Advanced Conducting Project

Suite Provencale by Jan Van der Roost Shenandoah by Frank Ticheli First Suite in E-flat for Military Band by Gustav Holst An Irish Rhapsody by Claire Grundman English Folk Song Suite by Ralph Vaughan Williams

Evaluation Outcomes of a Modified Early Warning System for Early Identification of Sepsis in the Adult Population Requiring Acute Care

Objectives: To examine the use of a Modified Early Warning System (MEWS) for sepsis identification and evaluate its effects on treatment and outcomes for those patients diagnosed with sepsis after admission, during their stay at an acute care facility. Design: A retrospective chart audit was conducted on the electronic medical records (EMRs) of patients who developed, and were diagnosed with, sepsis post admission. Specifically, a retrospective separate sample pretest posttest design was used to examine the accuracy of the MEWS, differences in outcomes (ICU days, length of hospital stay, qSOFA Score and mortality rates), and treatment initiation time (fluid resuscitation, antibiotic therapy, and lactate levels) during 12-months pre- and 12-months post-MEWS initiation. Setting: This study was conducted at Ephraim McDowell Regional Medical Center (EMRMC), a 222-bed non-profit regional hospital that serves more than 119,000 residents from six counties in central Kentucky. Patients: Inclusion criteria for the study were adults greater than or equal to 18 years of age, and an ICD-9 or ICD -10 diagnosis of sepsis, severe sepsis or septic shock post admission. Exclusion criteria were a sepsis diagnosis on admission, and patients younger than 18 years of age. Interventions: A retrospective chart audit was completed to compare pre- and post-initiation of a MEWS for the identification of sepsis and to evaluate differences in treatment initiation and patient outcomes. Measurements and Main Results: There were no differences found in the demographic variables between the pre- and post-MEWS samples including age, gender, and ethnicity. The ability of the MEWS to identify possible sepsis, severe sepsis, and septic shock before diagnosis was 92.3%. Compliance with treatment initiation was significantly increased with the ordering of lactates (p \u3c .001), while marginally significant with antibiotic initiation (p=.052) as well as fluid resuscitation in septic shock (p=.054). No differences were found between ICU days or mortality rates. A significant 3.5 day decrease in length of stay was identified for the post-MEWS initiation sample, which resulted in an estimated $131,176 savings on room cost alone across the one year sample. Conclusion: During the one year period post-initiation, the MEWS at EMRMC proved to be accurate at the identification of sepsis, severe sepsis, and septic shock before the diagnosis was made. In addition, compliance with treatment initiation and patient overall length of stay were positively affected and contributed to a significant cost savings. Adding the MEWS proved to be an accurate way to provide an increase in the quality of care while reducing healthcare costs

The nesting habits of the hen

Suitable nesting equipment is essential for the successful management of laying hens. It should be planned to minimize the labor required in gathering eggs, in keeping nests clean and in supplying suitable nesting material. It is also important that the nests be made attractive and satisfactory to the hens. The tendency of hens to lay their eggs on the poultry house floor, in the poultry yard or in “stolen” nests causes serious losses to poultry keepers. It increases the labor of finding and gathering the eggs; it causes the entire loss of many eggs and a deterioration in the quality of many others, and not infrequently it becomes the direct cause of the fowls acquiring the vicious egg eating habit. This bulletin reports the results of experiments and observations made by the poultry section of the Iowa Agricultural Experiment Station to determine the important factors that influence hens in selecting the place in which they lay their eggs and to learn how they can best be prevented from laying in promiscuous places

Single atom edge-like states via quantum interference

We demonstrate how quantum interference may lead to the appearance of robust edge-like states of a single ultracold atom in a two-dimensional optical ribbon. We show that these states can be engineered either within the manifold of local ground states of the sites forming the ribbon, or of states carrying one unit of angular momentum. In the former case, we show that the implementation of edge-like states can be extended to other geometries, such as tilted square lattices. In the latter case, we suggest to use the winding number associated to the angular momentum as a synthetic dimension.Comment: 5 pages, 5 figure

A successful Iowa shed roof poultry house

After putting it to practical test on the Iowa State College poultry farm, the Iowa Agricultural Experiment Station recommends the permanent shed roof poultry house described in this bulletin. This house was planned and built by the Poultry and Agricultural Engineering sections of the station for housing 75 or more laying hens kept under Iowa conditions. It has given good results in practical use at the poultry farm and on this basis it is recommended to those who have need of a poultry house of this type

Visual contrast detection cannot be predicted from surrogate measures of retinal ganglion cell number and sampling density in healthy young adults

To establish whether a clinically exploitable relationship exists between surrogate measures of retinal ganglion cell number and functional sampling density and visual contrast sensitivity in healthy young eyes

Conical refraction healing after partially blocking the input beam

In conical refraction, when a focused Gaussian beam passes along one of the optic axes of a biaxial crystal it is transformed into a pair of concentric bright rings at the focal plane. We demonstrate both theoretically and experimentally that this transformation is hardly affected by partially blocking the Gaussian input beam with an obstacle. We analyze the influence of the size of the obstruction both on the transverse intensity pattern of the beam and on its state of polarization, which is shown to be very robust

Classifying visual field loss in glaucoma through baseline matching of stable reference sequences

Glaucoma is a common disease of the eye that often results in partial blindness. The main symptom of glaucoma is progressive loss of sight in the visual field over time. The clinical management of glaucoma involves monitoring the progress of the disease using a sequence of regular visual field tests. However, there is currently no universally accepted standard method for classifying changes in the visual field test data. Sequence matching techniques typically rely on similarity measures. However, visual field measurements are very noisy, particularly in people with glaucoma. It is therefore difficult to establish a reference data set including both stable and progressive visual fields. This paper proposes a method that uses a "baseline" computed from a query sequence, to match stable sequences in a database of visual field measurements collected from volunteers. The purpose of the new method is to classify a given query sequence as being stable or progressive. The results suggest that the new method gives a significant improvement in accuracy for identifying progressive sequences, though there is a small penalty for stable sequences