Coming in Warm: Qualitative Study and Concept Map to Cultivate Patient‐Centered Empathy in Emergency Care

Background Increased empathy may improve patient perceptions and outcomes. No training tool has been derived to teach empathy to emergency care providers. Accordingly, we engaged patients to assist in creating a concept map to teach empathy to emergency care providers. Methods We recruited patients, patient caretakers and patient advocates with emergency department experience to participate in three separate focus groups (n = 18 participants). Facilitators guided discussion about behaviors that physicians should demonstrate in order to rapidly create trust, enhance patient perception that the physician understood the patient's point of view, needs, concerns, fears, and optimize patient/caregiver understanding of their experience. Verbatim transcripts from the three focus groups were read by the authors and by consensus, 5 major themes with 10 minor themes were identified. After creating a codebook with thematic definitions, one author reviewed all transcripts to a library of verbatim excerpts coded by theme. To test for inter‐rater reliability, two other authors similarly coded a random sample of 40% of the transcripts. Authors independently chose excerpts that represented consensus and strong emotional responses from participants. Results Approximately 90% of opinions and preferences fell within 15 themes, with five central themes: Provider transparency, Acknowledgement of patient's emotions, Provider disposition, Trust in physician, and Listening. Participants also highlighted the need for authenticity, context and individuality to enhance empathic communication. For empathy map content, patients offered example behaviors that promote perceptions of physician warmth, respect, physical touch, knowledge of medical history, explanation of tests, transparency, and treating patients as partners. The resulting concept map was named the “Empathy Circle”. Conclusions Focus group participants emphasized themes and tangible behaviors to improve empathy in emergency care. These were incorporated into the “Empathy Circle”, a novel concept map that can serve as the framework to teach empathy to emergency care providers

Acute effects of elevated NEFA on vascular function: a comparison of SFA and MUFA

There is emerging evidence to show that high levels of NEFA contribute to endothelial dysfunction and impaired insulin sensitivity. However, the impact of NEFA composition remains unclear. A total of ten healthy men consumed test drinks containing 50 g of palm stearin (rich in SFA) or high-oleic sunflower oil (rich in MUFA) on separate occasions; a third day included no fat as a control. The fats were emulsified into chocolate drinks and given as a bolus (approximately 10 g fat) at baseline followed by smaller amounts (approximately 3 g fat) every 30 min throughout the 6 h study day. An intravenous heparin infusion was initiated 2 h after the bolus, which resulted in a three- to fourfold increase in circulating NEFA level from baseline. Mean arterial stiffness as measured by digital volume pulse was higher during the consumption of SFA (P,0·001) but not MUFA (P¼0·089) compared with the control. Overall insulin and gastric inhibitory peptide response was greater during the consumption of both fats compared with the control (P,0·001); there was a second insulin peak in response to MUFA unlike SFA. Consumption of SFA resulted in higher levels of soluble intercellular adhesion molecule-1 (sI-CAM) at 330 min than that of MUFA or control (P#0·048). There was no effect of the test drinks on glucose, total nitrite, plasminogen activator inhibitor-1 or endothelin-1 concentrations. The present study indicates a potential negative impact of elevated NEFA derived from the consumption of SFA on arterial stiffness and sI-CAM levels. More studies are needed to fully investigate the impact of NEFA composition on risk factors for CVD

Leaky Pipes, Leaky Wallet: A Look At OSU's Steam/Water Condensate Return System

Course Code: ENR/AEDE 4567One of The Ohio State University’s (OSU) goal is to reduce 5% potable water consumption per capita every five years and reset the baseline every five years thereafter.To achieve a 5% reduction in water consumption, H2 Block O’s research focuses on improving the efficiency of the steam condensate return system at McCracken Power Plant; a boiler plant that generates steam for 131 buildings on The Ohio State University’s campus. The motivation for this undertaking is to increase OSU’s water use rating with AASHE STARS, which is a tracking, assessment, and rating system used to measure sustainability among universities. The research objectives of this project include comparing McCracken’s current state to an efficient system, calculating a payback period analysis in order to weigh the decision-making process, and finally, the third objective is to make recommendations the university can embark on in the future to continue down a path of increased reduction in potable water consumption.Academic Major: Environment, Economy, Development, and Sustainabilit

A techno-economic analysis of energy recovery from organic fraction of municipal solid waste (MSW) by an integrated intermediate pyrolysis and combined heat and power (CHP) plant

