Web based nursing home information system : needs, benefits, and success in providing efficient care at long term care facilities

The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file.Title from PDF of title page (University of Missouri--Columbia, viewed on April 15, 2011).Vita.Thesis advisor: Mihail Popescu"December 2010"M.S. University of Missouri-Columbia 2010.Most of the nursing homes in the United States do not have clinical information systems at their facility due to which elderly people who reside in the facilities are not reaping the benefits that these systems are thought to have. Some Nursing homes that do have clinical information systems deployed are not primarily designed to support nursing care coordination. The purpose of this study is to explore the emerging need for Nursing Home Information Systems (NHIS) in long term care facilities and the promise they hold for increased efficiency, better accuracy, reduced cost, and improved outcomes. This study reports a pilot research done in development of a home-grown, web based, nursing home electronic health record (EHR) system for Aging in Place - TigerPlace; an independent housing with services facility, licensed assisted living facility, located in Columbia, Missouri. With Internet becoming an important topic in health care industry due to its capability for increased accessibility to information, a web based information system proves more beneficial to organizations. The emergence of World Wide Web technology constitutes one significant milestone on the road to efficient developments and deployment of clinically useful systems (Kittredge et al., 1996). Considering these benefits of web technology, this study first analyzes differences between traditional stand alone clinical systems and web based clinical systems. Further study concentrates on the need for TigerPlace facility to develop and implement a web based clinical information system, the process adopted towards developing the required system, its implementation and use at the facility, success of the system, and future enhancement possibilities for the system.Includes bibliographical references (p. 37-40)

Assessment of Basal Metabolic Rate (BMR) w.s.r. to Dwandwaja Prakriti

Introduction: Prakriti (constitution) is formed at the time of union of sperm and ovum inside the womb. Predominance of Doshas (Bio-energies) at the time of fertilization determines the physical and mental characters. Ayurveda classifies human beings into three distinct types: Vata, Pitta and Kapha with multiple subtypes. According to Ayurveda physiological function of body depends upon the three Doshas and in modern science calories are needed to perform body function which is calculated by BMR. The study was designed to asses BMR with respect to Prakriti. Materials and Methods: For this present Observational and Analytical study, 60 female volunteers were selected between 18 to 30 yrs. Prakriti Pariksha was done by questionnaire and six groups were made. BMR was calculated. Results: It was observed that the P value is < 0.0001, which is extremely significant. Discussion: By statistical analysis it was concluded that BMR is significantly different in Dwandwaja Prakriti. From the analyzed data, it is found that Kapha Vata Prakriti persons have maximum BMR and Vata Pitta Prakriti persons have minimum BMR

Plastic Deformation of High Explosive Projectile 155 mm during Gun Launch Conditions using Finite Element Method

The structural integrity of artillery projectile 155mm high explosive Extended Range Full Bore (ERFB)boat tail designed for 155mm howitzer guns of 39, 45 and 52 calibre plays a key role inside the gun barrel. Thisprojectile comprises a shell body, a driving band, a boat tail, nubs, an explosive, and a fuze. Plastic deformationof the projectile and stripping of driving band are not permitted, when projectile is fired. An investigational study is necessitated to check the plastic deformation of the projectile subjected to maximum propellant charge pressure.The aim of this study is to check the effective plastic deformation and affirm the structural integrity. A 3-D explicit dynamic structural analysis of 155 mm HE ERFB BT during gun launch conditions is carried out by finite element method using FE code ABAQUS/Explicit. To understand the non-linear mechanical behavior of the projectile, the true stress-strain curves of the materials are considered. The plastic behavior of the projectile subjected to the time-dependent loading is studied by using the von Mises plasticity model. The results reveal that the shell body and boat tail have no plastic deformation and the most stressed component is the driving band. The investigation has affirmed the structural integrity of the projectile during gun launch conditions

Consumer Preference for Eco-Friendly Products in Relation to Sustainability Awareness

