Alien Registration- Mckinley, Robert M. (Union, Knox County)

https://digitalmaine.com/alien_docs/12977/thumbnail.jp

Teaching and learning clinical reasoning: tutors' perceptions of change in their own clinical practice

BACKGROUND: Clinical reasoning is an important skill for all clinicians and historically has rarely been formally taught either at undergraduate or postgraduate level. Clinical reasoning is taught as a formal course in the fourth year of the undergraduate programme at Keele School of Medicine by tutors who are all practicing general practitioners. AIM: We aimed to explore the tutors' perceptions about how teaching on the course has impacted on their own consultation skills. DESIGN AND SETTING: All 11 course tutors who had taught on the course for at least one full academic year were invited to take part in recorded individual semi-structured interviews with an experienced, non-clinical, qualitative researcher. The data were analysed using qualitative methods. RESULTS: Eleven tutors participated, with a range of 7 to 32 years of clinical experience. They reported better decision-making, greater use of metacognition, more self-awareness, more reflective practice, more confidence and greater job satisfaction. They also reported positive impacts on their own knowledge and learning, and assumed concomitant benefits for their patients. CONCLUSION: All clinicians in this group perceived benefits on their consultation skills as a result of teaching clinical reasoning. There is a need to provide education, training and continuing professional development in cognitive consultation skills to students, trainees and established practitioners

Utilizing Dynamic Tensiometry to Quantify Contact Angle Hysteresis and Wetting State Transitions on Nonwetting Surfaces

Goniometric techniques traditionally quantify two parameters, the advancing and receding contact angles, that are useful for characterizing the wetting properties of a solid surface; however, dynamic tensiometry, which measures changes in the net force on a surface during the repeated immersion and emersion of a solid into a probe liquid, can provide further insight into the wetting properties of a surface. We detail a framework for analyzing tensiometric results that allows for the determination of wetting hysteresis, wetting state transitions, and characteristic topographical length scales on textured, nonwetting surfaces, in addition to the more traditional measurement of apparent advancing and receding contact angles. Fluorodecyl POSS, a low-surface-energy material, was blended with commercially available poly(methyl methacrylate) (PMMA) and then dip- or spray-coated onto glass substrates. These surfaces were probed with a variety of liquids to illustrate the effects of probe liquid surface tension, solid surface chemistry, and surface texture on the apparent contact angles and wetting hysteresis of nonwetting surfaces. Woven meshes were then used as model structured substrates to add a second, larger length scale for the surface texture. When immersed into a probe liquid, these spray-coated mesh surfaces can form a metastable, solid–liquid–air interface on the largest length scale of surface texture. The increasing hydrostatic pressure associated with progressively greater immersion depths disrupts this metastable, composite interface and forces penetration of the probe liquid into the mesh structure. This transition is marked by a sudden change in the wetting hysteresis, which can be systematically probed using spray-coated, woven meshes of varying wire radius and spacing. We also show that dynamic tensiometry can accurately and quantitatively characterize topographical length scales that are present on microtextured surfaces.United States. Air Force Office of Scientific Research (W 911NF-07-D-0004

Solution spraying of poly(methyl methacrylate) blends to fabricate microtextured, superoleophobic surfaces

We describe a simple technique to prepare superhydrophobic and superoleophobic microtextured surfaces by spray coating a blend of poly(methyl methacrylate) (PMMA) and the low surface energy molecule 1H,1H,2H,2H-heptadecafluorodecyl polyhedral oligomeric silsesquioxane (fluorodecyl POSS, γ[subscript sv] ≈ 10 mN/m) using an air brush with a pressurized nitrogen stream. Scanning electron micrographs show the formation of microtextured surfaces possessing re-entrant curvature; a critical feature for obtaining liquid repellency with low surface tension liquids. The surface morphology can be tuned systematically from a corpuscular or spherical microstructure to a beads-on-string structure and finally to bundled fibers by controlling the solution concentration and molecular weight of the sprayed polymer. The oleophobicity of the resulting structures is characterized by advancing and receding contact angle measurements with liquids of a range of surface tensions.United States. Army Research Office (Contract W911NF-07-D-0004)Air Force Research Laboratory (Wright-Patterson Air Force Base, Ohio). Propulsion DirectorateUnited States. Air Force Office of Scientific Researc

Astrophysical Adaptation of Points, the Precision Optical Interferometer in Space

