Liberalism and Sovietism

https://stars.library.ucf.edu/prism/1487/thumbnail.jp

Reconfigurable optical add-drop multiplexer using microring resonators

We report a reconfigurable four-channel optical add-drop multiplexer for use in access networks. The optical add-drop multiplexer (OADM) is based on vertically coupled thermally tunable Si/sub 3/N/sub 4/--SiO/sub 2/ microring resonators (MRs) and has been realized on a footprint of 0.25 mm/sup 2/. Individual MRs in the OADM can be tuned across the full free-spectral range of 4.18 nm and have a 3-dB bandwidth of 50 GHz

Annie Arden: Alfred Tennyson\u27s Story of Enoch Arden in Five Verses

1. Once a noble youth and maiden, Woo\u27d and wed beside the shore; And they dwelt within a cottage, That looked the ocean o\u27er; And the fishing boat he daily rowed, Gave a scanty fare; So he left his wife and children, A sailor\u27s life to share. Chorus: And she waited long for his return, Across the waters blue; And she mourned her Enoch Arden, Annie Arden, Annie true 2. She was faithful Annie Arden; And she waited long in vain; Till they told her he had perished Far, far, across the main. And she wed another kind and true; For love and pity said, That the children must be cared for, Have clothing, and be fed. 3. From a lone and barren island, Where the sailor had been thrown, He had wandered back all weary, To meet his wife, his own. But they told him ere he reached his home, Another\u27s love reigned there; So he kept his coming secret, His Annie\u27s grief to spare. 4. From the garden, in the evening, Where no one could see or hear, Long he watched his darling Annie, And all his heart held dear. But her smiles were shared with him who saw his infant playing there; And his boy had grown so manly, His girl had grown so fair. 5. How his noble heart was yearning, There to clasp those forms again! But he loved them still too fondly, To give their bosom pain. With a broken heart he turned away He cared not now to live - Tell my Annie how I loved her - My life for her I give

On the properties of strange modes

Properties of the so-called strange modes occurring in linear stability calculations of stellar models are discussed. The behaviour of these modes is compared for two different sets of stellar models, for very massive zero-age main-sequence stars and for luminous hydrogen-deficient stars, both with high luminosity-to-mass ratios. We have found that the peculiar behaviour of the frequencies of the strange modes with the change of a control parameter is caused by the pulsation amplitude of a particular eigenmode being strongly confined to the outer part of the envelope, around the density inversion zone. The frequency of a strange mode changes because the depth of the confinement zone changes with the control parameter. Weakly non-adiabatic strange modes tend to be overstable because the amplitude confinement quenches the effect of radiative damping. On the other hand, extremely non-adiabatic strange modes become overstable because the perturbation of radiation force (gradient of radiation pressure) provides a restoring force that can be out of phase with the density perturbation. We discuss this mechanism by using a plane-parallel two-zone mode

Exploring intentional medication non-adherence in patients with systemic lupus erythematosus: The role of physician-patient interactions

OBJECTIVE: Medication non-adherence contributes to worse health outcomes among SLE patients. The underlying mechanisms that drive medication non-adherence are poorly understood. The purpose of this study was to explore possible mechanisms of medication non-adherence by eliciting patient experiences. METHODS: Consented adult patients with ACR- or SLICC-classified SLE were recruited. Ten semi-structured interviews were conducted across six participants. Interviews were audio recorded, transcribed, and analysed using an iterative process. The findings were presented to an interactive public forum with SLE patients, family members and friends of patients, and health-care professionals to assess validity and for elaboration of the concepts developed. RESULTS: The following three interrelated themes emerged from the interviews. First, why do rheumatologists not know more about lupus or share what they do know with their patients? Second, why do I have to take so many drugs and why do the drugs not work? Third, if my rheumatologist cannot communicate with me, why should I follow the prescribed medication regimen? CONCLUSION: Our exploratory findings lay out a possible underlying logic by which patients might choose intentionally to engage with medication non-adherence behaviours. Patients suggested that poor communication with their rheumatologists along with a lack of validation of their symptoms contributed to them not valuing the recommendations of physicians. This also contributed to development of a cynical outlook and little belief that medication would improve their condition. Although further work is needed to validate these findings, our preliminary work suggests that interventions focusing on the development of communication skills among both patients and rheumatologists are necessary to reduce medication non-adherence

