6,003 research outputs found

    Analysis of referrals and triage patterns in a South African metropolitan adult intensive care service

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    Background. Intensive care unit (ICU) beds are scarce resources in low- and middle-income countries. Currently there is little literature that quantifies the extent of the demand placed on these resources or examines their allocation.Objectives. To analyse the number and nature of referrals to ICUs in the Pietermaritzburg metropolitan area, South Africa, over a 1-year period, to observe the triage process involved in selecting patients for admission.Methods. A retrospective review of the patients referred to ICUs at Grey’s and Edendale hospitals, Pietermaritzburg, was performed over a year. The spectrum of patients was evaluated with respect to various demographics, and the current triage process was observed.Results. The Pietermaritzburg Metropolitan Critical Care service (PMCCS) received 2 081 patient referrals, 53.4% (1 111/2 081) of males and 46.6% (970/2 081) of females, with a mean patient age of 32 years. The majority of referrals were of surgical patients (39.3%, 818/2 081), followed by medical (18.9%, 393/2 081), trauma (18.6%, 387/2 081) and obstetrics and gynaecology (11.7%, 244/2 081). The chief indications for referral were the need for cardiovascular and respiratory support. Of these referrals, 72.0% (1 499/2 081) were accepted and planned for admission and 28.0% (582/2 081) were refused ICU care. Of the patients accepted, 60.7% (910/1 499) experienced delays prior to admission and 37.4% (561/1 499) were never physically admitted to the units.Conclusions. The PMCCS receives a far greater number of patient referrals than it is able to accommodate, necessitating triage. Patient demographics reflect a young patient population referred with chiefly surgical pathology needing physiological support

    Realization of a semiconductor-based cavity soliton laser

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    The realization of a cavity soliton laser using a vertical-cavity surface-emitting semiconductor gain structure coupled to an external cavity with a frequency-selective element is reported. All-optical control of bistable solitonic emission states representing small microlasers is demonstrated by injection of an external beam. The control scheme is phase-insensitive and hence expected to be robust for all-optical processing applications. The motility of these structures is also demonstrated

    The visual word form system in context

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    According to the “modular” hypothesis, reading is a serial feedforward process, with part of left ventral occipitotemporal cortex the earliest component tuned to familiar orthographic stimuli. Beyond this region, the model predicts no response to arrays of false font in reading-related neural pathways. An alternative “connectionist” hypothesis proposes that reading depends on interactions between feedforward projections from visual cortex and feedback projections from phonological and semantic systems, with no visual component exclusive to orthographic stimuli. This is compatible with automatic processing of false font throughout visual and heteromodal sensory pathways that support reading, in which responses to words may be greater than, but not exclusive of, responses to false font. This functional imaging study investigated these alternative hypotheses by using narrative texts and equivalent arrays of false font and varying the hemifield of presentation using rapid serial visual presentation. The “null” baseline comprised a decision on visually presented numbers. Preferential activity for narratives relative to false font, insensitive to hemifield of presentation, was distributed along the ventral left temporal lobe and along the extent of both superior temporal sulci. Throughout this system, activity during the false font conditions was significantly greater than during the number task, with activity specific to the number task confined to the intraparietal sulci. Therefore, both words and false font are extensively processed along the same temporal neocortical pathways, separate from the more dorsal pathways that process numbers. These results are incompatible with a serial, feedforward model of reading

    A Deep Chandra Observation of the AGN Outburst and Merger in Hickson Compact Group 62

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    We report on an analysis of new Chandra data of the galaxy group HCG 62, well known for possessing cavities in its intragroup medium (IGM) that were inflated by the radio lobes of its central active galactic nucleus (AGN). With the new data, a factor of three deeper than previous Chandra data, we re-examine the energetics of the cavities and determine new constraints on their contents. We confirm that the ratio of radiative to mechanical power of the AGN outburst that created the cavities is less than 10^-4, among the lowest of any known cavity system, implying that the relativistic electrons in the lobes can supply only a tiny fraction of the pressure required to support the cavities. This finding implies additional pressure support in the lobes from heavy particles (e.g., protons) or thermal gas. Using spectral fits to emission in the cavities, we constrain any such volume-filling thermal gas to have a temperature kT > 4.3 keV. For the first time, we detect X-ray emission from the central AGN, with a luminosity of L(2-10 keV) = (1.1 +/- 0.4) x 10^39 erg s^-1 and properties typical of a low-luminosity AGN. Lastly, we report evidence for a recent merger from the surface brightness, temperature, and metallicity structure of the IGM.Comment: Accepted to MNRAS, 14 pages, 9 figure

