The Effect of an Educational Intervention on Oral Anticoagulation Therapy Knowledge in Primary Care

It is estimated that three million people in the United States are on oral anticoagulation therapy (warfarin). Populations studied have been found in therapeutic range 64% of the time (Pernod, Labarere, & Bosson, 2008). The low percentage of therapeutic range is attributable to (a) adherence, (b) monitoring infrequency, (c) Vitamin K antagonists, and (d) the effects of aging and comorbidities. The purpose of this evidence-based practice (EBP) project was to examine whether an educational intervention would improve the knowledge of patients receiving warfarin therapy. Roy’s model for patient adaptation and the Stetler Model for EBP were used as frameworks for the project. A pretest/posttest design was used over a 2-week period that included 38 patients aged 42 through 90 (M = 74.7, SD = 10.1). An educational intervention done by the project manager using a booklet, video, and food models on warfarin therapy was completed after the pretest. Patients’ INR (International Normalized Ratio) values were tracked at pretest, posttest, and every two weeks for twelve weeks. A paired sample t test found a statistically significant difference between the pre- and posttest scores. The mean pretest score was 11.11; SD = 2.35 compared to the posttest mean score of 12.48; SD = 1.45; (t (37) = - 4.215, p \u3c .001). No significant difference from pretest INR to posttest INR was found (t (26) = -2.002, p \u3e .056). A Cochran’s Q test showed INR results from 4 to 12 weeks were not statistically significant (x²(4) = 4, p \u3e .406). Results demonstrated that an educational intervention improved patient knowledge, but the intervention did not improve the patients’ INR values over two weeks, or over the four to 12 week time frame. There were no trends over time, other than to support the literature of a low percentage of the population in therapeutic range. Replication of this EBP project has been patterned by the project manager’s institution

Ice core records of atmospheric CO2 around the last three glacial terminations

Air trapped in bubbles in polar ice cores constitutes an archive for the reconstruction of the global carbon cycle and the relation between greenhouse gases and climate in the past. High-resolution records from Antarctic ice cores show that carbon dioxide concentrations increased by 80 to 100 parts per million by volume 600 ± 400 years after the warming of the last three deglaciations. Despite strongly decreasing temperatures, high carbon dioxide concentrations can be sustained for thousands of years during glaciations; the size of this phase lag is probably connected to the duration of the preceding warm period, which controls the change in land ice coverage and the buildup of the terrestrial biosphere.</jats:p

Holocene carbon-cycle dynamics based on CO2 trapped in ice at Taylor Dome, Antarctica

A high-resolution ice-core record of atmospheric CO2 concentration over the Holocene epoch shows that the global carbon cycle has not been in steady state during the past 11,000 years. Analysis of the CO2 concentration and carbon stable-isotope records, using a one-dimensional carbon-cycle model,uggests that changes in terrestrial biomass and sea surface temperature were largely responsible for the observed millennial-scale changes of atmospheric CO2 concentrations

Community next steps for making globally unique identifiers work for biocollections data

Biodiversity data is being digitized and made available online at a rapidly increasing rate but current practices typically do not preserve linkages between these data, which impedes interoperation, provenance tracking, and assembly of larger datasets. For data associated with biocollections, the biodiversity community has long recognized that an essential part of establishing and preserving linkages is to apply globally unique identifiers at the point when data are generated in the field and to persist these identifiers downstream, but this is seldom implemented in practice. There has neither been coalescence towards one single identifier solution (as in some other domains), nor even a set of recommended best practices and standards to support multiple identifier schemes sharing consistent responses. In order to further progress towards a broader community consensus, a group of biocollections and informatics experts assembled in Stockholm in October 2014 to discuss community next steps to overcome current roadblocks. The workshop participants divided into four groups focusing on: identifier practice in current field biocollections; identifier application for legacy biocollections; identifiers as applied to biodiversity data records as they are published and made available in semantically marked-up publications; and cross-cutting identifier solutions that bridge across these domains. The main outcome was consensus on key issues, including recognition of differences between legacy and new biocollections processes, the need for identifier metadata profiles that can report information on identifier persistence missions, and the unambiguous indication of the type of object associated with the identifier. Current identifier characteristics are also summarized, and an overview of available schemes and practices is provided

Polymer Structures on Surface Acoustic Wave Biosensors

The influence of surface structuring on surface acoustic wave (SAW) biosensor signals has been investigated. Polymer structures on the sensor surfaces were applied by lithography or by self-assembling of polystyrene microparticles. In first experiments, structured and unstructured sensors led to similar results in a model affinity assay using streptavidin and biotinylated protein. On the other hand, structuring had a strong effect on SAW sensor signals obtained by protein adsorption on parylene C coated sensors. Depending on the protein, both decreased (albumin, streptavidin) and increased (fibrinogen) signals were observed with structured SAW sensors. Particularly the latter could contribute to facilitated blood analysis in the future

La recherche expérimentale en aérodynamique à l’ONERA – L’exemple du buffet transsonique

