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Daniel J Beckett, Elaine Thomson, Lindsay Em Reid, Robert C Lloyd
Although there are national recommendations on the function of Acute Medicine Units (AMUs), there is no single agreed best model of care. Additionally, robust data is not always available to determine whether system changes have resulted in improvement. We designed an Excel file to interface with the hospital patient management system to provide real-time data on a number of metrics including AMU length of stay (AMULOS), mortality and readmissions. This demonstrated that improving consultant continuity of care was associated with a reduction in AMULOS and reduced variation in AMULOS...
2016: Acute Medicine
C Wan, M Scala, G W Morley, Atm A Rahman, H Ulbricht, J Bateman, P F Barker, S Bose, M S Kim
We propose an interferometric scheme based on an untrapped nano-object subjected to gravity. The motion of the center of mass (c.m.) of the free object is coupled to its internal spin system magnetically, and a free flight scheme is developed based on coherent spin control. The wave packet of the test object, under a spin-dependent force, may then be delocalized to a macroscopic scale. A gravity induced dynamical phase (accrued solely on the spin state, and measured through a Ramsey scheme) is used to reveal the above spatially delocalized superposition of the spin-nano-object composite system that arises during our scheme...
September 30, 2016: Physical Review Letters
Alexander L Vogel, Johannes Schneider, Christina Müller-Tautges, Thomas Klimach, Thorsten Hoffmann
Atmospheric oxidation of volatile organic compounds (VOCs) yields a large number of different organic molecules which comprise a wide range of volatility. Depending on their volatility, they can be involved in new particle formation and particle growth, thus affecting the number concentration of cloud condensation nuclei in the atmosphere. Here, we identified oxidation products of VOCs in the particle phase during a field study at a rural mountaintop station in central Germany. We used atmospheric pressure chemical ionization mass spectrometry ((-)APCI-MS) and aerosol mass spectrometry for time-resolved measurements of organic species and of the total organic aerosol (OA) mass in the size range of 0...
October 6, 2016: Environmental Science & Technology
Farideh Sabri, Alejandro Prados, Raquel Muñoz-Fernández, Rebecka Lantto, Pablo Fernandez-Rubio, Aikaterini Nasi, Sylvie Amu, Jan Albert, Enrique Garcia Olivares, Francesca Chiodi
BACKGROUND: Follicular dendritic cells (FDCs) are important components in the organization of germinal centers in lymphoid tissue where, following antigen presentation, B cells differentiate into memory B cells. The possibility of establishing primary cell lines from FDCs isolated from lymphoid tissue paved the way for characterization of FDC biological properties. We exposed primary FDC cell lines to HIV-1 strains in vitro and studied changes in the chemo-attractive properties of FDCs and release of inflammatory cytokines...
2016: Retrovirology
Oluyemisi Aderomilehin, Angella Hanciles-Amu, Oluwatobi Ohiole Ozoya
BACKGROUND: Sub-Saharan Africa (SSA) has the highest prevalence of HIV globally, and this is due to persistent new HIV infections and decline in HIV/AIDS-related mortality from improved access to antiretroviral (ART) therapy. There is a limited body of work on perspectives of health-care providers (HCPs) concerning disclosing outcomes of HIV investigations to children and adolescents in SSA. Most studies are country-specific, indicating a need for a regional scope. OBJECTIVE: To review the current literature on the perspectives of HCPs and caregivers of children and adolescents on age group-specific and culture-sensitive HIV disclosure practice...
2016: Frontiers in Public Health
V H M Visschers, M Postma, M Sjölund, A Backhans, L Collineau, S Loesken, C Belloc, J Dewulf, U Emanuelson, E Grosse Beilage, M Siegrist, K D C Stärk
The prudent use of antimicrobials (AMs) should be widened in pig farming to reduce the risk of AM resistance (AMR) in human and veterinary medicine. It is therefore important to understand pig farmers' motivators and the barriers to AM usage (AMU) on their farms. The authors investigated pig farmers' self-estimated levels of AMU, their perceived benefits and risks and the need for AMs in a cross-sectional survey in Belgium, France, Germany and Sweden. The authors also compared these perceptions between the four countries and related them to pig farmers' actual AMU...
