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Sample records for residence time based

  1. Estimate of Water Residence Times in Tudor Creek, Kenya Based ...

    African Journals Online (AJOL)

    Runoff in general was also too small to give reliable rating curves (correlation between rainfall and river runoff). For this reason, heat conservation was used for the calculation of water exchange. Although estimates of sea surface heat fluxes were based on coarse global climatology data with large seasonal variations in the ...

  2. Conceptual framework for model-based analysis of residence time distribution in twin-screw granulation

    DEFF Research Database (Denmark)

    Kumar, Ashish; Vercruysse, Jurgen; Vanhoorne, Valerie

    2015-01-01

    within each module where different granulation rate processes dominate over others. Currently, experimental data is used to determine the residence time distributions. In this study, a conceptual model based on classical chemical engineering methods is proposed to better understand and simulate...... the residence time distribution in a TSG. The experimental data were compared with the proposed most suitable conceptual model to estimate the parameters of the model and to analyse and predict the effects of changes in number of kneading discs and their stagger angle, screw speed and powder feed rate...

  3. Inferring detailed space use from movement paths: A unifying, residence time-based framework.

    Science.gov (United States)

    Kapota, Dror; Dolev, Amit; Saltz, David

    2017-10-01

    The residence time is the amount of time spent within a predefined circle surrounding each point along the movement path of an animal, reflecting its response to resource availability/quality. Two main residence time-based methods exist in the literature: (1) The variance of residence times along the path plotted against the radius of the circle was suggested to indicate the scale at which the animal perceives its resources; and (2) segments of the path with homogeneous residence times were suggested to indicate distinct behavioral modes, at a certain scale. Here, we modify and integrate these two methods to one framework with two steps of analysis: (1) identifying several distinct, nested scales of area-restricted search (ARS), providing an indication of how animals view complex resource landscapes, and also the resolutions at which the analysis should proceed; and (2) identifying places which the animal revisits multiple times and performs ARS; for these, we extract two scale-dependent statistical measures-the mean visit duration and the number of revisits in each place. The association between these measures is suggested as a signature of how animals utilize different habitats or resource types. The framework is validated through computer simulations combining different movement strategies and resource maps. We suggest that the framework provides information that is especially relevant when interpreting movement data in light of optimal behavior models, and which would have remained uncovered by either coarser or finer analyses.

  4. Conceptual framework for model-based analysis of residence time distribution in twin-screw granulation.

    Science.gov (United States)

    Kumar, Ashish; Vercruysse, Jurgen; Vanhoorne, Valérie; Toiviainen, Maunu; Panouillot, Pierre-Emmanuel; Juuti, Mikko; Vervaet, Chris; Remon, Jean Paul; Gernaey, Krist V; De Beer, Thomas; Nopens, Ingmar

    2015-04-25

    Twin-screw granulation is a promising continuous alternative for traditional batchwise wet granulation processes. The twin-screw granulator (TSG) screws consist of transport and kneading element modules. Therefore, the granulation to a large extent is governed by the residence time distribution within each module where different granulation rate processes dominate over others. Currently, experimental data is used to determine the residence time distributions. In this study, a conceptual model based on classical chemical engineering methods is proposed to better understand and simulate the residence time distribution in a TSG. The experimental data were compared with the proposed most suitable conceptual model to estimate the parameters of the model and to analyse and predict the effects of changes in number of kneading discs and their stagger angle, screw speed and powder feed rate on residence time. The study established that the kneading block in the screw configuration acts as a plug-flow zone inside the granulator. Furthermore, it was found that a balance between the throughput force and conveying rate is required to obtain a good axial mixing inside the twin-screw granulator. Although the granulation behaviour is different for other excipients, the experimental data collection and modelling methods applied in this study are generic and can be adapted to other excipients. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Exposure in emergency general surgery in a time-based residency ...

    African Journals Online (AJOL)

    Objective: This paper aimed to characterize the resident exposure to acute general surgical conditions during a three-months rotation in a general surgical unit. Setting: The Department of Surgery, University of Nairobi and Kenyatta National Referral and Teaching Hospital in Nairobi. MethodS: Four residents (in their first to ...

  6. Impact of repository depth on residence times for leaking radionuclides in land-based surface water

    Science.gov (United States)

    Wörman, Anders; Marklund, Lars; Xu, Shulan; Dverstorp, Björn

    2007-03-01

    The multiple scales of landscape topography produce a wide distribution of groundwater circulation cells that control the hydro-geological environments surrounding geological repositories for nuclear waste. The largest circulation cells tend to discharge water into major river reaches, large freshwater systems or the nearby Baltic Sea. We investigated numerically the release of radionuclides from repositories placed in bedrock with depths between 100 to 2000 meters in a Swedish coastal area and found that leakage from the deeper positions emerges primarily in the major aquatic systems. In effect, radionuclides from the deeper repositories are more rapidly transported towards the Sea by the stream system compared to leakage from more shallow repositories. The release from the shallower repositories is significantly retained in the initial stage of the transport in the (superficial) landscape because the discharge occurs in or near low-order streams with high retention characteristics. This retention and residence time for radioactivity in the landscape control radiological doses to biota and can, thus, be expected to constitute an essential part of an associated risk evaluation.

  7. A decade of robot-assisted radical prostatectomy training: Time-based metrics and qualitative grading for fellows and residents.

    Science.gov (United States)

    Altok, Muammer; Achim, Mary F; Matin, Surena F; Pettaway, Curtis A; Chapin, Brian F; Davis, John W

    2018-01-01

    As modern urology residency and fellowship training in robot-assisted surgery evolves toward standardized curricula (didactics, dry/wet-laboratory exercises, and surgical assistance), additional tools are needed to evaluate on-console performance. At the start of our robotics program in 2006, we set-up a time- and quality-based evaluation program and aim to consolidate this data into a simple set of metrics for self-evaluation. Using our index procedure of robot-assisted radical prostatectomy (RARP), we prospectively collected data on 2,215 cases over 10 years from 6 faculty surgeons and 94 trainees (43 urologic oncology fellows and 51 urology residents). The steps of the operation were divided into 11 consistent steps, and the metrics included time to completion and quality using a 6-level grading system. Time metrics were consolidated into quartiles for benchmarking. The median times for trainees to complete each step were 15% to 120% higher than those of the staff (Pstaff results. Steps performed by trainees were carefully chosen for a high success rate, and on our Likert-like scale were graded 4 to 5 in more than 95% of cases. There were no grade 0 (very poor) cases, and grades 1 (multiple technical errors) and 2 (could not be completed but without safety issues) were rare (staff. As a trainee progress through a rotation, these benchmarks can assist in prioritizing the need for more attention to a basic step vs. progression to more advanced steps. Copyright © 2018 Elsevier Inc. All rights reserved.

  8. A Time Study of Plastic Surgery Residents.

    Science.gov (United States)

    Lau, Frank H; Sinha, Indranil; Jiang, Wei; Lipsitz, Stuart R; Eriksson, Elof

    2016-05-01

    Resident work hours are under scrutiny and have been subject to multiple restrictions. The studies supporting these changes have not included data on surgical residents. We studied the workday of a team of plastic surgery residents to establish prospective time-study data of plastic surgery (PRS) residents at a single tertiary-care academic medical center. Five trained research assistants observed all residents (n = 8) on a PRS service for 10 weeks and produced minute-by-minute activity logs. Data collection began when the team first met in the morning and continued until the resident being followed completed all non-call activities. We analyzed our data from 3 perspectives: 1) time spent in direct patient care (DPC), indirect patient care, and didactic activities; 2) time spent in high education-value activities (HEAs) versus low education-value activities; and 3) resident efficiency. We defined HEAs as activities that surgeons must master; other activities were LEAs. We quantified resident efficiency in terms of time fragmentation and time spent waiting. A total of 642.4 hours of data across 50 workdays were collected. Excluding call, residents worked an average of 64.2 hours per week. Approximately 50.7% of surgical resident time was allotted to DPC, with surgery accounting for the largest segment of this time (34.8%). Time spent on HEAs demonstrated trended upward with higher resident level (P = 0.086). Time in spent in surgery was significantly associated with higher resident levels (P time study of PRS residents, we found that compared with medicine trainees, surgical residents spent 3.23 times more time on DPC. High education-value activities comprised most of our residents' workdays. Surgery was the leading component of both DPC and HEAs. Our residents were highly efficient and fragmented, with the majority of all activities requiring 4 minutes or less. Residents spent a large portion of their time waiting for other services. In light of these data, we

  9. The residence time of water in the atmosphere revisited

    NARCIS (Netherlands)

    Van Der Ent, Ruud J.; Tuinenburg, Obbe A.

    2017-01-01

    This paper revisits the knowledge on the residence time of water in the atmosphere. Based on state-of-the-art data of the hydrological cycle we derive a global average residence time of 8.9 ± 0.4 days (uncertainty given as 1 standard deviation). We use two different atmospheric moisture tracking

  10. An estimation of the average residence times and onshore-offshore diffusivities of beached microplastics based on the population decay of tagged meso- and macrolitter.

    Science.gov (United States)

    Hinata, Hirofumi; Mori, Keita; Ohno, Kazuki; Miyao, Yasuyuki; Kataoka, Tomoya

    2017-09-15

    Residence times of microplastics were estimated based on the dependence of meso- and macrolitter residence times on their upward terminal velocities (UTVs) in the ocean obtained by one- and two-year mark-recapture experiments conducted on Wadahama Beach, Nii-jima Island, Japan. A significant linear relationship between the residence time and UTV was found in the velocity range of about 0.3-0.9ms -1 , while there was no significant difference between the residence times obtained in the velocity range of about 0.9-1.4ms -1 . This dependence on the UTV would reflect the uprush-backwash response of the target items to swash waves on the beach. By extrapolating the linear relationship down to the velocity range of microplastics, the residence times of microplastics and the 1D onshore-offshore diffusion coefficients were inferred, and are one to two orders of magnitude greater than the coefficients of the macroplastics. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Resident fatigue in otolaryngology residents: a Web based survey.

    Science.gov (United States)

    Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Drug target residence time: a misleading concept.

    Science.gov (United States)

    Folmer, Rutger H A

    2018-01-01

    Since the importance of drug target residence time was first highlighted more 10 years ago, slow binding kinetics has received much attention in the drug discovery literature, and indeed within pharmaceutical research. However, the residence concept as presented in most papers is supported by rather misleading simulations and arguments, and by examples where compounds are taken out of their pharmacokinetic context. Moreover, fast association is typically more desirable than slow, and advantages of long residence time, notably a potential disconnect between pharmacodynamics (PD) and pharmacokinetics (PK), would be partially or completely offset by slow on-rate. Therefore, plain potency is likely a better predictor of drug development success than is residence time. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Elective time during dermatology residency: A survey of residents and program directors.

    Science.gov (United States)

    Uppal, Pushpinder; Shantharam, Rohini; Kaufmann, Tara Lynn

    2017-12-15

    Elective time during residency training provides residents with exposure to different subspecialties. This opportunity gives residents the chance tonurture growth in particular areas of interest and broaden their knowledge base in certain topics in dermatology by having the chance to work withexperts in the field. The purpose of this study was to assess the views of residency program directors and dermatology residents on the value of elective time through a cross sectional survey. An eight-questionIRB exempt survey was sent out to 113 residency program directors via email through the American Professors of Dermatology (APD) program director listserv. Program directors were asked to forward a separate set of 9 questions to their residents. The majority of programs that responded allowed for some elective time within their schedule, often duringthe PGY 4 (3rd year of dermatology training), but the amount of time allowed widely varied among many residency programs. Overall, residents and program directors agree that elective is important in residencytraining, but no standardization is established across programs.

  14. The role of residence time in diagnostic models of global carbon storage capacity: model decomposition based on a traceable scheme.

    Science.gov (United States)

    Yizhao, Chen; Jianyang, Xia; Zhengguo, Sun; Jianlong, Li; Yiqi, Luo; Chengcheng, Gang; Zhaoqi, Wang

    2015-11-06

    As a key factor that determines carbon storage capacity, residence time (τE) is not well constrained in terrestrial biosphere models. This factor is recognized as an important source of model uncertainty. In this study, to understand how τE influences terrestrial carbon storage prediction in diagnostic models, we introduced a model decomposition scheme in the Boreal Ecosystem Productivity Simulator (BEPS) and then compared it with a prognostic model. The result showed that τE ranged from 32.7 to 158.2 years. The baseline residence time (τ'E) was stable for each biome, ranging from 12 to 53.7 years for forest biomes and 4.2 to 5.3 years for non-forest biomes. The spatiotemporal variations in τE were mainly determined by the environmental scalar (ξ). By comparing models, we found that the BEPS uses a more detailed pool construction but rougher parameterization for carbon allocation and decomposition. With respect to ξ comparison, the global difference in the temperature scalar (ξt) averaged 0.045, whereas the moisture scalar (ξw) had a much larger variation, with an average of 0.312. We propose that further evaluations and improvements in τ'E and ξw predictions are essential to reduce the uncertainties in predicting carbon storage by the BEPS and similar diagnostic models.

  15. The role of residence time in diagnostic models of global carbon storage capacity: model decomposition based on a traceable scheme

    Science.gov (United States)

    Yizhao, Chen; Jianyang, Xia; Zhengguo, Sun; Jianlong, Li; Yiqi, Luo; Chengcheng, Gang; Zhaoqi, Wang

    2015-01-01

    As a key factor that determines carbon storage capacity, residence time (τE) is not well constrained in terrestrial biosphere models. This factor is recognized as an important source of model uncertainty. In this study, to understand how τE influences terrestrial carbon storage prediction in diagnostic models, we introduced a model decomposition scheme in the Boreal Ecosystem Productivity Simulator (BEPS) and then compared it with a prognostic model. The result showed that τE ranged from 32.7 to 158.2 years. The baseline residence time (τ′E) was stable for each biome, ranging from 12 to 53.7 years for forest biomes and 4.2 to 5.3 years for non-forest biomes. The spatiotemporal variations in τE were mainly determined by the environmental scalar (ξ). By comparing models, we found that the BEPS uses a more detailed pool construction but rougher parameterization for carbon allocation and decomposition. With respect to ξ comparison, the global difference in the temperature scalar (ξt) averaged 0.045, whereas the moisture scalar (ξw) had a much larger variation, with an average of 0.312. We propose that further evaluations and improvements in τ′E and ξw predictions are essential to reduce the uncertainties in predicting carbon storage by the BEPS and similar diagnostic models. PMID:26541245

  16. Atmospheric residence times of continental aerosols

    International Nuclear Information System (INIS)

    Balkanski, Y.J.

    1991-01-01

    The global atmospheric distributions of Rn-222 are simulated with a three-dimensional model of atmospheric transport based on the meteorology of the NASA Goddard Institute for Space Studies (GISS) general circulation model. The short-lived radioactive gas Rn-222 (half-life = 3.8d) is emitted almost exclusively from land, at a relatively uniform rate; hence it is an excellent tracer of continental influences. Lead-210 is produced by decay of Rn-222 and immediately condenses to preexisting aerosol surfaces. It provides an excellent measure of aerosol residence times in the atmosphere because its source is accurately defined by the Rn-222 distribution. Results from the three-dimensional model are compared to measurements of Rn-222 and Pb-210 atmospheric concentrations to evaluate model's long-range transport over oceanic regions and to study the deposition mechanisms of atmospheric aerosols. Model results for Rn-222 are used to examine the long-range transport of continental air over two selected oceanic regions, the subantarctic Indian Ocean and the North Pacific. It is shown that the fast transport of air from southern Africa causes substantial continental pollution at southern mid-latitudes, a region usually regarded as pristine. Air over the North Pacific is heavily impacted by continental influences year round, but the altitude at which the transport occurs varies seasonally. Observations of aerosols at island sites, which are commonly used as diagnostics of continental influences, may be misleading because they do not account for influences at high altitude and because aerosols are efficiently scavenged by deposition during transport. The study of Pb-210 focuses on defining the residence times of submicron aerosols in the troposphere. Scavenging in wet convective updrafts is found to provide the dominant sink on a global scale

  17. Residence time distribution studies on water-softening reactors

    International Nuclear Information System (INIS)

    Baranyai, L.

    1989-01-01

    Based on radiotracer techniques residence time distribution (RTD) studies were carried out on a water-softening reactor consisting of three physically separated units in order to characterize its hydrodynamical behaviour. The measured RTD curves and the actual mean residence times were compared with the theoretical values set up by modelling the reactor as a hydrodynamical system. Neither mixing nor sedimentation reaches ideal flow. The flow type in the settling cylinder is far of that what is expected. (author)

  18. Performance linked to residence time distribution by a novel wool-based bioreactor for tertiary sewage treatment.

    Science.gov (United States)

    Hu, Bibo; Wheatley, Andrew; Ishtchenko, Vera; Huddersman, Katherine

    2012-05-01

    Laboratory-scale experiments were carried out using up-flow 7 L Submerged Aerated Filter reactors packed with wool fibre or commercial plastic pall rings, Kaldnes, (70% by volume) support media for the tertiary treatment of sewage. The performance of the wool bioreactor was more consistent than that with Kaldnes medium, for both TOC removal (93%) and SS removal (90%). Both plastic and wool-packed bioreactors achieved complete nitrification at the load of about 0.4 kgCOD/m(3)/day. The sludge yield of the wool bioreactor was almost half that of the bioreactor with Kaldnes suggesting that wool could retain residual organics and particulates. The wool however was degraded and it was concluded that wool would have to be considered as additional sacrificial adsorption capacity rather than an alternative medium. The performance was linked to the residence time distribution studies and these changes in the wool structure. Biomass growth increased the retention of the tracer in the wool reactor by, it was suggested, exposing a greater surface area. Results from the plastic media on the other hand showed increased mixing possibly by increasing the mobility of the plastic. Aeration increased the mixing in both reactors, and patterns were in all cases predominantly well-mixed.

  19. Residence time and physical processes in lakes

    Directory of Open Access Journals (Sweden)

    Nicoletta SALA

    2003-09-01

    Full Text Available The residence time of a lake is highly dependent on internal physical processes in the water mass conditioning its hydrodynamics; early attempts to evaluate this physical parameter emphasize the complexity of the problem, which depends on very different natural phenomena with widespread synergies. The aim of this study is to analyse the agents involved in these processes and arrive at a more realistic definition of water residence time which takes account of these agents, and how they influence internal hydrodynamics. With particular reference to temperate lakes, the following characteristics are analysed: 1 the set of the lake's caloric components which, along with summer heating, determine the stabilizing effect of the surface layers, and the consequent thermal stratification, as well as the winter destabilizing effect; 2 the wind force, which transfers part of its momentum to the water mass, generating a complex of movements (turbulence, waves, currents with the production of active kinetic energy; 3 the water flowing into the lake from the tributaries, and flowing out through the outflow, from the standpoint of hydrology and of the kinetic effect generated by the introduction of these water masses into the lake. These factors were studied in the context of the general geographical properties of the lake basin and the watershed (latitude, longitude, morphology, also taking account of the local and regional climatic situation. Also analysed is the impact of ongoing climatic change on the renewal of the lake water, which is currently changing the equilibrium between lake and atmosphere, river and lake, and relationships

  20. Real time curriculum map for internal medicine residency.

    Science.gov (United States)

    Wong, Roger Y; Roberts, J Mark

    2007-11-07

    To manage the voluminous formal curriculum content in a limited amount of structured teaching time, we describe the development and evaluation of a curriculum map for academic half days (AHD) in a core internal medicine residency program. We created a 3-year cyclical curriculum map (an educational tool combining the content, methodology and timetabling of structured teaching), comprising a matrix of topics under various specialties/themes and corresponding AHD hours. All topics were cross-matched against the ACP-ASIM in-training examination, and all hours were colour coded based on the categories of core competencies. Residents regularly updated the map on a real time basis. There were 208 topics covered in 283 AHD hours. All topics represented core competencies with minimal duplication (78% covered once in 3 years). Only 42 hours (15%) involved non-didactic teaching, which increased after implementation of the map (18-19 hours/year versus baseline 5 hours/year). Most AHD hours (78%) focused on medical expert competencies. Resident satisfaction (90% response) was high throughout (range 3.64 +/- 0.21, 3.84 +/- 0.14 out of 4), which improved after 1 year but returned to baseline after 2 years. We developed and implemented an internal medicine curriculum map based on real time resident input, with minimal topic duplication and high resident satisfaction. The map provided an opportunity to balance didactic versus non-didactic teaching, and teaching on medical versus non medical expert topics.

  1. Improving Timely Resident Follow-Up and Communication of Results in Ambulatory Clinics Utilizing a Web-Based Audit and Feedback Module.

    Science.gov (United States)

    Boggan, Joel C; Swaminathan, Aparna; Thomas, Samantha; Simel, David L; Zaas, Aimee K; Bae, Jonathan G

    2017-04-01

    Failure to follow up and communicate test results to patients in outpatient settings may lead to diagnostic and therapeutic delays. Residents are less likely than attending physicians to report results to patients, and may face additional barriers to reporting, given competing clinical responsibilities. This study aimed to improve the rates of communicating test results to patients in resident ambulatory clinics. We performed an internal medicine, residency-wide, pre- and postintervention, quality improvement project using audit and feedback. Residents performed audits of ambulatory patients requiring laboratory or radiologic testing by means of a shared online interface. The intervention consisted of an educational module viewed with initial audits, development of a personalized improvement plan after Phase 1, and repeated real-time feedback of individual relative performance compared at clinic and program levels. Outcomes included results communicated within 14 days and prespecified "significant" results communicated within 72 hours. A total of 76 of 86 eligible residents (88%) reviewed 1713 individual ambulatory patients' charts in Phase 1, and 73 residents (85%) reviewed 1509 charts in Phase 2. Follow-up rates were higher in Phase 2 than Phase 1 for communicating results within 14 days and significant results within 72 hours (85% versus 78%, P  audit and feedback quality improvement project can improve rates of resident follow-up and communication of results, although communication gaps remained.

  2. An Innovative Approach to Resident Scheduling: Use of a Point-Based System to Account for Resident Preferences

    Science.gov (United States)

    Chow, Robert Tao-Ping; Tamhane, Shrikant; Zhang, Manling; Fisher, Lori-Ann; Yoon, Jenni; Sehgal, Sameep; Lumbres, Madel; Han, Ma Ai Thanda; Win, Tiffany

    2015-01-01

    Background The scheduling of residents for rotation assignments and on-call responsibilities is a time-consuming process that challenges the resources of residency programs. Assignment of schedules is traditionally done by chief residents or program administration with variable input from the residents involved. Intervention We introduced an innovative point-based scheduling system to increase transparency in the scheduling process, foster a sense of fairness and equality in scheduling, and increase resident ownership for making judicious scheduling choices. Methods We devised a point-based system in which each resident in our 40-member program was allocated an equal number of points. The residents assigned these points to their preferred choices of rotations. Residents were then surveyed anonymously on their perceptions of this new scheduling system and were asked to compare it with their traditional scheduling system. Results The schedule was successfully implemented, and it allowed residents to express their scheduling preferences using an innovative point-based approach. Residents were generally satisfied with the new system, would recommend it to other programs, and perceived a greater sense of involvement. However, resident satisfaction with the new system was not significantly greater compared with the previous approach to scheduling (P = .20). Chief residents expressed satisfaction with the new scheduling model. Conclusions Residents were equally satisfied with the traditional preference-based scheduling approach and the new point-based system. Chief residents' feedback on the new system reflected reduced stress and time commitment in the new point-based system. PMID:26457154

  3. Particle image velocimetry-validated, computational fluid dynamics-based design to reduce shear stress and residence time in central venous hemodialysis catheters.

    Science.gov (United States)

    Mareels, Guy; Kaminsky, Radoslav; Eloot, Sunny; Verdonck, Pascal R

    2007-01-01

    As crucial factors in blood clot formation, shear stress distribution and low flow zones are assessed in different central venous catheter tip designs by using a combined numeric and experimental approach. Computational Fluid Dynamics was validated with Particle Image Velocimetry by comparing simulated and measured velocities and shear strains in three designs of the blood withdrawing arterial lumen: cylindrical and with tip (1) cut straight, (2) cut at an angle, or (3) cut straight with a sleeve entrance. After validation, four additional designs were studied: (4) with two side holes and tip cut straight or (5) at an angle, (6) concentric lumens, and (7) Ash Split-based. In these seven designs, shear stress (SS), blood residence time (RT), and Platelet Lysis Index, which combines the influence of shear stress magnitude and exposure time, were simulated. Concentric catheter was discarded due to highly elevated SS. Ash Split-based design had elevated RT values in the distal tip zone as major inflow occurs through the most proximal side holes, but this is compensated by low average SS. A straight-cut tip and possibly two side holes are preferred when aiming at minimal SS and RT. These data may lead to more patent catheters.

  4. Real time curriculum map for internal medicine residency

    Directory of Open Access Journals (Sweden)

    Roberts J Mark

    2007-11-01

    Full Text Available Abstract Background To manage the voluminous formal curriculum content in a limited amount of structured teaching time, we describe the development and evaluation of a curriculum map for academic half days (AHD in a core internal medicine residency program. Methods We created a 3-year cyclical curriculum map (an educational tool combining the content, methodology and timetabling of structured teaching, comprising a matrix of topics under various specialties/themes and corresponding AHD hours. All topics were cross-matched against the ACP-ASIM in-training examination, and all hours were colour coded based on the categories of core competencies. Residents regularly updated the map on a real time basis. Results There were 208 topics covered in 283 AHD hours. All topics represented core competencies with minimal duplication (78% covered once in 3 years. Only 42 hours (15% involved non-didactic teaching, which increased after implementation of the map (18–19 hours/year versus baseline 5 hours/year. Most AHD hours (78% focused on medical expert competencies. Resident satisfaction (90% response was high throughout (range 3.64 ± 0.21, 3.84 ± 0.14 out of 4, which improved after 1 year but returned to baseline after 2 years. Conclusion We developed and implemented an internal medicine curriculum map based on real time resident input, with minimal topic duplication and high resident satisfaction. The map provided an opportunity to balance didactic versus non-didactic teaching, and teaching on medical versus non medical expert topics.

  5. Prolonged and tunable residence time using reversible covalent kinase inhibitors.

    Science.gov (United States)

    Bradshaw, J Michael; McFarland, Jesse M; Paavilainen, Ville O; Bisconte, Angelina; Tam, Danny; Phan, Vernon T; Romanov, Sergei; Finkle, David; Shu, Jin; Patel, Vaishali; Ton, Tony; Li, Xiaoyan; Loughhead, David G; Nunn, Philip A; Karr, Dane E; Gerritsen, Mary E; Funk, Jens Oliver; Owens, Timothy D; Verner, Erik; Brameld, Ken A; Hill, Ronald J; Goldstein, David M; Taunton, Jack

    2015-07-01

    Drugs with prolonged on-target residence times often show superior efficacy, yet general strategies for optimizing drug-target residence time are lacking. Here we made progress toward this elusive goal by targeting a noncatalytic cysteine in Bruton's tyrosine kinase (BTK) with reversible covalent inhibitors. Using an inverted orientation of the cysteine-reactive cyanoacrylamide electrophile, we identified potent and selective BTK inhibitors that demonstrated biochemical residence times spanning from minutes to 7 d. An inverted cyanoacrylamide with prolonged residence time in vivo remained bound to BTK for more than 18 h after clearance from the circulation. The inverted cyanoacrylamide strategy was further used to discover fibroblast growth factor receptor (FGFR) kinase inhibitors with residence times of several days, demonstrating the generalizability of the approach. Targeting of noncatalytic cysteines with inverted cyanoacrylamides may serve as a broadly applicable platform that facilitates 'residence time by design', the ability to modulate and improve the duration of target engagement in vivo.

  6. Residence time determination for adsorbent beds of different configurations

    Energy Technology Data Exchange (ETDEWEB)

    Otermat, J.E.; Wikoff, W.O.; Kovach, J.L.

    1995-02-01

    The residence time calculations of ASME AG-1 Code, Section FC, currently specify a screen surface area method, that is technically incorrect. Test data has been obtained on Type II adsorber trays of different configurations to establish residence time in the adsorber trays. These data indicate that the air volume/carbon volume ratio or the average screen area are more appropriate for the calculation of the residence time calculation than the currently used, smallest screen area basis.

  7. Residence time determination for adsorbent beds of different configurations

    International Nuclear Information System (INIS)

    Otermat, J.E.; Wikoff, W.O.; Kovach, J.L.

    1995-01-01

    The residence time calculations of ASME AG-1 Code, Section FC, currently specify a screen surface area method, that is technically incorrect. Test data has been obtained on Type II adsorber trays of different configurations to establish residence time in the adsorber trays. These data indicate that the air volume/carbon volume ratio or the average screen area are more appropriate for the calculation of the residence time calculation than the currently used, smallest screen area basis

  8. A patient safety curriculum for medical residents based on the perspectives of residents and supervisors

    NARCIS (Netherlands)

    Jansma, J.D.; Wagner, C.; Bijnen, A.B.

    2011-01-01

    Objectives: To develop a patient safety course for medical residents based on the views of medical residents and their supervisors. Methods: In 2007, questionnaires were distributed to investigate residents' and supervisors' perspectives on the current patient safety performance and educational

  9. Long residence times - bad tracer tests?

    Science.gov (United States)

    Ghergut, Julia; Behrens, Horst; Sauter, Martin

    2015-04-01

    Tracer tests conducted at geothermal well doublets or triplets in the Upper Rhine Rift Valley [1] all face, with very few exceptions so far, one common issue: lack of conclusive tracer test results, or tracer signals still undetectable for longer than one or two years after tracer injection. While the reasons for this surely differ from site to site (Riehen, Landau, Insheim, Bruchsal, ...), its effects on how the usefulness of tracer tests is perceived by the non-tracer community are pretty much the same. The 'poor-signal' frustration keeps nourishing two major 'alternative' endeavours : (I) design and execute tracer tests in single-well injection-withdrawal (push-pull), 'instead of' inter-well flow-path tracing configurations; (II) use 'novel' tracer substances instead of the 'old' ones which have 'obviously failed'. Frustration experienced with most inter-well tracer tests in the Upper Rhine Rift Valley has also made them be regarded as 'maybe useful for EGS' ('enhanced', or 'engineered' geothermal systems, whose fluid RTD typically include a major share of values below one year), but 'no longer worthwhile a follow-up sampling' in natural, large-scale hydrothermal reservoirs. We illustrate some of these arguments with the ongoing Bruchsal case [2]. The inter-well tracer test conducted at Bruchsal was (and still is!) aimed at assessing inter-well connectivity, fluid residence times, and characterizing the reservoir structure [3]. Fluid samples taken at the geothermal production well after reaching a fluid turnover of about 700,000 m3 showed tracer concentrations in the range of 10-8 Minj per m3, in the liquid phase of each sample (Minj being the total quantity of tracer injected as a short pulse at the geothermal re-injection well). Tracer signals might actually be higher, owing to tracer amounts co-precipitated and/or adsorbed onto the solid phase whose accumulation in the samples was unavoidable (due to pressure relief and degassing during the very sampling

  10. The role of topography on catchment‐scale water residence time

    Science.gov (United States)

    McGuire, K.J.; McDonnell, Jeffery J.; Weiler, M.; Kendall, C.; McGlynn, B.L.; Welker, J.M.; Seibert, J.

    2005-01-01

    The age, or residence time, of water is a fundamental descriptor of catchment hydrology, revealing information about the storage, flow pathways, and source of water in a single integrated measure. While there has been tremendous recent interest in residence time estimation to characterize watersheds, there are relatively few studies that have quantified residence time at the watershed scale, and fewer still that have extended those results beyond single catchments to larger landscape scales. We examined topographic controls on residence time for seven catchments (0.085–62.4 km2) that represent diverse geologic and geomorphic conditions in the western Cascade Mountains of Oregon. Our primary objective was to determine the dominant physical controls on catchment‐scale water residence time and specifically test the hypothesis that residence time is related to the size of the basin. Residence times were estimated by simple convolution models that described the transfer of precipitation isotopic composition to the stream network. We found that base flow mean residence times for exponential distributions ranged from 0.8 to 3.3 years. Mean residence time showed no correlation to basin area (r2 organization (i.e., topography) rather than basin area controls catchment‐scale transport. Results from this study may provide a framework for describing scale‐invariant transport across climatic and geologic conditions, whereby the internal form and structure of the basin defines the first‐order control on base flow residence time.

  11. Residence time modeling of hot melt extrusion processes.

    Science.gov (United States)

    Reitz, Elena; Podhaisky, Helmut; Ely, David; Thommes, Markus

    2013-11-01

    The hot melt extrusion process is a widespread technique to mix viscous melts. The residence time of material in the process frequently determines the product properties. An experimental setup and a corresponding mathematical model were developed to evaluate residence time and residence time distribution in twin screw extrusion processes. The extrusion process was modeled as the convolution of a mass transport process described by a Gaussian probability function, and a mixing process represented by an exponential function. The residence time of the extrusion process was determined by introducing a tracer at the extruder inlet and measuring the tracer concentration at the die. These concentrations were fitted to the residence time model, and an adequate correlation was found. Different parameters were derived to characterize the extrusion process including the dead time, the apparent mixing volume, and a transport related axial mixing. A 2(3) design of experiments was performed to evaluate the effect of powder feed rate, screw speed, and melt viscosity of the material on the residence time. All three parameters affect the residence time of material in the extruder. In conclusion, a residence time model was developed to interpret experimental data and to get insights into the hot melt extrusion process. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Markov analysis for estimation of residence time | Agunwamba ...

    African Journals Online (AJOL)

    Accurate estimation of residence time is very useful for the design of water and wastewater treatment plants. Its determination is difficult because it depends on complex interaction among many factors such as geometry, hydrodynamic and environmental factors. In this paper, the estimation of residence time is formulated as ...

  13. Mean Residence Time and Emergency Drinking Water Supply.

    Science.gov (United States)

    Kralik, Martin; Humer, Franko

    2013-04-01

    Mean Residence Times (MRTs) of the raw water of drinking water supplies is the measurement of the water-isotopes (oxygen-18, hydrogen-2 and tritium (3H)). The traceability and the quality oft he lumped model calculation is based on the quality and the density of input (meteorological) stations in the region with monthly measurements. In addition, noble gas measurements in the groundwater (helium-3, krypton-85) and of industrial tracer gases (chlorofluorocarbon (CFC) and sulphurhexaflorid (SF6)) are important tools to estimate the MRTs of the raw water in the aquifers. To exclude the presence of small amounts of very recent waters, which are in cases of accidents some times heavily polluted, the raw water is tested for natural radionuclides (beryllium-7 or sulphur-35) with very short half-life or artificial fluorescence tracers. In addition, the estimate of the MRTs of groundwater is an essential part of the vulnerability assessment of drinking water supplies due to climate change impacts (frequency of droughts and floods in the recharge area) and offers a valuable tool to specify a sustainable water abstraction. The applicability of this approach was tested in several springs and groundwater monitoring wells used for raw water abstraction for drinking water supply in Austria.

  14. DNA residence time is a regulatory factor of transcription repression.

    Science.gov (United States)

    Clauß, Karen; Popp, Achim P; Schulze, Lena; Hettich, Johannes; Reisser, Matthias; Escoter Torres, Laura; Uhlenhaut, N Henriette; Gebhardt, J Christof M

    2017-11-02

    Transcription comprises a highly regulated sequence of intrinsically stochastic processes, resulting in bursts of transcription intermitted by quiescence. In transcription activation or repression, a transcription factor binds dynamically to DNA, with a residence time unique to each factor. Whether the DNA residence time is important in the transcription process is unclear. Here, we designed a series of transcription repressors differing in their DNA residence time by utilizing the modular DNA binding domain of transcription activator-like effectors (TALEs) and varying the number of nucleotide-recognizing repeat domains. We characterized the DNA residence times of our repressors in living cells using single molecule tracking. The residence times depended non-linearly on the number of repeat domains and differed by more than a factor of six. The factors provoked a residence time-dependent decrease in transcript level of the glucocorticoid receptor-activated gene SGK1. Down regulation of transcription was due to a lower burst frequency in the presence of long binding repressors and is in accordance with a model of competitive inhibition of endogenous activator binding. Our single molecule experiments reveal transcription factor DNA residence time as a regulatory factor controlling transcription repression and establish TALE-DNA binding domains as tools for the temporal dissection of transcription regulation. © The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.

  15. Experimental determination of residence time distribution in continuous dry granulation.

    Science.gov (United States)

    Mangal, Haress; Kleinebudde, Peter

    2017-05-30

    With increasing importance of continuous manufacturing, the interest in integrating dry granulation into a continuous manufacturing line is growing. Residence time distribution measurements are of importance as they provide information about duration of materials within the process. These data enable traceability and are highly beneficial for developing control strategies. A digital image analysis system was used to determine the residence time distribution of two materials with different deformation behavior (brittle, plastic) in the milling unit of dry granulation systems. A colorant was added to the material (20%w/w iron oxide), which did not affect the material properties excessively, so the milling process could be mimicked well. Experimental designs were conducted to figure out which parameters effect the mean residence time strongly. Moreover, two types of dry granulation systems were contrasted. Longer mean residence times were obtained for the oscillating mill (OM) compared to the conical mill (CM). For co-processed microcrystalline cellulose residence times of 19.8-44.4s (OM) and 11.6-29.1s (CM) were measured, mainly influenced by the specific compaction force, the mill speed and roll speed. For dibasic calcium phosphate anhydrate residence times from 17.7-46.4 (OM) and 5.4-10.2s (CM) were measured, while here the specific compaction force, the mill speed and their interactions with the roll speed had an influence on the mean residence time. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Prediction of residence time distributions in food processing machinery

    DEFF Research Database (Denmark)

    Karlson, Torben; Friis, Alan; Szabo, Peter

    1996-01-01

    The velocity field in a co-rotating disc scraped surface heat exchanger (CDHE) is calculated using a finite element method. The residence time distribution for the CDHE is then obtained by tracing particles introduced in the inlet....

  17. Children's postdivorce residence arrangements and parental experienced time pressure

    NARCIS (Netherlands)

    van der Heijden, Franciëlla; Poortman, Anne Rigt; van der Lippe, Tanja

    2016-01-01

    Although the rise in postdivorce joint physical custody has fueled scholarly interest in its impact on children, consequences for parents remain understudied. Because children's residence arrangements determine time and coordination demands associated with child care, this study investigated the

  18. Prediction of residence time distributions in food processing machinery

    DEFF Research Database (Denmark)

    Karlson, Torben; Friis, Alan; Szabo, Peter

    1996-01-01

    The velocity field in a co-rotating disc scraped surface heat exchanger (CDHE) is calculated using a finite element method. The residence time distribution for the CDHE is then obtained by tracing particles introduced in the inlet.......The velocity field in a co-rotating disc scraped surface heat exchanger (CDHE) is calculated using a finite element method. The residence time distribution for the CDHE is then obtained by tracing particles introduced in the inlet....

  19. Modelling travel and residence times in the eastern Irish Sea

    International Nuclear Information System (INIS)

    Dabrowski, T.; Hartnett, M.

    2008-01-01

    The Irish Sea, which lies between 51 deg. N-56 deg. N and 2 deg. 50'W-7 deg. W, provides a sheltered environment to exploit valuable fisheries resource. Anthropogenic activity is a real threat to its water quality. The majority of freshwater input down rivers flows into the eastern Irish Sea. The structure of the water circulation was not well understood during the planning of Sellafield nuclear plant outfall site in the eastern Irish Sea. A three-dimensional primitive equation numerical model was applied to the Irish Sea to simulate both barotropic and baroclinic circulation within the region. High accuracy was achieved with regard to the prediction of both tidal circulation and surface and nearbed water temperatures across the region. The model properly represented the Western Irish Sea Gyre, induced by thermal stratification and not known during planning Sellafield. Passive tracer simulations based on the developed hydrodynamic model were used to deliver residence times of the eastern Irish Sea region for various times of the year as well as travel times from the Sellafield outfall site to various locations within the Irish Sea. The results indicate a strong seasonal variability of travel times from Sellafield to the examined locations. Travel time to the Clyde Sea is the shortest for the autumnal tracer release (90 days); it takes almost a year for the tracer to arrive at the same location if it is released in January. Travel times from Sellafield to Dublin Bay fall within the range of 180-360 days. The average residence time of the entire eastern Irish Sea is around 7 months. The areas surrounding the Isle of Man are initially flushed due to a predominant northward flow; a backwater is formed in Liverpool Bay. Thus, elevated tracer concentrations are predicted in Liverpool Bay in the case of accidental spills at the Sellafield outfall site

  20. [Competency-based Neurosurgery Residency Programme].

    Science.gov (United States)

    Lobato, Ramiro D; Jiménez Roldan, Luis; Alen, José F; Castaño, Ana M; Munarriz, Pablo M; Cepeda, Santiago; Lagares, Alfonso

    2016-01-01

    A programme proposal for competency-based Neurosurgery training adapted to the specialization project is presented. This proposal has been developed by a group of neurosurgeons commissioned by the SENEC (Spanish Society of Neurosurgery) and could be modified to generate a final version that could come into force coinciding with the implementation of the specialization programme. This document aims to facilitate the test of the new programme included in the online version of our journal. Total training period is 6 years; initial 2 years belong to the surgery specialization and remaining 4 years belong to core specialty period. It is a competency-based programmed based on the map used by the US Accreditation Council for Graduate Medical Education (ACGME) including the following domains of clinical competency: Medical knowledge, patient care, communication skills, professionalism, practice-based learning and improvement, health systems, interprofessional collaboration and professional and personal development. Subcompetencies map in the domains of Knowledge and Patient care (including surgical competencies) was adapted to the one proposed by AANS and CNS (annex 1 of the programme). A subcompetency map was also used for the specialization rotations. Resident's training is based on personal study (self-learning) supported by efficient use of information sources and supervised clinical practice, including bioethical instruction, clinical management, research and learning techniques. Resident evaluation proposal includes, among other instruments, theoretical knowledge tests, objective and structured evaluation of the level of clinical competency with real or standardised patients, global competency scales, 360-degree evaluation, clinical record audits, milestones for residents progress and self-assessment (annex 2). Besides, residents periodically assess the teaching commitment of the department's neurosurgeons and other professors participating in rotations, and annually

  1. Residents' perception of skill decay during dedicated research time.

    Science.gov (United States)

    D'Angelo, Anne-Lise D; Ray, Rebecca D; Jenewein, Caitlin G; Jones, Grace F; Pugh, Carla M

    2015-11-01

    Surgery residents may take years away from clinical responsibilities for dedicated research time. As part of a longitudinal project, the study aim was to investigate residents' perceptions of clinical skill reduction during dedicated research time. Our hypothesis was that residents would perceive a greater potential reduction in skill during research time for procedures they were less confident in performing. Surgical residents engaged in dedicated research training at multiple training programs participated in four simulated procedures: urinary catheterization, subclavian central line, bowel anastomosis, and laparoscopic ventral hernia (LVH) repair. Using preprocedure and postprocedure surveys, participants rated procedures for confidence and difficulty. Residents also indicated the perceived level of skills reduction for the four procedures as a result of time in the laboratory. Thirty-eight residents (55% female) completed the four clinical simulators. Participants had between 0-36 mo in a laboratory (M = 9.29 mo, standard deviation = 9.38). Preprocedure surveys noted lower confidence and higher perceived difficulty for performing the LVH repair followed by bowel anastomosis, central line insertion, and urinary catheterization (P perception for urinary catheterization (P perception and may provide a mechanism for maintaining skills and keeping confidence grounded in experience. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Residence Time Distributions in a Cold, Confined Swirl Flow

    DEFF Research Database (Denmark)

    Lans, Robert Pieter Van Der; Glarborg, Peter; Dam-Johansen, Kim

    1997-01-01

    -burner zone of the laboratory furnace-model were studied. RTD results have been used to derive a chemical reaction engineering model for the mixing process. The model is based on a combination of plug flow reactors and continuous stirred tank reactors, which represent the main flow characteristics in regard......, well characterised flow pattern makes it possible to investigate the importance of mixing intensity on the (pollution) chemistry in furnaces. The reactor model developed here will be the basis for the development of a chemical reaction engineering combustion model.......Residence time distributions (RTD) in a confined, cold swirling flow have been measured with a fast-response probe and helium as a tracer. The test-rig represented a scaled down version of a burner. The effect of variation of flow velocities and swirl angle on the flow pattern in the near...

  3. Halogen-aromatic π-interactions modulate inhibitor residence time.

    Science.gov (United States)

    Heroven, Christina; Georgi, Victoria; Ganotra, Gaurav K; Brennan, Paul E; Wolfreys, Finn; Wade, Rebecca C; Fernández-Montalván, Amaury E; Chaikuad, Apirat; Knapp, Stefan

    2018-03-30

    Prolonged drug residence times may result in longer lasting drug efficacy, improved pharmacodynamic properties and "kinetic selectivity" over off-targets with fast drug dissociation rates. However, few strategies have been elaborated to rationally modulate drug residence time and thereby to integrate this key property into the drug development process. Here, we show that the interaction between a halogen moiety on an inhibitor and an aromatic residue in the target protein can significantly increase inhibitor residence time. By using the interaction of the serine/threonine kinase haspin with 5-iodotubercidin (5-iTU) derivatives as a model for an archetypal active state (type I) kinase-inhibitor binding mode, we demonstrate that inhibitor residence times markedly increase with the size and polarizability of the halogen atom. This key interaction is dependent on the interactions with an aromatic residue in the gatekeeper position and we observe this interaction in other kinases with an aromatic gatekeeper residue. We provide a detailed mechanistic characterization of the halogen-aromatic π interactions in the haspin-inhibitor complexes by means of kinetic, thermodynamic, and structural measurements along with binding energy calculations. Since halogens are frequently used in drugs and aromatic residues are often present in the binding sites of proteins, our results provide a compelling rationale for introducing aromatic-halogen interactions to prolong drug-target residence times. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  4. Classifying terrestrial surface water systems using integrated residence time

    Science.gov (United States)

    Jones, Allan; Hodges, Ben; McClelland, James; Hardison, Amber; Moffett, Kevan

    2017-04-01

    Linkages between ecology and hydrology in terrestrial surface water often invoke a discussion of lentic (reservoir) vs. lotic (riverine) system behaviors. However, the literature shows a wide range of thresholds separating lentic/lotic regimes and little agreement on a quantitative, repeatable classification metric that can be broadly and reliably applied across a range of systems hosting various flow regimes and suspended/benthic taxa. We propose an integrated Residence Time (iTR) metric as part of a new Freshwater Continuum Classification (FCC) to address this issue. The iTR is computed as the transit time of a water parcel across a system given observed temporal variations in discharge and volume, which creates a temporally-varying metric applicable across a defined system length. This approach avoids problems associated with instantaneous residence times or average residence times that can lead to misleading characterizations in seasonally- or episodically-dynamic systems. The iTR can be directly related to critical flow thresholds and timescales of ecology (e.g., zooplankton growth). The FCC approach considers lentic and lotic to be opposing end-members of a classification continuum and also defines intermediate regimes that blur the line between the two ends of the spectrum due to more complex hydrological system dynamics. We also discover the potential for "oscillic" behavior, where a system switches between lentic and lotic classifications either episodically or regularly (e.g., seasonally). Oscillic behavior is difficult to diagnose with prior lentic/lotic classification schemes, but can be readily identified using iTR. The FCC approach was used to analyze 15 tidally-influenced river segments along the Texas (USA) coast of the Gulf of Mexico. The results agreed with lentic/lotic designations using prior approaches, but also identified more nuanced intermediate and oscillic regimes. Within this set of systems, the oscillic nature of some of the river

  5. Competency-Based Medical Education: Can Both Junior Residents and Senior Residents Achieve Competence After a Sports Medicine Training Module?

    Science.gov (United States)

    Dwyer, Tim; Wright, Sara; Kulasegaram, Kulamakan M; Theodoropoulos, John; Chahal, Jaskarndip; Wasserstein, David; Ringsted, Charlotte; Hodges, Brian; Ogilvie-Harris, Darrell

    2015-12-02

    Competency-based medical education as a resident-training format will move postgraduate training away from time-based training, to a model based on observable outcomes. The purpose of this study was to determine whether junior residents and senior residents could demonstrate clinical skills to a similar level, after a sports medicine rotation. All residents undertaking a three-month sports medicine rotation had to pass an Objective Structured Clinical Examination. The stations tested the fundamentals of history-taking, examination, image interpretation, differential diagnosis, informed consent, and clinical decision-making. Performance at each station was assessed with a binary station-specific checklist and an overall global rating scale, in which 1 indicated novice, 2 indicated advanced beginner, 3 indicated competent, 4 indicated proficient, and 5 indicated expert. A global rating scale was also given for each domain of knowledge. Over eighteen months, thirty-nine residents (twenty-one junior residents and eighteen senior residents) and six fellows (for a total of forty-five participants) completed the examination. With regard to junior residents and senior residents, analysis using a two-tailed t test demonstrated a significant difference (p < 0.01) in both total checklist score and overall global rating scale; the mean total checklist score (and standard deviation) was 56.15% ± 10.99% for junior residents and 71.87% ± 8.94% for senior residents, and the mean global rating scale was 2.44 ± 0.55 for junior residents and 3.79 ± 0.49 for senior residents. There was a significant difference between junior residents and senior residents for each knowledge domain, with a significance of p < 0.05 for history-taking and p < 0.01 for the remainder of the domains. Despite intensive teaching within a competency-based medical education model, junior residents were not able to demonstrate knowledge as well as senior residents, suggesting that overall clinical experience

  6. Effect of oven residence time on mechanical properties in ...

    Indian Academy of Sciences (India)

    Simulation studies were conducted using ROTOSIM software to analyze thermal transitions and phase changes during the process. Degree of curing of the polymers was also assessed and correlated with mechanical properties. Experiments were further conducted to obtain favourable oven residence time to obtain highest ...

  7. Studies on steps affecting tritium residence time in solid blanket

    International Nuclear Information System (INIS)

    Tanaka, Satoru

    1987-01-01

    For the self sustaining of CTR fuel cycle, the effective tritium recovery from blankets is essential. This means that not only tritium breeding ratio must be larger than 1.0, but also high recovering speed is required for the short residence time of tritium in blankets. Short residence time means that the tritium inventory in blankets is small. In this paper, the tritium residence time and tritium inventory in a solid blanket are modeled by considering the steps constituting tritium release. Some of these tritium migration processes were experimentally evaluated. The tritium migration steps in a solid blanket using sintered breeding materials consist of diffusion in grains, desorption at grain edges, diffusion and permeation through grain boundaries, desorption at particle edges, diffusion and percolation through interconnected pores to purging stream, and convective mass transfer to stream. Corresponding to these steps, diffusive, soluble, adsorbed and trapped tritium inventories and the tritium in gas phase are conceivable. The code named TTT was made for calculating these tritium inventories and the residence time of tritium. An example of the results of calculation is shown. The blanket is REPUTER-1, which is the conceptual design of a commercial reversed field pinch fusion reactor studied at the University of Tokyo. The experimental studies on the migration steps of tritium are reported. (Kako, I.)

  8. Relationships between removal processes and residence times for atmospheric pollutants

    International Nuclear Information System (INIS)

    Slinn, W.G.N.

    1978-01-01

    This report is concerned with improving estimates for the residence times of atmospheric trace constituents in various atmospheric reservoirs. Residence times are defined only for steady-state conditions; i.e., when the net growth rate vanishes. The most useful case of vanishing net growth rate is when the total growth rate is equal to the decay rate. It is demonstrated that the most important advance towards improving estimates of pollutant residence times is through proper choices of reservoirs. Chosen reservoirs should possess the following features: steady-state conditions, uniform mixing ratio throughout or throughout specified subreservoirs, and subreservoirs chosen in which removal rates can be treated as approximate constants. An example of a poorly mixed reservoir, the stratosphere, is discussed. In another example, it is suggested that commonly used reservoirs for atmospheric CO 2 have been chosen poorly and that a substantial portion of the anthropogenic CO 2 released during the past 50 years may still be mixing into the stratosphere. In another example, it is suggested that determination of the dry deposition velocity for accumulation-mode aerosol particles may not be so important as previously thought. To improve estimates for the atmospheric residence times of these particles, it is important to increase knowledge of what is called the ascension velocity

  9. Effect of oven residence time on mechanical properties in ...

    Indian Academy of Sciences (India)

    In rotational moulding of plastics, improving the mechanical properties without sacrificing the processibility is a challenging task. In this paper, an attempt has been made to investigate the effect of oven residence time on the mechanical properties of the rotationally moulded products made using linear low ...

  10. Financial and Time Burdens for Medical Students Interviewing for Residency.

    Science.gov (United States)

    Callaway, Paul; Melhado, Trisha; Walling, Anne; Groskurth, Jordan

    2017-02-01

    Interviewing for residency positions is increasingly stressful for students and challenging for programs. Little information is available about the costs and time invested by students in interviewing or about the key factors in decisions to accept interview offers. Our objective was to assess the time and financial costs of residency interviewing for an entire class at a regional campus and explore factors influencing student decisions to accept interviews. We used a 14-item survey administered electronically immediately following National Resident Matching Program results. The response rate was 75% (49 of 65 students). About half interviewed in primary care specialties. Thirty students (63%) applied to 20 or more programs, and 91% were offered multiple interviews out of state. Seventy percent limited interviews by time and cost. Other important factors included personal "fit," program reputation, and the quality of residents. About 50% of the students spent more than 20 days and $1,000-$5,000 interviewing; 29% reported spending over $5,000. Students used multiple funding sources, predominantly loans and savings. Primary care applicants applied to fewer out-of-state programs, reported fewer interview days and lower expenses, but received more financial support from programs. Students invested considerable time and resources in interviewing, and these factors significantly influenced their decisions about accepting interviews. The other major factors in interview decisions concerned personal comfort with the program, especially the residents. The costs and time reported in this study could be greater than other schools due to the regional campus location or lower due to the high proportion of students interviewing in primary care.

  11. Modeling the Residence Time of Mobile Bay in Alabama

    Science.gov (United States)

    Han, M. M.; Park, K.

    2016-02-01

    The Three-dimensional Hydrodynamic-Eutrophication Model/Environmental Fluid Dynamics Code (HEM3D/EFDC) was used to calculate the residence time of Mobile Bay in Alabama using Eulerian passive tracer method. Mobile Bay is about 50 km long and 20 km wide, so it can be divided into several sections which may have different residence times. Three typical boundary conditions that affect residence time are tide, river discharge, and wind. Mobile Bay is located in the northern Gulf of Mexico and is a micro-tidal region. Two most important tidal components here are K1 and O1, and the maximum tidal range of tropic (spring) tide is less than 0.6 m. There is a difference between the simulation results with and without tidal condition (K1+O1) even though the tidal range is relatively smaller than that in macro-tidal regions. Also the minimum, mean, and maximum of daily mean river discharge for 38 years (1976-2013) in Mobile and Tensaw River are 80.7 m3/s, 1700.8 m3/s, and 14186.7 m3/s respectively, and there are daily, monthly, seasonal, and annual variations. The residence time can be largely affected by the river discharge because of its large deviation. Even though the dominant wind here is southerly in the spring and summer and is northerly in the fall and winter, the wind speed and direction change over time. Continuous winds from similar directions can reduce and increase the residence time such as the southerly, southwesterly, northerly, and northeasterly winds in alignment with the direction of the inlet and outlet of Mobile Bay. Also the short term changes of wind direction and speed can affect it complicatedly. Therefore, the simulations with the combinations of three boundary conditions allow us to understand the water circulation in Mobile Bay well and to predict the residence time when some accidents happen such as contaminations by factories, sewage plants, ships and oil spills.

  12. How Entrustment Is Informed by Holistic Judgments Across Time in a Family Medicine Residency Program: An Ethnographic Nonparticipant Observational Study.

    Science.gov (United States)

    Sagasser, Margaretha H; Fluit, Cornelia R M G; van Weel, Chris; van der Vleuten, Cees P M; Kramer, Anneke W M

    2017-06-01

    Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study explored how supervisors made entrustment decisions based on residents' performance in a long-term family medicine training program. A qualitative nonparticipant observational study was conducted in 2014-2015 at competency-based family medicine residency programs in the Netherlands. Seven supervisor-resident pairs participated. During two days, one researcher observed first-year residents' patient encounters, debriefing sessions, and supervisor-resident educational meetings and interviewed them separately afterwards. Data were collected and analyzed using iterative, phenomenological inductive research methodology. The entrustment process developed over three phases. Supervisors based their initial entrustment on prior knowledge about the resident. In the ensuing two weeks, entrustment decisions regarding independent patient care were derived from residents' observed general competencies necessary for a range of health problems (clinical reasoning, decision making, relating to patients); medical knowledge and skills; and supervisors' intuition. Supervisors provided supervision during and after encounters. Once residents performed independently, supervisors kept reevaluating their decisions, informed by residents' overall growth in competencies rather than by adhering to a predefined set of tasks. Supervisors in family medicine residency training took a holistic approach to trust, based on general competencies, knowledge, skills, and intuition. Entrustment started before training and developed over time. Building trust is a mutual process between supervisor and resident, requiring a good working relationship.

  13. Allocation of Internal Medicine Resident Time in a Swiss Hospital: A Time and Motion Study of Day and Evening Shifts.

    Science.gov (United States)

    Wenger, Nathalie; Méan, Marie; Castioni, Julien; Marques-Vidal, Pedro; Waeber, Gérard; Garnier, Antoine

    2017-04-18

    Little current evidence documents how internal medicine residents spend their time at work, particularly with regard to the proportions of time spent in direct patient care versus using computers. To describe how residents allocate their time during day and evening hospital shifts. Time and motion study. Internal medicine residency at a university hospital in Switzerland, May to July 2015. 36 internal medicine residents with an average of 29 months of postgraduate training. Trained observers recorded the residents' activities using a tablet-based application. Twenty-two activities were categorized as directly related to patients, indirectly related to patients, communication, academic, nonmedical tasks, and transition. In addition, the presence of a patient or colleague and use of a computer or telephone during each activity was recorded. Residents were observed for a total of 696.7 hours. Day shifts lasted 11.6 hours (1.6 hours more than scheduled). During these shifts, activities indirectly related to patients accounted for 52.4% of the time, and activities directly related to patients accounted for 28.0%. Residents spent an average of 1.7 hours with patients, 5.2 hours using computers, and 13 minutes doing both. Time spent using a computer was scattered throughout the day, with the heaviest use after 6:00 p.m. The study involved a small sample from 1 institution. At this Swiss teaching hospital, internal medicine residents spent more time at work than scheduled. Activities indirectly related to patients predominated, and about half the workday was spent using a computer. Information Technology Department and Department of Internal Medicine of Lausanne University Hospital.

  14. Use and utility of Web-based residency program information: a survey of residency applicants.

    Science.gov (United States)

    Embi, Peter J; Desai, Sima; Cooney, Thomas G

    2003-01-01

    The Internet has become essential to the residency application process. In recent years, applicants and residency programs have used the Internet-based tools of the National Residency Matching Program (NRMP, the Match) and the Electronic Residency Application Service (ERAS) to process and manage application and Match information. In addition, many residency programs have moved their recruitment information from printed brochures to Web sites. Despite this change, little is known about how applicants use residency program Web sites and what constitutes optimal residency Web site content, information that is critical to developing and maintaining such sites. To study the use and perceived utility of Web-based residency program information by surveying applicants to an internal medicine program. Our sample population was the applicants to the Oregon Health & Science University Internal Medicine Residency Program who were invited for an interview. We solicited participation using the group e-mail feature available through the Electronic Residency Application Service Post-Office application. To minimize the possibility for biased responses, the study was confined to the period between submission of National Residency Matching Program rank-order lists and release of Match results. Applicants could respond using an anonymous Web-based form or by reply to the e-mail solicitation. We tabulated responses, calculated percentages for each, and performed a qualitative analysis of comments. Of the 431 potential participants, 218 responded (51%) during the study period. Ninety-nine percent reported comfort browsing the Web; 52% accessed the Web primarily from home. Sixty-nine percent learned about residency Web sites primarily from residency-specific directories while 19% relied on general directories. Eighty percent found these sites helpful when deciding where to apply, 69% when deciding where to interview, and 36% when deciding how to rank order programs for the Match. Forty

  15. Effects of a Short Video-Based Resident-as-Teacher Training Toolkit on Resident Teaching.

    Science.gov (United States)

    Ricciotti, Hope A; Freret, Taylor S; Aluko, Ashley; McKeon, Bri Anne; Haviland, Miriam J; Newman, Lori R

    2017-10-01

    To pilot a short video-based resident-as-teacher training toolkit and assess its effect on resident teaching skills in clinical settings. A video-based resident-as-teacher training toolkit was previously developed by educational experts at Beth Israel Deaconess Medical Center, Harvard Medical School. Residents were recruited from two academic hospitals, watched two videos from the toolkit ("Clinical Teaching Skills" and "Effective Clinical Supervision"), and completed an accompanying self-study guide. A novel assessment instrument for evaluating the effect of the toolkit on teaching was created through a modified Delphi process. Before and after the intervention, residents were observed leading a clinical teaching encounter and scored using the 15-item assessment instrument. The primary outcome of interest was the change in number of skills exhibited, which was assessed using the Wilcoxon signed-rank test. Twenty-eight residents from two academic hospitals were enrolled, and 20 (71%) completed all phases of the study. More than one third of residents who volunteered to participate reported no prior formal teacher training. After completing two training modules, residents demonstrated a significant increase in the median number of teaching skills exhibited in a clinical teaching encounter, from 7.5 (interquartile range 6.5-9.5) to 10.0 (interquartile range 9.0-11.5; Pteaching skills assessed, there were significant improvements in asking for the learner's perspective (P=.01), providing feedback (P=.005), and encouraging questions (P=.046). Using a resident-as-teacher video-based toolkit was associated with improvements in teaching skills in residents from multiple specialties.

  16. The residence time of intensively managed agricultural landscapes

    Science.gov (United States)

    Bowling, Laura; Cherkauer, Keith; Chiu, Chun-mei; Rahman, Sanoar

    2015-04-01

    Much of the agricultural landscape across the Midwestern United States is intensively managed through numerous surface and subsurface drainage improvements, and the growing extraction of groundwater resources. The relatively recent glaciation of the North Central region means that the landscape is less dissected and hydrologically connected than older till areas. Low topographic gradients and underlying dense till which restricts vertical water movement, as well as kettle depressions, have led to poorly drained soils and extensive wetlands within the landscape. Large areas of this land could only be farmed once the excess water was removed through artificial surface and subsurface drainage. Conventional wisdom in the region maintains that subsurface tile drainage reduces the occurrence of peak flow events by increasing soil water storage capacity. At the watershed scale, this view does not take into account the coincident increase in surface drainage and reduction in residence time in surface depressions. This paper explores to what degree water management and irrigation has changed surface and subsurface water storage and residence time over the last century and how this has impacted flow duration throughout the Wabash River system in Indiana, USA. The effects of subsurface tile drains, wetlands and aquifer storage are explicitly represented within the Variable Infiltration Capacity (VIC) macroscale hydrology model. We maintain a focus on the entire Wabash River, a river system of historic importance that is also representative of many similar areas in the till plain region of the agricultural Midwest, which contribute to water quality and flood dynamics of the Mississippi river system. By lowering the water table, surface and subsurface drainage improvements have increased the subsurface storage capacity at the beginning of rain events, but this is overwhelmed by the decrease in surface storage capacity for intermediate to large events, decreasing the current

  17. Characterizing Drug-Target Residence Time with Metadynamics: How To Achieve Dissociation Rate Efficiently without Losing Accuracy against Time-Consuming Approaches.

    Science.gov (United States)

    Sun, Huiyong; Li, Youyong; Shen, Mingyun; Li, Dan; Kang, Yu; Hou, Tingjun

    2017-08-28

    Drug-target residence time plays a vital role in drug efficacy. However, there is still no effective strategy to predict drug residence time. Here, we propose to use the optimized (or minimized) structures derived from holo-state proteins to calculate drug residence time, which could give a comparable or even better prediction accuracy compared with those calculated utilizing a large number of molecular dynamics (MD) structures based on the Poisson process. Besides, in addition to the Poisson process, one may use fewer samples for predicting residence time due to the reason that, in a large extent, the calculated drug residence time is stable and independent of the number of samples used for the prediction. With remarkably reduced computational load, the proposed strategy may be promising for large-scale drug residence time prediction, such as post-processing in virtual screening (VS) and lead compound optimization.

  18. An Evidence-based, Longitudinal Curriculum for Resident Physician Wellness: The 2017 Resident Wellness Consensus Summit

    Directory of Open Access Journals (Sweden)

    Jacob Arnold

    2018-02-01

    Full Text Available Introduction: Physicians are at much higher risk for burnout, depression, and suicide than their non-medical peers. One of the working groups from the May 2017 Resident Wellness Consensus Summit (RWCS addressed this issue through the development of a longitudinal residency curriculum to address resident wellness and burnout. Methods: A 30-person (27 residents, three attending physicians Wellness Curriculum Development workgroup developed the curriculum in two phases. In the first phase, the workgroup worked asynchronously in the Wellness Think Tank – an online resident community – conducting a literature review to identify 10 core topics. In the second phase, the workgroup expanded to include residents outside the Wellness Think Tank at the live RWCS event to identify gaps in the curriculum. This resulted in an additional seven core topics. Results: Seventeen foundational topics served as the framework for the longitudinal resident wellness curriculum. The curriculum includes a two-module introduction to wellness; a seven-module “Self-Care Series” focusing on the appropriate structure of wellness activities and everyday necessities that promote physician wellness; a two-module section on physician suicide and self-help; a four-module “Clinical Care Series” focusing on delivering bad news, navigating difficult patient encounters, dealing with difficult consultants and staff members, and debriefing traumatic events in the emergency department; wellness in the workplace; and dealing with medical errors and shame. Conclusion: The resident wellness curriculum, derived from an evidence-based approach and input of residents from the Wellness Think Tank and the RWCS event, provides a guiding framework for residency programs in emergency medicine and potentially other specialties to improve physician wellness and promote a culture of wellness.

  19. The determination of residence times in a pilot plant

    Science.gov (United States)

    Ramírez, F. Pablo; Cortés, M. Eugenia

    2004-01-01

    It is well known that residence time distributions (RTD) are very important in many chemical processes such as separation, reforming, hydrocracking, fluid catalytic cracking, hydrodesulfuration, hydrogenation among others [3 Procédés de transformation, Editions Technip, Institute Francais du Petrole, Paris, France, 1998]. In addition, tracers can be used to measure the velocity, distribution and residence time of any stream through any part of an industrial [Guidebook on Radioisotope Tracers in Industry, IAEA, Vienna, 1990] or experimental system. Perhaps the best quality of radiotracers is that they do not interfere with normal unit operations or production scheduling. In this paper are presented the RTDs obtained in a pilot plant for a hydrogenation process [IMP, Technical Report, Determinación del tiempo de residencia promedio en el reactor de la planta piloto de hidroagotamiento de crudo, 2002]. The RTDs show a random phenomenon, which is not typical of this type of chemical processes. Several RTDs were determined in order to confirm this random behavior. The data were obtained using as a tracer a radioactive form of sodium iodide containing iodine-131 [The Condensed Chemical Dictionary, 10th Ed., Van Nostrand Reinhold, USA, 1981]. The process works with two phases in a countercurrent flow, inside a packed column. The liquid phase goes down by gravity. The gas phase goes up due to pressure difference [3 Procédés de transformation, Editions Technip, Institute Francais du Petrole, Paris, France, 1998]. The tracer was selected such that it would follow the liquid phase.

  20. Residence Times in Central Valley Aquifers Recharged by Dammed Rivers

    Science.gov (United States)

    Loustale, M.; Paukert Vankeuren, A. N.; Visser, A.

    2017-12-01

    Groundwater is a vital resource for California, providing between 30-60% of the state's water supply. Recent emphasis on groundwater sustainability has induced a push to characterize recharge rates and residence times for high priority aquifers, including most aquifers in California's Central Valley. Flows in almost all rivers from the western Sierra to the Central Valley are controlled by dams, altering natural flow patterns and recharge to local aquifers. In eastern Sacramento, unconfined and confined shallow aquifers (depth BGS. Variation in groundwater age in the vertical and horizontal directions are used to determine groundwater flow path and velocity. These data are then used to calculate residence time of groundwater in the unconfined and confined aquifer systems for the Central Valley in eastern Sacramento. Applying groundwater age tracers can benefit future compliance metrics of the California Sustainable Groundwater Resources Act (SGMA), by quantifying river seepage rates and impacts of groundwater management on surface water resources. 1Moran et al., UCRL-TR-203258, 2004.

  1. Design strategies to address kinetics of drug binding and residence time.

    Science.gov (United States)

    Cusack, Kevin P; Wang, Ying; Hoemann, Michael Z; Marjanovic, Jasmina; Heym, Roland G; Vasudevan, Anil

    2015-01-01

    The kinetics of drug binding and drug residence time are recognized to be important in the clinical effectiveness of drug candidates. In most cases a long residence time of the drug-target complex results in an extended duration of pharmacodynamic activity, even when systemic concentrations of drug have been notably reduced through elimination routes. Hence, if selective for target, long residence times can increase the duration of drug efficacy in vivo and can significantly diminish the potential for off-target-mediated toxicities. Furthermore, a compound with a slower dissociation rate may allow a reduced dosing schedule relative to a compound with a rapid dissociation rate. Factors contributing to long residence time that could be useful to medicinal chemists in the prospective design of compounds with long residence times will be discussed in this perspective. Particular emphasis will be on case studies highlighting how kinetics can be measured, modulated based on supporting structure kinetic relationships and whether these effects are translatable into man. Copyright © 2015 Elsevier Ltd. All rights reserved.

  2. Strategic Application of Residence-Time Control in Continuous-Flow Reactors

    Science.gov (United States)

    Mándity, István M; Ötvös, Sándor B; Fülöp, Ferenc

    2015-01-01

    As a sustainable alternative for conventional batch-based synthetic techniques, the concept of continuous-flow processing has emerged in the synthesis of fine chemicals. Systematic tuning of the residence time, a key parameter of continuous-reaction technology, can govern the outcome of a chemical reaction by determining the reaction rate and the conversion and by influencing the product selectivity. This review furnishes a brief insight into flow reactions in which high chemo- and/or stereoselectivity can be attained by strategic residence-time control and illustrates the importance of the residence time as a crucial parameter in sustainable method development. Such a fine reaction control cannot be performed in conventional batch reaction set-ups. PMID:26246983

  3. Computation of residence time in the simulation of pulsatile ventricular assist devices

    Science.gov (United States)

    Long, C. C.; Esmaily-Moghadam, M.; Marsden, A. L.; Bazilevs, Y.

