WorldWideScience

Sample records for primary electron range

  1. Short Rayleigh Range Free Electron Laser Amplifiers

    CERN Document Server

    Yu, L H; Murphy, J B; Rose, J; Shaftan, T V; Wang, X J; Watanabe, T

    2005-01-01

    An important requirement for a high average power laser system is a manageable power density on the first optical element. One possibility to achieve this is a single pass amplifier which generates a short Rayleigh range (SRL) light beam. We present design parameters and calculated performances for several SRL configurations. These include a simulation of the optically guided (pinched) MW class FEL [1], the scalloped beam FEL amplifier [2] and high gain TOK amplifiers we propose to explore at our SDL facility.

  2. Screening for primary aldosteronism- normal ranges for aldosterone ...

    African Journals Online (AJOL)

    Objective. To establish normal ranges for plasma aldosterone, renin and aldosterone / renin (A/ R) ratio in South African normotensives under typical ou tpatient conditions, and to estimate the prevalence of primary aldosteronism (PA) among hypertensives in primary care settings. Design and methods. One hundred and ...

  3. Primary Paralleled Isolated Boost Converter with Extended Operating Voltage Range

    DEFF Research Database (Denmark)

    Hernandez Botella, Juan Carlos; Sen, Gökhan; Mira Albert, Maria del Carmen

    2012-01-01

    Applications requiring wide input and output voltage range cannot often be satisfied by using buck or boost derived topologies. Primary paralleled isolated boost converter (PPIBC) [1]-[2] is a high efficiency boost derived topology. This paper proposes a new operation mode for extending the input...

  4. Short range correlations in a one dimensional electron gas

    OpenAIRE

    Tas, Murat; Tomak, Mehmet

    2001-01-01

    We use the SSTL (Singwi, Sjolander, Tosi, Land) approximation to investigate the short--range correlations in a one dimensional electron gas, for the first time. Although SSTL is introduced to better satisfy the compressibility sum rule in three dimensions, the widely used STLS (Singwi, Tosi, Land, Sjolander) approximation turns out to be more successful in the case of the one dimensional electron gas.

  5. Characteristic energy range of electron scattering due to plasmaspheric hiss

    Science.gov (United States)

    Ma, Q.; Li, W.; Thorne, R. M.; Bortnik, J.; Reeves, G. D.; Kletzing, C. A.; Kurth, W. S.; Hospodarsky, G. B.; Spence, H. E.; Baker, D. N.; Blake, J. B.; Fennell, J. F.; Claudepierre, S. G.; Angelopoulos, V.

    2016-12-01

    We investigate the characteristic energy range of electron flux decay due to the interaction with plasmaspheric hiss in the Earth's inner magnetosphere. The Van Allen Probes have measured the energetic electron flux decay profiles in the Earth's outer radiation belt during a quiet period following the geomagnetic storm that occurred on 7 November 2015. The observed energy of significant electron decay increases with decreasing L shell and is well correlated with the energy band corresponding to the first adiabatic invariant μ = 4-200 MeV/G. The electron diffusion coefficients due to hiss scattering are calculated at L = 2-6, and the modeled energy band of effective pitch angle scattering is also well correlated with the constant μ lines and is consistent with the observed energy range of electron decay. Using the previously developed statistical plasmaspheric hiss model during modestly disturbed periods, we perform a 2-D Fokker-Planck simulation of the electron phase space density evolution at L = 3.5 and demonstrate that plasmaspheric hiss causes the significant decay of 100 keV-1 MeV electrons with the largest decay rate occurring at around 340 keV, forming anisotropic pitch angle distributions at lower energies and more flattened distributions at higher energies. Our study provides reasonable estimates of the electron populations that can be most significantly affected by plasmaspheric hiss and the consequent electron decay profiles.

  6. Characteristics of different frequency ranges in scanning electron microscope images

    Energy Technology Data Exchange (ETDEWEB)

    Sim, K. S., E-mail: kssim@mmu.edu.my; Nia, M. E.; Tan, T. L.; Tso, C. P.; Ee, C. S. [Faculty of Engineering and Technology, Multimedia University, 75450 Melaka (Malaysia)

    2015-07-22

    We demonstrate a new approach to characterize the frequency range in general scanning electron microscope (SEM) images. First, pure frequency images are generated from low frequency to high frequency, and then, the magnification of each type of frequency image is implemented. By comparing the edge percentage of the SEM image to the self-generated frequency images, we can define the frequency ranges of the SEM images. Characterization of frequency ranges of SEM images benefits further processing and analysis of those SEM images, such as in noise filtering and contrast enhancement.

  7. Electronic health records and support for primary care teamwork

    Science.gov (United States)

    Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A.; Scholle, Sarah Hudson

    2015-01-01

    Objective Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Methods Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. Results EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Discussion Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. Conclusions EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. PMID:25627278

  8. Electronic health records and support for primary care teamwork.

    Science.gov (United States)

    O'Malley, Ann S; Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A; Scholle, Sarah Hudson

    2015-03-01

    Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.

  9. Electronic consultation system demonstrates educational benefit for primary care providers.

    Science.gov (United States)

    Kwok, Jonas; Olayiwola, J Nwando; Knox, Margae; Murphy, Elizabeth J; Tuot, Delphine S

    2017-01-01

    Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales. Differences in primary care providers' perceptions were examined overall and by primary care providers' speciality, provider type and years of experience. Results Among 221 primary care provider participants (35% response rate), 83.9% agreed or strongly agreed that the integrated electronic consultation and referral system provided educational value. There were no significant differences in educational value reported by provider type (attending physician, mid-level provider, or trainee physician), primary care providers' speciality, or years of experience. Perceived benefit of the electronic consultation and referral system in clinical management appeared stronger for laboratory-based conditions (i.e. subclinical hypothyroidism) than more diffuse conditions (i.e. abdominal pain). Nurse practitioners/physician assistants and trainee physicians were more likely to report improved abilities to manage specific clinical conditions when using the electronic consultation and/or referral system than were attending physicians, as were primary care providers with ≤10 years experience, versus those with >20 years of experience. Conclusions Primary care providers report overwhelmingly positive perceptions of the educational value of an integrated electronic consultation and referral system. Nurse

  10. Short-Range Correlation Models in Electronic Structure Theory

    Science.gov (United States)

    Goldey, Matthew Bryant

    Correlation methods within electronic structure theory focus on recovering the exact electron-electron interaction from the mean-field reference. For most chemical systems, including dynamic correlation, the correlation of the movement of electrons proves to be sufficient, yet exact methods for capturing dynamic correlation inherently scale polynomially with system size despite the locality of the electron cusp. This work explores a new family of methods for enhancing the locality of dynamic correlation methodologies with an aim toward improving accuracy and scalability. The introduction of range-separation into ab initio wavefunction methods produces short-range correlation methodologies, which can be supplemented with much faster approximate methods for long-range interactions. First, I examine attenuation of second-order Moller-Plesset perturbation theory (MP2) in the aug-cc-pVDZ basis. MP2 treats electron correlation at low computational cost, but suffers from basis set superposition error (BSSE) and fundamental inaccuracies in long-range contributions. The cost differential between complete basis set (CBS) and small basis MP2 restricts system sizes where BSSE can be removed. Range-separation of MP2 could yield more tractable and/or accurate forms for short- and long-range correlation. Retaining only short-range contributions proves to be effective for MP2 in the small aug-cc-pVDZ (aDZ) basis. Using one range-separation parameter within either the complementary error function (erfc) or a sum of two error functions (terfc), superior behavior is obtained versus both MP2/aDZ and MP2/CBS for inter- and intra-molecular test sets. Attenuation of the long-range helps to cancel both BSSE and intrinsic MP2 errors. Direct scaling of the MP2 correlation energy (SMP2) proves useful as well. The resulting SMP2/aDZ, MP2(erfc, aDZ), and MP2(terfc, aDZ) methods perform far better than MP2/aDZ across systems with hydrogen-bonding, dispersion, and mixed interactions at a

  11. Photon and primary electron arithmetics in photoconductors for digital mammography: Monte Carlo simulation studies

    Energy Technology Data Exchange (ETDEWEB)

    Sakellaris, T; Spyrou, G; Panayiotakis, G [University of Patras, School of Medicine, Department of Medical Physics, Patras, 26500 (Greece); Tzanakos, G [University of Athens, Department of Physics, Div. Nucl. and Particle Physics, Athens, 15771 (Greece)], E-mail: panayiot@upatras.gr

    2009-06-15

    Materials like CdTe, CdZnTe, Cd{sub 0.8}Zn{sub 0.2}Te and ZnTe are suitable photoconductors for direct conversion digital flat panel x-ray image detectors. The x-ray induced primary electrons inside photoconductor's bulk comprise the initial signal that propagates and forms the final signal (image) on detector's electrodes. An already developed Monte Carlo model that simulates the primary electron generation in photoconducting materials, such as those mentioned above, has been used to study the arithmetics of fluorescent photons, escaping photons and primary electrons in these materials in the mammographic energy range. In this way insights are gained concerning the primitive stage of signal formation that lead to the investigation of the factors that affect the primary electron generation. It was found that for the typical photoconductor thicknesses (300-1000 {mu}m): (i) in all materials and incident energies the escaping of primary photons is negligible and does not influence the number of primary electrons, (ii) the overwhelming majority of escaping photons is backwards escaping fluorescent photons, (iii) the number of primary electrons increases at energies higher than Cd and Te K-edges where the fluorescent photon escaping decreases and their absorption is followed by long atomic deexcitation cascades and (iv) ZnTe has the maximum number of primary electrons produced for energies between 16 and 26 keV while CdTe for higher energies.

  12. Electron scattering from neon via effective range theory

    Energy Technology Data Exchange (ETDEWEB)

    Fedus, Kamil, E-mail: kamil@fizyka.umk.pl [Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Torun (Poland)

    2014-07-01

    Elastic cross-sections for electron scattering on neon from 0 energy up to 16 eV are analyzed by an analytical approach to the modified effective range theory (MERT). It is shown that energy and angular variations of elastic differential, integral and momentum transfer cross sections can be accurately parameterized by six MERT coefficients up to the energy threshold for the first Feshbach resonance. MERT parameters are determined empirically by numerical comparison with large collection of available experimental data of elastic total (integral) cross-sections. The present analysis is validated against numerous electron beams and swarm experiments. The comparison of derived MERT parameters with those found for other noble gases, helium, argon and krypton, is done. The derived scattering length (for the s-partial wave) in neon, 0.227a0, agrees well with recent theories; it is small but, differently from Ar and Kr, still positive. Analogue parameters for the p-wave and the d-wave are negative and positive respectively for all the four gases compared. (author)

  13. ‘Excess’ of primary cosmic ray electrons

    Directory of Open Access Journals (Sweden)

    Xiang Li

    2015-10-01

    Full Text Available With the accurate cosmic ray (CR electron and positron spectra (denoted as Φe− and Φe+, respectively measured by AMS-02 Collaboration, the difference between the electron and positron fluxes (i.e., ΔΦ=Φe−−Φe+, dominated by the propagated primary electrons, can be reliably inferred. In the standard model, the spectrum of propagated primary CR electrons at energies ≥30GeV softens with the increase of energy. The absence of any evidence for such a continuous spectral softening in ΔΦ strongly suggests a significant ‘excess’ of primary CR electrons and at energies of 100–400GeV the identified excess component has a flux comparable to that of the observed positron excess. Middle-age but ‘nearby’ supernova remnants (e.g., Monogem and Geminga are favored sources for such an excess.

  14. Profile Monitors for Wide Multiplicity Range Electron Beams

    CERN Document Server

    Buonomo, B; Quintieri, L

    2005-01-01

    The DAFNE Beam Test Facility (BTF) provides electron and positron beams in a wide range of intensity, from single particle up to 1010 particles per pulse, and energy, from a few tens of MeV up to 800 MeV. The pulse time width can be adjusted between 1 and 10 ns and the maximum repetition rate is 50 Hz. The large range of operation of the facility requires the implementation of different beam profile and multiplicity monitors. In the single particle operation mode the beam spot profile and position are measured by a x-y scintillating fiber system with millimetric resolution and multi-anode PMT readout. From a few tens up to 106-107 particles per pulse, a silicon chamber made of two 9.5x9.5 cm2 wide 400μm thick silicon strip detectors organized in a x-y configuration with a pitch of 121μm has been developed. Once calibrated, the system can be used also as an intensity monitor. The description of the devices and the results obtained during the data taking periods of several experiments at the...

  15. The range and intensity of backscattered electrons for use in the creation of high fidelity electron beam lithography patterns.

    Science.gov (United States)

    Czaplewski, David A; Holt, Martin V; Ocola, Leonidas E

    2013-08-02

    We present a set of universal curves that predict the range and intensity of backscattered electrons which can be used in conjunction with electron beam lithography to create high fidelity nanoscale patterns. The experimental method combines direct write dose, backscattered dose, and a self-reinforcing pattern geometry to measure the dose provided by backscattered electrons to a nanoscale volume on the substrate surface at various distances from the electron source. Electron beam lithography is used to precisely control the number and position of incident electrons on the surface of the material. Atomic force microscopy is used to measure the height of the negative electron beam lithography resist. Our data shows that the range and the intensity of backscattered electrons can be predicted using the density and the atomic number of any solid material, respectively. The data agrees with two independent Monte Carlo simulations without any fitting parameters. These measurements are the most accurate electron range measurements to date.

  16. The range and intensity of backscattered electrons for use in the creation of high fidelity electron beam lithography patterns

    Science.gov (United States)

    Czaplewski, David A.; Holt, Martin V.; Ocola, Leonidas E.

    2013-08-01

    We present a set of universal curves that predict the range and intensity of backscattered electrons which can be used in conjunction with electron beam lithography to create high fidelity nanoscale patterns. The experimental method combines direct write dose, backscattered dose, and a self-reinforcing pattern geometry to measure the dose provided by backscattered electrons to a nanoscale volume on the substrate surface at various distances from the electron source. Electron beam lithography is used to precisely control the number and position of incident electrons on the surface of the material. Atomic force microscopy is used to measure the height of the negative electron beam lithography resist. Our data shows that the range and the intensity of backscattered electrons can be predicted using the density and the atomic number of any solid material, respectively. The data agrees with two independent Monte Carlo simulations without any fitting parameters. These measurements are the most accurate electron range measurements to date.

  17. Expanding the Range of Text Types Used in the Primary Grades

    Science.gov (United States)

    Strachan, Stephanie L.

    2015-01-01

    Primary-grade students' experiences with text should prepare them to critically read an extensive range of text types throughout their schooling and career, a primary goal of the Common Core State Standards (CCSS). However, research demonstrates that narrative text overshadows other text types in the primary grades. The purpose of this…

  18. Long-Range Photoinduced Electron Transfer Through a DNA Helix

    Science.gov (United States)

    Murphy, C. J.; Arkin, M. R.; Jenkins, Y.; Ghatlia, N. D.; Bossmann, S. H.; Turro, N. J.; Barton, J. K.

    1993-11-01

    Rapid photoinduced electron transfer is demonstrated over a distance of greater than 40 angstroms between metallointercalators that are tethered to the 5' termini of a 15-base pair DNA duplex. An oligomeric assembly was synthesized in which the donor is Ru(phen)_2dppz^2+ (phen, phenanthroline, and dppz, dipyridophenazine) and the acceptor is Rh(phi)_2phen^3+ (phi, phenanthrenequinone diimine). These metal complexes are intercalated either one or two base steps m from the helix termini. Although the ruthenium-modified oligonucleotide hybridized to an unmodified complement luminesces intensely, the ruthenium-modified oligomer hybridized to the rhodium-modified oligomer shows no detectable luminescence. Time-resolved studies point to a lower limit of 109 per second for the quenching rate. No quenching was observed upon metallation of two complementary octamers by Ru(phen)_32+ and Rh(phen)_33+ under conditions where the phen complexes do not intercalate. The stacked aromatic heterocycles of the DNA duplex therefore serve as an efficient medium for coupling electron donors and acceptors over very long distances.

  19. Long-range photoinduced electron transfer through a DNA helix

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, C.J.; Arkin, M.R.; Jenkins, Y.; Barton, J.K. (California Institute of Technology, Pasadena, CA (United States)); Ghatlia, N.D.; Bossmann, S.H.; Turro, N.J. (Columbia Univ., New York, NY (United States))

    1993-11-12

    Rapid photoinduced electron transfer is demonstrated over a distance of greater than 40 angstroms between metallointercalators that are tethered to the 5' termini of a 15-base pair DNA duplex. An oligomeric assembly was synthesized in which the donor is Ru(phen)[sub 2]dppz[sup 2+] (phen, phenanthroline, and dppz, dipyridophenazine) and the acceptor is Rh(phi)[sub 2]phen[sup 3+] (phi, phenanthrenequinone diimine). These metal complexes are intercalated either one or two base steps in from the helix termini. Although the ruthenium-modified oligonucleotide hybridized to an unmodified complement luminesces intensely, the ruthenium-modified oligomer hybridized to the rhodium-modified oligomer shows no detectable luminescence. Time-resolved studies point to a lower limit of 10[sup 9] per second for the quenching rate. No quenching was observed upon metallation of two complementary octamers by Ru(phen)[sub 3][sup 2+] and Rh(phen)[sub 3][sup 3+] under conditions where the phen complexes do not intercalate. The stacked aromatic heterocycles of the DNA duplex therefore serve as an efficient medium for coupling electron donors and acceptors over very long distances.

  20. Enzymatic cellulose oxidation is linked to lignin by long-range electron transfer

    DEFF Research Database (Denmark)

    Westereng, Bjorge; Cannella, David; Wittrup Agger, Jane

    2015-01-01

    cell walls. Electron transfer was confirmed by electron paramagnetic resonance spectroscopy showing that LPMO activity on cellulose changes the level of unpaired electrons in the lignin. The discovery of a long-range electron transfer mechanism links the biodegradation of cellulose and lignin and sheds...

  1. Pelletron-based MeV-range electron beam recirculation

    CERN Document Server

    Crawford, A C; Sharapa, A N; Shemyakin, A

    1999-01-01

    In this paper we describe the successful recirculation of a DC electron beam at energies 1-1.5 MeV and currents up to 0.7 A with typical relative losses of 5-20x10 sup - sup 6. Currents of 200 mA were maintained for periods of up to five hours without a single breakdown. We found that the aperture-limiting diaphragm in the gun anode significantly increased the stability of the recirculation. We also found that the stability depended strongly on vacuum pressure in the beamline. The performance of the collector with transverse magnetic fields was found to be adequate for beam currents up to 0.6 A, which is in agreement with our low-energy bench test results. (author)

  2. Stopping-Power and Range Tables for Electrons, Protons, and Helium Ions

    Science.gov (United States)

    SRD 124 Stopping-Power and Range Tables for Electrons, Protons, and Helium Ions (Web, free access)   The databases ESTAR, PSTAR, and ASTAR calculate stopping-power and range tables for electrons, protons, or helium ions. Stopping-power and range tables can be calculated for electrons in any user-specified material and for protons and helium ions in 74 materials.

  3. Enzymatic cellulose oxidation is linked to lignin by long-range electron transfer

    Science.gov (United States)

    Westereng, Bjørge; Cannella, David; Wittrup Agger, Jane; Jørgensen, Henning; Larsen Andersen, Mogens; Eijsink, Vincent G.H.; Felby, Claus

    2015-01-01

    Enzymatic oxidation of cell wall polysaccharides by lytic polysaccharide monooxygenases (LPMOs) plays a pivotal role in the degradation of plant biomass. While experiments have shown that LPMOs are copper dependent enzymes requiring an electron donor, the mechanism and origin of the electron supply in biological systems are only partly understood. We show here that insoluble high molecular weight lignin functions as a reservoir of electrons facilitating LPMO activity. The electrons are donated to the enzyme by long-range electron transfer involving soluble low molecular weight lignins present in plant cell walls. Electron transfer was confirmed by electron paramagnetic resonance spectroscopy showing that LPMO activity on cellulose changes the level of unpaired electrons in the lignin. The discovery of a long-range electron transfer mechanism links the biodegradation of cellulose and lignin and sheds new light on how oxidative enzymes present in plant degraders may act in concert. PMID:26686263

  4. Primary electron energy dependent flashover in surface polarity on Au films

    Science.gov (United States)

    Catalfano, M.; Kanjilal, A.; Al-Ajlony, A.; Harilal, S. S.; Hassanein, A.

    2013-05-01

    Primary electron energy (Ep) dependent change in target current was studied on a grounded Au film in the range of 40 to 3500 eV. The current jumped suddenly from a negative to a positive value at ˜650 eV with increasing Ep, while it disappeared in reverse sweep and with increasing substrate temperature. Detailed analysis suggests that Ep dependent surface charging plays a pivotal role in flashover. Prior to critical Ep in the forward sweep, a gradual shift of a double peak-like structure towards high kinetic energy region in the secondary electron spectra also confirms surface charging effect.

  5. Strategies for Primary Care Stakeholders to Improve Electronic Health Records (EHRs).

    Science.gov (United States)

    Olayiwola, J Nwando; Rubin, Ashley; Slomoff, Theo; Woldeyesus, Tem; Willard-Grace, Rachel

    2016-01-01

    The use of electronic health records (EHRs) and the vendors that develop them have increased exponentially in recent years. While there continues to emerge literature on the challenges EHRs have created related to primary care provider satisfaction and workflow, there is sparse literature on the perspective of the EHR vendors themselves. We examined the role of EHR vendors in optimizing primary care practice through a qualitative study of vendor leadership and developers representing 8 companies. We found that EHR vendors apply a range of strategies to elicit feedback from their clinical users and to engage selected users in their development and design process, but priorities are heavily influenced by the macroenvironment and government regulations. To improve the "marriage" between primary care and the EHR vendor community, we propose 6 strategies that may be most impactful for primary care stakeholders seeking to influence EHR development processes. © Copyright 2016 by the American Board of Family Medicine.

  6. Two-dimensional electron density measurement of pulsed positive primary streamer discharge in atmospheric-pressure air

    Science.gov (United States)

    Inada, Yuki; Aono, Kaiho; Ono, Ryo; Kumada, Akiko; Hidaka, Kunihiko; Maeyama, Mitsuaki

    2017-05-01

    Elucidating the electron density of streamer discharges propagating in atmospheric-pressure air is critical for achieving a systematic understanding of the production mechanisms of reactive species. Using Shack-Hartmann-type laser wavefront sensors with a temporal resolution of 2 ns, we carried out single-shot two-dimensional electron density measurements for positive primary streamers generated in a 13 mm air gap between pin-to-plate electrodes. The electron density over the positive primary streamers decayed from 1015 to {{10}14}\\text{c}{{\\text{m}}-3} during the propagation. The decay time constant of the electron density in the primary streamer channels was estimated to be  ˜2 ns. The distribution widths of the electron density were in good agreement with those of the light emission, typically ranging from 0.8 to 1.5 mm.

  7. High dynamic range isotope ratio measurements using an analog electron multiplier

    Czech Academy of Sciences Publication Activity Database

    Williams, P.; Lorinčík, Jan; Franzreb, K.; Herwig, R.

    2013-01-01

    Roč. 45, č. 1 (2013), s. 549-552 ISSN 0142-2421 R&D Projects: GA MŠk ME 894 Institutional support: RVO:67985882 Keywords : Isotope ratios * electron multiplier * dynamic range Subject RIV: JA - Electronics ; Optoelectronics, Electrical Engineering Impact factor: 1.393, year: 2013

  8. The Range of 1-3 keV Electrons in Solid Oxygen and Carbon Monoxide

    DEFF Research Database (Denmark)

    Oehlenschlæger, M.; Andersen, H.H.; Schou, Jørgen

    1985-01-01

    The range of 1-3 keV electrons in films of solid oxygen and carbon monoxide has been measured by a mirror substrate method. The technique used here is identical to the one previously used for range measurements in solid hydrogen and nitrogen. The range in oxygen is slightly shorter than that in n......The range of 1-3 keV electrons in films of solid oxygen and carbon monoxide has been measured by a mirror substrate method. The technique used here is identical to the one previously used for range measurements in solid hydrogen and nitrogen. The range in oxygen is slightly shorter than...... that in nitrogen whereas the range in carbon monoxide is about 20% larger than that in the nitrogen....

  9. Patient Perspectives on Discussions of Electronic Cigarettes in Primary Care.

    Science.gov (United States)

    Doescher, Mark P; Wu, Ming; Rainwater, Elizabeth; Khan, Ali S; Rhoades, Dorothy A

    2018-01-01

    Patient preferences regarding the role of the primary care provider (PCP) in discussing electronic cigarette (e-cigarette) use are unknown. We administered a cross-sectional survey to 568 adult patients in a family medicine clinic to explore e-cigarette use, sources of information on e-cigarettes, perceived knowledge about e-cigarette health effects, views regarding PCP knowledge of e-cigarettes, interest in discussing e-cigarettes with PCPs and preferred format for e-cigarette information. We performed χ2 testing with a 2-tailed P 30 days) use. Prevalence was significantly higher among those who were younger, less educated, or smoked cigarettes, but did not vary by sex or self-reported health status. Roughly one quarter of participants believed they were knowledgeable about the health effects of e-cigarettes, secondhand smoke, and quitting cigarettes. Sources of e-cigarette information included television advertisements (56.6%), friends and family (49.9%), or e-cigarette shops (25.5%), but included physician offices much less frequently (6.0%). Although 30.2% disagreed that their PCP knew a lot about e-cigarettes, 62.0% were comfortable discussing e-cigarettes with their PCP. However, only 25% of all patients wanted their PCP to discuss e-cigarettes with them, but 62.0% of recent e-cigarette users wanted such a discussion. Most preferred a brief discussion or handout to a lengthy discussion. PCPs were infrequent sources of information for patients regarding e-cigarette use. PCPs need evidence-based strategies to help them address e-cigarettes in primary care. © Copyright 2018 by the American Board of Family Medicine.

  10. Valence electronic structure of cobalt phthalocyanine from an optimally tuned range-separated hybrid functional

    Science.gov (United States)

    Brumboiu, Iulia Emilia; Prokopiou, Georgia; Kronik, Leeor; Brena, Barbara

    2017-07-01

    We analyse the valence electronic structure of cobalt phthalocyanine (CoPc) by means of optimally tuning a range-separated hybrid functional. The tuning is performed by modifying both the amount of short-range exact exchange (α ) included in the hybrid functional and the range-separation parameter (γ ), with two strategies employed for finding the optimal γ for each α . The influence of these two parameters on the structural, electronic, and magnetic properties of CoPc is thoroughly investigated. The electronic structure is found to be very sensitive to the amount and range in which the exact exchange is included. The electronic structure obtained using the optimal parameters is compared to gas-phase photo-electron data and GW calculations, with the unoccupied states additionally compared with inverse photo-electron spectroscopy measurements. The calculated spectrum with tuned γ , determined for the optimal value of α = 0.1 , yields a very good agreement with both experimental results and with GW calculations that well-reproduce the experimental data.

  11. Survival analysis using primary care electronic health record data: A systematic review of the literature.

    Science.gov (United States)

    Hodgkins, Adam Jose; Bonney, Andrew; Mullan, Judy; Mayne, Darren John; Barnett, Stephen

    2017-01-01

    An emerging body of research involves observational studies in which survival analysis is applied to data obtained from primary care electronic health records (EHRs). This systematic review of these studies examined the utility of using this approach. An electronic literature search of the Scopus, PubMed, Web of Science, CINAHL, and Cochrane databases was conducted. Search terms and exclusion criteria were chosen to select studies where survival analysis was applied to the data extracted wholly from EHRs used in primary care medical practice. A total of 46 studies that met the inclusion criteria for the systematic review were examined. All were published within the past decade (2005-2014) with a majority ( n = 26, 57%) being published between 2012 and 2014. Even though citation rates varied from nil to 628, over half ( n = 27, 59%) of the studies were cited 10 times or more. The median number of subjects was 18,042 with five studies including over 1,000,000 patients. Of the included studies, 35 (76%) were published in specialty journals and 11 (24%) in general medical journals. The many conditions studied largely corresponded well with conditions important to general practice. Survival analysis applied to primary care electronic medical data is a research approach that has been frequently used in recent times. The utility of this approach was demonstrated by the ability to produce research with large numbers of subjects, across a wide range of conditions and with the potential of a high impact. Importantly, primary care data were thus available to inform primary care practice.

  12. Time-of-flight electron spectrometer for a broad range of kinetic energies

    Energy Technology Data Exchange (ETDEWEB)

    Kothe, Alexander; Metje, Jan; Wilke, Martin; Moguilevski, Alexandre; Engel, Nicholas; Al-Obaidi, Ruba; Richter, Clemens; Golnak, Ronny; Kiyan, Igor Yu.; Aziz, Emad F. [Joint Ultrafast Dynamics Lab in Solutions and at Interfaces (JULiq), Helmholtz-Zentrum Berlin fuer Materialien und Energie (HZB), Albert-Einstein-Str. 15, 12489 Berlin (Germany) and Freie Universitaet Berlin, Fachbereich Physik, Arnimallee 14, 14195 Berlin (Germany)

    2013-02-15

    A newly constructed time-of-flight electron spectrometer of the magnetic bottle type is characterized for electron detection in a broad range of kinetic energies. The instrument is designed to measure the energy spectra of electrons generated from liquids excited by strong laser fields and photons in the range of extreme ultra violet and soft X-rays. Argon inner shell electrons were recorded to calibrate the spectrometer and investigate its characteristics, such as energy resolution and collection efficiency. Its energy resolution {Delta}E/E of 1.6% allows resolving the Ar 2p spin orbit structure at kinetic energies higher than 100 eV. The collection efficiency is determined and compared to that of the spectrometer in its field-free configuration.

  13. Electron and Positron Fluxes in Primary Cosmic Rays Measured with the Alpha Magnetic Spectrometer on the International Space Station

    CERN Document Server

    Aguilar, M; Alvino, A; Ambrosi, G; Andeen, K; Arruda, L; Attig, N; Azzarello, P; Bachlechner, A; Barao, F; Barrau, A; Barrin, L; Bartoloni, A; Basara, L; Battarbee, M; Battiston, R; Bazo, J; Becker, U; Behlmann, M; Beischer, B; Berdugo, J; Bertucci, B; Bigongiari, G; Bindi, V; Bizzaglia, S; Bizzarri, M; Boella, G; de Boer, W; Bollweg, K; Bonnivard, V; Borgia, B; Borsini, S; Boschini, M J; Bourquin, M; Burger, J; Cadoux, F; Cai, X D; Capell, M; Caroff, S; Casaus, J; Cascioli, V; Castellini, G; Cernuda, I; Cervelli, F; Chae, M J; Chang, Y H; Chen, A I; Chen, H; Cheng, G M; Chen, H S; Cheng, L; Chikanian, A; Chou, H Y; Choumilov, E; Choutko, V; Chung, C H; Clark, C; Clavero, R; Coignet, G; Consolandi, C; Contin, A; Corti, C; Coste, B; Cui, Z; Dai, M; Delgado, C; Della Torre, S; Demirköz, M B; Derome, L; Di Falco, S; Di Masso, L; Dimiccoli, F; Díaz, C; von Doetinchem, P; Du, W J; Duranti, M; D’Urso, D; Eline, A; Eppling, F J; Eronen, T; Fan, Y Y; Farnesini, L; Feng, J; Fiandrini, E; Fiasson, A; Finch, E; Fisher, P; Galaktionov, Y; Gallucci, G; García, B; García-López, R; Gast, H; Gebauer, I; Gervasi, M; Ghelfi, A; Gillard, W; Giovacchini, F; Goglov, P; Gong, J; Goy, C; Grabski, V; Grandi, D; Graziani, M; Guandalini, C; Guerri, I; Guo, K H; Habiby, M; Haino, S; Han, K C; He, Z H; Heil, M; Hoffman, J; Hsieh, T H; Huang, Z C; Huh, C; Incagli, M; Ionica, M; Jang, W Y; Jinchi, H; Kanishev, K; Kim, G N; Kim, K S; Kirn, Th; Kossakowski, R; Kounina, O; Kounine, A; Koutsenko, V; Krafczyk, M S; Kunz, S; La Vacca, G; Laudi, E; Laurenti, G; Lazzizzera, I; Lebedev, A; Lee, H T; Lee, S C; Leluc, C; Li, H L; Li, J Q; Li, Q; Li, Q; Li, T X; Li, W; Li, Y; Li, Z H; Li, Z Y; Lim, S; Lin, C H; Lipari, P; Lippert, T; Liu, D; Liu, H; Lomtadze, T; Lu, M J; Lu, Y S; Luebelsmeyer, K; Luo, F; Luo, J Z; Lv, S S; Majka, R; Malinin, A; Mañá, C; Marín, J; Martin, T; Martínez, G; Masi, N; Maurin, D; Menchaca-Rocha, A; Meng, Q; Mo, D C; Morescalchi, L; Mott, P; Müller, M; Ni, J Q; Nikonov, N; Nozzoli, F; Nunes, P; Obermeier, A; Oliva, A; Orcinha, M; Palmonari, F; Palomares, C; Paniccia, M; Papi, A; Pedreschi, E; Pensotti, S; Pereira, R; Pilo, F; Piluso, A; Pizzolotto, C; Plyaskin, V; Pohl, M; Poireau, V; Postaci, E; Putze, A; Quadrani, L; Qi, X M; Rancoita, P G; Rapin, D; Ricol, J S; Rodríguez, I; Rosier-Lees, S; Rozhkov, A; Rozza, D; Sagdeev, R; Sandweiss, J; Saouter, P; Sbarra, C; Schael, S; Schmidt, S M; Schuckardt, D; Schulz von Dratzig, A; Schwering, G; Scolieri, G; Seo, E S; Shan, B S; Shan, Y H; Shi, J Y; Shi, X Y; Shi, Y M; Siedenburg, T; Son, D; Spada, F; Spinella, F; Sun, W; Sun, W H; Tacconi, M; Tang, C P; Tang, X W; Tang, Z C; Tao, L; Tescaro, D; Ting, Samuel C C; Ting, S M; Tomassetti, N; Torsti, J; Türkoğlu, C; Urban, T; Vagelli, V; Valente, E; Vannini, C; Valtonen, E; Vaurynovich, S; Vecchi, M; Velasco, M; Vialle, J P; Wang, L Q; Wang, Q L; Wang, R S; Wang, X; Wang, Z X; Weng, Z L; Whitman, K; Wienkenhöver, J; Wu, H; Xia, X; Xie, M; Xie, S; Xiong, R Q; Xin, G M; Xu, N S; Xu, W; Yan, Q; Yang, J; Yang, M; Ye, Q H; Yi, H; Yu, Y J; Yu, Z Q; Zeissler, S; Zhang, J H; Zhang, M T; Zhang, X B; Zhang, Z; Zheng, Z M; Zhuang, H L; Zhukov, V; Zichichi, A; Zimmermann, N; Zuccon, P; Zurbach, C

    2014-01-01

    Precision measurements by the Alpha Magnetic Spectrometer on the International Space Station of the primary cosmic-ray electron flux in the range 0.5 to 700 GeV and the positron flux in the range 0.5 to 500 GeV are presented. The electron flux and the positron flux each require a description beyond a single power-law spectrum. Both the electron flux and the positron flux change their behavior at ∼30  GeV but the fluxes are significantly different in their magnitude and energy dependence. Between 20 and 200 GeV the positron spectral index is significantly harder than the electron spectral index. The determination of the differing behavior of the spectral indices versus energy is a new observation and provides important information on the origins of cosmic-ray electrons and positrons.

  14. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners

    Directory of Open Access Journals (Sweden)

    van der Sande Marianne AB

    2011-07-01

    Full Text Available Abstract Background Chlamydia is the most common curable sexually transmitted infection (STI in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs. Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening in the Netherlands. The aim of this study was to assess the usefulness of electronic medical records for monitoring the incidence of chlamydia cases diagnosed in primary care in the Netherlands. Methods In the electronic records of two regional and two national networks, we identified chlamydia diagnoses by means of ICPC codes (International Classification of Primary Care, laboratory results in free text and the prescription of antibiotics. The year of study was 2007 for the two regional networks and one national network, for the other national network the year of study was 2005. We calculated the incidence of diagnosed chlamydia cases per sex, age group and degree of urbanization. Results A large diversity was observed in the way chlamydia episodes were coded in the four different GP networks and how easily information concerning chlamydia diagnoses could be extracted. The overall incidence ranged from 103.2/100,000 to 590.2/100,000. Differences were partly related to differences between patient populations. Nevertheless, we observed similar trends in the incidence of chlamydia diagnoses in all networks and findings were in line with earlier reports. Conclusions Electronic patient records, originally intended for individual patient care in general practice, can be an additional source of data for monitoring chlamydia incidence in primary care and can be of use in assessing the future impact of population-based chlamydia screening programs. To increase the usefulness of data we recommend more efforts to standardize registration by (specific ICPC code and laboratory results across the existing GP networks.

  15. Ranges and limits of the electron-phonon coupling constant of ...

    African Journals Online (AJOL)

    A simplified study of the effect of including self energy and vertex corrections to the BCS critical temperature Tc expression is carried out her to identify the possible ranges and limits of the electron-phonon coupling constant λ in superconductivity. The results show that the inclusion of the self energy will reduce the BCS Tc to ...

  16. Surface treatment by the ion flow from electron beam generated plasma in the forevacuum pressure range

    Directory of Open Access Journals (Sweden)

    Klimov Aleksandr

    2018-01-01

    Full Text Available The paper presents research results of peculiarities of gas ion flows usage and their generation from large plasma formation (>50 sq.cm obtained by electron beam ionization of gas in the forevacuum pressure range. An upgraded source was used for electron beam generation, which allowed obtaining ribbon electron beam with no transmitting magnetic field. Absence of magnetic field in the area of ion flow formation enables to obtain directed ion flows without distorting their trajectories. In this case, independent control of current and ion energy is possible. The influence of electron beam parameters on the parameters of beam plasma and ion flow – current energy and density – was determined. The results of alumina ceramics treatment with a beam plasma ions flow are given.

  17. Effects of secondary electrons from heavy primary cosmic rays in a MWPC hodoscope. [Multi-Wire Proportional Counter

    Science.gov (United States)

    Derrickson, J. H.; Parnell, T. A.; Gregory, J. C.

    1978-01-01

    A multi-wire proportional counter hodoscope, efficient for both primary track recovery and reading out all wires set by secondary electrons, was flown in a balloon flight experiment covering the range of cosmic ray charge from 4 to 28 and kinetic energy T greater than 0.5 GeV/nucleon. Data on the secondary electron effects in the hodoscope is presented for primary nuclei between C and Fe and kinetic energies between 0.6 and 7.0 GeV/nucleon. The total number of affected anodes in the hodoscope is seen to increase linearly with the cosmic ray change, with a slope that depends strongly on energy over this limited primary energy range.

  18. Prototype system for proton beam range measurement based on gamma electron vertex imaging

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Han Rim [Neutron Utilization Technology Division, Korea Atomic Energy Research Institute, 111, Daedeok-daero 989beon-gil, Yuseong-gu, Daejeon 34057 (Korea, Republic of); Kim, Sung Hun; Park, Jong Hoon [Department of Nuclear Engineering, Hanyang University, Seongdong-gu, Seoul 04763 (Korea, Republic of); Jung, Won Gyun [Heavy-ion Clinical Research Division, Korean Institute of Radiological & Medical Sciences, Seoul 01812 (Korea, Republic of); Lim, Hansang [Department of Electronics Convergence Engineering, Kwangwoon University, Seoul 01897 (Korea, Republic of); Kim, Chan Hyeong, E-mail: chkim@hanyang.ac.kr [Department of Nuclear Engineering, Hanyang University, Seongdong-gu, Seoul 04763 (Korea, Republic of)

    2017-06-11

    In proton therapy, for both therapeutic effectiveness and patient safety, it is very important to accurately measure the proton dose distribution, especially the range of the proton beam. For this purpose, recently we proposed a new imaging method named gamma electron vertex imaging (GEVI), in which the prompt gammas emitting from the nuclear reactions of the proton beam in the patient are converted to electrons, and then the converted electrons are tracked to determine the vertices of the prompt gammas, thereby producing a 2D image of the vertices. In the present study, we developed a prototype GEVI system, including dedicated signal processing and data acquisition systems, which consists of a beryllium plate (= electron converter) to convert the prompt gammas to electrons, two double-sided silicon strip detectors (= hodoscopes) to determine the trajectories of those converted electrons, and a plastic scintillation detector (= calorimeter) to measure their kinetic energies. The system uses triple coincidence logic and multiple energy windows to select only the events from prompt gammas. The detectors of the prototype GEVI system were evaluated for electronic noise level, energy resolution, and time resolution. Finally, the imaging capability of the GEVI system was tested by imaging a {sup 90}Sr beta source, a {sup 60}Co gamma source, and a 45-MeV proton beam in a PMMA phantom. The overall results of the present study generally show that the prototype GEVI system can image the vertices of the prompt gammas produced by the proton nuclear interactions.

  19. Electron Transfer in Chemistry and Biology - The Primary Events in ...

    Indian Academy of Sciences (India)

    J J Thomson it would be most appropriate to recount how such a discovery has really enlarged our understanding of many facets of chemistry and biology. Chemistry as it is practised today cannot exist without a proper appreciation of the role of the electron. The concept of a chemical bond as the electron distribution ...

  20. Consistency of denominator data in electronic health records in Australian primary healthcare services: enhancing data quality.

    Science.gov (United States)

    Bailie, Ross; Bailie, Jodie; Chakraborty, Amal; Swift, Kevin

    2015-01-01

    The quality of data derived from primary healthcare electronic systems has been subjected to little critical systematic analysis, especially in relation to the purported benefits and substantial investment in electronic information systems in primary care. Many indicators of quality of care are based on numbers of certain types of patients as denominators. Consistency of denominator data is vital for comparison of indicators over time and between services. This paper examines the consistency of denominator data extracted from electronic health records (EHRs) for monitoring of access and quality of primary health care. Data collection and analysis were conducted as part of a prospective mixed-methods formative evaluation of the Commonwealth Government's Indigenous Chronic Disease Package. Twenty-six general practices and 14 Aboriginal Health Services (AHSs) located in all Australian States and Territories and in urban, regional and remote locations were purposively selected within geographically defined locations. Percentage change in reported number of regular patients in general practices ranged between -50% and 453% (average 37%). The corresponding figure for AHSs was 1% to 217% (average 31%). In approximately half of general practices and AHSs, the change was ≥ 20%. There were similarly large changes in reported numbers of patients with a diagnosis of diabetes or coronary heart disease (CHD), and Indigenous patients. Inconsistencies in reported numbers were due primarily to limited capability of staff in many general practices and AHSs to accurately enter, manage, and extract data from EHRs. The inconsistencies in data required for the calculation of many key indicators of access and quality of care places serious constraints on the meaningful use of data extracted from EHRs. There is a need for greater attention to quality of denominator data in order to realise the potential benefits of EHRs for patient care, service planning, improvement, and policy. We

  1. High Dynamic Range Pixel Array Detector for Scanning Transmission Electron Microscopy.

    Science.gov (United States)

    Tate, Mark W; Purohit, Prafull; Chamberlain, Darol; Nguyen, Kayla X; Hovden, Robert; Chang, Celesta S; Deb, Pratiti; Turgut, Emrah; Heron, John T; Schlom, Darrell G; Ralph, Daniel C; Fuchs, Gregory D; Shanks, Katherine S; Philipp, Hugh T; Muller, David A; Gruner, Sol M

    2016-02-01

    We describe a hybrid pixel array detector (electron microscope pixel array detector, or EMPAD) adapted for use in electron microscope applications, especially as a universal detector for scanning transmission electron microscopy. The 128×128 pixel detector consists of a 500 µm thick silicon diode array bump-bonded pixel-by-pixel to an application-specific integrated circuit. The in-pixel circuitry provides a 1,000,000:1 dynamic range within a single frame, allowing the direct electron beam to be imaged while still maintaining single electron sensitivity. A 1.1 kHz framing rate enables rapid data collection and minimizes sample drift distortions while scanning. By capturing the entire unsaturated diffraction pattern in scanning mode, one can simultaneously capture bright field, dark field, and phase contrast information, as well as being able to analyze the full scattering distribution, allowing true center of mass imaging. The scattering is recorded on an absolute scale, so that information such as local sample thickness can be directly determined. This paper describes the detector architecture, data acquisition system, and preliminary results from experiments with 80-200 keV electron beams.

  2. Interaction of a relativistic electron beam with radiation in the THz frequency range

    Science.gov (United States)

    Sung, Chieh

    The ability to generate a train of microbunches that are only typically tens of femtosecond wide and are separated by a picosecond is a topic of contemporary interest in the field of free electron lasers and plasma based accelerators. Moreover the usefulness of the high gradients present in plasma accelerators will depend on the ability to obtain mono-energetic relativistic electrons. This means that in addition to being prebunched on a scale shorter than the plasma wavelength the externally injected electron beam must be phase-locked to the accelerating plasma wave structure. In this thesis we investigate two techniques, Free Electron Laser interaction (FEL) and the Inverse Free Electron Laser interaction (IFEL), by which a medium energy electron beam can be prebunched into a series of microbunches with the same periodicity as a plasma wave and is phase locked to it. Using full-scale, 3-D simulations we show in this thesis that when a relativistic electron beam and an electromagnetic wave propagate collinearly through a magnetic undulator, FEL and IFEL interactions have the capability to form electron microbunches with periodicity 300-100 mum (1-3 THz range), which contain 50% of electrons within a small fraction of the ponderomotive buckets. Such a bunched beam is suitable for injection into plasma densities in the range 1016-1017 cm-3, respectively. Microbunching using the FEL mechanism requires a narrowband THz radiation source to act as a seed whereas the IFEL mechanism requires, in addition, such a source to be high power. In this thesis the generation of THz radiation in the Neptune Laboratory by mixing of two CO2 laser lines in a non-collinearly phase matched GaAs at room temperature is described A high-power THz pulse with up to 2 MW of peak power in a 250 ps pulse was generated using a TW class CO2 laser pulse. Such high power THz radiation is needed for the IFEL approach to microbunching. We also produced a high repetition rate THz source tunable in the

  3. Electrical, optical, and electronic properties of Al:ZnO films in a wide doping range

    Energy Technology Data Exchange (ETDEWEB)

    Valenti, Ilaria; Valeri, Sergio [CNR, Istituto Nanoscienze, S3, Via G. Campi 213/a, 41125 Modena (Italy); Dipartimento di Scienze Fisiche, Informatiche e Matematiche, Università di Modena e Reggio Emilia, Via G. Campi 213/a, 41125 Modena (Italy); Benedetti, Stefania, E-mail: stefania.benedetti@unimore.it; Bona, Alessandro di [CNR, Istituto Nanoscienze, S3, Via G. Campi 213/a, 41125 Modena (Italy); Lollobrigida, Valerio [Dipartimento di Scienze, Università Roma Tre, I-00146 Rome, Italy and Dipartimento di Matematica e Fisica, Università Roma Tre, I-00146 Rome (Italy); Perucchi, Andrea; Di Pietro, Paola [INSTM Udr Trieste-ST and Elettra-Sincrotrone Trieste S.C.p.A., Area Science Park, I-34012 Trieste (Italy); Lupi, Stefano [CNR-IOM and Dipartimento di Fisica, Università di Roma Sapienza, P.le Aldo Moro 2, I-00185 Roma (Italy); Torelli, Piero [Laboratorio TASC, IOM-CNR, S.S. 14 km 163.5, Basovizza, I-34149 Trieste (Italy)

    2015-10-28

    The combination of photoemission spectroscopies, infrared and UV-VIS absorption, and electric measurements has allowed to clarify the mechanisms governing the conductivity and the electronic properties of Al-doped ZnO (AZO) films in a wide doping range. The contribution of defect-related in-gap states to conduction has been excluded in optimally doped films (around 4 at. %). The appearance of gap states at high doping, the disappearance of occupied DOS at Fermi level, and the bands evolution complete the picture of electronic structure in AZO when doped above 4 at. %. In this situation, compensating defects deplete the conduction band and increase the electronic bandgap of the material. Electrical measurements and figure of merit determination confirm the high quality of the films obtained by magnetron sputtering, and thus allow to extend their properties to AZO films in general.

  4. 100 keV electron backscattered range and coefficient for silicon.

    Energy Technology Data Exchange (ETDEWEB)

    Czaplewski, D.A.; Ocola, L.E. (Center for Nanoscale Materials)

    2012-01-01

    The authors have measured the range and intensity of backscattered electrons in silicon from a 100 keV source using a process independent method. Backscattered electrons contributed to the total dose of features written in a negative tone electron beam resist. Instead of measuring the height of the resist and using a contrast curve to convert the resist height to dose, the heights of the features were made equal by adjusting the backscattered contribution through dose assignments. Creating features of equal height eliminated the need to use a contrast curve to convert from resist height to total dose. Also, it allowed for measurements of the backscattered contribution from larger distances. Using a circularly symmetric torus pattern, the three-dimensional backscatter problem was reduced to a 1-dimensional Gaussian form. The authors measured the range of the backscattered electrons, {beta}, to be 31.08 {+-} 0.06 {micro}m. By varying the writing dose of the pattern, we determined the backscatter coefficient, {eta}, to be 0.63 {+-} 0.03.

  5. Short Range Correlations in Nuclei at Large xbj through Inclusive Quasi-Elastic Electron Scattering

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Zhihong [Univ. of Virginia, Charlottesville, VA (United States)

    2013-12-01

    The experiment, E08-014, in Hall-A at Jefferson Lab aims to study the short-range correlations (SRC) which are necessary to explain the nuclear strength absent in the mean field theory. The cross sections for 2H, 3He, 4He, 12C, 40Ca and 48Ca, were measured via inclusive quasi-elastic electron scattering from these nuclei in a Q2 range between 0.8 and 2.8 (GeV/c)2 for x>1. The cross section ratios of heavy nuclei to 2H were extracted to study two-nucleon SRC for 1

  6. Electron scattering on the short-range potential of crystal lattice defects in gallium nitride

    Energy Technology Data Exchange (ETDEWEB)

    Malyk, Orest [Semiconductor Electronics Department, Lviv Polytechnic National University, Bandera Street 12, 79013 Lviv (Ukraine)

    2012-03-15

    The processes of the charge carrier scattering on the short-range potential caused by interaction with polar and nonpolar optical phonons, piezoelectric and acoustic phonons, static strain, neutral and ionized impurities in wurtzite n-GaN with impurity concentration 4 x 10{sup 16}-2 x 10{sup 19} cm{sup -3} are considered. The temperature dependences of electron mobility in the range 40-500 K are calculated. (copyright 2012 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  7. Configurable Electronics with Low Noise and 14-bit Dynamic Range for Photodiode-based Photon Detectors

    CERN Document Server

    Müller, H; Yin, Z; Zhou, D; Cao, X; Li, Q; Liu, Y; Zou, F; Skaali, B; Awes, T C

    2006-01-01

    We describe the principles and measured performance characteristics of custom configurable 32-channel shaper/digitizer Front End Electronics (FEE) cards with 14-bit dynamic range for use with gain-adjustable photon detectors. The electronics has been designed for the PHOS calorimeter of ALICE with avalanche photodiode (APD) readout operated at -25 C ambient temperature and a signal shaping time of $1 {\\mu}s$. The electronics has also been adopted by the EMCal detector of ALICE with the same APD readout, but operated at an ambient temperature of +20 C and with a shaping time of 100ns. The CR-RC2 signal shapers on the FEE cards are implemented in discrete logic on a 10-layer board with two shaper sections for each input channel. The two shaper sections with gain ratio of 16:1 are digitized by 10-bit ADCs and provide an effective dynamic range of 14 bits. Gain adjustment for each individual APD is available through 32 bias voltage control registers of 10-bit range. The fixed gains and shaping times of the pole-z...

  8. Seeded free-electron and inverse free-electron laser techniques for radiation amplification and electron microbunching in the terahertz range

    Directory of Open Access Journals (Sweden)

    C. Sung

    2006-12-01

    Full Text Available A comprehensive analysis is presented that describes amplification of a seed THz pulse in a single-pass free-electron laser (FEL driven by a photoinjector. The dynamics of the radiation pulse and the modulated electron beam are modeled using the time-dependent FEL code, GENESIS 1.3. A 10-ps (FWHM electron beam with a peak current of 50–100 A allows amplification of a ∼1  kW seed pulse in the frequency range 0.5–3 THz up to 10–100 MW power in a relatively compact 2-m long planar undulator. The electron beam driving the FEL is strongly modulated, with some inhomogeneity due to the slippage effect. It is shown that THz microbunching of the electron beam is homogeneous over the entire electron pulse when saturated FEL amplification is utilized at the very entrance of an undulator. This requires seeding of a 30-cm long undulator buncher with a 1–3 MW of pump power with radiation at the resonant frequency. A narrow-band seed pulse in the THz range needed for these experiments can be generated by frequency mixing of CO_{2} laser lines in a GaAs nonlinear crystal. Two schemes for producing MW power pulses in seeded FELs are considered in some detail for the beam parameters achievable at the Neptune Laboratory at UCLA: the first uses a waveguide to transport radiation in the 0.5–3 THz range through a 2-m long FEL amplifier and the second employs high-gain third harmonic generation using the FEL process at 3–9 THz.

  9. A Monte Carlo study of primary electron production inside photoconductors for digital mammography and indications of material suitability

    Energy Technology Data Exchange (ETDEWEB)

    Sakellaris, T; Spyrou, G; Panayiotakis, G [University of Patras, School of Medicine, Department of Medical Physics, Patras, 26500 (Greece); Tzanakos, G, E-mail: msakellar@gmail.co [University of Athens, Department of Physics, Div. Nucl. and Particle Physics, Athens, 15771 (Greece)

    2010-08-15

    Materials like a-Se, a-As{sub 2}Se{sub 3}, GaSe, GaAs, Ge, CdTe, CdZnTe, Cd{sub 0.8}Zn{sub 0.2}Te, ZnTe, PbO, TlBr, PbI{sub 2} and HgI{sub 2} are possible photoconductors for direct conversion digital mammography detectors. The physical characteristics of primary electrons, such as their number, energies, direction angles and spatial distributions, strongly affect the characteristics of the final signal and hence image quality. In previous work, a Monte Carlo model has been developed that simulates the generation of primary electrons inside these materials for x-ray spectra in the mammographic energy range. Using this model the energy, angular and spatial distributions of primary electrons have been studied. For the case of CdTe, CdZnTe, Cd{sub 0.8}Zn{sub 0.2}Te and ZnTe, an investigation was also made concerning the dependence of the primary electron production on the incident x-ray energy. In this paper, this investigation has been extended to include the rest of the photoconducting materials. The investigation is realized studying the number of primary electrons produced along with the escaping of photons (both incident and fluorescent) and the number of fluorescent photons emitted for 39 monoenergetic x-ray spectra with energies between 2 and 40 keV. The information obtained from the overall investigation of the primary signal in the various photoconductors gives some good indications of the suitability of PbI{sub 2} and HgI{sub 2}.

  10. A Monte Carlo study of primary electron production inside photoconductors for digital mammography and indications of material suitability

    Science.gov (United States)

    Sakellaris, T.; Spyrou, G.; Panayiotakis, G.; Tzanakos, G.

    2010-08-01

    Materials like a-Se, a-As2Se3, GaSe, GaAs, Ge, CdTe, CdZnTe, Cd0.8Zn0.2Te, ZnTe, PbO, TlBr, PbI2 and HgI2 are possible photoconductors for direct conversion digital mammography detectors. The physical characteristics of primary electrons, such as their number, energies, direction angles and spatial distributions, strongly affect the characteristics of the final signal and hence image quality. In previous work, a Monte Carlo model has been developed that simulates the generation of primary electrons inside these materials for x-ray spectra in the mammographic energy range. Using this model the energy, angular and spatial distributions of primary electrons have been studied. For the case of CdTe, CdZnTe, Cd0.8Zn0.2Te and ZnTe, an investigation was also made concerning the dependence of the primary electron production on the incident x-ray energy. In this paper, this investigation has been extended to include the rest of the photoconducting materials. The investigation is realized studying the number of primary electrons produced along with the escaping of photons (both incident and fluorescent) and the number of fluorescent photons emitted for 39 monoenergetic x-ray spectra with energies between 2 and 40 keV. The information obtained from the overall investigation of the primary signal in the various photoconductors gives some good indications of the suitability of PbI2 and HgI2.

  11. Electron Processing at 50 eV of Terphenylthiol Self-Assembled Monolayers: Contributions of Primary and Secondary Electrons.

    Science.gov (United States)

    Houplin, Justine; Dablemont, Céline; Sala, Leo; Lafosse, Anne; Amiaud, Lionel

    2015-12-22

    Aromatic self-assembled monolayers (SAMs) can serve as platforms for development of supramolecular assemblies driven by surface templates. For many applications, electron processing is used to locally reinforce the layer. To achieve better control of the irradiation step, chemical transformations induced by electron impact at 50 eV of terphenylthiol SAMs are studied, with these SAMs serving as model aromatic SAMs. High-resolution electron energy loss spectroscopy (HREELS) and electron-stimulated desorption (ESD) of neutral fragment measurements are combined to investigate electron-induced chemical transformation of the layer. The decrease of the CH stretching HREELS signature is mainly attributed to dehydrogenation, without a noticeable hybridization change of the hydrogenated carbon centers. Its evolution as a function of the irradiation dose gives an estimate of the effective hydrogen content loss cross-section, σ = 2.7-4.7 × 10(-17) cm(2). Electron impact ionization is the major primary mechanism involved, with the impact electronic excitation contributing only marginally. Therefore, special attention is given to the contribution of the low-energy secondary electrons to the induced chemistry. The effective cross-section related to dissociative secondary electron attachment at 6 eV is estimated to be 1 order of magnitude smaller. The 1 eV electrons do not induce significant chemical modification for a 2.5 mC cm(-2) dose, excluding their contribution.

  12. Investigation of Multiconfigurational Short-Range Density Functional Theory for Electronic Excitations in Organic Molecules

    DEFF Research Database (Denmark)

    Hubert, Mickaël; Hedegård, Erik D.; Jensen, Hans Jørgen Aa

    2016-01-01

    -srDFT for a selected benchmark set of electronic excitations of organic molecules, covering the most common types of organic chromophores. This investigation confirms the expectation that the MC-srDFT method is accurate for a broad range of excitations and comparable to accurate wave function methods such as CASPT2......Computational methods that can accurately and effectively predict all types of electronic excitations for any molecular system are missing in the toolbox of the computational chemist. Although various Kohn-Sham density-functional methods (KS-DFT) fulfill this aim in some cases, they become...... and double excitations have been promising, it is nevertheless important that the accuracy of MC-srDFT is at least comparable to the best KS-DFT methods also for organic molecules that are typically of single-reference character. In this paper we therefore systematically investigate the performance of MC...

  13. Multiplicity spectrum of muon bundles and primary CR composition in the range 1 – 10000 TeV

    Directory of Open Access Journals (Sweden)

    Alikhanov I.

    2013-06-01

    Full Text Available Multiplicity spectrum of muon bundles underground, with Eμ ≥ few × 100 GeV, is an effective tool for study of primary Cosmic Ray spectrum and composition in wide range of the primary energies. In this paper we study integral muon number distribution measured at the Baksan Underground Scintillation Telescope (BUST. The analyzed range of the number of muon tracks crossing BUST (1 - 170 approximately corresponds to the primary energy range 1 – 104 TeV. The analysis shows that non-power law primary spectra are preferable below the knee. Such a spectrum can be obtained as superposition of the basic power law primary spectrum and an additional component from nearby supernova remnant in the Galaxy.

  14. Long-range protein electron transfer observed at the single-molecule level

    DEFF Research Database (Denmark)

    Chi, Qijin; Farver, Ole; Ulstrup, Jens

    2005-01-01

    potential. Maximum resonance appears around the equilibrium redox potential of azurin with an on/off current ratio of approximately 9. Simulation analyses, based on a two-step interfacial ET model for the scanning tunneling microscopy redox process, were performed and provide quantitative information......A biomimetic long-range electron transfer (ET) system consisting of the blue copper protein azurin, a tunneling barrier bridge, and a gold single-crystal electrode was designed on the basis of molecular wiring self-assembly principles. This system is sufficiently stable and sensitive in a quasi...

  15. Correlations Among Foot Arching, Ankle Dorsiflexion Range of Motion, and Obesity Level in Primary School Children.

    Science.gov (United States)

    Jankowicz-Szymanska, Agnieszka; Mikolajczyk, Edyta; Wodka, Katarzyna

    2017-03-01

    This study sought to assess the prevalence of flat feet in primary school children and to find correlations among arch height, ankle dorsiflexion range of motion (ROM), and obesity level. The 400 children aged 10 to 12 years who took part in the study had their body height, weight, and fat percentage measured. Based on these measurements, body mass index was calculated and weight status was categorized for all of the participants. The height of the longitudinal arch of the foot was measured on a computerized podoscope and given in Clarke's angles. Dorsiflexion ROM was assessed with the child in the nonweightbearing sitting position with the knees 90° flexed. The arithmetic mean and standard deviation were implemented to analyze the data. Intergroup differences were assessed by Mann-Whitney U, Kruskal-Wallis, and post hoc Tukey tests. Significance was accepted at P = .05. Flat feet were found in 36% of participants; limited ROM was found in both feet in 25% of participants and in one foot in 12%. No significant differences in dorsiflexion ROM in children with high-arched, normal, and flat feet were revealed. Excessive body weight was disclosed in 21% of participants. Overweight and obese children had significantly lower foot arches and notably smaller ankle dorsiflexion ROM than those with normal weight. Ankle dorsiflexion ROM is similar in children with high-arched, normal, and flat feet. However, limited dorsiflexion ROM is more often found in children with excessive weight.

  16. Variable range hopping in TiO2 insulating layers for oxide electronic devices

    Directory of Open Access Journals (Sweden)

    Y. L. Zhao

    2012-03-01

    Full Text Available TiO2 thin films are of importance in oxide electronics, e.g., Pt/TiO2/Pt for memristors and Co-TiO2/TiO2/Co-TiO2 for spin tunneling devices. When such structures are deposited at a variety of oxygen pressures, how does TiO2 behave as an insulator? We report the discovery of an anomalous resistivity minimum in a TiO2 film at low pressure (not strongly dependent on deposition temperature. Hall measurements rule out band transport and in most of the pressure range the transport is variable range hopping (VRH though below 20 K it was difficult to differentiate between Mott and Efros-Shklovskii's (ES mechanism. Magnetoresistance (MR of the sample with lowest resistivity was positive at low temperature (for VRH but negative above 10 K indicating quantum interference effects.

  17. Electron reactivity in aqueous media: a femtosecond investigation of the primary species

    Energy Technology Data Exchange (ETDEWEB)

    Gauduel, Y.; Pommeret, S.; Migus, A.; Antonetti, A. (Ecole Polytechnique, 91 - Palaiseau (France))

    1989-01-01

    The electron is universally considered as a primary species in the radiolysis and photolysis of aqueous media. The existence of this simplest aqueous radical implicates fascinating questions concerning the coupling of excess electrons with polar liquids whose chemical and physical properties may have a determinant influence on reactivity in chemistry and biology. The recent experimental results available from the femtosecond spectroscopy of water or ionic aqueous solutions provide unique experimental data for the elucidation of detailed mechanisms of primary processes involved in electron reactivity with an essentially protic solvent. (author).

  18. Energy, angular and spatial distributions of primary electrons inside photoconducting materials for digital mammography: Monte Carlo simulation studies

    Energy Technology Data Exchange (ETDEWEB)

    Sakellaris, T [University of Patras, School of Medicine, Department of Medical Physics, 265 00 Patras (Greece); Spyrou, G [University of Patras, School of Medicine, Department of Medical Physics, 265 00 Patras (Greece); Tzanakos, G [University of Athens, Department of Physics, 157 71 Athens (Greece); Panayiotakis, G [University of Patras, School of Medicine, Department of Medical Physics, 265 00 Patras (Greece)

    2007-11-07

    Materials such as a-Se, a-As{sub 2}Se{sub 3}, GaSe, GaAs, Ge, CdTe, CdZnTe, Cd{sub 0.8}Zn{sub 0.2}Te, ZnTe, PbO, TlBr, PbI{sub 2} and HgI{sub 2} are potential candidates as photoconductors in direct detectors for digital mammography. The x-ray induced primary electrons inside a photoconductor's bulk comprise the initial signal that propagates and forms the final signal (image) on the detector's electrodes. An already developed model for a-Se has been properly extended to simulate the primary electron production in the materials mentioned. Primary electron characteristics, such as their energy, angular and spatial distributions that strongly influence the characteristics of the final image, were studied for both monoenergetic and polyenergetic x-ray spectra in the mammographic energy range. The characteristic feature in the electron energy distributions for PbI{sub 2} and HgI{sub 2} is the atomic deexcitation peaks, whereas for the rest of the materials their shape can also be influenced by the electrons produced from primary photons. The electrons have a small tendency to be forward ejected whereas they prefer to be ejected perpendicular ({theta} = {pi}/2) to the incident beam's axis and at two lobes around {psi} = 0 and {psi} = {pi}. At practical mammographic energies (15-40 keV) a-Se, a-As{sub 2}Se{sub 3} and Ge have the minimum azimuthal uniformity whereas CdZnTe, Cd{sub 0.8}Zn{sub 0.2}Te and CdTe the maximum one. The spatial distributions for a-Se, a-As{sub 2}Se{sub 3}, GaSe, GaAs, Ge, PbO and TlBr are almost independent of the polyenergetic spectrum, while those for CdTe, CdZnTe, Cd{sub 0.8}Zn{sub 0.2}Te, ZnTe, PbI{sub 2} and HgI{sub 2} have a spectrum dependence. In the practical mammographic energy range and at this primitive stage of primary electron production, a-Se has the best inherent spatial resolution as compared to the rest of the photoconductors. PbO has the minimum bulk space in which electrons can be produced whereas CdTe has the

  19. Energy, angular and spatial distributions of primary electrons inside photoconducting materials for digital mammography: Monte Carlo simulation studies.

    Science.gov (United States)

    Sakellaris, T; Spyrou, G; Tzanakos, G; Panayiotakis, G

    2007-11-07

    Materials such as a-Se, a-As(2)Se(3), GaSe, GaAs, Ge, CdTe, CdZnTe, Cd(0.8)Zn(0.2)Te, ZnTe, PbO, TlBr, PbI(2) and HgI(2) are potential candidates as photoconductors in direct detectors for digital mammography. The x-ray induced primary electrons inside a photoconductor's bulk comprise the initial signal that propagates and forms the final signal (image) on the detector's electrodes. An already developed model for a-Se has been properly extended to simulate the primary electron production in the materials mentioned. Primary electron characteristics, such as their energy, angular and spatial distributions that strongly influence the characteristics of the final image, were studied for both monoenergetic and polyenergetic x-ray spectra in the mammographic energy range. The characteristic feature in the electron energy distributions for PbI(2) and HgI(2) is the atomic deexcitation peaks, whereas for the rest of the materials their shape can also be influenced by the electrons produced from primary photons. The electrons have a small tendency to be forward ejected whereas they prefer to be ejected perpendicular (theta = pi/2) to the incident beam's axis and at two lobes around phi = 0 and phi = pi. At practical mammographic energies (15-40 keV) a-Se, a-As(2)Se(3) and Ge have the minimum azimuthal uniformity whereas CdZnTe, Cd(0.8)Zn(0.2)Te and CdTe the maximum one. The spatial distributions for a-Se, a-As(2)Se(3), GaSe, GaAs, Ge, PbO and TlBr are almost independent of the polyenergetic spectrum, while those for CdTe, CdZnTe, Cd(0.8)Zn(0.2)Te, ZnTe, PbI(2) and HgI(2) have a spectrum dependence. In the practical mammographic energy range and at this primitive stage of primary electron production, a-Se has the best inherent spatial resolution as compared to the rest of the photoconductors. PbO has the minimum bulk space in which electrons can be produced whereas CdTe has the maximum one.

  20. A Scanning Transmission Electron Microscopy Method for Determining Manganese Composition in Welding Fume as a Function of Primary Particle Size.

    Science.gov (United States)

    Richman, Julie D; Livi, Kenneth J T; Geyh, Alison S

    2011-06-01

    Increasing evidence suggests that the physicochemical properties of inhaled nanoparticles influence the resulting toxicokinetics and toxicodynamics. This report presents a method using scanning transmission electron microscopy (STEM) to measure the Mn content throughout the primary particle size distribution of welding fume particle samples collected on filters for application in exposure and health research. Dark field images were collected to assess the primary particle size distribution and energy-dispersive X-ray and electron energy loss spectroscopy were performed for measurement of Mn composition as a function of primary particle size. A manual method incorporating imaging software was used to measure the primary particle diameter and to select an integration region for compositional analysis within primary particles throughout the size range. To explore the variation in the developed metric, the method was applied to 10 gas metal arc welding (GMAW) fume particle samples of mild steel that were collected under a variety of conditions. The range of Mn composition by particle size was -0.10 to 0.19 %/nm, where a positive estimate indicates greater relative abundance of Mn increasing with primary particle size and a negative estimate conversely indicates decreasing Mn content with size. However, the estimate was only statistically significant (p<0.05) in half of the samples (n=5), which all had a positive estimate. In the remaining samples, no significant trend was measured. Our findings indicate that the method is reproducible and that differences in the abundance of Mn by primary particle size among welding fume samples can be detected.

  1. De-identification of primary care electronic medical records free-text data in Ontario, Canada.

    Science.gov (United States)

    Tu, Karen; Klein-Geltink, Julie; Mitiku, Tezeta F; Mihai, Chiriac; Martin, Joel

    2010-06-18

    Electronic medical records (EMRs) represent a potentially rich source of health information for research but the free-text in EMRs often contains identifying information. While de-identification tools have been developed for free-text, none have been developed or tested for the full range of primary care EMR data We used deid open source de-identification software and modified it for an Ontario context for use on primary care EMR data. We developed the modified program on a training set of 1000 free-text records from one group practice and then tested it on two validation sets from a random sample of 700 free-text EMR records from 17 different physicians from 7 different practices in 5 different cities and 500 free-text records from a group practice that was in a different city than the group practice that was used for the training set. We measured the sensitivity/recall, precision, specificity, accuracy and F-measure of the modified tool against manually tagged free-text records to remove patient and physician names, locations, addresses, medical record, health card and telephone numbers. We found that the modified training program performed with a sensitivity of 88.3%, specificity of 91.4%, precision of 91.3%, accuracy of 89.9% and F-measure of 0.90. The validations sets had sensitivities of 86.7% and 80.2%, specificities of 91.4% and 87.7%, precisions of 91.1% and 87.4%, accuracies of 89.0% and 83.8% and F-measures of 0.89 and 0.84 for the first and second validation sets respectively. The deid program can be modified to reasonably accurately de-identify free-text primary care EMR records while preserving clinical content.

  2. De-identification of primary care electronic medical records free-text data in Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Mitiku Tezeta F

    2010-06-01

    Full Text Available Abstract Background Electronic medical records (EMRs represent a potentially rich source of health information for research but the free-text in EMRs often contains identifying information. While de-identification tools have been developed for free-text, none have been developed or tested for the full range of primary care EMR data Methods We used deid open source de-identification software and modified it for an Ontario context for use on primary care EMR data. We developed the modified program on a training set of 1000 free-text records from one group practice and then tested it on two validation sets from a random sample of 700 free-text EMR records from 17 different physicians from 7 different practices in 5 different cities and 500 free-text records from a group practice that was in a different city than the group practice that was used for the training set. We measured the sensitivity/recall, precision, specificity, accuracy and F-measure of the modified tool against manually tagged free-text records to remove patient and physician names, locations, addresses, medical record, health card and telephone numbers. Results We found that the modified training program performed with a sensitivity of 88.3%, specificity of 91.4%, precision of 91.3%, accuracy of 89.9% and F-measure of 0.90. The validations sets had sensitivities of 86.7% and 80.2%, specificities of 91.4% and 87.7%, precisions of 91.1% and 87.4%, accuracies of 89.0% and 83.8% and F-measures of 0.89 and 0.84 for the first and second validation sets respectively. Conclusion The deid program can be modified to reasonably accurately de-identify free-text primary care EMR records while preserving clinical content.

