Home Telemonitoring in Heart Failure

Heart failure (HF) exacerbation is a major source of hospitalization, mortality, and healthcare cost to home health agencies. Unmonitored accumulative fluid retention between skilled nurse visits, base knowledge deficits in HF pathophysiology and dietary restrictions, and lack of basic monitoring equipment such weighing scales are primary contributors to HF related hospitalizations in the home health setting. It has been discovered that early recognition of decompensating HF can reduce or eliminate HF related hospitalization, mortality, and healthcare costs associated with the management of exacerbation. When a patient is sent to the emergency room (ER) for fluid overload secondary to HF, massive costs are generated including ER transportation, ER consultation fees, hospital stay fee if admitted, and increased home health visit fees for adding additional skilled nurse visits for follow up assessments. Having a method of filling in the monitoring gaps of this patient population can reduce negative outcomes associated with managing HF in home health. The current method of monitoring weekly or bi-weekly by a skilled nurse in these complex HF patients is not best practice. For patients to receive improved and effective HF monitoring on non-skilled nurse days, additional monitoring options should be implemented. Technological advancement in modern healthcare allows the integration of technology to aide in reducing the negative impact HF exacerbation has on home health agencies. Telemonitoring (TM) heart failure in the home health setting is an evidence-based implementation option to reduce patient mortality, decrease healthcare costs, and assist healthcare providers in accessing current and relevant data for point-of-care decision making. TM devices should be installed in the homes of patients who meet the HF exacerbation risk criteria to reduce hospitalization, mortality, and healthcare costs

A Middle to Late Holocene Record of Arroyo Cut-Fill Events in Kitchen Corral Wash, Southern Utah

This study examines middle to late Holocene episodes of arroyo incision and aggradation in the Kitchen Corral Wash (KCW), a tributary of the Paria River in southern Utah. Arroyos are entrenched channels in valley-fill alluvium, and are capable of capturing decadal- to centennial-scale fluctuations in watershed hydrology as evidenced by the Holocene cut-fill stratigraphy recorded within near-vertical arroyo-channel walls. KCW has experienced both historic (ca. 1880-1920 AD) and prehistoric (Holocene) episodes of arroyo cutting and filling. The near-synchronous timing of arroyo cut-fill events between the Paria River and regional drainages over the last - 1 have led some researchers to argue that arroyo development is climatically driven. However, the influence of allogenic (climate-related) or autogenic (geomorphic threshold) forcings on arroyo dynamics are less clear. Uncertainty in influence of the controlling mechanisms of arroyo cutting and filling is partly due to the limited or poorly dated alluvial chronologies. This study tests the applicability of AMS radiocarbon and optically stimulated luminescence (OSL) dating to reconstruct alluvial chronologies in dryland fluvial systems, such as the KCW arroyo. Results from 12 arroyo-wall study sites in KCW indicate that 24 of the 39 analyzed AMS radiocarbon sample s and preliminary results from 12 of the 14 OSL sample s returned strati graphically consistent ages. Applying a combination of these two dating techniques allowed for increased sampling opportunities and cross-checking of ages to determine aberrant age results. By using detailed stratigraphic panels, sedimentologic descriptions, and the age control from AMS radiocarbon and OSL dating, this study produces a new chronostratigraphy that suggests at least five arroyo cut-fill cycles during the middle to late Holocene with periods of aggradation at: - 4.3 5 - 3 .4 ka (Qfl ), - 3 .2 - 2.25 ka (Qf2), - 2. 15 - 1 .45 ka (Qf3), - 1.3 - 0.8 ka (Qf4), - 0. 7- 0.12 ka (Qf5), and an older period of aggradation from - 7 .3 - 4.85 ka identified in an earlier stud y. This newly developed KCW cut-fill chronostratigraphy is compared to regional alluvial and paleoclimate records to test hypotheses regarding allogenic or autogenic forcings. Regional alluvial chronologies do not show coherent patterns of arroyo cut -fill dynamics, but instead appear to be affected by both allogenic and autogenic influences

The effect of three controlled levels of fat thickness upon production and carcass characteristics in beef steers of similar age

Factors which affect demand for beef include population,disposable income of the consumer, tastes and preferences, substitute foods and environmental conditions influencing food consumption. These factors are not clearly separable in their influence upon demand and this list is not complete. However, these factors must be considered in beef production. Since the population continues to increase, incomes continue to rise and a smaller proportion of the consumer dollar is spent for food, the consumer seems to be in a better position to purchase food than ever before. Therefore, the producer must continue to search for new ideas that will enable his product to compete with substitute foods such as eggs, milk and poultry. He must be inconstant combat with various environmental conditions and economic disturbances in his search for ways to furnish the consumer with a product at a reasonable price. One important problem that confronts the beef producer is the consumer\u27s discrimination against excess fat. The consumer\u27s belief that too much fat in the diet is unhealthy has motivated researchers to devote a considerable amount of time and money toward development of a beef animal that has a minimum degree of finish, but one that is acceptable in meat quality and can be economically produced. The objectives of this study were to determine the effect of three controlled levels of fat thickness upon carcass and production characteristics and to determine the level of fatness which would produce the highest yield of trimmed retail cuts but still maintain acceptable quality in beef from steers of similar age

Holographic enhanced remote sensing system

The Holographic Enhanced Remote Sensing System (HERSS) consists of three primary subsystems: (1) an Image Acquisition System (IAS); (2) a Digital Image Processing System (DIPS); and (3) a Holographic Generation System (HGS) which multiply exposes a thermoplastic recording medium with sequential 2-D depth slices that are displayed on a Spatial Light Modulator (SLM). Full-parallax holograms were successfully generated by superimposing SLM images onto the thermoplastic and photopolymer. An improved HGS configuration utilizes the phase conjugate recording configuration, the 3-SLM-stacking technique, and the photopolymer. The holographic volume size is currently limited to the physical size of the SLM. A larger-format SLM is necessary to meet the desired 6 inch holographic volume. A photopolymer with an increased photospeed is required to ultimately meet a display update rate of less than 30 seconds. It is projected that the latter two technology developments will occur in the near future. While the IAS and DIPS subsystems were unable to meet NASA goals, an alternative technology is now available to perform the IAS/DIPS functions. Specifically, a laser range scanner can be utilized to build the HGS numerical database of the objects at the remote work site