Hospitalized self-inflicted firearm injuries have not been extensively studied, particularly regarding clinical diagnoses at the index admission. The objective of this study was to discover the diagnostic phenotypes (DPs) or clusters of hospitalized self-inflicted firearm injuries. Using Nationwide Inpatient Sample data in the US from 1993 to 2014, we used International Classification of Diseases, Ninth Revision codes to identify self-inflicted firearm injuries among those ≥18 years of age. The 25 most frequent diagnostic codes were used to compute a dissimilarity matrix and the optimal number of clusters. We used hierarchical clustering to identify the main DPs. The overall cohort included 14072 hospitalizations, with self-inflicted firearm injuries occurring mainly in those between 16 to 45 years of age, black, with co-occurring tobacco and alcohol use, and mental illness. Out of the three identified DPs, DP1 was the largest (n=10,110), and included most common diagnoses similar to overall cohort, including major depressive disorders (27.7%), hypertension (16.8%), acute post hemorrhagic anemia (16.7%), tobacco (15.7%) and alcohol use (12.6%). DP2 (n=3,725) was not characterized by any of the top 25 ICD-9 diagnoses codes, and included children and peripartum women. DP3, the smallest phenotype (n=237), had high prevalence of depression similar to DP1, and defined by fewer fatal injuries of chest and abdomen. There were three distinct diagnostic phenotypes in hospitalizations due to self-inflicted firearm injuries. Further research is needed to determine how DPs can be used to tailor clinical care and prevention efforts.
We systematically investigate ellipticity dependence of high-order harmonic generation of Ar and N2 in intense elliptically polarized laser fields. The experimental normalized ratios of low-order harmonic intensity to high-order harmonic intensity increase with ellipticity for both Ar and N2, and quantitatively depend on targets and trajectory paths. The experimental results are well reproduced by a nonadiabatic semiclassical simulation and explained by trajectory-based analysis. In addition, the influence of nuclear distance on the ratios is theoretically investigated. Our work reveals that the difference between atoms and molecules can be attributed to the influence of different ionic potentials, which depends on the molecular structure (internuclear distance) and alignment, on the evolution of the photoelectron.
Why are organizations sometimes so similar, and in other cases so different? For decades this question has been central to research on organizations, and two leading theories have answered the question very differently. Neo-institutional theory has pointed to the importance of mimetic isomorphism, where organizations imitate one another as they navigate decisions in the context of uncertainty over what is regarded as legitimate action. By contrast, ecological theory argues that competitive exclusion explains the differences we see around us, as organizations repel one another when they vie for the same resources. Decades of empirical work has tended to confirm one or the other theory, with scant effort being made to reconcile these conflicting predictions. Furthermore, much of the existing empirical work is limited to descriptive studies that make little or no attempt to empirically identify their findings, leaving the empirical record open to concerns over endogeneity. This paper conducts an identified empirical test, in a context where the two arguments make opposing predictions. In an analysis of auditor selection after the collapse of Arthur Andersen, we find evidence of competitive exclusion, but no evidence of mimetic isomorphism. Implications for the continued progress of organization theory are discussed.
Complex foam flows in series and parallel are investigated by means of a self-designed high-pressure high-temperature laboratory physical model. A total of twenty-two foam flow experiments were conducted in the porous media with a wide permeability range over two orders of magnitude. Specifically, fifteen single and seven dual foam flows in porous media with respective permeability range of 37−9705 mD and 41−7838 mD were performed to determine a series of physiochemical properties in terms of foam rheology, fluid profile and mobility control. For the foam flows in series, the overall gas saturation with process of foam injection is found to quickly increase within initial period but then tend to be stable. At the end of foam injection, the gas saturation curve could be clearly distinguished with permeability variances that a sharp rising range for permeability from 37 to 1233 mD while a quasi-stable range from 1233 to 9705 mD. Mobility reduction factor and apparent viscosity of the single flow cases are found to increase initially but in subsequent a decline with the permeability increase, whose maximum values were equal to 726.34 and 646.44 mPa•s at the permeability of 4386 mD. Moreover, the mobility curve basically performs as a U shape with three distinct periods: a sharp initial decrease period from 37 to 564 mD in subsequent of a second uniform mobility from 564 to 7309 and third increase period from 7309 to 9705 mD. On the other hand, for the foam flow in parallel, the profile control effect is determined to be favorable for a medium permeability ranging from 282 to 3855 mD but unfavorable for either lower- or higher-permeability cases. In the post-foam water injection period, the gas saturation for the single flow case monotonically decreases while for the flow in parallel, the gas and liquid production profiles perform oppositely to the profile control effect with respect to the permeability. Overall, gas and liquid mobilities are proven to be simultaneously controlled for foam flows in series and parallel through multiscale porous media, whereas a gas mobility is better controlled, particularly in porous media with lower permeability.
Nanopore structure development in shale is intimated with lithofacies that demonstrates a large variety in different formations. It is critical to differentiate and quantify the separate impact of lithological components (minerals and organic matter (OM)) on pore structure attributes associated with shale gas storage capacity. In this study, we classified shales into 12 lithofacies for compositional and petrophysical quantification. Parameters of our main target, the Goldwyer shales (argillaceous OM-poor, argillaceous OM-moderate, and argillaceous OM-rich lithofacies) were further compared with other shale lithofacies, pure clays and isolated kerogens, using XRD, Rock-Eval pyrolysis, Ar-SEM and low-pressure CO2/N2 gas adsorption techniques. Results show that argillaceous OM-rich lithofacies (TOC > 2% and illite-dominated clay contents > 50%) develop more interconnected pores with better hydrocarbon storage potential. The argillaceous lithofacies have large amounts of cleavage-sheet pores with large pore volumes; the accumulative pore volume of the pores in diameter from 2 to 17 nm constitutes the major amount of total pore volume that is associated with free gas. The OM-rich lithofacies develop more OM-pores (particularly in pore diameter <2 nm) that contain extraordinarily high specific surface area (SSA); the SSA of micropores makes up the major total surface area that is intimated with adsorbed gas. Further investigation on pure clays and isolated kerogens clarifies that illite mainly controls the pore sizes from 2 to 17 nm, resulting in large pore volumes in argillaceous shales. By contrast, isolated kerogen dominantly controls micropores in diameter <2 nm, leading to a larger surface area with higher adsorbed gas storage in organic-rich shales.
The invention relates to composite compositions including a carbonaceous material and a photocatalyst. The invention includes compositions and various methods, including methods for removing one or more contaminants from a substance such as air, soil, and water.