To send content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about sending content to .
To send content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about sending to your Kindle.
Note you can select to send to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To assess the impact of a newly developed Central-Line Insertion Site Assessment (CLISA) score on the incidence of local inflammation or infection for CLABSI prevention.
A pre- and postintervention, quasi-experimental quality improvement study.
Setting and participants:
Adult inpatients with central venous catheters (CVCs) hospitalized in an intensive care unit or oncology ward at a large academic medical center.
We evaluated CLISA score impact on insertion site inflammation and infection (CLISA score of 2 or 3) incidence in the baseline period (June 2014–January 2015) and the intervention period (April 2015–October 2017) using interrupted times series and generalized linear mixed-effects multivariable analyses. These were run separately for days-to-line removal from identification of a CLISA score of 2 or 3. CLISA score interrater reliability and photo quiz results were evaluated.
Among 6,957 CVCs assessed 40,846 times, percentage of lines with CLISA score of 2 or 3 in the baseline and intervention periods decreased by 78.2% (from 22.0% to 4.7%), with a significant immediate decrease in the time-series analysis (P < .001). According to the multivariable regression, the intervention was associated with lower percentage of lines with a CLISA score of 2 or 3, after adjusting for age, gender, CVC body location, and hospital unit (odds ratio, 0.15; 95% confidence interval, 0.06–0.34; P < .001). According to the multivariate regression, days to removal of lines with CLISA score of 2 or 3 was 3.19 days faster after the intervention (P < .001). Also, line dwell time decreased 37.1% from a mean of 14 days (standard deviation [SD], 10.6) to 8.8 days (SD, 9.0) (P < .001). Device utilization ratios decreased 9% from 0.64 (SD, 0.08) to 0.58 (SD, 0.06) (P = .039).
The CLISA score creates a common language for assessing line infection risk and successfully promotes high compliance with best practices in timely line removal.
Loneliness and social networks have been extensively studied in relation to cognitive impairments, but how they interact with each other in relation to cognition is still unclear. This study aimed at exploring the interaction of loneliness and various types of social networks in relation to cognition in older adults.
a cross-sectional study.
497 older adults with normal global cognition were interviewed.
Loneliness was assessed with Chinese 6-item De Jong Gierverg’s Loneliness Scale. Confiding network was defined as people who could share inner feelings with, whereas non-confiding network was computed by subtracting the confiding network from the total network size. Cognitive performance was expressed as a global composite z-score of Cantonese version of mini mental state examination (CMMSE), Categorical verbal fluency test (CVFT) and delayed recall. Linear regression was used to test the main effects of loneliness and the size of various networks, and their interaction on cognitive performance with the adjustment of sociodemographic, physical and psychological confounders.
Significant interaction was found between loneliness and non-confiding network on cognitive performance (B = .002, β = .092, t = 2.099, p = .036). Further analysis showed a significant interaction between loneliness and the number of family members in non-confiding network on cognition (B = .021, β = .119, t = 2.775, p = .006).
Results suggested that a non-confiding relationship with family members might put lonely older adults at risk of cognitive impairment. Our study might have implications on designing psychosocial intervention for those who are vulnerable to loneliness as an early prevention of neurocognitive impairments.
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.
An engineering service project can be highly interactive, collaborative, and distributed. The implementation of such projects needs to generate, utilize, and share large amounts of data and heterogeneous digital objects. The information overload prevents the effective reuse of project data and knowledge, and makes the understanding of project characteristics difficult. Toward solving these issues, this paper emphasized the using of data mining and machine learning techniques to improve the project characteristic understanding process. The work presented in this paper proposed an automatic model and some analytical approaches for learning and predicting the characteristics of engineering service projects. To evaluate the model and demonstrate its functionalities, an industrial data set from the aerospace sector is considered as a the case study. This work shows that the proposed model could enable the project members to gain comprehensive understanding of project characteristics from a multidimensional perspective, and it has the potential to support them in implementing evidence-based design and decision making.
Identify trends of enrolment and key challenges when recruiting infants with complex cardiac diseases into a multi-centre, randomised, placebo-controlled drug trial and assess the impact of efforts to share successful strategies on enrolment of subjects.
Rates of screening, eligibility, consent, and randomisation were determined for three consecutive periods of time. Sites collectively addressed barriers to recruitment and shared successful strategies resulting in the Inventory of Best Recruiting Practices. Study teams detailed institutional practices of recruitment in post-trial surveys that were compared with strategies of enrolment initially proposed in the Inventory.
