The Relationship Between Patient Safety Outcomes and Hospital Characteristics

To augment the discussion of the extent to which quality is universal, this study presents the results of an analysis of 13.5 million inpatient discharges from 1,640 general hospitals from 16 states. Factor analysis was performed on 588 general U.S. hospitals and 18 PSIs were reduced to seven factors. Hospital tiers were profiled utilizing demographic variables. Contrary to expectations the best quality hospitals tended to be smaller, non-teaching hospitals whereas larger, teaching hospitals tended to be poor quality performers. This analysis provided evidence patient safety quality rates may not be universal and organizational context may be an important influencing factor

Anti-Nirvana: crime, culture and instrumentalism in the age of insecurity

‘Anti-Nirvana’ explores the relationship between consumer culture, media and criminal motivations. It has appeared consistently on the list of the top-ten most-read articles in this award-winning international journal, and it mounts a serious neo-Freudian challenge to the predominant naturalistic notion of ‘resistance’ at the heart of liberal criminology and media studies. It is also cited in the Oxford Handbook of Criminology and other criminology texts as a persuasive argument in support of the theory that criminality amongst young people is strongly linked to the acquisitive values of consumerism and the images of possessive individualism that dominate mass media

Objective cough frequency, airway inflammation, and disease control in asthma

Background Cough is recognized as an important troublesome symptom in the diagnosis and monitoring of asthma. Asthma control is thought to be determined by the degree of airway inflammation and hyperresponsiveness but how these factors relate to cough frequency is unclear. The goal of this study was to investigate the relationships between objective cough frequency, disease control, airflow obstruction, and airway inflammation in asthma. Methods Participants with asthma underwent 24-h ambulatory cough monitoring and assessment of exhaled nitric oxide, spirometry, methacholine challenge, and sputum induction (cell counts and inflammatory mediator levels). Asthma control was assessed by using the Global Initiative for Asthma (GINA) classification and the Asthma Control Questionnaire (ACQ). The number of cough sounds was manually counted and expressed as coughs per hour (c/h). Results Eighty-nine subjects with asthma (mean ± SD age, 57 ± 12 years; 57% female) were recruited. According to GINA criteria, 18 (20.2%) patients were classified as controlled, 39 (43.8%) partly controlled, and 32 (36%) uncontrolled; the median ACQ score was 1 (range, 0.0-4.4). The 6-item ACQ correlated with 24-h cough frequency (r = 0.40; P < .001), and patients with uncontrolled asthma (per GINA criteria) had higher median 24-h cough frequency (4.2 c/h; range, 0.3-27.6) compared with partially controlled asthma (1.8 c/h; range, 0.2-25.3; P = .01) and controlled asthma (1.7 c/h; range, 0.3-6.7; P = .002). Measures of airway inflammation were not significantly different between GINA categories and were not correlated with ACQ. In multivariate analyses, increasing cough frequency and worsening FEV1 independently predicted measures of asthma control. Conclusions Ambulatory cough frequency monitoring provides an objective assessment of asthma symptoms that correlates with standard measures of asthma control but not airflow obstruction or airway inflammation. Moreover, cough frequency and airflow obstruction represent independent dimensions of asthma control

Numerical and experimental analysis of micro HAWTs designed for wind tunnel applications

In this paper the authors describe a design and optimization process of micro HAWTs using a numerical and experimental approach. An in-house 1D BEM model was used to obtain a first geometrical draft. It allowed to quickly optimize blade geometry to maximize energy production as well. As these models are quite sensitive to airfoil coefficients, above all at low Reynolds numbers, an accurate 3D CFD model was developed to support and validate the 1D BEM design, analyzing and fixing the discrepancies between model output. The 3D CFD model was developed and optimized using ANSYS Fluent solver and a RANS transition turbulence model. This allowed to correctly reproduce the transition and stall phenomena that characterize the aerodynamic behavior of micro wind turbines, solving the issues related to low Reynolds flows. The procedure was completed, thus building two micro HAWTs with different scales, testing them in the subsonic wind tunnel of the University of Catania. Wind tunnel features, experimental set-up and testing procedures are presented in the paper. Through the comparison of numerical CFD and experimental test results, a good compatibility was found. This allowed the authors to analyze and compare numerical calculation results and verify blockage effects on the prototypes as well

