Adverse Events ‒ One of the Most Important Health Care Quality Indicators: A Case Study

The aim of study: to evaluate inpatients, experienced adverse events (AE) in Klaipeda university hospital (KUH) contingent, healthcare profiles, location and causal factors, the degree of risk, possibility to avoide its, and to compare assessment of doctors and experts, and estimate their changes in different analyzed periods. Material and methods. The study carried out by analyzing the AE reporting forms in KUH at 2000-2014time period. Exploring and comparing 1690 patients, experienced AE data by age, gender, health care profile, the reasons. Results. The survey showed that AE was 0.3 % of hospitalized patients, most of them (54.9 %) ‒ associated with surgery. The largest group of AE ‒ repeated operations (44.8 %), related to childbirth AE (26.2 %) and related to infection ‒ (13.1 %). Almost half (43.2 %) AE were medium risk, one-third (33.8 %) ‒ minimal and one-fifth (21.6 %) ‒ high risk. Doctors (nurses) and experts opinions on the major causative factors of AE ‒ the individual characteristics of the patients (88.5 % and 90.3 %) basically was similar. However, due to the individual characteristics of doctors (nurses) ‒ experts often (14.2 %) could see them as causal factor than doctors or nurses (9.8 %). Due possibility of AE avoidance ‒ doctors (nurses) and experts opinion that almost half of them (44.7 % and 48.8 %) were avoidable was the same, but stood for full possibility of avoidance (11.2 % doctors (nurses) and 16.9 % experts) and complete inevitability (44.1 % doctor (nurses) and 34.3 % experts) of AE. Conclusions: Long-term operating adverse events reporting and registration system and analysis showed that adverse events in KUH is much less than in comparable large multiprofile hospitals of other countries. The structure of AE have advantages with structure in other countries ‒ the most adverse events related to surgery, infections, nursing, but there are significant differences ‒ reported little adverse events related to drugs, diagnostics, and a small number of falls compared with many births related AE. The majority ‒ almost four fifths of the AE was minimal or medium risk, one-fifths ‒ high-risk. The AE related with deaths were few. The main causal factors of AE ‒ individual characteristics of the patients and the doctors, and team work failure. A twothirds of AE could be fully or partially prevented

Parametric frequency mixing in the magneto-elastically driven FMR-oscillator

We demonstrate the nonlinear frequency conversion of ferromagnetic resonance (FMR) frequency by optically excited elastic waves in a thin metallic film on dielectric substrates. Time-resolved probing of the magnetization directly witnesses magneto-elastically driven second harmonic generation, sum- and difference frequency mixing from two distinct frequencies, as well as parametric downconversion of each individual drive frequency. Starting from the Landau-Lifshitz-Gilbert equations, we derive an analytical equation of an elastically driven nonlinear parametric oscillator and show that frequency mixing is dominated by the parametric modulation of FMR frequency

Memory-multi-fractional Brownian motion with continuous correlations

We propose a generalization of the widely used fractional Brownian motion (FBM), memory-multi-FBM (MMFBM), to describe viscoelastic or persistent anomalous diffusion with time-dependent memory exponent $\alpha(t)$ in a changing environment. In MMFBM the built-in, long-range memory is continuously modulated by $\alpha(t)$. We derive the essential statistical properties of MMFBM such as response function, mean-squared displacement (MSD), autocovariance function, and Gaussian distribution. In contrast to existing forms of FBM with time-varying memory exponents but reset memory structure, the instantaneous dynamic of MMFBM is influenced by the process history, e.g., we show that after a step-like change of $\alpha(t)$ the scaling exponent of the MSD after the $\alpha$-step may be determined by the value of $\alpha(t)$ before the change. MMFBM is a versatile and useful process for correlated physical systems with non-equilibrium initial conditions in a changing environment.Comment: 15 pages, 10 figures, RevTe

Selective excitation of localized spin-wave modes by optically pumped surface acoustic waves

