363 research outputs found
Focal plate structure alignment of the Dark Energy Spectroscopic Instrument
The Dark Energy Spectroscopic Instrument (DESI) is under construction to measure the expansion history of the universe using the Baryon Acoustic Oscillation technique. The spectra of 35 million galaxies and quasars spanning over 14,000  deg2 are measured during the life of the experiment. A prime focus corrector for the Kitt Peak National Observatory Mayall telescope delivers light to 5000 robotically positioned optic fibers. The fibers in turn feed 10 broadband spectrographs. Proper alignment of the focal plate structure, mainly consisting of a focal plate ring and 10 focal plate petals, is crucial in ensuring minimal loss of light in the focal plane. A coordinate measurement machine (CMM) metrology-based approach to alignment requires comprehensive characterization of critical dimensions of the petals and the ring, all of which are 100% inspected. The metrology data not only serve for quality assurance but also, with careful modeling of geometric transformations, inform the initial choice of integration accessories, such as gauge blocks, pads, and shims. The integrated focal plate structure is inspected again on a CMM, and each petal is adjusted individually according to the updated focal plate metrology data until all datums are extremely close to nominal positions and optical throughput nearly reached the theoretically best possible value. We present our metrology and alignment methodology and complete results for 12 official DESI petals. The as-aligned, total RMS optical throughput for 6168 positioner holes of 12 production petals is indirectly measured to be 99.88  %    ±  0.12  %  , well above the 99.5% project requirement. The successful alignment fully demonstrated the wealth of data, reproducibility, and micron-level precision made available by our CMM metrology-based approach
DESI Focal Plate Alignment
The Dark Energy Spectroscopic Instrument (DESI) is under construction to measure the expansion history of the universe using the Baryon Acoustic Oscillation (BAO) technique. The spectra of 35 million galaxies and quasars over 14000 deg2 will be measured during the life of the experiment. A new prime focus corrector for the KPNO Mayall telescope will deliver light to 5000 robotically positioned optic fibres. The fibres in turn feed ten broadband spectrographs. Proper alignment of focal plate structure, mainly consisting of a focal plate ring (FPR) and ten focal plate petals (FPP), is crucial in ensuring minimal loss of light in the focal plane. A coordinate measurement machine (CMM) metrology-based approach to alignment requires comprehensive characterisation of critical dimensions of the petals and the ring, all of which were 100% inspected. The metrology data not only served for quality assurance (QA), but also, with careful modelling of geometric transformations, informed the initial choice of integration accessories such as gauge blocks, pads, and shims. The integrated focal plate structure was inspected again on a CMM, and each petal was adjusted according to the updated focal plate metrology data until all datums were extremely close to nominal positions and optical throughput nearly reached the theoretically best possible value. This paper presents our metrology and alignment methodology and complete results for twelve official DESI pe tals. The as-aligned, total RMS optical throughput for 6168 positioner holes of twelve production petals was indirectly measured to be 99:88 0:12%, well above the 99.5% project requirement. The successful alignment fully demonstrated the wealth of data, reproducibility, and micron-level precision made available by our CMM metrology-based approach
Coherent motion of stereocilia assures the concerted gating of hair-cell transduction channels
The hair cell's mechanoreceptive organelle, the hair bundle, is highly
sensitive because its transduction channels open over a very narrow range of
displacements. The synchronous gating of transduction channels also underlies
the active hair-bundle motility that amplifies and tunes responsiveness. The
extent to which the gating of independent transduction channels is coordinated
depends on how tightly individual stereocilia are constrained to move as a
unit. Using dual-beam interferometry in the bullfrog's sacculus, we found that
thermal movements of stereocilia located as far apart as a bundle's opposite
edges display high coherence and negligible phase lag. Because the mechanical
degrees of freedom of stereocilia are strongly constrained, a force applied
anywhere in the hair bundle deflects the structure as a unit. This feature
assures the concerted gating of transduction channels that maximizes the
sensitivity of mechanoelectrical transduction and enhances the hair bundle's
capacity to amplify its inputs.Comment: 24 pages, including 6 figures, published in 200
Rapid sympathetic cooling to Fermi degeneracy on a chip
Neutral fermions present new opportunities for testing many-body condensed
matter systems, realizing precision atom interferometry, producing ultra-cold
molecules, and investigating fundamental forces. However, since their first
observation, quantum degenerate Fermi gases (DFGs) have continued to be
challenging to produce, and have been realized in only a handful of
laboratories. In this Letter, we report the production of a DFG using a simple
apparatus based on a microfabricated magnetic trap. Similar approaches applied
to Bose-Einstein Condensation (BEC) of 87Rb have accelerated evaporative
cooling and eliminated the need for multiple vacuum chambers. We demonstrate
sympathetic cooling for the first time in a microtrap, and cool 40K to Fermi
degeneracy in just six seconds -- faster than has been possible in conventional
magnetic traps. To understand our sympathetic cooling trajectory, we measure
the temperature dependence of the 40K-87Rb cross-section and observe its
Ramsauer-Townsend reduction.Comment: 5 pages, 4 figures (v3: new collision data, improved atom number
calibration, revised text, improved figures.
