1,772 research outputs found

    Beyond the Big Leave: The Future of U.S. Automotive Human Resources

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    Based on industry interviews and trends analyses, forecasts employment levels and hiring nationwide and in Michigan through 2016, and compiles automakers' input on technical needs, hiring criteria, and suggestions for training and education curricula

    Roughness effects on contact angle measurements

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    We have developed a simple and economical procedure to demonstrate the effects of roughness and wetting fraction on the equilibrium contact angles of liquid droplets on solid surfaces. Contact angles for droplets placed on a rough surface, which wet only a portion of the surface, are larger than the contact angles of droplets formed by condensation of steam, which wet the surface more completely. These contact angle data facilitate assessments of changes in true surface area, due to surface roughening, as well as changes in the fractional contact areas of the water droplets, due to the formation of air pockets between the rough surface and the droplet

    When Operating on Dead People Saves Lives: Benefits of Surgical Organ Donor Intensivists

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    Solid organ transplantation has emerged as a life-saving treatment for many patients suffering from end-stage organ failure. Organs have been successfully recovered after a variety of aggressive interventions. We propose that decompressive laparotomy, when clinically indicated, should be considered in the aggressive resuscitation of potential organ donors. A thorough literature review examining aggressive interventions on potential organ donors was conducted after experience with a unique case at this institution. Articles were reviewed for the types of interventions performed as well as the time frame in relation to organ donation. In our case, several ethical issues were raised when considering decompressive laparotomy in a patient pronounced dead by neurologic criteria. We propose that having a surgical intensivist involved in the management of potential donors will further increase the salvage rate, as more invasive resuscitation options are possible

    When Operating on Dead People Saves Lives: Benefits of Surgical Organ Donor Intensivists

    Get PDF
    Solid organ transplantation has emerged as a life-saving treatment for many patients suffering from end-stage organ failure. Organs have been successfully recovered after a variety of aggressive interventions. We propose that decompressive laparotomy, when clinically indicated, should be considered in the aggressive resuscitation of potential organ donors. A thorough literature review examining aggressive interventions on potential organ donors was conducted after experience with a unique case at this institution. Articles were reviewed for the types of interventions performed as well as the time frame in relation to organ donation. In our case, several ethical issues were raised when considering decompressive laparotomy in a patient pronounced dead by neurologic criteria. We propose that having a surgical intensivist involved in the management of potential donors will further increase the salvage rate, as more invasive resuscitation options are possible

    The Tanzanian Trauma patients' Prehospital Experience: A Qualitative Interview-based Study.

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    We sought to characterise the prehospital experience of Tanzanian trauma patients, and identify barriers and facilitators to implement community-based emergency medical systems (EMS). Our study was conducted in the emergency department of an urban national referral hospital in Tanzania. A convenience sample of 34 adult trauma patients, or surrogate family members, presenting or referred to an urban referral emergency department in Tanzania for treatment of injury, participated in the study. Participation in semistructured, iteratively developed interviews until saturation of responses was reached. A grounded theory-based approach to qualitative analysis was used to identify recurrent themes. We characterised numerous deficiencies within the existing clinic-to-hospital referral network, including missed/delayed diagnoses, limited management capabilities at pre-referral facilities and interfacility transfer delays. Potential barriers to EMS implementation include patient financial limitations and lack of insurance, limited public infrastructure and resources, and the credibility of potential first aid responders. Potential facilitators of EMS include communities' tendency to pool resources, individuals' trust of other community members to be first aid responders, and faith in community leaders to organise EMS response. Participants expressed a strong desire to learn first aid. The composite themes generated by the data suggest that there are myriad structural, financial, institutional and cultural barriers to the implementation of a formal prehospital system. However, our analysis also revealed potential facilitators to a first-responder system that takes advantage of close-knit local communities and the trust of recognised leaders in society. The results suggest favourable acceptability for community-based response by trained lay people. There is significant opportunity for care improvements with short trainings and low-cost supply planning. Further research looking at the effects of delay on outcomes in this population is needed

    Identification of a novel population of Langerin+ dendritic cells

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    Langerhans cells (LCs) are antigen-presenting cells that reside in the epidermis of the skin and traffic to lymph nodes (LNs). The general role of these cells in skin immune responses is not clear because distinct models of LC depletion resulted in opposite conclusions about their role in contact hypersensitivity (CHS) responses. While comparing these models, we discovered a novel population of LCs that resides in the dermis and does not represent migrating epidermal LCs, as previously thought. Unlike epidermal LCs, dermal Langerin+ dendritic cells (DCs) were radiosensitive and displayed a distinct cell surface phenotype. Dermal Langerin+ DCs migrate from the skin to the LNs after inflammation and in the steady state, and represent the majority of Langerin+ DCs in skin draining LNs. Both epidermal and dermal Langerin+ DCs were depleted by treatment with diphtheria toxin in Lang-DTREGFP knock-in mice. In contrast, transgenic hLang-DTA mice lack epidermal LCs, but have normal numbers of dermal Langerin+ DCs. CHS responses were abrogated upon depletion of both epidermal and dermal LCs, but were unaffected in the absence of only epidermal LCs. This suggests that dermal LCs can mediate CHS and provides an explanation for previous differences observed in the two-model systems

    Pleistocene Brawley and Ocotillo Formations: Evidence for Initial Strike-Slip Deformation Along the San Felipe and San Jacinto Fault Zones, Southern California

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    We examine the Pleistocene tectonic reorganization of the Pacific–North American plate boundary in the Salton Trough of southern California with an integrated approach that includes basin analysis, magnetostratigraphy, and geologic mapping of upper Pliocene to Pleistocene sedimentary rocks in the San Felipe Hills. These deposits preserve the earliest sedimentary record of movement on the San Felipe and San Jacinto fault zones that replaced and deactivated the late Cenozoic West Salton detachment fault. Sandstone and mudstone of the Brawley Formation accumulated between ∼1.1 and ∼0.6–0.5 Ma in a delta on the margin of an arid Pleistocene lake, which received sediment from alluvial fans of the Ocotillo Formation to the west-southwest. Our analysis indicates that the Ocotillo and Brawley formations prograded abruptly to the east-northeast across a former mud-dominated perennial lake (Borrego Formation) at ∼1.1 Ma in response to initiation of the dextral-oblique San Felipe fault zone. The ∼25-km-long San Felipe anticline initiated at about the same time and produced an intrabasinal basement-cored high within the San Felipe–Borrego basin that is recorded by progressive unconformities on its north and south limbs. A disconformity at the base of the Brawley Formation in the eastern San Felipe Hills probably records initiation and early blind slip at the southeast tip of the Clark strand of the San Jacinto fault zone. Our data are consistent with abrupt and nearly synchronous inception of the San Jacinto and San Felipe fault zones southwest of the southern San Andreas fault in the early Pleistocene during a pronounced southwestward broadening of the San Andreas fault zone. The current contractional geometry of the San Jacinto fault zone developed after ∼0.5–0.6 Ma during a second, less significant change in structural style

    Post-construction support and the sustainability of rural water projects in Ghana

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    Many rural community-managed water supply programs in developing countries have been characterized by poor performance. In response, governments and non-governmental organizations have organized two types of “post-construction support” for village water and sanitation committees. The first, “demand-driven” approach leaves it largely up to communities themselves to seek out repair and other support services and to pay for them when needed. The second is a more “supply-driven” approach – to provide unsolicited technical assistance, training, trouble-shooting, and even financial assistance to communities. We evaluate the effect of these types of post construction support on the technical sustainability of community water supplies in rural Ghana using data collected from 200 villages in Volta and Brong Ahafo
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