Theoretical and experimental studies of femto-second streak and picosecond framing image tubes

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An Analysis of the Parasites of a Mid-winter Population of the Snowshoe Hare, Lepus americanus, on Insular Newfoundland During a Cyclical Peak

A mid-winter sample of 78 Snowshoe Hares (Lepus americanus) was collected during their cyclical peak in population from three eco-regions (Western Newfoundland, North Shore and Avalon Forest) on insular Newfoundland and was examined for the presence of enteric parasites. The length of the hares was significantly shorter in the Avalon Forest Region (n = 27) than those of the Western Newfoundland Region (n = 25) and North Shore Region (n = 26) samples (P ≤ 0.001 and P ≤ 0.003 respectively); however, no significant differences occurred for other morphological measurements. Four species of parasites, two cestodes (Mosgovoyia pectinata and Taenia pisiformis) and two nematodes (Obeliscoides cuniculi and Rauschia triangularis), were recovered. Taenia pisiformis was recovered from the North Shore eco-region only. No other significant differences with respect to their prevalence, intensity, mean intensity, relative density and dispersion between eco-regions were found. Within eco-regions, only R. triangularis showed a significantly higher value (P ≤ 0.027) for males and the prevalence of this species was lower than that previously reported. The occurrence of O. cuniculi was significantly different between the higher weight classes of hares and the prevalence of this species was higher than that previously reported. No trends for multiple infections were noted. The expansion of a new animal species, the Coyote, Canis latrans, to Newfoundland appeared to have had no effect on the diversity of parasites found in the hare

Interdisciplinary communication in the intensive care unit

Background. Patient safety research has shown poor communication among intensive care unit (ICU) nurses and doctors to be a common causal factor underlying critical incidents in intensive care. This study examines whether ICU doctors and nurses have a shared perception of interdisciplinary communication in the UK ICU. Methods. Cross-sectional survey of ICU nurses and doctors in four UK hospitals using a previously established measure of ICU interdisciplinary collaboration. Results. A sample of 48 doctors and 136 nurses (47% response rate) from four ICUs responded to the survey. Nurses and doctors were found to have differing perceptions of interdisciplinary communication, with nurses reporting lower levels of communication openness between nurses and doctors. Compared with senior doctors, trainee doctors also reported lower levels of communication openness between doctors. A regression path analysis revealed that communication openness among ICU team members predicted the degree to which individuals reported understanding their patient care goals (adjR2 = 0.17). It also showed that perceptions of the quality of unit leadership predicted open communication. Conclusions. Members of ICU teams have divergent perceptions of their communication with one another. Communication openness among team members is also associated with the degree to which they understand patient care goals. It is necessary to create an atmosphere where team members feel they can communicate openly without fear of reprisal or embarrassment

Growth and Tolerance of Preterm Infants Fed a New Extensively Hydrolyzed Liquid Human Milk Fortifier

OBJECTIVES: This study was a comparison of growth and tolerance in premature infants fed either standard powdered human milk fortifier (HMF) or a newly formulated concentrated liquid that contained extensively hydrolyzed protein. METHODS: This was an unblinded randomized controlled multicenter noninferiority study on preterm infants receiving human milk (HM) supplemented with 2 randomly assigned HMFs, either concentrated liquid HMF containing extensively hydrolyzed protein (LE-HMF) or a powdered intact protein HMF (PI-HMF) as the control. The study population consisted of preterm infants ≤33 weeks who were enterally fed HM. Infants were studied from the first day of HM fortification until day 29 or hospital discharge, whichever came first. RESULTS: A total of 147 preterm infants were enrolled. Noninferiority was observed in weight gain reported in the intent-to-treat (ITT) analysis was 18.2 and 17.5 g · kg(−1) · day(−1) for the LE-HMF and PI-HMF groups, respectively. In an a priori defined subgroup of strict protocol followers (n = 75), the infants fed LE-HMF achieved greater weight over time than those fed PI-HMF (P = 0.036). The LE-HMF group achieved greater linear growth over time compared to the PI-HMF (P = 0.029). The protein intake from fortified HM was significantly higher in the LE-HMF group compared with the PI-HMF group (3.9 vs 3.3 g · kg(−1) · day(−1), P < 0.0001). Both fortifiers were well tolerated with no significant differences in overall morbidity. CONCLUSIONS: Both fortifiers showed excellent weight gain (grams per kilograms per day), tolerance, and low incidence of morbidity outcomes with the infants who were strict protocol followers fed LE-HMF having improved growth during the study. These data point to the safety and suitability of this new concentrated liquid HMF (LE-HMF) in preterm infants. Growth with this fortifier closely matches the recent recommendations for a weight gain of >18 g · kg(−1) · day(−1)

