38 research outputs found
Master’s Engineering Portfolio
For my CE, I’d like to craft a Master’s Engineering Portfolio of 30-45 minutes of music that I will track, mix, and master myself. I will mostly be operating out of my established comfort zone - focusing on styles that I don’t typically produce, such as jazz, electronic, world, r&b, hip-hop, and acoustic singer-songwriter music. By exposing myself to new musical and technological frontiers, readjusting the way I listen, and finding new ways to translate emotions effectively from the mind of the artist, to the ear of the listener, I hope to build a portfolio that will show more than enough professional and artistic prowess to open doors to new opportunities all over the world, whether that may lead to working in top-tier studios, pursuing my education even further at another academic institution, or becoming a pedagogue myself.https://remix.berklee.edu/graduate-studies-production-technology/1039/thumbnail.jp
Physician Training and Support in Managing Dilemmas Around Benzodiazepine Prescribing
Numerous concerns have emerged regarding the dangers of extended benzodiazepine use and abuse, as well as continued prescribing by medical professionals despite related contraindications. Primary care physicians (PCPs) may find decisions around benzodiazepine prescription and related patient encounters to be especially challenging. Little is known on the efficacy of routine medical training and supervision/consultation models in preparing emerging PCPs for managing the dilemmas that may ensue with regards to prescribing benzodiazepines. The present study sought to begin addressing this gap by conducting an initial qualitative inquiry into the training and supervision experiences and needs of a group of current family medicine residents. A 30-minute semi-structured focus group interview (consisting of four participants) was conducted via video. Two main themes, Variability in Resources and Supports and Patient–Provider Interactions, were identified through thematic analysis. Participants highlighted concerns that inconsistencies in resources and supervisory approaches to benzodiazepines might adversely impact their therapeutic relationship with patients, and an initial hypothesis regarding this possible association was presented for further research. Participants identified increased empathy from supervisors around this concern as a primary area of need for future support. Limitations of the study, implications for practice, and future directions for research were discussed. The present study found that a better understanding of the early training and supervision experiences of emerging primary care providers around benzodiazepines will be critical in supporting the next generation of providers, improving patient care, and shaping future prescribing practices related to this difficult class of medications
Running of the Spectral Index and Violation of the Consistency Relation Between Tensor and Scalar Spectra from trans-Planckian Physics
One of the firm predictions of inflationary cosmology is the consistency
relation between scalar and tensor spectra. It has been argued that such a
relation -if experimentally confirmed- would offer strong support for the idea
of inflation. We examine the possibility that trans-Planckian physics violates
the consistency relation in the framework of inflation with a cut-off proposed
in astro-ph/0009209. We find that despite the ambiguity that exists in choosing
the action, Planck scale physics modifies the consistency relation
considerably. It also leads to the running of the spectral index. For modes
that are larger than our current horizon, the tensor spectral index is
positive. For a window of k values with amplitudes of the same order of the
modes which are the precursor to structure formation, the behavior of tensor
spectral index is oscillatory about the standard Quantum Field theory result,
taking both positive and negative values. There is a hope that in the light of
future experiments, one can verify this scenario of short distance physics.Comment: v1: 18 pages, 8 figures; v4: matched with the NPB versio
Stress Induced Protein Changes in Tall Fescue
Tall fescue (Festuca arundinacea Schreb.), the most important pasture grass in Arkansas, exhibits different agricultural properties when it is infected by its mutualistic endophyte Acremonium coenophialum Morgan-Jones and Gams. We postulate that the presence of endophyte exerts a stress on the host that enhances or detracts from the host\u27s ability to express specific genes. We tested this hypothesis by heat stressing infected and non-infected, juvenile and mature tall fescue, and examining their protein profiles by SDS-PAGE analysis. The results indicate that mature, infected, stressed grass produced greater amounts of Rubisco (ribulose bisphosphate carboxylase-oxygenase) than all other treatments. Additionally, the mature, infected, stressed grass exhibited a 20 k Dalton protein band which was not apparent in other treatments. These observations support the possibility that the endophyte prestresses the grass, and they suggest a molecular mechanism for this response
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High-flow nasal cannulae for respiratory support in adult intensive care patients
Background
High-flow nasal cannulae (HFNC) deliver high flows of blended humidified air and oxygen via wide-bore nasal cannulae and may be useful in providing respiratory support for adult patients experiencing acute respiratory failure in the intensive care unit (ICU).
Objectives
We evaluated studies that included participants 16 years of age and older who were admitted to the ICU and required treatment with HFNC. We assessed the safety and efficacy of HFNC compared with comparator interventions in terms of treatment failure, mortality, adverse events, duration of respiratory support, hospital and ICU length of stay, respiratory effects, patient-reported outcomes, and costs of treatment.
Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3), MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Web of Science, proceedings from four conferences, and clinical trials registries; and we handsearched reference lists of relevant studies. We conducted searches from January 2000 to March 2016 and reran the searches in December 2016. We added four new studies of potential interest to a list of ‘Studies awaiting classification' and will incorporate them into formal review findings during the review update.
Selection criteria
We included randomized controlled studies with a parallel or cross-over design comparing HFNC use in adult ICU patients versus other forms of non-invasive respiratory support (low-flow oxygen via nasal cannulae or mask, continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP)).
