Implementing Radio Frequency Identification within the Perioperative Process: A Case Study Perspective

As a technology solution, radio frequency identification (RFID) has proven increased efficiency and accuracy within traditional production and inventory control environments. RFID also offers increased transparency, accountability, and quality across the healthcare industry. This paper provides an a priori perspective to implementing RFID applications in a hospital environment. The paper describes, examines, and discusses the opportunities and challenges that RFID poses across an individual hospital’s perioperative and auxiliary services. Based on an 87-month longitudinal study of a large 909 registered-bed teaching hospital, this paper investigates the complexity of technological change dynamics, integrated information systems, as well as the benefits and learning curves associated with implementing RFID technology in a hospital’s perioperative processes. This paper also provides theoretical and practical implications, as well as study limitations

Optical control of photon tunneling through an array of nanometer scale cylindrical channels

We report first observation of photon tunneling gated by light at a different wavelength in an artificially created array of nanometer scale cylindrical channels in a thick gold film. Polarization properties of gated light provide strong proof of the enhanced nonlinear optical mixing in nanometric channels involved in the process. This suggests the possibility of building a new class of "gated" photon tunneling devices for massive parallel all-optical signal and image processing.Comment: 4 pages, 4 figure

An elastoplastic framework for granular materials becoming cohesive through mechanical densification. Part I - small strain formulation

Mechanical densification of granular bodies is a process in which a loose material becomes increasingly cohesive as the applied pressure increases. A constitutive description of this process faces the formidable problem that granular and dense materials have completely different mechanical behaviours (nonlinear elastic properties, yield limit, plastic flow and hardening laws), which must both be, in a sense, included in the formulation. A treatment of this problem is provided here, so that a new phenomenological, elastoplastic constitutive model is formulated, calibrated by experimental data, implemented and tested, that is capable of describing the transition between granular and fully dense states of a given material. The formulation involves a novel use of elastoplastic coupling to describe the dependence of cohesion and elastic properties on the plastic strain. The treatment falls within small strain theory, which is thought to be appropriate in several situations; however, a generalization of the model to large strain is provided in Part II of this paper.Comment: 42 pages, 27 figure

Examining sex differences in knee pain: the Multicenter Osteoarthritis Study

SummaryObjectiveTo determine whether women experience greater knee pain severity than men at equivalent levels of radiographic knee osteoarthritis (OA).Design and methodsA cross-sectional analysis of 2712 individuals (60% women) without knee replacement or a recent steroid injection. Sex differences in pain severity at each Kellgren–Lawrence (KL) grade were assessed by knee using visual analog scale (VAS) scale and Western Ontario and McMaster Universities Arthritis Index (WOMAC) with and without adjustment for age, analgesic use, Body mass index (BMI), clinic site, comorbid conditions, depression score, education, race, and widespread pain (WSP) using generalized estimating equations. Effect sizes (Cohen's d) were also calculated. Analyses were repeated in those with and without patellofemoral OA (PFOA).ResultsWomen reported higher VAS pain at all KL grades in unadjusted analyses (d = 0.21–0.31, P < 0.0001–0.0038) and in analyses adjusted for all covariates except WSP (d = 0.16–0.22, P < 0.0001–0.0472). Pain severity differences further decreased with adjustment for WSP (d = 0.10–0.18) and were significant for KL grade ≤2 (P = 0.0015) and 2 (P = 0.0200). Presence compared with absence of WSP was associated with significantly greater knee pain at all KL grades (d = 0.32–0.52, P < 0.0001–0.0008). In knees with PFOA, VAS pain severity sex differences were greater at each KL grade (d = 0.45–0.62, P = 0.0006–0.0030) and remained significant for all KL grades in adjusted analyses (d = 0.31–0.57, P = 0.0013–0.0361). Results using WOMAC were similar.ConclusionsWomen reported greater knee pain than men regardless of KL grade, though effect sizes were generally small. These differences increased in the presence of PFOA. The strong contribution of WSP to sex differences in knee pain suggests that central sensitivity plays a role in these differences

