Improving specialised care for neuromuscular patients reduces the frequency of preventable emergency hospital admissions

Two retrospective audits were undertaken across several hospitals to understand the frequency and preventability of emergency admissions in people with neuromuscular disease (NMD). Following audit 1 (A1), a number of preventable themes emerged on the basis of which recommendations were made to improve quality and co-ordination of care and a network approach was developed to improve awareness and education amongst patients and non-expert professionals. Audit 2 (A2) was undertaken to determine the effect of these measures. The central NHS IT database identified emergency NMD admissions. Case notes were reviewed and audited against pre-agreed criteria. A1 included 576 admissions (395 patients) A2 included 361 admissions (314 patients). Preventable admissions (where an NMD was known) accounted for 63% in A1 and 33% in A2, with more patients followed up at a specialized neuromuscular centre in A2. There were fewer re-admissions in A2 (12%) compared with A1 (25%) and lower mortality (A1: 4.5%, A2: 0.3%). A2 showed a significant rise in patients admitted under the care of neuroscience during the acute admission and fewer preventable ITU admissions. These audits demonstrate a significant impact for both patient care and potential for financial savings following the implementation of recommendations made after A1

Pass-by characterization of noise emitted by different categories of seagoing ships in ports

In the light of sustainability, satisfactory living conditions is an important factor for people's positive feedback in their own living environment. Acoustic comfort and noise exposure should then be carefully monitored in all human settlements. Furthermore, it is already well-known that high or prolonged noise levels may lead to unwanted health effects. Unfortunately, while in the last decades scientists and public authorities have investigated the noise produced by roads, trains, and airports, not enough efforts have been spent in studying what happens around the coastal and port areas. Following the attention brought to the subject by recent European projects on noise in port areas, the present paper characterizes the sound power level and 1/3 octave band sound power spectrum of seagoing ships while moving at low speeds. Five different categories have been distinguished: Roll-on/roll-off (RORO), container ship, oil tanker, chemical tanker, and ferry. The analysis is based on a continuous noise measurement lasting more than three months, performed in the industrial canal of the port of Livorno (Italy). The resulting noise emissions are new and useful data that could be inserted in acoustic propagation models to properly assess the noise in the areas affected by port activities. Thus, the present work can act as a supporting tool in planning ship traffic in ports towards better sustainability

Oral health conditions in an Albanian adolescent population: An epidemiological study

The aim of this study was to determine the oral health conditions of an adolescent population of Tirana

Parameters affecting noise emitted by ships moving in port areas

Only recently has noise been considered in the assessment of the sustainability of port infrastructures, after decades of unawareness. INTERREG Maritime projects unveiled problems that have been neglected so far, such as the lack of proper regulation and noise exposure assessments for citizens. While it is true that a port area includes a huge variety of possible noise sources, very few of them have been characterized from an acoustical point of view. INTERREG projects have boosted research in the field, and previous studies have dealt with noise produced by moving ships in ports. The present work starts from a previous measurement campaign used to obtain broadband and 1/3-octave-band noise emissions of moving ships, and it aims to explain their uncertainties. More than a month’s worth of continuous acoustic measurements and video recordings were deeply analyzed in order to obtain an input database that is as precise as possible. A multiple regression analysis was performed in order to understand the influence that parameters such as minimum distance, speed, and draught have on ships’ noise emissions, which were calculated using pass-by measurements, with a special focus on ferries. The minimum distance of each ship’s passage from the microphone was measured using a video recording with an innovative methodology, providing results with 3 m of uncertainty. Knowing which parameter is more influential would help in planning proper measurements for monitoring or for drafting correct guidelines. Draught was determined to be uninfluential in ferries’ noise emissions, while the minimum distance and speed relations were estimated and accounted for in the calculation of a refined sound power level. From a spectrum point of view, the frequencies from 500 Hz to 2.5 kHz were determined to be those that contributed the most to the noise produced by the transit of a ship, and they vary with speed. With the studied corrections, different ferry models resulted in similar noise emissions. The standard deviation of noise emitted was reduced by 0.5 dB (A), and the average was also improved by positioning the ships’ flow at the correct average minimum distance. Furthermore, the right placement of a source is also important in the acoustic mapping phase for a correct evaluation of the propagation of noise at a distance. The use of more precise input data is important for improving the output of acoustic propagation models during the assessment of port noise in the surrounding areas