Global quantitative indices reflecting provider process-of-care: data-base derivation
Background: Controversy has attended the relationship between risk-adjusted mortality and process-of-care. There would be advantage in the establishment, at the data-base level, of global quantitative indices subsuming the diversity of process-of-care. Methods: A retrospective, cohort study of patients identified in the Australian and New Zealand Intensive Care Society Adult Patient Database, 1993-2003, at the level of geographic and ICU-level descriptors (n = 35), for both hospital survivors and non-survivors. Process-of-care indices were established by analysis of: (i) the smoothed time-hazard curve of individual patient discharge and determined by pharmaco-kinetic methods as area under the hazard-curve (AUC), reflecting the integrated experience of the discharge process, and time-to-peak-hazard (TMAX, in days), reflecting the time to maximum rate of hospital discharge; and (ii) individual patient ability to optimize output (as length-of-stay) for recorded data-base physiological inputs; estimated as a technical production-efficiency (TE, scaled [0,(maximum)1]), via the econometric technique of stochastic frontier analysis. For each descriptor, multivariate correlation-relationships between indices and summed mortality probability were determined. Results: The data-set consisted of 223129 patients from 99 ICUs with mean (SD) age and APACHE III score of 59.2(18.9) years and 52.7(30.6) respectively; 41.7% were female and 45.7% were mechanically ventilated within the first 24 hours post-admission. For survivors, AUC was maximal in rural and for-profit ICUs, whereas TMAX (≥ 7.8 days) and TE (≥ 0.74) were maximal in tertiary-ICUs. For non-survivors, AUC was maximal in tertiary-ICUs, but TMAX (≥ 4.2 days) and TE (≥ 0.69) were maximal in for-profit ICUs. Across descriptors, significant differences in indices were demonstrated (analysisof- variance, P ≤ 0.0001). Total explained variance, for survivors (0.89) and non-survivors (0.89), was maximized by combinations of indices demonstrating a low correlation with mortality probability. Conclusions: Global indices reflecting process of care may be formally established at the level of national patient databases. These indices appear orthogonal to mortality outcome.John L Moran, Patricia J Solomon and the Adult Database Management Committee (ADMC) of the Australian and New Zealand Intensive Care Society (ANZICS
Hospital competition, resource allocation and quality of care
BACKGROUND: A variety of approaches have been used to contain escalating hospital costs. One approach is intensifying price competition. The increase in price based competition, which changes the incentives hospitals face, coupled with the fact that consumers can more easily evaluate the quality of hotel services compared with the quality of clinical care, may lead hospitals to allocate more resources into hotel rather than clinical services. METHODS: To test this hypothesis we studied hospitals in California in 1982 and 1989, comparing resource allocations prior to and following selective contracting, a period during which the focus of competition changed from quality to price. We estimated the relationship between clinical outcomes, measured as risk-adjusted-mortality rates, and resources. RESULTS: In 1989, higher competition was associated with lower clinical expenditures levels compared with 1982. The trend was stronger for non-profit hospitals. Lower clinical resource use was associated with worse risk adjusted mortality outcomes. CONCLUSIONS: This study raises concerns that cost reductions may be associated with increased mortality
Association of nail biting and psychiatric disorders in children and their parents in a psychiatrically referred sample of children
<p>Abstract</p> <p>Background</p> <p>Nail biting (NB) is a very common unwanted behavior. The majority of children are motivated to stop NB and have already tried to stop it, but are generally unsuccessful in doing so. It is a difficult behavior to modify or treat. The objective of this study was to investigate the prevalence of co-morbid psychiatric disorders in a clinical sample of children with NB who present at a child and adolescent mental healthcare outpatient clinic and the prevalence of psychiatric disorders in their parents.</p> <p>Method</p> <p>A consecutive sample of 450 referred children was examined for NB and 63 (14%) were found to have NB. The children and adolescents with nail biting and their parents were interviewed according to DSM-IV diagnostic criteria. They were also asked about lip biting, head banging, skin biting, and hair pulling behaviors.