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Emergency Medicine Palliative Care Access (EMPallA): Protocol for a multicentre randomised controlled trial comparing the effectiveness of specialty outpatient versus nurse-led telephonic palliative care of older adults with advanced illness
Introduction Emergency department (ED)-initiated palliative care has been shown to improve patient-centred outcomes in older adults with serious, life-limiting illnesses. However, the optimal modality for providing such interventions is unknown. This study aims to compare nurse-led telephonic case management to specialty outpatient palliative care for older adults with serious, life-limiting illness on: (1) quality of life in patients; (2) healthcare utilisation; (3) loneliness and symptom burden and (4) caregiver strain, caregiver quality of life and bereavement. Methods and analysis This is a protocol for a pragmatic, multicentre, parallel, two-arm randomised controlled trial in ED patients comparing two established models of palliative care: nurse-led telephonic case management and specialty, outpatient palliative care. We will enrol 1350 patients aged 50+ years and 675 of their caregivers across nine EDs. Eligible patients: (1) have advanced cancer (metastatic solid tumour) or end-stage organ failure (New York Heart Association class III or IV heart failure, end-stage renal disease with glomerular filtration rate /min/m2, or global initiative for chronic obstructive lung disease stage III, IV or oxygen-dependent chronic obstructive pulmonary disease); (2) speak English; (3) are scheduled for ED discharge or observation status; (4) reside locally; (5) have a working telephone and (6) are insured. Patients will be excluded if they: (1) have dementia; (2) have received hospice care or two or more palliative care visits in the last 6 months or (3) reside in a long-term care facility. We will use patient-level block randomisation, stratified by ED site and disease. Effectiveness will be compared by measuring the impact of each intervention on the specified outcomes. The primary outcome will measure change in patient quality of life. Ethics and dissemination Institutional Review Board approval was obtained at all study sites. Trial results will be submitted for publication in a peer-reviewed journal
Factorization in graviton interactions
The study of factorization in the linearized gravity is extended to the
graviton scattering processes with a massive scalar particle, with a massless
vector boson and also with a graviton. Every transition amplitude is shown to
be completely factorized and the physical implications of their common factors
are discussed.Comment: 5 pages, Revtex 3.0, SNUTP 93-7
Decoherence window and electron-nuclear cross-relaxation in the molecular magnet V 15
Rabi oscillations in the V_15 Single Molecule Magnet (SMM) embedded in the
surfactant DODA have been studied at different microwave powers. An intense
damping peak is observed when the Rabi frequency Omega_R falls in the vicinity
of the Larmor frequency of protons w_N, while the damping time t_R of
oscillations reaches values 10 times shorter than the phase coherence time t_2
measured at the same temperature. The experiments are interpreted by the N-spin
model showing that t_R is directly associated with the decoherence via
electronic/nuclear spin cross-relaxation in the rotating reference frame. It is
shown that this decoherence is accompanied with energy dissipation in the range
of the Rabi frequencies w_N - sigma_e < Omega_R < w_N, where sigma_e is the
mean super-hyperfine field (in frequency units) induced by protons at SMMs.
Weaker damping without dissipation takes place outside this dissipation window.
Simple local field estimations suggest that this rapid cross-relaxation in
resonant microwave field observed for the first time in SMMV_15 should take
place in other SMMs like Fe_8 and Mn_12 containing protons, too
Electron-hole asymmetry in Co- and Mn-doped SrFe2As2
Phase diagram of electron and hole-doped SrFe2As2 single crystals is
investigated using Co and Mn substitution at the Fe-sites. We found that the
spin-density-wave state is suppressed by both dopants, but the superconducting
phase appears only for Co (electron)-doping, not for Mn (hole)-doping. Absence
of the superconductivity by Mn-doping is in sharp contrast to the hole-doped
system with K-substitution at the Sr sites. Distinct structural change, in
particular the increase of the Fe-As distance by Mn-doping is important to have
a magnetic and semiconducting ground state as confirmed by first principles
calculations. The absence of electron-hole symmetry in the Fe-site-doped
SrFe2As2 suggests that the occurrence of high-Tc superconductivity is sensitive
to the structural modification rather than the charge doping.Comment: 7 pages, 6 figure
Mathematical modelling of nitrate removal from water using a submerged membrane adsorption hybrid system with four adsorbents
© 2018 by the authors. Excessive concentrations of nitrate in ground water are known to cause human health hazards. A submerged membrane adsorption hybrid system that includes a microfilter membrane and four different adsorbents (Dowex 21K XLT ion exchange resin (Dowex), Fe-coated Dowex, amine-grafted (AG) corn cob and AG coconut copra) operated at four different fluxes was used to continuously remove nitrate. The experimental data obtained in this study was simulated mathematically with a homogeneous surface diffusion model that incorporated membrane packing density and membrane correlation coefficient, and applied the concept of continuous flow stirred tank reactor. The model fit with experimental data was good. The surface diffusion coefficient was constant for all adsorbents and for all fluxes. The mass transfer coefficient increased with flux for all adsorbents and generally increased with the adsorption capacity of the adsorbents
Retraction notice: Influence of compressing pressure on macro void formation carbon monolith for methane adsorption
RETRACTION NOTICEOn 21rd February 2019, the Editorial Board of the Mongolian Journal of Chemistry decided to retract this article entitled "Influence of compressing pressure on macro void formation of carbon monolith for methane adsorption" because of an authorship dispute. The article was originally published in Vol.18 No.44 2017 pp.24-35. doi: https://doi.org/10.5564/mjc.v18i44.93
Influence of compressing pressure on macro void formation of carbon monolith for methane adsorption
Carbon monoliths for adsorbed natural gas (ANG) storage were prepared from Mongolian anthracite-based activated carbons using carboxy-methyl cellulose as a binder under different compressing pressures. Nitrogen adsorption/desorption experiments were carried out to obtain the specific surface area, pore volume, and pore size distribution of the monoliths. Methane adsorption experiments on the carbon monoliths were conducted at different temperatures and pressures up to around 3.5 MPa in a high pressure volumetric adsorption apparatus. As expected, adsorption results indicated that the methane adsorption capacity of the carbon monoliths increased with increasing specific surface area and packing density. The maximum volumetric adsorption of methane was observed as 163 V/V at 293 K and 3.5 MPa on a carbon monolith sample, PMAC1/2-3-65, that does not have the highest specific surface area but relatively high packing density comparing with other monoliths, which implies that two physical properties contribute contradictorily to the methane adsorption capacity. Based on experimental results, the carbon monoliths prepared from Mongolian anthracite-based activated carbons can be promising media for ANG storage application
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