258 research outputs found

    An occultation satellite system for determining pressure levels in the atmosphere

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    A two-satellite microwave occultation system is described that will fix, as an absolute function of altitude, the pressure-temperature profile generated by a passive infrared sounder. The 300 mb pressure level is determined to within 24 m rms, assuming the temperture errors produced by the infrared sensor are not greater than 2 K rms. Error caused by water vapor in the radio path is corrected by climatological adjustments. A ground test of the proposed system is described. A microwave signal propagating between two mountain tops was found to be subject to periods of intense fading. Computer analysis of the raypath between the transmitting and receiving stations indicates that multipath and defocusing were responsible for this fading. It is unlikely that an operational pressure-reference-level system will be subject to the deep fades observed in the ground test, because the phenomena are associated with lower altitudes than the closest approach altitude of an occultation-system raypath

    Lunar radar measurements of the earth's magnetospheric wake Scientific report no. 11

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    Lunar radar echo measurments to determine size and electron density of earth magnetospheric wak

    Optimization in the design of a 12 gigahertz low cost ground receiving system for broadcast satellites. Volume 1: System design, performance, and cost analysis

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    The technical and economical feasibility of using the 12 GHz band for broadcasting from satellites were examined. Among the assigned frequency bands for broadcast satellites, the 12 GHz band system offers the most channels. It also has the least interference on and from the terrestrial communication links. The system design and analysis are carried out on the basis of a decision analysis model. Technical difficulties in achieving low-cost 12 GHz ground receivers are solved by making use of a die cast aluminum packaging, a hybrid integrated circuit mixer, a cavity stabilized Gunn oscillator and other state-of-the-art microwave technologies for the receiver front-end. A working model was designed and tested, which used frequency modulation. A final design for the 2.6 GHz system ground receiver is also presented. The cost of the ground-terminal was analyzed and minimized for a given figure-of-merit (a ratio of receiving antenna gain to receiver system noise temperature). The results were used to analyze the performance and cost of the whole satellite system

    Optimization in the design of a 12 gigahertz low cost ground receiving system for broadcast satellites. Volume 2: Antenna system and interference

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    The antenna characteristics are analyzed of a low cost mass-producible ground station to be used in broadcast satellite systems. It is found that a prime focus antenna is sufficient for a low-cost but not a low noise system. For the antenna feed waveguide systems are the best choice for the 12 GHz band, while printed-element systems are recommended for the 2.6 GHz band. Zoned reflectors are analyzed and appear to be attractive from the standpoint of cost. However, these reflectors suffer a gain reduction of about one db and a possible increase in sidelobe levels. The off-axis gain of a non-auto-tracking station can be optimized by establishing a special illumination function at the reflector aperture. A step-feed tracking system is proposed to provide automatic procedures for searching for peak signal from a geostationary satellite. This system uses integrated circuitry and therefore results in cost saving under mass production. It is estimated that a complete step-track system would cost only $512 for a production quantity of 1000 units per year

    Predicting the prevalence of chronic kidney disease in the English population: a cross-sectional study.

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    BACKGROUND: There is concern that not all cases of chronic kidney disease (CKD) are known to general practitioners, leading to an underestimate of its true prevalence. We carried out this study to develop a model to predict the prevalence of CKD using a large English primary care dataset which includes previously undiagnosed cases of CKD. METHODS: Cross-sectional analysis of data from the Quality Improvement in CKD trial, a representative sample of 743 935 adults in England aged 18 and over. We created multivariable logistic regression models to identify important predictive factors. RESULTS: A prevalence of 6.76% was recorded in our sample, compared to a national prevalence of 4.3%. Increasing age, female gender and cardiovascular disease were associated with a significantly increased prevalence of CKD (p < 0.001 for all). Age had a complex association with CKD. Cardiovascular disease was a stronger predictive factor in younger than in older patients. For example, hypertension has an odds ratio of 2.02 amongst patients above average and an odds ratio of 3.91 amongst patients below average age. CONCLUSION: In England many cases of CKD remain undiagnosed. It is possible to use the results of this study to identify areas with high levels of undiagnosed CKD and groups at particular risk of having CKD

