THE EFFECTS OF FIELD EMITTED ELECTRONS ON RF SURFACE

The ever-growing demand for higher RF gradients has considerably increased the risk of breakdown in accelerating structures. Field emission is the most common form of RF breakdown that generates free electrons capable of inflicting irreversible damages on the RF surface. This paper presents a systematic experimental and simulation programme to understand possible sources and their influence on RF cavity operatio

Website design: Technical, social and medical issues for self-reporting by elderly patients

There is growing interest in the use of the Internet for interacting with patients, both in terms of healthcare information provision and information gathering. In this paper we examine the issues in designing healthcare websites for elderly users. In particular this paper uses a year-long case study of the development of a web-based system for self-reporting of symptoms and quality of life with a view to examine the issues relating to website design for elderly users. The issues identified included the technical, social and medical aspects of website design for elderly users. The web-based system developed was based upon the EQ5D health-status questionnaire, a commonly used tool for patient self-reporting of quality of life, and the more specific CROQ (coronary revascularisation outcome questionnaire) questionnaire. Currently self-reporting is generally administered in the form of paper-based questionnaires to be completed in the out-patient clinic, or at home. There are a variety of issues relating to elderly users that imply that websites for elderly patients may involve different design considerations to other types of websites

Floristic variability, distribution and an extension of range for the endangered Pittwater Spotted Gum Forest, Central Coast, New South Wales

Multivariate analysis and non-metric multidimensional scaling have been used to compare the floristic composition of vegetation dominated by Spotted Gum, Corymbia maculata, and Grey Ironbark, Eucalyptus paniculata, from the Pittwater and Gosford local government areas, and elsewhere on the Central Coast of New South Wales. When placed within a regional context, vegetation from both local government areas is strongly related, and is sufficiently distinct (at 30% similarity) from other areas of Spotted Gum-Ironbark vegetation within the region to warrant their collective consideration as Pittwater Spotted Gum Forest (PSGF), an Endangered Ecological Community in New South Wales. Within Pittwater local government area, two forms of PSGF are present: a dryer, more widespread form present on ridges and slopes, and a moister form with strong littoral rainforest affinities confined to gullies. Gosford local government area supports only the dryer form. Extant and pre-1750 mapping of PSGF from both local government areas (excluding Ku-ring-gai Chase National Park) shows a total extant distribution of 227 ha, and since 1750 an estimated loss of 727 ha (76%) from the original 954 ha. PSGF is present in two secure conservation reserves: Ku-ring-gai Chase National Park (~40 ha, Thomas & Benson 1985) and Bouddi National Park (~30 ha, Bell 2009), totaling ~ 70 ha. Despite this, much of the extant distribution lies at the reserve-urban interface, and is subject to ongoing threats of regular low-intensity fire, unmitigated clearing and weed invasion

Investigating the prevalence, predictors, and prognosis of suboptimal statin use early after a non-ST elevation acute coronary syndrome

BACKGROUND:High-potency statin therapy is recommended in the secondary prevention of car-diovascular disease but discontinuation, dose reduction, statin switching, and/or nonadherence occurin practice.OBJECTIVES:To determine the prevalence and predictors of deviation from high-potency statin useearly after a non-ST elevation acute coronary syndrome (NSTE-ACS) and its association with subse-quent major adverse cardiovascular events (MACE) and all-cause mortality (ACM).METHODS:A total of 1005 patients from a UK-based prospective NSTE-ACS cohort study dis-charged on high-potency statin therapy (atorvastatin 80 mg, rosuvastatin 20 mg, or 40 mg daily)were included. At 1 month, patients were divided into constant high-potency statin users, and subop-timal users incorporating statin discontinuation, dose reduction, switching statin to a lower equivalentpotency, and/or statin nonadherence. Follow-up was a median of 16 months.RESULTS:There were 156 suboptimal (w15.5%) and 849 constant statin users. Factors associatedin multivariable analysis with suboptimal statin occurrence included female sex (odds ratio 1.75, 95%confidence interval [CI] 1.14–2.68) and muscular symptoms (odds ratio 4.28, 95% CI 1.30–14.08).Suboptimal statin use was associated with increased adjusted risks of time to MACE (hazard ratio2.10, 95% CI 1.25–3.53,P5.005) and ACM (hazard ratio 2.46, 95% CI 1.38–4.39,P5.003). Sub-group analysis confirmed that the increased MACE/ACM risks were principally attributable to statindiscontinuation or nonadherence.CONCLUSIONS:Conversion to suboptimal statin use is common early after NSTE-ACS and ispartly related to muscular symptoms. Statin discontinuation or non-adherence carries an adverse prog-nosis. Interventions that preserve and enhance statin utilization could improve post NSTE-ACSoutcomes

