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Introduction: With the increasing volume of medical literature published each year, it is difficult for clinicians to translate the latest research into practice. Awareness is the first step of knowledge translation and journals have begun using social media to increase the dissemination and awareness of their publications. Infographics can describe research findings visually, are shared broadly on social media, and may be a more effective way to convey information. We hypothesized that infographic abstracts would increase the social media dissemination and online readership of research articles relative to traditional abstracts. Methods: In this randomized controlled trial, 24 original research articles were chosen from the six issues of the Canadian Journal of Emergency Medicine (CJEM) published between July 2016 and May 2017 (4 articles per issue). Half were randomized to the infographic and control groups within each issue. Infographic articles were promoted using a visual infographic outlining the findings of the article. Control articles were promoted using a screen capture image of each articles abstract. Both were disseminated through the journals social media accounts (Twitter and Facebook) along with the link to the selected article. Infographics were also published on CanadiEM.org. Abstract views, full text views, and the change in Altmetric score were tracked for 30 days and compared between groups. Unpaired two-tailed t-tests were used to detect significant differences. Results: Abstract views (mean, SD) were significantly higher for infographic articles (378.9, 162.0) than control articles (175.5, 69.2, p<0.001). Mean Altmetric scores were significantly higher for infographic articles (26.4, 13.8) than control articles (3.4, 1.7, p<0.0001). There was no statistically significant difference in full-text views between infographic (49.7, 90.4) and control articles (25.3, 12.3). Conclusion: CJEM articles promoted on social media using infographics had higher abstract viewership and Altmetric scores than those promoted with traditional abstracts. Although there was no difference in full-text readership, our results suggest that infographic abstracts may have a role in increasing the dissemination of medical literature.
In rock engineering, evaluating the post-peak strength and deformation of rock is necessary. To explore the elasto-plastic behavior of sandstone in the post-peak stage, a series of strain-controlled triaxial tests were conducted under different confining pressures. According to the post-peak characteristics, a constitutive model based on nonlinear elasticity and generalized plasticity is proposed. This proposed model is characterized by the following features: (1) Nonlinear elasticity is observed under hydrostatic and shear loading; (2) the associated flow rule is followed; (3) substantial plastic deformation occurs during shear loading; and (4) post-peak softening behavior is accurately predicted. This model requires twelve material parameters, three for elasticity and nine for plasticity. The proposed model was validated by comparing the triaxial test results of Mushan sandstone at different hydrostatic pressures under dry and saturated conditions. In addition, the model is versatile; it can simulate the deformational behavior of two other sandstones. In summary, the proposed model can reasonably predict the complete stress–strain curve of sandstone.
The San Francisco Fire Department’s (SFFD; San Francisco, California USA) Homeless Outreach and Medical Emergency (HOME) Team is the United States’ first Emergency Medical Services (EMS)-based outreach effort using a specially trained paramedic to redirect frequent users of EMS to other types of services. The effectiveness of this program at reducing repeat use of emergency services during the first seven months of the team’s existence was examined.
A retrospective analysis of EMS use frequency and demographic characteristics of frequent users was conducted. Clients that used emergency services at least four times per month from March 2004 through May 2005 were contacted for intervention. Patterns for each frequent user before and after intervention were analyzed. Changes in EMS use during the 15-month study interval was the primary outcome measurement.
A total of 59 clients were included. The target population had a median age of 55.1 years and was 68% male. Additionally, 38.0% of the target population was homeless, 43.4% had no primary care, 88.9% had a substance abuse disorder at time of contact, and 83.0% had a history of psychiatric disorder. The HOME Team undertook 320 distinct contacts with 65 frequent users during the study period. The average EMS use prior to HOME Team contact was 18.72 responses per month (SD=19.40), and after the first contact with the HOME Team, use dropped to 8.61 (SD=10.84), P<.001.
Frequent users of EMS suffer from disproportionate comorbidities, particularly substance abuse and psychiatric disorders. This population responds well to the intervention of a specially trained paramedic as measured by EMS usage.
TangherliniN, VillarJ, BrownJ, RodriguezRM, YehC, FriedmanBT, WadaP. The HOME Team: Evaluating the Effect of an EMS-based Outreach Team to Decrease the Frequency of 911 Use Among High Utilizers of EMS. Prehosp Disaster Med. 2016;31(6):603–607.
