Appropriate Use Criteria for Echocardiography

Transthoracic Echocardiography (TTE) is one of the most common diagnostic imaging tests used in Cardiology. It is portable, noninvasive and provides important data regarding diagnosis and management of many cardiac conditions. In recent years TTE has had an increased in popularity for its use in both inpatient and outpatient settings. This has resulted in an increase of inappropriate use leading to overutilization of resources. At our institution, University of New Mexico Hospitals we evaluated the prevalence rate of appropriateness of TTE with a quality improvement project. During the first phase of the project 100 TTEs each were randomly selected in both the outpatient and inpatient settings. We evaluated appropriateness based on the AUC of TTE published in 2011 by the American College of Cardiology. Results demonstrated inpatient TTE orders had reduced number of inappropriate echo orders compared to outpatient echo orders. The percentage of inappropriate TTE orders in the outpatient setting was unacceptably high approaching 30% of all outpatient TTE requests. Recent studies have shown that education of physicians concerning the appropriate use of echocardiography can improve resource utilization in clinical practice. The purpose of the second phase of this quality improvement project is to reduce the number of inappropriate TTE orders in the outpatient settings at our UNM clinics through multiple and continued mechanisms. This will be achieved through educational material, EMR modifications, follow up audit reports and feedback sessions

A 3D mathematical model for planning ostectomy on long-bone angular deformities

This study describes a 3D mathematical model for planning a corrective ostectomy on long bones with angular deformities based on CT imaging. The use of three-dimensional information allows the model to compute and correct the bone angulation and rotation. The cutting point selection is developed minimizing the bone length reduction inherent in an ostectomy process. An example of its application on a two year old dog is shown at the end of the paper.Veterinari

Effect of Modified Pin Profile and Process Parameters on the Friction Stir Welding of Aluminum Alloy 6061-T6

This work deals with the effect of a new “bolt-head” pin profile on the friction stir welding performance of the aluminum alloy 6061-T6, compared to traditional pin profiles. Friction stir welding parameters such as the tool rotation speed and the welding speed were investigated together with the different pin profiles; the results show that the new “bolt-head” pin profile leads to better mechanical properties of welded specimens. The pin profiles used in this work were the straight square (SS), straight hexagon (SH), taper cylindrical (TC), and the straight hexagon “bolt-head” (SHBH). It was found that the last pin profile improves the material flow behavior and the uniform distribution of plastic deformation and reduces the formation of macroscopic defects on the welded zone. Mechanical tensile tests on welded specimens were performed to determine the tensile strength: the specimens welded with the SHBH pin profile have shown the highest mechanical properties. An approach is presented for material flow on this aluminum alloy using the SHBH pin profile, which is related to the improvement on the resulting mechanical properties

Granite stone subjected to ultrasonic fatigue tests under three point bending modality

Ultrasonic fatigue tests are carried out under the modality of three points bending on the granite stone. The testing specimens present a prismatic shape with the dimensions: 12 x 3 x 0.8 centimeters, in order to be supported at the two ends (1 centimeter of support each side), and to configure the three points bending modality. Granite specimens are supported on an acrylic structure destined to fix and immobilize the specimens. Vibrating load is applied at the center of testing specimens by a self-designed and fabricated aluminum alloy awl, which dimensions have been obtained by modal numerical analysis to fit the resonance condition, necessary for the ultrasonic fatigue tests. Experimental results are obtained at room temperature and humidity comprised between 60 and 75%. The fatigue endurance is determined on this material under this modality of loading, and the fracture surfaces are analyzed to identify the principal trends related to crack initiation and propagation on this material.  &nbsp

Plaza de toros de Salamanca : programa oficial de las corridas de feria septiembre 1956.

Ganadería: día 12 : D. Alipio Pérez T. Sanchón, Excmo. Sr. Vizconde de Garci-Grande ; día 13 : D. Antonio Pérez ; día 14 : Excmo. Sr. Marqués de Albayda; día 21: D. Salvador Guardiola.Espadas: día 12 : Julio Aparicio, Manolo Vázquez, Jose María Martorell, Emilio Ortuño (Jumillano) ; día 13 : Antonio Bienvenida, Miguel Báez (Litri), Antonio Ordónez ; día 14 : César Girón, Manuel Jiménez (Chicuelo ll), Gregorio Sánchez ; día 21 : Emilio Ortuño (Jumillano), Dámaso Gómez, Paco Mendes, Marcos de Celis.Litografía de escena taurina en tinta de colores, firmado por J. Reus e Imp. y Lit. J. Ortega, en reverso, viñetas taurinas, orden de corridas, precios y publicidad.Acompañado de: artículo periodístico explicando la finalización de temporada del torero Manolo Vázquez (con sello del 11 septiembre de 1956

Independent measurement of the Hoyle state β\beta feeding from 12B using Gammasphere

Using an array of high-purity Compton-suppressed germanium detectors, we performed an independent measurement of the $\beta$-decay branching ratio from $^{12}\mathrm{B}$ to the second-excited (Hoyle) state in $^{12}\mathrm{C}$. Our result is $0.64(11)\%$, which is a factor $\sim 2$ smaller than the previously established literature value, but is in agreement with another recent measurement. This could indicate that the Hoyle state is more clustered than previously believed. The angular correlation of the Hoyle state $\gamma$ cascade has also been measured for the first time. It is consistent with theoretical predictions

Granite stone subjected to ultrasonic fatigue tests under three point bending loading

Ultrasonic fatigue tests are carried out under the modality of three point bending on the granite stone. The testing specimens present a prismatic shape with the dimensions: 12 x 3 x 0.8 centimeters, in order to be supported by its two ends, and to configure the three point bending modality. Granite specimens are supported on an acrylic structure destined to fix and immobilize the specimens. Vibrating load is applied at the center of testing specimens by a self-designed and fabricated aluminum alloy awl, whose dimensions have been obtained by modal numerical analysis to fit the resonance condition, necessary for the ultrasonic fatigue tests. Experimental results are obtained at room temperature and humidity between 65 and 75%. The fatigue endurance is determined on the granite under this modality of loading, and the fracture surfaces are analyzed to identify the principal trends related to crack initiation and propagation on this material

A compactness theorem for scalar-flat metrics on manifolds with boundary

Let (M,g) be a compact Riemannian manifold with boundary. This paper is concerned with the set of scalar-flat metrics which are in the conformal class of g and have the boundary as a constant mean curvature hypersurface. We prove that this set is compact for dimensions greater than or equal to 7 under the generic condition that the trace-free 2nd fundamental form of the boundary is nonzero everywhere.Comment: 49 pages. Final version, to appear in Calc. Var. Partial Differential Equation