Poppyland

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Does the Type of Skin Marker Prevent Marking Erasure of Surgical-Site Markings?

Objective: Site marking is essential to prevent wrong-site surgery, and there are many skin markers commercially available. However, preoperative skin preparation can erase the site mark, especially when a chlorhexidine skin preparation solution that requires skin scrubbing is used. The purpose of our study was to test the hypothesis that some markers can withstand skin preparation with a chlorhexidine-based skin preparation solution in a manner similar to that of an iodine-based solution. Methods: On each of 5 cadaveric skin flaps, we made 2 rows of site markings with 9 types of markers. We then subjected one row of markings on each flap to a chlorhexidine-based solution and the other row to an iodine-based solution. A digital photograph was taken before and after each skin preparation. Using imaging software, the contrast in grayscale between the skin and skin marking was measured on each photograph. The effect of the type of marker and skin preparation solution on the difference in grayscale contrast was evaluated by multiple linear regression analysis and significant differences were determined (P < .05). Results: In all cases, the chlorhexidine-based skin preparation solution significantly decreased the contrast measured. No marker was significantly better than another. Conclusions: We conclude that all 9 skin markers are significantly erased with the chlorhexidine-based skin preparation solution. The development of a better skin marker or a chlorhexidine-based skin preparation solution that does not erase site markings is essential to prevent wrong-site surgeries and promote patient safety

Modeling the power flow in normal conductor-insulator-superconductor junctions

Normal conductor-insulator-superconductor (NIS) junctions promise to be interesting for x-ray and phonon sensing applications, in particular due to the expected self-cooling of the N electrode by the tunneling current. Such cooling would enable the operation of the active element of the sensor below the cryostat temperature and at a correspondingly higher sensitivity. It would also allow the use of MS junctions as microcoolers. At present, this cooling has not been realized in large area junctions (suitable for a number of detector applications). In this article, we discuss a detailed modeling of the heat flow in such junctions; we show how the heat flow into the normal electrode by quasiparticle back-tunneling and phonon absorption from quasiparticle pair recombination can overcompensate the cooling power. This provides a microscopic explanation of the self-heating effects we observe in our large area NIS junctions. The model suggests a number of possible solutions

Does Standing on a Cycle-ergometer, Towards the Conclusion of a Graded Exercise Test, Yield Cardiorespiratory Values Equivalent to Treadmill Testing?

Graded exercise testing (GXT), per a cycle-ergometer (CE), offers safety and monitoring advantages over treadmill (TM) GXT. Unfortunately, CE-VO2max and some other cardiorespiratory (CR) variables are frequently lower than TM-GXT values. It has been difficult to compare TM and CE-GXT values. However, it was hypothesized that standing towards the conclusion of the CE-GXT (Stand-CE) might increase CE values to those equal to TM-GXT. If Stand-CE and TM-GXT CR values were equal, Stand-CE-GXT could become the method of choice for GXT for the general population. The purpose of this investigation was to investigate the effect of Stand-CE on CR variables. An intentionally diverse sample (N = 34, 24 males and 10 females, aged 18-54 y, with VO2max values 25-76 ml/kg/min) representing the general population participated. Volunteers completed two GXT trials, one per TM (Bruce protocol) and the other per a MET-TM-matched CE-GXT where initially-seated participants stood and pedaled after their respiratory exchange ratio (RER) reached 1.0. Eighteen participants underwent a third MET-TM-matched trial where they remained seated throughout GXT (Sit-CE). Trials were counter-balanced with at least 48 h between GXT. There were significant statistical differences (p \u3c 0.05) between TM and Stand-CE per matched-samples T-test (N = 34) on the following variables: VEmax (TM = 115 + 24.4 l/min, Stand-CE = 99.4 + 28.1), VCO2max (TM = 4.26 + 0.9 l/min, Stand-CE = 3.56 + 0.84), VO2max (TM = 44.9 + 9.1 ml/kg/min, Stand-CE = 39.3 + 9.0), METSmax (TM = 12.8 + 2.6 METS, Stand-CE = 11.2 + 2.5), and HRmax (TM = 175 + 13 bpm, Stand-CE = 166 + 12). One-way repeated measures ANOVA (N = 18) demonstrated no statistical differences between all trials: VEmax (TM = 112.8 + 25.3 l/min, Stand-CE = 102.3 + 25.2, Sit-CE = 107.3 + 33.1), VCO2max (TM = 4.17 + 0.99 l/min, Stand-CE = 3.62 + 0.80, Sit-CE = 3.55 + 0.83), VO2max (TM = 47.1 + 9.8 ml/kg/min, Stand-CE = 42.0 + 9.0, Sit-CE = 43.3 + 8.9), METSmax (TM = 13.5 + 2.8 METS, Stand-CE = 12.0 + 2.6, Sit-CE = 12.4 + 2.5), and HRmax (TM = 176 + 13 bpm, Stand-CE = 171 + 12, Sit-CE = 173 + 11). Results of this investigation suggest that TM-GXT CR values are larger than Stand-CE, and Stand-CE values are not different from Sit-CE. Future studies will test validity of these findings per gender, aerobic training status, in populations that are highly-skilled with TM and CE (tri-athletes), children, the elderly, and diseased populations

