Injury and repair of the anterior cruciate ligament

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Frameworks for Patient Safety in the Nursing Curriculum

Patient safety (i.e., the degree to which patients are free from accidental injury) has received a great deal of media coverage during the past few years. Professional and regulatory agencies have indicated that patient safety education should be provided to healthcare workers to improve health outcomes. The primary purpose of this exploratory study was to gain a better understanding of the current status of patient safety awareness among pre-licensure nursing students. To this end, six research questions guided the study: 1. Will interpretable item constructs be identified when responses to the Healthcare Professional Patient Safety Assessment Curriculum Survey (HPPSACS) are intercorrelated and factor analyzed using R-technique exploratory factor analysis? 2. Will responses to items on the HPPSACS yield scores that are intemally consistent as indicated by alpha reliability coefficients? 3. What are the perceptions of nursing students about their awareness, skills, and attitudes regarding patient safety? 4. (a) To what extent is there a relationship between the demographic variables of age and gender and nursing students\u27 perceptions of their patient safety awareness, skills, and attitudes? (b) To what extent is there a relationship between the demographic variable of race/ethnicity and nursing students\u27 perceptions of their patient safety awareness, skills, and attitudes? 5. To what extent is there a relationship between the type of collegiate nursing program and nursing students\u27 perceptions of their patient safety awareness, skills, and attitudes? 6. To what extent are there discernable program curriculum and instructional methodologies that have been traditionally associated with more positive nursing student perceptions of awareness, skills, and attitudes regarding patient safety? Phase I was a pilot test for reliability and construct validity for the HPPSACS. Data were factor analyzed to determine factor constructs for the purpose of identifying the key themes accounting for the variation in response across 23 survey items. Three factors with themes that were found to relate to perceptions of patient safety among a scholarly professional group of nurses were identified as comfort, error reporting, and denial. Findings in Phase II of the study indicated that there were four identifiable constructs with the study data: the themes of comfort, error reporting, denial, and culture. Older male participants had higher comfort subscale scores and lower culture subscales scores than did younger female participants. The Asian American participants were clearly distinguished from the combined set of African American and Hispanic participants on the denial and culture scores. The other ethnic identity was clearly distinguished from the combined set of Caucasian and Hispanic participants on the comfort and error reporting scores. The associate nursing degree programs were clearly distinguished from the combined set of the accelerated and traditional nursing degree programs. Findings in Phase III of the study indicated that all seven of the participating nursing schools included at least three of the Institute of Medicine\u27s six core competencies, with one school exhibiting all of the core competencies

Modelling of metal forming processes and multi-physic coupling

http://congress.cimne.com/complas05/admin/Files/FilePaper/p377.pdfInternational audienceThe main physical phenomena which can be coupled with the mechanical computation of metal forming processes are analyzed. Recalling the classical thermal coupling, it is shown that a stronger numerical coupling is necessary when localization of the deformation occurs. Several situations where we have mechanical solid and liquid interactions with thermal coupling are briefly mentioned. A more complete description of electro magnetic and thermal coupling is given in view of induction heating. Finally the case of multi scale coupling for metallurgic microstructure evolution is introduced

Systematic Review of Clinical Trials Assessing the Effectiveness of Ivy Leaf (Hedera Helix) for Acute Upper Respiratory Tract Infections

Introduction. Among nonantibiotic cough remedies, herbal preparations containing extracts from leaves of ivy (Hedera helix) enjoy great popularity. Objective. A systematic review to assess the effectiveness and tolerability of ivy for acute upper respiratory tract infections (URTIs). Methods. We searched for randomized controlled trials (RCTs), nonrandomized controlled clinical trials and observational studies evaluating the efficacy of ivy preparations for acute URTIs. Study quality was assessed by the Jadad score or the EPHPP tool. Results. 10 eligible studies were identified reporting on 17463 subjects. Studies were heterogeneous in design and conduct; 2 were RCTs. Three studies evaluated a combination of ivy and thyme, 7 studies investigated monopreparations of ivy. Only one RCT (n = 360) investigating an ivy/thyme combination used a placebo control and showed statistically significant superiority in reducing the frequency and duration of cough. All other studies lack a placebo control and show serious methodological flaws. They all conclude that ivy extracts are effective for reducing symptoms of URTI. Conclusion. Although all studies report that ivy extracts are effective to reduce symptoms of URTI, there is no convincing evidence due to serious methodological flaws and lack of placebo controls. The combination of ivy and thyme might be more effective but needs confirmation

