HEALTHCARE STRATEGIC SUSTAINABILITY: KEY FACTORS AFFECTING THE TRIPLE BOTTOM LINE IN CONVERTING INPATIENT TO OUTPATIENT FACILITIES

Healthcare strategic sustainability seeks to integrate in a cost effective manner sustainable development and design practices with health care facilities that are holistic places of healing for patients; and a safe, efficient, and effective environment for staff. This study focused on six United States Army military healthcare facilities involving conversion from inpatient to outpatient facilities. Data was collected in an intensive interview process from twenty-nine participants representing three stakeholder categories: planners (design and construction), operators (facility management and information technology), and users (clinical staff). The specific research questions addressed what design/building changes were made to accommodate the change from an in-patient to an outpatient care business model; and which existing design/building elements generated significant constraints or benefits when implementing the desired new design concept? The research also explored whether any desired design/building changes were not made, and why; and the extent to which social (quality of care and/or quality of life), economic (cost), or environmental (adaptable and sustainable) factors were considered? The findings confirm the impact of certain design elements on the conversion and adaptability of hospitals; and suggest the need to educate organizations on which design elements to invest in that not only meet cost and environmental quality goals, but also contribute positively to staff quality of life

Characterizing non-Markovian Off-Resonant Errors in Quantum Gates

As quantum gates improve, it becomes increasingly difficult to characterize the remaining errors. Here we describe a class of coherent non-Markovian errors -- excitations due to an off-resonant drive -- that occur naturally in quantum devices that use time-dependent fields to generate gate operations. We show how these errors are mischaracterized using standard Quantum Computer Verification and Validation (QCVV) techniques that rely on Markovianity and are therefore often overlooked or assumed to be incoherent. We first demonstrate off-resonant errors within a simple toy model of Z-gates created by the AC Stark effect, then show how off-resonant errors manifest in all gates driven on a fixed-frequency transmon architecture, a prominent example being incidental cross-resonance interaction driven during single-qubit gates. Furthermore, the same methodology can access the errors caused by two-level systems (TLS), showing evidence of coherent, off-resonant interactions with subsystems that are not intentional qubits. While we explore these results and their impact on gate error for fixed-frequency devices, we note that off-resonant excitations potentially limit any architectures that use frequency selectivity.Comment: fixed typos, updated references, and improved explanation

Sidescan Sonar Image, Surficial Geological Interpretation, and Bathymetry of the Long Island Sound Sea Floor off Milford, Connecticut

The surficial geology of a 6-km X 8-km section of the western part of Long Island Sound has been mapped. The map area is 4 to 12 km south of the mouth of the Housatonic River in 14 to 40 m water depth (see location map). This study is part of an interdisciplinary program to define the surficial geology and benthic habitats in Long Island Sound and to see how they are changing with time, and includes, in addition to this map area, the other survey areas shown on the location map. The U.S. Geological Survey, in cooperation with the University of New Haven and the Connecticut Geological and Natural History Survey, completed a bathymetric, sidescan sonar, and high-resolution seismic-reflection survey of the study area during November 1993 as the first phase of this long-term program. The second phase, which involved bottom sampling and photography, was completed during April-August 1995. Presented in this report is the surficial geological information including the bathymetry, a sidescan sonar mosaic, a preliminary interpretation of the mosaic, and a sediment distribution map of the study area

Targeted and all-sky search for nanosecond optical pulses at Harvard-Smithsonian

We have built a system to detect nanosecond pulsed optical signals from a target list of some 10,000 sun-like stars, and have made some 20,000 observations during its two years of operation. A beamsplitter feeds a pair of hybrid avalanche photodetectors at the focal plane of the 1.5m Cassegrain at the Harvard/Smithsonian Oak Ridge Observatory (Agassiz Station), with a coincidence triggering measurement of pulse width and intensity at sub-nanosecond resolution. A flexible web-enabled database, combined with mercifully low background coincidence rates (approximately 1 event per night), makes it easy to sort through far-flung data in search of repeated events from any candidate star. An identical system will soon begin observations, synchronized with ours, at the 0.9m Cassegrain at Princeton University. These will permit unambiguous identification of even a solitary pulse. We are planning an all-sky search for optical pulses, using a dedicated 1.8m f/2.4 spherical glass light bucket and an array of pixelated photomultipliers deployed in a pair of matched focal planes. The sky pixels, 1.5 arcmin square, tessellate a 1.6 by 0.2 degree patch of sky in transit mode, covering the Northern sky in approximately 150 clear nights. Fast custom IC electronics will monitor corresponding pixels for coincident optical pulses of nanosecond timescale, triggering storage of a digitized waveform of the light flash