    2014-10-01

    A continuum-based model of particle residence time for moving-domain fluid mechanics and fluid-structure interaction (FSI) computations is proposed, analyzed, and applied to the simulation of an adult pulsatile ventricular assist device (PVAD). Residence time is a quantity of clinical interest for blood pumps because it correlates with thrombotic risk. The proposed technique may be easily implemented in any flow or FSI solver. In the context of PVADs the results of the model may be used to assess how efficiently the pump moves the blood through its interior. Three scalar measures of particle residence time are also proposed. These scalar quantities may be used in the PVAD design with the goal of reducing thrombotic risk.

  4. Implication of discharge pattern of radionuclides in the landscape on surface hydrological pathways and residence times

    International Nuclear Information System (INIS)

    Anders Woerman; Lars Marklund; Xu Shulan; Bjoern Dverstorp

    2005-01-01

    The safety analysis of the final repository of spent nuclear fuel will include large-scale migration behaviour of radionuclides that accidentally leak from the repository in deep bedrock. Physically based models of radionuclides release-processes would typically take into account the flow and transport in the hydrosphere as well as spreading through ecosystems to individual humans. This study addresses the coupling between discharge pattern in the landscape and factors controlling the residence times or radionuclides in the biosphere on land. The overall residence time on land is crucial because it controls the maximum exposure of radioactivity to individual humans. Numerical analysis indicate that variation in topography and quaternary deposits affect the discharge pattern in the landscape for radionuclides that escapes the waste repository in deep bedrock. Those analyses are based on extensive geographical data covering surface topography, stream network characteristics and geological structure on the continental scale of Scandinavia. Results on the discharge pattern in three typical Swedish landscapes are used as a basis for comparative analyses of the residence time distribution in surface hydrological systems for radionuclides that escape the waste repository. The groundwater flow analyses show that pathways of deep groundwater predominantly lead to the stream network, but to some extent also to lakes, wetlands and root uptake. The proportion varies slightly with altitude in the watershed as well as between different watersheds. The residence times in the stream network was based on convoluting the residence times for single discharge points over the entire stream network according to the technique of and data on stream distance distribution. The retardation due to uptake in the hyporheic zone was accounted for using the methods of and estimated sorption properties for Cs-137. The residence time for radionuclides in the hydrological systems of the continent

  5. Mean Transit Time and Mean Residence Time for Linear Diffusion–Convection–Reaction Transport System

    Directory of Open Access Journals (Sweden)

    Jacek Waniewski

    2007-01-01

    Full Text Available Characteristic times for transport processes in biological systems may be evaluated as mean transit times (MTTs (for transit states or mean residence times (MRT (for steady states. It is shown in a general framework of a (linear reaction–diffusion–convection equation that these two times are related. Analytical formulas are also derived to calculate moments of exit time distribution using solutions for a stationary state of the system.

  6. Educating pediatric residents about breastfeeding: evaluation of 3 time-efficient teaching strategies.

    Science.gov (United States)

    Tender, Jennifer A F; Cuzzi, Sandra; Kind, Terry; Simmens, Samuel J; Blatt, Benjamin; Greenberg, Larrie

    2014-11-01

    Previously reported breastfeeding curricula for residents have combined different teaching methods, have focused on knowledge and attitudes, and have been time-intensive. This study aimed to evaluate 3 time-efficient breastfeeding curricula for effectiveness in regard to pediatric residents' knowledge, confidence, and skills in managing a simulated breastfeeding scenario. First-year pediatric residents during their 4-week community hospital newborn nursery rotation were consecutively assigned to 1 of 3 groups. Group 1 shadowed an International Board Certified Lactation Consultant (IBCLC) for 1 hour; group 2 watched a 25-minute case-based breastfeeding DVD; and group 3 observed a 3-hour prenatal parent breastfeeding class (CLS). Residents were assessed by (1) a pretest and posttest evaluating their breastfeeding knowledge and confidence, and (2) a clinical skills scenario managing a breastfeeding standardized patient (SP). Thirty-nine pediatric residents participated in the study (11 in IBCLC, 16 DVD, 12 CLS) over a 1-year period. All groups significantly improved their knowledge scores and confidence in managing breastfeeding problems, with the IBCLC group showing more improvement in knowledge than the other groups (P = .02) and a higher rating of their teaching method (P = .01). All groups performed well on the SP clinical skills scenario, with no significant difference between groups. All 3 teaching methods were time-efficient and produced important gains in knowledge and confidence, with residents in the IBCLC group demonstrating greatest improvement in knowledge and a higher rating of their teaching method. Our study provides support for 3 methods of teaching residents breastfeeding management and demonstrates that IBCLCs are well-received as interprofessional educators. © The Author(s) 2014.

  7. Extra-regional residence time as a correlate of plant invasiveness: European archaeophytes in North America.

    Science.gov (United States)

    La Sorte, Frank A; Pysek, Petr

    2009-09-01

    Human activities have degraded biogeographical barriers to dispersal resulting in the spread and naturalization of increasing numbers of nonnative invasive species. One correlate of invasiveness within a region is residence time or time since introduction. Plant species that were introduced into Europe prior to AD 1500 (European archaeophytes) that were subsequently introduced into North America provide a unique opportunity to examine the effect of extra-regional residence time (i.e., residence time that occurred in a nonnative region before a species was introduced into a new region). Here, we examine how nonnative species with extensive extra-regional residence times have affected beta diversity among states in the contiguous United States of America based on an analysis of occupancy and distance decay of similarity. State floras contained an average of 3106 +/- 922 species (mean +/- SD) with 2318 +/- 757 species classified as native, 180 +/- 43 species as European archaeophyte, and 608 -236 species as other exotic with no European archaeophyte association. For European archaeophytes, 42% were identified as noxious weeds in the United States with 8% identified as agricultural and 14% as natural-area weeds (20%, 2%, and 13% for other exotics, respectively). In strong contrast to natives and other exotics, European archaeophytes were more widespread and presented weaker distance-decay patterns. Thus, European archaeophytes were more likely to become noxious weeds, particularly within agricultural areas, and were associated with significant losses in beta diversity. We suggest that this outcome is a consequence of extra-regional residence time, which allowed for the selection of species or the evolution of traits that favored the colonization of arable habitats associated with early agricultural activities in Europe, habitats that are widespread, resource rich, and uniformly distributed in the United States. Our findings suggest that a long-term trajectory can be

  8. Effect of oven residence time on mechanical properties in ...

    Indian Academy of Sciences (India)

    P L Ramkumar

    Source based formu- lation was proposed by Banerjee et al [16] for modelling layer by layer non-isothermal deposition of plastic. The proposed method was also used for calculating the cycle time for ... alternative to reduce the cycle time in comparison with ... the energy inputs to the processes and save significant energy as ...

  9. Using just-in-time teaching and peer instruction in a residency program's core curriculum: enhancing satisfaction, engagement, and retention.

    Science.gov (United States)

    Schuller, Mary C; DaRosa, Debra A; Crandall, Marie L

    2015-03-01

    To assess use of the combined just-in-time teaching (JiTT) and peer instruction (PI) instructional strategy in a residency program's core curriculum. In 2010-2011, JiTT/PI was piloted in 31 core curriculum sessions taught by 22 faculty in the Northwestern University Feinberg School of Medicine's general surgery residency program. JiTT/PI required preliminary and categorical residents (n=31) to complete Web-based study questions before weekly specialty topic sessions. Responses were examined by faculty members "just in time" to tailor session content to residents' learning needs. In the sessions, residents answered multiple-choice questions (MCQs) using clickers and engaged in PI. Participants completed surveys assessing their perceptions of JiTT/PI. Videos were coded to assess resident engagement time in JiTT/PI sessions versus prior lecture-based sessions. Responses to topic session MCQs repeated in review sessions were evaluated to study retention. More than 70% of resident survey respondents indicated that JiTT/PI aided in the learning of key points. At least 90% of faculty survey respondents reported positive perceptions of aspects of the JiTT/PI strategy. Resident engagement time for JiTT/PI sessions was significantly greater than for prior lecture-based sessions (z=-2.4, P=.016). Significantly more review session MCQ responses were correct for residents who had attended corresponding JiTT/PI sessions than for residents who had not (chi-square=13.7; df=1; P<.001). JiTT/PI increased learner participation, learner retention, and the amount of learner-centered time. JiTT/PI represents an effective approach for meaningful and active learning in core curriculum sessions.

  10. Pathology residency training: time for a new paradigm.

    Science.gov (United States)

    Domen, Ronald E; Baccon, Jennifer

    2014-06-01

    The exponential growth of the field of pathology over the past several decades has created challenges for residency training programs. These challenges include the ability to train competent pathologists in 4 years, an increased demand for fellowship training, and the structuring and completion of maintenance of certification. The authors feel that pathology residency training has reached a critical point and that a new paradigm for training is required. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Chaotic itinerancy and power-law residence time distribution in stochastic dynamical systems.

    Science.gov (United States)

    Namikawa, Jun

    2005-08-01

    Chaotic itinerant motion among varieties of ordered states is described by a stochastic model based on the mechanism of chaotic itinerancy. The model consists of a random walk on a half-line and a Markov chain with a transition probability matrix. The stability of attractor ruin in the model is investigated by analyzing the residence time distribution of orbits at attractor ruins. It is shown that the residence time distribution averaged over all attractor ruins can be described by the superposition of (truncated) power-law distributions if the basin of attraction for each attractor ruin has a zero measure. This result is confirmed by simulation of models exhibiting chaotic itinerancy. Chaotic itinerancy is also shown to be absent in coupled Milnor attractor systems if the transition probability among attractor ruins can be represented as a Markov chain.

  12. Impacts of residence time during storage on potential of water saving for grey water recycling system.

    Science.gov (United States)

    Liu, S; Butler, D; Memon, F A; Makropoulos, C; Avery, L; Jefferson, B

    2010-01-01

    Grey water recycling has been generally accepted and is about to move into practice in terms of sustainable development. Previous research has revealed the bacteria re-growth in grey water and reclaimed municipal water during storage. However, in most present grey water recycling practices, impacts of water quality changes during storage on the system's performance and design regulation have not been addressed. In this paper, performance of a constructed wetland based grey water recycling system was analysed by taking the constraint of residence time during storage into account using an object based household water cycle model. Two indicators, water saving efficiency (WSE) and residence time index (RTI), are employed to reflect the system's performance and residence time during storage respectively. Results show that WSE and RTI change with storage tank volumes oppositely. As both high WSE and RTI cannot be achieved simultaneously, it is concluded that in order to achieve the most cost-effective and safe solution, systems with both small grey and green tanks are needed, whilst accepting that only relatively modest water saving efficiency targets can be achieved. Higher efficiencies will only be practicable if water quality deterioration in the green water tank can be prevented by some means (e.g. disinfection).

  13. Classification of Animal Movement Behavior through Residence in Space and Time.

    Science.gov (United States)

    Torres, Leigh G; Orben, Rachael A; Tolkova, Irina; Thompson, David R

    2017-01-01

    Identification and classification of behavior states in animal movement data can be complex, temporally biased, time-intensive, scale-dependent, and unstandardized across studies and taxa. Large movement datasets are increasingly common and there is a need for efficient methods of data exploration that adjust to the individual variability of each track. We present the Residence in Space and Time (RST) method to classify behavior patterns in movement data based on the concept that behavior states can be partitioned by the amount of space and time occupied in an area of constant scale. Using normalized values of Residence Time and Residence Distance within a constant search radius, RST is able to differentiate behavior patterns that are time-intensive (e.g., rest), time & distance-intensive (e.g., area restricted search), and transit (short time and distance). We use grey-headed albatross (Thalassarche chrysostoma) GPS tracks to demonstrate RST's ability to classify behavior patterns and adjust to the inherent scale and individuality of each track. Next, we evaluate RST's ability to discriminate between behavior states relative to other classical movement metrics. We then temporally sub-sample albatross track data to illustrate RST's response to less resolved data. Finally, we evaluate RST's performance using datasets from four taxa with diverse ecology, functional scales, ecosystems, and data-types. We conclude that RST is a robust, rapid, and flexible method for detailed exploratory analysis and meta-analyses of behavioral states in animal movement data based on its ability to integrate distance and time measurements into one descriptive metric of behavior groupings. Given the increasing amount of animal movement data collected, it is timely and useful to implement a consistent metric of behavior classification to enable efficient and comparative analyses. Overall, the application of RST to objectively explore and compare behavior patterns in movement data can

  14. Classification of Animal Movement Behavior through Residence in Space and Time.

    Directory of Open Access Journals (Sweden)

    Leigh G Torres

    Full Text Available Identification and classification of behavior states in animal movement data can be complex, temporally biased, time-intensive, scale-dependent, and unstandardized across studies and taxa. Large movement datasets are increasingly common and there is a need for efficient methods of data exploration that adjust to the individual variability of each track. We present the Residence in Space and Time (RST method to classify behavior patterns in movement data based on the concept that behavior states can be partitioned by the amount of space and time occupied in an area of constant scale. Using normalized values of Residence Time and Residence Distance within a constant search radius, RST is able to differentiate behavior patterns that are time-intensive (e.g., rest, time & distance-intensive (e.g., area restricted search, and transit (short time and distance. We use grey-headed albatross (Thalassarche chrysostoma GPS tracks to demonstrate RST's ability to classify behavior patterns and adjust to the inherent scale and individuality of each track. Next, we evaluate RST's ability to discriminate between behavior states relative to other classical movement metrics. We then temporally sub-sample albatross track data to illustrate RST's response to less resolved data. Finally, we evaluate RST's performance using datasets from four taxa with diverse ecology, functional scales, ecosystems, and data-types. We conclude that RST is a robust, rapid, and flexible method for detailed exploratory analysis and meta-analyses of behavioral states in animal movement data based on its ability to integrate distance and time measurements into one descriptive metric of behavior groupings. Given the increasing amount of animal movement data collected, it is timely and useful to implement a consistent metric of behavior classification to enable efficient and comparative analyses. Overall, the application of RST to objectively explore and compare behavior patterns in

  15. Optimization of Occupancy Based Demand Controlled Ventilation in Residences

    DEFF Research Database (Denmark)

    Mortensen, Dorthe Kragsig; Walker, Iain; Sherman, Max

    2011-01-01

    Although it has been used for many years in commercial buildings, the application of demand controlled ventilation in residences is limited. In this study we used occupant exposure to pollutants integrated over time (referred to as "dose") as the metric to evaluate the effectiveness and air quality...... implications of demand controlled ventilation in residences. We looked at air quality for two situations. The first is that typically used in ventilation standards: the exposure over a long term. The second is to look at peak exposures that are associated with time variations in ventilation rates and pollutant...... generation. The pollutant generation had two components: a background rate associated with the building materials and furnishings and a second component related to occupants. The demand controlled ventilation system operated at a low airflow rate when the residence was unoccupied and at a high airflow rate...

  16. Does residence time affect responses of alien species richness to environmental and spatial processes?

    Directory of Open Access Journals (Sweden)

    Matteo Dainese

    2012-08-01

    Full Text Available One of the most robust emerging generalisations in invasion biology is that the probability of invasion increases with the time since introduction (residence time. We analysed the spatial distribution of alien vascular plant species in a region of north-eastern Italy to understand the influence of residence time on patterns of alien species richness. Neophytes were grouped according to three periods of arrival in the study region (1500–1800, 1800–1900, and > 1900. We applied multiple regression (spatial and non-spatial with hierarchical partitioning to determine the influence of climate and human pressure on species richness within the groups. We also applied variation partitioning to evaluate the relative importance of environmental and spatial processes. Temperature mainly influenced groups with speciesa longer residence time, while human pressure influenced the more recently introduced species, although its influence remained significant in all groups. Partial regression analyses showed that most of the variation explained by the models is attributable to spatially structured environmental variation, while environment and space had small independent effects. However, effects independent of environment decreased, and spatially independent effects increased, from older to the more recent neophytes. Our data illustrate that the distribution of alien species richness for species that arrived recently is related to propagule pressure, availability of novel niches created by human activity, and neutral-based (dispersal limitation processes, while climate filtering plays a key role in the distribution of species that arrived earlier. This study highlights the importance of residence time, spatial structure, and environmental conditions in the patterns of alien species richness and for a better understanding of its geographical variation.

  17. Simulation-based interpersonal communication skills training for neurosurgical residents.

    Science.gov (United States)

    Harnof, Sagi; Hadani, Moshe; Ziv, Amitai; Berkenstadt, Haim

    2013-09-01

    Communication skills are an important component of the neurosurgery residency training program. We developed a simulation-based training module for neurosurgery residents in which medical, communication and ethical dilemmas are presented by role-playing actors. To assess the first national simulation-based communication skills training for neurosurgical residents. Eight scenarios covering different aspects of neurosurgery were developed by our team: (1) obtaining informed consent for an elective surgery, (2) discharge of a patient following elective surgery, (3) dealing with an unsatisfied patient, (4) delivering news of intraoperative complications, (5) delivering news of a brain tumor to parents of a 5 year old boy, (6) delivering news of brain death to a family member, (7) obtaining informed consent for urgent surgery from the grandfather of a 7 year old boy with an epidural hematoma, and (8) dealing with a case of child abuse. Fifteen neurosurgery residents from all major medical centers in Israel participated in the training. The session was recorded on video and was followed by videotaped debriefing by a senior neurosurgeon and communication expert and by feedback questionnaires. All trainees participated in two scenarios and observed another two. Participants largely agreed that the actors simulating patients represented real patients and family members and that the videotaped debriefing contributed to the teaching of professional skills. Simulation-based communication skill training is effective, and together with thorough debriefing is an excellent learning and practical method for imparting communication skills to neurosurgery residents. Such simulation-based training will ultimately be part of the national residency program.

  18. An estimate of hydrothermal fluid residence times and vent chimney growth rates based on 210Pb/Pb ratios and mineralogic studies of sulfides dredged from the Juan de Fuca Ridge

    International Nuclear Information System (INIS)

    Kadko, D.; Tatsumoto, Mitsunobu

    1985-01-01

    The 210 Pb/Pb ratios across two sulfide samples dredged from the Juan de Fuca Ridge are used to estimate the growth rate of the sulfide material and the residence time of the hydrothermal fluid within the oceanic crust from the onset of basalt alteration. 210 Pb is added to the hydrothermal fluid by two processes: 1) high-temperature alteration of basalt and 2) if the residence time of the fluid is on the order of the 22.3-year half-life of 210 Pb, by in-situ growth from 222 Rn (Krishnaswami and Turekian, 1982). Stable lead is derived only from the alteration of basalt. The 210 Pb/Pb ratio across one sample was proportional 0.5 dpm/10 -6 g Pb, and across the other is was proportional 0.4 dpm/10 -6 g Pb. These values are quite close to the 238 U/Pb ratios of basalts from the area, suggesting that the residence time of the hydrothermal fluid from the onset of basalt alteration is appreciably less than the mean life of 210 Pb, i.e., the time required for ingrowth from the radon. An apparent growth rate of 1.2 cm/yr is derived from the slope of the 210 Pb/Pb curve for one of the samples. This is consistent with its mineralogy and texture which suggest an accretionary pattern of development. There is no obvious sequential growth pattern, and virtually no gradient in 210 Pb/Pb across the second sample. This is consistent with alteration of the original 210 Pb/Pb distribution by extensive remobilization reactions which are inferred from the mineralogic and textural relationships of the sample. (orig.)

  19. Effects of zebra mussels on food webs: Interactions with juvenile bluegill and water residence time

    Science.gov (United States)

    Richardson, W.B.; Bartsch, L.A.

    1997-01-01

    We evaluated how water residence time mediated the impact of zebra mussels Dreissena polymorpha and bluegill sunfish Lepomis macrochirus on experimental food webs established in 1100-1 outdoor mesocosms. Water residence time was manipulated as a surrogate for seston resupply - a critical variable affecting growth and survival of suspension-feeding invertebrates. We used a 2 x 2 x 2 factorial experimental design with eight treatment combinations (3 replicates/treatment) including the presence or absence of Dreissena (2000 per m2), juvenile bluegill (40 per mesocosm), and short (1100 1 per d) or long (220 1 per d) water residence time. Measures of seston concentration (chlorophyll a, turbidity and suspended solids) were greater in the short- compared to long water-residence mesocosms, but intermediate in short water-residence mesocosms containing Dreissena. Abundance of rotifers (Keratella and Polyarthra) was reduced in Dreissena mesocosms and elevated in short residence time mesocosms. Cladocera abundance, in general, was unaffected by the presence of Dreissena; densities were higher in short-residence time mesocosms, and reduced in the presence of Lepomis. The growth of juvenile Lepomis were unaffected by Dreissena because of abundant benthic food. The final total mass of Dreissena was significantly greater in short- than long-residence mesocosms. Impacts of Dreissena on planktonic food webs may not only depend on the density of zebra mussels but also on the residence time of the surrounding water and the resupply of seston. ?? 1997 Kluwer Academic Publishers.

  20. The Boston Teacher Residency: District-Based Teacher Education

    Science.gov (United States)

    Solomon, Jesse

    2009-01-01

    This article describes an effort to create a coherent teacher recruitment, preparation and induction program in a large urban school district, based in part on the medical residency model. The article argues for several core principles in the creation of such a program: a) the program serves the school district, b) the program is structured to…

  1. First-Year Residents Outperform Third-Year Residents after Simulation-Based Education in Critical Care Medicine

    Science.gov (United States)

    Singer, Benjamin D.; Corbridge, Thomas C.; Schroedl, Clara J.; Wilcox, Jane E.; Cohen, Elaine R.; McGaghie, William C.; Wayne, Diane B.

    2012-01-01

    Introduction Prior research shows that gaps exist in internal medicine residents’ critical care knowledge and skills. The purpose of this study was to compare the bedside critical care competency of first-year residents who received a simulation-based educational intervention plus clinical training to third-year residents who received clinical training alone. Methods During their first three months of residency, a group of first-year residents completed a simulation-based educational intervention. A group of traditionally-trained third-year residents who did not receive simulation-based training served as a comparison group. Both groups were evaluated using a 20-item clinical skills assessment at the bedside of a patient receiving mechanical ventilation at the end of their medical intensive care unit rotation. Scores on the skills assessment were compared between groups. Results Simulator-trained first-year residents (n=40) scored significantly higher compared to traditionally-trained third-year residents (n=27) on the bedside assessment, 91.3% (95% CI 88.2% to 94.3%) vs. 80.9% (95% CI 76.8% to 85.0%), P = simulation-based educational intervention demonstrated higher clinical competency than third-year residents who did not undergo simulation training. Critical care competency cannot be assumed after clinical ICU rotations; simulation-based curricula can help ensure residents are proficient to care for critically ill patients. PMID:23222546

  2. Defining and measuring the mean residence time of lateral surface transient storage zones in small streams

    Science.gov (United States)

    T.R. Jackson; R. Haggerty; S.V. Apte; A. Coleman; K.J. Drost

    2012-01-01

    Surface transient storage (STS) has functional significance in stream ecosystems because it increases solute interaction with sediments. After volume, mean residence time is the most important metric of STS, but it is unclear how this can be measured accurately or related to other timescales and field-measureable parameters. We studied mean residence time of lateral...

  3. Interactive case-based learning improves resident knowledge and confidence in reproductive endocrinology and infertility.

    Science.gov (United States)

    Goldman, Kara N; Tiegs, Ashley W; Uquillas, Kristen; Nachtigall, Margaret; Fino, M Elizabeth; Winkel, Abigail F; Lerner, Veronica

    2017-06-01

    Resident physicians' scores on the REI section of the CREOG exam are traditionally low, and nearly 40% of house staff nation-wide perceive their REI knowledge to be poor. We aimed to assess whether an interactive case-based group-learning curriculum would narrow the REI knowledge gap by improving understanding and retention of core REI concepts under the time constraints affecting residents. A three-hour case-based workshop was developed to address four primary CREOG objectives. A multiple-choice test was administered immediately before and after the intervention and 7 weeks post-workshop, to evaluate both knowledge and confidence. Following the intervention, residents self-reported increased confidence with counseling and treatment of PCOS, ovulation induction cycle monitoring, counseling and treatment of POI, and breaking bad news related to infertility (p learning can be successfully integrated into a residency curriculum, and significantly improves knowledge and confidence of critical concepts in REI.

  4. Reshaping orthopaedic resident education in systems-based practice.

    Science.gov (United States)

    Roberts, Susanne M; Jarvis-Selinger, Sandra; Pratt, Daniel D; Polonijo, Andrea; Polinijo, Andrea; Stacy, Elizabeth; Wisener, Katherine; Black, Kevin P

    2012-08-01

    Despite advances in understanding the "systems-based practice" competency in resident education, this topic has remained difficult to teach, assess, and document. The goal of this study was to perform a needs assessment and an analysis of the current state of systems-based practice education in orthopaedic residency programs across the U.S. and within our own institution. A sample of orthopaedic educators and residents from across the U.S. who were attending the 2010 American Orthopaedic Association (AOA) Effective Orthopaedic Educator Course, AOA Resident Leadership Forum, and AOA Council of Residency Directors meeting were surveyed to determine (1) which aspects of systems-based practice, if any, were being taught; (2) how systems-based practice is being taught; and (3) how residency programs are assessing systems-based practice. In addition, an in-depth case study of these issues was performed by means of seven semi-structured focus group sessions with diverse stakeholders who participated in the care of musculoskeletal patients at the authors' institution. A quantitative approach was used to analyze the survey data. The focus group data were analyzed with procedures associated with grounded theory, relying on a constant comparative method to develop salient themes arising from the discussion. "Clinical observation" (33%) and "didactic case-based learning" (23%) were reported by the survey respondents as the most commonly used teaching methods, but specific topics were taught inconsistently. Competency assessment was reported to occur infrequently, and 36% of respondents reported that systems-based practice areas were not being assessed by any methods. The focus group discussions emphasized the need for standardized experiential learning that was closely linked to the patient's perspective. Orthopaedic faculty members were uncomfortable with their knowledge of this competency and their ability to teach and assess it. Teaching the systems-based practice

  5. Residence-Based Fear of Crime: A Routine Activities Approach.

    Science.gov (United States)

    Lai, Yung-Lien; Ren, Ling; Greenleaf, Richard

    2017-07-01

    Most fear-of-crime research uses resident's neighborhood as a key reference location to measure fear, yet the location effects of one's own dwelling unit on crime-specific fear has not been explicitly studied theoretically in the literature. Drawing upon routine activities theory, this study undertakes an investigation into the levels and determinants of residence-based fear of crime across three racial/ethnic groups-Whites, African Americans, and non-White Hispanics. Data used in the analyses were collected from a random-sample telephone survey of 1,239 respondents in Houston, Texas. The results derived from factor analyses revealed that residents do distinguish between fear in the neighborhood and fear at home. Proximity to motivated offenders measured by perception of crime was found to be the most salient predictor of fear, followed by the measures of target vulnerability and capable guardianship. In addition, residence-based fear varies significantly across racial/ethnic groups. The significance of these findings and the policy implications are highlighted.

  6. Lawful Permanent Residents Fiscal Year 2014 Core Based Statistical Area (CBSA) of Residence

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  7. Lawful Permanent Residents Fiscal Year 2015 Core Based Statistical Area (CBSA) of Residence

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  8. Lawful Permanent Residents Fiscal Year 2016 Core Based Statistical Area (CBSA) of Residence

    Data.gov (United States)

    Department of Homeland Security — Lawful permanet residents (LPRs) are foreign nationals who have been gratned the right to reside permanently in the United States. LPRs are also known as 'permanent...

  9. Lawful Permanent Residents Fiscal Year 2011 Core Based Statistical Area (CBSA) of Residence

    Data.gov (United States)

    Department of Homeland Security — Lawful permanent residents (LPRs) are foreign nationals who have been granted the right to reside permanently in the United States. LPRs are also known as 'permanent...

  10. The impact of dredging on residence time in the Amba estuary, west coast of India

    Digital Repository Service at National Institute of Oceanography (India)

    Velamala, S.N.; Thomas, J.; Bari, S.; Kachave, S.

    increase from 1.2 to 1.3 tidal cycles after dredging. Keywords: Residence time. flushing time. modeling. lagrangian particle track. Amba estuary: India. 1. Introduction The rate of water exchange between an estuary and the open sea plays...; Monsen et al. 2002). For example, Delesalle and Sournia (1992) established a direct linear relationship between phytoplankton biomass in coral lagoons and the Residence time (RT). The rate of exchange is generally determined by 3 time scales, viz...

  11. Fluoroscopy time during uncomplicated unilateral ureteroscopy for urolithiasis decreases with urology resident experience.

    Science.gov (United States)

    Weld, Lancaster R; Nwoye, Uzoamaka O; Knight, Richard B; Baumgartner, Timothy S; Ebertowski, James S; Stringer, Matthew T; Kasprenski, Matthew C; Weld, Kyle J

    2015-01-01

    To determine predictors of fluoroscopy time during uncomplicated, unilateral ureteroscopy for urolithiasis performed by urology residents during the first 2 years of residency. The patient charts and computed tomography scans of consecutive, unilateral, uncomplicated ureteroscopy cases for urolithiasis were retrospectively reviewed. The cases were performed by beginning urology residents over the course of their first 2 years of urology residency training. A total of 200 ureteroscopy cases were reviewed. The mean stone diameter was 7.1 (±3.2) mm. Forty-three percent of cases were performed for renal stones and 58 % for ureteral stones. The mean operative time was 80.2 (±36.9) min. The mean fluoroscopy time was 69.1 (±38.2) s. No significant differences existed between cases performed by each of the two residents, and no statistical differences in case difficulty were observed throughout the study period. Linear regression analysis revealed the strongest association with lower fluoroscopy time to be increasing resident experience (p fluoroscopy time decreased by 79 % from 135 to 29 s per case. Other significant factors associated with increasing fluoroscopy time were placement of a postoperative stent under fluoroscopic guidance (p Fluoroscopy time during uncomplicated, unilateral ureteroscopy for urolithiasis decreases with increasing urology resident operative experience. Other technical options during ureteroscopy were also found to influence fluoroscopy time.

  12. Optimization of Occupancy Based Demand Controlled Ventilation in Residences

    DEFF Research Database (Denmark)

    Mortensen, Dorthe Kragsig; Walker, Iain; Sherman, Max

    2011-01-01

    Although it has been used for many years in commercial buildings, the application of demand controlled ventilation in residences is limited. In this study we used occupant exposure to pollutants integrated over time (referred to as "dose") as the metric to evaluate the effectiveness and air quality...... implications of demand controlled ventilation in residences. We looked at air quality for two situations. The first is that typically used in ventilation standards: the exposure over a long term. The second is to look at peak exposures that are associated with time variations in ventilation rates and pollutant...... when occupied. We used analytical solutions to the continuity equation to determine the ventilation effectiveness and the long-term chronic dose and peak acute exposure for a representative range of occupancy periods, pollutant generation rates and airflow rates. The results of the study showed that we...

  13. Research during general surgery residency: a Web-based review of opportunities, structure and outputs.

    Science.gov (United States)

    Brochu, Audrey; Aggarwal, Rajesh

    2018-03-01

    Academic research is an integral part of general surgery training. Despite the recent research curriculum requirements of the Accreditation Council for Graduate Medical Education, there is perceived lack of research structure for residents. The aim of this study was to identify research opportunities, structure, and academic outputs during general surgical United States (US) residency. A Web-based review of all accredited general surgery US residency programs was undertaken. Individual websites were reviewed for resident research duration, type, and structure. Research outputs, departmental projects, and availability of faculty supervisors were also identified. Data were available for 242 general surgery residency programs of which 137 (56.6%) offer dedicated research years, ranging from 1 to 4 years, and 30 (12.4%) programs mandate such time as required. One hundred forty-two (58.7%) programs mentioned opportunities in clinical research, 129 (53.3%) in basic sciences, 29 (12.0%) in health services and outcomes-based research, and 15 (6.2%) in education. Advanced degrees were mentioned by 38 (15.7%) programs, the majority being Master of Public Health, Master of Business Administration, or Doctor of Philosophy. Nineteen (7.9%) programs mentioned research structure, mostly qualitative in description. Thirty-four (14.0%) programs provided examples of resident presentations or publications, and 25 (10.3%) mentioned a resident research day. One hundred ninety-nine (82.2%) programs offered a list of faculty supervisors and 129 (53.3%) listed examples of department research projects. Although research opportunities are ample within surgical US residency training, programs should consider the opportunity to offer varied types of research, with the potential to pursue an advanced degree. Finally, guidelines should be developed with regard to resident research structure, process, and outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. How Do Residents Spend Their Shift Time? A Time and Motion Study With a Particular Focus on the Use of Computers.

    Science.gov (United States)

    Mamykina, Lena; Vawdrey, David K; Hripcsak, George

    2016-06-01

    To understand how much time residents spend using computers compared with other activities, and what residents use computers for. This time and motion study was conducted in June and July 2010 at NewYork-Presbyterian/Columbia University Medical Center with seven residents (first-, second-, and third-year) on the general medicine service. An experienced observer shadowed residents during a single day shift, captured all their activities using an iPad application, and took field notes. The activities were captured using a validated taxonomy of clinical activities, expanded to describe computer-based activities with a greater level of detail. Residents spent 364.5 minutes (50.6%) of their shift time using computers, compared with 67.8 minutes (9.4%) interacting with patients. In addition, they spent 292.3 minutes (40.6%) talking with others in person, 186.0 minutes (25.8%) handling paper notes, 79.7 minutes (11.1%) in rounds, 80.0 minutes (11.1%) walking or waiting, and 54.0 minutes (7.5%) talking on the phone. Residents spent 685 minutes (59.6%) multitasking. Computer-based documentation activities amounted to 189.9 minutes (52.1%) of all computer-based activities time, with 128.7 minutes (35.3%) spent writing notes and 27.3 minutes (7.5%) reading notes composed by others. The study showed that residents spent considerably more time interacting with computers (over 50% of their shift time) than in direct contact with patients (less than 10% of their shift time). Some of this may be due to an increasing reliance on computing systems for access to patient data, further exacerbated by inefficiencies in the design of the electronic health record.

  15. Connections between residence time distributions and watershed characteristics across the continental US

    Science.gov (United States)

    Condon, L. E.; Maxwell, R. M.; Kollet, S. J.; Maher, K.; Haggerty, R.; Forrester, M. M.

    2016-12-01

    Although previous studies have demonstrated fractal residence time distributions in small watersheds, analyzing residence time scaling over large spatial areas is difficult with existing observational methods. For this study we use a fully integrated groundwater surface water simulation combined with Lagrangian particle tracking to evaluate connections between residence time distributions and watershed characteristics such as geology, topography and climate. Our simulation spans more than six million square kilometers of the continental US, encompassing a broad range of watershed sizes and physiographic settings. Simulated results demonstrate power law residence time distributions with peak age rages from 1.5 to 10.5 years. These ranges agree well with previous observational work and demonstrate the feasibility of using integrated models to simulate residence times. Comparing behavior between eight major watersheds, we show spatial variability in both the peak and the variance of the residence time distributions that can be related to model inputs. Peak age is well correlated with basin averaged hydraulic conductivity and the semi-variance corresponds to aridity. While power law age distributions have previously been attributed to fractal topography, these results illustrate the importance of subsurface characteristics and macro climate as additional controls on groundwater configuration and residence times.

  16. Resident response to integration of simulation-based education into emergency medicine conference.

    Science.gov (United States)

    Wang, Ernest E; Beaumont, Jennifer; Kharasch, Morris; Vozenilek, John A

    2008-11-01

    Utilization of simulation-based training has become increasingly prevalent in residency training. The authors compared emergency medicine (EM) resident feedback for simulation sessions to traditional lectures from an EM residency didactic program. The authors performed a retrospective review of all written EM conference evaluations over a 29-month period. Evaluation questions were scored on a 1-9 Likert scale. Lectures and simulation accounted for 77.6 and 22.4% of the conferences, respectively. Scored means (+/-standard deviations [SDs]) were as follows: overall, lecture 7.97 +/- 0.74 versus simulation 8.373 +/- 0.44 (p higher than traditional lectures. The scores over time suggest that this preference for simulation can be sustainable long term. Residents perceive simulation as more desirable teaching method compared to the traditional lecture format.

  17. Numerical and machine learning simulation of parametric distributions of groundwater residence time in streams and wells

    Science.gov (United States)

    Starn, J. J.; Belitz, K.; Carlson, C.

    2017-12-01

    Groundwater residence-time distributions (RTDs) are critical for assessing susceptibility of water resources to contamination. This novel approach for estimating regional RTDs was to first simulate groundwater flow using existing regional digital data sets in 13 intermediate size watersheds (each an average of 7,000 square kilometers) that are representative of a wide range of glacial systems. RTDs were simulated with particle tracking. We refer to these models as "general models" because they are based on regional, as opposed to site-specific, digital data. Parametric RTDs were created from particle RTDs by fitting 1- and 2-component Weibull, gamma, and inverse Gaussian distributions, thus reducing a large number of particle travel times to 3 to 7 parameters (shape, location, and scale for each component plus a mixing fraction) for each modeled area. The scale parameter of these distributions is related to the mean exponential age; the shape parameter controls departure from the ideal exponential distribution and is partly a function of interaction with bedrock and with drainage density. Given the flexible shape and mathematical similarity of these distributions, any of them are potentially a good fit to particle RTDs. The 1-component gamma distribution provided a good fit to basin-wide particle RTDs. RTDs at monitoring wells and streams often have more complicated shapes than basin-wide RTDs, caused in part by heterogeneity in the model, and generally require 2-component distributions. A machine learning model was trained on the RTD parameters using features derived from regionally available watershed characteristics such as recharge rate, material thickness, and stream density. RTDs appeared to vary systematically across the landscape in relation to watershed features. This relation was used to produce maps of useful metrics with respect to risk-based thresholds, such as the time to first exceedance, time to maximum concentration, time above the threshold

  18. Fractional-time random walk subdiffusion and anomalous transport with finite mean residence times: faster, not slower.

    Science.gov (United States)

    Goychuk, Igor

    2012-08-01

    Continuous time random walk (CTRW) subdiffusion along with the associated fractional Fokker-Planck equation (FFPE) is traditionally based on the premise of random clock with divergent mean period. This work considers an alternative CTRW and FFPE description which is featured by finite mean residence times (MRTs) in any spatial domain of finite size. Transient subdiffusive transport can occur on a very large time scale τ(c) which can greatly exceed mean residence time in any trap, τ(c) >(τ), and even not being related to it. Asymptotically, on a macroscale transport becomes normal for t > τ(c). However, mesoscopic transport is anomalous. Differently from viscoelastic subdiffusion no long-range anticorrelations among position increments are required. Moreover, our study makes it obvious that the transient subdiffusion and transport are faster than one expects from their normal asymptotic limit on a macroscale. This observation has profound implications for anomalous mesoscopic transport processes in biological cells because the macroscopic viscosity of cytoplasm is finite.

  19. Flow and Residence Times of Dynamic River Bank Storage and Sinuosity-Driven Hyporheic Exchange

    Science.gov (United States)

    Gomez-Velez, J. D.; Wilson, J. L.; Cardenas, M. B.; Harvey, J. W.

    2017-10-01

    Hydrologic exchange fluxes (HEFs) vary significantly along river corridors due to spatiotemporal changes in discharge and geomorphology. This variability results in the emergence of biogeochemical hot-spots and hot-moments that ultimately control solute and energy transport and ecosystem services from the local to the watershed scales. In this work, we use a reduced-order model to gain mechanistic understanding of river bank storage and sinuosity-driven hyporheic exchange induced by transient river discharge. This is the first time that a systematic analysis of both processes is presented and serves as an initial step to propose parsimonious, physics-based models for better predictions of water quality at the large watershed scale. The effects of channel sinuosity, alluvial valley slope, hydraulic conductivity, and river stage forcing intensity and duration are encapsulated in dimensionless variables that can be easily estimated or constrained. We find that the importance of perturbations in the hyporheic zone's flux, residence times, and geometry is mainly explained by two-dimensionless variables representing the ratio of the hydraulic time constant of the aquifer and the duration of the event (Γd) and the importance of the ambient groundwater flow (Δh∗). Our model additionally shows that even systems with small sensitivity, resulting in small changes in the hyporheic zone extent, are characterized by highly variable exchange fluxes and residence times. These findings highlight the importance of including dynamic changes in hyporheic zones for typical HEF models such as the transient storage model.

  20. Optimization of Occupancy Based Demand Controlled Ventilation in Residences

    Energy Technology Data Exchange (ETDEWEB)

    Mortensen, Dorthe K.; Walker, Iain S.; Sherman, Max H.

    2011-05-01

    Although it has been used for many years in commercial buildings, the application of demand controlled ventilation in residences is limited. In this study we used occupant exposure to pollutants integrated over time (referred to as 'dose') as the metric to evaluate the effectiveness and air quality implications of demand controlled ventilation in residences. We looked at air quality for two situations. The first is that typically used in ventilation standards: the exposure over a long term. The second is to look at peak exposures that are associated with time variations in ventilation rates and pollutant generation. The pollutant generation had two components: a background rate associated with the building materials and furnishings and a second component related to occupants. The demand controlled ventilation system operated at a low airflow rate when the residence was unoccupied and at a high airflow rate when occupied. We used analytical solutions to the continuity equation to determine the ventilation effectiveness and the long-term chronic dose and peak acute exposure for a representative range of occupancy periods, pollutant generation rates and airflow rates. The results of the study showed that we can optimize the demand controlled airflow rates to reduce the quantity of air used for ventilation without introducing problematic acute conditions.

  1. Residence times and nitrate transport in ground water discharging to streams in the Chesapeake Bay Watershed

    Science.gov (United States)

    Lindsey, Bruce D.; Phillips, Scott; Donnelly, Colleen A.; Speiran, Gary K.; Plummer, Niel; Bohlke, John Karl; Focazio, Michael J.; Burton, William C.; Busenberg, Eurybiades

    2003-01-01

    One of the major water-quality problems in the Chesapeake Bay is an overabundance of nutrients from the streams and rivers that discharge to the Bay. Some of these nutrients are from nonpoint sources such as atmospheric deposition, agricultural manure and fertilizer, and septic systems. The effects of efforts to control nonpoint sources, however, can be difficult to quantify because of the lag time between changes at the land surface and the response in the base-flow (ground water) component of streams. To help resource managers understand the lag time between implementation of management practices and subsequent response in the nutrient concentrations in the base-flow component of streamflow, a study of ground-water discharge, residence time, and nitrate transport in springs throughout the Chesapeake Bay Watershed and in four smaller watersheds in selected hydrogeomorphic regions (HGMRs) was conducted. The four watersheds were in the Coastal Plain Uplands, Piedmont crystalline, Valley and Ridge carbonate, and Valley and Ridge siliciclastic HGMRs.A study of springs to estimate an apparent age of the ground water was based on analyses for concentrations of chlorofluorocarbons in water samples collected from 48 springs in the Chesapeake Bay Watershed. Results of the analysis indicate that median age for all the samples was 10 years, with the 25th percentile having an age of 7 years and the 75th percentile having an age of 13 years. Although the number of samples collected in each HGMR was limited, there did not appear to be distinct differences in the ages between the HGMRs. The ranges were similar between the major HGMRs above the Fall Line (modern to about 50 years), with only two HGMRs of small geographic extent (Piedmont carbonate and Mesozoic Lowland) having ranges of modern to about 10 years. The median values of all the HGMRs ranged from 7 to 11 years. Not enough samples were collected in the Coastal Plain for comparison. Spring samples showed slightly younger

  2. MODELING HOW A HURRICANE BARRIER IN NEW BEDFORD HARBOR, MASSACHUSETTS, AFFECTS THE HYDRODYNAMICS AND RESIDENCE TIMES

    Science.gov (United States)

    Two-dimensional hydrodynamic and transport models were used to simulate tidal and subtidal circulation, residence times, and the longitudinal distributions of conservative constituents in New Bedford Harbor, Massachusetts, before and after a hurricane barrier was constructed. The...

  3. Residents' surgical performance during the laboratory years: an analysis of rule-based errors.

    Science.gov (United States)

    Nathwani, Jay N; Wise, Brett J; Garren, Margaret E; Mohamadipanah, Hossein; Van Beek, Nicole; DiMarco, Shannon M; Pugh, Carla M

    2017-11-01

    Nearly one-third of surgical residents will enter into academic development during their surgical residency by dedicating time to a research fellowship for 1-3 y. Major interest lies in understanding how laboratory residents' surgical skills are affected by minimal clinical exposure during academic development. A widely held concern is that the time away from clinical exposure results in surgical skills decay. This study examines the impact of the academic development years on residents' operative performance. We hypothesize that the use of repeated, annual assessments may result in learning even without individual feedback on participants simulated performance. Surgical performance data were collected from laboratory residents (postgraduate years 2-5) during the summers of 2014, 2015, and 2016. Residents had 15 min to complete a shortened, simulated laparoscopic ventral hernia repair procedure. Final hernia repair skins from all participants were scored using a previously validated checklist. An analysis of variance test compared the mean performance scores of repeat participants to those of first time participants. Twenty-seven (37% female) laboratory residents provided 2-year assessment data over the 3-year span of the study. Second time performance revealed improvement from a mean score of 14 (standard error = 1.0) in the first year to 17.2 (SD = 0.9) in the second year, (F[1, 52] = 5.6, P = 0.022). Detailed analysis demonstrated improvement in performance for 3 grading criteria that were considered to be rule-based errors. There was no improvement in operative strategy errors. Analysis of longitudinal performance of laboratory residents shows higher scores for repeat participants in the category of rule-based errors. These findings suggest that laboratory residents can learn from rule-based mistakes when provided with annual performance-based assessments. This benefit was not seen with operative strategy errors and has important implications for

  4. Evaluation of Residence Time on Nitrogen Oxides Removal in Non-Thermal Plasma Reactor

    Science.gov (United States)

    Talebizadeh, Pouyan; Rahimzadeh, Hassan; Babaie, Meisam; Javadi Anaghizi, Saeed; Ghomi, Hamidreza; Ahmadi, Goodarz; Brown, Richard

    2015-01-01

    Non-thermal plasma (NTP) has been introduced over the last few years as a promising after- treatment system for nitrogen oxides and particulate matter removal from diesel exhaust. NTP technology has not been commercialised as yet, due to its high rate of energy consumption. Therefore, it is important to seek out new methods to improve NTP performance. Residence time is a crucial parameter in engine exhaust emissions treatment. In this paper, different electrode shapes are analysed and the corresponding residence time and NOx removal efficiency are studied. An axisymmetric laminar model is used for obtaining residence time distribution numerically using FLUENT software. If the mean residence time in a NTP plasma reactor increases, there will be a corresponding increase in the reaction time and consequently the pollutant removal efficiency increases. Three different screw thread electrodes and a rod electrode are examined. The results show the advantage of screw thread electrodes in comparison with the rod electrode. Furthermore, between the screw thread electrodes, the electrode with the thread width of 1 mm has the highest NOx removal due to higher residence time and a greater number of micro-discharges. The results show that the residence time of the screw thread electrode with a thread width of 1 mm is 21% more than for the rod electrode. PMID:26496630

  5. Evaluation of Residence Time on Nitrogen Oxides Removal in Non-Thermal Plasma Reactor.

    Directory of Open Access Journals (Sweden)

    Pouyan Talebizadeh

    Full Text Available Non-thermal plasma (NTP has been introduced over the last few years as a promising after- treatment system for nitrogen oxides and particulate matter removal from diesel exhaust. NTP technology has not been commercialised as yet, due to its high rate of energy consumption. Therefore, it is important to seek out new methods to improve NTP performance. Residence time is a crucial parameter in engine exhaust emissions treatment. In this paper, different electrode shapes are analysed and the corresponding residence time and NOx removal efficiency are studied. An axisymmetric laminar model is used for obtaining residence time distribution numerically using FLUENT software. If the mean residence time in a NTP plasma reactor increases, there will be a corresponding increase in the reaction time and consequently the pollutant removal efficiency increases. Three different screw thread electrodes and a rod electrode are examined. The results show the advantage of screw thread electrodes in comparison with the rod electrode. Furthermore, between the screw thread electrodes, the electrode with the thread width of 1 mm has the highest NOx removal due to higher residence time and a greater number of micro-discharges. The results show that the residence time of the screw thread electrode with a thread width of 1 mm is 21% more than for the rod electrode.

  6. Evaluation of Residence Time on Nitrogen Oxides Removal in Non-Thermal Plasma Reactor.

    Science.gov (United States)

    Talebizadeh, Pouyan; Rahimzadeh, Hassan; Babaie, Meisam; Javadi Anaghizi, Saeed; Ghomi, Hamidreza; Ahmadi, Goodarz; Brown, Richard

    2015-01-01

    Non-thermal plasma (NTP) has been introduced over the last few years as a promising after- treatment system for nitrogen oxides and particulate matter removal from diesel exhaust. NTP technology has not been commercialised as yet, due to its high rate of energy consumption. Therefore, it is important to seek out new methods to improve NTP performance. Residence time is a crucial parameter in engine exhaust emissions treatment. In this paper, different electrode shapes are analysed and the corresponding residence time and NOx removal efficiency are studied. An axisymmetric laminar model is used for obtaining residence time distribution numerically using FLUENT software. If the mean residence time in a NTP plasma reactor increases, there will be a corresponding increase in the reaction time and consequently the pollutant removal efficiency increases. Three different screw thread electrodes and a rod electrode are examined. The results show the advantage of screw thread electrodes in comparison with the rod electrode. Furthermore, between the screw thread electrodes, the electrode with the thread width of 1 mm has the highest NOx removal due to higher residence time and a greater number of micro-discharges. The results show that the residence time of the screw thread electrode with a thread width of 1 mm is 21% more than for the rod electrode.

  7. A non-discrete method for computation of residence time in fluid mechanics simulations.

    Science.gov (United States)

    Esmaily-Moghadam, Mahdi; Hsia, Tain-Yen; Marsden, Alison L

    2013-11-01

    Cardiovascular simulations provide a promising means to predict risk of thrombosis in grafts, devices, and surgical anatomies in adult and pediatric patients. Although the pathways for platelet activation and clot formation are not yet fully understood, recent findings suggest that thrombosis risk is increased in regions of flow recirculation and high residence time (RT). Current approaches for calculating RT are typically based on releasing a finite number of Lagrangian particles into the flow field and calculating RT by tracking their positions. However, special care must be taken to achieve temporal and spatial convergence, often requiring repeated simulations. In this work, we introduce a non-discrete method in which RT is calculated in an Eulerian framework using the advection-diffusion equation. We first present the formulation for calculating residence time in a given region of interest using two alternate definitions. The physical significance and sensitivity of the two measures of RT are discussed and their mathematical relation is established. An extension to a point-wise value is also presented. The methods presented here are then applied in a 2D cavity and two representative clinical scenarios, involving shunt placement for single ventricle heart defects and Kawasaki disease. In the second case study, we explored the relationship between RT and wall shear stress, a parameter of particular importance in cardiovascular disease.

  8. The imprint of climate and geology on the residence times of groundwater

    Science.gov (United States)

    Maxwell, Reed M.; Condon, Laura E.; Kollet, Stefan J.; Maher, Kate; Haggerty, Roy; Forrester, Mary Michael

    2016-01-01

    Surface and subsurface flow dynamics govern residence time or water age until discharge, which is a key metric of storage and water availability for human use and ecosystem function. Although observations in small catchments have shown a fractal distribution of ages, residence times are difficult to directly quantify or measure in large basins. Here we use a simulation of major watersheds across North America to compute distributions of residence times. This simulation results in peak ages from 1.5 to 10.5 years, in agreement with isotopic observations from bomb-derived radioisotopes, and a wide range of residence times—from 0.1 to 10,000 years. This simulation suggests that peak residence times are controlled by the mean hydraulic conductivity, a function of the prevailing geology. The shape of the residence time distribution is dependent on aridity, which in turn determines water table depth and the frequency of shorter flow paths. These model results underscore the need for additional studies to characterize water ages in larger systems.

  9. Implementation and evaluation of a simulation curriculum for paediatric residency programs including just-in-time in situ mock codes.

    Science.gov (United States)

    Sam, Jonathan; Pierse, Michael; Al-Qahtani, Abdullah; Cheng, Adam

    2012-02-01

    To develop, implement and evaluate a simulation-based acute care curriculum in a paediatric residency program using an integrated and longitudinal approach. Curriculum framework consisting of three modular, year-specific courses and longitudinal just-in-time, in situ mock codes. Paediatric residency program at BC Children's Hospital, Vancouver, British Columbia. The three year-specific courses focused on the critical first 5 min, complex medical management and crisis resource management, respectively. The just-in-time in situ mock codes simulated the acute deterioration of an existing ward patient, prepared the actual multidisciplinary code team, and primed the surrounding crisis support systems. Each curriculum component was evaluated with surveys using a five-point Likert scale. A total of 40 resident surveys were completed after each of the modular courses, and an additional 28 surveys were completed for the overall simulation curriculum. The highest Likert scores were for hands-on skill stations, immersive simulation environment and crisis resource management teaching. Survey results also suggested that just-in-time mock codes were realistic, reinforced learning, and prepared ward teams for patient deterioration. A simulation-based acute care curriculum was successfully integrated into a paediatric residency program. It provides a model for integrating simulation-based learning into other training programs, as well as a model for any hospital that wishes to improve paediatric resuscitation outcomes using just-in-time in situ mock codes.

  10. Prevalence and cost of full-time research fellowships during general surgery residency: a national survey.

    Science.gov (United States)

    Robertson, Charles M; Klingensmith, Mary E; Coopersmith, Craig M

    2009-01-01

    To quantify the prevalence, outcomes, and cost of surgical resident research. General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1 to 3 years performing full-time research. No comprehensive data exists on the scope of this practice. Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Response rate was 200 of 239 (84%). A total of 381 of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and postresidency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (P < 0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of Accreditation Council for Graduate Medical Education work hour regulations for clinical residents, whereas a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. Although performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after postgraduate training.

  11. The electronic residency application service application can predict accreditation council for graduate medical education competency-based surgical resident performance.

    Science.gov (United States)

    Tolan, Amy M; Kaji, Amy H; Quach, Chi; Hines, O Joe; de Virgilio, Christian

    2010-01-01

    Program directors often struggle to determine which factors in the Electronic Residency Application Service (ERAS) application are important in the residency selection process. With the establishment of the Accreditation Council for Graduate Medical Education (ACGME) competencies, it would be important to know whether information available in the ERAS application can predict subsequent competency-based performance of general surgery residents. This study is a retrospective correlation of data points found in the ERAS application with core competency-based clinical rotation evaluations. ACGME competency-based evaluations as well as technical skills assessment from all rotations during residency were collected. The overall competency score was defined as an average of all 6 competencies and technical skills. A total of77 residents from two (one university and one community based university-affiliate) general surgery residency programs were included in the analysis. Receiving honors for many of the third year clerkships and AOA membership were associated with a number of the individual competencies. USMLE scores were predictive only of Medical Knowledge (p = 0.004). Factors associated with higher overall competency were female gender (p = 0.02), AOA (p = 0.06), overall number of honors received (p = 0.04), and honors in Ob/Gyn (p = 0.03) and Pediatrics (p = 0.05). Multivariable analysis showed honors in Ob/Gyn, female gender, older age, and total number of honors to be predictive of a number of individual core competencies. USMLE scores were only predictive of Medical Knowledge. The ERAS application is useful for predicting subsequent competency based performance in surgical residents. Receiving honors in the surgery clerkship, which has traditionally carried weight when evaluating a potential surgery resident, may not be as strong a predictor of future success. Copyright © 2010 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights

  12. Estimation of sediment residence times in subtropical highland catchments of central Mexico combining river gauging and fallout radionuclides

    Science.gov (United States)

    Evrard, Olivier; Némery, Julien; Gratiot, Nicolas; Duvert, Clément; Lefèvre, Irène; Ayrault, Sophie; Esteves, Michel; Bonté, Philippe

    2010-05-01

    Subtropical regions of the world are affected by intense soil erosion associated with deforestation, overgrazing and cropping intensification. This land degradation leads to important on-site (e.g. decrease in soil fertility) and off-site impacts (e.g. reservoir sedimentation, water pollution). This study determined the mean sediment residence times in soils and rivers of three catchments (3 - 12 km²) with contrasted land uses (i.e. cropland, forests, rangelands, extended gully networks) located in highlands of the transvolcanic belt of central Mexico. Calculations were based on rainfall and river gauging as well as on fallout radionuclide measurements (Be-7, Cs-137, Pb-210). Atmospheric deposition of Be-7 and Pb-210 was estimated based on the analysis of rainfall precipitated samples. Rainfall samples were collected all throughout the rainy season in order to take account of the temporal variations of the radionuclide fluxes. Furthermore, sampling of suspended sediment was conducted at the outlet of each catchment during most of the storms that occurred throughout the 2009 rainy season. Be-7, Cs-137 and Pb-210 concentrations of this sediment were determined by gamma-spectrometry. A two-box balance model was then used to estimate the sediment residence time and the inventory of radionuclides in the three selected catchments. This model subdivided each catchment into two boxes: (i) a "soil-box" characterised by low transport velocities and hence long radionuclide residence times and (ii) a "river-box" covering the river surface and its surroundings characterised by quicker exchanges and shorter radionuclide residence times. Input and output fluxes of sediment and radionuclides were taken into account in each box. Radioactive decay during the residence time of sediment was also considered. The mean residence time of sediment in soils ranged between 13,300 - 28,500 years. In contrast, sediment residence time in rivers was much shorter, fluctuating between 28 and 393

  13. Effect of Residence Time of Graphitisation on Thermal Conductivity of Molded Graphite

    Directory of Open Access Journals (Sweden)

    Pedy Artsanti

    2010-06-01

    Full Text Available The effect of residence time of graphitisation on thermal conductivity of molded graphite has been examined. The examination has been conducted by varying residence time of graphitisation of molded carbon with petroleum coke as raw material and coal tar pitch. Graphitisation has been conducted by heating molded graphite at 2500 °C in argon atmosphere with residention time of 10, 30 and 90 minutes. Graphitisation degree, density, shrinking mass and porosity of molded graphite were examined and so was its thermal conductivity. The result showed that the decrease of porosity and the increase of graphitisation degree due to the increasing of residention time of graphitisation will increase the thermal conductivity of graphite. Molded graphite graphitisized with residence time for 90 minutes residention time gave thermal conductivity of 2.134 Watt/mK and graphitization degree 0.718.

  14. Variability in benthic exchange rate, depth, and residence time beneath a shallow coastal estuary

    Science.gov (United States)

    Russoniello, C. J.; Michael, H. A.; Heiss, J.

    2017-12-01

    Hydrodynamically-driven exchange of water between the water column and shallow seabed aquifer, benthic exchange, is a significant and dynamic component of coastal and estuarine fluid budgets, but wave-induced benthic exchange has not been measured in the field. Mixing between surface water and groundwater solutes promotes ecologically important chemical reactions, so quantifying benthic exchange rates, depths, and residence times, constrains estimates of coastal chemical cycling. In this study, we present the first field-based direct measurements of wave-induced exchange and compare it to exchange induced by the other primary drivers of exchange - tides, and currents. We deployed instruments in a shallow estuary to measure benthic exchange and temporal variability over an 11-day period. Differential pressure sensors recorded pressure gradients across the seabed, and up-and down-looking ADCPs recorded currents and pressures from which wave parameters, surface-water currents, and water depth were determined. Wave-induced exchange was calculated directly from 1) differential pressure measurements, and indirectly with an analytical solution based on wave parameters from 2) ADCP and 3) weather station data. Groundwater flow models were used to assess the effects of aquifer properties on benthic exchange depth and residence time. Benthic exchange driven by tidal pumping or current-bedform interaction was calculated from tidal stage variation and from ADCP-measured currents at the bed, respectively. Waves were the primary benthic exchange driver (average = 20.0 cm/d, maximum = 92.3 cm/d) during the measurement period. Benthic exchange due to tides (average = 3.7 cm/d) and current-bedform interaction (average = 6.5x10-2 cm/d) was much lower. Wave-induced exchange calculated from pressure measurements and ADCP-measured wave parameters matched well, but wind-based rates underestimated wave energy and exchange. Groundwater models showed that residence time and depth increased

  15. Residence time of pollutants discharged in the Gulf of Kachchh, northwestern Arabian Sea

    Digital Repository Service at National Institute of Oceanography (India)

    Patgaonkar, R.S.; Vethamony, P.; Lokesh, K.S.; Babu, M.T.

    − = 0 The residence time is defined as the time when the mass declines to 1/e of its initial value m 0 , i.e. τ== k t 1 This theory assumes steady state flow. It also assumes complete and instantaneous mixing and that mass leaving the system... of the time of release (spring vs neap tide), the location of release and the initial vertical placement (Warner et al, 2010). Generally during neap tides, residence time is maximum near the bottom of the estuary at the mid-salt intrusion length. During...

  16. Residence times and decay rates of downed woody debris biomass/carbon in eastern US forests

    Science.gov (United States)

    Matthew B. Russell; Christopher W. Woodall; Shawn Fraver; Anthony W. D' Amato; Grant M. Domke; Kenneth E. Skog

    2014-01-01

    A key component in describing forest carbon (C) dynamics is the change in downed dead wood biomass through time. Specifically, there is a dearth of information regarding the residence time of downed woody debris (DWD), which may be reflected in the diversity of wood (for example, species, size, and stage of decay) and site attributes (for example, climate) across the...

  17. The Target Residence Time of Antihistamines Determines Their Antagonism of the G Protein-Coupled Histamine H1 Receptor

    Directory of Open Access Journals (Sweden)

    Reggie Bosma

    2017-09-01

    Full Text Available The pharmacodynamics of drug-candidates is often optimized by metrics that describe target binding (Kd or Ki value or target modulation (IC50. However, these metrics are determined at equilibrium conditions, and consequently information regarding the onset and offset of target engagement and modulation is lost. Drug-target residence time is a measure for the lifetime of the drug-target complex, which has recently been receiving considerable interest, as target residence time is shown to have prognostic value for the in vivo efficacy of several drugs. In this study, we have investigated the relation between the increased residence time of antihistamines at the histamine H1 receptor (H1R and the duration of effective target-inhibition by these antagonists. Hela cells, endogenously expressing low levels of the H1R, were incubated with a series of antihistamines and dissociation was initiated by washing away the unbound antihistamines. Using a calcium-sensitive fluorescent dye and a label free, dynamic mass redistribution based assay, functional recovery of the H1R responsiveness was measured by stimulating the cells with histamine over time, and the recovery was quantified as the receptor recovery time. Using these assays, we determined that the receptor recovery time for a set of antihistamines differed more than 40-fold and was highly correlated to their H1R residence times, as determined with competitive radioligand binding experiments to the H1R in a cell homogenate. Thus, the receptor recovery time is proposed as a cell-based and physiologically relevant metric for the lead optimization of G protein-coupled receptor antagonists, like the H1R antagonists. Both, label-free or real-time, classical signaling assays allow an efficient and physiologically relevant determination of kinetic properties of drug molecules.

  18. The Target Residence Time of Antihistamines Determines Their Antagonism of the G Protein-Coupled Histamine H1 Receptor

    Science.gov (United States)

    Bosma, Reggie; Witt, Gesa; Vaas, Lea A. I.; Josimovic, Ivana; Gribbon, Philip; Vischer, Henry F.; Gul, Sheraz; Leurs, Rob

    2017-01-01

    The pharmacodynamics of drug-candidates is often optimized by metrics that describe target binding (Kd or Ki value) or target modulation (IC50). However, these metrics are determined at equilibrium conditions, and consequently information regarding the onset and offset of target engagement and modulation is lost. Drug-target residence time is a measure for the lifetime of the drug-target complex, which has recently been receiving considerable interest, as target residence time is shown to have prognostic value for the in vivo efficacy of several drugs. In this study, we have investigated the relation between the increased residence time of antihistamines at the histamine H1 receptor (H1R) and the duration of effective target-inhibition by these antagonists. Hela cells, endogenously expressing low levels of the H1R, were incubated with a series of antihistamines and dissociation was initiated by washing away the unbound antihistamines. Using a calcium-sensitive fluorescent dye and a label free, dynamic mass redistribution based assay, functional recovery of the H1R responsiveness was measured by stimulating the cells with histamine over time, and the recovery was quantified as the receptor recovery time. Using these assays, we determined that the receptor recovery time for a set of antihistamines differed more than 40-fold and was highly correlated to their H1R residence times, as determined with competitive radioligand binding experiments to the H1R in a cell homogenate. Thus, the receptor recovery time is proposed as a cell-based and physiologically relevant metric for the lead optimization of G protein-coupled receptor antagonists, like the H1R antagonists. Both, label-free or real-time, classical signaling assays allow an efficient and physiologically relevant determination of kinetic properties of drug molecules. PMID:29033838

  19. The Target Residence Time of Antihistamines Determines Their Antagonism of the G Protein-Coupled Histamine H1 Receptor.

    Science.gov (United States)

    Bosma, Reggie; Witt, Gesa; Vaas, Lea A I; Josimovic, Ivana; Gribbon, Philip; Vischer, Henry F; Gul, Sheraz; Leurs, Rob

    2017-01-01

    The pharmacodynamics of drug-candidates is often optimized by metrics that describe target binding (K d or K i value) or target modulation (IC 50 ). However, these metrics are determined at equilibrium conditions, and consequently information regarding the onset and offset of target engagement and modulation is lost. Drug-target residence time is a measure for the lifetime of the drug-target complex, which has recently been receiving considerable interest, as target residence time is shown to have prognostic value for the in vivo efficacy of several drugs. In this study, we have investigated the relation between the increased residence time of antihistamines at the histamine H 1 receptor (H 1 R) and the duration of effective target-inhibition by these antagonists. Hela cells, endogenously expressing low levels of the H 1 R, were incubated with a series of antihistamines and dissociation was initiated by washing away the unbound antihistamines. Using a calcium-sensitive fluorescent dye and a label free, dynamic mass redistribution based assay, functional recovery of the H 1 R responsiveness was measured by stimulating the cells with histamine over time, and the recovery was quantified as the receptor recovery time . Using these assays, we determined that the receptor recovery time for a set of antihistamines differed more than 40-fold and was highly correlated to their H 1 R residence times, as determined with competitive radioligand binding experiments to the H 1 R in a cell homogenate. Thus, the receptor recovery time is proposed as a cell-based and physiologically relevant metric for the lead optimization of G protein-coupled receptor antagonists, like the H 1 R antagonists. Both, label-free or real-time, classical signaling assays allow an efficient and physiologically relevant determination of kinetic properties of drug molecules.

  20. On the joint residence time of N independent two-dimensional Brownian motions

    International Nuclear Information System (INIS)

    Benichou, O; Coppey, M; Klafter, J; Moreau, M; Oshanin, G

    2003-01-01

    We study the behaviour of several joint residence times of N independent Brownian particles in a disc of radius R in two dimensions. We consider: (i) the time T N (t) spent by all N particles simultaneously in the disc within the time interval [0, t], (ii) the time T (m) N (t) which at least m out of N particles spend together in the disc within the time interval [0, t], and (iii) the time T-tilde (m) N (t) which exactly m out of N particles spend together in the disc within the time interval [0, t]. We obtain very simple exact expressions for the expectations of these three residence times in the limit t → ∞

  1. Hydraulic residence time and iron removal in a wetland receiving ferruginous mine water over a 4 year period from commissioning.

    Science.gov (United States)

    Kusin, F M; Jarvis, A P; Gandy, C J

    2010-01-01

    Analysis of residence time distribution (RTD) has been conducted for the UK Coal Authority's mine water treatment wetland at Lambley, Northumberland, to determine the hydraulic performance of the wetland over a period of approximately 4 years since site commissioning. The wetland RTD was evaluated in accordance with moment analysis and modelled based on a tanks-in-series (TIS) model to yield the hydraulic characteristics of system performance. Greater hydraulic performance was seen during the second site monitoring after 21 months of site operation i.e. longer hydraulic residence time to reflect overall system hydraulic efficiency, compared to wetland performance during its early operation. Further monitoring of residence time during the third year of wetland operation indicated a slight reduction in hydraulic residence time, thus a lower system hydraulic efficiency. In contrast, performance during the fourth year of wetland operation exhibited an improved overall system hydraulic efficiency, suggesting the influence of reed growth over the lifetime of such systems on hydraulic performance. Interestingly, the same pattern was found for iron (which is the primary pollutant of concern in ferruginous mine waters) removal efficiency of the wetland system from the second to fourth year of wetland operation. This may therefore, reflect the maturity of reeds for maintaining efficient flow distribution across the wetland to retain a longer residence time and significant fractions of water involved to enhance the extent of treatment received for iron attenuation. Further monitoring will be conducted to establish whether such performance is maintained, or whether efficiency decreases over time due to accumulation of dead plant material within the wetland cells.

  2. Age and residence time of terrestrial source water in the northwest Atlantic shelf seas

    Science.gov (United States)

    He, R.; Todd, A. C.

    2016-02-01

    Coastal river mouths and bays are the junctions where terrestrial-source water meets and mixes with water from the open ocean. Once the riverine water reaches the coastal ocean, its eventual fate is largely unknown and difficult to trace. Rivers that flow into the ocean may contain high levels of nutrients and organic matter, so understanding the fate of terrestrial source water is important for a variety of biogeochemical processes that occur in the shelf seas. The fate of this terrestrial source water may be described in terms of its mean age (the time since it reached the ocean) and its residence time (the time it remains on the continental shelf). Using a high-resolution ocean model, we apply the constituent-oriented age and residence time (CART) theory to a large region encompassing the northwest Atlantic shelf seas to calculate the mean age of terrestrial source water and its residence time. For this application, 196 river mouths are used as sources of terrestrial water from South America to Nova Scotia. We investigate the spatial and seasonal variability of the water's mean age and compute the residence time within four different shelf regions: the Carribean Sea, the Gulf of Mexico, the South Atlantic Bight, and the Mid-Atlantic Bight/Gulf of Maine. From the estimates of mean age and residence time, we describe the impact of the coastal circulation on the eventual fate of terrestrial waters, and provide conjecture on how varying transport time scales may affect the general biogeochemical processes in the coastal ocean.

  3. Particle residence times in waters of the Yangtze and Amazon continental shelves

    International Nuclear Information System (INIS)

    McKee, B.A.; Nittrouer, C.A.; DeMaster, D.J.

