Increasing the Capacity of Primary Care Through Enabling Technology.

Primary care is the foundation of effective and high-quality health care. The role of primary care clinicians has expanded to encompass coordination of care across multiple providers and management of more patients with complex conditions. Enabling technology has the potential to expand the capacity for primary care clinicians to provide integrated, accessible care that channels expertise to the patient and brings specialty consultations into the primary care clinic. Furthermore, technology offers opportunities to engage patients in advancing their health through improved communication and enhanced self-management of chronic conditions. This paper describes enabling technologies in four domains (the body, the home, the community, and the primary care clinic) that can support the critical role primary care clinicians play in the health care system. It also identifies challenges to incorporating these technologies into primary care clinics, care processes, and workflow

The mainstreaming of university life: a critical examination of social justice policy at four Canadian universities

Bibliography: p. 261-28

Beyond the Born-Oppenheimer approximation: high-resolution overtone spectroscopy of H2D+ and D2H+

Transitions to overtone 2v2 and 2v3, and combination v2 + v3 vibrations in jet-cooled H2D+ and D2H+ molecular ions have been measured for the first time by high-resolution IR spectroscopy. The source of these ions is a pulsed slit jet supersonic discharge, which allows for efficient generation, rotational cooling, and high frequency (100 KHz) concentration modulation for detection via sensitive lock-in detection methods. Isotopic substitution and high-resolution overtone spectroscopy in this fundamental molecular ion permit a systematic, first principles investigation of Born–Oppenheimer "breakdown" effects due to large amplitude vibrational motion as well as provide rigorous tests of approximate theoretical methods beyond the Born–Oppenheimer level. The observed overtone transitions are in remarkably good agreement (<0.1 cm–1) with non-Born–Oppenheimer ab initio theoretical predictions, with small but systematic deviations for 2v2, 2v + 3v, and 2v3 excited states indicating directions for further improvement in such treatments. Spectroscopic assignment and analysis of the isotopomeric transitions reveals strong Coriolis mixing between near resonant 2v3 and 2v + 3v vibrations in D2H+. Population-independent line intensity ratios for transitions from common lower states indicate excellent overall agreement with theoretical predictions for D2H+, but with statistically significant discrepancies noted for H2D+. Finally, H2D+ versus D2H+ isotopomer populations are analyzed as a function of D2/H2 mixing ratio and can be well described by steady state kinetics in the slit discharge expansion

Flight Test Methodology for NASA Advanced Inlet Liner on 737MAX-7 Test Bed (Quiet Technology Demonstrator 3)

This paper describes the acoustic flight test results of an advanced nacelle inlet acoustic liner concept designed by NASA Langley, in a campaign called Quiet Technology Demonstrator 3 (QTD3). NASA has been developing multiple acoustic liner concepts to benefit acoustics with multiple-degrees of freedom (MDOF) honeycomb cavities, and lower the excrescence drag. Acoustic and drag performance were assessed at a lab-scale, flow duct level in 2016. Limitations of the lab-scale rig left open-ended questions regarding the in-flight acoustic performance. This led to a joint project to acquire acoustic flyover data with this new liner technology built into full scale inlet hardware containing the NASA MDOF Low Drag Liner. Boeing saw an opportunity to collect the acoustic flyover data on the 737 MAX-7 between certification tests at no impact to the overall program schedule, and successfully executed within the allotted time. The flight test methodology and the test configurations are detailed and the acoustic analysis is summarized in this paper. After the tone and broadband deltas associated with the inlet hardware were separated and evaluated, the result was a significant decrease in cumulative EPNL (Effective Perceived Noise Level)

Copper recovery in a bench-scale carrier facilitated tubular supported liquid membrane system

The extraction of copper ions in a tubular supported liquid membrane using LIX 984NC as a mobile carrier was studied, evaluating the effect of the feed characteristics (flowrate, density, viscosity) on the feedside laminar layer of the membrane. A vertical countercurrent, double pipe perspex benchscale reactor consisting of a single hydrophobic PVDF tubular membrane mounted inside was used in all test work. The membrane was impregnated with LIX 984NC and became the support for this organic transport medium. Dilute Copper solution passed through the centre pipe and sulphuric acid as strippant passed through the shell side. Copper was successfully transported from the feedside to the stripside and from the data obtained, a relationship between Schmidt, Reynolds and Sherwood number was achieved of

Manipulation of the Upper Respiratory Microbiota to Reduce Incidence and Severity of Upper Respiratory Viral Infections: A Literature Review.

