1,776 research outputs found
Respect, bullying, and public sector work outcomes in Vietnam
© 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This article examines empirical links between a subordinate’s felt recognition respect from his/her supervisor, the subordinate’s appraisal respect for that supervisor, and bullying, work engagement, and organizational citizenship behaviour in Vietnam’s public sector. Data from 274 employees in six branches of a public sector agency were used to test the hypothesized model. Within Vietnam’s public sector, the followers who receive recognition respect from the leaders have greater appraisal respect for their leaders, experience less bullying, and reveal higher work engagement and organizational citizenship behaviour. This article theoretically and empirically contributes to the respect literature developed in the Western context
Feasibility of Tomotherapy-Based Image-Guided Radiotherapy to Reduce Aspiration Risk in Patients with Non-Laryngeal and Non-Pharyngeal Head and Neck Cancer
PURPOSE: The study aims to assess the feasibility of Tomotherapy-based image-guided radiotherapy (IGRT) to reduce the aspiration risk in patients with non-laryngeal and non-hypopharyngeal cancer. A retrospective review of 48 patients undergoing radiation for non-laryngeal and non-hypopharyngeal head and neck cancers was conducted. All patients had a modified barium swallow (MBS) prior to treatment, which was repeated one month following radiotherapy. Mean middle and inferior pharyngeal dose was recorded and correlated with the MBS results to determine aspiration risk. RESULTS: Mean pharyngeal dose was 23.2 Gy for the whole group. Two patients (4.2%) developed trace aspiration following radiotherapy which resolved with swallowing therapy. At a median follow-up of 19 months (1-48 months), all patients were able to resume normal oral feeding without aspiration. CONCLUSION AND CLINICAL RELEVANCE: IGRT may reduce the aspiration risk by decreasing the mean pharyngeal dose in the presence of large cervical lymph nodes. Further prospective studies with IGRT should be performed in patients with non-laryngeal and non-hypopharyngeal head and neck cancers to verify this hypothesis
Fuzzy sliding mode control of an offshore container crane
© 2017 A fuzzy sliding mode control strategy for offshore container cranes is investigated in this study. The offshore operations of loading and unloading containers are performed between a mega container ship, called the mother ship, and a smaller ship, called the mobile harbor (MH), which is equipped with a container crane. The MH is used to transfer the containers, in the open sea, and deliver them to a conventional stevedoring port, thereby minimizing the port congestion and also eliminating the need of expanding outwards. The control objective during the loading and unloading process is to keep the payload in a desired tolerance in harsh conditions of the MH motion. The proposed control strategy combines a fuzzy sliding mode control law and a prediction algorithm based on Kalman filtering for the MH roll angle. Here, the sliding surface is designed to incorporate the desired trolley trajectory while suppressing the sway motion of the payload. To improve the control performance, the discontinuous gain of the sliding control is adjusted with fuzzy logic tuning schemes with respect to the sliding function and its rate of change. Chattering is further reduced by a saturation function. Simulation and experimental results are provided to verify the effectiveness of the proposed control system for offshore container cranes
Reduced Length of Stay in Major Hepatectomy Surgery After Implementation of an Enhanced Recovery Pathway in the United States Veteran Population
Introduction
Enhanced recovery after surgery (ERAS) pathways are associated with better postoperative recovery, however, evidence is lacking in major liver surgery, .This study aimed to evaluate the impact of an ERAS pathway in U.S. veterans undergoing major hepatectomy surgery. We hypothesized that the adoption of an ERAS pathway reduces decreased length of stay (LOS).
Methods
After approval from the Hunter Holmes McGuire VA Medical Center IRB, we compared data from consecutive patients undergoing elective open hepatectomy within an ERAS pathway (January 2019-December 2019) to a previous cohort of patients before introduction of ERAS (July 2016-December 2017). One surgeon performed all the procedures. LOS and perioperative narcotic usage were analyzed for both cohorts. Pre-operative components of the protocol included patient education, avoidance of bowel preparation, and consumption of clear carbohydrate drinks until two hours prior to surgery. Intraoperative measures included standardized anesthetic management, minimizing the use of opiates, and favoring regional anesthesia. Post-operative components included avoidance of nasogastric tubes, encouragement of liquids immediately after surgery, and early ambulation.
Results
A total of 24 patients were evaluated. Eight completed the ERAS pathway versus sixteen in the traditional group. There was a clinically significant reduction in LOS in the ERAS group (7.5 days +/- 4.9) compared to traditional care (10 +/- 5.9, p=0.07). Patient in the ERAS group also had lower intraoperative morphine equivalent consumption (65.6mg +/-38.6) than the control group (104.7mg +/- 38.7, p=0.04) and less need for postoperative PCA (0% vs 73%, p=0.00046).
