Improving Pneumococcal Vaccination Rates in Jefferson Hospital Ambulatory Practice Patients

AIM: To improve the pneumococcal vaccination initiation rates in patients 65 years and older in Jefferson Hospital Ambulatory Practice (JHAP) to the institutional quality measure goal of 80% over a 4 month period from January to May of 2017.https://jdc.jefferson.edu/patientsafetyposters/1031/thumbnail.jp

Book Review: Making all the Difference. Psychotherapy: The Art of Wooing Nature

Book Review: PSYCHOTHERAPY: THE ART OF WOOlNG NATURE Sheldon Roth, M.D. Jason Aronson Inc. Northvale, N.J. (1987), 294 pages

An Educational Case for Applying the Alveolar- Arterial Gradient in Hypoxemia: An Underutilized and Underappreciated Clinical Tool

The Alveolar-arterial gradient, commonly known as the A-a gradient, measures the difference in the oxygen concentration in the alveoli and the arteries across the capillary membrane in the lung. In an ideal system, the A-a gradient would be zero because there would be perfect equilibrium as oxygen diffuses and equalizes across the alveolar and arterial sides of the capillary membrane. However, there is a physiologic A-a gradient because of the differences in perfusion and ventilation in the apical and basilar regions of the lungs. Because this relationship exists, the changes in the A-a gradient have clinical utility in guiding the differential diagnosis of hypoxemia

Integration of cost modelling within the micro-siting design optimisation of tidal turbine arrays

AbstractThe location of individual turbines within a tidal current turbine array – micro-siting – can have a significant impact on the power that the array may extract from the flow. Due to the infancy of the industry and the challenges of exploiting the resource, the economic costs of realising industrial scale tidal current energy projects are significant and should be considered as one of the key drivers of array design. This paper proposes a framework for the automated design of tidal current turbine arrays in which costs over the lifespan of the array may be modelled and considered as part of the design optimisation process. To demonstrate this approach, the cost of sub-sea cabling is incorporated by implementing a cable-routing algorithm alongside an existing gradient-based array optimisation algorithm. Three idealised test scenarios are used to demonstrate the effects of a financial-return optimising design approach as contrasted with a power maximisation approach

Spud 1.0: generalising and automating the user interfaces of scientific computer models

The interfaces by which users specify the scenarios to be simulated by scientific computer models are frequently primitive, under-documented and ad-hoc text files which make using the model in question difficult and error-prone and significantly increase the development cost of the model. In this paper, we present a model-independent system, Spud, which formalises the specification of model input formats in terms of formal grammars. This is combined with an automated graphical user interface which guides users to create valid model inputs based on the grammar provided, and a generic options reading module, libspud, which minimises the development cost of adding model options. <br><br> Together, this provides a user friendly, well documented, self validating user interface which is applicable to a wide range of scientific models and which minimises the developer input required to maintain and extend the model interface

Calibration, inversion and sensitivity analysis for hydro-morphodynamic models through the application of adjoint methods

The development of reliable, sophisticated hydro-morphodynamic models is essential for protecting the coastal environment against hazards such as flooding and erosion. There exists a high degree of uncertainty associated with the application of these models, in part due to incomplete knowledge of various physical, empirical and numerical closure related parameters in both the hydrodynamic and morphodynamic solvers. This uncertainty can be addressed through the application of adjoint methods. These have the notable advantage that the number and/or dimension of the uncertain parameters has almost no effect on the computational cost associated with calculating the model sensitivities. Here, we develop the first freely available and fully flexible adjoint hydro-morphodynamic model framework. This flexibility is achieved through using the pyadjoint library, which allows us to assess the uncertainty of any parameter with respect to any model functional, without further code implementation. The model is developed within the coastal ocean model Thetis constructed using the finite element code-generation library Firedrake. We present examples of how this framework can perform sensitivity analysis, inversion and calibration for a range of uncertain parameters based on the final bedlevel. These results are verified using so-called dual-twin experiments, where the ‘correct’ parameter value is used in the generation of synthetic model test data, but is unknown to the model in subsequent testing. Moreover, we show that inversion and calibration with experimental data using our framework produces physically sensible optimum parameters and that these parameters always lead to more accurate results. In particular, we demonstrate how our adjoint framework can be applied to a tsunami-like event to invert for the tsunami wave from sediment deposits

On the potential of linked-basin tidal power plants: An operational and coastal modelling assessment

Single-basin tidal range power plants have the advantage of predictable energy outputs, but feature non-generation periods in every tidal cycle. Linked-basin tidal power systems can reduce this variability and consistently generate power. However, as a concept the latter are under-studied with limited information on their performance relative to single-basin designs. In addressing this, we outline the basic principles of linked-basin power plant operation and report results from their numerical simulation. Tidal range energy operational models are applied to gauge their capabilities relative to conventional, single-basin tidal power plants. A coastal ocean model (Thetis) is then refined with linked-basin modelling capabilities. Simulations demonstrate that linked-basin systems can reduce non-generation periods at the expense of the extractable energy output relative to conventional tidal lagoons and barrages. As an example, a hypothetical case is considered for a site in the Severn Estuary, UK. The linked-basin system is seen to generate energy 80–100% of the time over a spring-neap cycle, but harnesses at best 30% of the energy of an equivalent-area single-basin design

Ferredoxin C2 is required for chlorophyll biosynthesis and accumulation of photosynthetic antennae in Arabidopsis

Ferredoxins (Fd) are small iron-sulphur proteins, with sub-types that have evolved for specific redox functions. Ferredoxin C2 (FdC2) proteins are essential Fd homologues conserved in all photosynthetic organisms and a number of different FdC2 functions have been proposed in angiosperms. Here we use RNAi silencing in Arabidopsis thaliana to generate a viable fdC2 mutant line with near-depleted FdC2 protein levels. Mutant leaves have ~50% less chlorophyll a and b, and chloroplasts have poorly developed thylakoid membrane structure. Transcriptomics indicates upregulation of genes involved in stress responses. Although fdC2 antisense plants show increased damage at photosystem II (PSII) when exposed to high light, PSII recovers at the same rate as wild type in the dark. This contradicts literature proposing that FdC2 regulates translation of the D1 subunit of PSII, by binding to psbA transcript. Measurement of chlorophyll biosynthesis intermediates revealed a build-up of Mg-protoporphyrin IX, the substrate of the aerobic cyclase. We localise FdC2 to the inner chloroplast envelope and show that the FdC2 RNAi line has a disproportionately lower protein abundance of antennae proteins, which are nuclear-encoded and must be refolded at the envelope after import