Investigation of stress-induced (100) platelet formation and surface exfoliation in plasma hydrogenated Si

We have studied the mechanisms underlying stress-induced platelet formation during plasma hydrogenation. The stress is purposely introduced by a buried SiGe stained layer in a Si substrate. During plasma hydrogenation, diffusing H is trapped in the region of the SiGe layer and H platelets are formed. The platelet orientation is controlled by the in-plane compressive stress, which favors nucleation and growth of platelets in the plane of stress and parallel to the substrate surface, and ultimately leads to controlled fracture along the SiGe layer. Also, the SiSiGeSi structure is found to be more efficient in utilizing H for platelet formation and growth compared to H ion implanted Si because there are fewer defects to trap H (e.g., Vn Hm and In Hm); therefore, the total H dose needed for layer exfoliation is greatly reduced. © 2007 American Institute of Physics

The road to developing economically feasible plans for green, comfortable and energy efficient buildings

Owing to the current challenges in energy and environmental crises, improving buildings, as one of the biggest concerns and contributors to these issues, is increasingly receiving attention from the world. Due to a variety of choices and situations for improving buildings, it is important to review the building performance optimization studies to find the proper solution. In this paper, these studies are reviewed by analyzing all the different key parameters involved in the optimization process, including the considered decision variables, objective functions, constraints, and case studies, along with the software programs and optimization algorithms employed. As the core literature, 44 investigations recently published are considered and compared. The current investigation provides sufficient information for all the experts in the building sector, such as architects and mechanical engineers. It is noticed that EnergyPlus and MATLAB have been employed more than other software for building simulation and optimization, respectively. In addition, among the nine different aspects that have been optimized in the literature, energy consumption, thermal comfort, and economic benefits are the first, second, and third most optimized, having shares of 38.6%, 22.7%, and 17%, respectively

Design of an epithermal column for BNCT based on D–D fusion neutron facility

Abstract Boron Neutron Capture Therapy (BNCT) is currently performed on patients at nuclear reactors. At the same time the international BNCT community is engaged in the development of alternative facilities for in-hospital treatments. This paper investigates the potential of a novel high-output D–D neutron generator, developed at Lawrence Berkeley National Laboratory (CA, USA), for BNCT. The simulation code MCNP-4C is used to realize an accurate study of the epithermal column in view of the treatment of deep tumours. Different materials and Beam Shaping Assemblies (BSA) are investigated and an optimized configuration is proposed. The neutron beam quality is defined by the standard free beam parameters, calculated averaging over the collimator aperture. The results are discussed and compared with the performances of other facilities

Fostering collaborative knowledge construction with visualization tools

This study investigates to what extent collaborative knowledge construction can be fostered by providing students with visualization tools as structural support. Thirty-two students of Educational Psychology took part in the study. The students were subdivided into dyads and asked to solve a case problem of their learning domain under one of two conditions: 1) with content-specific visualization 2) with content-unspecific visualization. Results show that by being provided with a content-specific visualization tool, both the process and the outcome of the cooperative effort improved. More specifically, dyads under that condition referred to more adequate concepts, risked more conflicts, and were more successful in integrating prior knowledge into the collaborative solution. Moreover, those learning partners had a more similar individual learning outcome

Ab Initio Construction of Interatomic Potentials for Uranium Dioxide Across all Interatomic Distances

We provide a methodology for generating interatomic potentials for use in classical molecular dynamics simulations of atomistic phenomena occurring at energy scales ranging from lattice vibrations to crystal defects to high energy collisions. A rigorous method to objectively determine the shape of an interatomic potential over all length scales is introduced by building upon a charged-ion generalization of the well-known Ziegler-Biersack-Littmark universal potential that provides the short- and long-range limiting behavior of the potential. At intermediate ranges the potential is smoothly adjusted by fitting to ab initio data. Our formalism provides a complete description of the interatomic potentials that can be used at any energy scale, and thus, eliminates the inherent ambiguity of splining different potentials generated to study different kinds of atomic materials behavior. We exemplify the method by developing rigid-ion potentials for uranium dioxide interactions under conditions ranging from thermodynamic equilibrium to very high atomic energy collisions relevant for fission events.Comment: Figure 4c correcte