  3. REVIEW ARTICLE: From single photons to milliwatt radiant power—electron storage rings as radiation sources with a high dynamic range

    Science.gov (United States)

    Klein, Roman; Thornagel, Reiner; Ulm, Gerhard

    2010-10-01

    The spectral radiant intensity of synchrotron radiation from electron storage rings can be calculated from basic electrodynamic relations (Schwinger equation) and it is directly proportional to the stored electron beam current, i.e. the number of stored electrons. With the necessary equipment installed to measure and control the electron beam current over a wide dynamic range, the radiant intensity of the synchrotron radiation can be adjusted accordingly without changing the spectrum. This is done, e.g., at the Metrology Light Source (MLS), the dedicated electron storage ring of the Physikalisch-Technische Bundesanstalt. The MLS is operated as a primary radiation source standard from the near IR up to the soft x-ray region and its operational parameters can be adjusted and accurately measured in a wide range: the electron beam current can be varied from 1 pA (one stored electron) up to 200 mA and thus the radiant intensity can be changed by more than 11 decades. The photon flux or radiant power for typical angular acceptances can thus be varied from single photons to milliwatts. This is a very powerful tool, e.g., for the characterization of the linearity of the response of radiation detectors or for the calibration of photon counting detectors. In this article we present an overview of past, current and possible future activities exploiting this feature.

  4. Overpotential-induced lability of the electronic overlap factor in long-range electrochemical electron transfer: charge and distance dependence

    DEFF Research Database (Denmark)

    Kornyshev, A. A.; Kuznetsov, A. M.; Nielsen, Jens Ulrik

    2000-01-01

    Long-distance electrochemical electron transfer exhibits approximately exponential dependence on the electron transfer distance. On the basis of a jellium model of the metal surface we show that the slope of the logarithm of the current vs. the transfer distance also depends strongly...... on the electrode charge. The slope is smaller the more negative the charge density due to enhanced extension of the surface electronic density profile on the solution side, and thereby better electronic overlap with the reacting molecule. The effect is sensitive to the bulk electron density of the metal...... and the localization of the electronic state at the molecular reactant site. Effects similar to these have been observed experimentally and could be common for electronically light metals....

  5. Electronic Health Record Challenges, Workarounds, and Solutions Observed in Practices Integrating Behavioral Health and Primary Care.

    Science.gov (United States)

    Cifuentes, Maribel; Davis, Melinda; Fernald, Doug; Gunn, Rose; Dickinson, Perry; Cohen, Deborah J

    2015-01-01

    This article describes the electronic health record (EHR)-related experiences of practices striving to integrate behavioral health and primary care using tailored, evidenced-based strategies from 2012 to 2014; and the challenges, workarounds and initial health information technology (HIT) solutions that emerged during implementation. This was an observational, cross-case comparative study of 11 diverse practices, including 8 primary care clinics and 3 community mental health centers focused on the implementation of integrated care. Practice characteristics (eg, practice ownership, federal designation, geographic area, provider composition, EHR system, and patient panel characteristics) were collected using a practice information survey and analyzed to report descriptive information. A multidisciplinary team used a grounded theory approach to analyze program documents, field notes from practice observation visits, online diaries, and semistructured interviews. Eight primary care practices used a single EHR and 3 practices used 2 different EHRs, 1 to document behavioral health and 1 to document primary care information. Practices experienced common challenges with their EHRs' capabilities to 1) document and track relevant behavioral health and physical health information, 2) support communication and coordination of care among integrated teams, and 3) exchange information with tablet devices and other EHRs. Practices developed workarounds in response to these challenges: double documentation and duplicate data entry, scanning and transporting documents, reliance on patient or clinician recall for inaccessible EHR information, and use of freestanding tracking systems. As practices gained experience with integration, they began to move beyond workarounds to more permanent HIT solutions ranging in complexity from customized EHR templates, EHR upgrades, and unified EHRs. Integrating behavioral health and primary care further burdens EHRs. Vendors, in cooperation with

  6. Tyrosine oxidation in heme oxygenase: examination of long-range proton-coupled electron transfer.

    Science.gov (United States)

    Smirnov, Valeriy V; Roth, Justine P

    2014-10-01

    Heme oxygenase is responsible for the degradation of a histidine-ligated ferric protoporphyrin IX (Por) to biliverdin, CO, and the free ferrous ion. Described here are studies of tyrosyl radical formation reactions that occur after oxidizing Fe(III)(Por) to Fe(IV)=O(Por(·+)) in human heme oxygenase isoform-1 (hHO-1) and the structurally homologous protein from Corynebacterium diphtheriae (cdHO). Site-directed mutagenesis on hHO-1 probes the reduction of Fe(IV)=O(Por(·+)) by tyrosine residues within 11 Å of the prosthetic group. In hHO-1, Y58· is implicated as the most likely site of oxidation, based on the pH and pD dependent kinetics. The absence of solvent deuterium isotope effects in basic solutions of hHO-1 and cdHO contrasts with the behavior of these proteins in the acidic solution, suggesting that long-range proton-coupled electron transfer predominates over electron transfer.

  7. Primary production in an impounded baldcypress swamp (Taxodium distichum) at the northern limit of the range

    Science.gov (United States)

    Middleton, B.A.; McKee, K.L.

    2005-01-01

    The ability of baldcypress (Taxodium distichum)swamps to maintain themselves near the northern limit of their range depends on their levels of production, which is not only are response to climate but also to local environmental factors(e.g., impoundment). We asked if primary production was reduced under impounded conditions and if species' responses to impoundment were individualistic or more generalized. To examine long-term production trends in a permanently impounded baldcypress swamp, a 6-year study of leaf litterfall was conducted in Buttonland Swamp, Illinois, which had been impounded for 10 years before the beginning of the study. Buttonland Swamp is at the northern boundary of the baldcypress swamp region along the Cache River, Illinois, in the Mississippi River Alluvial Valley of the United States. When the litter production of impounded sites was compared to those with natural hydrology in the same region, impounded sites had about half of the total litterfall of natural sites. Overall, leaf litterfall rates declined during the study(201 vs. 113 gm-2 yr-1), but the pattern was negatively correlated with water depth, which explained 97% of the variation in the data. Along the transect with the lowest mean minimum water depth(<0.5 cm), leaf litterfall decreased linearly over 6 years from 377 to 154gm-2 yr-1. Total leaf litterfall rates were lower at the other three depths(5, 43, and 49 cm mean minimum water depths)and remained below 200 gm-2 yr -1 throughout the study. Acer saccharinum, Nyssa aquatica, and Salix nigra were most responsible for the decline in total leaf litterfall. Amounts of leaf litterfall of T. distichum and Liquidambar styraciflua also generally decreased, while that of Cephalanthus occidentalis increased overtime. Because species' responses to environmental factors such as impoundment are individualistic, models should be based on the responses of individual species, rather than on communities. Our study further suggests that the

  8. Accuracy of electronic apex locators in primary teeth: a meta-analysis.

    Science.gov (United States)

    Ahmad, I A; Pani, S C

    2015-03-01

    To conduct a meta-analysis on the accuracy of electronic apex locators (EALs) in determining working length in human primary teeth. An electronic literature search was conducted using a combination of the terms 'primary teeth', 'root canal length' and 'electronic apex locators'. Additional eligible articles were identified using a manual search. The full texts of identified articles were screened according to inclusion criteria. Overall, 19 studies met the inclusion criteria and were subjected to further data extraction. Meta-analysis of studies that reported mean lengths and difference in mean lengths between EAL and actual root canal length (ARCL) revealed a significant difference (P = 0.015) between the two readings whilst those studies that evaluated intraclass correlation (ICC) suggested a high correlation (P primary teeth. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  9. Galactic electrons and positrons at the Earth: new estimate of the primary and secondary fluxes

    Science.gov (United States)

    Delahaye, T.; Lavalle, J.; Lineros, R.; Donato, F.; Fornengo, N.

    2010-12-01

    Context. The so-called excess of cosmic ray (CR) positrons observed by the PAMELA satellite up to 100 GeV has led to many interpretation attempts, from standard astrophysics to a possible exotic contribution from dark matter annihilation or decay. The Fermi data subsequently obtained about CR electrons and positrons in the range 0.02-1 TeV, and HESS data above 1 TeV have provided additional information about the leptonic content of local Galactic CRs. Aims: We analyse predictions of the CR lepton fluxes at the Earth of both secondary and primary origins, evaluate the theoretical uncertainties, and determine their level of consistency with respect to the available data. Methods: For propagation, we use a relativistic treatment of the energy losses for which we provide useful parameterizations. We compute the secondary components by improving on the method that we derived earlier for positrons. For primaries, we estimate the contributions from astrophysical sources (supernova remnants and pulsars) by considering all known local objects within 2 kpc and a smooth distribution beyond. Results: We find that the electron flux in the energy range 5-30 GeV is well reproduced by a smooth distant distribution of sources with index γ ~ 2.3-2.4, while local sources dominate the flux at higher energy. For positrons, local pulsars have an important effect above 5-10 GeV. Uncertainties affecting the source modeling and propagation are degenerate and each translates into about one order of magnitude error in terms of local flux. The spectral shape at high energy is weakly correlated with the spectral indices of local sources, but more strongly with the hierarchy in their distance, age and power. Despite the large theoretical errors that we describe, our global and self-consistent analysis can explain all available data without over-tuning the parameters, and therefore without the need to consider any exotic physics. Conclusions: Though a standard paradigm of Galactic CRs is well

  10. Utilization of Patient Electronic Messaging to Promote Advance Care Planning in the Primary Care Setting.

    Science.gov (United States)

    Tieu, Christina; Chaudhry, Rajeev; Schroeder, Darrell R; Bock, Frank A; Hanson, Gregory J; Tung, Ericka E

    2017-08-01

    Advance care planning (ACP) is an instrumental mechanism aimed at preserving patient autonomy. Numerous interventions have been proposed to facilitate the implementation of ACP; however, rates of completed advance directives (ADs) are universally low. Patient electronic portal messaging is a newer tool in patient-provider communication which has not been studied as a method to promote ACP. In this study, we hypothesized that the use of ACP-specific patient electronic messages would increase rates of AD completion in patients aged 65 years and older in an academic primary care practice. All primary care patients, aged 65+, who had previously enrolled in a patient electronic messaging system, within an academic primary care practice, were included for randomization. Two hundred patients were randomized to receive an electronic message. The primary outcome was the proportion of patients in each group who completed an AD, 3 months after intervention. Secondary outcomes included clinical utility of the completed ADs and proportion of patients who viewed their electronic messages. The intervention group completed an AD 5.5% of the time when compared to 2% in the control group (odds ratio 3.2 [1.6-6.3]). Up to 74.5% of patients opened their electronic messages. Among primary care patients aged 65 years and older, use of AD-specific electronic messaging statistically significantly increased the rate of AD completion, but the absolute number of completed AD remained relatively low. These data suggest that this valuable communication tool holds opportunities for further improvement. Older, frailer adults were more likely to complete an AD, and prompted directives were more likely to include a written expression of the individual's health-care values and preference.

  11. Comparison of Simulated Responses Derived from Silicon Detectors Depending on the Consideration of Primary Electron Tracks

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Geehyun; Park, Chang Je [Sejong University, Seoul (Korea, Republic of)

    2015-05-15

    We have previously shown the alteration of the simulated spectral response from radiation detectors when the active detector volume is not as large as the penetration length, or diffusion areas of the primary and secondary electrons, i.e. the solid lines of electron path illustrated is not confined within the detector volume anymore. For thin-film-based detectors, such as nanostructure material based radiation detectors, it is important to include the incomplete charge carrier creation due to the primary electron escaping in the simulation of the spectral response and detection efficiency. If the effect due to the partial energy deposition from the primary electrons, thus limited charge creation by the initial energy deposition because of the electrons escaped from the active region is considered, the simulated spectra will reflect the effect accordingly. According to a simple simulation using PENELOPE 2011 Code, a Detector thickness of 200 μm can only embrace 70% of the recoiled electron tracks within the region. In this paper we will study how overall features in the simulated spectra, such as X-ray escape peaks, Compton continuum, the photopeak area and the peak-to-Compton ratio will be affected when the primary electron tracks are considered in a normal PIN-type silicon detectors. We used both PENELOPE and MCNP5 codes to calculate the electron particle tracks with the kinetic energy value down to the lower energy limit of each code (50 eV for PENELOPE and 1 keV for MCNP5) including variance reduction methods for the sake of extensive computing time.

  12. Improved Models and Tools for Prediction of Radiation Effects on Space Electronics in Wide Temperature Range Project

    Data.gov (United States)

    National Aeronautics and Space Administration — All NASA exploration systems operate in the extreme environments of space and require reliable electronics capable of handling a wide temperature range (-180:C to...

  13. Electron transfer in bacterial reaction centers with an energetically raised primary acceptor: ultrafast spectroscopy and ENDOR/TRIPLE studies

    Science.gov (United States)

    Wachtveitl, J.; Huber, H.; Feick, R.; Rautter, J.; Müh, F.; Lubitz, W.

    1998-08-01

    Femtosecond time resolved absorbance changes in the near infrared spectral region were recorded in photosynthetic reaction centers (RCs) of Rhodobacter ( Rb.) sphaeroides and Chloroflexus aurantiacus. For Rb. sphaeroides, wild type and site directed mutant RCs, where the tyrosine at the M210 position was replaced by phenylalanine and leucine, were investigated. In the mutant RCs the decay of the stimulated emission signal was drastically slower and displayed strong multiexponentiality. In the spectral range between 1000 and 1100 nm, the existence of a fast kinetic component with a time constant of 1 ps could be demonstrated. Based on the spectral and dichroic characteristics of the data, we suggest a weakly populated P +B A- state as first electron transfer intermediate in these mutants. The results indicate that primary electron transfer follows a stepwise mechanism, even in the case of an energetically increased primary acceptor. Investigations of the electronic structure of the photooxidized primary donor using ENDOR/TRIPLE spectroscopy demonstrated that changes at the position M210 mainly affect B A and not P.

  14. Electron Transfer in Chemistry and Biology–The Primary Events in ...

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 16; Issue 12. Electrons Transfer in Chemistry and Biology - The Primary Events in Photosynthesis. V Krishnan. Volume 16 Issue 12 December 2011 pp 1201-1210. Fulltext. Click here to view fulltext PDF. Permanent link:

  15. Electron Transfer in Chemistry and Biology–The Primary Events in ...

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 2; Issue 12. Electron Transfer in Chemistry and Biology – The Primary Events in Photosynthesis. V Krishnan. General Article Volume 2 Issue 12 December 1997 pp 77-86. Fulltext. Click here to view fulltext PDF. Permanent link:

  16. Assessment of oscillator strengths with multiconfigurational short-range density functional theory for electronic excitations in organic molecules

    DEFF Research Database (Denmark)

    Hedegård, Erik Donovan

    2017-01-01

    considered the large collection of organic molecules whose excited states were investigated with a range of electronic structure methods by Thiel et al. As a by-product of our calculations of oscillator strengths, we also obtain electronic excitation energies, which enable us to compare the performance......We have in a series of recent papers investigated electronic excited states with a hybrid between a complete active space self-consistent field (CASSCF) wave function and density functional theory (DFT). This method has been dubbed the CAS short-range DFT method (CAS–srDFT). The previous papers...

  17. Utility of electronic patient records in primary care for stroke secondary prevention trials

    Directory of Open Access Journals (Sweden)

    Ashworth Mark

    2011-02-01

    Full Text Available Abstract Background This study aimed to inform the design of a pragmatic trial of stroke prevention in primary care by evaluating data recorded in electronic patient records (EPRs as potential outcome measures. The study also evaluated achievement of recommended standards of care; variation between family practices; and changes in risk factor values from before to after stroke. Methods Data from the UK General Practice Research Database (GPRD were analysed for 22,730 participants with an index first stroke between 2003 and 2006 from 414 family practices. For each subject, the EPR was evaluated for the 12 months before and after stroke. Measures relevant to stroke secondary prevention were analysed including blood pressure (BP, cholesterol, smoking, alcohol use, body mass index (BMI, atrial fibrillation, utilisation of antihypertensive, antiplatelet and cholesterol lowering drugs. Intraclass correlation coefficients (ICC were estimated by family practice. Random effects models were fitted to evaluate changes in risk factor values over time. Results In the 12 months following stroke, BP was recorded for 90%, cholesterol for 70% and body mass index (BMI for 47%. ICCs by family practice ranged from 0.02 for BP and BMI to 0.05 for LDL and HDL cholesterol. For subjects with records available both before and after stroke, the mean reductions from before to after stroke were: mean systolic BP, 6.02 mm Hg; diastolic BP, 2.78 mm Hg; total cholesterol, 0.60 mmol/l; BMI, 0.34 Kg/m2. There was an absolute reduction in smokers of 5% and heavy drinkers of 4%. The proportion of stroke patients within the recommended guidelines varied from less than a third (29% for systolic BP, just over half for BMI (54%, and over 90% (92% on alcohol consumption. Conclusions Electronic patient records have potential for evaluation of outcomes in pragmatic trials of stroke secondary prevention. Stroke prevention interventions in primary care remain suboptimal but important

  18. How does Canada stack up? A bibliometric analysis of the primary healthcare electronic medical record literature.

    Science.gov (United States)

    Terry, Amanda L; Stewart, Moira; Fortin, Martin; Wong, Sabrina T; Kennedy, Maureen; Burge, Fred; Birtwhistle, Richard; Grava-Gubins, Inese; Webster, Greg; Thind, Amardeep

    2012-01-01

    Major initiatives are underway in Canada which are designed to increase electronic medical record (EMR) implementation and maximise its use in primary health care. These developments need to be supported by sufficient evidence from the literature, particularly relevant research conducted in the Canadian context. This study sought to quantify this lack of research by: (1) identifying and describing the primary health care EMR literature; and (2) comparing the Canadian and international primary healthcare EMR literature on the basis of content and publication levels. Seven bibliographic databases were searched using primary health care and EMR keywords. Publication abstracts were reviewed and categorised. First author affiliation was used to identify country of origin. Proportions of Canadian- and non-Canadian-authored publications were compared using Fisher's exact test. For countries having 10 or more primary healthcare EMR publications, publications per 10 000 researchers were calculated. After exclusions, 750 publications were identified. More than one-third used primary healthcare EMRs as a study data source. Twenty-two (3%) were Canadian-authored. There were significantly different publication levels in three categories between Canadian- and non-Canadian-authored publications. Based on publications per researchers, the Netherlands ranked first, while Canada ranked eighth of nine countries with 10 or more publications. A relatively small body of literature focused on EMRs in primary health care exists; publications by Canadian authors were low. This study highlights the need to develop a strong evidence base to support the effective implementation and use of EMRs in Canadian primary health care.

  19. "Feathered" fractal surfaces to minimize secondary electron emission for a wide range of incident angles

    Science.gov (United States)

    Swanson, Charles; Kaganovich, Igor D.

    2017-07-01

    Complex structures on a material surface can significantly reduce the total secondary electron emission from that surface. The reduction occurs due to the capture of low-energy, true secondary electrons emitted at one point of the structure and intersecting another. We performed Monte Carlo calculations to demonstrate that fractal surfaces can reduce net secondary electron emission produced by the surface as compared to the flat surface. Specifically, we describe one surface, a "feathered" surface, which reduces the secondary electron emission yield more effectively than other previously considered configurations. Specifically, feathers grown onto a surface suppress secondary electron emission from shallow angles of incidence more effectively than velvet. We find that, for the surface simulated, secondary electron emission yield remains below 20% of its un-suppressed value, even for shallow incident angles, where the velvet-only surface gives reduction factor of only 50%.

  20. Implementing change in primary care practices using electronic medical records: a conceptual framework

    Directory of Open Access Journals (Sweden)

    Stuart Gail W

    2008-01-01

    Full Text Available Abstract Background Implementing change in primary care is difficult, and little practical guidance is available to assist small primary care practices. Methods to structure care and develop new roles are often needed to implement an evidence-based practice that improves care. This study explored the process of change used to implement clinical guidelines for primary and secondary prevention of cardiovascular disease in primary care practices that used a common electronic medical record (EMR. Methods Multiple conceptual frameworks informed the design of this study designed to explain the complex phenomena of implementing change in primary care practice. Qualitative methods were used to examine the processes of change that practice members used to implement the guidelines. Purposive sampling in eight primary care practices within the Practice Partner Research Network-Translating Researching into Practice (PPRNet-TRIP II clinical trial yielded 28 staff members and clinicians who were interviewed regarding how change in practice occurred while implementing clinical guidelines for primary and secondary prevention of cardiovascular disease and strokes. Results A conceptual framework for implementing clinical guidelines into primary care practice was developed through this research. Seven concepts and their relationships were modelled within this framework: leaders setting a vision with clear goals for staff to embrace; involving the team to enable the goals and vision for the practice to be achieved; enhancing communication systems to reinforce goals for patient care; developing the team to enable the staff to contribute toward practice improvement; taking small steps, encouraging practices' tests of small changes in practice; assimilating the electronic medical record to maximize clinical effectiveness, enhancing practices' use of the electronic tool they have invested in for patient care improvement; and providing feedback within a culture of

  1. Characterization of motor units in behaving adult mice shows a wide primary range

    Science.gov (United States)

    Ritter, Laura K.; Tresch, Matthew C.; Heckman, C. J.; Manuel, Marin

    2014-01-01

    The mouse is essential for genetic studies of motor function in both normal and pathological states. Thus it is important to consider whether the structure of motor output from the mouse is in fact analogous to that recorded in other animals. There is a striking difference in the basic electrical properties of mouse motoneurons compared with those in rats, cats, and humans. The firing evoked by injected currents produces a unique frequency-current (F-I) function that emphasizes recruitment of motor units at their maximum force. These F-I functions, however, were measured in anesthetized preparations that lacked two key components of normal synaptic input: high levels of synaptic noise and neuromodulatory inputs. Recent studies suggest that the alterations in the F-I function due to these two components are essential for recreating firing behavior of motor units in human subjects. In this study we provide the first data on firing patterns of motor units in the awake mouse, focusing on steady output in quiet stance. The resulting firing patterns did not match the predictions from the mouse F-I behaviors but instead revealed rate modulation across a remarkably wide range (10–60 Hz). The low end of the firing range may be due to changes in the F-I relation induced by synaptic noise and neuromodulatory inputs. The high end of the range may indicate that, unlike other species, quiet standing in the mouse involves recruitment of relatively fast-twitch motor units. PMID:24805075

  2. Improved superconducting hot-electron bolometer devices for the THz range

    NARCIS (Netherlands)

    Klapwijk, T.M.; Barends, R.; Gao, J.R.; Hajenius, M.; Baselmans, J.J.A.

    2004-01-01

    Improved and reproducible heterodyne mixing (noise temperatures of 950 K at 2.5 THz) has been realized with NbN based hot-electron superconducting devices with low contact resistances. A distributed temperature numerical model of the NbN bridge, based on a local electron and a phonon temperature,

  3. Enzymatic cellulose oxidation is linked to lignin by long-range electron transfer

    DEFF Research Database (Denmark)

    Westereng, Bjorge; Cannella, David; Wittrup Agger, Jane

    2015-01-01

    Enzymatic oxidation of cell wall polysaccharides by lytic polysaccharide monooxygenases (LPMOs) plays a pivotal role in the degradation of plant biomass. While experiments have shown that LPMOs are copper dependent enzymes requiring an electron donor, the mechanism and origin of the electron supp...

  4. Long-range interactions and the sign of natural amplitudes in two-electron systems

    NARCIS (Netherlands)

    Giesbertz, K.J.H.; Van Leeuwen, R.

    In singlet two-electron systems, the natural occupation numbers of the one-particle reduced density matrix are given as squares of the natural amplitudes which are defined as the expansion coefficients of the two-electron wave function in a natural orbital basis. In this work, we relate the sign of

  5. Effects of long-range disorder and electronic interactions on the optical properties of graphene quantum dots

    Science.gov (United States)

    Altıntaş, A.; ćakmak, K. E.; Güçlü, A. D.

    2017-01-01

    We theoretically investigate the effects of long-range disorder and electron-electron interactions on the optical properties of hexagonal armchair graphene quantum dots consisting of up to 10 806 atoms. The numerical calculations are performed using a combination of tight-binding, mean-field Hubbard, and configuration interaction methods. Imperfections in the graphene quantum dots are modeled as a long-range random potential landscape, giving rise to electron-hole puddles. We show that, when the electron-hole puddles are present, the tight-binding method gives a poor description of the low-energy absorption spectra compared to mean-field and configuration interaction calculation results. As the size of the graphene quantum dot is increased, the universal optical conductivity limit can be observed in the absorption spectrum. When disorder is present, the calculated absorption spectrum approaches the experimental results for isolated monolayers of graphene sheets.

  6. [Perceptions on electronic prescribing by primary care physicians in madrid healthcare service].

    Science.gov (United States)

    Villímar Rodríguez, A I; Gangoso Fermoso, A B; Calvo Pita, C; Ariza Cardiel, G

    To investigate the opinion of Primary Care physicians regarding electronic prescribing. Descriptive study by means of a questionnaire sent to 527 primary care physicians. June 2014. The questionnaire included closed questions about interest shown, satisfaction, benefits, weaknesses, and barriers, and one open question about difficulties, all of them referred to electronic prescribing. Satisfaction was measured using 1-10 scale, and benefits, weaknesses, and barriers were evaluated by a 5-ítems Likert scale. Interest was measured using both methods. The questionnaire was sent by e-mail for on line response through Google Drive® tool. A descriptive statistical analysis was performed. The response rate was 47% (248/527). Interest shown was 8.7 (95% CI; 8.5-8.9) and satisfaction was 7.9 (95% CI; 7.8-8). The great majority 87.9% (95% CI; 83.8-92%) of respondents used electronic prescribing where possible. Most reported benefits were: 73.4% (95% CI; 67.8-78.9%) of respondents considered that electronic prescribing facilitated medication review, and 59.3% (95% CI; 53.1-65.4) of them felt that it reduced bureaucratic burden. Among the observed weaknesses, they highlighted the following: 87.9% (95% CI; 83.8-92%) of respondents believed specialist care physicians should also be able to use electronic prescribing. Concerning to barriers: 30.2% (95% CI; 24.5-36%) of respondents think that entering a patient into the electronic prescribing system takes too much time, and 4% (95% CI; 1.6-6.5%) of them perceived the application as difficult to use. Physicians showed a notable interest in using electronic prescribing and high satisfaction with the application performance. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Dynamic response of a two-dimensional electron gas: Effect of short-range correlations in the ladder approximation

    Science.gov (United States)

    Takayanagi, K.; Lipparini, E.

    1996-09-01

    The Dyson equation for the particle-hole Green's function, including exchange matrix elements, has been solved exactly for the effective interaction between two electrons in a two-dimensional electron gas. The effective interaction is obtained numerically by solving the Bethe-Goldstone integral equation in a two-dimensional electron gas. The effect of short-range correlations on static and dynamic dielectric functions is studied. Results are compared with the normal random-phase approximation, local-field theories, and recent quantum Monte Carlo results.

  8. Childhood obesity trends from primary care electronic health records in England between 1994 and 2013: population-based cohort study

    NARCIS (Netherlands)

    Jaarsveld, C.H.M. van; Gulliford, M.C.

    2015-01-01

    OBJECTIVE: This study aimed to use primary care electronic health records to evaluate the prevalence of overweight and obesity in 2-15-year-old children in England and compare trends over the last two decades. DESIGN: Cohort study of primary care electronic health records. SETTING: 375 general

  9. STATE OF USING ELECTRONIC LINGUOMETHODOLOGY TOOLS IN THE FUTURE PRIMARY SCHOOL TEACHERS’ PROFESSIONAL TRAINING

    Directory of Open Access Journals (Sweden)

    Inna Khyzhnyak

    2017-04-01

    Full Text Available Electronic linguomethodology is a methodology science innovative branch that appeared at the end of the twentieth century influenced by language education informatization. This innovative branch has essential significance for the future teachers’ training, but in modern researches, which concern problems of a primary school teachers training, it is reflected weakly. It has a negative influence on the teachers’ professional training quality. To justify the significance of this problem, the author conducts an empirical study, which is aimed at finding out the current state of the electronic linguomethodology tools being used in the practice of the primary school teachers’ training in the traditional learning environments in a higher school. Obtained results are hightlighted by the author in this article. The method of questionnaires was used and respondents were students of university linguomethodology courses. The author describes in detail the questionnaire structure that includes four blocks of the content: a respondent’s teaching experience; an availability of a general knowledge about electronic linguomethodology and its tools; a personal experience of electronic linguomethodology tools used in a teaching practice; a pedagogue’s opinion of students’ readiness for using electronic linguomethodology tools. A quantitative analysis of the responses for each questionnaire thematic block, conducted by using the method of ranking and qualitative analysis, gives the author an opportunity to make fundamental theoretical conclusions. The quantitative analysis results are shown in the diagrams, which are given in the article. Qualitative analysis allows the author to find that the state of using electronic linguomethodology tools in a practice of the primary school teachers’ training in the traditional learning environments in a higher school can be described as spontaneous. This state directly depends on personal acmeological aspirations

  10. Role of ligand substitution on long-range electron transfer in azurins

    DEFF Research Database (Denmark)

    Farver, O; Jeuken, L J; Canters, G W

    2000-01-01

    Azurin contains two potential redox sites, a copper centre and, at the opposite end of the molecule, a cystine disulfide (RSSR). Intramolecular electron transfer between a pulse radiolytically produced RSSR- radical anion and the blue Cu(II) ion was studied in a series of azurins in which single......-site mutations were introduced into the copper ligand sphere. In the Met121His mutant, the rate constant for intramolecular electron transfer is half that of the corresponding wild-type azurin. In the His46Gly and His117Gly mutants, a water molecule is co-ordinated to the copper ion when no external ligands...... are added. Both these mutants also exhibit slower intramolecular electron transfer than the corresponding wild-type azurin. However, for the His117Gly mutant in the presence of excess imidazole, an azurin-imidazole complex is formed and the intramolecular electron-transfer rate increases considerably...

  11. FTIR spectroscopy of the reaction center of Chloroflexus aurantiacus: photooxidation of the primary electron donor.

    Science.gov (United States)

    Zabelin, A A; Shkuropatova, V A; Shuvalov, V A; Shkuropatov, A Ya

    2012-02-01

    Photochemical oxidation of the primary electron donor P in reaction centers (RCs) of the filamentous anoxygenic phototrophic bacterium Chloroflexus (C.) aurantiacus was examined by light-induced Fourier transform infrared (FTIR) difference spectroscopy at 95 K in the spectral range of 4000-1200 cm(-1). The light-induced P(+)Q(A)(-)/PQ(A) IR spectrum of C. aurantiacus RCs is compared to the well-characterized FTIR difference spectrum of P photooxidation in the purple bacterium Rhodobacter (R.) sphaeroides R-26 RCs. The presence in the P(+)Q(A)(-)/PQ(A) FTIR spectrum of C. aurantiacus RCs of specific low-energy electronic transitions at ~2650 and ~2200 cm(-1), as well as of associated vibrational (phase-phonon) bands at 1567, 1481, and 1294-1285 cm(-1), indicates that the radical cation P(+) in these RCs has dimeric structure, with the positive charge distributed between the two coupled bacteriochlorophyll a molecules. The intensity of the P(+) absorbance band at ~1250 nm (upon chemical oxidation of P at room temperature) in C. aurantiacus RCs is approximately 1.5 times lower than that in R. sphaeroides R-26 RCs. This fact, together with the decreased intensity of the absorbance band at ~2650 cm(-1), is interpreted in terms of the weaker coupling of bacteriochlorophylls in the P(+) dimer in C. aurantiacus compared to R. sphaeroides R-26. In accordance with the previous (pre)resonance Raman data, FTIR measurements in the carbonyl stretching region show that in C. aurantiacus RCs (i) the 13(1)-keto C=O groups of P(A) and P(B-) molecules constituting the P dimer are not involved in hydrogen bonding in either neutral or photooxidized state of P and (ii) the 3(1)-acetyl C=O group of P(B) forms a hydrogen bond (probably with tyrosine M187) absorbing at 1635 cm(-1). Differential signals at 1757(+)/1749(-) and 1741(+)/1733(-) cm(-1) in the FTIR spectrum of C. aurantiacus RCs are attributed to the 13(3)-ester C=O groups of P in different environments.

  12. Structural, electronic and optical properties of well-known primary explosive: Mercury fulminate

    OpenAIRE

    Yedukondalu, N.; Vaitheeswaran, G.

    2016-01-01

    Mercury Fulminate (MF) is one of the well-known primary explosives since 17th century and it has rendered invaluable service over many years. However, the correct molecular and crystal structures are determined recently after 300 years of its discovery. In the present study, we report pressure dependent structural, elastic, electronic and optical properties of MF. Non-local correction methods have been employed to capture the weak van der Waals interactions in layered and molecular energetic ...

  13. Electronic working length determination in primary teeth by ProPex and Digital Signal Processing.

    Science.gov (United States)

    Nelson-Filho, Paulo; Lucisano, Marcela Pacífico; Leonardo, Mário Roberto; da Silva, Raquel Assed Bezerra; da Silva, Léa Assed Bezerra

    2010-12-01

    The purpose of this study was to evaluate the accuracy of electronic apex locators Digital Signal Processing (DSP) and ProPex, for root canal length determination in primary teeth. Fifteen primary molars (a total of 34 root canals) were divided into two groups: Group I - without physiological resorption (n = 16); and Group II - with physiological resorption (n = 18). The length of each canal was measured by introducing a file until its tip was visible and then it was retracted 1 mm. For electronic measurement, the devices were set to 1 mm short of the apical resorption. The data were analysed statistically using the intraclass correlation coefficient (ICC). Results showed that the ICC was high for both electronic apex locators in all situations - with (ICC: DSP = 0.82 and Propex = 0.89) or without resorption (ICC: DSP = 0.92 and Propex = 0.90). Both apex locators were extremely accurate in determining the working length in primary teeth, both with or without physiological resorption. © 2010 The Authors. Australian Endodontic Journal © 2010 Australian Society of Endodontology.

  14. Depth profiling of residual activity of ^{237}U fragments as a range verification technique for ^{238}U primary ion beam

    Directory of Open Access Journals (Sweden)

    I. Strašík

    2012-07-01

    Full Text Available Experimental and simulation data concerning fragmentation of ^{238}U ion beam in aluminum, copper, and stainless-steel targets with the initial energy 500 and 950  MeV/u are collected in the paper. A range-verification technique based on depth profiling of residual activity is presented. The irradiated targets were constructed in the stacked-foil geometry and analyzed using gamma-ray spectroscopy. One of the purposes of these experiments was depth profiling of residual activity of induced nuclides and projectile fragments. Among the projectile fragments, special attention is paid to the ^{237}U isotope that has a range very close to the range of the primary ^{238}U ions. Therefore, the depth profiling of the ^{237}U isotope can be utilized for experimental verification of the ^{238}U primary-beam range, which is demonstrated and discussed in the paper. The experimental data are compared with computer simulations by FLUKA, SRIM, and ATIMA, as well as with complementary experiments.

  15. Depth profiling of residual activity of U237 fragments as a range verification technique for U238 primary ion beam

    Science.gov (United States)

    Strašík, I.; Chetvertkova, V.; Mustafin, E.; Pavlovič, M.; Belousov, A.

    2012-07-01

    Experimental and simulation data concerning fragmentation of U238 ion beam in aluminum, copper, and stainless-steel targets with the initial energy 500 and 950MeV/u are collected in the paper. A range-verification technique based on depth profiling of residual activity is presented. The irradiated targets were constructed in the stacked-foil geometry and analyzed using gamma-ray spectroscopy. One of the purposes of these experiments was depth profiling of residual activity of induced nuclides and projectile fragments. Among the projectile fragments, special attention is paid to the U237 isotope that has a range very close to the range of the primary U238 ions. Therefore, the depth profiling of the U237 isotope can be utilized for experimental verification of the U238 primary-beam range, which is demonstrated and discussed in the paper. The experimental data are compared with computer simulations by FLUKA, SRIM, and ATIMA, as well as with complementary experiments.

  16. Cluster randomized trials utilizing primary care electronic health records: methodological issues in design, conduct, and analysis (eCRT Study).

    Science.gov (United States)

    Gulliford, Martin C; van Staa, Tjeerd P; McDermott, Lisa; McCann, Gerard; Charlton, Judith; Dregan, Alex

    2014-06-11

    There is growing interest in conducting clinical and cluster randomized trials through electronic health records. This paper reports on the methodological issues identified during the implementation of two cluster randomized trials using the electronic health records of the Clinical Practice Research Datalink (CPRD). Two trials were completed in primary care: one aimed to reduce inappropriate antibiotic prescribing for acute respiratory infection; the other aimed to increase physician adherence with secondary prevention interventions after first stroke. The paper draws on documentary records and trial datasets to report on the methodological experience with respect to research ethics and research governance approval, general practice recruitment and allocation, sample size calculation and power, intervention implementation, and trial analysis. We obtained research governance approvals from more than 150 primary care organizations in England, Wales, and Scotland. There were 104 CPRD general practices recruited to the antibiotic trial and 106 to the stroke trial, with the target number of practices being recruited within six months. Interventions were installed into practice information systems remotely over the internet. The mean number of participants per practice was 5,588 in the antibiotic trial and 110 in the stroke trial, with the coefficient of variation of practice sizes being 0.53 and 0.56 respectively. Outcome measures showed substantial correlations between the 12 months before, and after intervention, with coefficients ranging from 0.42 for diastolic blood pressure to 0.91 for proportion of consultations with antibiotics prescribed, defining practice and participant eligibility for analysis requires careful consideration. Cluster randomized trials may be performed efficiently in large samples from UK general practices using the electronic health records of a primary care database. The geographical dispersal of trial sites presents a difficulty for

  17. Return on investment in electronic health records in primary care practices: a mixed-methods study.

    Science.gov (United States)

    Jang, Yeona; Lortie, Michel A; Sanche, Steven

    2014-09-29

    The use of electronic health records (EHR) in clinical settings is considered pivotal to a patient-centered health care delivery system. However, uncertainty in cost recovery from EHR investments remains a significant concern in primary care practices. Guided by the question of "When implemented in primary care practices, what will be the return on investment (ROI) from an EHR implementation?", the objectives of this study are two-fold: (1) to assess ROI from EHR in primary care practices and (2) to identify principal factors affecting the realization of positive ROI from EHR. We used a break-even point, that is, the time required to achieve cost recovery from an EHR investment, as an ROI indicator of an EHR investment. Given the complexity exhibited by most EHR implementation projects, this study adopted a retrospective mixed-method research approach, particularly a multiphase study design approach. For this study, data were collected from community-based primary care clinics using EHR systems. We collected data from 17 primary care clinics using EHR systems. Our data show that the sampled primary care clinics recovered their EHR investments within an average period of 10 months (95% CI 6.2-17.4 months), seeing more patients with an average increase of 27% in the active-patients-to-clinician-FTE (full time equivalent) ratio and an average increase of 10% in the active-patients-to-clinical-support-staff-FTE ratio after an EHR implementation. Our analysis suggests, with a 95% confidence level, that the increase in the number of active patients (P=.006), the increase in the active-patients-to-clinician-FTE ratio (Prevenue (Pprocess changes seems to play a role. Policies that provide support to help primary care practices successfully make EHR-enabled changes, such as support of clinic workflow optimization with an EHR system, could facilitate the realization of positive ROI from EHR in primary care practices.

  18. Long-range coupling of electron-hole pairs in spatially separated organic donor-acceptor layers

    Science.gov (United States)

    Nakanotani, Hajime; Furukawa, Taro; Morimoto, Kei; Adachi, Chihaya

    2016-01-01

    Understanding exciton behavior in organic semiconductor molecules is crucial for the development of organic semiconductor-based excitonic devices such as organic light-emitting diodes and organic solar cells, and the tightly bound electron-hole pair forming an exciton is normally assumed to be localized on an organic semiconducting molecule. We report the observation of long-range coupling of electron-hole pairs in spatially separated electron-donating and electron-accepting molecules across a 10-nanometers-thick spacer layer. We found that the exciton energy can be tuned over 100 megaelectron volts and the fraction of delayed fluorescence can be increased by adjusting the spacer-layer thickness. Furthermore, increasing the spacer-layer thickness produced an organic light-emitting diode with an electroluminescence efficiency nearly eight times higher than that of a device without a spacer layer. Our results demonstrate the first example of a long-range coupled charge-transfer state between electron-donating and electron-accepting molecules in a working device. PMID:26933691

  19. Thermoluminescence response of sodalime glass irradiated with photon and electron beams in the 1-20 Gy range

    Energy Technology Data Exchange (ETDEWEB)

    Bartolotta, A., E-mail: antonio.bartolotta@unipa.it [Dipartimento Farmacochimico, Tossicologico e Biologico, via Archirafi 32, 90123 Palermo (Italy); Brai, M. [Dipartimento di Fisica e Tecnologie Relative, Universita di Palermo, Viale delle Scienze, Ed. 18, 90128 Palermo (Italy); Gruppo V, INFN, Sezione di Catania, Catania (Italy); Caputo, V. [Unita Operativa Complessa Fisica Sanitaria, ARNAS, Palermo (Italy); D' Oca, M.C. [Dipartimento Farmacochimico, Tossicologico e Biologico, via Archirafi 32, 90123 Palermo (Italy); Longo, A.; Marrale, M. [Dipartimento di Fisica e Tecnologie Relative, Universita di Palermo, Viale delle Scienze, Ed. 18, 90128 Palermo (Italy); Gruppo V, INFN, Sezione di Catania, Catania (Italy)

    2011-09-15

    The thermoluminescence response of a watch commercial glass was studied after irradiation with photons and electrons, in the range 1-20 Gy, of interest in accidental dosimetry; a linear response was obtained with both beams. This result, together with the satisfactory time stability of the thermoluminescence signal, indicates this glass as a potential material for retrospective dosimetry applications.

  20. A measurement of auroral electrons in the 1–10 MeV range

    NARCIS (Netherlands)

    Gils, J.N. van; Beek, H.F. van; Fetter, L.D. de; Hendrickx, R.V.

    Particle fluxes have been measured by means of shielded Geiger-Müller telescopes mounted m a rocket, which was launched from ESRANGE(Kiruna) into a diffuse aurora. The analysis of the dependence of the counting rates on altitude indicates that a weak flux of energetic electrons, 1–10 MeV, has been

  1. Single-molecule Mapping of Long-range Electron Transfer for a Cytochrome b562 Variant

    DEFF Research Database (Denmark)

    Della Pia, Eduardo Antonio; Chi, Qijin; Jones, D. Dafydd

    2011-01-01

    Cytochrome b562 was engineered to introduce a cysteine residue at a surface-exposed position to facilitate direct self-assembly on a Au(111) surface. The confined protein exhibited reversible and fast electron exchange with a gold substrate over a distance of 20 Å between the heme redox center an...

  2. Unconventional superconductivity in two-dimensional electron systems with long-range correlations

    Energy Technology Data Exchange (ETDEWEB)

    Clark, J.W.; Khodel, V.A.; Zverev, M.V.; Yakovenko, V.M

    2004-03-01

    We explore salient features of high-T{sub c} superconductivity in two-dimensional electron liquid, that are triggered by critical fluctuations enhanced in the vicinity of an impending second order phase transition. A simple theoretical explanation for the transition from d-wave to another type of superconducting pairing that has recently observed in the electron-doped cuprates is offered. The d{sub x{sup 2}}{sub -y{sup 2}} pairing potential {delta}, which has maximal magnitude at the hot spots on the Fermi surface, becomes suppressed under increase of electron doping, because the hot spots approach the Brillouin zone diagonals where the respective gap value vanishes, and pairing with d{sub x{sup 2}}{sub -y{sup 2}} symmetry is then replaced by either singlet s-wave or triplet p-wave pairing. We argue in favor of p-wave pairing and propose experiments to verify this assertion. The phenomenon of flattening of electron spectra in high-T{sub c} superconductors is discussed. We suggest that this phenomenon can be explained on the basis of the Fermi liquid approach, involving unconventional solutions emerging beyond the point where stability conditions for the traditional Landau state are violated. The problem of pairing in anisotropic electron systems possessing patches of fermion condensate in the vicinity of the van Hove points is analyzed. Attention is directed to opportunities for the occurrence of non-BCS pairing correlations between the states belonging to the fermion condensate. It is shown that the physical emergence of such pairing correlations would drastically alter the behavior of the single-particle Green function, the canonical pole of Fermi-liquid theory being replaced by a branch point.

  3. Jaundice in primary care: a cohort study of adults aged >45 years using electronic medical records.

    Science.gov (United States)

    Taylor, Anna; Stapley, Sally; Hamilton, William

    2012-08-01

    Jaundice is a rare but important symptom of malignant and benign conditions. When patients present in primary care, understanding the relative likelihood of different disease processes can help GPs to investigate and refer patients appropriately. To identify and quantify the various causes of jaundice in adults presenting in primary care. Historical cohort study using electronic primary care records. UK General Practice Research Database. Participants (186 814 men and women) aged >45 years with clinical events recorded in primary care records between 1 January 2005 and 31 December 2007. Data were searched for episodes of jaundice and explanatory diagnoses identified within the subsequent 12 months. If no diagnosis was found, the patient's preceding medical record was searched for relevant chronic diseases. From the full cohort, 277 patients had at least one record of jaundice between 1 January 2005 and 31 December 2006. Ninety-two (33%) were found to have bile duct stones; 74 (27%) had an explanatory cancer [pancreatic cancer 34 (12%), cholangiocarcinoma 13 (5%) and other diagnosed primary malignancy 27 (10%)]. Liver disease attributed to excess alcohol explained 26 (9%) and other diagnoses were identified in 24 (9%). Sixty-one (22%) had no diagnosis related to jaundice recorded. Although the most common cause of jaundice is bile duct stones, cancers are present in over a quarter of patients with jaundice in this study, demonstrating the importance of urgent investigation into the underlying cause.

  4. Increases in HIV screening in primary care clinics through an electronic reminder: an interrupted time series.

    Science.gov (United States)

    Avery, Ann K; Del Toro, Michelle; Caron, Aleece

    2014-03-01

    Identify and eliminate barriers to HIV testing in primary care and to decrease the rates of patients never being tested, and limit unnecessary repeat testing. Primary care clinics within an urban publicly funded safety net hospital and community health system in Cleveland, Ohio. Reported HIV prevalence among male Cleveland residents is 1193.5/100 000. A time series analysis using statistical process control was used. Primary care encounters of patients aged 13-64 years from selected sites were reviewed throughout the initiative for HIV testing prior to the visit and associated with the visit. Run charts of the proportion of men and women never tested for HIV demonstrated marked improvement and special cause variation with six sequential quarters falling outside of the trend lines. Evaluation of encounters associated with a first HIV test confirmed testing occurring within primary care rather than elsewhere in the health system. Implementing an electronic medical record-based reminder effectively increased HIV testing among primary care patients not previously tested, while education and practice feedback alone did not.

  5. arriba-lib: evaluation of an electronic library of decision aids in primary care physicians

    Directory of Open Access Journals (Sweden)

    Hirsch Oliver

    2012-06-01

    Full Text Available Abstract Background The successful implementation of decision aids in clinical practice initially depends on how clinicians perceive them. Relatively little is known about the acceptance of decision aids by physicians and factors influencing the implementation of decision aids from their point of view. Our electronic library of decision aids (arriba-lib is to be used within the encounter and has a modular structure containing evidence-based decision aids for the following topics: cardiovascular prevention, atrial fibrillation, coronary heart disease, oral antidiabetics, conventional and intensified insulin therapy, and unipolar depression. The aim of our study was to evaluate the acceptance of arriba-lib in primary care physicians. Methods We conducted an evaluation study in which 29 primary care physicians included 192 patients. The physician questionnaire contained information on which module was used, how extensive steps of the shared decision making process were discussed, who made the decision, and a subjective appraisal of consultation length. We used generalised estimation equations to measure associations within patient variables and traditional crosstab analyses. Results Only a minority of consultations (8.9% was considered to be unacceptably extended. In 90.6% of consultations, physicians said that a decision could be made. A shared decision was perceived by physicians in 57.1% of consultations. Physicians said that a decision was more likely to be made when therapeutic options were discussed “detailed”. Prior experience with decision aids was not a critical variable for implementation within our sample of primary care physicians. Conclusions Our study showed that it might be feasible to apply our electronic library of decision aids (arriba-lib in the primary care context. Evidence-based decision aids offer support for physicians in the management of medical information. Future studies should monitor the long-term adoption of

  6. Wide Temperature Range DC-DC Boost Converters for Command/Control/Drive Electronics Project

    Data.gov (United States)

    National Aeronautics and Space Administration — We shall develop wide temperature range DC-DC boost converters that can be fabricated using commercial CMOS foundries. The boost converters will increase the low...

  7. Parametric decay instability of an obliquely propagating ordinary wave in the electron cyclotron frequency range

    Science.gov (United States)

    Gusakov, E. Z.; Popov, A. Yu.

    2018-01-01

    The possibility of the low-power-threshold parametric decay of an obliquely propagating ordinary wave to an upper hybrid wave and a low-hybrid wave is analysed under conditions of nonmonotonic plasma density profile in a magnetic trap. The instability threshold and growth rate are derived explicitly. The analytical results are illustrated under the conditions typical of the ordinary mode fundamental electron cyclotron resonance heating harmonic experiments at the FTU tokamak.

  8. Factors influencing the development of primary care data collection projects from electronic health records: a systematic review of the literature.

    Science.gov (United States)

    Gentil, Marie-Line; Cuggia, Marc; Fiquet, Laure; Hagenbourger, Camille; Le Berre, Thomas; Banâtre, Agnès; Renault, Eric; Bouzille, Guillaume; Chapron, Anthony

    2017-09-25

    Primary care data gathered from Electronic Health Records are of the utmost interest considering the essential role of general practitioners (GPs) as coordinators of patient care. These data represent the synthesis of the patient history and also give a comprehensive picture of the population health status. Nevertheless, discrepancies between countries exist concerning routine data collection projects. Therefore, we wanted to identify elements that influence the development and durability of such projects. A systematic review was conducted using the PubMed database to identify worldwide current primary care data collection projects. The gray literature was also searched via official project websites and their contact person was emailed to obtain information on the project managers. Data were retrieved from the included studies using a standardized form, screening four aspects: projects features, technological infrastructure, GPs' roles, data collection network organization. The literature search allowed identifying 36 routine data collection networks, mostly in English-speaking countries: CPRD and THIN in the United Kingdom, the Veterans Health Administration project in the United States, EMRALD and CPCSSN in Canada. These projects had in common the use of technical facilities that range from extraction tools to comprehensive computing platforms. Moreover, GPs initiated the extraction process and benefited from incentives for their participation. Finally, analysis of the literature data highlighted that governmental services, academic institutions, including departments of general practice, and software companies, are pivotal for the promotion and durability of primary care data collection projects. Solid technical facilities and strong academic and governmental support are required for promoting and supporting long-term and wide-range primary care data collection projects.

  9. Characterization of the primary source of electrons in linear accelerators in clinical use; Caracterizacion de la fuente primaria de electrones en aceleradores lineales de uso clinico

    Energy Technology Data Exchange (ETDEWEB)

    Gomez Extremera, M.; Gonzalez Infantes, W.; Lallena rojo, A. M.; Anguiano Millan, M.

    2013-07-01

    Monte Carlo simulation is currently considered the most accurate method for calculations of doses due to electrons. The objective of the work is the characterization of the primary source of electrons from an accelerator of clinical use with Monte Carlo simulation, in order to build a model of sources involving a substantial saving of time of calculation in the simulation of treatment. (Author)

  10. Testing and Comparison of Imaging Detectors for Electrons in the Energy Range 10–20 keV

    Science.gov (United States)

    Matheson, J.; Moldovan, G.; Kirkland, A.; Allinson, N.; Abrahams, J. P.

    2017-11-01

    Interest in direct detectors for low-energy electrons has increased markedly in recent years. Detection of electrons in the energy range up to low tens of keV is important in techniques such as photoelectron emission microscopy (PEEM) and electron backscatter diffraction (EBSD) on scanning electron microscopes (SEMs). The PEEM technique is used both in the laboratory and on synchrotron light sources worldwide. The ubiquity of SEMs means that there is a very large market for EBSD detectors for materials studies. Currently, the most widely used detectors in these applications are based on indirect detection of incident electrons. Examples include scintillators or microchannel plates (MCPs), coupled to CCD cameras. Such approaches result in blurring in scintillators/phosphors, distortions in optical systems, and inefficiencies due the limited active area of MCPs. In principle, these difficulties can be overcome using direct detection in a semiconductor device. Growing out of a feasibility study into the use of a direct detector for use on an XPEEM, we have built at Rutherford Appleton Laboratory a system to illuminate detectors with an electron beam of energy up to 20 keV . We describe this system in detail. It has been used to measure the performance of a custom back-thinned monolithic active pixel sensor (MAPS), a detector based on the Medipix2 chip, and a commercial detector based on MCPs. We present a selection of the results from these measurements and compare and contrast different detector types.

  11. Electron probe microanalysis (EPMA) measurement of thin-film thickness in the nanometre range.

    Science.gov (United States)

    Procop, M; Radtke, M; Krumrey, M; Hasche, K; Schädlich, S; Frank, W

    2002-10-01

    The thickness of thin films of platinum and nickel on fused silica and silicon substrates has been determined by EPMA using the commercial software STRATAGEM for calculation of film thickness. Film thickness ranged in the order 10 nm. An attempt was made to estimate the confidence range of the method by comparison with results from other methods of analysis. The data show that in addition to the uncertainty of the spectral intensity measurement and the complicated fitting routine, systematic deviation caused by the underlying model should be added. The scattering in the results from other methods does not enable specification of a range of uncertainty, but deviations from the real thickness are estimated to be less than 20%.

  12. Solid-state pulsed microwave bridge for electron spin echo spectrometers of 8-mm wavelength range

    Directory of Open Access Journals (Sweden)

    Kalabukhova E. N.

    2012-12-01

    Full Text Available The article presents a construction of a coherent pulsed microwave bridge with an output power up to 10 Wt with a time resolution of 10–8 seconds at a pulse repetition rate of 1 kHz designed for electron spin echo spectrometers. The bridge is built on a homodyne scheme based on IMPATT diodes, which are used for modulation and amplification of microwave power coming from the reference Gunn diode oscillator. The advantages of the bridge are optimal power and minimum pulse width, simple operation, low cost.

  13. Electronic Goals of Care Alerts: An Innovative Strategy to Promote Primary Palliative Care.

    Science.gov (United States)

    Haley, Erin M; Meisel, Deborah; Gitelman, Yevgeniy; Dingfield, Laura; Casarett, David J; O'Connor, Nina R

    2017-05-01

    Given the shortage of palliative care specialists, strategies are needed to promote primary palliative care by nonpalliative care providers. Electronic reminders are frequently used in medicine to standardize practice, but their effectiveness in encouraging goals of care discussions is not well understood. To determine whether brief education and electronic alerts increase the frequency of goals of care discussions. All general medicine services at a large academic medical center were included. Each medicine team received brief education on rounds about goals of care communication tool. When a newly admitted patient met predefined criteria, an electronic alert that included the tool was sent to the patient's resident and attending physicians within 48 hours. Of 352 admissions screened over a four-week period, 18% met one or more criteria. The combination of alerts and education increased documentation of goals of care in the medical record from 20.5% (15/73) to 44.6% (25/56) of patients (risk ratio 2.17, 95% CI 1.23-3.72). There were no significant changes in code status, noncode status limitations in care, or palliative care consultation. The combination of brief education and electronic goals of care alerts significantly increased documented goals of care discussions. This intervention is simple and feasible in many settings, but larger studies are needed to determine impact on patient outcomes. Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  14. Approaches and challenges to optimising primary care teams’ electronic health record usage

    Directory of Open Access Journals (Sweden)

    Nancy Pandhi

    2014-07-01

    Full Text Available Background Although the presence of an electronic health record (EHR alone does not ensure high quality, efficient care, few studies have focused on the work of those charged with optimising use of existing EHR functionality.Objective To examine the approaches used and challenges perceived by analysts supporting the optimisation of primary care teams’ EHR use at a large U.S. academic health care system.Methods A qualitative study was conducted. Optimisation analysts and their supervisor were interviewed and data were analysed for themes.Results Analysts needed to reconcile the tension created by organisational mandates focused on the standardisation of EHR processes with the primary care teams’ demand for EHR customisation. They gained an understanding of health information technology (HIT leadership’s and primary care team’s goals through attending meetings, reading meeting minutes and visiting with clinical teams. Within what was organisationally possible, EHR education could then be tailored to fit team needs. Major challenges were related to organisational attempts to standardise EHR use despite varied clinic contexts, personnel readiness and technical issues with the EHR platform. Forcing standardisation upon clinical needs that current EHR functionality could not satisfy was difficult.Conclusions Dedicated optimisation analysts can add value to health systems through playing a mediating role between HIT leadership and care teams. Our findings imply that EHR optimisation should be performed with an in-depth understanding of the workflow, cognitive and interactional activities in primary care.

  15. Structural, electronic and optical properties of well-known primary explosive: Mercury fulminate

    Science.gov (United States)

    Yedukondalu, N.; Vaitheeswaran, G.

    2015-11-01

    Mercury Fulminate (MF) is one of the well-known primary explosives since 17th century and it has rendered invaluable service over many years. However, the correct molecular and crystal structures are determined recently after 300 years of its discovery. In the present study, we report pressure dependent structural, elastic, electronic and optical properties of MF. Non-local correction methods have been employed to capture the weak van der Waals interactions in layered and molecular energetic MF. Among the non-local correction methods tested, optB88-vdW method works well for the investigated compound. The obtained equilibrium bulk modulus reveals that MF is softer than the well known primary explosives Silver Fulminate (SF), silver azide and lead azide. MF exhibits anisotropic compressibility (b > a > c) under pressure, consequently the corresponding elastic moduli decrease in the following order: C22 > C11 > C33. The structural and mechanical properties suggest that MF is more sensitive to detonate along c-axis (similar to RDX) due to high compressibility of Hg⋯O non-bonded interactions along that axis. Electronic structure and optical properties were calculated including spin-orbit (SO) interactions using full potential linearized augmented plane wave method within recently developed Tran-Blaha modified Becke-Johnson (TB-mBJ) potential. The calculated TB-mBJ electronic structures of SF and MF show that these compounds are indirect bandgap insulators. Also, SO coupling is found to be more pronounced for 4d and 5d-states of Ag and Hg atoms of SF and MF, respectively. Partial density of states and electron charge density maps were used to describe the nature of chemical bonding. Ag—C bond is more directional than Hg—C bond which makes SF to be more unstable than MF. The effect of SO coupling on optical properties has also been studied and found to be significant for both (SF and MF) of the compounds.

  16. Characterisation of a detector based on microchannel plates for electrons in the energy range 10 20 keV

    Science.gov (United States)

    Moldovan, G.; Matheson, J.; Derbyshire, G.; Kirkland, A.

    2008-11-01

    As part of a feasibility study into the use of novel electron detectors for an X-ray photoelectron emission microscope (XPEEM), we have characterised a detector based on microchannel plates (MCPs), a phosphor screen and a CCD camera. For XPEEM, an imaging detector is required for electrons in the energy range 10-20 keV. This type of detector is a standard fitment on commercial instruments and we have studied its performance in some detail in order to provide a baseline against which to evaluate future detector technologies. We present detective quantum efficiency (DQE), noise power spectrum (NPS) and modulation transfer function (MTF) measurements of a commercial detector, in the energy range of interest, as a function of the detector bias voltage.

  17. Modular Power Electronic Converters in the Power Range 1 to 10 kW

    DEFF Research Database (Denmark)

    Klimczak, Pawel

    Thanks to CO2 emission reduction policies and increasing prices of fossil fuels a significant growth in field of sustainable energy sources (SES) is being observed during last decade. A government support and take-off projects in Europe and US shall ensure an increasing trend in future too. Some...... of SES based plants , like hydro-, geothermal-, biofuel-plants, use synchronous generators directly connected to the grid. But some other SES technologies, like fuel cell or photovoltaic, require a power electronic converter between the energy source and the load or the grid. Work presented...... in this thesis concentrates on dc-dc non-isolated converters suitable for high voltage gain applications, like uninterruptible power supply (UPS) and some of sustainable energy sources. A special attention is on reduction of power losses and efficiency improvements in non-isolated dc-dc step-up converters...

  18. Comparative Evaluation of Electronic Apex Locators and Radiovisiography for Working Length Determination in Primary Teeth in vivo.

    Science.gov (United States)

    Abdullah, Ahsan; Singh, Neerja; Rathore, Monika S; Tandon, Shobha; Rajkumar, Balakrishnan

    2016-01-01

    The aim of this study was to evaluate the effectiveness of two different varieties of electronic apex locators and radiovisiography (RVG) for working length determination in primary teeth. A total of 30 primary teeth indicated for pulpectomy in children aged 3 to 8 years were randomly selected and subjected to working length determination using two varieties of electronic apex locators and RVG separately. The data were then subjected to statistical analysis. A very strong correlation between electronic measurement methods and RVG length was observed. Radiovisiography and apex locators are equally effective in determining working length in primary teeth. How to cite this article: Abdullah A, Singh N, Rathore MS, Tandon S, Rajkumar B. Comparative Evaluation of Electronic Apex Locators and Radiovisiography for Working Length Determination in Primary Teeth in vivo. Int J Clin Pediatr Dent 2016;9(2):118-123.

  19. Comparative Evaluation of Electronic Apex Locators and Radiovisiography for Working Length Determination in Primary Teeth in vivo

    Science.gov (United States)

    Singh, Neerja; Rathore, Monika S; Tandon, Shobha; Rajkumar, Balakrishnan

    2016-01-01

    ABSTRACT Aims: The aim of this study was to evaluate the effectiveness of two different varieties of electronic apex locators and radiovisiography (RVG) for working length determination in primary teeth. Materials and methods: A total of 30 primary teeth indicated for pulpectomy in children aged 3 to 8 years were randomly selected and subjected to working length determination using two varieties of electronic apex locators and RVG separately. The data were then subjected to statistical analysis. Results: A very strong correlation between electronic measurement methods and RVG length was observed. Conclusion: Radiovisiography and apex locators are equally effective in determining working length in primary teeth. How to cite this article: Abdullah A, Singh N, Rathore MS, Tandon S, Rajkumar B. Comparative Evaluation of Electronic Apex Locators and Radiovisiography for Working Length Determination in Primary Teeth in vivo. Int J Clin Pediatr Dent 2016;9(2):118-123. PMID:27365931

  20. Variable-range electron hopping, conductivity cross-over and space-charge relaxation in C60Br6

    OpenAIRE

    Manesh, Zachariah; Romanini, Michela; Zygouri, Panagiota; Gournis, Dimitrios; Tamarit Mur, José Luis; Barrio Casado, María del; Macovez, Roberto

    2016-01-01

    Dielectric spectroscopy is employed to probe the frequency-dependent conductivity and dipolar dielectric response of solid C60Br6. Below approximately 215 K, charge conduction is electronic and well described by Mott's variable-range polaron hopping model, with effective hopping activation energy Ea varying between 0.12 eV at 125 K and 0.16 eV at 220 K, and most probable hopping range varying between 100 and 125% of the decay length of the localized polaron's wavefunction. Above 215 K a new c...

  1. Determination of Chromium Valence Over the Range Cr(0)-Cr(VI) by Electron Energy Loss Spectroscopy

    Science.gov (United States)

    2006-01-01

    be of Cr (VI): Cr (V) [14,40-45] and Cr (IV) [46]. To fully altered by microbes [11-13], green algae [14], higher plants understand the geochemistry of Cr ... Cr (III) by bacteria [42,44,45] and Further, nearly all mineralized Cr in the terrestrial crust is green algae [14], reacts with diphenylcarbazide to...Determination of chromium valence over the range Cr (O)- Cr (VI) by electron energy loss spectroscopy Tyrone L. Daultona , Brenda J. Littleb ’Marine

  2. Comparative Evaluation of Electronic Apex Locators and Radiovisiography for Working Length Determination in Primary Teeth in vivo

    OpenAIRE

    Abdullah, Ahsan; Singh, Neerja; Rathore, Monika S; Tandon, Shobha; Rajkumar, Balakrishnan

    2016-01-01

    ABSTRACT Aims: The aim of this study was to evaluate the effectiveness of two different varieties of electronic apex locators and radiovisiography (RVG) for working length determination in primary teeth. Materials and methods: A total of 30 primary teeth indicated for pulpectomy in children aged 3 to 8 years were randomly selected and subjected to working length determination using two varieties of electronic apex locators and RVG separately. The data were then subjected to statistical analys...

  3. Acceleration of Long-Range Photoinduced Electron Transfer through DNA by Hydroxyquinolines as Artificial Base Pairs.

    Science.gov (United States)

    Bätzner, Effi; Liang, Yu; Schweigert, Caroline; Unterreiner, Andreas-Neil; Wagenknecht, Hans-Achim

    2015-06-08

    The C-nucleoside based on the hydroxyquinoline ligand (Hq) is complementary to itself and forms stable Hq-Hq pairs in double-stranded DNA. These artificial Hq-Hq pairs may serve as artificial electron carriers for long-range photoinduced electron transfer in DNA, as elucidated by a combination of gel electrophoretic analysis of irradiated samples and time-resolved transient absorption spectroscopy. For this study, the Hq-Hq pair was combined with a DNA-based donor-acceptor system consisting of 6-N,N-dimethylaminopyrene conjugated to 2'-deoxyuridine as photoinducible electron donor, and methyl viologen attached to the 2'-position of uridine as electron acceptor. The Hq radical anion was identified in the time-resolved measurements and strand cleavage products support its role as an intermediate charge carrier. Hence, the Hq-Hq pair significantly enhances the electron hopping capability of DNA compared to natural DNA bases over long distances while keeping the self-assembly properties as the most attractive feature of DNA as a supramolecular architecture. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Electronic health record impact on work burden in small, unaffiliated, community-based primary care practices.

    Science.gov (United States)

    Howard, Jenna; Clark, Elizabeth C; Friedman, Asia; Crosson, Jesse C; Pellerano, Maria; Crabtree, Benjamin F; Karsh, Ben-Tzion; Jaen, Carlos R; Bell, Douglas S; Cohen, Deborah J

    2013-01-01

    The use of electronic health records (EHR) is widely recommended as a means to improve the quality, safety and efficiency of US healthcare. Relatively little is known, however, about how implementation and use of this technology affects the work of clinicians and support staff who provide primary health care in small, independent practices. To study the impact of EHR use on clinician and staff work burden in small, community-based primary care practices. We conducted in-depth field research in seven community-based primary care practices. A team of field researchers spent 9-14 days over a 4-8 week period observing work in each practice, following patients through the practices, conducting interviews with key informants, and collecting documents and photographs. Field research data were coded and analyzed by a multidisciplinary research team, using a grounded theory approach. All practice members and selected patients in seven community-based primary care practices in the Northeastern US. The impact of EHR use on work burden differed for clinicians compared to support staff. EHR use reduced both clerical and clinical staff work burden by improving how they check in and room patients, how they chart their work, and how they communicate with both patients and providers. In contrast, EHR use reduced some clinician work (i.e., prescribing, some lab-related tasks, and communication within the office), while increasing other work (i.e., charting, chronic disease and preventive care tasks, and some lab-related tasks). Thoughtful implementation and strategic workflow redesign can mitigate the disproportionate EHR-related work burden for clinicians, as well as facilitate population-based care. The complex needs of the primary care clinician should be understood and considered as the next iteration of EHR systems are developed and implemented.

  5. Polarized light and scanning electron microscopic investigation of enamel hypoplasia in primary teeth.

    Science.gov (United States)

    Sabel, Nina; Klingberg, Gunilla; Dietz, Wolfram; Nietzsche, Sandor; Norén, Jörgen G

    2010-01-01

    Enamel hypoplasia is a developmental disturbance during enamel formation, defined as a macroscopic defect in the enamel, with a reduction of the enamel thickness with rounded, smooth borders. Information on the microstructural level is still limited, therefore further studies are of importance to better understand the mechanisms behind enamel hypoplasia. To study enamel hypoplasia in primary teeth by means of polarized light microscopy and scanning electron microscopy. Nineteen primary teeth with enamel hypoplasia were examined in a polarized light microscope and in a scanning electron microscope. The cervical and incisal borders of the enamel hypoplasia had a rounded appearance, as the prisms in the rounded cervical area of the hypoplasia were bent. The rounded borders had a normal surface structure whereas the base of the defects appeared rough and porous. Morphological findings in this study indicate that the aetiological factor has a short duration and affects only certain ameloblasts. The bottom of the enamel hypoplasia is porous and constitutes possible pathways for bacteria into the dentin.

  6. Electron microscopy of primary cell cultures in solution and correlative optical microscopy using ASEM

    Energy Technology Data Exchange (ETDEWEB)

    Hirano, Kazumi; Kinoshita, Takaaki [Laboratory of Cell Biology, Department of Bioinformatics, Faculty of Engineering, Soka University, 1-236 Tangi-machi, Hachioji, Tokyo 192-8577 (Japan); Uemura, Takeshi [Department of Molecular Neurobiology and Pharmacology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Department of Molecular and Cellular Physiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano 390-8621 (Japan); Motohashi, Hozumi [Department of Gene Expression Regulation, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryo-cho, Aoba-ku, Sendai 980-8575 (Japan); Watanabe, Yohei; Ebihara, Tatsuhiko [Biomedical Research Institute, National Institute of Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba 305-8566 (Japan); Nishiyama, Hidetoshi [JEOL Ltd., 1-2 Musashino 3-chome, Akishima, Tokyo 196-8558 (Japan); Sato, Mari [Biomedical Research Institute, National Institute of Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba 305-8566 (Japan); Suga, Mitsuo [JEOL Ltd., 1-2 Musashino 3-chome, Akishima, Tokyo 196-8558 (Japan); Maruyama, Yuusuke; Tsuji, Noriko M. [Biomedical Research Institute, National Institute of Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba 305-8566 (Japan); Yamamoto, Masayuki [Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, 2-1 Seiryo-cho, Aoba-ku, Sendai 980-8575 (Japan); Nishihara, Shoko, E-mail: shoko@soka.ac.jp [Laboratory of Cell Biology, Department of Bioinformatics, Faculty of Engineering, Soka University, 1-236 Tangi-machi, Hachioji, Tokyo 192-8577 (Japan); Sato, Chikara, E-mail: ti-sato@aist.go.jp [Biomedical Research Institute, National Institute of Industrial Science and Technology (AIST), 1-1-1 Higashi, Tsukuba 305-8566 (Japan)

    2014-08-01

    Correlative light-electron microscopy of cells in a natural environment of aqueous liquid facilitates high-throughput observation of protein complex formation. ASEM allows the inverted SEM to observe the wet sample from below, while an optical microscope observes it from above quasi-simultaneously. The disposable ASEM dish with a silicon nitride (SiN) film window can be coated variously to realize the primary-culture of substrate-sensitive cells in a few milliliters of culture medium in a stable incubator environment. Neuron differentiation, neural networking, proplatelet-formation and phagocytosis were captured by optical or fluorescence microscopy, and imaged at high resolution by gold-labeled immuno-ASEM with/without metal staining. Fas expression on the cell surface was visualized, correlated to the spatial distribution of F-actin. Axonal partitioning was studied using primary-culture neurons, and presynaptic induction by GluRδ2-N-terminus-linked fluorescent magnetic beads was correlated to the presynaptic-marker Bassoon. Further, megakaryocytes secreting proplatelets were captured, and P-selectins with adherence activity were localized to some of the granules present by immuno-ASEM. The phagocytosis of lactic acid bacteria by dendritic cells was also imaged. Based on these studies, ASEM correlative microscopy promises to allow the study of various mesoscopic-scale dynamics in the near future. - Highlights: • In situ correlative light electron microscopy of samples in open solution by ASEM. • Primary cultures for in-solution CLEM by developing SiN-film coating methods • First visualization of fluorescent magnetic beads in aqueous solution by CLEM. • Presynaptic induction of neurons by GluRδ2-N-terminus-coated beads studied by CLEM. • Axonal partitioning, bacterial phagocytosis, platelet formation imaged by CLEM.