    1986-01-01

    Water column and seabed samples were analyzed for naturally occurring Th-234 to determine particle residence times in Yangtze and Amazon continental-shelf waters. On the Yangtze shelf, the water column was vertically well-mixed and suspended-sediment concentrations decreased offshore (from 230 mg/l near the river mouth to 2 mg/l in mid-shelf waters). Particle residence times increased offshore and ranged from 3.2 hours (12 m water depth) to 7.3 days (60 m water depth). Particle residence times ranged from 3 to 30 times shorter than values predicted by settling of discrete (4-8 micron) particles, suggesting that particles were settling in aggregate form. On the Amazon shelf, a two-layer estuarine flow dominated shelf circulation. Suspended-sediment concentrations on the inner shelf (10-12 m water depth) were much greater in bottom waters (range: 100-880 mg/l) than in surface waters (range 5-60 mg/l) as a result of resuspension. Particle residence times ranged from 1.1 days in surface waters to 2.5 days in bottom waters. Particles probably underwent several cycles of resuspension before permanent removal from the water column

  4. A High-Throughput Method for Measuring Drug Residence Time Using the Transcreener ADP Assay.

    Science.gov (United States)

    Kumar, Meera; Lowery, Robert G

    2017-08-01

    Analysis of drug-target residence times during drug development can result in improved efficacy, increased therapeutic window, and reduced side effects. Residence time can be estimated as the reciprocal of the dissociation rate ( k off ) of an inhibitor from its target. The traditional methods for measuring k off require synthesis of labeled ligands or low-throughput label-free methods. To provide an alternative that is better suited to an automated high-throughput screening (HTS) environment, we adapted a classic "jump dilution" catalytic assay method for determination of k off values for kinase inhibitor drugs. We used the Transcreener ADP 2 Kinase assay as a universal, homogenous method to monitor the recovery of kinase activity as the drugs dissociated from preformed inhibitor-kinase complexes. We measured residence times for several drugs that bind the epidermal growth factor receptor (EGFR), ABL1, and Aurora kinases and found that the rank ordering of inhibitor k off values correlated with literature values determined using ligand binding assays. Moreover, very similar results were obtained using the Transcreener assay with fluorescence polarization (FP), fluorescence intensity (FI), and time-resolved Förster resonance energy transfer (TR-FRET) detection modes. This HTS-compatible, generic assay method should facilitate the use of residence time as a parameter for compound prioritization and optimization early in kinase drug discovery programs.

  5. Pennsylvania SBIRT Medical and Residency Training: Developing, Implementing, and Evaluating an Evidenced-Based Program

    Science.gov (United States)

    Pringle, Janice L.; Melczak, Michael; Johnjulio, William; Campopiano, Melinda; Gordon, Adam J.; Costlow, Monica

    2012-01-01

    Medical residents do not receive adequate training in screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use disorders. The federally funded Pennsylvania SBIRT Medical and Residency Training program (SMaRT) is an evidence-based curriculum with goals of training residents in SBIRT knowledge and skills and…

  6. Effects of intergenerational Montessori-based activities programming on engagement of nursing home residents with dementia

    Directory of Open Access Journals (Sweden)

    Michelle M Lee

    2007-10-01

    Full Text Available Michelle M Lee1, Cameron J Camp2, Megan L Malone21Midwestern University, Department of Behavioral Medicine, Downers Grove, IL , USA; 2Myers Research Institute of Menorah Park Center for Senior Living, Beachwood, OH, USA Abstract: Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP with 15 preschool children from the facility’s on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose – the Myers Research Institute Engagement Scale (MRI-ES. These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented “lessons” to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.Keywords: Montessori-based activities, intergenerational programming, engagement, dementia

  7. "iBIM"--internet-based interactive modules: an easy and interesting learning tool for general surgery residents.

    Science.gov (United States)

    Azer, Nader; Shi, Xinzhe; de Gara, Chris; Karmali, Shahzeer; Birch, Daniel W

    2014-04-01

    The increased use of information technology supports a resident- centred educational approach that promotes autonomy, flexibility and time management and helps residents to assess their competence, promoting self-awareness. We established a web-based e-learning tool to introduce general surgery residents to bariatric surgery and evaluate them to determine the most appropriate implementation strategy for Internet-based interactive modules (iBIM) in surgical teaching. Usernames and passwords were assigned to general surgery residents at the University of Alberta. They were directed to the Obesity101 website and prompted to complete a multiple-choice precourse test. Afterwards, they were able to access the interactive modules. Residents could review the course material as often as they wanted before completing a multiple-choice postcourse test and exit survey. We used paired t tests to assess the difference between pre- and postcourse scores. Out of 34 residents who agreed to participate in the project, 12 completed the project (35.3%). For these 12 residents, the precourse mean score was 50 ± 17.3 and the postcourse mean score was 67 ± 14 (p = 0.020). Most residents who participated in this study recommended using the iBIMs as a study tool for bariatric surgery. Course evaluation scores suggest this novel approach was successful in transferring knowledge to surgical trainees. Further development of this tool and assessment of implementation strategies will determine how iBIM in bariatric surgery may be integrated into the curriculum.

  8. Variability in organic carbon reactivity across lake residence time and trophic gradients

    Science.gov (United States)

    Evans, Chris D.; Futter, Martyn N.; Moldan, Filip; Valinia, Salar; Frogbrook, Zoe; Kothawala, Dolly N.

    2017-11-01

    The transport of dissolved organic carbon from land to ocean is a large dynamic component of the global carbon cycle. Inland waters are hotspots for organic matter turnover, via both biological and photochemical processes, and mediate carbon transfer between land, oceans and atmosphere. However, predicting dissolved organic carbon reactivity remains problematic. Here we present in situ dissolved organic carbon budget data from 82 predominantly European and North American water bodies with varying nutrient concentrations and water residence times ranging from one week to 700 years. We find that trophic status strongly regulates whether water bodies act as net dissolved organic carbon sources or sinks, and that rates of both dissolved organic carbon production and consumption can be predicted from water residence time. Our results suggest a dominant role of rapid light-driven removal in water bodies with a short water residence time, whereas in water bodies with longer residence times, slower biotic production and consumption processes are dominant and counterbalance one another. Eutrophication caused lakes to transition from sinks to sources of dissolved organic carbon. We conclude that rates and locations of dissolved organic carbon processing and associated CO2 emissions in inland waters may be misrepresented in global carbon budgets if temporal and spatial reactivity gradients are not accounted for.

  9. Dynamics of nitrate production and removal as a function of residence time in the hyporheic zone

    Science.gov (United States)

    Jay P. Zarnetske; Roy Haggerty; Steven M. Wondzell; Michelle A. Baker

    2011-01-01

    Biogeochemical reactions associated with stream nitrogen cycling, such as nitrification and denitrification, can be strongly controlled by water and solute residence times in the hyporheic zone (HZ). We used a whole-stream steady state 15N-Iabeled nitrate and conservative tracer addition to investigate the spatial and temporal physiochemical...

  10. LABORATORY AND NUMERICAL INVESTIGATIONS OF RESIDENCE TIME DISTRIBUTION OF FLUIDS IN LAMINAR FLOW STIRRED ANNULAR PHOTOREACTOR

    Science.gov (United States)

    Laboratory and Numerical Investigations of Residence Time Distribution of Fluids in Laminar Flow Stirred Annular PhotoreactorE. Sahle-Demessie1, Siefu Bekele2, U. R. Pillai11U.S. EPA, National Risk Management Research LaboratorySustainable Technology Division,...

  11. Fertilizer residence time affects nitrogen uptake efficiency and growth of sweet corn

    NARCIS (Netherlands)

    Zotarelli, L.; Scholberg, J.M.S.; Dukes, M.D.; Munoz-Carpena, R.

    2008-01-01

    Understanding plant N uptake dynamics is critical for increasing fertilizer N uptake efficiency (FUE) and minimize the risk of N leaching. The objective of this research was to determine the effect of residence time of N fertilizer on N uptake and FUE of sweet corn. Plants were grown in 25 L columns

  12. Factors influencing the residence time of catchment waters : A virtual experiment approach

    NARCIS (Netherlands)

    Dunn, S.M.; McDonnell, J.J.; Vaché, K.B.

    Estimates of mean residence time (MRT) are increasingly used as simple summary descriptors of the hydrological processes involving storage and mixing of water within catchment systems. Current understanding of the physical controls on MRT remains limited, and various hypotheses have been proposed to

  13. Residence times of alluvium in an east Texas stream as indicated by sediment color

    Science.gov (United States)

    Jonathan D. Phillips; Daniel A. Marion

    2001-01-01

    The relationships between sediment production, storage, and transport in fluvial systems are complex and variable. Key issues in addressing these relationships are the residence times of sediment delivered to the channel, and the proportion derived from recent upland erosion as opposed to remobilized alluvium. The systematic changes in iron geochemistry often...

  14. Residence time controls on nitrogen transformations in a permeable nearshore aquifer

    Science.gov (United States)

    Robinson, C. E.

    2015-12-01

    Permeable nearshore aquifers are an important biogeochemical hotspot for nitrogen (N) cycling. Located at the land-sea interface this hotspot has been shown to regulate N fluxes to coastal waters via submarine groundwater discharge. N transformations in a nearshore aquifer may result in either a net production or net removal of NO3- with the transformations controlled by complex interacting physical transport and biogeochemical kinetic processes. Oceanic forcing including tides and waves cause large quantities of seawater and chemical constituents, including dissolved oxygen and organic matter, to recirculate through the nearshore aquifer. There is currently limited understanding of the impact of the oceanic forcing on the residence time of recirculating constituents and the subsequent implications on N transformations in the aquifer. A numerical model was applied to quantify the influence of varying tidal and wave conditions on residence times and evaluate how the interactions between the coupled transport and reaction kinetics control N transformations and fluxes. Simulations were performed using the variable-density groundwater flow model SEAWAT-2005 combined with the reactive multi-component transport model PHT3D v2.10. The model simulated the transport and transformation of both marine- and land-derived chemical consitituents and considered oxic DOM mineralization, nitrification and denitrification. Simulations demonstrate that the recirculation residence times, combined with oxygen removal rates, regulate whether a nearshore aquifer will act as a net source or sink of NO3. Dimensionless Damköhler numbers calculated as the ratio of the characteristic residence time to characterisitic oxygen reaction time were determined and provide valuable insight into the residence time controls on the ultimate flux of N to the sea.

  15. Timed Up And Go Risk Predictor Of Falls In Elderly People Residing In The Community?

    Directory of Open Access Journals (Sweden)

    Mayara Muniz Peixoto Rodrigues

    2017-04-01

    Full Text Available Objective: evaluate the risk of falls of elderly people residing in a community in northeastern Brazil using the “Timed up and go”. Method: descriptive study, with a quantitative approach, performed with elderly people residing in a community. The collected data related to the sociodemographic and economic characteristics of episodes of falls in the last two years, regular practice of physical exercise and complaint of pain at the time of the interview; and, at last, the application of the “Timed Up and Go” test. Result: Most of the elderly were classified as free and independent and independent. There is a direct relationship between advanced age and increased time to perform the test. Conclusion: the "Timed Up and Go" test was not effective in predicting risk of falls alone and should associate with other indicators. Descriptors: Elderly people; Accidents by fall; Walking; Postural balance.

  16. The role of residence times in two-patch dengue transmission dynamics and optimal strategies.

    Science.gov (United States)

    Lee, Sunmi; Castillo-Chavez, Carlos

    2015-06-07

    The reemergence and geographical dispersal of vector-borne diseases challenge global health experts around the world and in particular, dengue poses increasing difficulties in the Americas, due in part to explosive urban and semi-urban growth, increases of within and between region mobility, the absence of a vaccine, and the limited resources available for public health services. In this work, a simple deterministic two-patch model is introduced to assess the impact of dengue transmission dynamics in heterogeneous environments. The two-patch system models the movement (e.g. urban versus rural areas residence times) of individuals between and within patches/environments using residence-time matrices with entries that budget within and between host patch relative residence times, under the assumption that only the human budgets their residence time across regions. Three scenarios are considered: (i) resident hosts in Patch i visit patch j, where i≠j but not the other way around, a scenario referred to as unidirectional motion; (ii) symmetric bi-directional motion; and (iii) asymmetric bi-directional motion. Optimal control theory is used to identify and evaluate patch-specific control measures aimed at reducing dengue prevalence in humans and vectors at a minimal cost. Optimal policies are computed under different residence-matrix configurations mentioned above as well as transmissibility scenarios characterized by the magnitude of the basic reproduction number. Optimal patch-specific polices can ameliorate the impact of epidemic outbreaks substantially when the basic reproduction number is moderate. The final patch-specific epidemic size variation increases as the residence time matrix moves away from the symmetric case (asymmetry). As expected, the patch where individuals spend most of their time or in the patch where transmissibility is higher tend to support larger patch-specific final epidemic sizes. Hence, focusing on intervention that target areas where

  17. The role of librarians in teaching evidence-based medicine to pediatric residents: a survey of pediatric residency program directors.

    Science.gov (United States)

    Boykan, Rachel; Jacobson, Robert M

    2017-10-01

    The research sought to identify the general use of medical librarians in pediatric residency training, to define the role of medical librarians in teaching evidence-based medicine (EBM) to pediatric residents, and to describe strategies and curricula for teaching EBM used in pediatric residency training programs. We sent a 13-question web-based survey through the Association of Pediatric Program Directors to 200 pediatric residency program directors between August and December 2015. A total of 91 (46%) pediatric residency program directors responded. Most (76%) programs had formal EBM curricula, and more than 75% of curricula addressed question formation, searching, assessment of validity, generalizability, quantitative importance, statistical significance, and applicability. The venues for teaching EBM that program directors perceived to be most effective included journal clubs (84%), conferences (44%), and morning report (36%). While 80% of programs utilized medical librarians, most of these librarians assisted with scholarly or research projects (74%), addressed clinical questions (62%), and taught on any topic not necessarily EBM (58%). Only 17% of program directors stated that librarians were involved in teaching EBM on a regular basis. The use of a librarian was not associated with having an EBM curriculum but was significantly associated with the size of the program. Smaller programs were more likely to utilize librarians (100%) than were medium (71%) or large programs (75%). While most pediatric residency programs have an EBM curriculum and engage medical librarians in various ways, librarians' expertise in teaching EBM is underutilized. Programs should work to better integrate librarians' expertise, both in the didactic and clinical teaching of EBM.

  18. Simulation-based education with mastery learning improves residents' lumbar puncture skills

    Science.gov (United States)

    Cohen, Elaine R.; Caprio, Timothy; McGaghie, William C.; Simuni, Tanya; Wayne, Diane B.

    2012-01-01

    Objective: To evaluate the effect of simulation-based mastery learning (SBML) on internal medicine residents' lumbar puncture (LP) skills, assess neurology residents' acquired LP skills from traditional clinical education, and compare the results of SBML to traditional clinical education. Methods: This study was a pretest-posttest design with a comparison group. Fifty-eight postgraduate year (PGY) 1 internal medicine residents received an SBML intervention in LP. Residents completed a baseline skill assessment (pretest) using a 21-item LP checklist. After a 3-hour session featuring deliberate practice and feedback, residents completed a posttest and were expected to meet or exceed a minimum passing score (MPS) set by an expert panel. Simulator-trained residents' pretest and posttest scores were compared to assess the impact of the intervention. Thirty-six PGY2, 3, and 4 neurology residents from 3 medical centers completed the same simulated LP assessment without SBML. SBML posttest scores were compared to neurology residents' baseline scores. Results: PGY1 internal medicine residents improved from a mean of 46.3% to 95.7% after SBML (p < 0.001) and all met the MPS at final posttest. The performance of traditionally trained neurology residents was significantly lower than simulator-trained residents (mean 65.4%, p < 0.001) and only 6% met the MPS. Conclusions: Residents who completed SBML showed significant improvement in LP procedural skills. Few neurology residents were competent to perform a simulated LP despite clinical experience with the procedure. PMID:22675080

  19. Measurement of residence time distribution of liquid phase in an industrial-scale continuous pulp digester using radiotracer technique.

    Science.gov (United States)

    Sheoran, Meenakshi; Goswami, Sunil; Pant, Harish J; Biswal, Jayashree; Sharma, Vijay K; Chandra, Avinash; Bhunia, Haripada; Bajpai, Pramod K; Rao, S Madhukar; Dash, A

    2016-05-01

    A series of radiotracer experiments was carried out to measure residence time distribution (RTD) of liquid phase (alkali) in an industrial-scale continuous pulp digester in a paper industry in India. Bromine-82 as ammonium bromide was used as a radiotracer. Experiments were carried out at different biomass and white liquor flow rates. The measured RTD data were treated and mean residence times in individual digester tubes as well in the whole digester were determined. The RTD was also analyzed to identify flow abnormalities and investigate flow dynamics of the liquid phase in the pulp digester. Flow channeling was observed in the first section (tube 1) of the digester. Both axial dispersion and tanks-in-series with backmixing models preceded with a plug flow component were used to simulate the measured RTD and quantify the degree of axial mixing. Based on the study, optimum conditions for operating the digester were proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Sustained increase in resident meal time hand hygiene through an interdisciplinary intervention engaging long-term care facility residents and staff.

    Science.gov (United States)

    O'Donnell, Marguerite; Harris, Tony; Horn, Terancita; Midamba, Blondelle; Primes, Vickie; Sullivan, Nancy; Shuler, Rosalyn; Zabarsky, Trina F; Deshpande, Abhishek; Sunkesula, Venkata C K; Kundrapu, Sirisha; Donskey, Curtis J

    2015-02-01

    Hand hygiene by patients may prevent acquisition and dissemination of health care-associated pathogens, but limited efforts have been made to engage patients in hand hygiene interventions. In a long-term care facility, we found that residents were aware of the importance of hand hygiene, but barriers, such as inaccessible products or difficult to use products, limited compliance. A dramatic and sustained improvement in meal time hand hygiene was achieved through engagement of staff and residents. Published by Elsevier Inc.

  1. Effects of intergenerational Montessori-based activities programming on engagement of nursing home residents with dementia.

    Science.gov (United States)

    Lee, Michelle M; Camp, Cameron J; Malone, Megan L

    2007-01-01

    Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP) with 15 preschool children from the facility's on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose--the Myers Research Institute Engagement Scale (MRI-ES). These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented "lessons" to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.

  2. Incidence of pneumonia in nursing home residents with dementia in the Netherlands: an estimation based on three differently designed studies.

    Science.gov (United States)

    Zomer, T P; VAN DER Maaden, T; VAN Gageldonk-Lafeber, A B; DE Greeff, S C; VAN DER Steen, J T; Verhoef, L

    2017-08-01

    Pneumonia leads to considerable morbidity and mortality in nursing home residents with dementia. We assessed pneumonia incidence based on data from three different studies: (1) real-time national surveillance of healthcare-associated infections in nursing home residents in 2009-2015; (2) a randomized controlled trial in 2012-2015 to assess effects of a practical guideline in nursing home residents with dementia and pneumonia; and (3) a study in 2007-2010 to assess quality of dying in newly admitted nursing home residents with dementia. In national surveillance data, pneumonia incidence was calculated separately for psychogeriatric and somatic beds, as a proxy for residents with and without dementia. Weekly pneumonia incidence was significantly lower per 1000 psychogeriatric beds (3·9; 95% confidence interval (CI) 3·2-4·6) compared with 1000 somatic beds (5·7; 95% CI 5·1-6·3). Annual incidence per 1000 psychogeriatric beds was similar in national surveillance (range 78·9-117·1) and the trial (range 71·0-94·3), and significantly higher in newly admitted dementia residents (range 267·3-363·2). The incidence was highest during the first months after admission when compared with residents with longer stay. In conclusion, follow-up of pneumonia in newly admitted dementia residents may result in higher incidence, possibly due to higher risk in this population.

  3. Reducing the residence time of a bouncing drop with spoked macrotexture

    Science.gov (United States)

    Patterson, Colin; Bird, James

    2015-11-01

    Liquid drops can bounce when they impact non-wetting surfaces. Recently, studies have demonstrated that the time that the bouncing drop resides at the surface can be adjusted with the presence of ridged macrotextures. When non-parallel macrotextures are present, they intersect to create spoked junctions. At sufficient velocity, a drop impacting a junction might be expected to breakup into smaller droplets; yet it is unclear how many droplets would be produced and the time for these droplets to clear the surface. Here, we show that the number droplets and overall residence time depends on both the number of spokes and the Weber number. We experimentally demonstrate that the center-assisted recoil framework extends beyond superhydrophobic surfaces to those above the Leidenfrost temperature. Finally, we present a physical model that rationalizes our results.

  4. Use of Team-Based Learning Pedagogy for Internal Medicine Ambulatory Resident Teaching.

    Science.gov (United States)

    Balwan, Sandy; Fornari, Alice; DiMarzio, Paola; Verbsky, Jennifer; Pekmezaris, Renee; Stein, Joanna; Chaudhry, Saima

    2015-12-01

    Team-based learning (TBL) is used in undergraduate medical education to facilitate higher-order content learning, promote learner engagement and collaboration, and foster positive learner attitudes. There is a paucity of data on the use of TBL in graduate medical education. Our aim was to assess resident engagement, learning, and faculty/resident satisfaction with TBL in internal medicine residency ambulatory education. Survey and nominal group technique methodologies were used to assess learner engagement and faculty/resident satisfaction. We assessed medical learning using individual (IRAT) and group (GRAT) readiness assurance tests. Residents (N = 111) involved in TBL sessions reported contributing to group discussions and actively discussing the subject material with other residents. Faculty echoed similar responses, and residents and faculty reported a preference for future teaching sessions to be offered using the TBL pedagogy. The average GRAT score was significantly higher than the average IRAT score by 22%. Feedback from our nominal group technique rank ordered the following TBL strengths by both residents and faculty: (1) interactive format, (2) content of sessions, and (3) competitive nature of sessions. We successfully implemented TBL pedagogy in the internal medicine ambulatory residency curriculum, with learning focused on the care of patients in the ambulatory setting. TBL resulted in active resident engagement, facilitated group learning, and increased satisfaction by residents and faculty. To our knowledge this is the first study that implemented a TBL program in an internal medicine residency curriculum.

  5. Residence times of groundwater and nitrate transport in coastal aquifer systems: Daweijia area, northeastern China

    Energy Technology Data Exchange (ETDEWEB)

    Han, Dongmei [Key Laboratory of Water Cycle & Related Land Surface Processes, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101 (China); National Centre for Groundwater Research and Training, Flinders University, GPO Box 2100, Adelaide, SA 5001 (Australia); Cao, Guoliang [National Centre for Groundwater Research and Training, Flinders University, GPO Box 2100, Adelaide, SA 5001 (Australia); Center for Water Research, College of Engineering, Peking University, Beijing 100871 (China); McCallum, James [National Centre for Groundwater Research and Training, Flinders University, GPO Box 2100, Adelaide, SA 5001 (Australia); School of the Environment, Flinders University, GPO Box 2100, Adelaide, SA 5001 (Australia); Song, Xianfang [Key Laboratory of Water Cycle & Related Land Surface Processes, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101 (China)

    2015-12-15

    Groundwater within the coastal aquifer systems of the Daweijia area in northeastern China is characterized by a large of variations (33–521 mg/L) in NO{sub 3}{sup −} concentrations. Elevated nitrate concentrations, in addition to seawater intrusion in the Daweijia well field, both attributable to anthropogenic activities, may impact future water-management practices. Chemical and stable isotopic (δ{sup 18}O, δ{sup 2}H) analysis, {sup 3}H and CFCs methods were applied to provide a better understanding of the relationship between the distribution of groundwater mean residence time (MRT) and nitrate transport, and to identify sources of nitrate concentrations in the complex coastal aquifer systems. There is a relatively narrow range of isotopic composition (ranging from − 8.5 to − 7.0‰) in most groundwater. Generally higher tritium contents observed in the wet season relative to the dry season may result from rapid groundwater circulation in response to the rainfall through the preferential flow paths. In the well field, the relatively increased nitrate concentrations of groundwater, accompanied by the higher tritium contents in the wet season, indicate the nitrate pollution can be attributed to domestic wastes. The binary exponential and piston-flow mixing model (BEP) yielded feasible age distributions based on the conceptual model. The good inverse relationship between groundwater MRTs (92–467 years) and the NO{sub 3}{sup −} concentrations in the shallow Quaternary aquifers indicates that elevated nitrate concentrations are attributable to more recent recharge for shallow groundwater. However, there is no significant relationship between the MRTs (8–411 years) and the NO{sub 3}{sup −} concentrations existing in the carbonate aquifer system, due to the complex hydrogeological conditions, groundwater age distributions and the range of contaminant source areas. Nitrate in the groundwater system without denitrification effects could accumulate and be

  6. Using continuous underway isotope measurements to map water residence time in hydrodynamically complex tidal environments

    Science.gov (United States)

    Downing, Bryan D.; Bergamaschi, Brian; Kendall, Carol; Kraus, Tamara; Dennis, Kate J.; Carter, Jeffery A.; von Dessonneck, Travis

    2016-01-01

    Stable isotopes present in water (δ2H, δ18O) have been used extensively to evaluate hydrological processes on the basis of parameters such as evaporation, precipitation, mixing, and residence time. In estuarine aquatic habitats, residence time (τ) is a major driver of biogeochemical processes, affecting trophic subsidies and conditions in fish-spawning habitats. But τ is highly variable in estuaries, owing to constant changes in river inflows, tides, wind, and water height, all of which combine to affect τ in unpredictable ways. It recently became feasible to measure δ2H and δ18O continuously, at a high sampling frequency (1 Hz), using diffusion sample introduction into a cavity ring-down spectrometer. To better understand the relationship of τ to biogeochemical processes in a dynamic estuarine system, we continuously measured δ2H and δ18O, nitrate and water quality parameters, on board a small, high-speed boat (5 to >10 m s–1) fitted with a hull-mounted underwater intake. We then calculated τ as is classically done using the isotopic signals of evaporation. The result was high-resolution (∼10 m) maps of residence time, nitrate, and other parameters that showed strong spatial gradients corresponding to geomorphic attributes of the different channels in the area. The mean measured value of τ was 30.5 d, with a range of 0–50 d. We used the measured spatial gradients in both τ and nitrate to calculate whole-ecosystem uptake rates, and the values ranged from 0.006 to 0.039 d–1. The capability to measure residence time over single tidal cycles in estuaries will be useful for evaluating and further understanding drivers of phytoplankton abundance, resolving differences attributable to mixing and water sources, explicitly calculating biogeochemical rates, and exploring the complex linkages among time-dependent biogeochemical processes in hydrodynamically complex environments such as estuaries.

  7. Relationship between fiber degradation and residence time distribution in the processing of long fiber reinforced thermoplastics

    Directory of Open Access Journals (Sweden)

    2008-08-01

    Full Text Available Long fiber reinforced thermoplastics (LFT were processed by in-line compounding equipment with a modified single screw extruder. A pulse stimulus response technique using PET spheres as the tracer was adopted to obtain residence time distribution (RTD of extrusion compounding. RTD curves were fitted by the model based on the supposition that extrusion compounding was the combination of plug flow and mixed flow. Characteristic parameters of RTD model including P the fraction of plug flow reactor (PFR and d the fraction of dead volume of continuous stirred tank reactor (CSTR were used to associate with fiber degradation presented by fiber length and dispersion. The effects of screw speed, mixing length and channel depth on RTD curves, and characteristic parameters of RTD models as well as their effects on the fiber degradation were investigated. The influence of shear force with different screw speeds and variable channel depth on fiber degradation was studied and the main impetus of fiber degradation was also presented. The optimal process for obtaining the balance of fiber length and dispersion was presented.

  8. Subunit Stabilization and Polyethylene Glycolation of Cocaine Esterase Improves In Vivo Residence Time

    Energy Technology Data Exchange (ETDEWEB)

    Narasimhan, Diwahar; Collins, Gregory T.; Nance, Mark R.; Nichols, Joseph; Edwald, Elin; Chan, Jimmy; Ko, Mei-Chuan; Woods, James H.; Tesmer, John J.G.; Sunahara, Roger K. (Michigan)

    2012-03-15

    No small-molecule therapeutic is available to treat cocaine addiction, but enzyme-based therapy to accelerate cocaine hydrolysis in serum has gained momentum. Bacterial cocaine esterase (CocE) is the fastest known native enzyme that hydrolyzes cocaine. However, its lability at 37 C has limited its therapeutic potential. Cross-linking subunits through disulfide bridging is commonly used to stabilize multimeric enzymes. Herein we use structural methods to guide the introduction of two cysteine residues within dimer interface of CocE to facilitate intermolecular disulfide bond formation. The disulfide-crosslinked enzyme displays improved thermostability, particularly when combined with previously described mutations that enhance stability (T172R-G173Q). The newly modified enzyme yielded an extremely stable form of CocE (CCRQ-CocE) that retained greater than 90% of its activity after 41 days at 37 C, representing an improvement of more than 4700-fold over the wild-type enzyme. CCRQ-CocE could also be modified by polyethylene glycol (PEG) polymers, which improved its in vivo residence time from 24 to 72 h, as measured by a cocaine lethality assay, by self-administration in rodents, and by measurement of inhibition of cocaine-induced cardiovascular effects in rhesus monkeys. PEG-CCRQ elicited negligible immune response in rodents. Subunit stabilization and PEGylation has thus produced a potential protein therapeutic with markedly higher stability both in vitro and in vivo.

  9. Residence time of contaminants released in surface coal mines: A wind-tunnel study

    Energy Technology Data Exchange (ETDEWEB)

    Thompson, R.S.

    1993-08-01

    The 1990 Clean Air Act Amendments direct the U.S. Environmental Protection Agency to evaluate and modify, as required, existing dispersion models for the prediction of dispersion of dust from surface coal mines. The application of mathematical air pollution dispersion models to the dispersion of dust from surface coal mines requires knowledge of not only the amount of dust generated in the mine, but the fraction of that generated that actually escapes from the mine. The escape fraction can be related to the residence time that released material will remain, on average, within the mine. The concentration in the mine was found to follow an exponential decay function from which an exponential decay time constant (or residence time) was computed for each case. A semi-empirical formula was found that related the residence time to the mine geometry and wind direction quite well. This formula can be used to estimate escape fraction in determining the source strength for the application of mathematical dispersion models.

  10. Receptor residence time trumps drug-likeness and oral bioavailability in determining efficacy of complement C5a antagonists

    Science.gov (United States)

    Seow, Vernon; Lim, Junxian; Cotterell, Adam J.; Yau, Mei-Kwan; Xu, Weijun; Lohman, Rink-Jan; Kok, W. Mei; Stoermer, Martin J.; Sweet, Matthew J.; Reid, Robert C.; Suen, Jacky Y.; Fairlie, David P.

    2016-04-01

    Drug discovery and translation are normally based on optimizing efficacy by increasing receptor affinity, functional potency, drug-likeness (rule-of-five compliance) and oral bioavailability. Here we demonstrate that residence time of a compound on its receptor has an overriding influence on efficacy, exemplified for antagonists of inflammatory protein complement C5a that activates immune cells and promotes disease. Three equipotent antagonists (3D53, W54011, JJ47) of inflammatory responses to C5a (3nM) were compared for drug-likeness, receptor affinity and antagonist potency in human macrophages, and anti-inflammatory efficacy in rats. Only the least drug-like antagonist (3D53) maintained potency in cells against higher C5a concentrations and had a much longer duration of action (t1/2 ~ 20 h) than W54011 or JJ47 (t1/2 ~ 1-3 h) in inhibiting macrophage responses. The unusually long residence time of 3D53 on its receptor was mechanistically probed by molecular dynamics simulations, which revealed long-lasting interactions that trap the antagonist within the receptor. Despite negligible oral bioavailability, 3D53 was much more orally efficacious than W54011 or JJ47 in preventing repeated agonist insults to induce rat paw oedema over 24 h. Thus, residence time on a receptor can trump drug-likeness in determining efficacy, even oral efficacy, of pharmacological agents.

  11. Receptor residence time trumps drug-likeness and oral bioavailability in determining efficacy of complement C5a antagonists

    Science.gov (United States)

    Seow, Vernon; Lim, Junxian; Cotterell, Adam J.; Yau, Mei-Kwan; Xu, Weijun; Lohman, Rink-Jan; Kok, W. Mei; Stoermer, Martin J.; Sweet, Matthew J.; Reid, Robert C.; Suen, Jacky Y.; Fairlie, David P.

    2016-01-01

    Drug discovery and translation are normally based on optimizing efficacy by increasing receptor affinity, functional potency, drug-likeness (rule-of-five compliance) and oral bioavailability. Here we demonstrate that residence time of a compound on its receptor has an overriding influence on efficacy, exemplified for antagonists of inflammatory protein complement C5a that activates immune cells and promotes disease. Three equipotent antagonists (3D53, W54011, JJ47) of inflammatory responses to C5a (3nM) were compared for drug-likeness, receptor affinity and antagonist potency in human macrophages, and anti-inflammatory efficacy in rats. Only the least drug-like antagonist (3D53) maintained potency in cells against higher C5a concentrations and had a much longer duration of action (t1/2 ~ 20 h) than W54011 or JJ47 (t1/2 ~ 1–3 h) in inhibiting macrophage responses. The unusually long residence time of 3D53 on its receptor was mechanistically probed by molecular dynamics simulations, which revealed long-lasting interactions that trap the antagonist within the receptor. Despite negligible oral bioavailability, 3D53 was much more orally efficacious than W54011 or JJ47 in preventing repeated agonist insults to induce rat paw oedema over 24 h. Thus, residence time on a receptor can trump drug-likeness in determining efficacy, even oral efficacy, of pharmacological agents. PMID:27094554

  12. The use of 41Ar to investigate residence time distribution (RTD) in petrochemical industry

    International Nuclear Information System (INIS)

    Sirelkhatim, D. A.; Hassan, B. A.; ElTayeb, M. A. H.; Hills, A. E.

    2004-01-01

    Residence time measurements were carried out on a wax slurry bed reactor (SBR) and on a pilot FTDU reactor by means of radioisotope tracer technology using Ar-41 as tracer gas. Representative results were obtained as the behaviour of the gas in the SBR showed channeling downstream and in the FTDU, possible different mixing zones in the upper portion and the occurrence of air pockets was evident. ( Authors)

  13. Extra-regional residence time as a correlate of plant invasiveness: European archaeophytes in North America

    Czech Academy of Sciences Publication Activity Database

    La Sorte, F. A.; Pyšek, Petr

    2009-01-01

    Roč. 90, č. 9 (2009), s. 2589-2597 ISSN 0012-9658 R&D Projects: GA MŠk LC06073 Grant - others:Evropská komise(XE) GOCE-CT-2003-506675 Institutional research plan: CEZ:AV0Z60050516 Keywords : residence time * archaeophyte * North America Subject RIV: EF - Botanics Impact factor: 4.411, year: 2009

  14. New residence times of the Holocene reworked shells on the west coast of Bohai Bay, China

    Science.gov (United States)

    Shang, Zhiwen; Wang, Fu; Li, Jianfen; Marshall, William A.; Chen, Yongsheng; Jiang, Xingyu; Tian, Lizhu; Wang, Hong

    2016-01-01

    Shelly cheniers and shell-rich beds found intercalated in near-shore marine muds and sandy sediments can be used to indicate the location of ancient shorelines, and help to estimate the height of sea level. However, dating the deposition of material within cheniers and shell-rich beds is not straightforward because much of this material is transported and re-worked, creating an unknown temporal off-set, i.e., the residence time, between the death of a shell and its subsequent entombment. To quantify the residence time during the Holocene on a section of the northern Chinese coastline a total 47 shelly subsamples were taken from 17 discrete layers identified on the west coast of Bohai Bay. This material was AMS 14C dated and the calibrated ages were systematically compared. The subsamples were categorized by type as articulated and disarticulated bivalves, gastropod shells, and undifferentiated shell-hash. It was found that within most individual layers the calibrated ages of the subsamples got younger relative to the amount of apparent post-mortem re-working the material had been subject to. For examples, the 14C ages of the bivalve samples trended younger in this order: shell-hash → split shells → articulated shells. We propose that the younger subsample age determined within an individual layer will be the closest to the actual depositional age of the material dated. Using this approach at four Holocene sites we find residence times which range from 100 to 1260 cal yrs, with two average values of 600 cal yrs for the original 14C dates older than 1 ka cal BP and 100 cal yrs for the original 14C dates younger than 1 ka cal BP, respectively. Using this semi-empirical estimation of the shell residence times we have refined the existing chronology of the Holocene chenier ridges on the west coast of Bohai Bay.

  15. Residence Time Distribution (RTD) Prediction in Mixing Vessel via CFD Simulation Using Fluent: An Overview

    International Nuclear Information System (INIS)

    Mohd Rizal Mamat; Azraf Azman; Noraishah Othman

    2011-01-01

    A prototype mixing vessel has been developed by Industrial Technology Division and installed at a multiphase testing facility in MINT Tech Park. A task to investigate the mixing vessel performance using Computational Fluid Dynamics (CFD) has been undertaken using the available FLUENT software in Malaysian Nuclear Agency. This paper discusses the modeling and simulation done in obtaining the Residence Time Distribution (RTD) for the mixing vessel using FLUENT. (author)

  16. Creative solution for implementation of experiential, competency-based palliative care training for internal medicine residents.

    Science.gov (United States)

    Ross, Douglas D; Shpritz, Deborah W; Wolfsthal, Susan D; Zimrin, Ann B; Keay, Timothy J; Fang, Hong-Bin; Schuetz, Carl A; Stapleton, Laura M; Weissman, David E

    2011-09-01

    To graduate internal medicine residents with basic competency in palliative care, we employ a two-pronged strategy targeted at both residents and attending physicians as learners. The first prong provides a knowledge foundation using web-based learning programs designed specifically for residents and clinical faculty members. The second prong is assessment of resident competency in key palliative care domains by faculty members using direct observation during clinical rotations. The faculty training program contains Competency Assessment Tools addressing 19 topics distributed amongst four broad palliative care domains designed to assist faculty members in making the clinical competency assessments. Residents are required to complete their web-based training by the end of their internship year; they must demonstrate competency in one skill from each of the four broad palliative care domains prior to graduation. Resident and faculty evaluation of the training programs is favorable. Outcome-based measures are planned to evaluate long-term program effectiveness.

  17. Problem-based learning in laboratory medicine resident education: a satisfaction survey.

    Science.gov (United States)

    Lepiller, Quentin; Solis, Morgane; Velay, Aurélie; Gantner, Pierre; Sueur, Charlotte; Stoll-Keller, Françoise; Barth, Heidi; Fafi-Kremer, Samira

    2017-04-01

    Theoretical knowledge in biology and medicine plays a substantial role in laboratory medicine resident education. In this study, we assessed the contribution of problem-based learning (PBL) to improve the training of laboratory medicine residents during their internship in the department of virology, Strasbourg University Hospital, France. We compared the residents' satisfaction regarding an educational program based on PBL and a program based on lectures and presentations. PBL induced a high level of satisfaction (100%) among residents compared to lectures and presentations (53%). The main advantages of this technique were to create a situational interest regarding virological problems, to boost the residents' motivation and to help them identify the most relevant learning objectives in virology. However, it appears pertinent to educate the residents in appropriate bibliographic research techniques prior to PBL use and to monitor their learning by regular formative assessment sessions.

  18. Estimation of U.S. sewer residence time distributions for national-scale risk assessment of down-the-drain chemicals.

    Science.gov (United States)

    Kapo, Katherine E; Paschka, Michael; Vamshi, Raghu; Sebasky, Megan; McDonough, Kathleen

    2017-12-15

    Sewer residence time (the amount of time a given volume of wastewater resides in a sewer system prior to treatment) can have a significant influence on predictions of environmental fate and transport of wastewater constituents and corresponding risk assessment. In this study, a geographic information systems-based approach for estimating the distribution of sewer residence times for the U.S. was developed using road networks as a spatial proxy for sewer networks. The suitability of the approach was evaluated using case study municipalities, and the approach was subsequently extrapolated to 3422 wastewater treatment facilities of varying size across the U.S. to estimate a national distribution of sewer residence times. The estimated national median residence time for the U.S. was 3.3h. Facilities serving smaller municipalities (residence times to facilities serving larger municipalities, though the latter comprise a greater proportion of overall national wastewater volume. The results of this study provide an important data resource in combination with chemical in-sewer biodegradation data to enable probabilistic risk assessment of consumer product chemicals disposed of down the drain. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. A comparison of simulation-based education versus lecture-based instruction for toxicology training in emergency medicine residents.

    Science.gov (United States)

    Maddry, Joseph K; Varney, Shawn M; Sessions, Daniel; Heard, Kennon; Thaxton, Robert E; Ganem, Victoria J; Zarzabal, Lee A; Bebarta, Vikhyat S

    2014-12-01

    Simulation-based teaching (SIM) is a common method for medical education. SIM exposes residents to uncommon scenarios that require critical, timely actions. SIM may be a valuable training method for critically ill poisoned patients whose diagnosis and treatment depend on key clinical findings. Our objective was to compare medical simulation (SIM) to traditional lecture-based instruction (LEC) for training emergency medicine (EM) residents in the acute management of critically ill poisoned patients. EM residents completed two pre-intervention questionnaires: (1) a 24-item multiple-choice test of four toxicological emergencies and (2) a questionnaire using a five-point Likert scale to rate the residents' comfort level in diagnosing and treating patients with specific toxicological emergencies. After completing the pre-intervention questionnaires, residents were randomized to SIM or LEC instruction. Two toxicologists and three EM physicians presented four toxicology topics to both groups in four 20-min sessions. One group was in the simulation center, and the other in a lecture hall. Each group then repeated the multiple-choice test and questionnaire immediately after instruction and again at 3 months after training. Answers were not discussed. The primary outcome was comparison of immediate mean post-intervention test scores and final scores 3 months later between SIM and LEC groups. Test score outcomes between groups were compared at each time point (pre-test, post-instruction, 3-month follow-up) using Wilcoxon rank sum test. Data were summarized by descriptive statistics. Continuous variables were characterized by means (SD) and tested using t tests or Wilcoxon rank sum. Categorical variables were summarized by frequencies (%) and compared between training groups with chi-square or Fisher's exact test. Thirty-two EM residents completed pre- and post-intervention tests and comfort questionnaires on the study day. Both groups had higher post-intervention mean test

  20. Determination of the hydraulic residence time of two subsurface-flow constructed wetlands using radiotracers

    International Nuclear Information System (INIS)

    Debien, Bruno R.

    2013-01-01

    The adoption of constructed wetland systems (CW's) with subsuperficial drainage for sewage treatment is increasingly growing in places with low technological resources and available land. The efficient removal of pollutants depends on the internal flow characteristics in the CW and on its hydraulic residence time (HRT). In the present work 82 Br - a gamma radiation emitter, produced from soluble potassium bromide irradiated in the TRIGA reactor at the Centre for the Development of Nuclear Energy (CDTN) - was used as a pseudo-conservative tracer for the comparative study of aqueous phase flow dynamics in two CW's: one in which plants were grown (WP) whereas the other had no plants (WNP). Experimental hydraulic residence time values were found to be very close to the theoretical one, while dispersion numbers obtained for both CW's were quite small. Besides these measured hydrodynamic parameters, the residence time distribution (RTD) curves of the tracer test and the results of modeling of experimental data also demonstrate the tendency of the units to display a plug flow-like effluent hydraulic transport within their systems, as expected from their designs, considering the large length/width ratio (L/W=8). (author)

  1. Numerical modeling of general circulation, thermohaline structure, and residence time in Gorgan Bay, Iran

    Science.gov (United States)

    Ranjbar, Mohammad Hassan; Hadjizadeh Zaker, Nasser

    2018-01-01

    Gorgan Bay is a semi-enclosed basin located in the southeast of the Caspian Sea, Iran. The bay is recognized as a resting place for migratory birds as well as a spawning habitat for native fish. However, apparently, no detailed research on its physical processes has previously been conducted. In this study, a 3D coupled hydrodynamic and solute transport model was used to investigate general circulation, thermohaline structure, and residence time in Gorgan Bay. Model outputs were validated against a set of field observations. Bottom friction and attenuation coefficient of light intensity were tuned in order to achieve optimum agreement with the observations. Results revealed that, due to the interaction between bathymetry and prevailing winds, a barotropic double-gyre circulation, dominating the general circulation, existed during all seasons in Gorgan Bay. Furthermore, temperature and salinity fluctuations in the bay were seasonal, due to the seasonal variability of atmospheric fluxes. Results also indicated that under the prevailing winds, the domain-averaged residence time in Gorgan Bay would be approximately 95 days. The rivers discharging into Gorgan Bay are considered as the main sources of nutrients in the bay. Since their mouths are located in the area with a residence time of over 100 days, Gorgan Bay could be at risk of eutrophication; it is necessary to adopt preventive measures against water quality degradation.

  2. Residence time, native range size, and genome size predict naturalization among angiosperms introduced to Australia.

    Science.gov (United States)

    Schmidt, John P; Drake, John M; Stephens, Patrick

    2017-12-01

    Although critical to progress in understanding (i) if, and (ii) at what rate, introduced plants will naturalize and potentially become invasive, establishing causal links between traits and invasion success is complicated by data gaps, phylogenetic nonindependence of species, the inability to control for differences between species in residence time and propagule pressure, and covariance among traits. Here, we focus on statistical relationships between genomic factors, life history traits, native range size, and naturalization status of angiosperms introduced to Australia. In a series of analyses, we alternately investigate the role of phylogeny, incorporate introduction history, and use graphical models to explore the network of conditional probabilities linking traits and introduction history to naturalization status. Applying this ensemble of methods to the largest publicly available data set on plant introductions and their fates, we found that, overall, residence time and native range size best predicted probability of naturalization. Yet, importantly, probability of naturalization consistently increased as genome size decreased, even when the effects of shared ancestry and residence time in Australia were accounted for, and that this pattern was stronger in species without a history of cultivation, but present across annual-biennials, and herbaceous and woody perennials. Thus, despite introduction biases and indirect effects of traits via introduction history, across analyses, reduced genome size was nevertheless consistently associated with a tendency to naturalize.

  3. The relative importance of water temperature and residence time in predicting cyanobacteria abundance in regulated rivers.

    Science.gov (United States)

    Cha, YoonKyung; Cho, Kyung Hwa; Lee, Hyuk; Kang, Taegu; Kim, Joon Ha

    2017-11-01

    Despite a growing awareness of the problems associated with cyanobacterial blooms in rivers, and particularly in regulated rivers, the drivers of bloom formation and abundance in rivers are not well understood. We developed a Bayesian hierarchical model to assess the relative importance of predictors of summer cyanobacteria abundance, and to test whether the relative importance of each predictor varies by site, using monitoring data from 16 sites in the four major rivers of South Korea. The results suggested that temperature and residence time, but not nutrient levels, are important predictors of summer cyanobacteria abundance in rivers. Although the two predictors were of similar significance across the sites, the residence time was marginally better in accounting for the variation in cyanobacteria abundance. The model with spatial hierarchy demonstrated that temperature played a consistently significant role at all sites, and showed no effect from site-specific factors. In contrast, the importance of residence time varied significantly from site to site. This variation was shown to depend on the trophic state, indicated by the chlorophyll-a and total phosphorus levels. Our results also suggested that the magnitude of weir inflow is a key factor determining the cyanobacteria abundance under baseline conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Determination of the hydraulic residence time of two subsurface-flow constructed wetlands using radiotracers

    Energy Technology Data Exchange (ETDEWEB)

    Debien, Bruno R., E-mail: brunordebien@gmail.com [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Dept de Geografia. Lab. de Geomorfologia; Barreto, Alberto A.; Pinto, Amenonia M.F.; Moreira, Rubens M., E-mail: aab@cdtn.br, E-mail: amfp@cdtn.br, E-mail: rubens@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    The adoption of constructed wetland systems (CW's) with subsuperficial drainage for sewage treatment is increasingly growing in places with low technological resources and available land. The efficient removal of pollutants depends on the internal flow characteristics in the CW and on its hydraulic residence time (HRT). In the present work {sup 82}Br - a gamma radiation emitter, produced from soluble potassium bromide irradiated in the TRIGA reactor at the Centre for the Development of Nuclear Energy (CDTN) - was used as a pseudo-conservative tracer for the comparative study of aqueous phase flow dynamics in two CW's: one in which plants were grown (WP) whereas the other had no plants (WNP). Experimental hydraulic residence time values were found to be very close to the theoretical one, while dispersion numbers obtained for both CW's were quite small. Besides these measured hydrodynamic parameters, the residence time distribution (RTD) curves of the tracer test and the results of modeling of experimental data also demonstrate the tendency of the units to display a plug flow-like effluent hydraulic transport within their systems, as expected from their designs, considering the large length/width ratio (L/W=8). (author)

  5. Competency-based achievement system: using formative feedback to teach and assess family medicine residents' skills.

    Science.gov (United States)

    Ross, Shelley; Poth, Cheryl N; Donoff, Michel; Humphries, Paul; Steiner, Ivan; Schipper, Shirley; Janke, Fred; Nichols, Darren

    2011-09-01

    Family medicine residency programs require innovative means to assess residents' competence in "soft" skills (eg, patient-centred care, communication, and professionalism) and to identify residents who are having difficulty early enough in their residency to provide remedial training. To develop a method to assess residents' competence in various skills and to identify residents who are having difficulty. The Competency-Based Achievement System (CBAS) was designed to measure competence using 3 main principles: formative feedback, guided self-assessment, and regular face-to-face meetings. The CBAS is resident driven and provides a framework for meaningful interactions between residents and advisors. Residents use the CBAS to organize and review their feedback, to guide their own assessment of their progress, and to discern their future learning needs. Advisors use the CBAS to monitor, guide, and verify residents' knowledge of and competence in important skills. By focusing on specific skills and behaviour, the CBAS enables residents and advisors to make formative assessments and to communicate their findings. Feedback indicates that the CBAS is a user-friendly and helpful system to assess competence.

  6. The use of sleep aids among Emergency Medicine residents: a web based survey

    Directory of Open Access Journals (Sweden)

    Raja Ali

    2006-10-01

    Full Text Available Abstract Background Sleepiness is a significant problem among residents due to chronic sleep deprivation. Recent studies have highlighted medical errors due to resident sleep deprivation. We hypothesized residents routinely use pharmacologic sleep aids to manage their sleep deprivation and reduce sleepiness. Methods A web-based survey of US allopathic Emergency Medicine (EM residents was conducted during September 2004. All EM residency program directors were asked to invite their residents to participate. E-mail with reminders was used to solicit participation. Direct questions about use of alcohol and medications to facilitate sleep, and questions requesting details of sleep aids were included. Results Of 3,971 EM residents, 602 (16% replied to the survey. Respondents were 71% male, 78% white, and mean (SD age was 30 (4 years, which is similar to the entire EM resident population reported by the ACGME. There were 32% 1st year, 32% 2nd year, 28% 3rd year, and 8% 4th year residents. The Epworth Sleepiness Scale (ESS showed 38% of residents were excessively sleepy (ESS 11–16 and 7% were severely sleepy (ESS>16. 46% (95 CI 42%–50% regularly used alcohol, antihistamines, sleep adjuncts, benzodiazepines, or muscle relaxants to help them fall or stay asleep. Study limitations include low response and self-report. Conclusion Even with a low response rate, sleep aid use among EM residents may be common. How this affects performance, well-being, and health remains unknown.

  7. Estimating Estuarine Residence Times in the Westerschelde (the Netherlands) Using a Box Model with Fixed Dispersion Coefficients

    NARCIS (Netherlands)

    Soetaert, K.E.R.; Herman, P.M.J.

    1995-01-01

    The residence time of the water masses in the Westerschelde estuary was determined using a simple compartment-model that simulates the advective-diffusive transport of a conservative dissolved substance (chlorinity). The residence time of a water parcel in the upstream part of the estuary (i.e, the

  8. [Analysis on status and determinants of outpatient service utilization of rural floating population in Beijing at different residence time].

    Science.gov (United States)

    2017-06-18

    To study the status and identify the determinants of outpatient service utilization of rural floating population in Beijing who have different accumulated residence time. The survey data of rural floating population health and health care services in Beijing in 2014 were used, and the migrant population aged 18 years and above were taken as the research object. Whether to use outpatient service within two weeks was taken as dependent variable, gender, age, education level, self-assessment score of socioeconomic status, accumulated residence time in Beijing, health insurance, average household income, suffering from high blood pressure or diabetes as independent variables. Logistic regression model was used to analyze the influencing factors. The average age of the research object was 36.7 years, with mostly secondary education. The average accumulated residence time in Beijing was 8.4 years. The two-week prevalence rate was 10.3%, the two-week visiting rate calculated by person-time was 6.0%. The Logistic regression model suggested that, socioeconomic status, accumulated residence time and suffering from high blood pressure or diabetes were statistically significant determinants of outpatient service utilization. The research object is a younger and less educated population, their health status is better and outpatient service utilization is lower. It is found that people who have longer accumulated residence time in Beijing have lower outpatient service utilization. This is because people with longer residence time have lower age-adjusted two-week prevalence rate. This is also because people with longer residence time have larger proportion of taking continuous measures under doctor's advice. It does not mean people with longer residence time have lower utilization of medical service. The residence time variable plays the role of proxy variable. It can solve the problem of variables' endoge-neity. At the same time, it can reflect the influence to outpatient

  9. The Merits of a Two-Day Evidence-Based Medicine Course for Surgical Residents

    NARCIS (Netherlands)

    Ubbink, Dirk T.; Legemate, Dink A.; Koelemay, Mark J.

    2016-01-01

    Over 10 years ago, we introduced a two-day, evidence-based surgery course for surgical residents. During the last 4 years, we evaluated its effect on the participants' evidence-based medicine (EBM) knowledge and skills. Between 2012 and 2015, six courses were organised for residents of various

  10. Alongshore Variation in the Depth of Activation: Implications of Oil Residence Time

    Science.gov (United States)

    Flores, P.; Houser, C.

    2016-12-01

    In 2010 the Deepwater Horizon Oil Spill released approximately 5 million barrels of oil into the Gulf of Mexico just as the nearshore and beach profile were recovering from winter storms. As a consequence, oil mats and tar balls were trapped at depth within the beach and nearshore profile. Excavation of this buried oil during subsequent storms creates the potential for the contamination of adjacent beaches and the degradation of marine ecosystems, which can in turn negatively impact local economies that depend on fisheries and tourism. The potential for oil burial and persistence is dependent on four things: the physio-chemical nature of the oil as it reaches the nearshore environment, the pre-existing morphology of the beach and nearshore, and the evolution of that morphology after the oil is deposited. The depth at which the oil is buried is also dependent on the beach profile during the time of the spill. The purpose of this study is to characterize the alongshore variation in depth of activation on a Deepwater Horizon impacted section of Pensacola Beach, Florida with regards to the implications of oil residence time. Ground- Penetrating Radar (GPR) surveys were conducted along two parallel 1-km transects adjacent to the swash zone and the dune. Additional cross- shore transects were completed every 150 m from the base of the dune to the top of the swash zone. Sediments cores were taken at the crossing points of the alongshore and cross-shore transects, to calibrate the GPR surveys and complete an elemental analysis for the identification of storm layers. The cores were also analyzed for the presence of buried oil.

  11. Probabilistic approach of water residence time and connectivity using Markov chains with application to tidal embayments

    Science.gov (United States)

    Bacher, C.; Filgueira, R.; Guyondet, T.

    2016-01-01

    Markov chain analysis was recently proposed to assess the time scales and preferential pathways into biological or physical networks by computing residence time, first passage time, rates of transfer between nodes and number of passages in a node. We propose to adapt an algorithm already published for simple systems to physical systems described with a high resolution hydrodynamic model. The method is applied to bays and estuaries on the Eastern Coast of Canada for their interest in shellfish aquaculture. Current velocities have been computed by using a 2 dimensional grid of elements and circulation patterns were summarized by averaging Eulerian flows between adjacent elements. Flows and volumes allow computing probabilities of transition between elements and to assess the average time needed by virtual particles to move from one element to another, the rate of transfer between two elements, and the average residence time of each system. We also combined transfer rates and times to assess the main pathways of virtual particles released in farmed areas and the potential influence of farmed areas on other areas. We suggest that Markov chain is complementary to other sets of ecological indicators proposed to analyse the interactions between farmed areas - e.g., depletion index, carrying capacity assessment. Markov chain has several advantages with respect to the estimation of connectivity between pair of sites. It makes possible to estimate transfer rates and times at once in a very quick and efficient way, without the need to perform long term simulations of particle or tracer concentration.

  12. Objective classification of residents based on their psychomotor laparoscopic skills

    NARCIS (Netherlands)

    M.K. Chmarra (Magdalena); S. Klein (Stefan); J.C.F. van Winter (Joost); F-W. Jansen (Frank-Willem); J. Dankelman (Jenny)

    2010-01-01

    textabstractBackground From the clinical point of view, it is important to recognize residents' level of expertise with regard to basic psychomotor skills. For that reason, surgeons and surgical organizations (e.g., Acreditation Council for Graduate Medical Education, ACGME) are calling for

  13. Root microbiota dynamics of perennial Arabis alpina are dependent on soil residence time but independent of flowering time.

    Science.gov (United States)

    Dombrowski, Nina; Schlaeppi, Klaus; Agler, Matthew T; Hacquard, Stéphane; Kemen, Eric; Garrido-Oter, Ruben; Wunder, Jörg; Coupland, George; Schulze-Lefert, Paul

    2017-01-01

    Recent field and laboratory experiments with perennial Boechera stricta and annual Arabidopsis thaliana suggest that the root microbiota influences flowering time. Here we examined in long-term time-course experiments the bacterial root microbiota of the arctic-alpine perennial Arabis alpina in natural and controlled environments by 16S rRNA gene profiling. We identified soil type and residence time of plants in soil as major determinants explaining up to 15% of root microbiota variation, whereas environmental conditions and host genotype explain maximally 11% of variation. When grown in the same soil, the root microbiota composition of perennial A. alpina is largely similar to those of its annual relatives A. thaliana and Cardamine hirsuta. Non-flowering wild-type A. alpina and flowering pep1 mutant plants assemble an essentially indistinguishable root microbiota, thereby uncoupling flowering time from plant residence time-dependent microbiota changes. This reveals the robustness of the root microbiota against the onset and perpetual flowering of A. alpina. Together with previous studies, this implies a model in which parts of the root microbiota modulate flowering time, whereas, after microbiota acquisition during vegetative growth, the established root-associated bacterial assemblage is structurally robust to perturbations caused by flowering and drastic changes in plant stature.

  14. A case-based approach for teaching professionalism to residents with online discussions

    Directory of Open Access Journals (Sweden)

    MARK T. NADEAU

    2016-01-01

    Full Text Available Introduction: Programs must demonstrate that their residents are taught and assessed in professionalism. Most programs struggle with finding viable ways to teach and assess this critical competency. UTHSCSA Family and Community Medicine Residency developed an innovative option for interactive learning and assessment of residents in this competency which would be transferrable to other programs and specialties. Methods: The innovative approach uses an asynchronous online format on Blackboard. Threaded discussions on Blackboard require thoughtful reflective writing after case assessment and critical evaluation of other resident posts. Participation, content and progress of all resident postings are monitored by administrative staff and faculty. Faculty can further engage the residents at any point to deepen the discussion and learning. Results: 100% of all senior residents attained the required learning objectives. All were actively engaged in the assignments. Six cases have been developed using a Learning Matrix to demonstrate evaluation areas from the specialty specific competencies. Written feedback from residents verified the validity of case content in context of their current clinical practice. Postings by residents have provided value and insight for the faculty to access the professional development of our Family Medicine residents. The Clinical Competency Committee evaluates all third year residents using this information specific to the professionalism milestones. By using an asynchronous online approach to case discussion, all residents are involved with all aspects of this curriculum. Conclusions: More specific measurable learning outcomes are possible using this approach. Resident participation and engagement is easier to track and monitor than a lecture-based format and easier to capture valuable data than relying on evaluation feedback. Our Annual Review process will identify areas for improvement in the existing cases and help

  15. Method for Making Measurements of the Post-Combustion Residence Time in a Gas Turbine Engine

    Science.gov (United States)

    Miles, Jeffrey H. (Inventor)

    2017-01-01

    A method of measuring a residence time in a gas-turbine engine is disclosed that includes measuring a combustor pressure signal at a combustor entrance and a turbine exit pressure signal at a turbine exit. The method further includes computing a cross-spectrum function between the combustor pressure signal and the turbine exit pressure signal, calculating a slope of the cross-spectrum function, shifting the turbine exit pressure signal an amount corresponding to a time delay between the measurement of the combustor pressure signal and the turbine exit pressure signal, and recalculating the slope of the cross-spectrum function until the slope reaches zero.

  16. Teaching and Assessing Systems-based Competency in Ophthalmology Residency Training Programs

    NARCIS (Netherlands)

    Lee, Andrew G.; Beaver, Hilary A.; Greenlee, Emily; Oetting, Thomas A.; Boldt, H. Culver; Olson, Richard; Abramoff, Michael; Carter, Keith

    2007-01-01

    The Accreditation Council for Graduate Medical Education (ACGME) has mandated that residency programs, including ophthalmology, teach and assess specific competencies, including systems-based learning. We review the pertinent literature on systems-based learning for ophthalmology and recommend

  17. A toolkit for groundwater mean residence time interpretation with gaseous tracers

    Science.gov (United States)

    Dávila, Pablo Fernando; Külls, Christoph; Weiler, Markus

    2013-12-01

    An analytical Excel-based toolkit called Gas-Tracer-Interpretation (GTI) was developed for determining mean residence time (MRT) of groundwater samples and for validating conceptual model assumptions. This novel data interpretation toolkit improves data handling during analysis and resolves some problems in the interpretation of data from environmental tracers. The toolkit can assist error detection, uncertainty and ambiguity during data analysis, particularly ambiguity due to the decline in atmospheric data of CFC input functions (air-mixing ratios of tracers). The innovative interpretation methodologies are: (1) corrections of environmental tracer data are conducted in concentrations in water instead of air (atmosphere), allowing comparison of different tracer input functions under similar conditions and thereby replacing the use of unique global atmospheric data; (2) a multi-model, multi-tracer approach is adopted to improve the number of different combinations of environmental tracers and lumped-parameter models (piston flow (PM), exponential (EM), exponential-piston flow (EPM), advection-dispersion (DM) and gamma (GM)); and (3) generation of sufficient information for determination of erroneous, unclear and ambiguous outcomes. Results are linked to graphical analysis to improve data view. GTI supports the environmental tracers CFC-11, CFC-12, CFC-113, SF6, 3H, and also SF5CF3, which is included as it represents a promising environmental tracer in hydrological research. The toolkit compares modeled input functions of tracers and data from samples. The apparent recharge age and MRT are estimated by combining explicit graphical and numerical data presentation. Due to the multi-model approach, it is possible to contrast selected models and estimate the best fit for a given sample, which is particularly useful for validating conceptual model assumptions. The toolkit has been developed in Microsoft ®Excel, and hence is user-friendly such that advanced programming

  18. Automated data mining: an innovative and efficient web-based approach to maintaining resident case logs.

    Science.gov (United States)

    Bhattacharya, Pratik; Van Stavern, Renee; Madhavan, Ramesh

    2010-12-01

    Use of resident case logs has been considered by the Residency Review Committee for Neurology of the Accreditation Council for Graduate Medical Education (ACGME). This study explores the effectiveness of a data-mining program for creating resident logs and compares the results to a manual data-entry system. Other potential applications of data mining to enhancing resident education are also explored. Patient notes dictated by residents were extracted from the Hospital Information System and analyzed using an unstructured mining program. History, examination and ICD codes were obtained and compared to the existing manual log. The automated data History, examination, and ICD codes were gathered for a 30-day period and compared to manual case logs. The automated method extracted all resident dictations with the dates of encounter and transcription. The automated data-miner processed information from all 19 residents, while only 4 residents logged manually. The manual method identified only broad categories of diseases; the major categories were stroke or vascular disorder 53 (27.6%), epilepsy 28 (14.7%), and pain syndromes 26 (13.5%). In the automated method, epilepsy 114 (21.1%), cerebral atherosclerosis 114 (21.1%), and headache 105 (19.4%) were the most frequent primary diagnoses, and headache 89 (16.5%), seizures 94 (17.4%), and low back pain 47 (9%) were the most common chief complaints. More detailed patient information such as tobacco use 227 (42%), alcohol use 205 (38%), and drug use 38 (7%) were extracted by the data-mining method. Manual case logs are time-consuming, provide limited information, and may be unpopular with residents. Data mining is a time-effective tool that may aid in the assessment of resident experience or the ACGME core competencies or in resident clinical research. More study of this method in larger numbers of residency programs is needed.

  19. Mucoadhesive nano-sized supramolecular assemblies for improved pre-corneal drug residence time.

    Science.gov (United States)

    Fabiano, Angela; Chetoni, Patrizia; Zambito, Ylenia

    2015-01-01

    Mucoadhesive nanoparticles were compared with non-aggregated constituent polymers for effect on pre-corneal residence of dexamethasone phosphate (DP) or met-enkephalin (ME), administered by eye-drops to rabbits. Deepening the knowledge of ophthalmic nanoparticulate systems in terms of ability to prolong pre-corneal residence. Medicated nanoparticles resulted from gelation of quaternary ammonium-chitosan conjugate or its thiolated derivative with hyaluronan in the presence of drug. Particles were analyzed by light scattering. Dialysis removed non-encapsulated drug, dynamic dialysis measured drug-polymer interactions, and lyophilization-stabilized product. Dispersions were regenerated from lyophilized products. Also solutions of non-thiolated or thiolated chitosan derivative were administered. Mean drug residence time (MRT) in tears was determined by collecting samples from lower marginal tear strip of albino rabbits using capillaries. Nanoparticle size of regenerated dispersions was 400-430 nm (DP-systems), 360-370 nm (ME-systems); the drug content was 2.5 mg/mL (DP) or 0.3 mg/mL (ME). The MRT for DP nanoparticles from non-thiolated derivative was higher than that for non-aggregated polymer, due to stronger concurrent interactions of positively charged nanoparticles with ocular surface and drug. Thiolated polymer nanoparticles and non-aggregated parent polymer, both interacting weakly with DP, showed similar MRT values. The MRT of ME could only be enhanced by protecting drug from enzymatic hydrolysis. This was done by nanoparticle systems, whereas non-aggregated polymers were ineffective. Developing a nanoparticle system rather than a solution of mucoadhesive polymer, for prolonging pre-corneal residence, is convenient, provided nanoparticles interact strongly with both ocular surface and drug, or protect drug from metabolic degradation.

  20. Uniting Evidence-Based Evaluation with the ACGME Plastic Surgery Milestones: A Simple and Reliable Assessment of Resident Operative Performance.

    Science.gov (United States)

    Kobraei, Edward M; Bohnen, Jordan D; George, Brian C; Mullen, John T; Lillemoe, Keith D; Austen, William G; Liao, Eric C

    2016-08-01

    Milestones evaluations in plastic surgery reflect a shift toward competency-based training but have created a number of challenges. The authors have incorporated the smartphone application evaluation tool, System for Improving and Measuring Procedural Learning (SIMPL), that was recently developed by a multi-institutional research collaborative. In this pilot study, the authors hypothesize that SIMPL can improve resident evaluation and also collect granular performance data to simplify compliance with the plastic surgery Milestones. SIMPL was prospectively piloted with a plastic surgery resident and faculty surgeon at Massachusetts General Hospital in this institutional review board-approved study. The study period was a 2-month interval corresponding to the resident's rotation. The resident-faculty combination performed 20 cases together. All cases were evaluated with SIMPL. SIMPL evaluations uniformly took under 1 minute to submit. The average time to completed evaluation from surgery completion was 5 hours (plastic surgery resident participates. SIMPL's competency-based framework can be easily scaled to facilitate data collection and reporting of mandatory Milestones evaluations at the program and national levels. This technology will support a shared vocabulary between residents and faculty to enhance intraoperative education.

  1. Residence time and movements of postbreeding shorebirds on the northern coast of Alaska

    Science.gov (United States)

    Taylor, Audrey R.; Lanctot, Richard B.; Powell, Abby N.; Kendall, Steven J.; Nigro, Debora A.

    2011-01-01

    Relatively little is known about shorebird movements across the coast of northern Alaska, yet postbreeding shorebirds use this coastline extensively prior to fall migration. We deployed 346 radio transmitters on 153 breeding and 193 postbreeding shorebirds of five species from 2005 to 2007.We examined two hypotheses regarding postbreeding shorebirds' movements: (1) whether such movements reflect ultimate routes of southbound migration and (2) whether migration strategy (length of flights) or timing of molt in relation to migration (molt occurring in breeding or winter range) are more influential in determining postbreeding shorebirds' behavior. Semipalmated Sandpipers (Calidris pusilla) moved east, consistent with the direction of their ultimate migration, but patterns of other species' movements did not reflect ultimate migration direction. Timing of postnuptial molt appeared to have more influence over residence time and movements than did migration strategy. Postcapture residence time for the Semipalmated Sandpiper was less than for the Western Sandpiper (C. mauri) and significantly less than for Dunlin (C. alpina), and the Semipalmated Sandpiper's movements between were quicker and more frequent than those of the Dunlin. We expected to see the opposite patterns if migration strategy were more influential. Our data shed light on how different shorebird species use the northern Alaska coast after breeding: most species are likely to be stopping over at postbreeding areas, whereas the Dunlin and some Western Sandpipers may be staging. We suggest the coast of northern Alaska be viewed as an interconnected network of postbreeding sites that serve multiple populations of breeding shorebirds.

  2. Filling the Gap: Simulation-based Crisis Resource Management Training for Emergency Medicine Residents

    Directory of Open Access Journals (Sweden)

    Jessica R. Parsons

    2017-12-01

    Full Text Available Introduction In today’s team-oriented healthcare environment, high-quality patient care requires physicians to possess not only medical knowledge and technical skills but also crisis resource management (CRM skills. In emergency medicine (EM, the high acuity and dynamic environment makes CRM skills of physicians particularly critical to healthcare team success. The Accreditation Council of Graduate Medicine Education Core Competencies that guide residency program curriculums include CRM skills; however, EM residency programs are not given specific instructions as to how to teach these skills to their trainees. This article describes a simulation-based CRM course designed specifically for novice EM residents. Methods The CRM course includes an introductory didactic presentation followed by a series of simulation scenarios and structured debriefs. The course is designed to use observational learning within simulation education to decrease the time and resources required for implementation. To assess the effectiveness in improving team CRM skills, two independent raters use a validated CRM global rating scale to measure the CRM skills displayed by teams of EM interns in a pretest and posttest during the course. Results The CRM course improved leadership, problem solving, communication, situational awareness, teamwork, resource utilization and overall CRM skills displayed by teams of EM interns. While the improvement from pretest to posttest did not reach statistical significance for this pilot study, the large effect sizes suggest that statistical significance may be achieved with a larger sample size. Conclusion This course can feasibly be incorporated into existing EM residency curriculums to provide EM trainees with basic CRM skills required of successful emergency physicians. We believe integrating CRM training early into existing EM education encourages continued deliberate practice, discussion, and improvement of essential CRM skills.