This Research overarching goal is to assess how much sustainability education influences shoppers' decisions to buy green goods. The purpose of this research is to learn how customers' concerns about the environment and the need to make sustainable purchases influence their preferences. A survey distributed nationally will be used to collect data from customers. The poll will inquire as to the extent, to which consumers are concerned with environmental issues, the value they place on eco-friendly goods and their purchase patterns. The research will employ regression analysis to find links between sustainability consciousness and green product preference. Marketers and politicians can benefit greatly from this study's findings by learning more about how to promote eco-friendly products and increase sustainable consumption. Also, in the context of emerging economies, this study will add to the expanding body of literature on sustainability and consumer behaviour

Shape Optimization of an Asymmetric Airfoil for Low Wind Speed Region having Adjoint-Based Optimization Technique

The land needed to install wind turbines is shrinking as power generation from renewable energy sources increases significantly. A large number of studies are being conducted to maximize the power extraction from wind turbines in areas with low wind speeds. Wind turbine blades play a significant role in utilizing the maximum amount of energy from the wind. The aerodynamic performance of a wind turbine blade depends on the airfoil shape. The shape optimization of an asymmetric S2027 airfoil for a low wind speed region was investigated using the adjoint-based optimization technique. The primary objectives of this study were to maximize the lift coefficient, minimize the drag coefficient, and maximize the lift-to-drag ratio. The optimization is based on the adjoint method for Reynolds number variation in the range of 2 × 105 to 5 × 105 and an angle of attack variation from 0° to 12°. A two-dimensional Reynolds–Averaged Navier–Strokes Computational Fluid Dynamics model was created with all the operating parameters and used for optimization. The aerodynamic performance was validated experimentally. For each optimization function, approximately 16 shapes were obtained. The aerodynamic performance for each optimized shape was determined under different operating conditions. Different airfoil shapes with a specific chord, leading and trailing edges, and span arrangement was obtained. The drag coefficient was reduced by 2%–30%; the lift coefficient was improved by 2%–35%, and the lift-to-drag ratio was improved up to 40%

Mycobacterium tuberculosis MycP1 Protease Plays a Dual Role in Regulation of ESX-1 Secretion and Virulence

SummaryMycobacterium tuberculosis uses the ESX-1 secretion system to deliver virulence proteins during infection of host cells. Here we report a mechanism of posttranscriptional control of ESX-1 mediated by MycP1, a M. tuberculosis serine protease. We show that MycP1 is required for ESX-1 secretion but that, unexpectedly, genetic inactivation of MycP1 protease activity increases secretion of ESX-1 substrates. We demonstrate that EspB, an ESX-1 substrate required for secretion, is a target of MycP1 in vitro and in vivo. During macrophage infection, an inactive MycP1 protease mutant causes hyperactivation of ESX-1-stimulated innate signaling pathways. MycP1 is required for growth in mice during acute infection, while loss of its protease activity leads to attenuated virulence during chronic infection. As the key ESX-1 substrates ESAT-6 and CFP-10 are highly immunogenic, fine-tuning of their secretion by MycP1 may balance virulence and immune detection and be essential for successful maintenance of long-term M. tuberculosis infection

Real-World Outcomes of Glucose Sensor Use in Type 1 Diabetes—Findings from a Large UK Centre

From MDPI via Jisc Publications RouterHistory: accepted 2021-11-10, pub-electronic 2021-11-15Publication status: PublishedFlash glucose monitoring (FGM) and real-time continuous glucose monitoring (RT-CGM) are increasingly used in clinical practice, with improvements in HbA1c and time in range (TIR) reported in clinical studies. We aimed to evaluate the impact of FGM and RT-CGM use on glycaemic outcomes in adults with type 1 diabetes (T1DM) under routine clinical care. We performed a retrospective data analysis from electronic outpatient records and proprietary web-based glucose monitoring platforms. We measured HbA1c (pre-sensor vs. on-sensor data) and sensor-based outcomes from the previous three months as per the international consensus on RT-CGM reporting guidelines. Amongst the 789 adults with T1DM, HbA1c level decreased from 61.0 (54.0, 71.0) mmol/mol to 57 (49, 65.8) mmol/mol in 561 people using FGM, and from 60.0 (50.0, 70.0) mmol/mol to 58.8 (50.3, 66.8) mmol/mol in 198 using RT-CGM (p 0.001 for both). We found that 23% of FGM users and 32% of RT-CGM users achieved a time-in-range (TIR) (3.9 to 10 mmol/L) of >70%. For time-below-range (TBR) 4 mmol/L, 70% of RT-CGM users and 58% of FGM users met international recommendations of 4%. Our data add to the growing body of evidence supporting the use of FGM and RT-CGM in T1DM