The number of screened patients increased by 30% between the Initial Period and the Intermediate Period (p = 0.007), whereas eligibility decreased slightly by 7%. Of those eligible for entry into the study, the rate of consent increased by 42% (p = 0.025) and randomisation increased by 71% (p = 0.10). During the Final Period, after launch of a competing trial, fewer patients were screened (−14%, p = 0.06), consented (−19%, p = 0.12), and randomised (−34%, p = 0.012). Practices of recruitment in the post-trial survey closely mirrored those in the Inventory.
Early identification and sharing of best strategies of recruitment among all recruiting sites can be effective in increasing recruitment of critically ill infants with congenital cardiac disease and possibly other populations. Strategies of recruitment should focus on those that build relationships with families and create partnerships with the medical providers who care for them. Competing studies pose challenges for enrolment in trials, but fostering trusting relationships with families can result in successful enrolment into multiple studies.
Field experiments were conducted in Chile and western Canada to measure
short-distance (0 to 100 m) outcrossing from transgenic safflower
(Carthamus tinctorius L.) intended for plant molecular farming to non-transgenic commodity
safflower of the same variety. The transgenic safflower used as the pollen
source was transformed with a construct for seed-specific expression of a
high-value protein and constitutive expression of a gene conferring
resistance to the broad-spectrum herbicide glufosinate. Progeny of
non-transgenic plants grown in plots adjacent to the transgenic pollen
source were screened for glufosinate resistance to measure outcrossing
frequency. Outcrossing frequency differed among locations: values closest to
the transgenic pollen source (0 to 3 m) ranged from 0.48 to 1.67% and
rapidly declined to between 0.0024 to 0.03% at distances of 50 to 100 m.
At each location, outcrossing frequency was spatially heterogeneous,
indicating insects or wind moved pollen asymmetrically. A power analysis
assuming a binomial distribution and a range of alpha values (type 1 error)
was conducted to estimate an upper and lower confidence interval for the
probable transgenic seed frequency in each sample. This facilitated
interpretation when large numbers of seeds were screened from the
outcrossing experiments and no transgenic seeds were found. This study
should aid regulators and the plant molecular farming industry in developing
confinement strategies to mitigate pollen mediated gene flow from transgenic
to non-transgenic safflower.
While early eukaryotic life must have been unicellular, multicellular lifeforms evolved multiple times from protistan ancestors in diverse eukaryotic lineages. The origins of multicellularity are of special interest because they require evolutionary transitions towards increased levels of complexity. We have generated new sequence data from the nuclear large subunit ribosomal DNA gene (LSU rDNA) and the SSU rDNA gene of several unicellular opisthokont protists – a nucleariid amoeba (Nuclearia simplex) and four choanoflagellates (Codosiga gracilis, Choanoeca perplexa, Proterospongia choanojuncta and Stephanoeca diplocostata) to provide the basis for re-examining relationships among several unicellular lineages and their multicellular relatives (animals and fungi). Our data indicate that: (1) choanoflagellates are a monophyletic rather than a paraphyletic assemblage that independently gave rise to animals and fungi as suggested by some authors and (2) the nucleariid filose amoebae are the likely sister group to Fungi. We also review published information regarding the origin of multicellularity in the opisthokonts.
Being able to obtain and analyze quantitative data are an essential components of any undergraduate education in science or engineering. At the most basic level, this begins with characterizing the measurement system using proper statistical techniques. Although most undergraduates in the sciences and engineering are required to take a course in statistics, the knowledge gained in the statistics course does not always find its way into practice. In this paper we will present 4 experimental modules that will enable the student to: 1. Assess the precision of a measurement system; 2. Determine if the system is stable with respect to a number of variables; 3. Quantify the amount of variation that exists within a particular sample; 4. Quantify the amount of variation from sample to sample (i.e., process variation). Our modules were applied to the measurement of silicon dioxide thickness from an oxidation process. However, they generally apply to any process that involves measuring a physical quantity. Assessing these sources of variation in a process form the foundation for more advanced techniques such as process control and experimental design.