</p> <p>Results</p> <p>Nail biting is common amongst children and adolescents referred to a child and adolescent mental health clinic. The most common co-morbid psychiatric disorders in these children were attention deficit hyperactivity disorder (74.6%), oppositional defiant disorder (36%), separation anxiety disorder (20.6%), enuresis (15.6%), tic disorder (12.7%) and obsessive compulsive disorder (11.1%). The rates of major depressive disorder, mental retardation, and pervasive developmental disorder were 6.7%, 9.5%, 3.2%, respectively. There was no association between the age of onset of nail biting and the co-morbid psychiatric disorder. Severity and frequency of NB were not associated with any co-morbid psychiatric disorder. About 56.8% of the mothers and 45.9% of the fathers were suffering from at least one psychiatric disorder. The most common psychiatric disorder found in these parents was major depression.</p> <p>Conclusion</p> <p>Nail biting presents in a significant proportion of referrals to a mental healthcare clinic setting. Nail biting should be routinely looked for and asked for in the child and adolescent mental healthcare setting because it is common in a clinical population, easily visible in consultation and relatively unintrusive to ask about. If present, its detection can then be followed by looking for other more subtle stereotypic or self-mutilating behaviors.</p
Unplanned readmission rates, length of hospital stay, mortality, and medical costs of ten common medical conditions: a retrospective analysis of Hong Kong hospital data
<p>Abstract</p> <p>Background</p> <p>Studies on readmissions attributed to particular medical conditions, especially heart failure, have generally not addressed the factors associated with readmissions and the implications for health outcomes and costs. This study aimed to investigate the factors associated with 30-day unplanned readmission for 10 common conditions and to determine the cost implications.</p> <p>Methods</p> <p>This population-based retrospective cohort study included patients admitted to all public hospitals in Hong Kong in 2007. The sample consisted of 337,694 hospitalizations in Internal Medicine. The disease-specific risk-adjusted odd ratio (OR), length of stay (LOS), mortality and attributable medical costs for the year were examined for unplanned readmissions for 10 medical conditions, namely malignant neoplasms, heart diseases, cerebrovascular diseases, pneumonia, injury and poisoning, nephritis and nephrosis, diabetes mellitus, chronic liver disease and cirrhosis, septicaemia, and aortic aneurysm.</p> <p>Results</p> <p>The overall unplanned readmission rate was 16.7%. Chronic liver disease and cirrhosis had the highest OR (1.62, 95% confidence interval (CI) 1.39-1.87). Patients with cerebrovascular disease had the longest LOS, with mean acute and rehabilitation stays of 6.9 and 3.0 days, respectively. Malignant neoplasms had the highest mortality rate (30.8%) followed by aortic aneurysm and pneumonia. The attributed medical cost of readmission was highest for heart disease (US2 579 443-803 393).</p> <p>Conclusions</p> <p>Our findings showed variations in readmission rates and mortality for different medical conditions which may suggest differences in the quality of care provided for various medical conditions. In-hospital care, comprehensive discharge planning, and post-discharge community support for patients need to be reviewed to improve the quality of care and patient health outcomes.</p
Hypnosis for treatment of insomnia in school-age children: a retrospective chart review
BACKGROUND: The purposes of this study are to document psychosocial stressors and medical conditions associated with development of insomnia in school-age children and to report use of hypnosis for this condition. METHODS: A retrospective chart review was performed for 84 children and adolescents with insomnia, excluding those with central or obstructive sleep apnea. All patients were offered and accepted instruction in self-hypnosis for treatment of insomnia, and for other symptoms if it was felt that these were amenable to therapy with hypnosis. Seventy-five patients returned for follow-up after the first hypnosis session. Their mean age was 12 years (range, 7–17). When insomnia did not resolve after the first instruction session, patients were offered the opportunity to use hypnosis to gain insight into the cause. RESULTS: Younger children were more likely to report that the insomnia was related to fears. Two or fewer hypnosis sessions were provided to 68% of the patients. Of the 70 patients reporting a delay in sleep onset of more than 30 minutes, 90% reported a reduction in sleep onset time following hypnosis. Of the 21 patients reporting nighttime awakenings more than once a week, 52% reported resolution of the awakenings and 38% reported improvement. Somatic complaints amenable to hypnosis were reported by 41%, including chest pain, dyspnea, functional abdominal pain, habit cough, headaches, and vocal cord dysfunction. Among these patients, 87% reported improvement or resolution of the somatic complaints following hypnosis. CONCLUSION: Use of hypnosis appears to facilitate efficient therapy for insomnia in school-age children
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