The increasing environmental concerns and the significant growth of the waste to energy market calls for innovative and flexible technology that can effectively process and convert municipal solid waste into fuels and power at high efficiencies. To ensure the technical and economic feasibility of new technology, a sound understanding of the characteristics of the integrated energy system is essential. In this work, a comprehensive techno-economic analysis of a waste to power and heat plant based on integrated intermediate pyrolysis and CHP (Pyro-CHP) system was performed. The overall plant CHP efficiency was found to be nearly 60% defined as heat and power output compared to feedstock fuel input. By using an established economic evaluation model, the capital investment of a 5 tonne per hour plant was calculated to be £27.64 million and the Levelised Cost of Electricity was £0.063/kWh. This agrees the range of cost given by the UK government. To maximise project viability, technology developers should endeavour to seek ways to reduce the energy production cost. Particular attention should be given to the factors with the greatest influence on the profitability, such as feedstock cost (or gate fee for waste), maintaining plant availability, improving energy productivity and reducing capital cost

Transferrin-bound Yb2 uptake by U-87 MG cells and effect of Yb on proliferation of the cells

2003-2004 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe

Fully automated convolutional neural network-based affine algorithm improves liver registration and lesion co-localization on hepatobiliary phase T1-weighted MR images.

BackgroundLiver alignment between series/exams is challenged by dynamic morphology or variability in patient positioning or motion. Image registration can improve image interpretation and lesion co-localization. We assessed the performance of a convolutional neural network algorithm to register cross-sectional liver imaging series and compared its performance to manual image registration.MethodsThree hundred fourteen patients, including internal and external datasets, who underwent gadoxetate disodium-enhanced magnetic resonance imaging for clinical care from 2011 to 2018, were retrospectively selected. Automated registration was applied to all 2,663 within-patient series pairs derived from these datasets. Additionally, 100 within-patient series pairs from the internal dataset were independently manually registered by expert readers. Liver overlap, image correlation, and intra-observation distances for manual versus automated registrations were compared using paired t tests. Influence of patient demographics, imaging characteristics, and liver uptake function was evaluated using univariate and multivariate mixed models.ResultsCompared to the manual, automated registration produced significantly lower intra-observation distance (p < 0.001) and higher liver overlap and image correlation (p < 0.001). Intra-exam automated registration achieved 0.88 mean liver overlap and 0.44 mean image correlation for the internal dataset and 0.91 and 0.41, respectively, for the external dataset. For inter-exam registration, mean overlap was 0.81 and image correlation 0.41. Older age, female sex, greater inter-series time interval, differing uptake, and greater voxel size differences independently reduced automated registration performance (p ≤ 0.020).ConclusionA fully automated algorithm accurately registered the liver within and between examinations, yielding better liver and focal observation co-localization compared to manual registration

Fabrication of Diamond Nanowires for Quantum Information Processing Applications

We present a design and a top-down fabrication method for realizing diamond nanowires in both bulk single crystal and polycrystalline diamond. Numerical modeling was used to study coupling between a Nitrogen Vacancy (NV) color center and optical modes of a nanowire, and to find an optimal range of nanowire diameters that allows for large collection efficiency of emitted photons. Inductively coupled plasma (ICP) reactive ion etching (RIE) with oxygen is used to fabricate the nanowires. Drop-casted nanoparticles (including $\mathrm{Au}$, $\mathrm{SiO_{2}}$ and $\mathrm{Al_2O_3}$) as well as electron beam lithography defined spin-on glass and evaporated $\mathrm{Au}$ have been used as an etch mask. We found $\mathrm{Al_2O_3}$ nanoparticles to be the most etch resistant. At the same time FOx e-beam resist (spin-on glass) proved to be a suitable etch mask for fabrication of ordered arrays of diamond nanowires. We were able to obtain nanowires with near vertical sidewalls in both polycrystalline and single crystal diamond. The heights and diameters of the polycrystalline nanowires presented in this paper are \unit[\approx1]{\mu m} and \unit[120-340]{nm}, respectively, having a \unit[200]{nm/min} etch rate. In the case of single crystal diamond (types Ib and IIa) nanowires the height and diameter for different diamonds and masks shown in this paper were \unit[1-2.4]{\mu m} and \unit[120-490]{nm} with etch rates between \unit[190-240]{nm/min}.Comment: 11 pages, 26 figures, submitted to Diamond and related Materials; http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6TWV-4Y7MM1M-1&_user=10&_coverDate=01%2F25%2F2010&_rdoc=1&_fmt=high&_orig=search&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=6dc58b30f4773a710c667306fc541cc