Instrument Construction: An Examination of the Effect of Lead Pipe Design Variability on Tuba Response

The document begins with a brief description of the main parts of the tuba: the mouthpiece, the valves, the body and the bell; in addition to a short explanation of the different types of material used to construct brass instruments. This study will function as the first installment of a bigger series exploring the variations in tuba sound when the different main parts are physically altered or swapped for other designs of the same part. This first installment of the series seeks to examine the section of the tuba known as the lead pipe in relation to the implications of varying the lead pipe and observing the effects of these changes. One of the goals of this research is to, through review of related literature, understand the acoustic processes that go into the creation of sound energy within a brass wind instrument. Another purpose of this writing is to discuss, through interviews of experts in the field, the lead pipe and how it is constructed, shaped, and designed, while gaining information as to how it could relate to the sound and response of the tuba. Finally, the primary objective of this study is to gather data through a series of performance tests in which the lead pipe design will be modified with results recorded

Value Based Purchasing: Positioning a Healthcare Organization for the Future

In 2005, the Deficit Reduction Act introduced Value Based Purchasing (VBP) into the healthcare system as a means of hospital reimbursement for acute care hospitals receiving reimbursements from the Centers of Medicare and Medicaid (CMS). The purpose of this Capstone Project was to increase the knowledge of healthcare executives concerning Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and VBP and the effect it will place on the organization though the utilization of a consultant program. The role of the consultant in this project is to provide expert advice to healthcare executives about the impacts of HCAHPS and provide organizational strategies to increase hospital reimbursements related to CMS and VBP. The nurse consultant theory used in this project is central to the process of health service modernization, helping to provide clients with services that are organized and structured and served as the framework for this capstone project. Robb’s (2006) guiding principles and techniques were used to guide the framework through its entirety. Additionally, using the American Association of College of Nursing’s (AACN) (2006) Doctoral of Nursing Practice (DNP) Essentials II and V supported this capstone through system changes related to healthcare policy redesign. The entire senior leadership team (7 members) of a rural acute care hospital in southwest Mississippi participated in the consultant program. A post-implementation evaluation was utilized by the DNP to give the organization a starting point for performance improvement. The DNP in this project will continue to monitor the organization for one year post implementation of the project. Information will be provided to the DNP through the Performance Improvement Committee initiated in this project. The Performance Improvement Team will use original HCAHPS scores from September 2012 and provide monthly feedback of new scores until September 2013. After this time the Performance Improvement Team will only submit data to their senior leadership team

A New Species of Cerapus Say, 1817 (Crustacea: Amphipoda) from the Northern Gulf of Mexico, with Notes on its Ecology

During research in coastal marshes of the Mississippi Delta region in 1975, a large, undescribed amphipod belonging to the genus Cerapus was discovered in tidal channels. This new species, C. benthophilus, is characterized by its large size and 7-12 segmented antennal flagella. Habitat preference is muddy silt bottoms upon which it constructs conspicuous mats or tufts of interwoven tubes in shallow coastal bays and marshes from Louisiana to the panhandle areas of northern Florida

Structural and electronic characterisation of sub-nanometre metal particles

Electronic structure calculation methods, coupled with unbiased global optimization schemes are developed and employed, for the exploration of the energy landscape of subnanometre scale metallic clusters of noble metals. Structure prediction, along with statistical analysis of the potential energy surfaces for ultrasmall metallic and bimetallic particles of the coinage metals (Cu, Ag, Au) and platinum group metals (Pd, Pt) is undertaken, to determine favourable cluster geometries. Prediction of energetic and electronic properties, including charge distributions, electronic and configurational densities of states, binding, adsorption and mixing energies are made, in order to support the predictions of novel experimental work on a potential catalytic and optoelectronic systems. The environment of the particle is a focus, with surface-bound, ligated and gas phase clusters all considered, in addition to modelling of the adsorption of small molecules. Subnanoscale metal systems show promise in a range of reactive and electronic roles, and by producing accurate theoretical predictions of optical, binding and electronic properties, we contribute to the rational design of such new materials