There is a high incidence of upper respiratory viral infections in the human population, with infection severity being unique to each individual. Upper respiratory viruses have been associated previously with secondary bacterial infection, however, several cross-sectional studies analyzed in the literature indicate that an inverse relationship can also occur. Pathobiont abundance and/or bacterial dysbiosis can impair epithelial integrity and predispose an individual to viral infection. In this review we describe common commensal microorganisms that have the capacity to reduce the abundance of pathobionts and maintain bacterial symbiosis in the upper respiratory tract and discuss the potential and limitations of localized probiotic formulations of commensal bacteria to reduce the incidence and severity of viral infections

Acoustic Phased Array Quantification of Quiet Technology Demonstrator 3 Advanced Inlet Liner Noise Component

Acoustic phased array flyover noise measurements were acquired as part of the Boeing 737 MAX-7 NASA Advanced Inlet Liner segment of the Quiet Technology Demonstrator 3 (QTD3) flight test program. This paper reports on the processes used for separating and quantifying the engine inlet, exhaust and airframe noise source components and provides sample phased array-based comparisons of the component noise source levels associated with the inlet liner treatment configurations. Full scale flyover noise testing of NASA advanced inlet liners was conducted as part of the Quiet Technology Demonstrator 3 flight test program in July and August of 2018. Details on the inlet designs and testing are provided in the companion paper of Reference 1. The present paper provides supplemental details relating to the acoustic phased array portion of the analyses provided in Ref. 1. In brief, the test article was a Boeing 737MAX-7 aircraft with a modified right hand (starboard side) engine inlet, which consisted of either a production inlet liner, a NASA designed inlet liner or a simulated hard wall configuration (accomplished by applying speed tape over the inlet acoustic treatment areas). In all three configurations, the engine forward fan case acoustic panel was replaced with a unperforated (hardwall) panel. No other modifications to any other acoustic treatment areas were made. The left hand (port side) engine was a production engine and was flown at idle thrust for all measurements in order to isolate the effects of the inlet liners to the right hand engine. As described in Ref. 1, the NASA inlet treatment consists of laterally cut slots (cut perpendicular to the flow direction) which are designed to reduce excrescence drag while maintaining or exceeding the liner acoustic noise reduction capabilities. The NASA inlet liner consists of a Multi-Degree of Freedom (MDOF) design with two breathable septum layers inserted into each honeycomb cell [1]. The aircraft noise measurements were acquired for both takeoff (flaps 1 setting, gear up) and approach (flaps 30 gear up and gear down) configurations. The inlet and flight test configurations are summarized in Table 1. Table 1: Inlet Treatment and Flight Configurations Inlet Forward Fan Case Aircraft Production Hardwall Flaps 1, gear up; flaps 30 gear up; flaps 30 gear down NASA Hardwall Flaps 1, gear up; flaps 30 gear up; flaps 30 gear down Hardwall Hardwall Flaps 1, gear up; flaps 30 gear up; flaps 30 gear down III.Test Description and Hardware The flight testing was conducted at the Grant County airport in Moses Lake, WA, between 27 July and 6 August 2018. The noise measurement instrumentation included 8 flush dish microphones arranged in a noise certification configuration as well as an 840 microphone phased array. The flush dish microphones were used to quantify the levels and differences in levels between the various inlet treatments. The phased array was used to separate and quantify the narrowband (tonal) and broadband noise component levels from the engine inlet/exhaust and from the airframe. Phased array extraction of the broadband component was critical to this study because it allowed for the separation of the inlet component from the total airplane level noise even when it was significantly below the total level. Figure 1 provides an overview of the phased array microphone layout as well as a detailed image of an individual phased array microphone mounted in a plate holder (the microphone sensor is the dot in the center of the plate). The ground plane ensemble array microphones (referred to as ensemble array in this paper) were mounted in plates with flower petal edges designed to minimize edge scattering effects. Fig. 1 Flyover test microphone layout. The phased array configuration was the result of a progressive development of concepts originally implemented in Ref. 2 and refined over the following years, consisting namely of multiple multi-arm logarithmic spiral subarrays designed to cover overlapping frequency ranges and optimized for various aircraft emission angles. For the present case, the signals from all 840 microphones were acquired on a single system. The 840 microphones were parsed into 11 primary subarray sets spanning from smallest to largest aperture size and labeled accordingly as a, b, , k, where a corresponds to the smallest fielded subarray and k corresponds to the largest aperture subarray. The apertures ranged from approximately 10 ft to 427 ft in size (in the flight direction) with the subarrays consisting of between 215 and 312 microphones. Figure 2 shows three such subarrays, k, h and a. As done in Ref. 2, microphones were shared between subarrays in order to reduce total channel count. Fig. 2 Sample subarray sizes (20 from overhead refer to Figure 3a discussion). In addition to the above, each of the 11 primary subarray sets consisted of four subarrays optimized to provide near equivalent array spatial resolution in both the flight and lateral directions within 30 degrees of overhead (i.e., airplane directly above the center of the array), namely, at angles of 0, 10, 20 and 30 degrees relative to overhead where angle is defined as shown in Figure 3a. This allowed for optimized aircraft noise measurements from 60 to 120 degree emission angle.6 An example of this pletharray design is shown in Figure 3b for the k subarray. When the aircraft is at overhead, the microphones indicated by the blue markers are used for beamforming. When the aircraft is at angles 10 degrees from overhead, both the blue and red colored microphones are used, and so on for the 20 and 30 degree aircraft locations. See Ref. 3 for extensive details on pletharray design for aeroacoustic phased array testing. 6 In the discussions that follow, emission angle values are used. These are the angles at the time sound is emitted relative to the engine axis and are calculated based on flight path angle, body aircraft body angle with respect to the relative wind direction, and engine axis angle relative to aircraft body angle

