760 research outputs found

    Finite-element simulations of hysteretic ac losses in a magnetically coated superconducting tubular wire subject to an oscillating transverse magnetic field

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    Numerical simulations of hysteretic ac losses in a tubular superconductor/paramagnet heterostructure subject to an oscillating transverse magnetic field are performed within the quasistatic approach, calling upon the COMSOL finite-element software package and exploiting magnetostatic-electrostatic analogues. It is shown that one-sided magnetic shielding of a thin, type-II superconducting tube by a coaxial paramagnetic support results in a slight increase of hysteretic ac losses as compared to those for a vacuum environment, when the support is placed inside; a spectacular shielding effect with a possible reduction of hysteretic ac losses by orders of magnitude, however, ensues, depending on the magnetic permeability and the amplitude of the applied magnetic field, when the support is placed outside.Comment: 7 pages, 4 figure

    Karak syndrome: a novel degenerative disorder of the basal ganglia and cerebellum

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    Two brothers are reported with early onset progressive cerebellar ataxia, dystonia, spasticity, and intellectual decline. • Neuroradiology showed cerebellar atrophy and features compatible with iron deposition in the putamen (including the “eye of the tiger sign”) and substantia nigra. • Diagnosis was compatible with pantothenate kinase associated neuropathy resulting from pantothenate kinase 2 mutation (PKAN due to PANK2) but linkage to PNAK2 was eliminated suggesting Karak syndrome to be a novel disorder. • The “eye of the tiger” sign has previously only been reported to occur in PKAN due to PKAN

    Studi Drainase Berwawasan Lingkungan Untuk Jalan Pangeran Antasari Banjarmasin

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    Pangeran Antasari road which located in Eastern District of Banjarmasin frequent damage to roads due to drainage channels do not function properly , resulting in a puddle of water on the road . Therefore drainage planning is a good way on the road , in order to determine the design rainfall and discharge large plan dimensions of effective drainage on the road .This anaysis use rainfall data and calculate the maximum that would be obtained by Log Pearson III methods . It is examined in conformance testing , after that recalculated rainfall to rainfall intensity obtained by the method Mononobe . The area of the drainage channel is calculated per section and see the conditions in the field can then be used to calculate water discharge plan using rational methods that will be used to plan the dimensions of good drainage and economical as well as applying the concept ekodrainase.In the cross-sectional results of drainage planning on Prince Street Antasari water discharge plan obtained ranged from 0.7317 to 1.631 m2/sec for left and right channels on Pangeran Antasari road planned Square -shaped channel . with 3 ( three ) comparisons : ( 1 ) precast concrete channel with reference steel ( N = 0,011 ) with the cross-sectional area ranged from 0.5802 to 0.7296 m2 right channel and left channel 0.5033 to 0.7836 m2 . ( 2 ) soil Channel created by Excavator ( N = 0028 ) with cross-sectional area ranged from 0.8237 to 1.0803 m2 right channel and left channel 0.7145 to 1.1124 m2 . ( 3 ) Channel masonry ( N = 0.03 ) with the right- channel cross-sectional area ranged from 0.8453 to 1.1086 and from 0.7332 to 1.1416 m2 left channel

    SISTEM INFORMASI MANUFAKTUR PADA PT. INDOPAL HARAPAN MURNI

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    The purpose of this paper is to analyze and design the manufacturing information systems at PT. Indopal Harapan Murni. The method used in building this application is the method of iterations. Analysis conducted among others by conducting a survey of the running system, conducting interviews and collecting data to obtain the information needed. And the results of the analysis and design of this application isexpected to provide convenience, increase effectiveness and efficiency for those whouse it

    A qualitative study on factors influencing the implementation of a Clostridium difficile risk prediction tool in the Scottish secondary care setting