POINTS (Precision Optical INTerferometer in Space) would perform microarcsecond optical astrometric measurements from space, yielding submicroarcsecond astrometric results from the mission. It comprises a pair of independent Michelson stellar interferometers and a laser metrology system that measures both the critical starlight paths and the angle between the baselines. The instrument has two baselines of 2 m, each with two subapertures of 35 cm; by articulating the angle between the baselines, it observes targets separated by 87 to 93 deg. POINTS does global astrometry, i.e., it measures widely separated targets, which yields closure calibration, numerous bright reference stars, and absolute parallax. Simplicity, stability, and the mitigation of systematic error are the central design themes. The instrument has only three moving-part mechanisms, and only one of these must move with sub-milliradian precision; the other two can tolerate a precision of several tenths of a degree. Optical surfaces preceding the beamsplitter or its fold flat are interferometrically critical; on each side of the interferometer, there are only three such. Thus, light loss and wavefront distortion are minimized. POINTS represents a minimalistic design developed ab initio for space. Since it is intended for astrometry, and therefore does not require the u-v-plane coverage of an imaging, instrument, each interferometer need have only two subapertures. The design relies on articulation of the angle between the interferometers and body pointing to select targets; the observations are restricted to the 'instrument plane.' That plane, which is fixed in the pointed instrument, is defined by the sensitive direction for the two interferometers. Thus, there is no need for siderostats and moving delay lines, which would have added many precision mechanisms with rolling and sliding parts that would be required to function throughout the mission. Further, there is no need for a third interferometer, as is required when out-of-plane observations are made. An instrument for astrometry, unlike those for imaging, can be compact and yet scientifically productive. The POINTS instrument is compact and therefore requires no deployment of precision structures, has no low-frequency (i.e., under 100 Hz) vibration modes, and is relatively easy to control thermally. Because of its small size and mass, it is easily and quickly repointed between observations. Further, because of the low mass, it can be economically launched into high Earth orbit which, in conjunction with a solar shield, yields nearly unrestricted sky coverage and a stable thermal environment

Layer-by-layer functionalized nanotube arrays: A versatile microfluidic platform for biodetection

We demonstrate the layer-by-layer (LbL) assembly of polyelectrolyte multilayers (PEM) on three-dimensional nanofiber scaffolds. High porosity (99%) aligned carbon nanotube (CNT) arrays are photolithographically patterned into elements that act as textured scaffolds for the creation of functionally coated (nano)porous materials. Nanometer-scale bilayers of poly(allylamine hydrochloride)/poly(styrene sulfonate) (PAH/SPS) are formed conformally on the individual nanotubes by repeated deposition from aqueous solution in microfluidic channels. Computational and experimental results show that the LbL deposition is dominated by the diffusive transport of the polymeric constituents, and we use this understanding to demonstrate spatial tailoring on the patterned nanoporous elements. A proof-of-principle application, microfluidic bioparticle capture using N-hydroxysuccinimide-biotin binding for the isolation of prostate-specific antigen (PSA), is demonstrated.National Science Foundation (U.S.) (Award DMR-0819762

Genetic versus Rearing-Environment Effects on Phenotype: Hatchery and Natural Rearing Effects on Hatchery- and Wild-Born Coho Salmon

With the current trends in climate and fisheries, well-designed mitigative strategies for conserving fish stocks may become increasingly necessary. The poor post-release survival of hatchery-reared Pacific salmon indicates that salmon enhancement programs require assessment. The objective of this study was to determine the relative roles that genotype and rearing environment play in the phenotypic expression of young salmon, including their survival, growth, physiology, swimming endurance, predator avoidance and migratory behaviour. Wild- and hatchery-born coho salmon adults (Oncorhynchus kisutch) returning to the Chehalis River in British Columbia, Canada, were crossed to create pure hatchery, pure wild, and hybrid offspring. A proportion of the progeny from each cross was reared in a traditional hatchery environment, whereas the remaining fry were reared naturally in a contained side channel. The resulting phenotypic differences between replicates, between rearing environments, and between cross types were compared. While there were few phenotypic differences noted between genetic groups reared in the same habitat, rearing environment played a significant role in smolt size, survival, swimming endurance, predator avoidance and migratory behaviour. The lack of any observed genetic differences between wild- and hatchery-born salmon may be due to the long-term mixing of these genotypes from hatchery introgression into wild populations, or conversely, due to strong selection in nature—capable of maintaining highly fit genotypes whether or not fish have experienced part of their life history under cultured conditions

Core components for effective infection prevention and control programmes: new WHO evidence-based recommendations