Air Pressure Responses to Sudden Vocal Tract Pressure Bleeds During Production of Stop Consonants: New Evidence of Aeromechanical Regulation

Two studies were conducted to evaluate short-latency vocal tract air pressure responses to sudden pressure bleeds during production of voiceless bilabial stop consonants. It was hypothesized that the occurrence of respiratory reflexes would be indicated by distinct patterns of responses as a function of bleed magnitude. In Study 1, 19 adults produced syllable trains of /pΛ/ using a mouthpiece coupled to a computer-controlled perturbator. The device randomly created bleed apertures that ranged from 0 to 40 mm2 during production of the 2nd or 4th syllable of an utterance. Although peak oral air pressure dropped in a linear manner across bleed apertures, it averaged 2 to 3 cm H2O at the largest bleed. While slope of oral pressure also decreased in a linear trend, duration of the oral pressure pulse remained relatively constant. The patterns suggest that respiratory reflexes, if present, have little effect on oral air pressure levels. In Study 2, both oral and subglottal air pressure responses were monitored in 2 adults while bleed apertures of 20 and 40 mm2 were randomly created. For 1 participant, peak oral air pressure dropped across bleed apertures, as in Study 1. Subglottal air pressure and slope, however, remained relatively stable. These patterns provide some support for the occurrence of respiratory reflexes to regulate subglottal air pressure. Overall, the studies indicate that the inherent physiologic processes of the respiratory system, which may involve reflexes, and passive aeromechanical resistance of the upper airway are capable of developing oral air pressure in the face of substantial pressure bleeds. Implications for understanding speech production and the characteristics of individuals with velopharyngeal dysfunction are discussed

Velopharyngeal Status of Stop Consonants and Vowels Produced by Young Children With and Without Repaired Cleft Palate at 12, 14, and 18 Months of Age: A Preliminary Analysis

The objective was to determine velopharyngeal (VP) status of stop consonants and vowels produced by young children with repaired cleft palate (CP) and typically developing (TD) children from 12 to 18 months of age

Exogenous Short Chain Fatty Acid Effects in APP/PS1 Mice

Elucidating the impact of the gut microbiome on Alzheimer’s Disease (AD) is an area of intense interest. Short chain fatty acids (SCFAs) are major microbiota metabolites that have been implicated as a mediator of gut microbiome effects in the brain. Here, we tested the effects of SCFA-treated water vs. saline-treated water on APPswe/PSEN1dE9 mice maintained under standard laboratory conditions. Mice were treated with SCFAs from five months of age until ten months of age, when they were evaluated for microbiome profile, impaired spatial memory as evaluated with the radial arm water maze, astrocyte activation as measured by Gfap expression and amyloid burden as assessed by histochemistry and MSD ELISA. We report that SCFA treatment increased alpha-diversity and impacted the gut microbiome profile by increasing, in part, the relative abundance of several bacteria that typically produce SCFAs. However, SCFA treatment did not significantly affect behavior. Similarly, SCFAs did not affect cortical or hippocampal astrocyte activation observed in the APP/PS1 mice. Lastly, although robust levels of soluble and insoluble amyloid were present in the APP/PS1 mice, SCFA treatment had no effect on these indices. Overall, our findings are that SCFA treatment modifies the microbiome in a fashion that may increase further SCFA production. However, SCFA treatment did not alter behavior, astrocyte activation, nor amyloid neuropathology in APP/PS1 mice maintained with a conventional microbiome