  3. Filling the Gap: Simulation-based Crisis Resource Management Training for Emergency Medicine Residents

    Science.gov (United States)

    Parsons, Jessica R.; Crichlow, Amanda; Ponnuru, Srikala; Shewokis, Patricia A.; Goswami, Varsha; Griswold, Sharon

    2018-01-01

    Introduction In today’s team-oriented healthcare environment, high-quality patient care requires physicians to possess not only medical knowledge and technical skills but also crisis resource management (CRM) skills. In emergency medicine (EM), the high acuity and dynamic environment makes CRM skills of physicians particularly critical to healthcare team success. The Accreditation Council of Graduate Medicine Education Core Competencies that guide residency program curriculums include CRM skills; however, EM residency programs are not given specific instructions as to how to teach these skills to their trainees. This article describes a simulation-based CRM course designed specifically for novice EM residents. Methods The CRM course includes an introductory didactic presentation followed by a series of simulation scenarios and structured debriefs. The course is designed to use observational learning within simulation education to decrease the time and resources required for implementation. To assess the effectiveness in improving team CRM skills, two independent raters use a validated CRM global rating scale to measure the CRM skills displayed by teams of EM interns in a pretest and posttest during the course. Results The CRM course improved leadership, problem solving, communication, situational awareness, teamwork, resource utilization and overall CRM skills displayed by teams of EM interns. While the improvement from pretest to posttest did not reach statistical significance for this pilot study, the large effect sizes suggest that statistical significance may be achieved with a larger sample size. Conclusion This course can feasibly be incorporated into existing EM residency curriculums to provide EM trainees with basic CRM skills required of successful emergency physicians. We believe integrating CRM training early into existing EM education encourages continued deliberate practice, discussion, and improvement of essential CRM skills. PMID:29383082

  4. Filling the Gap: Simulation-based Crisis Resource Management Training for Emergency Medicine Residents.

    Science.gov (United States)

    Parsons, Jessica R; Crichlow, Amanda; Ponnuru, Srikala; Shewokis, Patricia A; Goswami, Varsha; Griswold, Sharon

    2018-01-01

    In today's team-oriented healthcare environment, high-quality patient care requires physicians to possess not only medical knowledge and technical skills but also crisis resource management (CRM) skills. In emergency medicine (EM), the high acuity and dynamic environment makes CRM skills of physicians particularly critical to healthcare team success. The Accreditation Council of Graduate Medicine Education Core Competencies that guide residency program curriculums include CRM skills; however, EM residency programs are not given specific instructions as to how to teach these skills to their trainees. This article describes a simulation-based CRM course designed specifically for novice EM residents. The CRM course includes an introductory didactic presentation followed by a series of simulation scenarios and structured debriefs. The course is designed to use observational learning within simulation education to decrease the time and resources required for implementation. To assess the effectiveness in improving team CRM skills, two independent raters use a validated CRM global rating scale to measure the CRM skills displayed by teams of EM interns in a pretest and posttest during the course. The CRM course improved leadership, problem solving, communication, situational awareness, teamwork, resource utilization and overall CRM skills displayed by teams of EM interns. While the improvement from pretest to posttest did not reach statistical significance for this pilot study, the large effect sizes suggest that statistical significance may be achieved with a larger sample size. This course can feasibly be incorporated into existing EM residency curriculums to provide EM trainees with basic CRM skills required of successful emergency physicians. We believe integrating CRM training early into existing EM education encourages continued deliberate practice, discussion, and improvement of essential CRM skills.

  5. Target Residence Time-Guided Optimization on TTK Kinase Results in Inhibitors with Potent Anti-Proliferative Activity.

    Science.gov (United States)

    Uitdehaag, Joost C M; de Man, Jos; Willemsen-Seegers, Nicole; Prinsen, Martine B W; Libouban, Marion A A; Sterrenburg, Jan Gerard; de Wit, Joeri J P; de Vetter, Judith R F; de Roos, Jeroen A D M; Buijsman, Rogier C; Zaman, Guido J R

    2017-07-07

    The protein kinase threonine tyrosine kinase (TTK; also known as Mps1) is a critical component of the spindle assembly checkpoint and a promising drug target for the treatment of aggressive cancers, such as triple negative breast cancer. While the first TTK inhibitors have entered clinical trials, little is known about how the inhibition of TTK with small-molecule compounds affects cellular activity. We studied the selective TTK inhibitor NTRC 0066-0, which was developed in our own laboratory, together with 11 TTK inhibitors developed by other companies, including Mps-BAY2b, BAY 1161909, BAY 1217389 (Bayer), TC-Mps1-12 (Shionogi), and MPI-0479605 (Myrexis). Parallel testing shows that the cellular activity of these TTK inhibitors correlates with their binding affinity to TTK and, more strongly, with target residence time. TTK inhibitors are therefore an example where target residence time determines activity in in vitro cellular assays. X-ray structures and thermal stability experiments reveal that the most potent compounds induce a shift of the glycine-rich loop as a result of binding to the catalytic lysine at position 553. This "lysine trap" disrupts the catalytic machinery. Based on these insights, we developed TTK inhibitors, based on a (5,6-dihydro)pyrimido[4,5-e]indolizine scaffold, with longer target residence times, which further exploit an allosteric pocket surrounding Lys553. Their binding mode is new for kinase inhibitors and can be classified as hybrid Type I/Type III. These inhibitors have very potent anti-proliferative activity that rivals classic cytotoxic therapy. Our findings will open up new avenues for more applications for TTK inhibitors in cancer treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Spatial distribution of triazine residues in a shallow alluvial aquifer linked to groundwater residence time.

    Science.gov (United States)

    Sassine, Lara; Le Gal La Salle, Corinne; Khaska, Mahmoud; Verdoux, Patrick; Meffre, Patrick; Benfodda, Zohra; Roig, Benoît

    2017-03-01

    At present, some triazine herbicides occurrence in European groundwater, 13 years after their use ban in the European Union, remains of great concern and raises the question of their persistence in groundwater systems due to several factors such as storage and remobilization from soil and unsaturated zone, limited or absence of degradation, sorption in saturated zones, or to continuing illegal applications. In order to address this problem and to determine triazine distribution in the saturated zone, their occurrence is investigated in the light of the aquifer hydrodynamic on the basis of a geochemical approach using groundwater dating tracers ( 3 H/ 3 He). In this study, atrazine, simazine, terbuthylazine, deethylatrazine, deisopropylatrazine, and deethylterbuthylazine are measured in 66 samples collected between 2011 and 2013 from 21 sampling points, on the Vistrenque shallow alluvial aquifer (southern France), covered by a major agricultural land use. The frequencies of quantification range from 100 to 56 % for simazine and atrazine, respectively (LQ = 1 ng L -1 ). Total triazine concentrations vary between 15 and 350 ng L -1 and show three different patterns with depth below the water table: (1) low concentrations independent of depth but related to water origin, (2) an increase in concentrations with depth in the aquifer related to groundwater residence time and triazine use prior to their ban, and (3) relatively high concentrations at low depths in the saturated zone more likely related to a slow desorption of these compounds from the soil and unsaturated zone. The triazine attenuation rate varies between 0.3 for waters influenced by surface water infiltration and 4.8 for water showing longer residence times in the aquifer, suggesting an increase in these rates with water residence time in the saturated zone. Increasing triazine concentrations with depth is consistent with a significant decrease in the use of these pesticides for the last 10 years on

  7. Finite elements-based 2D theoretical analysis of the effect of IEX membrane thickness and salt solution residence time on the ion transport within a salinity gradient power reverse electrodialysis half cell pair

    OpenAIRE

    Etienne, Brauns

    2013-01-01

    Reverse electrodialysis electrical power generation is based on the transport of salt ions through ion conductive membranes. The ion flux, equivalent to an electric current, results from a salinity gradient, induced by two salt solutions at significantly different concentrations. Such equivalent electric current in combination with the corresponding electrochemical potential difference across the membrane, equivalent to an electric potential, results in a battery equivalency. While having a c...

  8. The muddle of ages, turnover, transit, and residence times in the carbon cycle.

    Science.gov (United States)

    Sierra, Carlos A; Müller, Markus; Metzler, Holger; Manzoni, Stefano; Trumbore, Susan E

    2017-05-01

    Comparisons among ecosystem models or ecosystem dynamics along environmental gradients commonly rely on metrics that integrate different processes into a useful diagnostic. Terms such as age, turnover, residence, and transit times are often used for this purpose; however, these terms are variably defined in the literature and in many cases, calculations ignore assumptions implicit in their formulas. The aim of this opinion piece was i) to make evident these discrepancies and the incorrect use of formulas, ii) highlight recent results that simplify calculations and may help to avoid confusion, and iii) propose the adoption of simple and less ambiguous terms. © 2016 John Wiley & Sons Ltd.

  9. Stable isotope fractionation in response to variable fluid residence time distributions

    Science.gov (United States)

    Druhan, J. L.; Maher, K.

    2013-12-01

    Hydrogeochemical processes governing groundwater quantity and quality are often inferred from fluid samples that are the flux-weighted average of a heterogeneous system. This connection has been demonstrated for solutes subject to transport and equilibrium constraints, in which the steady state concentration - discharge relationship is cast in terms of the choice of expression for residence time distribution (Maher, 2011). Here, we examine the extent to which the spatial correlation of the permeability field, which governs the fluid residence time distribution, exerts a principle control on the partitioning of stable isotopes between reactant and product species during heterogeneous reactions in groundwater systems. We demonstrate this relationship using numerical simulations of δ53Cr fractionation due to abiotic CrO42- reduction by Fe2+, implemented in the reactive transport code CrunchFlow. The chemically homogeneous redox reaction generates Cr3+ with an isotope ratio distinct from the reactant pool, and in turn this product species precipitates as a mineral phase Cr(OH)3(s) through a non-fractionating reaction. The corresponding chromate δ53Cr enrichment across a homogeneous domain varies from a maximum value set by the kinetic fractionation factor (αk) at high mean fluid residence times, to a value reaction-limited to transport-limited regimes. For physically heterogeneous flow fields, the transition in isotopic fractionation from a reaction-limited to a transport-limited regime becomes variable, and falls between the upper and lower bounds set by the homogeneous simulations at slow and fast precipitation rates, respectively. Our results show that while minimal variation occurs in the steady-state isotopic profile of the reactant species (δ53Cr of CrO42-), the combined effects of the precipitation rate and the heterogeneous structure of the porous media lead to a wide range in the steady state isotopic composition of the product species (δ53Cr of Cr3

  10. “iBIM” — Internet-based interactive modules: an easy and interesting learning tool for general surgery residents

    Science.gov (United States)

    Azer, Nader; Shi, Xinzhe; de Gara, Chris; Karmali, Shahzeer; Birch, Daniel W.

    2014-01-01

    Background The increased use of information technology supports a resident-centred educational approach that promotes autonomy, flexibility and time management and helps residents to assess their competence, promoting self-awareness. We established a web-based e-learning tool to introduce general surgery residents to bariatric surgery and evaluate them to determine the most appropriate implementation strategy for Internet-based interactive modules (iBIM) in surgical teaching. Methods Usernames and passwords were assigned to general surgery residents at the University of Alberta. They were directed to the Obesity101 website and prompted to complete a multiple-choice precourse test. Afterwards, they were able to access the interactive modules. Residents could review the course material as often as they wanted before completing a multiple-choice postcourse test and exit survey. We used paired t tests to assess the difference between pre- and postcourse scores. Results Out of 34 residents who agreed to participate in the project, 12 completed the project (35.3%). For these 12 residents, the precourse mean score was 50 ± 17.3 and the postcourse mean score was 67 ± 14 (p = 0.020). Conclusion Most residents who participated in this study recommended using the iBIMs as a study tool for bariatric surgery. Course evaluation scores suggest this novel approach was successful in transferring knowledge to surgical trainees. Further development of this tool and assessment of implementation strategies will determine how iBIM in bariatric surgery may be integrated into the curriculum. PMID:24666457

  11. A simulation-based resident-as-teacher program: The impact on teachers and learners.

    Science.gov (United States)

    Miloslavsky, Eli M; Sargsyan, Zaven; Heath, Janae K; Kohn, Rachel; Alba, George A; Gordon, James A; Currier, Paul F

    2015-12-01

    Residency training is charged with improving resident teaching skills. Utilizing simulation in teacher training has unique advantages such as providing a controlled learning environment and opportunities for deliberate practice. We assessed the impact of a simulation-based resident-as-teacher (RaT) program. A RaT program was embedded in an existing 8-case simulation curriculum for 52 internal medicine (IM) interns. Residents participated in a workshop, then served as facilitators in the curriculum and received feedback from faculty. Residents' teaching and feed back skills were measured using a pre- and post-program self-assessment and post-session and post-curriculum evaluations by intern learners. Forty-one second- and third-year residents participated in the study August 2013 to October 2013 at a single center. Pre- and post-program teaching skills were assessed for 34 of 41 resident facilitators (83%) participating in 3.9 sessions on average. Partaking in the program led to improvements in resident facilitators' self-reported teaching and feedback skills across all domains. The most significant improvement was in teaching in a simulated environment (2.81 to 4.16, P model for the development of simulation curricula and RaT programs within IM residencies. © 2015 Society of Hospital Medicine.

  12. A multidisciplinary systems-based practice learning experience and its impact on surgical residency education.

    Science.gov (United States)

    Siri, Jean; Reed, Alan I; Flynn, Timothy C; Silver, Michele; Behrns, Kevin E

    2007-01-01

    To design and implement a multidisciplinary systems-based practice learning experience that is focused on improving and standardizing the preoperative quality of care for general surgical patients. Four parameters of preoperative care were designated as quality assessment variables, including bowel preparation, perioperative beta-blockade, prophylactic antibiotic use, and deep venous thrombosis prevention. Four groups of general surgery residents (PGY I-V), each led by 1 chief resident, were assigned a quality parameter, performed an evidence-based current literature review, and formulated a standardized management approach based on the level of evidence and recommendations available. Because preoperative preparation includes anesthetic care and operating room preparation, we presented our findings at the Department of Surgery Grand Rounds in a multidisciplinary format that included presentations by each resident group, the Department of Anesthesia, the Department of Medicine, and the Department of Nursing. The aim of the multidisciplinary quality assurance conference was to present the evidence-based literature findings in order to determine how standardization of preoperative care would alter anesthetic and nursing care, and to obtain feedback about management protocols. To determine the educational impact of this model of integrated systems-based practice quality assessment on the teaching experience, residents were queried regarding the value of this educational venue and responses were rated on a Likert scale. Resident participation was excellent. The residents garnered valuable information by performing a literature review and evaluating the best preoperative preparation given each parameter. Furthermore, integration of their findings into systems-based practice including anesthesia and nursing care provided an appreciation of the complexities of care as well as the associated need for appropriate medical knowledge, communication, and professionalism. The

  13. The Status of Social and Leisure Time Activities in the Elderly Residing In Iran and Sweden

    Directory of Open Access Journals (Sweden)

    Seyed Bagher Madah

    2008-07-01

    Full Text Available Objectives: Among social determinants of health, culture and ethnicity play a key role in defining the needs of different population groups. The aim of this study was to consider and compare the social and leisure time activities of the three elderly groups: Iranian residing in Iran, Iranian residing in Sweden and Swedish residing in Sweden. Methods & Materials: Via the cross-sectional design, 825 Iranian elderly who were living in Tehran compared with 305 Swedish elderly and 101 Iranian elderly living in Stockholm on social relations, group activities and leisure time activities. Only, elderly who could communicate properly entered the study. A structured questionnaire designed by the Iranian and Swedish Research Group on the" Assessment of Social Health Status and Needs" implemented for the subjects. Estimation method and logistic regression used to analyze the gathered data. Results: Subjects of all 3 groups were in the age range of 60-77 years old and mostly were married. Results showed despite very common characteristics, there are, also, many differences which can be explained by cultural and environmental factors. Rapid urbanization, limited resources and unawareness of or disregard for healthy life style resulted in lower levels of satisfaction with social and leisure life in the Iranian elderly. On the other hand, level of activities related to the spiritual dimension of health were more in Iranians than Swedish and the difference was significant (P=0.000, whereas the reverse was true for the group activities (P=0.000. Poor attitude toward physical activity and exercise in Iranian elderly, especially women, with consequent hazards for health, needs special consideration on behalf of the health planners and providers. Conclusion: Needs assessment with trance- cultural approach, especially on social determinants of the health of elderly is a necessity. Using valid and reliable instruments, designed to overcome the cultural barriers would

  14. Keeping up with the times: revising the dermatology residency curriculum in the era of molecular diagnostics and personalized medicine.

    Science.gov (United States)

    LaChance, Avery; Murphy, Michael J

    2014-11-01

    The clinical use of molecular diagnostics, genomics, and personalized medicine is increasing and improving rapidly over time. However, medical education incorporating the practical application of these techniques is lagging behind. Although instruction in these areas should be expanded upon and improved at all levels of training, residency provides a concentrated period of time in which to hone in on skills that are practically applicable to a trainee's specialty of choice. Although residencies in some fields, such as pathology, have begun to incorporate practical molecular diagnostics training, this area remains a relative gap in dermatology residency programs. Herein, we advocate for the incorporation of training in molecular diagnostics and personalized medicine into dermatology residency programs and propose a basic curriculum template for how to begin approaching these topics. By incorporating molecular diagnostics into dermatology residency training, dermatologists have the opportunity to lead the way and actively shape the specialty's transition into the era of personalized medicine. © 2014 The International Society of Dermatology.

  15. Macrotextured spoked surfaces reduce the residence time of a bouncing Leidenfrost drop

    Science.gov (United States)

    Patterson, Colin J.; Shiri, Samira; Bird, James C.

    2017-02-01

    Liquid drops can bounce when they impact non-wetting surfaces. Recently, studies have demonstrated that the time that the bouncing drop contacts a superhydrophobic surface can be reduced by incorporating ridged macrotextures on the surface. Yet the existing models aimed at explaining this phenomenon offer incompatible predictions of the contact time when a drop impacts multiple intersecting macrotextures, or spokes. Furthermore, it is unclear whether the effects of the macrotexture on the drop hydrodynamics extend to non-wetting surfaces in which direct contact is avoided by a thin vapor layer. Here we demonstrate that the phenomenon observed for macrotextured, superhydrophobic surfaces extends to macrotextured, wettable surfaces above the Leidenfrost temperature. We show that the number of droplets and overall residence time both depend on the number of intersecting spokes. Finally, we compare and contrast our results with mechanistic models to rationalize various elements of the phenomenon.

  16. Simulation for Teaching Orthopaedic Residents in a Competency-based Curriculum: Do the Benefits Justify the Increased Costs?

    Science.gov (United States)

    Nousiainen, Markku T; McQueen, Sydney A; Ferguson, Peter; Alman, Benjamin; Kraemer, William; Safir, Oleg; Reznick, Richard; Sonnadara, Ranil

    2016-04-01

    Although simulation-based training is becoming widespread in surgical education and research supports its use, one major limitation is cost. Until now, little has been published on the costs of simulation in residency training. At the University of Toronto, a novel competency-based curriculum in orthopaedic surgery has been implemented for training selected residents, which makes extensive use of simulation. Despite the benefits of this intensive approach to simulation, there is a need to consider its financial implications and demands on faculty time. This study presents a cost and faculty work-hours analysis of implementing simulation as a teaching and evaluation tool in the University of Toronto's novel competency-based curriculum program compared with the historic costs of using simulation in the residency training program. All invoices for simulation training were reviewed to determine the financial costs before and after implementation of the competency-based curriculum. Invoice items included costs for cadavers, artificial models, skills laboratory labor, associated materials, and standardized patients. Costs related to the surgical skills laboratory rental fees and orthopaedic implants were waived as a result of special arrangements with the skills laboratory and implant vendors. Although faculty time was not reimbursed, faculty hours dedicated to simulation were also evaluated. The academic year of 2008 to 2009 was chosen to represent an academic year that preceded the introduction of the competency-based curriculum. During this year, 12 residents used simulation for teaching. The academic year of 2010 to 2011 was chosen to represent an academic year when the competency-based curriculum training program was functioning parallel but separate from the regular stream of training. In this year, six residents used simulation for teaching and assessment. The academic year of 2012 to 2013 was chosen to represent an academic year when simulation was used equally

  17. Spatio-Temporal Characteristics of Resident Trip Based on Poi and OD Data of Float CAR in Beijing

    Science.gov (United States)

    Mou, N.; Li, J.; Zhang, L.; Liu, W.; Xu, Y.

    2017-09-01

    Due to the influence of the urban inherent regional functional distribution, the daily activities of the residents presented some spatio-temporal patterns (periodic patterns, gathering patterns, etc.). In order to further understand the spatial and temporal characteristics of urban residents, this paper research takes the taxi trajectory data of Beijing as a sample data and studies the spatio-temporal characteristics of the residents' activities on the weekdays. At first, according to the characteristics of the taxi trajectory data distributed along the road network, it takes the Voronoi generated by the road nodes as the research unit. This paper proposes a hybrid clustering method - based on grid density, which is used to cluster the OD (origin and destination) data of taxi at different times. Then combining with the POI data of Beijing, this research calculated the density of the POI data in the clustering results, and analyzed the relationship between the activities of residents in different periods and the functional types of the region. The final results showed that the residents were mainly commuting on weekdays. And it found that the distribution of travel density showed a concentric circle of the characteristics, focusing on residential areas and work areas. The results of cluster analysis and POI analysis showed that the residents' travel had experienced the process of "spatial relative dispersion - spatial aggregation - spatial relative dispersion" in one day.

  18. SPATIO-TEMPORAL CHARACTERISTICS OF RESIDENT TRIP BASED ON POI AND OD DATA OF FLOAT CAR IN BEIJING

    Directory of Open Access Journals (Sweden)

    N. Mou

    2017-09-01

    Full Text Available Due to the influence of the urban inherent regional functional distribution, the daily activities of the residents presented some spatio-temporal patterns (periodic patterns, gathering patterns, etc.. In order to further understand the spatial and temporal characteristics of urban residents, this paper research takes the taxi trajectory data of Beijing as a sample data and studies the spatio-temporal characteristics of the residents' activities on the weekdays. At first, according to the characteristics of the taxi trajectory data distributed along the road network, it takes the Voronoi generated by the road nodes as the research unit. This paper proposes a hybrid clustering method – based on grid density, which is used to cluster the OD (origin and destination data of taxi at different times. Then,combining with the POI data of Beijing, this research calculated the density of the POI data in the clustering results, and analyzed the relationship between the activities of residents in different periods and the functional types of the region. The final results showed that the residents were mainly commuting on weekdays. And it found that the distribution of travel density showed a concentric circle of the characteristics, focusing on residential areas and work areas. The results of cluster analysis and POI analysis showed that the residents' travel had experienced the process of "spatial relative dispersion – spatial aggregation – spatial relative dispersion" in one day.

  19. Impact of Resident Surgeons on Procedure Length based on Common Pediatric Otolaryngology Cases

    Science.gov (United States)

    Puram, Sidharth V.; Kozin, Elliott D.; Sethi, Rosh; Alkire, Blake; Lee, Daniel J.; Gray, Stacey T.; Shrime, Mark G.; Cohen, Michael

    2015-01-01

    Background Surgical education remains an important mission of academic medical centers. Financial pressures, however, may favor improved operating room (OR) efficiency at the expense of surgical education. We aim to characterize resident impact on the duration of procedural time using common pediatric otolaryngologic cases which do not necessitate a surgical assistant and assess whether other factors modify the extent to which residents impact OR efficiency. Study Design We retrospectively reviewed resident and attending surgeon total OR and procedural times for isolated tonsillectomy, adenoidectomy, tonsillectomy with adenoidectomy (T&A) and bilateral myringotomy with tube insertion between 2009 and 2013. We included cases supervised or performed by one of four teaching surgeons in children with ASA < 3. Regression analyses were used to identify predictors of procedural time. Results We identified a total of 3,922 procedures. Residents had significantly longer procedure times for all four procedures compared to an attending surgeon (range: 4.9 to 12.8 minutes, p<0.001). These differences were proportional to case complexity. When comparing mean procedural times, similar differences between the resident surgeon and attending surgeon cohorts were appreciated (p<0.0001). In T&A patients, older patient age, and attending surgeon identity were also significant predictors of increased mean procedural time (p<0.05). Conclusions Resident participation contributes to increased procedure time for common otolaryngology procedures. While residents may increase operative times, addressing other system-wide issues may decrease impact of time needed for education and added efficiencies of resident participation may exist throughout the perioperative period. Our model is applicable to surgical education across specialties. Level of Evidence 4 PMID:25251257

  20. Evaluation of a web-based portal to improve resident education by neonatology fellows.

    Science.gov (United States)

    Lakshmanan, Ashwini; Leeman, Kristen T; Brodsky, Dara; Parad, Richard

    2014-01-01

    Integration of web-based educational tools into medical training has been shown to increase accessibility of resources and optimize teaching. We developed a web-based educational portal (WBEP) to support teaching of pediatric residents about newborn medicine by neonatology fellows. 1) To compare residents' attitudes about their fellow-led education in the NICU pre- and post-WBEP; including assessment of factors that impact their education and usefulness of teaching tools. 2) To compare fellow utilization of various teaching modalities pre- and post-WBEP. We queried residents about their attitudes regarding fellow-led education efforts and various teaching modalities in the NICU and logistics potentially impacting effectiveness. Based on these data, we introduced the WBEP - a repository of teaching tools (e.g., mock code cases, board review questions, journal articles, case-based discussion scenarios) for use by fellows to supplement didactic sessions in a faculty-based curriculum. We surveyed residents about the effectiveness of fellow teaching pre- and post-WBEP implementation and the type of fellow-led teaching modalities that were used. After analysis of survey responses, we identified that residents cited fellow level of interest as the most important factor impacting their education. Post-implementation, residents described greater utilization of various teaching modalities by fellows, including an increase in use of mock codes (14% to 76%, pteaching modalities by fellows and may encourage fellow involvement in resident teaching.

  1. Simulation improves resident performance in catheter-based intervention: results of a randomized, controlled study.

    Science.gov (United States)

    Chaer, Rabih A; Derubertis, Brian G; Lin, Stephanie C; Bush, Harry L; Karwowski, John K; Birk, Daniel; Morrissey, Nicholas J; Faries, Peter L; McKinsey, James F; Kent, K Craig

    2006-09-01

    Surgical simulation has been shown to enhance the training of general surgery residents. Since catheter-based techniques have become an important part of the vascular surgeon's armamentarium, we explored whether simulation might impact the acquisition of catheter skills by surgical residents. Twenty general surgery residents received didactic training in the techniques of catheter intervention. Residents were then randomized with 10 receiving additional training with the Procedicus, computer-based, haptic simulator. All 20 residents then participated in 2 consecutive mentored catheter-based interventions for lower extremity occlusive disease in an OR/angiography suite. Resident performance was graded by attending surgeons blinded to the resident's training status, using 18 procedural steps as well as a global rating scale. There were no differences between the 2 resident groups with regard to demographics or scores on a visuospatial test administered at study outset. Overall, residents exposed to simulation scored higher than controls during the first angio/OR intervention: procedural steps (simulation/control) (50 +/- 6 vs. 33 +/- 9, P = 0.0015); global rating scale (30 +/- 7 vs. 19 +/- 5, P = 0.0052). The advantage provided by simulator training persisted with the second intervention (53 +/- 6 vs. 36 +/- 7, P = 0.0006); global rating scale (33 +/- 6 vs. 21 +/- 6, P = 0.0015). Moreover, simulation training, particularly for the second intervention, led to enhancement in almost all of the individual measures of performance. Simulation is a valid tool for instructing surgical residents and fellows in basic endovascular techniques and should be incorporated into surgical training programs. Moreover, simulators may also benefit the large number of vascular surgeons who seek retraining in catheter-based intervention.

  2. An instrument to characterize the environment for residents' evidence-based medicine learning and practice.

    Science.gov (United States)

    Mi, Misa; Moseley, James L; Green, Michael L

    2012-02-01

    Many residency programs offer training in evidence-based medicine (EBM). However, these curricula often fail to achieve optimal learning outcomes, perhaps because they neglect various contextual factors in the learning environment. We developed and validated an instrument to characterize the environment for EBM learning and practice in residency programs. An EBM Environment Scale was developed following scale development principles. A survey was administered to residents across six programs in primary care specialties at four medical centers. Internal consistency reliability was analyzed with Cronbach's coefficient alpha. Validity was assessed by comparing predetermined subscales with the survey's internal structure as assessed via factor analysis. Scores were also compared for subgroups based on residency program affiliation and residency characteristics. Out of 262 eligible residents, 124 completed the survey (response rate 47%). The overall mean score was 3.89 (standard deviation=0.56). The initial reliability analysis of the 48-item scale had a high reliability coefficient (Cronbach α=.94). Factor analysis and further item analysis resulted in a shorter 36-item scale with a satisfactory reliability coefficient (Cronbach α=.86). Scores were higher for residents with prior EBM training in medical school (4.14 versus 3.62) and in residency (4.25 versus 3.69). If further testing confirms its properties, the EBM Environment Scale may be used to understand the influence of the learning environment on the effectiveness of EBM training. Additionally, it may detect changes in the EBM learning environment in response to programmatic or institutional interventions.

  3. Determination of the hydraulic residence time of trickling filters using radiotracer experiments

    International Nuclear Information System (INIS)

    Debien, Bruno R.; Ferreira, Ladislau M.; Barreto, Alberto A.; Pinto, Amenonia M.F.

    2013-01-01

    Trickling filters (TF) are bioreactors fulfilled with inert materials working as support for biofilm development, and have been used in a large scale in wastewater treatment for organic matter, ammonia nitrogen and nitrate removal. TF's can be widely used in Brazil, especially because of its simplicity and operational low cost. The efficiency of pollutants removal processes depends on the water flow dynamics inside the reactor. For this reason, in the present work the mean residence time of two TF's containing different support materials were determined by means of tracer testes. The radioisotope 82Br - a gamma radiation emitter, produced from soluble potassium bromide irradiated in the TRIGA reactor at the Centre for the Development of Nuclear Energy (CDTN) - was used as a pseudo-conservative tracer for the comparative study of aqueous phase flow dynamics in both TF's. Mean residence time for the first TF (containing a single support material) was 0,3 hours, much smaller than the value obtained for the second TF (containing two alternated support materials), around 2 hours. These results were already expected, once the alternated material is denser than the single one, and are very important for numerical modeling studies aiming to determine the kinetic constant for removal of the pollutants cited above. (author)

  4. Determination of flow patterns in industrial gold leaching tank by radiotracer residence time distribution measurement

    International Nuclear Information System (INIS)

    Stegowski, Z.; Furman, L.; Dagadu, Ch.P.K.; Akaho, E.H.K.; Danso, K.A.; Mumuni, I.I.; Adu, P.S; Amoah, Ch.

    2010-01-01

    The carbon-in-leach (CIL) process is one the most efficient methods of gold recovery from gold bearing ores. The efficiency of the leaching process greatly depends on the flow structure created by mechanical agitation (in some cases air agitation) in the leaching tanks. Residence time distribution (RTD) measurement was conducted in the CIL section of a gold processing plant in order to determine the flow structure in the first tank using the 131 I radioactive tracer. The shape of the experimental data revealed that the flow behaviour in the tank was close to an ideal mixer. Modelling of the experimental data, however, revealed that the tank was not behaving as a single perfect mixer, but consisted of two mixing zones. The flow structure in the tank was best described by the '' perfect mixers with exchange '' model consisting of two mixing zones. The model allowed the determination of flow parameters including the mean residence time, flow rate and volumes of the mixing zones. (authors)

  5. Tritium activity concentrations and residence times of groundwater collected in Rokkasho, Japan.

    Science.gov (United States)

    Hasegawa, Hidenao; Ueda, Shinji; Akata, Naofumi; Kakiuchi, Hideki; Hisamatsu, Shun'ichi

    2015-11-01

    Tritium ((3)H) concentrations were measured in groundwater samples from four surface wells (4-10 m deep), four shallow wells (24-26.5 m deep) and a 150-m-deep well in the Futamata River catchment area, which is adjacent to the large-scale commercial spent nuclear fuel reprocessing plant in Rokkasho, Japan. The (3)H concentrations in most of the surface- and shallow-well samples (<0.03-0.57 Bq l(-1)) were similar to those in precipitation (annual mean: 0.31-0.79 Bq l(-1)), suggesting that the residence time of the water in those wells was 0-15 y. The (3)H concentrations in the samples from a 26-m-deep well and the 150-m-deep well were lower than those in the other wells, indicating that groundwater with a long residence time exists in deep aquifers and the estuary area of the catchment. It is not clear whether (3)H released during test operation of the plant with actual spent nuclear fuel affected the (3)H concentrations observed in this study. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Determination of the hydraulic residence time of trickling filters using radiotracer experiments

    Energy Technology Data Exchange (ETDEWEB)

    Debien, Bruno R.; Ferreira, Ladislau M.; Barreto, Alberto A.; Pinto, Amenonia M.F., E-mail: brunordebien@gmail.com [Universidade Federal de Minas Gerais (UFMG), Minas Gerais, MG (Brazil). Dept. de Geografia. Lab. de Geomorfologia; Moreira, Rubens M., E-mail: aab@cdtn.br, E-mail: amfp@cdtn.br, E-mail: rubens@cdtn.br [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2013-07-01

    Trickling filters (TF) are bioreactors fulfilled with inert materials working as support for biofilm development, and have been used in a large scale in wastewater treatment for organic matter, ammonia nitrogen and nitrate removal. TF's can be widely used in Brazil, especially because of its simplicity and operational low cost. The efficiency of pollutants removal processes depends on the water flow dynamics inside the reactor. For this reason, in the present work the mean residence time of two TF's containing different support materials were determined by means of tracer testes. The radioisotope 82Br - a gamma radiation emitter, produced from soluble potassium bromide irradiated in the TRIGA reactor at the Centre for the Development of Nuclear Energy (CDTN) - was used as a pseudo-conservative tracer for the comparative study of aqueous phase flow dynamics in both TF's. Mean residence time for the first TF (containing a single support material) was 0,3 hours, much smaller than the value obtained for the second TF (containing two alternated support materials), around 2 hours. These results were already expected, once the alternated material is denser than the single one, and are very important for numerical modeling studies aiming to determine the kinetic constant for removal of the pollutants cited above. (author)

  7. Chemotaxis Increases the Residence Time Distribution of Bacteria in Granular Media Containing Distributed Contaminant Sources

    Science.gov (United States)

    Adadevoh, J.; Triolo, S.; Ramsburg, C. A.; Ford, R.

    2015-12-01

    The use of chemotactic bacteria in bioremediation has the potential to increase access to, and biotransformation of, contaminant mass within the subsurface environment. This laboratory-scale study aimed to understand and quantify the influence of chemotaxis on residence times of pollutant-degrading bacteria within homogeneous treatment zones. Focus was placed on a continuous flow sand-packed column system in which a uniform distribution of naphthalene crystals created distributed sources of dissolved phase contaminant. A 10 mL pulse of Pseudomonas putida G7, which is chemotactic to naphthalene, and Pseudomonas putida G7 Y1, a non-chemotactic mutant strain, were simultaneously introduced into the sand-packed column at equal concentrations. Breakthrough curves obtained for the bacteria from column experiments conducted with and without naphthalene were used to quantify the effect of chemotaxis on transport parameters. In the presence of the chemoattractant, longitudinal dispersivity of PpG7 increased by a factor of 3 and percent recovery decreased from 21% to 12%. The results imply that pore-scale chemotaxis responses are evident at an interstitial fluid velocity of 1.7 m/d, which is within the range of typical groundwater flow. Within the context of bioremediation, chemotaxis may work to enhance bacterial residence times in zones of contamination thereby improving treatment.

  8. Catchment virtual observatory for sharing flow and transport models outputs: using residence time distribution to compare contrasting catchments

    Science.gov (United States)

    Thomas, Zahra; Rousseau-Gueutin, Pauline; Kolbe, Tamara; Abbott, Ben; Marcais, Jean; Peiffer, Stefan; Frei, Sven; Bishop, Kevin; Le Henaff, Geneviève; Squividant, Hervé; Pichelin, Pascal; Pinay, Gilles; de Dreuzy, Jean-Raynald

    2017-04-01

    The distribution of groundwater residence time in a catchment provides synoptic information about catchment functioning (e.g. nutrient retention and removal, hydrograph flashiness). In contrast with interpreted model results, which are often not directly comparable between studies, residence time distribution is a general output that could be used to compare catchment behaviors and test hypotheses about landscape controls on catchment functioning. In this goal, we created a virtual observatory platform called Catchment Virtual Observatory for Sharing Flow and Transport Model Outputs (COnSOrT). The main goal of COnSOrT is to collect outputs from calibrated groundwater models from a wide range of environments. By comparing a wide variety of catchments from different climatic, topographic and hydrogeological contexts, we expect to enhance understanding of catchment connectivity, resilience to anthropogenic disturbance, and overall functioning. The web-based observatory will also provide software tools to analyze model outputs. The observatory will enable modelers to test their models in a wide range of catchment environments to evaluate the generality of their findings and robustness of their post-processing methods. Researchers with calibrated numerical models can benefit from observatory by using the post-processing methods to implement a new approach to analyzing their data. Field scientists interested in contributing data could invite modelers associated with the observatory to test their models against observed catchment behavior. COnSOrT will allow meta-analyses with community contributions to generate new understanding and identify promising pathways forward to moving beyond single catchment ecohydrology. Keywords: Residence time distribution, Models outputs, Catchment hydrology, Inter-catchment comparison

  9. The Removal of Aquacultural Wastes by Foams Separator from Sea Water II. The Effect of Hydraulic Residence Time

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kuen Hack; Kim, Byong Jin; Kim, Yong Ha; Yi, Gyeongbeom; Lim, Jung Heok [Department of Chemical Engineering, Pukyong National University, Pusan (Korea); Kim, Sung Koo [Department of Biotechnology and Bioengineering, Pukyong National University, Pusan (Korea)

    2001-04-01

    Experimental investigations on the effect of the hydraulic residence time(HRT) for the removal of aquacultural waste, such as protein, total suspended solids(TSS), chemical oxygen demand(COD), turbidity and total ammonia nitrogen(TAN) from sea water were carried out by using foam separator. The foam separator as an aerator was also evaluated for increasing dissolved oxygen concentration. The increase in hydraulic residence time increased the removal efficiencies of aquacultural waste. Optimum hydraulic residence time was 0.48 min and the highest protein removal rate was 10.25 g/m{sup 3} min. The changes of removal rates and efficiencies of TSS, COD and turbidity were similar to proteins. The hydraulic residence time for highest overall oxygen mass transfer coefficient was the optimum condition for the highest protein removal rate. 23 refs., 15 figs., 1 tab.

  10. The significance of oxygen as oxides and hydroxides in controlling the abundance and residence times of elements in seawater

    Digital Repository Service at National Institute of Oceanography (India)

    DileepKumar, M.

    A model is presented which signifies the role of oxygen (as oxides and hydroxides) in controlling the composition of seawater. respective concentration and residence times for the unknown elements can be estimated. Geometric and statistical indices...

  11. Prevalence and Cost of Full-Time Research Fellowships During General Surgery Residency – A National Survey

    Science.gov (United States)

    Robertson, Charles M.; Klingensmith, Mary E.; Coopersmith, Craig M.

    2009-01-01

    Structured Abstract Objective To quantify the prevalence, outcomes, and cost of surgical resident research. Summary Background Data General surgery is unique among graduate medical education programs because a large percentage of residents interrupt their clinical training to spend 1-3 years performing full-time research. No comprehensive data exists on the scope of this practice. Methods Survey sent to all 239 program directors of general surgery residencies participating in the National Resident Matching Program. Results Response rate was 200/239 (84%). A total of 381 out of 1052 trainees (36%) interrupt residency to pursue full-time research. The mean research fellowship length is 1.7 years, with 72% of trainees performing basic science research. A significant association was found between fellowship length and post-residency activity, with a 14.7% increase in clinical fellowship training and a 15.2% decrease in private practice positions for each year of full-time research (p<0.0001). Program directors at 31% of programs reported increased clinical duties for research fellows as a result of ACGME work hour regulations for clinical residents, while a further 10% of programs are currently considering such changes. It costs $41.5 million to pay the 634 trainees who perform research fellowships each year, the majority of which is paid for by departmental funds (40%) and institutional training grants (24%). Conclusions Interrupting residency to perform a research fellowship is a common and costly practice among general surgery residents. While performing a research fellowship is associated with clinical fellowship training after residency, it is unclear to what extent this practice leads to the development of surgical investigators after post-graduate training. PMID:19106692

  12. The effect of residence time on the dynamics of a condensating aerosol in a Hiemenz-type stagnation flow

    Science.gov (United States)

    Alshaarawi, Amjad; Zhou, Kun; Scribano, Gianfranco; Attili, Antonio; Bisetti, Fabrizio; Clean Combustion Research Center Team

    2013-11-01

    The effect of residence time on the formation and growth of a condensating aerosol is simulated in a Hiemenz-type stagnation flow setup, for which a unique and well-defined time scale characterizes the velocity field. In this configuration, a hot stream saturated with dibutyle phthalate (DBP) vapor mixes with a cold dry stream. A mixing layer forms at the stagnation plane triggering supersaturation and droplets are generated by homogeneous nucleation. Aerosol dynamics are simulated using the Quadrature Method of Moments (QMOM). Two regimes related to the flow residence time are observed, i.e., a nucleation regime and a condensation regime. The nucleation regime, at short residence times, is characterized by the consumption of DBP vapor into droplets having a negligible effect on the vapor phase. In this regime, both the number density and volume fraction of droplets increase with residence time. In the condensation regime, at long residence times, vapor condensation consumes the vapor phase considerably. For longer residence times, more vapor is consumed, resulting in lower number densities due to the lower nucleation rates, whereas the volume fraction saturates.

  13. Stress and burnout in residents: impact of mindfulness-based resilience training

    Directory of Open Access Journals (Sweden)

    Goldhagen BE

    2015-08-01

    Full Text Available Brian E Goldhagen,1 Karen Kingsolver,2 Sandra S Stinnett,1 Jullia A Rosdahl1 1Department of Ophthalmology, 2Department of Family and Community Medicine, Duke University Medical Center, Durham, NC, USABackground and objective: Stress and burnout impact resident physicians. This prospective study tests the hypothesis that a mindfulness-based resilience intervention would decrease stress and burnout in residents.Methods: Resident physicians from the Departments of Family Medicine, Psychiatry, and Anesthesia at Duke University, Durham, NC, USA, participated in two or three 1-hour sessions of mindfulness-based resilience activities, which introduced mindful-awareness and included practical exercises for nurturing resilience. Anonymous surveys were distributed before (completed by 47 residents and after the intervention (both completed by 30 residents; a follow-up survey was distributed 1 month later (seven residents completed all three surveys. The survey included the Depression Anxiety Stress Scale, 21-question version (DASS-21, the Oldenburg Burnout Inventory, the Mindful Attention Awareness Scale, and ten questions from the Cognitive Failures Questionnaire.Results: At baseline, most residents’ scores were in the normal range with respect to stress; however, female residents had higher DASS-21 scores than male residents (31.7, females vs 18.4, males; P=0.002. Most residents’ burnout scores were in the abnormal range, both with respect to exhaustion (38/47 residents, subscore ≥2.25 and disengagement (37/47 residents, subscore ≥2.1. Higher perceived levels of stress correlated with the instruments. Analysis of the surveys before and after the intervention showed no significant short-term change in stress, burnout, mindful-awareness, or cognitive failure. There was a trend for females and post-medical school graduate year 1 and 2 (PGY1 and PGY2 residents to have a reduction in DASS-21 scores after intervention. There was also a trend of

  14. Training in Buprenorphine and Office-Based Opioid Treatment: A Survey of Psychiatry Residency Training Programs.

    Science.gov (United States)

    Suzuki, Joji; Ellison, Tatyana V; Connery, Hilary S; Surber, Charles; Renner, John A

    2016-06-01

    Psychiatrists are well suited to provide office-based opioid treatment (OBOT), but the extent to which psychiatry residents are exposed to buprenorphine training and OBOT during residency remains unknown. Psychiatry residency programs in the USA were recruited to complete a survey. Forty-one programs were included in the analysis for a response rate of 23.7 %. In total, 75.6 % of the programs currently offered buprenorphine waiver training and 78.1 % provided opportunities to treat opioid dependence with buprenorphine under supervision. Programs generally not only reported favorable beliefs about OBOT and buprenorphine waiver training but also reported numerous barriers. The majority of psychiatry residency training programs responding to this survey offer buprenorphine waiver training and opportunities to treat opioid-dependent patients, but numerous barriers continue to be cited. More research is needed to understand the role residency training plays in impacting future practice of psychiatrists.

  15. Impact of Temperature and Hydrological Residence Time on the Fate and Transport of Iron and Organic Carbon in Subalpine Wetlands

    Science.gov (United States)

    Schneider, L. M.; Borch, T.; Rhoades, C.; Pallud, C. E.

    2015-12-01

    Wetlands contain one third of the planet's soil carbon (C) and are characterized by markedly different chemical and physical environments than terrestrial ecosystems. The hydrologic residence time and temperature in wetlands influences their redox conditions and thus biogeochemical reaction rates. In these environments, transformation and movement of C and iron (Fe) are closely linked due to the sorption of organic C by solid Fe(III)-phases. Therefore, changes in Fe biogeochemical cycling will influence the size and turnover rate of soil C pools, which could negatively impact water quality and C storage. We examined the effects of hydrologic residence time and temperature on reduction of autochtonous Fe(III)-oxides. Fe(II)-export rates, used as a lower bound for bulk Fe(III)-reduction rates, and dissolved organic carbon (DOC) export rates were measured on intact mineral soil cores using flow-through reactor experiments exposed to temperatures based on mean annual conditions (6°, 12°, and 18°C). Soils were from a slope and a depressional subalpine wetland (USDA Fraser Experimental Forest, CO, USA), characterized by different hydrologic residence times, were compared. In the depressional wetland we observed the shallower soil depths have higher overall Fe(II)-export rates than the deeper soil depths. As temperature increases, Fe(II)-export rate increases, with a more than doubling in magnitude from 12 to 18° C. In comparing sites that are continuously inundated to those that are seasonally inundated, surprisingly we see higher Fe(II)-export rates in the seasonally inundated sites for all temperatures and depths. In the slope wetland we observed an opposite trend with depth and with temperature, with Fe(II)-export rates declining by almost an order of magnitude between 6 and 12°C. In addition, our results showed a positive correlation between Fe(II)-export rates and DOC export rates suggesting Fe(III)-reduction exerts a biogeochemical control on water quality

  16. Orion: a web-based application designed to monitor resident and fellow performance on-call.

    Science.gov (United States)

    Itri, Jason N; Kim, Woojin; Scanlon, Mary H

    2011-10-01

    Radiology residency and fellowship training provides a unique opportunity to evaluate trainee performance and determine the impact of various educational interventions. We have developed a simple software application (Orion) using open-source tools to facilitate the identification and monitoring of resident and fellow discrepancies in on-call preliminary reports. Over a 6-month period, 19,200 on-call studies were interpreted by 20 radiology residents, and 13,953 on-call studies were interpreted by 25 board-certified radiology fellows representing eight subspecialties. Using standard review macros during faculty interpretation, each of these reports was classified as "agreement", "minor discrepancy", and "major discrepancy" based on the potential to impact patient management or outcome. Major discrepancy rates were used to establish benchmarks for resident and fellow performance by year of training, modality, and subspecialty, and to identify residents and fellows demonstrating a significantly higher major discrepancy rate compared with their classmates. Trends in discrepancies were used to identify subspecialty-specific areas of increased major discrepancy rates in an effort to tailor the didactic and case-based curriculum. A series of missed-case conferences were developed based on trends in discrepancies, and the impact of these conferences is currently being evaluated. Orion is a powerful information technology tool that can be used by residency program directors, fellowship programs directors, residents, and fellows to improve radiology education and training.

  17. Temporal evolution and variability of dissolved inorganic nitrogen in beach pore water revealed using radon residence times.

    Science.gov (United States)

    Goodridge, Blair M; Melack, John M

    2014-12-16

    We coupled measurements of beach pore water residence time, determined using the radioisotopic tracer (222)Rn, with dissolved carbon and nitrogen chemistry to identify the temporal evolution and variability of dissolved inorganic nitrogen (DIN) concentrations in beach pore water along the Santa Barbara, California coastline. Pore water dissolved organic carbon (DOC) and total dissolved nitrogen (TDN) ratios (DOC:TDN) were negative exponentially correlated with residence time. Mean pore water residence times were positively correlated with tidal amplitudes, and ranged from 4.4 to 6.4 days. We used this range in mean residence times to model radon residence time distributions (RTDs), and integrated them with modeled DIN vs residence time relationships (DIN-temporal evolution, or DIN-te curves) to derive volume-weighted mean (VWM) DIN concentrations. We observed 1.2-fold and 5.2-fold differences (20% and 420% increases) in VWM DIN concentrations over the range in modeled RTDs and DIN-te curves, respectively, and a maximum 6.4-fold difference (540% increase) in VWM DIN concentrations for an interactive shift in the RTD and the DIN-te curve. Our study suggests that accounting for temporal variability in the RTD and DIN concentration of pore water is necessary to obtain more accurate estimates of DIN delivery to coastal oceans.

  18. Trait differences between naturalized and invasive plant species independent of residence time and phylogeny.

    Science.gov (United States)

    Gallagher, R V; Randall, R P; Leishman, M R

    2015-04-01

    The ability to predict which alien plants will transition from naturalized to invasive prior to their introduction to novel regions is a key goal for conservation and has the potential to increase the efficacy of weed risk assessment (WRA). However, multiple factors contribute to plant invasion success (e.g., functional traits, range characteristics, residence time, phylogeny), and they all must be taken into account simultaneously in order to identify meaningful correlates of invasion success. We compiled 146 pairs of phylogenetically paired (congeneric) naturalized and invasive plant species in Australia with similar minimum residence times (i.e., time since introduction in years). These pairs were used to test for differences in 5 functional traits (flowering duration, leaf size, maximum height, specific leaf area [SLA], seed mass) and 3 characteristics of species' native ranges (biome occupancy, mean annual temperature, and rainfall breadth) between naturalized and invasive species. Invasive species, on average, had larger SLA, longer flowering periods, and were taller than their congeneric naturalized relatives. Invaders also exhibited greater tolerance for different environmental conditions in the native range, where they occupied more biomes and a wider breadth of rainfall and temperature conditions than naturalized congeners. However, neither seed mass nor leaf size differed between pairs of naturalized and invasive species. A key finding was the role of SLA in distinguishing between naturalized and invasive pairs. Species with high SLA values were typically associated with faster growth rates, more rapid turnover of leaf material, and shorter lifespans than those species with low SLA. This suite of characteristics may contribute to the ability of a species to transition from naturalized to invasive across a wide range of environmental contexts and disturbance regimes. Our findings will help in the refinement of WRA protocols, and we advocate the inclusion

  19. Calculation of residence times and radiation doses using the standard PC software Excel

    International Nuclear Information System (INIS)

    Herzog, H.; Zilken, H.; Niederbremer, A.; Friedrich, W.; Mueller-Gaertner, H.W.

    1997-01-01

    We developed a program which aims to facilitate the calculation of radiation doses to single organs and the whole body. IMEDOSE uses Excel to include calculations, graphical displays, and interactions with the user in a single general-purpose PC software tool. To start the procedure the input data are copied into a spreadsheet. They must represent percentage uptake values of several organs derived from measurements in animals or humans. To extrapolate these data up to seven half-lives of the radionuclide, fitting to one or two exponentional functions is included and can be checked by the user. By means of the approximate time-activity information the cumulated activity or residence times are calculated. Finally these data are combined with the absorbed fraction doses (S-values) given by MIRD pamphlet No. 11 to yield radiation doses, the effective dose equivalent and the effective dose. These results are presented in a final table. Interactions are realized with push-buttons and drop-down menus. Calculations use the Visual Basic tool of Excel. In order to test our program, biodistribution data of fluorine-18 fluorodeoxyglucose were taken from the literature (Meija et al., J Nucl Med 1991; 32:699-706). For a 70-kg adult the resulting radiation doses of all target organs listed in MIRD 11 were different from the ICRP 53 values by 1%±18% on the average. When the residence times were introduced into MIRDOSE3 (Stabin, J Nucl Med 1996; 37:538-546) the mean difference between our results and those of MIRDOSE3 was -3%±6%. Both outcomes indicate the validity of the present approach. (orig.)

  20. Calculation of residence times and radiation doses using the standard PC software Excel.

    Science.gov (United States)

    Herzog, H; Zilken, H; Niederbremer, A; Friedrich, W; Müller-Gärtner, H W

    1997-12-01

    We developed a program which aims to facilitate the calculation of radiation doses to single organs and the whole body. IMEDOSE uses Excel to include calculations, graphical displays, and interactions with the user in a single general-purpose PC software tool. To start the procedure the input data are copied into a spreadsheet. They must represent percentage uptake values of several organs derived from measurements in animals or humans. To extrapolate these data up to seven half-lives of the radionuclide, fitting to one or two exponentional functions is included and can be checked by the user. By means of the approximate time-activity information the cumulated activity or residence times are calculated. Finally these data are combined with the absorbed fraction doses (S-values) given by MIRD pamphlet No. 11 to yield radiation doses, the effective dose equivalent and the effective dose. These results are presented in a final table. Interactions are realized with push-buttons and drop-down menus. Calculations use the Visual Basic tool of Excel. In order to test our program, biodistribution data of fluorine-18 fluorodeoxyglucose were taken from the literature (Meija et al., J Nucl Med 1991; 32:699-706). For a 70-kg adult the resulting radiation doses of all target organs listed in MIRD 11 were different from the ICRP 53 values by 1%+/-18% on the average. When the residence times were introduced into MIRDOSE3 (Stabin, J Nucl Med 1996; 37:538-546) the mean difference between our results and those of MIRDOSE3 was -3%+/-6%. Both outcomes indicate the validity of the present approach.

  1. Calculation of residence times and radiation doses using the standard PC software Excel

    Energy Technology Data Exchange (ETDEWEB)

    Herzog, H.; Zilken, H.; Niederbremer, A.; Friedrich, W. [Institute of Medicine, Research Center Juelich, Juelich (Germany); Mueller-Gaertner, H.W. [Institute of Medicine, Research Center Juelich, Juelich (Germany)]|[Department of Nuclear Medicine, Heinrich-Heine University Hospital Duesseldorf (Germany)

    1997-12-01

    We developed a program which aims to facilitate the calculation of radiation doses to single organs and the whole body. IMEDOSE uses Excel to include calculations, graphical displays, and interactions with the user in a single general-purpose PC software tool. To start the procedure the input data are copied into a spreadsheet. They must represent percentage uptake values of several organs derived from measurements in animals or humans. To extrapolate these data up to seven half-lives of the radionuclide, fitting to one or two exponentional functions is included and can be checked by the user. By means of the approximate time-activity information the cumulated activity or residence times are calculated. Finally these data are combined with the absorbed fraction doses (S-values) given by MIRD pamphlet No. 11 to yield radiation doses, the effective dose equivalent and the effective dose. These results are presented in a final table. Interactions are realized with push-buttons and drop-down menus. Calculations use the Visual Basic tool of Excel. In order to test our program, biodistribution data of fluorine-18 fluorodeoxyglucose were taken from the literature (Meija et al., J Nucl Med 1991; 32:699-706). For a 70-kg adult the resulting radiation doses of all target organs listed in MIRD 11 were different from the ICRP 53 values by 1%{+-}18% on the average. When the residence times were introduced into MIRDOSE3 (Stabin, J Nucl Med 1996; 37:538-546) the mean difference between our results and those of MIRDOSE3 was -3%{+-}6%. Both outcomes indicate the validity of the present approach. (orig.) With 5 figs., 2 tabs., 18 refs.

  2. Residence time distribution measurements in a pilot-scale poison tank using radiotracer technique.

    Science.gov (United States)

    Pant, H J; Goswami, Sunil; Samantray, J S; Sharma, V K; Maheshwari, N K

    2015-09-01

    Various types of systems are used to control the reactivity and shutting down of a nuclear reactor during emergency and routine shutdown operations. Injection of boron solution (borated water) into the core of a reactor is one of the commonly used methods during emergency operation. A pilot-scale poison tank was designed and fabricated to simulate injection of boron poison into the core of a reactor along with coolant water. In order to design a full-scale poison tank, it was desired to characterize flow of liquid from the tank. Residence time distribution (RTD) measurement and analysis was adopted to characterize the flow dynamics. Radiotracer technique was applied to measure RTD of aqueous phase in the tank using Bromine-82 as a radiotracer. RTD measurements were carried out with two different modes of operation of the tank and at different flow rates. In Mode-1, the radiotracer was instantaneously injected at the inlet and monitored at the outlet, whereas in Mode-2, the tank was filled with radiotracer and its concentration was measured at the outlet. From the measured RTD curves, mean residence times (MRTs), dead volume and fraction of liquid pumped in with time were determined. The treated RTD curves were modeled using suitable mathematical models. An axial dispersion model with high degree of backmixing was found suitable to describe flow when operated in Mode-1, whereas a tanks-in-series model with backmixing was found suitable to describe flow of the poison in the tank when operated in Mode-2. The results were utilized to scale-up and design a full-scale poison tank for a nuclear reactor. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Factors Affecting Gender-based Experiences for Residents in Radiation Oncology

    Energy Technology Data Exchange (ETDEWEB)

    Barry, Parul N., E-mail: pnbarr01@louisville.edu [Department of Radiation Oncology, University of Louisville, School of Medicine, Louisville, Kentucky (United States); Miller, Karen H.; Ziegler, Craig [Department of Graduate Medical Education, University of Louisville, School of Medicine, Louisville, Kentucky (United States); Hertz, Rosanna [Departments of Women' s and Gender Studies and Sociology, Wellesley College, Wellesley, Massachusetts (United States); Hanna, Nevine [Department of Radiation Oncology, University of Utah, School of Medicine, Salt Lake City, Utah (United States); Dragun, Anthony E. [Department of Radiation Oncology, University of Louisville, School of Medicine, Louisville, Kentucky (United States)

    2016-07-01

    Purpose: Although women constitute approximately half of medical school graduates, an uneven gender distribution exists among many specialties, including radiation oncology, where women fill only one third of residency positions. Although multiple social and societal factors have been theorized, a structured review of radiation oncology resident experiences has yet to be performed. Methods and Materials: An anonymous and voluntary survey was sent to 611 radiation oncology residents practicing in the United States. Residents were asked about their gender-based experiences in terms of mentorship, their professional and learning environment, and their partnerships and personal life. Results: A total of 203 participants submitted completed survey responses. Fifty-seven percent of respondents were men, and 43% were women, with a mean age of 31 years (standard deviation=3.7 years). Although residents in general value having a mentor, female residents prefer mentors of the same gender (P<.001), and noted having more difficulty finding a mentor (P=.042). Women were more likely to say that they have observed preferential treatment based on gender (P≤.001), and they were more likely to perceive gender-specific biases or obstacles in their professional and learning environment (P<.001). Women selected residency programs based on gender ratios (P<.001), and female residents preferred to see equal numbers of male and female faculty (P<.001). Women were also more likely to perceive work-related strain than their male counterparts (P<.001). Conclusions: Differences in experiences for male and female radiation oncology residents exist with regard to mentorship and in their professional and learning environment.

  4. Factors Affecting Gender-based Experiences for Residents in Radiation Oncology

    International Nuclear Information System (INIS)

    Barry, Parul N.; Miller, Karen H.; Ziegler, Craig; Hertz, Rosanna; Hanna, Nevine; Dragun, Anthony E.

    2016-01-01

    Purpose: Although women constitute approximately half of medical school graduates, an uneven gender distribution exists among many specialties, including radiation oncology, where women fill only one third of residency positions. Although multiple social and societal factors have been theorized, a structured review of radiation oncology resident experiences has yet to be performed. Methods and Materials: An anonymous and voluntary survey was sent to 611 radiation oncology residents practicing in the United States. Residents were asked about their gender-based experiences in terms of mentorship, their professional and learning environment, and their partnerships and personal life. Results: A total of 203 participants submitted completed survey responses. Fifty-seven percent of respondents were men, and 43% were women, with a mean age of 31 years (standard deviation=3.7 years). Although residents in general value having a mentor, female residents prefer mentors of the same gender (P<.001), and noted having more difficulty finding a mentor (P=.042). Women were more likely to say that they have observed preferential treatment based on gender (P≤.001), and they were more likely to perceive gender-specific biases or obstacles in their professional and learning environment (P<.001). Women selected residency programs based on gender ratios (P<.001), and female residents preferred to see equal numbers of male and female faculty (P<.001). Women were also more likely to perceive work-related strain than their male counterparts (P<.001). Conclusions: Differences in experiences for male and female radiation oncology residents exist with regard to mentorship and in their professional and learning environment.

  5. Can we differentiate alpine groundwater storages regarding volume and residence time by recession observations, ion composition and tracer balance?

    Science.gov (United States)

    Floriancic, Marius; Smoorenburg, Maarten; Margreth, Michael; Naef, Felix

    2015-04-01

    Research on how catchments store and release water is essential to improve flood and low flow prediction in (un)gauged watersheds. Despite their importance for catchment scale assessments on runoff generation, knowledge on storage properties and residence times is still limited. Here we present some approaches to separate different storage types regarding their residence time and a quantification of the volumes of these storages based on a dataset of winter recession observation in the alpine Poschiavino headwater area. This spatially highly resolved dataset of discharge, electric conductivity and ion composition from a watershed with strongly contrasting storage properties, allowed separating three main contributing sources: continuous discharge from bedrock cracks, strongly delayed discharge from thick sediment deposits and fractured rock and rapid discharge from shallow layers. The gradients of the recession curves, the variation of electric conductivity in the river network and calculated tracer balance were used to separate contribution from different sources. Additionally contribution from sedimentary rocks and crystalline layers could be separated based on the variation of ion composition in the water samples. We derived recession curves for a period of four months for the separated storages in different parts of the catchment allowing estimation of the contributed volumes in this time period. Finally the spatial distribution of the storage types could be mapped throughout the catchment based on information like geo(morpho)logical maps, aerial photographs, DEM and field observations. We found significant variation comparing the discharged volume and specific discharge throughout the winter season in the different subcatchments. Constant discharge from bedrock cracks is similar in all catchment parts. Storage in the shallow deposits depleted quickly. High winter discharge could be attributed to thick quaternary deposits contributing during the whole

  6. Determination of the resident time distribution (RTD) in copper concentrate drying plants using radioactive tracers

    International Nuclear Information System (INIS)

    Diaz V, Francisco J.; Duran P, Oscar U.; Hernandez A, Fernando A.

    1996-01-01

    This paper is a study on the drying process of copper concentrate, on two fluidized bed dryers at Fundicion Caletones, Division El Teniente, Codelco-Chile. The problem was investigated by experimental determination of the resident Time Distribution (RTD) for the material to be dry and by an analysis of the influence of the grain size in the drying process. The stimulus-response technique was used in the experiments, where the stimulation was a pulse of an adequate radioactive tracer injected at the dryer's input. Under these conditions, the response obtained at the dryer's outputs, i.e., the concentration variation curve as a function of time, represents directly the RTD of the system between the injection and measuring points. The tracer used was the same material to be dried, and it was irradiated with neutrons in the nuclear reactor at La Reina Nuclear Centre, thus producing a solid gamma radiation emitter tracer of identical behaviour as the material under study. The approximate activity of each sample was equivalent to 8 mCi of Cu-64 at the time of the injection and the measurement of the tracer was made on-line using NaI(Tl) gamma radiation detectors. The results obtained showed average times less than the estimated and would indicate a fast drying using minimum volume in the dryer. The drying of the fine particles was three times faster than the coarse ones. (author)

  7. Evaluation of clinical teaching quality in competency-based residency training in Lithuania.

    Science.gov (United States)

    Vaižgėlienė, Eglė; Padaiga, Žilvinas; Rastenytė, Daiva; Tamelis, Algimantas; Petrikonis, Kęstutis; Fluit, Cornelia

    2017-12-01

    In 2013, all residency programs at the Lithuanian University of Health Sciences were renewed into the competency-based medical education curriculum (CBME). In 2015, we implemented the validated EFFECT questionnaire together with the EFFECT-System for quality assessment of clinical teaching in residency training. The aim of this study was to investigate the influence of characteristics of the resident (year of training) and clinical teacher (gender, age, and type of academic position) on teaching quality, as well as to assess areas for teaching quality improvement. Residents from 7 different residency study programs filled out 333 EFFECT questionnaires evaluating 146 clinical teachers. We received 143 self-evaluations of clinical teachers using the same questionnaire. Items were scored on a 6-point Likert scale. Main outcome measures were residents' mean overall (MOS), mean subdomain (MSS) and clinical teachers' self-evaluation scores. The overall comparisons of MOS and MSS across study groups and subgroups were done using Student's t test and ANOVA for trend. The intraclass correlation coefficient (ICC) was calculated in order to see how residents' evaluations match with self-evaluations for every particular teacher. To indicate areas for quality improvement items were analyzed subtracting their mean score from the respective (sub)domain score. MOS for domains of "role modeling", "task allocation", "feedback", "teaching methodology" and "assessment" valued by residents were significantly higher than those valued by teachers (Pevaluation questionnaires were rated significantly higher by residents in role modeling subdomains (Phigher than the female teachers (Phigher (Pevaluations of clinical teachers are influenced by teachers' age, gender, year of residency training, type of teachers' academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers

  8. Effecting Change in an Evidence-Based Medicine Curriculum: Librarians' Role in a Pediatric Residency Program.

    Science.gov (United States)

    Zeblisky, Kathy; Birr, Rebecca A; Sjursen Guerrero, Anne Marie

    2015-01-01

    Librarians for the joint Phoenix Children's Hospital/Maricopa Medical Center Pediatric Residency Program were asked to assist on the Evidence-Based Medicine (EBM) Subcommittee for the program. Faculty was open to recommendations for revising and improving the curriculum and desired librarian assistance in completing the task. The annual program review and conference evaluations revealed a gap between the objectives of the EBM curriculum and the residents' perceived abilities to integrate knowledge into meaningful literature searches. This column demonstrates how librarians can collaborate with their residency programs to revise and improve processes to effect change in their program's EBM curriculum.

  9. Residence time, dispersal, and harvest of waterfowl using a radioactive leaching pond in southeastern Idaho

    International Nuclear Information System (INIS)

    Browers, H.W. Jr.; Flake, L.D.

    1983-01-01

    A study was initiated in the fall of 1980 to determine residence times, dispersal, and harvest of waterfowl using the Test Reactor Area (TRA) radioactive leaching pond complex on the Idaho National Engineering Laboratory (INEL) site. Attempts were made to capture and band waterfowl using the ponds during migration. Three common goldeneyes (Bucephala clangula) and six mallards (Anas platyrynchos) were captured in the fall of 1980. Three mallards were also captured in the fall of 1981. Two bands have been recovered to date. In addition, daily observations were made from August to December 1980 and from October to December 1981 and the number and species of waterfowl were recorded. As of December 15, 1981, 665 waterfowl representing 14 species had been observed. However,the total number of waterfowl observed does not represent an accurate census due to recounts of some individuals

  10. Devolatilization kinetics of woody biomass at short residence times and high heating rates and peak temperatures

    DEFF Research Database (Denmark)

    Johansen, Joakim M.; Gadsbøll, Rasmus; Thomsen, Jesper

    2016-01-01

    were conducted on a laboratory laminar entrained flow reactor (LFR) using solid fuel feed rates on the order of 10-20mgh-1. Employing a simple single step first order (SFOR) mechanism with an Arrhenius type rate expression, the best fit of the pyrolysis kinetics was found to be: A=18.9×103s-1, Ea=21305......This work combines experimental and computational fluid dynamics (CFD) results to derive global kinetics for biomass (pine wood) devolatilization during heating rates on the order of 105Ks-1, bulk flow peak temperatures between 1405 and 1667K, and particle residence times below 0.1s. Experiments......Jmol-1. The accuracy of the derived global kinetics was supported by comparing predictions to experimental results from a 15kW furnace. The work emphasizes the importance of characterizing the temperature history of the biomass particles when deriving pyrolysis kinetics. The present results indicate...

  11. Recent extensions of the residence time distribution concept: unsteady state conditions and hydrodynamic model developments

    Directory of Open Access Journals (Sweden)

    Claudel S.

    2000-01-01

    Full Text Available Two recent extensions of the residence time distribution concept are developed. The first one concerns the use of this method under transient conditions, a concept theoretically treated but rarely confirm by relevant experiments. In the present work, two experimental set-ups have been used to verify some limits of the concept. The second extension is devoted to the development of hydrodynamic models. Up to now, the hydrodynamics of the process are either determined by simple models (mixing cells in series, plug flow reactor with axial dispersion or by the complex calculation of the velocity profile obtained via the Navier-Stokes equations. An alternative is to develop a hydrodynamic model by use of a complex network of interconnected elementary reactors. Such models should be simple enough to be derived easily and sufficiently complex to give a good representation of the behavior of the process.

  12. Evaluation of Problem- and Simulator-Based Learning in Lumbar Puncture in Adult Neurology Residency Training.

    Science.gov (United States)

    Sun, Chenjing; Qi, Xiaokun

    2018-01-01

    Lumbar puncture (LP) is an essential part of adult neurology residency training. Technologic as well as nontechnologic training is needed. However, current assessment tools mostly focus on the technologic aspects of LP. We propose a training method-problem- and simulator-based learning (PSBL)-in LP residency training to develop overall skills of neurology residents. We enrolled 60 neurology postgraduate-year-1 residents from our standardized residents training center and randomly divided them into 2 groups: traditional teaching group and PSBL group. After training, we assessed the extent that the residents were ready to perform LP and tracked successful LPs performed by the residents. We then asked residents to complete questionnaires about the training models. Performance scores and the results of questionnaires were compared between the 2 groups. Students and faculty concluded that PSBL provided a more effective learning experience than the traditional teaching model. Although no statistical difference was found in the pretest, posttest, and improvement rate scores between the 2 groups, based on questionnaire scores and number of successful LPs after training, the PSBL group showed a statistically significant improvement compared with the traditional group. Findings indicated that nontechnical elements, such as planning before the procedure and controlling uncertainties during the procedure, are more crucial than technical elements. Compared with traditional teaching model, PSBL for LP training can develop overall surgical skills, including technical and nontechnical elements, improving performance. Residents in the PSBL group were more confident and effective in performing LP. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Groundwater residence times in Shenandoah National Park, Blue Ridge Mountains, Virginia, USA: A multi-tracer approach

    Science.gov (United States)

    Plummer, Niel; Busenberg, E.; Böhlke, J.K.; Nelms, D.L.; Michel, R.L.; Schlosser, P.