  7. Electronic health records: essential tools in integrating substance abuse treatment with primary care

    Science.gov (United States)

    Tai, Betty; Wu, Li-Tzy; Clark, H Westley

    2012-01-01

    While substance use problems are considered to be common in medical settings, they are not systematically assessed and diagnosed for treatment management. Research data suggest that the majority of individuals with a substance use disorder either do not use treatment or delay treatment-seeking for over a decade. The separation of substance abuse services from mainstream medical care and a lack of preventive services for substance abuse in primary care can contribute to under-detection of substance use problems. When fully enacted in 2014, the Patient Protection and Affordable Care Act 2010 will address these barriers by supporting preventive services for substance abuse (screening, counseling) and integration of substance abuse care with primary care. One key factor that can help to achieve this goal is to incorporate the standardized screeners or common data elements for substance use and related disorders into the electronic health records (EHR) system in the health care setting. Incentives for care providers to adopt an EHR system for meaningful use are part of the Health Information Technology for Economic and Clinical Health Act 2009. This commentary focuses on recent evidence about routine screening and intervention for alcohol/drug use and related disorders in primary care. Federal efforts in developing common data elements for use as screeners for substance use and related disorders are described. A pressing need for empirical data on screening, brief intervention, and referral to treatment (SBIRT) for drug-related disorders to inform SBIRT and related EHR efforts is highlighted. PMID:24474861

  8. Use of an electronic medical record improves the quality of urban pediatric primary care.

    Science.gov (United States)

    Adams, William G; Mann, Adriana M; Bauchner, Howard

    2003-03-01

    To evaluate the quality of pediatric primary care, including preventive services, before and after the introduction of an electronic medical record (EMR) developed for use in an urban pediatric primary care center. A pre-postintervention analysis was used in the study. The intervention was a pediatric EMR. Routine health care maintenance visits for children lead risk assessment (RR: 106.54), exposure to domestic or community violence (RR: 35.19), guns in the home (RR: 58.11), behavioral or social developmental milestones (RR: 2.49), infant sleep position (RR: 9.29), breastfeeding (RR: 1.99), poison control (RR: 3.82), and child safety (RR: 1.29). Trends toward improved lead exposure, vision, and hearing screening were seen; however, differences were not significant. Users of the system reported that its use had improved the overall quality of care delivered, was well-accepted by families, and improved guidance quality; however, 5 of 7 users reported that eye-to-eye contact with patients was reduced, and 4 of 7 reported that use of the system increased the duration of visits (mean: 9.3 minutes longer). All users recommended continued use of the system. Use of the EMR in this study was associated with improved quality of care. This experience suggests that EMRs can be successfully used in busy urban pediatric primary care centers and, as recommended by the Institute of Medicine, must play a central role in the redesign of the US health care system.

  9. [Injuries treated in primary care in the Community of Madrid: analyses of electronic medical records].

    Science.gov (United States)

    Zoni, Ana Clara; Domínguez-Berjón, María Felicitas; Esteban-Vasallo, María Dolores; Regidor, Enrique

    2014-01-01

    To describe the incidence of injuries treated in primary care by type of injury, age groups, and sex in the publicly-funded health system of the region of Madrid in Spain. A descriptive cross sectional study was performed of injury episodes registered in the primary care electronic medical records of the health system of Madrid in 2011. We calculated the global incidence of injuries, injury-specific rates for fractures, sprains, wounds, burns, foreign body injuries, poisoning and bruises, and their rate ratios with 95% confidence intervals, all of which were stratified by sex and age groups. In 2011 there were 707,800 injury episodes (3.5% of all episodes treated in primary care). Most of the injuries occurred in women (54.0%) and in persons older than 34 years (58.0%). The most common injuries were wounds in men (35.3%) and bruises in women (30.6%). Overall, women had higher rates of injuries among the elderly and men had more injuries in the group younger than 15 years. By type of injury, the highest rates of fractures, burns and bruises were observed in the older population, foreign body injuries and wounds in children, sprains in youth, and poisonings in extreme ages. The special vulnerability of boys younger than 5 years and elderly women suggests that intervention strategies should be targeted to the specific needs of these groups. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  10. Quantum efficiency of cesium iodide photocathodes in the 120-220 nm spectral range traceable to a primary detector standard

    CERN Document Server

    Rabus, H; Richter, M; Ulm, G; Friese, J; Gernhäuser, R; Kastenmüller, A; Maier-Komor, P; Zeitelhack, K

    1999-01-01

    Differently prepared CsI samples have been investigated in the 120-220 nm spectral range for their quantum efficiency, spatial uniformity and the effect of radiation aging. The experiments were performed at the PTB radiometry laboratory at the Berlin synchrotron radiation facility BESSY. A calibrated GaAsP Schottky photodiode was used as transfer detector standard to establish traceability to the primary detector standard, because this type of photodiode - unlike silicon p-on-n photodiodes - proved to be of sufficiently stable response when exposed to vacuum ultraviolet radiation. The paper reviews the experimental procedures that were employed to characterize and calibrate the GaAsP photodiode and reports the results that were obtained on the investigated CsI photocathodes.

  11. Gold nanoparticle assisted assembly of a heme protein for enhancement of long-range interfacial electron transfer

    DEFF Research Database (Denmark)

    Jensen, Palle Skovhus; Chi, Qijin; Grumsen, Flemming Bjerg

    2007-01-01

    -defined stoichiometry. The systems were investigated in homogeneous solution and at liquid/solid interface. Conjugation of cyt c results in a small but consistent broadening of the nanoparticle plasmon band. This phenomenon can be explained in terms of long-range electronic interactions between the gold nanoparticle...... and characterization of water-soluble gold nanoparticles (AuNPs) with core diameter 3-4 nm and their application for the enhancement of long-range interfacial ET of a heme protein. Gold nanoparticles were electrostatically conjugated with cyt c to form nanoparticle-protein hybrid ET systems with well...... and the protein molecule. When the nanoparticle-protein conjugates are assembled on Au(111) surfaces, long-range interfacial ET across a physical distance of over 50 A via the nanoparticle becomes feasible. Moreover, significant enhancement of the interfacial ET rate by more than an order of magnitude compared...

  12. A wide dynamic range BF{sub 3} neutron monitor with front-end electronics based on a logarithmic amplifier

    Energy Technology Data Exchange (ETDEWEB)

    Ferrarini, M., E-mail: michele.ferrarini@polimi.i [Politecnico di Milano, Dipartimento Energia, via G. Ponzio 34/3, I-20133 Milano (Italy); Fondazione CNAO, via Caminadella 16, 20123 Milano (Italy); Varoli, V. [Politecnico di Milano, Dipartimento Energia, via G. Ponzio 34/3, I-20133 Milano (Italy); Favalli, A. [European Commission, Joint Research Centre, Institute for the Protection and Security of Citizen, TP 800, Via E. Fermi, 21027 Ispra (Vatican City State, Holy See) (Italy); Caresana, M. [Politecnico di Milano, Dipartimento Energia, via G. Ponzio 34/3, I-20133 Milano (Italy); Pedersen, B. [European Commission, Joint Research Centre, Institute for the Protection and Security of Citizen, TP 800, Via E. Fermi, 21027 Ispra (Italy)

    2010-02-01

    This paper describes a wide dynamic range neutron monitor based on a BF{sub 3} neutron detector. The detector is used in current mode, and front-end electronics based on a logarithmic amplifier are used in order to have a measurement capability ranging over many orders of magnitude. The system has been calibrated at the Polytechnic of Milan, CESNEF, with an AmBe neutron source, and has been tested in a pulsed field at the PUNITA facility at JRC, Ispra. The detector has achieved a dynamic range of over 6 orders of magnitude, being able to measure single neutron pulses and showing saturation-free response for a reaction rate up to 10{sup 6} s{sup -1}. It has also proved effective in measuring the PUNITA facility pulse integral fluence.

  13. Aromatic amino acids required for pili conductivity and long-range extracellular electron transport in Geobacter sulfurreducens.

    Science.gov (United States)

    Vargas, Madeline; Malvankar, Nikhil S; Tremblay, Pier-Luc; Leang, Ching; Smith, Jessica A; Patel, Pranav; Snoeyenbos-West, Oona; Synoeyenbos-West, Oona; Nevin, Kelly P; Lovley, Derek R

    2013-03-12

    It has been proposed that Geobacter sulfurreducens requires conductive pili for long-range electron transport to Fe(III) oxides and for high-density current production in microbial fuel cells. In order to investigate this further, we constructed a strain of G. sulfurreducens, designated Aro-5, which produced pili with diminished conductivity. This was accomplished by modifying the amino acid sequence of PilA, the structural pilin protein. An alanine was substituted for each of the five aromatic amino acids in the carboxyl terminus of PilA, the region in which G. sulfurreducens PilA differs most significantly from the PilAs of microorganisms incapable of long-range extracellular electron transport. Strain Aro-5 produced pili that were properly decorated with the multiheme c-type cytochrome OmcS, which is essential for Fe(III) oxide reduction. However, pili preparations of the Aro-5 strain had greatly diminished conductivity and Aro-5 cultures were severely limited in their capacity to reduce Fe(III) compared to the control strain. Current production of the Aro-5 strain, with a graphite anode serving as the electron acceptor, was less than 10% of that of the control strain. The conductivity of the Aro-5 biofilms was 10-fold lower than the control strain's. These results demonstrate that the pili of G. sulfurreducens must be conductive in order for the cells to be effective in extracellular long-range electron transport. Extracellular electron transfer by Geobacter species plays an important role in the biogeochemistry of soils and sediments and has a number of bioenergy applications. For example, microbial reduction of Fe(III) oxide is one of the most geochemically significant processes in anaerobic soils, aquatic sediments, and aquifers, and Geobacter organisms are often abundant in such environments. Geobacter sulfurreducens produces the highest current densities of any known pure culture, and close relatives are often the most abundant organisms colonizing anodes

  14. Transmission electron microscopy and electron diffraction study of the short-range ordering structure of alpha-LiFeO2.

    Science.gov (United States)

    Mitome, Masanori; Kohiki, Shigemi; Murakawa, Yusuke; Hori, Kyoko; Kurashima, Keiji; Bando, Yoshio

    2004-12-01

    The basic structure of alpha-LiFeO2, lithium iron oxide, is a cubic NaCl-type structure with a lattice constant of 0.42 nm; some short-range ordering characterized by octahedral clusters exists. The local structure of the short-range ordering was investigated by transmission electron microscopy and electron diffraction. A new short-range ordering structure was found in local areas. The local structure has a cubic lattice with a doubled lattice constant. The occupation factors of cations on Wyckoff sites 4(a) and 4(b) are different from those on 24(d) sites, but the stoichiometric composition in cubic clusters is the same as the macroscopic composition. The number of pairs in which iron cations exist in nearest-neighbor sites and next nearest-neighbor sites is reduced in the structure. This means that a magnetic interaction between the iron cations is reduced by cation ordering even without spin ordering at room temperature.

  15. Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records.

    Science.gov (United States)

    Shallcross, Laura; Beckley, Nick; Rait, Greta; Hayward, Andrew; Petersen, Irene

    2017-06-01

    Reducing inappropriate antibiotic prescribing in primary care is a public health priority. We hypothesized that a subset of patients account for the majority of antibiotic prescriptions in primary care. We investigated the relationship between the total amount of antibiotics prescribed, individual-level antibiotic use and comorbidity. This was a cohort study using electronic health records from 1 948 390 adults registered with 385 primary care practices in the UK in 2011-13. We estimated the average number of antibiotic prescriptions per patient and the association between prescribing and comorbidity. We modelled the impact on total prescribing of reducing antibiotic use in those prescribed antibiotics most frequently. On average 30.1% (586 194/1 948 390) of patients were prescribed at least one antibiotic per year. Nine percent (174 602/1 948 390) of patients were prescribed 53% (2 091 496/3 922 732) of the total amount of antibiotics, each of whom received at least five antibiotic prescriptions over 3 years. The presence of any comorbidity increased the prescribing rate by 44% [adjusted incidence rate ratio (IRR) 1.44, 95% CI 1.43-1.45]; rates of prescribing to women exceeded those in men by 62% (adjusted IRR 1.62, 95% CI 1.62-1.63). Half of antibiotics prescribed to adults in primary care were for <10% of patients. Efforts to tackle antimicrobial resistance should consider the impact of this on total prescribing.

  16. Rat injury model under controlled field-relevant primary blast conditions: acute response to a wide range of peak overpressures.

    Science.gov (United States)

    Skotak, Maciej; Wang, Fang; Alai, Aaron; Holmberg, Aaron; Harris, Seth; Switzer, Robert C; Chandra, Namas

    2013-07-01

    We evaluated the acute (up to 24 h) pathophysiological response to primary blast using a rat model and helium driven shock tube. The shock tube generates animal loadings with controlled pure primary blast parameters over a wide range and field-relevant conditions. We studied the biomechanical loading with a set of pressure gauges mounted on the surface of the nose, in the cranial space, and in the thoracic cavity of cadaver rats. Anesthetized rats were exposed to a single blast at precisely controlled five peak overpressures over a wide range (130, 190, 230, 250, and 290 kPa). We observed 0% mortality rates in 130 and 230 kPa groups, and 30%, 24%, and 100% mortality rates in 190, 250, and 290 kPa groups, respectively. The body weight loss was statistically significant in 190 and 250 kPa groups 24 h after exposure. The data analysis showed the magnitude of peak-to-peak amplitude of intracranial pressure (ICP) fluctuations correlates well with mortality rates. The ICP oscillations recorded for 190, 250, and 290 kPa are characterized by higher frequency (10-20 kHz) than in other two groups (7-8 kHz). We noted acute bradycardia and lung hemorrhage in all groups of rats subjected to the blast. We established the onset of both corresponds to 110 kPa peak overpressure. The immunostaining against immunoglobulin G (IgG) of brain sections of rats sacrificed 24-h post-exposure indicated the diffuse blood-brain barrier breakdown in the brain parenchyma. At high blast intensities (peak overpressure of 190 kPa or more), the IgG uptake by neurons was evident, but there was no evidence of neurodegeneration after 24 h post-exposure, as indicated by cupric silver staining. We observed that the acute response as well as mortality is a non-linear function over the peak overpressure and impulse ranges explored in this work.

  17. Structural, electronic and optical properties of well-known primary explosive: Mercury fulminate

    Energy Technology Data Exchange (ETDEWEB)

    Yedukondalu, N.; Vaitheeswaran, G., E-mail: gvsp@uohyd.ernet.in [Advanced Centre of Research in High Energy Materials (ACRHEM), University of Hyderabad, Prof. C. R. Rao Road, Gachibowli, Hyderabad, Telangana 500046 (India)

    2015-11-28

    Mercury Fulminate (MF) is one of the well-known primary explosives since 17th century and it has rendered invaluable service over many years. However, the correct molecular and crystal structures are determined recently after 300 years of its discovery. In the present study, we report pressure dependent structural, elastic, electronic and optical properties of MF. Non-local correction methods have been employed to capture the weak van der Waals interactions in layered and molecular energetic MF. Among the non-local correction methods tested, optB88-vdW method works well for the investigated compound. The obtained equilibrium bulk modulus reveals that MF is softer than the well known primary explosives Silver Fulminate (SF), silver azide and lead azide. MF exhibits anisotropic compressibility (b > a > c) under pressure, consequently the corresponding elastic moduli decrease in the following order: C{sub 22} > C{sub 11} > C{sub 33}. The structural and mechanical properties suggest that MF is more sensitive to detonate along c-axis (similar to RDX) due to high compressibility of Hg⋯O non-bonded interactions along that axis. Electronic structure and optical properties were calculated including spin-orbit (SO) interactions using full potential linearized augmented plane wave method within recently developed Tran-Blaha modified Becke-Johnson (TB-mBJ) potential. The calculated TB-mBJ electronic structures of SF and MF show that these compounds are indirect bandgap insulators. Also, SO coupling is found to be more pronounced for 4d and 5d-states of Ag and Hg atoms of SF and MF, respectively. Partial density of states and electron charge density maps were used to describe the nature of chemical bonding. Ag—C bond is more directional than Hg—C bond which makes SF to be more unstable than MF. The effect of SO coupling on optical properties has also been studied and found to be significant for both (SF and MF) of the compounds.

  18. Effect of Long-Range Coulomb Interaction on NMR Shift in Massless Dirac Electrons of Organic Conductor

    Science.gov (United States)

    Suzumura, Yoshikazu

    2018-02-01

    The nuclear magnetic resonance (NMR) shift, χα, at low temperatures is examined for massless Dirac electrons in the organic conductor, α-(BEDT-TTF)2I3, where α [= A (= A'), B, and C] denotes the sites of the four molecules in the unit cell. The Dirac cone exists within an energy of 0.01 eV between the conduction and valence bands. The magnetic response function is calculated by taking account of the long-range Coulomb interaction and electron doping. Calculating the interaction within the first order in the perturbation, the chemical potential is determined self-consistently, and the self-energy and vertex corrections are taken to satisfy the Ward identity. The site-dependent χα is calculated at low temperatures of 0.0002 χ B. The relevance of the shift to the experiment is discussed.

  19. Coherent diffraction and Cherenkov radiation of relativistic electrons from a dielectric target in the millimeter wavelength range

    Energy Technology Data Exchange (ETDEWEB)

    Bleko, V.V., E-mail: bleko_vitold@mail.ru; Konkov, A.S., E-mail: Ekwinus@tpu.ru; Soboleva, V.V.

    2015-07-15

    The coherent diffraction radiation (DR) and Cherenkov radiation (ChR) emitted by bunched electron beam of 6.1 MeV passing near a flat dielectric target have been observed in the millimeter wavelength range. The simple geometry of experiment allows testing different theoretical approaches, which consider the process of simultaneous emission of DR and ChR from dielectric targets. Properties of the radiation have been experimentally investigated in far-field zone. The angular distribution of the observed radiation at various tilt angles of the target in respect to the electron beam have shown the effect of interference between DR and ChR. The comparison of experimental results with the theoretical calculations based on the approach of polarization currents has been done.

  20. Weighting Primary Care Patient Panel Size: A Novel Electronic Health Record-Derived Measure Using Machine Learning

    Science.gov (United States)

    Grumbach, Kevin; Parekh, Ami

    2016-01-01

    Background Characterizing patient complexity using granular electronic health record (EHR) data regularly available to health systems is necessary to optimize primary care processes at scale. Objective To characterize the utilization patterns of primary care patients and create weighted panel sizes for providers based on work required to care for patients with different patterns. Methods We used EHR data over a 2-year period from patients empaneled to primary care clinicians in a single academic health system, including their in-person encounter history and virtual encounters such as telephonic visits, electronic messaging, and care coordination with specialists. Using a combination of decision rules and k-means clustering, we identified clusters of patients with similar health care system activity. Phenotypes with basic demographic information were used to predict future health care utilization using log-linear models. Phenotypes were also used to calculate weighted panel sizes. Results We identified 7 primary care utilization phenotypes, which were characterized by various combinations of primary care and specialty usage and were deemed clinically distinct by primary care physicians. These phenotypes, combined with age-sex and primary payer variables, predicted future primary care utilization with R2 of .394 and were used to create weighted panel sizes. Conclusions Individual patients’ health care utilization may be useful for classifying patients by primary care work effort and for predicting future primary care usage. PMID:27742603

  1. Weighting Primary Care Patient Panel Size: A Novel Electronic Health Record-Derived Measure Using Machine Learning.

    Science.gov (United States)

    Rajkomar, Alvin; Yim, Joanne Wing Lan; Grumbach, Kevin; Parekh, Ami

    2016-10-14

    Characterizing patient complexity using granular electronic health record (EHR) data regularly available to health systems is necessary to optimize primary care processes at scale. To characterize the utilization patterns of primary care patients and create weighted panel sizes for providers based on work required to care for patients with different patterns. We used EHR data over a 2-year period from patients empaneled to primary care clinicians in a single academic health system, including their in-person encounter history and virtual encounters such as telephonic visits, electronic messaging, and care coordination with specialists. Using a combination of decision rules and k-means clustering, we identified clusters of patients with similar health care system activity. Phenotypes with basic demographic information were used to predict future health care utilization using log-linear models. Phenotypes were also used to calculate weighted panel sizes. We identified 7 primary care utilization phenotypes, which were characterized by various combinations of primary care and specialty usage and were deemed clinically distinct by primary care physicians. These phenotypes, combined with age-sex and primary payer variables, predicted future primary care utilization with R(2) of .394 and were used to create weighted panel sizes. Individual patients' health care utilization may be useful for classifying patients by primary care work effort and for predicting future primary care usage.

  2. Anatomical challenges, electronic working length determination and current developments in root canal preparation of primary molar teeth.

    Science.gov (United States)

    Ahmed, H M A

    2013-11-01

    Paediatric endodontics is an integral part of dental practice that aims to preserve fully functional primary teeth in the dental arch. Pulpectomy of primary molars presents a unique challenge for dental practitioners. Negotiation and thorough instrumentation of bizarre and tortuous canals encased in roots programmed for physiological resorption are the main challenges for this treatment approach. Consequently, numerous in vitro and in vivo studies have been conducted to validate the application of some contemporary endodontic armamentarium for effective treatment in primary molars whilst maintaining favourable clinical outcomes. Electronic apex locators, rotary nickel-titanium files and irrigation techniques are at the forefront of endodontic armamentarium in paediatric dentistry. Hence, this review aims to map out the root and root canal morphology of primary molars, to discuss the application of electronic apex locators in primary molars and to provide an update on the preparation of their root canal systems. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

  3. Total projectile electron loss cross sections of U^{28+} ions in collisions with gaseous targets ranging from hydrogen to krypton

    Directory of Open Access Journals (Sweden)

    G. Weber

    2015-03-01

    Full Text Available Beam lifetimes of stored U^{28+} ions with kinetic energies of 30 and 50  MeV/u, respectively, were measured in the experimental storage ring of the GSI accelerator facility. By using the internal gas target station of the experimental storage ring, it was possible to obtain total projectile electron loss cross sections for collisions with several gaseous targets ranging from hydrogen to krypton from the beam lifetime data. The resulting experimental cross sections are compared to predictions by two theoretical approaches, namely the CTMC method and a combination of the DEPOSIT code and the RICODE program.

  4. Ranges, Reflection and Secondary Electron Emission for keV Hydrogen Ions Incident on Solid N2

    DEFF Research Database (Denmark)

    Børgesen, P.; Sørensen, H.; Hao-Ming, Chen

    1983-01-01

    Ranges were measured for 0.67–3.3 keV/amu hydrogen and deuterium ions in solid N2. Comparisons with similar results for N2-gas confirm the previously observed large phase effect in the stopping cross section. Measurements of the secondary electron emission coefficient for bulk solid N2 bombarded...... by 0.67–9 keV/amu ions also seem to support such a phase effect. It is argued that we may also extract information about the charge state of reflected projectiles....

  5. Adverse events recording in electronic health record systems in primary care.

    Science.gov (United States)

    de Hoon, Sabine E M; Hek, Karin; van Dijk, Liset; Verheij, Robert A

    2017-12-06

    Adequate record keeping of medication adverse events in electronic health records systems is important for patient safety. Events that remain unrecorded cannot be communicated from one health professional to another. In the absence of a gold standard, we investigate the variation between Dutch general practices in the extent to which they record medication adverse events. Data were derived from electronic health records (EHR) of Dutch general practices participating in NIVEL Primary Care Database (NIVEL-PCD) in 2014, including 308 general practices with a total practice population of 1,256,049 listed patients. Medication adverse events were defined as recorded ICPC-code A85 (adverse effect medical agent). Between practice variation was studied using multilevel logistic regression analysis corrected for age, gender, number of different medicines prescriptions and number of chronic diseases. In 2014 there were 8330 patients with at least one medication adverse event recorded. This corresponds to 6.9 medication adverse events per 1000 patients and is higher for women, elderly, patients with polypharmacy and for patients with comorbidity. Corrected for these patient characteristics the median odds ratio (MOR = 1.92) suggests an almost twofold difference between general practices in recorded medication adverse events. Our results suggest that improvement in terms of uniformity in recording medication adverse events is possible, preventing potential damage for patients. We suggest that creating a learning health system by individual practice feedback on the number of recordings of adverse events would help practitioners to improve their recording habits.

  6. Electron microscopy of primary cell cultures in solution and correlative optical microscopy using ASEM.

    Science.gov (United States)

    Hirano, Kazumi; Kinoshita, Takaaki; Uemura, Takeshi; Motohashi, Hozumi; Watanabe, Yohei; Ebihara, Tatsuhiko; Nishiyama, Hidetoshi; Sato, Mari; Suga, Mitsuo; Maruyama, Yuusuke; Tsuji, Noriko M; Yamamoto, Masayuki; Nishihara, Shoko; Sato, Chikara

    2014-08-01

    Correlative light-electron microscopy of cells in a natural environment of aqueous liquid facilitates high-throughput observation of protein complex formation. ASEM allows the inverted SEM to observe the wet sample from below, while an optical microscope observes it from above quasi-simultaneously. The disposable ASEM dish with a silicon nitride (SiN) film window can be coated variously to realize the primary-culture of substrate-sensitive cells in a few milliliters of culture medium in a stable incubator environment. Neuron differentiation, neural networking, proplatelet-formation and phagocytosis were captured by optical or fluorescence microscopy, and imaged at high resolution by gold-labeled immuno-ASEM with/without metal staining. Fas expression on the cell surface was visualized, correlated to the spatial distribution of F-actin. Axonal partitioning was studied using primary-culture neurons, and presynaptic induction by GluRδ2-N-terminus-linked fluorescent magnetic beads was correlated to the presynaptic-marker Bassoon. Further, megakaryocytes secreting proplatelets were captured, and P-selectins with adherence activity were localized to some of the granules present by immuno-ASEM. The phagocytosis of lactic acid bacteria by dendritic cells was also imaged. Based on these studies, ASEM correlative microscopy promises to allow the study of various mesoscopic-scale dynamics in the near future. © 2013 Published by Elsevier B.V.

  7. Home monitoring after ambulatory implanted primary cardiac implantable electronic devices: The home ambulance pilot study.

    Science.gov (United States)

    Parahuleva, Mariana S; Soydan, Nedim; Divchev, Dimitar; Lüsebrink, Ulrich; Schieffer, Bernhard; Erdogan, Ali

    2017-11-01

    The Home Monitoring (HM) system of cardiac implantable electronic devices (CIEDs) permits early detection of arrhythmias or device system failures. The aim of this pilot study was to examine how the safety and efficacy of the HM system in patients after ambulatory implanted primary CIEDs compare to patients with a standard procedure and hospitalization. We hypothesized that HM and their modifications would be a useful extension of the present concepts for ambulatory implanted CIEDs. This retrospective analysis evaluates telemetric data obtained from 364 patients in an ambulatory single center over 6 years. Patients were assigned to an active group (n = 217), consisting of those who were discharged early on the day of implantation of the primary CIED, or to a control group (n = 147), consisting of those discharged and followed up with the HM system according to usual medical practices. The mean duration of hospitalization was 73.2% shorter in the active group than in the control group, corresponding to 20.5 ± 13 fewer hours (95% confidence interval [CI]: 6.3-29.5; P ambulatory implanted CIED when compared with standard management of these patients. Early discharge with the HM system after ambulatory CIED implantation was safe and not inferior to the classic medical procedure. Thus, together with lower costs, HM and its modifications would be a useful extension of the present concepts for ambulatory implanted CIEDs. © 2017 Wiley Periodicals, Inc.

  8. Impact of the implementation of electronic guidelines for cardiovascular prevention in primary care: study protocol

    Directory of Open Access Journals (Sweden)

    Eva Comin

    2013-03-01

    Full Text Available Background The electronic medical records software of the Catalan Institute of Health has recently incorporated an electronic version of clinical practice guidelines (e-CPGs. This study aims to assess the impact of the implementation of e-CPGs on the diagnosis, treatment, control and management of hypercholesterolaemia, diabetes mellitus type 2 and hypertension.Methods Eligible study participants are those aged 35–74 years assigned to family practitioners (FPs of the Catalan Institute of Health. Routinely collected data from electronic primary care registries covering 80% of the Catalan population will be analysed using two approaches: (1 a cross-sectional study to describe the characteristics of the sample before e-CPG implementation; (2 a controlled before-and-after study with 1-year follow-up to ascertain the effect of e-CPG implementation. Patients of FPs who regularly use the e-CPGs will constitute the intervention group; the control group will comprise patients assigned to FPs not regularly using the e-CPG. The outcomes are: (1 suspected and confirmed diagnoses, (2 control of clinical variables, (3 requests for tests and (4 proportions of patients with adequate drug prescriptions.Results This protocol should represent a reproducible process to assess the impact of the implementation of e-CPGs. We anticipate reporting results in late 2013.Conclusion This project will assess the effectiveness of e-CPGs to improve clinical decisions and healthcare procedures in the three disorders analysed. The results will shed light on the use of evidence-based medicine to improve clinical practice of FPs.

  9. Electronic discharge summary and prescription: improving communication between hospital and primary care.

    Science.gov (United States)

    Murphy, S F; Lenihan, L; Orefuwa, F; Colohan, G; Hynes, I; Collins, C G

    2017-05-01

    The discharge letter is a key component of the communication pathway between the hospital and primary care. Accuracy and timeliness of delivery are crucial to ensure continuity of patient care. Electronic discharge summaries (EDS) and prescriptions have been shown to improve quality of discharge information for general practitioners (GPs). The aim of this study was to evaluate the effect of a new EDS on GP satisfaction levels and accuracy of discharge diagnosis. A GP survey was carried out whereby semi-structured interviews were conducted with 13 GPs from three primary care centres who receive a high volume of discharge letters from the hospital. A chart review was carried out on 90 charts to compare accuracy of ICD-10 coding of Non-Consultant Hospital Doctors (NCHDs) with that of trained Hopital In-Patient Enquiry (HIPE) coders. GP satisfaction levels were over 90 % with most aspects of the EDS, including amount of information (97 %), accuracy (95 %), GP information and follow-up (97 %) and medications (91 %). 70 % of GPs received the EDS within 2 weeks. ICD-10 coding of discharge diagnosis by NCHDs had an accuracy of 33 %, compared with 95.6 % when done by trained coders (p < 0.00001). The introduction of the EDS and prescription has led to improved quality of timeliness of communication with primary care. It has led to a very high satisfaction rating with GPs. ICD-10 coding was found to be grossly inaccurate when carried out by NCHDs and it is more appropriate for this task to be carried out by trained coders.

  10. Identifying primary care patients at risk for future diabetes and cardiovascular disease using electronic health records

    Directory of Open Access Journals (Sweden)

    Shrader Peter

    2009-09-01

    Full Text Available Abstract Background Prevention of diabetes and coronary heart disease (CHD is possible but identification of at-risk patients for targeting interventions is a challenge in primary care. Methods We analyzed electronic health record (EHR data for 122,715 patients from 12 primary care practices. We defined patients with risk factor clustering using metabolic syndrome (MetS characteristics defined by NCEP-ATPIII criteria; if missing, we used surrogate characteristics, and validated this approach by directly measuring risk factors in a subset of 154 patients. For subjects with at least 3 of 5 MetS criteria measured at baseline (2003-2004, we defined 3 categories: No MetS (0 criteria; At-risk-for MetS (1-2 criteria; and MetS (≥ 3 criteria. We examined new diabetes and CHD incidence, and resource utilization over the subsequent 3-year period (2005-2007 using age-sex-adjusted regression models to compare outcomes by MetS category. Results After excluding patients with diabetes/CHD at baseline, 78,293 patients were eligible for analysis. EHR-defined MetS had 73% sensitivity and 91% specificity for directly measured MetS. Diabetes incidence was 1.4% in No MetS; 4.0% in At-risk-for MetS; and 11.0% in MetS (p MetS vs No MetS = 6.86 [6.06-7.76]; CHD incidence was 3.2%, 5.3%, and 6.4% respectively (p Conclusion Risk factor clustering in EHR data identifies primary care patients at increased risk for new diabetes, CHD and higher resource utilization.

  11. Electronic cigarettes and thirdhand tobacco smoke: two emerging health care challenges for the primary care provider

    Directory of Open Access Journals (Sweden)

    Nidhi Mehrotra

    2011-02-01

    Full Text Available Ware G Kuschner, Sunayana Reddy, Nidhi Mehrotra, Harman S PaintalDivision of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Palo Alto, CA, USAAbstract: Primary care providers should be aware of two new developments in nicotine addiction and smoking cessation: 1 the emergence of a novel nicotine delivery system known as the electronic (e- cigarette; and 2 new reports of residual environmental nicotine and other biopersistent toxicants found in cigarette smoke, recently described as “thirdhand smoke”. The purpose of this article is to provide a clinician-friendly introduction to these two emerging issues so that clinicians are well prepared to counsel smokers about newly recognized health concerns relevant to tobacco use. E-cigarettes are battery powered devices that convert nicotine into a vapor that can be inhaled. The World Health Organization has termed these devices electronic nicotine delivery systems (ENDS. The vapors from ENDS are complex mixtures of chemicals, not pure nicotine. It is unknown whether inhalation of the complex mixture of chemicals found in ENDS vapors is safe. There is no evidence that e-cigarettes are effective treatment for nicotine addiction. ENDS are not approved as smoking cessation devices. Primary care givers should anticipate being questioned by patients about the advisability of using e-cigarettes as a smoking cessation device. The term thirdhand smoke first appeared in the medical literature in 2009 when investigators introduced the term to describe residual tobacco smoke contamination that remains after the cigarette is extinguished. Thirdhand smoke is a hazardous exposure resulting from cigarette smoke residue that accumulates in cars, homes, and other indoor spaces. Tobacco-derived toxicants can react to form potent cancer causing compounds. Exposure to thirdhand smoke can occur through the skin, by breathing, and by ingestion long after smoke has cleared from a room

  12. Measurement of cervical range of motion (CROM) by electronic CROM goniometer: a test of reliability and validity.

    Science.gov (United States)

    Law, Ellis Yuk Hung; Chiu, Thomas Tai-Wing

    2013-01-01

    To investigate the reliability and validity of the Electronic Cervical Range of Motion (CROM) Goniometer in measurement of cervical spine mobility in adults with and without neck pain. A cross-sectional reliability study was conducted on 54 subjects (26 neck pain and 26 non-neck pain) aged from 20-70 years old. The Numerical Pain Rating Scale and Chinese version of Northwick Park Neck Pain Questionnaire were used to assess neck pain severity and disability respectively. The CROM was measured in sitting position except left to right rotation was measured in supine lying. All the cervical active movements were measured by using the Electronic CROM Goniometer from ARCON TM Functional Capacity Evaluation (FCE) systems. The intra-tester and inter-tester reliability were high in both normal and chronic neck pain groups with ICC coefficients ranged from 0.75-*0.92. There was significant difference in the total CROM between the normal (374.7°) and chronic neck pain group (292.6°). The ACRON cervical goniometer was found to be reliable for measuring cervical mobility in 3 planes for both normal and patient subjects. Construct validity of the goniometer was supported as the test's result documented significant difference in CROM between the control and the neck pain groups.

  13. Optimal all-optical switching of a microcavity resonance in the telecom range using the electronic Kerr effect.

    Science.gov (United States)

    Yüce, Emre; Ctistis, Georgios; Claudon, Julien; Gérard, Jean-Michel; Vos, Willem L

    2016-01-11

    We have switched GaAs/AlAs and AlGaAs/AlAs planar microcavities that operate in the "Original" (O) telecom band by exploiting the instantaneous electronic Kerr effect. We observe that the resonance frequency reversibly shifts within one picosecond when the nanostructure is pumped with low-energy photons. We investigate experimentally and theoretically the role of several parameters: the material backbone and its electronic bandgap, the quality factor, and the duration of the switch pulse. The magnitude of the frequency shift is reduced when the backbone of the central λ-layer has a greater electronic bandgap compared to the cavity resonance frequency and the frequency of the pump. This observation is caused by the fact that pumping with photon energies near the bandgap resonantly enhances the switched magnitude. We thus find that cavities operating in the telecom O-band are more amenable to ultrafast Kerr switching than those operating at lower frequencies, such as the C-band. Our results indicate that the large bandgap of AlGaAs/AlAs cavity allows to tune both the pump and the probe to the telecom range to perform Kerr switching without detrimental two-photon absorption. We observe that the magnitude of the resonance frequency shift decreases with increasing quality factor of the cavity. Our model shows that the magnitude of the resonance frequency shift depends on the pump pulse duration and is maximized when the duration matches the cavity storage time to within a factor two. In our experiments, we obtain a maximum shift of the cavity resonance relative to the cavity linewidth of 20%. We project that the shift of the cavity resonance can be increased twofold with a pump pulse duration that better matches the cavity storage time. We provide the essential parameter settings for different materials so that the frequency shift of the cavity resonance can be maximized using the electronic Kerr effect.

  14. Neonatal lines in the enamel of primary teeth--a morphological and scanning electron microscopic investigation.

    Science.gov (United States)

    Sabel, Nina; Johansson, Carina; Kühnisch, Jan; Robertson, Agneta; Steiniger, Frank; Norén, Jörgen G; Klingberg, Gunilla; Nietzsche, Sandor

    2008-10-01

    The neonatal line (NNL) is in principle found in all primary teeth and the line represents the time of birth. Earlier findings of the appearance of the NNL in light microscope and in microradiographs have shown not only changes in the prism direction of the enamel, but that the NNL has a hypomineralized character. The neonatal line was analyzed in un-decalcified sections of primary lower and central incisors, collected from individuals of different ages utilizing polarized light microscopy, microradiography, scanning electron microscopy (SEM) and X-ray analysis (XRMA). In polarized light the NNL appeared to have a more porous structure than the enamel in general. The appearance of the NNL as a dark line in microradiographs is interpreted as the NNL being less mineralized than neighbouring enamel. Analysis with ImageJ visualized the reduction of the amount of grey value, indicating that the NNL is less mineralized. Analysis of the NNL in SEM showed a reduction of the diameter of enamel prisms, the more narrow diameters continued through the postnatal enamel. A change of the growth direction of the prisms was also observed at the NNL. In a three-dimensional image the NNL appeared as a grove, however, in non-etched enamel no grove was seen. The elemental analyses with XRMA showed no marked changes in the content of C, Ca, P, N, O or S in the area around the NNL. The NNL is an optical phenomenon due to alterations in height, and degree of mineralization of the enamel prisms.

  15. Electronic cigarette liquid increases inflammation and virus infection in primary human airway epithelial cells.

    Directory of Open Access Journals (Sweden)

    Qun Wu

    Full Text Available The use of electronic cigarettes (e-cigarettes is rapidly increasing in the United States, especially among young people since e-cigarettes have been perceived as a safer alternative to conventional tobacco cigarettes. However, the scientific evidence regarding the human health effects of e-cigarettes on the lung is extremely limited. The major goal of our current study is to determine if e-cigarette use alters human young subject airway epithelial functions such as inflammatory response and innate immune defense against respiratory viral (i.e., human rhinovirus, HRV infection.We examined the effects of e-cigarette liquid (e-liquid on pro-inflammatory cytokine (e.g., IL-6 production, HRV infection and host defense molecules (e.g., short palate, lung, and nasal epithelium clone 1, SPLUNC1 in primary human airway epithelial cells from young healthy non-smokers. Additionally, we examined the role of SPLUNC1 in lung defense against HRV infection using a SPLUNC1 knockout mouse model. We found that nicotine-free e-liquid promoted IL-6 production and HRV infection. Addition of nicotine into e-liquid further amplified the effects of nicotine-free e-liquid. Moreover, SPLUNC1 deficiency in mice significantly increased lung HRV loads. E-liquid inhibited SPLUNC1 expression in primary human airway epithelial cells. These findings strongly suggest the deleterious health effects of e-cigarettes in the airways of young people. Our data will guide future studies to evaluate the impact of e-cigarettes on lung health in human populations, and help inform the public about potential health risks of e-cigarettes.

  16. The electronic structure of the primary electron donor of reaction centers of purple bacteria at atomic resolution as observed by photo-CIDNP 13C NMR.

    Science.gov (United States)

    Daviso, Eugenio; Prakash, Shipra; Alia, A; Gast, Peter; Neugebauer, Johannes; Jeschke, Gunnar; Matysik, Jörg

    2009-12-29

    Composed of the two bacteriochlorophyll cofactors, P(L) and P(M), the special pair functions as the primary electron donor in bacterial reaction centers of purple bacteria of Rhodobacter sphaeroides. Under light absorption, an electron is transferred to a bacteriopheophytin and a radical pair is produced. The occurrence of the radical pair is linked to the production of enhanced nuclear polarization called photochemically induced dynamic nuclear polarization (photo-CIDNP). This effect can be used to study the electronic structure of the special pair at atomic resolution by detection of the strongly enhanced nuclear polarization with laser-flash photo-CIDNP magic-angle spinning NMR on the carotenoid-less mutant R26. In the electronic ground state, P(L) is strongly disturbed, carrying a slightly negative charge. In the radical cation state, the ratio of total electron spin densities between P(L) and P(M) is 2:1, although it is 2.5:1 for the pyrrole carbons, 2.2:1 for all porphyrinic carbons, and 4:1 for the pyrrole nitrogen. It is shown that the symmetry break between the electronic structures in the electronic ground state and in the radical cation state is an intrinsic property of the special pair supermolecule, which is particularly attributable to a modification of the structure of P(L). The significant difference in electron density distribution between the ground and radical cation states is explained by an electric polarization effect of the nearby histidine.

  17. Identifying clinical features in primary care electronic health record studies: methods for codelist development.

    Science.gov (United States)

    Watson, Jessica; Nicholson, Brian D; Hamilton, Willie; Price, Sarah

    2017-11-22

    Analysis of routinely collected electronic health record (EHR) data from primary care is reliant on the creation of codelists to define clinical features of interest. To improve scientific rigour, transparency and replicability, we describe and demonstrate a standardised reproducible methodology for clinical codelist development. We describe a three-stage process for developing clinical codelists. First, the clear definition a priori of the clinical feature of interest using reliable clinical resources. Second, development of a list of potential codes using statistical software to comprehensively search all available codes. Third, a modified Delphi process to reach consensus between primary care practitioners on the most relevant codes, including the generation of an 'uncertainty' variable to allow sensitivity analysis. These methods are illustrated by developing a codelist for shortness of breath in a primary care EHR sample, including modifiable syntax for commonly used statistical software. The codelist was used to estimate the frequency of shortness of breath in a cohort of 28 216 patients aged over 18 years who received an incident diagnosis of lung cancer between 1 January 2000 and 30 November 2016 in the Clinical Practice Research Datalink (CPRD). Of 78 candidate codes, 29 were excluded as inappropriate. Complete agreement was reached for 44 (90%) of the remaining codes, with partial disagreement over 5 (10%). 13 091 episodes of shortness of breath were identified in the cohort of 28 216 patients. Sensitivity analysis demonstrates that codes with the greatest uncertainty tend to be rarely used in clinical practice. Although initially time consuming, using a rigorous and reproducible method for codelist generation 'future-proofs' findings and an auditable, modifiable syntax for codelist generation enables sharing and replication of EHR studies. Published codelists should be badged by quality and report the methods of codelist generation including

  18. Opto-electronic device for frequency standard generation and terahertz-range optical demodulation based on quantum interference

    Science.gov (United States)

    Georgiades, Nikos P.; Polzik, Eugene S.; Kimble, H. Jeff

    1999-02-02

    An opto-electronic system and technique for comparing laser frequencies with large frequency separations, establishing new frequency standards, and achieving phase-sensitive detection at ultra high frequencies. Light responsive materials with multiple energy levels suitable for multi-photon excitation are preferably used for nonlinear mixing via quantum interference of different excitation paths affecting a common energy level. Demodulation of a carrier with a demodulation frequency up to 100's THZ can be achieved for frequency comparison and phase-sensitive detection. A large number of materials can be used to cover a wide spectral range including the ultra violet, visible and near infrared regions. In particular, absolute frequency measurement in a spectrum from 1.25 .mu.m to 1.66 .mu.m for fiber optics can be accomplished with a nearly continuous frequency coverage.

  19. Tilt-pair analysis of images from a range of different specimens in single-particle electron cryomicroscopy.

    Science.gov (United States)

    Henderson, Richard; Chen, Shaoxia; Chen, James Z; Grigorieff, Nikolaus; Passmore, Lori A; Ciccarelli, Luciano; Rubinstein, John L; Crowther, R Anthony; Stewart, Phoebe L; Rosenthal, Peter B

    2011-11-11

    The comparison of a pair of electron microscope images recorded at different specimen tilt angles provides a powerful approach for evaluating the quality of images, image-processing procedures, or three-dimensional structures. Here, we analyze tilt-pair images recorded from a range of specimens with different symmetries and molecular masses and show how the analysis can produce valuable information not easily obtained otherwise. We show that the accuracy of orientation determination of individual single particles depends on molecular mass, as expected theoretically since the information in each particle image increases with molecular mass. The angular uncertainty is less than 1° for particles of high molecular mass (~50 MDa), several degrees for particles in the range 1-5 MDa, and tens of degrees for particles below 1 MDa. Orientational uncertainty may be the major contributor to the effective temperature factor (B-factor) describing contrast loss and therefore the maximum resolution of a structure determination. We also made two unexpected observations. Single particles that are known to be flexible showed a wider spread in orientation accuracy, and the orientations of the largest particles examined changed by several degrees during typical low-dose exposures. Smaller particles presumably also reorient during the exposure; hence, specimen movement is a second major factor that limits resolution. Tilt pairs thus enable assessment of orientation accuracy, map quality, specimen motion, and conformational heterogeneity. A convincing tilt-pair parameter plot, where 60% of the particles show a single cluster around the expected tilt axis and tilt angle, provides confidence in a structure determined using electron cryomicroscopy. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Electronic Health Record Alert-Related Workload as a Predictor of Burnout in Primary Care Providers.

    Science.gov (United States)

    Gregory, Megan E; Russo, Elise; Singh, Hardeep

    2017-07-05

    Electronic health records (EHRs) have been shown to increase physician workload. One EHR feature that contributes to increased workload is asynchronous alerts (also known as inbox notifications) related to test results, referral responses, medication refill requests, and messages from physicians and other health care professionals. This alert-related workload results in negative cognitive outcomes, but its effect on affective outcomes, such as burnout, has been understudied. To examine EHR alert-related workload (both objective and subjective) as a predictor of burnout in primary care providers (PCPs), in order to ultimately inform interventions aimed at reducing burnout due to alert workload. A cross-sectional questionnaire and focus group of 16 PCPs at a large medical center in the southern United States. Subjective, but not objective, alert workload was related to two of the three dimensions of burnout, including physical fatigue (p = 0.02) and cognitive weariness (p = 0.04), when controlling for organizational tenure. To reduce alert workload and subsequent burnout, participants indicated a desire to have protected time for alert management, fewer unnecessary alerts, and improvements to the EHR system. Burnout associated with alert workload may be in part due to subjective differences at an individual level, and not solely a function of the objective work environment. This suggests the need for both individual and organizational-level interventions to improve alert workload and subsequent burnout. Additional research should confirm these findings in larger, more representative samples.

  1. Getting on with your computer is associated with job satisfaction in primary care: entrants to primary care should be assessed for their competency with electronic patient record systems

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan

    2014-02-01

    Full Text Available Job satisfaction in primary care is associated with getting on with your computer. Many primary care professionals spend longer interacting with their computer than anything else in their day. However, the computer often makes demands rather than be an aid or supporter that has learned its user’s preferences. The use of electronic patient record (EPR systems is underrepresented in the assessment of entrants to primary care, and in definitions of the core competencies of a family physician/general practitioner. We call for this to be put right: for the use of the EPR to support direct patient care and clinical governance to be given greater prominence in training and assessment. In parallel, policy makers should ensure that the EPR system use is orientated to ensuring patients receive evidence-based care, and EPR system suppliers should explore how their systems might better support their clinician users, in particular learning their preferences.

  2. Primary uncleansed 2D versus primary electronically cleansed 3D in limited bowel preparation CT-colonography. Is there a difference for novices and experienced readers?

    Energy Technology Data Exchange (ETDEWEB)

    Vries, Ayso H. de; Liedenbaum, Marjolein H.; Bipat, Shandra; Heutinck, Anneke; Stoker, Jaap [University of Amsterdam, Department of Radiology Academic Medical Centre, Amsterdam (Netherlands); Truyen, Roel; Serlie, Iwo W.O. [Philips Medical Systems 3, Department of Healthcare Informatics, Best (Netherlands); Cohen, Rutger H. [Ziekenhuis Amstelland, Department of Radiology, Amstelveen (Netherlands); Elderen, Saskia G.C. van [Leids Universitair Medisch Centrum, Department of Radiology, Leiden (Netherlands); Kesselring, Oskar; Wiersma, Tjeerd [Ziekenhuis Rijnstate, Department of Radiology, Arnhem (Netherlands); Monye, Wouter de [Kennemer Gasthuis, Department of Radiology, Haarlem (Netherlands); Strake, Lambertus te [Middlemore Hospital, Department of Radiology, Otahuhu, Auckland (New Zealand)

    2009-08-15

    The purpose of this study was to compare a primary uncleansed 2D and a primary electronically cleansed 3D reading strategy in CTC in limited prepped patients. Seventy-two patients received a low-fibre diet with oral iodine before CT-colonography. Six novices and two experienced observers reviewed both cleansed and uncleansed examinations in randomized order. Mean per-polyp sensitivity was compared between the methods by using generalized estimating equations. Mean per-patient sensitivity, and specificity were compared using the McNemar test. Results were stratified for experience (experienced observers versus novice observers). Mean per-polyp sensitivity for polyps 6 mm or larger was significantly higher for novices using cleansed 3D (65%; 95%CI 57-73%) compared with uncleansed 2D (51%; 95%CI 44-59%). For experienced observers there was no significant difference. Mean per-patient sensitivity for polyps 6 mm or larger was significantly higher for novices as well: respectively 75% (95%CI 70-80%) versus 64% (95%CI 59-70%). For experienced observers there was no statistically significant difference. Specificity for both novices and experienced observers was not significantly different. For novices primary electronically cleansed 3D is better for polyp detection than primary uncleansed 2D. (orig.)

  3. Monte Carlo simulation of primary electron production inside an a-selenium detector for x-ray mammography: physics.

    Science.gov (United States)

    Sakellaris, T; Spyrou, G; Tzanakos, G; Panayiotakis, G

    2005-08-21

    Selenium is among the materials under investigation that may form effective detectors and provide a major contribution to digital mammography. Till the final image formation, there is an intervention of the x-ray photons transformation to primary electrons and their subsequent ionizing drift towards the electrodes that collect them. The characteristics of the generated primary electrons inside a-Se material such as their angular, spatial and energy distribution affect the characteristics of the final image. A Monte Carlo based model has been developed that simulates the x-ray irradiation of an a-Se detector plate, including primary photon interactions (photoelectric absorption, coherent and incoherent scattering), as well as secondary ones, such as fluorescence (Kalpha, Kbeta) and emission of Auger electrons. The angular, spatial and energy distributions for the generated primary electrons inside a-Se have been produced for various mammographic x-ray spectra and their usefulness in designing and optimizing a detector made of a-Se for digital mammography is discussed.

  4. The Effectiveness of Electronic Mind Maps in Developing Academic Achievement and the Attitude towards Learning English among Primary School Students

    Science.gov (United States)

    Aljaser, Afaf M.

    2017-01-01

    The present study aimed to identify the effect of using electronic Mind Maps on the academic achievement of the fifth-grade primary female students in the English language curriculum compared to the traditional teaching method adopted in the teacher's guide. It also aimed to indicate the attitudes of the fifth-grade female students towards the use…

  5. Cross sections for electron scattering by methylfluoride (CH{sub 3}F) in the low- and intermediate-energy ranges

    Energy Technology Data Exchange (ETDEWEB)

    Ferraz, J.R.; Santos, A.S. dos [Departamento de Física, UFSCar, 13565-905 São Carlos, SP (Brazil); Souza, G.L.C. de; Lee, M.-T. [Departamento de Química, UFSCar, 13565-905 São Carlos, SP (Brazil); Brescansin, L.M. [Instituto de Física “Gleb Wataghin”, UNICAMP, 13083-970 Campinas, SP (Brazil); Lucchese, R.R. [Department of Chemistry, Texas A and M University, College Station, TX 7784-3255 (United States); Machado, L.E., E-mail: dlem@df.ufscar.br [Departamento de Física, UFSCar, 13565-905 São Carlos, SP (Brazil)

    2014-03-01

    Highlights: • Theoretical investigation on e{sup −}–CH{sub 3}F collisions. • Complex optical potential is used to evaluate elastic, total, and total absorption cross sections. • Single-center expansion, combined with the Padé approximant technique, is used to solve the scattering equations. • Calculated results are in good agreement with existing theoretical and experimental data. - Abstract: We report a theoretical study on electron scattering by methylfluoride (CH{sub 3}F) in the intermediate-energy range. Calculated elastic differential, integral, and momentum-transfer, as well as grand-total (elastic + inelastic) and total absorption cross sections are reported for impact energies ranging from 15 to 500 eV. A complex optical potential is used to represent the electron–molecule interaction dynamics. A theoretical method based on the single-center-expansion close-coupling framework and corrected by the Padé approximant technique is used to solve the scattering equations. The comparison of our calculated results with experimental and other available theoretical data is encouraging.

  6. ELECTRONIC TEXTBOOK ON LANGUAGE AND SPEECH DEVELOPMENT IN THE SYSTEM OF E-LINGUOMETHODOLOGY MEANS FOR PRIMARY SCHOOL

    Directory of Open Access Journals (Sweden)

    Inna A. Khyzhnyak

    2016-02-01

    Full Text Available The article reveals the problems of primary school teachers professional activity under the conditions of education informatization, gives the general characteristic of e-linguomethodology’s researches directions as an innovative area of methodology science, argues the necessity of general classification of e-linguomethodology’s genres for primary school, presents an analysis of existing research on the topic, summarizes their results on the electronic books as a genre of educational software. The author substantiates her own classification of e-linguomethodology’s means for primary school, accents attention on importance of their system use in an educational process, pays special attention to psychological and pedagogical, methodical and technical requirements to electronic textbooks on language and speech development.

  7. Workarounds and Test Results Follow-up in Electronic Health Record-Based Primary Care.

    Science.gov (United States)

    Menon, Shailaja; Murphy, Daniel R; Singh, Hardeep; Meyer, Ashley N D; Sittig, Dean F

    2016-01-01

    Electronic health records (EHRs) have potential to facilitate reliable communication and follow-up of test results. However, limitations in EHR functionality remain, leading practitioners to use workarounds while managing test results. Workarounds can lead to patient safety concerns and signify indications as to how to build better EHR systems that meet provider needs. To understand why primary care practitioners (PCPs) use workarounds to manage test results by analyzing data from a previously conducted national cross-sectional survey on test result management. We conducted a secondary data analysis of quantitative and qualitative data from a national survey of PCPs practicing in the Department of Veterans Affairs (VA) and explored the use of workarounds in test results management. We used multivariate logistic regression analysis to examine the association between key sociotechnical factors that could affect test results follow-up (e.g., both technology-related and those unrelated to technology, such as organizational support for patient notification) and workaround use. We conducted a qualitative content analysis of free text survey data to examine reasons for use of workarounds. Of 2554 survey respondents, 1104 (43%) reported using workarounds related to test results management. Of these 1028 (93%) described the type of workaround they were using; 719 (70%) reported paper-based methods, while 230 (22%) used a combination of paper- and computer-based workarounds. Primary care practitioners who self-reported limited administrative support to help them notify patients of test results or described an instance where they personally (or a colleague) missed results, were more likely to use workarounds (p=0.02 and p=0.001, respectively). Qualitative analysis identified three main reasons for workaround use: 1) as a memory aid, 2) for improved efficiency and 3) for facilitating internal and external care coordination. Workarounds to manage EHR-based test results are

  8. Electronic messaging between primary and secondary care: a four-year case report

    NARCIS (Netherlands)

    P.W. Moorman (Peter); P.J. Branger (Peter); W.J. van der Kam (Wouter); J. van der Lei (Johan)

    2001-01-01

    textabstractOBJECTIVE: To observe how electronic messaging between a hospital consultant and general practitioners (GPs) in 15 practices about patients suffering from diabetes evolved over a 3-year period after an initial 1-year study. DESIGN: Case report. Electronic

  9. Radiation-Hardening of Best-in-Class SiGe Mixed-Signal and RF Electronics for Ultra-Wide Temperature Range Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Innovative, reliable, low-power, and low-noise electronics that can operate over a wide temperature range and high radiation are critical for future NASA missions....

  10. Validation of fragility fractures in primary care electronic medical records: A population-based study.

    Science.gov (United States)

    Martinez-Laguna, Daniel; Soria-Castro, Alberto; Carbonell-Abella, Cristina; Orozco-López, Pilar; Estrada-Laza, Pilar; Nogues, Xavier; Díez-Perez, Adolfo; Prieto-Alhambra, Daniel

    2017-11-28

    Electronic medical records databases use pre-specified lists of diagnostic codes to identify fractures. These codes, however, are not specific enough to disentangle traumatic from fragility-related fractures. We report on the proportion of fragility fractures identified in a random sample of coded fractures in SIDIAP. Patients≥50 years old with any fracture recorded in 2012 (as per pre-specified ICD-10 codes) and alive at the time of recruitment were eligible for this retrospective observational study in 6 primary care centres contributing to the SIDIAP database (www.sidiap.org). Those with previous fracture/s, non-responders, and those with dementia or a serious psychiatric disease were excluded. Data on fracture type (traumatic vs fragility), skeletal site, and basic patient characteristics were collected. Of 491/616 (79.7%) patients with a registered fracture in 2012 who were contacted, 331 (349 fractures) were included. The most common fractures were forearm (82), ribs (38), and humerus (32), and 225/349 (64.5%) were fragility fractures, with higher proportions for classic osteoporotic sites: hip, 91.7%; spine, 87.7%; and major fractures, 80.5%. This proportion was higher in women, the elderly, and patients with a previously coded diagnosis of osteoporosis. More than 4 in 5 major fractures recorded in SIDIAP are due to fragility (non-traumatic), with higher proportions for hip (92%) and vertebral (88%) fracture, and a lower proportion for fractures other than major ones. Our data support the validity of SIDIAP for the study of the epidemiology of osteoporotic fractures. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología. All rights reserved.

  11. Improving management of gout in primary care using a customised electronic records template.

    Science.gov (United States)

    Moffat, Keith; McNab, Duncan

    2015-01-01

    It is known that the management of chronic gout in relation to serum uric acid (SUA) monitoring, allopurinol dosing, and lifestyle advice is often sub-optimal in primary care.[1] A quality improvement project in the form of a criterion based audit was carried out in an urban general practice to improve the care of patients being treated for gout. Baseline searching of EMIS confirmed that management of patients with gout who were taking allopurinol was not in line with current guidance. 51(40%) had a SUA checked in the past 12 months, 88(25%) had a SUA below target level, and gout lifestyle advice was not being recorded. An audit was performed to measure and improve the following criteria: Monitoring of SUA levels in the past 12 monthsTitration of urate lowering therapy to bring the SUA below target levelLifestyle advice in the past 12 months An audit standard of 60% achievement at 2 months and 80% achievement at 4 months was set. The intervention consisted of a custom electronic template within EMIS which allowed guidance of gout management to be displayed and for data to be entered. All members of the team including GPs and administrative staff were educated regarding the intervention. This resulted in a sustained improvement over a 6 month period in all 3 components of the audit with 112(84%) having a SUA level checked, 79(51%) having a SUA below target level and 76(57%) receiving lifestyle advice. Although the improvement did not reach the audit standard in 2 of the criteria it would be expected that outcomes would continue given the systems changes which have been made.

  12. The Primary Care Electronic Library: RSS feeds using SNOMED-CT indexing for dynamic content delivery.

    Science.gov (United States)

    Robinson, Judas; de Lusignan, Simon; Kostkova, Patty; Madge, Bruce; Marsh, A; Biniaris, C

    2006-01-01

    Rich Site Summary (RSS) feeds are a method for disseminating and syndicating the contents of a website using extensible mark-up language (XML). The Primary Care Electronic Library (PCEL) distributes recent additions to the site in the form of an RSS feed. When new resources are added to PCEL, they are manually assigned medical subject headings (MeSH terms), which are then automatically mapped to SNOMED-CT terms using the Unified Medical Language System (UMLS) Metathesaurus. The library is thus searchable using MeSH or SNOMED-CT. Our syndicate partner wished to have remote access to PCEL coronary heart disease (CHD) information resources based on SNOMED-CT search terms. To pilot the supply of relevant information resources in response to clinically coded requests, using RSS syndication for transmission between web servers. Our syndicate partner provided a list of CHD SNOMED-CT terms to its end-users, a list which was coded according to UMLS specifications. When the end-user requested relevant information resources, this request was relayed from our syndicate partner's web server to the PCEL web server. The relevant resources were retrieved from the PCEL MySQL database. This database is accessed using a server side scripting language (PHP), which enables the production of dynamic RSS feeds on the basis of Source Asserted Identifiers (CODEs) contained in UMLS. Retrieving resources using SNOMED-CT terms using syndication can be used to build a functioning application. The process from request to display of syndicated resources took less than one second. The results of the pilot illustrate that it is possible to exchange data between servers using RSS syndication. This method could be utilised dynamically to supply digital library resources to a clinical system with SNOMED-CT data used as the standard of reference.

  13. Electron scattering on the short-range potential in narrow gap Cd {sub x}Hg{sub 1-x}Te

    Energy Technology Data Exchange (ETDEWEB)

    Malyk, O.P. [Lviv Polytechnic National University, Semiconductor Electronics Department, Bandera Street 12, 79013 Lviv (Ukraine)]. E-mail: omalyk@mail.lviv.ua

    2006-04-15

    Models of electron scattering on the short-range potential caused by the interaction with polar and nonpolar optical phonons, piezoelectric and acoustic phonons, ionized and neutral impurities in the narrow gap solid solution Cd {sub x}Hg{sub 1-x}Te (x = 0, 0.08, 0.17, 0.26 and 0.36) are proposed. The temperature dependences of electron mobility in temperature range 4.2-300 K are calculated.

  14. The value of structured data elements from electronic health records for identifying subjects for primary care clinical trials.

    Science.gov (United States)

    Ateya, Mohammad B; Delaney, Brendan C; Speedie, Stuart M

    2016-01-11

    An increasing number of clinical trials are conducted in primary care settings. Making better use of existing data in the electronic health records to identify eligible subjects can improve efficiency of such studies. Our study aims to quantify the proportion of eligibility criteria that can be addressed with data in electronic health records and to compare the content of eligibility criteria in primary care with previous work. Eligibility criteria were extracted from primary care studies downloaded from the UK Clinical Research Network Study Portfolio. Criteria were broken into elemental statements. Two expert independent raters classified each statement based on whether or not structured data items in the electronic health record can be used to determine if the statement was true for a specific patient. Disagreements in classification were discussed until 100 % agreement was reached. Statements were also classified based on content and the percentages of each category were compared to two similar studies reported in the literature. Eligibility criteria were retrieved from 228 studies and decomposed into 2619 criteria elemental statements. 74 % of the criteria elemental statements were considered likely associated with structured data in an electronic health record. 79 % of the studies had at least 60 % of their criteria statements addressable with structured data likely to be present in an electronic health record. Based on clinical content, most frequent categories were: "disease, symptom, and sign", "therapy or surgery", and "medication" (36 %, 13 %, and 10 % of total criteria statements respectively). We also identified new criteria categories related to provider and caregiver attributes (2.6 % and 1 % of total criteria statements respectively). Electronic health records readily contain much of the data needed to assess patients' eligibility for clinical trials enrollment. Eligibility criteria content categories identified by our study can be

  15. Syntrophic growth with direct interspecies electron transfer as the primary mechanism for energy exchange

    DEFF Research Database (Denmark)

    Shrestha, Pravin Malla; Rotaru, Amelia-Elena; Aklujkar, Muktak

    2013-01-01

    Direct interspecies electron transfer (DIET) through biological electrical connections is an alternative to interspecies H2 transfer as a mechanism for electron exchange in syntrophic cultures. However, it has not previously been determined whether electrons received via DIET yield energy to supp...... dehydrogenase, the pilus-associated c-type cytochrome OmcS and pili consistent with electron transfer via DIET. These results suggest that electrons transferred via DIET can serve as the sole energy source to support anaerobic respiration....... to support cell growth. In order to investigate this, co-cultures of Geobacter metallireducens, which can transfer electrons to wild-type G. sulfurreducens via DIET, were established with a citrate synthase-deficient G. sulfurreducens strain that can receive electrons for respiration through DIET only...

  16. Comparative study of primary and secondary tumors from patients with laryngeal and oropharyngeal cancer, using transmission electron microscopy

    Science.gov (United States)

    Ghetea, Ligia Gabriela; Niculescu, Ana-Maria; Motoc, Rozalia Magda; Mihaescu, Grigore; Duma, Virgil-Florin; Manu, Dorel Augustin; Gavrila, Lucian

    2008-04-01

    In modern laboratories, the study of cancer is performed using a series of cellular and molecular methods based on optical instruments measurements. Optical and electron microscopy are valuable tools for revealing morphological features of cancer cells. Our study was focused on laryngeal and oropharyngeal cancers, which have nowadays an increased incidence, especially for women, due to unhealthy habits like tobacco and alcohol consumption. We used transmission electron microscopy (TEM) for highlighting the ultrastructural features of cancer cells, both in primary and secondary tumors. The primary tumor is considered that which appears for the first time, at a certain organ; the secondary tumor is that which reappears at the same region or neighbouring regions, at a certain interval of time after the primary one has been surgically removed. The differences between the inner architecture of the cells from primary and secondary tumors where correlated with the expression of some genes (oncogenes and tumor suppressor factors), in order to establish the aggressiveness of the tumor, in different disease stages. The main stress in the study is placed upon electron microscopy, in order to achieve a more precise characterization of both these type of cancer cells. These ultrastructural data complete the image of laryngeal and pharyngeal cancer cells, along with molecular data obtained by Real-Time PCR.

  17. O-phthalaldehyde: fluorogenic detection of primary amines in the picomole range. Comparison with fluorescamine and ninhydrin.

    Science.gov (United States)

    Benson, J R; Hare, P E

    1975-01-01

    O-Phthalaldehyde, in the presence of 2-mercaptoethanol, reacts with primary amines to form highly fluorescent products. Picomole quantities of amino acids, peptides, and proteins can be detected easily. o-Phthalaldehyde is five to ten times more sensitive than fluorescamine and is soluble and stable in aqueous buffers. PMID:1054843

  18. Investigation of the electronic structure of the primary electron donor in bacterial photosynthesis. Measurements of the anisotropy of the electronic G-tensor using high-field/high-frequency EPR

    Energy Technology Data Exchange (ETDEWEB)

    Huber, M. [Institut fuer Organische Chemie, FU Berlin, Berlin (Germany); Toerring, J.T.; Plato, M.; Moebius, K. [Institut fuer Experimentalphysik, FU Berlin, Berlin (Germany); Fink, U.; Lubitz, W. [Max-Volmer Institut, TU Berlin, Berlin (Germany); Feick, R. [Max-Planck-Institut fuer Biochemie, Martinsried (Germany); Schenck, C.C. [Department of Biochemistry, Colorado State University, Fort Collins (United States)

    1995-08-01

    Cation radicals of the primary electron donor (D{sup +}) in bacterial photosynthesis were investigated by high field, high frequency (95 GHz) EPR. Measurements on frozen solutions of D{sup +}, a dimeric {pi}-cation radical, of various organisms (Rps. viridis, Rb. sphaeroides, Chloroflexus aurantiacus and a heterodimer mutant) are reported, revealing differences in the principal values of the G-tensor. Elements of a theory relating the magnitudes of G principal values to the electronic structure are discussed

  19. Preservation of photosynthetic electron transport from senescence-induced inactivation in primary leaves after decapitation and defoliation of bean plants.

    Science.gov (United States)

    Yordanov, Ivan; Goltsev, Vasilij; Stefanov, Detelin; Chernev, Petko; Zaharieva, Ivelina; Kirova, Maria; Gecheva, Velichka; Strasser, Reto Jörg

    2008-12-01

    The comparative effects of decapitation and defoliation on the senescence-induced inactivation of photosynthetic activity in primary leaves of bean plants were investigated. Decapitation was performed during different phases of bean plant ontogenesis, immediately after the appearance of the 1st, 2nd, 3rd and 4th composite leaf. In addition, we examined a variant with primary leaves and stem with an apical bud, but without composite leaves, i.e. defoliated plants. Analyses of chlorophyll fluorescence, millisecond delayed fluorescence and absorption at 830nm in primary leaves were undertaken to investigate the alterations in photosystems II and I electron transport during the decapitation-induced delayed senescence in the non-detached leaves. Analysis of the OKJIP transients using the JIP-test (see [Strasser R, Srivastava A, Tsimilli-Michael M. Analysis of the chlorophyll a fluorescence transient. In: Papageorgiou G, Govindjee, editors. Chlorophyll a fluorescence: a signature of photosynthesis. The Netherlands: Kluwer Academic Publishers, 2004; pp. 321-362]) showed an increase in several biophysical parameters of photosystem II in decapitated plants, specifically, the density of active reaction centers on a chlorophyll basis, the yields of trapping and electron transport, and the performance index. We also observed a decrease in the absorbed light energy per reaction center. Such a decrease in light absorption could be a result of the photosystem II down regulation that appeared as an increase in Q(B)-non-reducing photosystem II centers. The effect was identical when all leaves except the primary leaves were removed. The variant with a preserved apical bud, the defoliated plant, showed values similar to those of decapitated plants with primary leaves only. The changes in the induction curves of the delayed fluorescence also indicated an acceleration of electron transport beyond photosystem II in the decapitated and in defoliated plants. In these plants, the

  20. Reconfigurable Resonant Regulating Rectifier With Primary Equalization for Extended Coupling- and Loading-Range in Bio-Implant Wireless Power Transfer.

