Expected quality of medical services in patients' opinion

Medical services are unique type of industry in which measurement, evaluation and improvement of quality is not evident. This is due to the fact that the final results, even fully correct and consistent with the current medical knowledge of the treatment process, are not always predictable. In the medical profession, the quality of services provided is largely based on the subjective perceptions of the patients, that is why the field requires a different approach than other services. Objective. The aim of the study was to elitic and hierarchize elements that are the most important and most displeasing for patients in the process of using medical services as those factors determine the perceived level of medical services' quality. Material and method. The research method used in the study was a diagnostic survey, the technique was author's questionnaire. The study was conducted from January to May 2016. During this period 185 surveys were completed for statistical analysis. Surveys were filled in by respondents who declared active use of services provided by Polish public health care institutions. Results and conclusions. Regardless of the age and gender of the respondents, responses were very similar and clearly indicated that the most important element that determines the assessment of services is competence of the staff (education, knowledge, experience but also respect for patients) and availability and waiting times. In turn, the most displeasing elements are: long waiting times for health services, long queues, difficulties with availability of health services, hasty medical visits (short, superficial visit without thourough medical interview). Results of the study show, that patients' expectations are reasonable and possible to meet by health care institutions

A modal approach to modelling spin wave scattering

Efficient numerical methods are required for the design of optimised devices. In magnonics, the primary computational tool is micromagnetic simulations, which solve the Landau-Lifshitz equation discretised in time and space. However, their computational cost is high, and the complexity of their output hinders insight into the physics of the simulated system, especially in the case of multimode propagating wave-based devices. We propose a finite-element modal method allowing an efficient solution of the scattering problem for dipole-exchange spin waves propagating perpendicularly to the magnetisation direction. The method gives direct access to the scattering matrix of the whole system and its components. We extend the formula for the power carried by a magnetostatic mode in the Damon-Eshbach configuration to the case with exchange, allowing the scattering coefficients to be normalised to represent the fraction of the input power transferred to each output channel. We apply the method to the analysis of spin-wave scattering on a basic functional block of magnonic circuits, consisting of a resonator dynamically coupled to a thin film. The results and the method are validated by comparison with micromagnetic simulations

rac-(1S,2R)-Diethyl 6-hydr­oxy-1-(4-methoxy­phen­yl)-3-oxo-2,3-di­hydro-1H-benzo[f]chromen-2-yl]­phospho­nate

In the title compound, C24H25O7P, the δ-valerolactonyl ring exists in a distorted screw-boat conformation with the diethoxy­phosphoryl substituent occupying an axial position. The latter adopts an almost syn-periplanar conformation around the P—C bond. The mol­ecules form centrosymmetric dimers connected by O—H⋯O hydrogen bonds

Advanced magnon-optic effects with spin-wave leaky modes

We numerically demonstrate the excitation of leaky spin waves (SWs) guided along a ferromagnetic stripe by an obliquely incident SW beam on the thin film edge placed below the stripe. During propagation, leaky waves emit energy back to the layer in the form of plane waves and several laterally shifted parallel SW beams. This resonance excitation, combined with interference effects of the reflected and re-emitted waves, results in the magnonic Woods anomaly and significant increase of the Goos-Hanchen shift magnitude. Hence, we provide a unique platform to control SW reflection and to transfer SWs from a 2D platform into the 1D guiding mode that can be used to form a transdimensional magnonic router

Perioperative lung ultrasound pattern changes in patients undergoing gynecological procedures — a prospective observational study

Objectives: General anesthesia and positive pressure ventilation are associated with perioperative pulmonary complications.Lung ultrasound (LUS) is a method used to evaluate lung parenchyma. The purpose of this study was to evaluate LUSpatterns in a cohort of women undergoing gynecological surgery with uncomplicated general anesthesia.Material and methods: Patients were assessed according to the 8-zone LUS assessment protocol used to detect lungsliding, A-lines, B-lines, interstitial syndrome and lung consolidation. Each patient was screened at specific time intervals:before induction of anesthesia, at induction, 30 and 60 minutes after induction and within two hours after recovery.Results: A total of 99 patients undergoing gynecological surgery with uneventful anesthesia from November 2017 to November2018 were included in this study. A total of 426 LUS records were retained for further analysis. Overall, no significantchanges to patients’ A-line appearance were detected, regardless of the time of assessment. There was, however, an increasein the number of B-lines at the screening times of 30 and 60 minutes after induction, as compared to initial assessments(p = 0.011 and p < 0.001 respectively), and an increase in the number of positive regions (≥ 3 B-lines) at 30 and 60 minutesafter induction and after recovery, as compared to initial assessment (p < 0.001; p < 0.001 and p = 0.001 respectively).Conclusions: An uneventful anesthesia may predispose to abnormal LUS findings and should be considered while interpretingof LUS results in cases with perioperative pulmonary complications