In long-term care facilities (LTCFs), the elderly are apt to be infected because those with latent tuberculosis infections (LTBIs) are at an increased risk for reactivation and post-primary TB disease. We report an outbreak of TB in staff and residents in a LTCF. An outbreak investigation was conducted after two TB cases were reported from the LTCF. A tuberculin skin test (TST), bacteriological examination and chest radiograph were administered to all facility staff and residents. An outbreak is defined as at least two epidemiologically linked cases that have identical Mycobacterium tuberculosis genotype isolates. This outbreak infected eight residents and one staff member, who were confirmed to have TB in a LTCF between September 2011 and October 2012. Based on the Becker method, the latent and infectious periods were estimated at 223·6 and 55·9 days. Two initial TST-negative resident contacts were diagnosed as TB cases through comprehensive TB screening. Observing elderly people who have a negative TST after TB screening appears to be necessary, given the long latent period for controlling a TB outbreak in a LTCF. It is important to consider providing LTBI treatment for elderly contacts.
Formalin is a saturated aqueous solution comprising 37–40 per cent formaldehyde. It is often used in histopathology laboratories as a tissue preservative. The ingestion or injection of formalin has an immediate, powerful and destructive impact on humans. This paper reports a case of formalin injection and reviews the relevant world literature.
A 36-year-old male attempted suicide by injecting formalin into the right side of his neck, resulting in a critical airway situation. An endotracheal tube was inserted and a tracheostomy was then performed to secure his airway. After receiving medical treatment, including antibiotics and N-acetyl cysteine, the status of the patient's airway improved.
When examining patients who have injected substances into their neck, the possibility of deep neck inflammation with airway compromise should be considered. Immediate management, which should include establishment of a definitive airway and prophylactic infection control, is crucial.
A few months after the fourteenth Dalai Lama stated at the Kalachakra Initiation
Ceremony in India in January 2006 that Tibetans should cease wearing clothing lined
with endangered animal skins, Tibetans across the Tibetan Plateau destroyed millions
of yuan worth of otter, leopard, tiger, and other pelts. Outsiders' interpretations
of these events have flattened out the complexity of participants' motivations, which
included not only religious and national loyalty, but also concerns about inequality
wrought by capitalist development, framed through a lens of modern Chinese history.
This paper traces heated debates among Tibetans about the burnings, including their
implications for Tibetans' global reputation, the survival of Tibetan culture, and
the possibility of a moral economy in an era of deepening commodification. It also
explores the embodied, visual, and performative elements of the burnings through
participants' videos. The role of local filmmaking efforts in spreading the burnings
makes the accompanying videos especially relevant.
This paper proposes a complete basis set for analyzing elastic wave scattering in half-space. The half-space is an isotropic, linear, and homogeneous medium except for a finite inhomogeneity. The wave bases are obtained by combining buried source functions and their reflected counter-waves generated from the infinite-plane boundary. The source functions are the vector wave functions of infinite-space. Based on the source functions expressed in the Fourier expansion form, the reflected counter-waves are easily obtained by solving the infinite-plane boundary conditions. Few representations adopt Wely's integration, but the Fourier expansion is developed from it and applied to decouple the angular-differential terms of the vector wave functions. In addition to the scattering of the finite inhomogeneity, the transition matrix method is extended to express the surface boundary conditions. For the numerical application in this paper, the P- and the SV- waves are assumed as the incoming fields. As an example, this paper computes stress concentrations around a cavity. The steepest-descent path method yielding the optimum integral paths is used to ensure the numerical convergence of the wave bases in the Fourier expansion. The resultant patterns from these approaches are compared with those obtained from numerical simulations.
Bandgap engineered ZnSxO1-x films were grown on Fluorinated Ethylene Propylene (FEP) substrates and analyzed using transmission spectroscopy. FEP is considered as a potential substrate for application in flexible electronics and semiconductor films.
Shigella flexneri 4a caused sustained outbreaks in a large long-stay psychiatric centre, Taiwan, 2001–2006. Trimethoprim-sulphamethoxazole (SXT) prophylaxis was administered in 2004. We recovered 108 S. flexneri 4a isolates from 83 symptomatic (including one caregiver) and 12 asymptomatic subjects (11 contacts, one caregiver). The isolates were classified into eight antibiogram types and 15 genotypes (six clusters) by using antimicrobial susceptibility testing and pulsed-field gel electrophoresis of NotI-digested DNA, respectively. These characteristics altered significantly after SXT prophylaxis (P < 0·05), with concomitant emergence of SXT-resistant isolates in two antibiogram types. P01 (n = 71), the predominant epidemic genotype, caused infection in two caregivers and five patients under their care; two P01 isolates were recovered from the same patient 6 months apart. These results indicate the importance of sustained person-to-person transmission of S. flexneri 4a by long-term convalescent, asymptomatic or caregiver carriers, and support the emergence of SXT-resistant strains following selective pressure by SXT prophylaxis.