    Science.gov (United States)

    Li, Xing; Meng, Xiaodong; Tsui, Chi-Ying; Ki, Wing-Hung

    2015-12-01

    Wireless power transfer using reconfigurable resonant regulating (R(3)) rectification suffers from limited range in accommodating varying coupling and loading conditions. A primary-assisted regulation principle is proposed to mitigate these limitations, of which the amplitude of the rectifier input voltage on the secondary side is regulated by accordingly adjusting the voltage amplitude Veq on the primary side. A novel current-sensing method and calibration scheme track Veq on the primary side. A ramp generator simultaneously provides three clock signals for different modules. Both the primary equalizer and the R(3) rectifier are implemented as custom integrated circuits fabricated in a 0.35 μm CMOS process, with the global control implemented in FPGA. Measurements show that with the primary equalizer, the workable coupling and loading ranges are extended by 250% at 120 mW load and 300% at 1.2 cm coil distance compared to the same system without the primary equalizer. A maximum rectifier efficiency of 92.5% and a total system efficiency of 62.4% are demonstrated.

  1. Total Skin Electron Beam for Primary Cutaneous T-cell Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Elsayad, Khaled; Kriz, Jan; Moustakis, Christos; Scobioala, Sergiu; Reinartz, Gabriele; Haverkamp, Uwe; Willich, Normann [Department of Radiation Oncology, University Hospital of Muenster, Muenster (Germany); Weishaupt, Carsten [Department of Dermatology, University Hospital of Muenster, Muenster (Germany); Stadler, Rudolf [Department of Dermatology, Johannes-Wesling-Klinikum Minden, Minden (Germany); Sunderkötter, Cord [Department of Dermatology, University Hospital of Muenster, Muenster (Germany); Eich, Hans Theodor, E-mail: Hans.Eich@ukmuenster.de [Department of Radiation Oncology, University Hospital of Muenster, Muenster (Germany)

    2015-12-01

    Purpose: Recent trials with low-dose total skin electron beam (TSEB) therapy demonstrated encouraging results for treating primary cutaneous T-cell lymphoma (PCTCL). In this study, we assessed the feasibility of different radiation doses and estimated survival rates of different pathologic entities and stages. Methods and Materials: We retrospectively identified 45 patients with PCTCL undergoing TSEB therapy between 2000 and 2015. Clinical characteristics, treatment outcomes, and toxicity were assessed. Results: A total of 49 courses of TSEB therapy were administered to the 45 patients. There were 26 pathologically confirmed cases of mycosis fungoides (MF) lymphoma, 10 cases of Sézary syndrome (SS), and 9 non-MF/SS PCTCL patients. In the MF patients, the overall response rate (ORR) was 92% (50% complete remission [CR]), 70% ORR in SS patients (50% CR), and 89% ORR in non-MF/SS patients (78% CR). The ORR for MF/SS patients treated with conventional dose (30-36 Gy) regimens was 92% (63% CR) and 75% (25% CR) for low-dose (<30-Gy) regimens (P=.09). In MF patients, the overall survival (OS) was 77 months with conventional dose regimens versus 14 months with low-dose regimens (P=.553). In SS patients, the median OS was 48 versus 16 months (P=.219), respectively. Median event-free survival (EFS) for MF in conventional dose patients versus low-dose patients was 15 versus 8 months, respectively (P=.264) and 19 versus 3 months for SS patients (P=.457). Low-dose regimens had shorter treatment time (P=.009) and lower grade 2 adverse events (P=.043). A second TSEB course was administered in 4 MF patients with 100% ORR. There is a possible prognostic impact of supplemental/boost radiation (P<.001); adjuvant treatment (P<.001) and radiation tolerability (P=.021) were detected. Conclusions: TSEB therapy is an efficacious treatment modality in the treatment of several forms of cutaneous T-cell lymphoma. There is a nonsignificant trend to higher and longer clinical benefit

  2. Exhaled breath analysis using electronic nose in cystic fibrosis and primary ciliary dyskinesia patients with chronic pulmonary infections

    DEFF Research Database (Denmark)

    Joensen, Odin; Paff, Tamara; Haarman, Eric G

    2014-01-01

    The current diagnostic work-up and monitoring of pulmonary infections may be perceived as invasive, is time consuming and expensive. In this explorative study, we investigated whether or not a non-invasive exhaled breath analysis using an electronic nose would discriminate between cystic fibrosis...... (CF) and primary ciliary dyskinesia (PCD) with or without various well characterized chronic pulmonary infections. We recruited 64 patients with CF and 21 with PCD based on known chronic infection status. 21 healthy volunteers served as controls. An electronic nose was employed to analyze exhaled......, this method significantly discriminates CF patients suffering from a chronic pulmonary P. aeruginosa (PA) infection from CF patients without a chronic pulmonary infection. Further studies are needed for verification and to investigate the role of electronic nose technology in the very early diagnostic workup...

  3. Estimating impacts on safety caused by the introduction of electronic medical records in primary care

    Directory of Open Access Journals (Sweden)

    Ranjit Singh

    2004-12-01

    Conclusions This FMEA-like approach identified changes in practice hazards apparently related to EMR implementation. This in turn can help in targeting pre-existing and new vulnerabilities in primary care practices.

  4. On the Monte Carlo simulation of electron transport in the sub-1 keV energy range.

    Science.gov (United States)

    Thomson, Rowan M; Kawrakow, Iwan

    2011-08-01

    The validity of "classic" Monte Carlo (MC) simulations of electron and positron transport at sub-1 keV energies is investigated in the context of quantum theory. Quantum theory dictates that uncertainties on the position and energy-momentum four-vectors of radiation quanta obey Heisenberg's uncertainty relation; however, these uncertainties are neglected in "classical" MC simulations of radiation transport in which position and momentum are known precisely. Using the quantum uncertainty relation and electron mean free path, the magnitudes of uncertainties on electron position and momentum are calculated for different kinetic energies; a validity bound on the classical simulation of electron transport is derived. In order to satisfy the Heisenberg uncertainty principle, uncertainties of 5% must be assigned to position and momentum for 1 keV electrons in water; at 100 eV, these uncertainties are 17 to 20% and are even larger at lower energies. In gaseous media such as air, these uncertainties are much smaller (less than 1% for electrons with energy 20 eV or greater). The classical Monte Carlo transport treatment is questionable for sub-1 keV electrons in condensed water as uncertainties on position and momentum must be large (relative to electron momentum and mean free path) to satisfy the quantum uncertainty principle. Simulations which do not account for these uncertainties are not faithful representations of the physical processes, calling into question the results of MC track structure codes simulating sub-1 keV electron transport. Further, the large difference in the scale at which quantum effects are important in gaseous and condensed media suggests that track structure measurements in gases are not necessarily representative of track structure in condensed materials on a micrometer or a nanometer scale.

  5. Improved Models and Tools for Prediction of Radiation Effects on Space Electronics in Wide Temperature Range Project

    Data.gov (United States)

    National Aeronautics and Space Administration — All NASA exploration systems operate in the extreme environments of space (Moon, Mars, etc.) and require reliable electronics capable of handling a wide temperature...

  6. iPad applications that required a range of motor skills promoted motor coordination in children commencing primary school.

    Science.gov (United States)

    Axford, Caitlin; Joosten, Annette V; Harris, Courtenay

    2018-01-21

    Children are reported to spend less time engaged in outdoor activity and object-related play than in the past. The increased use and mobility of technology, and the ease of use of tablet devices are some of the factors that have contributed to these changes. Concern has been raised that the use of such screen and surface devices in very young children is reducing their fine motor skill development. We examined the effectiveness of iPad applications that required specific motor skills designed to improve fine motor skills. We conducted a two-group non-randomised controlled trial with two pre-primary classrooms (53 children; 5-6 years) in an Australian co-educational school, using a pre- and post-test design. The effectiveness of 30 minutes daily use of specific iPad applications for 9 weeks was compared with a control class. Children completed the Beery Developmental Test of Visual Motor Integration (VMI) and observation checklist, the Shore Handwriting Screen, and self-care items from the Hawaii Early Learning Profile. On post testing, the experimental group made a statistically and clinically significant improvement on the VMI motor coordination standard scores with a moderate clinical effect size (P motor skill-specific applications as an intervention in occupational therapy practice and as part of at home or school play. © 2018 Occupational Therapy Australia.

  7. The decreasing range between dry- and wet- season precipitation over land and its effect on vegetation primary productivity

    Science.gov (United States)

    2017-01-01

    One consequence of climate change is the alteration of global water fluxes, both in amount and seasonality. As a result, the seasonal difference between dry- (p 100 mm/month) precipitation (p) has increased over land during recent decades (1980–2005). However, our analysis expanding to a 60-year period (1950–2009) showed the opposite trend. This is, dry-season precipitation increased steadily, while wet-season precipitation remained constant, leading to reduced seasonality at a global scale. The decrease in seasonality was not due to a change in dry-season length, but in precipitation rate; thus, the dry season is on average becoming wetter without changes in length. Regionally, wet- and dry-season precipitations are of opposite sign, causing a decrease in the seasonal variation of the precipitation over 62% of the terrestrial ecosystems. Furthermore, we found a high correlation (r = 0.62) between the change in dry-season precipitation and the trend in modelled net primary productivity (NPP), which is explained based on different ecological mechanisms. This trend is not found with wet-season precipitation (r = 0.04), These results build on the argument that seasonal water availability has changed over the course of the last six decades and that the dry-season precipitation is a key driver of vegetation productivity at the global scale. PMID:29284050

  8. A conceptual data model for a primary health care patient-centric electronic medical record system

    CSIR Research Space (South Africa)

    Kotzé, P

    2014-09-01

    Full Text Available The development and use of national guidelines for the exchange of patient-centric healthcare data from electronic medical record systems are essential for the consistent and efficient use and analysis of those data. These guidelines must be based...

  9. Estimating primary production rates from photosynthetic electron transport in estuarine microphytobenthos

    NARCIS (Netherlands)

    Barranguet, C.; Kromkamp, J.C.

    2000-01-01

    Microphytobenthos primary production was measured using C fixation and compared with production estimates based on measurements on intact cores using variable chlorophyll fluorescence with a PAM (pulse-amplitude-modulated) fluorometer at a number of different sites on intertidal flats in the

  10. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners

    NARCIS (Netherlands)

    Suijkerbuijk, A.W.M.; van den Broek, I.V.F.; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; van der Sande, M.A.B.; Kretzschmar, M.E.E.

    2011-01-01

    Background: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening

  11. Usefulness of primary care electronic networks to assess the incidence of chlamydia, diagnosed by general practitioners.

    NARCIS (Netherlands)

    Suijkerbuijk, A.W.M.; Broek, I.V.F. van den; Brouwer, H.J.; Vanrolleghem, A.M.; Joosten, J.H.K.; Verheij, R.A.; Sande, M.A.B. van der; Kretzschmar, M.E.E.

    2011-01-01

    BACKGROUND: Chlamydia is the most common curable sexually transmitted infection (STI) in the Netherlands. The majority of chlamydia diagnoses are made by general practitioners (GPs). Baseline data from primary care will facilitate the future evaluation of the ongoing large population-based screening

  12. Species dependence of the redox potential of the primary electron donor p700 in photosystem I of oxygenic photosynthetic organisms revealed by spectroelectrochemistry.

    Science.gov (United States)

    Nakamura, Akimasa; Suzawa, Tomoyuki; Kato, Yuki; Watanabe, Tadashi

    2011-05-01

    The redox potential of the primary electron donor P700, E(m)(P700/P700(+)), of Photosystem I (PSI) has been determined for 10 oxygenic photosynthesis organisms, ranging from cyanobacteria, red algae, green algae to higher plants, by spectroelectrochemistry with an optically transparent thin-layer electrode (OTTLE) cell to elucidate the scattering by as much as 150 mV in reported values of E(m)(P700/P700(+)). The E(m)(P700/P700(+)) values determined within error ranges of ± 1-4 mV exhibited a significant species dependence, with a span >70 mV, from +398 to +470 mV vs. the standard hydrogen electrode (SHE). The E(m)(P700/P700(+)) value appears to change systematically in going from cyanobacteria and primitive eukaryotic red algae, then to green algae and higher plants. From an evolutionary point of view, this result suggests that the species believed to appear later in evolution of photosynthetic organisms exhibit higher values of E(m)(P700/P700(+)). Further, the species dependence of E(m)(P700/P700(+)) seems to originate in the species-dependent redox potentials of soluble metalloproteins, Cyt c(6) and plastocyanin, which re-reduce the oxidized P700 in the electron transfer chain.

  13. A comparative evaluation of electronic and radiographic determination of root canal length in primary teeth: An in vitro study

    Directory of Open Access Journals (Sweden)

    Iyer Satishkumar Krishnan

    2012-01-01

    Full Text Available Aims: The purpose of this in vitro study was to compare the root canal length determination by Electronic apex locator (EAL (Raypex 5 and conventional radiography, and then compare them with the actual measurements obtained by direct visualization. Settings and Design: This study was conducted at the Department of Pedodontics and Preventive Dentistry, Government Dental College, Thiruvananthapuram, Kerala, India. Subjects and Methods: One hundred single rooted primary teeth extracted due to extensive caries, trauma, serial extraction or unwillingness of the parent to save the teeth were selected. The teeth were numbered and root canal length was determined using the visual, electronic and the radiographic methods. The actual, electronic and the radiographic measurements were recorded. Statistical Analysis Used: Data were analyzed using Intraclass correlation test and linear regression analysis. Results: The accuracy of EAL and radiographic methods were 92% and 72%, respectively within + 0.5 mm. Both the electronic and conventional radiographic methods showed a high correlation and agreement (ICC intraclass correlation coefficient = 0.99 and 0.98 respectively with the actual measurements. Conclusions: EALs proved to be more accurate in determining the root canal length than the radiographic method.

  14. Calorimetry for dose measurement at electron accelerators in the 80-120 keV energy range

    DEFF Research Database (Denmark)

    Helt-Hansen, J.; Miller, A.; Duane, S.

    2005-01-01

    Calorimeters for dose measurement at low-energy electron accelerator energies (80-120 keV) are described. Three calorimeters with different characteristics were designed and their dose response and measurement uncertainties were characterized. The heated air between the beam exit window and the c...

  15. Primary role of electron work function for evaluation of nanostructured titania implant surface against bacterial infection.

    Science.gov (United States)

    Golda-Cepa, M; Syrek, K; Brzychczy-Wloch, M; Sulka, G D; Kotarba, A

    2016-09-01

    The electron work function as an essential descriptor for the evaluation of metal implant surfaces against bacterial infection is identified for the first time. Its validity is demonstrated on Staphylococcus aureus adhesion to nanostructured titania surfaces. The established correlation: work function-bacteria adhesion is of general importance since it can be used for direct evaluation of any electrically conductive implant surfaces. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. Expectations for the next generation of electronic patient records in primary care: a triangulated study

    Directory of Open Access Journals (Sweden)

    Tom Christensen

    2008-05-01

    Conclusions Progress toward a problem-oriented EPR system based on episodes of care that includes decision support is necessary to satisfy the needs expressed by GPs. Further research could solve the problem of integration of functionality for consultation with specialists and integration with patient held records. Results from this study could contribute to further development of the next generation of EPRs in primary care, as well as inspire the application of EPRs in other parts of the health sector.

  17. Electronic clinical records in primary care for estimating disease burden and management. An example of COPD

    Directory of Open Access Journals (Sweden)

    Luis Verde-Remeseiro

    2015-09-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is a significant health problem in developed countries. We aimed to estimate the prevalence of COPD in a single Spanish healthcare area. We also aimed to assess if there are any differences in prevalence and spirometry use among primary care services by utilizing already registered information. We designed a cross-sectional study to determine the prevalence of COPD and the performance of spirometries in each primary care service. A total of 8,444 patients were diagnosed with COPD, with a prevalence of 2.6% for individuals older than 39 years. The prevalence increased with age and was much higher in men. Significant heterogeneity was found in the prevalence of COPD and spirometry use among primary care services. COPD was underdiagnosed and there was wide variability in spirometry use in our area. Greater efforts are needed to diagnose COPD in order to improve its clinical outcomes and to refine registries so that they can be used as reliable sources of information

  18. Coordination between primary and secondary care: the role of electronic messages and economic incentives.

    Science.gov (United States)

    La Rocca, Antonella; Hoholm, Thomas

    2017-02-17

    In Norway, a government reform has recently been introduced to enhance coordination between primary and secondary care. This paper examines the effects of two newly introduced measures to improve the coordination: an ICT-based communication tool/standard and an economic incentive scheme. This qualitative study is based primarily on 27 open-ended interviews. We interviewed nine employees at a hospital (the focal actor), 17 employees from seven different municipalities, and a representative of a Regional Health Authority. ICT-based communication is perceived to facilitate information exchange between primary and secondary care, thus positively affecting coordination. However, the economic incentive scheme appears to have the opposite effect by creating tensions between the two organizations and accentuating power asymmetry in favor of secondary care. The inter-organizational nature of coordination in health care makes it crucial for policymakers and management of care organizations to conceive incentives and instruments that work jointly across organizations rather than at only one of the health care organizations involved. Such an approach is likely to favor a more symmetrical pattern of collaboration between primary and secondary care.

  19. Optimal all-optical switching of a microcavity resonance in the telecom range using the electronic Kerr effect

    CERN Document Server

    Yüce, Emre; Claudon, Julien; Gérard, Jean-Michel; Vos, Willem L

    2015-01-01

    We have switched GaAs/AlAs and AlGaAs/AlAs planar microcavities operating in the "original" telecom band by exploiting the instantaneous electronic Kerr effect. We demonstrate that resonance frequency reversibly shifts within a picosecond and the magnitude of the shift is affected by the backbone of the $\\lambda-$layer. We investigate experimentally and theoretically the role of the quality factor in terms of its effect on resonance frequency shift. Our model shows that the magnitude of the resonance frequency shift depends on the pump pulse duration and is maximized when the cavity cavity storage time is matched. Our experiments and our calculations indicate that the resonance frequency shift induced via the electronic Kerr effect can be maximized by judicious tuning of the pump frequency, pump power and pump pulse duration relative to the storage time of the cavity.

  20. Research Investigation Directed Toward Extending the Useful Range of the Electromagnetic Spectrum. [atomic spectra and electronic structure of alkali metals

    Science.gov (United States)

    Hartmann, S. R.; Happer, W.

    1974-01-01

    The report discusses completed and proposed research in atomic and molecular physics conducted at the Columbia Radiation Laboratory from July 1972 to June 1973. Central topics described include the atomic spectra and electronic structure of alkali metals and helium, molecular microwave spectroscopy, the resonance physics of photon echoes in some solid state systems (including Raman echoes, superradiance, and two photon absorption), and liquid helium superfluidity.

  1. Accurate transport simulation of electron tracks in the energy range 1 keV-4 MeV

    Energy Technology Data Exchange (ETDEWEB)

    Cobut, V. E-mail: vincent.cobut@chim.u-cergy.fr; Cirioni, L.; Patau, J.P

    2004-01-01

    Multipurpose electron transport simulation codes are widely used in the fields of radiation protection and dosimetry. Broadly based on multiple scattering theories and continuous energy loss stopping powers with some mechanism taking straggling into account, they give reliable answers to many problems. However they may be unsuitable in some specific situations. In fact, many of them are not able to accurately describe particle transport through very thin slabs and/or in high atomic number materials, or also when knowledge of high-resolution depth dose distributions is required. To circumvent these deficiencies, we developed a Monte Carlo code simulating each interaction along electron tracks. Gas phase elastic cross sections are corrected to take into account solid state effects. Inelastic interactions are described within the framework of the Martinez et al. [J. Appl. Phys. 67 (1990) 2955] theory intended to deal with energy deposition in both condensed insulators and conductors. The model described in this paper is validated for some materials as aluminium and silicon, encountered in spectrometric and dosimetric devices. Comparisons with experimental, theoretical and other simulation results are made for angular distributions and energy spectra of transmitted electrons through slabs of different thicknesses and for depth energy distributions in semi-infinite media. These comparisons are quite satisfactory.

  2. Two-band electronic metal and neighboring spin Bose-metal on a zigzag strip with longer-ranged repulsion

    Science.gov (United States)

    Lai, Hsin-Hua; Motrunich, Olexei I.

    2010-01-01

    We consider an electronic model for realizing the spin Bose-metal (SBM) phase on a two-leg triangular strip—a spin liquid phase found by Sheng [Phys. Rev. B 79, 205112 (2009)] in a spin-1/2 model with ring exchanges. The SBM can be viewed as a “C1S2” Mott insulator of electrons where the overall charge transporting mode is gapped out. We start from a two-band “C2S2” metal and consider extended repulsion motivated by recent ab initio derivation of electronic model for κ-ET spin liquid material [K. Nakamura , J. Phys. Soc. Jpn. 78, 083710 (2009)]. Using weak coupling renormalization group analysis, we find that the extended interactions allow much wider C2S2 metallic phase than in the Hubbard model with on-site repulsion only. An eight-fermion umklapp term plays a crucial role in producing a Mott insulator but cannot be treated in weak coupling. We use bosonization to extend the analysis to intermediate coupling and study phases obtained out of the C2S2 metal upon increasing overall repulsion strength, finding that the SBM phase is a natural outcome for extended interactions.

  3. Primary role of electron work function for evaluation of nanostructured titania implant surface against bacterial infection

    Energy Technology Data Exchange (ETDEWEB)

    Golda-Cepa, M., E-mail: golda@chemia.uj.edu.pl [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland); Syrek, K. [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland); Brzychczy-Wloch, M. [Department of Bacteriology, Microbial Ecology and Parasitology, Jagiellonian University Medical College, Czysta 18, 31-121 Krakow (Poland); Sulka, G.D. [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland); Kotarba, A., E-mail: kotarba@chemia.uj.edu.pl [Faculty of Chemistry, Jagiellonian University, Ingardena 3, 30-060 Krakow (Poland)

    2016-09-01

    The electron work function as an essential descriptor for the evaluation of metal implant surfaces against bacterial infection is identified for the first time. Its validity is demonstrated on Staphylococcus aureus adhesion to nanostructured titania surfaces. The established correlation: work function–bacteria adhesion is of general importance since it can be used for direct evaluation of any electrically conductive implant surfaces. - Highlights: • The correlation between work function and bacteria adhesion was discovered. • The discovered correlation is rationalized in terms of electrostatic bacteria–surface repulsion. • The results provide basis for the simple evaluation of implant surfaces against infection.

  4. Primary malignant mesothelioma of the tunica vaginalis of the testis. Immunohistochemistry and electron microscopy.

    Science.gov (United States)

    Berti, E; Schiaffino, E; Minervini, M S; Longo, G; Schmid, C

    1997-02-01

    A case of primary malignant mesothelioma of the tunica vaginalis of the testis in a 75 year old man is here presented. Anamnesis for asbestos exposure was negative. Recurrent left hydrocele was the main symptom. Echography revealed a nodular mass in the caudal aspect of the epididymis and papillary projection on the surface of the tunica vaginalis of the testis. An inguinal left orchiectomy was performed. The tumor both in the solid area and in the papillary projections was identified as a malignant mesothelioma of epithelial type. The role of immunohistochemistry and ultrastructure for a correct definition of the tumor is underlined.

  5. Interplanetary transport of solar near-relativistic electrons on 2014 August 1 over a narrow range of heliolongitudes

    Directory of Open Access Journals (Sweden)

    Pacheco Daniel

    2017-01-01

    Full Text Available We study two consecutive solar near-relativistic (>50 keV electron events observed on 2014 August 1 by both STEREO spacecraft with a longitudinal separation of only about 35°. The events were unambiguously associated with a solar source location and not accompanied by type II radio bursts or coronal mass ejections. Despite their close location, the two spacecraft were embedded in different solar wind streams and the electron intensities observed by the two STEREOs showed clear differences in onset times, peak intensities and pitch-angle distributions. The apparently better connected spacecraft, STEREO B, observed a smaller and more isotropic intensity increase and a later event onset time than STEREO A. Since the interplanetary transport conditions of solar energetic particles (SEPs have a direct influence on the characteristics of the observed temporal profiles and the particle anisotropies at the spacecraft location, our aim is to understand if the observations on 2014 August 1 could be explained by different interplanetary transport conditions along each flux tube connecting the spacecraft with the solar source. For that purpose, we use a Monte Carlo interplanetary transport model combined with an inversion procedure to fit the in-situ observations of the two near-relativistic multi-spacecraft electron events. This allows us to obtain the injection profiles at the Sun and infer the transport conditions, which are characterized by the electron radial mean free path, λr. We obtain an almost simultaneous release of electrons for both spacecraft in both events. The release is consistent with the timing and duration of the type III radio burst emission and it is larger for STEREO B, the better connected spacecraft. In addition, we obtain different transport conditions in different solar wind streams. We find that the stream in which STEREO B was embedded was more diffusive (λr = 0.1AU for Event I and λr = 0.06AU for Event II than the

  6. Interplanetary transport of solar near-relativistic electrons on 2014 August 1 over a narrow range of heliolongitudes

    Science.gov (United States)

    Pacheco, Daniel; Agueda, Neus; Gómez-Herrero, Raúl; Aran, Angels

    2017-11-01

    We study two consecutive solar near-relativistic (>50 keV) electron events observed on 2014 August 1 by both STEREO spacecraft with a longitudinal separation of only about 35°. The events were unambiguously associated with a solar source location and not accompanied by type II radio bursts or coronal mass ejections. Despite their close location, the two spacecraft were embedded in different solar wind streams and the electron intensities observed by the two STEREOs showed clear differences in onset times, peak intensities and pitch-angle distributions. The apparently better connected spacecraft, STEREO B, observed a smaller and more isotropic intensity increase and a later event onset time than STEREO A. Since the interplanetary transport conditions of solar energetic particles (SEPs) have a direct influence on the characteristics of the observed temporal profiles and the particle anisotropies at the spacecraft location, our aim is to understand if the observations on 2014 August 1 could be explained by different interplanetary transport conditions along each flux tube connecting the spacecraft with the solar source. For that purpose, we use a Monte Carlo interplanetary transport model combined with an inversion procedure to fit the in-situ observations of the two near-relativistic multi-spacecraft electron events. This allows us to obtain the injection profiles at the Sun and infer the transport conditions, which are characterized by the electron radial mean free path, λr. We obtain an almost simultaneous release of electrons for both spacecraft in both events. The release is consistent with the timing and duration of the type III radio burst emission and it is larger for STEREO B, the better connected spacecraft. In addition, we obtain different transport conditions in different solar wind streams. We find that the stream in which STEREO B was embedded was more diffusive (λr = 0.1AU for Event I and λr = 0.06AU for Event II) than the stream in which STEREO A

  7. [Validity and concordance of electronic health records in primary care (AP-Madrid) for surveillance of diabetes mellitus. PREDIMERC study].

    Science.gov (United States)

    Gil Montalbán, Elisa; Ortiz Marrón, Honorato; López-Gay Lucio-Villegas, Dulce; Zorrilla Torrás, Belén; Arrieta Blanco, Francisco; Nogales Aguado, Pedro

    2014-01-01

    To assess the validity and concordance of diabetes data in the electronic health records of primary care (Madrid-PC) by comparing with those from the PREDIMERC study. The sensitivity, specificity, positive predictive value, negative predictive value and kappa index of diabetes cases recorded in the health records of Madrid-PC were calculated by using data from PREDIMERC as the gold standard. The prevalence of diabetes was also determined according to each data source. The sensitivity of diabetes recorded in Madrid-PC was 74%, the specificity was 98.8%, the positive predictive value was 87.9%, the negative predictive value was 97.3%, and the kappa index was 0.78. The prevalence of diabetes recorded in Madrid-PC was 6.7% versus 8.1% by PREDIMERC, where known diabetes was 6.3%. The electronic health records of primary care are a valid source for epidemiological surveillance of diabetes in Madrid. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. Total cross sections for electron scattering by CO{sub 2} molecules in the energy range 400{endash}5000 eV

    Energy Technology Data Exchange (ETDEWEB)

    Garcia, G.; Manero, F. [Direccion de Tecnologia, Centro de Investigaciones Energeticas Medioambientales y Tecnologicas (CIEMAT), Avenida Complutense 22, 28040 Madrid (Spain)]|[Instituto de Investigacion Basica, Centro de Investigaciones Energeticas Medioambientales y Tecnologicas (CIEMAT), Avenida Complutense 22, 28040 Madrid (Spain)

    1996-01-01

    Total cross sections for electron scattering by CO{sub 2} molecules in the energy range 400{endash}5000 eV have been measured with experimental errors of {approximately}3{percent}. The present results have been compared with available experimental and theoretical data. The dependence of the total cross sections on electron energy shows an asymptotic behavior with increasing energies, in agreement with the Born-Bethe approximation. In addition, an analytical formula is provided to extrapolate total cross sections to higher energies. {copyright} {ital 1996 The American Physical Society.}

  9. The physical limits of metal reduction by long-range extracellular electron transfer, and the role of cytochrome-bound flavins

    Science.gov (United States)

    Michelson, K.; Sanford, R. A.; Valocchi, A. J.; Werth, C. J.

    2015-12-01

    Microbial reduction of metals and radionuclides in the subsurface plays an essential role in the biogeochemical cycling of micronutrients and the remediation of contaminated groundwater. While recent advances in the field have improved our ability to understand and predict bioreduction in these environments, the contribution of long-range extracellular electron transfer (EET) by electron shuttling or reduction along conductive pili remains elusive. Long-range EET is implicated in the reduction of radionuclides like uranium that are reversibly sorbed in clay nanopores and exist as persistant sources of contamination. In regions of low hydraulic conductivity, electron shuttles and conductive pili may increase physical mixing beyond what is possible by advection and diffusion, resulting in reduction over a larger area than predicted by current models. We present a novel microfluidic platform that allows us to study long-range EET to the exclusion of other mechanisms, directly observe these phenomena under a controlled environment representative of groundwater conditions, monitor the metabolic activity and redox state of bacteria, and determine the presence of reduced products in-situ. Using Geobacter sulfurreducens as a model metal-reducing bacteria, insoluble manganese dioxide as an electron acceptor, and Escherichia coli K-12 as a reductant and redox buffer, we demonstate that 1) long-range EET by conductive pili requires the presence of flavins 2) Reduction by direct contact only requires the presence of a lowered electric potential 3) The limit of reduction by conductive pili is on the order of 15-20 microns. We are actively exploring the influence of hydrological conditions on the expression of different mechanisms of long-range EET, and the importance of extracellular cytochromes and pili conductivity on metal reduction.

  10. Medical assistants' roles in electronic health record processes in primary care practices: the untold story.

    Science.gov (United States)

    Adewale, Victoria; Anthony, David; Borkan, Jeffery

    2014-01-01

    The role of the medical assistant has been undervalued in the past. Many publications have detailed the integral role of the nursing staff and physicians, but the medical assistant role has come last in formal recognition. As healthcare settings move toward a more Patient-Centered Medical Home (PCMH) model, the attitudes of this model will need to be adopted, two of which are team-based care and adoption of the electronic health record (EHR). As the EHR continues to gain more traction in healthcare, a thorough understanding of it, by everyone, will be vital for its success. In this article, the medical assistant's relationship with the EHR is outlined through qualitative interviews and observations with medical assistants in PCMH programs. The data describe diverse EHR experiences and how these experiences are influenced by and reflected in workflow issues, training, patient care, and an expanding role of the medical assistant.

  11. How physician electronic health record screen sharing affects patient and doctor non-verbal communication in primary care.

    Science.gov (United States)

    Asan, Onur; Young, Henry N; Chewning, Betty; Montague, Enid

    2015-03-01

    Use of electronic health records (EHRs) in primary-care exam rooms changes the dynamics of patient-physician interaction. This study examines and compares doctor-patient non-verbal communication (eye-gaze patterns) during primary care encounters for three different screen/information sharing groups: (1) active information sharing, (2) passive information sharing, and (3) technology withdrawal. Researchers video recorded 100 primary-care visits and coded the direction and duration of doctor and patient gaze. Descriptive statistics compared the length of gaze patterns as a percentage of visit length. Lag sequential analysis determined whether physician eye-gaze influenced patient eye gaze, and vice versa, and examined variations across groups. Significant differences were found in duration of gaze across groups. Lag sequential analysis found significant associations between several gaze patterns. Some, such as DGP-PGD ("doctor gaze patient" followed by "patient gaze doctor") were significant for all groups. Others, such DGT-PGU ("doctor gaze technology" followed by "patient gaze unknown") were unique to one group. Some technology use styles (active information sharing) seem to create more patient engagement, while others (passive information sharing) lead to patient disengagement. Doctors can engage patients in communication by using EHRs in the visits. EHR training and design should facilitate this. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  12. Electronic medical record alert improves HCV testing for baby boomers in primary care setting: adults born during 1945-1965.

    Science.gov (United States)

    Al-Hihi, Eyad; Shankweiler, Caylin; Stricklen, David; Gibson, Cheryl; Dunn, Winston

    2017-01-01

    This project aims to implement the HCV birth cohort screening guidelines over a 9-month period in the primary care setting at the University of Kansas Health System General Internal Medicine Division. The project team measured the number of patients in the baby boomer population who received a one-time screen for HCV. An electronic medical record (EMR) intervention was implemented to identify baby boomers who did not have an HCV screening or diagnosis. Additionally, education was provided to all primary care providers in the clinic to increase awareness of the HCV birth cohort screening. The quality improvement methods increased the percentage of baby boomers who obtained a one-time screening test for HCV from a baseline of 30% to a 55% screening rate during the nine-month project period. Identifying the HCV screening needs and creating a visual reminder in the EMR can be used to facilitate sustainable awareness and improvement of screening rates. The project team recognizes that continued work is required to close the HCV screening care gaps in the primary care setting.

  13. Electronic medical record alert improves HCV testing for baby boomers in primary care setting: adults born during 1945–1965

    Science.gov (United States)

    Al-hihi, Eyad; Shankweiler, Caylin; Stricklen, David; Gibson, Cheryl; Dunn, Winston

    2017-01-01

    Method This project aims to implement the HCV birth cohort screening guidelines over a 9-month period in the primary care setting at the University of Kansas Health System General Internal Medicine Division. The project team measured the number of patients in the baby boomer population who received a one-time screen for HCV. An electronic medical record (EMR) intervention was implemented to identify baby boomers who did not have an HCV screening or diagnosis. Additionally, education was provided to all primary care providers in the clinic to increase awareness of the HCV birth cohort screening. Results The quality improvement methods increased the percentage of baby boomers who obtained a one-time screening test for HCV from a baseline of 30% to a 55% screening rate during the nine-month project period. Conclusion Identifying the HCV screening needs and creating a visual reminder in the EMR can be used to facilitate sustainable awareness and improvement of screening rates. The project team recognizes that continued work is required to close the HCV screening care gaps in the primary care setting. PMID:29209663

  14. On the effect of impurities on resistivity recovery, short-range ordering, and defect migration in electron-irradiated concentrated Fe-Cr alloys

    CERN Document Server

    Nikolaev, A L; Davletshin, A E

    1997-01-01

    The resistivity recovery of pure and impurity-doped (0.2-1.5% Si, 0.15% C+N) concentrated ferritic Fe-Cr alloys after electron irradiation at 50-60 K has been investigated over the temperature range 110-390 K. A fine recovery spectrum structure consisting of five peaks has been observed over the range 135-230 K. Short-range ordering starts with the onset of vacancy long-range migration. Doping with both types of impurity suppresses the recovery spectrum structure over the range 160-220 K in a similar manner. Additional effects of impurity doping on the resistivity recovery caused by deviation from Matthiessen's rule have been analysed. A stage III peak is found at 210 K, and two peaks - at 175 K and 195 K - are interpreted as being due to the vacancy short-range migration. It is supposed that such a manifestation of short-range vacancy migration is due to a strong immobilization of self-interstitial atoms, and suppression of short-range and long-range defect annealing processes in stage I, according to a conf...

  15. Cryo electron tomography of herpes simplex virus during axonal transport and secondary envelopment in primary neurons.

    Directory of Open Access Journals (Sweden)

    Iosune Ibiricu

    2011-12-01

    Full Text Available During herpes simplex virus 1 (HSV1 egress in neurons, viral particles travel from the neuronal cell body along the axon towards the synapse. Whether HSV1 particles are transported as enveloped virions as proposed by the 'married' model or as non-enveloped capsids suggested by the 'separate' model is controversial. Specific viral proteins may form a recruitment platform for microtubule motors that catalyze such transport. However, their subviral location has remained elusive. Here we established a system to analyze herpesvirus egress by cryo electron tomography. At 16 h post infection, we observed intra-axonal transport of progeny HSV1 viral particles in dissociated hippocampal neurons by live-cell fluorescence microscopy. Cryo electron tomography of frozen-hydrated neurons revealed that most egressing capsids were transported independently of the viral envelope. Unexpectedly, we found not only DNA-containing capsids (cytosolic C-capsids, but also capsids lacking DNA (cytosolic A-/B-capsids in mid-axon regions. Subvolume averaging revealed lower amounts of tegument on cytosolic A-/B-capsids than on C-capsids. Nevertheless, all capsid types underwent active axonal transport. Therefore, even few tegument proteins on the capsid vertices seemed to suffice for transport. Secondary envelopment of capsids was observed at axon terminals. On their luminal face, the enveloping vesicles were studded with typical glycoprotein-like spikes. Furthermore, we noted an accretion of tegument density at the concave cytosolic face of the vesicle membrane in close proximity to the capsids. Three-dimensional analysis revealed that these assembly sites lacked cytoskeletal elements, but that filamentous actin surrounded them and formed an assembly compartment. Our data support the 'separate model' for HSV1 egress, i.e. progeny herpes viruses being transported along axons as subassemblies and not as complete virions within transport vesicles.

  16. Long-range organization of bacteriochlorophyll in chlorosomes of Chlorobium tepidum investigated by cryo-electron microscopy

    NARCIS (Netherlands)

    Oostergetel, Gert T.; Reus, Michael; Chew, Aline Gomez Maqueo; Bryant, Donald A.; Boekema, Egbert J.; Holzwarth, Alfred R.

    2007-01-01

    Intact chlorosomes of Chlorobium tepidum were embedded in amorphous ice layers and examined by cryoelectron microscopy to study the long-range organization of bacteriochlorophyll ( BChl) layers. End-on views reveal that chlorosomes are composed of several multi-layer tubules of variable diameter

  17. Ionization Energies, Electron Affinities, and Polarization Energies of Organic Molecular Crystals: Quantitative Estimations from a Polarizable Continuum Model (PCM)–Tuned Range-Separated Density Functional Approach

    KAUST Repository

    Sun, Haitao

    2016-05-16

    We propose a new methodology for the first-principles description of the electronic properties relevant for charge transport in organic molecular crystals. This methodology, which is based on the combination of a non-empirical, optimally tuned range-separated hybrid functional with the polarizable continuum model, is applied to a series of eight representative molecular semiconductor crystals. We show that it provides ionization energies, electron affinities, and transport gaps in very good agreement with experimental values as well as with the results of many-body perturbation theory within the GW approximation at a fraction of the computational costs. Hence, this approach represents an easily applicable and computationally efficient tool to estimate the gas-to-crystal-phase shifts of the frontier-orbital quasiparticle energies in organic electronic materials.

  18. The Au-S bond and SAM-protein contact in long-range electron transfer of pure and biomimetic metalloproteins via functionalized alkanethiol linkers

    DEFF Research Database (Denmark)

    Chi, Qijin; Ford, Michael J.; Halder, Arnab

    functionalized alkanethiols have emerged as core linkers. We have studied molecular linking in the long-range ET (LRET) processes in detail using electrochemistry, in situ STM and AFM, and electronic structure computations. A focus is the electronic structure of the Au-S link and the SAM packing. We have...... illustrate this by high-resolution in situ STM of straight, branched, and chiral alkanethiols on Au(111)-electrode surfaces. We discuss next LRET of two SAM immobilized multi-copper enzymes, nitrite reductase and laccase, mapped to single-molecule resolution by in situ STM and AFM. The voltammetry...... degree of electronic structure sophistication. At the molecular scale this requirement is met by NPs of the renownedmixed-valence Prussian Blue (PB) assembled on Au(111)-electrode surfaces via functionalized alkanethiols. PBNP SAMs show LRET comparable to metalloproteins. Alkanethiols with different...

  19. Ion cyclotron range of frequencies mode conversion electron heating in deuterium-hydrogen plasmas in the Alcator C-Mod tokamak

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Y [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Wukitch, S J [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Bonoli, P T [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Marmar, E [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Mossessian, D [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Nelson-Melby, E [Centre de Recherches en Physique des Plasmas, Association EURATOM - Confederation Suisse, Ecole Polytechnique Federale de Lausanne, CH-1015 Lausanne (Switzerland); Phillips, P [Fusion Research Center, University of Texas, Austin, Texas 78712 (United States); Porkolab, M [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Schilling, G [Plasma Physics Laboratory, Princeton, NJ 08543 (United States); Wolfe, S [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States); Wright, J [Plasma Science and Fusion Center, Massachusetts Institute of Technology, Cambridge, MA 02139 (United States)

    2003-06-01

    Localized direct electron heating (EH) by mode-converted (MC) ion cyclotron range of frequencies (ICRF) waves in D(H) tokamak plasmas has been clearly observed for the first time in Alcator C-Mod. Both on- and off-axis (high field side) mode conversion EH (MCEH) have been observed. The MCEH profile was obtained from a break-in-slope analysis of electron temperature signals in the presence of radio frequency shut-off. The temperature was measured by a 32-channel high spatial resolution ({<=}7 mm) 2nd harmonic heterodyne electron cyclotron emission system. The experimental profiles were compared with the predictions from a toroidal full-wave ICRF code TORIC. Using the hydrogen concentration measured by a high-resolution optical spectrometer, TORIC predictions were shown qualitatively in agreement with the experimental results for both on- and off-axis MC cases. From the simulations, the EH from MC ion cyclotron wave and ion Bernstein wave is examined.

  20. Organic electronic materials: Recent advances in the dft description of the ground and excited states using tuned range-separated hybrid functionals

    KAUST Repository

    Körzdörfer, Thomas

    2014-11-18

    Density functional theory (DFT) and its time-dependent extension (TD-DFT) are powerful tools enabling the theoretical prediction of the ground- and excited-state properties of organic electronic materials with reasonable accuracy at affordable computational costs. Due to their excellent accuracy-to-numerical-costs ratio, semilocal and global hybrid functionals such as B3LYP have become the workhorse for geometry optimizations and the prediction of vibrational spectra in modern theoretical organic chemistry. Despite the overwhelming success of these out-of-the-box functionals for such applications, the computational treatment of electronic and structural properties that are of particular interest in organic electronic materials sometimes reveals severe and qualitative failures of such functionals. Important examples include the overestimation of conjugation, torsional barriers, and electronic coupling as well as the underestimation of bond-length alternations or excited-state energies in low-band-gap polymers.In this Account, we highlight how these failures can be traced back to the delocalization error inherent to semilocal and global hybrid functionals, which leads to the spurious delocalization of electron densities and an overestimation of conjugation. The delocalization error for systems and functionals of interest can be quantified by allowing for fractional occupation of the highest occupied molecular orbital. It can be minimized by using long-range corrected hybrid functionals and a nonempirical tuning procedure for the range-separation parameter.We then review the benefits and drawbacks of using tuned long-range corrected hybrid functionals for the description of the ground and excited states of π-conjugated systems. In particular, we show that this approach provides for robust and efficient means of characterizing the electronic couplings in organic mixed-valence systems, for the calculation of accurate torsional barriers at the polymer limit, and for the

  1. Models of primary runaway electron distribution in the runaway vortex regime

    Science.gov (United States)

    Guo, Zehua; Tang, Xian-Zhu; McDevitt, Christopher J.

    2017-11-01

    A number of recent numerical calculations have shown the formation of a bump in runaway electron (RE) energy distribution by taking into account the synchrontron radiational damping force due to RE's gyromotions. Here, we present a detailed examination on how the bump location changes at different pitch-angles and the characteristics of the RE pitch-angle distribution. Although REs moving along the magnetic field are preferably accelerated and then populate the phase-space of larger pitch-angle mainly through diffusions, an off-axis (i.e., at finite pitch) peak can still form due to the presence of a runaway vortex that accumulates REs at a finite pitch-angle. A simplified Fokker-Planck model and its semi-analytical solutions based on local expansions around the O point are used to illustrate the characteristics of RE distribution around the O point of the runaway vortex in phase-space. The calculated energy location of the O point together with the local energy and pitch-angle distributions agree with the full numerical solution, confirming a previous empirical model for the runaway vortex location and explaining the off-axis peak in the distribution.

  2. Using electronic patient records to inform strategic decision making in primary care.

    Science.gov (United States)

    Mitchell, Elizabeth; Sullivan, Frank; Watt, Graham; Grimshaw, Jeremy M; Donnan, Peter T

    2004-01-01

    Although absolute risk of death associated with raised blood pressure increases with age, the benefits of treatment are greater in elderly patients. Despite this, the 'rule of halves' particularly applies to this group. We conducted a randomised controlled trial to evaluate different levels of feedback designed to improve identification, treatment and control of elderly hypertensives. Fifty-two general practices were randomly allocated to either: Control (n=19), Audit only feedback (n=16) or Audit plus Strategic feedback, prioritising patients by absolute risk (n=17). Feedback was based on electronic data, annually extracted from practice computer systems. Data were collected for 265,572 patients, 30,345 aged 65-79. The proportion of known hypertensives in each group with BP recorded increased over the study period and the numbers of untreated and uncontrolled patients reduced. There was a significant difference in mean systolic pressure between the Audit plus Strategic and Audit only groups and significantly greater control in the Audit plus Strategic group. Providing patient-specific practice feedback can impact on identification and management of hypertension in the elderly and produce a significant increase in control.

  3. [Electronic medical records: Evolution of physician-patient relationship in the Primary Care clinic].

    Science.gov (United States)

    Pérez-Santonja, T; Gómez-Paredes, L; Álvarez-Montero, S; Cabello-Ballesteros, L; Mombiela-Muruzabal, M T

    2017-04-01

    The introduction of electronic medical records and computer media in clinics, has influenced the physician-patient relationship. These modifications have many advantages, but there is concern that the computer has become too important, going from a working tool to the centre of our attention during the clinical interview, decreasing doctor interaction with the patient. The objective of the study was to estimate the percentage of time that family physicians spend on computer media compared to interpersonal communication with the patient, and whether this time is modified depending on different variables such as, doctor's age or reason for the consultation. An observational and descriptive study was conducted for 10 weeks, with 2 healthcare centres involved. The researchers attended all doctor- patient interviews, recording the patient time in and out of the consultation. Each time the doctor fixed his gaze on computer media the time was clocked. A total of 436 consultations were collected. The doctors looked at the computer support a median 38.33% of the total duration of an interview. Doctors of 45 years and older spent more time fixing their eyes on computer media (P<.05). Family physicians used almost 40% of the consultation time looking at computer media, and depends on age of physician, number of queries, and number of medical appointments. Copyright © 2016 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Simulation of electron transport in GaAs/AlAs superlattices with a small number of periods for the THz frequency range

    Energy Technology Data Exchange (ETDEWEB)

    Pavelyev, D. G., E-mail: pavelev@rf.unn.ru, E-mail: obolensk@rf.unn.ru [Lobachevsky State University of Nizhny Novgorod (Russian Federation); Vasilev, A. P., E-mail: vasiljev@mail.ioffe.ru [Russian Academy of Sciences, Submicron Heterostructures for Microelectronics, Research and Engineering Center (Russian Federation); Kozlov, V. A., E-mail: kozlov@ipm.sci-nnov.ru; Koschurinov, Yu. I.; Obolenskaya, E. S.; Obolensky, S. V. [Lobachevsky State University of Nizhny Novgorod (Russian Federation); Ustinov, V. M., E-mail: vmust@beam.ioffe.ru [Russian Academy of Sciences, Ioffe Physical–Technical Institute (Russian Federation)

    2016-11-15

    The electron transport in superlattices based on GaAs/AlAs heterostructures with a small number of periods (6 periods) is calculated by the Monte Carlo method. These superlattices are used in terahertz diodes for the frequency stabilization of quantum cascade lasers in the range up to 4.7 THz. The band structure of superlattices with different numbers of AlAs monolayers is considered and their current–voltage characteristics are calculated. The calculated current–voltage characteristics are compared with the experimental data. The possibility of the efficient application of these superlattices in the THz frequency range is established both theoretically and experimentally.

  5. The Noble Gas Dimers as a Probe of the Energetic Contributions of Dispersion and Short-Range Electron Correlation in Weakly-Bound Systems

    OpenAIRE

    Housden, Michael Philip; Pyper, Nicholas Charles

    2008-01-01

    Abstract The binding of the noble gas dimers is examined using a theory in which the Hartree-Fock interaction energy is augmented with both a short-range correlation term derived from the theory of a uniform electron-gas plus a dispersion energy damped according to the theory of Jabobi and Csanak. The good agreement between the predicted and experimental binding energies and equilibrium inter-nuclear separations confirms that this approach captures the essential physics of the int...

  6. Community Health Worker Impact on Chronic Disease Outcomes Within Primary Care Examined Using Electronic Health Records.

    Science.gov (United States)

    Ingram, Maia; Doubleday, Kevin; Bell, Melanie L; Lohr, Abby; Murrieta, Lucy; Velasco, Maria; Blackburn, John; Sabo, Samantha; Guernsey de Zapien, Jill; Carvajal, Scott C

    2017-10-01

    To investigate community health worker (CHW) effects on chronic disease outcomes using electronic health records (EHRs). We examined EHRs of 32 147 patients at risk for chronic disease during 2012 to 2015. Variables included contact with clinic-based CHWs, vitals, and laboratory tests. We estimated a mixed model for all outcomes. Within-group findings showed statistically significant improvements in chronic disease indicators after exposure to CHWs. In health center 1, HbA1c (glycated hemoglobin) decreased 0.15 millimoles per mole (95% confidence interval [CI] = -0.24, -0.06), body mass index decreased 0.29 kilograms per meter squared (CI = -0.39, -0.20), and total cholesterol decreased 11.9 milligrams per deciliter (CI = -13.5, -10.2). In health center 2, HbA1c decreased 0.43 millimoles per mole (CI = -0.7, -0.17), body mass index decreased by 0.08 kilograms per meter squared (CI = -0.14, -0.02), and triglycerides decreased by 22.50 milligrams per deciliter (CI = -39.0, -6.0). Total cholesterol of 3.62 milligrams per deciliter (CI = -6.6, -0.6) in health center 1 was the only improvement tied to CHW contact. Although patients' chronic disease indicators consistently improved, between-group models provided no additional evidence of impact. EHRs' evolution may elucidate CHW contributions moving forward.

  7. Primary Study about Intensity Signal of Electron Paramagnetic Resonance in vivo Tooth Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hoon; Gang, Seo Gon; Kim, Jeong In; Lee, Byung Il [KHNP Radiation Health Institute, Gyeongju (Korea, Republic of)

    2017-04-15

    The signal of Electron Paramagnetic Resonance(EPR) dosimetry system using human tooth has been well introduced as one of the efficient tool to evaluate radiation exposure. But, EPR dosimetry, even in the case of classical in vitro EPR system using tooth sample(measured molars), was regarded as having big signal fluctuation. One of reason for such difficulty in getting accurate intensity was the big effect of organic materials mixed in enamel part of teeth samples. They are mainly caused by the adaptation process of system itself to the movement of measured human subject. Generally, when we measured human teeth in vivo, five of six teeth spectrum were gathered and averaged for real evaluation. The these spectrum are measured under very different environment like angle of external magnet making magnetic filed with teeth(incisor). Random movement of these signals should be considered in different view point to understand and compare each EPR in vivo EPR spectrum. The peak to peak value of obtained five or six in vivo EPR system to get averaged value for final quantity of free radicals in hydroxy apatite crystal construction in enamel part of human teeth looks so randomly changed without regulation. But, in overall view, the EPR signal, especially at no irradiation level, is almost same for every measurement trial which is mainly composed of big noise and very small signal from real free radicals. The peak to peak value of obtained five or six in vivo EPR system to get averaged value for final quantity of free radicals in hydroxy apatite crystal construction in enamel part of human teeth looks so randomly changed without regulation.

  8. Evaluation of Electronic Medical Record (EMR at large urban primary care sexual health centre.

    Directory of Open Access Journals (Sweden)

    Christopher K Fairley

    Full Text Available OBJECTIVE: Despite substantial investment in Electronic Medical Record (EMR systems there has been little research to evaluate them. Our aim was to evaluate changes in efficiency and quality of services after the introduction of a purpose built EMR system, and to assess its acceptability by the doctors, nurses and patients using it. METHODS: We compared a nine month period before and after the introduction of an EMR system in a large sexual health service, audited a sample of records in both periods and undertook anonymous surveys of both staff and patients. RESULTS: There were 9,752 doctor consultations (in 5,512 consulting hours in the Paper Medical Record (PMR period and 9,145 doctor consultations (in 5,176 consulting hours in the EMR period eligible for inclusion in the analysis. There were 5% more consultations per hour seen by doctors in the EMR period compared to the PMR period (rate ratio = 1.05; 95% confidence interval, 1.02, 1.08 after adjusting for type of consultation. The qualitative evaluation of 300 records for each period showed no difference in quality (P>0.17. A survey of clinicians demonstrated that doctors and nurses preferred the EMR system (P<0.01 and a patient survey in each period showed no difference in satisfaction of their care (97% for PMR, 95% for EMR, P = 0.61. CONCLUSION: The introduction of an integrated EMR improved efficiency while maintaining the quality of the patient record. The EMR was popular with staff and was not associated with a decline in patient satisfaction in the clinical care provided.

  9. The impact of long-range electron-hole interaction on the charge separation yield of molecular photocells

    Science.gov (United States)

    Nemati Aram, Tahereh; Ernzerhof, Matthias; Asgari, Asghar; Mayou, Didier

    2017-01-01

    We discuss the effects of charge carrier interaction and recombination on the operation of molecular photocells. Molecular photocells are devices where the energy conversion process takes place in a single molecular donor-acceptor complex attached to electrodes. Our investigation is based on the quantum scattering theory, in particular on the Lippmann-Schwinger equation; this minimizes the complexity of the problem while providing useful and non-trivial insight into the mechanism governing photocell operation. In this study, both exciton pair creation and dissociation are treated in the energy domain, and therefore there is access to detailed spectral information, which can be used as a framework to interpret the charge separation yield. We demonstrate that the charge carrier separation is a complex process that is affected by different parameters, such as the strength of the electron-hole interaction and the non-radiative recombination rate. Our analysis helps to optimize the charge separation process and the energy transfer in organic solar cells and in molecular photocells.

  10. The TSH dynamics in upperand low-normal range in patients with primary hypothyroidism: clinical presentation, well-being and quality of life

    Directory of Open Access Journals (Sweden)

    A V Podzolkov

    2010-12-01

    Full Text Available In our study we try to determine whether small changes in thyroxine treatment is effective in patients with symptoms of hypothyroidism but with thyroid function tests within the reference range, and to investigate the effect of thyroxine treatment on psychological and physical wellbeing in healthy participants. Sixty ambulatory patients with primary hypothyroidism receiving levothyroxine (L-T4 participated in the study. Patients were divided into 2 groups according to their TSH level. The first group was in TSH low-normal range (0.4–2.0 mU/l, the second in upper-normal (2.1–4.0 mU/l range. We analyzed the results of several tests: “12 classical hypothyroidism symp- toms”, SF36, HARS, HDRS, Zung scale at baseline and in 3 months. With a small-dose changes we cross the groups to compare the results. Results: At baseline analyze there was a small differ-ence between two groups. Women with in the upper-normal TSH range had more expressed symptoms of hypothyroidism. After small changes in thyroxine treatment we could not say that the clinical picture of a hypothyroidism has changed cardinally, however, it is necessary to notice that there was dynamics of separate symptoms. The same picture was noticed with the depression and anxiety levels. The meanings were rather close and small dose changes in L-T4 treatment were more expressed in group with upper-normal range. The positive dynamics of well-being after dose changing were registered in both groups. Conclusion: Small changes in T4 dosage do not produce measurable changes in hypothyroid symptoms, well-being, or quality of life.

  11. Proposal and verification numerical simulation for a microwave forward scattering technique at upper hybrid resonance for the measurement of electron gyroscale density fluctuations in the electron cyclotron frequency range in magnetized plasmas

    Science.gov (United States)

    Kawamori, E.; Igami, H.

    2017-11-01

    A diagnostic technique for detecting the wave numbers of electron density fluctuations at electron gyro-scales in an electron cyclotron frequency range is proposed, and the validity of the idea is checked by means of a particle-in-cell (PIC) numerical simulation. The technique is a modified version of the scattering technique invented by Novik et al. [Plasma Phys. Controlled Fusion 36, 357-381 (1994)] and Gusakov et al., [Plasma Phys. Controlled Fusion 41, 899-912 (1999)]. The novel method adopts forward scattering of injected extraordinary probe waves at the upper hybrid resonance layer instead of the backward-scattering adopted by the original method, enabling the measurement of the wave-numbers of the fine scale density fluctuations in the electron-cyclotron frequency band by means of phase measurement of the scattered waves. The verification numerical simulation with the PIC method shows that the technique has a potential to be applicable to the detection of electron gyro-scale fluctuations in laboratory plasmas if the upper-hybrid resonance layer is accessible to the probe wave. The technique is a suitable means to detect electron Bernstein waves excited via linear mode conversion from electromagnetic waves in torus plasma experiments. Through the numerical simulations, some problems that remain to be resolved are revealed, which include the influence of nonlinear processes such as the parametric decay instability of the probe wave in the scattering process, and so on.

  12. Polymers in waste electric and electronic equipment (WEEE) contain PBDD/F in the ppb-range

    Energy Technology Data Exchange (ETDEWEB)

    Schlummer, M.; Brandl, F.; Maeurer, A.; Gruber, L.; Wolz, G. [Fraunhofer-Institut fuer Verfahrenstechnik und Verpackung (IVV), Freising (Germany)

    2004-09-15

    Waste electric and electronic equipment (WEEE) consists of metals (60%), polymers (20%) and residual materials as wood or glass (20%). Whereas state-of the art-technologies are able to recover most of the metals present, recovery rates for polymers and residuals are negligible low. Primarily, this is due to low disposal costs, which refers to landfill or incineration depending on geographic circumstances. The European WEEE directive, which assesses material recovery rates above 70%, and changes in the German disposal regulation, which will prohibit the landfill of organic materials starting 2005, currently alter the legislative conditions. This leads to an increased interest in polymer recovery strategies. Approaches discussed include polymer recycling and pyrolysis-based material recovery, both characterised by temperatures below 240 C or 600 C, respectively. Polybrominated biphenyls (PBB) and/or diphenyl ethers (PBDE) in these waste streams complicate waste treatment techniques, since they are known to form brominated dioxins and furans (PBDD/F) under thermal stress, either in polymer recyclates or in pyrolysis products. Additionally, polymer recycling is affected by European directive 2003/11/EC, restricting the distribution of products containing more than 0.1% of octa- or pentabrominated diphenyl ethers, respectively. Aim of this study was to determine concentration levels of polybrominated compounds including PBDD/F and brominated flame retardants in polymers from WEEE. Both, mixed polymer waste and pre-sorted polymer fractions consisting mainly of monitors, TV-sets or telecommunication housings, were examined. Furthermore, the dependency of PBDD/F concentrations on waste source, pre-treatment and flame retardant system was investigated, implication on waste treatment alternatives are discussed.

  13. Distance-including rigorous upper bounds and tight estimates for two-electron integrals over long- and short-range operators

    Science.gov (United States)

    Thompson, Travis H.; Ochsenfeld, Christian

    2017-10-01

    We introduce both rigorous and non-rigorous distance-dependent integral estimates for four-center two-electron integrals derived from a distance-including Schwarz-type inequality. The estimates are even easier to implement than our so far most efficient distance-dependent estimates [S. A. Maurer et al., J. Chem. Phys. 136, 144107 (2012)] and, in addition, do not require well-separated charge-distributions. They are also applicable to a wide range of two-electron operators such as those found in explicitly correlated theories and in short-range hybrid density functionals. For two such operators with exponential distance decay [e-r12 and erfc (0.11 ṡr12 ) /r12], the rigorous bound is shown to be much tighter than the standard Schwarz estimate with virtually no error penalty. The non-rigorous estimate gives results very close to an exact screening for these operators and for the long-range 1/r12 operator, with errors that are completely controllable through the integral screening threshold. In addition, we present an alternative form of our non-rigorous bound that is particularly well-suited for improving the PreLinK method [J. Kussmann and C. Ochsenfeld, J. Chem. Phys. 138, 134114 (2013)] in the context of short-range exchange calculations.

  14. Sustained improvement in clinical preventive service delivery among independent primary care practices after implementing electronic health record systems.

    Science.gov (United States)

    Wang, Jason J; Sebek, Kimberly M; McCullough, Colleen M; Amirfar, Sam J; Parsons, Amanda S; Singer, Jesse; Shih, Sarah C

    2013-08-01

    Studies showing sustained improvements in the delivery of clinical preventive services are limited. Fewer studies demonstrate sustained improvements among independent practices that are not affiliated with hospitals or integrated health systems. This study examines the continued improvement in clinical quality measures for a group of independent primary care practices using electronic health records (EHRs) and receiving technical support from a local public health agency. We analyzed clinical quality measure performance data from a cohort of primary care practices that implemented an EHR at least 3 months before October 2009, the study baseline. We assessed trends for 4 key quality measures: antithrombotic therapy, blood pressure control, smoking cessation intervention, and hemoglobin A1c (HbA1c) testing based on monthly summary data transmitted by the practices. Of the 151 practices, 140 were small practices and 11 were community health centers; average time using an EHR was 13.7 months at baseline. From October 2009 through October 2011, average rates increased for antithrombotic therapy (from 58.4% to 74.8%), blood pressure control (from 55.3% to 64.1%), HbA1c testing (from 46.4% to 57.7%), and smoking cessation intervention (from 29.3% to 46.2%). All improvements were significant. During 2 years, practices showed significant improvement in the delivery of several key clinical preventive services after implementing EHRs and receiving support services from a public health agency.

  15. Effect of endodontic irrigation with 1% sodium hypochlorite and 17% EDTA on primary teeth: a scanning electron microscope analysis.

    Science.gov (United States)

    Ximenes, Marcos; Triches, Thaisa C; Beltrame, Ana Paula C A; Hilgert, Leandro A; Cardoso, Mariane

    2013-01-01

    This study evaluated the efficacy of 2 final irrigation solutions for removal of the smear layer (SL) from root canals of primary teeth, using scanning electron microscope (SEM) analysis. Thirty primary molars were selected and a single operator instrumented the canals. The initial irrigation was done with a 1% sodium hypochlorite (NaOCl) solution. After the preparation, the roots were randomly divided into 3 groups for final irrigation: Group 1, 1% NaOCl (n = 10); Group 2, 17% EDTA + 1% NaOCl (n = 10); and Group 3, 17% EDTA + saline solution (n = 10). The roots were prepared for SEM analysis (magnification 1000X). The photomicrographs were independently analyzed by 2 investigators with SEM experience, attributing scores to each root third in terms of SL removal. Kruskal-Wallis and Mann-Whitney tests revealed that there was no statistical difference between the groups (P = 0.489). However, a statistical difference was found (P < 0.05) in a comparison of root thirds, with the apical third having the worst results. Comparing the thirds within the same group, all canals showed statistical differences between the cervical and apical thirds (P < 0.05). The authors determined that no substance or association of substances were able to completely remove SL.

  16. Medium-Range Order in Amorphous Silicon Measured by Fluctuation Electron Microscopy: Final Report, 23 June 1999--23 August 2002

    Energy Technology Data Exchange (ETDEWEB)

    Voyles, P. M.; Abelson, J. R.

    2003-10-01

    Despite occasional experimental hints, medium-range structural order in covalently bonded amorphous semiconductors had largely escaped detection until the advent of fluctuation electron microscopy (FEM) in 1996. Using FEM, we find that every sample of amorphous silicon and germanium we have investigated, regardless of deposition method or hydrogen content, is rich in medium-range order. The paracrystalline structural model, which consists of small, topologically ordered grains in an amorphous matrix, is consistent with the FEM data; but due to strain effects, materials with a paracrystalline structure appear to be amorphous in diffraction measurements. We present measurements on hydrogenated amorphous silicon deposited by different methods, some of which are reported to have greater stability against the Staebler-Wronski effect. FEM reveals that the matrix material of these samples is relatively similar, but the order changes in different ways upon both light soaking and thermal annealing. Some materials are inhomogeneous, with either nanocrystalline inclusions or large area-to-area variation in the medium-range order. We cite recent calculations that electronic states in the conduction band tail are preferentially located around the boundaries of the nm-scale paracrystalline regions that we have identified. This is new evidence in support of spatially inhomogeneous conduction mechanisms in a-Si. The key discovery in our work is that all samples of amorphous silicon must be described as having nm-scale topological crystalline order. This strongly modifies the long-standing model of a covalent random network. Our new understanding of medium-range order must be considered in all future models of electronic properties and the Staebler-Wronski effect.

  17. Ab initio electronic transport and thermoelectric properties of solids from full and range-separated hybrid functionals

    Science.gov (United States)

    Sansone, Giuseppe; Ferretti, Andrea; Maschio, Lorenzo

    2017-09-01

    Within the semiclassical Boltzmann transport theory in the constant relaxation-time approximation, we perform an ab initio study of the transport properties of selected systems, including crystalline solids and nanostructures. A local (Gaussian) basis set is adopted and exploited to analytically evaluate band velocities as well as to access full and range-separated hybrid functionals (such as B3LYP, PBE0, or HSE06) at a moderate computational cost. As a consequence of the analytical derivative, our approach is computationally efficient and does not suffer from problems related to band crossings. We investigate and compare the performance of a variety of hybrid functionals in evaluating Boltzmann conductivity. Demonstrative examples include silicon and aluminum bulk crystals as well as two thermoelectric materials (CoSb3, Bi2Te3). We observe that hybrid functionals other than providing more realistic bandgaps—as expected—lead to larger bandwidths and hence allow for a better estimate of transport properties, also in metallic systems. As a nanostructure prototype, we also investigate conductivity in boron-nitride (BN) substituted graphene, in which nanoribbons (nanoroads) alternate with BN ones.

  18. Semi empirical formula to calculate MSP of relativistic electrons in the range of 940 keV–1020 keV

    Directory of Open Access Journals (Sweden)

    S. Ramesh Babu

    2016-01-01

    Full Text Available A semi empirical formula has been obtained to calculate the Mass stopping power (MSP of relativistic electrons in the energy range of 950 keV–1050 keV, for any material of atomic number or Zeff ranging from 10–82. The MSP of 942 keV and 1016 keV internal conversion electrons of Bi207 are obtained by allowing them to pass through the targets of atomic numbers 13, 29, 47, 50, 79 and 82. The energies of the incident and transmitted electrons are measured using a Si(Li detector coupled to 8 K multi channel analyzer and the MSP has been determined from the measured incident and transmitted energies. The resultant variation of MSP with the atomic number of the material is plotted and best fitted to a first order exponential equation. The results predicted by this semi empirical formula are compared with the NIST-ESTAR database & Batra's formula and found to be in good agreement. Application of this formula to calculate the MSP and effective atomic number of any biological sample or compound is discussed.

  19. A closed-form formulation for the build-up factor and absorbed energy for photons and electrons in the Compton energy range in Cartesian geometry

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Volnei; Vilhena, Marco Tullio, E-mail: borges@ufrgs.b, E-mail: vilhena@pq.cnpq.b [Universidade Federal do Rio Grande do Sul (PROMEC/UFRGS), Porto Alegre, RS (Brazil). Programa de Pos-Graduacao em Engenharia Mecanica; Fernandes, Julio Cesar Lombaldo, E-mail: julio.lombaldo@ufrgs.b [Universidade Federal do Rio Grande do Sul (DMPA/UFRGS), Porto Alegre, RS (Brazil). Dept. de Matematica Pura e Aplicada. Programa de Pos Graduacao em Matematica Aplicada

    2011-07-01

    In this work, we report on a closed-form formulation for the build-up factor and absorbed energy, in one and two dimensional Cartesian geometry for photons and electrons, in the Compton energy range. For the one-dimensional case we use the LTS{sub N} method, assuming the Klein-Nishina scattering kernel for the determination of the angular radiation intensity for photons. We apply the two-dimensional LTS{sub N} nodal solution for the averaged angular radiation evaluation for the two-dimensional case, using the Klein-Nishina kernel for photons and the Compton kernel for electrons. From the angular radiation intensity we construct a closed-form solution for the build-up factor and evaluate the absorbed energy. We present numerical simulations and comparisons against results from the literature. (author)

  20. Development of a low-energy x-ray camera for the imaging of secondary electron bremsstrahlung x-ray emitted during proton irradiation for range estimation

    Science.gov (United States)

    Ando, Koki; Yamaguchi, Mitsutaka; Yamamoto, Seiichi; Toshito, Toshiyuki; Kawachi, Naoki

    2017-06-01

    Imaging of secondary electron bremsstrahlung x-ray emitted during proton irradiation is a possible method for measurement of the proton beam distribution in phantom. However, it is not clear that the method is used for range estimation of protons. For this purpose, we developed a low-energy x-ray camera and conducted imaging of the bremsstrahlung x-ray produced during irradiation of proton beams. We used a 20 mm  ×  20 mm  ×  1 mm finely grooved GAGG scintillator that was optically coupled to a one-inch square high quantum efficiency (HQE)-type position-sensitive photomultiplier tube to form an imaging detector. The imaging detector was encased in a 2 cm-thick tungsten container, and a pinhole collimator was attached to its camera head. After performance of the camera was evaluated, secondary electron bremsstrahlung x-ray imaging was conducted during irradiation of the proton beams for three different proton energies, and the results were compared with Monte Carlo simulation as well as calculated value. The system spatial resolution and sensitivity of the developed x-ray camera with 1.5 mm-diameter pinhole collimator were estimated to be 32 mm FWHM and 5.2  ×  10-7 for ~35 keV x-ray photons at 100 cm from the collimator surface, respectively. We could image the proton beam tracks by measuring the secondary electron bremsstrahlung x-ray during irradiation of the proton beams, and the ranges for different proton energies could be estimated from the images. The measured ranges from the images were well matched with the Monte Carlo simulation, and slightly smaller than the calculated values. We confirmed that the imaging of the secondary electron bremsstrahlung x-ray emitted during proton irradiation with the developed x-ray camera has the potential to be a new tool for proton range estimations.

  1. Long-range protein electron transfer observed at the single-molecule level: In situ mapping of redox-gated tunneling resonance

    DEFF Research Database (Denmark)

    Chi, Qijin; Farver, O; Ulstrup, Jens

    2005-01-01

    on the redox potential. Maximum resonance appears around the equilibrium redox potential of azurin with an on/off current ratio of approximate to 9. Simulation analyses, based on a two-step interfacial ET model for the scanning tunneling microscopy redox process, were performed and provide quantitative......A biomimetic long-range electron transfer (ET) system consisting of the blue copper protein azurin, a tunneling barrier bridge, and a gold single-crystal electrode was designed on the basis of molecular wiring self-assembly principles. This system is sufficiently stable and sensitive in a quasi...