    2001-01-01

    Chemical and isotopic properties of water discharging from springs and wells in Shenandoah National Park (SNP), near the crest of the Blue Ridge Mountains, VA, USA were monitored to obtain information on groundwater residence times. Investigated time scales included seasonal (wet season, April, 1996; dry season, August–September, 1997), monthly (March through September, 1999) and hourly (30-min interval recording of specific conductance and temperature, March, 1999 through February, 2000). Multiple environmental tracers, including tritium/helium-3 (3H/3He), chlorofluorocarbons (CFCs), sulfur hexafluoride (SF6), sulfur-35 (35S), and stable isotopes (δ18O and δ2H) of water, were used to estimate the residence times of shallow groundwater discharging from 34 springs and 15 wells. The most reliable ages of water from springs appear to be based on SF6 and 3H/3He, with most ages in the range of 0–3 years. This range is consistent with apparent ages estimated from concentrations of CFCs; however, CFC-based ages have large uncertainties owing to the post-1995 leveling-off of the CFC atmospheric growth curves. Somewhat higher apparent ages are indicated by 35S (>1.5 years) and seasonal variation of δ18O (mean residence time of 5 years) for spring discharge. The higher ages indicated by the 35S and δ18O data reflect travel times through the unsaturated zone and, in the case of 35S, possible sorption and exchange of S with soils or biomass. In springs sampled in April, 1996, apparent ages derived from the 3H/3He data (median age of 0.2 years) are lower than those obtained from SF6 (median age of 4.3 years), and in contrast to median ages from 3H/3He (0.3 years) and SF6 (0.7 years) obtained during the late summer dry season of 1997. Monthly samples from 1999 at four springs in SNP had SF6apparent ages of only 1.2 to 2.5±0.8 years, and were consistent with the 1997 SF6 data. Water from springs has low excess air (0–1 cm3 kg−1) and N2–Ar temperatures that vary

  14. On-site residence time in a driven diffusive system: Violation and recovery of a mean-field description.

    Science.gov (United States)

    Messelink, J; Rens, R; Vahabi, M; MacKintosh, F C; Sharma, A

    2016-01-01

    We investigate simple one-dimensional driven diffusive systems with open boundaries. We are interested in the average on-site residence time defined as the time a particle spends on a given site before moving on to the next site. Using mean-field theory, we obtain an analytical expression for the on-site residence times. By comparing the analytic predictions with numerics, we demonstrate that the mean-field significantly underestimates the residence time due to the neglect of time correlations in the local density of particles. The temporal correlations are particularly long-lived near the average shock position, where the density changes abruptly from low to high. By using domain wall theory, we obtain highly accurate estimates of the residence time for different boundary conditions. We apply our analytical approach to residence times in a totally asymmetric exclusion process (TASEP), TASEP coupled to Langmuir kinetics (TASEP+LK), and TASEP coupled to mutually interactive LK (TASEP+MILK). The high accuracy of our predictions is verified by comparing these with detailed Monte Carlo simulations.

  15. Geochemical modelling of groundwater evolution and residence time at the Kivetty site

    Energy Technology Data Exchange (ETDEWEB)

    Pitkaenen, P.; Luukkonen, A. [VTT Communities and Infrastructure, Espoo (Finland); Ruotsalainen, P. [Fintact Oy, Helsinki (Finland); Leino-Forsman, H.; Vuorinen, U. [VTT Chemical Technology, Espoo (Finland)

    1998-12-01

    groundwater are due to carbonate reactions: oxidising of organic carbon, and dissolution and precipitation of calcite. The carbonate reactions and slight hydrolysis of silicates stabilise the pH value at 8-9. In addition to aerobic oxidation of organic matter, oxidative dissolution of biotite seems to be an important oxygen consumer at shallow depth during recharge. The most important process controlling the redox state deeper in the bedrock was interpreted to be the microbially mediated sulphate reduction with simultaneous anaerobic respiration of organic carbon. This process buffers the redox level of about -200 - -300 mV depending on the pH. Even though the salinities of the groundwater samples and mass-transfer along flow paths remain low, the geochemical evolution was fully developed and has reached quite a stable thermodynamic state. The residence times of the groundwater samples cover the time span back to glaciation. Young ages seem to be limited to the upper part of bedrock, and any really dynamic natural flowpath with deep observed recently recharged water cannot be demonstrated. Deglacial or subglacial ages (over 9,700 years old at Kivetty) are typical below the 150-300m level in the bedrock. Subglacial waters are interpreted to derive from mixing of preglacial water and meltwater, the input of which is estimated to be about 20% at the most. Indications of elevated oxygen intrusion cannot be observed in groundwater having glacial signals. (orig.) 122 refs.

  16. Influence of a systems-based approach to prescribing errors in a pediatric resident clinic.

    Science.gov (United States)

    Condren, Michelle; Honey, Brooke L; Carter, Sandra M; Ngo, Nelson; Landsaw, Jeremy; Bryant, Cheryl; Gillaspy, Stephen

    2014-01-01

    To measure the difference in prescribing error rates between 2 clinics, 1 with a system in place to reduce errors and 1 with no such system; to determine variables that affect the likelihood of prescription errors. This was a retrospective study at 2 university-based general pediatric clinics utilizing the same electronic medical record (EMR) system. Clinic 1 employed pharmacists who provided daily prescription review, provider feedback and education, and EMR customization to decrease errors. Clinic 2 had no systems in place for reducing prescribing errors. Prescriptions written by resident physicians over 2 months were identified and reviewed. A total of 1361 prescriptions were reviewed, 40.7% from clinic 1 and 59.3% from clinic 2. Errors were found in 201 prescriptions (14.8%). Clinics 1 and 2 had error rates of 11% and 17.5%, respectively (P = .0012). The odds of a prescription error at clinic 2 were 1.7 times the odds of a prescription error at clinic 1. Logistic regression identified clinic, nonpediatric resident, liquid dose forms, and younger patient age as significant predictors of prescription errors. Half of the errors could have been prevented with consistent use of a custom medication list within the EMR. We found 37% fewer prescribing errors in a clinic with systems in place for prescribing error detection and prevention. Pediatric clinics should explore systematic procedures for identifying, resolving, and providing education about prescribing errors to reduce patient risk. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. Resident Load Influence Analysis Method for Price Based on Non-intrusive Load Monitoring and Decomposition Data

    Science.gov (United States)

    Jiang, Wenqian; Zeng, Bo; Yang, Zhou; Li, Gang

    2018-01-01

    In the non-invasive load monitoring mode, the load decomposition can reflect the running state of each load, which will help the user reduce unnecessary energy costs. With the demand side management measures of time of using price, a resident load influence analysis method for time of using price (TOU) based on non-intrusive load monitoring data are proposed in the paper. Relying on the current signal of the resident load classification, the user equipment type, and different time series of self-elasticity and cross-elasticity of the situation could be obtained. Through the actual household load data test with the impact of TOU, part of the equipment will be transferred to the working hours, and users in the peak price of electricity has been reduced, and in the electricity at the time of the increase Electrical equipment, with a certain regularity.

  18. An internet-based learning portfolio in resident education: the KOALA multicentre programme.

    Science.gov (United States)

    Fung, M F; Walker, M; Fung, K F; Temple, L; Lajoie, F; Bellemare, G; Bryson, S C

    2000-06-01

    To describe the Computerized Obstetrics and Gynecology Automated Learning Anaalysis (KOALAtrade mark), a multicentre, Internet-based learning portfolio and to determine its effects on residents' perception of their self-directed learning abilities. The KOALA programme allows residents to record their obstetrical, surgical, ultrasound, and ambulatory patient encounters and to document critical incidents of learning or elements of surprise that arose during these encounters. By prompting the student to reflect on these learning experiences, KOALA encourages residents to articulate questions which can be directly pursued through hypertext links to evidence-based literature. Four Canadian residency training programmes participated in the pilot project, from February to May 1997, using a dynamic relational database with a central server. All participants completed the Self-directed Learning Readiness Scale and a learning habits questionnaire. The impact of the KOALA programme on residents' perception of their self-directed learning abilities was measured by comparing KOALA-naive schools (schools 2, 3, and 4) with school 1 (exposed to the KOALA prototype for 1 year). Ordered variables were compared using the Mann-Whitney U test and continuous variables with the Student t test (statistical significance P learning were recorded by 41 residents in the four participating universities. Residents at the exposed school (school 1) had a significantly higher perception of their self-directed learning (P learning was less likely to be from continuing medical education (P learning portfolio with online resources. This Internet-based, multi-user, multicentre learning portfolio has a significant effect on residents' perception of their self-directed learning abilities.

  19. Geochemical modelling of groundwater evolution and residence time at the Olkiluoto site

    International Nuclear Information System (INIS)

    Pitkaenen, P.; Luukkonen, A.; Ruotsalainen, P.; Leino-Forsman, H.; Vuorinen, U.

    1999-05-01

    external conditions such as glaciation, palaeo Baltic stages, land uplift and ancient hydrothermal events, have had a significant effect on local palaeohydrogeological conditions. They have caused great variability, which is observable in the chemical data notably in salinity (up to 70 g/l), water type and contents of conservative parameters, such as Cl, Br and stable isotopes of water. However, their influence is also significant on the water-rock interaction that principally controls the pH and redox conditions - varying 7.5 to 8 and -200 to -300 mV, respectively - in the groundwater, although the calculated mass transfer in the reactions is minor compared with conservative mixing at the site. Calcite in fractures is interpreted to principally control pH level in groundwater. Sulphidic redox conditions dominate in the upper 500 m in brackish and slightly saline groundwater. Deeper sulphur species are absent and methanic processes are obtained. The water types can be connected to certain palaeo stages. This enables to estimate mean residence time of groundwaters. Current meteoric recharge stage (< 2500 a) mainly dominates in the upper 150 m. Groundwater from Litorina stage (7500-2500 a ago) forms the bulk at 100 - 250 m. Glacial melt water (about 10 000 a old) is an important component of groundwater between 100 - 500 m. However, any remarks of oxygen intrusion cannot be interpreted neither from mineralogy nor from groundwater. Deeper, subglacial and older saline groundwater predominates. Despite the current locations of different groundwater bodies it seems according to hydrogeochemical interpretation that dynamic flow conditions has been limited to upper 150 - 200 m. (orig.)

  20. Geochemical modelling of groundwater evolution and residence time at the Olkiluoto site

    Energy Technology Data Exchange (ETDEWEB)

    Pitkaenen, P.; Luukkonen, A. [VTT Communities and Infrastructure, Espoo (Finland); Ruotsalainen, P. [Fintact Oy (Finland); Leino-Forsman, H.; Vuorinen, U. [VTT Chemical Technology, Espoo (Finland)

    1999-05-01

    external conditions such as glaciation, palaeo Baltic stages, land uplift and ancient hydrothermal events, have had a significant effect on local palaeohydrogeological conditions. They have caused great variability, which is observable in the chemical data notably in salinity (up to 70 g/l), water type and contents of conservative parameters, such as Cl, Br and stable isotopes of water. However, their influence is also significant on the water-rock interaction that principally controls the pH and redox conditions - varying 7.5 to 8 and -200 to -300 mV, respectively - in the groundwater, although the calculated mass transfer in the reactions is minor compared with conservative mixing at the site. Calcite in fractures is interpreted to principally control pH level in groundwater. Sulphidic redox conditions dominate in the upper 500 m in brackish and slightly saline groundwater. Deeper sulphur species are absent and methanic processes are obtained. The water types can be connected to certain palaeo stages. This enables to estimate mean residence time of groundwaters. Current meteoric recharge stage (< 2500 a) mainly dominates in the upper 150 m. Groundwater from Litorina stage (7500-2500 a ago) forms the bulk at 100 - 250 m. Glacial melt water (about 10 000 a old) is an important component of groundwater between 100 - 500 m. However, any remarks of oxygen intrusion cannot be interpreted neither from mineralogy nor from groundwater. Deeper, subglacial and older saline groundwater predominates. Despite the current locations of different groundwater bodies it seems according to hydrogeochemical interpretation that dynamic flow conditions has been limited to upper 150 - 200 m. (orig.) 82 refs.

  1. A longitudinal simulation-based ethical-legal curriculum for otolaryngology residents.

    Science.gov (United States)

    Fanous, Amanda; Rappaport, Jamie; Young, Meredith; Park, Yoon Soo; Manoukian, John; Nguyen, Lily H P

    2017-11-01

    To develop, implement, and evaluate a longitudinal, simulation-based ethics and legal curriculum designed specifically for otolaryngology residents. Otolaryngology residents were recruited to participate in a yearly half-day ethical-legal module, the curriculum of which spanned 4 years. Each module included: three simulated scenarios, small-group multisource feedback, and large-group debriefings. Scenarios involved encounters with standardized patients. Residents' ethical-legal knowledge was assessed pre- and postmodule with multiple-choice questions, and ethical reasoning was assessed by a variety of evaluators during the simulated scenario using a locally developed assessment tool. Participants completed an exit survey at the end of each module. Eighteen residents completed four modules from the academic years of 2008 to 2009 to 2011 to 2012. The first year was considered a pilot module, and data were collected for the following 3 years. Knowledge of legal issues improved significantly among residents (mean at pre = 3.40 and post = 4.60, P simulation-based ethical-legal curriculum tailored to otolaryngology-head and neck surgery residents. This educational program resulted in a both objective and subjective improvement in legal and ethics knowledge and skills. NA. Laryngoscope, 127:2501-2509, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Residence times and alluvial architecture of a sediment superslug in response to different flow regimes

    Science.gov (United States)

    Moody, John A.

    2017-10-01

    A superslug was deposited in a basin in the Colorado Front Range Mountains as a consequence of an extreme flood following a wildfire disturbance in 1996. The subsequent evolution of this superslug was measured by repeat topographic surveys (31 surveys from 1996 through 2014) of 18 cross sections approximately uniformly spaced over 1500 m immediately above the basin outlet. These surveys allowed the identification within the superslug of chronostratigraphic units deposited and eroded by different geomorphic processes in response to different flow regimes. Over the time period of the study, the superslug went through aggradation, incision, and stabilization phases that were controlled by a shift in geomorphic processes from generally short-duration, episodic, large-magnitude floods that deposited new chronostratigraphic units to long-duration processes that eroded units. These phases were not contemporaneous at each channel cross section, which resulted in a complex response that preserved different chronostratigraphic units at each channel cross section having, in general, two dominant types of alluvial architecture-laminar and fragmented. Age and transit-time distributions for these two alluvial architectures evolved with time since the extreme flood. Because of the complex shape of the distributions they were best modeled by two-parameter Weibull functions. The Weibull scale parameter approximated the median age of the distributions, and the Weibull shape parameter generally had a linear relation that increased with time since the extreme flood. Additional results indicated that deposition of new chronostratigraphic units can be represented by a power-law frequency distribution, and that the erosion of units decreases with depth of burial to a limiting depth. These relations can be used to model other situations with different flow regimes where vertical aggradation and incision are dominant processes, to predict the residence time of possible contaminated

  3. Organizational and Individual Conditions Associated with Depressive Symptoms among Nursing Home Residents over Time

    Science.gov (United States)

    Cassie, Kimberly M.; Cassie, William E.

    2012-01-01

    Purpose: To examine the effect of organizational culture and climate on depressive symptoms among nursing home residents. Design and Methods: Using a pooled cross-sectional design, this study examines a sample of 23 nursing homes, 1,114 employees, and 5,497 residents. Depressive symptoms were measured using the Minimum Data Set, Depression Rating…

  4. Hydrolysis evolution in a codigestion reactor at various hydraulic residence times

    Directory of Open Access Journals (Sweden)

    Gloria González

    2014-01-01

    Full Text Available The aim of this research is to study the influence of two different hydraulic residence times (HRT's, 5 and 10 days, on the process of hydrolysis-solubilization in a codigestion reactor. Tap water was used to simulate recirculation of a treated leachate. Organic solid waste (OSW from urban solid waste (USW and excess sludge from an urban wastewater treatment plant were first characterized and then treated together by anaerobic codigestion. This was done using a 27.2-L total volume pilot scale bioreactor, which was loaded with equal amounts (w/w of OSW and sludge to a total useful volume of 13-L. The bioreactor was filled with tap water to ensure high humidity. In order to assure suitable mixing and good microbial-substrate contact in the reactor, recirculation of treated effluent was maintained by continuous water flow. The influence of HRT on the process performance was determined through physicochemical characterization of the effluent. Results indicate that HRT is a determinant factor in the efficiency of the system. Reducing HRT increases hydrodynamics and solubilization kinetic rate of organic matter in the bioreactor. Stabilization time of solids is reduced from 20 to 10 days when HRT is shortened from 10 to 5 days.

  5. Plan for radionuclide tracer studies of the residence time distribution in the Wilsonville dissolver and preheater

    Energy Technology Data Exchange (ETDEWEB)

    Jolley, R.L.; Begovich, J.M.; Brashear, H.R.; Case, N.; Clark, T.G.; Emery, J.F.; Patton, B.D.; Rodgers, B.R.; Villiers-Fisher, J.F.; Watson, J.S.

    1983-12-01

    Stimulus-response measurements using radiotracers to measure residence time distribution (RTD) and hydrodynamic parameters for the preheaters and dissolvers at the Ft. Lewis Solvent Refined Coal (SRC) and the Exxon Donor Solvent (EDS) coal conversion pilot plants are reviewed. A plan is also presented for a series of radioactive tracer studies proposed for the Advanced Coal Liquefaction Facility at Wilsonville, Alabama, to measure the RTD for the preheater and dissolvers in the SRC-I mode. The tracer for the gas phase will be /sup 133/Xe, and /sup 198/Au (on carbonized resin or as an aqueous colloidal suspension) will be used as the slurry tracer. Four experimental phases are recommended for the RTD tracer studies: (1) preheater; (2) dissolver with 100% takeoff; (3) dissolver with 100% takeoff and solids withdrawal; and (4) dissolver with 50% takeoff. Eighteen gas-tracer and 22 liquid-tracer injections are projected to accomplish the four experimental phases. Two to four tracer injections are projected for preliminary tests to ensure the capability of safe injection of the radiotracers and the collection of statistically significant data. A complete projected cost and time schedule is provided, including procurement of necessary components, preparation of the radiotracers, assembly and testing of tracer injection apparatus and detection systems, onsite work and tracer injections, laboratory experimentation, data analysis, and report writing.

  6. Plan for radionuclide tracer studies of the residence time distribution in the Wilsonville dissolver and preheater

    International Nuclear Information System (INIS)

    Jolley, R.L.; Begovich, J.M.; Brashear, H.R.

    1983-12-01

    Stimulus-response measurements using radiotracers to measure residence time distribution (RTD) and hydrodynamic parameters for the preheaters and dissolvers at the Ft. Lewis Solvent Refined Coal (SRC) and the Exxon Donor Solvent (EDS) coal conversion pilot plants are reviewed. A plan is also presented for a series of radioactive tracer studies proposed for the Advanced Coal Liquefaction Facility at Wilsonville, Alabama, to measure the RTD for the preheater and dissolvers in the SRC-I mode. The tracer for the gas phase will be 133 Xe, and 198 Au (on carbonized resin or as an aqueous colloidal suspension) will be used as the slurry tracer. Four experimental phases are recommended for the RTD tracer studies: (1) preheater; (2) dissolver with 100% takeoff; (3) dissolver with 100% takeoff and solids withdrawal; and (4) dissolver with 50% takeoff. Eighteen gas-tracer and 22 liquid-tracer injections are projected to accomplish the four experimental phases. Two to four tracer injections are projected for preliminary tests to ensure the capability of safe injection of the radiotracers and the collection of statistically significant data. A complete projected cost and time schedule is provided, including procurement of necessary components, preparation of the radiotracers, assembly and testing of tracer injection apparatus and detection systems, onsite work and tracer injections, laboratory experimentation, data analysis, and report writing

  7. Competency-based residency training and the web log: modeling practice-based learning and enhancing medical knowledge.

    Science.gov (United States)

    Hollon, Matthew F

    2015-01-01

    By using web-based tools in medical education, there are opportunities to innovatively teach important principles from the general competencies of graduate medical education. Postulating that faculty transparency in learning from uncertainties in clinical work could help residents to incorporate the principles of practice-based learning and improvement (PBLI) in their professional development, faculty in this community-based residency program modeled the steps of PBLI on a weekly basis through the use of a web log. The program confidentially surveyed residents before and after this project about actions consistent with PBLI and knowledge acquired through reading the web log. The frequency that residents encountered clinical situations where they felt uncertain declined over the course of the 24 weeks of the project from a mean frequency of uncertainty of 36% to 28% (Wilcoxon signed rank test, p=0.008); however, the frequency with which residents sought answers when faced with uncertainty did not change (Wilcoxon signed rank test, p=0.39), remaining high at approximately 80%. Residents answered a mean of 52% of knowledge questions correct when tested prior to faculty posts to the blog, rising to a mean of 65% of questions correct when tested at the end of the project (paired t-test, p=0.001). Faculty role modeling of PBLI behaviors and posting clinical questions and answers to a web log led to modest improvements in medical knowledge but did not alter behavior that was already taking place frequently among residents.

  8. Internal Medicine Residents' Perceptions of Team-Based Care and its Educational Value in the Continuity Clinic: A Qualitative Study.

    Science.gov (United States)

    Soones, Tacara N; O'Brien, Bridget C; Julian, Katherine A

    2015-09-01

    In order to teach residents how to work in interprofessional teams, educators in graduate medical education are implementing team-based care models in resident continuity clinics. However, little is known about the impact of interprofessional teams on residents' education in the ambulatory setting. To identify factors affecting residents' experience of team-based care within continuity clinics and the impact of these teams on residents' education. This was a qualitative study of focus groups with internal medicine residents. Seventy-seven internal medicine residents at the University of California San Francisco at three continuity clinic sites participated in the study. Qualitative interviews were audiotaped and transcribed. The authors used a general inductive approach with sensitizing concepts in four frames (structural, human resources, political and symbolic) to develop codes and identify themes. Residents believed that team-based care improves continuity and quality of care. Factors in four frames affected their ability to achieve these goals. Structural factors included communication through the electronic medical record, consistent schedules and regular team meetings. Human resources factors included the presence of stable teams and clear roles. Political and symbolic factors negatively impacted team-based care, and included low staffing ratios and a culture of ultimate resident responsibility, respectively. Regardless of the presence of these factors or resident perceptions of their teams, residents did not see the practice of interprofessional team-based care as intrinsically educational. Residents' experiences practicing team-based care are influenced by many principles described in the interprofessional teamwork literature, including understanding team members' roles, good communication and sufficient staffing. However, these attributes are not correlated with residents' perceptions of the educational value of team-based care. Including residents in

  9. Accessing doctors at times of need-measuring the distance tolerance of rural residents for health-related travel.

    Science.gov (United States)

    McGrail, Matthew Richard; Humphreys, John Stirling; Ward, Bernadette

    2015-05-29

    Poor access to doctors at times of need remains a significant impediment to achieving good health for many rural residents. The two-step floating catchment area (2SFCA) method has emerged as a key tool for measuring healthcare access in rural areas. However, the choice of catchment size, a key component of the 2SFCA method, is problematic because little is known about the distance tolerance of rural residents for health-related travel. Our study sought new evidence to test the hypothesis that residents of sparsely settled rural areas are prepared to travel further than residents of closely settled rural areas when accessing primary health care at times of need. A questionnaire survey of residents in five small rural communities of Victoria and New South Wales in Australia was used. The two outcome measures were current travel time to visit their usual doctor and maximum time prepared to travel to visit a doctor, both for non-emergency care. Kaplan-Meier charts were used to compare the association between increased distance and decreased travel propensity for closely-settled and sparsely-settled areas, and ordinal multivariate regression models tested significance after controlling for health-related travel moderating factors and town clustering. A total of 1079 questionnaires were completed with 363 from residents in closely-settled locations and 716 from residents in sparsely-settled areas. Residents of sparsely-settled communities travel, on average, 10 min further than residents of closely-settled communities (26.3 vs 16.9 min, p time prepared to travel (54.1 vs 31.9 min, p time remained significant after controlling for demographic and other constraints to access, such as transport availability or difficulties getting doctor appointments, as well as after controlling for town clustering and current travel times. Improved geographical access remains a key issue underpinning health policies designed to improve the provision of rural primary health care

  10. Improving resident's skills in the management of circulatory shock with a knowledge-based e-learning tool.

    Science.gov (United States)

    Riaño, David; Real, Francis; Alonso, Jose Ramon

    2018-05-01

    Correct clinical management of circulatory shock in emergency departments (ER) and intensive care units (ICU) is critical. In this context, the transmission of professional skills by means of the practical supervision of real cases at the point of care entails important issues that can be widely overcome with the use of computer knowledge-based e-learning tools. Shock-Instructor is a web-based e-learning tool implementing the already tested training program model (TPM) that uses a knowledge base about the evidence found in the clinical practice guidelines about seven types of shock. This tool is expected to reduce the learning times and to improve the skills of hospital residents with regard to both the correct application of the guidelines and patient recovery, suppressing the risks of direct interventions. Shock-Instructor has been used to train residents in the Emergency Department of the Hospital Clínic de Barcelona (Spain) in order to reduce the learning cycle without affecting quality. A case-base with the description of 51 cases with shock and a knowledge-base with 137 clinical rules about the treatment of shock were incorporated to the Shock-Instructor system. A group of 33 residents was involved in a randomized controlled trial to check whether the use of Shock-Instructor can significantly improve the skills of clinicians after one week of problem-based training. No significant differences were found in the skill levels of the intervention (IG) and control (CG) groups prior to learning. However, we observed an improvement of the IG clinicians capacity to stabilize patients with shock in better clinical conditions (5% improvement, p = 0.004), and to reduce the risk of death in 19.52% (p = 0.004), after training. First-year residents in IG enhanced 14.3% their sensitivity in the correct application of guidelines (p = 0.01), and 14.9% the mean survival rate of their patients (p = 0.01), after being trained with Shock-Instructor for a week

  11. Education research: a case-based bioethics curriculum for neurology residents.

    Science.gov (United States)

    Tolchin, Benjamin; Willey, Joshua Z; Prager, Kenneth

    2015-03-31

    In 2012, the American Academy of Neurology (AAN) updated and expanded its ethics curriculum into Practical Ethics in Clinical Neurology, a case-based ethics curriculum for neurologists. We piloted a case-based bioethics curriculum for neurology residents using the framework and topics recommended by the AAN, matched to clinical cases drawn from Columbia's neurologic services. Our primary outcome was residents' ability to analyze and manage ethically complex cases as measured on precurriculum and postcurriculum multiple-choice quizzes. Secondary outcomes included precurriculum and postcurriculum self-assessed comfort in discussing and managing ethically complex cases, as well as attendance at ethics discussion sessions as compared to attendance at other didactic sessions. Resident performance on quizzes improved from 75.8% to 86.7% (p = 0.02). Comfort in discussing ethically complex cases improved from 6.4 to 7.4 on a 10-point scale (p = 0.03). Comfort in managing such cases trended toward improvement but did not reach statistical significance. Attendance was significantly better at ethics discussions (73.5%) than at other didactic sessions (61.7%, p = 0.04). Our formal case-based ethics curriculum for neurology residents, based on core topics drawn from the AAN's published curricula, was successfully piloted. Our study showed a statistically significant improvement in residents' ability to analyze and manage ethically complex cases as measured by multiple-choice tests and self-assessments. © 2015 American Academy of Neurology.

  12. Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents.

    Science.gov (United States)

    Park, Yeonhwan; Oh, Seieun; Chang, Heekyung; Bang, Hwal Lan

    2015-11-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents" found on pages 30-39, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until October 31, 2018. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Explain the development and testing of the Evidence-Based Nursing Care Algorithm of

  13. Videoconferencing of a national program for residents on evidence-based practice: early performance evaluation.

    LENUS (Irish Health Repository)

    O'Regan, Kevin

    2010-01-01

    The aim of this study was to evaluate the effectiveness of the medium of videoconferencing for the delivery of a course for radiology residents in practice-based learning (PBL), including evidence-based practice, at centers geographically separated from the principal teaching site.

  14. Informatics in radiology: web-based preliminary reporting system for radiology residents with PACS integration.

    Science.gov (United States)

    O'Connell, Timothy; Chang, Debra

    2012-01-01

    While on call, radiology residents review imaging studies and issue preliminary reports to referring clinicians. In the absence of an integrated reporting system at the training sites of the authors' institution, residents were typing and faxing preliminary reports. To partially automate the on-call resident workflow, a Web-based system for resident reporting was developed by using the free open-source xAMP Web application framework and an open-source DICOM (Digital Imaging and Communications in Medicine) software toolkit, with the goals of reducing errors and lowering barriers to education. This reporting system integrates with the picture archiving and communication system to display a worklist of studies. Patient data are automatically entered in the preliminary report to prevent identification errors and simplify the report creation process. When the final report for a resident's on-call study is available, the reporting system queries the report broker for the final report, and then displays the preliminary report side by side with the final report, thus simplifying the review process and encouraging review of all of the resident's reports. The xAMP Web application framework should be considered for development of radiology department informatics projects owing to its zero cost, minimal hardware requirements, ease of programming, and large support community.

  15. Burnout in Medical Residents: A Study Based on the Job Demands-Resources Model

    Directory of Open Access Journals (Sweden)

    Panagiotis Zis

    2014-01-01

    Full Text Available Purpose. Burnout is a prolonged response to chronic emotional and interpersonal stressors on the job. The purpose of our cross-sectional study was to estimate the burnout rates among medical residents in the largest Greek hospital in 2012 and identify factors associated with it, based on the job demands-resources model (JD-R. Method. Job demands were examined via a 17-item questionnaire assessing 4 characteristics (emotional demands, intellectual demands, workload, and home-work demands’ interface and job resources were measured via a 14-item questionnaire assessing 4 characteristics (autonomy, opportunities for professional development, support from colleagues, and supervisor’s support. The Maslach Burnout Inventory (MBI was used to measure burnout. Results. Of the 290 eligible residents, 90.7% responded. In total 14.4% of the residents were found to experience burnout. Multiple logistic regression analysis revealed that each increased point in the JD-R questionnaire score regarding home-work interface was associated with an increase in the odds of burnout by 25.5%. Conversely, each increased point for autonomy, opportunities in professional development, and each extra resident per specialist were associated with a decrease in the odds of burnout by 37.1%, 39.4%, and 59.0%, respectively. Conclusions. Burnout among medical residents is associated with home-work interface, autonomy, professional development, and resident to specialist ratio.

  16. General surgery morning report: a competency-based conference that enhances patient care and resident education.

    Science.gov (United States)

    Stiles, Brendon M; Reece, T Brett; Hedrick, Traci L; Garwood, Robert A; Hughes, Michael G; Dubose, Joseph J; Adams, Reid B; Schirmer, Bruce D; Sanfey, Hilary A; Sawyer, Robert G

    2006-01-01

    After adopting a night float system, the residency program at the University of Virginia Health System Department of Surgery initiated a daily morning report (MR). The conference was originated to sign out new admissions and consults from the previous day to the services that would assume care. Although initially oriented toward transfer of patient information, MR is also hypothesized to serve as a competency-based resident education tool. An anonymous survey was distributed to on-service residents (n = 25). Questions were asked on a 5-point Likert scale. Respondents also ranked the weekly conferences, including MR, in terms of educational benefit derived. Most residents agreed that MR is an efficient method to sign-out patient care [84% stongly agree (SA) or agree (A)] and that it provides an excellent educational experience (88% SA or A). They agreed that it is presented in an evidence-based format (88% SA or A). Regarding the core competencies, residents all asserted that MR addresses "patient care" (100% SA or A) and "medical knowledge" (100% SA or A). Most agreed that it addresses "professionalism" (60% SA or A), "interpersonal skills and communication" (76% SA or A), and "practice-based learning and improvement" (92% SA or A). The 4 most important components identified with respect to continuing to improve both patient care and resident education were the presence of the on-call attending, a review of relevant radiology, provision of follow-up on select cases, and critical review of the literature. On average, MR was seen as the most educational conference, with 52% of residents ranking it first. Although MR is ubiquitous in most primary care residency programs, such a conference has not typically been held on surgical services. The MR was developed at the University of Virginia Health System Department of Surgery as a necessity for patient sign-out. As this conference has continued to evolve, it has become an excellent tool for resident education. It now

  17. Are general surgery residents adequately prepared for hepatopancreatobiliary fellowships? A questionnaire-based study

    Science.gov (United States)

    Osman, Houssam; Parikh, Janak; Patel, Shirali; Jeyarajah, D Rohan

    2015-01-01

    Background The present study was conducted to assess the preparedness of hepatopancreatobiliary (HPB) fellows upon entering fellowship, identify challenges encountered by HPB fellows during the initial part of their HPB training, and identify potential solutions to these challenges that can be applied during residency training. Methods A questionnaire was distributed to all HPB fellows in accredited HPB fellowship programmes in two consecutive academic years (n = 42). Reponses were then analysed. Results A total of 19 (45%) fellows responded. Prior to their fellowship, 10 (53%) were in surgical residency and the rest were in other surgical fellowships or surgical practice. Thirteen (68%) were graduates of university-based residency programmes. All fellows felt comfortable in performing basic laparoscopic procedures independently at the completion of residency and less comfortable in performing advanced laparoscopy. Eight (42%) fellows cited a combination of inadequate case volume and lack of autonomy during residency as the reasons for this lack of comfort. Thirteen (68%) identified inadequate preoperative workup and management as their biggest fear upon entering practice after general surgery training. A total of 17 (89%) fellows felt they were adequately prepared to enter HPB fellowship. Extra rotations in transplant, vascular or minimally invasive surgery were believed to be most helpful in preparing general surgery residents pursing HPB fellowships. Conclusions Overall, HPB fellows felt themselves to be adequately prepared for fellowship. Advanced laparoscopic procedures and the perioperative management of complex patients are two of the challenges facing HPB fellows. General surgery residents who plan to pursue an HPB fellowship may benefit from spending extra rotations on certain subspecialties. Focus on perioperative workup and management should be an integral part of residency and fellowship training. PMID:25387852

  18. Time-motion studies of internal medicine residents' duty hours: a systematic review and meta-analysis.

    Science.gov (United States)

    Leafloor, Cameron W; Lochnan, Heather A; Code, Catherine; Keely, Erin J; Rothwell, Deanna M; Forster, Alan J; Huang, Allen R

    2015-01-01

    Since the mid-1980s, medical residents' long duty hours have been under scrutiny as a factor affecting patient safety and the work environment for the residents. After several mandated changes in duty hours, it is important to understand how residents spend their time before proposing and implementing future changes. Time-motion methodology may provide reliable information on what residents do while on duty. The purpose of this study is to review all available literature pertaining to time-motion studies of internal medicine residents while on a medicine service and to understand how much of their time is apportioned to various categories of tasks, and also to determine the effects of the Accreditation Council for Graduate Medical Education (ACGME)-mandated duty hour changes on resident workflow in North America. Electronic bibliographic databases were searched for articles in English between 1941 and April 2013 reporting time-motion studies of internal medicine residents rotating through a general medicine service. Eight articles were included. Residents spent 41.8% of time in patient care activities, 18.1% communicating, 13.8% in educational activities, 19.7% in personal/other, and 6.6% in transit. North American data showed the following changes after the implementation of the ACGME 2003 duty hours standard: patient care activities from 41.8% to 40.8%, communication activities from 19.0% to 22.3%, educational activities from 17.7% to 11.6%, and personal/other activities from 21.5% to 17.1%. There was a paucity of time-motion data. There was great variability in the operational definitions of task categories reported in the studies. Implementation of the ACGME duty hour standards did not have a significant effect on the percentage of time spent in particular tasks. There are conflicting reports on how duty hour changes have affected patient safety. A low proportion of time spent in educational activities deserves further study and may point to a review of the

  19. Use of tritium for estimation of groundwater mean residence time, a case study of the Ain Al-Samak Karst springs (Central Syria)

    International Nuclear Information System (INIS)

    Kattan, Z.

    2003-01-01

    This work is an attempt to estimate the mean residence time of groundwater in the Ain Al-Tanour and Ain-Samak, which are the major karst springs in the Upper Orontes Basin (Central Syria). This estimate, which consists on the application of a mathematical modeling approach, was based on the use of tritium, as a natural radioisotope tracer and a tool for ground water age dating. By adopting a completely mixed reservoir model, linked with exponential time distribution function, the mean residence time (turnover time) of these two springs was evaluated to be about 50 years. This result is in good agreement with previous estimation obtained for the Figeh main spring, which belongs to the same aquifer (Cenomanian-Turonian complex) in the Damascus Basin. On the basis of this evaluation, a value of about 800 million m 3 was obtained for the maximum groundwater reservoir size

  20. Evaluation of a web-based portal to improve resident education by neonatology fellows

    Directory of Open Access Journals (Sweden)

    Ashwini Lakshmanan

    2014-07-01

    Full Text Available Background: Integration of web-based educational tools into medical training has been shown to increase accessibility of resources and optimize teaching. We developed a web-based educational portal (WBEP to support teaching of pediatric residents about newborn medicine by neonatology fellows. Objectives: 1 To compare residents’ attitudes about their fellow-led education in the NICU pre- and post-WBEP; including assessment of factors that impact their education and usefulness of teaching tools. 2 To compare fellow utilization of various teaching modalities pre- and post-WBEP. Design/methods: We queried residents about their attitudes regarding fellow-led education efforts and various teaching modalities in the NICU and logistics potentially impacting effectiveness. Based on these data, we introduced the WBEP – a repository of teaching tools (e.g., mock code cases, board review questions, journal articles, case-based discussion scenarios for use by fellows to supplement didactic sessions in a faculty-based curriculum. We surveyed residents about the effectiveness of fellow teaching pre- and post-WBEP implementation and the type of fellow-led teaching modalities that were used. Results: After analysis of survey responses, we identified that residents cited fellow level of interest as the most important factor impacting their education. Post-implementation, residents described greater utilization of various teaching modalities by fellows, including an increase in use of mock codes (14% to 76%, p<0.0001 and journal articles (33% to 59%, p=0.02. Conclusions: A web-based resource that supplements traditional curricula led to greater utilization of various teaching modalities by fellows and may encourage fellow involvement in resident teaching.

  1. Milk performance of two cow breeds at two levels of supplementation in long residence time grazing paddocks

    OpenAIRE

    Roca Fernandez, Ana Isabel; González-Rodríguez, Antonio; Leurent, S.; López-Mosquera, M.E.; Gallard, Yves; Delaby, Luc

    2012-01-01

    Milk performance of four groups of cows (H0, H4, N0 and N4) was studied under grazing: two cow breeds, Holstein-Friesian (H) vs. Normande (N), supplemented at pasture with two levels of concentrate, low vs. high (0 and 4 kg cow–1 day–1). A simplified rotational grazing system using three paddocks per rotation with a mean residence time per paddock of 10-days was examined. During this long residence time, maximum milk yield (MY max.) was reached at day 4 followed by a milk yield drop (Dm) at t...

  2. Investigation of residence time and groundwater flux in Venice Lagoon: comparing radium isotope and hydrodynamic models.

    Science.gov (United States)

    Rapaglia, John; Ferrarin, Christian; Zaggia, Luca; Moore, Willard S; Umgiesser, Georg; Garcia-Solsona, Ester; Garcia-Orellana, Jordi; Masqué, Pere

    2010-07-01

    The four naturally-occurring isotopes of radium were coupled with a previously evaluated hydrodynamic model to determine the apparent age of surface waters and to quantify submarine groundwater discharge (SGD) into the Venice Lagoon, Italy. Mean apparent age of water in the Venice Lagoon was calculated using the ratio of 224Ra to 228Ra determined from 30 monitoring stations and a mean pore water end member. Average apparent age was calculated to be 6.0 d using Ra ratios. This calculated age was very similar to average residence time calculated for the same period using a hydrodynamic model (5.8 d). A mass balance of Ra was accomplished by quantifying each of the sources and sinks of Ra in the lagoon, with the unknown variable being attributed to SGD. Total SGD were calculated to be 4.1 +/- 1.5, 3.8 +/- 0.7, 3.0 +/- 1.3, and 3.5 +/- 1.0 x 10(10) L d(-1) for (223,224,226, 228)Ra, respectively, which are an order of magnitude larger than total mean fluvial discharge into the Venice Lagoon (3.1 x 10(9) L d(-1)). The SGD as a source of nutrients in the Venice Lagoon is also discussed and, though significant to the nutrient budget, is likely to be less important as the dominant control on SGD is recirculated seawater rather than freshwater. 2009 Elsevier Ltd. All rights reserved.

  3. Elucidating the Origin of Long Residence Time Binding for Inhibitors of the Metalloprotease Thermolysin.

    Science.gov (United States)

    Cramer, Jonathan; Krimmer, Stefan G; Fridh, Veronica; Wulsdorf, Tobias; Karlsson, Robert; Heine, Andreas; Klebe, Gerhard

    2017-01-20

    Kinetic parameters of protein-ligand interactions are progressively acknowledged as valuable information for rational drug discovery. However, a targeted optimization of binding kinetics is not easy to achieve, and further systematic studies are necessary to increase the understanding about molecular mechanisms involved. We determined association and dissociation rate constants for 17 inhibitors of the metalloprotease thermolysin by surface plasmon resonance spectroscopy and correlated kinetic data with high-resolution crystal structures in complex with the protein. From the structure-kinetics relationship, we conclude that the strength of interaction with Asn112 correlates with the rate-limiting step of dissociation. This residue is located at the beginning of a β-strand motif that lines the binding cleft and is commonly believed to align a substrate for catalysis. A reduced mobility of the Asn112 side chain owing to an enhanced engagement in charge-assisted hydrogen bonds prevents the conformational adjustment associated with ligand release and transformation of the enzyme to its open state. This hypothesis is supported by kinetic data of ZF P LA, a known pseudopeptidic inhibitor of thermolysin, which blocks the conformational transition of Asn112. Interference with this retrograde induced-fit mechanism results in variation of the residence time of thermolysin inhibitors by a factor of 74 000. The high conservation of this structural motif within the M4 and M13 metalloprotease families underpins the importance of this feature and has significant implications for drug discovery.

  4. Optimized Inhibitors of Soluble Epoxide Hydrolase Improve in Vitro Target Residence Time and in Vivo Efficacy

    Science.gov (United States)

    2015-01-01

    Diabetes is affecting the life of millions of people. A large proportion of diabetic patients suffer from severe complications such as neuropathic pain, and current treatments for these complications have deleterious side effects. Thus, alternate therapeutic strategies are needed. Recently, the elevation of epoxy-fatty acids through inhibition of soluble epoxide hydrolase (sEH) was shown to reduce diabetic neuropathic pain in rodents. In this report, we describe a series of newly synthesized sEH inhibitors with at least 5-fold higher potency and doubled residence time inside both the human and rodent sEH enzyme than previously reported inhibitors. These inhibitors also have better physical properties and optimized pharmacokinetic profiles. The optimized inhibitor selected from this new series displayed improved efficacy of almost 10-fold in relieving pain perception in diabetic neuropathic rats as compared to the approved drug, gabapentin, and previously published sEH inhibitors. Therefore, these new sEH inhibitors could be an attractive alternative to treat diabetic neuropathy in humans. PMID:25079952

  5. Relating hyporheic fluxes, residence times, and redox-sensitive biogeochemical processes upstream of beaver dams

    Science.gov (United States)

    Briggs, Martin A.; Lautz, Laura; Hare, Danielle K.

    2013-01-01

    Abstract. Small dams enhance the development of patchy microenvironments along stream corridors by trapping sediment and creating complex streambed morphologies. This patchiness drives intricate hyporheic flux patterns that govern the exchange of O2 and redox-sensitive solutes between the water column and the stream bed. We used multiple tracer techniques, naturally occurring and injected, to evaluate hyporheic flow dynamics and associated biogeochemical cycling and microbial reactivity around 2 beaver dams in Wyoming (USA). High-resolution fiber-optic distributed temperature sensing was used to collect temperature data over 9 vertical streambed profiles and to generate comprehensive vertical flux maps using 1-dimensional (1-D) heat-transport modeling. Coincident with these locations, vertical profiles of hyporheic water were collected every week and analyzed for dissolved O2, pH, dissolved organic C, and several conservative and redox-sensitive solutes. In addition, hyporheic and net stream aerobic microbial reactivity were analyzed with a constant-rate injection of the biologically sensitive resazurin (Raz) smart tracer. The combined results revealed a heterogeneous system with rates of downwelling hyporheic flow organized by morphologic unit and tightly coupled to the redox conditions of the subsurface. Principal component analysis was used to summarize the variability of all redox-sensitive species, and results indicated that hyporheic water varied from oxic-stream-like to anoxic-reduced in direct response to the hydrodynamic conditions and associated residence times. The anaerobic transition threshold predicted by the mean O2 Damko

  6. Drug-target residence time--a case for G protein-coupled receptors.

    Science.gov (United States)

    Guo, Dong; Hillger, Julia M; IJzerman, Adriaan P; Heitman, Laura H

    2014-07-01

    A vast number of marketed drugs act on G protein-coupled receptors (GPCRs), the most successful category of drug targets to date. These drugs usually possess high target affinity and selectivity, and such combined features have been the driving force in the early phases of drug discovery. However, attrition has also been high. Many investigational new drugs eventually fail in clinical trials due to a demonstrated lack of efficacy. A retrospective assessment of successfully launched drugs revealed that their beneficial effects in patients may be attributed to their long drug-target residence times (RTs). Likewise, for some other GPCR drugs short RT could be beneficial to reduce the potential for on-target side effects. Hence, the compounds' kinetics behavior might in fact be the guiding principle to obtain a desired and durable effect in vivo. We therefore propose that drug-target RT should be taken into account as an additional parameter in the lead selection and optimization process. This should ultimately lead to an increased number of candidate drugs moving to the preclinical development phase and on to the market. This review contains examples of the kinetics behavior of GPCR ligands with improved in vivo efficacy and summarizes methods for assessing drug-target RT. © 2014 Wiley Periodicals, Inc.

  7. Scrutinizing the carbon cycle and CO2 residence time in the atmosphere

    Science.gov (United States)

    Harde, Hermann

    2017-05-01

    Climate scientists presume that the carbon cycle has come out of balance due to the increasing anthropogenic emissions from fossil fuel combustion and land use change. This is made responsible for the rapidly increasing atmospheric CO2 concentrations over recent years, and it is estimated that the removal of the additional emissions from the atmosphere will take a few hundred thousand years. Since this goes along with an increasing greenhouse effect and a further global warming, a better understanding of the carbon cycle is of great importance for all future climate change predictions. We have critically scrutinized this cycle and present an alternative concept, for which the uptake of CO2 by natural sinks scales proportional with the CO2 concentration. In addition, we consider temperature dependent natural emission and absorption rates, by which the paleoclimatic CO2 variations and the actual CO2 growth rate can well be explained. The anthropogenic contribution to the actual CO2 concentration is found to be 4.3%, its fraction to the CO2 increase over the Industrial Era is 15% and the average residence time 4 years.

  8. The effect of residence time on the tensile properties of superelastic and thermal activated Ni-Ti orthodontic wires

    Directory of Open Access Journals (Sweden)

    Kathia Maria Fosenca de Britto

    2011-09-01

    Full Text Available Since the 1980s, different devices based on superelastic alloys have been developed to fulfill orthodontic applications. Particularly in the last decades several researches have been carried out to evaluate the mechanical behavior of Ni-Ti alloys, including their tensile, torsion and fatigue properties. However, studies regarding the dependence of elastic properties on residence time of Ni-Ti wires in the oral cavity are scarce. Such approach is essential since metallic alloys are submitted to mechanical stresses during orthodontic treatment as well as pH and temperature fluctuations. The goal of the present contribution is to provide elastic stress-strain results to guide the orthodontic choice between martensitic thermal activated and austenitic superelastic Ni-Ti alloys. From the point of view of an orthodontist, the selection of appropriate materials and the correct maintenance of the orthodontic apparatus are essential needs during clinical treatment. The present work evaluated the elastic behavior of Ni-Ti alloy wires with diameters varying from 0.014 to 0.020 inches, submitted to hysteresis tensile tests with 8% strain. Tensile tests were performed after periods of use of 1, 2 and 3 months in the oral cavity of patients submitted to orthodontic treatment. The results from the hysteresis tests allowed to exam the strain range covered by isostress lines upon loading and unloading, as well as the residual strain after unloading for both superelastic and thermal activated Ni-Ti wires. Superelastic Ni-Ti wires exhibited higher load isostress values compared to thermal activated wires. It was found that such differences in the load isostress values can increase with increasing residence time.

  9. The decadal state of the terrestrial carbon cycle: Global retrievals of terrestrial carbon allocation, pools, and residence times.

    Science.gov (United States)

    Bloom, A Anthony; Exbrayat, Jean-François; van der Velde, Ivar R; Feng, Liang; Williams, Mathew

    2016-02-02

    The terrestrial carbon cycle is currently the least constrained component of the global carbon budget. Large uncertainties stem from a poor understanding of plant carbon allocation, stocks, residence times, and carbon use efficiency. Imposing observational constraints on the terrestrial carbon cycle and its processes is, therefore, necessary to better understand its current state and predict its future state. We combine a diagnostic ecosystem carbon model with satellite observations of leaf area and biomass (where and when available) and soil carbon data to retrieve the first global estimates, to our knowledge, of carbon cycle state and process variables at a 1° × 1° resolution; retrieved variables are independent from the plant functional type and steady-state paradigms. Our results reveal global emergent relationships in the spatial distribution of key carbon cycle states and processes. Live biomass and dead organic carbon residence times exhibit contrasting spatial features (r = 0.3). Allocation to structural carbon is highest in the wet tropics (85-88%) in contrast to higher latitudes (73-82%), where allocation shifts toward photosynthetic carbon. Carbon use efficiency is lowest (0.42-0.44) in the wet tropics. We find an emergent global correlation between retrievals of leaf mass per leaf area and leaf lifespan (r = 0.64-0.80) that matches independent trait studies. We show that conventional land cover types cannot adequately describe the spatial variability of key carbon states and processes (multiple correlation median = 0.41). This mismatch has strong implications for the prediction of terrestrial carbon dynamics, which are currently based on globally applied parameters linked to land cover or plant functional types.

  10. The decadal state of the terrestrial carbon cycle: Global retrievals of terrestrial carbon allocation, pools, and residence times

    Science.gov (United States)

    Bloom, A. Anthony; Exbrayat, Jean-François; van der Velde, Ivar R.; Feng, Liang; Williams, Mathew

    2016-01-01

    The terrestrial carbon cycle is currently the least constrained component of the global carbon budget. Large uncertainties stem from a poor understanding of plant carbon allocation, stocks, residence times, and carbon use efficiency. Imposing observational constraints on the terrestrial carbon cycle and its processes is, therefore, necessary to better understand its current state and predict its future state. We combine a diagnostic ecosystem carbon model with satellite observations of leaf area and biomass (where and when available) and soil carbon data to retrieve the first global estimates, to our knowledge, of carbon cycle state and process variables at a 1° × 1° resolution; retrieved variables are independent from the plant functional type and steady-state paradigms. Our results reveal global emergent relationships in the spatial distribution of key carbon cycle states and processes. Live biomass and dead organic carbon residence times exhibit contrasting spatial features (r = 0.3). Allocation to structural carbon is highest in the wet tropics (85–88%) in contrast to higher latitudes (73–82%), where allocation shifts toward photosynthetic carbon. Carbon use efficiency is lowest (0.42–0.44) in the wet tropics. We find an emergent global correlation between retrievals of leaf mass per leaf area and leaf lifespan (r = 0.64–0.80) that matches independent trait studies. We show that conventional land cover types cannot adequately describe the spatial variability of key carbon states and processes (multiple correlation median = 0.41). This mismatch has strong implications for the prediction of terrestrial carbon dynamics, which are currently based on globally applied parameters linked to land cover or plant functional types. PMID:26787856

  11. Water availability limits tree productivity, carbon stocks, and carbon residence time in mature forests across the western US

    Science.gov (United States)

    Berner, Logan T.; Law, Beverly E.; Hudiburg, Tara W.

    2017-01-01

    Water availability constrains the structure and function of terrestrial ecosystems and is projected to change in many parts of the world over the coming century. We quantified the response of tree net primary productivity (NPP), live biomass (BIO), and mean carbon residence time (CRT = BIO / NPP) to spatial variation in water availability in the western US. We used forest inventory measurements from 1953 mature stands (> 100 years) in Washington, Oregon, and California (WAORCA) along with satellite and climate data sets covering the western US. We summarized forest structure and function in both domains along a 400 cm yr-1 hydrologic gradient, quantified with a climate moisture index (CMI) based on the difference between precipitation and reference evapotranspiration summed over the water year (October-September) and then averaged annually from 1985 to 2014 (CMIwy). Median NPP, BIO, and CRT computed at 10 cm yr-1 intervals along the CMIwy gradient increased monotonically with increasing CMIwy across both WAORCA (rs = 0.93-0.96, p the western US (rs = 0.93-0.99, p the driest and wettest 5 % of sites, while BIO increased from 26 to 281 Mg C ha-1 and CRT increased from 11 to 49 years. The satellite data sets revealed similar changes over the western US, though these data sets tended to plateau in the wettest areas, suggesting that additional efforts are needed to better quantify NPP and BIO from satellites in high-productivity, high-biomass forests. Our results illustrate that long-term average water availability is a key environmental constraint on tree productivity, carbon storage, and carbon residence time in mature forests across the western US, underscoring the need to assess potential ecosystem response to projected warming and drying over the coming century.

  12. Google Glass for Residents Dealing With Pediatric Cardiopulmonary Arrest: A Randomized, Controlled, Simulation-Based Study.

    Science.gov (United States)

    Drummond, David; Arnaud, Cécile; Guedj, Romain; Duguet, Alexandre; de Suremain, Nathalie; Petit, Arnaud

    2017-02-01

    To determine whether real-time video communication between the first responder and a remote intensivist via Google Glass improves the management of a simulated in-hospital pediatric cardiopulmonary arrest before the arrival of the ICU team. Randomized controlled study. Children's hospital at a tertiary care academic medical center. Forty-two first-year pediatric residents. Pediatric residents were evaluated during two consecutive simulated pediatric cardiopulmonary arrests with a high-fidelity manikin. During the second evaluation, the residents in the Google Glass group were allowed to seek help from a remote intensivist at any time by activating real-time video communication. The residents in the control group were asked to provide usual care. The main outcome measures were the proportion of time for which the manikin received no ventilation (no-blow fraction) or no compression (no-flow fraction). In the first evaluation, overall no-blow and no-flow fractions were 74% and 95%, respectively. During the second evaluation, no-blow and no-flow fractions were similar between the two groups. Insufflations were more effective (p = 0.04), and the technique (p = 0.02) and rate (p Google Glass group than in the control group. Real-time video communication between the first responder and a remote intensivist through Google Glass did not decrease no-blow and no-flow fractions during the first 5 minutes of a simulated pediatric cardiopulmonary arrest but improved the quality of the insufflations and chest compressions provided.

  13. Evidence-based practice in radiology: Knowledge, attitude and perceived barriers to practice among residents in radiology

    International Nuclear Information System (INIS)

    Anuradha, Chandramohan; Jacob, K.S.; Shyamkumar, N.K.; Sridhar, Gibikote

    2013-01-01

    Aim: We examinted the attitude, knowledge and perceived barriers to evidence-based practice of radiology (EBPR) among residents in radiology. Study design and setting: We used the McColl questionnaire (1) and the BARRIERS scale (2) to assess the issues among radiology trainees attending an annual refresher course. Ninety six residents from 32 medical colleges from Southern India attended the course. Results: Eighty (83.3%) residents, 55 male and 25 female of age range 24–34 years, consented and returned the questionnaire. The majority of the participants had a positive attitude towards EBPR. However, 45% were unaware of sources for evidence based literature although many had access to Medline (45%) and the internet (80%). The majority (70%) were aware of the common technical terms (e.g. odds ratio, absolute and relative risk) but other complex details (e.g. meta-analysis, clinical effectiveness, confidence interval, publication bias and number needed to treat) were poorly understood. Though majority of residents (59%) were currently following guidelines and protocols laid by colleagues within their departments, 70% of residents were interested in learning the skills of EBPR and were willing to appraise primary literature or systematic reviews by themselves. Insufficient time on the job to implement new ideas (70.1%); relevant literature is not being complied in one place (68.9%); not being able to understand statistical methods (68.5%) were considered to be the major barriers to EBPR. Training in critical appraisal significantly influence usage of bibliographic databases (p < 0.0001). Attitude of collegues (p = 0.006) influenced attitude of the trainees towards EBPR. Those with higher knowledge scores (p = 0.02) and a greater awareness of sources for seeking evidence based literature (p = 0.05) held stronger beliefs that EBPR significantly improved patient care. Conclusions: The large knowledge gap related to EBPR suggests the need to incorporate structured

  14. Current situation and consideration of training base hospitals for residents of neurosurgical specialization in China

    Directory of Open Access Journals (Sweden)

    Feng-zeng JIAN

    2015-07-01

    Full Text Available Resident training of neurosurgical specialization will be tried and carried out in all over China. From the point of view of training base hospitals, a majority of 3A level hospitals have sufficient patients and good equipments which will ensure the success of training process; however, division of subspecialty, teaching motivation and teaching method still have a great potential to improve. In order to establish and improve training bases for residents of specialization, supervision from national administrative department should be strengthened; professional society also plays an important role in standardizing and controlling the training quality. Considering our nation's situation, integration of postgraduate education and resident training is worth of discussion. DOI: 10.3969/j.issn.1672-6731.2015.07.015

  15. The research rotation: competency-based structured and novel approach to research training of internal medicine residents

    Directory of Open Access Journals (Sweden)

    Dimitrov Vihren

    2006-10-01

    Full Text Available Abstract Background In the United States, the Accreditation Council of graduate medical education (ACGME requires all accredited Internal medicine residency training programs to facilitate resident scholarly activities. However, clinical experience and medical education still remain the main focus of graduate medical education in many Internal Medicine (IM residency-training programs. Left to design the structure, process and outcome evaluation of the ACGME research requirement, residency-training programs are faced with numerous barriers. Many residency programs report having been cited by the ACGME residency review committee in IM for lack of scholarly activity by residents. Methods We would like to share our experience at Lincoln Hospital, an affiliate of Weill Medical College Cornell University New York, in designing and implementing a successful structured research curriculum based on ACGME competencies taught during a dedicated "research rotation". Results Since the inception of the research rotation in 2004, participation of our residents among scholarly activities has substantially increased. Our residents increasingly believe and appreciate that research is an integral component of residency training and essential for practice of medicine. Conclusion Internal medicine residents' outlook in research can be significantly improved using a research curriculum offered through a structured and dedicated research rotation. This is exemplified by the improvement noted in resident satisfaction, their participation in scholarly activities and resident research outcomes since the inception of the research rotation in our internal medicine training program.

  16. Temperature sensitivity of soil organic carbon decomposition increased with mean carbon residence time: Field incubation and data assimilation.

    Science.gov (United States)

    Zhou, Xuhui; Xu, Xia; Zhou, Guiyao; Luo, Yiqi

    2018-02-01

    Temperature sensitivity of soil organic carbon (SOC) decomposition is one of the major uncertainties in predicting climate-carbon (C) cycle feedback. Results from previous studies are highly contradictory with old soil C decomposition being more, similarly, or less sensitive to temperature than decomposition of young fractions. The contradictory results are partly from difficulties in distinguishing old from young SOC and their changes over time in the experiments with or without isotopic techniques. In this study, we have conducted a long-term field incubation experiment with deep soil collars (0-70 cm in depth, 10 cm in diameter of PVC tubes) for excluding root C input to examine apparent temperature sensitivity of SOC decomposition under ambient and warming treatments from 2002 to 2008. The data from the experiment were infused into a multi-pool soil C model to estimate intrinsic temperature sensitivity of SOC decomposition and C residence times of three SOC fractions (i.e., active, slow, and passive) using a data assimilation (DA) technique. As active SOC with the short C residence time was progressively depleted in the deep soil collars under both ambient and warming treatments, the residences times of the whole SOC became longer over time. Concomitantly, the estimated apparent and intrinsic temperature sensitivity of SOC decomposition also became gradually higher over time as more than 50% of active SOC was depleted. Thus, the temperature sensitivity of soil C decomposition in deep soil collars was positively correlated with the mean C residence times. However, the regression slope of the temperature sensitivity against the residence time was lower under the warming treatment than under ambient temperature, indicating that other processes also regulated temperature sensitivity of SOC decomposition. These results indicate that old SOC decomposition is more sensitive to temperature than young components, making the old C more vulnerable to future warmer

  17. Effects of Surgical Assistant's Level of Resident Training on Surgical Treatment of Intermittent Exotropia: Operation Time and Surgical Outcomes.

    Science.gov (United States)

    Kim, Moo Hyun; Chung, Hyunuk; Kim, Won Jae; Kim, Myung Mi

    2018-02-01

    To evaluate the effects of the surgical assistant's level of resident training on operation time and surgical outcome in the surgical treatment of intermittent exotropia. This study included 456 patients with intermittent exotropia who underwent lateral rectus recession and medial rectus resection and were followed up for 24 months after surgery. The patients were divided into two groups according to the surgical assistant's level of resident training: group F (surgery assisted by a first-year resident [n = 198]) and group S (surgery assisted by a second-, third-, or fourth-year resident [n = 258]). The operation time and surgical outcomes (postoperative exodeviation and the number of patients who underwent a second operation) were compared between the two groups. The average operation times in groups F and S were 36.54 ± 7.4 and 37.34 ± 9.94 minutes, respectively (p = 0.33). Immediate postoperative exodeviation was higher in group F (0.79 ± 3.82 prism diopters) than in group S (0.38 ± 3.75 prism diopters). However, repeated-measures analysis of variance revealed no significant difference in exodeviation between the two groups during the 24-month follow-up period (p = 0.45). A second operation was performed in 29.3% (58 / 198) of the patients in group F, and in 32.2% (83 / 258) of those in group S (p = 0.51). No significant difference in operation time was observed when we compared the effects of the level of resident training in the surgical treatment of intermittent exotropia. Although the immediate postoperative exodeviation was higher in patients who had undergone surgery assisted by a first-year resident, the surgical outcome during the 24-month follow-up was not significantly different.

  18. The role of exposure time in computerized training of prostate cryosurgery: performance comparison of surgical residents with engineering students.

    Science.gov (United States)

    Joshi, Purva; Sehrawat, Anjali; Rabin, Yoed

    2018-04-01

    This study aims at the evaluation of a prototype of a computerized trainer for cryosurgery-the controlled destruction of cancer tumors by freezing. The hypothesis in this study is that computer-based cryosurgery training for an optimal cryoprobe layout is essentially a matter of exposure time, rather than trainee background or the specific computer-generated planning target. Key geometric features under considerations are associated with spatial limitations on cryoprobes placement and the match between the resulted thermal field and the unique anatomy of the prostate. All experiments in this study were performed on the cryosurgery trainer-a prototype platform for computerized cryosurgery training, which has been presented previously. Among its key features, the cryosurgery trainer displays the prostate shape and its contours and provides a distance measurement tool on demand, in order to address spatial constraints during ultrasound imaging guidance. Another unique feature of the cryosurgery trainer is an output movie, displaying the simulated thermal field at the end of the cryoprocedure. The current study was performed on graduate engineering students having no formal background in medicine, and the results were benchmarked against data obtained on surgical residents having no experience with cryosurgery. Despite fundamental differences in background and experience, neither group displayed superior performance when it comes to cryoprobe layout planning. This study demonstrates that computer-based training of an optimal cryoprobe layout is feasible. This study demonstrates that the training quality is essentially related to the training exposure time, rather than to a specific planning strategy from those investigated.

  19. Importance of powder residence time for the aerosol delivery performance of a commercial dry powder inhaler Aerolizer(®).

    Science.gov (United States)

    Jiang, Liqun; Tang, Yue; Zhang, Hongjiu; Lu, Xifeng; Chen, Xijing; Zhu, Jiabi

    2012-10-01

    The performance of dry powder aerosol delivery systems depends not only on the powder formulation but also on the dry powder inhalers (DPIs). Effects of turbulence, grid, mouthpiece, inlet size, air flow, and capsule on the DPIs performance have been investigated previously. Considering powder dispersion in DPIs is a time-dependent process, the powder residence time in DPIs is supposed to have a great impact on DPIs efficiency. This study sought to investigate the effect of powder residence time on the performance of a commercial DPI Aerolizer(®). A standard Aerolizer(®) (SD) and five modified devices (MD1, MD2, MD3, MD4, and MD5) were employed for this research. Computational fluid dynamics analysis was used to calculate the flow field and the powder residence time in these devices. Recombinant human interleukin-2 inhalation powders and a twin impinger were used for the deposition experiment. The powder mean residence time in the secondary atomization zone of the devices was increased from 0 ms for SD to 0.33, 0.96, 1.42, 1.76, and 2.14 ms for MD1, MD2, MD3, MD4, and MD5, respectively. At a flow rate of 60 L/min, with an increase in the powder residence time in these devices, a significant gradual and increasing trend in the powder respirable fraction was observed from 29.1%± 1.1% (MD1) to 32.6% ± 2.2% (MD2), 37.1% ± 1.1% (MD3), and 43.7% ± 2.1% (MD4). There was no significant difference in the powder respirable fraction between SD and MD1 or between MD4 and MD5. Within a certain range, increasing the powder residence time could improve the performance of Aerolizer(®) by increasing the powder-air interaction time (the main reason) and increasing the powder-device compaction (the secondary reason). Combination of high turbulence level and sufficient powder residence time could further improve the device performance.

  20. LYSO based precision timing calorimeters

    Science.gov (United States)

    Bornheim, A.; Apresyan, A.; Ronzhin, A.; Xie, S.; Duarte, J.; Spiropulu, M.; Trevor, J.; Anderson, D.; Pena, C.; Hassanshahi, M. H.

    2017-11-01

    In this report we outline the study of the development of calorimeter detectors using bright scintillating crystals. We discuss how timing information with a precision of a few tens of pico seconds and below can significantly improve the reconstruction of the physics events under challenging high pileup conditions to be faced at the High-Luminosity LHC or a future hadron collider. The particular challenge in measuring the time of arrival of a high energy photon lies in the stochastic component of the distance of initial conversion and the size of the electromagnetic shower. We present studies and measurements from test beams for calorimeter based timing measurements to explore the ultimate timing precision achievable for high energy photons of 10 GeV and above. We focus on techniques to measure the timing with a high precision in association with the energy of the photon. We present test-beam studies and results on the timing performance and characterization of the time resolution of LYSO-based calorimeters. We demonstrate time resolution of 30 ps is achievable for a particular design.

  1. A proposed solution to integrating cognitive-affective neuroscience and neuropsychiatry in psychiatry residency training: The time is now.

    Science.gov (United States)

    Torous, John; Stern, Adam P; Padmanabhan, Jaya L; Keshavan, Matcheri S; Perez, David L

    2015-10-01

    Despite increasing recognition of the importance of a strong neuroscience and neuropsychiatry education in the training of psychiatry residents, achieving this competency has proven challenging. In this perspective article, we selectively discuss the current state of these educational efforts and outline how using brain-symptom relationships from a systems-level neural circuit approach in clinical formulations may help residents value, understand, and apply cognitive-affective neuroscience based principles towards the care of psychiatric patients. To demonstrate the utility of this model, we present a case of major depressive disorder and discuss suspected abnormal neural circuits and therapeutic implications. A clinical neural systems-level, symptom-based approach to conceptualize mental illness can complement and expand residents' existing psychiatric knowledge. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Groundwater residence time and movement in the Maltese islands - A geochemical approach

    Energy Technology Data Exchange (ETDEWEB)

    Stuart, M.E., E-mail: mest@bgs.ac.uk [British Geological Survey, Wallingford, Oxfordshire OX10 8BB (United Kingdom); Maurice, L. [British Geological Survey, Wallingford, Oxfordshire OX10 8BB (United Kingdom); Heaton, T.H.E. [British Geological Survey, NERC Isotope Geoscience Laboratory, Keyworth, Nottinghamshire NG12 5GG (United Kingdom); Sapiano, M.; Micallef Sultana, M. [Malta Resources Authority, Marsa MRS 9065 (Malta); Gooddy, D.C.; Chilton, P.J. [British Geological Survey, Wallingford, Oxfordshire OX10 8BB (United Kingdom)

    2010-05-15

    The Maltese islands are composed of two limestone aquifers, the Upper and Lower Coralline Limestone separated by an aquitard, the 'Blue Clay'. The Lower Coralline Limestone is overlain in part by the poorly permeable Globigerina Limestone. The upper perched aquifers are discontinuous and have very limited saturated thickness and a short water level response time to rainfall. Frequent detections of coliforms suggest a rapid route to groundwater. However, the unsaturated zone has a considerable thickness in places and the primary porosity of the Upper Coralline Limestone is high, so there is likely to be older recharge by slow matrix flow as well as rapid recharge from fractures. Measurement of SF{sub 6} from a pumping station in a deep part of one of the perched aquifers indicated a mean saturated zone age of about 15 a. The Main Sea Level aquifers (MSL) on both Malta and Gozo have a large unsaturated thickness as water levels are close to sea level. On Malta, parts of the aquifer are capped by the perched aquifers and more extensively by the Globigerina Limestone. The limited detection of coliform bacteria suggests only some rapid recharge from the surface via fractures or karst features. Transmissivity is low and {sup 3}H and CFC/SF{sub 6} data indicate that saturated zone travel times are in the range 15-40 a. On Gozo the aquifer is similar but is more-extensively capped by impermeable Blue Clay. CFC data show the saturated zone travel time is from 25 a to possibly more than 60 a. Groundwater age is clearly related to the extent of low-permeability cover. The {delta}{sup 13}C signature of groundwater is related to the geochemical processes which occur along the flowpath and is consistent with residence time ages in the sequence; perched aquifers < Malta MSL < Gozo MSL. The {sup 18}O and {sup 2}H enriched isotopic signature of post 1983 desalinated water can be seen in more-modern groundwater, particularly the urbanized areas of the perched and Malta MSL

  3. Developing an integrated evidence-based medicine curriculum for family medicine residency at the University of Alberta.