The formation of a uniform, low-resistance silicide is dependent on the contamination level of the silicon surface upon which the Ti or Co is deposited. Contamination may be in the form of embedded carbon and fluorine residues from previous processing steps, such as the LDD spacer etch. The extent to which the spacer etch contributes impurities can be determined by making contact angle measurements; that is, measurement of the angle formed by a droplet of water placed on the wafer surface. A clean silicon surface provides a contact angle of > 70°, whereas a contaminated silicon surface produces contact angles down to only a few degrees. By using contact angle as a metric, a post-spacer etch clean was developed to remove impurities from the silicon surface without significant silicon loss. The clean procedure entails the use of a CF4/H2O plasma to treat the wafer directly after spacer etch. The clean process was then evaluated by the formation of a blanket Ti silicide followed by sheet resistance measurement. By using this cleaning process, a Ti silicide sheet resistance comparable to that formed on virgin silicon wafers was obtained on wafers that experienced the spacer etch. By comparison, wafers that were subjected to the spacer etch but not the post-spacer clean yielded a higher sheet resistance. Additional study of the post-spacer etch clean process revealed that oxide on the wafer (even the small amount formed during an O2-based resist ash process) can prevent the CF4/H2O plasma from cleaning the surface, perhaps by blocking H in the cleaning plasma from extracting C and other contaminants from the silicon surface. Co silicide formation is even more sensitive to surface impurities than Ti silicide. Using the same post-spacer etch clean, uniform, low-resistance Co silicide formation has been demonstrated.
Graphite intercalation compounds (GIC's) are metal-semimetal superlattices which exhibit crystalline order, and have atomically perfect interfaces between the layers of the constituent species. From the standpoint of superconductivity, the KHg-GIC's are particularly interesting. The preparation and properties of these compounds are described, along with a series of recent experiments with hydrogen doping which have helped to elucidate their electronic properties. A density of states model suggested by the results of the hydrogen–doping experiments is presented and used to explain the variation of the superconducting transition temperature in these materials.
A mechanistic study of Mo etching in a CF4/O2 plasma has been performed using optical emission spectroscopy, mass spectrometry and x-ray photoelectron spectroscopy.Etching characteristics of Mo for a wide range of conditions relevant to plasma processing are also reported.Addition of small amount of O2 to the CF4 plasma dramatically increases the Mo etch rates, as well as concentrations of 0 and F in plasma.However, further addition of O2 above 50 % leads to decrease in etch rates.Two types of neutral molybdenum oxifluorides and a trace amount of molybdenum hexafluoride were observed in the effluent gas.Comparing the etch rates with the concentration changes of F and 0 with and without Mo present in plasma, it is suggested that Mo is chemically etched by F and 0.Atomic oxygen enhances the etch rate by increasing the F concentration in the plasma as well as by removing a carbon layer forming desorbed CO on the surface.XPS and AES analysis results for the etched surface inferred that chemisorbed fluorocarbon radicals dissociate into carbon and fluorine atoms, which in turn form a passivating graphite-like layer and a volatile molybdenum oxifluoride and molybdenum hexafluoride layer.
We report the photoemission spectra from a high quality thin film sample of Y1Ba2Cu3C7-δ at room temperature and bulk samples of Y1Ba2Cu3C7-δ at different temperatures. The experimental data are interpreted within the configuration interaction model of Anderson Hamiltonian. The experimental values for Δ, U and T are determined. We also give the reasons why we think PES data reflect the intrinsic property of the superconductors. Furthermore, we emphasize the importance of the presence of a 3d8-like satellite which signals the strong correlation among 3d electrons.
Because of the difference in charge transfer and superlattice formation of the various intercalant species, graphite intercalation compounds (GICs) exhibit a variety of interesting electronic properties and phonon properties. These compounds form monolayered metallic superlattices along the c—axis, in contrast to the multilayered metallic superlattices grown from MBE and sputtering synthesis methods. GICs are generally divided into donor—type and acceptor—type compounds, depending on whether the electrons are transferred to the graphite or from the graphite. The modification of the electronic energy bands of GICs by charge transfer is analogous to that of the nipi superlattices. Because of the strong electron affinity of hydrogen relative to that of graphite, the addition of hydrogen into donor—type GICs (e.g. K—GICs, KHg—GICs) modifies the charge transfer from the intercalates to the graphite л-bands. Therefore, studies of the donor—type KHx—GICs provide us with new understanding of the variation of the electronic properties of alkali—metal GICs as the as charge transfer is modified.
Thin carbon films were prepared by RF diode sputtering of a graphite target in a mixed nitrogen/argon plasma. A series of carbon films were deposited as a function of nitrogen partial pressure. We have observed a systematic variation of the properties of the carbon films with an increase of the nitrogen partial pressure. AES, XPS and energy gap studies showed that nitrogen will enhance the diamond sp3 bonding. Consistent with this the optical energy gap of our C:N films shows an increase from 1.1 eV to 1.4 eV using, respectively, 25 to 100 % nitrogen plasma. The mechanical properties also are shown to be enhanced for certain applications.