  2. Patterns of routine primary care for osteoarthritis in the UK: a cross-sectional electronic health records study.

    Science.gov (United States)

    Jackson, Holly; Barnett, Lauren A; Jordan, Kelvin P; Dziedzic, Krysia S; Cottrell, Elizabeth; Finney, Andrew G; Paskins, Zoe; Edwards, John J

    2017-12-29

    To determine common patterns of recorded primary care for osteoarthritis (OA), and patient and provider characteristics associated with the quality of recorded care. An observational study nested within a cluster-randomised controlled trial. Eight UK general practices who were part of the Management of Osteoarthritis in Consultations study. Patients recorded as consulting within the eight general practices for clinical OA. Achievement of seven quality indicators of care (pain/function assessment, information provision, exercise/weight advice, analgesics, physiotherapy), recorded through an electronic template or routinely recorded in the electronic healthcare records, was identified for patients aged ≥45 years consulting over a 6-month period with clinical OA. Latent class analysis was used to cluster patients based on care received. Clusters were compared on patient and clinician-level characteristics. 1724 patients (median by practice 183) consulted with clinical OA. Common patterns of recorded quality care were: cluster 1 (38%, High ) received most quality indicators of care; cluster 2 (11%, Moderate ) had pain and function assessment, and received or were considered for other indicators; cluster 3 (17%, Low ) had pain and function assessment, and received or were considered for paracetamol or topical non-steroidal anti-inflammatory drugs; cluster 4 (35%, None ) had no recorded quality indicators. Patients with higher levels of recorded care consulted a clinician who saw more patients with OA, consulted multiple times and had less morbidity. Those in the High cluster were more likely to have recorded diagnosed OA and have knee/hip OA. Patterns of recorded care for OA fell into four natural clusters. Appropriate delivery of core interventions and relatively safe pharmacological options for OA are still not consistently recorded as provided in primary care. Further research to understand clinical recording behaviours and determine potential barriers to quality

  3. Analysis of enamel microbiopsies in shed primary teeth by Scanning Electron Microscopy (SEM) and Polarizing Microscopy (PM)

    Energy Technology Data Exchange (ETDEWEB)

    Costa de Almeida, Glauce Regina; Molina, Gabriela Ferian; Meschiari, Cesar Arruda [Department of Morphology, Stomatology and Physiology, Dental School of Ribeirao Preto, University of Sao Paulo - FORP/USP, Av. do Cafe, S/N, Monte Alegre, CEP 14040-904, Ribeirao Preto, SP (Brazil); Barbosa de Sousa, Frederico [Department of Morphology, Dental School of Joao Pessoa, Federal University of Paraiba - UFPB, Av Castelo Branco - Campus I, CEP 58.059-900, Joao Pessoa, PB (Brazil); Gerlach, Raquel Fernanda, E-mail: rfgerlach@forp.usp.br [Department of Morphology, Stomatology and Physiology, Dental School of Ribeirao Preto, University of Sao Paulo - FORP/USP, Av. do Cafe, S/N, Monte Alegre, CEP 14040-904, Ribeirao Preto, SP (Brazil)

    2009-09-01

    The aims of this study were 1) to verify how close to the theoretically presumed areas are the areas of enamel microbiopsies carried out in vivo or in exfoliated teeth; 2) to test whether the etching solution penetrates beyond the tape borders; 3) to test whether the etching solution demineralizes the enamel in depth. 24 shed upper primary central incisors were randomly divided into two groups: the Rehydrated Teeth Group and the Dry Teeth Group. An enamel microbiopsy was performed, and the enamel microbiopsies were then analyzed by Scanning Electron Microscopy (SEM) and Polarizing Microscopy (PM). Quantitative birefringence measurements were performed. The 'true' etched area was determined by measuring the etched enamel using the NIH Image analysis program. Enamel birefringence was compared using the paired t test. There was a statistically significant difference when the etched areas in the Rehydrated teeth were compared with those of the Dry teeth (p = 0.04). The etched areas varied from - 11.6% to 73.5% of the presumed area in the Rehydrated teeth, and from 6.6% to 61.3% in the Dry teeth. The mean percentage of variation in each group could be used as a correction factor for the etched area. Analysis of PM pictures shows no evidence of in-depth enamel demineralization by the etching solution. No statistically significant differences in enamel birefringence were observed between values underneath and outside the microbiopsy area in the same tooth, showing that no mineral loss occurred below the enamel superficial layer. Our data showed no evidence of in-depth enamel demineralization by the etching solution used in the enamel microbiopsy proposed for primary enamel. This study also showed a variation in the measured diameter of the enamel microbiopsy in nineteen teeth out of twenty four, indicating that in most cases the etching solution penetrated beyond the tape borders.

  4. Soft x-ray free-electron laser imaging by LiF crystal and film detectors over a wide range of fluences.

    Science.gov (United States)

    Pikuz, Tatiana A; Faenov, Anatoly Ya; Fukuda, Yuji; Kando, Masaki; Bolton, Paul; Mitrofanov, Alexander; Vinogradov, Alexander V; Nagasono, Mitsuru; Ohashi, Haruhiko; Yabashi, Makina; Tono, Kensuke; Senba, Yasunori; Togashi, Tadashi; Ishikawa, Tetsuya

    2013-01-20

    LiF crystal and film detectors were used to measure the far-field fluence profile of a self-amplified spontaneous-emission free-electron laser beam and diffraction imaging with high spatial resolution. In these measurements the photoluminescence (PL) response of LiF crystal and film was compared over a wide range of soft x-ray fluences. It was found that the soft x-ray fluence dependences of LiF crystal and film differ. At low fluence, the LiF crystal shows higher PL response compared to LiF film, while this comparison is the opposite at higher fluence. Accurate measurement of LiF crystal and film PL response is important for precise characterization of the spatial, spectral, and coherence features of x-ray beams across the full profile and in localized areas. For such measurements, crucial LiF detector attributes are high spatial resolution and high dynamic range.

  5. Effective atomic numbers and electron densities of bacteriorhodopsin and its comprising amino acids in the energy range 1 keV–100 GeV

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadi, Morteza; Lunscher, Nolan [Waterloo Institute for Nanotechnology and Department of Systems Design Engineering, University of Waterloo, 200 University Ave., W., Waterloo, Ontario, Canada N2L 3G1 (Canada); Yeow, John T.W., E-mail: jyeow@uwaterloo.ca [Waterloo Institute for Nanotechnology and Department of Systems Design Engineering, University of Waterloo, 200 University Ave., W., Waterloo, Ontario, Canada N2L 3G1 (Canada)

    2013-04-01

    Recently, there has been an interest in fabrication of X-ray sensors based on bacteriorhodopsin, a proton pump protein in cell membrane of Halobacterium salinarium. Therefore, a better understanding of interaction of X-ray photons with bacteriorhodopsin is required. We use WinXCom program to calculate the mass attenuation coefficient of bacteriorhodopsin and its comprising amino acids for photon energies from 1 keV to 100 GeV. These amino acids include alanine, arginine, asparagine, aspartic acid, glutamine, glutamic acid, glycine, isoleucine, leucine, lysine, methionine, phenylalanine, proline, serine, threonine, tryptophan, tyrosine, valine, Asx1, Asx2, Glx1 and Glx2. We then use that data to calculate effective atomic number and electron densities for the same range of energy. We also emphasize on two ranges of energies (10–200 keV and 1–20 MeV) in which X-ray imaging and radiotherapy machines work.

  6. New analytical model for the ozone electronic ground state potential surface and accurate ab initio vibrational predictions at high energy range.

    Science.gov (United States)

    Tyuterev, Vladimir G; Kochanov, Roman V; Tashkun, Sergey A; Holka, Filip; Szalay, Péter G

    2013-10-07

    An accurate description of the complicated shape of the potential energy surface (PES) and that of the highly excited vibration states is of crucial importance for various unsolved issues in the spectroscopy and dynamics of ozone and remains a challenge for the theory. In this work a new analytical representation is proposed for the PES of the ground electronic state of the ozone molecule in the range covering the main potential well and the transition state towards the dissociation. This model accounts for particular features specific to the ozone PES for large variations of nuclear displacements along the minimum energy path. The impact of the shape of the PES near the transition state (existence of the "reef structure") on vibration energy levels was studied for the first time. The major purpose of this work was to provide accurate theoretical predictions for ozone vibrational band centres at the energy range near the dissociation threshold, which would be helpful for understanding the very complicated high-resolution spectra and its analyses currently in progress. Extended ab initio electronic structure calculations were carried out enabling the determination of the parameters of a minimum energy path PES model resulting in a new set of theoretical vibrational levels of ozone. A comparison with recent high-resolution spectroscopic data on the vibrational levels gives the root-mean-square deviations below 1 cm(-1) for ozone band centres up to 90% of the dissociation energy. New ab initio vibrational predictions represent a significant improvement with respect to all previously available calculations.

  7. Rural primary care practices and meaningful use of electronic health records: the role of Regional Extension Centers.

    Science.gov (United States)

    Casey, Michelle M; Moscovice, Ira; McCullough, Jeffrey

    2014-01-01

    To examine the role of Regional Extension Centers (RECs) in helping rural physician practices adopt electronic health records (EHRs) and achieve meaningful use. Using data from the Office of the National Coordinator for Health Information Technology, we conducted a county-level regression analysis using ordinary least squares to better understand rural-urban differences in REC participation, EHR implementation, and meaningful use, controlling for counties' economic conditions. We prepared case studies of 2 RECs that are serving a large number of rural practices, based on interviews with key individuals at the RECs, their partner organizations, and rural primary care practices that received assistance from the RECs. RECs are largely achieving their objective of targeting providers in communities that face barriers to EHRs. REC participants are disproportionately rural and more likely to come from high poverty and low employment communities. The case study RECs had long-standing relationships with rural providers, as well as extensive staff expertise in quality improvement and EHR implementation, and employed a variety of strategies to successfully assist rural providers. Rural providers report that REC assistance was invaluable in helping them implement EHRs and achieve meaningful use status. Modifying the criteria for Medicare and Medicaid EHR incentives could help additional rural providers pay for EHRs. REC federal funding is scheduled to end in 2014, but practices that have not yet adopted EHRs may need significant, ongoing assistance to receive meaningful use. © 2013 National Rural Health Association.

  8. Analysis of the attributes of primary health care using the electronic medical records in the city of Rio de Janeiro.

    Science.gov (United States)

    Soranz, Daniel; Pinto, Luiz Felipe; Camacho, Luiz Antonio Bastos

    2017-03-01

    Epidemiology plays a strategic role at this stage of the policy cycle, contributing to goal setting, resource allocation and use of information systems. In 2009, the Municipal Health Secretariat of Rio de Janeiro initiated a reform of the health care model under the main influence the Primary Health Care concept. This study evaluates the trend of selected pay-for-performance indicators that measure the health care process in the city's PHC. This a study on repeated panels, from the administrative and clinical records of electronic medical records in the period from 2012 to 2016. We selected seven indicators that analyzed longitudinal performance within the established goal, among those that represent access, longitudinality, coordination of care - APS attributes, as well as other characteristics of the services, such as care performance and economic efficiency. This study demonstrated that management decentralization to levels closer to the user is potentially successful for the recording of clinical data under an adequate monitoring of indicators, regular clinical audits and feedback to health professionals, along with data and indicators monitoring.

  9. A hollow cathode ion source for production of primary ions for the BNL electron beam ion source

    Energy Technology Data Exchange (ETDEWEB)

    Alessi, James, E-mail: alessi@bnl.gov; Beebe, Edward; Carlson, Charles; McCafferty, Daniel; Pikin, Alexander; Ritter, John [Collider-Accelerator Department, Brookhaven National Laboratory, Upton, New York 11973 (United States)

    2014-02-15

    A hollow cathode ion source, based on one developed at Saclay, has been modified significantly and used for several years to produce all primary 1+ ions injected into the Relativistic Heavy Ion Collider Electron Beam Ion Source (EBIS) at Brookhaven. Currents of tens to hundreds of microamperes have been produced for 1+ ions of He, C, O, Ne, Si, Ar, Ti, Fe, Cu, Kr, Xe, Ta, Au, and U. The source is very simple, relying on a glow discharge using a noble gas, between anode and a solid cathode containing the desired species. Ions of both the working gas and ionized sputtered cathode material are extracted, and then the desired species is selected using an ExB filter before being transported into the EBIS trap for charge breeding. The source operates pulsed with long life and excellent stability for most species. Reliable ignition of the discharge at low gas pressure is facilitated by the use of capacitive coupling from a simple toy plasma globe. The source design, and operating experience for the various species, is presented.

  10. DETECTION OF OH{sup +} IN TRANSLUCENT INTERSTELLAR CLOUDS: NEW ELECTRONIC TRANSITIONS AND PROBING THE PRIMARY COSMIC RAY IONIZATION RATE

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, D.; Linnartz, H. [Sackler Laboratory for Astrophysics, Leiden Observatory, University of Leiden, PO Box 9513, 2300 RA Leiden (Netherlands); Galazutdinov, G. A. [Instituto de Astronomia, Universidad Catolica del Norte, Av. Angamos 0610, Antofagasta (Chile); Krełowski, J., E-mail: zhao@strw.leidenuniv.nl [Center for Astronomy, Nicholas Copernicus University, Gagarina 11, Pl-87-100 Toruń (Poland)

    2015-06-01

    We present the detection of rotationally resolved electronic transitions in the OH{sup +} A{sup 3}Π–X{sup 3}Σ{sup −} (0, 0) and (1, 0) bands toward CD-32 4348, HD 63804, HD 78344, and HD 80077. These four translucent clouds have been studied in a recent Very Large Telescope/Ultraviolet and Visual Echelle Spectrograph observational run. In total, seven absorption features of OH{sup +} are detected, and six of them are identified here for the first time, providing a precise tool to trace OH{sup +} in translucent interstellar clouds. An improved set of line positions and oscillator strengths is compiled to support our data interpretation. A dedicated analysis of the observed features in individual targets yields an accurate determination of OH{sup +} column densities. The results are applied to estimate the primary cosmic ray ionization rate in the investigated translucent clouds, which yields a typical value of ∼1.0 × 10{sup −16} s{sup −1}. In addition, following this work, two of the new interstellar features recently reported by Bhatt and Cami, at ∼3572.65 and 3346.96 Å, can be identified as OH{sup +} absorption lines now.

  11. Primary proton and helium spectra at energy range from 50 TeV to 1015 eV observed with the new Tibet AS core detector array

    Directory of Open Access Journals (Sweden)

    Huang Jing

    2013-06-01

    Full Text Available A new EAS hybrid experiment has been designed by constructing a YAC (Yangbajing Air shower Core detector array inside the existing Tibet-III air shower array. The first step of YAC, called “YAC-I” has been successfully carried out in 2009–2010 together with Tibet-III air-shower array. YAC-II has also been operated from 2011. Preliminary results of YAC-I and performance of YAC-II are presented in this paper. The primary proton and helium spectra at energy range from50 TeV to 1015 eV derived from YAC-I data based on QGSJET2 and SIBYLL2.1 are reported. The obtained P+He spectrum is smoothly connected with directobservation data below 100 TeV and also with our previously reported results at higher energies within statistical error s. Based on these results and the sharp kneeof all-particle energy spectrum observed by our experiment, the possible origin of the sharp knee is discussed. See the published papers.

  12. Primary ciliary dyskinesia in the paediatric population: range and severity of radiological findings in a cohort of patients receiving tertiary care

    Energy Technology Data Exchange (ETDEWEB)

    Jain, K. [Department of Radiology, Royal Brompton and Harefield NHS Trust, London (United Kingdom); Padley, S.P.G. [Department of Radiology, Royal Brompton and Harefield NHS Trust, London (United Kingdom)], E-mail: s.padley@ic.ac.uk; Goldstraw, E.J.; Kidd, S.J. [Department of Radiology, Royal Brompton and Harefield NHS Trust, London (United Kingdom); Hogg, C.; Biggart, E.; Bush, A. [Department of Paediatric Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London (United Kingdom)

    2007-10-15

    Aim: To investigate the clinical range and severity of radiological findings in a cohort of patients with primary ciliary dyskinesia (PCD) receiving tertiary care. Materials and methods: The case notes and clinical test results of 89 children attending the paediatric respiratory disease clinic at our institution were retrospectively analysed. Demographic details including age at diagnosis and common presenting signs and symptoms were studied. Results of chest radiographs, microscopy, and high-resolution computed tomography (HRCT) for quantification of lung damage were analysed. Results: In a cohort of 89 children with PCD, a presentation chest radiograph was available in 62% of patients (n = 55), with all but one demonstrating changes of bronchial wall thickening. HRCT of the lungs, available in 26 patients, were scored using the system described by Brody et al. analysing five specific features of lung disease, including bronchiectasis, mucus plugging, peribronchial thickening, parenchymal changes of consolidation, and ground-glass density, and focal air-trapping in each lobe. Peribronchial thickening was observed using HRCT in 25 patients, while 20 patients had bronchiectasis. Severity scores were highest for the middle and the lingular lobes. Conclusion: The radiographic findings of the largest reported cohort of patients with PCD are presented, with associated clinical findings. Dextrocardia remains the commonest finding on chest radiography. HRCT demonstrates peribronchial thickening and bronchiectasis, which is most marked in the lower zones. Radiological scoring techniques developed for assessment of cystic fibrosis can also be applied for the assessment of disease severity in this patient population.

  13. Harmonized patient-reported data elements in the electronic health record: supporting meaningful use by primary care action on health behaviors and key psychosocial factors

    Science.gov (United States)

    Boyle, Maureen; Emmons, Karen M; Glasgow, Russell E; Hesse, Bradford W; Kaplan, Robert M; Krist, Alexander H; Moser, Richard P; Taylor, Martina V

    2012-01-01

    Background Electronic health records (EHR) have the potential to improve patient care through efficient access to complete patient health information. This potential may not be reached because many of the most important determinants of health outcome are rarely included. Successful health promotion and disease prevention requires patient-reported data reflecting health behaviors and psychosocial issues. Furthermore, there is a need to harmonize this information across different EHR systems. Methods To fill this gap a three-phased process was used to conceptualize, identify and recommend patient-reported data elements on health behaviors and psychosocial factors for the EHR. Expert panels (n=13) identified candidate measures (phase 1) that were reviewed and rated by a wide range of health professionals (n=93) using the grid-enabled measures wiki social media platform (phase 2). Recommendations were finalized through a town hall meeting with key stakeholders including patients, providers, researchers, policy makers, and representatives from healthcare settings (phase 3). Results Nine key elements from three areas emerged as the initial critical patient-reported elements to incorporate systematically into EHR—health behaviors (eg, exercise), psychosocial issues (eg, distress), and patient-centered factors (eg, demographics). Recommendations were also made regarding the frequency of collection ranging from a single assessment (eg, demographic characteristics), to annual assessment (eg, health behaviors), or more frequent (eg, patient goals). Conclusions There was strong stakeholder support for this initiative reflecting the perceived value of incorporating patient-reported elements into EHR. The next steps will include testing the feasibility of incorporating these elements into the EHR across diverse primary care settings. PMID:22511015

  14. Impact of an electronic health record alert in primary care on increasing hepatitis c screening and curative treatment for baby boomers.

    Science.gov (United States)

    Konerman, Monica A; Thomson, Mary; Gray, Kristen; Moore, Meghan; Choxi, Hetal; Seif, Elizabeth; Lok, Anna S F

    2017-12-01

    Despite effective treatment for chronic hepatitis C, deficiencies in diagnosis and access to care preclude disease elimination. Screening of baby boomers remains low. The aims of this study were to assess the impact of an electronic health record-based prompt on hepatitis C virus (HCV) screening rates in baby boomers in primary care and access to specialty care and treatment among those newly diagnosed. We implemented an electronic health record-based "best practice advisory" (BPA) that prompted primary care providers to perform HCV screening for patients seen in primary care clinic (1) born between 1945 and 1965, (2) who lacked a prior diagnosis of HCV infection, and (3) who lacked prior documented anti-HCV testing. The BPA had associated educational materials, order set, and streamlined access to specialty care for newly diagnosed patients. Pre-BPA and post-BPA screening rates were compared, and care of newly diagnosed patients was analyzed. In the 3 years prior to BPA implementation, 52,660 baby boomers were seen in primary care clinics and 28% were screened. HCV screening increased from 7.6% for patients with a primary care provider visit in the 6 months prior to BPA to 72% over the 1 year post-BPA. Of 53 newly diagnosed patients, all were referred for specialty care, 11 had advanced fibrosis or cirrhosis, 20 started treatment, and 9 achieved sustained virologic response thus far. Implementation of an electronic health record-based prompt increased HCV screening rates among baby boomers in primary care by 5-fold due to efficiency in determining needs for HCV screening and workflow design. Streamlined access to specialty care enabled patients with previously undiagnosed advanced disease to be cured. This intervention can be easily integrated into electronic health record systems to increase HCV diagnosis and linkage to care. (Hepatology 2017;66:1805-1813). © 2017 by the American Association for the Study of Liver Diseases.

  15. Cluster randomized trials utilizing primary care electronic health records : methodological issues in design, conduct, and analysis (eCRT Study)

    NARCIS (Netherlands)

    Gulliford, Martin C; van Staa, Tjeerd P; McDermott, Lisa; McCann, Gerard; Charlton, Judith; Dregan, Alex

    2014-01-01

    BACKGROUND: There is growing interest in conducting clinical and cluster randomized trials through electronic health records. This paper reports on the methodological issues identified during the implementation of two cluster randomized trials using the electronic health records of the Clinical

  16. InsuOnline, an Electronic Game for Medical Education on Insulin Therapy: A Randomized Controlled Trial With Primary Care Physicians.

    Science.gov (United States)

    Diehl, Leandro Arthur; Souza, Rodrigo Martins; Gordan, Pedro Alejandro; Esteves, Roberto Zonato; Coelho, Izabel Cristina Meister

    2017-03-09

    Most patients with diabetes mellitus (DM) are followed by primary care physicians, who often lack knowledge or confidence to prescribe insulin properly. This contributes to clinical inertia and poor glycemic control. Effectiveness of traditional continuing medical education (CME) to solve that is limited, so new approaches are required. Electronic games are a good option, as they can be very effective and easily disseminated. The objective of our study was to assess applicability, user acceptance, and educational effectiveness of InsuOnline, an electronic serious game for medical education on insulin therapy for DM, compared with a traditional CME activity. Primary care physicians (PCPs) from South of Brazil were invited by phone or email to participate in an unblinded randomized controlled trial and randomly allocated to play the game InsuOnline, installed as an app in their own computers, at the time of their choice, with minimal or no external guidance, or to participate in a traditional CME session, composed by onsite lectures and cases discussion. Both interventions had the same content and duration (~4 h). Applicability was assessed by the number of subjects who completed the assigned intervention in each group. Insulin-prescribing competence (factual knowledge, problem-solving skills, and attitudes) was self-assessed through a questionnaire applied before, immediately after, and 3 months after the interventions. Acceptance of the intervention (satisfaction and perceived importance for clinical practice) was also assessed immediately after and 3 months after the interventions, respectively. Subjects' characteristics were similar between groups (mean age 38, 51.4% [69/134] male). In the game group, 69 of 88 (78%) completed the intervention, compared with 65 of 73 (89%) in the control group, with no difference in applicability. Percentage of right answers in the competence subscale, which was 52% at the baseline in both groups, significantly improved

  17. Patients’ online access to their electronic health records and linked online services: a systematic review in primary care

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-01-01

    Background Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. Aim To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. Design and setting A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Method Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King’s Fund, Nuffield Health, PsycINFO, OpenGrey (1999–2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. Results A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. Conclusion While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of

  18. Patients' online access to their electronic health records and linked online services: a systematic review in primary care.

    Science.gov (United States)

    Mold, Freda; de Lusignan, Simon; Sheikh, Aziz; Majeed, Azeem; Wyatt, Jeremy C; Quinn, Tom; Cavill, Mary; Franco, Christina; Chauhan, Umesh; Blakey, Hannah; Kataria, Neha; Arvanitis, Theodoros N; Ellis, Beverley

    2015-03-01

    Online access to medical records by patients can potentially enhance provision of patient-centred care and improve satisfaction. However, online access and services may also prove to be an additional burden for the healthcare provider. To assess the impact of providing patients with access to their general practice electronic health records (EHR) and other EHR-linked online services on the provision, quality, and safety of health care. A systematic review was conducted that focused on all studies about online record access and transactional services in primary care. Data sources included MEDLINE, Embase, CINAHL, Cochrane Library, EPOC, DARE, King's Fund, Nuffield Health, PsycINFO, OpenGrey (1999-2012). The literature was independently screened against detailed inclusion and exclusion criteria; independent dual data extraction was conducted, the risk of bias (RoB) assessed, and a narrative synthesis of the evidence conducted. A total of 176 studies were identified, 17 of which were randomised controlled trials, cohort, or cluster studies. Patients reported improved satisfaction with online access and services compared with standard provision, improved self-care, and better communication and engagement with clinicians. Safety improvements were patient-led through identifying medication errors and facilitating more use of preventive services. Provision of online record access and services resulted in a moderate increase of e-mail, no change on telephone contact, but there were variable effects on face-to-face contact. However, other tasks were necessary to sustain these services, which impacted on clinician time. There were no reports of harm or breaches in privacy. While the RoB scores suggest many of the studies were of low quality, patients using online services reported increased convenience and satisfaction. These services positively impacted on patient safety, although there were variations of record access and use by specific ethnic and socioeconomic groups

  19. Frequency-resolved optical gating system with a tellurium crystal for characterizing free-electron lasers in the wavelength range of 10-30 microm.

    Science.gov (United States)

    Iijima, Hokuto; Nagai, Ryoji; Nishimori, Nobuyuki; Hajima, Ryoichi; Minehara, Eisuke J

    2009-12-01

    A second-harmonic generation frequency-resolved optical gating (SHG-FROG) system has been developed for the complete characterization of laser pulses in the wavelength range of 10-30 microm. A tellurium crystal is used so that spectrally resolved autocorrelation signals with a good signal-to-noise ratio are obtained. Pulses (wavelength approximately 22 microm) generated from a free-electron laser are measured by the SHG-FROG system. The SHG intensity profile and the spectrum obtained by FROG measurements are well consistent with those of independent measurements of the pulse length and spectrum. The pulse duration and spectral width determined from the FROG trace are 0.6 ps and 5.2 THz at full width half maximum, respectively.

  20. A Clinical Comparison of Accuracy of an Electronic Apex Locator (EAL and Radiography in the Determination of Working Length in Primary Molars

    Directory of Open Access Journals (Sweden)

    M Soruri

    2013-08-01

    Full Text Available Introduction: Radiography is the most common method for measurement of working length, though it is not the ideal method because of technical problems, radiation hazard, superimposition of permanent teeth bud on primary teeth, and so on. Electronic Apex Locator (EAL is a device for determination of working length. Therefore, this study aimed to compare the accuracy of an electronic apex locator and radiography for determining working length of primary necrotic molars. Methods: sixty canals of twenty necrotic mandibular primary molars were used in children with 5-7 years old. There were no calcified canal, previous root canal therapy and perforation of pulp chamber floor. Access cavity was prepared and working length was determined by means of NSK EAL and conventional radiography and then was compared. Moreover, Pulpectomy was completed. Data were analyzed by Paired Samples T test. Results: In 56(93.3% of the canals, the length measured by NSK EAL was determined to be equal to the length measured by radiography. In 3 canals(5%, NSK measurements were found to be less than radiography measurements for 1mm and in 1 canal (1.7%, it was greater than radiography measurements for 1mm. T test analysis indicated no significant difference between the two measurement methods (p=0.85. Conclusions: Electronic apex locator can accurately assess the length of canals in primary molars.

  1. A study of gunshot residue distribution for close-range shots with a silenced gun using optical and scanning electron microscopy, X-ray microanalysis and infrared spectroscopy.

    Science.gov (United States)

    Brożek-Mucha, Zuzanna

    2017-03-01

    Detailed physical and chemical analysis of gunshot residue deposited in the nearest vicinity of a submachine gun alone and with a sound suppressor was performed. The studies were inspired by recent shooting cases with the use of a firearm with a silencer and the need to estimate the shooting distance to human body naked and covered with clothing. A series of experiments were performed in the shooting range using a machine pistol and the appropriate ammunition cal. 7.65mm Browning. Targets were placed in the range of 0-30cm from the gun and covered either with white cotton fabric or a porcine skin that mocked people's clothing and the naked skin. Both the organic and inorganic residue were examined by means of optical microscopy, infrared spectrometry as well as scanning electron microscopy and energy dispersive X-ray spectrometry. The influence of factors, such as sound suppressor, shooting distance and the substrate type on the mechanism of particles spread and their availability for research was established and discussed. Copyright © 2016 The Chartered Society of Forensic Sciences. Published by Elsevier B.V. All rights reserved.

  2. Electronic sideband locking of 318.6nm UV laser to an ultrastable optical cavity with a wide continuously tunable range

    CERN Document Server

    Bai, Jiandong; He, Jun; Wang, Junmin

    2016-01-01

    We have demonstrated a frequency-stabilized tunable 318.6 nm ultraviolet (UV) laser system for the single-photon 6S1/2 - nP (n = 70 ~ 100) Rydberg excitation of cesium atoms. The 637.2 nm laser produced by single-pass sum frequency generation from two infrared fiber lasers is offset locked to a high-finesse ultra-low expansion (ULE) optical cavity placed in ultra-high vacuum using the electronic sideband locking technique. The generated 318.6 nm UV laser via cavity-enhanced second-harmonic generation can be continuously tuned over 4 GHz by indirectly changing modulation frequency on the electro-optic phase modulator while the whole laser system remains locked. We analyze the tuning range mainly depends on the modulator bandwidth and the tunable range of the seed laser. The locking scheme offers a method to compensate the frequency difference between the reference frequency and the goal frequency to a desired excited state, and has huge potential in precision spectroscopic experiments of cold atoms.

  3. Adopting electronic medical records in primary care: lessons learned from health information systems implementation experience in seven countries.

    Science.gov (United States)

    Ludwick, D A; Doucette, John

    2009-01-01

    The adoption of health information systems is seen world wide as one method to mitigate the widening health care demand and supply gap. The purpose of this review was to identify the current state of knowledge about health information systems adoption in primary care. The goal was to understand factors and influencers affecting implementation outcomes from previous health information systems implementations experiences. A comprehensive systematic literature review of peer reviewed and grey literature was undertaken to identify the current state of knowledge regarding the implementation of health information systems. A total of 6 databases, 27 journal websites, 20 websites from grey sources, 9 websites from medical colleges and professional associations as well as 22 government/commission websites were searched. The searches returned almost 3700 article titles. Eighty-six articles met our inclusion and exclusion criteria. Articles show that systems' graphical user interface design quality, feature functionality, project management, procurement and users' previous experience affect implementation outcomes. Implementers had concerns about factors such as privacy, patient safety, provider/patient relations, staff anxiety, time factors, quality of care, finances, efficiency, and liability. The review showed that implementers can insulate the project from such concerns by establishing strong leadership, using project management techniques, establishing standards and training their staff to ensure such risks do not compromise implementation success. The review revealed the concept of socio-technical factors, or "fit" factors, that complicate health information systems deployment. The socio-technical perspective considers how the technical features of a health information system interact with the social features of a health care work environment. The review showed that quality of care, patient safety and provider/patient relations were not, positively or negatively

  4. Electron Transport in a Dioxygenase-Ferredoxin Complex: Long Range Charge Coupling between the Rieske and Non-Heme Iron Center.

    Directory of Open Access Journals (Sweden)

    Wayne K Dawson

    Full Text Available Dioxygenase (dOx utilizes stereospecific oxidation on aromatic molecules; consequently, dOx has potential applications in bioremediation and stereospecific oxidation synthesis. The reactive components of dOx comprise a Rieske structure Cys2[2Fe-2S]His2 and a non-heme reactive oxygen center (ROC. Between the Rieske structure and the ROC, a universally conserved Asp residue appears to bridge the two structures forming a Rieske-Asp-ROC triad, where the Asp is known to be essential for electron transfer processes. The Rieske and ROC share hydrogen bonds with Asp through their His ligands; suggesting an ideal network for electron transfer via the carboxyl side chain of Asp. Associated with the dOx is an itinerant charge carrying protein Ferredoxin (Fdx. Depending on the specific cognate, Fdx may also possess either the Rieske structure or a related structure known as 4-Cys-[2Fe-2S] (4-Cys. In this study, we extensively explore, at different levels of theory, the behavior of the individual components (Rieske and ROC and their interaction together via the Asp using a variety of density function methods, basis sets, and a method known as Generalized Ionic Fragment Approach (GIFA that permits setting up spin configurations manually. We also report results on the 4-Cys structure for comparison. The individual optimized structures are compared with observed spectroscopic data from the Rieske, 4-Cys and ROC structures (where information is available. The separate pieces are then combined together into a large Rieske-Asp-ROC (donor/bridge/acceptor complex to estimate the overall coupling between individual components, based on changes to the partial charges. The results suggest that the partial charges are significantly altered when Asp bridges the Rieske and the ROC; hence, long range coupling through hydrogen bonding effects via the intercalated Asp bridge can drastically affect the partial charge distributions compared to the individual isolated

  5. Electron-Impact Ionization Cross Sections of H, He, N, O, Ar, Xe, Au, Pb Atoms and Their Ions in the Electron Energy Range from the Threshold up to 200 keV

    CERN Document Server

    Povyshev, V M; Shevelko, V P; Shirkov, G D; Vasina, E G; Vatulin, V V

    2001-01-01

    Single electron-impact ionization cross sections of H, He, N, O, Ar, Xe, Au, Pb atoms and their positive ions (i.e. all ionization stages) are presented in the electron energy range from the threshold up to 200 keV. The data-set for the cross sections has been created on the basis of available experimental data and calculations performed by the computer code ATOM. Consistent data for the ionization cross sections have been fitted by seven parameters using the LSM method. The accuracy of the calculated data presented is within a factor of 2 that in many cases is sufficient to solve the plasma kinetics problems. Contributions from excitation-autoionization and resonant-ionization processes as well as ionization of atoms and ions are not considered here. The results of the numerical calculations are compared with the well-known Lotz formulae for ionization of neutral atoms and positive ions. The material is illustrated by figures and includes tables of ionization cross sections, binding energies and fitting para...

  6. Cost of installing and operating an electronic clinical decision support system for maternal health care: case of Tanzania rural primary health centres.

    Science.gov (United States)

    Saronga, Happiness Pius; Dalaba, Maxwell Ayindenaba; Dong, Hengjin; Leshabari, Melkizedeck; Sauerborn, Rainer; Sukums, Felix; Blank, Antje; Kaltschmidt, Jens; Loukanova, Svetla

    2015-04-02

    Poor quality of care is among the causes of high maternal and newborn disease burden in Tanzania. Potential reason for poor quality of care is the existence of a "know-do gap" where by health workers do not perform to the best of their knowledge. An electronic clinical decision support system (CDSS) for maternal health care was piloted in six rural primary health centers of Tanzania to improve performance of health workers by facilitating adherence to World Health Organization (WHO) guidelines and ultimately improve quality of maternal health care. This study aimed at assessing the cost of installing and operating the system in the health centers. This retrospective study was conducted in Lindi, Tanzania. Costs incurred by the project were analyzed using Ingredients approach. These costs broadly included vehicle, computers, furniture, facility, CDSS software, transport, personnel, training, supplies and communication. These were grouped into installation and operation cost; recurrent and capital cost; and fixed and variable cost. We assessed the CDSS in terms of its financial and economic cost implications. We also conducted a sensitivity analysis on the estimations. Total financial cost of CDSS intervention amounted to 185,927.78 USD. 77% of these costs were incurred in the installation phase and included all the activities in preparation for the actual operation of the system for client care. Generally, training made the largest share of costs (33% of total cost and more than half of the recurrent cost) followed by CDSS software- 32% of total cost. There was a difference of 31.4% between the economic and financial costs. 92.5% of economic costs were fixed costs consisting of inputs whose costs do not vary with the volume of activity within a given range. Economic cost per CDSS contact was 52.7 USD but sensitive to discount rate, asset useful life and input cost variations. Our study presents financial and economic cost estimates of installing and operating an

  7. VUV photoionization of acetamide studied by electron/ion coincidence spectroscopy in the 8-24 eV photon energy range

    Energy Technology Data Exchange (ETDEWEB)

    Schwell, Martin, E-mail: Martin.Schwell@lisa.u-pec.fr [LISA UMR CNRS 7583, Universite Paris Est Creteil and Universite Paris Diderot, Institut Pierre Simon Laplace, 61 Avenue du General de Gaulle, 94010 Creteil (France); Benilan, Yves; Fray, Nicolas; Gazeau, Marie-Claire; Es-Sebbar, Et. [LISA UMR CNRS 7583, Universite Paris Est Creteil and Universite Paris Diderot, Institut Pierre Simon Laplace, 61 Avenue du General de Gaulle, 94010 Creteil (France); Garcia, Gustavo A.; Nahon, Laurent [Synchrotron SOLEIL, L' Orme des Merisiers, St. Aubin, B.P. 48, 91192 Gif-sur-Yvette Cedex (France); Champion, Norbert [LERMA UMR CNRS 8112, Observatoire de Paris-Meudon, 5 place Jules-Jansen, 92195 Meudon (France); Leach, Sydney, E-mail: Sydney.Leach@obspm.fr [LERMA UMR CNRS 8112, Observatoire de Paris-Meudon, 5 place Jules-Jansen, 92195 Meudon (France)

    2012-01-17

    Highlights: Black-Right-Pointing-Pointer We study the VUV photoionization of acetamide in the 8-24 eV photon energy range. Black-Right-Pointing-Pointer Electron/ion coincidence measurements are performed using synchrotron radiation. Black-Right-Pointing-Pointer The adiabatic ionization energy of acetamide is determined by TPEPICO measurements. Black-Right-Pointing-Pointer VUV induced fragmentation pathways of acetamide are assigned and discussed. - Abstract: A VUV photoionization study of acetamide was carried out over the 8-24 eV photon energy range using synchrotron radiation and photoelectron/photoion coincidence (PEPICO) spectroscopy. Threshold photoelectron photoion coincidence (TPEPICO) measurements were also made. Photoion yield curves and branching ratios were measured for the parent ion and six fragment ions. The adiabatic ionization energy of acetamide was determined as I.E. (1{sup 2}A Prime ) = (9.71 {+-} 0.02) eV, in agreement with an earlier reported photoionization mass spectrometry (PIMS) value. The adiabatic energy of the first excited state of the ion, 1{sup 2}A Double-Prime , was determined to be Almost-Equal-To 10.1 eV. Assignments of the fragment ions and the pathways of their formation by dissociative photoionization were made. The neutral species lost in the principal dissociative photoionization processes are CH{sub 3}, NH{sub 2}, NH{sub 3}, CO, HCCO and NH{sub 2}CO. Heats of formation are derived for all ions detected and are compared with literature values. Some astrophysical implications of these results are discussed.

  8. Electron spin resonance studies of Bi1-xScxFeO3 nanoparticulates: Observation of an enhanced spin canting over a large temperature range

    Science.gov (United States)

    Titus, S.; Balakumar, S.; Sakar, M.; Das, J.; Srinivasu, V. V.

    2017-12-01

    Bi1-xScxFeO3 (x = 0.0, 0.1, 0.15, 0.25) nano particles were synthesized by sol gel method. We then probed the spin system in these nano particles using electron spin resonance technique. Our ESR results strongly suggest the scenario of modified spin canted structures. Spin canting parameter Δg/g as a function of temperature for Scandium doped BFO is qualitatively different from undoped BFO. A broad peak is observed for all the Scandium doped BFO samples and an enhanced spin canting over a large temperature range (75-210 K) in the case of x = 0.15 doping. We also showed that the asymmetry parameter and thereby the magneto-crystalline anisotropy in these BSFO nanoparticles show peaks around 230 K for (x = 0.10 and 0.15) and beyond 300 K for x = 0.25 system. Thus, we established that the Sc doping significantly modifies the spin canting and magneto crystalline anisotropy in the BFO system.

  9. Calibration of the Modulation Transfer Function of Surface Profilometers with Binary Pseudorandom Test Standards: Expanding the Application Range to Fizeau Interferometers and Electron Microscopes

    Energy Technology Data Exchange (ETDEWEB)

    Yashchuk, V.V.; Takacs, P.; Anderson, E.H.; Barber, S.K.; Bouet, N.; Cambie, R.; Conley, R.; McKinney, W.R.; Voronov, D.L.

    2011-09-16

    A modulation transfer function (MTF) calibration method based on binary pseudorandom (BPR) gratings and arrays has been proven to be an effective MTF calibration method for interferometric microscopes and a scatterometer. Here we report on a further expansion of the application range of the method. We describe the MTF calibration of a 6 in. phase shifting Fizeau interferometer. Beyond providing a direct measurement of the interferometer's MTF, tests with a BPR array surface have revealed an asymmetry in the instrument's data processing algorithm that fundamentally limits its bandwidth. Moreover, the tests have illustrated the effects of the instrument's detrending and filtering procedures on power spectral density measurements. The details of the development of a BPR test sample suitable for calibration of scanning and transmission electron microscopes are also presented. Such a test sample is realized as a multilayer structure with the layer thicknesses of two materials corresponding to the BPR sequence. The investigations confirm the universal character of the method that makes it applicable to a large variety of metrology instrumentation with spatial wavelength bandwidths from a few nanometers to hundreds of millimeters.

  10. [Health Science Research with Primary Care Routine Data From Electronic Patient Records: the BeoNet Registry].

    Science.gov (United States)

    Lingner, Heidrun; Aumann, Ines; Wacker, Margarethe; Kreuter, Michael; Leidl, Reiner; von der Schulenburg, J-Matthias Graf; Welte, Tobias

    2017-07-11

    Reliable current information is needed for daily patient care and the health system, but comprehensive data, especially from primary care, are scarce and/or hard to access. The BeoNet Register-Database (BNR) aims to depict quality of medical care in Germany using routine data and with no additional documentation or costs for GPs. Registry design, data structure and database use will be demonstrated using chronic obstructive lung disease (COPD) as an example. The BNR is moving through pilot- and roll-out phases. Participating practices provide standardized information about (1) master data (2) practice profile (3) infrastructure and documentation systems. The routinely documented data will be pseudonymized before transmission via standardized secure interfaces to the registry database. Practices can participate in studies in cooperation with BNR if informed consent is obtained from the patients. The registry data will be linked with questionnaires on health care utilization, quality of life and disease-specific parameters. Researchers and physicians can access quasi anonymized data in specific datasets extracted from the registry. Regular automatic data quality checks and feedback from GPs, patients and researchers enhance the quality of the registry. Performance and data analysis are continuously optimized. The data security concept has been approved and ethical approval is on hand. GPs, pediatricians and pneumologists from Hanover, Munich and Heidelberg participated in the pilot phase. The registry database currently holds 98497 patient IDs and related information. BNR contains more than the standard billing data collected by health insurers. The data are applicable to a wide range of health practices, health care and economics and disease development questions. Questionnaires have been generated, tested and are being distributed. First descriptive analyses of prevalence, age and gender have been performed. Quality and validity checks have been implemented. 2016

  11. Exploring Electronic Medical Record and Self-Administered Medication Risk Screening Tools in a Primary Care Clinic.

    Science.gov (United States)

    Makowsky, Mark J; Cor, Ken; Wong, Tat

    2017-05-01

    Electronic medical record (EMR) screening for indicators of medication risk could improve efficiency in identifying primary care clinic patients in need of clinical pharmacist care compared with patient self-reporting. To (a) compare the performance of an EMR medication risk assessment questionnaire (MRAQ) with a self-administered (SA) MRAQ and (b) explore each tool's ability to predict indicators of health behavior, health status, and health care utilization. A prospective cohort study was conducted with 143 adults who attended an academic family medicine center and were taking ≥ 2 medications. All participants completed the 10-item SA-MRAQ, Morisky Medication Adherence Scale, Chew's health literacy screener, Stanford Health Distress Scale, and SF-36 overall rating of health. A blinded investigator completed the EMR-MRAQ and a chart review to ascertain 6 months of health care utilization. Outcome measures included the following: (a) scores from the 5- and 10-item SA-MRAQs and 5-item EMR-MRAQ; (b) sensitivity and specificity to determine the accuracy of the 5-item EMR versus the 5-item SA risk scores; (c) correlations between risk assessments and health behavior/status scales; and (d) area under the receiver operator curve to determine how well a high-risk score predicted health care utilization. The 5-item SA-MRAQ, the 5-item EMR-MRAQ, and the 10-item SA-MRAQ categorized 52.9% (55/104), 69.2% (99/143), and 17.6% (18/102) of participants as high risk, respectively. For the 104 participants who completed both 5-item MRAQ tools, the EMR-MRAQ had a sensitivity of 81.8% and specificity of 49.0% in detecting a high-risk SA-MRAQ score. Both 5-item risk assessments showed weak correlations with health distress and overall health, while the 10-item SA-MRAQ additionally showed weak correlations with medication adherence. The EMR-MRAQ was most effective in predicting all-cause emergency room visits/hospitalization (c-statistic = 0.69; 95% CI=0.57-0.81) and high clinic

  12. Cluster randomised trial in the General Practice Research Database: 1. Electronic decision support to reduce antibiotic prescribing in primary care (eCRT study

    Directory of Open Access Journals (Sweden)

    Charlton Judith

    2011-05-01

    Full Text Available Abstract Background The purpose of this research is to develop and evaluate methods for conducting cluster randomised trials in a primary care database that contains electronic patient records for large numbers of family practices. Cluster randomised trials are trials in which the units allocated represent groups of individuals, in this case family practices and their registered patients. Cluster randomised trials often suffer from the limitation that they include too few clusters, leading to problems of insufficient power and only imprecise estimation of the intraclass correlation coefficient, a key design parameter. This difficulty might be overcome by utilising databases that already hold electronic patient records for large numbers of practices. The protocol describes one application: a study of antibiotic prescribing for acute respiratory infection; a second protocol outlines an intervention in a less frequent chronic condition of public health importance, stroke. Methods/Design The objective of the study is to implement a cluster randomised trial to test the effectiveness of an electronic record-based intervention at achieving a reduction in antibiotic prescribing at consultations for respiratory illness in patients aged 18 and 59 years old in intervention family practices as compared with controls. Family practices will be recruited from the practices that presently contribute data to the UK General Practice Research Database (GPRD. Following randomisation, electronic prompts will be installed remotely at intervention practices to promote adherence with evidence-based standards of medical practice. The intervention was developed through qualitative research at non-intervention practices. Data for outcome assessment will be obtained from anonymised electronic patient records that are routinely collected into GPRD. This protocol outlines the proposed study designs, data sources, sample size requirements, analysis methods and dissemination

  13. [Scanning electron microscopy was used to observe dentin morphology in primary and permanent teeth treated by erbium: yttrium-aluminum-garnet laser].

    Science.gov (United States)

    Zhang, Sun; Chen, Tao; Ge, Li-hong

    2011-10-18

    To observe the morphological change of cavities in teeth prepared using the erbium: yttrium-aluminum-garnet (Er:YAG) laser with different parameters. Ten extracted cavity-free molars were divided into control group and experiment group. The control group included 2 permanent teeth and 2 primary teeth. The experiment group was divided into 3 groups according to the different laser parameters. Group 1 included 2 permanent teeth, while group 2 and group 3 included 2 primary teeth respectively. Cavities were prepared using traditional handpieces in the control group or the Er: YAG laser with different parameters in the experiment group (group 1: Er:YAG laser 20 Hz/200 mJ,group 2: Er:YAG laser 10 Hz/300 mJ,group 3: Er:YAG laser 10 Hz/400 mJ) .The samples were made for Scanning Electron Microscopy(SEM) analysis. The dentin surface of cavities using Er:YAG laser showed no formation of smear layer and open dentinal tubules. Dentin melting was not detected after preparation of groups 1 and 2. There were cracks and micro-fissures in the dentin surface of the primary teeth prepared using Er:YAG laser 10 Hz/400 mJ. Appropriate Er:YAG laser parameters(groups1 and 2) were effective and safe for ablation of hard tissue of primary and permanent teeth. The high power Er: YAG laser 10 Hz/400 mJ would damage the dentin surface when used in primary teeth.

  14. Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records.

    Science.gov (United States)

    Tyrstrup, Mia; Beckman, Anders; Mölstad, Sigvard; Engström, Sven; Lannering, Christina; Melander, Eva; Hedin, Katarina

    2016-11-25

    Swedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly with regards to antibiotic prescribing and adherence to national guidelines. A descriptive study of Sweden's largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS), for the years 2008, 2010 and 2013. Although the consultation rate for all infections remained around 30% each year, antibiotic prescribing rates decreased significantly over the years from 53.7% in 2008, to 45.5% in 2010, to 38.6% in 2013 (p = .032). The antibiotic prescribing rate for respiratory tract infections (RTIs) decreased from 40.5% in 2008 to 24.9% in 2013 while those for urinary tract infections and skin and soft tissue infections were unchanged. For most RTI diagnoses there was a decrease in prescription rate from 2008 to 2013, particularly for the age group 0-6 years. Phenoxymethylpenicillin (PcV) was the antibiotic most often prescribed, followed by tetracycline. Tonsillitis and acute otitis media were the two RTI diagnoses with the highest number of prescriptions per 1000 patient years (PY). For these diagnoses an increase in adherence to national guidelines was seen, with regards to treatment frequency, choice of antibiotics and use of rapid antigen detection test. The frequency in antibiotic prescribing varied greatly between different Primary Healthcare Centres (PHCCs). Falling numbers of consultations and decreased antibiotic prescription rates for RTIs have reduced the antibiotic use in Swedish primary care substantially. Overprescribing of antibiotics could still be suspected due to large variability in prescribing frequency, especially for acute bronchitis and

  15. Primary Calibration of Hydrophones in the Frequency Range of 250 Hz to 500 kHz Using Three-Transducer Spherical Wave Reciprocity

    Science.gov (United States)

    2016-08-01

    LIST OF MATHEMATICAL SYMBOLS AND UNITS ................................................. iii 1 INTRODUCTION ...HYDROPHONES IN THE FREQUENCY RANGE 250 HZ TO 500 KHZ USING THREE-TRANSDUCER SPHERICAL WAVE RECIPROCITY 1. INTRODUCTION This document describes the...for algae , there is little aquatic vegetation. Calibration measurements were performed on 22 June 2016. Environmental conditions during the

  16. [Experience of local radiation therapy and total irradiation of the skin by electron beam in patients with primary B and T-cell lymphomas of the skin].

    Science.gov (United States)

    Il'in, N V; Korytova, L I; Leenman, E E; Vinogradova, Iu N; Nikolaeva, E N; Gracheva, A V; Cherviakov, A M

    2013-01-01

    The problem of the treatment of primary malignant lymphomas of the skin is now becoming increasingly important due to the increase of cases among people of working age and disability of these patients. In most cases lymphomas of the skin have a T-cell origin, the most common of skin lymphoma is mycosis fungoides. It is poorly studied the role of electronic radiation therapy in local and systemic skin lymphomas as well as methodological questions of its application, so research in this field is actual. Therefore the aim of the study is improving of the efficiency of therapy in patients affected by non-Hodgkin's lymphoma with skin lesions by the use of local radiation therapy and total skin irradiation by electron beam.

  17. Using electronic medical records analysis to investigate the effectiveness of lifestyle programs in real-world primary care is challenging: a case study in diabetes mellitus.

    Science.gov (United States)

    Linmans, Joris J; Viechtbauer, Wolfgang; Koppenaal, Tjarco; Spigt, Mark; Knottnerus, J André

    2012-07-01

    The increasing prevalence of diabetes suggests a gap between real world and controlled trial effectiveness of lifestyle interventions, but real-world investigations are rare. Electronic medical registration facilitates research on real-world effectiveness, although such investigations may require specific methodology and statistics. We investigated the effects of real-world primary care for patients with type 2 diabetes mellitus (T2DM). We used medical records of patients (n=2,549) with T2DM from 10 primary health care centers. A mixed-effects regression model for repeated measurements was used to evaluate the changes in weight and Hemoglobin A1c (HbA1c) over time. There was no statistically significant change in weight (+0.07 kg, P=0.832) and HbA1c (+0.03%, P=0.657) during the observation period of 972 days. Most patients maintained their physical activity level (70%), and 54 % had an insufficient activity level. The variability in the course of weight and HbA1c was because of differences between patients and not between health care providers. Despite effective lifestyle interventions in controlled trial settings, we found that real-world primary care is only able to stabilize weight and HbA1c in patients with T2DM over time. Medical registration can be used to monitor the actual effectiveness of interventions in primary care. Copyright © 2012 Elsevier Inc. All rights reserved.

  18. Validity of smoking prevalence estimates from primary care electronic health records compared with national population survey data for England, 2007 to 2011.

    Science.gov (United States)

    Booth, Helen P; Prevost, A Toby; Gulliford, Martin C

    2013-12-01

    Primary care electronic health records (EHRs) are increasingly used as a resource for epidemiological research. Cigarette smoking is an important variable in many epidemiological studies. We evaluated the validity of smoking records in primary care EHRs by comparing estimates for smoking prevalence from primary care EHRs with national health survey data. Data were analysed for adults over 30 years of age from the Clinical Practice Research Datalink (CPRD) in comparison with data from the Health Survey for England between 2007 and 2011. Electronic health records in the CPRD were searched for records of smoking status and smoking cessation treatment. Annual age- and sex-standardised prevalence of current-, non- and former smoking were calculated, and compared with equivalent data from the Health Survey for England (HSE). The difference between estimates of current smoking in CPRD and HSE was generally HSE 24.2%. The mean difference was 0.1% (95% confidence interval −1.5 to 1.7%). In women, current smoking prevalence was CPRD 20.3%, HSE 19.0%; mean difference 1.3% (0.0 to 2.6%). Estimates for former smoking were lower in CPRD than HSE for men (CPRD 26.7%, HSE 31.3%) and women (CPRD 22.9%, HSE 25.0%). Prevalence estimates for current smoking, and non-smoking, from primary care EHRs are similar to those from nationally representative surveys, but former smoking may be under-recorded. © 2013 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

  19. Efficacy of various root canal irrigants on removal of smear layer in the primary root canals after hand instrumentation: A scanning electron microscopy study

    Directory of Open Access Journals (Sweden)

    Hariharan V

    2010-01-01

    Full Text Available Aim: The purpose of this in-vitro study is to determine the efficacy of various irrigants in removing the smear layer in primary teeth root canals after hand instrumentation. Materials and Methods: The present study consisted of 30 human primary incisors which were sectioned at the cementoenamel junction horizontally. The specimens were divided randomly into four experimental and one control group having six teeth each and each group was treated with the specific irrigant. 5.25% NaOCl, 5.25% NaOCl + 10% EDTA, 6% citric acid, 2% chlorhexidine, saline (control were the irrigants evaluated for efficacy in removal of smear layer. The specimens were split along the longitudinal axis using a chisel after placing superficial grooves in cementum not extending to the root canal. The exposed surface was subjected to scanning electron microscopic analysis to reveal the efficacy of irrigants in removal of smear layer. The representative areas were evaluated twice at 15 days interval by a single evaluator. The scale for the smear layer removal by Rome et al was modified and used in the present study. Results: The pictures from the scanning electron microscopy showed that among the tested irrigants, citric acid has the best efficacy to remove the smear layer without altering the normal dentinal structures, which was supported by the lowest mean smear scores. The pictures from the 10%EDTA + 5.25% sodium hypochlorite group showed that even though it removed the smear layer, it adversely affected the dentine structure. SEM pictures of the other groups like sodium hypochlorite, chlorhexidine revealed that these irrigants does not have the capacity to remove the smear layer in primary teeth. Conclusions: The results of the present study clearly indicate the superior efficacy of 6% citric acid than the other tested irrigants on removing the smear layer in primary teeth root canals.

  20. A Comparative Evaluation of Accuracy of New-generation Electronic Apex Locator with Conventional Radiography to determine Working Length in Primary Teeth: An in vivo Study

    Science.gov (United States)

    Shetty, Prakashchandra; Anandakrishna, Latha

    2017-01-01

    Aims The purpose of this study was to evaluate the accuracy of a new-generation electronic apex locator (iPex) to determine working length in primary teeth with or without root resorption as compared with the conventional radiographic method. Materials and methods A sample of 30 primary posterior teeth which are indicated for pulpectomy were selected for the study. After obtaining the informed consent from the parents, local anesthesia was administered. Access cavity was prepared with no.10 round bur. Initial exploration of the canals was done with no.10 K-file. Pulp was extirpated with a barbed broach followed by thorough irrigation of the canals with 0.9% saline. Initially, working length was obtained with iPex (new-generation by Nakanishi International) apex locator using no.10 K-file, which was then compared with conventional radiographic method (Ingle’s method). Results A total of 65 canals were available for the measurement. The data were analyzed using Statistical Analysis system and t-tests were carried out. There was no statistically significant difference found when using iPex apex locator for working length determination as compared with that of conventional radiographic method (p = 0.511). Conclusion Working length determined by iPex apex locator is comparable with that of conventional radiographic method, hence, can be used as an alternative in determining the working length of primary teeth. How to cite this article Bhat KV, Shetty P, Anandakrishna L. A Comparative Evaluation of Accuracy of New-generation Electronic Apex Locator with Conventional Radiography to determine Working Length in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017;10(1):34-36. PMID:28377652

  1. Effectiveness of Rotary Endodontic Instruments on Smear Layer Removal in Root Canals of Primary Teeth: A Scanning Electron Microscopy Study.

    Science.gov (United States)

    Subramaniam, Priya; Girish Babu, K L; Tabrez, T A

    2016-01-01

    The present SEM study was undertaken to evaluate the effect of root canal instrumentation using both manual and rotary files in the root canals of primary anterior teeth. Thirty freshly extracted primary maxillary incisors were divided into 3 groups of 10 teeth each. In Group I, root canals were instrumented with rotary NiTi files; in Group II, the root canals were instrumented using manual NiTi K files and; in Group III, manual instrumentation was done with stainless steel K files. Longitudinal sections were prepared and processed for observation under SEM at the coronal, middle and apical thirds. Scoring of smear layer was done according to Hulsmann and the data obtained was subjected to statistical analysis. Rotary files cleaned the coronal and middle thirds of root canals more effectively. Statistically there was no significant difference between the groups. Lowest score of 2.6 in the apical third of root canals was seen with hand NiTi files. Rotary instrumentation was as effective as manual instrumentation in removal of smear layer in the root canals of primary anterior teeth.

  2. Total electron scattering cross sections of molecules containing H, C, N, O and F in the energy range 0.2–6.0 keV

    Energy Technology Data Exchange (ETDEWEB)

    Gurung, Meera Devi; Ariyasinghe, W.M., E-mail: wickram_ariyasinghe@baylor.edu

    2017-03-15

    Based on the effective atomic total electron scattering cross sections (EATCS) of atoms in a molecular environment, a simple model is proposed to predict the total electron scattering cross sections (TCS) of H, C, N, O, and F containing molecules. The EATCS for these five atoms are reported for 0.2–6.0 keV energies. The predicted TCS by this model are compared with experimental TCS in the literature. The experimental TCS of CHF{sub 3}, C{sub 2}F{sub 4}, C{sub 2}F{sub 2}H{sub 2}, C{sub 4}F{sub 6}, and c-C{sub 4}F{sub 8} have been obtained for 0.2–4.5 keV electrons by measuring the attenuation of the electron beam through a gas cell.

  3. Reduction in antibiotic prescribing for respiratory tract infections in Swedish primary care- a retrospective study of electronic patient records

    Directory of Open Access Journals (Sweden)

    Mia Tyrstrup

    2016-11-01

    Full Text Available Abstract Background Swedish studies on antibiotic use in primary care have been based on one-week registrations of infections. In order to study adherence to guidelines, analyses based on large databases that provide information on diagnosis linked prescriptions, are needed. This study describes trends in management of infections in Swedish primary care particularly with regards to antibiotic prescribing and adherence to national guidelines. Methods A descriptive study of Sweden’s largest database regarding diagnosis linked antibiotic prescription data, the Primary care Record of Infections in Sweden (PRIS, for the years 2008, 2010 and 2013. Results Although the consultation rate for all infections remained around 30% each year, antibiotic prescribing rates decreased significantly over the years from 53.7% in 2008, to 45.5% in 2010, to 38.6% in 2013 (p = .032. The antibiotic prescribing rate for respiratory tract infections (RTIs decreased from 40.5% in 2008 to 24.9% in 2013 while those for urinary tract infections and skin and soft tissue infections were unchanged. For most RTI diagnoses there was a decrease in prescription rate from 2008 to 2013, particularly for the age group 0–6 years. Phenoxymethylpenicillin (PcV was the antibiotic most often prescribed, followed by tetracycline. Tonsillitis and acute otitis media were the two RTI diagnoses with the highest number of prescriptions per 1000 patient years (PY. For these diagnoses an increase in adherence to national guidelines was seen, with regards to treatment frequency, choice of antibiotics and use of rapid antigen detection test. The frequency in antibiotic prescribing varied greatly between different Primary Healthcare Centres (PHCCs. Conclusion Falling numbers of consultations and decreased antibiotic prescription rates for RTIs have reduced the antibiotic use in Swedish primary care substantially. Overprescribing of antibiotics could still be suspected due to large variability

  4. Primary events in the blue light sensor plant cryptochrome: intraprotein electron and proton transfer revealed by femtosecond spectroscopy.

    Science.gov (United States)

    Immeln, Dominik; Weigel, Alexander; Kottke, Tilman; Pérez Lustres, J Luis

    2012-08-01

    Photoreceptors are chromoproteins that undergo fast conversion from dark to signaling states upon light absorption by the chromophore. The signaling state starts signal transduction in vivo and elicits a biological response. Therefore, photoreceptors are ideally suited for analysis of protein activation by time-resolved spectroscopy. We focus on plant cryptochromes which are blue light sensors regulating the development and daily rhythm of plants. The signaling state of these flavoproteins is the neutral radical of the flavin chromophore. It forms on the microsecond time scale after light absorption by the oxidized state. We apply here femtosecond broad-band transient absorption to early stages of signaling-state formation in a plant cryptochrome from the green alga Chlamydomonas reinhardtii. Transient spectra show (i) subpicosecond decay of flavin-stimulated emission and (ii) further decay of signal until 100 ps delay with nearly constant spectral shape. The first decay (i) monitors electron transfer from a nearby tryptophan to the flavin and occurs with a time constant of τ(ET) = 0.4 ps. The second decay (ii) is analyzed by spectral decomposition and occurs with a characteristic time constant τ(1) = 31 ps. We reason that hole transport through a tryptophan triad to the protein surface and partial deprotonation of tryptophan cation radical hide behind τ(1). These processes are probably governed by vibrational cooling. Spectral decomposition is used together with anisotropy to obtain the relative orientation of flavin and the final electron donor. This narrows the number of possible electron donors down to two tryptophans. Structural analysis suggests that a set of histidines surrounding the terminal tryptophan may act as proton acceptor and thereby stabilize the radical pair on a 100 ps time scale.

  5. Primary defect transformations in high-resistivity p-type silicon irradiated with electrons at cryogenic temperatures

    CERN Document Server

    Makarenko, L F; Korshunov, F P; Murin, L I; Moll, M

    2009-01-01

    It has been revealed that self-interstitials formed under low intensity electron irradiationin high resistivity p-type silicon can be retained frozen up to room temperature. Low thermal mobility of the self-interstitials suggests that Frenkelpair sinsilicon can be stable at temperatures of about or higher than 100K. A broad DLTS peak with activation energy of 0.14–0.17eV can be identified as related to Frenkel pairs. This peak anneals out at temperatures of 120 140K. Experimental evidences are presented that be coming more mobile under forwardcurrent injection the self-interstitials change their charge state to a less positive one.

  6. Anticoagulant treatment in primary health care in Sweden – prevalence, incidence and treatment diagnosis: a retrospective study on electronic patient records in a registered population

    Directory of Open Access Journals (Sweden)

    Björholt Ingela

    2003-04-01

    Full Text Available Abstract Background The indications for warfarin treatment in primary health care are increasing. An undertreatment with warfarin is reported in the prevention of embolic stroke in patients with chronic atrial fibrillation, and can be suspected for other indications. Information on the prevalence and incidence of diseases treated with warfarin would reveal useful data for audits concerning management of anticoagulant treatment. We aimed to assess warfarin treatment in primary health care with regard to prevalence, incidence, treatment diagnosis and patient characteristics. Methods A one-year retrospective study of electronic patient records up to May 2000 in primary health care in Stockholm, Sweden. Five primary health care centres with a registered population of 75 146. Main outcome measures were prevalence, incidence and treatment diagnosis. Results Five hundred and seven patients, mean age 71.9 years, were on warfarin treatment. The prevalence was 0.67% (age-adjusted 0.75%, and it was significantly higher for men (0.78% than for women (0.58% (p = 0.01. In the age group 75–84 years the prevalence was 4.54%. The most prevalent treatment diagnosis was chronic atrial fibrillation (0.28%, which was more predominant for males (p = 0.02, followed by cerebrovascular disease (0.13% and deep venous thrombosis (0.13%. The yearly incidence of warfarin treatment was 0.17%, with chronic atrial fibrillation as the predominant treatment diagnosis. Conclusion Warfarin treatment in primary health care is prevalent among the elderly. Chronic atrial fibrillation is the main treatment diagnosis. There is a gender difference favouring men in general and chronic atrial fibrillation as the treatment diagnosis.

  7. Electron transport simulation in the range 1 keV-4 MeV for the purpose of high-resolution dosimetric application

    Energy Technology Data Exchange (ETDEWEB)

    Cobut, V. [Univ. de Cergy-Pontoise, Neuville/Oise (France). Lab. Pharmacophores Redox, Phytochimie et Radiobiologie; Cirioni, L.; Patau, J.P. [Univ. Paul Sabatier, Toulouse (France). Faculte de Pharmacie

    2001-07-01

    Experimental spectrometry and dosimetry can offer some reliable answers. However, they are not easy to implement in some specific situations. Furthermore, information on dose distributions cannot always be obtained with the desirable geometrical resolution. A way to get rid of these disadvantages consist in simulating every successive individual interactions suffered by electrons and photons along their path. We applied this principle to simulate the response of a detector placed in the field of beta-gamma sources, which maximum energy does not exceed 4 MeV. A part of this work is presented here, which concerns Monte Carlo simulation of electron transport in materials encountered in experimental dosimetric devices. Electrons were followed down to a cutoff energy of 1 keV. (orig.)

  8. Total cross sections for electron scattering by 1-propanol at impact energies in the range 40-500 eV

    Science.gov (United States)

    da Silva, D. G. M.; Gomes, M.; Ghosh, S.; Silva, I. F. L.; Pires, W. A. D.; Jones, D. B.; Blanco, F.; Garcia, G.; Buckman, S. J.; Brunger, M. J.; Lopes, M. C. A.

    2017-11-01

    Absolute total cross section (TCS) measurements for electron scattering from 1-propanol molecules are reported for impact energies from 40 to 500 eV. These measurements were obtained using a new apparatus developed at Juiz de Fora Federal University—Brazil, which is based on the measurement of the attenuation of a collimated electron beam through a gas cell containing the molecules to be studied at a given pressure. Besides these experimental measurements, we have also calculated TCS using the Independent-Atom Model with Screening Corrected Additivity Rule and Interference (IAM-SCAR+I) approach with the level of agreement between them being typically found to be very good.

  9. Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial.

    Science.gov (United States)

    Guiriguet-Capdevila, Carolina; Muñoz-Ortiz, Laura; Rivero-Franco, Irene; Vela-Vallespín, Carme; Vilarrubí-Estrella, Mercedes; Torres-Salinas, Miquel; Grau-Cano, Jaume; Burón-Pust, Andrea; Hernández-Rodríguez, Cristina; Fuentes-Peláez, Antonio; Reina-Rodríguez, Dolores; De León-Gallo, Rosa; Mendez-Boo, Leonardo; Torán-Monserrat, Pere

    2014-03-31

    Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effectiveness of an electronic reminder to promote the participation in a population-based colorectal cancer screening programme. Secondary aims are to learn population's reasons for refusing to take part in the screening programme and to find out the health professionals' opinion about the official programme implementation and on the new computerised tool. This is a parallel randomised trial with a cross-sectional second stage. all the invited subjects to participate in the public colorectal cancer screening programme that includes men and women aged between 50-69, allocated to the eleven primary care centres of the study and all their health professionals. The randomisation unit will be the primary care physician. The intervention will consist of activating an electronic reminder, in the patient's electronic medical record, in order to promote colorectal cancer screening, during a synchronous medical appointment, throughout the year that the intervention takes place. A comparison of the screening rates will then take place, using the faecal occult blood test of the patients from the control and the intervention groups. We will also take a questionnaire to know the opinions of the health professionals. The main outcome is the screening status at the end of the study. Data will be analysed with an intention-to-treat approach. We expect that the introduction of specific reminders in electronic medical records, as a tool to facilitate and encourage direct referral by physicians and nurse

  10. Primary defect transformations in high-resistivity p-type silicon irradiated with electrons at cryogenic temperatures

    Energy Technology Data Exchange (ETDEWEB)

    Makarenko, L.F., E-mail: makarenko@bsu.b [Department of Applied Mathematics and Computer Science, Belarusian State University, Independence Ave. 4, 220030 Minsk (Belarus); Lastovski, S.B.; Korshunov, F.P.; Murin, L.I. [Scientific-Practical Materials Research Centre of NAS of Belarus, Minsk (Belarus); Moll, M. [CERN, Geneva (Switzerland)

    2009-12-15

    It has been revealed that self-interstitials formed under low intensity electron irradiation in high resistivity p-type silicon can be retained frozen up to room temperature. Low thermal mobility of the self-interstitials suggests that Frenkel pairs in silicon can be stable at temperatures of about or higher than 100 K. A broad DLTS peak with activation energy of 0.14-0.17 eV can be identified as related to Frenkel pairs. This peak anneals out at temperatures of 120-140 K. Experimental evidences are presented that becoming more mobile under forward current injection the self-interstitials change their charge state to a less positive one.

  11. Primary care physicians' experiences with electronic medical records: implementation experience in community, urban, hospital, and academic family medicine.

    Science.gov (United States)

    Ludwick, Dave; Manca, Donna; Doucette, John

    2010-01-01

    To understand how remuneration and care setting affect the implementation of electronic medical records (EMRs). Semistructured interviews were used to illicit descriptions from community-based family physicians (paid on a fee-for-service basis) and from urban, hospital, and academic family physicians (remunerated via alternative payment models or sessional pay for activities pertaining to EMR implementation). Small suburban community and large urban-, hospital-, and academic-based family medicine clinics in Alberta. All participants were supported by a jurisdictional EMR certification funding mechanism. Physicians who practised in 1 or a combination of the above settings and had experience implementing and using EMRs. Purposive and maximum variation sampling was used to obtain descriptive data from key informants through individually conducted semistructured interviews. The interview guide, which was developed from key findings of our previous literature review, was used in a previous study of community-based family physicians on this same topic. Field notes were analyzed to generate themes through a comparative immersion approach. Physicians in urban, hospital, and academic settings leverage professional working relationships to investigate EMRs, a resource not available to community physicians. Physicians in urban, hospital, and academic settings work in larger interdisciplinary teams with a greater need for interdisciplinary care coordination, EMR training, and technical support. These practices were able to support the cost of project management or technical support resources. These physicians followed a planned system rollout approach compared with community physicians who installed their systems quickly and required users to transition to the new system immediately. Electronic medical records did not increase, or decrease, patient throughput. Physicians developed ways of including patients in the note-taking process. We studied physicians' procurement

  12. About the creation of proton-antiproton pair at electron-positron collider in the energy range of ψ(3770) mass

    Energy Technology Data Exchange (ETDEWEB)

    Ahmadov, A.I., E-mail: ahmadov@theor.jinr.ru [Joint Institute for Nuclear Research, 141980 Dubna, Moscow Region (Russian Federation); Institute of Physics, Azerbaijan National Academy of Science, Baku (Azerbaijan); Bystritskiy, Yu.M., E-mail: bystr@theor.jinr.ru [Joint Institute for Nuclear Research, 141980 Dubna, Moscow Region (Russian Federation); Kuraev, E.A. [Joint Institute for Nuclear Research, 141980 Dubna, Moscow Region (Russian Federation); Wang, P., E-mail: wangp@ihep.ac.cn [Institute of High Energy Physic, Chinese Academy of Science (China)

    2014-11-15

    The process of electron-positron annihilation into proton-antiproton pair is considered within the vicinity of ψ(3770) resonance. The interference between the pure electromagnetic intermediate state and the ψ(3770) state is evaluated. It is shown that this interference is destructive and the relative phase between these two contributions is large (ϕ{sub 0}≈250°)

  13. Socio-demographic inequalities across a range of health status indicators and health behaviours among pregnant women in prenatal primary care: a cross-sectional study.