The Enigmatic Esx Proteins:Looking Beyond Mycobacteria

Bacteria export proteins across membranes using a range of transport machineries. Type VII secretion systems (T7SSs), originally described in mycobacteria, are now known to be widespread across diverse bacterial phyla. Recent studies have characterized secretion components and mechanisms of type VII secretion in pathogenic and environmental bacteria. A variety of functions have been attributed to T7SS substrates, including interactions with eukaryotes and with other bacteria. Here, we evaluate the growing body of knowledge on T7SSs, with focus on the nonmycobacterial systems, reviewing their phylogenetic distribution, structure and function in diverse settings

StrathVoyager Student Team Technical Report to NJORD Challenge 2023

Starting from basic design and operational concepts on paper, as modular ASV was designed and built within approximately 12 months on a budget of around £5000. The boat participating in the Njord competition features a catamaran design comprised of two custom designed NPL hulls. The catamaran platform was designed to be fully modular and is constructed with 3D-printed hulls and carbon fibre decks. The platform is propelled using a static dual-thruster configuration. Computation is facilitated by an Nvidia Jetson, a Raspberry Pi 4B, and an Arduino MEGA. The system is powered by two custom-made 5S BMS 21V Li-Ion battery packs. The navigation sensor system consists of an Ouster OS32 3D Lidar with a built-in IMU, a Stereovision Zed Mini depth camera, an Adafruit Ultimate GPS Module PA1616D, and an Adafruit BNO055 Absolute Orientation Sensor. Further internal sensors, including voltage, current sensors, as well as a temperature sensor, are integrated. The ASV connects wirelessly to a remote control via an nRF2401 module, and to a laptop for operation monitoring via Holybro Telemetry Sik radio. Autonomous operation is enabled through sensor fusion of camera and Lidar information to identify environmental features, such as waypoints, and to generate virtual waypoints for the autonomous control system. The autonomous control system consists of an in-house developed deep reinforcement learning (DRL) algorithm that enables Line of Sight operation, as well as obstacle avoidance. As a backup, a general PID LOS waypoint tracking controller is also implemented in parallel. Extensive lab and pond testing has been carried out to develop and refine the system. Key features and innovations of the StrathVoyager ASV include: • Fully modular 3D printed and carbon fibre ASV. • Depth camera and 3D lidar sensor fusion for autonomous control. • DRL-based autonomous control

Suboptimal Activation of Antigen-Specific CD4+ Effector Cells Enables Persistence of M. tuberculosis In Vivo

Adaptive immunity to Mycobacterium tuberculosis controls progressive bacterial growth and disease but does not eradicate infection. Among CD4+ T cells in the lungs of M. tuberculosis-infected mice, we observed that few produced IFN-γ without ex vivo restimulation. Therefore, we hypothesized that one mechanism whereby M. tuberculosis avoids elimination is by limiting activation of CD4+ effector T cells at the site of infection in the lungs. To test this hypothesis, we adoptively transferred Th1-polarized CD4+ effector T cells specific for M. tuberculosis Ag85B peptide 25 (P25TCRTh1 cells), which trafficked to the lungs of infected mice and exhibited antigen-dependent IFN-γ production. During the early phase of infection, ∼10% of P25TCRTh1 cells produced IFN-γ in vivo; this declined to <1% as infection progressed to chronic phase. Bacterial downregulation of fbpB (encoding Ag85B) contributed to the decrease in effector T cell activation in the lungs, as a strain of M. tuberculosis engineered to express fbpB in the chronic phase stimulated P25TCRTh1 effector cells at higher frequencies in vivo, and this resulted in CD4+ T cell-dependent reduction of lung bacterial burdens and prolonged survival of mice. Administration of synthetic peptide 25 alone also increased activation of endogenous antigen-specific effector cells and reduced the bacterial burden in the lungs without apparent host toxicity. These results indicate that CD4+ effector T cells are activated at suboptimal frequencies in tuberculosis, and that increasing effector T cell activation in the lungs by providing one or more epitope peptides may be a successful strategy for TB therapy