Dark matter in the inner parts of barred galaxies: The data

This paper presents surface photometry (B,V, I, J, H, K) and H_alpha rotation curves of 27 isolated spiral galaxies. The final goal is to obtain the mass distribution of a sample of isolated spiral galaxies in order to model their gas kinematics. This is then compared to the observed rotation curve, to determine the necessity of a dark halo in the inner parts (Perez et al. 2004). The azimuthally averaged radial surface brightness profiles and the integrated magnitudes obtained from ellipse fitting are given for each of the sample galaxies. The ellipse fitting technique applied to the light distribution also allowed us to obtain the size of the bar, and the inclination and position angle of the outer isophotes that allow the galaxy deprojection. Using these profiles, 1-D disk-bulge decomposition was performed to obtain the disk scale-length and the bulge effective radius for the different bands. Through the fitting of a parametric function to the observed rotation curve, the maximum rotational velocity and the corresponding radius was obtained. The correlation between the bulge and disk parameters is in agreement with previous studies (de Jong 1996a; Marquez & Moles 1999; Baggett et al. 1998). Regarding the Kormendy relation (Kormendy 1977), in agreement with de Jong, no correlation between the bulge effective radius and its surface brightness is found, possibly due to the small range of bulge magnitudes covered. We find a smaller scatter in the structural relations when compared to non-isolated samples in agreement with Marquez & Moles (1999). Finally, a correlation between the disk scale-length and the bar size is observed, possibly reflecting the rapid growth of a bar.Comment: A&A accepted. Fig. 11 and Tables 3-8 can be downloaded at: http://www.astro.rug.nl/~isa (they will also be available at http://www.edpsciences.org

Control of human adenovirus type 5 gene expression by cellular Daxx/ATRX chromatin-associated complexes

Death domain–associated protein (Daxx) cooperates with X-linked α-thalassaemia retardation syndrome protein (ATRX), a putative member of the sucrose non-fermentable 2 family of ATP-dependent chromatin-remodelling proteins, acting as the core ATPase subunit in this complex, whereas Daxx is the targeting factor, leading to histone deacetylase recruitment, H3.3 deposition and transcriptional repression of cellular promoters. Despite recent findings on the fundamental importance of chromatin modification in host-cell gene regulation, it remains unclear whether adenovirus type 5 (Ad5) transcription is regulated by cellular chromatin remodelling to allow efficient virus gene expression. Here, we focus on the repressive role of the Daxx/ATRX complex during Ad5 replication, which depends on intact protein–protein interaction, as negative regulation could be relieved with a Daxx mutant that is unable to interact with ATRX. To ensure efficient viral replication, Ad5 E1B-55K protein inhibits Daxx and targets ATRX for proteasomal degradation in cooperation with early region 4 open reading frame protein 6 and cellular components of a cullin-dependent E3-ubiquitin ligase. Our studies illustrate the importance and diversity of viral factors antagonizing Daxx/ATRX-mediated repression of viral gene expression and shed new light on the modulation of cellular chromatin remodelling factors by Ad5. We show for the first time that cellular Daxx/ATRX chromatin remodelling complexes play essential roles in Ad gene expression and illustrate the importance of early viral proteins to counteract cellular chromatin remodelling

Initiation of Psychotropic Medication after Partner Bereavement: A Matched Cohort Study

Background Recent changes to diagnostic criteria for depression in DSM-5 remove the bereavement exclusion, allowing earlier diagnosis following bereavement. Evaluation of the potential effect of this change requires an understanding of existing psychotropic medication prescribing by non-specialists after bereavement. Aims To describe initiation of psychotropic medication in the first year after partner bereavement. Methods In a UK primary care database, we identified 21,122 individuals aged 60 and over with partner bereavement and no psychotropic drug use in the previous year. Prescribing (anxiolytic/hypnotic, antidepressant, antipsychotic) after bereavement was compared to age, sex and practice matched controls. Results The risks of receiving a new psychotropic prescription within two and twelve months of bereavement were 9.5% (95% CI 9.1 to 9.9%) and 17.9% (17.3 to 18.4%) respectively; an excess risk of initiation in the first year of 12.4% compared to non-bereaved controls. Anxiolytic/hypnotic and antidepressant initiation rates were highest in the first two months. In this period, the hazard ratio for initiation of anxiolytics/hypnotics was 16.7 (95% CI 14.7 to 18.9) and for antidepressants was 5.6 (4.7 to 6.7) compared to non-bereaved controls. 13.3% of those started on anxiolytics/hypnotics within two months continued to receive this drug class at one year. The marked variation in background family practice prescribing of anxiolytics/hypnotics was the strongest determinant of their initiation in the first two months after bereavement. Conclusion Almost one in five older people received a new psychotropic drug prescription in the year after bereavement. The early increase and trend in antidepressant use after bereavement suggests some clinicians did not adhere to the bereavement exclusion, with implications for its recent removal in DSM-5. Family practice variation in use of anxiolytics/hypnotics suggests uncertainty over their role in bereavement with the potential for inappropriate long term use