    Science.gov (United States)

    Baron, Ruth; Manniën, Judith; te Velde, Saskia J; Klomp, Trudy; Hutton, Eileen K; Brug, Johannes

    2015-10-13

    Suboptimal maternal health conditions (such as obesity, underweight, depression and stress) and health behaviours (such as smoking, alcohol consumption and unhealthy nutrition) during pregnancy have been associated with negative pregnancy outcomes. Our first aim was to give an overview of the self-reported health status and health behaviours of pregnant women under midwife-led primary care in the Netherlands. Our second aim was to identify potential differences in these health status indicators and behaviours according to educational level (as a proxy for socio-economic status) and ethnicity (as a proxy for immigration status). Our cross-sectional study (data obtained from the DELIVER multicentre prospective cohort study conducted from September 2009 to March 2011) was based on questionnaires about maternal health and prenatal care, which were completed by 6711 pregnant women. The relationships of education and ethnicity with 13 health status indicators and 10 health behaviours during pregnancy were examined using multilevel multiple logistic regression analyses, adjusted for age, parity, number of weeks pregnant and either education or ethnicity. Lower educated women were especially more likely to smoke (Odds Ratio (OR) 11.3; 95% confidence interval (CI) 7.6- 16.8); have passive smoking exposure (OR 6.9; 95% CI 4.4-11.0); have low health control beliefs (OR 10.4; 95% CI 8.5-12.8); not attend antenatal classes (OR 4.5; 95% CI 3.5-5.8) and not take folic acid supplementation (OR 3.4; 95% CI 2.7-4.4). They were also somewhat more likely to skip breakfast daily, be obese, underweight and depressed or anxious. Non-western women were especially more likely not to take folic acid supplementation (OR 4.5; 95% CI 3.5-5.7); have low health control beliefs (OR 4.1; 95% CI 3.1-5.2) and not to attend antenatal classes (OR 3.3; 95% CI 2.0-5.4). They were also somewhat more likely to have nausea, back pains and passive smoking exposure. Substantial socio-demographic inequalities

  14. A randomised controlled trial to compare a range of commercial or primary care led weight reduction programmes with a minimal intervention control for weight loss in obesity: the Lighten Up trial

    Directory of Open Access Journals (Sweden)

    Beach Jane

    2010-07-01

    Full Text Available Abstract Background Developed countries are facing a huge rise in the prevalence of obesity and its associated chronic medical problems. In the UK Primary Care Trusts are charged with addressing this in the populations they serve, but evidence about the most effective ways of delivering services is not available. The aim of this study is to determine the effectiveness of a range of weight loss programmes for obese patients in primary care and to determine the characteristics of patients who respond to an invitation to a free weight management programme. Methods/Design Lighten Up is a randomised controlled trial comparing a range of 12-week commercial and NHS weight reduction programmes with a comparator group who are provided with 12 vouchers enabling free entrance to a local leisure centre. The weight reduction programmes are: (i Weight Watchers, (ii Slimming World, (iii Rosemary Conley, (iv a group-based dietetics-led programme (Size Down, (v general practice one-to-one counselling, (vi pharmacy-led one-to-one counselling, (vii choice of any of the 6 programmes. People with obesity or overweight with a co-morbid disorder are invited to take part by a letter from their general practitioner. The sample size is 740 participants. The primary outcome is weight loss at programme-end (3 months. Secondary outcomes are weight-loss at one year, self-reported physical activity at 3 and 12 months follow-up and percentage weight-loss at 3 months and one year. Discussion This trial will provide evidence about the effectiveness of a range of different weight management programmes in a primary care population. Trial registration Current Controlled Trials ISRCTN25072883

  15. A randomised controlled trial to compare a range of commercial or primary care led weight reduction programmes with a minimal intervention control for weight loss in obesity: the Lighten Up trial

    Science.gov (United States)

    2010-01-01

    Background Developed countries are facing a huge rise in the prevalence of obesity and its associated chronic medical problems. In the UK Primary Care Trusts are charged with addressing this in the populations they serve, but evidence about the most effective ways of delivering services is not available. The aim of this study is to determine the effectiveness of a range of weight loss programmes for obese patients in primary care and to determine the characteristics of patients who respond to an invitation to a free weight management programme. Methods/Design Lighten Up is a randomised controlled trial comparing a range of 12-week commercial and NHS weight reduction programmes with a comparator group who are provided with 12 vouchers enabling free entrance to a local leisure centre. The weight reduction programmes are: (i) Weight Watchers, (ii) Slimming World, (iii) Rosemary Conley, (iv) a group-based dietetics-led programme (Size Down), (v) general practice one-to-one counselling, (vi) pharmacy-led one-to-one counselling, (vii) choice of any of the 6 programmes. People with obesity or overweight with a co-morbid disorder are invited to take part by a letter from their general practitioner. The sample size is 740 participants. The primary outcome is weight loss at programme-end (3 months). Secondary outcomes are weight-loss at one year, self-reported physical activity at 3 and 12 months follow-up and percentage weight-loss at 3 months and one year. Discussion This trial will provide evidence about the effectiveness of a range of different weight management programmes in a primary care population. Trial registration Current Controlled Trials ISRCTN25072883 PMID:20663185

  16. The Primary Glucose-Lowering Effect of Metformin Resides in the Gut, Not the Circulation: Results From Short-term Pharmacokinetic and 12-Week Dose-Ranging Studies.

    Science.gov (United States)

    Buse, John B; DeFronzo, Ralph A; Rosenstock, Julio; Kim, Terri; Burns, Colleen; Skare, Sharon; Baron, Alain; Fineman, Mark

    2016-02-01

    Delayed-release metformin (Met DR) is formulated to deliver the drug to the lower bowel to leverage the gut-based mechanisms of metformin action with lower plasma exposure. Met DR was assessed in two studies. Study 1 compared the bioavailability of single daily doses of Met DR to currently available immediate-release metformin (Met IR) and extended-release metformin (Met XR) in otherwise healthy volunteers. Study 2 assessed glycemic control in subjects with type 2 diabetes (T2DM) over 12 weeks. Study 1 was a phase 1, randomized, four-period crossover study in 20 subjects. Study 2 was a 12-week, phase 2, multicenter, placebo-controlled, dose-ranging study in 240 subjects with T2DM randomized to receive Met DR 600, 800, or 1,000 mg administered once daily; blinded placebo; or unblinded Met XR 1,000 or 2,000 mg (reference). The bioavailability of 1,000 mg Met DR b.i.d. was ∼50% that of Met IR and Met XR (study 1). In study 2, 600, 800, and 1,000 mg Met DR q.d. produced statistically significant, clinically relevant, and sustained reductions in fasting plasma glucose (FPG) levels over 12 weeks compared with placebo, with an ∼40% increase in potency compared with Met XR. The placebo-subtracted changes from baseline in HbA1c level at 12 weeks were consistent with changes in FPG levels. All treatments were generally well tolerated, and adverse events were consistent with Glucophage/Glucophage XR prescribing information. Dissociation of the glycemic effect from plasma exposure with gut-restricted Met DR provides strong evidence for a predominantly lower bowel-mediated mechanism of metformin action. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  17. Predicting potential ranges of primary malaria vectors and malaria in northern South America based on projected changes in climate, land cover and human population.

    Science.gov (United States)

    Alimi, Temitope O; Fuller, Douglas O; Qualls, Whitney A; Herrera, Socrates V; Arevalo-Herrera, Myriam; Quinones, Martha L; Lacerda, Marcus V G; Beier, John C

    2015-08-20

    Changes in land use and land cover (LULC) as well as climate are likely to affect the geographic distribution of malaria vectors and parasites in the coming decades. At present, malaria transmission is concentrated mainly in the Amazon basin where extensive agriculture, mining, and logging activities have resulted in changes to local and regional hydrology, massive loss of forest cover, and increased contact between malaria vectors and hosts. Employing presence-only records, bioclimatic, topographic, hydrologic, LULC and human population data, we modeled the distribution of malaria and two of its dominant vectors, Anopheles darlingi, and Anopheles nuneztovari s.l. in northern South America using the species distribution modeling platform Maxent. Results from our land change modeling indicate that about 70,000 km(2) of forest land would be lost by 2050 and 78,000 km(2) by 2070 compared to 2010. The Maxent model predicted zones of relatively high habitat suitability for malaria and the vectors mainly within the Amazon and along coastlines. While areas with malaria are expected to decrease in line with current downward trends, both vectors are predicted to experience range expansions in the future. Elevation, annual precipitation and temperature were influential in all models both current and future. Human population mostly affected An. darlingi distribution while LULC changes influenced An. nuneztovari s.l. distribution. As the region tackles the challenge of malaria elimination, investigations such as this could be useful for planning and management purposes and aid in predicting and addressing potential impediments to elimination.

  18. Electronic health records and patient safety: co-occurrence of early EHR implementation with patient safety practices in primary care settings.

    Science.gov (United States)

    Tanner, C; Gans, D; White, J; Nath, R; Pohl, J

    2015-01-01

    The role of electronic health records (EHR) in enhancing patient safety, while substantiated in many studies, is still debated. This paper examines early EHR adopters in primary care to understand the extent to which EHR implementation is associated with the workflows, policies and practices that promote patient safety, as compared to practices with paper records. Early adoption is defined as those who were using EHR prior to implementation of the Meaningful Use program. We utilized the Physician Practice Patient Safety Assessment (PPPSA) to compare primary care practices with fully implemented EHR to those utilizing paper records. The PPPSA measures the extent of adoption of patient safety practices in the domains: medication management, handoffs and transition, personnel qualifications and competencies, practice management and culture, and patient communication. Data from 209 primary care practices responding between 2006-2010 were included in the analysis: 117 practices used paper medical records and 92 used an EHR. Results showed that, within all domains, EHR settings showed significantly higher rates of having workflows, policies and practices that promote patient safety than paper record settings. While these results were expected in the area of medication management, EHR use was also associated with adoption of patient safety practices in areas in which the researchers had no a priori expectations of association. Sociotechnical models of EHR use point to complex interactions between technology and other aspects of the environment related to human resources, workflow, policy, culture, among others. This study identifies that among primary care practices in the national PPPSA database, having an EHR was strongly empirically associated with the workflow, policy, communication and cultural practices recommended for safe patient care in ambulatory settings.

  19. Formulae for the secondary electron yield and total stopping power ...

    Indian Academy of Sciences (India)

    Formulae for the secondary electron yield and total stopping power region. The energy loss of the primary electrons per unit path length S inside 1/α can be approximately written as. dWp dx. = −. 1. AnWn−1 p0 . (4). When primary electrons with energies ranging from 0.8 keV to 2 keV hit a metal, R is not much larger than 1/α, ...

  20. Response of CsI(Tl) scintillators over a large range in energy and atomic number of ions. Part I: recombination and {delta}-electrons

    Energy Technology Data Exchange (ETDEWEB)

    Parlog, M.; Borderie, B. E-mail: borderie@ipno.in2p3.fr; Rivet, M.F.; Tabacaru, G.; Chbihi, A.; Elouardi, M.; Le Neindre, N.; Lopez, O.; Plagnol, E.; Tassan-Got, L.; Auger, G.; Bacri, Ch.O.; Bellaize, N.; Bocage, F.; Bougault, R.; Bouriquet, B.; Brou, R.; Buchet, P.; Charvet, J.L.; Colin, J.; Cussol, D.; Dayras, R.; Demeyer, A.; Dore, D.; Durand, D.; Frankland, J.D.; Galichet, E.; Genouin-Duhamel, E.; Gerlic, E.; Hudan, S.; Guinet, D.; Lautesse, P.; Lavaud, F.; Laville, J.L.; Lecolley, J.F.; Leduc, C.; Legrain, R.; Louvel, M.; Maskay, A.M.; Nalpas, L.; Normand, J.; Peter, J.; Rosato, E.; Saint-Laurent, F.; Steckmeyer, J.C.; Tamain, B.; Tirel, O.; Vient, E.; Volant, C.; Wieleczko, J.P

    2002-04-21

    A simple formalism describing the light response of CsI(Tl) to heavy ions, which quantifies the luminescence and the quenching in terms of the competition between radiative transitions following the carrier trapping at the Tl activator sites and the electron-hole recombination, is proposed. The effect of the {delta}-rays on the scintillation efficiency is for the first time quantitatively included in a fully consistent way. The light output expression depends on four parameters determined by a procedure of global fit to experimental data.

  1. Long-range interfacial electron transfer and electrocatalysis of molecular scale Prussian Blue nanoparticles linked to Au(111)-electrode surfaces by different chemical contacting groups

    DEFF Research Database (Denmark)

    Zhu, Nan; Ulstrup, Jens; Chi, Qijin

    2017-01-01

    We have explored interfacial electrochemical electron transfer (ET) and electrocatalysis of 5–6 nm Prussian Blue nanoparticles (PBNPs) immobilized on Au(111)-electrode surfaces via molecular wiring with variable-length, and differently functionalized thiol-based self-assembled molecular monolayers...... forming linker molecules. The interfacial ET rate constants were found to depend exponentially on the ET distance for distances longer than a few methylene groups in the chain, with decay factors (β) of 0.9, 1.1, and 1.3 per CH2, for SAMs terminated by −NH3+,–COO–, and–CH3, respectively. This feature...

  2. The peculiarity of the construction of an optical-electronic system for measurement of geometrical parameters of objects in the micrometer range

    Science.gov (United States)

    Markina, Olga M.; Markin, Maksym O.; Filippova, Maryna V.; Harasim, Damian; Mussabekov, Kanat; Annabayev, Azamat

    2017-08-01

    The optical-electronic system for measuring of geometrical parameters of micrometrical objects is a difficult process that requires the observance of certain features designing or improvement. The observance of that will provide a higher measurement accuracy compared with the accuracy metrics of measurement that were developed without compliance with these design features. Every feature of the design reduces the error of the functioning of individual nodes of the system or errors in nodes under the influence of various internal or external factors. When reducing or eliminating each factor of occurrence of the error, respectively, will increase the overall measurement accuracy. In this work, the result of introducing measurement error for each factor is determined experimentally and proved the correctness of such actions. Experimental researches of the measurement error to the stage of compliance with subtleties in the improvement of the opto-electronic system was 10 ± 1.5 μm, and after improvement with considering of the specifics of the design measurement error of geometrical parameters was 10 ± 0,33 μm.

  3. Two-band electronic metal and neighboring spin liquid (spin Bose-metal) on a zigzag strip with longer-ranged repulsion

    Science.gov (United States)

    Lai, Hsin-Hua; Motrunich, Olexei I.

    2010-03-01

    We consider an electronic model for realizing the Spin Bose-metal (SBM) phase on a 2-leg triangular strip -- a spin liquid phase found by D. N. Sheng et al. [Phys. Rev. B 79, 205112 (2009)] in a spin-1/2 model with ring exchanges. Starting from a two-band ``C2S2'' metal, the SBM can be viewed as a ``C1S2'' Mott insulator with gapped overall conducting charge mode. We consider extended repulsive interactions motivated by the ab initio derivation of an electronic model for κ-ET spin liquid material [K. Nakamura et al., J. Phys. Soc. Jpn. 78, 083710(2009)]. Using weak coupling renormalization group analysis, we find that such interactions allow much wider C2S2 metallic phase than in the Hubbard model with on-site repulsion only. We identify a valid eight-fermion Umklapp term that is crucial for producing a Mott insulator and use Bosonization to study phases obtained out of the C2S2 metal upon increasing overall repulsion strength, finding that the SBM phase is a natural outcome for extended interactions.

  4. Evaluation of sealing ability of Biodentine™ and mineral trioxide aggregate in primary molars using scanning electron microscope: A randomized controlled in vitro trial

    Directory of Open Access Journals (Sweden)

    Allwyn Samuel

    2016-01-01

    Full Text Available Objective: The aim of this study was to compare the sealing ability of mineral trioxide aggregate (MTA and Biodentine™ when used to repair the furcal perforations in primary molars using scanning electron microscope (SEM. Study Design: The study sample comprised forty recently extracted primary molars. These teeth were placed in a 5.25% sodium hypochlorite solution for 24 h and washed with tap water. Access cavities were made using a round bur in high-speed handpiece. Perforations were made in the center of the floor of the pulpal chamber using a 0.5 mm round bur. The teeth were randomly assigned into two experimental groups based on the material used to seal the perforation: Group A - MTA and Group B - Biodentine™. The packed materials were allowed to set for 24 h. The samples were sectioned longitudinally and the extent of marginal adaptation was measured by SEM. Wilcoxon-signed rank test was used for statistical analysis using SPSS software. Results: All teeth exhibited microleakage, but Biodentine™ showed significantly less leakage (0.149 compared to MTA (0.583. Conclusion: Based on the results of this study, Biodentine™ showed lesser microleakage compared to MTA and thus may be a good alternative to MTA.

  5. Prevalence of heart failure signs and symptoms in a large primary care population identified through the use of text and data mining of the electronic health record.

    Science.gov (United States)

    Vijayakrishnan, Rajakrishnan; Steinhubl, Steven R; Ng, Kenney; Sun, Jimeng; Byrd, Roy J; Daar, Zahra; Williams, Brent A; deFilippi, Christopher; Ebadollahi, Shahram; Stewart, Walter F

    2014-07-01

    The electronic health record (EHR) contains a tremendous amount of data that if appropriately detected can lead to earlier identification of disease states such as heart failure (HF). Using a novel text and data analytic tool we explored the longitudinal EHR of over 50,000 primary care patients to identify the documentation of the signs and symptoms of HF in the years preceding its diagnosis. Retrospective analysis consisted of 4,644 incident HF cases and 45,981 group-matched control subjects. Documentation of Framingham HF signs and symptoms within encounter notes were carried out with the use of a previously validated natural language processing procedure. A total of 892,805 affirmed criteria were documented over an average observation period of 3.4 years. Among eventual HF cases, 85% had ≥1 criterion within 1 year before their HF diagnosis, as did 55% of control subjects. Substantial variability in the prevalence of individual signs and symptoms were found in both case and control subjects. HF signs and symptoms are frequently documented in a primary care population as identified through automated text and data mining of EHRs. Their frequent identification demonstrates the rich data available within EHRs that will allow for future work on automated criterion identification to help develop predictive models for HF. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Documentation of sexual partner gender is low in electronic health records: observations, predictors, and recommendations to improve population health management in primary care.

    Science.gov (United States)

    Nguyen, Giang T; Yehia, Baligh R

    2015-06-01

    The 2011 Institute of Medicine report on LGBT health recommended that sexual orientation and gender identity (SO/GI) be documented in electronic health records (EHRs). Most EHRs cannot document all aspects of SO/GI, but some can record gender of sexual partners. This study sought to determine the proportion of patients who have the gender of sexual partners recorded in the EHR and to identify factors associated with documentation. A retrospective analysis was done of EHR data for 40 family medicine (FM) and general internal medicine (IM) practices, comprising 170,570 adult patients seen in 2012. The primary outcome was EHR documentation of sexual partner gender. Multivariate logistic regression assessed the impact of patient, provider, and practice factors on documentation. In all, 76,767 patients (45%) had the gender of sexual partners recorded, 4.3% of whom had same-gender partners (3.5% of females, 5.6% of males). Likelihood of documentation was independently higher for women; blacks; those with a preventive visit; those with a physician assistant, nurse practitioner, or resident primary care provider (vs. attending); those at urban practices; those at smaller practices; and those at a residency FM practice. Older age and Medicare insurance were associated with lower documentation. Sexual partner gender documentation is important to identify patients for targeted prevention and support, and holds great potential for population health management, yet documentation in the EHR currently is low. Primary care practices should routinely record the gender of sexual partners, and additional work is needed to identify best practices for collecting and using SO/GI data in this setting.

  7. Primary secondary amine as a sorbent material in dispersive solid-phase extraction clean-up for the determination of indicator polychlorinated biphenyls in environmental water samples by gas chromatography with electron capture detection.

    Science.gov (United States)

    Guo, Yuanming; Hu, Hongmei; Li, Tiejun; Xue, Lijian; Zhang, Xiaoning; Zhong, Zhi; Zhang, Yurong; Jin, Yanjian

    2017-08-01

    A simple, rapid, and novel method has been developed and validated for determination of seven indicator polychlorinated biphenyls in water samples by gas chromatography with electron capture detection. 1 L of water samples containing 30 g of anhydrous sodium sulfate was first liquid-liquid extracted with an automated Jipad-6XB vertical oscillator using n-hexane/dichloromethane (1:1, v/v). The concentrated extract was cleaned up by dispersive solid-phase extraction with 100 mg of primary secondary amine as sorbent material. The linearity of this method ranged from 1.25 to 100 μg/L, with regression coefficients ranging between 0.9994 and 0.9999. The limits of detection were in the ng/L level, ranging between 0.2 and 0.3 ng/L. The recoveries of seven spiked polychlorinated biphenyls with external calibration method at different concentration levels in tap water, lake water, and sea water were in the ranges of 85-112, 76-116, and 72-108%, respectively, and with relative standard deviations of 3.3-4.5, 3.4-5.6, and 3.1-4.8% (n = 5), respectively. The performance of the proposed method was compared with traditional liquid-liquid extraction and solid-phase extraction clean-up methods, and comparable efficiencies were obtained. It is concluded that this method can be successfully applied for the determination of polychlorinated biphenyls in different water samples. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  8. Studies on effective atomic numbers for photon energy absorption and electron density of some narcotic drugs in the energy range 1 keV-20 MeV

    Science.gov (United States)

    Gounhalli, Shivraj G.; Shantappa, Anil; Hanagodimath, S. M.

    2013-04-01

    Effective atomic numbers for photon energy absorption ZPEA,eff, photon interaction ZPI,eff and for electron density Nel, have been calculated by a direct method in the photon-energy region from 1 keV to 20 MeV for narcotic drugs, such as Heroin (H), Cocaine (CO), Caffeine (CA), Tetrahydrocannabinol (THC), Cannabinol (CBD), Tetrahydrocannabivarin (THCV). The ZPEA,eff, ZPI,eff and Nel values have been found to change with energy and composition of the narcotic drugs. The energy dependence ZPEA,eff, ZPI,eff and Nel is shown graphically. The maximum difference between the values of ZPEA,eff, and ZPI,eff occurs at 30 keV and the significant difference of 2 to 33% for the energy region 5-100 keV for all drugs. The reason for these differences is discussed.

  9. Design of High Dynamic Range Digital to Analog Converters for the Calibration of the CALICE Si-W Ecal readout electronics

    CERN Document Server

    Gallin-Martel, L; Hostachy, J Y; Rarbi, F; Rossetto, O

    2009-01-01

    The ILC ECAL front-end chip will integrate many functions of the readout electronics including a DAC dedicated to calibration. We present two versions of DAC with respectively 12 and 14 bits, designed in a CMOS 0.35μm process. Both are based on segmented arrays of switched capacitors controlled by a Dynamic Element Matching (DEM) algorithm. A full differential architecture is used, and the amplifiers can be turned into a standby mode reducing the power dissipation. The 12 bit DAC features an INL lower than 0.3 LSB at 5MHz, and dissipates less than 7mW. The 14 bit DAC is an improved version of the 12 bit design.

  10. The electron spectro-microscopy beamline at National Synchrotron Light Source II: a wide photon energy range, micro-focusing beamline for photoelectron spectro-microscopies.

    Science.gov (United States)

    Reininger, R; Hulbert, S L; Johnson, P D; Sadowski, J T; Starr, D E; Chubar, O; Valla, T; Vescovo, E

    2012-02-01

    A comprehensive optical design for a high-resolution, high-flux, wide-energy range, micro-focused beamline working in the vacuum ultraviolet and soft x-ray photon energy range is proposed. The beamline is to provide monochromatic radiation to three photoelectron microscopes: a full-field x-ray photoelectron emission microscope and two scanning instruments, one dedicated to angle resolved photoemission spectroscopy (μ-ARPES) and one for ambient pressure x-ray photoelectron spectroscopy and scanning photoelectron microscopy (AP-XPS/SPEM). Microfocusing is achieved with state of the art elliptical cylinders, obtaining a spot size of 1 μm for ARPES and 0.5 μm for AP-XPS/SPEM. A detailed ray tracing analysis quantitatively evaluates the overall beamline performances.

  11. Extending the range of low energy electron diffraction (LEED) surface structure determination: Co-adsorbed molecules, incommensurate overlayers and alloy surface order studied by new video and electron counting LEED techniques

    Energy Technology Data Exchange (ETDEWEB)

    Ogletree, D.F.

    1986-11-01

    LEED multiple scattering theory is briefly summarized, and aspects of electron scattering with particular significance to experimental measurements such as electron beam coherence, instrument response and phonon scattering are analyzed. Diffuse LEED experiments are discussed. New techniques that enhance the power of LEED are described, including a real-time video image digitizer applied to LEED intensity measurements, along with computer programs to generate I-V curves. The first electron counting LEED detector using a ''wedge and strip'' position sensitive anode and digital electronics is described. This instrument uses picoampere incident beam currents, and its sensitivity is limited only by statistics and counting times. Structural results on new classes of surface systems are presented. The structure of the c(4 x 2) phase of carbon monoxide adsorbed on Pt(111) has been determined, showing that carbon monoxide molecules adsorb in both top and bridge sites, 1.85 +- 0.10 A and 1.55 +- 0.10 A above the metal surface, respectively. The structure of an incommensurate graphite overlayer on Pt(111) is analyzed. The graphite layer is 3.70 +- 0.05 A above the metal surface, with intercalated carbon atoms located 1.25 +- 0.10 A above hollow sites supporting it. The (2..sqrt..3 x 4)-rectangular phase of benzene and carbon monoxide coadsorbed on Pt(111) is analyzed. Benzene molecules adsorb in bridge sites parallel to and 2.10 +- 0.10 A above the surface. The carbon ring is expanded, with an average C-C bond length of 1.72 +- 0.15 A. The carbon monoxide molecules also adsorb in bridge sites. The structure of the (..sqrt..3 x ..sqrt..3) reconstruction on the (111) face of the ..cap alpha..-CuAl alloy has been determined.

  12. Rationale, design, and implementation protocol of an electronic health record integrated clinical prediction rule (iCPR randomized trial in primary care

    Directory of Open Access Journals (Sweden)

    Wisnivesky Juan

    2011-09-01

    Full Text Available Abstract Background Clinical prediction rules (CPRs represent well-validated but underutilized evidence-based medicine tools at the point-of-care. To date, an inability to integrate these rules into an electronic health record (EHR has been a major limitation and we are not aware of a study demonstrating the use of CPR's in an ambulatory EHR setting. The integrated clinical prediction rule (iCPR trial integrates two CPR's in an EHR and assesses both the usability and the effect on evidence-based practice in the primary care setting. Methods A multi-disciplinary design team was assembled to develop a prototype iCPR for validated streptococcal pharyngitis and bacterial pneumonia CPRs. The iCPR tool was built as an active Clinical Decision Support (CDS tool that can be triggered by user action during typical workflow. Using the EHR CDS toolkit, the iCPR risk score calculator was linked to tailored ordered sets, documentation, and patient instructions. The team subsequently conducted two levels of 'real world' usability testing with eight providers per group. Usability data were used to refine and create a production tool. Participating primary care providers (n = 149 were randomized and intervention providers were trained in the use of the new iCPR tool. Rates of iCPR tool triggering in the intervention and control (simulated groups are monitored and subsequent use of the various components of the iCPR tool among intervention encounters is also tracked. The primary outcome is the difference in antibiotic prescribing rates (strep and pneumonia iCPR's encounters and chest x-rays (pneumonia iCPR only between intervention and control providers. Discussion Using iterative usability testing and development paired with provider training, the iCPR CDS tool leverages user-centered design principles to overcome pervasive underutilization of EBM and support evidence-based practice at the point-of-care. The ongoing trial will determine if this collaborative

  13. Electronic spectrum in the visible frequency range of UF/sub 4/ molecules isolated in solid neon, and its interpretation in the crystal-field approximation

    Energy Technology Data Exchange (ETDEWEB)

    Belyaeva, A.A.; Golubev, Y.M.

    1987-09-01

    The matrix isolation method is used to obtain the spectra of molecules in solid neon in the 1000--400-nm range. All the recorded bands are referred to transitions within the 5f /sup 2/ configuration of U/sup 4 +/ ion in the field of four fluorine ions. The interpretation assumes the case of a weak crystal field in which the terms of U/sup 4 +/ ion with different J are not mixed up. It is concluded that the UF/sub 3/ molecule has the structure of either a tetrahedron or a slightly distorted tetrahedron.

  14. Embedding systematic quality assessments in supportive supervision at primary healthcare level: application of an electronic Tool to Improve Quality of Healthcare in Tanzania.

    Science.gov (United States)

    Mboya, Dominick; Mshana, Christopher; Kessy, Flora; Alba, Sandra; Lengeler, Christian; Renggli, Sabine; Vander Plaetse, Bart; Mohamed, Mohamed A; Schulze, Alexander

    2016-10-13

    Assessing quality of health services, for example through supportive supervision, is essential for strengthening healthcare delivery. Most systematic health facility assessment mechanisms, however, are not suitable for routine supervision. The objective of this study is to describe a quality assessment methodology using an electronic format that can be embedded in supervision activities and conducted by council health staff. An electronic Tool to Improve Quality of Healthcare (e-TIQH) was developed to assess the quality of primary healthcare provision. The e-TIQH contains six sub-tools, each covering one quality dimension: infrastructure and equipment of the facility, its management and administration, job expectations, clinical skills of the staff, staff motivation and client satisfaction. As part of supportive supervision, council health staff conduct quality assessments in all primary healthcare facilities in a given council, including observation of clinical consultations and exit interviews with clients. Using a hand-held device, assessors enter data and view results in real time through automated data analysis, permitting immediate feedback to health workers. Based on the results, quality gaps and potential measures to address them are jointly discussed and actions plans developed. For illustrative purposes, preliminary findings from e-TIQH application are presented from eight councils of Tanzania for the period 2011-2013, with a quality score <75 % classed as 'unsatisfactory'. Staff motivation (<50 % in all councils) and job expectations (≤50 %) scored lowest of all quality dimensions at baseline. Clinical practice was unsatisfactory in six councils, with more mixed results for availability of infrastructure and equipment, and for administration and management. In contrast, client satisfaction scored surprisingly high. Over time, each council showed a significant overall increase of 3-7 % in mean score, with the most pronounced improvements in staff

  15. Modelling and extraction of variability in free-text medication prescriptions from an anonymised primary care electronic medical record research database.

    Science.gov (United States)

    Karystianis, George; Sheppard, Therese; Dixon, William G; Nenadic, Goran

    2016-02-09

    Free-text medication prescriptions contain detailed instruction information that is key when preparing drug data for analysis. The objective of this study was to develop a novel model and automated text-mining method to extract detailed structured medication information from free-text prescriptions and explore their variability (e.g. optional dosages) in primary care research databases. We introduce a prescription model that provides minimum and maximum values for dose number, frequency and interval, allowing modelling variability and flexibility within a drug prescription. We developed a text mining system that relies on rules to extract such structured information from prescription free-text dosage instructions. The system was applied to medication prescriptions from an anonymised primary care electronic record database (Clinical Practice Research Datalink, CPRD). We have evaluated our approach on a test set of 220 CPRD prescription free-text directions. The system achieved an overall accuracy of 91 % at the prescription level, with 97 % accuracy across the attribute levels. We then further analysed over 56,000 most common free text prescriptions from CPRD records and found that 1 in 4 has inherent variability, i.e. a choice in taking medication specified by different minimum and maximum doses, duration or frequency. Our approach provides an accurate, automated way of coding prescription free text information, including information about flexibility and variability within a prescription. The method allows the researcher to decide how best to prepare the prescription data for drug efficacy and safety analyses in any given setting, and test various scenarios and their impact.

  16. Assessing variability in compliance with recommendations given by the International Diabetes Federation (IDF) for patients with type 2 diabetes in primary care using electronic records. The APNA study.

    Science.gov (United States)

    Brugos-Larumbe, Antonio; Aldaz-Herce, Pablo; Guillen-Grima, Francisco; Garjón-Parra, Francisco Javier; Bartolomé-Resano, Francisco Javier; Arizaleta-Beloqui, María Teresa; Pérez-Ciordia, Ignacio; Fernández-Navascués, Ana María; Lerena-Rivas, María José; Berjón-Reyero, Jesús; Jusué-Rípodas, Luisa; Aguinaga-Ontoso, Ines

    2018-02-01

    Assess compliance with the IDF recommendations for patients with Diabetes Type2 (DM2), and its variability, by groups of doctors and nurses who provide primary care services in Navarre (Spain). A cross-sectional study of a population of 462,568 inhabitants, aged ≥18 years in 2013, attended by 381 units of doctor/nurse (quota). Clinical data were collected retrospectively through electronic records. Using cluster analysis, we identified two groups of units according to the score for each indicator. We calculated the Odds Ratio, adjusted for age sex, BMI, socioeconomic status and smoking, for complying with each recommendation whether a patient was treated by one of the quota from the highest score to the lowest. 30,312 patients with DM2 were identified: prevalence: 6.39%; coefficient of variation between UDN: 22.8%; biggest cluster 7.7% and smallest 5.3%; OR=1.54 (1.50-1.58). The HbA1c control at ≤8% was 82.8% (82.2-83.3) and >9% was 7.6% (7.3-8.0), with OR 1.79 (1.69-1.89) and 2.62 (2.36-2.91) respectively. Control of BP and LDL-C show significant differences between the clusters. An important variability was identified according to the doctor treating patients. The average HbA1c control is acceptable being limited in BP and LDL-C. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  17. VUV photoionization of acetamide studied by electron/ion coincidence spectroscopy in the 8-24 eV photon energy range

    KAUST Repository

    Schwell, Martin

    2012-01-01

    A VUV photoionization study of acetamide was carried out over the 8-24 eV photon energy range using synchrotron radiation and photoelectron/photoion coincidence (PEPICO) spectroscopy. Threshold photoelectron photoion coincidence (TPEPICO) measurements were also made. Photoion yield curves and branching ratios were measured for the parent ion and six fragment ions. The adiabatic ionization energy of acetamide was determined as I.E. (1 2A′) = (9.71 ± 0.02) eV, in agreement with an earlier reported photoionization mass spectrometry (PIMS) value. The adiabatic energy of the first excited state of the ion, 1 2A″, was determined to be ≈10.1 eV. Assignments of the fragment ions and the pathways of their formation by dissociative photoionization were made. The neutral species lost in the principal dissociative photoionization processes are CH 3, NH 2, NH 3, CO, HCCO and NH 2CO. Heats of formation are derived for all ions detected and are compared with literature values. Some astrophysical implications of these results are discussed. © 2011 Elsevier B.V. All rights reserved.

  18. Energy loss, range, and bremsstrahlung yield for 10-keV to 100-MeV electrons in various elements and chemical compounds

    Science.gov (United States)

    Pages, Lucien; Bertel, Evelyne; Joffre, Henri; Sklavenitis, Laodamas

    2012-12-01

    Even though the United States lacks a national climate policy, significant action has occurred at the local and regional levels. Some of the most aggressive climate change policies have occurred at the state and local levels and in interagency cooperation on specific management issues. While there is a long history of partnerships in dealing with a wide variety of policy issues, the uncertainty and the political debate surrounding climate change has generated new challenges to establishing effective policy networks. This paper investigates the formation of climate policy networks in the State of Nevada. It presents a methodology based on social network analysis for assessing the structure and function of local policy networks across a range of substantive climate impacted resources (water, landscape management, conservation, forestry and others). It draws from an emerging literature on federalism and climate policy, public sector innovation, and institutional analysis in socio-ecological systems. Comparisons across different policy issue networks in the state are used to highlight the influence of network structure, connectivity, bridging across vertical and horizontal organizational units, organizational diversity, and flows between organizational nodes.

  19. Electron-impact rotationally elastic total cross sections for H{sub 2}CO and HCOOH over a wide range of incident energy (0.01-2000 eV)

    Energy Technology Data Exchange (ETDEWEB)

    Vinodkumar, Minaxi [V P and R P T P Science College, Vallabh Vidyanagar 388 120, Gujarat (India); Bhutadia, Harshad [Government Engineering College, Patan 384265, Gujarat (India); Antony, Bobby [Department of Applied Physics, Indian School of Mines, Dhanbad JH-826004 (India); Mason, Nigel [Department of Physics and Astronomy, Open University, Milton Keynes MK7 6AA (United Kingdom)

    2011-11-15

    This paper reports computational results of the total cross sections for electron impact on H{sub 2}CO and HCOOH over a wide range of electron impact energies from 0.01 eV to 2 keV. The total cross section is presented as sum of the elastic and electronic excitation cross sections for incident energies. The calculation uses two different methodologies, below the ionization threshold of the target the cross section is calculated using the UK molecular R-matrix code through the Quantemol-N software package while cross sections at higher energies are evaluated using the spherical complex optical potential formalism. The two methods are found to be consistent at the transition energy ({approx}15 eV). The present results are, in general, found to be in good agreement with previous experimental and theoretical results (wherever available) and, thus, the present results can serve as a benchmark for the cross section over a wide range of energy.

  20. Observational safety study of specific outcomes after trivalent cell culture seasonal influenza vaccination (Optaflu® ) among adults in THIN database of electronic UK primary healthcare records.

    Science.gov (United States)

    Hall, Gillian C; Davies, Paul T G; Karim, M Yousuf; Haag, Mendel D M; O'Leary, Caroline

    2018-01-01

    To investigate the safety of trivalent seasonal influenza vaccine (TIVc) (Optaflu® ), the first cell culture seasonal trivalent influenza vaccine available in Europe. Codes and unstructured text in adult electronic healthcare records (The Health Improvement Network) were searched for a TIVc brand name or batch number and possible outcomes within a 3 month pre- to 6 month post-TIVc exposure study period (2012-2015). The outcomes were severe allergic reactions, Bell's palsy, convulsions, demyelination, paresthesia, noninfectious encephalitis, neuritis (optic and brachial), vasculitis, inflammatory bowel disease, and thrombocytopenia. Risk periods were defined based on biologically plausible time frame postvaccination when an outcome caused by the vaccine might be expected to occur. Possible outcomes were adjudicated against outcome specific case definitions and a date of onset assigned by using electronic and other medical records. Observed (risk period) to expected (outside risk and preexposure periods) rate ratios, postexposure incidence, and plots of time from exposure to outcome were reported. Sixteen of 1011 events from 4578 exposures fulfilled a primary case definition and had a date of onset during the study period. Three were in observed time. The observed-to-expected rate ratios were (3.3, 95% CI 0.3, 31.7) for convulsions and (1.5, 95% CI 0.2, 14.9) for thrombocytopenia with 1 outcome each in observed time. There was 1 incident inflammatory bowel disease in observed, but none in expected, time. The small sample size restricts interpretation; however, no hypothesis of an increased risk of a study outcome was generated. Adjudication of events against case definitions to reduce misclassification of onset and outcomes allowed use of precise risk periods. KEY POINTS This observational study did not generate a hypothesis of an association between the first cell-culture seasonal influenza vaccination available in the European Union and any of the study outcomes

  1. Localized melt-scan strategy for site specific control of grain size and primary dendrite arm spacing in electron beam additive manufacturing

    Energy Technology Data Exchange (ETDEWEB)

    Raghavan, Narendran; Simunovic, Srdjan; Dehoff, Ryan; Plotkowski, Alex; Turner, John; Kirka, Michael; Babu, Suresh

    2017-11-01

    In addition to design geometry, surface roughness, and solid-state phase transformation, solidification microstructure plays a crucial role in controlling the performance of additively manufactured components. Crystallographic texture, primary dendrite arm spacing (PDAS), and grain size are directly correlated to local solidification conditions. We have developed a new melt-scan strategy for inducing site specific, on-demand control of solidification microstructure. We were able to induce variations in grain size (30 μm–150 μm) and PDAS (4 μm - 10 μm) in Inconel 718 parts produced by the electron beam additive manufacturing system (Arcam®). A conventional raster melt-scan resulted in a grain size of about 600 μm. The observed variations in grain size with different melt-scan strategies are rationalized using a numerical thermal and solidification model which accounts for the transient curvature of the melt pool and associated thermal gradients and liquid-solid interface velocities. The refinement in grain size at high cooling rates (>104 K/s) is also attributed to the potential heterogeneous nucleation of grains ahead of the epitaxially growing solidification front. The variation in PDAS is rationalized using a coupled numerical-theoretical model as a function of local solidification conditions (thermal gradient and liquid-solid interface velocity) of the melt pool.

  2. An Interrupted Time Series Analysis to Determine the Effect of an Electronic Health Record-Based Intervention on Appropriate Screening for Type 2 Diabetes in Urban Primary Care Clinics in New York City.

    Science.gov (United States)

    Albu, Jeanine B; Sohler, Nancy; Li, Rui; Li, Xuan; Young, Edwin; Gregg, Edward W; Ross-Degnan, Dennis

    2017-08-01

    To determine the impact of a health system-wide primary care diabetes management system, which included targeted guidelines for type 2 diabetes (T2DM) and prediabetes (dysglycemia) screening, on detection of previously undiagnosed dysglycemia cases. Intervention included electronic health record (EHR)-based decision support and standardized providers and staff training for using the American Diabetes Association guidelines for dysglycemia screening. Using EHR data, we identified 40,456 adults without T2DM or recent screening with a face-to-face visit (March 2011-December 2013) in five urban clinics. Interrupted time series analyses examined the impact of the intervention on trends in three outcomes: 1 ) monthly proportion of eligible patients receiving dysglycemia testing, 2 ) two negative comparison conditions (dysglycemia testing among ineligible patients and cholesterol screening), and 3 ) yield of undiagnosed dysglycemia among those tested. Baseline monthly proportion of eligible patients receiving testing was 7.4-10.4%. After the intervention, screening doubled (mean increase + 11.0% [95% CI 9.0, 13.0], proportion range 18.6-25.3%). The proportion of ineligible patients tested also increased (+5.0% [95% CI 3.0, 8.0]) with no concurrent change in cholesterol testing (+0% [95% CI -0.02, 0.05]). About 59% of test results in eligible patients showed dysglycemia both before and after the intervention. Implementation of a policy for systematic dysglycemia screening including formal training and EHR templates in urban academic primary care clinics resulted in a doubling of appropriate testing and the number of patients who could be targeted for treatment to prevent or delay T2DM. © 2017 by the American Diabetes Association.

  3. [Primary age-related tauopathy (PART): a novel term to describe age-related tangle pathology encompassing a wide range from cognitively normal condition to senile dementia of the neurofibrillary tangle type].

    Science.gov (United States)

    Yamada, Masahito

    2016-03-01

    It has been reported that neurofibrillary tangles (NFTs) are commonly observed in older people, and that some of older individuals with dementia have a large amount of NFTs in the medial temporal lobe without amyloid(Aβ) plaques, which have been referred to as senile dementia of the NFT type (SD-NFT), tangle-predominant senile dementia (TPSD), or tangle-only dementia. In 2014, our international collaborative group proposed a new term, "primary age-related tauopathy(PART)", to describe such age-related tangle pathology, clinically encompassing a wide range from normal to cognitive impairment/ dementia (SD-NFT). This nomenclature would provide a conceptual foundation for future studies leading to development of clinical diagnosis for this condition.

  4. Electron Tree

    DEFF Research Database (Denmark)

    Appelt, Ane L; Rønde, Heidi S

    2013-01-01

    The photo shows a close-up of a Lichtenberg figure – popularly called an “electron tree” – produced in a cylinder of polymethyl methacrylate (PMMA). Electron trees are created by irradiating a suitable insulating material, in this case PMMA, with an intense high energy electron beam. Upon discharge......, during dielectric breakdown in the material, the electrons generate branching chains of fractures on leaving the PMMA, producing the tree pattern seen. To be able to create electron trees with a clinical linear accelerator, one needs to access the primary electron beam used for photon treatments. We...... appropriated a linac that was being decommissioned in our department and dismantled the head to circumvent the target and ion chambers. This is one of 24 electron trees produced before we had to stop the fun and allow the rest of the accelerator to be disassembled....

  5. The effects of implementing a point-of-care electronic template to prompt routine anxiety and depression screening in patients consulting for osteoarthritis (the Primary Care Osteoarthritis Trial: A cluster randomised trial in primary care.

    Directory of Open Access Journals (Sweden)

    Christian D Mallen

    2017-04-01

    Full Text Available This study aimed to evaluate whether prompting general practitioners (GPs to routinely assess and manage anxiety and depression in patients consulting with osteoarthritis (OA improves pain outcomes.We conducted a cluster randomised controlled trial involving 45 English general practices. In intervention practices, patients aged ≥45 y consulting with OA received point-of-care anxiety and depression screening by the GP, prompted by an automated electronic template comprising five questions (a two-item Patient Health Questionnaire-2 for depression, a two-item Generalized Anxiety Disorder-2 questionnaire for anxiety, and a question about current pain intensity [0-10 numerical rating scale]. The template signposted GPs to follow National Institute for Health and Care Excellence clinical guidelines for anxiety, depression, and OA and was supported by a brief training package. The template in control practices prompted GPs to ask the pain intensity question only. The primary outcome was patient-reported current pain intensity post-consultation and at 3-, 6-, and 12-mo follow-up. Secondary outcomes included pain-related disability, anxiety, depression, and general health. During the trial period, 7,279 patients aged ≥45 y consulted with a relevant OA-related code, and 4,240 patients were deemed potentially eligible by participating GPs. Templates were completed for 2,042 patients (1,339 [31.6%] in the control arm and 703 [23.1%] in the intervention arm. Of these 2,042 patients, 1,412 returned questionnaires (501 [71.3%] from 20 intervention practices, 911 [68.0%] from 24 control practices. Follow-up rates were similar in both arms, totalling 1,093 (77.4% at 3 mo, 1,064 (75.4% at 6 mo, and 1,017 (72.0% at 12 mo. For the primary endpoint, multilevel modelling yielded significantly higher average pain intensity across follow-up to 12 mo in the intervention group than the control group (adjusted mean difference 0.31; 95% CI 0.04, 0.59. Secondary

  6. Secondary electron emission of thin carbon foils under the impact of hydrogen atoms, ions and molecular ions, under energies within the MeV range; Multiplicite des electrons secondaires emis par des cibles minces de carbone sous l'impact de projectiles H0, H2+, H3+ d'energie de l'ordre du MeV

    Energy Technology Data Exchange (ETDEWEB)

    Vidovic, Z

    1997-06-15

    This work focuses on the study of the emission statistics of secondary electrons from thin carbon foils bombarded with H{sup 0}, H{sub 2}{sup +} and H{sub 3}{sup +} projectiles in the 0.25-2.2 MeV energy range. The phenomenon of secondary electron emission from solids under the impact of swift ions is mainly due to inelastic interactions with target electrons. The phenomenological and theoretical descriptions, as well as a summary of the main theoretical models are the subject of the first chapter. The experimental set-up used to measure event by event the electron emission of the two faces of a thin carbon foil traversed by an energetic projectile is described in the chapter two. In this chapter are also presented the method and algorithms used to process experimental spectra in order to obtain the statistical distribution of the emitted electrons. Chapter three presents the measurements of secondary electron emission induced by H atoms passing through thin carbon foils. The secondary electron yields are studied in correlation with the emergent projectile charge state. We show the peculiar role of the projectile electron, whether it remains or not bound to the incident proton. The fourth chapter is dedicated to the secondary electron emission induced by H{sub 2}{sup +} and H{sub 3}{sup +} polyatomic ions. The results are interpreted in terms of collective effects in the interactions of these ions with solids. The role of the proximity of the protons, molecular ion fragments, upon the amplitude of these collective effects is evidenced from the study of the statistics of forward emission. These experiences allowed us to shed light on various aspects of atom and polyatomic ion inter-actions with solid surfaces. (author)

  7. Evaluating the Usability and Perceived Impact of an Electronic Medical Record Toolkit for Atrial Fibrillation Management in Primary Care: A Mixed-Methods Study Incorporating Human Factors Design.

    Science.gov (United States)

    Tran, Kim; Leblanc, Kori; Valentinis, Alissia; Kavanagh, Doug; Zahr, Nina; Ivers, Noah M

    2016-02-17

    Atrial fibrillation (AF) is a common and preventable cause of stroke. Barriers to reducing stroke risk through appropriate prescribing have been identified at the system, provider, and patient levels. To ensure a multifaceted initiative to address these barriers is effective, it is essential to incorporate user-centered design to ensure all intervention components are optimized for users. To test the usability of an electronic medical record (EMR) toolkit for AF in primary care with the goal of further refining the intervention to meet the needs of primary care clinicians. An EMR-based toolkit for AF was created and optimized through usability testing and iterative redesign incorporating a human factors approach. A mixed-methods pilot study consisting of observations, semi-structured interviews, and surveys was conducted to examine usability and perceived impact on patient care and workflow. A total of 14 clinicians (13 family physicians and 1 nurse practitioner) participated in the study. Nine iterations of the toolkit were created in response to feedback from clinicians and the research team; interface-related changes were made, additional AF-related resources were added, and functionality issues were fixed to make the toolkit more effective. After improvements were made, clinicians expressed that the toolkit improved accessibility to AF-related information and resources, served as a reminder for guideline-concordant AF management, and was easy to use. Most clinicians intended to continue using the toolkit for patient care. With respect to impact on care, clinicians believed the toolkit increased the thoroughness of their assessments for patients with AF and improved the quality of AF-related care received by their patients. The positive feedback surrounding the EMR toolkit for AF and its perceived impact on patient care can be attributed to the adoption of a user-centered design that merged clinically important information about AF management with user needs

  8. Clinician‐selected Electronic Information Resources do not Guarantee Accuracy in Answering Primary Care Physicians’ Information Needs. A review of: McKibbon, K. Ann, and Douglas B. Fridsma. “Effectiveness of Clinician‐selected Electronic Information Resources for Answering Primary Care Physicians’ Information Needs.” Journal of the American Medical Informatics Association 13.6 (2006: 653‐9.

    Directory of Open Access Journals (Sweden)

    Martha Ingrid Preddie

    2008-03-01

    Full Text Available Objective – To determine if electronic information resources selected by primary care physicians improve their ability to answer simulated clinical questions.Design – An observational study utilizing hour‐long interviews and think‐aloud protocols.Setting – The offices and clinics of primary care physicians in Canada and the United States.Subjects – Twenty‐five primary care physicians of whom 4 were women, 17 were from Canada, 22 were family physicians,and 24 were board certified.Methods – Participants provided responses to 23 multiple‐choice questions. Each physician then chose two questions and looked for the answers utilizing information resources of their own choice. The search processes, chosen resources and search times were noted. These were analyzed along with data on the accuracy of the answers and certainties related to the answer to each clinical question prior to the search.Main results – Twenty‐three physicians sought answers to 46 simulated clinical questions. Utilizing only electronic information resources, physicians spent a mean of 13.0 (SD 5.5 minutes searching for answers to the questions, an average of 7.3(SD 4.0 minutes for the first question and 5.8 (SD 2.2 minutes to answer the second question. On average, 1.8 resources were utilized per question. Resources that summarized information, such as the Cochrane Database of Systematic Reviews, UpToDate and Clinical Evidence, were favored 39.2% of the time, MEDLINE (Ovid and PubMed 35.7%, and Internet resources including Google 22.6%. Almost 50% of the search and retrieval strategies were keyword‐based, while MeSH, subheadings and limiting were used less frequently. On average, before searching physicians answered 10 of 23 (43.5% questions accurately. For questions that were searched using clinician‐selected electronic resources, 18 (39.1% of the 46 answers were accurate before searching, while 19 (42.1% were accurate after searching. The difference of

  9. End-user support for a primary care electronic medical record: a qualitative case study of a vendor’s perspective

    Directory of Open Access Journals (Sweden)

    Aviv Shachak

    2013-05-01

    Full Text Available Background In primary care settings, users often rely on vendors to provide support for health information technology (HIT. Yet, little is known about the vendors’ perspectives on the support they provide, how support personnel perceive their roles, the challenges they face and the ways they deal with them.Objective To provide in-depth insight into an electronic-medical record (EMR vendor’s perspective on end-user support.Methods As part of a larger case study research, we conducted nine semi-structured interviews with help desk staff, trainers and service managers of an EMR vendor, and observed two training sessions of a new client.Results With a growing client base, the vendor faced challenges of support staff shortage and high variance in users’ technical knowledge. Additionally, users sometimes needed assistance with infrastructure, and not just software problems. These challenges sometimes hindered the provision of timely support and required supporters to possess good interpersonal skills and adapt to diverse client population.Conclusion This study highlights the complexity of providing end-user support for HIT. With increased adoption, other vendors are likely to face similar challenges. To deal with these issues, supporters need not only strong technical knowledge of the systems, but also good interpersonal communication skills. Some responsibilities may be delegated to super-users. Users may find it useful to hire local IT staff, at least on an on-call basis, to provide assistance with infrastructure problems, which are not supported by the software vendor. Vendors may consider expanding their service packages to cover these elements.

  10. Primary electron transfer in reaction centers of YM210L and YM210L/HL168L mutants of Rhodobacter sphaeroides.

    Science.gov (United States)

    Yakovlev, A G; Vasilieva, L G; Khmelnitskaya, T I; Shkuropatova, V A; Shkuropatov, A Ya; Shuvalov, V A

    2010-07-01

    The role of tyrosine M210 in charge separation and stabilization of separated charges was studied by analyzing of the femtosecond oscillations in the kinetics of decay of stimulated emission from P* and of a population of the primary charge separated state P(+)B(A)(-) in YM210L and YM210L/HL168L mutant reaction centers (RCs) of Rhodobacter sphaeroides in comparison with those in native Rba. sphaeroides RCs. In the mutant RCs, TyrM210 was replaced by Leu. The HL168L mutation placed the redox potential of the P(+)/P pair 123 mV below that of native RCs, thus creating a theoretical possibility of P(+)B(A)(-) stabilization. Kinetics of P* decay at 940 nm of both mutants show a significant slowing of the primary charge separation reaction in comparison with native RCs. Distinct damped oscillations in these kinetics with main frequency bands in the range of 90-150 cm(-1) reflect mostly nuclear motions inside the dimer P. Formation of a very small absorption band of B(A)(-) at 1020 nm is registered in RCs of both mutants. The formation of the B(A)(-) band is accompanied by damped oscillations with main frequencies from ~10 to ~150 cm(-1). Only a partial stabilization of the P(+)B(A)(-) state is seen in the YM210L/HL168L mutant in the form of a small non-oscillating background of the 1020-nm kinetics. A similar charge stabilization is absent in the YM210L mutant. A model of oscillatory reorientation of the OH-group of TyrM210 in the electric fields of P(+) and B(A)(-) is proposed to explain rapid stabilization of the P(+)B(A)(-) state in native RCs. Small oscillatory components at ~330-380 cm(-1) in the 1020-nm kinetics of native RCs are assumed to reflect this reorientation. We conclude that the absence of TyrM210 probably cannot be compensated by lowering of the P(+)B(A)(-) free energy that is expected for the double YM210L/HL168L mutant. An oscillatory motion of the HOH55 water molecule under the influence of P(+) and B(A)(-) is assumed to be another potential

  11. Identifying individuals with physician-diagnosed chronic obstructive pulmonary disease in primary care electronic medical records: a retrospective chart abstraction study

    OpenAIRE

    Lee, Theresa M.; Tu, Karen; Wing, Laura L.; Gershon, Andrea S.

    2017-01-01

    Little is known about using electronic medical records to identify patients with chronic obstructive pulmonary disease to improve quality of care. Our objective was to develop electronic medical record algorithms that can accurately identify patients with obstructive pulmonary disease. A retrospective chart abstraction study was conducted on data from the Electronic Medical Record Administrative data Linked Database (EMRALD?) housed at the Institute for Clinical Evaluative Sciences. Abstracte...

  12. Promising adoption of an electronic clinical decision support system for antenatal and intrapartum care in rural primary healthcare facilities in sub-Saharan Africa: The QUALMAT experience.

    Science.gov (United States)

    Sukums, Felix; Mensah, Nathan; Mpembeni, Rose; Massawe, Siriel; Duysburgh, Els; Williams, Afua; Kaltschmidt, Jens; Loukanova, Svetla; Haefeli, Walter E; Blank, Antje

    2015-09-01

    The QUALMAT project has successfully implemented an electronic clinical decision support system (eCDSS) for antenatal and intrapartum care in two sub-Saharan African countries. The system was introduced to facilitate adherence to clinical practice guidelines and to support decision making during client encounter to bridge the know-do gap of health workers. This study aimed to describe health workers' acceptance and use of the eCDSS for maternal care in rural primary health care (PHC) facilities of Ghana and Tanzania and to identify factors affecting successful adoption of such a system. This longitudinal study was conducted in Lindi rural district in Tanzania and Kassena-Nankana district in Ghana between October 2011 and December 2013 employing mixed methods. The study population included healthcare workers who were involved in the provision of maternal care in six rural PHC facilities from one district in each country where the eCDSS was implemented. All eCDSS users participated in the study with 61 and 56 participants at the midterm and final assessment, respectively. After several rounds of user training and support the eCDSS has been successfully adopted and constantly used during patient care in antenatal clinics and maternity wards. The eCDSS was used in 71% (2703/3798) and 59% (14,189/24,204) of all ANC clients in Tanzania and Ghana respectively, while it was also used in 83% (1185/1427) and 67% (1435/2144) of all deliveries in Tanzania and in Ghana, respectively. Several barriers reported to hinder eCDSS use were related to individual users, tasks, technology, and organization attributes. Implementation of an eCDSS in resource-constrained PHC facilities in sub-Saharan Africa was successful and the health workers accepted and continuously used the system for maternal care. Facilitators for eCDSS use included sufficient training and regular support whereas the challenges to sustained use were unreliable power supply and perceived high workload. However our

  13. Using the diffusion of innovations theory to assess socio-technical factors in planning the implementation of an electronic health record alert across multiple primary care clinics

    Directory of Open Access Journals (Sweden)

    Ching-Pin Lin

    2016-04-01

    Conclusion: Understanding variation in organizational culture and infrastructure across primary care clinics is important in planning implementation of an intervention to reduce ADEs among patients with CKD.

  14. Optimising Use of Electronic Health Records to Describe the Presentation of Rheumatoid Arthritis in Primary Care: A Strategy for Developing Code Lists

    Science.gov (United States)

    Nicholson, Amanda; Ford, Elizabeth; Davies, Kevin A.; Smith, Helen E.; Rait, Greta; Tate, A. Rosemary; Petersen, Irene; Cassell, Jackie

    2013-01-01

    Background Research using electronic health records (EHRs) relies heavily on coded clinical data. Due to variation in coding practices, it can be difficult to aggregate the codes for a condition in order to define cases. This paper describes a methodology to develop ‘indicator markers’ found in patients with early rheumatoid arthritis (RA); these are a broader range of codes which may allow a probabilistic case definition to use in cases where no diagnostic code is yet recorded. Methods We examined EHRs of 5,843 patients in the General Practice Research Database, aged ≥30y, with a first coded diagnosis of RA between 2005 and 2008. Lists of indicator markers for RA were developed initially by panels of clinicians drawing up code-lists and then modified based on scrutiny of available data. The prevalence of indicator markers, and their temporal relationship to RA codes, was examined in patients from 3y before to 14d after recorded RA diagnosis. Findings Indicator markers were common throughout EHRs of RA patients, with 83.5% having 2 or more markers. 34% of patients received a disease-specific prescription before RA was coded; 42% had a referral to rheumatology, and 63% had a test for rheumatoid factor. 65% had at least one joint symptom or sign recorded and in 44% this was at least 6-months before recorded RA diagnosis. Conclusion Indicator markers of RA may be valuable for case definition in cases which do not yet have a diagnostic code. The clinical diagnosis of RA is likely to occur some months before it is coded, shown by markers frequently occurring ≥6 months before recorded diagnosis. It is difficult to differentiate delay in diagnosis from delay in recording. Information concealed in free text may be required for the accurate identification of patients and to assess the quality of care in general practice. PMID:23451024

  15. Wide-range high-resolution transmission electron microscopy reveals morphological and distributional changes of endomembrane compartments during log to stationary transition of growth phase in tobacco BY-2 cells.

    Science.gov (United States)

    Toyooka, Kiminori; Sato, Mayuko; Kutsuna, Natsumaro; Higaki, Takumi; Sawaki, Fumie; Wakazaki, Mayumi; Goto, Yumi; Hasezawa, Seiichiro; Nagata, Noriko; Matsuoka, Ken

    2014-09-01

    Rapid growth of plant cells by cell division and expansion requires an endomembrane trafficking system. The endomembrane compartments, such as the Golgi stacks, endosome and vesicles, are important in the synthesis and trafficking of cell wall materials during cell elongation. However, changes in the morphology, distribution and number of these compartments during the different stages of cell proliferation and differentiation have not yet been clarified. In this study, we examined these changes at the ultrastructural level in tobacco Bright yellow 2 (BY-2) cells during the log and stationary phases of growth. We analyzed images of the BY-2 cells prepared by the high-pressure freezing/freeze substitution technique with the aid of an auto-acquisition transmission electron microscope system. We quantified the distribution of secretory and endosomal compartments in longitudinal sections of whole cells by using wide-range gigapixel-class images obtained by merging thousands of transmission electron micrographs. During the log phase, all Golgi stacks were composed of several thick cisternae. Approximately 20 vesicle clusters (VCs), including the trans-Golgi network and secretory vesicle cluster, were observed throughout the cell. In the stationary-phase cells, Golgi stacks were thin with small cisternae, and only a few VCs were observed. Nearly the same number of multivesicular body and small high-density vesicles were observed in both the stationary and log phases. Results from electron microscopy and live fluorescence imaging indicate that the morphology and distribution of secretory-related compartments dramatically change when cells transition from log to stationary phases of growth. © The Author 2014. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  16. Using electronic medical records analysis to investigate the effectiveness of lifestyle programs in real-world primary care is challenging: a case study in diabetes mellitus.

    NARCIS (Netherlands)

    M. Spigt; Tjarco Koppenaal; Joris Linmans; Wolfgang Viechtbauer; J.A. Knottnerus

    2012-01-01

    OBJECTIVE: The increasing prevalence of diabetes suggests a gap between real world and controlled trial effectiveness of lifestyle interventions, but real-world investigations are rare. Electronic medical registration facilitates research on real-world effectiveness, although such investigations may

  17. Challenges associated with missing data in electronic health records: A case study of a risk prediction model for diabetes using data from Slovenian primary care.

    Science.gov (United States)

    Stiglic, Gregor; Kocbek, Primoz; Fijacko, Nino; Sheikh, Aziz; Pajnkihar, Majda

    2017-10-01

    The increasing availability of data stored in electronic health records brings substantial opportunities for advancing patient care and population health. This is, however, fundamentally dependant on the completeness and quality of data in these electronic health records. We sought to use electronic health record data to populate a risk prediction model for identifying patients with undiagnosed type 2 diabetes mellitus. We, however, found substantial (up to 90%) amounts of missing data in some healthcare centres. Attempts at imputing for these missing data or using reduced dataset by removing incomplete records resulted in a major deterioration in the performance of the prediction model. This case study illustrates the substantial wasted opportunities resulting from incomplete records by simulation of missing and incomplete records in predictive modelling process. Government and professional bodies need to prioritise efforts to address these data shortcomings in order to ensure that electronic health record data are maximally exploited for patient and population benefit.

  18. PAMELA and electrons

    Energy Technology Data Exchange (ETDEWEB)

    Mocchiutti, E., E-mail: Emiliano.Mocchiutti@ts.infn.i [INFN, Sezione di Trieste, Padriciano 99, I-34012 Trieste (Italy); Adriani, O. [University of Florence, Department of Physics, Via Sansone 1, I-50019 Sesto Fiorentino, Florence (Italy); INFN, Sezione di Firenze, Via Sansone 1, I-50019 Sesto Fiorentino, Florence (Italy); Barbarino, G.C. [University of Naples ' Federico II' , Department of Physics, Via Cintia, I-80126 Naples (Italy); INFN, Sezione di Napoli, Via Cintia, I-80126 Naples (Italy); Bazilevskaya, G.A. [Lebedev Physical Institute, Leninsky Prospekt 53, RU-119991 Moscow (Russian Federation); Bellotti, R. [University of Bari, Department of Physics, Via Amendola 173, I-70126 Bari (Italy); INFN, Sezione di Bari, Via Amendola 173, I-70126 Bari (Italy); Boezio, M. [INFN, Sezione di Trieste, Padriciano 99, I-34012 Trieste (Italy); Bogomolov, E.A. [Ioffe Physical Technical Institute, Polytekhnicheskaya 26, RU-194021 St. Petersburg (Russian Federation); Bonechi, L.; Bongi, M. [University of Florence, Department of Physics, Via Sansone 1, I-50019 Sesto Fiorentino, Florence (Italy); INFN, Sezione di Firenze, Via Sansone 1, I-50019 Sesto Fiorentino, Florence (Italy); Bonvicini, V. [INFN, Sezione di Trieste, Padriciano 99, I-34012 Trieste (Italy); Borisov, S. [INFN, Sezione di Roma ' Tor Vergata' , Via della Ricerca Scientifica 1, I-00133 Rome (Italy); Moscow Engineering and Physics Institute, Kashirskoe Shosse 31, RU-11540 Moscow (Russian Federation); Bottai, S. [INFN, Sezione di Firenze, Via Sansone 1, I-50019 Sesto Fiorentino, Florence (Italy); Bruno, A. [University of Bari, Department of Physics, Via Amendola 173, I-70126 Bari (Italy); INFN, Sezione di Bari, Via Amendola 173, I-70126 Bari (Italy); Cafagna, F. [INFN, Sezione di Bari, Via Amendola 173, I-70126 Bari (Italy); Campana, D. [INFN, Sezione di Napoli, Via Cintia, I-80126 Naples (Italy)

    2011-02-21

    The 15th of June 2006, the PAMELA satellite-borne experiment was launched from the Baikonur cosmodrome and it has been collecting data since July 2006. The apparatus comprises a time-of-flight system, a silicon-microstrip magnetic spectrometer, a silicon-tungsten electromagnetic calorimeter, an anticoincidence system, a shower tail counter scintillator and a neutron detector. The combination of these devices allows precision studies of the charged cosmic radiation to be conducted over a wide energy range (100 MeV-100's GeV) with high statistics. The measurement of the positron to electron fraction and of the electron energy spectrum in order to search for exotic sources, such as dark matter particle annihilations, are within the PAMELA primary scientific goal.

  19. The Primary Care National electronic Library for Health (NeLH-PC: a pilot of information-centred knowledge management for primary care - www.nelh-pc.nhs.uk

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan

    2002-06-01

    Conclusions: NeLH-PC provides an exemplar of how a limited range of knowledge management tools is utilised. More investment is needed if a broader range of tools is to be provided. Greater integration is required with educationalists and other information and knowledge services if the library's full potential is to be realised.

  20. ["Auriga-04" study on the use of a range of Allevyn hydro-cellular dressings in the treatment of bed sores and leg ulcers by primary health care professionals].

    Science.gov (United States)

    Verdú Soriano, José; Nolasco Bonmatí, Andreu; López Casanova, Pablo; Torra i Bou, Joan-Enric

    2006-04-01

    The objective of this study was to analyze the application and usefulness of a range of Allevyn trademark hydro-cellular dressings during cicatrisation and in the control of exudation and other various characteristics of chronic lesions in real clinical conditions where patients were treated by primary health care professionals. In this study, 441 patients having chronic wounds, either bed sores or leg ulcers, were studied, health care professionals applied a planned program of measures repeated during 20 dressing changes or until cicatrisation was completed if this happened during this interval. The sample population was comprised of elderly patients, the majority of whom were women whose general health could be classified from medium to poor. These patients suffered from these types of wounds: 63% had bed sores, 27.2% had varicose ulcers and 9.8% had leg ulcers caused by another etiology such as mixed ulcers, arterial ulcers or diabetic foot. On average, these lesions were characterized by an evolutionary period of 6.1 months and had a 30.43 square centimetre surface area at the start of the study. 126 lesions, or 28.8%, cicatrized on average of 47.3 days. Among the 315 lesions which had not cicatrized by the end of 20 dressing changes, 90.5% showed evidence of improvement. During the study these lesions showed a significant reduction in their surface area, as well as a significant improvement at the edges of these lesions and the peri-ulceral skin. The health personnel which carried out the treatment using these dressings gave a very favorable evaluation for their use. At the end of this study, in comparison with other dressings previous used, this study showed that in 43.43% of the cases an Allevyn dressing was deemed better in terms of ease in application, in 51.79% of the cases an Allevyn dressing was better in terms of absorption and in 43.23% of the cases an Allevyn dressing was better during removal.

  1. Reproducibility of cervical range of motion in patients with neck pain.

    NARCIS (Netherlands)

    Hoving, J.L.; Pool, J.J.M.; Mameren, H.H. van; Devillé, W.L.J.M.; Assendelft, W.J.J.; Vet, H.C.W. de; Winter, A.F. de; Koes, B.W.; Bouter, L.M.

    2005-01-01

    OBJECTIVE: To assess the intra-rater and inter-rater reproducibility of the measurement of active Range of Motion (ROM) in patients with neck pain using the Cybex Electronic Digital Inclinometer-320 (EDI-320). DESIGN: In an outpatient clinic in a primary care setting 32 patients with at least 2

  2. Reproducibility of cervical range of motion in patients with neck pain

    NARCIS (Netherlands)

    Hoving, J.L.; Pool, J.J.M.; Mameren, van H.; Deville, W.L.J.M.; Assendelft, W.J.J.; Vet, de H.C.W.; Winter, de A.F.; Koes, B.W.; Bouter, L.M.

    2005-01-01

    OBJECTIVE: To assess the intra-rater and inter-rater reproducibility of the measurement of active Range of Motion (ROM) in patients with neck pain using the Cybex Electronic Digital Inclinometer-320 (EDI-320). DESIGN: In an outpatient clinic in a primary care setting 32 patients with at least 2

  3. Exploring practical approaches to maximising data quality in electronic healthcare records in the primary care setting and associated benefits. Report of panel-led discussion held at SAPC in July 2014.

    Science.gov (United States)

    Dungey, Sheena; Glew, Simon; Heyes, Barbara; Macleod, John; Tate, A Rosemary

    2016-09-01

    Electronic healthcare records provide information about patient care over time which not only affords the opportunity to improve patient care directly through effective monitoring and identification of care requirements but also offers a unique platform for both clinical and service-model research essential to the longer-term development of the health service. The quality of the recorded data can, however, be variable and can compromise the validity of data use both for primary and secondary purposes. In order to explore the challenges and benefits of and approaches to recording high quality primary care electronic records, a Clinical Practice Research Datalink (CPRD) sponsored workshop was held at the Society of Academic Primary Care (SAPC) conference in 2014 with the aim of engaging GPs and other data users. The workshop was held as a structured discussion, led by an expert panel and focused around three questions: (1) What are the data quality priorities for clinicians and researchers? How do these priorities differ or overlap? (2) What challenges might GPs face in provision of good data quality both for treating their patients and for research? Do these aims conflict? (3) What tools (such as data metrics and visualisations or software components) could assist the GP in improving data quality and patient management and could this tie in with analytical processes occurring at the research stage? The discussion highlighted both overlap and differences in the perceived data quality priorities and challenges for different user groups. Five key areas of focus were agreed upon and recommendations determined for moving forward in improving quality. The importance of good high quality electronic healthcare records has been set forth along with the need for a practical user-considered and collaborative approach to its improvement.

