Alarm fatigue in the ward

This article addresses the need of including acoustical perspectives in the debate on alarm fatigue within the healthcare domain. We show how conceptualisations and proposed solutions to alarm fatigue are unequally distributed across what could be called the ‘alarm chain’: a generic model of the core structural elements and dynamic relations that constitute any alarm scenario. A focal point in the alarm chain – the ‘alarm mediation cleft’ – seems to divide the alarm fatigue literature from the segment of the alarm literature that deals with auditory alarm design. The current healthcare discourse on alarm fatigue is centred around the ‘premediated alarm phase’, which has the consequence of an unfortunate dichotomous approach to the functionality of sound. We address some shortcomings of this approach and outline some methodological implications and potentials of searching for signs of alarm fatigue in the ‘post-mediated alarm phase’

QuaSI: Quantile Sparse Image Prior for Spatio-Temporal Denoising of Retinal OCT Data

Optical coherence tomography (OCT) enables high-resolution and non-invasive 3D imaging of the human retina but is inherently impaired by speckle noise. This paper introduces a spatio-temporal denoising algorithm for OCT data on a B-scan level using a novel quantile sparse image (QuaSI) prior. To remove speckle noise while preserving image structures of diagnostic relevance, we implement our QuaSI prior via median filter regularization coupled with a Huber data fidelity model in a variational approach. For efficient energy minimization, we develop an alternating direction method of multipliers (ADMM) scheme using a linearization of median filtering. Our spatio-temporal method can handle both, denoising of single B-scans and temporally consecutive B-scans, to gain volumetric OCT data with enhanced signal-to-noise ratio. Our algorithm based on 4 B-scans only achieved comparable performance to averaging 13 B-scans and outperformed other current denoising methods.Comment: submitted to MICCAI'1

Gas-liquid mass transfer : a comparison of down-and up-pumping axial flow impellers with radial impellers

The performance of a down- and up-pumping pitched blade turbine and A315 for gas-liquid dispersion and mass transfer was evaluated and then compared with that of Rushton and Scaba turbines in a small laboratory scale vessel. The results show that when the axial flow impellers are operated in the up-pumping mode, the overall performance is largely improved compared with the down-pumping configuration. Compared with the radial turbines, the up-pumping A315 has a high gas handling capacity, equivalent to the Scaba turbine and is economically much more efficient in terms of mass transfer than both turbines. On the other hand, the uppumping pitched blade turbine is not as well adapted to such applications. Finally, the axial flow impellers in the down-pumping mode have the lowest performance of all the impellers studied, although the A315 is preferred of the pitched blade turbine

Effect of Axial Agitator Configuration (Up-Pumping, Down-Pumping, Reverse Rotation) on Flow Patterns Generated in Stirred Vessels

Single phase turbulent flow in a tank stirred with two different axial impellers - a pitched blade turbine (PBT) and a Mixel TT (MTT)- has been studied using Laser Doppler Velocimetry. The effect of the agitator configuration, i.e. up-pumping, down-pumping and reverse rotation, on the turbulent flow field, as well as power, circulation and pumping numbers has been investigated. An agitation index for each configuration was also determined. In the down-pumping mode, the impellers induced one circulation loop and the upper part of the tank was poorly mixed. When up-pumping, two circulation loops are formed, the second in the upper vessel. The PBT pumping upwards was observed to have a lower flow number and to consume more power than when down-pumping, however the agitation index and circulation efficiencies were notably higher. The MTT has been shown to circulate liquid more efficiently in the up-pumping configuration than in the other two modes. Only small effects of the MTT configuration on the power number, flow number and pumping effectiveness have been observed

Synthesis, Characterization, and Utilization of a Lignin-Based Adsorbent for Effective Removal of Azo Dye from Aqueous Solution

How to effectively remove toxic dyes from the industrial wastewater using a green low-cost lignocellulose-based adsorbent, such as lignin, has become a topic of great interest but remains quite challenging. In this study, cosolvent-enhanced lignocellulosic fractionation (CELF) pretreatment and Mannich reaction were combined to generate an aminated CELF lignin which is subsequently applied for removal of methylene blue and direct blue (DB) 1 dye from aqueous solution. 31P NMR was used to track the degree of amination, and an orthogonal design was applied to determine the relationship between the extent of amination and reaction parameters. The physicochemical, morphological, and thermal properties of the aminated CELF lignin were characterized to confirm the successful grafting of diethylenetriamine onto the lignin. The aminated CELF lignin proved to be an effective azo dye-adsorbent, demonstrating considerably enhanced dye decolorization, especially toward DB 1 dye (>90%). It had a maximum adsorption capacity of DB 1 dye of 502.7 mg/g, and the kinetic study suggested the adsorption process conformed to a pseudo-second-order kinetic model. The isotherm results also showed that the modified lignin-based adsorbent exhibited monolayer adsorption. The adsorbent properties were mainly attributed to the incorporated amine functionalities as well as the increased specific surface area of the aminated CELF lignin

A randomised controlled trial of the Neuro Emotional Technique (NET) for childhood Attention Deficit Hyperactivity Disorder (ADHD): a protocol

<p>Abstract</p> <p>Background</p> <p>An abundance of literature is dedicated to research for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Most, is in the area of pharmacological therapies with less emphasis in psychotherapy and psychosocial interventions and even less in the area of complementary and alternative medicine (CAM).</p> <p>The use of CAM has increased over the years, especially for developmental and behavioral disorders, such as ADHD. 60–65% of parents with children with ADHD have used CAM. Medical evidence supports a multidisciplinary approach (i.e. pharmacological and psychosocial) for the best clinical outcomes. The Neuro Emotional Technique (NET), a branch of Chiropractic, was designed to address the biopsychosocial aspects of acute and chronic conditions including non-musculoskeletal conditions. Anecdotally, it has been suggested that ADHD may be managed effectively by NET.</p> <p>Design/methods</p> <p>A placebo controlled, double blind randomised clinical trial was designed to assess the effectiveness of NET on a cohort of children with medically diagnosed ADHD.</p> <p>Children aged 5–12 years who met the inclusion criteria were randomised to one of three groups. The control group continued on their existing medical regimen and the intervention and placebo groups had the addition of the NET and sham NET protocols added to their regimen respectively. These two groups attended a clinical facility twice a week for the first month and then once a month for six months.</p> <p>The Conners' Parent and Teacher Rating Scales (CRS) were used at the start of the study to establish baseline data and then in one month and in seven months time, at the conclusion of the study. The primary outcome measures chosen were the Conners' ADHD Index and Conners' Global Index. The secondary outcome measures chosen were the DSM-IV: Inattentive, the DSM-IV:Hyperactive-Impulsive, and the DSM-IV:Total subscales from the Conners' Rating Scales, monitoring changes in inattention, hyperactivity and impulsivity.</p> <p>Calculations for the sample size were set with a significance level of 0.05 and the power of 80%, yielding a sample size of 93.</p> <p>Discussion</p> <p>The present study should provide information as to whether the addition of NET to an existing medical regimen can improve outcomes for children with ADHD.</p> <p>Trial registration</p> <p>Australian New Zealand Clinical Trial Registration Number: ANZCTRN 012606000332527</p