare the reason for intervention) and t-test (compare difference in time). Results There were 790 orders and 638 orders that involved a pharmacist’s interventions, pre-intervention and post-intervention, respectively (Tables 1 and 2). Pre-intervention, there were 200 antibiotic orders that had a documented pharmacist intervention and were administered. Post-intervention, there were 184 orders that had a documented pharmacist intervention and were administered. Abdominal/pelvic (29 orders, 16%), sepsis (19 orders, 10%), and surgical prophylaxis (18 orders, 9.7%) were the most frequent indications selected during order entry. Average time to order verification was 119 minutes pre-intervention and 123 minutes post-intervention (P =0.97). Average time to administration of antibiotics was 313 minutes and 360 minutes pre-intervention and post-intervention, respectively (P =0.45). Conclusion Inclusion of the selection of antibiotic indications during order entry did not significantly impact the number of pharmacist interventions, time to order verification nor time to administration. Disclosures All authors: No reported disclosures.

BACKGROUND: Infertility is social stigma. Male infertility also has significant contribution in Toto. Different habits among males i.e. smoking, tobacco chewing and alcohol intake have found adverse influence on sperm count and sperm motility. AIMS AND OBJECTIVES: To identify the role of smoking, tobacco chewing and alcohol in decreasing sperm count or motility. MATERIALS AND METHODS: Total 100 semen samples from the case of male infertility reported at C U Shah Medical College & Hospital were taken in this study. The results of alcoholics, tobacco chewers and smokers were studied and compared according to WHO guidelines, to that of non-alcoholics and non-smokers. RESULTS: Of 100 samples 68 showed decreased sperm count of which 39 men were chronic smokers, 26 men tobacco chewers and none drank chronically. 38 out of 100 samples showed decreased progressive motility, of which 21 men were addicted to either tobacco chewing or smoking. CONCLUSION: Smoking and tobacco chewing have a role in deteriorating the sperm quality and therefore in infertility of the male partners.

Aim: To develop a simple, accurate, sensitive, rapid and precise method for the determination of galantamine hydrobromide in bulk drug and pharmaceutical dosage form. Material and Methods: The method employs wavelength detection and determination of galantamine hydrobromide at excitation wavelength 282 nm and emission wavelength 607 nm in a solution of simple distilled water. Result and Conclusion: The method was found to be linear in the range of 2-14 μg/ml having r 2 = 0.9999. The mean accuracy was found to be 98.12% to 99.67%. The intraday and interday precision was found to be 0.18-0.35% and 0.13-0.46%, respectively. The limit of detection was found to be 0.29 μg/ml. The limit of quantification was found to be 0.89 μg/ml. The method was successfully applied for the determination of galantamine hydrobromide in bulk drug as well as pharmaceutical dosage form.

Background: Leaves of Tephrosia purpurea Linn. (sarpankh), belonging to the family Leguminaceae, are used for the treatment of jaundice and are also claimed to be effective in many other diseases. This research work was undertaken to investigate the in vitro antioxidant activity of aqueous and ethanolic extracts of the leaves. Method: The therapeutic effects of tannins and flavonoids can be largely attributed to their antioxidant properties. So, the quantitative determinations were undertaken. All the methods are based on UV-spectrophotometric determination. Result: The total phenolic content of aqueous and ethanolic extracts showed the content values of 9.44 ± 0.22% w/w and 18.44 ± 0.13% w/w, respectively, and total flavonoid estimation of aqueous and ethanolic extracts showed the content values of 0.91 ± 0.08% w/w and 1.56 ± 0.12%w/w, respectively, for quercetin and 1.85 ± 0.08% w/w and 2.54 ± 0.12% w/w, respectively, for rutin. Further investigations were carried out for in vitro antioxidant activity and radical scavenging activity by calculating its percentage inhibition by means of IC 50 values, all the extracts' concentrations were adjusted to fall under the linearity range and here many reference standards like tannic acid, gallic acid, quercetin, ascorbic acid were taken for the method suitability. Conclusion: The results revealed that leaves of this plant have antioxidant potential. The results also show the ethanolic extract to be more potent than the aqueous decoction which is claimed traditionally. In conclusion, T. purpurea Linn. (Leguminosae) leaves possess the antioxidant substance which may be responsible for the treatment of jaundice and other oxidative stress-related diseases.

Although $f(R)$ modification of late time cosmology is successful in explaining present cosmic acceleration, it is difficult to satisfy the fifth-force constraint simultaneously. Even when the fifth-force constraint is satisfied, the effective scalar degree of freedom may move to a point (close to its potential minima) in the field space where the Ricci scalar diverges. We elucidate this point further with a specific example of $f(R)$ gravity that incorporates several viable $f(R)$ gravity models in the literature. In particular, we show that the nonlinear evolution of the scalar field in pressureless contracting dust can easily lead to the curvature singularity, making this theory unviable., 15 pages, 4 figures, 1 table, minor changes in the text, a few references added

Intussusception is the cause of around 1% of all bowel obstructions in adults. Unlike in children, where intussusception is most often idiopathic in nature, cases in adults usually have an identifiable etiology, most commonly malignancy. Symptoms are usually non-specific, but timely identification and management is crucial due to high rates of carcinoma as the lead point of intussusception. Here we present a rare case of mucinous adenocarcinoma of the colon that presented as ileoileal intussusception. Diagnostic and treatment issues are also discussed.