Developing an Evaluation Process for Telehealth in a COPD Clinic

Background: Telehealth was broadly implemented as a care modality in response to a worldwide pandemic in 2020. Before the COVID-19 pandemic, while telehealth was not new, it was not widely utilized at the project site location, and a uniform method of evaluating its effectiveness was needed. This quality assurance project developed and piloted a uniform process to evaluate telehealth in a Chronic Obstructive Pulmonary Disease (COPD) clinic, then evaluated stakeholder perceptions about the process used in developing the evaluation tool. Methods: The telehealth evaluation tool was developed using the National Quality Forum (NQF) framework and Global Obstructive Lung Disease (GOLD) best practice recommendations. A modified Delphi technique was used to survey the stakeholder team to develop measures for the telehealth evaluation tool. The tool was piloted for one cycle of evaluation, then the process used to develop the tool was evaluated by the stakeholders using qualitative and quantitative data. Results: This project occurred from June 4, 2021, to December 10, 2021 and included 77 patients. The telehealth evaluation tool was piloted retrospectively for one cycle or six weeks. Two of the three quality measures met the level of satisfactory. The stakeholders were satisfied/very satisfied with the process used to develop the COPD telehealth tool. Discussion: The COPD telehealth evaluation tool should continue with further evaluation cycles and additional measurement criteria. This process can be applied to other specialty or primary care clinics and the tool could be transferrable to other service lines within the healthcare system

Ingested foreign bodies and societal wealth: three year observational study of swallowed coins

Objective To examine the relation between coins ingested by children and the Dow Jones Industrial Average

Hot Gas Structure in the Elliptical Galaxy NGC 4472

We present X-ray spectroscopic and morphological analyses using Chandra ACIS and ROSAT observations of the giant elliptical galaxy NGC 4472 in the Virgo cluster. We discuss previously unobserved X-ray structures within the extended galactic corona. In the inner 2' of the galaxy, we find X-ray holes or cavities with radii of ~2 kpc, corresponding to the position of radio lobes. These holes were produced during a period of nuclear activity that began 1.2 x 10^7 years ago and may be ongoing. We also find an asymmetrical edge in the galaxy X-ray emission 3' (14 kpc) northeast of the core and an ~8' tail (36 kpc) extending southwest of the galaxy. These two features probably result from the interaction of NGC 4472 gas with the Virgo gas, which produces compression in the direction of NGC 4472's infall and an extended tail from ram pressure stripping. Assuming the tail is in pressure equilibrium with the surrounding gas, we compute its angle to our line of sight and estimate that its true extent exceeds 100 kpc. Finally, in addition to emission from the nucleus (first detected by Soldatenkov, Vikhlinin & Pavlinsky), we detect two small extended sources within 10'' of the nucleus of the galaxy, both of which have luminosities of ~7 x 10^38 erg/s.Comment: 25 pages, 11 figures, accepted by Ap

Wegener’s Disease Presenting with Occipital Condyle Syndrome

Tumors or chronic inflammatory lesions of the occipital condyle may cause occipital pain associated with an ipsilateral hypoglossal nerve injury (occipital condyle syndrome). We describe a young woman with recurrent otitis media and occipital condyle syndrome associated with a limited form of Wegener’s disease

The SISO CSPI PDG standard for commercial off-the-shelf simulation package interoperability reference models

For many years discrete-event simulation has been used to analyze production and logistics problems in manufactur-ing and defense. Commercial-off-the-shelf Simulation Packages (CSPs), visual interactive modelling environ-ments such as Arena, Anylogic, Flexsim, Simul8, Witness, etc., support the development, experimentation and visua-lization of simulation models. There have been various attempts to create distributed simulations with these CSPs and their tools, some with the High Level Architecture (HLA). These are complex and it is quite difficult to assess how a set of models/CSP are actually interoperating. As the first in a series of standards aimed at standardizing how the HLA is used to support CSP distributed simula-tions, the Simulation Interoperability Standards Organiza-tion’s (SISO) CSP Interoperability Product Development Group (CSPI PDG) has developed and standardized a set of Interoperability Reference Models (IRM) that are in-tended to clearly identify the interoperability capabilities of CSP distributed simulations

Observers and Measurements in Noncommutative Spacetimes

We propose a "Copenhagen interpretation" for spacetime noncommutativity. The goal is to be able to predict results of simple experiments involving signal propagation directly from commutation relations. A model predicting an energy dependence of the speed of photons of the order E/E_Planck is discussed in detail. Such effects can be detectable by the GLAST telescope, to be launched in 2006.Comment: 10 pp; v2: equivalence of observers explicitely stated; v3: minor changes, references and remarks added, burst spreading with energy emphasized as a signature rather than nois