Distributed data processing for public health surveillance

BACKGROUND: Many systems for routine public health surveillance rely on centralized collection of potentially identifiable, individual, identifiable personal health information (PHI) records. Although individual, identifiable patient records are essential for conditions for which there is mandated reporting, such as tuberculosis or sexually transmitted diseases, they are not routinely required for effective syndromic surveillance. Public concern about the routine collection of large quantities of PHI to support non-traditional public health functions may make alternative surveillance methods that do not rely on centralized identifiable PHI databases increasingly desirable. METHODS: The National Bioterrorism Syndromic Surveillance Demonstration Program (NDP) is an example of one alternative model. All PHI in this system is initially processed within the secured infrastructure of the health care provider that collects and holds the data, using uniform software distributed and supported by the NDP. Only highly aggregated count data is transferred to the datacenter for statistical processing and display. RESULTS: Detailed, patient level information is readily available to the health care provider to elucidate signals observed in the aggregated data, or for ad hoc queries. We briefly describe the benefits and disadvantages associated with this distributed processing model for routine automated syndromic surveillance. CONCLUSION: For well-defined surveillance requirements, the model can be successfully deployed with very low risk of inadvertent disclosure of PHI – a feature that may make participation in surveillance systems more feasible for organizations and more appealing to the individuals whose PHI they hold. It is possible to design and implement distributed systems to support non-routine public health needs if required

Specialized High�Protein Oral Nutrition Supplement Improves Home Nutrient Intake of Malnourished Older Adults Without Decreasing Usual Food Intake

Background: Reduced nutrient intake is common in patients after hospitalization, contributing to increased risk for readmissionand mortality. Oral nutrition supplements can improve nutrition status and clinical outcomes, but intake of food is prioritized byclinicians. This study examines the impact of a high-protein oral nutrition supplement (S-ONS) on nutrient intake post discharge. Methods: In a subset of patients (14 S-ONS and 16 placebo) from the NOURISH (Nutrition effect On Unplanned ReadmIssionsand Survival in Hospitalized patients) trial, 24-hour dietary recalls were conducted on 3 randomly selected days during the weeksof 30, 60, and 90 days post discharge. Nutrient intake was estimated using Nutrition Data System for Research software. Adequateenergy and protein intake were dened as 30 kcal/kg/d and 1.2 g/kg/d, respectively. Dietary Reference Intakes (DRIs) were usedfor other nutrients. Results: Less than half of patients met the requirements for energy, protein, and 12 micronutrients from foodintake alone during the study. Energy and protein intakes from food were not diminished relative to placebo. Considering nutrientintake from both food and S-ONS, 50% and 71% of patients receiving S-ONSs met energy and protein goals respectively at 90 days(compared with 29% and 36%, in the placebo group), and 100% met the DRI for total carbohydrate, iron, phosphorus, copper,selenium, thiamin, and riboavin at all time points, all of which were consumed at higher amounts vs placebo. Conclusion: Threemonths of S-ONS consumption increases intake of numerous nutrients without decreasing nutrient intake from food in oldermalnourished adults post discharge

Search for Millicharged Particles at SLAC

Particles with electric charge q < 10^(-3)e and masses in the range 1--100 MeV/c^2 are not excluded by present experiments. An experiment uniquely suited to the production and detection of such "millicharged" particles has been carried out at SLAC. This experiment is sensitive to the infrequent excitation and ionization of matter expected from the passage of such a particle. Analysis of the data rules out a region of mass and charge, establishing, for example, a 95%-confidence upper limit on electric charge of 4.1X10^(-5)e for millicharged particles of mass 1 MeV/c^2 and 5.8X10^(-4)e for mass 100 MeV/c^2.Comment: 4 pages, REVTeX, multicol, 3 figures. Minor typo corrected. Submitted to Physical Review Letter