August 23, 2016: Veterinary Record
Luke E Hodgson, Borislav D Dimitrov, Jo Congleton, Richard Venn, Lui G Forni, Paul J Roderick
BACKGROUND: The National Early Warning Score (NEWS), proposed as a standardised track and trigger system, may perform less well in acute exacerbation of COPD (AECOPD). This study externally validated NEWS and modifications (Chronic Respiratory Early Warning Score (CREWS) and Salford-NEWS) in AECOPD. METHODS: An observational cohort study (2012-2014, two UK acute medical units (AMUs)), compared AECOPD (2361 admissions, 942 individuals, International Statistical Classification of Diseases and Related Health Problems-10 J40-J44 codes) with AMU patients (37 109 admissions, 20 415 individuals)...
August 23, 2016: Thorax
Cecilia Leoni, Jan Hovorka, Veronika Dočekalová, Tomáš Cajthaml, Soňa Marvanová
Industrial particulate matter (PM) air pollution exposing nearby residential areas forms several European air pollution hot-spots. One of these hot-spot is the residential district of Ostrava Radvanice-Bartovice with frequent exceedances for PM and benzo[a]pyrene B[a]P, a carcinogenic polycyclic aromatic hydrocarbon (PAH) of MW > 228 amu. Such PAHs are highly bonded to the ultrafine particles (UFPs), the smallest PM size fraction, which deposits most efficiently in the alveolar region of human lungs. Airborne measurements identified UFP point sources in the adjacent metallurgical complex and mapped limited horizontal and vertical dispersion of industrial plumes enriched with UFPs (3...
September 20, 2016: Environmental Science & Technology
David Patterson
Manipulating the motion of large polyatomic molecules, such as benzonitrile (C6H5CN), presents significant difficulties compared to the manipulation of diatomic molecules.Although recent impressive results have demonstrated manipulation, trapping, and cooling of molecules as large as CH3F, no general technique for trapping such molecules has been demonstrated, and cold neutral molecules larger than 5 atoms have not been trapped.In particular, extending Stark deceleration and electrostatic trapping to such species remains challenging...
July 25, 2016: Chemphyschem: a European Journal of Chemical Physics and Physical Chemistry
C G M Scherpenzeel, S H W Tijs, I E M den Uijl, I M G A Santman-Berends, A G J Velthuis, T J G M Lam
The attitude of Dutch dairy farmers toward selective dry cow treatment (SDCT) is unknown, although a favorable mindset toward application of SDCT seems crucial for successful implementation. Given the fact that blanket dry cow treatment has been strongly promoted until recently, the implementation of SDCT was expected to be quite a challenge. This study aimed to provide insight into the level of implementation of SDCT in 2013 in the Netherlands, the methods used by farmers for selection of cows for dry cow treatment (DCT), the relation between SDCT and udder health and antimicrobial usage (AMU) in 2013, and the mindset of farmers toward SDCT...
October 2016: Journal of Dairy Science
Liz Lees-Deutsch, Jan Christian, Ian Setchfield
This article conveys concerns raised by delegates at the International SAM Conference (Manchester, 2015) regarding how to advance nursing practice in acute medicine. It endeavors to capture the essence of 'how to advance practice' and 'how to integrate advanced practice' within the workforce structures of an acute medicine unit (AMU). It addresses the production of tacit knowledge and the recognition and integration of this to developing the nursing workforce. The current context of NHS efficiencies and recruitment issues emphasize the value of retaining tacit knowledge...