    The Primary Care Electronic Library: RSS feeds using SNOMED-CT indexing for dynamic content delivery

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    BACKGROUND: Rich Site Summary (RSS) feeds are a method for disseminating and syndicating the contents of a website using extensible mark-up language (XML). The Primary Care Electronic Library (PCEL) distributes recent additions to the site in the form of an RSS feed. When new resources are added to PCEL, they are manually assigned medical subject headings (MeSH terms), which are then automatically mapped to SNOMED-CT terms using the Unified Medical Language System (UMLS) Metathesaurus. The library is thus searchable using MeSH or SNOMED-CT. Our syndicate partner wished to have remote access to PCEL coronary heart disease (CHD) information resources based on SNOMED-CT search terms. OBJECTIVE: To pilot the supply of relevant information resources in response to clinically coded requests, using RSS syndication for transmission between web servers. METHOD: Our syndicate partner provided a list of CHD SNOMED-CT terms to its end-users, a list which was coded according to UMLS specifications. When the end-user requested relevant information resources, this request was relayed from our syndicate partner's web server to the PCEL web server. The relevant resources were retrieved from the PCEL MySQL database. This database is accessed using a server side scripting language (PHP), which enables the production of dynamic RSS feeds on the basis of Source Asserted Identifiers (CODEs) contained in UMLS. RESULTS: Retrieving resources using SNOMED-CT terms using syndication can be used to build a functioning application. The process from request to display of syndicated resources took less than one second. CONCLUSION: The results of the pilot illustrate that it is possible to exchange data between servers using RSS syndication. This method could be utilised dynamically to supply digital library resources to a clinical system with SNOMED-CT data used as the standard of reference

    The QICKD study protocol: a cluster randomised trial to compare quality improvement interventions to lower systolic BP in chronic kidney disease (CKD) in primary care

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    BACKGROUND: Chronic kidney disease (CKD) is a relatively newly recognised but common long-term condition affecting 5 to 10% of the population. Effective management of CKD, with emphasis on strict blood pressure (BP) control, reduces cardiovascular risk and slows the progression of CKD. There is currently an unprecedented rise in referral to specialist renal services, which are often located in tertiary centres, inconvenient for patients, and wasteful of resources. National and international CKD guidelines include quality targets for primary care. However, there have been no rigorous evaluations of strategies to implement these guidelines. This study aims to test whether quality improvement interventions improve primary care management of elevated BP in CKD, reduce cardiovascular risk, and slow renal disease progression DESIGN: Cluster randomised controlled trial (CRT) METHODS: This three-armed CRT compares two well-established quality improvement interventions with usual practice. The two interventions comprise: provision of clinical practice guidelines with prompts and audit-based education. The study population will be all individuals with CKD from general practices in eight localities across England. Randomisation will take place at the level of the general practices. The intended sample (three arms of 25 practices) powers the study to detect a 3 mmHg difference in systolic BP between the different quality improvement interventions. An additional 10 practices per arm will receive a questionnaire to measure any change in confidence in managing CKD. Follow up will take place over two years. Outcomes will be measured using anonymised routinely collected data extracted from practice computer systems. Our primary outcome measure will be reduction of systolic BP in people with CKD and hypertension at two years. Secondary outcomes will include biomedical outcomes and markers of quality, including practitioner confidence in managing CKD. A small group of practices (n = 4) will take part in an in-depth process evaluation. We will use time series data to examine the natural history of CKD in the community. Finally, we will conduct an economic evaluation based on a comparison of the cost effectiveness of each intervention. CLINICAL TRIALS REGISTRATION: ISRCTN56023731. ClinicalTrials.gov identifier

