Annotated Bibliography: Understanding Ambulatory Care Practices in the Context of Patient Safety and Quality Improvement.

The ambulatory care setting is an increasingly important component of the patient safety conversation. Inpatient safety is the primary focus of the vast majority of safety research and interventions, but the ambulatory setting is actually where most medical care is administered. Recent attention has shifted toward examining ambulatory care in order to implement better health care quality and safety practices. This annotated bibliography was created to analyze and augment the current literature on ambulatory care practices with regard to patient safety and quality improvement. By providing a thorough examination of current practices, potential improvement strategies in ambulatory care health care settings can be suggested. A better understanding of the myriad factors that influence delivery of patient care will catalyze future health care system development and implementation in the ambulatory setting

Flight Control Research Laboratory Unmanned Aerial System flying in turbulent air: an algorithm for parameter identification from flight data

This work addresses the identification of the dynamics of the research aircraft FCRL (Flight Control Research Laboratory) used for the Italian National Research Project PRIN2008 accounting for atmospheric turbulence. The subject vehicle is an unpressurized 2 seats, 427 kg maximum take of weight aircraft. It features a non retractable, tailwheel, landing gear and a powerplant made up of reciprocating engine capable of developing 60 HP, with a 60 inches diameter, two bladed, fixed pitch., tractor propeller. The aircraft stall speed is 41.6 kts, therefore it is capable of speeds up to about 115 kts (Sea level) and it will be cleared for altitudes up to 10.000 ft. The studied aircraft is equipped with a research avionic system composed by sensors and computers and their relative power supply subsystem. In particular the Sensors subsystem consists of : \uf02d Inertial Measurement Unit (three axis accelerometers and gyros) \uf02d Magnetometer (three axis) \uf02d Air Data Boom (static and total pressure port, vane sense for angle of attack and sideslip) \uf02d GPS Receiver and Antenna \uf02d Linear Potentiometers (Aileron, Elevator, Rudder and Throttle Command) \uf02d RPM (Hall Effect Gear Tooth Sensor) \uf02d Outside air temperature Sensor A nonlinear mathematical model of the subject aircraft longitudinal dynamics, has been tuned up through semi empirical methods, numerical simulations and ground tests. To taking into account the atmospheric turbulence the identification problem addressed in this work is solved by using the Filter error method approach .In this case, the mathematical model is given by the stochastic equations: \uf028 \uf029 \uf028 \uf028 \uf029 \uf028 \uf029 \uf028 \uf029 \uf029 \uf028 \uf029 \uf028 \uf028 \uf029 \uf028 \uf029 \uf029 \uf028 \uf029 \uf028 \uf029 \uf028 \uf029 \uf028 \uf029 0 0 , , , , , x t f x t u t w t y t h x t u t z k y k v k x t x \uf071 \uf071 \uf03d \uf03d \uf03d \uf02b \uf03d (1) where x is the state vector, u is the control input vector, f and h are dimensional general nonlinear vector functions, \uf071\uf020\uf020contains the unknown system parameters, z is the measurement vector ,w is the process noise and v(k) is the measurement noise. The presence of nonmeasurable process noise requires a suitable state estimator to propagate the states. To take into account model nonlinearities in the present paper an Extended Kalman Filter has been implemented as the estimation algorithm