Effects of force load, muscle fatigue and extremely low frequency magnetic stimulation on EEG signals during side arm lateral raise task

Objective: This study was to quantitatively investigate the effects of force load, muscle fatigue and extremely low frequency (ELF) magnetic stimulation on electroencephalography (EEG) signal features during side arm lateral raise task. Approach: EEG signals were recorded by a BIOSEMI Active Two system with Pin-Type active-electrodes from 18 healthy subjects when they performed the right arm side lateral raise task (90° away from the body) with three different loads (0 kg, 1 kg and 3 kg; their order was randomized among the subjects) on the forearm. The arm maintained the loads until the subject felt exhausted. The first 10 s recording for each load was regarded as non-fatigue status and the last 10 s before the subject was exhausted as fatigue status. The subject was then given a 5 min resting between different loads. Two days later, the same experiment was performed on each subject except that ELF magnetic stimulation was applied to the subject's deltoid muscle during the 5 min resting period. EEG features from C3 and C4 electrodes including the power of alpha, beta and gamma and sample entropy were analyzed and compared between different loads, non-fatigue/fatigue status, and with/without ELF magnetic stimulation. Main results: The key results were associated with the change of the power of alpha band. From both C3-EEG and C4-EEG, with 1 kg and 3 kg force loads, the power of alpha band was significantly smaller than that from 0 kg for both non-fatigue and fatigue periods (all p    0.05 for all the force loads except C4-EEG with ELF simulation). The power of alpha band at fatigue status was significantly increased for both C3-EEG and C4-EEG when compared with the non-fatigue status (p    0.05, except between non-fatigue and fatigue with magnetic stimulation in gamma band of C3-EEG at 1 kg, and in the SampEn at 1 kg and 3 kg force loads from C4-EEG). Significance: Our study comprehensively quantified the effects of force, fatigue and the ELF magnetic stimulation on EEG features with difference forces, fatigue status and ELF magnetic stimulation

Quiescent and flaring X-ray emission from the nearby M/T dwarf binary SCR 1845-6357

We investigate an XMM-Newton observation of SCR 1845-6357, a nearby, ultracool M8.5/T5.5 dwarf binary. The binary is unresolved in the XMM detectors, however the X-ray emission is very likely from the M8.5 dwarf. We compare its flaring emission to those of similar very low mass stars and additionally present an XMM observation of the M8 dwarf VB 10. We detect quasi-quiescent X-ray emission from SCR 1845-6357 at soft X-ray energies in the 0.2-2.0 keV band, as well as a strong flare with a count rate increase of a factor of 30 and a duration of only 10 minutes. The quasi-quiescent X-ray luminosity of log L_x = 26.2 erg/s and the corresponding activity level of log L_x/L_bol = -3.8 point to a fairly active star. Coronal temperatures of up to 5 MK and frequent minor variability support this picture. During the flare, that is accompanied by a significant brightening in the near-UV, plasma temperatures of 25-30 MK are observed and an X-ray luminosity of L_x= 8 x 10^27 erg/s is reached. SCR 1845-6357 is a nearby, very low mass star that emits X-rays at detectable levels in quasi-quiescence, implying the existence of a corona. The high activity level, coronal temperatures and the observed large flare point to a rather active star, despite its estimated age of a few Gyr.Comment: Accepted by A&A, 6 pages, 5 figure

Characterization of membrane vesicles in Alteromonas macleodii indicates potential roles in their copiotrophic lifestyle

Bacterial membrane vesicles (MVs) are abundant in the oceans, but their potential functional roles remain unclear. In this study we characterized MV production and protein content of six strains of Alteromonas macleodii, a cosmopolitan marine bacterium. Alteromonas macleodii strains varied in their MV production rates, with some releasing up to 30 MVs per cell per generation. Microscopy imaging revealed heterogenous MV morphologies, including some MVs aggregated within larger membrane structures. Proteomic characterization revealed that A. macleodii MVs are rich in membrane proteins related to iron and phosphate uptake, as well as proteins with potential functions in biofilm formation. Furthermore, MVs harbored ectoenzymes, such as aminopeptidases and alkaline phosphatases, which comprised up to 20% of the total extracellular enzymatic activity. Our results suggest that A. macleodii MVs may support its growth through generation of extracellular ‘hotspots’ that facilitate access to essential substrates. This study provides an important basis to decipher the ecological relevance of MVs in heterotrophic marine bacteria