Incompressible viscous flow near the leading edge of a flat plate admitting slip

The shear stress at the leading edge, calculated on basis of the Navier-Stokes equations and the no-slip boundary condition, approaches infinity. However, taking into account the mean free path of the molecules, which implies admitting a certain slip, the shear stress becomes inversely proportional to the square root of the Knudsen number κ if κ→0. κ is defined as the ratio between the mean free path and the viscous length. The new boundary condition modifies the shear stress only within the Knudsen region of which the size is of the order of 3 to 4 times the mean free path.

What’s in a Realist Configuration? Deciding Which Causal Configurations to Use, How, and Why

Background: Realist studies represent an increasingly popular approach for exploring complex interventions’ successes and failures. The theory-driven approach seeks to explain “what works, how, why, in which contexts, for whom, and to what extent” using context–mechanism–outcome (CMO) configurations. When the approach was first developed, CMO configurations were the method for expressing causal explanations. Increasingly, realist studies have been conducted using different variations of the heuristic such as strategy–context–mechanism–outcome (SCMO) configurations or intervention–context–actor–mechanism–outcome (ICAMO) configurations. Researchers have highlighted a lack of methodological guidance regarding which additional explanatory factors can be included in configurations (e.g., strategies, interventions, actors). This article aims to clarify and further develop the concept of configurations by discussing how explanatory factors could be robustly added to the original CMO configuration as put forward by Pawson and Tilley. Comparing the use of different types of configurations: We draw on two of our own studies, one which formulated CMO configurations and one which formulated SCMO configurations, and on an evidence scan of realist studies. We explored the effects these different configurations had on studies’ findings and highlight why researchers chose CMOs or SCMOs. Finally, we provide recommendations regarding the use of configurations. These are as follows: Using additional explanatory factors is possible but consider the research scope to select the configuration appropriate for the study; Be transparent about the choice in configuration and include examples of configurations; Further studies about the use of additional explanatory factors are needed to better understand the effects on each step in the realist evaluation cycle; and New ways of disseminating realist findings are needed to balance transparency regarding the use of configurations. Conclusions: Adding explanatory factors is possible and can be insightful depending on the study’s scope and aims; however, any configuration type must adhere to the rule of generative causation

Saturable elimination of piperacillin in critically ill patients:implications for continuous infusion

The study aimed to evaluate saturation of piperacillin elimination in critically ill adult patients. Seventeen critically ill adult patients received continuous and intermittent infusion of piperacillin/tazobactam. Piperacillin plasma concentrations (n = 217) were analysed using population pharmacokinetic (PopPK) modelling. Post-hoc simulations were performed to evaluate the type I error rate associated with the study. Unseen data were used to validate the final model. The mean error (ME) and root mean square error (RMSE) were calculated as a measure of bias and imprecision, respectively. A PopPK model with parallel linear and non-linear elimination best fitted the data. The median and 95% confidence interval (CI) for the model parameters drug clearance (CL), volume of central compartment (V), volume of peripheral compartment (V-p) and intercompartmental clearance (Q) were 9 (7.69-11) L/h, 6.18 (4.93-11.2) L, 11.17 (7.26-12) L and 15.61 (12.66-23.8) L/h, respectively. The Michaelis-Menten constant (K-m) and the maximum elimination rate for Michaelis-Menten elimination (V-max) were estimated without population variability in the model to avoid overfitting and inflation of the type I error rate. The population estimates for K-m and V-max were 37.09 mg/L and 353.57 mg/h, respectively. The bias (ME) was -20.8 (95% CI -26.2 to -15.4) mg/L, whilst imprecision (RMSE) was 49.2 (95% CI 41.2-56) mg/L. In conclusion, piperacillin elimination is (partially) saturable. Moreover, the population estimate for K-m lies within the therapeutic window and therefore saturation of elimination should be accounted for when defining optimum dosing regimens for piperacillin in critically ill patients. (C) 2019 Elsevier B.V. and International Society of Chemotherapy. All rights reserved

Patient safety culture measurement in general practice. Clinimetric properties of 'SCOPE'

<p>Abstract</p> <p>Background</p> <p>A supportive patient safety culture is considered to be an essential condition for improving patient safety. Assessing the current safety culture in general practice may be a first step to target improvements. To that end, we studied internal consistency and construct validity of a safety culture questionnaire for general practice (SCOPE) which was derived from a comparable questionnaire for hospitals (Dutch-HSOPS).</p> <p>Methods</p> <p>The survey was conducted among caregivers of Dutch general practice as part of an ongoing quality accreditation process using a 46 item questionnaire. We conducted factor analyses and studied validity by calculating correlations between the subscales and testing the hypothesis that respondents' <it>patient safety grade </it>of their practices correlated with their scores on the questionnaire.</p> <p>Results</p> <p>Of 72 practices 294 respondents completed the questionnaire. Eight factors were identified concerning <it>handover and teamwork, support and fellowship, communication openness, feedback and learning from error, intention to report events, adequate procedures and staffing, overall perceptions of patient safety </it>and <it>expectations and actions of managers</it>. Cronbach's alpha of the factors rated between 0.64 and 0.85. The subscales intercorrelated moderately, except for the factor about intention to report events. Respondents who graded patient safety highly scored significantly higher on the questionnaire than those who did not.</p> <p>Conclusions</p> <p>The SCOPE questionnaire seems an appropriate instrument to assess patient safety culture in general practice. The clinimetric properties of the SCOPE are promising, but future research should confirm the factor structure and construct of the SCOPE and delineate its responsiveness to changes in safety culture over time.</p

NOMAD spectrometer on the ExoMars trace gas orbiter mission: part 2—design, manufacturing, and testing of the ultraviolet and visible channel

NOMAD is a spectrometer suite on board the ESA/Roscosmos ExoMars Trace Gas Orbiter, which launched in March 2016. NOMAD consists of two infrared channels and one ultraviolet and visible channel, allowing the instrument to perform observations quasi-constantly, by taking nadir measurements at the day- and night-side, and during solar occultations. Here, in part 2 of a linked study, we describe the design, manufacturing, and testing of the ultraviolet and visible spectrometer channel called UVIS. We focus upon the optical design and working principle where two telescopes are coupled to a single grating spectrometer using a selector mechanism