Data collection and analysis
Two review authors independently assessed studies for inclusion, extracted data, and assessed risk of bias.
Main results
We included 11 studies with 1972 participants. Participants in six studies had respiratory failure, and in five studies required oxygen therapy after extubation. Ten studies compared HFNC versus low-flow oxygen devices; one of these also compared HFNC versus CPAP, and another compared HFNC versus BiPAP alone. Most studies reported randomization and allocation concealment inadequately and provided inconsistent details of outcome assessor blinding. We did not combine data for CPAP and BiPAP comparisons with data for low-flow oxygen devices; study data were insufficient for separate analysis of CPAP and BiPAP for most outcomes. For the primary outcomes of treatment failure (1066 participants; six studies) and mortality (755 participants; three studies), investigators found no differences between HFNC and low-flow oxygen therapies (risk ratio (RR), Mantel-Haenszel (MH), random-effects 0.79, 95% confidence interval (CI) 0.49 to 1.27; and RR, MH, random-effects 0.63, 95% CI 0.38 to 1.06, respectively). We used the GRADE approach to downgrade the certainty of this evidence to low because of study risks of bias and different participant indications. Reported adverse events included nosocomial pneumonia, oxygen desaturation, visits to general practitioner for respiratory complications, pneumothorax, acute pseudo-obstruction, cardiac dysrhythmia, septic shock, and cardiorespiratory arrest. However, single studies reported adverse events, and we could not combine these findings; one study reported fewer episodes of oxygen desaturation with HFNC but no differences in all other reported adverse events. We downgraded the certainty of evidence for adverse events to low because of limited data. Researchers noted no differences in ICU length of stay (mean difference (MD), inverse variance (IV), random-effects 0.15, 95% CI -0.03 to 0.34; four studies; 770 participants), and we downgraded quality to low because of study risks of bias and different participant indications. We found no differences in oxygenation variables: partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) (MD, IV, random-effects 7.31, 95% CI -23.69 to 41.31; four studies; 510 participants); PaO2 (MD, IV, random-effects 2.79, 95% CI -5.47 to 11.05; three studies; 355 participants); and oxygen saturation (SpO2) up to 24 hours (MD, IV, random-effects 0.72, 95% CI -0.73 to 2.17; four studies; 512 participants). Data from two studies showed that oxygen saturation measured after 24 hours was improved among those treated with HFNC (MD, IV, random-effects 1.28, 95% CI 0.02 to 2.55; 445 participants), but this difference was small and was not clinically significant. Along with concern about risks of bias and differences in participant indications, review authors noted a high level of unexplained statistical heterogeneity in oxygenation effect estimates, and we downgraded the quality of evidence to very low. Meta-analysis of three comparable studies showed no differences in carbon dioxide clearance among those treated with HFNC (MD, IV, random-effects -0.75, 95% CI -2.04 to 0.55; three studies; 590 participants). Two studies reported no differences in atelectasis; we did not combine these findings. Data from six studies (867 participants) comparing HFNC versus low-flow oxygen showed no differences in respiratory rates up to 24 hours according to type of oxygen delivery device (MD, IV, random-effects -1.51, 95% CI -3.36 to 0.35), and no difference after 24 hours (MD, IV, random-effects -2.71, 95% CI -7.12 to 1.70; two studies; 445 participants). Improvement in respiratory rates when HFNC was compared with CPAP or BiPAP was not clinically important (MD, IV, random-effects -0.89, 95% CI -1.74 to -0.05; two studies; 834 participants). Results showed no differences in patient-reported measures of comfort according to oxygen delivery devices in the short term (MD, IV, random-effects 0.14, 95% CI -0.65 to 0.93; three studies; 462 participants) and in the long term (MD, IV, random-effects -0.36, 95% CI -3.70 to 2.98; two studies; 445 participants); we downgraded the certainty of this evidence to low. Six studies measured dyspnoea on incomparable scales, yielding inconsistent study data. No study in this review provided data on positive end-expiratory pressure measured at the pharyngeal level, work of breathing, or cost comparisons of treatment.
Authors' conclusions
We were unable to demonstrate whether HFNC was a more effective or safe oxygen delivery device compared with other oxygenation devices in adult ICU patients. Meta-analysis could be performed for few studies for each outcome, and data for comparisons with CPAP or BiPAP were very limited. In addition, we identified some risks of bias among included studies, differences in patient groups, and high levels of statistical heterogeneity for some outcomes, leading to uncertainty regarding the results of our analysis. Consequently, evidence is insufficient to show whether HFNC provides safe and efficacious respiratory support for adult ICU patients
Syntactic Priming in German Sentence Production
Current theories of language production tend to differentiate between a (syntactic) functional level and a (surface) posi-tional level in the generation of sentences, where functional selection precedes and constrains positional processing. In this paper, we present evidence from a syntactic priming study in German, where position, function, and type of constituent are orthogonally specified for monotransitive and ditransitive verbs. In contrast to findings for English (in which these fac-tors are confounded) we show that previous generation of a ditransitive structure can inhibit the production of a further ditransitive when the order of potential arguments differs be-tween prime and target. Our results suggest that positional pro-cessing must at the least interact with functional processing in production, and point to the importance of cross-linguistic ev