86 research outputs found
Study of the modifications needed for effective operation NASTRAN on IBM virtual storage computers
The necessary modifications were determined to make NASTRAN operational under virtual storage operating systems (VS1 and VS2). Suggested changes are presented which will make NASTRAN operate more efficiently under these systems. Estimates of the cost and time involved in design, coding, and implementation of all suggested modifications are included
A moment problem for pseudo-positive definite functionals
A moment problem is presented for a class of signed measures which are termed
pseudo-positive. Our main result says that for every pseudo-positive definite
functional (subject to some reasonable restrictions) there exists a
representing pseudo-positive measure. The second main result is a
characterization of determinacy in the class of equivalent pseudo-positive
representation measures. Finally the corresponding truncated moment problem is
discussed.Comment: 23
A predictive model for the early identification of patients at risk for a prolonged intensive care unit length of stay
<p>Abstract</p> <p>Background</p> <p>Patients with a prolonged intensive care unit (ICU) length of stay account for a disproportionate amount of resource use. Early identification of patients at risk for a prolonged length of stay can lead to quality enhancements that reduce ICU stay. This study developed and validated a model that identifies patients at risk for a prolonged ICU stay.</p> <p>Methods</p> <p>We performed a retrospective cohort study of 343,555 admissions to 83 ICUs in 31 U.S. hospitals from 2002-2007. We examined the distribution of ICU length of stay to identify a threshold where clinicians might be concerned about a prolonged stay; this resulted in choosing a 5-day cut-point. From patients remaining in the ICU on day 5 we developed a multivariable regression model that predicted remaining ICU stay. Predictor variables included information gathered at admission, day 1, and ICU day 5. Data from 12,640 admissions during 2002-2005 were used to develop the model, and the remaining 12,904 admissions to internally validate the model. Finally, we used data on 11,903 admissions during 2006-2007 to externally validate the model.</p> <p>Results</p> <p>The variables that had the greatest impact on remaining ICU length of stay were those measured on day 5, not at admission or during day 1. Mechanical ventilation, PaO<sub>2</sub>: FiO<sub>2 </sub>ratio, other physiologic components, and sedation on day 5 accounted for 81.6% of the variation in predicted remaining ICU stay. In the external validation set observed ICU stay was 11.99 days and predicted total ICU stay (5 days + day 5 predicted remaining stay) was 11.62 days, a difference of 8.7 hours. For the same patients, the difference between mean observed and mean predicted ICU stay using the APACHE day 1 model was 149.3 hours. The new model's r<sup>2 </sup>was 20.2% across individuals and 44.3% across units.</p> <p>Conclusions</p> <p>A model that uses patient data from ICU days 1 and 5 accurately predicts a prolonged ICU stay. These predictions are more accurate than those based on ICU day 1 data alone. The model can be used to benchmark ICU performance and to alert physicians to explore care alternatives aimed at reducing ICU stay.</p
Cleavage modification did not alter blastomere fates during bryozoan evolution
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The study was funded by the core budget of the Sars Centre and by The
European Research Council Community’s Framework Program Horizon 2020
(2014–2020) ERC grant agreement 648861 to A
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
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Management of Subterranean Clover in Pine Forested Range
Subterranean clover (Trifolium subterraneum) is a cool-season forage legume that can be grown in the southeastern United States. Available varieties grow best on well-drained sites and tolerate acid soil conditions producing adequate forage without addition of lime if soil pH is 4.8 or higher. However, at least during the first few years, annual applications of at least 50 kg/ha of P2O5 and K2O are needed to maintain good production. In addition, summer growth of competing vegetation must be removed annually in late August or early September by heavy livetock grazing, use of herbicide, or close mowing. Unlike other clovers, subterranean will reseed even if heavily grazed during the flowering stage. Initial establishment under pine timber in the Southeast can be achieved by removal of hardwoods, prescribed burning, and broadcasting freshly inoculated seed on top of the soil in late October or early November when the soil surface is wet. Production of adequate forage before mid-winter remains a problem, especially if unregulated use by deer is heavy.This material was digitized as part of a cooperative project between the Society for Range Management and the University of Arizona Libraries.The Journal of Range Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202
The impact of seizure and gastrophageal reflux history on sleep and behaviour in Angelman syndrome
Background: Angelman syndrome (AS) is a rare neurodevelopmental disorder affecting 1 in 15 000 to 1 in 24 000 individuals. The condition results in severe delays in development and expressive language and motor impairments. The Global Angelman Syndrome Registry was developed by families to facilitate longitudinal studies to advance research and therapeutics. This study describes preliminary clinical and behavioural outcomes.
Methods: Caregivers completed the Sleep Disturbance Scale for Children (SDSC; N = 161) and a 29‐item behavioural scale developed for Angelman Syndrome (N = 184). Relationships between seizure and gastroesophageal history, and behaviour and sleep were explored.
Results: A history of seizures was associated with higher levels of excessive somnolence (Mann–Whitney U = 2733.000, p = .028, d = .336), and greater incidences of spontaneous laughter/smiling (Mann–Whitney U = 3709.000, p = .009, d = .406), behaviour dysregulation (Mann–Whitney U = 3,550.000, p = .039, d = .318), and repetitive behaviours (Mann–Whitney U = 3566.000, p = .042, d = .305). A history of gastroesophageal reflux in infancy was associated with spontaneous laughter/smiling (Mann–Whitney U = 2973.500, p = .016, d = .377). Individuals with severe gastroesophageal reflux had higher levels of disordered breathing in sleep compared to individuals with mild cases (Kruskal–Wallis = 9.924, p = .007, d = .796). Medical treatment of gastroesophageal reflux was associated with higher levels of self‐injury (Mann–Whitney U = 913.000, p = .044, d = .388) and repetitive behaviours (Mann–Whitney U = 1003.000, p = .031, d = .454). Spontaneous laughter/smiling, anxiety and repetitive behaviours were associated with sleep disorders (Spearman's r range = .055–.361).
Conclusions: Repetitive behaviours, spontaneous laughter and self‐injury may represent seizure activity or efforts to communicate discomfort associated with gastroesophageal reflux. Excessive somnolence may be a side effect of seizure activity or anti‐epileptics, while disordered breathing may occur in sleep due to reflux
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