1,374 research outputs found
From imagery to ecology: Leveraging time series of all available Landsat observations to map and monitor ecosystem state and dynamics
https://zslpublications.onlinelibrary.wiley.com/doi/full/10.1002/rse2.24Published versio
Applying Quality Improvement methods to address gaps in medicines reconciliation at transfers of care from an acute UK hospital
© Published by the BMJ Publishing Group Limited.Objectives Reliable reconciliation of medicines at admission and discharge from hospital is key to reducing unintentional prescribing discrepancies at transitions of healthcare. We introduced a team approach to the reconciliation process at an acute hospital with the aim of improving the provision of information and documentation of reliable medication lists to enable clear, timely communications on discharge. Setting An acute 400-bedded teaching hospital in London, UK. Participants The effects of change were measured in a simple random sample of 10 adult patients a week on the acute admissions unit over 18â €...months. Interventions Quality improvement methods were used throughout. Interventions included education and training of staff involved at ward level and in the pharmacy department, introduction of medication documentation templates for electronic prescribing and for communicating information on medicines in discharge summaries co-designed with patient representatives. Results Statistical process control analysis showed reliable documentation (complete, verified and intentional changes clarified) of current medication on 49.2% of patients discharge summaries. This appears to have improved (to 85.2%) according to a poststudy audit the year after the project end. Pharmacist involvement in discharge reconciliation increased significantly, and improvements in the numbers of medicines prescribed in error, or omitted from the discharge prescription, are demonstrated. Variation in weekly measures is seen throughout but particularly at periods of changeover of new doctors and introduction of new systems. Conclusions New processes led to a sustained increase in reconciled medications and, thereby, an improvement in the number of patients discharged from hospital with unintentional discrepancies (errors or omissions) on their discharge prescription. The initiatives were pharmacist-led but involved close working and shared understanding about roles and responsibilities between doctors, nurses, therapists, patients and their carers
Stacking Entropy of Hard Sphere Crystals
Classical hard spheres crystallize at equilibrium at high enough density.
Crystals made up of stackings of 2-dimensional hexagonal close-packed layers
(e.g. fcc, hcp, etc.) differ in entropy by only about per sphere
(all configurations are degenerate in energy). To readily resolve and study
these small entropy differences, we have implemented two different
multicanonical Monte Carlo algorithms that allow direct equilibration between
crystals with different stacking sequences. Recent work had demonstrated that
the fcc stacking has higher entropy than the hcp stacking. We have studied
other stackings to demonstrate that the fcc stacking does indeed have the
highest entropy of ALL possible stackings. The entropic interactions we could
detect involve three, four and (although with less statistical certainty) five
consecutive layers of spheres. These interlayer entropic interactions fall off
in strength with increasing distance, as expected; this fall-off appears to be
much slower near the melting density than at the maximum (close-packing)
density. At maximum density the entropy difference between fcc and hcp
stackings is per sphere, which is roughly 30% higher
than the same quantity measured near the melting transition.Comment: 15 page
Equilibrium Simulation of the Slip Coefficient in Nanoscale Pores
Accurate prediction of interfacial slip in nanoscale channels is required by
many microfluidic applications. Existing hydrodynamic solutions based on
Maxwellian boundary conditions include an empirical parameter that depends on
material properties and pore dimensions. This paper presents a derivation of a
new expression for the slip coefficient that is not based on the assumptions
concerning the details of solid-fluid collisions and whose parameters are
obtainable from \textit{equilibrium} simulation. The results for the slip
coefficient and flow rates are in good agreement with non-equilibrium molecular
dynamics simulation.Comment: 11 pages, 4 figures, submitted to Phys Rev Let
Time Scales for transitions between free energy minima of a hard sphere system
Time scales associated with activated transitions between glassy metastable
states of a free energy functional appropriate for a dense hard sphere system
are calculated by using a new Monte Carlo method for the local density
variables. We calculate the time the system,initially placed in a shallow
glassy minimum of the free energy, spends in the neighborhood of this minimum
before making a transition to the basin of attarction of another free energy
minimum. This time scale is found to increase with the average density. We find
a crossover density near which this time scale increases very sharply and
becomes longer than the longest times accessible in our simulation. This scale
shows no evidence of dependence on sample size.Comment: 25 pages, Revtex, 6 postscript figures. Will appear in Phys Rev E,
March 1996 or s
Slip and flow of hard-sphere colloidal glasses
We study the flow of concentrated hard-sphere colloidal suspensions along
smooth, non-stick walls using cone-plate rheometry and simultaneous confocal
microscopy. In the glass regime, the global flow shows a transition from
Herschel-Bulkley behavior at large shear rate to a characteristic Bingham slip
response at small rates, absent for ergodic colloidal fluids. Imaging reveals
both the `solid' microstructure during full slip and the local nature of the
`slip to shear' transition. Both the local and global flow are described by a
phenomenological model, and the associated Bingham slip parameters exhibit
characteristic scaling with size and concentration of the hard spheres.Comment: 4 pages, 4 figures. Accepted for publication in PR
Entropic Origin of the Growth of Relaxation Times in Simple Glassy Liquids
Transitions between ``glassy'' local minima of a model free-energy functional
for a dense hard-sphere system are studied numerically using a
``microcanonical'' Monte Carlo method that enables us to obtain the transition
probability as a function of the free energy and the Monte Carlo ``time''. The
growth of the height of the effective free energy barrier with density is found
to be consistent with a Vogel-Fulcher law. The dependence of the transition
probability on time indicates that this growth is primarily due to entropic
effects arising from the difficulty of finding low-free-energy saddle points
connecting glassy minima.Comment: Four pages, plus three postscript figure
Free energies of crystalline solids: a lattice-switch Monte Carlo method
We present a method for the direct evaluation of the difference between the
free energies of two crystalline structures, of different symmetry. The method
rests on a Monte Carlo procedure which allows one to sample along a path,
through atomic-displacement-space, leading from one structure to the other by
way of an intervening transformation that switches one set of lattice vectors
for another. The configurations of both structures can thus be sampled within a
single Monte Carlo process, and the difference between their free energies
evaluated directly from the ratio of the measured probabilities of each. The
method is used to determine the difference between the free energies of the fcc
and hcp crystalline phases of a system of hard spheres.Comment: 5 pages Revtex, 3 figure
Temperature regulates NF-κB dynamics and function through timing of A20 transcription
NF-κB signaling plays a pivotal role in control of the inflammatory response. We investigated how the dynamics and function of NF-κB were affected by temperature within the mammalian physiological range (34 °C to 40 °C). An increase in temperature led to an increase in NF-κB nuclear/cytoplasmic oscillation frequency following Tumor Necrosis Factor alpha (TNFα) stimulation. Mathematical modeling suggested that this temperature sensitivity might be due to an A20-dependent mechanism, and A20 silencing removed the sensitivity to increased temperature. The timing of the early response of a key set of NF-κB target genes showed strong temperature dependence. The cytokine-induced expression of many (but not all) later genes was insensitive to temperature change (suggesting that they might be functionally temperature-compensated). Moreover, a set of temperature- and TNFα-regulated genes were implicated in NF-κB cross-talk with key cell-fate–controlling pathways. In conclusion, NF-κB dynamics and target gene expression are modulated by temperature and can accurately transmit multidimensional information to control inflammation
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