    CASNET2: Evaluation of an Electronic Safety Netting cancer toolkit for the primary care electronic health record: protocol for a pragmatic stepped-wedge RCT

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    Introduction: Safety-netting in primary care is the best practice in cancer diagnosis, ensuring that patients are followed up until symptoms are explained or have resolved. Currently, clinicians use haphazard manual solutions. The ubiquitous use of electronic health records provides an opportunity to standardise safety-netting practices. A new electronic safety-netting toolkit has been introduced to provide systematic ways to track and follow up patients. We will evaluate the effectiveness of this toolkit, which is embedded in a major primary care clinical system in England:Egerton Medical Information System(EMIS)-Web. Methods and analysis: We will conduct a stepped-wedge cluster RCT in 60 general practices within the RCGP Research and Surveillance Centre (RSC) network. Groups of 10 practices will be randomised into the active phase at 2-monthly intervals over 12 months. All practices will be activated for at least 2 months. The primary outcome is the primary care interval measured as days between the first recorded symptom of cancer (within the year prior to diagnosis) and the subsequent referral to secondary care. Other outcomes include referrals rates and rates of direct access cancer investigation. Analysis of the clustered stepped-wedge design will model associations using a fixed effect for intervention condition of the cluster at each time step, a fixed effect for time and other covariates, and then include a random effect for practice and for patient to account for correlation between observations from the same centre and from the same participant. Ethics and dissemination: Ethical approval has been obtained from the North West—Greater Manchester West National Health Service Research Ethics Committee (REC Reference 19/NW/0692). Results will be disseminated in peer-reviewed journals and conferences, and sent to participating practices. They will be published on the University of Oxford Nuffield Department of Primary Care and RCGP RSC websites

    Viscoelasticity near the gel-point: a molecular dynamics study

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    We report on extensive molecular dynamics simulations on systems of soft spheres of functionality f, i.e. particles that are capable of bonding irreversibly with a maximum of f other particles. These bonds are randomly distributed throughout the system and imposed with probability p. At a critical concentration of bonds, p_c approximately equal to 0.2488 for f=6, a gel is formed and the shear viscosity \eta diverges according to \eta ~ (p_c-p)^{-s}. We find s is approximately 0.7 in agreement with some experiments and with a recent theoretical prediction based on Rouse dynamics of phantom chains. The diffusion constant decreases as the gel point is approached but does not display a well-defined power law.Comment: 4 pages, 4 figure

    A structured registration program can be validly used for quality assessment in general practice

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    ABSTRACT: BACKGROUND: Patient information, medical history, clinical outcomes and demographic information, can be registered in different ways in registration programs. For evaluation of diabetes care, data can easily be extracted from a structured registration program (SRP). The usability of data from this source depends on the agreement of this data with that of the usual data registration in the electronic medical record (EMR). Aim of the study was to determine the comparability of data from an EMR and from an SRP, to determine whether the use of SRP data for quality assessment is justified in general practice. METHODS: We obtained 196 records of diabetes mellitus patients in a sample of general practices in the Netherlands. We compared the agreement between the two programs in terms of laboratory and non-laboratory parameters. Agreement was determined by defining accordance between the programs in absent and present registrations, accordance between values of registrations, and whether the differences found in values were also a clinically relevant difference. RESULTS: No differences were found in the occurrence of registration (absent/present) in the SRP and EMR for all the laboratory parameters. Smoking behaviour, weight and eye examination were registered significantly more often in the SRP than in the EMR. In the EMR, blood pressure was registered significantly more often than in the SRP. Data registered in the EMR and in the SRP had a similar clinical meaning for all parameters (laboratory and non-laboratory). CONCLUSIONS: Laboratory parameters showed good agreement and non-laboratory acceptable agreement of the SRP with the EMR. Data from a structured registration program can be used validly for research purposes and quality assessment in general practice
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