Macroscopic authentication of Chinese materia medica (CMM): A UK market study of seeds and fruits

This small-scale macroscopic and quantitative authentication study, the first of its kind in the UK and elsewhere, assesses the identity and purity (excluding pesticides and heavy metals) of a selection of Chinese materia medica (CMM) seeds and fruits on the UK market. 25 fruit and seed CMM were chosen based on their inclusion in the Chinese Pharmacopoeia (2010, referred hereafter as ‘official species’), maximum dimension of 10 mm, and regular use in Traditional Chinese Medicine (TCM) practice in the UK according to UK practitioners. In 2012 samples were obtained from six TCM wholesale traders and eight retail dispensaries in southeast England. Macroscopic identity and purity testing was undertaken drawing on expertise at the Royal Botanic Gardens, Kew and its collection of vouchered CMM reference drugs, herbarium specimens and published identification texts. Of the 25 CMM requested from suppliers, 23 were obtained, represented by 211 samples. 191 samples were identified as being sourced from the correct drug; 20 were identified as sourced from unofficial species. Of the 191 correct samples, 5 displayed major contamination by other plant material, stones, earth, etc. (defined as > 5% of sample volume), and 12 had minor contamination (2–5%). 95% of samples derived from medicinally cultivated plants were sourced from an official species, 5% were contaminated; in contrast, 78% of wild-sourced CMM samples were sourced from an official species, and 14% showed contamination. These results aim to guide the further development of good practice in TCM herbal drug quality control, for which suggestions are provided