Project for the Terminus at Redycka Street

The aim of the paper is to present a modernization project for the terminus at Redycka street in Wroclaw. The social amenity for the drivers and for the terminus staff has been designed. Additional equipment has been suggested, whose aim is to improve the terminus proper functioning. Also staff and passengers comfort has been taken into consideration. Proper pavement for the terminus has been designed as well

Feasibility of FPGA to HPC computation migration of plasma impurities diagnostic algorithms

We present a feasibility study of fast events parameters estimation algorithms regarding their execution time. It is the first stage of procedure used on data gathered from gas electron multiplier (GEM) detector for diagnostic of plasma impurities. Measured execution times are estimates of achievable times for future and more complex algorithms. The work covers usage of Intel Xeon and Intel Xeon Phi - high-performance computing (HPC) devices as a possible replacement for FPGA with highlighted advantages and disadvantages. Results show that less than 10 ms feedback loop can be obtained with the usage of 25% hardware resources in Intel Xeon or 10% resources in Intel Xeon Phi which leaves space for future increase of algorithms complexity. Moreover, this work contains a simplified overview of basic problems in actual measurement systems for diagnostic of plasma impurities, and emerging trends in developed solutions

Współczesne poglądy dotyczące diagnostycznej wartości stężenia troponin u chorych z okołooperacyjnym uszkodzeniem mięśnia sercowego po chirurgicznym pomostowaniu tętnic wieńcowych

Ocenę zmian stężenia troponiny I (cTnI) we krwi pacjentów po zabiegach pomostowania aortalno-wieńcowego obecnie uznaje się za standardową procedurę w diagnostyce okołooperacyjnego uszkodzenia mięśnia sercowego. Swoistość cTnI sprawia, że wskaźnik ten uważa się za bardzo czuły i specyficzny marker w rozpoznaniu zawału okołooperacyjnego, a także nawet niewielkiego uszkodzenia miokardium. Niedokrwienie mięśnia sercowego w okresie okołooperacyjnym może być wynikiem zamknięcia pomostowanego naczynia lub tętnicy wieńcowej, na której nie przeprowadzono zabiegu pomostowania. Może być ono również wynikiem niedostatecznej protekcji mięśnia sercowego, hipotermii czy też przedłużonego czasu zaklemowania aorty. Określenie referencyjnych wartości parametrów biochemicznych w diagnostyce omawianej patologii jest przy tym niezmiernie ważne i umożliwia wczesne rozpoznanie ostrego niedokrwienia miokardium. Złożona procedura krążenia pozaustrojowego, a zwłaszcza stosowana standardowo normowolemiczna hemodylucja oraz śródoperacyjna hipotermia mogą wpływać na zmiany stężenia cTnI, a przez to zmieniać jej wartość diagnostyczną. Dlatego też cTnI nie może być uważana za jedyny marker niedokrwienia, chociaż jej podwyższone stężenie pozwala potwierdzić lub wykluczyć okołooperacyjne uszkodzenie mięśnia sercowego

Współczesne poglądy dotyczące diagnostycznej wartości stężenia troponin u chorych z okołooperacyjnym uszkodzeniem mięśnia sercowego po chirurgicznym pomostowaniu tętnic wieńcowych

Ocenę zmian stężenia troponiny I (cTnI) we krwi pacjentów po zabiegach pomostowania aortalno-wieńcowego obecnie uznaje się za standardową procedurę w diagnostyce okołooperacyjnego uszkodzenia mięśnia sercowego. Swoistość cTnI sprawia, że wskaźnik ten uważa się za bardzo czuły i specyficzny marker w rozpoznaniu zawału okołooperacyjnego, a także nawet niewielkiego uszkodzenia miokardium. Niedokrwienie mięśnia sercowego w okresie okołooperacyjnym może być wynikiem zamknięcia pomostowanego naczynia lub tętnicy wieńcowej, na której nie przeprowadzono zabiegu pomostowania. Może być ono również wynikiem niedostatecznej protekcji mięśnia sercowego, hipotermii czy też przedłużonego czasu zaklemowania aorty. Określenie referencyjnych wartości parametrów biochemicznych w diagnostyce omawianej patologii jest przy tym niezmiernie ważne i umożliwia wczesne rozpoznanie ostrego niedokrwienia miokardium. Złożona procedura krążenia pozaustrojowego, a zwłaszcza stosowana standardowo normowolemiczna hemodylucja oraz śródoperacyjna hipotermia mogą wpływać na zmiany stężenia cTnI, a przez to zmieniać jej wartość diagnostyczną. Dlatego też cTnI nie może być uważana za jedyny marker niedokrwienia, chociaż jej podwyższone stężenie pozwala potwierdzić lub wykluczyć okołooperacyjne uszkodzenie mięśnia sercowego