  4. Can an alert in primary care electronic medical records increase participation in a population-based screening programme for colorectal cancer? COLO-ALERT, a randomised clinical trial

    OpenAIRE

    Guiriguet-Capdevila, Carolina; Muñoz-Ortiz, Laura; Rivero-Franco, Irene; Vela-Vallespín, Carme; Vilarrubí-Estrella, Mercedes; Torres-Salinas, Miquel; Grau-Cano, Jaume; Burón-Pust, Andrea; Hernández-Rodríguez, Cristina; Fuentes-Peláez, Antonio; Reina-Rodríguez, Dolores; De León-Gallo, Rosa; Mendez-Boo, Leonardo; Torán-Monserrat, Pere

    2014-01-01

    Background Colorectal cancer is an important public health problem in Spain. Over the last decade, several regions have carried out screening programmes, but population participation rates remain below recommended European goals. Reminders on electronic medical records have been identified as a low-cost and high-reach strategy to increase participation. Further knowledge is needed about their effect in a population-based screening programme. The main aim of this study is to evaluate the effec...

  5. Report to Congress on Sustainable Ranges, 2015

    Science.gov (United States)

    2015-03-01

    no organic capability. HQ NTTR continues to work with JIOR to provide a mobile service which can be deployed at the Urban Operations Complex ( UOC ...NTTR continues to work with JIOR to provide a mobile service which can be deployed at the Urban Operations Complex ( UOC ) on Range 62. Electronic... UOC ) on Range 62. Electronic Combat Support h The range lacks a complete electronic target set. EA platforms do not get real-time feedback on their

  6. Electron Capture Supernovae from Close Binary Systems

    Science.gov (United States)

    Poelarends, Arend J. T.; Wurtz, Scott; Tarka, James; Cole Adams, L.; Hills, Spencer T.

    2017-12-01

    We present the first detailed study of the Electron Capture Supernova Channel (ECSN Channel) for a primary star in a close binary star system. Progenitors of ECSN occupy the lower end of the mass spectrum of supernova progenitors and are thought to form the transition between white dwarf progenitors and core-collapse progenitors. The mass range for ECSN from close binary systems is thought to be wider than the range for single stars, because of the effects of mass transfer on the helium core. Using the MESA stellar evolution code, we explored the parameter space of initial primary masses between 8 and 17 {M}⊙ , using a large grid of models. We find that the initial primary mass and the mass transfer evolution are important factors in the final fate of stars in this mass range. Mass transfer due to Roche lobe overflow during and after carbon burning causes the core to cool down so that it avoids neon ignition, even in helium-free cores with masses up to 1.52 {M}⊙ , which in single stars would ignite neon. If the core is able to contract to high enough densities for electron captures to commence, we find that, for the adopted Ledoux convection criterion, the initial mass range for the primary to evolve into an ECSN is between 13.5 and 17.6 {M}⊙ . The mass ratio, initial period, and mass-loss efficiency only marginally affect the predicted ranges.

  7. Is there any range-of-motion advantage to using bearings larger than 36mm in primary hip arthroplasty: A case-control study comparing 36-mm and large-diameter heads.

    Science.gov (United States)

    Delay, C; Putman, S; Dereudre, G; Girard, J; Lancelier-Bariatinsky, V; Drumez, E; Migaud, H

    2016-10-01

    Large-diameter (>36mm) total hip arthroplasty (THA) has developed rapidly since the advent of ceramic-on-ceramic (CoC) bearings and highly cross-linked polyethylene. Theoretically, the increase in diameter reduces the risk of instability, although the advantage of calibers beyond 36mm has not been demonstrated in terms of range-of-motion recovery. We conducted a comparative study with a single prosthesis model to determine whether increasing the caliber beyond 36mm provides: (1) better recovery of range-of-motion, (2) a higher functional score, and (3) reduction of the dislocation rate. Increasing the range-of-motion by increasing the caliber beyond 36mm provides better range-of-motion. We analyzed two consecutive, single-operator cementless THA series performed via the mini posterior approach, which differed only in the bearing system (51 metal-on-metal [MoM] with a mean caliber of 45mm±3.3 [range, 40-54] and 61 CoC with a 36-mm caliber). Both series were comparable preoperatively in terms of age, diagnosis, functional scores, preoperative range-of-motion, body mass index, UCLA activity level, and Charnley score. We compared the joint range of movement at follow-up and the gains in range of movement, onset of dislocation, and functional scores (Oxford, Postel-Merle d'Aubigné [PMA]). The mean overall joint range-of-motion was 254°±39° (range, 150-310°) for an 81°±44° (range, -50 to 180°) gain in the MoM group and 256°±23° (range, 200-280°) for an 84°±40° (range, 0-160°) gain in the CoC group (NS). The MoM group presented the following results: Oxford=13.71±3.66 (range, 12-33) for a gain of 24.82 points±7.9 (range, -1 to 40), PMA=17.75±1.06 (range, 11-18) for a gain of 7.78 points±4.01 (range, 2-15). The CoC group had: Oxford=14.98±4.42 (range, 12-36) for a gain of 24.75 points±6.55 (range, 12-40), PMA 17.66±0.7 (range, 14-18) for a gain of 8 points±3.77 (range, 1-15). None of the gains and scores at follow-up differed significantly between

  8. Electronic plants.

    Science.gov (United States)

    Stavrinidou, Eleni; Gabrielsson, Roger; Gomez, Eliot; Crispin, Xavier; Nilsson, Ove; Simon, Daniel T; Berggren, Magnus

    2015-11-01

    The roots, stems, leaves, and vascular circuitry of higher plants are responsible for conveying the chemical signals that regulate growth and functions. From a certain perspective, these features are analogous to the contacts, interconnections, devices, and wires of discrete and integrated electronic circuits. Although many attempts have been made to augment plant function with electroactive materials, plants' "circuitry" has never been directly merged with electronics. We report analog and digital organic electronic circuits and devices manufactured in living plants. The four key components of a circuit have been achieved using the xylem, leaves, veins, and signals of the plant as the template and integral part of the circuit elements and functions. With integrated and distributed electronics in plants, one can envisage a range of applications including precision recording and regulation of physiology, energy harvesting from photosynthesis, and alternatives to genetic modification for plant optimization.

  9. Use of Supplemental Short Pre-Contoured Accessory Rods and Cobalt Chrome Alloy Posterior Rods Reduces Primary Rod Strain and Range of Motion Across the Pedicle Subtraction Osteotomy Level

    DEFF Research Database (Denmark)

    Hallager, Dennis Winge; Gehrchen, Poul Martin; Dahl, Benny

    2016-01-01

    and rod strain is necessary to determine the biomechanical efficacy of these techniques. METHODS: Five specimens (T12-S1) underwent PSO at L3 with pedicle screw stabilization at L1-S1. Pedicle subtraction was adjusted to achieve a final lordosis of 70°. Flexion-extension (FE), lateral bending, and axial...... surface strain on the primary rod, irrespective of construct (P devices minimally affected motion...

  10. Electronics and electronic systems

    CERN Document Server

    Olsen, George H

    1987-01-01

    Electronics and Electronic Systems explores the significant developments in the field of electronics and electronic devices. This book is organized into three parts encompassing 11 chapters that discuss the fundamental circuit theory and the principles of analog and digital electronics. This book deals first with the passive components of electronic systems, such as resistors, capacitors, and inductors. These topics are followed by a discussion on the analysis of electronic circuits, which involves three ways, namely, the actual circuit, graphical techniques, and rule of thumb. The remaining p

  11. Optical properties and electronic transitions of zinc oxide, ferric oxide, cerium oxide, and samarium oxide in the ultraviolet and extreme ultraviolet

    DEFF Research Database (Denmark)

    Pauly, N; Yubero, F; Espinós, J P

    2017-01-01

    Optical properties and electronic transitions of four oxides, namely zinc oxide, ferric oxide, cerium oxide, and samarium oxide, are determined in the ultraviolet and extreme ultraviolet by reflection electron energy loss spectroscopy using primary electron energies in the range 0.3-2.0 keV. This...

  12. The electronic band structure of Ge1-x Sn x in the full composition range: indirect, direct, and inverted gaps regimes, band offsets, and the Burstein-Moss effect

    Science.gov (United States)

    Polak, M. P.; Scharoch, P.; Kudrawiec, R.

    2017-05-01

    A comprehensive and detailed study of the composition dependence of lattice constants, band gaps and band offsets has been performed for bulk Ge1-x Sn x alloy in the full composition range using state-of-the-art density functional theory methods. A spectral weight approach to band unfolding has been applied as a means of distinguishing the indirect and direct band gaps from folded supercell band structures. In this way, four characteristic regions of the band gap character have been identified for Ge1-x Sn x alloy: an indirect band gap (x    25%) with inverse spin-orbit split-off for 45%  text{C{{\\text{B}} Γ }}}   =  2.43  ±  0.06 eV, {{b}\\text{C{{\\text{B}}L}}}   =  0.64  ±  0.04 eV, {{b}\\text{VB}}   =  -0.59  ±  0.04 eV, and {{b}\\text{SO}}   =  -0.49  ±  0.05 eV). This indicates that Ge1-x Sn x behaves like a highly mismatched group IV alloy. The composition dependence of lattice constant shows negligible bowing (b a   =  -0.083 Å). Obtained results have been compared with available experimental data. The origin of band gap reduction and large bowing has been analyzed and conclusions have been drawn regarding the relationship between experimental and theoretical results. It is shown that due to the low DOS at the Γ-point, a significant filling of CB by electrons in the direct gap regime may easily take place. Therefore, the Burstein-Moss effect should be considered when comparing experimental data with theoretical predictions as has already been shown for other intrinsic n-type narrow gap semiconductors (e.g. InN).

  13. Electronics engineer's reference book

    CERN Document Server

    Turner, L W

    1976-01-01

    Electronics Engineer's Reference Book, 4th Edition is a reference book for electronic engineers that reviews the knowledge and techniques in electronics engineering and covers topics ranging from basics to materials and components, devices, circuits, measurements, and applications. This edition is comprised of 27 chapters; the first of which presents general information on electronics engineering, including terminology, mathematical equations, mathematical signs and symbols, and Greek alphabet and symbols. Attention then turns to the history of electronics; electromagnetic and nuclear radiatio

  14. Electronic detectors for electron microscopy.

    Science.gov (United States)

    Faruqi, A R; McMullan, G

    2011-08-01

    Electron microscopy (EM) is an important tool for high-resolution structure determination in applications ranging from condensed matter to biology. Electronic detectors are now used in most applications in EM as they offer convenience and immediate feedback that is not possible with film or image plates. The earliest forms of electronic detector used routinely in transmission electron microscopy (TEM) were charge coupled devices (CCDs) and for many applications these remain perfectly adequate. There are however applications, such as the study of radiation-sensitive biological samples, where film is still used and improved detectors would be of great value. The emphasis in this review is therefore on detectors for use in such applications. Two of the most promising candidates for improved detection are: monolithic active pixel sensors (MAPS) and hybrid pixel detectors (of which Medipix2 was chosen for this study). From the studies described in this review, a back-thinned MAPS detector appears well suited to replace film in for the study of radiation-sensitive samples at 300 keV, while Medipix2 is suited to use at lower energies and especially in situations with very low count rates. The performance of a detector depends on the energy of electrons to be recorded, which in turn is dependent on the application it is being used for; results are described for a wide range of electron energies ranging from 40 to 300 keV. The basic properties of detectors are discussed in terms of their modulation transfer function (MTF) and detective quantum efficiency (DQE) as a function of spatial frequency.

  15. New tools for an old trade: a socio-technical appraisal of how electronic decision support is used by primary care practitioners.

    Science.gov (United States)

    Peiris, David; Usherwood, Tim; Weeramanthri, Tarun; Cass, Alan; Patel, Anushka

    2011-11-01

    This article explores Australian general practitioners' (GPs) views on a novel electronic decision support (EDS) tool being developed for cardiovascular disease management. We use Timmermans and Berg's technology-in-practice approach to examine how technologies influence and are influenced by the social networks in which they are placed. In all, 21 general practitioners who piloted the tool were interviewed. The tool occupied an ill-defined middle ground in a dialectical relationship between GPs' routine care and factors promoting best practice. Drawing on Lipsky's concept of 'street-level bureaucrats', the tool's ability to process workloads expeditiously was of greatest appeal to GPs. This feature of the tool gave it the potential to alter the structure, process and content of healthcare encounters. The credibility of EDS tools appears to be mediated by fluid notions of best practice, based on an expert scrutiny of the evidence, synthesis via authoritative guidelines and dissemination through trusted and often informal networks. Balanced against this is the importance of 'soft' forms of knowledge such as intuition and timing in everyday decision-making. This resonates with Aristotle's theory of phronesis (practical wisdom) and may render EDS tools inconsequential if they merely process biomedical data. While EDS tools show promise in improving health practitioner performance, the socio-technical dimensions of their implementation warrant careful consideration. © 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.

  16. Recognition and response to electronic fetal heart rate patterns: impact on newborn outcomes and primary cesarean delivery rate in women undergoing induction of labor.

    Science.gov (United States)

    Clark, Steven L; Meyers, Janet A; Frye, Donna K; Garthwaite, Thomas; Lee, Alan J; Perlin, Jonathan B

    2015-04-01

    The objective of the study was to examine the clinical impact of specific fetal monitoring-related practices during induced labor. This was a prospective, nonrandomized study. We studied 14,398 women undergoing oxytocin induction of labor. A decrease in the infusion rate of oxytocin in the face of specified category II fetal heart rate tracings was associated with a significantly reduced rate of neonatal intensive care unit admission (3.8% vs 5.2%, P = .01) and Apgar score less than 7 at 1 and 5 minutes (4.9% vs 6.4%, P = .01, 0.6% vs 1.1%, P = .04). Compliance with an in-use checklist was associated with both a reduction in the rate of neonatal intensive care unit admission (2.9 vs 4.4, P = .00) and a reduction in the cesarean delivery rate (15.8% vs 18.8%, P = .00). Electronic fetal heart rate monitoring improves neonatal outcomes when unambiguous definitions of abnormal fetal heart rate and tachysystole are coupled with specific interventions. Utilization of a checklist for oxytocin monitoring is associated with improved neonatal outcomes and a reduction in the cesarean delivery rate. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Attitudes of a group of Brazilian orthodontists towards the diagnosis and management of primary headache (migraine: an electronic-based survey

    Directory of Open Access Journals (Sweden)

    Reynaldo Leite Martins Junior

    2011-12-01

    Full Text Available OBJECTIVES: The aim of this study was to investigate the knowledge and attitudes of orthodontists in the diagnosis and management of migraine without aura. MATERIAL AND METHODS: Participants were dentists, recruited among members of the Brazilian Association of Orthodontics and Facial Orthopedics (ABOR. An e-mail was sent to all ABOR members, with a link to a website, especially prepared for this research. Dentists were presented to a report of a fictional patient fulfilling diagnostic criteria for a primary headache disorder, known as migraine without aura. Participants were asked to describe how they would relieve the patient's pain. Professional procedures were classified as "adequate" or "inadequate" according to the answers given. RESULTS: 161 valid answers were received (18.8% response rate. Of them, 36% of the actions were considered to be "adequate" procedures, while 64% were "inadequate". The results yielded 12 main procedures, based on common characteristics. Eighty-two orthodontists suggested orthodontic treatment with or without orthognathic surgery, and some suggested using stabilization appliances prior to the orthodontic treatment. CONCLUSIONS: The majority of participants proposed inadequate therapies, and 51% suggested orthodontic correction of occlusion, including orthognathic surgery. Educational activities on migraine should also target orthodontists.

  18. Primary infertility (image)

    Science.gov (United States)

    Primary infertility is a term used to describe a couple that has never been able to conceive a pregnancy ... to do so through unprotected intercourse. Causes of infertility include a wide range of physical as well ...

  19. A randomised controlled trial of a consumer-focused e-health strategy for cardiovascular risk management in primary care: the Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) study protocol

    Science.gov (United States)

    Redfern, Julie; Usherwood, T; Harris, M F; Rodgers, A; Hayman, N; Panaretto, K; Chow, C; Lau, A Y S; Neubeck, L; Coorey, G; Hersch, F; Heeley, E; Patel, A; Jan, S; Zwar, N; Peiris, D

    2014-01-01

    Introduction Fewer than half of all people at highest risk of a cardiovascular event are receiving and adhering to best practice recommendations to lower their risk. In this project, we examine the role of an e-health-assisted consumer-focused strategy as a means of overcoming these gaps between evidence and practice. Consumer Navigation of Electronic Cardiovascular Tools (CONNECT) aims to test whether a consumer-focused e-health strategy provided to Aboriginal and Torres Strait Islander and non-indigenous adults, recruited through primary care, at moderate-to-high risk of a cardiovascular disease event will improve risk factor control when compared with usual care. Methods and analysis Randomised controlled trial of 2000 participants with an average of 18 months of follow-up to evaluate the effectiveness of an integrated consumer-directed e-health portal on cardiovascular risk compared with usual care in patients with cardiovascular disease or who are at moderate-to-high cardiovascular disease risk. The trial will be augmented by formal economic and process evaluations to assess acceptability, equity and cost-effectiveness of the intervention. The intervention group will participate in a consumer-directed e-health strategy for cardiovascular risk management. The programme is electronically integrated with the primary care provider's software and will include interactive smart phone and Internet platforms. The primary outcome is a composite endpoint of the proportion of people meeting the Australian guideline-recommended blood pressure (BP) and cholesterol targets. Secondary outcomes include change in mean BP and fasting cholesterol levels, proportion meeting BP and cholesterol targets separately, self-efficacy, health literacy, self-reported point prevalence abstinence in smoking, body mass index and waist circumference, self-reported physical activity and self-reported medication adherence. Ethics and dissemination Primary ethics approval was received from the

  20. The STEREO IMPACT Suprathermal Electron (STE) Instrument

    Science.gov (United States)

    Lin, R. P.; Curtis, D. W.; Larson, D. E.; Luhmann, J. G.; McBride, S. E.; Maier, M. R.; Moreau, T.; Tindall, C. S.; Turin, P.; Wang, Linghua

    2008-04-01

    The Suprathermal Electron (STE) instrument, part of the IMPACT investigation on both spacecraft of NASA’s STEREO mission, is designed to measure electrons from ˜2 to ˜100 keV. This is the primary energy range for impulsive electron/3He-rich energetic particle events that are the most frequently occurring transient particle emissions from the Sun, for the electrons that generate solar type III radio emission, for the shock accelerated electrons that produce type II radio emission, and for the superhalo electrons (whose origin is unknown) that are present in the interplanetary medium even during the quietest times. These electrons are ideal for tracing heliospheric magnetic field lines back to their source regions on the Sun and for determining field line lengths, thus probing the structure of interplanetary coronal mass ejections (ICMEs) and of the ambient inner heliosphere. STE utilizes arrays of small, passively cooled thin window silicon semiconductor detectors, coupled to state-of-the-art pulse-reset front-end electronics, to detect electrons down to ˜2 keV with about 2 orders of magnitude increase in sensitivity over previous sensors at energies below ˜20 keV. STE provides energy resolution of Δ E/ E˜10 25% and the angular resolution of ˜20° over two oppositely directed ˜80°×80° fields of view centered on the nominal Parker spiral field direction.

  1. User Manuals for a Primary Care Electronic Medical Record System: A Mixed Methods Study of User- and Vendor-Generated Documents.

    Science.gov (United States)

    Shachak, Aviv; Dow, Rustam; Barnsley, Jan; Tu, Karen; Domb, Sharon; Jadad, Alejandro R; Lemieux-Charles, Louise

    2013-06-04

    Tutorials and user manuals are important forms of impersonal support for using software applications including electronic medical records (EMRs). Differences between user- and vendor documentation may indicate support needs, which are not sufficiently addressed by the official documentation, and reveal new elements that may inform the design of tutorials and user manuals. What are the differences between user-generated tutorials and manuals for an EMR and the official user manual from the software vendor? Effective design of tutorials and user manuals requires careful packaging of information, balance between declarative and procedural texts, an action and task-oriented approach, support for error recognition and recovery, and effective use of visual elements. No previous research compared these elements between formal and informal documents. We conducted an mixed methods study. Seven tutorials and two manuals for an EMR were collected from three family health teams and compared with the official user manual from the software vendor. Documents were qualitatively analyzed using a framework analysis approach in relation to the principles of technical documentation described above. Subsets of the data were quantitatively analyzed using cross-tabulation to compare the types of error information and visual cues in screen captures between user- and vendor-generated manuals. The user-developed tutorials and manuals differed from the vendor-developed manual in that they contained mostly procedural and not declarative information; were customized to the specific workflow, user roles, and patient characteristics; contained more error information related to work processes than to software usage; and used explicit visual cues on screen captures to help users identify window elements. These findings imply that to support EMR implementation, tutorials and manuals need to be customized and adapted to specific organizational contexts and workflows. The main limitation of the study

  2. Limb-sparing management with surgical resection, external-beam and intraoperative electron-beam radiation therapy boost for patients with primary soft tissue sarcoma of the extremity. A multicentric pooled analysis of long-term outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Calvo, Felipe A. [Hospital General Universitario Gregorio Maranon, Department of Oncology, Madrid (Spain); Complutense University, School of Medicine, Madrid (Spain); Sole, Claudio V. [Hospital General Universitario Gregorio Maranon, Department of Oncology, Madrid (Spain); Complutense University, School of Medicine, Madrid (Spain); Instituto de Radiomedicina, Service of Radiation Oncology, Santiago (Chile); Polo, Alfredo; Montero, Angel [Hospital Universitario Ramon y Cajal, Service of Radiation Oncology, Madrid (Spain); Cambeiro, Mauricio; Martinez-Monge, Rafael [Clinica Universidad de Navarra, Service of Radiation Oncology, Pamplona (Spain); Alvarez, Ana [Hospital General Universitario Gregorio Maranon, Service of Radiation Oncology, Madrid (Spain); Cuervo, Miguel [Hospital General Universitario Gregorio Maranon, Service of Orthopedics and Traumatology, Madrid (Spain); Julian, Mikel San [Clinica Universidad de Navarra, Service of Orthopedics and Traumatology, Pamplona (Spain)

    2014-10-15

    A joint analysis of data from three contributing centres within the intraoperative electron-beam radiation therapy (IOERT) Spanish program was performed to investigate the main contributions of IORT to the multidisciplinary treatment of high-risk extremity soft tissue sarcoma (STS). Patients with an histologic diagnosis of primary extremity STS, with absence of distant metastases, undergoing limb-sparing surgery with radical intent, external beam radiotherapy (median dose 45 Gy) and IOERT (median dose 12.5 Gy) were considered eligible for participation in this study. From 1986-2012, a total of 159 patients were analysed in the study from three Spanish institutions. With a median follow-up time of 53 months (range 4-316 years), 5-year local control (LC) was 82 %. The 5-year IOERT in-field control, disease-free survival (DFS) and overall survival (OS) were 86, 62 and 72 %, respectively. On multivariate analysis, only microscopically involved margin (R1) resection status retained significance in relation to LC (HR 5.20, p < 0.001). With regard to IOERT in-field control, incomplete resection (HR 4.88, p = 0.001) and higher IOERT dose (≥ 12.5 Gy; HR 0.32, p = 0.02) retained a significant association in multivariate analysis. From this joint analysis emerges the fact that an IOERT dose ≥ 12.5 Gy increases the rate of IOERT in-field control, but DFS remains modest, given the high risk of distant metastases. Intensified local treatment needs to be tested in the context of more efficient concurrent, neo- and adjuvant systemic therapy. (orig.) [German] Um den therapeutischen Beitrag einer intraoperativen Bestrahlung mit Elektronen (IOERT) als Teil eines multidisziplinaeren Behandlungskonzepts von Weichteilsarkomen (STS) im Extremitaetenbereich mit hohem Risikoprofil evaluieren zu koennen, wurde anhand des spanischen IOERT-Programms eine gepoolte Datenanalyse von drei teilnehmenden Zentren vorgenommen. Eingeschlossen in diese Studie wurden Patienten mit histologisch

  3. Occupational therapy in primary care: Results from a national survey.

    Science.gov (United States)

    Donnelly, Catherine A; Leclair, Leanne L; Wener, Pamela F; Hand, Carri L; Letts, Lori J

    2016-04-12

    To support integration of occupational therapy in primary care and research in this area, it is critical to document examples of occupational therapy in primary care. This study describes occupational therapy roles and models of practice used in primary care. An electronic survey was sent to occupational therapists across Canada. Participants were identified using purposive and snowball sampling strategies. Descriptive statistics were used to analyze the data. Respondents (n = 52) were almost exclusively working on interprofessional teams. Intervention was provided most frequently to individual clients, and services were provided both within the home/community and in the clinic. Occupational therapists offered a range of health promotion and prevention services, predominantly to adults and older adults. A number of supports and barriers to the integration of occupational therapy were identified. A growing number of occupational therapists are working in primary care providing a broad range of services across the life span. © CAOT 2016.

  4. Does the Prevalence of Dyslipidemias Differ between Newfoundland and the Rest of Canada? Findings from the Electronic Medical Records of the Canadian Primary Care Sentinel Surveillance Network

    Science.gov (United States)

    Asghari, Shabnam; Aref-Eshghi, Erfan; Hurley, Oliver; Godwin, Marshall; Duke, Pauline; Williamson, Tyler; Mahdavian, Masoud

    2015-01-01

    Introduction: Newfoundland and Labrador (NL) has the highest prevalence of cardiovascular disease (CVD) in Canada. Dyslipidemia is a risk factor for CVD. This study compares the prevalence of dyslipidemia in the NL population with the rest of Canada. Methods: A cross-sectional study, using data from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN), was undertaken. The study population included adults, excluding pregnant women, aged 20 years and older. Canadian guidelines were used for classifying dyslipidemia. Univariate and multivariate analyses were conducted to compare the lipid levels and prevalence of dyslipidemia between NL and the rest of Canada. Results: About 128,825 individuals (NL: 7,772; rest of Canada: 121,053) were identified with a mean age of 59 years (55% females). Mean levels of total cholesterol (4.96 vs. 4.93, p = 0.03), low-density lipoprotein (LDL) (3.00 vs. 2.90 mmol/L, p < 0.0001), triglyceride (1.47 vs. 1.41 mmol/L, p < 0.0001), and high-density lipoprotein (HDL) (1.29 vs. 1.39 mmol/L, p < 0.0001) were significantly different in NL compared to the rest of Canada. Dyslipidemias of LDL (29 vs. 25% p < 0.0001), HDL (38 vs. 27%, p < 0.0001), and triglyceride (29 vs. 26%, p < 0.0001) were significantly more common in NL. After adjustment for confounding variables, NL inhabitants were more likely to have dyslipidemia of total cholesterol (OR: 1.16, 95% CI: 1.10–1.23, p < 0.0001), HDL (OR: 1.52, 95% CI: 1.44–1.60, p < 0.0001), LDL (OR: 1.38, 95% CI: 1.30–1.46, p < 0.0001), and ratio (OR: 1.53, 95% CI: 1.42–1.60, p < 0.0001). Conclusion: The NL population has a significantly higher rate of dyslipidemia compared to the rest of Canada, and the mean levels of all lipid components are worse in NL. Distinct cultural and genetic features of the NL population may explain this, accounting for a higher rate of CVD in NL. PMID:26664873

  5. Dabigatran and vitamin K antagonists' use in naïve patients with non-valvular atrial fibrillation: a cross-sectional study of primary care-based electronic health records.

    Science.gov (United States)

    Vlacho, Bogdan; Giner-Soriano, Maria; Zabaleta-Del-Olmo, Edurne; Roso-Llorach, Albert; García-Sangenís, Ana; Morros-Pedrós, Rosa

    2017-07-19

    The purpose of this study was to characterize the profile of patients with non-valvular atrial fibrillation who start an anticoagulant treatment after diagnosis with dabigatran and compare it with those who start with vitamin K antagonists (VKAs). We analysed primary health care-based electronic health records data from 15,075 people with new diagnosis of atrial fibrillation who initiated treatment with dabigatran or VKA spanning 2011-2013. Logistic regression analysis for determination of factors associated with initiation of dabigatran was performed. We identified 14,266 (94.6%) people who initiated VKA and 809 (5.4%) who initiated dabigatran. Mean age of people treated with dabigatran was lower than in VKA patients (73.7 vs 75.5 years, p Desigualdades Socioeconómicas index. Most patients recently diagnosed with non-valvular atrial fibrillation initiated treatment with VKA. Primary healthcare patients with non-valvular atrial fibrillation initiating dabigatran are younger, had a lower risk of stroke or bleeding, fewer comorbidity and more history of stroke and intracranial haemorrhage compared to those who were initiated on VKA.

  6. Provider Perspectives on Advance Care Planning Documentation in the Electronic Health Record: The Experience of Primary Care Providers and Specialists Using Advance Health-Care Directives and Physician Orders for Life-Sustaining Treatment.

    Science.gov (United States)

    Dillon, Ellis; Chuang, Judith; Gupta, Atul; Tapper, Sharon; Lai, Steve; Yu, Peter; Ritchie, Christine; Tai-Seale, Ming

    2017-12-01

    Advance care planning (ACP) is valued by patients and clinicians, yet documenting ACP in an accessible manner is problematic. In order to understand how providers incorporate electronic health record (EHR) ACP documentation into clinical practice, we interviewed providers in primary care and specialty departments about ACP practices (n = 13) and analyzed EHR data on 358 primary care providers (PCPs) and 79 specialists at a large multispecialty group practice. Structured interviews were conducted with 13 providers with high and low rates of ACP documentation in primary care, oncology, pulmonology, and cardiology departments. The EHR problem list data on Advance Health Care Directives (AHCDs) and Physician Orders for Life-Sustaining Treatment (POLST) were used to calculate ACP documentation rates. Examining seriously ill patients ≥65 years with no preexisting ACP documentation seen by providers during 2013 to 2014, 88.6% (AHCD) and 91.1% (POLST) of 79 specialists had zero ACP documentations. Of 358 PCPs, 29.1% (AHCD) and 62.3% (POLST) had zero ACP documentations. Interviewed PCPs often believed ACP documentation was beneficial and accessible, while specialists more often did not. Specialists expressed more confusion about documenting ACP, whereas PCPs reported standard clinic workflows. Problems with interoperability between outpatient and inpatient EHR systems and lack of consensus about who should document ACP were sources of variations in practices. Results suggest that providers desire standardized workflows for ACP discussion and documentation. New Medicare reimbursement for ACP and an increasing number of quality metrics for ACP are incentives for health-care systems to address barriers to ACP documentation.

  7. Training May Affect Primary Care Staff Access to the Biomedical Electronic Evidence Base. A review of: Doney, Liz, Helen Barlow, and Joe West. “Use of Libraries and Electronic Information Resources by Primary Care Staff: Outcomes from a Survey.” Health Information and Libraries Journal 22.3 (September 2005: 182-188.

    Directory of Open Access Journals (Sweden)

    Marcy L. Brown

    2006-03-01

    Full Text Available Objective – To assess use of existing local libraries, the Internet, and biomedical databases by primary care staff prior to implementation of the Primary Care Knowledge Management Projects. Additionally, to assess the need to train primary care staff to use the Internet and biomedical databases. Design – Cross‐sectional postal questionnaire survey. Setting – Nottingham and Rotherham, two cities in the Trent region of the UK. Subjects – Questionnaires were analyzed from 243 general practitioners, practice nurses, and practice managers in four Nottingham primary care trusts as well as practices in the Rotherham Health Authority area. Methods – Questionnaires and cover letters were sent between May 2001 and February 2002. To encourage response, a postage‐paid envelope was enclosed. A total of 709 questionnaires were sent in Nottingham, and 169 were returned for a response rate of 24%. In Rotherham, 179 questionnaires were sent and 61 returned, for a 34% response rate. Thirteen responses from a May 2001 pilot in Rotherham were also included in the data analysis. Survey questions included a variety of formats, including tick boxes and open‐ended questions. Data was entered into an Access database and analysis was performed using Stata software. Main results – Reported use of libraries was low overall, with only 30% of respondents claiming to have used library facilities. However, there was significant variation among professional groups. Practice nurses (PNs had significantly higher usage of libraries than general practitioners (GPs and practice managers (P Conclusion – Based on the results of this admittedly small study, additional training is needed – and desired – by primary care staff in both Nottingham and Rotherham. Developing and offering training in Internet searching and evaluation as well as use of the biomedical databases is one important way in which libraries can build partnerships with primary care practitioners

  8. Final report of key comparison AFRIMETS.AUV.A-K5: primary pressure calibration of LS1P microphones according to IEC 61094-2, over the frequency range 2 Hz to 10 kHz.

    Science.gov (United States)

    Nel, R.; Avison, J.; Harris, P.; Blabla, M.; Hämäläinen, J.

    2017-01-01

    The degrees of equivalence of the AFRIMETS.AUV.A-K5 regional key comparison are reported here as the final report. The scope of the comparison covered the complex pressure sensitivities of two LS1P microphones over the frequency range 2 Hz to 10 kHz in accordance with IEC 61094-2: 2009. Four national metrology institutes from two different regional metrology organisations participated in the comparison. Two LS1P microphones were circulated simultaneously to all the participants in a circular configuration. One of the microphones sensitivity shifted and all results associated with this microphone were subsequently excluded from further analysis and linking. The AFRIMETS.AUV.A-K5 comparison results were linked to the CCAUV.A-K5 comparison results via dual participation in the CCAUV.A-K5 and AFRIMETS.AUV.A-K5 comparisons. The degrees of equivalence, linked to the CCAUV.A-K5 comparison, were calculated for all participants of this comparison. Main text To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the CCAUV, according to the provisions of the CIPM Mutual Recognition Arrangement (CIPM MRA).

  9. Syphilis - primary

    Science.gov (United States)

    ... their newborn (congenital syphilis). Syphilis has three stages: Primary syphilis Secondary syphilis Tertiary syphilis (the late phase ... screening, and treatment. Symptoms The incubation period for primary syphilis is 14 to 21 days. Symptoms of ...

  10. Extreme environment electronics

    CERN Document Server

    Cressler, John D

    2012-01-01

    Unfriendly to conventional electronic devices, circuits, and systems, extreme environments represent a serious challenge to designers and mission architects. The first truly comprehensive guide to this specialized field, Extreme Environment Electronics explains the essential aspects of designing and using devices, circuits, and electronic systems intended to operate in extreme environments, including across wide temperature ranges and in radiation-intense scenarios such as space. The Definitive Guide to Extreme Environment Electronics Featuring contributions by some of the world's foremost exp

  11. ELECTRON GUN

    Science.gov (United States)

    Christofilos, N.C.; Ehlers, K.W.

    1960-04-01

    A pulsed electron gun capable of delivering pulses at voltages of the order of 1 mv and currents of the order of 100 amperes is described. The principal novelty resides in a transformer construction which is disposed in the same vacuum housing as the electron source and accelerating electrode structure of the gun to supply the accelerating potential thereto. The transformer is provided by a plurality of magnetic cores disposed in circumferentially spaced relation and having a plurality of primary windings each inductively coupled to a different one of the cores, and a helical secondary winding which is disposed coaxially of the cores and passes therethrough in circumferential succession. Additional novelty resides in the disposition of the electron source cathode filament input leads interiorly of the transformer secondary winding which is hollow, as well as in the employment of a half-wave filament supply which is synchronously operated with the transformer supply such that the transformer is pulsed during the zero current portions of the half-wave cycle.

  12. Proyecto Vedado: salud-electrónica en la atención primaria de salud. Diseño y resultados iniciales Vedado Project: electronic health in primary health care. Design and initial results

    Directory of Open Access Journals (Sweden)

    Rodolfo J. Stusser Beltranena

    2006-12-01

    Full Text Available Se expone brevemente el diseño, justificación, resultados iniciales y perspectivos, y dificultades del portafolio de proyectos “Vedado” de salud-electrónica (salud-e en la atención primaria de salud y medicina general integral, entre los años 2002 y 2006. Se describen los resultados obtenidos con un sistema de información gerencial de atención primaria, un sistema tele electrocardiográfico de 2da. y 3ra. opinión, unos sitios web del Policlínico Vedado, un tutorial en multimedia de anatomía en atención primaria, y una universidad virtual desde este propio nivel de atención. Se enuncian los resultados perspectivos de una red electrónica y centro colaborador en investigación a distancia y en línea del sistema nacional de salud a partir de la atención primaria, del uso de asistentes personales digitales y tecnología inalámbrica, así como de una historia clínica electrónica única desde el consultorio del Médico de Familia al resto del sistema. Se concluye que los resultados obtenidos han comenzado lentamente a mejorar la eficiencia de este nivel de atención y nuestra especialidad. Se vislumbra que la continuación de estos proyectos y extensión de sus resultados originará un salto de calidad en los servicios de la Medicina General Integral en las áreas de salud, sobre todo, las rurales y más aisladas del país. Se recomienda formalizar un centro y red de investigación en salud-e desde la atención primaria, con presupuesto para proyectos de investigación, incluir técnicas de tele-cirugía y cirugía de mínimo acceso, sobre todo en áreas rurales, así como también facilitar la investigación en colaboración en salud-e y los entrenamientos e intercambios académicos en los países de avanzada.The design, rationale, initial and future results of the “Vedado” electronic health (e-health projects in primary health care and comprehensive general medicine between 2002 and 2006 are briefly exposed. The results

  13. Low energy electron scattering from fuels

    Energy Technology Data Exchange (ETDEWEB)

    Lopes, M. Cristina A.; Silva, Daniel G.M.; Coelho, Rafael F.; Duque, Humberto V.; Santos, Rodrigo R. dos; Ribeiro, Thiago M. [Universidade Federal de Juiz de Fora (UFJF), MG (Brazil). Dept. de Fisica; Yates, Brent; Hong, Ling; Khakoo, Murtadha A. [California State University at Fullerton, CA (US). Physics Department; Bettega, Marcio H.F. [Universidade Federal do Parana (UFPR), Curitiba, PR (Brazil). Dept. de Fisica; Costa, Romarly F. da [Universidade Federal do ABC (UFABC), Santo Andre, SP (Brazil). Centro de Ciencias Naturais e Humanas; Lima, Marco A.P. [Laboratorio Nacional de Ciencia e Tecnologia do Bioetanol (CTBE/CNPEM), Campinas, SP (Brazil)

    2011-07-01

    Full text. Accurate and precise values of absolute total cross section (TCS) represent important information in many scientific and technological applications. In our case, for example, we are motivated to provide such information for electron-fuel collision processes which are specifically relevant to modeling spark ignition in alcohol-fuelled internal combustion engines. Many electron scattering TCS measurements are presently available for a diverse range of atomic and molecular targets. However, lack of data for important bio-molecular targets still remains. Disagreements between the available TCS data for the alcohols have prompted several studies of electron scattering collision of slow electrons with these molecules which are currently important in applications as bio- fuels. This relevance, which has attracted much attention, has been one of the subjects of a recent collaboration between experimental and theoretical groups in the USA and Brazil. Recently this collaboration reported first measurements and calculations of differential cross sections for elastic low-energy (rotationally unresolved) electron scattering by several primary alcohols. In this work we address methanol and ethanol TCSs at low energy range and report additional studies of resonant structure in ethanol using the detection of metastable states produced by electron impact excitation with high energy resolution. We have recently constructed a TCS apparatus in our laboratory at Universidade Federal de Juiz de Fora, Brazil, based on the well-known linear transmission technique. The experimental setup is based on the measurement of the attenuation of a collimated electron beam through a gas cell containing the atoms or molecules to be studied at a given pressure. It consists essentially of an electron gun, a gas cell and an electron energy analyzer composed of an array of decelerating electrostatic lenses, a cylindrical dispersive 127o analyzer and a Faraday cup. To our knowledge, there exist

  14. Electronic equipment packaging technology

    CERN Document Server

    Ginsberg, Gerald L

    1992-01-01

    The last twenty years have seen major advances in the electronics industry. Perhaps the most significant aspect of these advances has been the significant role that electronic equipment plays in almost all product markets. Even though electronic equipment is used in a broad base of applications, many future applications have yet to be conceived. This versatility of electron­ ics has been brought about primarily by the significant advances that have been made in integrated circuit technology. The electronic product user is rarely aware of the integrated circuits within the equipment. However, the user is often very aware of the size, weight, mod­ ularity, maintainability, aesthetics, and human interface features of the product. In fact, these are aspects of the products that often are instrumental in deter­ mining its success or failure in the marketplace. Optimizing these and other product features is the primary role of Electronic Equipment Packaging Technology. As the electronics industry continues to pr...

  15. Secondary electron emission characteristics of ion-textured copper and high-purity isotropic graphite surfaces

    Science.gov (United States)

    Curren, A. N.; Jensen, K. A.

    1984-01-01

    Experimentally determined values of true secondary electron emission and relative values of reflected primary electron yield for untreated and ion textured oxygen free high conductivity copper and untreated and ion textured high purity isotropic graphite surfaces are presented for a range of primary electron beam energies and beam impingement angles. This investigation was conducted to provide information that would improve the efficiency of multistage depressed collectors (MDC's) for microwave amplifier traveling wave tubes in space communications and aircraft applications. For high efficiency, MDC electrode surfaces must have low secondary electron emission characteristics. Although copper is a commonly used material for MDC electrodes, it exhibits relatively high levels of secondary electron emission if its surface is not treated for emission control. Recent studies demonstrated that high purity isotropic graphite is a promising material for MDC electrodes, particularly with ion textured surfaces. The materials were tested at primary electron beam energies of 200 to 2000 eV and at direct (0 deg) to near grazing (85 deg) beam impingement angles. True secondary electron emission and relative reflected primary electron yield characteristics of the ion textured surfaces were compared with each other and with those of untreated surfaces of the same materials. Both the untreated and ion textured graphite surfaces and the ion treated copper surface exhibited sharply reduced secondary electron emission characteristics relative to those of untreated copper. The ion treated graphite surface yielded the lowest emission levels.

  16. Primary explosives

    Energy Technology Data Exchange (ETDEWEB)

    Matyas, Robert; Pachman, Jiri [Pardubice Univ. (Czech Republic). Faculty of Chemical Technology

    2013-06-01

    The first chapter provides background such as the basics of initiation and differences between requirements on primary explosives used in detonators and igniters. The authors then clarify the influence of physical characteristics on explosive properties, focusing on those properties required for primary explosives. Furthermore, the issue of sensitivity is discussed. All the chapters on particular groups of primary explosives are structured in the same way, including introduction, physical and chemical properties, explosive properties, preparation and documented use.

  17. Primary fibromyalgia

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Jensen, L T; Foldager, Marie Viftrup

    1990-01-01

    Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen...... type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide...... concentrations of procollagen type III aminoterminal peptide of primary fibromyalgia patients are connected to the disease impact....

  18. Range management visual impacts

    Science.gov (United States)

    Bruce R. Brown; David Kissel

    1979-01-01

    Historical overgrazing of western public rangelands has resulted in the passage of the Public Rangeland Improvement Act of 1978. The main purpose of this Act is to improve unsatisfactory range conditions. A contributing factor to unfavorable range conditions is adverse visual impacts. These visual impacts can be identified in three categories of range management: range...

  19. Electron-electron correlations in liquid s-p metals

    CERN Document Server

    Leys, F E

    2003-01-01

    We present calculations for the valence electron-electron structure factor in liquid Mg near freezing, assuming knowledge of the jellium result. On the basis of this, we predict significant corrections to jellium short-range correlations in liquid s-p metals and in particular an increase in the electron-electron contact probability.

  20. Absent menstrual periods - primary

    Science.gov (United States)

    Primary amenorrhea; No periods - primary; Absent periods - primary; Absent menses - primary; Absence of periods - primary ... nutrition Tumors In many cases, the cause of primary amenorrhea is not known.

  1. ELECTRONS IN NONPOLAR LIQUIDS.

    Energy Technology Data Exchange (ETDEWEB)

    HOLROYD,R.A.

    2002-10-22

    Excess electrons can be introduced into liquids by absorption of high energy radiation, by photoionization, or by photoinjection from metal surfaces. The electron's chemical and physical properties can then be measured, but this requires that the electrons remain free. That is, the liquid must be sufficiently free of electron attaching impurities for these studies. The drift mobility as well as other transport properties of the electron are discussed here as well as electron reactions, free-ion yields and energy levels, Ionization processes typically produce electrons with excess kinetic energy. In liquids during thermalization, where this excess energy is lost to bath molecules, the electrons travel some distance from their geminate positive ions. In general the electrons at this point are still within the coulombic field of their geminate ions and a large fraction of the electrons recombine. However, some electrons escape recombination and the yield that escapes to become free electrons and ions is termed G{sub fi}. Reported values of G{sub fi} for molecular liquids range from 0.05 to 1.1 per 100 eV of energy absorbed. The reasons for this 20-fold range of yields are discussed here.

  2. The Electron

    Energy Technology Data Exchange (ETDEWEB)

    Thomson, George

    1972-01-01

    Electrons are elementary particles of atoms that revolve around and outside the nucleus and have a negative charge. This booklet discusses how electrons relate to electricity, some applications of electrons, electrons as waves, electrons in atoms and solids, the electron microscope, among other things.

  3. Improving Patient Experience and Primary Care Quality for Patients With Complex Chronic Disease Using the Electronic Patient-Reported Outcomes Tool: Adopting Qualitative Methods Into a User-Centered Design Approach.

    Science.gov (United States)

    Steele Gray, Carolyn; Khan, Anum Irfan; Kuluski, Kerry; McKillop, Ian; Sharpe, Sarah; Bierman, Arlene S; Lyons, Renee F; Cott, Cheryl

    2016-02-18

    Many mHealth technologies do not meet the needs of patients with complex chronic disease and disabilities (CCDDs) who are among the highest users of health systems worldwide. Furthermore, many of the development methodologies used in the creation of mHealth and eHealth technologies lack the ability to embrace users with CCDD in the specification process. This paper describes how we adopted and modified development techniques to create the electronic Patient-Reported Outcomes (ePRO) tool, a patient-centered mHealth solution to help improve primary health care for patients experiencing CCDD. This paper describes the design and development approach, specifically the process of incorporating qualitative research methods into user-centered design approaches to create the ePRO tool. Key lessons learned are offered as a guide for other eHealth and mHealth research and technology developers working with complex patient populations and their primary health care providers. Guided by user-centered design principles, interpretive descriptive qualitative research methods were adopted to capture user experiences through interviews and working groups. Consistent with interpretive descriptive methods, an iterative analysis technique was used to generate findings, which were then organized in relation to the tool design and function to help systematically inform modifications to the tool. User feedback captured and analyzed through this method was used to challenge the design and inform the iterative development of the tool. Interviews with primary health care providers (n=7) and content experts (n=6), and four focus groups with patients and carers (n=14) along with a PICK analysis-Possible, Implementable, (to be) Challenged, (to be) Killed-guided development of the first prototype. The initial prototype was presented in three design working groups with patients/carers (n=5), providers (n=6), and experts (n=5). Working group findings were broken down into categories of what works

  4. The Electronic Patient Reported Outcome Tool: Testing Usability and Feasibility of a Mobile App and Portal to Support Care for Patients With Complex Chronic Disease and Disability in Primary Care Settings

    Science.gov (United States)

    Gill, Ashlinder; Khan, Anum Irfan; Hans, Parminder Kaur; Kuluski, Kerry; Cott, Cheryl

    2016-01-01

    Background People experiencing complex chronic disease and disability (CCDD) face some of the greatest challenges of any patient population. Primary care providers find it difficult to manage multiple discordant conditions and symptoms and often complex social challenges experienced by these patients. The electronic Patient Reported Outcome (ePRO) tool is designed to overcome some of these challenges by supporting goal-oriented primary care delivery. Using the tool, patients and providers collaboratively develop health care goals on a portal linked to a mobile device to help patients and providers track progress between visits. Objectives This study tested the usability and feasibility of adopting the ePRO tool into a single interdisciplinary primary health care practice in Toronto, Canada. The Fit between Individuals, Fask, and Technology (FITT) framework was used to guide our assessment and explore whether the ePRO tool is: (1) feasible for adoption in interdisciplinary primary health care practices and (2) usable from both the patient and provider perspectives. This usability pilot is part of a broader user-centered design development strategy. Methods A 4-week pilot study was conducted in which patients and providers used the ePRO tool to develop health-related goals, which patients then monitored using a mobile device. Patients and providers collaboratively set goals using the system during an initial visit and had at least 1 follow-up visit at the end of the pilot to discuss progress. Focus groups and interviews were conducted with patients and providers to capture usability and feasibility measures. Data from the ePRO system were extracted to provide information regarding tool usage. Results Six providers and 11 patients participated in the study; 3 patients dropped out mainly owing to health issues. The remaining 8 patients completed 210 monitoring protocols, equal to over 1300 questions, with patients often answering questions daily. Providers and patients

  5. Range of the radiation monitor for the rigid vent of primary containment during normal and emergency operation for a BWR-5 in Laguna Verde; Rango del monitor de radiacion para el venteo rigido de la contencion primaria durante operacion normal y emergencia para un reactor BWR-5 en Laguna Verde

    Energy Technology Data Exchange (ETDEWEB)

    Tijerina S, F.; Pozos S, A. M.; Cabrera U, S.; Mata A, J. A.; Sandoval V, S.; Ovando C, R.; Vargas A, A.; Gallardo R, I.; Cruz G, M.; Amador C, C., E-mail: francisco.tijerina@cfe.gob.mx [Comision Federal de Electricidad, Central Nucleoelectrica Laguna Verde, Subgerencia de Ingenieria, Km 44.5 Carretera Cardel-Nautla, 91476 Laguna Verde, Alto Lucero, Veracruz (Mexico)

    2014-10-15

    The earthquake followed by a tsunami, happened in March, 2011 in the coasts of oriental Japan, caused damages in the nuclear power plants 1 at 4 of Fukushima Daiichi leading to damage of the fuel in three of the reactors and to the radiation liberation to the exterior. As consequence of those events, the regulations requires that the power plants with Primary Containment type Mark I and II evaluate to have a system of rigid vent with a monitoring equipment of radiation effluents. The present work covers the rigid vent of diameter 12 of the Primary Containment, type Mark-II, of nuclear power plant of Laguna Verde in conditions of severe accident and normal operation, low regime of Extended Power Up rate (EPU - 2317 MWt), using the codes MAAP3B, MICROSHILED 5.05 and the Bardach Black Boxes methodology. As a result the measurement range of the radiation monitor that is required for monitoring the gassy liberation to the atmosphere was determined. The conclusion is that the superior limit of the range of the radiation meter during a Severe Accident is of 8.55 E + 05 R/h (8.55 E + 08 m R/h) and the superior limit in normal operation of 1.412 E-11 at 2.540 E-7 R/h (1.412 E-14 at 2.540 E-10 m R/h). (Author)

  6. Electron radiography

    Science.gov (United States)

    Merrill, Frank E.; Morris, Christopher

    2005-05-17

    A system capable of performing radiography using a beam of electrons. Diffuser means receive a beam of electrons and diffuse the electrons before they enter first matching quadrupoles where the diffused electrons are focused prior to the diffused electrons entering an object. First imaging quadrupoles receive the focused diffused electrons after the focused diffused electrons have been scattered by the object for focusing the scattered electrons. Collimator means receive the scattered electrons and remove scattered electrons that have scattered to large angles. Second imaging quadrupoles receive the collimated scattered electrons and refocus the collimated scattered electrons and map the focused collimated scattered electrons to transverse locations on an image plane representative of the electrons' positions in the object.

  7. Minnesota Pheasant Range

    Data.gov (United States)

    Minnesota Department of Natural Resources — This dataset delineates the spatial range of wild pheasant populations in Minnesota as of 2002 by dividing the MN state boundary into 2 units: pheasant range and...

  8. Substring Range Reporting

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li

    2014-01-01

    We revisit various string indexing problems with range reporting features, namely, position-restricted substring searching, indexing substrings with gaps, and indexing substrings with intervals. We obtain the following main results. We give efficient reductions for each of the above problems...... to a new problem, which we call substring range reporting. Hence, we unify the previous work by showing that we may restrict our attention to a single problem rather than studying each of the above problems individually. We show how to solve substring range reporting with optimal query time and little...... for substring range reporting generalize to substring range counting and substring range emptiness variants. We also obtain non-trivial time-space trade-offs for these problems. Our bounds for substring range reporting are based on a novel combination of suffix trees and range reporting data structures...

  9. Supporting Goal-Oriented Primary Health Care for Seniors with Complex Care Needs Using Mobile Technology: Evaluation and Implementation of the Health System Performance Research Network, Bridgepoint Electronic Patient Reported Outcome Tool.

    Science.gov (United States)

    Steele Gray, Carolyn; Wodchis, Walter P; Upshur, Ross; Cott, Cheryl; McKinstry, Brian; Mercer, Stewart; Palen, Ted E; Ramsay, Tim; Thavorn, Kednapa

    2016-06-24

    Older adults experiencing multiple chronic illnesses are at high risk of hospitalization and health decline if they are unable to manage the significant challenges posed by their health conditions. Goal-oriented care approaches can provide better care for these complex patients, but clinicians find the process of ascertaining goals "too complex and too-time consuming," and goals are often not agreed upon between complex patients and their providers. The electronic patient reported outcomes (ePRO) mobile app and portal offers an innovative approach to creating and monitoring goal-oriented patient-care plans to improve patient self-management and shared decision-making between patients and health care providers. The ePRO tool also supports proactive patient monitoring by the patient, caregiver(s), and health care provider. It was developed with and for older adults with complex care needs as a means to improve their quality of life. Our proposed project will evaluate the use, effectiveness, and value for money of the ePRO tool in a 12-month multicenter, randomized controlled trial in Ontario; targeting individuals 65 or over with two or more chronic conditions that require frequent health care visits to manage their health conditions. Intervention groups using the ePRO tool will be compared with control groups on measures of quality of life, patient experience, and cost-effectiveness. We will also evaluate the implementation of the tool. The proposed project presented in this paper will be funded through the Canadian Institute for Health Research (CIHR) eHealth Innovation Partnerships Program (eHIPP) program (CIHR-348362). The expected completion date of the study is November, 2019. We anticipate our program of work will support improved quality of life and patient self-management, improved patient-centered primary care delivery, and will encourage the adoption of goal-oriented care approaches across primary health care systems. We have partnered with family health

  10. Radiative charge transfer in He{sup +}+ H{sub 2} collisions in the milli- to nano-electron-volt range: A theoretical study within state-to-state and optical potential approaches

    Energy Technology Data Exchange (ETDEWEB)

    Mrugala, Felicja [Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Grudziadzka 5, PL 87-100 Torun (Poland); Kraemer, Wolfgang P. [Max-Planck-Institute of Astrophysics, Postfach 1317, D-85741 Garching (Germany)

    2013-03-14

    The paper presents a theoretical study of the low-energy dynamics of the radiative charge transfer (RCT) reaction He{sup +}({sup 2}S)+H{sub 2}(X{sup 1}{Sigma}{sub g}{sup +}){yields}He({sup 1}S)+H{sub 2}{sup +}(X{sup 2}{Sigma}{sub g}{sup +})+h{nu} extending our previous studies on radiative association of HeH{sub 2}{sup +} [F. Mrugala, V. Spirko, and W. P. Kraemer, J. Chem. Phys. 118, 10547 (2003); F. Mrugala and W. P. Kraemer, ibid. 122, 224321 (2005)]. The calculations account for the vibrational and rotational motions of the H{sub 2}/H{sub 2}{sup +} diatomics and for the atom-diatom complex formation in the reactant and the product channels of the RCT reaction. Continuum states of He{sup +}+ H{sub 2}(v= 0, j= 0) in the collision energy range {approx}10{sup -7}-18.6 meV and all quasi-bound states of the He{sup +}- H{sub 2}(para;v= 0) complex formed in this range are taken into account. Close-coupling calculations are performed to determine rates of radiative transitions from these states to the continuum and quasi-bound states of the He +H{sub 2}{sup +} system in the energy range extending up to {approx}0.16 eV above the opening of the HeH{sup +}+ H arrangement channel. From the detailed state-to-state calculated characteristics global functions of the RCT reaction, such as cross-section {sigma}(E), emission intensity I({nu}, T), and rate constant k(T) are derived, and are presented together with their counterparts for the radiative association (RA) reaction He{sup +}({sup 2}S) +H{sub 2}(X{sup 1}{Sigma}{sub g}{sup +}){yields} HeH{sub 2}{sup +}(X{sup 2}A{sup Prime })+h{nu}. The rate constant k{sup RCT} is approximately 20 times larger than k{sup RA} at the considered temperatures, 0.1 {mu}K-50 K. Formation of rotational Feshbach resonances in the reactant channel plays an important role in both reactions. Transitions mediated by these resonances contribute more than 70% to the respective rates. An extension of the one-dimensional optical potential model is

  11. Electronic collection management

    CERN Document Server

    Mcginnis, Suzan D

    2013-01-01

    Build and manage your collection of digital resources with these successful strategies! This comprehensive volume is a practical guide to the art and science of acquiring and organizing electronic resources. The collections discussed here range in size from small college libraries to large research libraries, but all are facing similar problems: shrinking budgets, increasing demands, and rapidly shifting formats. Electronic Collection Management offers new ideas for coping with these issues. Bringing together diverse aspects of collection development, Electronic Collection

  12. Scanning Auger Electron Microscope

    Data.gov (United States)

    Federal Laboratory Consortium — A JEOL model 7830F field emission source, scanning Auger microscope.Specifications / Capabilities:Ultra-high vacuum (UHV), electron gun range from 0.1 kV to 25 kV,...

  13. Primary productivity

    Digital Repository Service at National Institute of Oceanography (India)

    Verlecar, X.N.; Parulekar, A.H.

    nutrients and ample solar radiation frequently trigger phytoplankton blooms in coastal polynias during Antarctic summer. Energy transfer model for primary productivity has been used to derive potential exploitable fishery resources in the Indian Ocean....

  14. Primary Inflation

    OpenAIRE

    Izawa, K. -I.

    1997-01-01

    We consider an inflationary universe scenario with multiple stages of inflation. The primary inflation, which may start at the Planck epoch, is followed by secondary inflations, which include the cosmological inflation that causes the primordial density fluctuations of our universe. We point out that an initial condition for a secondary inflation is naturally realized if the e-fold number of the primary inflation is sufficiently large.

  15. Report to Congress on Sustainable Ranges, 2010

    Science.gov (United States)

    2010-05-01

    Continuing to work with JIOR to provide a mobile service which can be deployed at the Urban Operations Complex ( UOC ) on Range 62. Electronic Combat...range; some means of facilitating IO play but no organic capability. NTTR continuing to work with JIOR to provide a mobile service to deploy at UOC ...no organic capability. Continuing to work with JIOR to provide a mobile service which can be deployed at the UOC . Collective Ranges Information

  16. Substring Range Reporting

    DEFF Research Database (Denmark)

    Bille, Philip; Gørtz, Inge Li

    2011-01-01

    We revisit various string indexing problems with range reporting features, namely, position-restricted substring searching, indexing substrings with gaps, and indexing substrings with intervals. We obtain the following main results. – We give efficient reductions for each of the above problems...... to a new problem, which we call substring range reporting. Hence, we unify the previous work by showing that we may restrict our attention to a single problem rather than studying each of the above problems individually. – We show how to solve substring range reporting with optimal query time and little...... range reporting are based on a novel combination of suffix trees and range reporting data structures. The reductions are simple and general and may apply to other combinations of string indexing with range reporting....

  17. Vacuum electronics applications at CERN

    CERN Document Server

    Jensen, E

    2009-01-01

    CERN operates a large number of vacuum electronics based RF power amplifiers covering a wide frequency range – over 300 sockets with 24 different grid tubes and klystrons are in use and require constant care to insure reliable operation of the accelerators. This is in particular true for the LHC and its injector chain, for which a program of improvement and stepwise upgrade has started. These include IOT’s for the SPS and klystrons and modulators for Linac4 and SPL. The CLIC study and the CTF3 facility are relevant to vacuum electronics in many ways: The CLIC primary RF power, to be provided at 1 GHz, requires highest possible efficiency and phase stability, MBK’s are likely candidates. The CLIC RF power source and CTF3 are themselves large vacuum electronics applications, consequently there are areas of common interest and concern, including fabrication techniques, pulse compression techniques, breakdown and multipactor theory and simulation, material fatigue, numerical analysis of slow-wave structures...

  18. Compact Antenna Range

    Data.gov (United States)

    Federal Laboratory Consortium — Facility consists of a folded compact antenna range including a computer controlled three axis position table, parabolic reflector and RF sources for the measurement...

  19. Dryden Aeronautical Test Range

    Data.gov (United States)

    Federal Laboratory Consortium — Recently redesignated to honor Dr. Hugh L. Dryden, NASA's Dryden Aeronautical Test Range (DATR) supports aerospace flight research and technology integration, space...

  20. Study of optical and electronic properties of nickel from reflection electron energy loss spectra

    Science.gov (United States)

    Xu, H.; Yang, L. H.; Da, B.; Tóth, J.; Tőkési, K.; Ding, Z. J.

    2017-09-01

    We use the classical Monte Carlo transport model of electrons moving near the surface and inside solids to reproduce the measured reflection electron energy-loss spectroscopy (REELS) spectra. With the combination of the classical transport model and the Markov chain Monte Carlo (MCMC) sampling of oscillator parameters the so-called reverse Monte Carlo (RMC) method was developed, and used to obtain optical constants of Ni in this work. A systematic study of the electronic and optical properties of Ni has been performed in an energy loss range of 0-200 eV from the measured REELS spectra at primary energies of 1000 eV, 2000 eV and 3000 eV. The reliability of our method was tested by comparing our results with the previous data. Moreover, the accuracy of our optical data has been confirmed by applying oscillator strength-sum rule and perfect-screening-sum rule.

  1. Primary fibromyalgia

    DEFF Research Database (Denmark)

    Jacobsen, Søren; Jensen, L T; Foldager, Marie Viftrup

    1990-01-01

    Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen...... type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide...... had more symptoms, a higher frequency of tender points and lesser quality of sleep compared to patients with normal serum concentrations of procollagen type III aminoterminal peptide (P less than 0.05). They also had a lower dynamic muscle strength (P less than 0.0005). We conclude that the serum...

  2. On Range of Skill

    DEFF Research Database (Denmark)

    Hansen, Thomas Dueholm; Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2008-01-01

    size (and doubly exponential in its depth). We also provide techniques that yield concrete bounds for unbalanced game trees and apply these to estimate the Range of Skill of Tic-Tac-Toe and Heads-Up Limit Texas Hold'em Poker. In particular, we show that the Range of Skill of Tic-Tac-Toe is more than...

  3. Range Scheduling Aid (RSA)

    Science.gov (United States)

    Logan, J. R.; Pulvermacher, M. K.

    1991-01-01

    Range Scheduling Aid (RSA) is presented in the form of the viewgraphs. The following subject areas are covered: satellite control network; current and new approaches to range scheduling; MITRE tasking; RSA features; RSA display; constraint based analytic capability; RSA architecture; and RSA benefits.

  4. Home range and travels

    Science.gov (United States)

    Stickel, L.F.; King, John A.

    1968-01-01

    The concept of home range was expressed by Seton (1909) in the term 'home region,' which Burr (1940, 1943) clarified with a definition of home range and exemplified in a definitive study of Peromyscus in the field. Burt pointed out the ever-changing characteristics of home-range area and the consequent absence of boundaries in the usual sense--a finding verified by investigators thereafter. In the studies summarized in this paper, sizes of home ranges of Peromyscus varied within two magnitudes, approximately from 0.1 acre to ten acres, in 34 studies conducted in a variety of habitats from the seaside dunes of Florida to the Alaskan forests. Variation in sizes of home ranges was correlated with both environmental and physiological factors; with habitat it was conspicuous, both in the same and different regions. Food supply also was related to size of home range, both seasonally and in relation to habitat. Home ranges generally were smallest in winter and largest in spring, at the onset of the breeding season. Activity and size also were affected by changes in weather. Activity was least when temperatures were low and nights were bright. Effects of rainfall were variable. Sizes varied according to sex and age; young mice remained in the parents' range until they approached maturity, when they began to travel more widely. Adult males commonly had larger home ranges than females, although there were a number of exceptions. An inverse relationship between population density and size of home range was shown in several studies and probably is the usual relationship. A basic need for activity and exploration also appeared to influence size of home range. Behavior within the home range was discussed in terms of travel patterns, travels in relation to home sites and refuges, territory, and stability of size of home range. Travels within the home range consisted of repeated use of well-worn trails to sites of food, shelter, and refuge, plus more random exploratory travels

  5. Electronics circuits and systems

    CERN Document Server

    Bishop, Owen

    2007-01-01

    The material in Electronics - Circuits and Systems is a truly up-to-date textbook, with coverage carefully matched to the electronics units of the 2007 BTEC National Engineering and the latest AS and A Level specifications in Electronics from AQA, OCR and WJEC. The material has been organized with a logical learning progression, making it ideal for a wide range of pre-degree courses in electronics. The approach is student-centred and includes: numerous examples and activities; web research topics; Self Test features, highlighted key facts, formulae and definitions. Each chapter ends with a set

  6. Electronics circuits and systems

    CERN Document Server

    Bishop, Owen

    2011-01-01

    The material in Electronics - Circuits and Systems is a truly up-to-date textbook, with coverage carefully matched to the electronics units of the 2007 BTEC National Engineering and the latest AS and A Level specifications in Electronics from AQA, OCR and WJEC. The material has been organized with a logical learning progression, making it ideal for a wide range of pre-degree courses in electronics. The approach is student-centred and includes: numerous examples and activities; web research topics; Self Test features, highlighted key facts, formulae and definitions. Ea

  7. Electronic circuits fundamentals & applications

    CERN Document Server

    Tooley, Mike

    2015-01-01

    Electronics explained in one volume, using both theoretical and practical applications.New chapter on Raspberry PiCompanion website contains free electronic tools to aid learning for students and a question bank for lecturersPractical investigations and questions within each chapter help reinforce learning Mike Tooley provides all the information required to get to grips with the fundamentals of electronics, detailing the underpinning knowledge necessary to appreciate the operation of a wide range of electronic circuits, including amplifiers, logic circuits, power supplies and oscillators. The

  8. Electron caustic lithography

    Directory of Open Access Journals (Sweden)

    S. M. Kennedy

    2012-06-01

    Full Text Available A maskless method of electron beam lithography is described which uses the reflection of an electron beam from an electrostatic mirror to produce caustics in the demagnified image projected onto a resist–coated wafer. By varying the electron optics, e.g. via objective lens defocus, both the morphology and dimensions of the caustic features may be controlled, producing a range of bright and tightly focused projected features. The method is illustrated for line and fold caustics and is complementary to other methods of reflective electron beam lithography.

  9. Primary Processing

    NARCIS (Netherlands)

    Mulder, W.J.; Harmsen, P.F.H.; Sanders, J.P.M.; Carre, P.; Kamm, B.; Schoenicke, P.

    2012-01-01

    Primary processing of oil-containing material involves pre-treatment processes, oil recovery processes and the extraction and valorisation of valuable compounds from waste streams. Pre-treatment processes, e.g. thermal, enzymatic, electrical and radio frequency, have an important effect on the oil

  10. Microchannel plate detector detection efficiency to monoenergetic electrons between 3 and 28 keV

    Science.gov (United States)

    Blase, Ryan C.; Benke, Roland R.; Miller, Gregory P.; Pickens, Keith S.; Waite, J. Hunter

    2017-05-01

    An unshielded microchannel plate (MCP) detector with an ultrafine pore diameter of 2 μm was irradiated by an electron beam to determine the detection efficiency of electrons for creating detector signals, or counts. Tested electron energies spanned a range of 3 kiloelectron volts (keV) to 28 keV. Higher detection efficiencies were measured at the lower end of this energy range, 0.376 counts per incident electron at 3 keV down to 0.155 at 15 keV with an increase to 0.217 at 18 keV and then another decrease down to 0.15 counts per incident electron at 28 keV. The increase at 18 keV is attributed to primary electron interaction with the L shell electrons of lead (Pb), leading to an increase in secondary electron and X-ray generation within the MCP and thus an increase in detection efficiency. For the electron beam directed normal to the MCP surface, the lowest efficiency of 0.15 counts per incident electron was observed at 28 keV. Detection efficiency was also tested as a function of incident angle with angular steps of 5°. Detection efficiency was more sensitive to the angle of incidence as the incident electron energy decreased. The detection efficiency at 3 keV decreased from 0.376 counts per electron at the zero degree angle (normal incidence to MCP surface) to 0.027 counts per electron at an incident angle of 50° (average in both orientations). At 28 keV, the decrease in detection efficiency as a function of increasing angle was less pronounced, ranging from 0.15 counts per electron at zero degrees to 0.08 counts per electron at 50° (average in both orientations). Experimental data showed lower detection efficiencies compared with previously published data.

  11. Electron diffraction study of the sillenites Bi{sub 12}SiO{sub 20}, Bi{sub 25}FeO{sub 39} and Bi{sub 25}InO{sub 39}: Evidence of short-range ordering of oxygen-vacancies in the trivalent sillenites

    Energy Technology Data Exchange (ETDEWEB)

    Scurti, Craig A.; Arenas, D. J. [Department of Physics, University of North Florida, Jacksonville, FL 32224 (United States); Auvray, Nicolas [Department of Physics, University of North Florida, Jacksonville, FL 32224 (United States); Laboratoire de Nanotechnologie et d’Instrumentation Optique - UMR CNRS 6279, Université Technologie de Troyes, 12 rue Marie Curie, Troyes 10010 (France); Lufaso, Michael W. [Department of Chemistry, University of North Florida, Jacksonville, FL 32224 (United States); Takeda, Seiji [The Institute of Scientific and Industrial Research, Osaka University, 8-1 Mihogaoka, Ibaraki, Osaka 567-0047 (Japan); Kohno, Hideo [School of Environmental Science and Engineering, Kochi University of Technology, Tosayamada, Kami, Kochi 782-8502 Japan (Japan)

    2014-08-15

    We present an electron diffraction study of three sillenites, Bi{sub 12}SiO{sub 20}, Bi{sub 25}FeO{sub 39}, and Bi{sub 25}InO{sub 39} synthesized using the solid-state method. We explore a hypothesis, inspired by optical studies in the literature, that suggests that trivalent sillenites have additional disorder not present in the tetravalent compounds. Electron diffraction patterns of Bi{sub 25}FeO{sub 39} and Bi{sub 25}InO{sub 39} show streaks that confirm deviations from the ideal sillenite structure. Multi-slice simulations of electron-diffraction patterns are presented for different perturbations to the sillenite structure - partial substitution of the M site by Bi{sup 3+}, random and ordered oxygen-vacancies, and a frozen-phonon model. Although comparison of experimental data to simulations cannot be conclusive, we consider the streaks as evidence of short-range ordered oxygen-vacancies.

  12. Long range image enhancement

    CSIR Research Space (South Africa)

    Duvenhage, B

    2015-11-01

    Full Text Available and Vision Computing, Auckland, New Zealand, 23-24 November 2015 Long Range Image Enhancement Bernardt Duvenhage Council for Scientific and Industrial Research South Africa Email: bduvenhage@csir.co.za Abstract Turbulent pockets of air...

  13. SNOWY RANGE WILDERNESS, WYOMING.

    Science.gov (United States)

    Houston, Robert S.; Bigsby, Philip R.