A field in which Brassica napus volunteers were not controlled by several applications of glyphosate was investigated in 1998. This field had been planted with glufosinate-resistant and imidazolinone-resistant B. napus in 1997 and was adjacent to a field that had grown glyphosate-resistant B. napus. Mature volunteer B. napus were collected on a 50- by 100-m grid in the field. Progeny from 34 volunteers were sprayed with glyphosate at 440 g ae ha−1, and the survivors were sprayed with either glufosinate or imazethapyr at 400 or 50 g ai ha−1, respectively. Where seed numbers permitted (14 volunteers), seedlings were also sprayed sequentially with glyphosate, glufosinate, and imazethapyr, at 440 g ae ha−1, 400 g ai ha−1, and 50 g ai ha−1, respectively. In total, 15 volunteers had progeny that were between 66 and 82% resistant to glyphosate, consistent with the predicted 3:1 resistant : susceptible ratio. Volunteer B. napus plants with glyphosate-resistant seedlings were most common close to the putative pollen source; however, a plant with glyphosate-resistant progeny was collected 500 m from the adjacent field edge. Seedlings from all nine volunteers collected from the glufosinate-resistant area showed multiple resistance to glyphosate and glufosinate, whereas seedlings from 10 of 20 volunteers collected from the imidazolinone-resistant area showed resistance to imazethapyr and glyphosate. DNA extraction and restriction fragment length polymorphism (RFLP) analysis of seedlings confirmed that mature B. napus volunteers were hybrids resulting from pollen transfer rather than inadvertent seed movement between fields. Two seedlings from the 924 screened were resistant to all three herbicides. Progeny from these self-pollinated individuals were resistant to glyphosate and glufosinate at the predicted 3:1 resistant : susceptible ratio and resistant to imazethapyr at the predicted 15:1 resistant : susceptible ratio. Sequential crossing of three herbicide-resistant varieties is the most likely explanation for the observed multiple herbicide resistance. Integrated management techniques, including suitable crop and herbicide rotations, herbicide mixtures, and nonchemical controls should be used to reduce the incidence and negative effect of B. napus volunteers with multiple herbicide resistance.
This study examines the generalizability of VanPatten and Cadierno (1993b) by investigating
the relative effect of two types of explicit grammar instruction on learners' ability to
interpret and produce sentences containing the French causative. Nine classes of 179
fourth-semester French students were assigned to three groups: (a) processing instruction, (b)
traditional instruction, and (c) no instruction. The results indicate that processing instruction is as
effective as traditional instruction in enabling learners to interpret the French causative and that
traditional instruction is more effective in enabling learners to produce the French causative.
Cal Poly is in the process of revolutionizing how science and engineering students learn about semiconducting materials. Semiconducting polymers currently attract widespread attention as the subjects of numerous research and development projects. Semiconducting polymers are also excellent materials with which to teach structure-property relationships, polymer synthesis, polymer film preparation, optical and electronic properties, semiconductor device fabrication principles, and device testing.
One key benefit of these materials is that they encourage student participation in educational activities that bridge several disciplines. Semiconducting polymers improve student learning by making normally obscure semiconductor concepts more tangible for students in several disciplines: chemistry students create electronics applications for the compounds they synthesize, materials engineering students learn about opto-electronics techniques, and electrical engineering students gain hands-on experience with core concepts in semiconductor devices.
This presentation describes the interdisciplinary projects that students and faculty have participated in thus far, particularly during the phase of lab design and construction.
CVD diamond films, ET 100 of Norton Diamond Film, were treateds in ultrahigh purity O2 from 420 to 575°C at 95 kPa. Auger and x-ray photoelectron spectra were collected from CVD and natural diamond surfaces. The Auger KVV line shapes of the CVD diamond with various surface conditions were compared to those of natural diamonds and sp2-bound graphite (HOPG) and glassy carbon. Comparisons were made on the peak shape of A1, which is the major satellite peak of carbon KVV. Auger KVV line shaped of oxidized CVD diamonds were more similar to that of natural diamond than either HOPG or glassy carbon. XPS is more sensitive to the change of surface chemisorbed species. The C Is binding energy of oxygenated and oxidized CVD diamonds (287.3 eV) was higher than that of natural diamond (285.7 eV), graphite (283.0 eV) and glassy carbon (284.2 eV). Auger and XPS findings indicated that when treated in O2 from 420 to 575°C at 95 kPa, direct oxidation of CVD diamond occurred without graphitization