TEMPERATURSUMME UND BLUHBEGINN BEI APFEL ZUSAMMENFASSUNG

Este artigo explora as maneiras pelas quais o design influencia as perceções e ações de estudantes e professores em cinco escolas secundárias do Reino Unido. O entendimento das diferentes práticas desenvolvidas nessas escolas vai além das típicas Avaliações Pós Ocupação (Post Occupancy Evaluations) que enfocam aspectos ambientais, como a aústica, a iluminação e a temperatura, usam métodos quantitativos e frequentemente deixam de explorar a forma como os diferentes fatores ambientais interagem com os usuários, ao longo do tempo time (HYGGE, 2003; GALASIU e VEITCH, 2006; SHAUGHNESSY et al., 2006; WINTERBOTTOM e WILKINS, 2009). Também ocorre uma falta de atenção em relação às maneiras como os processos de ocupação podem modelar as experiências em tais espaços (STABLES, LEAROYD-SMITH, DANIELS e TSE, 2014). A investigação envolveu estudos de casos que objetivavam documentar uma série de assuntos chave discutidos pelos professores e estudantes em cada uma dessas escolas. Os achados contribuem para o desenvolvimento de um entendimento mais holístico sobre as formas como o design pode contribuir para o processo de transformação pedagógica. Argumentamos que os espaços que são projetados para formas específicas de abordagem de ensino e aprendizagem podem ser transformados quando tais espaços são usados na prática (DANIELS et al., 2017 no prelo). Temos evidências de que mudanças subsequentes em termos de liderança frequentemente envolvem modificações adicionais dos espaços e das práticas de ensino e aprendizagem. Neste artigo, acrescentamos a ideia de que essas mudanças têm consequências para a experiência cotidiana de escolarização, como foi evidenciado nos comentários e nas ações dos professors e alunos. Esses aspectos são de particular importância neste momento. O Gabinete Nacional de Auditoria (The National Audit Office) (2017) chamou a atenção para o estado lamentável das construções que abrigam as escolas públicas. Apontou três preocupações: a condição dos prédios, a demanda crescente de vagas e os problemas relativos à entrega de projetos capitais. Fica claro que necessitamos aprender com as experiências e os resultados de abordagens recentes relativas ao design e à construção de novas escolas. Como o Departamento reconhece, desafios significativos permanecem. Espera-se que a condição das escolas piore na medida em que construções em estado ruim, mas não o pior possível, se deteriorem ainda mais. O número de estudantes continua a crecer e as demandas por vagas está voltada para as escolas secundárias, onde tais vagas são de provisão mais complexa e dispendiosa. O Departamento, as autoridades locais e as escolas necessitarão attender essas demandas em um momento em que sua capacidade de realizar programas capitais sofre pressão crescente decorrente da escassez de receita orcamentária

The effect of age on outcomes of coronary artery bypass surgery compared with balloon angioplasty or bare-metal stent implantation among patients with multivessel coronary disease. A collaborative analysis of individual patient data from 10 randomized trials.

OBJECTIVES: This study sought to assess whether patient age modifies the comparative effectiveness of coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI). BACKGROUND: Increasingly, CABG and PCI are performed in older patients to treat multivessel disease, but their comparative effectiveness is uncertain. METHODS: Individual data from 7,812 patients randomized in 1 of 10 clinical trials of CABG or PCI were pooled. Age was analyzed as a continuous variable in the primary analysis and was divided into tertiles for descriptive purposes (≤56.2 years, 56.3 to 65.1 years, ≥65.2 years). The outcomes assessed were death, myocardial infarction and repeat revascularization over complete follow-up, and angina at 1 year. RESULTS: Older patients were more likely to have hypertension, diabetes, and 3-vessel disease compared with younger patients (p < 0.001 for trend). Over a median follow-up of 5.9 years, the effect of CABG versus PCI on mortality varied according to age (interaction p < 0.01), with adjusted CABG-to-PCI hazard ratios and 95% confidence intervals (CI) of 1.23 (95% CI: 0.95 to 1.59) in the youngest tertile; 0.89 (95% CI: 0.73 to 1.10) in the middle tertile; and 0.79 (95% CI: 0.67 to 0.94) in the oldest tertile. The CABG-to-PCI hazard ratio of less than 1 for patients 59 years of age and older. A similar interaction of age with treatment was present for the composite outcome of death or myocardial infarction. In contrast, patient age did not alter the comparative effectiveness of CABG and PCI on the outcomes of repeat revascularization or angina. CONCLUSIONS: Patient age modifies the comparative effectiveness of CABG and PCI on hard cardiac events, with CABG favored at older ages and PCI favored at younger ages

Predicating from an early age: edusemiotics and the potential of children’s preconceptions

This paper aims to explain how semiotics and constructivism can collaborate in an educational epistemology by developing a joint approach to prescientific conceptions. Empirical data and findings of constructivist research are interpreted in the light of Peirce’s semiotics. Peirce’s semiotics is an anti-psychologistic logic (CP 2.252; CP 4.551; W 8:15; Pietarinen in Signs of logic, Springer, Dordrecht, 2006; Stjernfelt in Diagrammatology. An investigation on the borderlines of phenomenology, ontology and semiotics, Springer, Dordrecht, 2007) and relational logic. Constructivism was traditionally developed within psychology and sociology and, therefore, some incompatibilities can be expected between these two schools. While acknowledging the differences, we explain that constructivism and semiotics share the assumption of realism that knowledge can only be developed upon knowledge and, therefore, an epistemological collaboration is possible. The semiotic analysis performed confirms the constructivist results and provides a further insight into the teacher-student relation. Like the constructivist approach, Peirce’s doctrine of agapism infers that the personal dimension of teaching must not be ignored. Thus, we argue for the importance of genuine sympathy in teaching attitudes. More broadly, the article also contributes to the development of postmodern humanities. At the end of the modern age, the humanities are passing through a critical period of transformation. There is a growing interest in semiotics and semiotic philosophy in many areas of the humanities. Such a case, on which we draw, is the development of a theoretical semiotic approach to education, namely edusemiotics (Stables and Semetsky, Pedagogy and edusemiotics: theoretical challenge/practical opportunities, Sense Publishers, Rotterdam, 2015)