‘Suitable and sufficient’? UK regulation of post-construction fire safety

There have been considerable reductions in UK fire deaths and casualties over the last fifty years, but on-going innovation in the built environment means that fire risks need constantly to be reappraised and addressed. This innovation takes the form not only of new materials and architectural approaches, but also of new methods of fire safety regulation. While existing research has addressed many aspects of this innovation, one crucial area has been neglected: that of post-construction fire safety regulation. This thesis examines this topic focusing on how fire safety is maintained during the life times of buildings. All new buildings have fire safety features that are a requirement of design approval, but these need to be maintained and used appropriately for the remainder of the building’s operational life. The key development in UK post-construction regulation in recent years has been the shift towards self-regulation in which the onus is on duty holders (usually the employer) to assess and maintain an appropriate level of fire safety. This thesis documents the emergence, rationale, and operation of this system, and addresses key issues and concerns with the way it functions. In particular, the efficacy of the current UK approach to post-construction regulation depends on the capacity of duty holders to carry out suitable fire risk assessments, either themselves or by employing suitable fire risk assessors. However, this hinges not only on whether a sufficient number of assessors have sufficient competence, but also on the ability of the assessor to understand the intended functionality of the original fire safety design, approved in the pre-construction phase. In addition, the system relies on external oversight by the fire and rescue services for high-risk premises, and this thesis explores the way that this fire and rescue service role has evolved, and its current rationale for deciding which premises are sufficiently high risk to audit. Drawing on interviews with key actors such as fire safety engineers, fire safety managers, fire risk assessors, and fire safety enforcement officers, the thesis unravels this complex system of regulation. This analysis suggests that the system at present has internal inconsistencies that call into question its effectiveness, highlights the concerns of many of those central to the operation of the regulation, and provides evidence from serious fires and other regulatory breaches to support the conclusion that UK post-construction regulation could be more effective

‘FAN the SUN brighter': Fortifying Africa nutritionally (FAN) - the role of public private partnership in scaling up nutrition (SUN) in West Africa

The scaling up nutrition (SUN) policy framework requires extensive public-private partnership (PPP). Malnutrition is multi-dimensional and should engage multi-sectoral platforms. The SUN policy however did not fully embrace the dynamics of harnessing PPP. The objectives of the present paper are to highlight the reasons for the apprehension around PPP and illustrate how effective coordination of PPP in West Africa has contributed to implementing large-scale food fortification with micronutrients as a complementary nutrition intervention. The experience of Helen Keller International (HKI) in scaling up food fortification was emphasised with understanding of the factors contributing to indifference by the international community to private sector contribution to SUN. The roles of different stakeholders in a PPP are elucidated and the process linked to who, why and how to engage. The private sector provides direct nutrition services while the public sector creates the enabling environment for the private sector to thrive on social values. Through this approach fortified vegetable oil and wheat flour are now reaching over 70% of the population in West Africa. As a neutral broker HKI coordinated and facilitated dialogue among the different stakeholders. The core competencies of each stakeholder were harnessed and each partner was held accountable. It concludes that multi-sectoral relationship must be transparent, equitable and based on shared mutual interests. The rules and values of PPP offer opportunities for SU

Development of a digital toolkit to improve quality of life of patients with systemic lupus erythematosus