Sparse BSS in the presence of outliers

submitted to SPARS15—While real-world data are often grossly corrupted, most techniques of blind source separation (BSS) give erroneous results in the presence of outliers. We propose a robust algorithm that jointly estimates the sparse sources and outliers without requiring any prior knowledge on the outliers. More precisely, it uses an alternative weighted scheme to weaken the influence of the estimated outliers. A preliminary experiment is presented and demonstrates the advantage of the proposed algorithm in comparison with state-of-the-art BSS methods. I. PROBLEM FORMULATION Suppose we are given m noisy observations {Xi} i=1..m of unknown linear mixtures of n ≤ m sparse sources {Sj} j=1..n with t > m samples. It is generally assumed that these data are corrupted by a Gaussian noise, accounting for instrumental or model imperfections. However in many applications, some entries are additionally corrupted by outliers, leading to the following model: X = AS + O + N, with X the observations, A the mixing matrix, S the sources, O the outliers, and N the Gaussian noise. In the presence of outliers, the key difficulty lies in separating the components O and AS. To this end, assuming that the term AS has low-rank, some strategies [4] suggest to pre-process the data to estimate and remove the outliers with RPCA [3]. However, besides the fact that low-rankness is generally restrictive for most BSS problems, the source separation is severely hampered if the outliers are not well estimated. Therefore, we introduce a method that estimates the sources in the presence of the outliers without pre-processing. For the best of our knowledge, it has only been studied in [5] by using the β-divergence. Unlike [5], we propose to estimate jointly the outliers and the sources by exploiting their sparsity. II. ALGORITH

Un modelo viscoplástico de elementos finitos para calcular el abombado del acero colado en continuo

El abombado del acero de la colada continua entre los rodillos de apoyo se calcula con un modelo viscoplástico de elementos finitos. Los dos modelos, el bidimensional y el tridimensional, están basados en la minimización del funcional asociada con el comportamiento de flujo de Norton-Hoff y usan la integración del flujo laminar para calcular el abombado. Se ha comprobado la influencia de los parámetros numéricos y del proceso en la magnitud del abombado calculado utilizando datos industriales. La comparación de los resultados obtenidos con medidas experimentales confirma la validez de la hipótesis del comportamiento viscoplástico.The bulging of continuously cast steel between the support rolls has been computed using a viscoplastic finite eleinent model. Both two-dimensional and three-dimensional models are based on the iiiiniinization of tlie functional associated to the Norton-Hoff's law and uses the streamlines integration to calculate the bulging. By using industrial data, the influence of both numerical parameters and process parameters on the extent of the calculated bulging values have been investigated. The comparison of our results with experimental measurements confirms the relevance of the hypothesis of viscoplastic behaviour.Peer Reviewe

An upwind least square formulation for free surfaces calculation of viscoplastic steady-state metal forming problems

International audienceDespite using very large parallel computers, numerical simulation of some forming processes such as multi-pass rolling, extrusion or wire drawing, need long computation time due to the very large number of time steps required to model the steady regime of the process. The direct calculation of the steady-state, whenever possible, allows reducing by 10–20 the computational effort. However, removing time from the equations introduces another unknown, the steady final shape of the domain. Among possible ways to solve this coupled multi-fields problem, this paper selects a staggered fixed-point algorithm that alternates computation of mechanical fields on a prescribed domain shape with corrections of the domain shape derived from the velocity field and the stationary condition v.n = 0. It focuses on the resolution of the second step in the frame of unstructured 3D meshes, parallel computing with domain partitioning, and complex shapes with strong contact restraints. To insure these constraints a global finite elements formulation is used. The weak formulation based on a Galerkin method of the v.n = 0 equation is found to diverge in severe tests cases. The least squares formulation experiences problems in the presence of contact restraints, upwinding being shown necessary. A new upwind least squares formulation is proposed and evaluated first on analytical solutions. Contact being a key issue in forming processes, and even more with steady formulations, a special emphasis is given to the coupling of contact equations between the two problems of the staggered algorithm, the thermo-mechanical and free surface problems. The new formulation and algorithm is finally applied to two complex actual metal forming problems of rolling. Its accuracy and robustness with respect to the shape initialization of the staggered algorithm is discussed, and its efficiency is compared to non-steady simulations