601 research outputs found

    The use of immersive and virtual reality technologies to enable nursing students to experience scenario based, basic life support training- exploring the impact on confidence and skills

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    The link between effective basic life support (BLS) and survival following cardiac arrest is well known. Nurses are often first responders at in- hospital cardiac arrests and receive annual BLS training to ensure they have the adequate skills, and student nurses are taught this in preparation for their clinical practice. However, it is clear that some nurses still lack confidence and skills to perform BLS in an emergency situation. This innovative study included 209 participants, used a mixed methods approach and examined three environments to compare confidence and skills in BLS training. The environments were non- immersive (basic skills room), immersive, (the immersive room with video technology), and the Octave (mixed reality facility). The skills were measured using a Laerdal training manikin (QCPR manikin), with data recorded on a wireless Laerdal Simpad, and the pre and post confidence levels were measured using a questionnaire. The non-immersive and the immersive room rooms were familiar environments and the students felt more comfortable and relaxed and thus more confident. The Octave offered the higher level of simulation utilizing Virtual Reality (VR) technology. Students felt less comfortable and less confident in the Octave; we assert that this was because the environment was unfamiliar. The study identified that placing students in an unfamiliar environment influences the confidence and skills associated with BLS; this could be used as a way of preparing students / nurses with the necessary emotional resilience to cope in stressful situations

    Astrometric suitability of optically-bright ICRF sources for the alignment with the future Gaia celestial reference frame

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    The ICRF, currently based on the position of 717 extragalactic radio sources observed by VLBI, is the fundamental celestial reference frame adopted by the IAU in 1997. Within the next 10 years, the European space astrometry mission Gaia, to be launched by 2011, will permit determination of the extragalactic reference frame directly in the visible for the first time. Aligning these two frames with the highest accuracy will therefore be very important in the future for ensuring consistency between the measured radio and optical positions. This paper is aimed at evaluating the current astrometric suitability of the individual ICRF radio sources which are considered appropriate for the alignment with the future Gaia frame. To this purpose, we cross-identified the ICRF and the optical catalog V\'eron-Cetty and V\'eron (2006), to identify the optically-bright ICRF sources that will be positioned with the highest accuracy with Gaia. Then we investigated the astrometric suitability of these sources by examining their VLBI brightness distribution. We identified 243 candidate ICRF sources for the alignment with the Gaia frame (with an optical counterpart brighter than the apparent magnitude 18), but only 70 of these (10% of the ICRF sources) are found to have the necessary high astrometric quality (i.e. a brightness distribution that is compact enough) for this link. Additionally, it was found that the QSOs that will have the most accurate positions in the Gaia frame tend to have less-accurate VLBI positions, most probably because of their physical structures. Altogether, this indicates that identifying other high-quality VLBI radio sources suitable for the alignment with the future Gaia frame is mandatory.Comment: To be published in A&A (2008)

    Valorizing the Human Capital Within Organizations : A Competency Based Approach

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    Changes in the business environment and in the nature of work itself require the implementation of integrated and flexible methodologies in competencies’ definition in order to valorize the human capital and achieve organizational targets in a future-oriented perspective. However, extant research suggests that the available approaches to competency definition are more focused on describing past behaviors than on anticipating future requirements. Therefore, this study endeavors to provide a competency-based model that supports the top management in the identification of the competencies employees should posses, highlighting crucial competencies that can translate the strategy and vision of the organization into behaviors, skills, and terms that people can easily understand and implement. The results of our explorative case study led us to identify a set of competencies (digital/analytical/technical/adaptive/combinative/proactive), classified following the Knowledge Skills Attitudes (KSA) model, that collectively lead to a successful definition of future-oriented competencies.© 2019 Springer. This is a post-peer-review, pre-copyedit version of an article published in Advances in Human Factors, Business Management and Society. AHFE 2018. The final authenticated version is available online at: https://doi.org/10.1007/978-3-319-94709-9_6fi=vertaisarvioitu|en=peerReviewed

