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SNP in the vitamin D receptor (VDR) gene is associated with risk of lower respiratory infections. The influence of genetic variation in the vitamin D pathway resulting in susceptibility to upper respiratory infections (URI) has not been investigated. We evaluated the influence of thirty-three SNP in eleven vitamin D pathway genes (DBP, DHCR7, RXRA, CYP2R1, CYP27B1, CYP24A1, CYP3A4, CYP27A1, LRP2, CUBN and VDR) resulting in URI risk in 725 adults in London, UK, using an additive model with adjustment for potential confounders and correction for multiple comparisons. Significant associations in this cohort were investigated in a validation cohort of 737 children in Manchester, UK. In all, three SNP in VDR (rs4334089, rs11568820 and rs7970314) and one SNP in CYP3A4 (rs2740574) were associated with risk of URI in the discovery cohort after adjusting for potential confounders and correcting for multiple comparisons (adjusted incidence rate ratio per additional minor allele ≥1·15, Pfor trend ≤0·030). This association was replicated for rs4334089 in the validation cohort (Pfor trend=0·048) but not for rs11568820, rs7970314 or rs2740574. Carriage of the minor allele of the rs4334089 SNP in VDR was associated with increased susceptibility to URI in children and adult cohorts in the United Kingdom.
We extend the behavioral ethics literature to examining emotional labor as an antecedent to unethical behavior. We hypothesize that surface acting is positively associated with unethical behavior. In contrast, we produce competing hypotheses for the relationship between deep acting and unethical behavior. In Study 1, with a field sample of 123 full-time employees, surface acting was positively associated with unethical behavior, and emotional inauthenticity explained some of this relationship. In contrast, deep acting was not associated with unethical behavior. In Study 2, with a field sample of 117 full-time employees, we replicated the effect of surface acting in Study 1 and found a positive relationship between deep acting and unethical behavior via emotional inauthenticity. In Study 3, using a two-wave design, we replicated the results in Study 2 and found perceived fairness strengthens the relationship between surface acting and unethical behavior through emotional inauthenticity.
OBJECTIVES/SPECIFIC AIMS: To create a searchable public registry of all Quality Improvement (QI) projects. To incentivize the medical professionals at UF Health to initiate quality improvement projects by reducing startup burden and providing a path to publishing results. To reduce the review effort performed by the internal review board on projects that are quality improvement Versus research. To foster publication of completed quality improvement projects. To assist the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety in managing quality improvement across the hospital system. METHODS/STUDY POPULATION: This project used a variant of the spiral software development model and principles from the ADDIE instructional design process for the creation of a registry that is web based. To understand the current registration process and management of quality projects in the UF Health system a needs assessment was performed with the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety to gather project requirements. Biweekly meetings were held between the Quality Improvement office and the Clinical and Translational Science – Informatics and Technology teams during the entire project. Our primary goal was to collect just enough information to answer the basic questions of who is doing which QI project, what department are they from, what are the most basic details about the type of project and who is involved. We also wanted to create incentive in the user group to try to find an existing project to join or to commit the details of their proposed new project to a data registry for others to find to reduce the amount of duplicate QI projects. We created a series of design templates for further customization and feature discovery. We then proceed with the development of the registry using a Python web development framework called Django, which is a technology that powers Pinterest and the Washington Post Web sites. The application is broken down into 2 main components (i) data input, where information is collected from clinical staff, Nurses, Pharmacists, Residents, and Doctors on what quality improvement projects they intend to complete and (ii) project registry, where completed or “registered” projects can be viewed and searched publicly. The registry consists of a quality investigator profile that lists contact information, expertise, and areas of interest. A dashboard allows for the creation and review of quality improvement projects. A search function enables certain quality project details to be publicly accessible to encourage collaboration. We developed the Registry Matching Algorithm which is based on the Jaccard similarity coefficient that uses quality project features to find similar quality projects. The algorithm allows for quality investigators to find existing or previous quality improvement projects to encourage collaboration and to reduce repeat projects. We also developed the QIPR Approver Algorithm that guides the investigator through a series of questions that allows an appropriate quality project to get approved to start without the need for human intervention. RESULTS/ANTICIPATED RESULTS: A product of this project is an open source software package that is freely available on GitHub for distribution to other health systems under the Apache 2.0 open source license. Adoption of the Quality Improvement Project Registry and promotion of it to the intended audience are important factors for the success of this registry. Thanks goes to the UW-Madison and their QI/Program Evaluation Self-Certification Tool (https://uwmadison.co1.qualtrics.com/SE/?SID=SV_3lVeNuKe8FhKc73) used as example and inspiration for this project. DISCUSSION/SIGNIFICANCE OF IMPACT: This registry was created to help understand the impact of improved management of quality projects in a hospital system. The ultimate result will be to reduce time to approve quality improvement projects, increase collaboration across the UF Health Hospital system, reduce redundancy of quality improvement projects and translate more projects into publications.