Abstract Health care-associated infections (HAI) are a major public health problem with a significant impact on morbidity, mortality and quality of life. They represent also an important economic burden to health systems worldwide. However, a large proportion of HAI are preventable through effective infection prevention and control (IPC) measures. Improvements in IPC at the national and facility level are critical for the successful containment of antimicrobial resistance and the prevention of HAI, including outbreaks of highly transmissible diseases through high quality care within the context of universal health coverage. Given the limited availability of IPC evidence-based guidance and standards, the World Health Organization (WHO) decided to prioritize the development of global recommendations on the core components of effective IPC programmes both at the national and acute health care facility level, based on systematic literature reviews and expert consensus. The aim of the guideline development process was to identify the evidence and evaluate its quality, consider patient values and preferences, resource implications, and the feasibility and acceptability of the recommendations. As a result, 11 recommendations and three good practice statements are presented here, including a summary of the supporting evidence, and form the substance of a new WHO IPC guideline

Satellite sensor requirements for monitoring essential biodiversity variables of coastal ecosystems

© The Author(s), 2018. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Ecological Applications 28 (2018): 749-760, doi: 10.1002/eap.1682.The biodiversity and high productivity of coastal terrestrial and aquatic habitats are the foundation for important benefits to human societies around the world. These globally distributed habitats need frequent and broad systematic assessments, but field surveys only cover a small fraction of these areas. Satellite‐based sensors can repeatedly record the visible and near‐infrared reflectance spectra that contain the absorption, scattering, and fluorescence signatures of functional phytoplankton groups, colored dissolved matter, and particulate matter near the surface ocean, and of biologically structured habitats (floating and emergent vegetation, benthic habitats like coral, seagrass, and algae). These measures can be incorporated into Essential Biodiversity Variables (EBVs), including the distribution, abundance, and traits of groups of species populations, and used to evaluate habitat fragmentation. However, current and planned satellites are not designed to observe the EBVs that change rapidly with extreme tides, salinity, temperatures, storms, pollution, or physical habitat destruction over scales relevant to human activity. Making these observations requires a new generation of satellite sensors able to sample with these combined characteristics: (1) spatial resolution on the order of 30 to 100‐m pixels or smaller; (2) spectral resolution on the order of 5 nm in the visible and 10 nm in the short‐wave infrared spectrum (or at least two or more bands at 1,030, 1,240, 1,630, 2,125, and/or 2,260 nm) for atmospheric correction and aquatic and vegetation assessments; (3) radiometric quality with signal to noise ratios (SNR) above 800 (relative to signal levels typical of the open ocean), 14‐bit digitization, absolute radiometric calibration <2%, relative calibration of 0.2%, polarization sensitivity <1%, high radiometric stability and linearity, and operations designed to minimize sunglint; and (4) temporal resolution of hours to days. We refer to these combined specifications as H4 imaging. Enabling H4 imaging is vital for the conservation and management of global biodiversity and ecosystem services, including food provisioning and water security. An agile satellite in a 3‐d repeat low‐Earth orbit could sample 30‐km swath images of several hundred coastal habitats daily. Nine H4 satellites would provide weekly coverage of global coastal zones. Such satellite constellations are now feasible and are used in various applications.National Center for Ecological Analysis and Synthesis (NCEAS); National Aeronautics and Space Administration (NASA) Grant Numbers: NNX16AQ34G, NNX14AR62A; National Ocean Partnership Program; NOAA US Integrated Ocean Observing System/IOOS Program Office; Bureau of Ocean and Energy Management Ecosystem Studies program (BOEM) Grant Number: MC15AC0000

Satellite Sensor Requirements for Monitoring Essential Biodiversity Variables of Coastal Ecosystems

The biodiversity and high productivity of coastal terrestrial and aquatic habitats are the foundation for important benefits to human societies around the world. These globally distributed habitats need frequent and broad systematic assessments, but field surveys only cover a small fraction of these areas. Satellite-based sensors can repeatedly record the visible and near-infrared reflectance spectra that contain the absorption, scattering, and fluorescence signatures of functional phytoplankton groups, colored dissolved matter, and particulate matter near the surface ocean, and of biologically structured habitats (floating and emergent vegetation, benthic habitats like coral, seagrass, and algae). These measures can be incorporated into Essential Biodiversity Variables (EBVs), including the distribution, abundance, and traits of groups of species populations, and used to evaluate habitat fragmentation. However, current and planned satellites are not designed to observe the EBVs that change rapidly with extreme tides, salinity, temperatures, storms, pollution, or physical habitat destruction over scales relevant to human activity. Making these observations requires a new generation of satellite sensors able to sample with these combined characteristics: (1) spatial resolution on the order of 30 to 100-m pixels or smaller; (2) spectral resolution on the order of 5 nm in the visible and 10 nm in the short-wave infrared spectrum (or at least two or more bands at 1,030, 1,240, 1,630, 2,125, and/or 2,260 nm) for atmospheric correction and aquatic and vegetation assessments; (3) radiometric quality with signal to noise ratios (SNR) above 800 (relative to signal levels typical of the open ocean), 14-bit digitization, absolute radiometric calibratio