Automatic Landing System for Civil Unmanned Aerial System

In spite of a number of potentially valuable civil UAS applications The International Regulations prohibit UAS from operating in the National Air Space. Maybe the primary reasons are safety concerns. In fact their ability to respond to emergent situations involving the loss of contact between the aircraft and the ground station poses a serious problem. Therefore, to an efficient safe insertion of UAS in the Civil Air Transport System one important element is their ability to perform automatic landing afterwards the failure. Moreover, the mathematical model of ground effect is usually neither included in the model of the aircraft during takeoff and landing nor in the design requirements of the control system Usually two different mathematical models of the aircraft are used during landing: the first Out the Ground Effect (OGE) and the second In Ground Effect (IGE). The objective of this paper is to design a longitudinal automatic landing system taking ground effect into account. The designed control system will be tested and implemented on board by using the Preceptor N3 Ultrapup aircraft. In fact, such aircraft is used as technological demonstrator of new control navigation and guidance algorithms in the context of \u201cResearch Project of National Interest\u201d (PRIN 2008) by Universities of Bologna, Palermo, Ferrara and the Second University of Naples. First of all, a general mathematical model of the studied aircraft is built to obtain non \u2013 linear analytical equations for aerodynamic coefficients both Out of Ground Effect and In Ground Effect conditions. According to previous researches, aerodynamic characteristics of the aircraft , have been modelled by means of hyperbolic equations in the whole flight envelope. So it is possible to use a single model during the whole landing phase taking into account the actual ground effect. To overcome the difficulties due to the use of nonlinear models of the aircraft in ground effect for designing the controller, the control system has been designed using the following approach: \uf02d The Landing flight path has been divided into two segments: the descending path for aircraft altitudes h > b (OGE) and the flare for h <= b ( IGE); \uf02d The flare manoeuvre starts for h = b; \uf02d An acceptable number of linear models has been obtained by means of linearization of the original nonlinear model in various flight conditions; \uf02d A modified gain scheduling approach has been employed for the synthesis of the controller. It is made by six PID and by a supervisor. This one, by using the actual flight altitude, schedules the set of gains to be inserted online, depending on the real flight condition. Several tests have been carried out by means of simulation, in Matlab Simulink environment. The obtained results show a good accuracy of the control system for trajectory tracking in ground proximity. Further developments of the present research will be the extension of the designed control system to the take-off phase. Afterwards the aircraft model will be improved by evaluating both lateral stability derivatives variations In Ground Effect and the bank angle derivatives (\uf066\uf020derivatives). The present methodology will be employed to design a Lateral Automatic Landing System. The obtained results could be used later on, with the purpose to realize a fully autonomous UAS

Temperature dependent orbital degree of freedom in a bilayer manganite by magnetic Compton scattering

We have measured temperature-dependent magnetic Compton profiles (MCPs) from a single crystal of La$_{1.2}$Sr$_{1.8}$Mn$_2$O$_7$. The MCPs, which involved the scattering of circularly polarized x-rays, are in general related to the momentum density of all the unpaired spins in the system. Nevertheless, we show that when the x-ray scattering vector lies along the [110] direction, the number of magnetic electrons of a specific symmetry, i.e. $d$-electrons of $x^2-y^2$ symmetry, yield a distinct signature in the MCP, allowing us to monitor substantial changes in the occupancy of the $d_{x^2-y^2}$ states over the investigated temperature range of 5-200K. This study indicates that magnetic Compton scattering can provide a powerful window on the properties of specific magnetic electrons in complex materials.Comment: 5 pages, 4 figures, to appear in Phys. Rev. Let

Does It Really Matter?: Making the Case for a Materiality Requirement in False Claims to U.S. Citizenship Under the Immigration and Nationality Act

Materiality plays an important role in limiting the reach of laws that penalize misrepresentations. Laws that include no materiality element punish any covered misrepresentation regardless of its relevance—like lying about hair color on a loan application. By contrast, laws that include a materiality element withhold punishment for immaterial misrepresentations of that kind—in other words, misrepresentations that have no tendency to affect the ultimate decision.Our immigration laws make it a deportable offense for a noncitizen to “falsely represent” herself as a U.S. citizen for a purpose or benefit under the law. Although this law has been on the books for decades, a key question about its reach remains open: Does it include a materiality element? The Board of Immigration Appeals and three federal circuit courts have said “yes,” holding that misrepresentations of U.S. citizenship must be material to trigger deportability. But in a recent panel decision adopted by the en banc court, the Eleventh Circuit said “no,” holding that the unambiguous statutory text includes no materiality element.This Article examines the history of these immigration statutes and demonstrates why the Eleventh Circuit’s holding was wrong, although mainly for a reason no court has yet addressed: the common-law origins of the relevant statutory text. Under well-established principles of statutory construction, Congress is presumed to legislate with the understanding that common-law phrases carry their common-law meaning. At common law, the phrase “false representation” carried with it an implicit materiality element. Therefore, the immigration statutes at issue presumptively incorporate materiality because they penalize “false representations” of U.S. citizenship. This presumption is confirmed by other contextual clues. And, as this Article explains, ensuring fidelity to the statutes’ implicit materiality element is especially important given the statutes’ breadth and the draconian consequences that follow from the Eleventh Circuit’s contrary holding

Effect of energy density and virginiamycin supplementation in diets on growth performance and digestive function of finishing steers.