We explore the feasibility of exciting localized spin-wave modes in ferromagnetic nanostructures using surface acoustic waves. The time-resolved Faraday effect is used to probe the magnetization dynamics of an array of nickel nanowires. The optical-pump pulse excites both spin-wave modes of the nanowires and acoustic modes of the substrate and we observe that, when the frequencies of these modes coincide, the amplitude of magnetization dynamics is substantially enhanced due to magnetoelastic coupling between the two. Notably, by tuning the magnitude of an externally applied magnetic field, optically excited surface acoustic waves can selectively excite either the upper or lower branches of a splitting in the nanowire’s spin-wave spectrum, which micromagnetic simulations indicate is caused by localization of spin waves in different parts of the nanowire. Thus, our results indicate the feasibility of using acoustic waves to selectively excite spatially confined spin waves, an approach that may find utility in future magnonic devices where coherent structural deformations could be used as coherent sources of propagating spin waves

Transient Grating Spectroscopy in Magnetic Thin Films:Simultaneous Detection of Elastic and Magnetic Dynamics

Surface magnetoelastic waves are coupled elastic and magnetic excitations that propagate along the surface of a magnetic material. Ultrafast optical techniques allow for a non-contact excitation and detection scheme while providing the ability to measure both elastic and magnetic components individually. Here we describe a simple setup suitable for excitation and time resolved measurements of high frequency magnetoelastic waves, which is based on the transient grating technique. The elastic dynamics are measured by diffracting a probe laser pulse from the long-wavelength spatially periodic structural deformation. Simultaneously, a magnetooptical measurement, either Faraday or Kerr effect, is sensitive to the out-of-plane magnetization component. The correspondence in the response of the two channels probes the resonant interaction between the two degrees of freedom and reveals their intimate coupling. Unraveling the observed dynamics requires a detailed understanding of the spatio-temporal evolution of temperature, magnetization and thermo-elastic strain in the ferromagnet. Numerical solution of thermal diffusion in two dimensions provides the basis on which to understand the sensitivity in the magnetooptic detection

Driving Magnetization Dynamics in an On-Demand Magnonic Crystal via the Magnetoelastic Interactions

Using spatial light interference of ultrafast laser pulses, we generate a lateral modulation in the magnetization profile of an otherwise uniformly magnetized film, whose magnetic excitation spectrum is monitored via the coherent and resonant interaction with elastic waves. We find an unusual dependence of the magnetoelastic coupling as the externally applied magnetic field is angle- and field-tuned relative to the wave vector of the magnetization modulation, which can be explained by the emergence of spatially inhomogeneous spin-wave modes. In this regard, the spatial light interference methodology can be seen as a user-configurable, temporally windowed, on-demand magnonic crystal, potentially of arbitrary two-dimensional shape, which allows control and selectivity of the spatial distribution of spin waves. Calculations of spin waves using a variety of methods, demonstrated here using the plane-wave method and micromagnetic simulation, can identify the spatial distribution and associated energy scales of each excitation, which opens the door to a number of excitation methodologies beyond our chosen elastic wave excitation

Brief Report: Normal Intestinal Permeability at Elevated Platelet Serotonin Levels in a Subgroup of Children with Pervasive Developmental Disorders in Curaçao (The Netherlands Antilles)

This study investigated the relationship between platelet (PLT) serotonin (5-HT) and intestinal permeability in children with pervasive developmental disorders (PDD). Differential sugar absorption and PLT 5-HT were determined in 23 children with PDD. PLT 5-HT (2.0–7.1 nmol/109 PLT) was elevated in 4/23 patients. None exhibited elevated intestinal permeability (lactulose/mannitol ratio: 0.008–0.035 mol/mol). PLT 5-HT did not correlate with intestinal permeability or GI tract complaints. PLT 5-HT correlated with 24 h urinary 5-hydroxyindoleacetic acid (5-HIAA; p = .034). Also urinary 5-HIAA and urinary 5-HT were interrelated (p = .005). A link between hyperserotonemia and increased intestinal permeability remained unsupported. Increased PLT 5-HT in PDD is likely to derive from increased PLT exposure to 5-HT. Longitudinal studies, showing the (in)consistency of abnormal intestinal permeability and PLT 5-HT, may resolve present discrepancies in the literature