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    Introduction: Clostridium difficile is the leading cause of hospital acquired diarrhoea, driven by the consumption of 4C antibiotics (co-amoxiclav, clindamycin etc..). In order to support clinicians with the prescription of antibiotic in secondary care, an algorithm to help identify high risk patients to contract Clostridium difficile infection (CDI) has been created. The aim of this study is to identify factors that are influencing the development and implementation of a risk predictive tool for CDI in secondary care. Methods: Four Scottish Podiatrist from Fife were interviewed to gather their perception on CDI, their antibiotic prescription process and whether a CDI tool would support their prescription process. The interviews were inductively analysed in NVivo using the consolidated framework for implementation research to identify factors influencing the development and implementation of the CDI tool. Result: The preliminary interview themes suggests that although Podiatrist in secondary care don’t perceive many cases of CDI, they would like to have risk predictor for CDI for patient’s safety netting purposes. As there isn’t a concrete and accurate electronic health record in secondary care, the CDI tool can’t be implemented into their system, therefore a standalone app or website has to be developed. Conclusion: The next stage is to collaborate with a company to develop a prototype of the CDI tool and test it with secondary care clinicians using case scenarios

    Clinical and economic implications of therapeutic switching of Angiotensin receptor blockers to Angiotensin-converting enzyme inhibitors : a population-based study

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    OBJECTIVE: To evaluate the clinical and cost impact of switching angiotensin receptor blockers (ARBs) to angiotensin-converting enzyme inhibitors (ACEIs) in patients with hypertension. METHODS: This study used the UK Clinical Practice Research Datalink, linking with the Hospital Episode Statistics (April 2006 to March 2012). Adults with hypertension (n = 470) were followed from the first ARB prescription date to the switching date (preswitching period); then from the switching date to the date when study ended, patient left the dataset or died (postswitching period). Patients were divided into ACEIs-combined (n = 369) and ACEIs-monotherapy (n = 101) groups by whether additional antihypertensive drugs were prescribed with ACEIs in the postswitching period. Proportion of days covered (PDC), clinical outcomes and costs were compared between the preswitching and postswitching periods using a multilevel regression. RESULTS: Overall, in the postswitching period, there was a significant increase in the proportion of nonadherence (PDC < 80%) (OR: 2.4; 95% CI: 1.6-3.7), but a significant reduction in mean SBP (mean difference: -2.3; 95 CI: -3.4 to 1.2 mmHg) and mean DBP (mean difference: -1.9; 95% CI: -2.6 to -1.2 mmHg). However, these results were only observed in the ACEIs-combined group. There was no postswitching significant difference in either the incidence of individual or composite hypertension-related complications (OR: 0.9; 95% CI: 0.4-2.0). There was a significant reduction in the overall annual medical cost per patient by £329 (95% CI: -534 to -205). CONCLUSION: Switching of ARBs to ACEIs monotherapy appeared to be clinically effective and a cost-saving strategy. The observed changes in the ACEIs-combined group are assumed to be related to factors other than the ARBs switching

    Investigating a theoretical framework for e-learning technology acceptance

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    E-learning has gained recognition and fame in delivering and distributing educational resources, and the same has become possible with the occurrence of Internet and Web technologies. The research seeks to determine the factors that influence students' acceptance of E-learning and to find out the way these factors determine the students' intention to employ E-learning. A theoretical framework was developed based on the technology acceptance model (TAM). To obtain information from the 270 university students who utilized the E-learning system, a questionnaire was formulated. The results revealed that “social influence, perceived enjoyment, self-efficacy, perceived usefulness, and perceived ease of use” are the strongest and most important predictors in the intention of and students towards E-learning systems. The outcomes offer practical implications for practitioners, lawmakers, and developers in effective E-learning systems implementation to improve ongoing interests and activities of university students in a virtual E-learning atmosphere, valuable recommendations for E-learning practices are given by the research findings, and these may turn out to be as guidelines for the efficient design of E-learning systems

    Using the Canonical Correlation Analysis Method to Study Students’ Levels in Face-to-Face and Online Education in Jordan