    1984-01-01

    A mineral survey of the Snowy Range Wilderness in Wyoming was undertaken and was followed up with more detailed geologic and geochemical surveys, culminating in diamond drilling of one hole in the Snowy Range Wilderness. No mineral deposits were identified in the Snowy Range Wilderness, but inasmuch as low-grade uranium and associated gold resources were identified in rocks similar to those of the northern Snowy Range Wilderness in an area about 5 mi northeast of the wilderness boundary, the authors conclude that the northern half of the wilderness has a probable-resource potential for uranium and gold. Closely spaced drilling would be required to completely evaluate this mineral potential. The geologic terrane precludes the occurrence of fossil fuels.

  14. Atlantic Test Range (ATR)

    Data.gov (United States)

    Federal Laboratory Consortium — ATR controls fully-instrumented and integrated test ranges that provide full-service support for cradle-to-grave testing. Airspace and surface target areas are used...

  15. Light Detection And Ranging

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — LiDAR (Light Detection and Ranging) discrete-return point cloud data are available in the American Society for Photogrammetry and Remote Sensing (ASPRS) LAS format....

  16. Dual-phase steel structure visualized by extremely slow electrons.

    Science.gov (United States)

    Mikmeková, Šárka; Yamada, Katsumi; Noro, Hisato

    2015-12-01

    Mechanical properties of complex steels are affected by their multi-phase structure. Scanning electron microscopy (SEM) is routinely used for characterizing dual-phase (DP) steels, although the identification of steel constituents is not straightforward. In fact, there are several ways of enabling the ferrite-martensite segmentation by SEM, and a wide range of electron energies can be utilized. This study demonstrates the phase identification of DP steels at high, low and extremely low landing energies of the primary electrons from tens of keV to tens of eV. Visualization of the specimen surface at very low landing energies has been achieved by inserting an earthed detector between the pole piece and the negatively biased specimen. This 'cathode lens mode' enables the use of the full energy range up to the primary electron energies. It has been found that extremely slow electrons (phases clearly even in the images acquired at low magnification. The contrast between the phases at tens of eV can be explained by the different thickness of native oxide covering the martensite and the ferrite phase. © The Author 2015. Published by Oxford University Press on behalf of The Japanese Society of Microscopy. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  17. On Range of Skill

    DEFF Research Database (Denmark)

    Hansen, Thomas Dueholm; Miltersen, Peter Bro; Sørensen, Troels Bjerre

    2008-01-01

    is a small number, but only gave heuristic arguments for this. In this paper, we provide the first methods for rigorously estimating the Range of Skill of a given game. We provide some general, asymptotic bounds that imply that the Range of Skill of a perfectly balanced game tree is almost exponential in its......At AAAI'07, Zinkevich, Bowling and Burch introduced the Range of Skill measure of a two-player game and used it as a parameter in the analysis of the running time of an algorithm for finding approximate solutions to such games. They suggested that the Range of Skill of a typical natural game...... size (and doubly exponential in its depth). We also provide techniques that yield concrete bounds for unbalanced game trees and apply these to estimate the Range of Skill of Tic-Tac-Toe and Heads-Up Limit Texas Hold'em Poker. In particular, we show that the Range of Skill of Tic-Tac-Toe is more than...

  18. Radio pill antenna range test

    Science.gov (United States)

    Cummins, W. F.; Kane, R. J.

    1992-05-01

    In order to investigate the potential of a proposed 'radio pill' beacon transmitter, a range test experiment was devised and carried out in the VHF frequency range. Calculations and previous work indicated that optimum sensitivity and, thus, distance would be obtained in this frequency range provided body radio-frequency (RF) absorption was not too great. A ferrite-core loop antenna is compatible with a pill geometry and has better radiation efficiency than an air core loop. The ferrite core may be a hollow cylinder with the electronics and batteries placed inside. However, this range test was only concerned with experimentally developing test range data on the ferrite core antenna itself. A one turn strap loop was placed around a 9.5 mm diameter by 18.3 mm long stack of ferrite cores. This was coupled to a 50 Omega transmission line by 76 mm of twisted pair line and a capacitive matching section. This assembly was excited by a signal generator at output levels of -10 to +10 dBm. Signals were received on a VHF receiver and tape recorder coupled to a 14 element, circularly polarized Yagi antenna at a height of 2.5 m. Field strength measurements taken at ranges of 440, 1100, and 1714 m. Maximum field strengths referenced to 0 dBm transmitter level were -107 to -110 dB at 440 m, -124 to -127 dBm at 1100 m, and -116 to -119 dBm at 1714 m when the antenna cylinder was horizontal. Field strengths with a vertical antenna were about 6 dB below these values. The latter transmit site was elevated and had a clear line-of-site path to the receiving site. The performance of this test antenna was better than that expected from method-of-moment field calculations. When this performance data is scaled to a narrow bandwidth receiving system, ground level receiving ranges of a few to 10 km can be expected. Clear line-of-sight ranges where either or both the transmitter and receiver are elevated could vary from several km to 100 km.

  19. Educational paper: Primary antibody deficiencies

    NARCIS (Netherlands)

    G.J.A. Driessen (Gertjan); M. van der Burg (Mirjam)

    2011-01-01

    textabstractPrimary antibody deficiencies (PADs) are the most common primary immunodeficiencies and are characterized by a defect in the production of normal amounts of antigen-specific antibodies. PADs represent a heterogeneous spectrum of conditions, ranging from often asymptomatic selective IgA

  20. China’s Electronic Long-Range Reconnaissance

    Science.gov (United States)

    2008-12-01

    the talent of local communications , telecommunications, and financial departments and from scientific research institutes and institutions of... Bjorge , Combat Studies institute, Fort leavenworth, Kansas. 14. Ge Zhenfeng, chap. 24, sec. 6, 493. 15. Peng and yao, 418-19. 16. wen t’ao, “Pla Bent on

  1. Factors Associated with Range of Motion Recovery Following Manipulation Under Anesthesia.

    Science.gov (United States)

    Plate, Johannes F; Wohler, Andrew D; Brown, Matthew L; Sun, Daniel; Fino, Nora F; Lang, Jason E

    2016-10-26

    Stiffness and loss of motion following total knee arthroplasty (TKA) is a complex and multifactorial complication that may require manipulation under anesthesia (MUA). However, patient and surgical factors that potentially influence the development of knee stiffness following TKA are not fully understood. The purpose of this study was to identify patient and surgical factors that may influence range of motion loss following TKA by assessing a cohort of patients that underwent MUA and comparing them to a matched cohort of patients without complications. The joints registry was searched for patients who underwent MUA following primary TKA between 2004 and 2013. Demographic and surgical information was obtained from the electronic medical record including range of motion (ROM), comorbidities and timing of MUA. Patients who underwent MUA were then double-matched by baseline (prior to primary TKA) knee ROM to patients who underwent primary TKA with normal postoperative range of motion recovery during the same time period. Fifty-two patients (fifty-six knees) (66% female, mean BMI 32.4 kg/m2) underwent MUA after TKA during the study period. MUA was performed a mean of 13.6 weeks after primary TKA. Study patients were double-matched by baseline flexion (mean 107º±2º) to 111 patients (112 knees) with a similar mean baseline flexion (104º±2º, p=0.138). Patients requiring MUA were younger (mean age 56 vs. 64 years, p50 mL, and any complication during the hospital stay were not found to be associated with an increased risk of requiring MUA. Younger patients with more comorbidities and a history of previous knee surgery were found to have significantly higher risk for developing stiffness and loss of motion requiring MUA after primary TKA in the current study. Patients with this risk profile need to be counseled regarding the risk for postoperative knee stiffness and range of motion loss possibly requiring MUA after primary TKA.

  2. Dosimetric characteristics of backscattered electrons in lead

    Energy Technology Data Exchange (ETDEWEB)

    Perez-Calatayud, Jose; Carmona, Vicente [Physics section, Radiation Oncology Department, ' La Fe' University Hospital, Avda Campanar 21, E-46009 Valencia (Spain); Ballester, Facundo [Department of Atomic, Molecular and Nuclear Physics, University of Valencia, C/ Dr. Moliner 50, E-46100 Burjassot (Spain); IFIC-Instituto de Fisica Corpuscular, CSIC-Universitat de Valencia, C/ Dr. Moliner 50, E-46100 Burjassot (Spain). E-mail: Facundo.Ballester at uv.es; Serrano, Miguel A.; Lluch, Jose L. [Department of Atomic, Molecular and Nuclear Physics, University of Valencia, C/ Dr. Moliner 50, E-46100 Burjassot (Spain); Casal, Emilio [Department of Atomic, Molecular and Nuclear Physics, University of Valencia, C/ Dr. Moliner 50, E-46100 Burjassot (Spain); CND, Centro Nacional de Dosimetria, Avda. Campanar 21, E-46009 Valencia (Spain)

    2000-07-01

    In electron beam therapy, tissue overdose due to electrons backscattered from lead has been profusely studied. To quantify this dose enhancement effect, an electron backscatter factor (EBF) wasdefined as the ratio of dose at the tissue-inhomogeneity interface with and without the scatterer present. The dependence of the EBF on energy at the scatterer surface is not well known for energies lower than 3 MeV which is the most frequent clinical situation. In this work, we have done Monte Carlo calculations with the GEANT code to study EBF in lead at this energy range. The applicability of this code and the developed procedure for dose estimation has been experimentally verified. The dependence of the EBF on the beam energy incident on the scatterer has been studied for different nominal beam energies incident at the phantom's surface. The results show a trend of increase of EBF with the beam energy incident on the scatterer between 0.5 and 1.5 MeV, keeping practically constant above this energy up to 3 MeV. Backscattered electron energy spectra and depth dose curves in the 'up-stream' direction have been obtained at the various energies of the primary electron beam striking on the lead scatterer. The results of this work are compared with previously published data. (author)

  3. Hyperthyroidism (primary)

    DEFF Research Database (Denmark)

    Nygaard, Birte

    2010-01-01

    Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone. The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma. About 20 times more women than men have hyperthyroidism....... METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of drug treatments for primary hyperthyroidism? What are the effects of surgical treatments for primary hyperthyroidism? What are the effects of treatments for subclinical...... hyperthyroidism? We searched: Medline, Embase, The Cochrane Library, and other important databases up to February 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US...

  4. New methods for electron tomography

    NARCIS (Netherlands)

    Ziese, Ulrike

    2002-01-01

    Electron tomography is a method for obtaining three-dimensional structural information from electron micrographs. It can be applied to a wide range of samples that can be prepared for transmission electron microscopy (TEM)—may they be of biological origin like e.g. cryo or thin plastic sections of

  5. Electron attachment to boron trichloride

    Science.gov (United States)

    Tav, Cumali; Datskos, Panos G.; Pinnaduwage, Lal A.

    1998-11-01

    Low-energy electron attachment to BCl3 was measured using an electron swarm technique. The parent negative ion, BCl3-, was observed within a narrow electron range close to thermal energy. Previous negative ion measurements in BCl3 discharges, which yielded seemingly inconsistent results, can be shown to be self-consistent based on the present observations.

  6. Range Selection and Median

    DEFF Research Database (Denmark)

    Jørgensen, Allan Grønlund; Larsen, Kasper Green

    2011-01-01

    that supports queries in constant time, needs n1+ (1) space. For data structures that uses n logO(1) n space this matches the best known upper bound. Additionally, we present a linear space data structure that supports range selection queries in O(log k= log log n + log log n) time. Finally, we prove that any...

  7. Electric vehicles: Driving range

    Science.gov (United States)

    Kempton, Willett

    2016-09-01

    For uptake of electric vehicles to increase, consumers' driving-range needs must be fulfilled. Analysis of the driving patterns of personal vehicles in the US now shows that today's electric vehicles can meet all travel needs on almost 90% of days from a single overnight charge.

  8. Electron Microscopy.

    Science.gov (United States)

    Beer, Michael

    1980-01-01

    Reviews technical aspects of structure determination in biological electron microscopy (EM). Discusses low dose EM, low temperature microscopy, electron energy loss spectra, determination of mass or molecular weight, and EM of labeled systems. Cites 34 references. (CS)

  9. Electronic Commerce

    OpenAIRE

    Slavko Đerić

    2016-01-01

    Electronic commerce can be defined in different ways. Any definition helps to understand and explain that concept as better as possible.. Electronic commerce is a set of procedures and technologies that automate the tasks of financial transactions using electronic means. Also, according to some authors, electronic commerce is defined as a new concept, which is being developed and which includes process of buying and selling or exchanging products, services or information via computer networks...

  10. Understand electronics

    CERN Document Server

    Bishop, Owen

    2013-01-01

    Understand Electronics provides a readable introduction to the exciting world of electronics for the student or enthusiast with little previous knowledge. The subject is treated with the minimum of mathematics and the book is extensively illustrated.This is an essential guide for the newcomer to electronics, and replaces the author's best-selling Beginner's Guide to Electronics.The step-by-step approach makes this book ideal for introductory courses such as the Intermediate GNVQ.

  11. Vacuum electronics

    CERN Document Server

    Eichmeier, Joseph A

    2008-01-01

    Nineteen experts from the electronics industry, research institutes and universities have joined forces to prepare this book. ""Vacuum Electronics"" covers the electrophysical fundamentals, the present state of the art and applications, as well as the future prospects of microwave tubes and systems, optoelectronics vacuum devices, electron and ion beam devices, light and X-ray emitters, particle accelerators and vacuum interrupters. These topics are supplemented by useful information about the materials and technologies of vacuum electronics and vacuum technology.

  12. Electronic components

    CERN Document Server

    Colwell, Morris A

    1976-01-01

    Electronic Components provides a basic grounding in the practical aspects of using and selecting electronics components. The book describes the basic requirements needed to start practical work on electronic equipment, resistors and potentiometers, capacitance, and inductors and transformers. The text discusses semiconductor devices such as diodes, thyristors and triacs, transistors and heat sinks, logic and linear integrated circuits (I.C.s) and electromechanical devices. Common abbreviations applied to components are provided. Constructors and electronics engineers will find the book useful

  13. Single molecule electronic devices.

    Science.gov (United States)

    Song, Hyunwook; Reed, Mark A; Lee, Takhee

    2011-04-12

    Single molecule electronic devices in which individual molecules are utilized as active electronic components constitute a promising approach for the ultimate miniaturization and integration of electronic devices in nanotechnology through the bottom-up strategy. Thus, the ability to understand, control, and exploit charge transport at the level of single molecules has become a long-standing desire of scientists and engineers from different disciplines for various potential device applications. Indeed, a study on charge transport through single molecules attached to metallic electrodes is a very challenging task, but rapid advances have been made in recent years. This review article focuses on experimental aspects of electronic devices made with single molecules, with a primary focus on the characterization and manipulation of charge transport in this regime. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. ELECTRONIC SIGNATURES

    African Journals Online (AJOL)

    10332324

    'electronic signature' means data attached to, incorporated in, or logically associated with other data and which is intended by the user to serve as a signature;. The suggested new definition for an electronic signature reads as follows: 'electronic signature' means a sound, symbol or process that is (i) uniquely linked to the ...

  15. ELECTRONIC SIGNATURES

    African Journals Online (AJOL)

    10332324

    (a) facilitate ecommerce;2. (b) remove and prevent barriers to electronic communications in South Africa;3. (c) ensure that electronic transactions in the Republic conform to the highest international standards;4. (d) promote the development of electronic transactions services which are responsive to the needs of users and ...

  16. Decal electronics for printed high performance cmos electronic systems

    KAUST Repository

    Hussain, Muhammad Mustafa

    2017-11-23

    High performance complementary metal oxide semiconductor (CMOS) electronics are critical for any full-fledged electronic system. However, state-of-the-art CMOS electronics are rigid and bulky making them unusable for flexible electronic applications. While there exist bulk material reduction methods to flex them, such thinned CMOS electronics are fragile and vulnerable to handling for high throughput manufacturing. Here, we show a fusion of a CMOS technology compatible fabrication process for flexible CMOS electronics, with inkjet and conductive cellulose based interconnects, followed by additive manufacturing (i.e. 3D printing based packaging) and finally roll-to-roll printing of packaged decal electronics (thin film transistors based circuit components and sensors) focusing on printed high performance flexible electronic systems. This work provides the most pragmatic route for packaged flexible electronic systems for wide ranging applications.

  17. Sticker electronics

    KAUST Repository

    Hussain, Muhammad Mustafa

    2017-09-08

    Electronic stickers may be manufactured on flexible substrates (110, 120, 130) as layers and packaged together. The package may then have an adhesive applied to one side to provide capability for sticking the electronic devices to surfaces. The stickers can be wrappable, placed on surfaces, glued on walls or mirrors or wood or stone, and have electronics (112, 122, 132) which may or may not be ultrathin. Packaging for the electronic sticker can use polymer on cellulose manufacturing and/or three dimensional (3-D) printing. The electronic stickers may provide lighting capability, sensing capability, and/or recharging capabilities.

  18. Basic electronics

    CERN Document Server

    Holbrook, Harold D

    1971-01-01

    Basic Electronics is an elementary text designed for basic instruction in electricity and electronics. It gives emphasis on electronic emission and the vacuum tube and shows transistor circuits in parallel with electron tube circuits. This book also demonstrates how the transistor merely replaces the tube, with proper change of circuit constants as required. Many problems are presented at the end of each chapter. This book is comprised of 17 chapters and opens with an overview of electron theory, followed by a discussion on resistance, inductance, and capacitance, along with their effects on t

  19. Electronic Government and Electronic Participation

    NARCIS (Netherlands)

    Tambouris, E.; Scholl, H.J.; Janssen, M.F.W.H.A.; Wimmer, M.A.; Tarabanis, K.; Gascó, M.; Klievink, A.J.; Lindgren, I.; Milano, M.; Panagiotopoulos, P.; Pardo, T.A.; Parycek, P.; Sæbø, O.

    2015-01-01

    Electronic government and electronic participation continue to transform the public sector and society worldwide and are constantly being transformed themselves by emerging information and communication technologies. This book presents papers from the 14th International Federation for Information

  20. Electronic Government and Electronic Participation

    NARCIS (Netherlands)

    Tambouris, E; Scholl, H.J.; Janssen, M.F.W.H.A.; Wimmer, M.A.; Tarabanis, K; Gascó, M; Klievink, A.J.; Lindgren, I; Milano, M; Panagiotopoulos, P; Pardo, T.A.; Parycek, P; Sæbø, Ø

    2016-01-01

    Electronic government and electronic participation continue to transform the public sector and society worldwide and are constantly being transformed themselves by emerging information and communication technologies.This book presents papers from the 14th International Federation for Information

  1. Between-Visit Workload in Primary Care

    Science.gov (United States)

    Galpin, Kevin; Jones-Taylor, Cedrella; Anander, Steven; Demosthenes, Charles; Platt, Susan; Ponkshe, Sanjay

    2010-01-01

    Background The time spent and complexity of work done by primary internal medicine physicians between office visits has not been well studied. Objective To measure the time and complexity of this care. Design Cross-sectional study. Setting General internists practicing on primary care teams with electronic medical records at a tertiary Veterans Health Administration Medical Center. Participants Ten physicians. Main Measures The project was designed to measure physician work between office visits. The electronic record was used to record the number and complexity of work events by physicians for 1 month. Complexity of work was measured on five levels ranging from Level I with no change in management, Level II with change in management of one disease, Level III of two diseases, Level IV of three diseases, and Level V of four or more diseases. Time sampling was done over 5 days to determine the time spent by level of complexity. Total time per physician was calculated by multiplying the number of events each physician captured by the average time for that physician for that level of complexity. Key Results Physicians worked a median of 7.9 h per week between office visits. Work was apportioned among Level I (18.3%), Level II (38.3%), Level III (36.5%), Level IV (4.6%), and Level V (2.3%). Limitations Single VA population and self-reported data. Findings may not be generalizable to other practice settings. Conclusion Primary internists spent a median of 7.9 h per week in work between office visits with 82% of the time involved in changes in management. PMID:20700665

  2. Developing electronic textbooks

    Energy Technology Data Exchange (ETDEWEB)

    Zadoks, R.I. [Texas Univ., El Paso, TX (United States). Mechanical and Industrial Engineering Dept.; Ratner, J.A. [Sandia National Labs., Albuquerque, NM (United States)

    1996-03-01

    This paper discusses a new approach to the development of engineering education materials. The ``Electronic Textbook`` represents the logical progression of the printed textbook in the Electronic Age. The concept behind this approach is simple; to place all of the information contained in a textbook in electronic form. Currently, paper texts exist on the market with electronic supplements, however, this Electronic Textbook would include supplements fully integrated in the whole text. The computer hardware and software needed to make this advance possible have existed for nearly ten years, and they have been readily available to engineering educators and students for over three years. Computer based ``tools`` in engineering textbooks as are prevalent today range from computer styled algorithms and code snippets, to fully developed software applications with graphical user interfaces on floppy disks attached to the back covers of books. The next logical step in publishing is to dispense with the paper book entirely, by distributing textbooks via electronic media such as CD-ROM. Electronic Textbooks use the full range of multi-media technologies in the learning and teaching process including video clips, computer animations and fully functional numerical engines as integral parts of the textbook material. This is very appealing since interactive media provide teaching tools that appeal to divergent learning styles. The advantages of Electronic Textbooks lead to several challenges. Special attention must be paid to the development of user interfaces; navigation is of particular importance when non- linear exploration is encouraged. These issues are being addressed at the Sandia National Laboratories by an electronic documentation development team. This team includes experts in engineering, in human factors, and in computer hardware and software development. Guidelines for the development of electronic textbooks based on the experiences of this team are provided.

  3. Primary hyperparathyroidism.

    Science.gov (United States)

    Muñoz-Torres, Manuel; García-Martín, Antonia

    2017-10-06

    Primary hyperparathyroidism (PHPT) is a common endocrinological process, characterized by chronic elevation of serum concentrations of calcium and parathyroid hormone (PTH). Many years ago, the most frequent forms of clinical presentation were symptomatic renal or skeletal disease with moderate or severe hypercalcemia; however, currently, most patients have few symptoms and mild hypercalcemia. A new form of presentation called normocalcemic PHPT has also been described but clinical consequences are not well established. The biochemical profile of PHPT is characterized by hypercalcemia and high or inappropriately normal PTH concentrations. Parathyroidectomy is the only definitive cure. Medical treatment with the calcimimetic cinacalcet has been shown to normalize calcemia in a high percentage of cases. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. Communication between primary and secondary care.

    Science.gov (United States)

    Pannell, Laura Mk; Tyrrell-Price, Jonathan

    2017-08-02

    Background Up to date patient data is a cornerstone of optimal safety and care, so admission to hospital requires transfer of data held in the community to secondary care. Despite the advent of electronic medical record systems such as Connecting Care and EMIS, the telephone remains the mainstay of communication. Methods A prospective cross-sectional quality improvement project was conducted to assess the time taken in telephone communication between primary and secondary care doctors and determine if access to the electronic shared system, Connecting Care, would improve efficiency. As part of normal junior doctor activity, fifty GPs were contacted between September 2015 and February 2016 to obtain medical data on patients admitted to UH Bristol. Time taken to contact each GP and the duration of the conversation was recorded. One hundred patient records were accessed using Connecting Care between October 2015 and February 2016 and the length of time taken to access information documented. Results Out of 50 phone calls 27 resulted in direct transfer to a GP with time to transfer ranging from 12 seconds to 19 minutes 51 seconds (mean 8 minutes 10 seconds, median 7 minutes 16 seconds). A total of 28 messages were left with the receptionist with 16/28 phone calls being returned and time taken for the call to be returned ranged from 34 minutes to 21 hours 3 minutes (mean 5 hours 50 minutes 4 seconds, median 4 hours). Information was available for 88/100 patient records accessed using Connecting Care with a mean duration to access information required of 1 minute 47 seconds. This was significantly shorter than the mean duration of conversation with GPs (4 minutes 22 seconds), mean total duration of telephone call and mean total duration of time to achieve aim of call with GP practices of 13 minutes 18 seconds and 2 hours 14 minutes 11 seconds respectively. Conclusions This study identifies areas of potential improvement in current methods of communication between primary

  5. Long-range antigravity

    Energy Technology Data Exchange (ETDEWEB)

    Macrae, K.I.; Riegert, R.J. (Maryland Univ., College Park (USA). Center for Theoretical Physics)

    1984-10-01

    We consider a theory in which fermionic matter interacts via long-range scalar, vector and tensor fields. In order not to be in conflict with experiment, the scalar and vector couplings for a given fermion must be equal, as is natural in a dimensionally reduced model. Assuming that the Sun is not approximately neutral with respect to these new scalar-vector charges, and if the couplings saturate the experimental bounds, then their strength can be comparable to that of gravity. Scalar-vector fields of this strength can compensate for a solar quadrupole moment contribution to Mercury's anomalous perihelion precession.

  6. Online Sorted Range Reporting

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Fagerberg, Rolf; Greve, Mark

    2009-01-01

    We study the following one-dimensional range reporting problem: On an arrayA of n elements, support queries that given two indices i ≤ j and an integerk report the k smallest elements in the subarray A[i..j] in sorted order. We present a data structure in the RAM model supporting such queries...... in optimal O(k) time. The structure uses O(n) words of space and can be constructed in O(n logn) time. The data structure can be extended to solve the online version of the problem, where the elements in A[i..j] are reported one-by-one in sorted order, in O(1) worst-case time per element. The problem...... is motivated by (and is a generalization of) a problem with applications in search engines: On a tree where leaves have associated rank values, report the highest ranked leaves in a given subtree. Finally, the problem studied generalizes the classic range minimum query (RMQ) problem on arrays....

  7. Electron-positron pair production by ultrarelativistic electrons in a soft photon field

    Science.gov (United States)

    Mastichiadis, A.; Marscher, A. P.; Brecher, K.

    1986-01-01

    The fully differential cross section for photon-electron pair production is integrated numerically over phase space. Results are obtained for the astrophysically interesting case in which the interaction between an ultrarelativistic electron and a soft photon results in electron-positron pair production. The positron spectrum is a function of the energies of both the photon and the electron, as well as the angle of interaction. It is found that the energy at which the positron distribution peaks is inversely proportional to the photon energy and independent of the electron energy. The positron spectrum is integrated once more over initial electron energies for a power-law energy distribution of primary electrons. The same procedure is repeated for the recoil particle; it is shown that the peak of the recoil energy distribution depends linearly on the energy of the primary electron. Finally, semianalytical expressions are obtained for the energy losses of the primary electrons.

  8. Effects of electrons on the shape of nanopores prepared by focused electron beam induced etching

    Energy Technology Data Exchange (ETDEWEB)

    Liebes, Yael; Ashkenasy, Nurit [Department of Materials Engineering, Ben-Gurion University of the Negev, PO Box 653 Beer-Sheva (Israel); Hadad, Binyamin, E-mail: nurita@bgu.ac.il [The Ilze Kaz Institute for Nanoscale Science and Technology, Ben-Gurion University of the Negev, PO Box 653 Beer-Sheva (Israel)

    2011-07-15

    The fabrication of nanometric pores with controlled size is important for applications such as single molecule detection. We have recently suggested the use of focused electron beam induced etching (FEBIE) for the preparation of such nanopores in silicon nitride membranes. The use of a scanning probe microscope as the electron beam source makes this technique comparably accessible, opening the way to widespread fabrication of nanopores. Since the shape of the nanopores is critically important for their performance, in this work we focus on its analysis and study the dependence of the nanopore shape on the electron beam acceleration voltage. We show that the nanopore adopts a funnel-like shape, with a central pore penetrating the entire membrane, surrounded by an extended shallow-etched region at the top of the membrane. While the internal nanopore size was found to depend on the electron acceleration voltage, the nanopore edges extended beyond the primary electron beam spot size due to long-range effects, such as radiolysis and diffusion. Moreover, the size of the peripheral-etched region was found to be less dependent on the acceleration voltage. We also found that chemical etching is the rate-limiting step of the process and is only slightly dependent on the acceleration voltage. Furthermore, due to the chemical etch process the chemical composition of the nanopore rims was found to maintain the bulk membrane composition.

  9. 16 CFR 316.3 - Primary purpose.

    Science.gov (United States)

    2010-01-01

    ... Commercial Practices FEDERAL TRADE COMMISSION REGULATIONS UNDER SPECIFIC ACTS OF CONGRESS CAN-SPAM RULE § 316...-SPAM Act, 15 U.S.C. 7702(2), the “primary purpose” of an electronic mail message shall be deemed to be...” defined in the CAN-SPAM Act, 15 U.S.C. 7702(17), the “primary purpose” of an electronic mail message shall...

  10. Electronic Commerce

    Directory of Open Access Journals (Sweden)

    Slavko Đerić

    2016-12-01

    Full Text Available Electronic commerce can be defined in different ways. Any definition helps to understand and explain that concept as better as possible.. Electronic commerce is a set of procedures and technologies that automate the tasks of financial transactions using electronic means. Also, according to some authors, electronic commerce is defined as a new concept, which is being developed and which includes process of buying and selling or exchanging products, services or information via computer networks, including the Internet. Electronic commerce is not limited just to buying and selling, but it also includes all pre-sales and after-sales ongoing activities along the supply chain. Introducing electronic commerce, using the Internet and Web services in business, realizes the way to a completely new type of economy - internet economy.

  11. Lightning detection and ranging

    Science.gov (United States)

    Lennon, C. L.; Poehler, H. A.

    1982-01-01

    A lightning detector and ranging (LDAR) system developed at the Kennedy Space Center and recently transferred to Wallops Island is described. The system detects pulsed VHF signals due to electrical discharges occurring in a thunderstorm by means of 56-75 MHz receivers located at the hub and at the tips of 8 km radial lines. Incoming signals are transmitted by wideband links to a central computing facility which processes the times of arrival, using two independent calculations to determine position in order to guard against false data. The results are plotted on a CRT display, and an example of a thunderstorm lightning strike detection near Kennedy Space Center is outlined. The LDAR correctly identified potential ground strike zones and additionally provided a high correlation between updrafts and ground strikes.

  12. Micropower electronics

    CERN Document Server

    Keonjian, Edward

    1964-01-01

    Micropower Electronics deals with the operation of modern electronic equipment at micropower levels and the problems associated with micropower electronics. Topics covered include the relations between minimum required power density and frequency response for semiconductor triode amplifiers; physical realization of digital logic circuits; micropower microelectronic subsystems; and metal-oxide-semiconductor field-effect devices for micropower logic circuitry. This book is comprised of 10 chapters and begins with an analysis of fundamental relationships and basic requirements pertinent to the ph

  13. Microfluidic electronics.

    Science.gov (United States)

    Cheng, Shi; Wu, Zhigang

    2012-08-21

    Microfluidics, a field that has been well-established for several decades, has seen extensive applications in the areas of biology, chemistry, and medicine. However, it might be very hard to imagine how such soft microfluidic devices would be used in other areas, such as electronics, in which stiff, solid metals, insulators, and semiconductors have previously dominated. Very recently, things have radically changed. Taking advantage of native properties of microfluidics, advances in microfluidics-based electronics have shown great potential in numerous new appealing applications, e.g. bio-inspired devices, body-worn healthcare and medical sensing systems, and ergonomic units, in which conventional rigid, bulky electronics are facing insurmountable obstacles to fulfil the demand on comfortable user experience. Not only would the birth of microfluidic electronics contribute to both the microfluidics and electronics fields, but it may also shape the future of our daily life. Nevertheless, microfluidic electronics are still at a very early stage, and significant efforts in research and development are needed to advance this emerging field. The intention of this article is to review recent research outcomes in the field of microfluidic electronics, and address current technical challenges and issues. The outlook of future development in microfluidic electronic devices and systems, as well as new fabrication techniques, is also discussed. Moreover, the authors would like to inspire both the microfluidics and electronics communities to further exploit this newly-established field.

  14. Electron Bifurcation

    Energy Technology Data Exchange (ETDEWEB)

    Peters, John W.; Miller, Anne-Frances; Jones, Anne K.; King, Paul W.; Adams, Michael W. W.

    2016-04-01

    Electron bifurcation is the recently recognized third mechanism of biological energy conservation. It simultaneously couples exergonic and endergonic oxidation-reduction reactions to circumvent thermodynamic barriers and minimize free energy loss. Little is known about the details of how electron bifurcating enzymes function, but specifics are beginning to emerge for several bifurcating enzymes. To date, those characterized contain a collection of redox cofactors including flavins and iron-sulfur clusters. Here we discuss the current understanding of bifurcating enzymes and the mechanistic features required to reversibly partition multiple electrons from a single redox site into exergonic and endergonic electron transfer paths.

  15. Polymer electronics

    CERN Document Server

    Hsin-Fei, Meng

    2013-01-01

    Polymer semiconductor is the only semiconductor that can be processed in solution. Electronics made by these flexible materials have many advantages such as large-area solution process, low cost, and high performance. Researchers and companies are increasingly dedicating time and money in polymer electronics. This book focuses on the fundamental materials and device physics of polymer electronics. It describes polymer light-emitting diodes, polymer field-effect transistors, organic vertical transistors, polymer solar cells, and many applications based on polymer electronics. The book also disc

  16. Electron holography

    CERN Document Server

    Tonomura, Akira

    1993-01-01

    Holography was devised for breaking through the resolution limit of electron microscopes The advent of a "coherent" field emission electron beam has enabled the use of Electron Holography in various areas of magnetic domain structures observation, fluxon observation in superconductors, and fundamental experiments in physics which have been inaccessible using other techniques After examining the fundamentals of electron holography and its applications to the afore mentioned fields, a detailed discussion of the Aharonov-Bohm effect and the related experiments is presented Many photographs and illustrations are included to elucidate the text

  17. Secondary electron emission characteristics of untreated and ion-textured titanium

    Science.gov (United States)

    Curren, Arthur N.; Jensen, Kenneth A.; Blackford, Gary A.

    1989-01-01

    Experimentally determined values of true secondary electron emission and relative values of reflected primary electron yield are presented for untreated (simply machined) and ion-textured, high-purity titanium over ranges of primary electron beam energies and beam impingement angles. The purpose of the investigation was to explore the feasibility of using titanium as electrode material in the multistage depressed collectors (MDC's) used in microwave amplifier traveling wave tubes (TWT's) for space communications and aircraft applications. Because of its relatively low density and thermal expansion characteristics and relatively high strength, thermal emissivity, and melting temperature, titanium presents itself as a possible candidate for the MDC electrode application. A detailed description of the method of ion texturing the titanium is included. Although the ion-treated surface considered in this study is not presented as being optimum from the standpoint of secondary electron emission suppression, it nevertheless serves to demonstrate that the surface can be modified by this procedure to significantly reduce these emission characteristics relative to those of the untreated surface. Further studies can reasonably be expected to produce surfaces with even lower secondary emission characteristics. The titanium surface were tested at primary electron beam energies of 200 to 2000 eV and at direct (0 deg) to near-grazing (85 deg) beam impingement angles. True secondary electron emission and relative reflected primary electron yield characteristics of the surfaces were compared with each other and with textured titanium surface exhibited secondary electron emission characteristics sharply lower than those exhibited by untreated titanium or copper. Clearly, then, in consideration of the secondary electron emission suppression of ion-textured titanium along with its other favorable physical properties, it must be included as a potential candidate for use as MDC electrode

  18. Primary care workforce development in Europe.

    NARCIS (Netherlands)

    Groenewegen, P.; Heinemann, S.; Gress, S.; Schäfer, W.

    2014-01-01

    Background: There is a large variation in the organization of primary care in Europe. In some health care systems, primary care is the gatekeeper to more specialized care, whilst in others patients have the choice between a wide range of providers. Primary care has increasingly become teamwork.

  19. Reticle level compensation for long range effects

    Science.gov (United States)

    Figueiro, Thiago; Browning, Clyde; Thornton, Martin J.; Vannufel, Cyril; Schiavone, Patrick

    2013-03-01

    Proximity Effects in electron beam lithography impact feature dimensions, pattern fidelity and uniformity. Electron scattering effects are commonly addressed using a mathematical model representing the radial exposure intensity distribution induced by a point electron source, commonly named Point Spread Function (PSF). PSF models are usually employed for correcting "short-range" and "long-range" backscattering effects up to 10μm to 15μm. It is well known that there are also some process related phenomena impacting pattern uniformity that have a wider range (fogging, chemical mechanical polishing -CMP- effects, etc.) which impacts up to a few millimeters or more. There are a number of commercial strategies for mitigating such long range effects based on data density. However, those traditional ones are usually performed within a single chip on a reticle field and ignore the presence of adjacent fields, neglecting their influence. Full field reticles can contain several different designs or arrayed chips in a multitude of layout placements. Reticle level jobdeck placing each design at specific sites, independent of each other can be used to account for the density of each pattern that has a relative impact on its neighbors, even if they are several millimeters away from offending data. Therefore, full field density analysis accounting for scribe frames and all neighboring patterns is required for reaching fidelity control requirements such as critical dimension (CD) and line end shortening (LES) on the full plate. This paper describes a technique to compensate long range effects going across chip boundaries to the full reticle exposure field. The extreme long range effects are also represented with a model that is calibrated according to the characteristics of the user's process. Data correction can be based on dose and geometry modulation. Uniform pattern dimensional control matching the user's specific process long range variability can be achieved with the

  20. Cancer of unknown primary

    DEFF Research Database (Denmark)

    Dyrvig, Anne-Kirstine; Yderstræde, Knud Bonnet; Gerke, Oke

    2017-01-01

    Cancer of unknown primary (CUP) ranges within top 10 cancers in both incidence and mortality. As primary identification is crucial to choosing treatment, guidelines on CUP emphasize the diagnostic strategy. Whether guidelines are complied with, or if they are indeed helpful, is however unclear. We...... to procedures and patient survival. The cohort was investigated in terms of validity of diagnosis through cross-referencing with the Cancer Registry (CR), which served as gold standard for cancer diagnoses and patients' cancer histories.The NPR cohort consisted of 542 patients (275 males, 264 females) of whom...... after 4 years.The validity of a CUP diagnosis in NPR was low when using data from CR as reference. More than half the suspected CUP patients had a previous cancer diagnosis with CUP being the most frequent. Patients were diagnosed in compliance with guidelines indicating high external validity, but less...

  1. Electronic nicotine delivery systems: a research agenda

    Science.gov (United States)

    Etter, Jean-François; Bullen, Chris; Flouris, Andreas D; Laugesen, Murray; Eissenberg, Thomas

    2011-01-01

    Electronic nicotine delivery systems (ENDS, also called electronic cigarettes or e-cigarettes) are marketed to deliver nicotine and sometimes other substances by inhalation. Some tobacco smokers report that they used ENDS as a smoking cessation aid. Whether sold as tobacco products or drug delivery devices, these products need to be regulated, and thus far, across countries and states, there has been a wide range of regulatory responses ranging from no regulation to complete bans. The empirical basis for these regulatory decisions is uncertain, and more research on ENDS must be conducted in order to ensure that the decisions of regulators, health care providers and consumers are based on science. However, there is a dearth of scientific research on these products, including safety, abuse liability and efficacy for smoking cessation. The authors, who cover a broad range of scientific expertise, from basic science to public health, suggest research priorities for non-clinical, clinical and public health studies. They conclude that the first priority is to characterize the safety profile of these products, including in long-term users. If these products are demonstrated to be safe, their efficacy as smoking cessation aids should then be tested in appropriately designed trials. Until these studies are conducted, continued marketing constitutes an uncontrolled experiment and the primary outcome measure, poorly assessed, is user health. Potentially, this research effort, contributing to the safety and efficacy of new smoking cessation devices and to the withdrawal of dangerous products, could save many lives. PMID:21415064

  2. Printed Electronics

    Science.gov (United States)

    Crain, John M. (Inventor); Lettow, John S. (Inventor); Aksay, Ilhan A. (Inventor); Korkut, Sibel (Inventor); Chiang, Katherine S. (Inventor); Chen, Chuan-Hua (Inventor); Prud'Homme, Robert K. (Inventor)

    2016-01-01

    Printed electronic device comprising a substrate onto at least one surface of which has been applied a layer of an electrically conductive ink comprising functionalized graphene sheets and at least one binder. A method of preparing printed electronic devices is further disclosed.

  3. Electronic Cereal.

    Science.gov (United States)

    Frentrup, Julie R.; Phillips, Donald B.

    1996-01-01

    Describes activities that use Froot Loops breakfast cereal to help students master the concepts of valence electrons and chemical bonding and the implications of the duet and octet rules. Involves students working in groups to create electron dot structures for various compounds. (JRH)

  4. The art of linear electronics

    CERN Document Server

    Hood, John Linsley

    2013-01-01

    The Art of Linear Electronics presents the principal aspects of linear electronics and techniques in linear electronic circuit design. The book provides a wide range of information on the elucidation of the methods and techniques in the design of linear electronic circuits. The text discusses such topics as electronic component symbols and circuit drawing; passive and active semiconductor components; DC and low frequency amplifiers; and the basic effects of feedback. Subjects on frequency response modifying circuits and filters; audio amplifiers; low frequency oscillators and waveform generato

  5. A possible gamma ray primary as the highest energy cosmic rays

    Directory of Open Access Journals (Sweden)

    H A Kermani

    2011-03-01

    Full Text Available Muon-electron ratio and median zenith angle of Extensive Air Shower (EAS is calculated for the energy range of 1019 to bigger than 1020 eV. The results are compared with the simulation work of Capdevielle et al [1]. The results show a good correspondence with proton primary composition up to energy level of 7×1019 eV. In higher energies above GZK cut off, a considerable increase is calculated in cosmic primary photons. In addition, event frequency distribution above energy 7×1019 eV shows increasing concentration towards super galactic plane.

  6. Electronic states of myricetin

    DEFF Research Database (Denmark)

    Vojta, Danijela; Karlsen, Eva; Spanget-Larsen, Jens

    2017-01-01

    Myricetin (3,3',4',5,5',7'-hexahydroxyflavone) was investigated by linear dichroism spectroscopy on molecular samples partially aligned in stretched poly(vinyl alcohol) (PVA). At least five electronic transitions in the range 40000 – 20000 cm–1 were characterized with respect to their wavenumbers...

  7. Fuel cell electronics packaging

    National Research Council Canada - National Science Library

    Kuang, Ken; Easler, Keith

    2007-01-01

    ... more energy independent. Despite the fact that the primary focus of the new initiative revolved around automotive technologies, the President's Hydrogen Fuel Initiative was crafted into a balanced program that benefited a wide range of technologies and applications, including micro, portable, stationary fuel cells. This massive effort was given an addition...

  8. Experimental observation of electron-temperature-gradient turbulence in a laboratory plasma.

    Science.gov (United States)

    Mattoo, S K; Singh, S K; Awasthi, L M; Singh, R; Kaw, P K

    2012-06-22

    We report the observation of electron-temperature-gradient (ETG) driven turbulence in the laboratory plasma of a large volume plasma device. The removal of unutilized primary ionizing and nonthermal electrons from uniform density plasma and the imposition and control of the gradient in the electron temperature (T[Symbol: see text] T(e)) are all achieved by placing a large (2 m diameter) magnetic electron energy filter in the middle of the device. In the dressed plasma, the observed ETG turbulence in the lower hybrid range of frequencies ν = (1-80 kHz) is characterized by a broadband with a power law. The mean wave number k perpendicular ρ(e) = (0.1-0.2) satisfies the condition k perpendicular ρ(e) ≤ 1, where ρ(e) is the electron Larmor radius.

  9. Electron and Photon ID

    CERN Document Server

    Hryn'ova, Tetiana; The ATLAS collaboration

    2017-01-01

    The identification of prompt photons and the rejection of background coming mostly from photons from hadron decays relies on the high granularity of the ATLAS calorimeter. The electron identification used in ATLAS for run 2 is based on a likelihood discrimination to separate isolated electron candidates from candidates originating from photon conversions, hadron misidentification and heavy flavor decays. In addition, isolation variables are used as further handles to separate signal and background. Several methods are used to measure with data the efficiency of the photon identification requirements, to cover a broad energy spectrum. At low energy, photons from radiative Z decays are used. In the medium energy range, similarities between electrons and photon showers are exploited using Z->ee decays. At high energy, inclusive photon samples are used. The measurement of the efficiencies of the electron identification and isolation cuts are performed with the data using tag and probe techniques with large statis...

  10. Primary care research in Denmark

    DEFF Research Database (Denmark)

    Vedsted, Peter; Kallestrup, Per

    2016-01-01

    histories from research-rich to resource-poor nations that illustrate the range of research development and capacity building. This book argues the importance of primary care research, especially to policy makers, decision makers and funders in informing best practice, training primary health care providers......International Perspectives on Primary Care Research examines how the evidence base from primary care research can strengthen health care services and delivery, tackle the growing burden of disease, improve quality and safety, and increase a person-centred focus to health care. Demonstrating...... the inter-professional nature of the discipline, the book also features a section on cross-nation organisations and primary care networks supporting research. National perspectives are offered from researchers in 20 countries that form part of the World Organization of Family Doctors, providing case...

  11. Primary Colours’

    Directory of Open Access Journals (Sweden)

    Edmund Thomas

    2011-12-01

    Full Text Available Review of: Mark Bradley, Colour and Meaning in Ancient Rome, Cambridge and New York: Cambridge University Press, 2009. This article reviews Mark Bradley’s monograph Colour and Meaning in Ancient Rome, Cambridge: Cambridge University Press, 2009. This book is the first major study in English of the conceptual history of colour in ancient Rome. It re-examines a range of Latin philosophical, rhetorical and literary texts, focusing on the period of the late Republic and early Empire. The work considers Roman attempts to understand the colours of the rainbow and assimilates the role of metaphorical colour in rhetorical presentation to the addition of colour through cosmetics. It ends with a consideration of the colours of the Roman triumph in comparison with modern ceremony. The book will be useful for philologists, philosophers and historians and is accessible to students. Its conclusion is that colour was a negotiable concept, leading to the confusion of appearance and reality, a conclusion which applies particularly to the specific historical and cultural context of Neronian Rome. The book raises the further issue of how these theoretical principles were applied to the interpretation of visual evidence, as well as wider uses of colour in social and religious contexts.

  12. Digital electronics

    CERN Document Server

    Morris, John

    2013-01-01

    An essential companion to John C Morris's 'Analogue Electronics', this clear and accessible text is designed for electronics students, teachers and enthusiasts who already have a basic understanding of electronics, and who wish to develop their knowledge of digital techniques and applications. Employing a discovery-based approach, the author covers fundamental theory before going on to develop an appreciation of logic networks, integrated circuit applications and analogue-digital conversion. A section on digital fault finding and useful ic data sheets completes th

  13. Electronic diagrams

    CERN Document Server

    Colwell, Morris A

    1976-01-01

    Electronic Diagrams is a ready reference and general guide to systems and circuit planning and in the preparation of diagrams for both newcomers and the more experienced. This book presents guidelines and logical procedures that the reader can follow and then be equipped to tackle large complex diagrams by recognition of characteristic 'building blocks' or 'black boxes'. The goal is to break down many of the barriers that often seem to deter students and laymen in learning the art of electronics, especially when they take up electronics as a spare time occupation. This text is comprised of nin

  14. Electronic identity

    CERN Document Server

    de Andrade, Norberto Nuno Gomes; Argles, David

    2014-01-01

    With the increasing availability of electronic services, security and a reliable means by which identity is verified is essential.Written by Norberto Andrade the first chapter of this book provides an overview of the main legal and regulatory aspects regarding electronic identity in Europe and assesses the importance of electronic identity for administration (public), business (private) and, above all, citizens. It also highlights the role of eID as a key enabler of the economy.In the second chapter Lisha Chen-Wilson, David Argles, Michele Schiano di Zenise and Gary Wills discuss the user-cent

  15. Polymer electronics

    CERN Document Server

    Geoghegan, Mark

    2013-01-01

    Polymer electronics is the science behind many important new developments in technology, such as the flexible electronic display (e-ink) and many new developments in transistor technology. Solar cells, light-emitting diodes, and transistors are all areas where plastic electronics is likely to, or is already having, a serious impact on our daily lives. With polymer transistors and light-emitting diodes now being commercialised, there is a clear need for a pedagogic text thatdiscusses the subject in a clear and concise fashion suitable for senior undergraduate and graduate students. The content

  16. Stretchable electronics

    CERN Document Server

    Someya, Takao

    2012-01-01

    With its comprehensive coverage this handbook and ready reference brings together some of the most outstanding scientists in the field to lay down the undisputed knowledge on how to make electronics stretchable.As such, it focuses on gathering and evaluating the materials, designs, models and technologies that enable the fabrication of fully elastic electronic devices which can sustain high strain. Furthermore, it provides a review of those specific applications that directly benefit from highly compliant electronics, including transistors, photonic devices and sensors. In addition to stre

  17. Electron optics

    CERN Document Server

    Grivet, Pierre; Bertein, F; Castaing, R; Gauzit, M; Septier, Albert L

    1972-01-01

    Electron Optics, Second English Edition, Part I: Optics is a 10-chapter book that begins by elucidating the fundamental features and basic techniques of electron optics, as well as the distribution of potential and field in electrostatic lenses. This book then explains the field distribution in magnetic lenses; the optical properties of electrostatic and magnetic lenses; and the similarities and differences between glass optics and electron optics. Subsequent chapters focus on lens defects; some electrostatic lenses and triode guns; and magnetic lens models. The strong focusing lenses and pris

  18. Starting electronics

    CERN Document Server

    Brindley, Keith

    2005-01-01

    Starting Electronics is unrivalled as a highly practical introduction for hobbyists, students and technicians. Keith Brindley introduces readers to the functions of the main component types, their uses, and the basic principles of building and designing electronic circuits. Breadboard layouts make this very much a ready-to-run book for the experimenter; and the use of multimeter, but not oscilloscopes, puts this practical exploration of electronics within reach of every home enthusiast's pocket. The third edition has kept the simplicity and clarity of the original. New material

  19. A mixed methods protocol to evaluate the effect and cost-effectiveness of an Integrated electronic Diagnosis Approach (IeDA) for the management of childhood illnesses at primary health facilities in Burkina Faso.

    Science.gov (United States)

    Blanchet, Karl; Lewis, James J; Pozo-Martin, Francisco; Satouro, Arsene; Somda, Serge; Ilboudo, Patrick; Sarrassat, Sophie; Cousens, Simon

    2016-08-04

    Burkina Faso introduced the Integrated Management of Childhood Illnesses (IMCI) strategy in 2003. However, an evaluation conducted in 2013 found that only 28 % of children were assessed for three danger signs as recommended by IMCI, and only 15 % of children were correctly classified. About 30 % of children were correctly prescribed with an antibiotic for suspected pneumonia or oral rehydration salts (ORS) for diarrhoea, and 40 % were correctly referred. Recent advances in information and communication technologies (ICT) and use of electronic clinical protocols hold the potential to transform healthcare delivery in low-income countries. However, no evidence is available on the effect of ICT on adherence to IMCI. This paper describes the research protocol of a mixed methods study that aims to measure the effect of the Integrated electronic Diagnosis Approach innovation (an electronic IMCI protocol provided to nurses) in two regions of Burkina Faso. The study combines a stepped-wedge trial, a realistic evaluation and an economic study in order to capture the effect of the innovation after its introduction on the level of adherence, cost and acceptability. The main challenge is to interconnect the three substudies. In integrating outcome, process and cost data, we focus on three key questions: (i) How does the effectiveness and the cost of the intervention vary by type of health worker and type of health centre? (ii) What is the impact of changes in the content, coverage and quality of the IeDA intervention on adherence and cost-effectiveness? (iii) What mechanisms of change (including costs) might explain the relationship between the IeDA intervention and adherence? Clinicaltrials.gov, NCT02341469 .

  20. Public Participation Guide: Electronic Democracy

    Science.gov (United States)

    Electronic democracy describes a wide range of interactive tools that embrace existing and emergent media sources as a forum for allowing members of the public to express opinions and seek to influence decision-making.

  1. Biosynthesis of electron transfer flavoprotein in a cell-free system and in cultured human fibroblasts. Defect in the alpha subunit synthesis is a primary lesion in glutaric aciduria type II.

    OpenAIRE

    Ikeda, Y; Keese, S M; Tanaka, K.

    1986-01-01

    We investigated the biosynthesis of electron transfer flavoprotein (ETF) in a cell-free system. Both alpha-(alpha-ETF, 32,000 molecular weight [mol wt]) and beta-subunits (beta-ETF, 27,000 mol wt) were nuclear-coded, and synthesized in the cytosol. alpha-ETF was synthesized as a precursor (p alpha-ETF), 3,000 mol wt larger than its mature counterpart, and was translocated into the mitochondria and processed to the mature alpha-ETF. The newly synthesized beta-ETF was the same as the mature bet...

  2. Paper electronics.

    Science.gov (United States)

    Tobjörk, Daniel; Österbacka, Ronald

    2011-05-03

    Paper is ubiquitous in everyday life and a truly low-cost substrate. The use of paper substrates could be extended even further, if electronic applications would be applied next to or below the printed graphics. However, applying electronics on paper is challenging. The paper surface is not only very rough compared to plastics, but is also porous. While this is detrimental for most electronic devices manufactured directly onto paper substrates, there are also approaches that are compatible with the rough and absorptive paper surface. In this review, recent advances and possibilities of these approaches are evaluated and the limitations of paper electronics are discussed. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  3. Electronic Cigarettes

    Science.gov (United States)

    ... Campaigns Infogallery Be Tobacco Free Search betobaccofree.gov Menu Search ABOUT TOBACCO Tobacco Facts and Figures Tobacco and Nicotine Smoked Tobacco Products Smokeless Tobacco Products Electronic Cigarettes New FDA Regulations HEALTH EFFECTS Nicotine Addiction ...

  4. Electronic Elections

    DEFF Research Database (Denmark)

    Schürmann, Carsten

    2009-01-01

    Electronic voting technology is a two edged sword. It comes with many risks but brings also many benefits. Instead of flat out rejecting the technology as uncontrollably dangerous, we advocate in this paper a different technological angle that renders electronic elections trustworthy beyond...... the usual levels of doubt. We exploit the trust that voters currently have into the democratic process and model our techniques around that observation accordingly. In particular, we propose a technique of trace emitting computations to record the individual steps of an electronic voting machine...... for a posteriori validation on an acceptably small trusted computing base. Our technology enables us to prove that an electronic elections preserves the voter’s intent, assuming that the voting machine and the trace verifier are independent....

  5. Electron Microprobe

    Data.gov (United States)

    Federal Laboratory Consortium — The JEOL JXA-8600 is a conventional hairpin filament thermal emission electron microprobe that is more than 20 years old. It is capable of performing qualitative and...

  6. Attainment of Electron Beam Suitable for Medium Energy Electron Cooling

    Energy Technology Data Exchange (ETDEWEB)

    Seletskiy, Sergei M. [Univ. of Rochester, NY (United States)

    2005-01-01

    Electron cooling of charged particle beams is a well-established technique at electron energies of up to 300 keV. However, up to the present time the advance of electron cooling to the MeV-range energies has remained a purely theoretical possibility. The electron cooling project at Fermilab has recently demonstrated the ¯rst cooling of 8.9 GeV/c antiprotons in the Recycler ring, and therefore, has proved the validity of the idea of relativistic electron cool- ing. The Recycler Electron Cooler (REC) is the key component of the Teva- tron Run II luminosity upgrade project. Its performance depends critically on the quality of electron beam. A stable electron beam of 4.3 MeV car- rying 0.5 A of DC current is required. The beam suitable for the Recycler Electron Cooler must have an angular spread not exceeding 200 ¹rad. The full-scale prototype of the REC was designed, built and tested at Fermilab in the Wideband laboratory to study the feasibility of attaining the high-quality electron beam. In this thesis I describe various aspects of development of the Fermilab electron cooling system, and the techniques used to obtain the electron beam suitable for the cooling process. In particular I emphasize those aspects of the work for which I was principally responsible.

  7. Feasibility for p+/p- intensity-ratio evaluation in the 0.5 - 1.5 TeV primary energy range, based on Moon-shadow muon measurements, to be carried out in the Pyramid of the Sun, Teotihuacan, Experiment

    Science.gov (United States)

    Grabski, V.; Morales, A.; Reche, R.; Orozco, O.

    Several experimental works demonstrate the possibility of observation of shadows of the Moon and the Sun for the mean energy of primaries higher than 1 TeV. Calculations are presented to demonstrate the feasibility of Moon shadow observations for mean primary energies in the region 0.5-1 TeV in a muon detector operating under the Pyramid of the Sun at Teotihuacan, Mexico. Due to the relatively small height of that monument (65 m), the experiment is capable of providing considerably high statistics, but with deterioration in the angular accuracy for primary particle direction reconstruction. Our estimates are based on simulations of muon production and transport in the atmosphere by CORSICA, while the transport along the body of the pyramid is simulated using GEANT4. The deflection of primaries in magnetic field of the earth is calculated using the IGRF model. The analysis aims at discriminating between positively and negatively charged primaries traveling along directions corresponding to the Moon shadow region. The statistics for antiproton shadow observations, which depends on different factors affecting the accuracy of the primary particle direction reconstruction, is analyzed in detail.

  8. A study of energy correction for the electron beam data in the BGO ECAL of the DAMPE

    CERN Document Server

    Li, Zhiying; Wei, Yifeng; Wang, Chi; Zhang, Yunlong; Wen, Sicheng; Wang, Xiaolian; Xu, Zizong; Huang, Guangshun

    2015-01-01

    The DArk Matter Particle Explorer (DAMPE) is an orbital experiment aiming at searching for dark matter indirectly by measuring the spectra of photons, electrons and positrons originating from deep space. The BGO electromagnetic calorimeter is one of the key sub-detectors of the DAMPE, which is designed for high energy measurement with a large dynamic range from 5 GeV to 10 TeV. In this paper, some methods for energy correction are discussed and tried, in order to reconstruct the primary energy of the incident electrons. Different methods are chosen for the appropriate energy ranges. The results of Geant4 simulation and beam test data (at CERN) are presented.

  9. Radiation damage in electron cryomicroscopy.

    Science.gov (United States)

    Baker, Lindsay A; Rubinstein, John L

    2010-01-01

    In an electron microscope, the electron beam used to determine the structures of biological tissues, cells, and molecules destroys the specimen as the image is acquired. This destruction occurs before a statistically well-defined image can be obtained and is consequently the fundamental limit to resolution in biological electron cryomicroscopy (cryo-EM). Damage from the destructive interaction of electrons with frozen-hydrated specimens occurs in three stages: primary damage, as electrons ionize the sample, break bonds, and produce secondary electrons and free radicals; secondary damage, as the secondary electrons and free radicals migrate through the specimen and cause further chemical reactions; and tertiary damage, as hydrogen gas is evolved within the sample, causing gross morphological changes to the specimen. The deleterious effects of radiation are minimized in cryo-EM by limiting the exposure of the specimen to incident electrons and cooling the sample to reduce secondary damage. This review emphasizes practical considerations for minimizing radiation damage, including measurement of electron exposure, estimation of absorbed doses of energy, selection of microscope voltage and specimen temperature, and selection of electron exposure to optimize images. Copyright © 2010 Elsevier Inc. All rights reserved.

  10. Trophic transfer potential of aluminium oxide nanoparticles using representative primary producer (Chlorella ellipsoides) and a primary consumer (Ceriodaphnia dubia)

    Energy Technology Data Exchange (ETDEWEB)

    Pakrashi, Sunandan; Dalai, Swayamprava; Chandrasekaran, Natarajan; Mukherjee, Amitava, E-mail: amit.mookerjea@gmail.com

    2014-07-01

    Highlights: • Trophic transfer of alumina nanoparticles using Chlorella ellipsoides and Ceriodaphnia dubia. • Subtle alterations in the feeding behaviour of the daphnids. • Disruption the energy flow through the food chain. • Transmission electron microscopy validated the disrupted feeding behaviour. - Abstract: The transfer of nanoparticles through the food chain can lead to bioaccumulation and biomagnification resulting in a long term negative impact on the ecosystem functions. The primary objective of this study was evaluation of aluminium oxide nanoparticles transfer from primary producers to primary consumers. A simple set up consisting of a primary producer (Chlorella ellipsoides) and a primary consumer (Ceriodaphnia dubia) was used. Here, C. ellipsoides were exposed to the varying concentrations of the nanoparticles ranging from 20 to 120 μg/mL (196 to 1176 μM) for 48 h and the infested algal cells were used as the feed to C. dubia. The bioaccumulation of the nanoparticles into the daphnids was noted and the biomagnification factors were computed. The exposure was noted to cause subtle alterations in the feeding behaviour of the daphnids. This might have long term consequences in the energy flow through the food chain. The reproductive behaviour of the daphnids remained unaffected upon exposure to nanoparticle infested algal feed. Distinct observations at ultra-structural scale using transmission electron microscopy provided visual evidences for the disrupted feeding behaviour upon exposure to nanoparticle treated algae. Internalization of nanoparticle like inclusion bodies in the intracellular space of algae was also detected. The findings were further substantiated by a detailed analysis of hydrodynamic stability, bioavailability and dissolution of ions from the nanoparticles over the exposure period. Altogether, the study brings out the first of its kind of observation of trophic transfer potential/behaviour of aluminium oxide nanoparticles and

  11. Surface electronic structure of fullerides : effects of correlation, electron-phonon coupling, and polymerization

    NARCIS (Netherlands)

    Macovez, Roberto

    2007-01-01

    The phenomenology of C60 both as isolated molecule and in condensed phases is reviewed. C60 compounds (fullerides) display a wide range of electronic ground states ranging from magnetic insulators to superconductors. The fundamental properties and interactions (electron correlation, electron-phonon

  12. Spin electronics

    CERN Document Server

    Buhrman, Robert; Daughton, James; Molnár, Stephan; Roukes, Michael

    2004-01-01

    This report is a comparative review of spin electronics ("spintronics") research and development activities in the United States, Japan, and Western Europe conducted by a panel of leading U.S. experts in the field. It covers materials, fabrication and characterization of magnetic nanostructures, magnetism and spin control in magnetic nanostructures, magneto-optical properties of semiconductors, and magnetoelectronics and devices. The panel's conclusions are based on a literature review and a series of site visits to leading spin electronics research centers in Japan and Western Europe. The panel found that Japan is clearly the world leader in new material synthesis and characterization; it is also a leader in magneto-optical properties of semiconductor devices. Europe is strong in theory pertaining to spin electronics, including injection device structures such as tunneling devices, and band structure predictions of materials properties, and in development of magnetic semiconductors and semiconductor heterost...

  13. Electronic Commerce

    Energy Technology Data Exchange (ETDEWEB)

    Laird, N. [NRG Information Services Inc., Calgary, AB (Canada)

    1995-11-01

    The concept of electronic commerce in the gas industry was discussed. It was defined as the integration of communication technology, advanced information processing capability and business standards, to improve effectiveness of the business process. Examples of electronic data interchange from the automotive, airline, and banking industry were given. The objective of using this technology in the gas industry was described as the provision of one electronic facility to make seamless contractual and operational arrangements for moving natural gas across participating pipelines. The benefit of seamless integration - one readily available standard system used by several companies - was highlighted. A list of value-added services such as the free movement of bulletins, directories, nominations,and other documents was provided.

  14. High Precision Ranging and Range-Rate Measurements over Free-Space-Laser Communication Link

    Science.gov (United States)

    Yang, Guangning; Lu, Wei; Krainak, Michael; Sun, Xiaoli

    2016-01-01

    We present a high-precision ranging and range-rate measurement system via an optical-ranging or combined ranging-communication link. A complete bench-top optical communication system was built. It included a ground terminal and a space terminal. Ranging and range rate tests were conducted in two configurations. In the communication configuration with 622 data rate, we achieved a two-way range-rate error of 2 microns/s, or a modified Allan deviation of 9 x 10 (exp -15) with 10 second averaging time. Ranging and range-rate as a function of Bit Error Rate of the communication link is reported. They are not sensitive to the link error rate. In the single-frequency amplitude modulation mode, we report a two-way range rate error of 0.8 microns/s, or a modified Allan deviation of 2.6 x 10 (exp -15) with 10 second averaging time. We identified the major noise sources in the current system as the transmitter modulation injected noise and receiver electronics generated noise. A new improved system will be constructed to further improve the system performance for both operating modes.

  15. Long-Range Charge Order in the Extended Holstein-Hubbard Model

    Science.gov (United States)

    Miyao, Tadahiro

    2016-10-01

    This study investigated the extended Holstein-Hubbard model at half-filling as a model for describing the interplay of electron-electron and electron-phonon couplings. When the electron-phonon and nearest-neighbor electron-electron interactions are strong, we prove the existence of long-range charge order in three or more dimensions at a sufficiently low temperature. As a result, we rigorously justify the phase competition between the antiferromagnetism and charge orders.

  16. Electron processing at low energies: from basics to environmental and biological applications.

    Science.gov (United States)

    Illenberger, Eugen

    2006-10-01

    Electron initiated reactions play a key role in nearly any field of pure and applied sciences, in the gas phase as well as in condensed phases or at interfaces. This include substrate induced photochemistry, radiation damage of biological material (and, accordingly, the molecular mechanisms, how radio sensitizers used in tumour therapy operate), reactions induced by electrons in surface tunnelling microscopy (STM), or any kind of plasma used in industrial plasma processing. In each of these fields the electron-molecule interaction represents a key step within an eventually complex reaction sequence. A particularly interesting field is the interaction of electrons with molecules at energies below the level of electronic excitation. In this range many molecules exhibit large cross sections for resonant electron capture, often followed by the decomposition of the transient negative compound (M^-# ) according to e^- + M --> M^-# --> R + X^-.^ We report on such dissociative electron attachment (DEA) processes studied at different stages of aggregation, namely in single molecules under collision free conditions, in clusters formed by supersonic gas expansion, and on the surface of solids or in molecular nanofilms. In the meantime it has also been recognised that in the damage of living cells by high energy radiation the attachment of low energy secondary electrons to DNA is a key initial process leading to strand breaks. These secondary electrons are created along the ionisation track of the primary high-energy quantum. Apart from that, bio-molecular systems exhibit unique features in DEA, like bond and site selective decompositions.

  17. Measurement of the primary and scatter dose in high energy photon beams

    Energy Technology Data Exchange (ETDEWEB)

    Van der Linden, P.M. [Catharina Ziekenhuis, Eindhoven (Netherlands). Radiotherapy Dept.; Tiourina, T.B.; Dries, W.

    1995-12-01

    A method is presented to measure the primary and scatter components separately in a water tank using a small cylindrical absorber. Results from this experiment are compared with Monte Carlo calculations. The measurement setup consists of a small cylindrical absorber placed on a central axis of the beam a few centimetres above the radiation detector. Both absorber and detector move along the central axis while absorbed dose is registered. As the primary radiation is fully blocked, only scatter component is measured when a cylindrical absorber is used. Measurements in open fields result in the total absorbed dose being the sum of primary and scatter components. The primary dose component can be derived by substraction. Absorbers with different diameters are used. With decreasing dimensions the relative contribution of the dose due to scatter radiation increases. A steep increase is observed when the range of laterally scattered electrons becomes comparable with the radius of the absorber. Two different Monte Carlo simulations have been performed: with and without secondary electron transport. The data obtained for the former case perfectly agrees with the experiment. The situation where the secondary electron is assumed zero (i.e. local energy deposition) simulates the Cunningham model. Our results show that the Cunningham model predicts lower scatter component under the block edge which can be important for these applications.

  18. Primary total elbow arthroplasty

    Directory of Open Access Journals (Sweden)

    Suresh Kumar

    2013-01-01

    Full Text Available Background: Primary total elbow arthroplasty (TEA is a challenging procedure for orthopedic surgeons. It is not performed as frequently as compared to hip or knee arthroplasty. The elbow is a nonweight-bearing joint; however, static loading can create forces up to three times the body weight and dynamic loading up to six times. For elderly patients with deformity and ankylosis of the elbow due to posttraumatic arthritis or rheumatoid arthritis or comminuted fracture distal humerus, arthroplasty is one of the option. The aim of this study is to analyze the role of primary total elbow arthroplasty in cases of crippling deformity of elbow. Materials and Methods: We analyzed 11 cases of TEA, between December 2002 and September 2012. There were 8 females and 3 males. The average age was 40 years (range 30-69 years. The indications for TEA were rheumatoid arthritis, comminuted fracture distal humerus with intraarticular extension, and posttraumatic bony ankylosis of elbow joint. The Baksi sloppy (semi constrained hinge elbow prosthesis was used. Clinico-radiological followup was done at 1 month, 3 months, 6 months, 1 year, and then yearly basis. Results: In the present study, average supination was 70° (range 60-80° and average pronation was 70° (range 60-80°. Average flexion was 135° (range 130-135°. However, in 5 cases, there was loss of 15 to 35° (average 25° of extension (45° out of 11 cases. The mean Mayo elbow performance score was 95.4 points (range 70-100. Arm length discrepancy was only in four patients which was 36% out of 11 cases. Clinico-radiologically all the elbows were stable except in one case and no immediate postoperative complication was noted. Radiolucency or loosening of ulnar stem was seen in 2 cases (18% out of 11 cases, in 1 case it was noted after 5 years and in another after 10 years. In second case, revision arthroplasty was done, in which only ulnar hinge section, hinge screw and lock screw with hexagonal head

  19. PREFACE: Spin Electronics

    Science.gov (United States)

    Dieny, B.; Sousa, R.; Prejbeanu, L.

    2007-04-01

    Conventional electronics has in the past ignored the spin on the electron, however things began to change in 1988 with the discovery of giant magnetoresistance in metallic thin film stacks which led to the development of a new research area, so called spin-electronics. In the last 10 years, spin-electronics has achieved a number of breakthroughs from the point of view of both basic science and application. Materials research has led to several major discoveries: very large tunnel magnetoresistance effects in tunnel junctions with crystalline barriers due to a new spin-filtering mechanism associated with the spin-dependent symmetry of the electron wave functions new magnetic tunnelling barriers leading to spin-dependent tunnelling barrier heights and acting as spin-filters magnetic semiconductors with increasingly high ordering temperature. New phenomena have been predicted and observed: the possibility of acting on the magnetization of a magnetic nanostructure with a spin-polarized current. This effect, due to a transfer of angular momentum between the spin polarized conduction electrons and the local magnetization, can be viewed as the reciprocal of giant or tunnel magnetoresistance. It can be used to switch the magnetization of a magnetic nanostructure or to generate steady magnetic excitations in the system. the possibility of generating and manipulating spin current without charge current by creating non-equilibrium local accumulation of spin up or spin down electrons. The range of applications of spin electronics materials and phenomena is expanding: the first devices based on giant magnetoresistance were the magnetoresistive read-heads for computer disk drives. These heads, introduced in 1998 with current-in plane spin-valves, have evolved towards low resistance tunnel magnetoresistice heads in 2005. Besides magnetic recording technology, these very sensitive magnetoresistive sensors are finding applications in other areas, in particular in biology. magnetic

  20. Recycling of electronic scrap

    DEFF Research Database (Denmark)

    Legarth, Jens Brøbech

    This Ph.D. thesis deals with the growingly important field of electronics recycling with special attention to the problem of printed circuit board recycling. A literature survey of contemporary electronics recycling and printed circuit board recycling is presented.Further, an analysis of the role...... of recycling in the modern quest for a sustainable global society is performed, clearly showing that without intensified focus on recycling, the global community cannot hope to reach even the most modest goals for sustainability in resource use. A general method for finding new recycling alternatives...... resource recovery is largest. It is clearly shown with the two printed circuit board scrap cases that the currently used copper recycling scenario is environmentally inferior to the tin and lead primary production scenarios. The method is a novelty, since no-one has previously put forward a method...