Aeronautic Instruments. Section II : Altitude Instruments

This report is Section two of a series of reports on aeronautic instruments (Technical Report nos. 125 to 132, inclusive). This section discusses briefly barometric altitude determinations, and describes in detail the principal types of altimeters and barographs used in aeronautics during the recent war. This is followed by a discussion of performance requirements for such instruments and an account of the methods of testing developed by the Bureau of Standards. The report concludes with a brief account of the results of recent investigations. For accurate measurements of altitude, reference must also be made to thermometer readings of atmospheric temperature, since the altitude is not fixed by atmospheric pressure alone. This matter is discussed in connection with barometric altitude determination

Spectroscopic signature of phosphate crystallization in Erbium-doped optical fibre preforms

In rare-earth-doped silica optical fibres, the homogeneous distribution of amplifying ions and part of their spectroscopic properties are usually improved by adding selected elements, such as phosphorus or aluminum, as structural modifier. In erbium ion (Er3+) doped fibres, phosphorus preferentially coordinates to Er3+ ions to form regular cages around it. However, the crystalline structures described in literature never gave particular spectroscopic signature. In this article, we report emission and excitation spectra of Er3+ in a transparent phosphorus-doped silica fibre preform. The observed line features observed at room and low temperature are attributed to ErPO4 crystallites

Clinicians’ experience of providing care: a rapid review

Background: Health care services internationally are refocussing care delivery towards patient centred, integrated care that utilises effective, efficient and innovative models of care to optimise patient outcomes and system sustainability. Whilst significant efforts have been made to examine and enhance patient experience, to date little has progressed in relation to provider experience. This review aims to explore this knowledge gap by capturing evidence of clinician experience, and how this experience is defined and measured in the context of health system change and innovation. Methods: A rapid review of published and grey literature review was conducted utilising a rapid evidence assessment methodology. Seventy-nine studies retrieved from the literature were included in the review. Fourteen articles were identified from the grey literature search and one article obtained via hand searching. In total, 94 articles were included in the review. This study was commissioned by and co-designed with the New South Wales, Ministry of Health. Results: Clinician experience of delivering health care is inconsistently defined in the literature, with identified articles lacking clarity regarding distinctions between experience, engagement and work-related outcomes such as job satisfaction. Clinician experience was commonly explored using qualitative research that focused on experiences of discrete health care activities or events in which a change was occurring. Such research enabled exploration of complex experiences. In these contexts, clinician experience was captured in terms of self-reported information that clinicians provided about the health care activity or event, their perceptions of its value, the lived impacts they experienced, and the specific behaviours they displayed in relation to the activity or event. Moreover, clinician’s experience has been identified to have a paucity of measurement tools. Conclusion: Literature to date has not examined clinician experience in a holistic sense. In order to achieve the goals identified in relation to value-based care, further work is needed to conceptualise clinician experience and understand the nature of measurement tools required to assess this. In health system application, a broader ‘clinician pulse’ style assessment may be valuable to understand the experience of clinical work on a continuum rather than in the context of episodes of change/care

Reengineering legacy software to object-oriented systems

NASA has a legacy of complex software systems that are becoming increasingly expensive to maintain. Reengineering is one approach to modemizing these systems. Object-oriented technology, other modem software engineering principles, and automated tools can be used to reengineer the systems and will help to keep maintenance costs of the modemized systems down. The Software Technology Branch at the NASA/Johnson Space Center has been developing and testing reengineering methods and tools for several years. The Software Technology Branch is currently providing training and consulting support to several large reengineering projects at JSC, including the Reusable Objects Software Environment (ROSE) project, which is reengineering the flight analysis and design system (over 2 million lines of FORTRAN code) into object-oriented C++. Many important lessons have been learned during the past years; one of these is that the design must never be allowed to diverge from the code during maintenance and enhancement. Future work on open, integrated environments to support reengineering is being actively planned

Suited for Success? : Suits, Status, and Hybrid Masculinity

This document is the Accepted Manuscript version. The final, definitive version of this paper has been published in Men and Masculinities, March 2017, doi: https://doi.org/10.1177/1097184X17696193, published by SAGE Publishing, All rights reserved.This article analyzes the sartorial biographies of four Canadian men to explore how the suit is understood and embodied in everyday life. Each of these men varied in their subject positions—body shape, ethnicity, age, and gender identity—which allowed us to look at the influence of men’s intersectional identities on their relationship with their suits. The men in our research all understood the suit according to its most common representation in popular culture: a symbol of hegemonic masculinity. While they wore the suit to embody hegemonic masculine configurations of practice—power, status, and rationality—most of these men were simultaneously marginalized by the gender hierarchy. We explain this disjuncture by using the concept of hybrid masculinity and illustrate that changes in the style of hegemonic masculinity leave its substance intact. Our findings expand thinking about hybrid masculinity by revealing the ways subordinated masculinities appropriate and reinforce hegemonic masculinity.Peer reviewe