    Science.gov (United States)

    Allan, G Michael; Korownyk, Christina; Tan, Amy; Hindle, Hugh; Kung, Lina; Manca, Donna

    2008-06-01

    There is general consensus in the academic community that evidence-based medicine (EBM) teaching is essential. Unfortunately, many postgraduate programs have significant weakness in their EBM programs. The Family Medicine Residency committee at the University of Alberta felt their EBM curriculum would benefit from critical review and revision. An EBM Curriculum Committee was created to evaluate previous components and develop new strategies as needed. Input from stakeholders including faculty and residents was sought, and evidence regarding the teaching and practical application of EBM was gathered. The committee drafted goals and objectives, the primary of which were to assist residents to (1) become competent self-directed, lifelong learners with skills to effectively and efficiently keep up to date, and 2) develop EBM skills to solve problems encountered in daily practice. New curriculum components, each evidence based, were introduced in 2005 and include a family medicine EBM workshop to establish basic EBM knowledge; a Web-based Family Medicine Desktop promoting easier access to evidence-based Internet resources; a brief evidence-based assessment of the research project enhancing integration of EBM into daily practice; and a journal club to support peer learning and growth of rapid appraisal skills. Issues including time use, costs, and change management are discussed. Ongoing evaluation of the curriculum and its components is a principal factor of the design, allowing critical review and adaptation of the curriculum. The first two years of the curriculum have yielded positive feedback from faculty and statistically significant improvement in multiple areas of residents' opinions of the curriculum and comfort with evidence-based practice.

  4. Japanese Resident Physicians' Attitudes, knowledge, and Perceived Barriers on the Practice of Evidence Based Medicine: a Survey

    Directory of Open Access Journals (Sweden)

    Emura Sei SE

    2011-09-01

    Full Text Available Abstract Background Evidence based medicine plays a crucial role as a tool that helps integrate research evidence into clinical practice. However, few reports have yet to examine its application in daily practice among resident physicians in Japan. The aim of this study was to assess the attitudes towards and knowledge of EBM among resident physicians in Japanese and determine perceived barriers to its use. Findings A cross-sectional, self-administered anonymous questionnaire was distributed to 60 resident staffs at Saga University Hospital in Japan. Forty residents completed and returned the questionnaire. Fifty four percent of respondents understood the basic terminology of EBM, 3% could explain this to others, and 41% indicated they would like to understand the terminology more. Thirteen percent admitted having a good understanding of EBM basic skills. Fifty respondents indicated having read EBM sources, but only 3% indicated that they use these sources in clinical decision making. The most prominent barriers of EBM application revealed in this study were insufficient time to access the sources, a lack of native language references, and insufficient basic EBM skills, but not scepticism about the EBM concept. Conclusions In general, respondents positively welcomed EBM, and moderately understood and knew basic EBM skill; however, barriers in its application were shown to exist.

  5. Using acupressure and Montessori-based activities to decrease agitation for residents with dementia: a cross-over trial.

    Science.gov (United States)

    Lin, Li-Chan; Yang, Man-Hua; Kao, Chieh-Chun; Wu, Shiao-Chi; Tang, Sai-Hung; Lin, Jaung-Geng

    2009-06-01

    To explore the effectiveness of acupressure and Montessori-based activities in decreasing the agitated behaviors of residents with dementia. A double-blinded, randomized (two treatments and one control; three time periods) cross-over design was used. Six special care units for residents with dementia in long-term care facilities in Taiwan were the sites for the study. One hundred thirty-three institutionalized residents with dementia. Subjects were randomized into three treatment sequences: acupressure-presence-Montessori methods, Montessori methods-acupressure-presence and presence-Montessori methods-acupressure. All treatments were done once a day, 6 days per week, for a 4-week period. The Cohen-Mansfield Agitation Inventory, Ease-of-Care, and the Apparent Affect Rating Scale. After receiving the intervention, the acupressure and Montessori-based-activities groups saw a significant decrease in agitated behaviors, aggressive behaviors, and physically nonaggressive behaviors than the presence group. Additionally, the ease-of-care ratings for the acupressure and Montessori-based-activities groups were significantly better than for the presence group. In terms of apparent affect, positive affect in the Montessori-based-activities group was significantly better than in the presence group. This study confirms that a blending of traditional Chinese medicine and a Western activities program would be useful in elderly care and that in-service training for formal caregivers in the use of these interventions would be beneficial for patients

  6. Linking granulation performance with residence time and granulation liquid distributions in twin-screw granulation: An experimental investigation

    DEFF Research Database (Denmark)

    Kumar, Ashish; Alakarjula, Maija; Vanhoorne, Valérie

    2016-01-01

    elements in the granulator screw allowing the production of granules with a size distribution appropriate for tableting. The distribution of residence time and granulation liquid is governed by the field conditions (such as location and length of mixing zones) in the twin-screw granulator, thus contain...

  7. The decadal state of the terrestrial carbon cycle : Global retrievals of terrestrial carbon allocation, pools, and residence times

    NARCIS (Netherlands)

    Bloom, A Anthony; Exbrayat, Jean-François; van der Velde, Ivar R; Feng, Liang; Williams, Mathew

    2016-01-01

    The terrestrial carbon cycle is currently the least constrained component of the global carbon budget. Large uncertainties stem from a poor understanding of plant carbon allocation, stocks, residence times, and carbon use efficiency. Imposing observational constraints on the terrestrial carbon cycle

  8. Residence time distribution and hold-up in a cocurrent upflow packed bed reactor at elevated pressure

    NARCIS (Netherlands)

    van Gelder, Klaas B.; Westerterp, K.R.

    1990-01-01

    The residence time distribution in liquid phase was measured in a cocurrent upflow packed bed reactor for the system methanol-hydrogen at low Reynolds numbers and at elevated pressure. The plug flow with axial dispersion model was used to describe mixing in the system. The imperfect pulse method was

  9. Comparison of the tritium residence times of various ceramic breeder materials irradiated in EXOTIC experiments 4 and 5

    International Nuclear Information System (INIS)

    Kwast, H.; Elen, J.D.; Conrad, R.; Casadio, S.; Werle, H.; Verstappen, G.

    1990-09-01

    Tritium residence times have been determined for various ceramic tritium breeding materials from in-situ release measurements. The irradiations, codenamed EXOTIC (EXtraction Of Tritium In Ceramics), were carried out in the High Flux Reactor (HFR) Petten. During the irradiation more than 450 transients were performed and the corresponding tritium release measured. Materials supplied by SCK/CEN (Li 2 ZrO 3 ), CEA (Li 2 ZrO 3 and LiAlO 2 ), ENEA (LiAlO 2 ), KfK (Li 4 SiO 4 ), NRL (Li 6 Zr 2 O 7 ) and ECN (Li 8 ZrO 6 ) were irradiated in EXOTIC-5 to compare the tritium residence times obtained under equal conditions. Apart from differences in density, grain size, pore size and OPV it appeared that the tritium residence times of the lithium zirconates (pellets) were shorter than those of the Li 4 SiO 4 pebbles. The tritium residence times of the Li 4 SiO 4 pebbles were shorter than those of the LiAlO 2 pellets. (author). 7 refs.; 5 figs.; 3 tabs

  10. The Effectiveness of Computer-Based Hypermedia Teaching Modules for Radiology Residents.

    Science.gov (United States)

    Azevedo, Roger; And Others

    This paper explains the rationale for utilizing computer-based, hypermedia tutorials for radiology education and presents the results of a field test of this educational technique. It discusses the development of the hypermedia tutorials at Montreal General Hospital (Quebec, Canada) in 1991-92 and their use in the radiology residency program. The…

  11. Perspectives on the changing healthcare system: teaching systems-based practice to medical residents

    Directory of Open Access Journals (Sweden)

    Johanna Martinez

    2013-09-01

    Full Text Available Purpose: The Accreditation Council for Graduate Medical Education restructured its accreditation system to be based on educational outcomes in six core competencies. Systems-based practice is one of the six core competencies. The purpose of this report is to describe Weill Cornell Medical College's Internal Medicine Residency program curriculum for systems-based practice (SBP and its evaluation process. Methods: To examine potential outcomes of the POCHS curriculum, an evaluation was conducted, examining participants': (1 knowledge gain; (2 course ratings; and (3 qualitative feedback. Results: On average, there was a 19 percentage point increase in knowledge test scores for all three cohorts. The course was rated overall highly, receiving an average of 4.6 on a 1–5 scale. Lastly, the qualitative comments supported that the material is needed and valued. Conclusion: The course, entitled Perspectives on the Changing Healthcare System (POCHS and its evaluation process support that systems-based practice is crucial to residency education. The course is designed not only to educate residents about the current health care system but also to enable them to think critically about the risk and benefits of the changes. POCHS provides a framework for teaching and assessing this competency and can serve as a template for other residency programs looking to create or restructure their SBP curriculum.

  12. Students' Sense of Community Based on Experiences with Residence Hall Design

    Science.gov (United States)

    Heasley, Christopher L.

    2013-01-01

    This study seeks to determine students' sense of community outcomes based on experiences with different residence hall architectural designs. Sense of community is a "feeling that members have of belonging, a feeling that members matter to one another and to the group, and a shared faith that members' needs will be met through their…

  13. An evidence-based journal club for dental residents in a GPR program.

    Science.gov (United States)

    Grant, William D

    2005-06-01

    The journal club offers a significant opportunity to serve as both an educational experience but also as a real-world example of the application of the principles and practices of evidence-based dentistry (EBD). Designed around the American Dental Association's recommended four steps in the implementation of the EBD process, the journal clubs are held once per month for GPR residents. The structured process allows residents to formulate answerable clinical questions, track down with maximum efficiency the best evidence with which to answer the questions, critically appraise the evidence for its validity and usefulness, and apply the results of this appraisal in clinical practice as appropriate.

  14. Residence time distributions of artificially infiltrated groundwater used for drinking water production

    Science.gov (United States)

    Popp, A. L.; Marçais, J.; Moeck, C.; Brennwald, M. S.; Kipfer, R.

    2017-12-01

    Public drinking water supply in urban areas is often challenging due to exposure to potential contamination and high water demands. At our study site, a drinking water supply field in Switzerland, managed aquifer recharge (MAR) was implemented to overcome an increasing water demand and decreasing water quality. Water from the river Rhine is put on a system of channels and ponds to artificially infiltrate and hence, increase the natural groundwater availability. The groundwater system consists of two overlying aquifers, with hydraulic connections related to fractures and faults. The deeper aquifer contains contaminants, which possibly originate from nearby landfills and industrial areas. The operating water works aims to pump recently infiltrated water only. However, we suspect that the pumped water contains a fraction of old water due to the fractured zones which serve as hydraulic connection between the two aquifers. With this study, we aim to better understand the mixing patterns between recently infiltrated water and old groundwater to evaluate the risk for contamination of the system. To reach our objective, we used a set of gas tracers (222Rn, 3H/3He, 4He) from fifteen wells distributed throughout the area to estimate the residence time distribution (RTD) of each well. We calibrated the RTD with a Binary Mixing Model, where the fraction of young groundwater is assumed to follow a Piston Flow Model. The older groundwater fraction is calibrated with a Dispersion Model. Our results reflect the heterogeneity of the system with some abstraction wells containing young water only and others showing an admixture of old water which can only be explained by a connection to the deeper aquifer. We also show that our results on calibrated RTDs are in accordance with other geochemical data such as electrical conductivity, major ions and pH. Our results will contribute to a sound conceptual flow and transport understanding and will help to optimize the water supply system.

  15. Carbon residence time dominates uncertainty in terrestrial vegetation responses to future climate and atmospheric CO2

    Science.gov (United States)

    Friend, Andrew D.; Lucht, Wolfgang; Rademacher, Tim T.; Keribin, Rozenn; Betts, Richard; Cadule, Patricia; Ciais, Philippe; Clark, Douglas B.; Dankers, Rutger; Falloon, Pete D.; Ito, Akihiko; Kahana, Ron; Kleidon, Axel; Lomas, Mark R.; Nishina, Kazuya; Ostberg, Sebastian; Pavlick, Ryan; Peylin, Philippe; Schaphoff, Sibyll; Vuichard, Nicolas; Warszawski, Lila; Wiltshire, Andy; Woodward, F. Ian

    2014-01-01

    Future climate change and increasing atmospheric CO2 are expected to cause major changes in vegetation structure and function over large fractions of the global land surface. Seven global vegetation models are used to analyze possible responses to future climate simulated by a range of general circulation models run under all four representative concentration pathway scenarios of changing concentrations of greenhouse gases. All 110 simulations predict an increase in global vegetation carbon to 2100, but with substantial variation between vegetation models. For example, at 4 °C of global land surface warming (510–758 ppm of CO2), vegetation carbon increases by 52–477 Pg C (224 Pg C mean), mainly due to CO2 fertilization of photosynthesis. Simulations agree on large regional increases across much of the boreal forest, western Amazonia, central Africa, western China, and southeast Asia, with reductions across southwestern North America, central South America, southern Mediterranean areas, southwestern Africa, and southwestern Australia. Four vegetation models display discontinuities across 4 °C of warming, indicating global thresholds in the balance of positive and negative influences on productivity and biomass. In contrast to previous global vegetation model studies, we emphasize the importance of uncertainties in projected changes in carbon residence times. We find, when all seven models are considered for one representative concentration pathway × general circulation model combination, such uncertainties explain 30% more variation in modeled vegetation carbon change than responses of net primary productivity alone, increasing to 151% for non-HYBRID4 models. A change in research priorities away from production and toward structural dynamics and demographic processes is recommended. PMID:24344265

  16. Firing technology in practice - temperature, residence time, corrosion; Feuerungstechnik in der Praxis - Temperatur, Verweilzeit, Korrosion

    Energy Technology Data Exchange (ETDEWEB)

    Freimann, P.; Holl, D. [Muellheizkraftwerk Betriebsgesellschaft mbH, Burgkirchen/Alz (Germany)

    1998-09-01

    In a circular dated 1st Sept. 1994, i.e., after the issue of the pertinent planning decision, the Federal Environmental Ministry, BMU, laid down uniform standards on measurements and the parameterisation of the evaluation system for different operation states and loads. Subsequently, TUeV, the German Technical Control Board, prepared the parameterisation curves on the basis of these specifications. The implementation of the BMU paper of 1st Sept. 1994 did not result in any advantage, nor did it lead to a reduction of plant emissions, nor to advantages in the operation of the waste-fuelled cogeneration plant. On the contrary, elevated gas consumption and operating trouble due to frequent feed stops worsened the operating state of the plant. Elevated crude gas temperature in the boiler reduced the lifetime of the two boilers to a critical degree. An operating temperature of 850 C and a residence time of approx. 1 sec. in Burgkirchen waste-fuelled cogeneration plant have not worsened emission values while rendering the plant operable again. [Deutsch] Durch Rundschreiben d. BMU vom 01.09.1994 - also nach Erlass des Planfeststellungsbeschlusses - wurden einheitliche Vorgaben ueber Messungen und Parametrierung des Auswertesystems fuer die verschiedenen Betriebs- bzw. Lastzustaende erlassen. Unter Beruecksichtigung dieser Vorgaben wurden vom TUeV die Parametrierungskurven erstellt. Die Umsetzung des BMU-Papieres vom 01.09.1994 ergab keinerlei Vorteile, weder gab es eine Verringerung der anlagenbedingten Emissionen noch Vorteile fuer den Betrieb des MHKW`s. Im Gegenteil, erhoehte Gasverbraeuche und Betriebsstoerungen durch oftmalige Beschickungsstops verschlechterten den Betriebszustand. Erhoehte Rohgastemperatur im Kessel reduzierten die Lebensdauer der beiden Kessel kritisch. Der Betrieb mit 850 C und mit einer Verweilzeit von ca. 1 sec. fuehrt im MHKW Burgkirchen zu keiner Verschlechterung der Emissionswerte, macht aber die Anlagen wieder betreibbar. (orig./SR)

  17. Groundwater residence time and paleohydrology in the Baltic Artesian basin:isotope geochemical data

    Science.gov (United States)

    Vaikmae, R.; Gerber, C.; Purtschert, R.; Aeschbach, W.; Raidla, V., Sr.; Lu, Z. T.; Zappala, J. C.; Mueller, P.; Mokrik, R., Sr.; Jiang, W.

    2016-12-01

    In this study of the Cambrian aquifer system(CAS) in the Baltic Artesian Basin(BAS) (, chemistry, stable isotopes, noble gas measurements, and dating tracers were combined for study the flow and recharge dynamics of the system over the last million years We find that the variability in chemical composition, stable isotopes and noble gas content in the basin is predominately controlled by mixing of three distinct water masses: Holocene and Pleistocene interglacial water, glacial meltwater, and brine. 81Kr is a nearly ideal dating tracer for such old systems. The radiogenic 4He and 40Ar provide additional information, but are more difficult to interpret in terms of groundwater age. In this study, we did not consider diffusive loss of 81Kr to stagnant water, which might result in an overestimation of groundwater ages ). However, the relatively high porosity and large thickness of the CAS, together with the presumed high salinity and low Kr content of the stagnant water all diminish the effect of diffusive 81Kr loss on age estimates. Our results confirm that under normal conditions, underground production of 81Kr is not affecting the dating results. 81Kr, 4He, and 40Ar all indicate a residence time of the brine of more than 1-3 Ma. Some uncertainty about the brine formation process remains, but the combination of chemical and stable isotope composition of the brine, noble gas concentrations and dating results favors evaporative enrichment of seawater. Tracer ages of interglacial water and glacial meltwater are on the order of several hundred thousand years, which means that several reversals of the flow direction in the CAS as a result of the paleoclimatology of the area have to be taken into account. Under such conditions, small vertical leakage, through fracture zones for example, might considerably impact the net flow pattern. Due to the cyclic flow direction reversals, the aquifer was probably in a transient state over most of the last 1 Ma period.

  18. Carbon residence time dominates uncertainty in terrestrial vegetation responses to future climate and atmospheric CO2.

    Science.gov (United States)

    Friend, Andrew D; Lucht, Wolfgang; Rademacher, Tim T; Keribin, Rozenn; Betts, Richard; Cadule, Patricia; Ciais, Philippe; Clark, Douglas B; Dankers, Rutger; Falloon, Pete D; Ito, Akihiko; Kahana, Ron; Kleidon, Axel; Lomas, Mark R; Nishina, Kazuya; Ostberg, Sebastian; Pavlick, Ryan; Peylin, Philippe; Schaphoff, Sibyll; Vuichard, Nicolas; Warszawski, Lila; Wiltshire, Andy; Woodward, F Ian

    2014-03-04

    Future climate change and increasing atmospheric CO2 are expected to cause major changes in vegetation structure and function over large fractions of the global land surface. Seven global vegetation models are used to analyze possible responses to future climate simulated by a range of general circulation models run under all four representative concentration pathway scenarios of changing concentrations of greenhouse gases. All 110 simulations predict an increase in global vegetation carbon to 2100, but with substantial variation between vegetation models. For example, at 4 °C of global land surface warming (510-758 ppm of CO2), vegetation carbon increases by 52-477 Pg C (224 Pg C mean), mainly due to CO2 fertilization of photosynthesis. Simulations agree on large regional increases across much of the boreal forest, western Amazonia, central Africa, western China, and southeast Asia, with reductions across southwestern North America, central South America, southern Mediterranean areas, southwestern Africa, and southwestern Australia. Four vegetation models display discontinuities across 4 °C of warming, indicating global thresholds in the balance of positive and negative influences on productivity and biomass. In contrast to previous global vegetation model studies, we emphasize the importance of uncertainties in projected changes in carbon residence times. We find, when all seven models are considered for one representative concentration pathway × general circulation model combination, such uncertainties explain 30% more variation in modeled vegetation carbon change than responses of net primary productivity alone, increasing to 151% for non-HYBRID4 models. A change in research priorities away from production and toward structural dynamics and demographic processes is recommended.

  19. Improving residents' handovers through just-in-time training for structured communication.

    Science.gov (United States)

    Rourke, Liam; Amin, Aditi; Boyington, Curtiss; Ao, Peter; Frolova, Natalia

    2016-01-01

    In a recent quality assurance project we learned that nearly half of the handovers we examined were characterized as unsatisfactory by our residents, who provided examples in which their anxiety had been piqued and patient care had been affected. These reports substantiated a growing body of literature on the relationship between the quality of handover and the quality of patient care, so we sought to improve the quality and consistency of the in-hosptial handovers undertaken by our internal medicine residents. Senior residents attended morning report for three consecutive month long blocks and evaluated the quality of the handovers using an observational protocol comprised of 16 aspects of effective handover. During the first block, the resident observed a median of eight of the 16 practices occurring across the 46 handovers, and a large amount of variability. At the beginning of the subsequent block we presented a concise introduction to a structured handover procedure (SBARR). The median quality of the subsequent 33 handovers rose to 11, and the variability decreased considerably. In the next block we refined the SBARR orientation to focus on the errors observed in the previous blocks, and the improvement in the quality and variability was sustained. The minor change, which requires few resources to sustain, had a favourable impact on the quality of our residents' in-hospital handovers.

  20. Capricorn-A Web-Based Automatic Case Log and Volume Analytics for Diagnostic Radiology Residents.

    Science.gov (United States)

    Chen, Po-Hao; Chen, Yin Jie; Cook, Tessa S

    2015-10-01

    On-service clinical learning is a mainstay of radiology education. However, an accurate and timely case log is difficult to keep, especially in the absence of software tools tailored to resident education. Furthermore, volume-related feedback from the residency program sometimes occurs months after a rotation ends, limiting the opportunity for meaningful intervention. We surveyed the residents of a single academic institution to evaluate the current state of and the existing need for tracking interpretation volume. Using the results of the survey, we created an open-source automated case log software. Finally, we evaluated the effect of the software tool on the residency in a 1-month, postimplementation survey. Before implementation of the system, 89% of respondents stated that volume is an important component of training, but 71% stated that volume data was inconvenient to obtain. Although the residency program provides semiannual reviews, 90% preferred reviewing interpretation volumes at least once monthly. After implementation, 95% of the respondents stated that the software is convenient to access, 75% found it useful, and 88% stated they would use the software at least once a month. The included analytics module, which benchmarks the user using historical aggregate average volumes, is the most often used feature of the software. Server log demonstrates that, on average, residents use the system approximately twice a week. An automated case log software system may fulfill a previously unmet need in diagnostic radiology training, making accurate and timely review of volume-related performance analytics a convenient process. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  1. Joint Residence-Workplace Location Choice Model Based on Household Decision Behavior

    Directory of Open Access Journals (Sweden)

    Pengpeng Jiao

    2015-01-01

    Full Text Available Residence location and workplace are the two most important urban land-use types, and there exist strong interdependences between them. Existing researches often assume that one choice dimension is correlated to the other. Using the mixed logit framework, three groups of choice models are developed to illustrate such choice dependencies. First, for all households, this paper presents a basic methodology of the residence location and workplace choice without decision sequence based on the assumption that the two choice behaviors are independent of each other. Second, the paper clusters all households into two groups, choosing residence or workplace first, and formulates the residence location and workplace choice models under the constraint of decision sequence. Third, this paper combines the residence location and workplace together as the choice alternative and puts forward the joint choice model. A questionnaire survey is implemented in Beijing city to collect the data of 1994 households. Estimation results indicate that the joint choice model fits the data significantly better, and the elasticity effects analyses show that the joint choice model reflects the influences of relevant factors to the choice probability well and leads to the job-housing balance.

  2. Individualized behavior management program for Alzheimer's/dementia residents using behavior-based ergonomic therapies.

    Science.gov (United States)

    Bharwani, Govind; Parikh, Pratik J; Lawhorne, Larry W; VanVlymen, Eric; Bharwani, Meena

    2012-05-01

    Person-centered, nonpharmacological interventions for managing Alzheimer's/dementia-related behavioral disturbances have received significant attention. However, such interventions are quite often of a single type limiting their benefits. We develop a comprehensive nonpharmacological intervention, the Behavior-Based Ergonomic Therapy (BBET), which consists of multiple therapies. This low-cost, 24/7 program uses learning, personality, and behavioral profiles and cognitive function of each resident to develop a set of individualized therapies. These therapies are made available through an accessible resource library of music and video items, games and puzzles, and memory props to provide comfort or stimulation depending on an individual resident's assessment. The quantitative and qualitative benefits of the BBET were evaluated at the dementia care unit in a not-for-profit continuing care retirement community in west central Ohio. The 6-month pilot study reduced falls by 32.5% and markedly reduced agitation through increased resident engagement.

  3. Innovative partnerships to advance public health training in community-based academic residency programs

    Directory of Open Access Journals (Sweden)

    Lo JC

    2017-10-01

    Full Text Available Joan C Lo,1–3 Thomas E Baudendistel,2,3 Abhay Dandekar,3,4 Phuoc V Le,5 Stanton Siu,2,3 Bruce Blumberg6 1Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; 2Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 3Graduate Medical Education, Kaiser Permanente East Bay, Oakland, CA, USA; 4Department of Pediatrics, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA; 5School of Public Health, University of California Berkeley, Berkeley, CA, USA; 6Graduate Medical Education, Kaiser Permanente Northern California, Oakland, CA, USA Abstract: Collaborative partnerships between community-based academic residency ­training programs and schools of public health, represent an innovative approach to training future physician leaders in population management and public health. In Kaiser Permanente Northern California, development of residency-Masters in Public Health (MPH tracks in the Internal Medicine Residency and the Pediatrics Residency programs, with MPH graduate studies completed at the University of California Berkeley School of Public Health, enables physicians to integrate clinical training with formal education in epidemiology, biostatistics, health policy, and disease prevention. These residency-MPH programs draw on more than 50 years of clinical education, public health training, and health services research – creating an environment that sparks inquiry and added value by developing skills in patient-centered care through the lens of population-based outcomes. Keywords: graduate medical education, public health, master’s degree, internal medicine, pediatrics, residency training

  4. Evaluation of an Evidence-Based Tobacco Treatment Curriculum for Psychiatry Residency Training Programs

    Science.gov (United States)

    Prochaska, Judith J.; Fromont, Sebastien C.; Leek, Desiree; Hudmon, Karen Suchanek; Louie, Alan K.; Jacobs, Marc H.; Hall, Sharon M.

    2009-01-01

    Objective Smokers with mental illness and addictive disorders account for nearly one in two cigarettes sold in the United States and are at high risk for smoking-related deaths and disability. Psychiatry residency programs provide a unique arena for disseminating tobacco treatment guidelines, influencing professional norms, and increasing access to tobacco cessation services among smokers with mental illness. The current study evaluated the Rx for Change in Psychiatry curriculum, developed for psychiatry residency programs and focused on identifying and treating tobacco dependence among individuals with mental illness. Methods The 4-hour curriculum emphasized evidence-based, patient-oriented cessation treatments relevant for all tobacco users, including those not yet ready to quit. The curriculum was informed by comprehensive literature review, consultation with an expert advisory group, faculty interviews, and a focus group with psychiatry residents. This study reports on evaluation of the curriculum in 2005–2006, using a quasi-experimental design, with 55 residents in three psychiatry residency training programs in Northern California. Results The curriculum was associated with improvements in psychiatry residents’ knowledge, attitudes, confidence, and counseling behaviors for treating tobacco use among their patients, with initial changes from pre- to posttraining sustained at 3-months’ follow-up. Residents’ self-reported changes in treating patients’ tobacco use were substantiated through systematic chart review. Conclusion The evidence-based Rx for Change in Psychiatry curriculum is offered as a model tobacco treatment curriculum that can be implemented in psychiatry residency training programs and disseminated widely, thereby effectively reaching a vulnerable and costly population of smokers. PMID:19190293

  5. Structure-kinetic relationship studies of cannabinoid CB2receptor agonists reveal substituent-specific lipophilic effects on residence time.

    Science.gov (United States)

    Soethoudt, Marjolein; Hoorens, Mark W H; Doelman, Ward; Martella, Andrea; van der Stelt, Mario; Heitman, Laura H

    2018-03-21

    A decade ago, the drug-target residence time model has been (re-)introduced, which describes the importance of binding kinetics of ligands on their protein targets. Since then, it has been applied successfully for multiple protein targets, including GPCRs, for the development of lead compounds with slow dissociation kinetics (i.e. long target residence time) to increase in vivo efficacy or with short residence time to prevent on-target associated side effects. To date, this model has not been applied in the design and pharmacological evaluation of novel selective ligands for the cannabinoid CB 2 receptor (CB 2 R), a GPCR with therapeutic potential in the treatment of tissue injury and inflammatory diseases. Here, we have investigated the relationships between physicochemical properties, binding kinetics and functional activity in two different signal transduction pathways, G protein activation and β-arrestin recruitment. We synthesized 24 analogues of 3-cyclopropyl-1-(4-(6-((1,1-dioxidothiomorpholino)methyl)-5-fluoropyridin-2-yl)benzyl)imidazoleidine-2,4-dione (LEI101), our previously reported in vivo active and CB 2 R-selective agonist, with varying basicity and lipophilicity. We identified a positive correlation between target residence time and functional potency due to an increase in lipophilicity on the alkyl substituents, which was not the case for the amine substituents. Basicity of the agonists did not show a relationship with affinity, residence time or functional activity. Our findings provide important insights about the effects of physicochemical properties of the specific substituents of this scaffold on the binding kinetics of agonists and their CB 2 R pharmacology. This work therefore shows how CB 2 R agonists can be designed to have optimal kinetic profiles, which could aid the lead optimization process in drug discovery for the study or treatment of inflammatory diseases. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights

  6. Preliminary estimates of residence times and apparent ages of ground water in the Chesapeake Bay watershed, and water-quality data from a survey of springs

    Science.gov (United States)

    Focazio, Michael J.; Plummer, Niel; Bohlke, John K.; Busenberg, Eurybiades; Bachman, L. Joseph; Powars, David S.

    1998-01-01

    discharging from 30 of the 46 springs sampled were less than 20 years, including 5 that were 'modern' (0-4 years). Four samples had apparent ages of 22 to 34 years, and two others from thermal springs were 40 years or greater. The remaining ten samples were contaminated with local sources of CFC and could not be dated. Nitrate concentrations and nitrate delta 15 nitrogen (15N) values in water from many springs are similar to those in shallow ground water beneath fertilized fields, and some values are high enough to indicate a probable source from animal-waste components. The nitrogen data reported here highlight the significance of the springs sampled during this study as pathways for nutrient transport in the Chesapeake Bay watershed. Ground-water samples were collected from springs during an unusually high flow period and thus may not be representative of low base-flow conditions. Residence times estimated from plausible ranges of aquifer properties and results of previous age-dating analyses generally corroborate the apparent-age analysis made in the current study and suggests that some residence times could be much longer. The shortest residence times tend to be in the Blue Ridge and northern carbonate areas; however, the data are preliminary and not appropriate for statistical tests of significance or variance. Because the age distributions in the aquifer discharging to the springs are not known, and because the apparent ages of water from the springs are based on various com-binations of CFC criteria, the apparent ages and calculated residence times are compared for illustrative purposes but are considered preliminary until further work is accomplished.

  7. Contrasting residence times and fluxes of water and sulfate in two small forested watersheds in Virginia, USA.

    Science.gov (United States)

    Böhlke, John Karl; Michel, Robert L

    2009-07-01

    Watershed mass balances for solutes of atmospheric origin may be complicated by the residence times of water and solutes at various time scales. In two small forested headwater catchments in the Appalachian Mountains of Virginia, USA, mean annual export rates of SO(4)(=) differ by a factor of 2, and seasonal variations in SO(4)(=) concentrations in atmospheric deposition and stream water are out of phase. These features were investigated by comparing (3)H, (35)S, delta(34)S, delta(2)H, delta(18)O, delta(3)He, CFC-12, SF(6), and chemical analyses of open deposition, throughfall, stream water, and spring water. The concentrations of SO(4)(=) and radioactive (35)S were about twice as high in throughfall as in open deposition, but the weighted composite values of (35)S/S (11.1 and 12.1x10(-15)) and delta(34)S (+3.8 and +4.1 per thousand) were similar. In both streams (Shelter Run, Mill Run), (3)H concentrations and delta(34)S values during high flow were similar to those of modern deposition, delta(2)H and delta(18)O values exhibited damped seasonal variations, and (35)S/S ratios (0-3x10(-15)) were low throughout the year, indicating inter-seasonal to inter-annual storage and release of atmospheric SO(4)(=) in both watersheds. In the Mill Run watershed, (3)H concentrations in stream base flow (10-13 TU) were consistent with relatively young groundwater discharge, most delta(34)S values were approximately the same as the modern atmospheric deposition values, and the annual export rate of SO(4)(=) was equal to or slightly greater than the modern deposition rate. In the Shelter Run watershed, (3)H concentrations in stream base flow (1-3 TU) indicate that much of the discharging ground water had been deposited prior to the onset of atmospheric nuclear bomb testing in the 1950s, base flow delta(34)S values (+1.6 per thousand) were significantly lower than the modern deposition values, and the annual export rate of SO(4)(=) was less than the modern deposition rate

  8. Care staff training based on person-centered care and dementia care mapping, and its effects on the quality of life of nursing home residents with dementia.

    Science.gov (United States)

    Yasuda, Mami; Sakakibara, Hisataka

    2017-09-01

    To assess the effects of care staff training based on person-centered care (PCC) and dementia care mapping (DCM) on the quality of life (QOL) of residents with dementia in a nursing home. An intervention of staff training based on PCC and DCM was conducted with 40 care staff members at a geriatric nursing home. The effects of the staff training on the QOL of residents with dementia were evaluated by the DCM measurements of 40 residents with dementia three times at about one-month intervals (first, baseline; second, pre-intervention; third, post-intervention). The well-being and ill-being values (WIB values) of the residents with dementia measured by DCM were not different between the first and second rounds before the staff training (p = 0.211). Meanwhile, the WIB values increased from the first and second rounds to the third post-intervention round (p = 0.035 and p dementia.

  9. Estimation of gastric residence time of the Heidelberg capsule in humans: effect of varying food composition

    International Nuclear Information System (INIS)

    Mojaverian, P.; Ferguson, R.K.; Vlasses, P.H.; Rocci, M.L. Jr.; Oren, A.; Fix, J.A.; Caldwell, L.J.; Gardner, C.

    1985-01-01

    In animal and human studies, the gastric emptying of large (greater than 1 mm) indigestible solids is due to the activity of the interdigestive migrating myoelectric complex. The gastric residence time (GRT) of an orally administered, nondigestible, pH-sensitive, radiotelemetric device (Heidelberg capsule) was evaluated in three studies in healthy volunteers. In 6 subjects, the GRT of the Heidelberg capsule was compared with the half-emptying time (t1/2) of diethylenetriaminepentaacetic acid labeled with technetium 99m after a 4-ml/kg liquid fatty meal. The mean (+/-SD) GRT (4.3 +/- 1.4 h) was significantly (p less than 0.001) longer than the mean t1/2 (1.1 +/- 0.3 h); the GRT was prolonged compared with the t1/2 in each subject. In a randomized, crossover trial in 10 subjects, frequent feeding caused a dramatic prolongation in mean GRT of the capsule compared with the fasting state (greater than 14.5 vs. 0.5 h, p less than 0.005). In another crossover study in 6 subjects, the GRT of the capsule was evaluated after an overnight fast, a standard breakfast including solid food, and a liquid meal (i.e., 200 ml of diluted light cream). The mean GRT was 2.6 +/- 0.9 h after the liquid meal vs. 1.2 +/- 0.8 h after fasting (p less than 0.025). The mean GRT after the breakfast was 4.8 +/- 1.5 h, which was significantly greater than that after fasting (p less than 0.001) and after the liquid meal (p less than 0.01). These data suggest that the GRT of the Heidelberg capsule is a marker of the interdigestive migrating myoelectric complex in humans, the interdigestive migrating myoelectric complex can be markedly delayed by frequent feedings with solids, and the interdigestive migrating myoelectric complex is delayed by both liquid and solid meals

  10. Estimation of gastric residence time of the Heidelberg capsule in humans: effect of varying food composition

    Energy Technology Data Exchange (ETDEWEB)

    Mojaverian, P.; Ferguson, R.K.; Vlasses, P.H.; Rocci, M.L. Jr.; Oren, A.; Fix, J.A.; Caldwell, L.J.; Gardner, C.

    1985-08-01

    In animal and human studies, the gastric emptying of large (greater than 1 mm) indigestible solids is due to the activity of the interdigestive migrating myoelectric complex. The gastric residence time (GRT) of an orally administered, nondigestible, pH-sensitive, radiotelemetric device (Heidelberg capsule) was evaluated in three studies in healthy volunteers. In 6 subjects, the GRT of the Heidelberg capsule was compared with the half-emptying time (t1/2) of diethylenetriaminepentaacetic acid labeled with technetium 99m after a 4-ml/kg liquid fatty meal. The mean (+/-SD) GRT (4.3 +/- 1.4 h) was significantly (p less than 0.001) longer than the mean t1/2 (1.1 +/- 0.3 h); the GRT was prolonged compared with the t1/2 in each subject. In a randomized, crossover trial in 10 subjects, frequent feeding caused a dramatic prolongation in mean GRT of the capsule compared with the fasting state (greater than 14.5 vs. 0.5 h, p less than 0.005). In another crossover study in 6 subjects, the GRT of the capsule was evaluated after an overnight fast, a standard breakfast including solid food, and a liquid meal (i.e., 200 ml of diluted light cream). The mean GRT was 2.6 +/- 0.9 h after the liquid meal vs. 1.2 +/- 0.8 h after fasting (p less than 0.025). The mean GRT after the breakfast was 4.8 +/- 1.5 h, which was significantly greater than that after fasting (p less than 0.001) and after the liquid meal (p less than 0.01). These data suggest that the GRT of the Heidelberg capsule is a marker of the interdigestive migrating myoelectric complex in humans, the interdigestive migrating myoelectric complex can be markedly delayed by frequent feedings with solids, and the interdigestive migrating myoelectric complex is delayed by both liquid and solid meals.

  11. Linking granulation performance with residence time and granulation liquid distributions in twin-screw granulation: An experimental investigation.

    Science.gov (United States)

    Kumar, Ashish; Alakarjula, Maija; Vanhoorne, Valérie; Toiviainen, Maunu; De Leersnyder, Fien; Vercruysse, Jurgen; Juuti, Mikko; Ketolainen, Jarkko; Vervaet, Chris; Remon, Jean Paul; Gernaey, Krist V; De Beer, Thomas; Nopens, Ingmar

    2016-07-30

    Twin-screw granulation is a promising wet granulation technique for the continuous manufacturing of pharmaceutical solid dosage forms. A twin screw granulator displays a short residence time. Thus, the solid-liquid mixing must be achieved quickly by appropriate arrangement of transport and kneading elements in the granulator screw allowing the production of granules with a size distribution appropriate for tableting. The distribution of residence time and granulation liquid is governed by the field conditions (such as location and length of mixing zones) in the twin-screw granulator, thus contain interesting information on granulation time, mixing and resulting sub-processes such as wetting, aggregation and breakage. In this study, the impact of process (feed rate, screw speed and liquid-to-solid ratio) and equipment parameters (number of kneading discs and stagger angle) on the residence time (distribution), the granulation liquid-powder mixing and the resulting granule size distributions during twin-screw granulation were investigated. Residence time and axial mixing data was extracted from tracer maps and the solid-liquid mixing was quantified from moisture maps, obtained by monitoring the granules at the granulator outlet using near infra-red chemical imaging (NIR-CI). The granule size distribution was measured using the sieving method. An increasing screw speed dominantly reduced the mean residence time. Interaction of material throughput with the screw speed and with the number of kneading discs led to most variation in the studied responses including residence time and mixing capacity. At a high screw speed, granulation yield improved due to high axial mixing. However, increasing material throughput quickly lowers the yield due to insufficient mixing of liquid and powder. Moreover, increasing liquid-to-solid ratio resulted in more oversized granules, and the fraction of oversized granules further increased at higher throughput. Although an increasing number

  12. Development of a Physiologically Based Pharmacokinetic Model for Sinogliatin, a First-in-Class Glucokinase Activator, by Integrating Allometric Scaling, In Vitro to In Vivo Exploration and Steady-State Concentration-Mean Residence Time Methods: Mechanistic Understanding of its Pharmacokinetics.

    Science.gov (United States)

    Song, Ling; Zhang, Yi; Jiang, Ji; Ren, Shuang; Chen, Li; Liu, Dongyang; Chen, Xijing; Hu, Pei

    2018-04-06

    The objective of this study was to develop a physiologically based pharmacokinetic (PBPK) model for sinogliatin (HMS-5552, dorzagliatin) by integrating allometric scaling (AS), in vitro to in vivo exploration (IVIVE), and steady-state concentration-mean residence time (C ss -MRT) methods and to provide mechanistic insight into its pharmacokinetic properties in humans. Human major pharmacokinetic parameters were analyzed using AS, IVIVE, and C ss -MRT methods with available preclinical in vitro and in vivo data to understand sinogliatin drug metabolism and pharmacokinetic (DMPK) characteristics and underlying mechanisms. On this basis, an initial mechanistic PBPK model of sinogliatin was developed. The initial PBPK model was verified using observed data from a single ascending dose (SAD) study and further optimized with various strategies. The final model was validated by simulating sinogliatin pharmacokinetics under a fed condition. The validated model was applied to support a clinical drug-drug interaction (DDI) study design and to evaluate the effects of intrinsic (hepatic cirrhosis, genetic) factors on drug exposure. The two-species scaling method using rat and dog data (TS- rat,dog ) was the best AS method in predicting human systemic clearance in the central compartment (CL). The IVIVE method confirmed that sinogliatin was predominantly metabolized by cytochrome P450 (CYP) 3A4. The C ss -MRT method suggested dog pharmacokinetic profiles were more similar to human pharmacokinetic profiles. The estimated CL using the AS and IVIVE approaches was within 1.5-fold of that observed. The C ss -MRT method in dogs also provided acceptable prediction of human pharmacokinetic characteristics. For the PBPK approach, the 90% confidence intervals (CIs) of the simulated maximum concentration (C max ), CL, and area under the plasma concentration-time curve (AUC) of sinogliatin were within those observed and the 90% CI of simulated time to C max (t max ) was closed to that

  13. Residents' views of the role of classroom-based learning in graduate medical education through the lens of academic half days.

    Science.gov (United States)

    Chen, Luke Y C; McDonald, Julie A; Pratt, Daniel D; Wisener, Katherine M; Jarvis-Selinger, Sandra

    2015-04-01

    To examine the role of classroom-based learning in graduate medical education through the lens of academic half days (AHDs) by exploring residents' perceptions of AHDs' purpose and relevance and the effectiveness of teaching and learning in AHDs. The authors invited a total of 186 residents in three programs (internal medicine, orthopedic surgery, and hematology) at the University of British Columbia Faculty of Medicine to participate in semistructured focus groups from October 2010 to February 2011. Verbatim transcripts of the interviews underwent inductive analysis. Twenty-seven residents across the three programs volunteered to participate. Two major findings emerged. Purpose and relevance of AHDs: Residents believed that AHDs are primarily for knowledge acquisition and should complement clinical learning. Classroom learning facilitated consolidation of clinical experiences with expert clinical reasoning. Social aspects of AHDs were highly valued as an important secondary purpose. Perceived effectiveness of teaching and learning: Case-based teaching engaged residents in critical thinking; active learning was valued. Knowledge retention was considered suboptimal. Perspectives on the concept of AHDs as "protected time" varied in the three programs. Findings suggest that (1) engagement in classroom learning occurs through participation in clinically oriented discussions that highlight expert reasoning processes; (2) formal classroom teaching, which focuses on knowledge acquisition, can enhance informal learning occurring during clinical activity; and (3) social aspects of AHDs, including their role in creating communities of practice in residency programs and in professional identity formation, are an important, underappreciated asset for residency programs.

  14. Does Faculty Follow the Recommended Structure for a New Classroom-based, Daily Formal Teaching Session for Anesthesia Residents?

    DEFF Research Database (Denmark)

    Anwar, Anjum; Tanaka, Pedro; Madsen, Matias V

    2016-01-01

    BACKGROUND: A newly implemented 15-minute classroom-based, formal teaching session for anesthesia residents is given three times daily by the same faculty. The faculty member was provided a suggested template for the presentation. The template structure was developed by a group of residents...... and faculty to include best teaching practices. The goal of the current study was to measure how frequently the faculty teaching these sessions followed the template. METHODS: From February 20, 2015 to February 6, 2016, a research assistant trained in education mapped a total of 48 teaching sessions...... to determine how frequently the teaching sessions included each of the elements in the recommended template structure. The assistant was chosen from outside the anesthesia department so as to minimize biases. RESULTS: It was found that 98% of the sessions used the teaching template's suggestion of using...

  15. Competency-based residency training and the web log: modeling practice-based learning and enhancing medical knowledge†

    Science.gov (United States)

    Hollon, Matthew F.

    2015-01-01

    Background By using web-based tools in medical education, there are opportunities to innovatively teach important principles from the general competencies of graduate medical education. Objectives Postulating that faculty transparency in learning from uncertainties in clinical work could help residents to incorporate the principles of practice-based learning and improvement (PBLI) in their professional development, faculty in this community-based residency program modeled the steps of PBLI on a weekly basis through the use of a web log. Method The program confidentially surveyed residents before and after this project about actions consistent with PBLI and knowledge acquired through reading the web log. Results The frequency that residents encountered clinical situations where they felt uncertain declined over the course of the 24 weeks of the project from a mean frequency of uncertainty of 36% to 28% (Wilcoxon signed rank test, p=0.008); however, the frequency with which residents sought answers when faced with uncertainty did not change (Wilcoxon signed rank test, p=0.39), remaining high at approximately 80%. Residents answered a mean of 52% of knowledge questions correct when tested prior to faculty posts to the blog, rising to a mean of 65% of questions correct when tested at the end of the project (paired t-test, p=0.001). Conclusions Faculty role modeling of PBLI behaviors and posting clinical questions and answers to a web log led to modest improvements in medical knowledge but did not alter behavior that was already taking place frequently among residents. PMID:26653701

  16. Competency-based residency training and the web log: modeling practice-based learning and enhancing medical knowledge

    Directory of Open Access Journals (Sweden)

    Matthew F. Hollon

    2015-12-01

    Full Text Available Background: By using web-based tools in medical education, there are opportunities to innovatively teach important principles from the general competencies of graduate medical education. Objectives: Postulating that faculty transparency in learning from uncertainties in clinical work could help residents to incorporate the principles of practice-based learning and improvement (PBLI in their professional development, faculty in this community-based residency program modeled the steps of PBLI on a weekly basis through the use of a web log. Method: The program confidentially surveyed residents before and after this project about actions consistent with PBLI and knowledge acquired through reading the web log. Results: The frequency that residents encountered clinical situations where they felt uncertain declined over the course of the 24 weeks of the project from a mean frequency of uncertainty of 36% to 28% (Wilcoxon signed rank test, p=0.008; however, the frequency with which residents sought answers when faced with uncertainty did not change (Wilcoxon signed rank test, p=0.39, remaining high at approximately 80%. Residents answered a mean of 52% of knowledge questions correct when tested prior to faculty posts to the blog, rising to a mean of 65% of questions correct when tested at the end of the project (paired t-test, p=0.001. Conclusions: Faculty role modeling of PBLI behaviors and posting clinical questions and answers to a web log led to modest improvements in medical knowledge but did not alter behavior that was already taking place frequently among residents.

  17. Estimation of Transport Trajectory and Residence Time in Large River–Lake Systems: Application to Poyang Lake (China Using a Combined Model Approach

    Directory of Open Access Journals (Sweden)

    Yunliang Li

    2015-09-01

    Full Text Available The biochemical processes and associated water quality in many lakes mainly depend on their transport behaviors. Most existing methodologies for investigating transport behaviors are based on physically based numerical models. The pollutant transport trajectory and residence time of Poyang Lake are thought to have important implications for the steadily deteriorating water quality and the associated rapid environmental changes during the flood period. This study used a hydrodynamic model (MIKE 21 in conjunction with transport and particle-tracking sub-models to provide comprehensive investigation of transport behaviors in Poyang Lake. Model simulations reveal that the lake’s prevailing water flow patterns cause a unique transport trajectory that primarily develops from the catchment river mouths to the downstream area along the lake’s main flow channels, similar to a river-transport behavior. Particle tracking results show that the mean residence time of the lake is 89 days during July–September. The effect of the Yangtze River (the effluent of the lake on the residence time is stronger than that of the catchment river inflows. The current study represents a first attempt to use a combined model approach to provide insights into the transport behaviors for a large river–lake system, given proposals to manage the pollutant inputs both directly to the lake and catchment rivers.

  18. Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training

    Directory of Open Access Journals (Sweden)

    Ada Hindle

    2015-01-01

    Full Text Available Introduction. Web-based learning (WBL is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre- and postmodule test scores and survey Likert scores were analysed using the paired t test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice.

  19. Web-Based Learning for Emergency Airway Management in Anesthesia Residency Training.

    Science.gov (United States)

    Hindle, Ada; Cheng, Ji; Thabane, Lehana; Wong, Anne

    2015-01-01

    Introduction. Web-based learning (WBL) is increasingly used in medical education; however, residency training programs often lack guidance on its implementation. We describe how the use of feasibility studies can guide the use of WBL in anesthesia residency training. Methods. Two case-based WBL emergency airway management modules were developed for self-directed use by anesthesia residents. The feasibility of using this educational modality was assessed using a single cohort pretest/posttest design. Outcome measures included user recruitment and retention rate, perceptions of educational value, and knowledge improvement. The differences between pre- and postmodule test scores and survey Likert scores were analysed using the paired t test. Results. Recruitment and retention rates were 90% and 65%, respectively. User-friendliness of the modules was rated highly. There was a significant improvement in perceptions of the value of WBL in the postsurvey. There was a significant knowledge improvement of 29% in the postmodule test. Conclusions. Feasibility studies can help guide appropriate use of WBL in curricula. While our study supported the potential feasibility of emergency airway management modules for training, collaboration with other anesthesia residency programs may enable more efficient development, implementation, and evaluation of this resource-intensive modality in anesthesia education and practice.

  20. Human Emotion and Response in Surgery (HEARS): a simulation-based curriculum for communication skills, systems-based practice, and professionalism in surgical residency training.

    Science.gov (United States)

    Larkin, Anne C; Cahan, Mitchell A; Whalen, Giles; Hatem, David; Starr, Susan; Haley, Heather-Lyn; Litwin, Demetrius; Sullivan, Kate; Quirk, Mark

    2010-08-01

    This study examines the development and implementation of a pilot human factors curriculum during a 2-year period. It is one component of a comprehensive 5-year human factors curriculum spanning core competencies of interpersonal and communication skills, systems-based practice, and professionalism and using low-and high-fidelity simulation techniques. Members of the Department of Surgery and the Center for Clinical Communication and Performance Outcomes jointly constructed a curriculum for PGY1 and PGY2 residents on topics ranging from challenging communication to time and stress management. Video demonstrations, triggers, and simulated scenarios involving acting patients were created by surgeons and medical educators. Pre- and postintervention measures were obtained for communication skills, perceived stress level, and teamwork. Communication skills were evaluated using a series of video vignettes. The validated Perceived Stress Scale and Teamwork and Patient Safety Attitudes survey were used. Residents' perceptions of the program were also measured. Twenty-seven PGY1 residents and 15 PGY2 residents participated during 2 years. Analyses of video vignette tests indicated significant improvement in empathic communication for PGY1 (t = 3.62, p = 0.001) and PGY2 (t = 5.00, p = 0.004). There were no significant changes to teamwork attitudes. Perceived levels of stress became considerably higher. PGY1 residents reported trying 1 to 3 strategies taught in the time management session, with 60% to 75% reporting improvement post-training. This unique and comprehensive human factors curriculum is shown to be effective in building communication competency for junior-level residents in the human and emotional aspects of surgical training and practice. Continued refinement and ongoing data acquisition and analyses are underway. Copyright 2010 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  1. A web-based test of residents' skills in diagnostic radiology

    International Nuclear Information System (INIS)

    Finlay, K.; Norman, G.R.; Keane, D.R.; Stolberg, H.

    2006-01-01

    To develop an objective, Web-based tool for evaluating residents' knowledge of diagnostic radiology. We developed and tested a Web-based evaluation tool (the Diagnostic Radiology Skills Test) that consists of 3 tests, one in each of 3 domains of diagnostic radiology: chest, gastrointestinal, and musculoskeletal imaging. Each test comprises 30 cases representing a range of difficulty in the domain, including normal states, normal variants, typical cases of common diagnoses, and cases with more subtle findings. Cases are presented with a long menu of domain-specific possible diagnoses (response options), each coded for diagnostic appropriateness. Our subjects were 21 residents in postgraduate year (PGY) 2 to 5 and 11 experts in diagnostic radiology. Subjects accessed the tool via a Web site on our Web server. Residents test results were compared for reliability and validity across domain, case, and training level. In addition, results were correlated with commonly used established and objective evaluation tools. The tool demonstrated consistent monotonic improvement in performance with training level. It showed acceptable reliability in discriminating between residents at different performance levels, both within and across training levels (r = 0.53 within level and 0.69 across levels). Test results also had concurrent validity against the American College of Radiology In-Training Examination, a widely accepted objective assessment tool (r = 0.65, P < 0.01), and 2 Objective Structured Clinical Examinations (OSCEs) focusing on diagnostic skills (r = 0.78 and r 0.69, P < 0.01, respectively). Our study demonstrates the feasibility of a Web-based, standardized, objective assessment method for evaluating residents' performance. (author)

  2. Chemical composition profiles during alkaline flooding at different temperatures and extended residence times

    Energy Technology Data Exchange (ETDEWEB)

    Aflaki, R.; Handy, L.L.

    1992-12-01

    The objective of this work was to investigate whether or not caustic sweeps the major portion of the reservoir efficiently during an alkaline flood process. It was also the objective of this work to study the state of final equilibrium during a caustic flood through determination of the pH and chemical composition profiles along the porous medium. For this purpose, a long porous medium which provided extended residence times was required. It was necessary to set up the porous medium such that the changes in the pH and chemical composition of the solution could be monitored. Four Berea sandstone cores (8 in. length and1 in. diameter) placed in series provided the desired length and the opportunity for sampling in-between cores. This enabled establishment of pH and chemical composition profiles. The experiments were run at, temperatures up.to 180{degrees}C, and the flow rates varied from 4.8 to 0.2 ft/day. The samples were analyzed for pH and for Si and Al concentrations.The results show that caustic consumption is insignificant for temperatures up to 100{degrees}C. Above 100{degrees}C consumption increases and is accompanied by a significant decrease in pH. The sharp decline in pH also coincides with a sharp decline in concentration of silica in solution. The results also show that alumina is removed from the solution and solubility of alumina ultimately reaches zero. Sharp silica and pH declines take place even in the absence of any alumina in solution. As a result, removal of silica from solution is attributed to the irreversible caustic/rock interaction. This interaction is in the form of chemisorption reactions in which silica is adsorbed onto the rock surface consuming hydroxyl ion. Once these reactions were satisfied, caustic breakthrough occurs at a high pH. However, significant pore volumes of caustic must be injected for completion of the chemisorption.

  3. Chemical composition profiles during alkaline flooding at different temperatures and extended residence times

    Energy Technology Data Exchange (ETDEWEB)

    Aflaki, R.; Handy, L.L.

    1992-12-01

    The objective of this work was to investigate whether or not caustic sweeps the major portion of the reservoir efficiently during an alkaline flood process. It was also the objective of this work to study the state of final equilibrium during a caustic flood through determination of the pH and chemical composition profiles along the porous medium. For this purpose, a long porous medium which provided extended residence times was required. It was necessary to set up the porous medium such that the changes in the pH and chemical composition of the solution could be monitored. Four Berea sandstone cores (8 in. length and1 in. diameter) placed in series provided the desired length and the opportunity for sampling in-between cores. This enabled establishment of pH and chemical composition profiles. The experiments were run at, temperatures up.to 180[degrees]C, and the flow rates varied from 4.8 to 0.2 ft/day. The samples were analyzed for pH and for Si and Al concentrations.The results show that caustic consumption is insignificant for temperatures up to 100[degrees]C. Above 100[degrees]C consumption increases and is accompanied by a significant decrease in pH. The sharp decline in pH also coincides with a sharp decline in concentration of silica in solution. The results also show that alumina is removed from the solution and solubility of alumina ultimately reaches zero. Sharp silica and pH declines take place even in the absence of any alumina in solution. As a result, removal of silica from solution is attributed to the irreversible caustic/rock interaction. This interaction is in the form of chemisorption reactions in which silica is adsorbed onto the rock surface consuming hydroxyl ion. Once these reactions were satisfied, caustic breakthrough occurs at a high pH. However, significant pore volumes of caustic must be injected for completion of the chemisorption.

  4. Validation of a Web-Based Curriculum for Resident Education in Orthopedic Surgery.

    Science.gov (United States)

    Boody, Barrett; Johnson, Patrick; Pugely, Andrew; Miller, Daniel; Geller, Jeffrey; Payne, William; Boegener, James; Schafer, Michael; Beal, Matthew

    The Orthopedic In-Training Examination is an annual standardized examination with multiple-choice questions focused on application of orthopedic surgery core knowledge and principles. The outcome of this test can be used to both predict how residents are progressing in their orthopedic knowledge as well as assess their likelihood to pass the Orthopedic Board Examinations, that is the American Boards of Orthopedic Surgery Part 1, following completion of residency. Preparation for the examination can be difficult, as residents commonly have limited study time to review the vast amounts of available published literature. The objective of our study is to evaluate the effectiveness of the Orthopaedic In Training Examination (OITE) scores and the participants' perceived utility of the curriculum for OITE preparation. Residents from 5 US Orthopedic residencies (4 M.D. and 1 D.O.) were included in a pilot program of the Orthobullets PASS curriculum in the academic year 2013 to 2014. Only residents enrolled in the PASS curriculum who completed both the 2013 and 2014 OITEs were included in the final analysis (n = 71). We used the OITE 2013 and 2014 rank postgraduate year (RPGY) reported scores to assess for efficacy of the PASS curriculum, as the RPGY score provides postgraduate year-of-training matched analysis to control for expected increased levels of knowledge with subsequent retesting. While OITE scores incrementally increased for the group as a whole (n = 71, RPGY mean improvement = +2.5%, p = 0.406), the junior resident subgroup (postgraduate year 1-2) produced a statistically significant increase in scores (n = 28, RPGY mean increase = 10.1%, p = 0.0260). Nearly 90% (38/42) of curriculum participants surveyed reported a preference to complete a similar review curriculum for future OITE preparation. The participants completing greater than 150 PASS questions (n = 57) were analyzed for OITE predictive capacity of the PASS curriculum. Pearson analysis with PASS

  5. Using spaced retrieval and Montessori-based activities in improving eating ability for residents with dementia.

    Science.gov (United States)

    Lin, Li-Chan; Huang, Ya-Ju; Su, Su-Gen; Watson, Roger; Tsai, Belina W-J; Wu, Shiao-Chi

    2010-10-01

    To construct a training protocol for spaced retrieval (SR) and to investigate the effectiveness of SR and Montessori-based activities in decreasing eating difficulty in older residents with dementia. A single evaluator, blind, and randomized control trial was used. Eighty-five residents with dementia were chosen from three special care units for residents with dementia in long-term care facilities in Taiwan. To avoid any confounding of subjects, the three institutions were randomized into three groups: spaced retrieval, Montessori-based activities, and a control group. The invention consisted of three 30-40 min sessions per week, for 8 weeks. After receiving the intervention, the Edinburgh Feeding Evaluation in Dementia (EdFED) scores and assisted feeding scores for the SR and Montessori-based activity groups were significantly lower than that of the control group. However, the frequencies of physical assistance and verbal assistance for the Montessori-based activity group after intervention were significantly higher than that of the control group, which suggests that residents who received Montessori-based activity need more physical and verbal assistance during mealtimes. In terms of the effects of nutritional status after intervention, Mini-Nutritional Assessment (MNA) in the SR group was significantly higher than that of the control group. This study confirms the efficacy of SR and Montessori-based activities for eating difficulty and eating ability. A longitudinal study to follow the long-term effects of SR and Montessori-based activities on eating ability and nutritional status is recommended. Copyright © 2010 John Wiley & Sons, Ltd.

  6. Trait differences between naturalized and invasive plant species independent of residence time and phylogeny

    Science.gov (United States)

    Gallagher, R V; Randall, R P; Leishman, M R

    2015-01-01

    The ability to predict which alien plants will transition from naturalized to invasive prior to their introduction to novel regions is a key goal for conservation and has the potential to increase the efficacy of weed risk assessment (WRA). However, multiple factors contribute to plant invasion success (e.g., functional traits, range characteristics, residence time, phylogeny), and they all must be taken into account simultaneously in order to identify meaningful correlates of invasion success. We compiled 146 pairs of phylogenetically paired (congeneric) naturalized and invasive plant species in Australia with similar minimum residence times (i.e., time since introduction in years). These pairs were used to test for differences in 5 functional traits (flowering duration, leaf size, maximum height, specific leaf area [SLA], seed mass) and 3 characteristics of species’ native ranges (biome occupancy, mean annual temperature, and rainfall breadth) between naturalized and invasive species. Invasive species, on average, had larger SLA, longer flowering periods, and were taller than their congeneric naturalized relatives. Invaders also exhibited greater tolerance for different environmental conditions in the native range, where they occupied more biomes and a wider breadth of rainfall and temperature conditions than naturalized congeners. However, neither seed mass nor leaf size differed between pairs of naturalized and invasive species. A key finding was the role of SLA in distinguishing between naturalized and invasive pairs. Species with high SLA values were typically associated with faster growth rates, more rapid turnover of leaf material, and shorter lifespans than those species with low SLA. This suite of characteristics may contribute to the ability of a species to transition from naturalized to invasive across a wide range of environmental contexts and disturbance regimes. Our findings will help in the refinement of WRA protocols, and we advocate the

  7. Fast Pyrolysis Behavior of Banagrass as a Function of Temperature and Volatiles Residence Time in a Fluidized Bed Reactor.

    Science.gov (United States)

    Morgan, Trevor James; Turn, Scott Q; George, Anthe

    2015-01-01

    A reactor was designed and commissioned to study the fast pyrolysis behavior of banagrass as a function of temperature and volatiles residence time. Four temperatures between 400 and 600°C were examined as well as four residence times between ~1.0 and 10 seconds. Pyrolysis product distributions of bio-oil, char and permanent gases were determined at each reaction condition. The elemental composition of the bio-oils and chars was also assessed. The greatest bio-oil yield was recorded when working at 450°C with a volatiles residence time of 1.4 s, ~37 wt% relative to the dry ash free feedstock (excluding pyrolysis water). The amounts of char (organic fraction) and permanent gases under these conditions are ~4 wt% and 8 wt% respectively. The bio-oil yield stated above is for 'dry' bio-oil after rotary evaporation to remove solvent, which results in volatiles and pyrolysis water being removed from the bio-oil. The material removed during drying accounts for the remainder of the pyrolysis products. The 'dry' bio-oil produced under these conditions contains ~56 wt% carbon which is ~40 wt% of the carbon present in the feedstock. The oxygen content of the 450°C, 1.4 s 'dry' bio-oil is ~38 wt%, which accounts for ~33 wt% of the oxygen in the feedstock. At higher temperature or longer residence time less bio-oil and char is recovered and more gas and light volatiles are produced. Increasing the temperature has a more significant effect on product yields and composition than increasing the volatiles residence time. At 600°C and a volatiles residence time of 1.2 seconds the bio-oil yield is ~21 wt% of the daf feedstock, with a carbon content of 64 wt% of the bio-oil. The bio-oil yield from banagrass is significantly lower than from woody biomass or grasses such as switchgrass or miscanthus, but is similar to barley straw. The reason for the low bio-oil yield from banagrass is thought to be related to its high ash content (8.5 wt% dry basis) and high concentration of alkali

  8. Fast Pyrolysis Behavior of Banagrass as a Function of Temperature and Volatiles Residence Time in a Fluidized Bed Reactor.

    Directory of Open Access Journals (Sweden)

    Trevor James Morgan

    Full Text Available A reactor was designed and commissioned to study the fast pyrolysis behavior of banagrass as a function of temperature and volatiles residence time. Four temperatures between 400 and 600°C were examined as well as four residence times between ~1.0 and 10 seconds. Pyrolysis product distributions of bio-oil, char and permanent gases were determined at each reaction condition. The elemental composition of the bio-oils and chars was also assessed. The greatest bio-oil yield was recorded when working at 450°C with a volatiles residence time of 1.4 s, ~37 wt% relative to the dry ash free feedstock (excluding pyrolysis water. The amounts of char (organic fraction and permanent gases under these conditions are ~4 wt% and 8 wt% respectively. The bio-oil yield stated above is for 'dry' bio-oil after rotary evaporation to remove solvent, which results in volatiles and pyrolysis water being removed from the bio-oil. The material removed during drying accounts for the remainder of the pyrolysis products. The 'dry' bio-oil produced under these conditions contains ~56 wt% carbon which is ~40 wt% of the carbon present in the feedstock. The oxygen content of the 450°C, 1.4 s 'dry' bio-oil is ~38 wt%, which accounts for ~33 wt% of the oxygen in the feedstock. At higher temperature or longer residence time less bio-oil and char is recovered and more gas and light volatiles are produced. Increasing the temperature has a more significant effect on product yields and composition than increasing the volatiles residence time. At 600°C and a volatiles residence time of 1.2 seconds the bio-oil yield is ~21 wt% of the daf feedstock, with a carbon content of 64 wt% of the bio-oil. The bio-oil yield from banagrass is significantly lower than from woody biomass or grasses such as switchgrass or miscanthus, but is similar to barley straw. The reason for the low bio-oil yield from banagrass is thought to be related to its high ash content (8.5 wt% dry basis and high

  9. Fast Pyrolysis Behavior of Banagrass as a Function of Temperature and Volatiles Residence Time in a Fluidized Bed Reactor

    Science.gov (United States)

    Morgan, Trevor James; Turn, Scott Q.; George, Anthe

    2015-01-01

    A reactor was designed and commissioned to study the fast pyrolysis behavior of banagrass as a function of temperature and volatiles residence time. Four temperatures between 400 and 600°C were examined as well as four residence times between ~1.0 and 10 seconds. Pyrolysis product distributions of bio-oil, char and permanent gases were determined at each reaction condition. The elemental composition of the bio-oils and chars was also assessed. The greatest bio-oil yield was recorded when working at 450°C with a volatiles residence time of 1.4 s, ~37 wt% relative to the dry ash free feedstock (excluding pyrolysis water). The amounts of char (organic fraction) and permanent gases under these conditions are ~4 wt% and 8 wt% respectively. The bio-oil yield stated above is for 'dry' bio-oil after rotary evaporation to remove solvent, which results in volatiles and pyrolysis water being removed from the bio-oil. The material removed during drying accounts for the remainder of the pyrolysis products. The 'dry' bio-oil produced under these conditions contains ~56 wt% carbon which is ~40 wt% of the carbon present in the feedstock. The oxygen content of the 450°C, 1.4 s 'dry' bio-oil is ~38 wt%, which accounts for ~33 wt% of the oxygen in the feedstock. At higher temperature or longer residence time less bio-oil and char is recovered and more gas and light volatiles are produced. Increasing the temperature has a more significant effect on product yields and composition than increasing the volatiles residence time. At 600°C and a volatiles residence time of 1.2 seconds the bio-oil yield is ~21 wt% of the daf feedstock, with a carbon content of 64 wt% of the bio-oil. The bio-oil yield from banagrass is significantly lower than from woody biomass or grasses such as switchgrass or miscanthus, but is similar to barley straw. The reason for the low bio-oil yield from banagrass is thought to be related to its high ash content (8.5 wt% dry basis) and high concentration of alkali

  10. Emergency medicine resident crisis resource management ability: a simulation-based longitudinal study

    Directory of Open Access Journals (Sweden)

    Samuel Clarke

    2014-12-01

    Full Text Available Background: Simulation has been identified as a means of assessing resident physicians’ mastery of technical skills, but there is a lack of evidence for its utility in longitudinal assessments of residents’ non-technical clinical abilities. We evaluated the growth of crisis resource management (CRM skills in the simulation setting using a validated tool, the Ottawa Crisis Resource Management Global Rating Scale (Ottawa GRS. We hypothesized that the Ottawa GRS would reflect progressive growth of CRM ability throughout residency. Methods: Forty-five emergency medicine residents were tracked with annual simulation assessments between 2006 and 2011. We used mixed-methods repeated-measures regression analyses to evaluate elements of the Ottawa GRS by level of training to predict performance growth throughout a 3-year residency. Results: Ottawa GRS scores increased over time, and the domains of leadership, problem solving, and resource utilization, in particular, were predictive of overall performance. There was a significant gain in all Ottawa GRS components between postgraduate years 1 and 2, but no significant difference in GRS performance between years 2 and 3. Conclusions: In summary, CRM skills are progressive abilities, and simulation is a useful modality for tracking their development. Modification of this tool may be needed to assess advanced learners’ gains in performance.

  11. Time-motion studies of internal medicine residents' duty hours: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Leafloor CW

    2015-11-01

    Full Text Available Cameron W Leafloor,1 Heather A Lochnan,2,3,6 Catherine Code,2,4 Erin J Keely,2,3,6 Deanna M Rothwell,5,6 Alan J Forster,2,4–6 Allen R Huang2,6,7 1Faculty of Medicine, 2Department of Medicine, 3Division of Endocrinology and Metabolism, 4Division of General Internal Medicine, 5Performance Measurement and Innovation, 6Ottawa Hospital Research Institute, 7Division of Geriatric Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, ON, Canada Background: Since the mid-1980s, medical residents' long duty hours have been under scrutiny as a factor affecting patient safety and the work environment for the residents. After several mandated changes in duty hours, it is important to understand how residents spend their time before proposing and implementing future changes. Time-motion methodology may provide reliable information on what residents do while on duty.Purpose: The purpose of this study is to review all available literature pertaining to time-motion studies of internal medicine residents while on a medicine service and to understand how much of their time is apportioned to various categories of tasks, and also to determine the effects of the Accreditation Council for Graduate Medical Education (ACGME-mandated duty hour changes on resident workflow in North America.Methods: Electronic bibliographic databases were searched for articles in English between 1941 and April 2013 reporting time-motion studies of internal medicine residents rotating through a general medicine service.Results: Eight articles were included. Residents spent 41.8% of time in patient care activities, 18.1% communicating, 13.8% in educational activities, 19.7% in personal/other, and 6.6% in transit. North American data showed the following changes after the implementation of the ACGME 2003 duty hours standard: patient care activities from 41.8% to 40.8%, communication activities from 19.0% to 22.3%, educational activities from 17.7% to 11.6%, and personal

  12. Mastery of Status Epilepticus Management via Simulation-Based Learning for Pediatrics Residents

    Science.gov (United States)

    Malakooti, Marcelo R.; McBride, Mary E.; Mobley, Bonnie; Goldstein, Joshua L.; Adler, Mark D.; McGaghie, William C.