International audienceThe paper reviews research conducted at ONERA over the last thirty years on the transonic buffet. We first present the transonic buffet phenomenon and we explain its importance for aeronautical applications. Then, a distinction is made between the 2D buffet produced by an airfoil and the 3D buffet that characterizes swept wings of finite span. The 2D buffet amounts to a pure oscillation of the shock phase-locked with the detachment and reattachment of the boundary layer downstream, whereas the 3D buffet takes the form of a pocket of broadband perturbations located in a limitedportion of the wing. We recall that these mechanisms were first studied in the 1980s through a series of tests conducted in the transonic wind tunnel ONERA T2 at Toulouse and in the large transonic wind tunnel ONERA S2Ma at Modane. Since this pioneering work, progress in the measurement techniques has led to the constitution of a comprehensive database of the 2D buffet that we describe. This database, obtained in the wind tunnel ONERA S3Ch at Meudon, has been extensively used to validate various CFD tools, with the latter being used in turn to investigate the buffet physics. We illustrate this collaboration between simulation and physics by recalling that a linear stability analysis of accurate Reynolds-Averaged-Navier-Stokes (RANS) solutions made it possible to prove that the buffet on a 2D airfoil stems from a global instability mechanism.We also review more recent tests done in the case of a laminar airfoil, which reveal very distinct behaviors of the buffet flow. This illustrates how sensitive the buffet is to the nature of the boundary layer. The last section of the paper gives a short overview of advanced simulations for these different test cases. In the conclusion, we list research perspectives, which include some more general topics such as data assimilation.L'article passe en revue les recherches menées à l'ONERA au cours des trente dernières années sur le buffet transsonique. Nous présentons d'abord le phénomène du buffet transsonique et nous expliquons son importance pour les applications aéronautiques. On distingue ensuite le buffet 2D produit par une aile bidimensionnelle et le buffet 3D qui caractérise les ailes en flèches d’envergure finie. Le buffet 2D se présente sous la forme d’une oscillation d’ensemble de tout l’écoulement couplant un déplacement de l’onde de choc et le décollement de la couche limite en aval de ce choc. Le buffet 3D prend quant à lui la forme d'une poche de perturbations localisées dans une portion limitée de l'aile. Nous rappelons que ces mécanismes ont d'abord été étudiés à l’ONERA dans les années 80 à travers une série de tests réalisés dans la soufflerie transsonique T2 à Toulouse et dans la grande soufflerie transsonique S2 de Modane. Ces travaux pionniers ont ensuite été approfondis dans la soufflerie S3Ch de Meudon de manière à élaborer une base de données complète du buffet 2D sur une aile 2D en régime turbulent, que nous décrivons. Cette base de données a été utilisée de façon extensive, à l’ONERA et dans d’autres institutions pour valider différents outils de simulation, ces derniers étant alors utilisés à leur tour pour étudier la physique du buffet. Nous illustrons cette collaboration entre la simulation et la physique en rappelant qu'une analyse de stabilité linéaire de solutions précises des équations de Navier-Stokes moyennées au sens de Reynolds (RANS) a permis de prouver que le buffet 2D provient d'un mécanisme d'instabilité globale. Nous passons également en revue des essais plus récents réalisés dans la soufflerie S3Ch sur le cas d'une aile 2D laminaire qui révèlent des comportements très distincts par rapport au cas turbulent. Cela illustre la sensibilité du buffet à la nature de la couche limite. Le dernier paragraphe du document donne un bref aperçu des simulations avancées de ces différents cas tests. Dans la conclusion, nous énumérons les perspectives de recherche sur le sujet, qui incluent aussi des thématiques méthodologiques plus générales telles que l'assimilation de données

Independent control of polar and azimuthal anchoring

Monte Carlo simulation, experiment and continuum theory are used to examine the anchoring exhibited by a nematic liquid crystal at a patterned substrate comprising a periodic array of rectangles that, respectively, promote vertical and planar alignment. It is shown that the easy axis and effective anchoring energy promoted by such surfaces can be readily controlled by adjusting the design of the pattern. The calculations reveal rich behavior: for strong anchoring, as exhibited by the simulated system, for rectangle ratios $\geq 2$ the nematic aligns in the direction of the long edge of the rectangles, the azimuthal anchoring coefficient changing with pattern shape. In weak anchoring scenarios, however, including our experimental systems, preferential anchoring is degenerate between the two rectangle diagonals. Bistability between diagonally-aligned and edge-aligned arrangement is predicted for intermediate combinations of anchoring coefficient and system length-scale.Comment: 12 pages, 12 figure

Are Subjects Making Financial Decisions in Lab Auctions or Are They Just Gambling?

Optimal bidding strategies in first-price and Dutch auctions are theoretically isomorphic but depend on bidder risk attitudes. However, laboratory experiments consistently find different behaviour between auction formats. This article explores whether the notion in psychology that financial and gambling risks are viewed differently can explain the discrepancy. Ultimately, the evidence does not support this hypothesis, but a bidder\u27s propensity to gamble is associated with how much risk he takes in both auctions whereas his propensity to take financial risks is not. The results suggest that subjects may view themselves as gambling in laboratory auctions rather than making financial decisions

Early Switch in Glial Protein and Fibronectin Markers on Cells during the Culture of Human Gliomas

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75201/1/j.1749-6632.1984.tb13851.x.pd