Spatially Resolved Spectroscopy of Sub-AU-Sized Regions of T Tauri and Herbig Ae/Be Disks

We present spatially resolved near-IR spectroscopic observations of 15 young stars. Using a grism spectrometer behind the Keck Interferometer, we obtained an angular resolution of a few milli-arcseconds and a spectral resolution of 230, enabling probes of both gas and dust in the inner disks surrounding the target stars. We find that the angular size of the near-IR emission typically increases with wavelength, indicating hot, presumably gaseous material within the dust sublimation radius. Our data also clearly indicate Brackett-gamma emission arising from hot hydrogen gas, and suggest the presence of water vapor and carbon monoxide gas in the inner disks of several objects. This gaseous emission is more compact than the dust continuum emission in all cases. We construct simple physical models of the inner disk and fit them to our data to constrain the spatial distribution and temperature of dust and gas emission components.Comment: 40 pages, 8 figures. Accepted for publication in Ap

Functional diversity of chemokines and chemokine receptors in response to viral infection of the central nervous system.

Encounters with neurotropic viruses result in varied outcomes ranging from encephalitis, paralytic poliomyelitis or other serious consequences to relatively benign infection. One of the principal factors that control the outcome of infection is the localized tissue response and subsequent immune response directed against the invading toxic agent. It is the role of the immune system to contain and control the spread of virus infection in the central nervous system (CNS), and paradoxically, this response may also be pathologic. Chemokines are potent proinflammatory molecules whose expression within virally infected tissues is often associated with protection and/or pathology which correlates with migration and accumulation of immune cells. Indeed, studies with a neurotropic murine coronavirus, mouse hepatitis virus (MHV), have provided important insight into the functional roles of chemokines and chemokine receptors in participating in various aspects of host defense as well as disease development within the CNS. This chapter will highlight recent discoveries that have provided insight into the diverse biologic roles of chemokines and their receptors in coordinating immune responses following viral infection of the CNS

The combined positive impact of Lean methodology and Ventana Symphony autostainer on histology lab workflow

<p>Abstract</p> <p>Background</p> <p>Histologic samples all funnel through the H&E microtomy staining area. Here manual processes intersect with semi-automated processes creating a bottleneck. We compare alternate work processes in anatomic pathology primarily in the H&E staining work cell.</p> <p>Methods</p> <p>We established a baseline measure of H&E process impact on personnel, information management and sample flow from historical workload and production data and direct observation. We compared this to performance after implementing initial Lean process modifications, including workstation reorganization, equipment relocation and workflow levelling, and the Ventana Symphony stainer to assess the impact on productivity in the H&E staining work cell.</p> <p>Results</p> <p>Average time from gross station to assembled case decreased by 2.9 hours (12%). Total process turnaround time (TAT) exclusive of processor schedule changes decreased 48 minutes/case (4%). Mean quarterly productivity increased 8.5% with the new methods. Process redesign reduced the number of manual steps from 219 to 182, a 17% reduction. Specimen travel distance was reduced from 773 ft/case to 395 ft/case (49%) overall, and from 92 to 53 ft/case in the H&E cell (42% improvement).</p> <p>Conclusions</p> <p>Implementation of Lean methods in the H&E work cell of histology can result in improved productivity, improved through-put and case availability parameters including TAT.</p