    2015-01-01

    Background Management of status epilepticus (SE) in the pediatric population is highly time-sensitive. Failure to follow a standard management algorithm may be due to ineffective provider education, and can lead to unfavorable outcomes. Objective To design a learning module using high-fidelity simulation technology to teach mastery achievement of a hospital algorithm for managing SE. Methods Thirty pediatrics interns were enrolled. Using the Angoff method, an expert panel developed the minimal passing score, which defined mastery. Scoring of simulated performance was done by 2 observers. Sessions were digitally recorded. After the pretest, participants were debriefed on the algorithm and required to repeat the simulation. If mastery (minimal passing score) was not achieved, debriefing and the simulation were repeated until mastery was met. Once mastery was met, participants graded their comfort level in managing SE. Results No participants achieved mastery at pretest. After debriefing and deliberate simulator training, all (n = 30) achieved mastery of the algorithm: 30% achieved mastery after 1 posttest, 63% after a second, and 6.7% after a third. The Krippendorff α was 0.94, indicating strong interrater agreement. Participants reported more self-efficacy in managing SE, a preference for simulation-based education for learning practice-based algorithms of critical conditions, and highly rated the educational intervention. Conclusions A simulation-based mastery learning program using deliberate practice dramatically improves pediatrics residents' execution of a SE management protocol. Participants enjoyed and benefited from simulation education. Future applications include improving adherence to other hospital protocols. PMID:26221431

  13. In vivo eye surface residence determination by high-resolution scintigraphy of a novel ion-sensitive hydrogel based on gellan gum and kappa-carrageenan.

    Science.gov (United States)

    Fernández-Ferreiro, Anxo; Silva-Rodríguez, Jesús; Otero-Espinar, Francisco Javier; González-Barcia, Miguel; Lamas, María Jesús; Ruibal, Alvaro; Luaces-Rodríguez, Andrea; Vieites-Prado, Alba; Lema, Isabel; Herranz, Michel; Gómez-Lado, Noemí; Blanco-Mendez, José; Gil-Martínez, María; Pardo, María; Moscoso, Alexis; Cortes, Julia; Sánchez-Martínez, María; Pardo-Montero, Juan; Aguiar, Pablo

    2017-05-01

    In last years, sensitive hydrogels have become a breakthrough in ophthalmic pharmaceutical technology aimed at developing new strategies to increase the residence time of active substances. In a previous paper, we qualitatively demonstrated the capacity of a new ion sensitive hydrogel to increase the residence time. Nevertheless, the clearance of the gel from the ocular surface was not quantifiable with the used methodology. The aim of the present work was to use a well-established approach based on scintigraphy to quantitatively estimate the residence time of the previously proposed hydrogel. The rat corneal residence time of a topic ophthalmic formulation containing gellan gum and kappa carragenan (0.82% w/v) labeled with 99m Tc-DTPA radiotracer was evaluated and compared with the residence of an aqueous solution. Ophthalmic safety studies such as eye irritation or passage through the cornea were also carried out. After 1.5h of contact, 77% of the hydrogel remained in the ocular surface, presenting kinetics of disappearance one-phase decay and a half time of 262min. We conclude that the novel ophthalmic hydrogel developed with kappa carrageenan and gellan gum remains for long periods of time on the corneal surface, presenting a drop that fits an exponential decay. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. Caregiver Person-Centeredness and Behavioral Symptoms in Nursing Home Residents With Dementia: A Timed-Event Sequential Analysis.

    Science.gov (United States)

    Gilmore-Bykovskyi, Andrea L; Roberts, Tonya J; Bowers, Barbara J; Brown, Roger L

    2015-06-01

    Evidence suggests that person-centered caregiving approaches may reduce dementia-related behavioral symptoms; however, little is known about the sequential and temporal associations between specific caregiver actions and behavioral symptoms. The aim of this study was to identify sequential associations between caregiver person-centered actions, task-centered actions, and resident behavioral symptoms and the temporal variation within these associations. Videorecorded observations of naturally occurring interactions (N = 33; 724min) between 12 nursing home (NH) residents with dementia and eight certified nursing assistants were coded for caregiver person-centered actions, task-centered actions, and resident behavioral symptoms and analyzed using timed-event sequential analysis. Although caregiver actions were predominantly person-centered, we found that resident behavioral symptoms were significantly more likely to occur following task-centered caregiver actions than person-centered actions. Findings suggest that the person-centeredness of caregivers is sequentially and temporally related to behavioral symptoms in individuals with dementia. Additional research examining the temporal structure of these relationships may offer valuable insights into the utility of caregiver person-centeredness as a low-cost strategy for improving behavioral symptom management in the NH setting. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Increasing functional modularity with residence time in the co-distribution of native and introduced vascular plants.

    Science.gov (United States)

    Hui, Cang; Richardson, David M; Pyšek, Petr; Le Roux, Johannes J; Kučera, Tomáš; Jarošík, Vojtěch

    2013-01-01

    Species gain membership of regional assemblages by passing through multiple ecological and environmental filters. To capture the potential trajectory of structural changes in regional meta-communities driven by biological invasions, one can categorize species pools into assemblages of different residence times. Older assemblages, having passed through more environmental filters, should become more functionally ordered and structured. Here we calculate the level of compartmentalization (modularity) for three different-aged assemblages (neophytes, introduced after 1500 AD; archaeophytes, introduced before 1500 AD, and natives), including 2,054 species of vascular plants in 302 reserves in central Europe. Older assemblages are more compartmentalized than younger ones, with species composition, phylogenetic structure and habitat characteristics of the modules becoming increasingly distinctive. This sheds light on two mechanisms of how alien species are functionally incorporated into regional species pools: the settling-down hypothesis of diminishing stochasticity with residence time, and the niche-mosaic hypothesis of inlaid neutral modules in regional meta-communities.

  16. Isotopic and geochemical tracers in the evaluation of groundwater residence time and salinization problems at Santiago Island, Cape Verde

    Energy Technology Data Exchange (ETDEWEB)

    Carreira, Paula M.; Nunes, Dina [Quimica Analitica e Ambiental, IST/ITN, Universidade Tecnica de Lisboa, Estrada Nacional no. 10, 2686-953 Sacavem (Portugal); Marques, Jose M. [Centro de Petrologia e Geoquimica. Instituto Superior Tecnico, UTL, Av. Rovisco Pais, 1049-001 Lisboa (Portugal); Monteiro Santos, Fernando A. [Universidade de Lisboa-IDL, 1749-016 Lisboa (Portugal); Goncalves, Rui [Inst. Politecnico de Tomar, Quinta do Contador, Estrada da Serra, 2300 Tomar (Portugal); Pina, Antonio; Mota Gomes, Antonio [Instituto Superior de Educacao, Praia, Santiago (Cape Verde)

    2013-07-01

    Stable isotopes (δ{sup 18}O, δ{sup 2}H) and tritium ({sup 3}H), together with geochemistry and geophysical data, were used for evaluating groundwater recharge sources, flow paths, and residence times in a watershed on Santiago Island, Cape Verde, West Africa. Stable isotopes indicate the predominance of high-elevation precipitation that undergoes little evaporation prior to groundwater recharge. Low tritium concentrations at seven sampling sites indicate groundwater residence times greater than 50 years. Higher tritium values at other locations suggest more recent recharge. Young ages indicate local recharge and potential groundwater vulnerability to surface contamination and/or salt-water intrusion. Geochemical results indicate that water-rock interaction mechanisms are the major processes responsible for the groundwater quality (mainly calcium-bicarbonate type), reflecting the lithological composition of subsurface soil. (authors)

  17. Optimization of Drug Delivery Systems for Intraperitoneal Therapy to Extend the Residence Time of the Chemotherapeutic Agent

    Directory of Open Access Journals (Sweden)

    L. De Smet

    2013-01-01

    Full Text Available Intraperitoneal (IP chemotherapy is an effective way of treating peritoneal carcinomatosis of colorectal origin after complete cytoreduction. Although IP therapy has been already performed for many years, no standardized treatment design has been developed in terms of schedule, residence time, drug, or carrier solution. Because of the fast clearance of the conventional intravenous (IV drug delivery systems used for IP therapy, a lot of research is performed to optimize IP drug delivery and extend the residence time of the cytotoxic agent in the peritoneal cavity. This paper reviews the recent advances made in drug delivery systems for IP chemotherapy, discussing the use of microparticles, nanoparticles, liposomes, micelles, implants, and injectable depots for IP delivery.

  18. Isotopic and geochemical tracers in the evaluation of groundwater residence time and salinization problems at Santiago Island, Cape Verde

    International Nuclear Information System (INIS)

    Carreira, Paula M.; Nunes, Dina; Marques, Jose M.; Monteiro Santos, Fernando A.; Goncalves, Rui; Pina, Antonio; Mota Gomes, Antonio

    2013-01-01

    Stable isotopes (δ 18 O, δ 2 H) and tritium ( 3 H), together with geochemistry and geophysical data, were used for evaluating groundwater recharge sources, flow paths, and residence times in a watershed on Santiago Island, Cape Verde, West Africa. Stable isotopes indicate the predominance of high-elevation precipitation that undergoes little evaporation prior to groundwater recharge. Low tritium concentrations at seven sampling sites indicate groundwater residence times greater than 50 years. Higher tritium values at other locations suggest more recent recharge. Young ages indicate local recharge and potential groundwater vulnerability to surface contamination and/or salt-water intrusion. Geochemical results indicate that water-rock interaction mechanisms are the major processes responsible for the groundwater quality (mainly calcium-bicarbonate type), reflecting the lithological composition of subsurface soil. (authors)

  19. The distribution of range sizes of native and alien plants in four European countries and the effects of residence time

    Czech Academy of Sciences Publication Activity Database

    Williamson, M.; Dehnen-Schmutz, K.; Kühn, I.; Hill, M.; Klotz, S.; Milbau, A.; Stout, J.; Pyšek, Petr

    2009-01-01

    Roč. 15, č. 1 (2009), s. 158-166 ISSN 1366-9516 R&D Projects: GA MŠk LC06073 Grant - others:Evropská komise(XE) SSPI-CT-2003-511202 Institutional research plan: CEZ:AV0Z60050516 Keywords : invasions * distribution range * residence time Subject RIV: EF - Botanics Impact factor: 4.224, year: 2009

  20. Regional oxygen reduction and denitrification rates in groundwater from multi-model residence time distributions, San Joaquin Valley, USA

    Science.gov (United States)

    Green, Christopher T.; Jurgens, Bryant; Zhang, Yong; Starn, Jeffrey; Singleton, Michael J.; Esser, Bradley K.

    2016-01-01

    Rates of oxygen and nitrate reduction are key factors in determining the chemical evolution of groundwater. Little is known about how these rates vary and covary in regional groundwater settings, as few studies have focused on regional datasets with multiple tracers and methods of analysis that account for effects of mixed residence times on apparent reaction rates. This study provides insight into the characteristics of residence times and rates of O2 reduction and denitrification (NO3− reduction) by comparing reaction rates using multi-model analytical residence time distributions (RTDs) applied to a data set of atmospheric tracers of groundwater age and geochemical data from 141 well samples in the Central Eastern San Joaquin Valley, CA. The RTD approach accounts for mixtures of residence times in a single sample to provide estimates of in-situ rates. Tracers included SF6, CFCs, 3H, He from 3H (tritiogenic He),14C, and terrigenic He. Parameter estimation and multi-model averaging were used to establish RTDs with lower error variances than those produced by individual RTD models. The set of multi-model RTDs was used in combination with NO3− and dissolved gas data to estimate zero order and first order rates of O2 reduction and denitrification. Results indicated that O2 reduction and denitrification rates followed approximately log-normal distributions. Rates of O2 and NO3− reduction were correlated and, on an electron milliequivalent basis, denitrification rates tended to exceed O2 reduction rates. Estimated historical NO3− trends were similar to historical measurements. Results show that the multi-model approach can improve estimation of age distributions, and that relatively easily measured O2 rates can provide information about trends in denitrification rates, which are more difficult to estimate.

  1. Successful invaders co-opt pollinators of native flora and accumulate insect pollinators with increasing residence time

    Czech Academy of Sciences Publication Activity Database

    Pyšek, Petr; Jarošík, Vojtěch; Chytrý, M.; Danihelka, Jiří; Kuhn, D.; Pergl, Jan; Tichý, L.; Biesmeijer, J. C.; Ellis, W. N.; Kunin, W. E.; Settele, J.

    2011-01-01

    Roč. 81, č. 2 (2011), s. 277-293 ISSN 0012-9615 R&D Projects: GA MŠk LC06073; GA ČR GA206/09/0563 Grant - others:European Comission(XE) GOCE-CT-2003-506675 Institutional research plan: CEZ:AV0Z60050516 Keywords : pollination * residence time * plant invasion Subject RIV: EF - Botanics Impact factor: 7.433, year: 2011

  2. Comparison of Residence Time Distributions of Liquid for Different Types of Input Signal Using a Stimulus-Response Technique

    Czech Academy of Sciences Publication Activity Database

    Čermáková, Jiřina; Siyakatshana, N.; Šilar, F.; Kudrna, V.; Jahoda, M.; Machoň, V.

    2003-01-01

    Roč. 57, č. 6 (2003), s. 427-431 ISSN 0366-6352. [International Conference of Slovak Society of Chemical Engineering /30./. Tatranské Matliare, 26.05.2003-30.05.2003] Institutional research plan: CEZ:AV0Z4072921 Keywords : stirred tank * stimulus-response technique * residence time distribution Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 0.226, year: 2003

  3. A multitracer approach to estimate groundwater residence time distributions at a managed aquifer recharge site

    Science.gov (United States)

    Popp, Andrea; Kipfer, Rolf

    2017-04-01

    Managed aquifer recharge (MAR) has become a common water management tool and serves various purposes such as improving the quality of groundwater (GW). At the study site, the Hardwald in Muttenz (Switzerland), MAR has been implemented in the mid-1950s to overcome increasing water demands. GW is artificially recharged with water from the river Rhine through a system of channels and ponds. The area is surrounded by potential contamination sites such as chemical industry, former landfills, a highway and a freight depot. Furthermore, the area shows a complex hydrogeologic setting with several fault zones and two main aquifers, the Quaternary Rhine gravel aquifer overlying a karstified Upper Muschelkalk limestone aquifer. Water from the deeper limestone aquifer is suspected to contain contaminants originating from the landfills. The fractures might serve as a hydraulic connection between the upper and lower aquifer. Further, groundwater pumping might enhance the mixing of recently infiltrated water with older water from the lower aquifer. Hence, the proximity to potential contamination sites and the complex geologic setting both pose risks for GW pollution and challenge the drinking water production in this area. To guarantee a safe drinking water supply, it is crucial to know the mixing patterns of young and old GW abstracted from the pumping wells. With this study we aim to determine the spatial variability of GW residence time distributions to differentiate between recently infiltrated river water and older groundwater. To reach our objectives, we use a combination of the following tracers to cover a wide range of possible GW ages: (1) radiogenic 222Rn (young water := <3 weeks); (2) tritium (3H) in combination with its tritiogenic decay product 3He (old water := 0.5-50 years); and (3) radiogenic 4He (very old water := 100-1000 years). Additionally, we analysed other dissolved (noble) gases (O2, N2, Ar, Kr) to estimate the amount of excess air and to derive the

  4. Simulation-based Assessment to Reliably Identify Key Resident Performance Attributes.

    Science.gov (United States)

    Blum, Richard H; Muret-Wagstaff, Sharon L; Boulet, John R; Cooper, Jeffrey B; Petrusa, Emil R; Baker, Keith H; Davidyuk, Galina; Dearden, Jennifer L; Feinstein, David M; Jones, Stephanie B; Kimball, William R; Mitchell, John D; Nadelberg, Robert L; Wiser, Sarah H; Albrecht, Meredith A; Anastasi, Amanda K; Bose, Ruma R; Chang, Laura Y; Culley, Deborah J; Fisher, Lauren J; Grover, Meera; Klainer, Suzanne B; Kveraga, Rikante; Martel, Jeffrey P; McKenna, Shannon S; Minehart, Rebecca D; Mitchell, John D; Mountjoy, Jeremi R; Pawlowski, John B; Pilon, Robert N; Shook, Douglas C; Silver, David A; Warfield, Carol A; Zaleski, Katherine L

    2018-04-01

    Obtaining reliable and valid information on resident performance is critical to patient safety and training program improvement. The goals were to characterize important anesthesia resident performance gaps that are not typically evaluated, and to further validate scores from a multiscenario simulation-based assessment. Seven high-fidelity scenarios reflecting core anesthesiology skills were administered to 51 first-year residents (CA-1s) and 16 third-year residents (CA-3s) from three residency programs. Twenty trained attending anesthesiologists rated resident performances using a seven-point behaviorally anchored rating scale for five domains: (1) formulate a clear plan, (2) modify the plan under changing conditions, (3) communicate effectively, (4) identify performance improvement opportunities, and (5) recognize limits. A second rater assessed 10% of encounters. Scores and variances for each domain, each scenario, and the total were compared. Low domain ratings (1, 2) were examined in detail. Interrater agreement was 0.76; reliability of the seven-scenario assessment was r = 0.70. CA-3s had a significantly higher average total score (4.9 ± 1.1 vs. 4.6 ± 1.1, P = 0.01, effect size = 0.33). CA-3s significantly outscored CA-1s for five of seven scenarios and domains 1, 2, and 3. CA-1s had a significantly higher proportion of worrisome ratings than CA-3s (chi-square = 24.1, P < 0.01, effect size = 1.50). Ninety-eight percent of residents rated the simulations more educational than an average day in the operating room. Sensitivity of the assessment to CA-1 versus CA-3 performance differences for most scenarios and domains supports validity. No differences, by experience level, were detected for two domains associated with reflective practice. Smaller score variances for CA-3s likely reflect a training effect; however, worrisome performance scores for both CA-1s and CA-3s suggest room for improvement.

  5. Case based teaching at the bed side versus in classroom for undergraduates and residents of pediatrics

    Directory of Open Access Journals (Sweden)

    MAHDI SHAHRIARI

    2014-07-01

    Full Text Available Introduction: Bedside teaching is defined as teaching in the presence of a patient, it is a vital component of medical education. The aim of this study was to evaluate the effectiveness of two methods of case based teaching (at the bedside and in the classroom in the teaching hospitals (for both undergraduates and residents of pediatrics. Methods: Thirty undergraduates and twenty pediatric residents were asked to study a topic of their curriculum from their text then pretest was taken from learners in the two levels; then either lecture with power point or case presentation or bed side discussion were conducted. One week later posttest was taken, and then evaluation of these three methods was done by a questionnaire from learners. Results: The majority of under-graduates and all of pediatric residents had evaluated case based teaching superior to bedside teaching and these two methods superior to lecture method. Conclusion: They believed that in the case based teaching they are more relaxed and have more self-esteem than at the bedside of the patients. Clinician teacher must involve patients and learners in the process of bedside teaching, by preparing a comfortable situation and by using available technolgy.

  6. DNA binding by PHF1 prolongs PRC2 residence time on chromatin and thereby promotes H3K27 methylation.

    Science.gov (United States)

    Choi, Jeongyoon; Bachmann, Andreas Linus; Tauscher, Katharina; Benda, Christian; Fierz, Beat; Müller, Jürg

    2017-12-01

    Polycomb repressive complex 2 (PRC2) trimethylates histone H3 at lysine 27 to mark genes for repression. We measured the dynamics of PRC2 binding on recombinant chromatin and free DNA at the single-molecule level using total internal reflection fluorescence (TIRF) microscopy. PRC2 preferentially binds free DNA with multisecond residence time and midnanomolar affinity. PHF1, a PRC2 accessory protein of the Polycomblike family, extends PRC2 residence time on DNA and chromatin. Crystallographic and functional studies reveal that Polycomblike proteins contain a winged-helix domain that binds DNA in a sequence-nonspecific fashion. DNA binding by this winged-helix domain accounts for the prolonged residence time of PHF1-PRC2 on chromatin and makes it a more efficient H3K27 methyltranferase than PRC2 alone. Together, these studies establish that interactions with DNA provide the predominant binding affinity of PRC2 for chromatin. Moreover, they reveal the molecular basis for how Polycomblike proteins stabilize PRC2 on chromatin and stimulate its activity.

  7. Survey of some natural decay-series isotopes in the Wairakei geothermal area and possible residence-time applications

    International Nuclear Information System (INIS)

    Concentrations of selected isotopes in the uranium decay series were determined for samples collected from the Wairakei, Broadlands/Ohaaki and Waiotapu areas. /sup 226/Ra concentrations were found to be low (0.05-0.22 dpm/l), similar to values reported in neutral hot springs at Tatun geothermal area, Taiwan, but lower than other geothermal systems (Yellowstone, USA, and Latera, Central Italy) (up to 25 dpm/l). The potential of /sup 226/Ra//sup 228/Ra ratios for indicating water residence times could not be explored because /sup 228/Ra data was not available. /sup 222/Rn concentrations are higher and related to steam fractions and CO/sub 2/ concentrations. The short half-life (3.8 days) makes /sup 222/Rn suitable for estimating residence times of radon in steam, and therefore the distance of travel of steam from its source (e.g., wells WK9 and 52). /sup 210/Pb and /sup 210/Po concentrations were very low and less than detection limits in many of the Wairakei waters; no residence time applications are apparent for these isotopes. (author). 11 refs.; 5 figs.; 3 tabs

  8. Residence half-time of {sup 137}Cs in the top-soils of Japanese paddy and upland fields

    Energy Technology Data Exchange (ETDEWEB)

    Komamura, Misako [National Inst. of Agro-Environmental Sciences, Tsukuba, Ibaraki (Japan); Tsumura, Akito; Kodaira, Kiyoshi

    1999-03-01

    A series of top-soil samples of 14 paddy fields and 10 upland fields in Japan, were annually collected during more than 30 years, to be examined in the contents of {sup 137}Cs. The data, which were obtained by the use of a gamma spectrometric system, received some statistical treatments to distinguish the annual decline of {sup 137}Cs contents from deviations. Then the authors calculated `residence half-time of {sup 137}Cs` within top-soil, and `eluviation rate of {sup 137}Cs` from top to the sub-layer of the soil. The following nationwide results were obtained irrespective of paddy or upland field: (1) The `apparent residence half-time` was estimated as 16 - 17 years. This consists of both effects of eluviation and nuclear disintegration. (2) The true residence half-time` was reported as 41 - 42 years. This depends on the eluviation speed of {sup 137}Cs exclusively, because the influence of nuclear disintegration has been compensated. (3) The eluviation rate of {sup 137}Cs from top-soil down to the sub-soil was 1.6 - 1.7% per year. (4) The ratio of distribution of {sup 137}Cs between top-soil and the sub-soil was estimated to be 6:4 as average at the date of 1996. (author)

  9. Whale shark (Rhincodon typus seasonal presence, residence time and habitat use at darwin island, galapagos marine reserve.

    Directory of Open Access Journals (Sweden)

    David Acuña-Marrero

    Full Text Available The life history of the whale shark (Rhincodon typus, including its reproductive ecology, still remains largely unknown. Here, we present results from the first whale shark population study around Darwin Island, Galapagos Marine Reserve. Following a diversified approach we characterized seasonal occurrence, population structure and size, and described habitat use of whale sharks based on fine scale movements around the island. Whale shark presence at Darwin Island was negatively correlated with Sea Surface Temperature (SST, with highest abundance corresponding to a cool season between July and December over six years of monitoring. From 2011 to 2013 we photo-identified 82 whale sharks ranging from 4 to 13.1 m Total Length (TL. Size distribution was bimodal, with a great majority (91.5% of adult female individuals averaging 11.35 m±0.12 m (TL±SE, all but one showing signs of a potential pregnancy. Population dynamics models for apparently pregnant sharks estimated the presence of 3.76±0.90 (mean ± SE sharks in the study area per day with an individual residence time of 2.09±0.51 (mean ± SE days. Movement patterns analysis of four apparently pregnant individuals tracked with acoustic tags at Darwin Island revealed an intense use of Darwin's Arch, where no feeding or specific behavior has been recorded, together with periodic excursions around the island's vicinity. Sharks showed a preference for intermediate depths (20-30 m with occasional dives mostly to mid-water, remaining the majority of their time at water temperatures between 24-25°C. All of our results point to Darwin Island as an important stopover in a migration, possibly with reproductive purposes, rather than an aggregation site. Current studies carried out in this area to investigate regional scale movement patterns may provide essential information about possible pupping grounds for this enigmatic species.

  10. Whale Shark (Rhincodon typus) Seasonal Presence, Residence Time and Habitat Use at Darwin Island, Galapagos Marine Reserve

    Science.gov (United States)

    Acuña-Marrero, David; Jiménez, Jesús; Smith, Franz; Doherty, Paul F.; Hearn, Alex; Green, Jonathan R.; Paredes-Jarrín, Jules; Salinas-de-León, Pelayo

    2014-01-01

    The life history of the whale shark (Rhincodon typus), including its reproductive ecology, still remains largely unknown. Here, we present results from the first whale shark population study around Darwin Island, Galapagos Marine Reserve. Following a diversified approach we characterized seasonal occurrence, population structure and size, and described habitat use of whale sharks based on fine scale movements around the island. Whale shark presence at Darwin Island was negatively correlated with Sea Surface Temperature (SST), with highest abundance corresponding to a cool season between July and December over six years of monitoring. From 2011 to 2013 we photo-identified 82 whale sharks ranging from 4 to 13.1 m Total Length (TL). Size distribution was bimodal, with a great majority (91.5%) of adult female individuals averaging 11.35 m±0.12 m (TL±SE), all but one showing signs of a potential pregnancy. Population dynamics models for apparently pregnant sharks estimated the presence of 3.76±0.90 (mean ± SE) sharks in the study area per day with an individual residence time of 2.09±0.51 (mean ± SE) days. Movement patterns analysis of four apparently pregnant individuals tracked with acoustic tags at Darwin Island revealed an intense use of Darwin's Arch, where no feeding or specific behavior has been recorded, together with periodic excursions around the island's vicinity. Sharks showed a preference for intermediate depths (20–30 m) with occasional dives mostly to mid-water, remaining the majority of their time at water temperatures between 24–25°C. All of our results point to Darwin Island as an important stopover in a migration, possibly with reproductive purposes, rather than an aggregation site. Current studies carried out in this area to investigate regional scale movement patterns may provide essential information about possible pupping grounds for this enigmatic species. PMID:25551553

  11. Whale shark (Rhincodon typus) seasonal presence, residence time and habitat use at darwin island, galapagos marine reserve.

    Science.gov (United States)

    Acuña-Marrero, David; Jiménez, Jesús; Smith, Franz; Doherty, Paul F; Hearn, Alex; Green, Jonathan R; Paredes-Jarrín, Jules; Salinas-de-León, Pelayo

    2014-01-01

    The life history of the whale shark (Rhincodon typus), including its reproductive ecology, still remains largely unknown. Here, we present results from the first whale shark population study around Darwin Island, Galapagos Marine Reserve. Following a diversified approach we characterized seasonal occurrence, population structure and size, and described habitat use of whale sharks based on fine scale movements around the island. Whale shark presence at Darwin Island was negatively correlated with Sea Surface Temperature (SST), with highest abundance corresponding to a cool season between July and December over six years of monitoring. From 2011 to 2013 we photo-identified 82 whale sharks ranging from 4 to 13.1 m Total Length (TL). Size distribution was bimodal, with a great majority (91.5%) of adult female individuals averaging 11.35 m±0.12 m (TL±SE), all but one showing signs of a potential pregnancy. Population dynamics models for apparently pregnant sharks estimated the presence of 3.76±0.90 (mean ± SE) sharks in the study area per day with an individual residence time of 2.09±0.51 (mean ± SE) days. Movement patterns analysis of four apparently pregnant individuals tracked with acoustic tags at Darwin Island revealed an intense use of Darwin's Arch, where no feeding or specific behavior has been recorded, together with periodic excursions around the island's vicinity. Sharks showed a preference for intermediate depths (20-30 m) with occasional dives mostly to mid-water, remaining the majority of their time at water temperatures between 24-25°C. All of our results point to Darwin Island as an important stopover in a migration, possibly with reproductive purposes, rather than an aggregation site. Current studies carried out in this area to investigate regional scale movement patterns may provide essential information about possible pupping grounds for this enigmatic species.

  12. Using tablet computers to teach evidence-based medicine to pediatrics residents: a prospective study.

    Science.gov (United States)

    Soma, David B; Homme, Jason H; Jacobson, Robert M

    2013-01-01

    We sought to determine if tablet computers-supported by a laboratory experience focused upon skill-development-would improve not only evidence-based medicine (EBM) knowledge but also skills and behavior. We conducted a prospective cohort study where we provided tablet computers to our pediatric residents and then held a series of laboratory sessions focused on speed and efficiency in performing EBM at the bedside. We evaluated the intervention with pre- and postintervention tests and surveys based on a validated tool available for use on MedEdPORTAL. The attending pediatric hospitalists also completed surveys regarding their observations of the residents' behavior. All 38 pediatric residents completed the preintervention test and the pre- and postintervention surveys. All but one completed the posttest. All 7 attending pediatric hospitalists completed their surveys. The testing, targeted to assess EBM knowledge, revealed a median increase of 16 points out of a possible 60 points (P computer and laboratory sessions designed to teach the quick and efficient application of EBM at the bedside. Copyright © 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  13. The distribution of range sizes of native and alien plants in four European countries and the effects of residence time

    OpenAIRE

    Williamson, Mark; Dehnen-Schmutz, Katharina; Kühn, Ingolf; Hill, Mark; Klotz, Stefan; Milbau , Ann; Stout, Jane; Pyšek, Petr

    2009-01-01

    Aim Do the statistical distributions of range sizes of native and alien species differ? If so, is this because of residence time effects? And can such effects indicate an average time to a maximum?\\ud \\ud Location Ireland, Britain, Germany and the Czech Republic.\\ud \\ud Methods The data are presence or absence of higher plants in mapping units of 100 km2 (Ireland and Britain) or c. 130 km2 (Germany and the Czech Republic) in areas varying from 79 to 357 thousand km2. Logit transforms of range...

  14. The effectiveness of spaced retrieval combined with Montessori-based activities in improving the eating ability of residents with dementia.

    Science.gov (United States)

    Wu, Hua Shan; Lin, Li Chan; Wu, Shiao Chi; Lin, Ke Neng; Liu, Hsiu Chih

    2014-08-01

    To explore the long-term effects of standardized and individualized spaced retrieval combined with Montessori-based activities on the eating ability of residents with dementia. Eating difficulty is common in residents with dementia, resulting in low food intake, followed by eating dependence, weight loss and malnutrition. A single-blinded and quasi-experimental design with repeated measures. Ninety residents with dementia from four veterans' homes in Taiwan took part in this study. The intervention consisted of spaced retrieval combined with Montessori-based activities. Twenty-five participants in the standardized group received 24 intervention sessions over 8 weeks. Thirty-eight participants in the individualized group received tailored intervention sessions. The number of intervention sessions was adjusted according to the participant's recall responses in spaced retrieval. Twenty-seven participants in the control group received no treatment. The Chinese version of the Edinburgh Feeding Evaluation in Dementia was used, and eating amounts and body weight were measured pre-test, posttest and at 1-, 3- and 6-month follow-ups. Data were collected between July 2008-February 2010. Repeated measures of all dependent variables for the three groups were analysed by the linear mixed model. The standardized and individualized interventions could significantly decrease the scores for the Chinese version of the Edinburgh Feeding Evaluation in Dementia and increase the eating amount and body weight over time. Trained nurses in institutions can schedule the standardized or individualized intervention in usual activity time to ameliorate eating difficulty and its sequels. © 2014 John Wiley & Sons Ltd.

  15. Utility of Combining a Simulation-Based Method With a Lecture-Based Method for Fundoscopy Training in Neurology Residency.

    Science.gov (United States)

    Gupta, Deepak K; Khandker, Namir; Stacy, Kristin; Tatsuoka, Curtis M; Preston, David C

    2017-10-01

    Fundoscopic examination is an essential component of the neurologic examination. Competence in its performance is mandated as a required clinical skill for neurology residents by the American Council of Graduate Medical Education. Government and private insurance agencies require its performance and documentation for moderate- and high-level neurologic evaluations. Traditionally, assessment and teaching of this key clinical examination technique have been difficult in neurology residency training. To evaluate the utility of a simulation-based method and the traditional lecture-based method for assessment and teaching of fundoscopy to neurology residents. This study was a prospective, single-blinded, education research study of 48 neurology residents recruited from July 1, 2015, through June 30, 2016, at a large neurology residency training program. Participants were equally divided into control and intervention groups after stratification by training year. Baseline and postintervention assessments were performed using questionnaire, survey, and fundoscopy simulators. After baseline assessment, both groups initially received lecture-based training, which covered fundamental knowledge on the components of fundoscopy and key neurologic findings observed on fundoscopic examination. The intervention group additionally received simulation-based training, which consisted of an instructor-led, hands-on workshop that covered practical skills of performing fundoscopic examination and identifying neurologically relevant findings on another fundoscopy simulator. The primary outcome measures were the postintervention changes in fundoscopy knowledge, skills, and total scores. A total of 30 men and 18 women were equally distributed between the 2 groups. The intervention group had significantly higher mean (SD) increases in skills (2.5 [2.3] vs 0.8 [1.8], P = .01) and total (9.3 [4.3] vs 5.3 [5.8], P = .02) scores compared with the control group. Knowledge scores (6.8 [3

  16. Maintaining social cohesion is a more important determinant of patch residence time than maximizing food intake rate in a group-living primate, Japanese macaque (Macaca fuscata).

    Science.gov (United States)

    Kazahari, Nobuko

    2014-04-01

    Animals have been assumed to employ an optimal foraging strategy (e.g., rate-maximizing strategy). In patchy food environments, intake rate within patches is positively correlated with patch quality, and declines as patches are depleted through consumption. This causes patch-leaving and determines patch residence time. In group-foraging situations, patch residence times are also affected by patch sharing. Optimal patch models for groups predict that patch residence times decrease as the number of co-feeding animals increases because of accelerated patch depletion. However, group members often depart patches without patch depletion, and their patch residence time deviates from patch models. It has been pointed out that patch residence time is also influenced by maintaining social proximity with others among group-living animals. In this study, the effects of maintaining social cohesion and that of rate-maximizing strategy on patch residence time were examined in Japanese macaques (Macaca fuscata). I hypothesized that foragers give up patches to remain in the proximity of their troop members. On the other hand, foragers may stay for a relatively long period when they do not have to abandon patches to follow the troop. In this study, intake rate and foraging effort (i.e., movement) did not change during patch residency. Macaques maintained their intake rate with only a little foraging effort. Therefore, the patches were assumed to be undepleted during patch residency. Further, patch residence time was affected by patch-leaving to maintain social proximity, but not by the intake rate. Macaques tended to stay in patches for short periods when they needed to give up patches for social proximity, and remained for long periods when they did not need to leave to keep social proximity. Patch-leaving and patch residence time that prioritize the maintenance of social cohesion may be a behavioral pattern in group-living primates.

  17. A population-based study on health-related quality of life among urban community residents in Shenyang, Northeast of China.

    Science.gov (United States)

    Song, Tian; Ding, Yan-wei; Sun, Yan; He, Yi-Ni; Qi, Dian-Jun; Wu, Ying; Wu, Bin; Lang, Lang; Yu, Kai; Zhao, Xin; Zhu, Liang-liang; Wang, Shuang; Yu, Xiao-Song

    2015-09-19

    Due to the rising standard of living environment and advances in public health and medical care in China, it has been a tendency in recent years that health-related quality of life (HRQoL) has been increasingly acknowledged in community health management. However, large-scale population-based study on evaluating HQRoL in northeast of China was not conducted. This article aims to investigate the HRQoL in community residents in Northeast China and explore the associated factors. Stratified multiple-stage sampling method was used in the cross-sectional survey to investigate HRQoL of community residents in northeast of China. Univariate analysis and multiple linear regressions were used to analyze the factors associated to HRQoL of the community residents. The results were confirmed that HRQoL in general population was well performed for the first time in northeast of China in a large scale population. Community residents had better mental health than physical health. The factors influencing HRQoL included gender, age, educational level, marital status, ethnic group, chronic disease status, having breakfast frequency weekly and sleep quality. However, drinking and smoking habits did not affect residents' HRQoL. In this study, the result of the large-scale survey was satisfactory in northeast of China, providing HRQoL status of community residents. Policies on specific health management in community public health would emphasize on lifestyle behaviors especially eating habits in order to improving HRQoL.

  18. Systematic Analysis of the Effect of Small Scale Permeability Heterogeneity on Hyporheic Exchange Flux and Residence Times

    Science.gov (United States)

    Laube, G.; Schmidt, C.; Fleckenstein, J. H.

    2014-12-01

    The hyporheic zone (HZ) contributes significantly to whole stream biogeochemical cycling. Biogeochemical reactions within the HZ are often transport limited, thus, understanding these reactions requires knowledge about the magnitude of hyporheic fluxes (HF) and the residence time (RT) of these fluxes within the HZ. While the hydraulics of HF are relatively well understood, studies addressing the influence of permeability heterogeneity lack systematic analysis and have even produced contradictory results (e.g. [1] vs. [2]). In order to close this gap, this study uses a statistical numerical approach to elucidate the influence of permeability heterogeneity on HF and RT. We simulated and evaluated 3750 2D-scenarios of sediment heterogeneity by means of Gaussian random fields with focus on total HF and RT distribution. The scenarios were based on ten realizations of each of all possible combinations of 15 different correlation lengths, 5 dipping angles and 5 permeability variances. Roughly 500 hyporheic stream traces were analyzed per simulation, for a total of almost two million stream traces analyzed for correlations between permeability heterogeneity, HF, and RT. Total HF and the RT variance positively correlated with permeability variance while the mean RT negatively correlated with permeability variance. In contrast, changes in correlation lengths and dipping angles had little effect on the examined properties RT and HF. These results provide a possible explanation of the seemingly contradictory conclusions of recent studies, given that the permeability variances in these studies differ by several orders of magnitude. [1] Bardini, L., Boano, F., Cardenas, M.B, Sawyer, A.H, Revelli, R. and Ridolfi, L. "Small-Scale Permeability Heterogeneity Has Negligible Effects on Nutrient Cycling in Streambeds." Geophysical Research Letters, 2013. doi:10.1002/grl.50224. [2] Zhou, Y., Ritzi, R. W., Soltanian, M. R. and Dominic, D. F. "The Influence of Streambed Heterogeneity on

  19. Effect of temperature, hydraulic residence time and elevated PCO2 on acid neutralization within a pulsed limestone bed reactor

    Science.gov (United States)

    Watten, B.J.; Lee, P.C.; Sibrell, P.L.; Timmons, M.B.

    2007-01-01

    Limestone has potential for reducing reagent costs and sludge volume associated with treatment of acid mine drainage, but its use is restricted by slow dissolution rates and the deposition of Fe, Al and Mn-based hydrolysis products on reactive surfaces. We evaluated a pulsed limestone bed (PLB) reactor (15 L/min capacity) that uses a CO2 pretreatment step to accelerate dissolution and hydraulic shearing forces provided by intermittent fluidization to abrade and carry away surface scales. We established the effects of hydraulic residence time (HRT, 5.1-15.9 min), temperature (T, 12-22 ??C) and CO2 tension (PCO2, 34.5-206.8 kPa) on effluent quality when inlet acidity (Acy) was fixed at 440 mg/L (pH=2.48) with H2SO4. The PLB reactor neutralized all H+ acidity (N=80) while concurrently providing unusually high levels of effluent alkalinity (247-1028 mg/L as CaCO3) that allow for side-stream treatment with blending. Alkalinity (Alk) yields rose with increases in PCO2, HRT and settled bed height (BH, cm) and decreased with T following the relationship (R2=0.926; p<0.001): (Alk)non-filtered=-548.726+33.571??(PCO2)0.5+33.671??(HRT)+7.734??(BH)-5.197??(T). Numerical modeling showed CO2 feed requirements for a target Alk yield decrease with increases in HRT, T and the efficiency of off-gas (CO2) recycling. ?? 2007 Elsevier Ltd. All rights reserved.

  20. A review of radioactive isotopes and other residence time tracers in understanding groundwater recharge: Possibilities, challenges, and limitations

    Science.gov (United States)

    Cartwright, Ian; Cendón, Dioni; Currell, Matthew; Meredith, Karina

    2017-12-01

    Documenting the location and magnitude of groundwater recharge is critical for understanding groundwater flow systems. Radioactive tracers, notably 14C, 3H, 36Cl, and the noble gases, together with other tracers whose concentrations vary over time, such as the chlorofluorocarbons or sulfur hexafluoride, are commonly used to estimate recharge rates. This review discusses some of the advantages and problems of using these tracers to estimate recharge rates. The suite of tracers allows recharge to be estimated over timescales ranging from a few years to several hundred thousand years, which allows both the long-term and modern behaviour of groundwater systems to be documented. All tracers record mean residence times and mean recharge rates rather than a specific age and date of recharge. The timescale over which recharge rates are averaged increases with the mean residence time. This is an advantage in providing representative recharge rates but presents a problem in comparing recharge rates derived from these tracers with those from other techniques, such as water table fluctuations or lysimeters. In addition to issues relating to the sampling and interpretation of specific tracers, macroscopic dispersion and mixing in groundwater flow systems limit how precisely groundwater residence times and recharge rates may be estimated. Additionally, many recharge studies have utilised existing infrastructure that may not be ideal for this purpose (e.g., wells with long screens that sample groundwater several kilometres from the recharge area). Ideal recharge studies would collect sufficient information to optimise the use of specific tracers and minimise the problems of mixing and dispersion.

  1. Modeling sediment transport processes and residence times in the shallow coastal bay complex of the Virginia Coast Reserve

    Science.gov (United States)

    Safak, I.; Wiberg, P. L.

    2011-12-01

    Patterns of sediment transport and particle residence times influence the morphology and ecology of shallow coastal bays in important ways. The Virginia Coast Reserve (VCR), a barrier island-lagoon-marsh system on the Eastern Shore of Virginia, is typical of many shallow coastal bay complexes that lack a significant fluvial source of freshwater and sediment. Sediment redistribution within the bays in response to storms and sea-level rise, together with the dynamics of marsh and lagoon-bottom plants, largely governs the morphological evolution of this system. There are also important feedbacks between sediment and ecosystem dynamics. This is particularly true in the VCR, which is relatively unaffected by human activities. As a step towards evaluating the impact of hydrodynamics on sediment and ecological processes in the VCR, a single unified model that accounts for circulation, surface waves, wave-current interaction, and sediment processes is employed. This three-dimensional unstructured grid finite-volume coastal ocean model (FVCOM) is validated with field observations of wind- and tide-induced water flow (water level and current velocities) in Hog Island Bay, centrally located within the VCR. Here, the resulting patterns of sediment transport and particle residence times over event and seasonal time scales are presented. Water and particle exchange within the VCR and between the VCR and the ocean is examined with the Lagrangian particle-tracking module in FVCOM. We focus on three bays with strongly varying bathymetry and coastline geometry, which are also located along a gradient of nitrogen input to the system. The results indicate that residence time of particles within the system vary greatly depending on the location of particle release, bay morphology, and wind conditions. The implications for morphologic evolution and ecosystem response to climate and land-use changes are evaluated.

  2. Changing restoration rules: exotic bivalves interact with residence time and depth to control phytoplankton productivity

    Science.gov (United States)

    Lucas, Lisa V.; Thompson, Janet K.

    2012-01-01

    Non-native species are a prevalent ecosystem stressor that can interact with other stressors to confound resource management and restoration. We examine how interactions between physical habitat attributes and a particular category of non-native species (invasive bivalves) influence primary production in aquatic ecosystems. Using mathematical models, we show how intuitive relationships between phytoplankton productivity and controllable physical factors (water depth, hydraulic transport time) that hold in the absence of bivalves can be complicated—and even reversed—by rapid bivalve grazing. In light-limited environments without bivalves, shallow, hydrodynamically “slow” habitats should generally have greater phytoplankton biomass and productivity than deeper, “faster” habitats. But shallower, slower environments can be less productive than deeper, faster ones if benthic grazing is strong. Moreover, shallower and slower waters exhibit a particularly broad range of possible productivity outcomes that can depend on whether bivalves are present. Since it is difficult to predict the response of non-native bivalves to habitat restoration, outcomes for new shallow, slow environments can be highly uncertain. Habitat depth and transport time should therefore not be used as indicators of phytoplankton biomass and production where bivalve colonization is possible. This study provides for ecosystem management a particular example of a broad lesson: abiotic ecosystem stressors should be managed with explicit consideration of interactions with other major (including biotic) stressors. We discuss the applicability and management implications of our models and results for a range of aquatic system types, with a case study focused on the Sacramento-San Joaquin Delta (California, USA). Simple mathematical models like those used here can illuminate interactions between ecosystem stressors and provide process-based guidance for resource managers as they develop strategies

  3. The effect of electronic health record software design on resident documentation and compliance with evidence-based medicine.

    Directory of Open Access Journals (Sweden)

    Yasaira Rodriguez Torres

    Full Text Available This study aimed to determine the role of electronic health record software in resident education by evaluating documentation of 30 elements extracted from the American Academy of Ophthalmology Dry Eye Syndrome Preferred Practice Pattern. The Kresge Eye Institute transitioned to using electronic health record software in June 2013. We evaluated the charts of 331 patients examined in the resident ophthalmology clinic between September 1, 2011, and March 31, 2014, for an initial evaluation for dry eye syndrome. We compared documentation rates for the 30 evidence-based elements between electronic health record chart note templates among the ophthalmology residents. Overall, significant changes in documentation occurred when transitioning to a new version of the electronic health record software with average compliance ranging from 67.4% to 73.6% (p 90% in 13 elements while Electronic Health Record B had high compliance (>90% in 11 elements. The presence of dialog boxes was responsible for significant changes in documentation of adnexa, puncta, proptosis, skin examination, contact lens wear, and smoking exposure. Significant differences in documentation were correlated with electronic health record template design rather than individual resident or residents' year in training. Our results show that electronic health record template design influences documentation across all resident years. Decreased documentation likely results from "mouse click fatigue" as residents had to access multiple dialog boxes to complete documentation. These findings highlight the importance of EHR template design to improve resident documentation and integration of evidence-based medicine into their clinical notes.

  4. The Effects of Particle Size, Different Corn Stover Components, and Gas Residence Time on Torrefaction of Corn Stover

    Directory of Open Access Journals (Sweden)

    Sarah Rahn

    2012-04-01

    Full Text Available Large scale biofuel production will be possible only if significant quantities of biomass feedstock can be stored, transported, and processed in an economic and sustainable manner. Torrefaction has the potential to significantly reduce the cost of transportation, storage, and downstream processing through the improvement of physical and chemical characteristics of biomass. The main objective of this study was to investigate the effects of particle size, plant components, and gas residence time on the production of torrefied corn (Zea mays stover. Different particle sizes included 0.85 mm and 20 mm. Different stover components included ground corn stover, whole corn stalk, stalk shell and pith, and corn cob shell. Three different purge gas residence times were employed to assess the effects of interaction of volatiles and torrefied biomass. Elemental analyses were performed on all of the samples, and the data obtained was used to estimate the energy contents and energy yields of different torrefied biomass samples. Particle density, elemental composition, and fiber composition of raw biomass fractions were also determined. Stalk pith torrefied at 280 °C and stalk shell torrefied at 250 °C had highest and lowest dry matter loss, of about 44% and 13%, respectively. Stalk pith torrefied at 250 °C had lowest energy density of about 18–18.5 MJ/kg, while cob shell torrefied at 280 °C had the highest energy density of about 21.5 MJ/kg. The lowest energy yield, at 59%, was recorded for stalk pith torrefied at 280 °C, whereas cob and stalk shell torrefied at 250 °C had highest energy yield at 85%. These differences were a consequence of the differences in particle densities, hemicellulose quantities, and chemical properties of the original biomass samples. Gas residence time did not have a significant effect on the aforementioned parameters.

  5. Evaluating the impact of land use changes on the behaviour of shallow aquifers, by quantifying the groundwater mean residence times distribution

    Science.gov (United States)

    Vincent, Aude; Gillon, Marina; Marc, Vincent; Cognard-Plancq, Anne-Laure; Baillieux, Antoine; Babic, Milanka; Simler, Roland

    2017-04-01

    Residence time is one of the key factors of the groundwater resource management. The Crau aquifer (Mediterranean area, south of France) is a major resource for drinking water supply, threatened by climate change, changes in irrigation patterns, and urban expansion. Water residence time in the aquifer is expected to be highly dependent on these changes. We propose to determinate it using an isotopic approach, associated to numerical modelling. The Crau aquifer is a palaeo-alluvial fan of the Durance river, made of alluviums lying on a Miocene substratum, and recharged by rainwater and gravity irrigation water, diverted from the Durance river. The irrigation water being more depleted in 18O than the rain water, the contribution of irrigation to the aquifer recharge can be quantified (up to 80 to 85% of the total recharge), but is variable in space and time. The modelling approach uses two models, a lumped one and a discretised one. They are based on daily recharge data (rainfall, drainage rates under irrigated crops calculated from the STICS crop model, Olioso et al., 2013), and on monthly water sampling conducted from February 2012 to November 2016 for δ18O content in rainwater, surface water and groundwater. The lumped approach was carried out at a monthly time step, using a binary mixing model, including two exponentially draining reservoirs in parallel. It leads to a satisfying simulation of the δ18O variations in the monitored wells, and gives mean residence times between 3 and 20 months depending on the wells locations. The discretised model is a combination of MODFLOW and MODPATH, through the free user interface MODELMUSE, on a daily time-step. The permeability map used is the one calibrated by Baillieux et al. (2015). Recharge is applied with an increasing spatial complexity, in three successive steps: - a homogeneous recharge, provided by the intermediate output of the lumped model, in order to compare the two models results; - a recharge discretised in

  6. Effect of a Community-Based Service Learning Experience in Geriatrics on Internal Medicine Residents and Community Participants.

    Science.gov (United States)

    Miller, Rachel K; Michener, Jennifer; Yang, Phyllis; Goldstein, Karen; Groce-Martin, Jennine; True, Gala; Johnson, Jerry

    2017-09-01

    Community-based service learning (CBSL) provides an opportunity to teach internal medicine residents the social context of aging and clinical concepts. The objectives of the current study were to demonstrate the feasibility of a CBSL program targeting internal medicine residents and to assess its effect on medical residents and community participants. internal medicine residents participated in a CBSL experience for half a day during ambulatory blocks from 2011 to 2014. Residents attended a senior housing unit or center, delivered a presentation about a geriatric health topic, toured the facility, and received information about local older adult resources. Residents evaluated the experience. Postgraduate Year 3 internal medicine residents (n = 71) delivered 64 sessions. Residents felt that the experience increased their ability to communicate effectively with older adults (mean 3.91 ± 0.73 on a Likert scale with 5 = strongly agree), increased their knowledge of resources (4.09 ± 1.01), expanded their knowledge of a health topic pertinent to aging (3.48 ± 1.09), and contributed to their capacity to evaluate and care for older adults (3.84 ± 0.67). Free-text responses demonstrated that residents thought that this program would change their practice. Of 815 older adults surveyed from 36 discrete teaching sessions, 461 (56%) thought that the medical residents delivered health information clearly (4.55 ± 0.88) and that the health topics were relevant (4.26 ± 0.92). Free-text responses showed that the program helped them understand their health concerns. This CBSL program is a feasible and effective tool for teaching internal medicine residents and older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  7. Fly Ash Formation during Suspension-Firing of Biomass. Effects of Residence Time and Fuel-Type

    DEFF Research Database (Denmark)

    Damø, Anne Juul; Jensen, Peter Arendt; Jappe Frandsen, Flemming

    2017-01-01

    particles were subjected to various analyses, including char burnout level, particle size distribution, elemental composition, and particle morphology and composition. Furthermore, the transient release, i.e. the vaporization of the flame-volatile inorganic elements K, Cl and S, from the burning fuel...... particles to the gas phase, has been quantified by using two different calculation methods. The ash formation mechanisms were found to be quite similar for straw and wood. The degree of conversion (char burn-out level) was generally good at residence times ≥ 1s. The size distribution of the residual fly ash...

  8. Determination of the residence time of rain water in some hydrographic basins by means of stable isotopes

    International Nuclear Information System (INIS)

    Goncalves, A.R.L.

    1979-10-01

    Samples of rain-and river water, monthly collected during one year from ten stations of the Amazon basin analysed in their 18 O and D content. The residence time of rain water for each station was determined using the values of Δ 18 O(%o) and ΔD(%). The values of Δ 18 O(%o) were correlated with the precipitation ones (mm) in order to determine the occurence of 'amount effect' in the stations. An analysis of samples was done along the Amazon River for simple observation of the 'isotopic fractionation' phenomenon the values of Δ 18 O(%o). (Author) [pt

  9. Field-based generation and social validation managers and staff competencies for small community residences.

    Science.gov (United States)

    Thousand, J S; Burchard, S N; Hasazi, J E

    1986-01-01

    Characteristics and competencies for four staff positions in community residences for individuals with mental retardation were identified utilizing multiple empirical and deductive methods with field-based practitioners and field-based experts. The more commonly used competency generation methods of expert opinion and job performance analysis generated a high degree of knowledge and skill-based competencies similar to course curricula. Competencies generated by incumbent practitioners through open-ended methods of personal structured interview and critical incident analysis were ones which related to personal style, interpersonal interaction, and humanistic orientation. Although seldom included in staff, paraprofessional, or professional training curricula, these latter competencies include those identified by Carl Rogers as essential for developing an effective helping relationship in a therapeutic situation (i.e., showing liking, interest, and respect for the clients; being able to communicate positive regard to the client). Of 21 core competency statements selected as prerequisites to employment for all four staff positions, the majority (17 of 21) represented interpersonal skills important to working with others, including responsiveness to resident needs, personal valuation of persons with mental retardation, and normalization principles.

  10. Permanent resident

    Directory of Open Access Journals (Sweden)

    John F. Fisher

    2016-05-01

    Full Text Available The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  11. Permanent resident.

    Science.gov (United States)

    Fisher, John F

    2016-01-01

    The training of physicians in the past century was based primarily on responsibility and the chain-of-command. Those with the bulk of that responsibility in the fields of pediatrics and internal medicine were residents. Residents trained the medical students and supervised them carefully in caring for patients. Most attending physicians supervised their teams at arm's length, primarily serving as teachers of the finer points of diagnosis and treatment during set periods of the day or week with a perfunctory signature on write-ups or progress notes. Residents endeavored to protect the attending physician from being heavily involved unless they were unsure about a clinical problem. Before contacting the attending physician, a more senior resident would be called. Responsibility was the ultimate teacher. The introduction of diagnosis-related groups by the federal government dramatically changed the health care delivery system, placing greater emphasis on attending physician visibility in the medical record, ultimately resulting in more attending physician involvement in day-to-day care of patients in academic institutions. Without specified content in attending notes, hospital revenues would decline. Although always in charge technically, attending physicians increasingly have assumed the role once dominated by the resident. Using biographical experiences of more than 40 years, the author acknowledges and praises the educational role of responsibility in his own training and laments its declining role in today's students and house staff.

  12. Sewage sludge ash to phosphate fertilizer by chlorination and thermal treatment: residence time requirements for heavy metal removal.

    Science.gov (United States)

    Nowak, Benedikt; Wegerer, Harald; Aschenbrenner, Philipp; Rechberger, Helmut; Winter, Franz

    2012-01-01

    Heavy metal removal from sewage sludge ash can be performed by mixing the ash with environmentally compatible chlorides (e.g. CaCl2 or MgCl2) and water, pelletizing the mixture and treating the pellets in a rotary reactor at about 1000 degrees C. Thermogravimetry-mass spectroscopy, muffle oven tests (500-1150 degrees C) and investigations in a laboratory-scale rotary reactor (950-1050 degrees C, residence time 1-25 min) were carried out. In the rotary reactor, up to 97% of Cu, 95% Pb and 95% Zn can be removed at 1050 degrees C. As Cl release starts from 400 degrees C (obtained from thermogravimetry-mass spectrometry experiments), heavy metals are already removed partially within the heating period. This heavy metal removal can be described as being similar to a first-order rate law. To meet the limit values specified in the Austrian and German fertilizer ordinances, residence times of the order of minutes are sufficient at 950 degrees C.

  13. Radiotracer investigation on the measurement of residence time distribution in an ethyl acetate reactor system with a large recycle ratio.

    Science.gov (United States)

    Datta, Arghya; Kumar Gupta, Raj; Goswami, Sunil; Kumar Sharma, Vijay; Bhunia, Haripada; Singh, Damandeep; Jagat Pant, Harish

    2017-12-01

    A radiotracer investigation was carried out on the measurement of residence time distribution (RTD) of process fluid in an industrial-scale ethyl acetate reactor system, which consists of two independent reactors with recirculation and connected in series with each other. Bromine-82 as ammonium bromide was used as the radiotracer for the RTD experiments at different operating conditions. The individual reactors and the overall reactor system were modelled using physically representative phenomenological models comprising of continuously stirred tank reactors (CSTRs). The results showed that the recirculation rate considerably affected the flow mixing behaviour and mean residence time of the process fluid in the reactor system. The results also showed that there was bypassing of the fluid in the first reactor that ranged from 12% to 22% and 40% dead volume at different operating conditions, whereas the second reactor behaved closely as an ideal CSTR. The results of the investigation can be used to optimise the process parameters and design new improved reactor systems for the production of ethyl acetate. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Coupled Long-Term Simulation of Reach-Scale Water and Heat Fluxes Across the River-Groundwater Interface for Retrieving Hyporheic Residence Times and Temperature Dynamics

    Science.gov (United States)

    Munz, Matthias; Oswald, Sascha E.; Schmidt, Christian

    2017-11-01

    Flow patterns in conjunction with seasonal and diurnal temperature variations control ecological and biogeochemical conditions in hyporheic sediments. In particular, hyporheic temperatures have a great impact on many temperature-sensitive microbial processes. In this study, we used 3-D coupled water flow and heat transport simulations applying the HydroGeoSphere code in combination with high-resolution observations of hydraulic heads and temperatures to quantify reach-scale water and heat flux across the river-groundwater interface and hyporheic temperature dynamics of a lowland gravel bed river. The model was calibrated in order to constrain estimates of the most sensitive model parameters. The magnitude and variations of the simulated temperatures matched the observed ones, with an average mean absolute error of 0.7°C and an average Nash Sutcliffe efficiency of 0.87. Our results indicate that nonsubmerged streambed structures such as gravel bars cause substantial thermal heterogeneity within the saturated sediment at the reach scale. Individual hyporheic flow path temperatures strongly depend on the flow path residence time, flow path depth, river, and groundwater temperature. Variations in individual hyporheic flow path temperatures were up to 7.9°C, significantly higher than the daily average (2.8°C), but still lower than the average seasonal hyporheic temperature difference (19.2°C). The distribution between flow path temperatures and residence times follows a power law relationship with exponent of about 0.37. Based on this empirical relation, we further estimated the influence of hyporheic flow path residence time and temperature on oxygen consumption which was found to partly increase by up to 29% in simulations.

  15. Strontium isotopes as tracers of water-rocks interactions, mixing processes and residence time indicator of groundwater within the granite-carbonate coastal aquifer of Bonifacio (Corsica, France).

    Science.gov (United States)

    Santoni, S; Huneau, F; Garel, E; Aquilina, L; Vergnaud-Ayraud, V; Labasque, T; Celle-Jeanton, H

    2016-12-15

    This study aims at identifying the water-rock interactions and mixing rates within a complex granite-carbonate coastal aquifer under high touristic pressure. Investigations have been carried out within the coastal aquifer of Bonifacio (southern Corsica, France) mainly composed of continental granitic weathering products and marine calcarenite sediments filling a granitic depression. A multi-tracer approach combining physico-chemical parameters, major ions, selected trace elements, stable isotopes of the water molecule and 87 Sr/ 86 Sr ratios measurements is undertaken for 20 groundwater samples during the low water period in November 2014. 5 rock samples of the sedimentary deposits and surrounding granites are also analysed. First, the water-rock interactions processes governing the groundwater mineralization are described in order to fix the hydrogeochemical background. Secondly, the flow conditions are refined through the quantification of inter aquifer levels mixing, and thirdly, the kinetics of water-rock interaction based on groundwater residence time from a previous study using CFCs and SF 6 are quantified for the two main flow lines. A regional contrast in the groundwater recharge altitude allowed the oxygene-18 to be useful combined with the 87 Sr/ 86 Sr ratios to differentiate the groundwater origins and to compute the mixing rates, revealing the real extension of the watershed and the availability of the resource. The results also highlight a very good correlation between the groundwater residence time and the spatial evolution of 87 Sr/ 86 Sr ratios, allowing water-rock interaction kinetics to be defined empirically for the two main flow lines through the calcarenites. These results demonstrate the efficiency of strontium isotopes as tracers of water-rock interaction kinetics and by extension their relevance as a proxy of groundwater residence time, fundamental parameter documenting the long term sustainability of the hydrosystem. Copyright © 2016

  16. Training Internal Medicine Residents in Social Medicine and Research-Based Health Advocacy: A Novel, In-Depth Curriculum.

    Science.gov (United States)

    Basu, Gaurab; Pels, Richard J; Stark, Rachel L; Jain, Priyank; Bor, David H; McCormick, Danny

    2017-04-01

    Health disparities are pervasive worldwide. Physicians have a unique vantage point from which they can observe the ways social, economic, and political factors impact health outcomes and can be effective advocates for enhanced health outcomes and health equity. However, social medicine and health advocacy curricula are uncommon in postgraduate medical education. In academic year (AY) 2012, the Cambridge Health Alliance internal medicine residency program transformed an elective into a required social medicine and research-based health advocacy curriculum. The course has three major innovations: it has a yearlong longitudinal curriculum, it is required for all residents, and all residents complete a group research-based health advocacy project within the curricular year. The authors describe the structure, content, and goals of this curriculum. Over the last four years (AYs 2012-2015), residents (17/32; 53%) have rated the overall quality of the course highly (mean = 5.2, where 6 = outstanding; standard deviation = 0.64). In each year since the new course has been implemented, all scholarly work from the course has been presented at conferences by 31 resident presenters and/or coauthors. The course seems to enhance the residency program's capacity to recruit high-caliber residents and faculty members. The authors are collecting qualitative and quantitative data on the impact of the course. They will use their findings to advocate for a national health advocacy competency framework. Recommendations about how to initiate or further develop social medicine and health advocacy curricula are offered.

  17. How Entrustment Is Informed by Holistic Judgments Across Time in a Family Medicine Residency Program: An Ethnographic Nonparticipant Observational Study

    NARCIS (Netherlands)

    Sagasser, M.H.; Fluit, C.R.M.G.; Weel, C. van; Vleuten, C.P.M. van der; Kramer, A.W.M.

    2017-01-01

    PURPOSE: Entrustment has mainly been conceptualized as delegating discrete professional tasks. Because residents provide most of their patient care independently, not all resident performance is visible to supervisors; the entrustment process involves more than granting discrete tasks. This study

  18. Breaking Bad News Training Program Based on Video Reviews and SPIKES Strategy: What do Perinatology Residents Think about It?

    Science.gov (United States)

    Setubal, Maria Silvia Vellutini; Gonçalves, Andrea Vasconcelos; Rocha, Sheyla Ribeiro; Amaral, Eliana Martorano

    2017-10-01

    Objective  Resident doctors usually face the task to communicate bad news in perinatology without any formal training. The impact on parents can be disastrous. The objective of this paper is to analyze the perception of residents regarding a training program in communicating bad news in perinatology based on video reviews and setting, perception, invitation, knowledge, emotion, and summary (SPIKES) strategy. Methods  We performed the analysis of complementary data collected from participants in a randomized controlled intervention study to evaluate the efficacy of a training program on improving residents' skills to communicate bad news. Data were collected using a Likert scale. Through a thematic content analysis we tried to to apprehend the meanings, feelings and experiences expressed by resident doctors in their comments as a response to an open-ended question. Half of the group received training, consisting of discussions of video reviews of participants' simulated encounters communicating a perinatal loss to a "mother" based on the SPIKES strategy. We also offered training sessions to the control group after they completed participation. Twenty-eight residents who were randomized to intervention and 16 from the control group received training. Twenty written comments were analyzed. Results  The majority of the residents evaluated training highly as an education activity to help increase knowledge, ability and understanding about breaking bad news in perinatology. Three big categories emerged from residents' comments: SPIKES training effects; bad news communication in medical training; and doctors' feelings and relationship with patients. Conclusions  Residents took SPIKES training as a guide to systematize the communication of bad news and to amplify perceptions of the emotional needs of the patients. They suggested the insertion of a similar training in their residency programs curricula. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

  19. Foraging strategy of a Neotropical primate: how intrinsic and extrinsic factors influence destination and residence time

    DEFF Research Database (Denmark)

    Plante, Sabrina; Colchero, Fernando; Calmé, Sophie

    2014-01-01

    accounting for intrinsic and extrinsic factors, which are often overlooked when modelling foraging behaviour. 2.We identified the decision rules for foraging in black howler monkeys (Alouatta pigra), according to food preferences, locations of high quality patches and previously eaten trees, phenology...... of food resources and hunger state. We depicted foraging in two stages: 1) the choice of the immediate next tree and 2) the time spent on this tree. We used a recently developed model for inference of movement processes, incorporating resource selection functions into a Markov Chain framework. 3.We found....... Time spent on a tree was positively and strongly affected by the presence of preferred food items, but not by its species. We also showed that time spent on trees increased as a function of satiation state. We suggest that the strategy adopted by black howlers tends to be efficient because choosing...

  20. Mean residence time of kaolinite and smectite-bound organic matter in mozambiquan soils

    NARCIS (Netherlands)

    Wattel-Koekkoek, E.J.W.; Buurman, P.

    2004-01-01

    To gain understanding about the process of global warming, it is essential to study the global C cycle. In the global C cycle, soil organic matter (SOM) is a major source and sink of atmospheric C. Turnover times of C in these soil organic compounds vary from hours to thousands of years. Clay

  1. Pediatric Program Leadership's Contribution Toward Resident Wellness.

    Science.gov (United States)

    Carson, Savanna L; Perkins, Kate; Reilly, Maura R; Sim, Myung-Shin; Li, Su-Ting T

    2018-02-27

    Residency program leaders are required to support resident well-being, but often do not receive training in how to do so. Determine frequency in which program leadership provides support for resident well-being, comfort in supporting resident well-being, and factors associated with need for additional training in supporting resident well-being. National cross-sectional web-based survey of pediatric program directors, associate program directors, and coordinators in June 2015, on their experience supporting resident well-being. Univariate and bivariate descriptive statistics compared responses between groups. Generalized linear modeling, adjusting for program region, size, program leadership role, and number of years in role determined factors associated with need for additional training. 39.3% (322/820) of participants responded. Most respondents strongly agreed that supporting resident well-being is an important part of their role, but few reported supporting resident well-being as part of their job description. Most reported supporting residents' clinical, personal, and health issues at least annually, and in some cases weekly, with 72% spending >10% of their time on resident well-being. Most program leaders desired more training. After adjusting for level of comfort in dealing with resident well-being issues, program leaders more frequently exposed to resident well-being issues were more likely to desire additional training (pProgram leaders spend a significant amount of time supporting resident well-being. While they feel that supporting resident well-being is an important part of their job, opportunities exist for developing program leaders through including resident wellness on job descriptions and training program leaders how to support resident well-being. Copyright © 2018 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  2. Batch leachate treatment using stirred electrocoagulation reactor with variation of residence time and stirring rate

    Science.gov (United States)

    Sitorus, I. S.; Astono, W.; Iswanto, B.

    2018-01-01

    This study aims to reduce pollutant levels of the leachate by electrocoagulation method using a stirred electrocoagulation reactor as the electrochemical water treatment. The release of active coagulants as metallic ions took place in the anode, while in the cathode, the electrolysis reaction in the form of hydrogen gas dischargeoccurred. The source of wastewater is Waste Water Treatment Plant inlet III of Bantar Gebang, Bekasi. Some parameters were analyzed in this research, i.e., Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), NH3, NO3 -, NO2 -, N-total, and organic substances as well as the microorganism growth before and after electrocoagulation, with variations of detention time (seconds) of 10, 20, 120, 600 and rapid mixing conditions (rpm) of 60, 100 and 200. The results show that the greater the rapid mixing speed and the detention time of electrolysis, the higher the removal of contaminants in liquid waste. The optimum condition of electrocoagulation was encountered at 200 rpm rapid mixing with 600 seconds of processing time. The removal efficiencies of electrocoagulation method for each parameter are TSS of 46.80%, BOD5 of 71.33%, COD of 73.77%, Pb of 62.5%,and NH3-N of 57.92%,whereas the pH value has been increased from 8.03 to 8.95. The electrocoagulation method can reduce levels of pollutants, complying with the environmental standards.

  3. Prevalence and predictors of non-evidence based proton pump inhibitor use among elderly nursing home residents in the US.

    Science.gov (United States)

    Rane, Pratik P; Guha, Sushovan; Chatterjee, Satabdi; Aparasu, Rajender R

    Proton pump inhibitors (PPIs) can lead to several adverse effects among the elderly, particularly when used inappropriately or in contrast to evidence suggested protocols. The aim of this study was to examine the prevalence and predictors of non-evidence based PPI use in elderly nursing home residents. A cross-sectional study was conducted using data from the 2004 National Nursing Home Survey (NNHS). The study sample included nursing home residents 65 years and older. Descriptive statistics were used to examine the prevalence of non-evidence based PPI use. Multivariable logistic regression was used to evaluate the patient and facility-level factors associated with non-evidence based PPI use among the elderly nursing home residents. A total of 355,600 elderly nursing home residents received at least one PPI for an overall prevalence of 26.99%. Among those elderly receiving PPIs, 48.59% of the use was not evidence based. Multivariable logistic regression revealed that residents with osteoporosis (Odds Ratio (OR): 0.55, 95% CI: 0.45-0.68), SSRI users (OR: 0.81, 95% CI: 0.68-0.97) and those residing in micropolitan area (OR: 0.79, 95% CI: 0.63-0.98) were negatively associated with prescription of PPIs without an indication. Patients with chronic cough (OR: 2.10, 95% CI: 1.12-3.96) and Medicare insurance (OR: 1.23, 95% CI: 1.01-1.50) were positively associated with prescription of PPIs without an indication. The current study found that almost half of the elderly nursing home residents used PPIs for non-evidence based indications. Given the safety concerns and high non-evidence based use of PPIs in nursing homes, there is an urgent need to optimize PPI use in the elderly. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Cadaver-Based Simulation Increases Resident Confidence, Initial Exposure to Fundamental Techniques, and May Augment Operative Autonomy.