OBJECTIVE: The purpose of this manuscript is to detail development and initial usability testing of an e-toolkit designed to provide skills and knowledge around self-management behaviors for individuals living with systemic lupus erythematosus. METHODS: Researchers worked with a steering committee of patients and providers to (1) develop a clickable prototype of an e-toolkit and (2) conduct alpha (individuals not affiliated with an academic clinic as patient or provider) and beta (individual patients with systemic lupus erythematosus as well as members of the clinic healthcare team and individuals who work in patient advocacy organizations) usability testing through semistructured interviews. RESULTS: During the review of the e-toolkit, the feedback provided by participants in both alpha and beta groups centered on two overarching themes: (1) improving user interface and materials and (2) integration of information and supports between toolkit and clinical personnel. CONCLUSION: Digital approaches that are tailored to individual symptom variation and integrated with a clinical system have the opportunity to enhance ongoing clinical care. These findings support movement toward integrated, team-based care models, tailored digital resources, and use of expanded virtual interaction options to ensure on-going engagement between healthcare providers and systemic lupus erythematosus patients

Gadolinium decreases inflammation related to myocardial ischemia and reperfusion injury

<p>Abstract</p> <p>Background</p> <p>The lanthanide cation, gadolinium (GdCl₃) protects the myocardium against infarction following ischemia and reperfusion. Neutrophils and macrophages are the main leukocytes responsible for infarct expansion after reperfusion. GdCl₃interferes with macrophage and neutrophil function in the liver by decreasing macrophage secretion of inflammatory cytokines and neutrophil infiltration. We hypothesized that GdCl₃protects against ischemia and reperfusion injury by decreasing inflammation. We determined the impact of GdCl₃treatment for reperfusion injury on 1) circulating monoctye and neutrophil counts, 2) secretion of inflammatory cytokines, and 3) influx of monocytes and neutrophils into the myocardium.</p> <p>Methods</p> <p>Rats (n = 3-6/gp) were treated with saline or GdCl₃(20 μmol/kg) 15 min prior to a 30 min period of regional ischemia and 120 min reperfusion. Sham rats were not subject to ischemia. Blood was collected either after 30 min ischemia or 120 min reperfusion and hearts were harvested at 120 min reperfusion for tissue analysis. Blood was analyzed for leukocytes counts and cytokines. Tissue was analyzed for cytokines and markers of neutrophil and monocyte infiltration by measuring myeloperoxidase (MPO) and α-naphthyl acetate esterase (ANAE).</p> <p>Results</p> <p>GdCl₃did not affect the number of circulating neutrophils prior to ischemia. Two hours reperfusion resulted in a 2- and 3- fold increase in circulating monocytes and neutrophils, respectively. GdCl₃decreased the number of circulating monocytes and neutrophils during reperfusion to levels below those present prior to ischemia. Furthermore, after 120 min of reperfusion, GdCl₃decreased ANAE and MPO activity in the myocardium by 1.9-fold and 6.5-fold respectively. GdCl₃decreased MPO activity to levels below those measured in the Sham group. Serum levels of the major neutrophil chemoattractant cytokine, IL-8 were increased from pre-ischemic levels during ischemia and reperfusion in both control and GdCl₃treated rats. Likewise, IL-8 levels increased throughout the 3 hour time period in the Sham group. There was no difference in IL-8 detected in the myocardium after 120 min reperfusion between groups. In contrast, after 120 min reperfusion GdCl₃decreased the myocardial tissue levels of macrophage secreted cytokines, GM-CSF and IL-1.</p> <p>Conclusion</p> <p>GdCl₃treatment prior to ischemia and reperfusion injury decreased circulating monocytes and neutrophils, macrophage secreted cytokines, and leukocyte infiltration into injured myocardium. These results suggest GdCl₃decreased monoctye and neutrophil migration and activation and may be a novel treatment for inflammation during ischemia and reperfusion.</p

Patients’ and family members’ views on how clinicians enact and how they should enact incident disclosure: the “100 patient stories” qualitative study

Objectives To investigate patients’ and family members’ perceptions and experiences of disclosure of healthcare incidents and to derive principles of effective disclosure