    The Decay D0Kˉ0πe+νeD^0\to \bar K^{*0} \pi^- e^+ \nu_e in the Context of Chiral Perturbation Theory

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    We study the decay D0Kˉ0πe+νeD^0\rightarrow \bar K^{*0} \pi^- e^+ \nu_e, using SU(2)LSU(2)RSU(2)_L \otimes SU(2)_R chiral perturbation theory for heavy charmed mesons and vector mesons, in the kinematic regime where pMpπ/mMp_M \cdot p_\pi/m_M (here M=D0M = D^0 or Kˉ0\bar K^{*0}) is much smaller than the chiral symmetry breaking scale, ΛχSB\Lambda_{\chi SB} ( ΛχSB\Lambda_{\chi SB} \sim 1 GeV). We present the leading diagrams and amplitude, and calculate the rate, in the region where, to leading order in our calculations, the Kˉ0\bar K^{*0} is at zero recoil in the D0D^0 rest frame. The rate thus calculated is given in terms of a known form factor and depends on the DDπDD^* \pi coupling constant gDg_D of the heavy (charmed) meson chiral perturbation theory Lagrangian. A measurement of the above decay, in the aforementioned kinematic regime, can result in the extraction of an experimental value for gDg_D, accurate at the level of our approximations, and give us a measure of the validity of approaches based on chiral perturbation theory in studying similar processes.Comment: 17 pages, Latex, 2 embedded postscript figure

    Cosmological Effects of Powerful AGN Outbursts in Galaxy Clusters: Insights from an XMM-Newton Observation of MS0735+7421

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    We report on the results of an analysis of XMM-Newton observations of MS0735+7421, the galaxy cluster which hosts the most energetic AGN outburst currently known. The previous Chandra image shows twin giant X-ray cavities (~200 kpc diameter) filled with radio emission and surrounded by a weak shock front. XMM data are consistent with these findings. The total energy in cavities and shock (~6 \times 10^{61} erg) is enough to quench the cooling flow and, since most of the energy is deposited outside the cooling region (~100 kpc), to heat the gas within 1 Mpc by ~1/4 keV per particle. The cluster exhibits an upward departure (factor ~2) from the mean L-T relation. The boost in emissivity produced by the ICM compression in the bright shells due to the cavity expansion may contribute to explain the high luminosity and high central gas mass fraction that we measure. The scaled temperature and metallicity profiles are in general agreement with those observed in relaxed clusters. Also, the quantities we measure are consistent with the observed M-T relation. We conclude that violent outbursts such as the one in MS0735+7421 do not cause dramatic instantaneous departures from cluster scaling relations (other than the L-T relation). However, if they are relatively common they may play a role in creating the global cluster properties.Comment: 69 pages, 30 figures, accepted for publication in ApJ Main Journa

    Effects of social capital on operational performance: impacts of servitisation

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    Studies on servitisation have largely overlooked the roles of social capital with suppliers and knowledge management. We propose a moderated mediation model to investigate the impacts of servitisation on the mechanisms through which social capital with suppliers improves operational performance. The hypotheses are empirically tested using structural equation modelling and data collected from 276 manufacturing firms in China. The results show that social capital improves operational performance both directly and indirectly through knowledge management, and the relationships are influenced by servitisation. In particular, social capital improves operational performance directly and indirectly through knowledge combination in servitised firms, whereas social capital only improves operational performance indirectly through knowledge acquisition in traditional manufacturers. The findings contribute to the literature by revealing that the effects of social capital with suppliers on operational performance are partially mediated by knowledge acquisition and knowledge combination and the mediation effects are moderated by servitisation, and by providing insights into how to design purchasing and production systems to profit from servitisation

    Explorations in anatomy: the remains from Royal London Hospital

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    This paper considers the faunal remains from recent excavations at the Royal London Hospital. The remains date to the beginning of the 19th century and offer an insight into the life of the hospital's patients and practices of the attached medical school. Many of the animal remains consist of partially dissected skeletons, including the unique finds of Hermann's tortoise (Testudo hermanni) and Cercopithecus monkey. The hospital diet and developments in comparative anatomy are discussed by integrating the results with documentary research. They show that zooarchaeological study of later post-medieval material can significantly enhance our understanding of the exploitation of animals in this perio
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