An Adult PCV13 Vaccination Protocol in the Retail Healthcare Setting

Purpose – To establish an adult Pneumococcal (PCV13) vaccination protocol within a chain of retail healthcare clinics. Background - Invasive Pneumococcal disease results in significant morbidity and mortality in patients ≥65 and those with immunocompromised status. Despite CDC recommendations, national PCV13 vaccination rates remain low in these populations. No adult PCV13 vaccination protocol existed in the project retail healthcare clinics. Project Plan Process – An evidence-based PCV13 vaccination protocol based on the CDC guidelines using the Provus Discrepancy Evaluation Model as a framework was implemented. NPs were educated on indications for PCV13 vaccinations and a questionnaire to identify those patients who qualified. Qualified patients were either vaccinated or referred elsewhere for vaccination. The EMR system was reviewed to determine the number of patients who qualified for the PCV13 vaccination who were screened. Results: Of the 3,202 patients, 4-6% qualified for the PCV13 vaccination, 27.7% were identified and offered the PCV13 vaccination and 11% were vaccinated or referred elsewhere for vaccination. Regarding age, 65.2% of patients who qualified for PCV13 were ≥65 in contrast to 34.8% who were 19-64 years old. As for those patients who were actually vaccinated, 76.5% were ≥65 while 23.5% were 19-64 years old. Conclusions/Implications - Retail health care clinics can be an effective venue for providing essential vaccinations. Nurse practitioners are well prepared with the knowledge base and skill set to assume a leadership role in the development of vaccination programs within our communities

Distinct order of Gd 4f and Fe 3d moments coexisting in GdFe4Al8

Single crystals of flux-grown tetragonal GdFe4Al8 were characterized by thermodynamic, transport, and x-ray resonant magnetic scattering measurements. In addition to antiferromagnetic order at TN ~ 155 K, two low-temperature transitions at T1 ~ 21 K and T2 ~ 27 K were identified. The Fe moments order at TN with an incommensurate propagation vector (tau,tau,0) with tau varying between 0.06 and 0.14 as a function of temperature, and maintain this order over the entire T<TN range. The Gd 4f moments order below T2 with a ferromagnetic component mainly out of plane. Below T1, the ferromagnetic components are confined to the crystallographic plane. Remarkably, at low temperatures the Fe moments maintain the same modulation as at high temperatures, but the Gd 4f moments apparently do not follow this modulation. The magnetic phase diagrams for fields applied in [110] and [001] direction are presented and possible magnetic structures are discussed.Comment: v2: 14 pages, 12 figures; PRB in prin

Stabilization Control of the Differential Mobile Robot Using Lyapunov Function and Extended Kalman Filter

This paper presents the design of a control model to navigate the differential mobile robot to reach the desired destination from an arbitrary initial pose. The designed model is divided into two stages: the state estimation and the stabilization control. In the state estimation, an extended Kalman filter is employed to optimally combine the information from the system dynamics and measurements. Two Lyapunov functions are constructed that allow a hybrid feedback control law to execute the robot movements. The asymptotical stability and robustness of the closed loop system are assured. Simulations and experiments are carried out to validate the effectiveness and applicability of the proposed approach.Comment: arXiv admin note: text overlap with arXiv:1611.07112, arXiv:1611.0711

Two-State Migration of DNA in a structured Microchannel

DNA migration in topologically structured microchannels with periodic cavities is investigated experimentally and with Brownian dynamics simulations of a simple bead-spring model. The results are in very good agreement with one another. In particular, the experimentally observed migration order of Lambda- and T2-DNA molecules is reproduced by the simulations. The simulation data indicate that the mobility may depend on the chain length in a nonmonotonic way at high electric fields. This is found to be the signature of a nonequilibrium phase transition between two different migration states, a slow one and a fast one, which can also be observed experimentally under appropriate conditions.Comment: Revised edition corresponding to the comments by the referees, submitted to Physical Review

Efficiently Clustering Very Large Attributed Graphs

Attributed graphs model real networks by enriching their nodes with attributes accounting for properties. Several techniques have been proposed for partitioning these graphs into clusters that are homogeneous with respect to both semantic attributes and to the structure of the graph. However, time and space complexities of state of the art algorithms limit their scalability to medium-sized graphs. We propose SToC (for Semantic-Topological Clustering), a fast and scalable algorithm for partitioning large attributed graphs. The approach is robust, being compatible both with categorical and with quantitative attributes, and it is tailorable, allowing the user to weight the semantic and topological components. Further, the approach does not require the user to guess in advance the number of clusters. SToC relies on well known approximation techniques such as bottom-k sketches, traditional graph-theoretic concepts, and a new perspective on the composition of heterogeneous distance measures. Experimental results demonstrate its ability to efficiently compute high-quality partitions of large scale attributed graphs.Comment: This work has been published in ASONAM 2017. This version includes an appendix with validation of our attribute model and distance function, omitted in the converence version for lack of space. Please refer to the published versio

Relation between the Ultrasonic Attenuation and the Porosity of a RTM Composite Plate

AbstractWe propose a comparative study of X-ray tomography and ultrasonic reflection methods, for determining the porosity of a composite plate realized in LOMC with an industrial process. We measure the attenuation of ultrasound propagating in the thickness by using 10MHz plane transducer in pulse-echo mode. Comparing these results to the 2D porosity tomographic map allows establishing a relation between attenuation and porosity. A C-scan picture of the plate given by the echoes reflected by the rear surface also provides a local information on the attenuation. Furthermore, we propose a method for the mapping of the reflecting sources as the included bubbles and the interfaces resin/fibers