The Impossibility of a Perfectly Competitive Labor Market

Using the institutional theory of transaction cost, I demonstrate that the assumptions of the competitive labor market model are internally contradictory and lead to the conclusion that on purely theoretical grounds a perfectly competitive labor market is a logical impossibility. By extension, the familiar diagram of wage determination by supply and demand is also a logical impossibility and the neoclassical labor demand curve is not a well-defined construct. The reason is that the perfectly competitive market model presumes zero transaction cost and with zero transaction cost all labor is hired as independent contractors, implying multi-person firms, the employment relationship, and labor market disappear. With positive transaction cost, on the other hand, employment contracts are incomplete and the labor supply curve to the firm is upward sloping, again causing the labor demand curve to be ill-defined. As a result, theory suggests that wage rates are always and everywhere an amalgam of an administered and bargained price. Working Paper 06-0

Anaerobic utilization of pectinous substrates at extremely haloalkaline conditions by Natranaerovirga pectinivora gen. nov., sp. nov., and Natranaerovirga hydrolytica sp. nov., isolated from hypersaline soda lakes

Anaerobic enrichments at pH 10, with pectin and polygalacturonates as substrates and inoculated with samples of sediments of hypersaline soda lakes from the Kulunda Steppe (Altai, Russia) demonstrated the potential for microbial pectin degradation up to soda-saturating conditions. The enrichments resulted in the isolation of six strains of obligately anaerobic fermentative bacteria, which represented a novel deep lineage within the order Clostridiales loosely associated with the family Lachnospiraceae. The isolates were rod-shaped and formed terminal round endospores. One of the striking features of the novel group is a very narrow substrate spectrum for growth, restricted to galacturonic acid and its polymers (e.g. pectin). Acetate and formate were the final fermentation products. Growth was possible in a pH range from 8 to 10.5, with an optimum at pH 9.5–10, and in a salinity range from 0.2 to 3.5 M Na+. On the basis of unique phenotypic properties and distinct phylogeny, the pectinolytic isolates are proposed to be assigned to a new genus Natranaerovirga with two species N. hydrolytica (APP2T=DSM24176T=UNIQEM U806T) and N. pectinivora (AP3T=DSM24629T=UNIQEM U805T)

The contribution of visual information to the perception of speech in noise with and without informative temporal fine structure

Understanding what is said in demanding listening situations is assisted greatly by looking at the face of a talker. Previous studies have observed that normal-hearing listeners can benefit from this visual information when a talker’s voice is presented in background noise. These benefits have also been observed in quiet listening conditions in cochlear-implant users, whose device does not convey the informative temporal fine structure cues in speech, and when normal-hearing individuals listen to speech processed to remove these informative temporal fine structure cues. The current study (1) characterised the benefits of visual information when listening in background noise; and (2) used sine-wave vocoding to compare the size of the visual benefit when speech is presented with or without informative temporal fine structure. The accuracy with which normal-hearing individuals reported words in spoken sentences was assessed across three experiments. The availability of visual information and informative temporal fine structure cues was varied within and across the experiments. The results showed that visual benefit was observed using open- and closed-set tests of speech perception. The size of the benefit increased when informative temporal fine structure cues were removed. This finding suggests that visual information may play an important role in the ability of cochlear-implant users to understand speech in many everyday situations. Models of audio-visual integration were able to account for the additional benefit of visual information when speech was degraded and suggested that auditory and visual information was being integrated in a similar way in all conditions. The modelling results were consistent with the notion that audio-visual benefit is derived from the optimal combination of auditory and visual sensory cues

Identification of Radiopure Titanium for the LZ Dark Matter Experiment and Future Rare Event Searches

The LUX-ZEPLIN (LZ) experiment will search for dark matter particle interactions with a detector containing a total of 10 tonnes of liquid xenon within a double-vessel cryostat. The large mass and proximity of the cryostat to the active detector volume demand the use of material with extremely low intrinsic radioactivity. We report on the radioassay campaign conducted to identify suitable metals, the determination of factors limiting radiopure production, and the selection of titanium for construction of the LZ cryostat and other detector components. This titanium has been measured with activities of $^{238}$U$_{e}$~$<$1.6~mBq/kg, $^{238}$U$_{l}$~$<$0.09~mBq/kg, $^{232}$Th$_{e}$~$=0.28\pm 0.03$~mBq/kg, $^{232}$Th$_{l}$~$=0.25\pm 0.02$~mBq/kg, $^{40}$K~$<$0.54~mBq/kg, and $^{60}$Co~$<$0.02~mBq/kg (68\% CL). Such low intrinsic activities, which are some of the lowest ever reported for titanium, enable its use for future dark matter and other rare event searches. Monte Carlo simulations have been performed to assess the expected background contribution from the LZ cryostat with this radioactivity. In 1,000 days of WIMP search exposure of a 5.6-tonne fiducial mass, the cryostat will contribute only a mean background of $0.160\pm0.001$(stat)$\pm0.030$(sys) counts.Comment: 13 pages, 3 figures, accepted for publication in Astroparticle Physic