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    The study aims to identify the existing correlations between the two sets of variables by finding the linear combinations of the two sets of variables with the highest correlation and test the strength of the relationship between the levels of students face-to-face education and online business students at Al-Balqa Applied University by using the canonical correlation test, The study was applied to a sample of students from Al-Balqa Applied University, specifically the faculty of Business, and for the purposes of analysis and extraction of results, (SPSS ver.26), and (Stata graphics ver.11) programs were used. The study reached the following results the first, second, and third Canonical correlations are statistically significant at the level of significance (α ≤ 0.05), and the first, second, and third canonical correlation between canonical variables independents and dependents is equal (0.98, 0.965, 0.907) respectively, and the variance explained between independent and dependent canonical variable is equal (93.24%, 4.7%, 2.047%) for first, second, and third Canonical correlations respectively. The study recommends using the canonical correlation to evaluate Jordans experience in online education in schools and universities

    Proactive risk assessment of vincristine use process in a teaching and referral hospital in Kenya

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    Background: The chemotherapy use process is considered as potentially risky for cancer patients due to its complex process, use of agents with narrow therapeutic indeces, multiple drug use and use of potentially toxic compounds adding to morbidity and mortality for patients with cancer. Vincristine, a "High Alert" medicine, has been associated with fatal but preventable medication errors. Objective: To determine hazards associated with vincristine use process by performing proactive risk assessments using Healthcare Failure Mode Effect Analysis (HFMEA). Methods: A multidisciplinary health team identified and evaluated potential failure modes based on vincristine use process flow diagram using a hazard scoring matrix in a leading referral hospital in Kenya treating patients with cancer. The hazard score matrix was based on the published literature. Failure modes were prioritized using decision tree analysis in which recommendations to counteract the risks were determined. Results: The processes evaluated were; prescribing, preparation and dispensing, transportation and storage, administration and monitoring of use. A total of 77 failure modes were identified over the 3 months period of the study, April to June 2017, of which 25 were classified as high risk. Thirteen were adequately covered by existing control measures while the other 12 required the development of mitigation strategies. Two of the 12 failure modes were single-point weaknesses. Conclusions: Multiple medication errors, some with serious consequences, can occur at each stage of the chemotherapy use process making it a high-risk process. HFMEA is a useful tool to identify improvements to medication safety and reduce patient harm. The HFMEA process brings together the multidisciplinary team involved in patient care in actively identifying potential failure modes and therefore owning the recommendations made. This is now being followed up

    Massive pulmonary embolism in patients with extreme bleeding risk: a case series on the successful use of ultrasound-assisted, catheter directed thrombolysis in a district general hospital

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    This is the final version. Available from the publisher via the DOI in this record.Massive pulmonary embolism (PE), characterised by profound arterial hypotension, is a life-threatening emergency with a 90-day mortality of over 50%. Systemic thrombolysis can signifcantly reduce the risk of death or cardiovascular collapse in these patients, by around 50%, but these benefts are ofset by a fvefold increased risk of intracranial haemorrhage and major bleeding, which may limit its use in patients at high risk of catastrophic haemorrhage. We describe a case series of 3 patients presenting with massive PE, each with extreme risk of bleeding and contra-indication to systemic thrombolysis, treated successfully with ultrasound-assisted, catheter directed thrombolysis (U-ACDT). Our experience of this novel technique using the EkoSonic Endovascular System (Ekos, BTG, London, UK) on carefully selected patients has demonstrated the potential to improve clinical status in shocked patients, with minimal bleed risk. There have been several clinical studies evaluating the Ekos system. Both the ULTIMA and SEATTLE II studies have shown signifcant reductions in RV/LV ratio by CT scanning when compared to standard anticoagulation in patients with intermediate-risk PE, with minimal bleeding complications. However, there is a pressing need for a randomised trial demonstrating improvement in robust clinical outcomes when comparing U-ACDT to simple anticoagulation. We believe that this case series adds new insight and highlights the potential of catheter directed thrombolysis in this high-risk patient cohort and consideration should be made to its use in cases where systemic thrombolysis is felt to be too high ris
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