Radio survey datasets comprise an increasing number of individual observations stored as sets of multidimensional data. In large survey projects, astronomers commonly face limitations regarding: 1) interactive visual analytics of sufficiently large subsets of data; 2) synchronous and asynchronous collaboration; and 3) documentation of the discovery workflow. To support collaborative data inquiry, we present encube, a large-scale comparative visual analytics framework. encube can utilise advanced visualization environments such as the CAVE2 (a hybrid 2D and 3D virtual reality environment powered with a 100 Tflop/s GPU-based supercomputer and 84 million pixels) for collaborative analysis of large subsets of data from radio surveys. It can also run on standard desktops, providing a capable visual analytics experience across the display ecology. encube is composed of four primary units enabling compute-intensive processing, advanced visualisation, dynamic interaction, parallel data query, along with data management. Its modularity will make it simple to incorporate astronomical analysis packages and Virtual Observatory capabilities developed within our community. We discuss how encube builds a bridge between high-end display systems (such as CAVE2) and the classical desktop, preserving all traces of the work completed on either platform – allowing the research process to continue wherever you are.
Density multiplication of patterned templates by directed self-assembly (DSA) of block copolymers (BCP) stands out as a promising alternative to overcome the limitation of conventional lithography. Using the 300mm pilot line available in LETI and Arkema’s materials, the main objective is to integrate DSA directly into the conventional CMOS lithography process in order to achieve high resolution and pattern density multiplication at a low cost. Thus we investigate the potential of DSA to address contact and via level patterning by performing either CD shrink or contact multiplication. Our approach is based on the graphoepitaxy of PS-b-PMMA block copolymers. Lithographic performances of block copolymers are evaluated both for contact shrink and contact doubling. Furthermore, advanced characterization technics are used to monitor in-film self-assembly process. These results show that DSA has a high potential to be integrated directly into the conventional CMOS lithography process in order to achieve high resolution contact holes.
The ‘holy grail’ in planet hunting is the detection of an Earth-analogue: a planet with similar mass as the Earth and an orbit inside the habitable zone. If we can find such an Earth-analogue around one of the stars in the immediate solar neighbourhood, we could potentially even study it in such great detail to address the question of its potential habitability. Several groups have focused their planet detection efforts on the nearest stars. Our team is currently performing an intensive observing campaign on the α Centauri system using the High Efficiency and Resolution Canterbury University Large Échelle Spectrograph (Hercules) at the 1 m McLellan telescope at Mt John University Observatory in New Zealand. The goal of our project is to obtain such a large number of radial velocity (RV) measurements with sufficiently high temporal sampling to become sensitive to signals of Earth-mass planets in the habitable zones of the two stars in this binary system. Over the past few years, we have collected more than 45 000 spectra for both stars combined. These data are currently processed by an advanced version of our RV reduction pipeline, which eliminates the effect of spectral cross-contamination. Here we present simulations of the expected detection sensitivity to low-mass planets in the habitable zone by the Hercules programme for various noise levels. We also discuss our expected sensitivity to the purported Earth-mass planet in a 3.24-day orbit announced by Dumusque et al. (2012).
Desiccation following prolonged air exposure challenges survival of aquatic plants during droughts, water drawdowns, and overland dispersal. To improve predictions of plant response to air exposure, we observed the viability of vegetative fragments of 10 aquatic plant species (Cabomba caroliniana, Ceratophyllum demersum, Elodea canadensis, Egeria densa, Myriophyllum aquaticum, Myriophyllum heterophyllum, Myriophyllum spicatum, Potamogeton crispus, Potamogeton richardsonii, and Hydrilla verticillata) following desiccation. We recorded mass loss, desiccation rate, and plant fragment survival across a range of air exposures. Mass loss accurately predicted viability of aquatic plant fragments upon reintroduction to water. However, similar periods of air exposure differentially affected viability between species. Understanding viability following desiccation can contribute to predicting dispersal, improving eradication protocols, and disposing of aquatic plants following removal from invaded lakes or contaminated equipment.