    TYROBP genetic variants in early-onset Alzheimer's disease

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    We aimed to identify new candidate genes potentially involved in early-onset Alzheimer's disease (EOAD). Exome sequencing was conducted on 45 EOAD patients with either a family history of Alzheimer's disease (AD, <65 years) or an extremely early age at the onset (≤55 years) followed by multiple variant filtering according to different modes of inheritance. We identified 29 candidate genes potentially involved in EOAD, of which the gene TYROBP, previously implicated in AD, was selected for genetic and functional follow-up. Using 3 patient cohorts, we observed rare coding TYROBP variants in 9 out of 1110 EOAD patients, whereas no such variants were detected in 1826 controls (p = 0.0001), suggesting that at least some rare TYROBP variants might contribute to EOAD risk. Overexpression of the p.D50_L51ins14 TYROBP mutant led to a profound reduction of TREM2 expression, a well-established risk factor for AD. This is the first study supporting a role for genetic variation in TYROBP in EOAD, with in vitro support for a functional effect of the p.D50_L51ins14 TYROBP mutation on TREM2 expression

    Treatment With Simvastatin and Rifaximin Restores the Plasma Metabolomic Profile in Patients With Decompensated Cirrhosis

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    Patients with decompensated cirrhosis, particularly those with acute-on-chronic liver failure (ACLF), show profound alterations in plasma metabolomics. The aim of this study was to investigate the effect of treatment with simvastatin and rifaximin on plasma metabolites of patients with decompensated cirrhosis, specifically on compounds characteristic of the ACLF plasma metabolomic profile. Two cohorts of patients were investigated. The first was a descriptive cohort of patients with decompensated cirrhosis (n = 42), with and without ACLF. The second was an intervention cohort from the LIVERHOPE-SAFETY randomized, double-blind, placebo-controlled trial treated with simvastatin 20 mg/day plus rifaximin 1,200 mg/day (n = 12) or matching placebo (n = 13) for 3 months. Plasma samples were analyzed using ultrahigh performance liquid chromatography–tandem mass spectroscopy for plasma metabolomics characterization. ACLF was characterized by intense proteolysis and lipid alterations, specifically in pathways associated with inflammation and mitochondrial dysfunction, such as the tryptophan–kynurenine and carnitine beta-oxidation pathways. An ACLF-specific signature was identified. Treatment with simvastatin and rifaximin was associated with changes in 161 of 985 metabolites in comparison to treatment with placebo. A remarkable reduction in levels of metabolites from the tryptophan–kynurenine and carnitine pathways was found. Notably, 18 of the 32 metabolites of the ACLF signature were affected by the treatment. Conclusion: Treatment with simvastatin and rifaximin modulates some of the pathways that appear to be key in ACLF development. This study unveils some of the mechanisms involved in the effects of treatment with simvastatin and rifaximin in decompensated cirrhosis and sets the stage for the use of metabolomics to investigate new targeted therapies in cirrhosis to prevent ACLF development

    Physician and Clinical Integration Among Rural Hospitals

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    The pressures for closer alignment between physicians and hospitals in both rural and urban areas are increasing. This study empirically specifies independent dimensions of physician and clinical integration and compares the extent to which such activities are practiced between rural and urban hospitals and among rural hospitals in different organizational and market contexts. Results suggest that both rural and urban hospitals practice physician integration, although each emphasizes different types of strategies. Second, urban hospitals engage in clinical integration with greater frequency than their rural counterparts. Finally, physician integration approaches in rural hospitals are more common among larger rural hospitals, those proximate to urban facilities, those with system affiliations, and those not under public control.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72074/1/j.1748-0361.1998.tb00637.x.pd

    Two-step fabrication of nanoporous copper films with tunable morphology for SERS application

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    peer-reviewedIt is important to design and fabricate nanoporous metals (NPMs) with optimized microstructures for specific applications. In this contribution, nanoporous coppers (NPCs) with controllable thicknesses and pore sizes were fabricated via the combination of a co-sputtering of Cu/Ti with a subsequent dealloying process. The effect of dealloying time on porous morphology and the corresponding surface enhanced Raman scattering (SERS) behaviors were systematically investigated. Transmission electron microscopy (TEM) identified the presences of the gaps formed between ligaments and also the nanobumps on the nanoparticle-aggregated ligament surface, which were likely to contribute as the “hot spots” for electromagnetic enhancement. The optimal NPC film exhibited excellent SERS performance towards Rhodamine 6G (R6G) with a low limiting detection (10−9 M), along with good uniformity and reproducibility. The calculated enhancement factor of ca. 4.71 × 107 was over Au substrates and comparable to Ag systems, promising the proposed NPC as a cheap candidate for high-performance SERS substrate
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