Acetaminophen-cysteine adducts during therapeutic dosing and following overdose

<p>Abstract</p> <p>Background</p> <p>Acetaminophen-cysteine adducts (APAP-CYS) are a specific biomarker of acetaminophen exposure. APAP-CYS concentrations have been described in the setting of acute overdose, and a concentration >1.1 nmol/ml has been suggested as a marker of hepatic injury from acetaminophen overdose in patients with an ALT >1000 IU/L. However, the concentrations of APAP-CYS during therapeutic dosing, in cases of acetaminophen toxicity from repeated dosing and in cases of hepatic injury from non-acetaminophen hepatotoxins have not been well characterized. The objective of this study is to describe APAP-CYS concentrations in these clinical settings as well as to further characterize the concentrations observed following acetaminophen overdose.</p> <p>Methods</p> <p>Samples were collected during three clinical trials in which subjects received 4 g/day of acetaminophen and during an observational study of acetaminophen overdose patients. Trial 1 consisted of non-drinkers who received APAP for 10 days, Trial 2 consisted of moderate drinkers dosed for 10 days and Trial 3 included subjects who chronically abuse alcohol dosed for 5 days. Patients in the observational study were categorized by type of acetaminophen exposure (single or repeated). Serum APAP-CYS was measured using high pressure liquid chromatography with electrochemical detection.</p> <p>Results</p> <p>Trial 1 included 144 samples from 24 subjects; Trial 2 included 182 samples from 91 subjects and Trial 3 included 200 samples from 40 subjects. In addition, we collected samples from 19 subjects with acute acetaminophen ingestion, 7 subjects with repeated acetaminophen exposure and 4 subjects who ingested another hepatotoxin. The mean (SD) peak APAP-CYS concentrations for the Trials were: Trial 1- 0.4 (0.20) nmol/ml, Trial 2- 0.1 (0.09) nmol/ml and Trial 3- 0.3 (0.12) nmol/ml. APAP-CYS concentrations varied substantially among the patients with acetaminophen toxicity (0.10 to 27.3 nmol/ml). No subject had detectable APAP-CYS following exposure to a non-acetaminophen hepatotoxin.</p> <p>Conclusions</p> <p>Lower concentrations of APAP-CYS are detectable after exposure to therapeutic doses of acetaminophen and higher concentrations are detected after acute acetaminophen overdose and in patients with acetaminophen toxicity following repeated exposure.</p

The Number and Types of Procedures Performed at JeffHOPE Clinics

Introduction: Procedures performed as part of the urgent care medical services provided at JeffHOPE Clinics (JHCs) are common in daily operations, but the number and types of procedures performed at each JHC have not yet been reported. The goal of this research was to provide JHCs the data needed to ensure clinic-specific evidence-based training for incoming procedures committee members, and thus ensure the highest quality patient care. The inquiry question was what are the number and types of procedures performed at each JHC? Methods: An IRB waiver of authorization was obtained. A chart review of patients 18 years or older seen at JeffHOPE clinics during 2019, was performed. For each clinic, the procedure type and month when the procedure was performed were recorded using Microsoft Excel®. The electronic medical record, Practice Fusion, was queried for scheduled patients based on date of clinic attendance. Results: In total, 1987 charts were reviewed revealing 462 procedures performed. The JeffHOPE clinic at Sunday Breakfast Rescue Mission recorded the most blood draws, urinalyses, and urine samples. The JeffHOPE clinic at Eliza Shirly House recorded the most Depo-Provera injections and pregnancy tests. The JeffHOPE clinic at Our Brothers Place Shelter recorded the most blood glucose checks and wounds cared for. Conclusion: The number and types of procedures performed at each JeffHOPE clinic in 2019 for patients greater than 18 years or older have been determined. Next steps include developing a procedures committee training protocol using these data as a guide for training incoming committee members

Tests of an alternate mobile transporter and extravehicular activity assembly procedure for the Space Station Freedom truss

Results are presented from a ground test program of an alternate mobile transporter (MT) concept and extravehicular activity (EVA) assembly procedure for the Space Station Freedom (SSF) truss keel. A three-bay orthogonal tetrahedral truss beam consisting of 44 2-in-diameter struts and 16 nodes was assembled repeatedly in neutral buoyancy by pairs of pressure-suited test subjects working from astronaut positioning devices (APD's) on the MT. The truss bays were cubic with edges 15 ft long. All the truss joint hardware was found to be EVA compatible. The average unit assembly time for a single pair of experienced test subjects was 27.6 sec/strut, which is about half the time derived from other SSF truss assembly tests. A concept for integration of utility trays during truss assembly is introduced and demonstrated in the assembly tests. The concept, which requires minimal EVA handling of the trays, is shown to have little impact on overall assembly time. The results of these tests indicate that by using an MT equipped with APD's, rapid EVA assembly of a space station-size truss structure can be expected

Wildlife-friendly farming increases crop yield: evidence for ecological intensification

Ecological intensification has been promoted as a means to achieve environmentally sustainable increases in crop yields by enhancing ecosystem functions that regulate and support production. There is, however, little direct evidence of yield benefits from ecological intensification on commercial farms growing globally important foodstuffs (grains, oilseeds and pulses). We replicated two treatments removing 3 or 8% of land at the field edge from production to create wildlife habitat in 50–60 ha patches over a 900 ha commercial arable farm in central England, and compared these to a business as usual control (no land removed). In the control fields, crop yields were reduced by as much as 38% at the field edge. Habitat creation in these lower yielding areas led to increased yield in the cropped areas of the fields, and this positive effect became more pronounced over 6 years. As a consequence, yields at the field scale were maintained—and, indeed, enhanced for some crops—despite the loss of cropland for habitat creation. These results suggested that over a 5-year crop rotation, there would be no adverse impact on overall yield in terms of monetary value or nutritional energy. This study provides a clear demonstration that wildlife-friendly management which supports ecosystem services is compatible with, and can even increase, crop yields