Significant new opportunities for astrophysics and cosmology have been identified at low radio frequencies. The Murchison Widefield Array is the first telescope in the southern hemisphere designed specifically to explore the low-frequency astronomical sky between 80 and 300 MHz with arcminute angular resolution and high survey efficiency. The telescope will enable new advances along four key science themes, including searching for redshifted 21-cm emission from the EoR in the early Universe; Galactic and extragalactic all-sky southern hemisphere surveys; time-domain astrophysics; and solar, heliospheric, and ionospheric science and space weather. The Murchison Widefield Array is located in Western Australia at the site of the planned Square Kilometre Array (SKA) low-band telescope and is the only low-frequency SKA precursor facility. In this paper, we review the performance properties of the Murchison Widefield Array and describe its primary scientific objectives.
We present a new, three-dimensional (3D) plotting library with advanced features, and support for standard and enhanced display devices. The library — s2plot — is written in c and can be used by c, c++, and fortran programs on GNU/Linux and Apple/OSX systems. s2plot draws objects in a 3D (x,y,z) Cartesian space and the user interactively controls how this space is rendered at run time. With a pgplot-inspired interface, s2plot provides astronomers with elegant techniques for displaying and exploring 3D data sets directly from their program code, and the potential to use stereoscopic and dome display devices. The s2plot architecture supports dynamic geometry and can be used to plot time-evolving data sets, such as might be produced by simulation codes. In this paper, we introduce s2plot to the astronomical community, describe its potential applications, and present some example uses of the library.
End tidal CO2 (ETCO2) has been established as a standard for confirmation of an airway, but its role is expanding. In certain settings ETCO2 closely approximates the partial pressure of arterial CO2 (PaCO2) and has been described as a tool to optimize a patient's ventilatory status. ETCO2 monitors are increasingly being used by EMS personnel to guide ventilation in the prehospital setting. Severely traumatized and burn patients represent a unique population to which this practice has not been validated.
The sole use of ETCO2 to monitor ventilation may lead to avoidable respiratory acidosis.
A consecutive series of patients with burns or trauma intubated in the prehospital setting over a 24-month period were evaluated. Prehospital arrests were excluded. Absence of ETCO2 transport data and patients without an arterial blood gas (ABG) within 15 minutes of arrival were also excluded. Data collected included demographics, place and time of intubation, service performing intubation, ETCO2 maintained en-route to hospital, and ABG upon arrival. Further data included length of stay, mortality, and injury severity scores.
One hundred sixty patients met the inclusion criteria. Prehospital ETCO2 did not correlate with measured PaCO2 (R2 = 0.08). Mean ETCO2 was significantly lower than mean PaCO2 (34 mmHg vs 44 mmHg, P < .005). Patients arriving acidotic were more likely to die. Mean pH on arrival for survivors and decedents was 7.32 and 7.19 respectively (P < .001). Mortality, acidosis, higher base deficits, and more severe injury patterns were all predictors for a worse correlation between ETCO2 and PaCO2 and increased mean difference between the two values. Decedents and patients presenting with a pH <7.2 demonstrated the greatest discrepancy between ETCO2 and PaCO2. The data suggest that patients may be hypoventilated by prehospital providers in order to obtain a prescribed ETCO2.
ETCO2 is an inadequate tool for predicting PaCO2 or optimizing ventilation in severely injured patients. Adherence to current ETCO2 guidelines in the prehospital setting may contribute to acidosis and increased mortality. Consideration should be given to developing alternate protocols to guide ventilation of the severely injured in the prehospital setting.
CooperCJ, KraatzJJ, KubiakDS, KesselJW, BarnesSL. Utility of Prehospital Quantitative End Tidal CO2?. Prehosp Disaster Med. 2013;28(2):1-6.