ObjectiveThis study was determined the influence of virginiamycin supplementation on growth-performance and characteristics of digestion of cattle with decreasing dietary net energy value of the diet for maintenance (NEm) from 2.22 to 2.10 Mcal/kg.MethodsEighty crossbred beef steers (298.2±6.3 kg) were used in a 152-d performance evaluation consisting of a 28-d adaptation period followed by a 124-d growing-finishing period. During the 124-d period steers were fed either a lesser energy dense (LED, 2.10 Mcal/kg NEm) or higher energy dense (HED, 2.22 Mcal/kg NEm) diet. Diets were fed with or without 28 mg/kg (dry matter [DM] basis) virginiamycin in a 2×2 factorial arrangement. Four Holstein steers (170.4±5.6 kg) with cannulas in the rumen (3.8 cm internal diameter) and proximal duodenum were used in 4×4 Latin square experiment to study treatment effects on characteristics of digestion.ResultsNeither diet energy density nor virginiamycin affected average daily gain (p&gt;0.10). As expected, dry matter intake and gain efficiency were greater (p&lt;0.01) for LED- than for HED-fed steers. Virginiamycin did not affect estimated net energy value of the LED diet. Virginiamycin increased estimated NE of the HED diet. During daylight hours when the temperature humidity index averaged 81.3±2.7, virginiamycin decreased (p&lt;0.05) ruminal temperature. Virginiamycin did not influence (p&gt;0.10) ruminal or total tract digestion. Ruminal (p = 0.02) and total tract digestion (p&lt;0.01) of organic matter, and digestible energy (p&lt;0.01) were greater for HED vs LED. Ruminal microbial efficiency was lower (p&lt;0.01) for HED vs LED diets.ConclusionThe positive effect of virginiamycin on growth performance of cattle is due to increased efficiency of energy utilization, as effects of virginiamycin on characteristics of digestion were not appreciable. Under conditions of high ambient temperature virginiamycin may reduce body temperature

Influence of ruminal degradable intake protein restriction on characteristics of digestion and growth performance of feedlot cattle during the late finishing phase.

Two trials were conducted to evaluate the influence of supplemental urea withdrawal on characteristics of digestion (Trial 1) and growth performance (Trial 2) of feedlot cattle during the last 40 days on feed. Treatments consisted of a steam-flaked corn-based finishing diet supplemented with urea to provide urea fermentation potential (UFP) of 0, 0.6, and 1.2%. In Trial 1, six Holstein steers (160 ± 10 kg) with cannulas in the rumen and proximal duodenum were used in a replicated 3 × 3 Latin square experiment. Decreasing supplemental urea decreased (linear effect, P ≤ 0.05) ruminal OM digestion. This effect was mediated by decreases (linear effect, P ≤ 0.05) in ruminal digestibility of NDF and N. Passage of non-ammonia and microbial N (MN) to the small intestine decreased (linear effect, P = 0.04) with decreasing dietary urea level. Total tract digestion of OM (linear effect, P = 0.06), NDF (linear effect, P = 0.07), N (linear effect, P = 0.04) and dietary DE (linear effect, P = 0.05) decreased with decreasing urea level. Treatment effects on total tract starch digestion, although numerically small, likewise tended (linear effect, P = 0.11) to decrease with decreasing urea level. Decreased fiber digestion accounted for 51% of the variation in OM digestion. Ruminal pH was not affected by treatments averaging 5.82. Decreasing urea level decreased (linear effect, P ≤ 0.05) ruminal N-NH and blood urea nitrogen. In Trial 2, 90 crossbred steers (468 kg ± 8), were used in a 40 d feeding trial (5 steers/pen, 6 pens/ treatment) to evaluate treatment effects on final-phase growth performance. Decreasing urea level did not affect DMI, but decreased (linear effect, P ≤ 0.03) ADG, gain efficiency, and dietary NE. It is concluded that in addition to effects on metabolizable amino acid flow to the small intestine, depriving cattle of otherwise ruminally degradable N (RDP) during the late finishing phase may negatively impact site and extent of digestion of OM, depressing ADG, gain efficiency, and dietary NE