Conclusion
The implementation of ERAS for major hepatectomy in a U.S. Veteran population translates into decreased LOS and perioperative opioid consumption
Feasibility of intensity-modulated and image-guided radiotherapy for locally advanced esophageal cancer
BACKGROUND:In this study the feasibility of intensity-modulated radiotherapy (IMRT) and tomotherapy-based image-guided radiotherapy (IGRT) for locally advanced esophageal cancer was assessed.METHODS:A retrospective study of ten patients with locally advanced esophageal cancer who underwent concurrent chemotherapy with IMRT (1) and IGRT (9) was conducted. The gross tumor volume was treated to a median dose of 70Gy (62.4-75Gy).RESULTS:At a median follow-up of 14months (1-39 months), three patients developed local failures, six patients developed distant metastases, and complications occurred in two patients (1 tracheoesophageal fistula, 1 esophageal stricture requiring repeated dilatations). No patients developed grade 3-4 pneumonitis or cardiac complications.CONCLUSIONS:IMRT and IGRT may be effective for the treatment of locally advanced esophageal cancer with acceptable complications.This item is part of the UA Faculty Publications collection. For more information this item or other items in the UA Campus Repository, contact the University of Arizona Libraries at [email protected]
Microwave-assisted noncatalytic esterification of fatty acid for biodiesel production: A kinetic study
© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This study developed a microwave-mediated noncatalytic esterification of oleic acid for producing ethyl biodiesel. The microwave irradiation process outperformed conventional heating methods for the reaction. A highest reaction conversion, 97.62%, was achieved by performing esterification with microwave irradiation at a microwave power of 150 W, 2:1 ethanol:oleic acid molar ratio, reaction time of 6 h, and temperature of 473 K. A second-order reaction model (R2 of up to 0.997) was established to describe esterification. The reaction rate constants were promoted with increasing microwave power and temperature. A strong linear relation of microwave power to pre-exponential factors was also established, and microwave power greatly influenced the reaction due to nonthermal effects. This study suggested that microwave-assisted noncatalytic esterification is an efficient approach for biodiesel synthesis
Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review
Job satisfaction among anesthetists in Ethiopia-a national cross-sectional study
Background Ethiopia has substantially increased production of associate clinician anesthetists. This study aimed to determine the level of and factors that predict job satisfaction among a national sample of anesthetists. Methods A cross-sectional study conducted in 2014 sampled 252 anesthetists. Respondents rated 37 items related to job satisfaction and working and living conditions using a Likert scale, which ranged from 1 (strongly disagree) to 5 (strongly agree). Univariate and multivariable logistic regressions were used to determine factors associated with the main outcome variable, level of job satisfaction. Adjusted odds ratios and 95% confidence intervals were calculated to show the magnitude of associations. Results Less than half (n = 107, 42.5%) of anesthetists were satisfied with their job. Work environment (aOR = 1.87, 95% CI = 1.06, 3.31) and more than 10 years of experience working in the public health system (aOR = 4.96, 95% CI = 1.11, 22.13) were predictors of job satisfaction in the multivariable model. Conclusion Ethiopian anesthetists have low levels of job satisfaction, with work environment and years of experience being factors that predict their satisfaction positively. Motivation and retention of this cadre will require emphasis on creating a safe and conducive work environment, and interventions designed to motivate junior anesthetists
The Location and Nature of General Anesthetic Binding Sites on the Active Conformation of Firefly Luciferase; A Time Resolved Photolabeling Study
Firefly luciferase is one of the few soluble proteins that is acted upon by a wide variety of general anesthetics and alcohols; they inhibit the ATP–driven production of light. We have used time–resolved photolabeling to locate the binding sites of alcohols during the initial light output, some 200 ms after adding ATP. The photolabel 3-azioctanol inhibited the initial light output with an IC50 of 200 µM, close to its general anesthetic potency. Photoincorporation of [3H]3-azioctanol into luciferase was saturable but weak. It was enhanced 200 ms after adding ATP but was negligible minutes later. Sequencing of tryptic digests by HPLC–MSMS revealed a similar conformation–dependence for photoincorporation of 3-azioctanol into Glu-313, a residue that lines the bottom of a deep cleft (vestibule) whose outer end binds luciferin. An aromatic diazirine analog of benzyl alcohol with broader side chain reactivity reported two sites. First, it photolabeled two residues in the vestibule, Ser-286 and Ile-288, both of which are implicated with Glu-313 in the conformation change accompanying activation. Second, it photolabeled two residues that contact luciferin, Ser-316 and Ser-349. Thus, time resolved photolabeling supports two mechanisms of action. First, an allosteric one, in which anesthetics bind in the vestibule displacing water molecules that are thought to be involved in light output. Second, a competitive one, in which anesthetics bind isosterically with luciferin. This work provides structural evidence that supports the competitive and allosteric actions previously characterized by kinetic studies
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