General-purpose computing on graphics processing units (GPGPU) is dramatically changing the landscape of high performance computing in astronomy. In this paper, we identify and investigate several key decision areas, with a goal of simplifying the early adoption of GPGPU in astronomy. We consider the merits of OpenCL as an open standard in order to reduce risks associated with coding in a native, vendor-specific programming environment, and present a GPU programming philosophy based on using brute force solutions. We assert that effective use of new GPU-based supercomputing facilities will require a change in approach from astronomers. This will likely include improved programming training, an increased need for software development best practice through the use of profiling and related optimisation tools, and a greater reliance on third-party code libraries. As with any new technology, those willing to take the risks and make the investment of time and effort to become early adopters of GPGPU in astronomy, stand to reap great benefits.
We review the possible formation and orbital stability of Earth-mass or super Earth-mass planets around either of the stars Alpha Centauri A or B and describe a program at Mt John University Observatory using the Doppler method that aims to detect such planets. From New Zealand, we are able to observe the Alpha Centauri system year-round. This is critical in order to acquire data of sufficient quantity and phase coverage to detect the orbit of a terrestrial-mass planet in the habitable zone. Our observations are being made at high resolution (R = 70,000) and high signal-to-noise with the Hercules vacuum echelle spectrograph attached to the 1-m McLellan telescope by a 25-m long optical fibre and using an iodine cell. We discuss the velocity precision and instrumental stability required for success and outline the progress of the observations so far. At present we are collecting about 10,000 observations of each star, A and B, per year with a typical precision of 2.5 m/s per observation.
While the law of the sea is rightly viewed as the most suitable international legal regime for the settlement of disputes in the Arctic, the militarization of this region in an era of climate change is also observable. Yet curiously, scant attention has been paid to the constraints the international humanitarian law (IHL) would impose on armed conflict in the Arctic, as unlikely as such conflict may be. These constraints include the specific prohibition on causing widespread, long-term, and severe environmental damage under Additional Protocol I to the Geneva Conventions as well as the related obligation to have “due regard” for the natural environment, as referred to in, for example, the San Remo Manual on International Law Applicable to Armed Conflict at Sea. Similarly, environmental factors must play into military assessments of targets based on the general principles of IHL related to targeting. The authors explore how these various legal obligations could be applied in the Arctic context. Referring to the scientific literature, they suggest that, due to the particularly vulnerable nature of this regional environment, many traditional war-fighting techniques would lead to damage that is not legally permissible. This conclusion should provide an additional incentive to policy makers to demilitarize the Arctic and to solve peacefully any disputes that may arise over sovereignty, navigation, or resources.
TO evaluate whether a hybrid electronic screening algorithm using a total joint replacement (TJR) registry, electronic surgical site infection (SSI) screening, and electronic health record (EHR) review of SSI is sensitive and specific for SSI detection and reduces chart review volume for SSI surveillance.
A large health maintenance organization (HMO) with 8.6 million members.
Using codes for infection, wound complications, cellullitis, procedures related to infections, and surgeon-reported complications from the International Classification of Diseases, Ninth Revision, Clinical Modification, we screened each TJR procedure performed in our HMO between January 2006 and December 2008 for possible infections. Flagged charts were reviewed by clinical-content experts to confirm SSIs. SSIs identified by the electronic screening algorithm were compared with SSIs identified by the traditional indirect surveillance methodology currently employed in our HMO. Positive predictive values (PPVs), negative predictive values (NPVs), and specificity and sensitivity values were calculated. Absolute reduction of chart review volume was evaluated.
The algorithm identified 4,001 possible SSIs (9.5%) for the 42,173 procedures performed for our TJR patient population. A total of 440 case patients (1.04%) had SSIs (PPV, 11.0%; NPV, 100.0%). The sensitivity and specificity of the overall algorithm were 97.8% and 91.5%, respectively.
An electronic screening algorithm combined with an electronic health record review of flagged cases can be used as a valid source for TJR SSI surveillance. The algorithm successfully reduced the volume of chart review for surveillance by 90.5%.
In this paper, fabrication of nanocomposite thin films with introduction of fullerene (C60) molecules in PolyMethyl MethAcrylate resist (PMMA) was investigated from a material and electrical point of view. The effective inclusion of C60 molecules in the samples was characterized by using UV-vis and Tof-SIMS instruments. The modified resist PMMA:C60 was also studied with Thermal analysis (TGA, DSC) where modification of physical properties is reported. Films were included in MIS and MIM devices and results on non volatile trapping of C60 doped PMMA are presented. Moreover, e-beam exposure tests showed that PMMA:C60 active layers for memory devices, were scalable in size.