Publications

[H]istory … suggests taking more seriously concerns about inequality and, specifically, the resentment and alienation of once-privileged groups who feel left behind.

Abstract The design, synthesis, and properties of supermolecules consisting of well defined assemblies of linear and globular macromolecules is studied. Therefore, several families of hybrid block polymers based on polyether dendrimers linked to well‐defined blocks of polyethylene oxide, polyethylene glycol, polyester, or polystyrene have been prepared. The unique topological macromolecules that result from the assembly of such components having different shapes and internal densities can assemble in highly stable supramolecular micelles whose characteristics vary as a function of the medium. The hybrid macromolecules are usually prepared by the nucleophilic displacement of a reactive functionality located at the focal point of a convergent polyether dendrimer, with a nucleophilic anion located at one or both chain ends of a linear polymer. Alternately, the focal point of the dendrimer may be used to attach a polymerizable vinyl group affording a dendritic macromonomer that may be used to create variety of copolymers. Finally, the focal point of the convergent dendrimer may serve as an initiator in the polymerization of a linear chain thereby affording the hybrid linear‐dendritic entity. In the latter case the unique microenvironment provided by the dendrimer is useful in the prevention of undesirable side‐reactions during growth of the linear block. This demonstrates that the differences between the globular and linear fragments of these unique molecules can be used to design nanoscale reactors that perform functions not normally achieved with small molecules. The very unusual solution properties of the dendritic‐linear supermolecules are a direct result of the forced combination of their dissimilar building blocks.

Chemical sensors for detection of biological analytes in their native settings with spatial and temporal resolution can enable the study of their physiological and pathological contributions by molecular imaging. An emerging area of sensor research is activity-based sensing (ABS), which leverages the unique chemical reactivity of a given analyte of interest, rather than traditional binding-based approaches that rely on lock-and-key molecular recognition, to achieve selectivity in the complex biological environments. This chapter summarizes foundational design principles of ABS and provides a survey of three representative examples of activity-based imaging probes using oxidative, reductive, or redox-neutral reactivity for selective analyte detection, highlighting the broad applicability of this synthetic reaction chemistry approach to identify and characterize new biology.

Pyometra is a life-threatening uterine condition in unspayed bitches, typically developing during the luteal phase and characterized by purulent uterine discharge and systemic inflammatory manifestations. This case study reports the diagnostic, therapeutic, and monitoring approach in a 6.3-year-old female Chow Chow presented with lethargy, inappetence, and purulent vaginal discharge. Comprehensive evaluation included clinical, hematological, biochemical, imaging, and cytological investigations. Marked leukocytosis, neutrophilia, anemia, and thrombocytopenia were noted, along with significant biochemical alterations indicating systemic involvement. Diagnosis was confirmed via abdominal ultrasound and laboratory profiles. Complications during hospitalization included epistaxis, progressive anemia, and secondary infections with Mycoplasma haemocanis and Candida parapsilosis, necessitating blood transfusions and antifungal therapy. Hematological biomarkers were dynamically monitored throughout treatment and proved valuable in evaluating disease progression, therapeutic efficacy, and clinical prognosis. The case highlights the importance of serial hematological and biochemical assessments in managing canine pyometra and its complications.

Packet classification is an ubiquitous and key building block of many critical network functions like routing, firewalling, and load balancing. However, classification is currently implemented, deployed and configured in an ad-hoc manner. Reliance on ad-hoc mechanisms make classification hard to configure, inefficient and inflexible. In this thesis, we address the above limitations by elevating packet classification as a fundamental network primitive. We do so by introducing a new classification layer in the network protocol stack, and by defining two control plane protocols—policy-based classifier deployment and generic classification offload. In policy-based classifier deployment, packets are explicitly redirected through the classifiers specified by network policy. Generic classification offload provides a signaling mechanism that enables different entities to collaboratively implement classification. Through prototype implementations, testbed experiments and formal analysis, we demonstrate that our solution simplifies deployment and configuration, and improves flexibility, efficiency and performance of packet classification.

The effective management of patients with chronic illnesses is critical to bending the curve of health care spending in the United States and is a crucial test for health care reform. In this article we used data from three national surveys of physician practices between 2006 and 2013 to determine the extent to which practices of all sizes have increased their use of evidence-based care management processes associated with patient-centered medical homes for patients with asthma, congestive heart failure, depression, and diabetes. We found relatively large increases over time in the overall use of these processes for small and medium-size practices as well as for large practices. However, the large practices used fewer than half of the recommended processes, on average. We also identified the individual processes whose use increased the most and show that greater use of care management processes is positively associated with public reporting of patient experience and clinical quality and with pay-for-performance.

Coupled-bistable-oscillator machines have recently generated significant interest due to their observed ability to rapidly produce high-quality solutions to nondeterministic-polynomial-time-complete optimization problems. While the dynamics of such systems are often derived in the literature, it has hitherto been unclear why exactly the system dynamics perform optimization so well. This paper answers this question by presenting a complete equivalence between coupled-oscillator machines and the primal-dual method of Lagrange multipliers. This equivalence explains how coupled-oscillator solvers implement the correct optimization constraints and find high-quality solutions. The equivalence also provides precise mathematical meaning to each system component and enables the principled design of systems that implement more-sophisticated optimization algorithms. We simulate the system dynamics and demonstrate (1) that its performance is competitive with performance of the best-known digital algorithms, (2) that the circuit is robust with regard to large component variations, hinting that the traditional shortcomings of analog computation may be less important for these applications, and (3) that the circuit consumes extremely low amounts of power (on the order of milliwatts) and energy (approximately <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" display="inline" overflow="scroll"><a:mn>100</a:mn></a:math> nJ) per optimization even for problems of 2000 variables. Published by the American Physical Society 2024

Objective. To examine the association between the scope of quality improvement (QI) implementation in hospitals and hospital performance on selected indicators of clinical quality. Data Sources. Secondary data from 1997 mailed survey of hospital QI practices, Medicare Inpatient Database, American Hospital Association's Annual Survey of Hospitals, the Bureau of Health Professions' Area Resource File, and two proprietary data sets compiled by Solucient Inc. containing data on managed care penetration and hospital financial performance. Study Design. Cross‐sectional study of 1,784 community hospitals to assess relationship between QI implementation approach and six hospital‐level quality indicators. Data Collection/Abstraction Methods. Two‐stage instrumental variables estimation in which predicted values (instruments) of four QI scope variables and control (exogenous) variables used to estimate hospital‐level quality indicators. Principal Findings. Involvement by multiple hospital units in QI effort is associated with worse values on hospital‐level quality indicators. Percentage of hospital staff and percentage of senior managers participating in formally organized QI teams are associated with better values on quality indicators. Percentage of physicians participating in QI teams is not associated with better values on the hospital‐level quality indicators studied. Conclusions. Results supported the proposition that the scope of QI implementation in hospitals is significantly associated with hospital‐level quality indicators. However, the direction of the association varied across different measures of QI implementation scope.