    Science.gov (United States)

    Kim, Steven C; Fisher, Jeremy G; Delman, Keith A; Hinman, Johanna M; Srinivasan, Jahnavi K

    Surgical simulation is an important adjunct in surgical education. The majority of operative procedures can be simplified to core components. This study aimed to quantify a cadaver-based simulation course utility in improving exposure to fundamental maneuvers, resident and attending confidence in trainee capability, and if this led to earlier operative independence. A list of fundamental surgical procedures was established by a faculty panel. Residents were assigned to a group led by a chief resident. Residents performed skills on cadavers appropriate for PGY level. A video-recorded examination where they narrated and demonstrated a task independently was then graded by attendings using standardized rubrics. Participants completed surveys regarding improvements in knowledge and confidence. The course was conducted at the Emory University School of Medicine and the T3 Laboratories in Atlanta, GA. A total of 133 residents and 41 attendings participated in the course. 133 (100%) participating residents and 32 (78%) attendings completed surveys. Resident confidence in completing the assigned skill independently increased from 3 (2-3) to 4 (3-4), p 80%), p < 0.04. Attendings were more likely to grant autonomy in the operating room after this exercise (4 [3-5]). A cadaveric skills course focused on fundamental maneuvers with objective confirmation of success is a viable adjunct to clinical operative experience. Residents were formally exposed to fundamental surgical maneuvers earlier as a result of this course. This activity improved both resident and attending confidence in trainee operative skill, resulting in increased attending willingness to grant a higher level of autonomy in the operating room. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Use of the QR Reader to Provide Real-Time Evaluation of Residents' Skills Following Surgical Procedures.

    Science.gov (United States)

    Reynolds, Kellin; Barnhill, Danny; Sias, Jamie; Young, Amy; Polite, Florencia Greer

    2014-12-01

    A portable electronic method of providing instructional feedback and recording an evaluation of resident competency immediately following surgical procedures has not previously been documented in obstetrics and gynecology. This report presents a unique electronic format that documents resident competency and encourages verbal communication between faculty and residents immediately following operative procedures. The Microsoft Tag system and SurveyMonkey platform were linked by a 2-D QR code using Microsoft QR code generator. Each resident was given a unique code (TAG) embedded onto an ID card. An evaluation form was attached to each resident's file in SurveyMonkey. Postoperatively, supervising faculty scanned the resident's TAG with a smartphone and completed the brief evaluation using the phone's screen. The evaluation was reviewed with the resident and automatically submitted to the resident's educational file. The evaluation system was quickly accepted by residents and faculty. Of 43 residents and faculty in the study, 38 (88%) responded to a survey 8 weeks after institution of the electronic evaluation system. Thirty (79%) of the 38 indicated it was superior to the previously used handwritten format. The electronic system demonstrated improved utilization compared with paper evaluations, with a mean of 23 electronic evaluations submitted per resident during a 6-month period versus 14 paper assessments per resident during an earlier period of 6 months. This streamlined portable electronic evaluation is an effective tool for direct, formative feedback for residents, and it creates a longitudinal record of resident progress. Satisfaction with, and use of, this evaluation system was high.

  6. Linear and Nonlinear Time-Frequency Analysis for Parameter Estimation of Resident Space Objects

    Science.gov (United States)

    2017-02-22

    technical report is organised as follows: • In Section 2 Time-Frequency transforms are discussed and parameters of interests are identified. • In Section...NRMSE 0,206 0,292 0,428 %NRMSE 0,375 0,405 0,501 Table 5: table 4 continued The worst behaviour is obtained in the case of RSO 2. The reason behind...quantisation effect. On the other hand, the best behaviour is produced by RSO 1, whose Doppler frequency is the highest. By looking at tables 4 and 5, and not

  7. Flexible competency based medical education: More time efficient, higher costs.

    Science.gov (United States)

    van Rossum, Tiuri R; Scheele, Fedde; Sluiter, Henk E; Bosman, Peter J; Rijksen, Lotte; Heyligers, Ide C

    2018-03-01

    The financing of postgraduate medical education (PGME) becomes an important topic. PGME is costly, and in most western countries is partly paid by public funding. One of the models that can help to reduce costs is time-variable PGME. Moving to true outcome-based education can lead to more efficient training programs while maintaining educational quality. We analyzed the financial effects of time-variable PGME by identifying the educational activities of PGME programs and comparing the costs and revenues of these activities in gynecology training as an example. This resulted in a revenue-cost balance of PGME activities in gynecology. As gynecology consists of both surgical and non-surgical parts, this specialty is a good starting point for a training cost analysis that can be used for a more general discussion. Shortening PGME programs without losing educational quality appears to be possible with time-variable structures. However, shortening is only safely possible on those areas in which residents have already obtained the desired level of competence. This means that time can be gained at the expense of those educational activities in which residents generate the highest revenues. We therefore conclude that shorter education with the help of time-variable training schemes leads to overall higher costs at the hospital level.

  8. Recovery of Sleep or Recovery of Self? A Grounded Theory Study of Residents' Decision Making Regarding How to Spend Their Nonclinical Postcall Time.

    Science.gov (United States)

    Taylor, Taryn S; Nisker, Jeff; Teunissen, Pim W; Dornan, Tim; Lingard, Lorelei

    2016-03-01

    As resident work hours policies evolve, residents' off-duty time remains poorly understood. Despite assumptions about how residents should be using their postcall, off-duty time, there is little research on how residents actually use this time and the reasoning underpinning their activities. This study sought to understand residents' nonclinical postcall activities when they leave the hospital, their decision-making processes, and their perspectives on the relationship between these activities and their well-being or recovery. The study took place at a Liaison Committee on Medical Education-accredited Canadian medical school from 2012 to 2014. The authors recruited a purposive and convenience sample of postgraduate year 1-5 residents from six surgical and nonsurgical specialties at three hospitals affiliated with the medical school. Using a constructivist grounded theory approach, semistructured interviews were conducted, audio-taped, transcribed, anonymized, and combined with field notes. The authors analyzed interview transcripts using constant comparative analysis and performed post hoc member checking. Twenty-four residents participated. Residents characterized their predominant approach to postcall decision making as one of making trade-offs between multiple, competing, seemingly incompatible, but equally valuable, activities. Participants exhibited two different trade-off orientations: being oriented toward maintaining a normal life or toward mitigating fatigue. The authors' findings on residents' trade-off orientations suggest a dual recovery model with postcall trade-offs motivated by the recovery of sleep or of self. This model challenges the dominant viewpoint in the current duty hours literature and suggests that the duty hours discussion must be broadened to include other recovery processes.

  9. The price of 'free'. Quantifying the costs incurred by rural residents attending publically funded outpatient clinics in rural and base hospitals.

    Science.gov (United States)

    Fearnley, David; Kerse, Ngaire; Nixon, Garry

    2016-09-01

    INTRODUCTION Rural living is associated with increased costs in many areas, including health care. However, there is very little local data to quantify these costs, and their unknown quantity means that costs are not always taken into account in health service planning and delivery. AIM The aim of this study was to calculate the average time and travel costs of attending rural and base hospital outpatient clinics for rural Central Otago residents. METHODS A survey of 51 people attending rural hospital outpatient clinics. Individual costs in terms of travel and time were quantified and an average cost of both rural and base hospital attendance was calculated. RESULTS The average travel and lost time cost of attending a rural outpatient clinic was NZ$182 and 61% of respondents reported this cost had a significant effect on their weekly budget. The average cost incurred by residents associated with a base hospital attendance in Dunedin was NZ$732. DISCUSSION This study data show that costs are substantial and probably higher than most people might expect for both rural and base hospital attendances. It seems likely that these costs are a potential barrier to service access. However, the full implications of the personal costs incurred by rural residents in accessing health services are largely unstudied and therefore remain unknown in New Zealand.

  10. Exploring community health center and faith-based partnerships: community residents' perspectives.

    Science.gov (United States)

    Patel, Kavita K; Frausto, Kenneth A; Staunton, Anne D; Souffront, Janine; Derose, Kathryn Pitkin

    2013-02-01

    Community health centers (CHCs) play a critical role in the primary care safety net. Partnerships between CHCs and faith-based organizations are promoted as a way to increase outreach to underserved populations and support health-promoting behaviors and effective disease management. Through six focus groups (totaling 58 participants), we explored low-income residents' perspectives (African American, Latino, and White) of their communities, the meaning of health, the role of spirituality, and their experiences with and preferences for congregation-based health programming to inform future outreach efforts of a CHC. We found that community perspectives varied based on race/ethnicity and neighborhood, but health concerns tended to cluster by race/ethnicity alone. We also found that spirituality was deemed important for health by all racial-ethnic groups, but attendance at religious services, religious affiliation, and preferences for congregation-based health programming varied across and within groups. Community health center-faith based partnerships could facilitate health care access in underserved communities but may have limited reach among certain subgroups and individuals.

  11. Time course of cesium radionuclides body burden in residents of regions with elevated background radiation

    International Nuclear Information System (INIS)

    Vasil'ev, V.N.; Luchkov, A.B.; Trushin, V.I.; Khazins, E.D.

    1990-01-01

    The authors represent summarized data on the time course of 134 Cs and 137 Cs body burden in the population of the Krasnogorsky District of the Bryansk Region (Byelorussian SSR) over the period of June 1986-Jule 1989. A RISh-5M was used as a whole-body counter, its performance and calibration methods were described. A retrospective analysis has shown that the main accumulation of radionuclides occurred before May 15 1986. The highest half-life noted from August 1986 till Februal 1987. The ratio of accumulated Cs in children and adults was 0.3, in men and women - 1.4. The effectiveness of measures aimed at reducing collective doses of internal irradiation was analyzed

  12. Polymer binding to carbon nanotubes in aqueous dispersions: residence time on the nanotube surface as obtained by NMR diffusometry.

    Science.gov (United States)

    Frise, Anton E; Pagès, Guilhem; Shtein, Michael; Pri Bar, Ilan; Regev, Oren; Furó, István

    2012-03-08

    The binding of block copolymer Pluronic F-127 in aqueous dispersions of single- (SWCNT) and multiwalled (MWCNT) carbon nanotubes has been studied by pulsed-field-gradient (PFG) (1)H NMR spectroscopy. We show that a major fraction of polymers exist as a free species while a minor fraction is bound to the carbon nanotubes (CNT). The polymers exchange between these two states with residence times on the nanotube surface of 24 ± 5 ms for SWCNT and of 54 ± 11 ms for MWCNT. The CNT concentration in the solution was determined by improved thermal gravimetric analysis (TGA) indicating that the concentration of SWCNT dispersed by F-127 was significantly higher than that for MWCNT. For SWCNT, the area per adsorbed Pluronic F-127 molecule is estimated to be about 40 nm(2).

  13. Comparison of groundwater residence time using isotope techniques and numerical groundwater flow model in Gneissic Terrain, Korea

    International Nuclear Information System (INIS)

    Bae, D.S.; Kim, C.S.; Koh, Y.K.; Kim, K.S.; Song, M.Y.

    1997-01-01

    The prediction of groundwater flow affecting the migration of radionuclides is an important component of the performance assessment of radioactive waste disposal. Groundwater flow in fractured rock mass is controlled by fracture networks, transmissivity and hydraulic gradient. Furthermore the scale-dependent and anisotropic properties of hydraulic parameters are resulted mainly from irregular patterns of fracture system, which are very complex to evaluate properly with the current techniques available. For the purpose of characterizing a groundwater flow in fractured rock mass, the discrete fracture network (DFN) concept is available on the basis of assumptions of groundwater flowing only along fractures and flowpaths in rock mass formed by interconnected fractures. To increase the reliability of assessment in groundwater flow phenomena, numerical groundwater flow model and isotopic techniques were applied. Fracture mapping, borehole acoustic scanning were performed to identify conductive fractures in gneissic terrane. Tracer techniques, using deuterium, oxygen-18 and tritium were applied to evaluate the recharge area and groundwater residence time

  14. The Colorado Humanitarian Surgical Skills Workshop: A Cadaver-Based Workshop to Prepare Residents for Surgery in Austere Settings.

    Science.gov (United States)

    Lin, Yihan; Mukhopadhyay, Swagoto; Meguid, Robert A; Kuwayama, David P

    2017-08-29

    Interest in humanitarian surgery is high among surgical and obstetric residents. The Colorado Humanitarian Surgical Skills Workshop is an annual 2-day course exposing senior residents to surgical techniques essential in low- and middle-income countries but not traditionally taught in US residencies. We evaluated the course's ability to foster resident comfort, knowledge, and competence in these skills. The cohort of course participants was studied prospectively. Participants attended didactic sessions followed by skills sessions using cadavers. Sample areas of focus included general surgery (mesh-free hernia repair), orthopedics (powerless external fixation), and neurosurgery (powerless craniotomy). Before and after the course, participants answered a questionnaire assessing confidence with taught skills; took a knowledge-based test composed of multiple choice and open-ended questions; and participated in a manual skills test of tibial external fixation. The Center for Surgical Innovation, University of Colorado School of Medicine. A total of 12 residents (11 general surgical and 1 obstetric) from ten US institutions. After the course, participants perceived increased confidence in performing all 27 taught procedures and ability to practice in low- and middle-income countries. In knowledge-based testing, 10 of 12 residents demonstrated improvement on multiple choice questioning and 9 of 12 residents demonstrated improvement on open-ended questioning with structured scoring. In manual skills testing, all external fixator constructs demonstrated objective improvement on structured scoring and subjective improvement on stability assessment. For senior residents interested in humanitarian surgery, a combination of skills-focused teaching and manual practice led to self-perceived and objective improvement in relevant surgical knowledge and skills. The Colorado Humanitarian Surgical Skills Workshop represents an effective model for transmitting essential surgical

  15. How does warming affect carbon allocation, respiration and residence time in trees? An isotope tracer approach in a eucalypt

    Science.gov (United States)

    Pendall, E.; Drake, J. E.; Furze, M.; Barton, C. V.; Carillo, Y.; Richter, A.; Tjoelker, M. G.

    2017-12-01

    Climate warming has the potential to alter the balance between photosynthetic carbon assimilation and respiratory losses in forest trees, leading to uncertainty in predicting their future physiological functioning. In a previous experiment, warming decreased canopy CO2 assimilation (A) rates of Eucalyptus tereticornis trees, but respiration (R) rates were usually not significantly affected, due to physiological acclimation to temperature. This led to a slight increase in (R/A) and thus decrease in plant carbon use efficiency with climate warming. In contrast to carbon fluxes, the effect of warming on carbon allocation and residence time in trees has received less attention. We conducted a study to test the hypothesis that warming would decrease the allocation of C belowground owing to reduced cost of nutrient uptake. E. parramattensis trees were grown in the field in unique whole-tree chambers operated at ambient and ambient +3 °C temperature treatments (n=3 per treatment). We applied a 13CO2 pulse and followed the label in CO2 respired from leaves, roots, canopy and soil, in plant sugars, and in rhizosphere microbes over a 3-week period in conjunction with measurements of tree growth. The 9-m tall, 57 m3 whole-tree chambers were monitored for CO2 concentrations in independent canopy and below ground (root and soil) compartments; periodic monitoring of δ13C values in air in the compartments allowed us to quantify the amount of 13CO2 assimilated and respired by each tree. Warmed trees grew faster and assimilated more of the label than control trees, but the 13C allocation to canopy, root and soil respiration was not altered. However, warming appeared to reduce the residence time of carbon respired from leaves, and especially from roots and soil, indicating that autotrophic respiration has the potential to feedback to climate change. This experiment provides insights into how warming may affect the fate of assimilated carbon from the leaf to the ecosystem scale.

  16. Estimation of residence times of coastal basins in the Laxemar- Simpevarp area between 3000 BC and 9000 AD

    Energy Technology Data Exchange (ETDEWEB)

    Engqvist, Anders (AandI Engqvist Konsult HB, Vaxholm (Sweden))

    2010-09-15

    The assignment has consisted of computation of the morpho- and bathymetry of the coastal area of Laxemar-Simpevarp for the time period 3000 BC through 9000 AD, in order to estimate the residence times as yearly means of volume-averaged specific age (Average Age, AvA) for water in coastal basins. These basins have been selected as belonging to earlier defined biosphere objects, containing anticipated exit points from possible radionuclides leaking from a hypothetical underground repository for spent nuclear fuel. This endeavor starts with partitioning of the coast into appropriate sub-basins interconnected by straits in an as objective manner as possible. This has been performed in cooperation with Umeaa Univ. followed by the transformation of these hypsographical data to a form that can serve as input data to the employed numerical CouBa-model. This model has been developed to simulate the water exchange of straits between densimetrically stably stratified basins with a free sea level including advection and mixing of water-borne conservative scalar properties, e.g. salinity, heat and specific age. The forcing of the model consists of run-off, wind-induced stress, thermal surface dynamics (heating/cooling) and density fluctuations at the open boundary toward the coastal zone, relative by which the specific water age is calculated For these ambient forcing factors there do not exist sufficiently precise climate data other than for contemporary times. For all other time periods the measured and/or model-computed forcing data regarding 2004 have been used. Estimated AvA-values for the different time periods are thus an expression of sub-basin configuration and hypsographical differences. An overriding directive has been to rather overestimate than underestimate the residence times, as to avoid underestimation of the subsequent dose calculations. The results of these AvA computations, presented as volume averages of yearly means of the sixteen biosphere object

  17. Fed and fasted gastric pH and gastric residence time in conscious beagle dogs.

    Science.gov (United States)

    Sagawa, Kazuko; Li, Fasheng; Liese, Ryan; Sutton, Steven C

    2009-07-01

    The gastric pH values are controversial in the literature. Some suggest the dog gastric pH is higher than human and dog gastric pH after fed with particular diet is uncertain. Gastric pH in 16 male beagle dogs was measured using Bravo pH telemetry system. For the fed study, the dogs received 10 or 200 g of dog dry food (5L18) 15 min before dosing the Bravo pH capsule, followed by a 50 mL of water to aid in swallowing. It was surprising to find a small, but statistically significantly lower pH in the fed compared to the fasted stomach. The average gastric pH in fasted dogs was 2.05 and 1.08 and 1.26 for 10 and 200 g fed dogs. The average gastric emptying time of the capsule was 1.4, 9.4 and 20 h for fasted, 10 g fed and 200 g fed dogs, respectively. The inter-individual variability was higher in fasted dogs than in fed dogs. The results showed the gastric pH in each colony of dogs can be different from reported values in the literature. It emphasizes that the importance of measuring the pH in each colony when dogs are used to evaluate pharmacokinetics of pH sensitive drugs or formulations.

  18. Implementation of a web-based, interactive polytrauma tutorial in computed tomography for radiology residents: How we do it

    International Nuclear Information System (INIS)

    Schlorhaufer, C.; Behrends, M.; Diekhaus, G.; Keberle, M.; Weidemann, J.

    2012-01-01

    Purpose: Due to the time factor in polytraumatized patients all relevant pathologies in a polytrauma computed tomography (CT) scan have to be read and communicated very quickly. During radiology residency acquisition of effective reading schemes based on typical polytrauma pathologies is very important. Thus, an online tutorial for the structured diagnosis of polytrauma CT was developed. Materials and methods: Based on current multimedia theories like the cognitive load theory a didactic concept was developed. As a web-environment the learning management system ILIAS was chosen. CT data sets were converted into online scrollable QuickTime movies. Audiovisual tutorial movies with guided image analyses by a consultant radiologist were recorded. Results: The polytrauma tutorial consists of chapterized text content and embedded interactive scrollable CT data sets. Selected trauma pathologies are demonstrated to the user by guiding tutor movies. Basic reading schemes are communicated with the help of detailed commented movies of normal data sets. Common and important pathologies could be explored in a self-directed manner. Conclusions: Ambitious didactic concepts can be supported by a web based application on the basis of cognitive load theory and currently available software tools.

  19. Geochemical modelling of groundwater evolution and residence time at the Haestholmen site

    Energy Technology Data Exchange (ETDEWEB)

    Pitkaenen, P.; Luukkonen, A. [VTT Communities and Infrastructure, Espoo (Finland); Ruotsalainen, P. [Fintact Oy, Helsinki (Finland); Leino- Forsman, H.; Vuorinen, U. [VTT Chemical Technology, Espoo (Finland)

    2001-01-01

    An understanding of the geochemical evolution of groundwater is an essential part of the performance assessment and safety analysis of the geological final disposal of radioactive waste. The performance of technical barriers and migration of possibly released radionuclides depend on the geochemical conditions. A prerequisite for understanding these factors is the ability to specify the water-rock interactions that control chemical conditions in groundwater. The objective of this study is to interpret the processes and factors that control the hydrogeochemistry, such as pH and redox conditions. A model of the hydrogeochemical progress in different parts of the crystalline bedrock at Haestholmen has been created and the significance of geochemical reactions and groundwater mixing along different flow paths calculated. Long term hydrodynamics have also been evaluated. The interpretation and modelling are based on water samples (64 altogether) obtained from precipitation, the Baltic Sea, the soil layer, shallow wells in the bedrock, and 14 deep boreholes in the bedrock for which a comprehensive data set on dissolved chemical species and isotopes was available. Some analyses of dissolved gases and their isotopic measurements were also utilised. The data covers the bedrock at Haestholmen to a depth of 1000 m. The results from groundwater chemistry, isotopes, petrography, hydrogeology of the site, geomicrobial studies, and PCA and speciation calculations were used to evaluate evolutionary processes at the site. The geochemical interpretation of water-rock interaction, isotope-chemical evolution ({delta}{sup 13}C and {delta}{sup 34}S) and mixing of palaeo-water types were approached by mass-balance calculations (NETPATH). Reaction-path calculations (EQ3/6) were used to verify the thermodynamic feasibility of the reaction models obtained. The interpretation and calculation of hydrochemical data from Haestholmen suggest that changes in external conditions, such as glaciation

  20. Time-frequency representation based on time-varying ...

    Indian Academy of Sciences (India)

    A parametric time-frequency representation is presented based on timevarying autoregressive model (TVAR), followed by applications to non-stationary vibration signal processing. The identification of time-varying model coefficients and the determination of model order, are addressed by means of neural networks and ...

  1. Uncertainties in carbon residence time and NPP-driven carbon uptake in terrestrial ecosystems of the conterminous USA: a Bayesian approach

    Directory of Open Access Journals (Sweden)

    Xuhui Zhou

    2012-10-01

    Full Text Available Carbon (C residence time is one of the key factors that determine the capacity of ecosystem C storage. However, its uncertainties have not been well quantified, especially at regional scales. Assessing uncertainties of C residence time is thus crucial for an improved understanding of terrestrial C sequestration. In this study, the Bayesian inversion and Markov Chain Monte Carlo (MCMC technique were applied to a regional terrestrial ecosystem (TECO-R model to quantify C residence times and net primary productivity (NPP-driven ecosystem C uptake and assess their uncertainties in the conterminous USA. The uncertainty was represented by coefficient of variation (CV. The 13 spatially distributed data sets of C pools and fluxes have been used to constrain TECO-R model for each biome (totally eight biomes. Our results showed that estimated ecosystem C residence times ranged from 16.6±1.8 (cropland to 85.9±15.3 yr (evergreen needleleaf forest with an average of 56.8±8.8 yr in the conterminous USA. The ecosystem C residence times and their CV were spatially heterogeneous and varied with vegetation types and climate conditions. Large uncertainties appeared in the southern and eastern USA. Driven by NPP changes from 1982 to 1998, terrestrial ecosystems in the conterminous USA would absorb 0.20±0.06 Pg C yr−1. Their spatial pattern was closely related to the greenness map in the summer with larger uptake in central and southeast regions. The lack of data or timescale mismatching between the available data and the estimated parameters lead to uncertainties in the estimated C residence times, which together with initial NPP resulted in the uncertainties in the estimated NPP-driven C uptake. The Bayesian approach with MCMC inversion provides an effective tool to estimate spatially distributed C residence time and assess their uncertainties in the conterminous USA.

  2. Family involvement in timely detection of changes in health of nursing homes residents: A qualitative exploratory study.

    Science.gov (United States)

    Powell, Catherine; Blighe, Alan; Froggatt, Katherine; McCormack, Brendan; Woodward-Carlton, Barbara; Young, John; Robinson, Louise; Downs, Murna

    2018-01-01

    To explore family perspectives on their involvement in the timely detection of changes in their relatives' health in UK nursing homes. Increasingly, policy attention is being paid to the need to reduce hospitalisations for conditions that, if detected and treated in time, could be managed in the community. We know that family continue to be involved in the care of their family members once they have moved into a nursing home. Little is known, however, about family involvement in the timely detection of changes in health in nursing home residents. Qualitative exploratory study with thematic analysis. A purposive sampling strategy was applied. Fourteen semi-structured one-to-one interviews with family members of people living in 13 different UK nursing homes. Data were collected from November 2015-March 2016. Families were involved in the timely detection of changes in health in three key ways: noticing signs of changes in health, informing care staff about what they noticed and educating care staff about their family members' changes in health. Families suggested they could be supported to detect timely changes in health by developing effective working practices with care staff. Families can provide a special contribution to the process of timely detection in nursing homes. Their involvement needs to be negotiated, better supported, as well as given more legitimacy and structure within the nursing home. Families could provide much needed support to nursing home nurses, care assistants and managers in timely detection of changes in health. This may be achieved through communication about their preferred involvement on a case-by-case basis as well as providing appropriate support or services. © 2017 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

  3. Randomized controlled resistance training based physical activity trial for central European nursing home residing older adults.

    Science.gov (United States)

    Barthalos, Istvan; Dorgo, Sandor; Kopkáné Plachy, Judit; Szakály, Zsolt; Ihász, Ferenc; Ráczné Németh, Teodóra; Bognár, József

    2016-10-01

    Nursing home residing older adults often experience fear of sickness or death, functional impairment and pain. It is difficult for these older adults to maintain a physically active lifestyle and to keep a positive outlook on life. This study evaluated the changes in quality of life, attitude to aging, assertiveness, physical fitness and body composition of nursing home residing elderly through a 15-week organized resistance training based physical activity program. Inactive older adults living in a state financed nursing home (N.=45) were randomly divided into two intervention groups and a control group. Both intervention groups were assigned to two physical activity sessions a week, but one of these groups also had weekly discussions on health and quality of life (Mental group). Data on anthropometric measures, fitness performance, as well as quality of life and attitudes to aging survey data were collected. Due to low attendance rate 12 subjects were excluded from the analyses. Statistical analysis included Paired Samples t-tests and Repeated Measures Analysis of Variance. Both intervention groups significantly improved their social participation, and their upper- and lower-body strength scores. Also, subjects in the Mental group showed improvement in agility fitness test and certain survey scales. No positive changes were detected in attitude towards aging and body composition measures in any groups. The post-hoc results suggest that Mental group improved significantly more than the Control group. Regular physical activity with discussions on health and quality of life made a more meaningful difference for the older adults living in nursing home than physical activity alone. Due to the fact that all participants were influenced by the program, it is suggested to further explore this area for better understanding of enhanced quality of life.

  4. A retrospective review of required projects in systems-based practice in a single anesthesiology residency: a 10-year experience.

    Science.gov (United States)

    Sakai, Tetsuro; Emerick, Trent D; Patel, Rita M

    2015-09-01

    The Accreditation Council for Graduate Medical Education has emphasized in its core competencies and more recently, in its Milestones Project, that residents understand the importance of systems-based practice (SBP). The objectives of the study are to evaluate the quality of residents' SBP projects and to determine the degrees that were subsequently implemented. A retrospective educational observational study. A university-based anesthesiology training institution. One hundred forty-nine anesthesiology residents in their final (postgraduate year 4) year of training who completed SBP projects for the last 10 years (2004-2013). A structured SBP course was provided for postgraduate year 4 anesthesiology residents with deadlines set such as project identification, data collection, and proposal draft. Each resident's written SBP proposal received inputs by 2 members of the department executive steering committee. The SBP projects concluded with oral presentations by each resident to the department executive steering committee, who provided overall scores. All SBP projects were categorized into 7 categories: safety initiatives, economic analysis, process analysis, policy change recommendations, education initiatives, teamwork/communication, and operating room efficiency. Evaluation scores using a Likert scale (1-9, where 9 is the best) were analyzed. The rate of implementation of project ideas within the department based on the presentations to the executive committee was examined. Of 149 projects, policy change recommendations was the most frequently chosen category (46 projects; 30.9%), followed by process analysis (36 projects; 24.2%). The overall evaluation score was 7.6 ± 0.6 (mean ± SD). A total of 53 projects (35.6%) were implemented in the department. There was no statistical difference between SBPs with implementation vs SBPs without implementation in terms of evaluation scores, year of the presentation, or categories. This SBP project has given residents the

  5. Local and national laparoscopic skill competitions: residents' opinions and impact on adoption of simulation-based training.

    Science.gov (United States)

    McCreery, Greig L; El-Beheiry, Mostafa; Schlachta, Christopher M

    2017-11-01

    Dedicated practice using laparoscopic simulators improves operative performance. Yet, voluntary utilization is minimal. We hypothesized that skill competition between peers, at the local and national level, positively influences residents' use of laparoscopic simulators. A web-based survey evaluated the relationship between Canadian General Surgery residents' use of laparoscopic simulation and participation in competition. Secondary outcomes assessed attitudes regarding simulation training, factors limiting use, and associations between competition level and usage. One hundred ninety (23%) of 826 potential participants responded. Eighty-three percent rated their laparoscopic abilities as novice or intermediate. More than 70% agreed that use of simulation practice improves intra-operative performance, and should be a mandatory component of training. However, 58% employed simulator practice less than once per month, and 18% never used a simulator. Sixty-five percent engaged in simulator training for 5 h or less over the preceding 6 months. Seventy-three percent had participated in laparoscopic skill competition. Of those, 51% agreed that competition was a motivation for simulation practice. No association was found between those with competition experience and simulator use. However, 83% of those who had competed nationally reported >5 h of simulator use in the previous 6 months compared to those with no competition experience (26%), local competition (40%), and local national-qualifying competition (23%) (p simulation-based training, with only the minority of individuals competing at the national level demonstrated significantly higher simulation use. However, simulation training was perceived as a valuable exercise. Lack of time and access to simulators, as opposed to lack of interest, were the most commonly reported to limited use.

  6. [Simulation-based intervention to improve anesthesiology residents communication with families of critically ill patients--preliminary prospective evaluation].

    Science.gov (United States)

    Berkenstadt, Haim; Perlson, Daria; Shalomson, Orit; Tuval, Atalia; Haviv-Yadid, Yael; Ziv, Amitai

    2013-08-01

    Although effective communication with families of critically ill patients is a vital component of quality care, training in this field is neglected. The article aims to validate communication skills training program for anesthesiology residents in the intensive care set up. Ten anesthesia residents, following 3 months of Intensive Care Unit (ICU) rotation, had 4 hours of lectures and one day simulation-based communication skills training with families of critically ill patients. Participants completed an attitude questionnaire over 3 time periods--before training [t1], immediately following training (t2) and three months following training (t3). The participants' communication skills were assessed by two blinded independent observers using the SEGUE framework while performing a simulation-based scenario at t1 and t3. Seven participants finished the study protocol. Participants ndicated communication importance as 3.68 +/- 0.58 (t1), 4.05 +/- 0.59 (t2), 4.13 +/- 0.64 (t3); their communication ability as 3.09 +/- 0.90 (t1), 3.70 +/- 0.80 (t2), 3.57 +/- 0.64 (t3); the contribution of lecture to communication 3.04 +/- 0.43 (t1), 3.83 +/- 0.39 (t2), 3.87 +/- 0.51 (t3), and contribution of simulation training to communication 3.00 +/- 0.71 (t1), 4.04 +/- 0.52 (t2), 3.84 +/- 0.31 (t3). The differences did not reach statistical significance. Objective assessment of the communication skills using the SEGUE framework indicated that 6/7 participants improved their communication skills, with communication ability before training at 2.66 +/- 0.83 and 1 month following training it was 3.38 +/- 0.78 (p = 0.09). This preliminary study demonstrates the value of communication skills training in the intensive care environment.

  7. Effect of cheese on intestinal transit time and other indicators of bowel function in residents of a retirement home.

    Science.gov (United States)

    Mykkänen, H M; Karhunen, L J; Korpela, R; Salminen, S

    1994-01-01

    Effects of increased intake of cheese on intestinal transit time and other indicators of bowel function were studied in 21 retirement home residents (18 women and 3 men; age, 68-87 years). The study was divided into four succeeding periods: 1) 1-week basal period (usual diet); 2)3-week cheese period (extra cheese was offered as such on bread or used in cooking); 3) 3-week no-cheese period (all cheese on bread was replaced with cured meats and cold cuts, and no cheese was used in cooking); 4) 3-week follow-up period (usual diet). During the last week of each period a questionnaire was filled out on fecal frequencies, consistency of feces (soft, normal, hard), and occurrence of abdominal pain and flatulence. Use of laxative medications and therapeutic foods (prunes) was registered. Eleven of the 21 subjects collected fecal samples for the determination of fecal wet weight and intestinal transit time by means of radiopaque Sitzmark capsules. Intakes of cheese, fiber-containing foods, and fluids by these 11 subjects during meals offered in the cafeteria were recorded on a prefilled questionnaire. In spite of a 10-fold increase in the intake of cheese no change in intestinal transit time, fecal frequency, fecal wet weight, consistency of feces, and occurrence of gastrointestinal symptoms was observed. The use of laxative medication was higher during the cheese period, but no change in the combined use of laxative medication and therapeutic foods (prunes) was observed.(ABSTRACT TRUNCATED AT 250 WORDS)

  8. Gasification of biomass wastes in an entrained flow gasifier: Effect of the particle size and the residence time

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez, Juan J.; Aranda-Almansa, Guadalupe [Universidad de Castilla-La Mancha, Departamento de Mecanica Aplicada e Ingenieria de Proyectos, Escuela Tecnica Superior de Ingenieros Industriales (Edificio Politecnico), Avenida Camilo Jose Cela s/n, 13071 Ciudad Real (Spain); Bula, Antonio [Universidad del Norte, Departamento de Ingenieria Mecanica, Km.5 Antigua Via Puerto Colombia, Barranquilla (Colombia)

    2010-06-15

    Experimental tests in an entrained flow gasifier have been carried out in order to evaluate the effect of the biomass particle size and the space residence time on the gasifier performance and the producer gas quality. Three types of biomass fuels (grapevine pruning and sawdust wastes, and marc of grape) and a fossil fuel (a coal-coke blend) have been tested. The results obtained show that a reduction in the fuel particle size leads to a significant improvement in the gasification parameters. The thermochemical characterisation of the resulting char-ash residue shows a sharp increase in the fuel conversion for particles below 1 mm diameter, which could be adequate to be used in conventional entrained flow gasifiers. Significant differences in the thermochemical behaviour of the biomass fuels and the coal-coke blend have been found, especially in the evolution of the H{sub 2}/CO ratio with the space time, mainly due to the catalytic effect of the coal-coke ash. The reaction temperature and the space time have a significant effect on the H{sub 2}/CO ratio (the relative importance of each of these parameters depending on the temperature), this value being independent of the fuel particle size. (author)

  9. Underwater Time Service and Synchronization Based on Time Reversal Technique

    Science.gov (United States)

    Lu, Hao; Wang, Hai-bin; Aissa-El-Bey, Abdeldjalil; Pyndiah, Ramesh

    2010-09-01

    Real time service and synchronization are very important to many underwater systems. But the time service and synchronization in existence cannot work well due to the multi-path propagation and random phase fluctuation of signals in the ocean channel. The time reversal mirror technique can realize energy concentration through self-matching of the ocean channel and has very good spatial and temporal focusing properties. Based on the TRM technique, we present the Time Reversal Mirror Real Time service and synchronization (TRMRT) method which can bypass the processing of multi-path on the server side and reduce multi-path contamination on the client side. So TRMRT can improve the accuracy of time service. Furthermore, as an efficient and precise method of time service, TRMRT could be widely used in underwater exploration activities and underwater navigation and positioning systems.

  10. Communication skills in pediatric training program: National-based survey of residents' perspectives in Saudi Arabia.

    Science.gov (United States)

    Alofisan, Tariq; Al-Alaiyan, Saleh; Al-Abdulsalam, Moath; Siddiqui, Khawar; Hussain, Ibrahim Bin; Al-Qahtani, Mohammad H

    2016-01-01

    Good communication skills and rapport building are considered the cardinal tools for developing a patient-doctor relationship. A positive, healthy competition among different health care organizations in Saudi Arabia underlines an ever increasing emphasis on effective patient-doctor relationship. Despite the numerous guidelines provided and programs available, there is a significant variation in the acceptance and approach to the use of this important tool among pediatric residents in this part of the world. To determine pediatric residents' attitude toward communication skills, their perception of important communication skills, and their confidence in the use of their communication skills in the performance of their primary duties. A cross-sectional study was conducted among all pediatrics trainee residents working in 13 different hospitals in Saudi Arabia. A standardized self-administered questionnaire developed by the Harvard Medical School was used. A total of 297 residents out of all trainees in these centers participated in the data collection. The 283 (95%) residents considered learning communication skills a priority in establishing a good patient-doctor relationship. Thirty four percent reported being very confident with regard to their communication skills. Few residents had the skills, and the confidence to communicate with children with serious diseases, discuss end-of-life issues, and deal with difficult patients and parents. Pediatric residents perceive the importance of communication skills and competencies as crucial components in their training. A proper comprehensive communication skills training should be incorporated into the pediatric resident training curriculum.

  11. A Simulation-based, cognitive assessment of resident decision making during complex urinary catheterization scenarios.

    Science.gov (United States)

    Nathwani, Jay N; Law, Katherine E; Witt, Anna K; Ray, R D; DiMarco, S M; Pugh, C M

    2017-04-01

    This study explores general surgery residents' decision making skills in uncommon, complex urinary catheter scenarios. 40 residents were presented with two scenarios. Scenario A was a male with traumatic urethral injury and scenario B was a male with complete urinary blockage. Residents verbalized whether they would catheterize the patient and described the workup and management of suspected pathologies. Residents' decision paths were documented and analyzed. In scenario A, 45% of participants chose to immediately consult Urology. 47.5% named five diagnostic tests to decide if catheterization was safe. In scenario B, 27% chose to catheterize with a 16 French Coude. When faced with catheterization failure, participants randomly upsized or downsized catheters. Chi-square analysis revealed no measurable consensus amongst participants. Residents need more training in complex decision making for urinary catheterization. The decision trees generated in this study provide a useful blueprint of residents' learning needs. Exploration of general surgery residents' decision making skills in uncommon, complex urinary catheter scenarios revealed major deficiencies. The resulting decision trees reveal residents' learning needs. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Evaluation of clinical teaching quality in competency-based residency training in Lithuania

    Directory of Open Access Journals (Sweden)

    Eglė Vaižgėlienė

    2017-12-01

    Conclusions: Resident evaluations of clinical teachers are influenced by teachers’ age, gender, year of residency training, type of teachers’ academic position and whether or not a clinical teacher performed self-evaluation. Development of CBME should be focused on the continuous evaluation of quality, clinical teachers educational support and the implementation of e-portfolio.

  13. Residence and transport time scales associated with Shatt Al-Arab discharges under various hydrological conditions estimated using a numerical model.

    Science.gov (United States)

    Alosairi, Yousef; Pokavanich, Tanuspong

    2017-05-15

    Over the last several decades, concerns in the Northwest Arabian Gulf have risen regarding water quality and ecological conditions, particularly near Kuwait. This interest is mainly attributed to the reduction of freshwater discharge and its associated constituents from the Shatt Al Arab as a result of human activities at diverse scales. From the hydrological perspective, the reduction has also resulted in alteration to the dynamic regime and related residence time and transport conditions. Using a previously well-validated three-dimensional numerical model of the Northern Arabian Gulf (NAG) (Alosairi and Pokavanich, 2017), the residence and transport conditions of numerical tracers have been assessed through a series of numerical tests. The results indicate that density-driven circulations have played a key role in reducing the residence time in the Northwest Gulf by approximately 15% to 20% compared to tidal forces only. The transport conditions correlated well with the Shatt Al Arab discharges, but they were only significant along the Kuwait coast due to counter-clockwise circulations and alongshore currents. Arrival times and mixing processes varied reasonably with the Shatt Al Arab discharges; the results exhibited the enhancement in mixing and transport with increases in discharge. Residence times in the NAG associated with Shatt Al Arab discharge displayed spatial variations, particularly in Kuwait Bay, where the residence time increased by 60days during low discharge compared to high discharge. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Quantifying the residence time and flushing characteristics of a shallow, back-barrier estuary: Application of hydrodynamic and particle tracking models

    Science.gov (United States)

    Defne, Zafer; Ganju, Neil K.

    2015-01-01

    Estuarine residence time is a major driver of eutrophication and water quality. Barnegat Bay-Little Egg Harbor (BB-LEH), New Jersey, is a lagoonal back-barrier estuary that is subject to anthropogenic pressures including nutrient loading, eutrophication, and subsequent declines in water quality. A combination of hydrodynamic and particle tracking modeling was used to identify the mechanisms controlling flushing, residence time, and spatial variability of particle retention. The models demonstrated a pronounced northward subtidal flow from Little Egg Inlet in the south to Pt. Pleasant Canal in the north due to frictional effects in the inlets, leading to better flushing of the southern half of the estuary and particle retention in the northern estuary. Mean residence time for BB-LEH was 13 days but spatial variability was between ∼0 and 30 days depending on the initial particle location. Mean residence time with tidal forcing alone was 24 days (spatial variability between ∼0 and 50 days); the tides were relatively inefficient in flushing the northern end of the Bay. Scenarios with successive exclusion of physical processes from the models revealed that meteorological and remote offshore forcing were stronger drivers of exchange than riverine inflow. Investigations of water quality and eutrophication should take into account spatial variability in hydrodynamics and residence time in order to better quantify the roles of nutrient loading, production, and flushing.

  15. ESTIMATION OF EARLY INTERNAL DOSES TO FUKUSHIMA RESIDENTS AFTER THE NUCLEAR DISASTER BASED ON THE ATMOSPHERIC DISPERSION SIMULATION.

    Science.gov (United States)

    Kim, Eunjoo; Tani, Kotaro; Kunishima, Naoaki; Kurihara, Osamu; Sakai, Kazuo; Akashi, Makoto

    2016-11-01

    Estimating the early internal doses to residents in the Fukushima Daiichi Nuclear Power Station accident is a difficult task because limited human/environmental measurement data are available. Hence, the feasibility of using atmospheric dispersion simulations created by the Worldwide version of System for Prediction of Environmental Emergency Dose Information 2nd Version (WSPEEDI-II) in the estimation was examined in the present study. This examination was done by comparing the internal doses evaluated based on the human measurements with those calculated using time series air concentration maps ( 131 I and 137 Cs) generated by WSPEEDI-II. The results showed that the latter doses were several times higher than the former doses. However, this discrepancy could be minimised by taking into account personal behaviour data that will be available soon. This article also presents the development of a prototype system for estimating the internal dose based on the simulations. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Simulation Training for Residents Focused on Mechanical Ventilation: A Randomized Trial Using Mannequin-Based Versus Computer-Based Simulation.

    Science.gov (United States)

    Spadaro, Savino; Karbing, Dan Stieper; Fogagnolo, Alberto; Ragazzi, Riccardo; Mojoli, Francesco; Astolfi, Luca; Gioia, Antonio; Marangoni, Elisabetta; Rees, Stephen Edward; Volta, Carlo Alberto

    2017-12-01

    Advances in knowledge regarding mechanical ventilation (MV), in particular lung-protective ventilation strategies, have been shown to reduce mortality. However, the translation of these advances in knowledge into better therapeutic performance in real-life clinical settings continues to lag. High-fidelity simulation with a mannequin allows students to interact in lifelike situations; this may be a valuable addition to traditional didactic teaching. The purpose of this study is to compare computer-based and mannequin-based approaches for training residents on MV. This prospective randomized single-blind trial involved 50 residents. All participants attended the same didactic lecture on respiratory pathophysiology and were subsequently randomized into two groups: the mannequin group (n = 25) and the computer screen-based simulator group (n = 25). One week later, each underwent a training assessment using five different scenarios of acute respiratory failure of different etiologies. Later, both groups underwent further testing of patient management, using in situ high-fidelity simulation of a patient with acute respiratory distress syndrome. Baseline knowledge was not significantly different between the two groups (P = 0.72). Regarding the training assessment, no significant differences were detected between the groups. In the final assessment, the scores of only the mannequin group significantly improved between the training and final session in terms of either global rating score [3.0 (2.5-4.0) vs. 2.0 (2.0-3.0), P = 0.005] or percentage of key score (82% vs. 71%, P = 0.001). Mannequin-based simulation has the potential to improve skills in managing MV.

  17. Viability of a Web-Based Module for Teaching Electrocardiogram Reading Skills to Psychiatry Residents: Learning Outcomes and Trainee Interest.

    Science.gov (United States)

    DeBonis, Katrina; Blair, Thomas R; Payne, Samuel T; Wigan, Katherine; Kim, Sara

    2015-12-01

    Web-based instruction in post-graduate psychiatry training has shown comparable effectiveness to in-person instruction, but few topics have been addressed in this format. This study sought to evaluate the viability of a web-based curriculum in teaching electrocardiogram (EKG) reading skills to psychiatry residents. Interest in receiving educational materials in this format was also assessed. A web-based curriculum of 41 slides, including eight pre-test and eight post-test questions with emphasis on cardiac complications of psychotropic medications, was made available to all psychiatry residents via email. Out of 57 residents, 30 initiated and 22 completed the module. Mean improvement from pre-test to post-test was 25 %, and all 22 completing participants indicated interest in future web-based instruction. This pilot study suggests that web-based instruction is feasible and under-utilized as a means of teaching psychiatry residents. Potential uses of web-based instruction, such as tracking learning outcomes or patient care longitudinally, are also discussed.

  18. Budget and residence time of {sup 210}Pb along the Gulf of Lion`s continental slope (Northwestern Mediterranean Sea)

    Energy Technology Data Exchange (ETDEWEB)

    Abassi, A.; Radakovitch, O.; Heussner, S.; Monaco, A. [Perpignan Univ., 66 (France). Lab. de Sedimentologie et Geochimie Marines

    1997-12-31

    Concentration of {sup 210}Pb has been measured in water and sediment trap samples collected on 7 experimental sites representative of the Gulf of Lion`s continental margin. This marine system is characterised by a major continental input through the Rhone river and a powerful along-slope cyclonic current (Northern Current). From the distribution of bulk {sup 210}Pb activities, it was intended to gain some information on the processes controlling the transport of trace metals at the ocean/continent boundary. Residence times of {sup 210}Pb relative to scavenging in surface waters (0-100 m) showed a constant along-slope (i.e., downstream) decrease that can be related to increasing concentrations in suspended particles. Annual time-series of {sup 210}Pb activities in settling particles were determined on samples collected by traps at 500 and 1000 m depth. From this data set, a budget for {sup 210}Pb on this margin was established which permitted to determine the flux of {sup 210}Pb theoretically adsorbed onto particles. This theoretical flux was compared, at each site, with fluxes effectively measured by traps and revealed that exchange processes - mainly in the form of large inputs of this nuclide (import of 47 to 93% of measured flux) - largely affect the {sup 210}Pb distribution on this continental margin. (author) 12 refs.

  19. Budget and residence time of 210Pb along the Gulf of Lion's continental slope (Northwestern Mediterranean Sea)

    International Nuclear Information System (INIS)

    Abassi, A.; Radakovitch, O.; Heussner, S.; Monaco, A.

    1997-01-01

    Concentration of 210 Pb has been measured in water and sediment trap samples collected on 7 experimental sites representative of the Gulf of Lion's continental margin. This marine system is characterised by a major continental input through the Rhone river and a powerful along-slope cyclonic current (Northern Current). From the distribution of bulk 210 Pb activities, it was intended to gain some information on the processes controlling the transport of trace metals at the ocean/continent boundary. Residence times of 210 Pb relative to scavenging in surface waters (0-100 m) showed a constant along-slope (i.e., downstream) decrease that can be related to increasing concentrations in suspended particles. Annual time-series of 210 Pb activities in settling particles were determined on samples collected by traps at 500 and 1000 m depth. From this data set, a budget for 210 Pb on this margin was established which permitted to determine the flux of 210 Pb theoretically adsorbed onto particles. This theoretical flux was compared, at each site, with fluxes effectively measured by traps and revealed that exchange processes - mainly in the form of large inputs of this nuclide (import of 47 to 93% of measured flux) - largely affect the 210 Pb distribution on this continental margin. (author)

  20. Groundwater residence time and aquifer recharge in mutilayered, semi-confined and faulted aquifer systems using environmental tracers

    Science.gov (United States)

    Batlle-Aguilar, J.; Banks, E.; Batelaan, O.; Kipfer, R.; Brennwald, M. S.; Cook, P. G.

    2016-12-01

    Population growth and ongoing climate change threatens the future of water supply in many regions. Therefore water resources need to be managed in a way such that water demands for industrial, agricultural, recreation and household uses are met in a sustainable approach. To do so, appropriate knowledge of groundwater residence time and aquifer recharge is paramount. But populations are largely concentrated on sedimentary basins where aquifers are often multi-layered, semi-confined and faulted, challenging the study of groundwater flow processes. The motivation of this work is to study the potential of environmental tracers (δ18O, δ2H, δ13C, 14C, 4He, 20Ne, 40Ar, N2) to assist our understanding of recharge processes and residence times in semi-confined, multilayered and faulted aquifer systems. For that purpose, the coastal aquifer system in the Adelaide Plains basin, South Australia, was studied. Carbon-14 groundwater ages were found to increase with depth and distance (30,000 years near the coast), confirming the system is semi-confined and the palaeometeoric origin of groundwater, as suggested by water stable isotopes. The presence of old groundwater near the top of deep semi-confined aquifers suggested that recharge mainly occurs in the mountain ranges east of the basin, a finding which was supported by higher Cl concentrations in the overlying Quaternary aquifers. Mean groundwater flow velocity of 0.8 m y-1 was estimated using 14C ages, and confirmed with 4He estimations. However 4He accumulation rates ranging between 8×10-12 and 1×10-10 cm3 STP g-1 y-1 and 1.7-7.1×10-7 cm3 STP g-1 km-1 confirmed slower flow velocities in some areas, velocities that could not be captured using 14C. Faults were found to play a paramount role in mixing old fluids rich in salts and 4He, but it was not possible to demonstrate the role of faults in changing flow velocities, which requires a higher density of sampling points. Our study shows that environmental tracers are a

  1. Possibility of retrospective follow up studies of mortality in the residents of Semipalatinsk region based on available archive data

    International Nuclear Information System (INIS)

    Bugembayeva, M.; Gaskov, A.; Valivach, M.; Musina, R.; Lipikhina, A.; Kurakina, N.; Kosatov, V.; Federbush, E.; Kusumi, S.

    2003-01-01

    Full text: Epidemiological follow up studies require the following basic data: exposure, people-years of observation, and registered events (incidence of diseases and/or deaths). Besides, it is important to register possible confounding factors such as sex, age, ethnicity, occupation, etc. Performing a joint Kazakhstan-Japanese project we are collecting such kind of data based on various archive documents. Retrospective radiation exposure reconstruction uses estimation methods with input data obtained from historic data, at present physical measurements and at present bio dosimetric measurements. Epidemiological studies is an important part of dose reconstruction, they provide the data on address history and occupation (for example, out-door or in-door job) in the period of atmospheric nuclear tests in 1949-1963. These data can be obtained from Household Books, which have been created and used by authorities for taxation purposes. Each Household Book cover a 2-3 year time band and contains lists of households (usually families), names, birth dates, occupation, ethnicity, and property. Unfortunately, Household Books have numerous mistakes in name spelling, birth dates, and handwriting is often bad. In addition, there are many cases when small children and old people are not mentioned in the lists. Correct data can be reconstructed by comparing the data of several subsequent Household Books and the data of ZAGSes (civilian registry offices). Such ZAGS document as birth certificate contains not only data on a newborn, but also correct names and birth dates of parents, place of birth. Marriage certificates include correct data on names and birth dates. If still there are any doubts, it is possible to collect additional information by interviewing old resident. Usually reconstruction of these data on a single person requires referral to 19 archive documents. A computer software designer A.Gaskov together with epidemiologists have developed a chain of technological

  2. Role of WhatsApp-based discussions in improving residents' knowledge of post-operative pain management: a pilot study.

    Science.gov (United States)

    Bakshi, Sumitra G; Bhawalkar, Pranay

    2017-10-01

    To provide a platform for the dissemination of basic knowledge of pain management, a WhatsApp group was created by residents and consultants. Common clinical scenarios, resident queries, and important instructions to be followed by residents with respect to running the Acute Pain Service were discussed in the group. This study evaluates the benefits of this interaction. This study was approved by the hospital ethics board and was registered with the Clinical Trial Registry of India. Second- and third-year anesthesia residents were included in a WhatsApp group, along with consultants (board certified anesthesiologists with a special interest in pain). Pain knowledge assessment was performed pre- and post-discussion using a standard 22-point questionnaire. A feedback form, which included self-rated confidence scores (1-10, 10-most confident) and opinions about the 3-month WhatsApp discussion, was collected. Improvements in the documentation in clinical sheets post-discussion were also analyzed. A total of 38 residents were included in the WhatsApp group. An improvement in the percentage of correct answers from 69.1% (pre-discussion) to 73.6% (post-discussion) was observed (P = 0.031). Improvements in the self-rated residents' confidence levels were also noted (P WhatsApp-based discussion was useful. Documentation of the details of epidural blockade in clinical sheets improved from 30% to 100%. The WhatsApp discussion improved residents' knowledge and confidence levels, and also resulted in improved documentation of essential details in the clinical notes. This form of education is promising and should be explored in future studies.

  3. Rational optimization of drug-target residence time: Insights from inhibitor binding to the S. aureus FabI enzyme-product complex

    Science.gov (United States)

    Chang, Andrew; Schiebel, Johannes; Yu, Weixuan; Bommineni, Gopal R.; Pan, Pan; Baxter, Michael V.; Khanna, Avinash; Sotriffer, Christoph A.; Kisker, Caroline; Tonge, Peter J.

    2013-01-01

    Drug-target kinetics has recently emerged as an especially important facet of the drug discovery process. In particular, prolonged drug-target residence times may confer enhanced efficacy and selectivity in the open in vivo system. However, the lack of accurate kinetic and structural data for series of congeneric compounds hinders the rational design of inhibitors with decreased off-rates. Therefore, we chose the Staphylococcus aureus enoyl-ACP reductase (saFabI) - an important target for the development of new anti-staphylococcal drugs - as a model system to rationalize and optimize the drug-target residence time on a structural basis. Using our new, efficient and widely applicable mechanistically informed kinetic approach, we obtained a full characterization of saFabI inhibition by a series of 20 diphenyl ethers complemented by a collection of 9 saFabI-inhibitor crystal structures. We identified a strong correlation between the affinities of the investigated saFabI diphenyl ether inhibitors and their corresponding residence times, which can be rationalized on a structural basis. Due to its favorable interactions with the enzyme, the residence time of our most potent compound exceeds 10 hours. In addition, we found that affinity and residence time in this system can be significantly enhanced by modifications predictable by a careful consideration of catalysis. Our study provides a blueprint for investigating and prolonging drug-target kinetics and may aid in the rational design of long-residence-time inhibitors targeting the essential saFabI enzyme. PMID:23697754

  4. Why wait until residency? Competency-based education in longitudinal integrated clerkships

    OpenAIRE

    Gentles, John Quinn

    2017-01-01

    This essay was selected as the winner of the 2015 Canadian Undergraduate Surgical Education Committee student essay competition. It was written in response to the prompt: ?How is your school preparing you for residency ? be it surgical or medical??.

  5. Residency training program: Perceptions of residents

    African Journals Online (AJOL)

    This study was carried out to ascertain the perception of the residency ... the time of the study. Analysis of the respondents showed similar findings for both senior and junior levels of training. Discussion. The introduction of the residency training program .... Overseas training/ attachment should be re-introduced. 12. (10.1).

  6. Thermal environment analysis and energy conservation research of rural residence in cold regions of China based on BIM platform

    Science.gov (United States)

    Dong, J. Y.; Cheng, W.; Ma, C. P.; Xin, L. S.; Tan, Y. T.

    2017-06-01

    In order to study the issue of rural residential energy consumption in cold regions of China, modeled an architecture prototype based on BIM platform according to the affecting factors of rural residential thermal environment, and imported the virtual model which contains building information into energy analysis tools and chose the appropriate building orientation. By analyzing the energy consumption of the residential buildings with different enclosure structure forms, we designed the optimal energy-saving residence form. There is a certain application value of this method for researching the energy consumption and energy-saving design for the rural residence in cold regions of China.

  7. Prevalence and regional correlates of road traffic injury among Chinese urban residents: A 21-city population-based study.

    Science.gov (United States)

    Rockett, Ian R H; Jiang, Shuhan; Yang, Qian; Yang, Tingzhong; Yang, Xiaozhao Y; Peng, Sihui; Yu, Lingwei

    2017-08-18

    This study estimated the prevalence of road traffic injury among Chinese urban residents and examined individual and regional-level correlates. A cross-sectional multistage process was used to sample residents from 21 selected cities in China. Survey respondents reported their history of road traffic injury in the past 12 months through a community survey. Multilevel, multivariable logistic regression analysis was used to identify injury correlates. Based on a retrospective 12-month reporting window, road traffic injury prevalence among urban residents was 13.2%. Prevalence of road traffic injury, by type, was 8.7, 8.7, 8.5, and 7.7% in the automobile, bicycle, motorcycle, and pedestrian categories, respectively. Multilevel analysis showed that prevalence of road traffic injury was positively associated with minority status, income, and mental health disorder score at the individual level. Regionally, road traffic injury was associated with geographic location of residence and prevalence of mental health disorders. Both individual and regional-level variables were associated with road traffic injury among Chinese urban residents, a finding whose implications transcend wholesale imported generic solutions. This descriptive research demonstrates an urgent need for longitudinal studies across China on risk and protective factors, in order to inform injury etiology, surveillance, prevention, treatment, and evaluation.

  8. Effects of first-pass metabolism on metabolite mean residence time determination after oral administration of parent drug.

    Science.gov (United States)

    Chan, K K; Gibaldi, M

    1990-01-01

    Metabolite kinetics after oral drug administration can be determined, without separate metabolite administration, using the concepts of mean residence time (MRT). The MRT of parent drug and metabolite after oral administration of the parent drug, MRTp,p(oral) and MRTm,p(oral), can be calculated directly from the drug and metabolite profiles. The difference between MRTm,p(oral) and MRTp,p(oral), termed Delta MRT, yields an estimate of MRT of metabolite when the metabolite is given as an iv bolus, MRTm,m(iv). The calculation is simple for drugs that are known to undergo, negligible first-pass metabolism. Correction can also be made when extent of first-pass metabolism is known. Ambiguity is encountered, however, when the degree of first-pass metabolism is unknown. When the delta MRT is negative, then first-pass metabolism must be considered. A positive value of delta MRT, on the other hand, is not a definitive indication of the absence of first-pass metabolism. It may occur in the presence or absence of first-pass metabolism. Ignoring the possibility of first-pass metabolism when a positive value of delta MRT occurs may lead to an incorrect estimate of MRTm,m(iv). The estimation error is relatively small, however, when MRTm,m(iv) much greater than MRTp,p(iv), even when first-pass metabolism is extensive. This situation may apply to the administration of a prodrug.

  9. Denitrification in a low-temperature bioreactor system at two different hydraulic residence times: laboratory column studies.

    Science.gov (United States)

    Nordström, Albin; Herbert, Roger B

    2017-06-01

    Nitrate removal rates in a mixture of pine woodchips and sewage sludge were determined in laboratory column studies at 5°C, 12°C, and 22°C, and at two different hydraulic residence times (HRTs; 58.2-64.0 hours and 18.7-20.6 hours). Baffles installed in the flow path were tested as a measure to reduce preferential flow behavior, and to increase the nitrate removal in the columns. The nitrate removal in the columns was simulated at 5°C and 12°C using a combined Arrhenius-Monod equation controlling the removal rate, and a first-order exchange model for incorporation of stagnant zones. Denitrification in the mixture of pine woodchips and sewage sludge reduced nitrate concentrations of 30 mg N L -1 at 5°C to below detection limits at a HRT of 58.2-64.0 hours. At a HRT of 18.7-20.6 hours, nitrate removal was incomplete. The Arrhenius frequency factor and activation energy retrieved from the low HRT data supported a biochemically controlled reaction rate; the same parameters, however, could not be used to simulate the nitrate removal at high HRT. The results show an inversely proportional relationship between the advection velocity and the nitrate removal rate, suggesting that bioreactor performance could be enhanced by promoting low advection velocities.

  10. Charge and energy dependence of the residence time of cosmic ray nuclei below 15 GeV/nucleon

    International Nuclear Information System (INIS)

    Soutoul, A.; Engelmann, J.J.; Ferrando, P.; Koch-Miramond, L.; Masse, P.; Webber, W.R.

    1985-01-01

    The relative abundance of nuclear species measured in cosmic rays at Earth has often been interpreted with the simple leaky box model. For this model to be consistent an essential requirement is that the escape length does not depend on the nuclear species. The discrepancy between escape length values derived from iron secondaries and from the B/C ratio was identified by Garcia-Munoz and his co-workers using a large amount of experimental data. Ormes and Protheroe found a similar trend in the HEAO data although they questioned its significance against uncertainties. They also showed that the change in the B/C ratio values implies a decrease of the residence time of cosmic rays at low energies in conflict with the diffusive convective picture. These conclusions crucially depend on the partial cross section values and their uncertainties. Recently new accurate cross sections of key importance for propagation calculations have been measured. Their statistical uncertainties are often better than 4% and their values significantly different from those previously accepted. Here, these new cross sections are used to compare the observed B/C+O and (Sc to Cr)/Fe ratio to those predicted with the simple leaky box model

  11. Rapid generation of volatile fatty acids (VFA) through anaerobic acidification of livestock organic waste at low hydraulic residence time (HRT).

    Science.gov (United States)

    Kuruti, Kranti; Nakkasunchi, Shalini; Begum, Sameena; Juntupally, Sudharshan; Arelli, Vijayalakshmi; Anupoju, Gangagni Rao

    2017-08-01

    The purpose of this study was to investigate the effect of pre-treatment and F/M (Food to Microorganism) ratios for the rapid generation of volatile fatty acids (VFA) from livestock organic wastes (cattle manure (CM) and poultry litter (PL)) through an anaerobic acidification process at a pH range of 4.5-5.5. Experiments were organized using CM and PL in batch reactors (1L and 25L) with and with no pre-treatment of substrate at F/M ratios (0.4, 0.6, 0.8 and 1). Among various existing pre-treatments methods, thermal-acidic (120°C; 1% H 2 SO 4 ) pre-treatment was found effective. The results revealed that 0.31 and 0.47kg VFA/(kg VS reduced) could be obtained from CM and PL respectively with no pre-treatment, whereas it improvised to 0.43 and 0.67kg VFA/(kg VS reduced) correspondingly due to pre-treatment. Aforesaid, better yield of VFA was obtained at F/M ratio of 1.0, pH-5.5 and hydraulic residence time of 4days. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Rural track training based at a small regional campus: equivalency of training, residency choice, and practice location of graduates.

    Science.gov (United States)

    Crump, William J; Fricker, R Steve; Ziegler, Craig; Wiegman, David L; Rowland, Michael L

    2013-08-01

    Ten years of data for the rural-based Trover Campus (ULTC) were compared with data for the main campus of the University of Louisville School of Medicine to determine whether educational outcomes were equivalent and whether this method of optimizing the affinity model was effective in placing graduates in rural practice. Demographic data and academic measures were compared for 1,391 graduates (60 from ULTC) for 2001-2010. A noninferiority model was developed to compare clinical experiences for each campus cohort. Residency match lists were examined for specialty choice. Graduates from 2001 to 2006 were matched to the American Medical Association Masterfile to determine practice site. ULTC students scored lower on United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Skills (CK) but tended to close this gap after clinical training when compared with Louisville graduates. The noninferiority model indicates that ULTC students' scores were noninferior to Louisville students' on adjusted shelf exams for obstetrics-gynecology, pediatrics, and surgery, and Step 2 CK (P<.001). ULTC graduates were 4.5 times more likely to choose family medicine (P<.001) and over 6 times more likely to choose a nonmetropolitan area as a practice site (P=.001). These data support the value of a small regional rural clinical campus in optimizing the affinity model to place rural students into rural practice. The ULTC students showed equivalent adjusted test scores and slightly narrowed the gap in unadjusted USMLE scores compared with the main campus students.

  13. Use of multiple age tracers to estimate groundwater residence times and long-term recharge rates in arid southern Oman

    Science.gov (United States)

    Müller, Th.; Osenbrück, K.; Strauch, G.; Pavetich, S.; Al-Mashaikhi, K.-S.; Herb, C.; Merchel, S.; Rugel, G.; Aeschbach, W.; Sanford, Ward E.

    2016-01-01

    Multiple age tracers were measured to estimate groundwater residence times in the regional aquifer system underlying southwestern Oman. This area, known as the Najd, is one of the most arid areas in the world and is planned to be the main agricultural center of the Sultanate of Oman in the near future. The three isotopic age tracers 4He, 14C and 36Cl were measured in waters collected from wells along a line that extended roughly from the Dhofar Mountains near the Arabian Sea northward 400 km into the Empty Quarter of the Arabian Peninsula. The wells sampled were mostly open to the Umm Er Radhuma confined aquifer, although, some were completed in the mostly unconfined Rus aquifer. The combined results from the three tracers indicate the age of the confined groundwater is Mountains, > 100 ka in the central section north of the mountains, and up to and > one Ma in the Empty Quarter. The 14C data were used to help calibrate the 4He and 36Cl data. Mixing models suggest that long open boreholes north of the mountains compromise 14C-only interpretations there, in contrast to 4He and 36Cl calculations that are less sensitive to borehole mixing. Thus, only the latter two tracers from these more distant wells were considered reliable. In addition to the age tracers, δ2H and δ18O data suggest that seasonal monsoon and infrequent tropical cyclones are both substantial contributors to the recharge. The study highlights the advantages of using multiple chemical and isotopic data when estimating groundwater travel times and recharge rates, and differentiating recharge mechanisms.

  14. Using stable isotopes to estimate and compare mean residence times in contrasting geologic catchments (Attert River, NW Luxembourg)

    Science.gov (United States)

    Martínez-Carreras, N.; Fenicia, F.; Frentress, J.; Wrede, S.; Pfister, L.

    2012-04-01

    In recent years, stable isotopes have been increasingly used to characterize important aspects of catchment hydrological functioning, such as water storage dynamics, flow pathways and water sources. These characteristics are often synthesized by the Mean Residence Time (MRT), which is a simple catchment descriptor that employ the relation of distinct stable isotopic signatures in the rainfall input and streamflow output of a catchment that are significantly dampened through sub-surface propagation. In this preliminary study, MRT was estimated in the Attert River catchment (NW Luxembourg), where previous studies have shown that lithology exerts a major control on runoff generation. The Attert catchment lies at the transition zone of contrasting bedrock lithology: the Northern part is characterized by Devonian schist of the Ardennes massif, while sedimentary deposits of sandstone and marls dominate in the south of the catchment. As a consequence of differing lithologic characteristics, hydrological processes change across scales. The schistose catchments exhibit a delayed shallow groundwater component, sandstone catchments have slow-responding year-round groundwater component, whereas flashy runoff regimes prevails in the marly catchments. Under these circumstances, the MRTs are expected to vary significantly according to lithology, and provide additional understanding in internal catchment processes and their scale dependencies. In order to test this, bi-weekly monitoring of rainfall and discharge stable water isotope composition (oxygen-18 and deuterium) has been carried out since 2007 in 10 nested sub-catchments ranging in size from 0.4 to 247 km2 in the Attert catchment. MRT was estimated using different lumped convolution integral models and sine wave functions with varying transit times distributions (TTDs). TTDs were evaluated through calibration. Further research efforts will deal with the application of conceptual models to simulate and compare TTD, using

  15. Use of simulation-based education to improve resident learning and patient care in the medical intensive care unit: a randomized trial.

    Science.gov (United States)

    Schroedl, Clara J; Corbridge, Thomas C; Cohen, Elaine R; Fakhran, Sherene S; Schimmel, Daniel; McGaghie, William C; Wayne, Diane B

    2012-04-01

    The purpose of this study is to determine the effect of simulation-based education on the knowledge and skills of internal medicine residents in the medical intensive care unit (MICU). From January 2009 to January 2010, 60 first-year residents at a tertiary care teaching hospital were randomized by month of rotation to an intervention group (simulator-trained, n = 26) and a control group (traditionally trained, n = 34). Simulator-trained residents completed 4 hours of simulation-based education before their medical intensive care unit (MICU) rotation. Topics included circulatory shock, respiratory failure, and mechanical ventilation. After their rotation, residents completed a standardized bedside skills assessment using a 14-item checklist regarding respiratory mechanics, ventilator settings, and circulatory parameters. Performance of simulator-trained and traditionally trained residents was compared using a 2-tailed independent-samples t test. Simulator-trained residents scored significantly higher on the bedside skills assessment compared with traditionally trained residents (82.5% ± 10.6% vs 74.8% ± 14.1%, P = .027). Simulator-trained residents were highly satisfied with the simulation curriculum. Simulation-based education significantly improved resident knowledge and skill in the MICU. Knowledge acquired in the simulated environment was transferred to improved bedside skills caring for MICU patients. Simulation-based education is a valuable adjunct to standard clinical training for residents in the MICU. Copyright © 2012 Elsevier Inc. All rights reserved.

  16. Simulation-Based Training for Residents in the Management of Acute Agitation: A Cluster Randomize