2016: Acute Medicine
Gary Peter Misselbrook, Patrick Lillie, Claire P Thomas
Soft tissue infections with Scedosporium spp. are an uncommon but serious and emerging cause of infection in immunocompromised patients. Acute Medical Units (AMUs) in the UK are increasingly managing patients with cellulitis in an outpatient setting, therefore acute physicians should be aware of some of the more uncommon causes of soft tissue infection, particularly in patients not responding to initial antibiotic therapy. We present two cases of Scedosporium presenting to the AMU as cellulitis not responding to initial antibiotic therapy and outline the assessment and management of this important condition...
2016: Acute Medicine
Elizabeth Janette Hamilton, Alistair Quentin Green, Jennifer Ann Cook, Henry Nash
This was a retrospective review of five years' data relating to patients referred to the Acute Medical Unit (AMU) of a large teaching hospital with suspected Pulmonary Embolism (PE) during pregnancy or 6 weeks postpartum. During this period, 210 patients in this group underwent half-dose perfusion scanning as investigation for possible PE and were managed via our ambulatory pathway. Pulmonary embolism was diagnosed in 5.2% of patients compared to 18% of non-pregnant patients identified in a previous audit. Half-dose Q scanning enabled exclusion of PE in almost 90% of patients without the need for further imaging...
2016: Acute Medicine
L Powter, T Brougham, C Gillett
AIMS: To create a system to co-ordinate the medical take, bed management and track patient flow. To use the system to continuously audit against Society for Acute Medicine Quality Indicators. To use the data to model patient flow and optimise working patterns to improve waiting times. METHOD: An online whiteboard and underlying database system were designed, tested and implemented. Data from this system were used to audit against SAM Quality Indicators and then analysed to optimise both trainee and consultant working patterns...
2016: Acute Medicine
Greg Habing, Catherine Djordjevic, Gustavo M Schuenemann, Jeff Lakritz
Reductions in livestock antimicrobial use (AMU) can be achieved through identification of effective antimicrobial alternatives as well as accurate and stringent identification of cases requiring antimicrobial therapy. Objective measurements of selectivity that incorporate appropriate case definitions are necessary to understand the need and potential for reductions in AMU through judicious use. The objective of this study was to measure selectivity using a novel disease severity treatment threshold for calf diarrhea, and identify predictors of more selective application of antimicrobials among conventional dairy producers...
August 1, 2016: Preventive Veterinary Medicine
Amanda R Corcos, József S Pap, Tzuhsiung Yang, John F Berry
Three new diruthenium oxyanion complexes have been prepared, crystallographically characterized, and screened for their potential to photochemically unmask a reactive Ru-Ru═O intermediate. The most promising candidate, Ru2(chp)4ONO2 (4, chp = 6-chloro-2-hydroxypyridinate), displays a set of signals centered around m/z = 733 amu in its MALDI-TOF mass spectrum, consistent with the formation of the [Ru2(chp)4O](+) ([6](+)) ion. These signals shift to 735 amu in 4*, which contains an (18)O-labeled nitrate. EPR spectroscopy and headspace GC-MS analysis indicate that NO2(•) is released upon photolysis of 4, also consistent with the formation of 6...
August 10, 2016: Journal of the American Chemical Society
Hubert Amu, Samuel H Nyarko
BACKGROUND: Preparedness of health care professionals for emergency situations is quite indispensable in quality health care; yet, information barely exists on the preparedness of health care professionals for emergency cases in health facilities in Ghana. This study sought to assess the preparedness of health professionals in preventing maternal mortality cases at a public health facility in Ghana. METHODS: This is a qualitative study that used purposive and convenient sampling techniques to recruit 12 health care professionals for in-depth interviews...
2016: BMC Health Services Research
Patrick J Tracy, Justin C Kasper, Jim M Raines, Paul Shearer, Jason A Gilbert, Thomas H Zurbuchen
We analyze the heavy ion components (A>4  amu) in collisionally young solar wind plasma and show that there is a clear, stable dependence of temperature on mass, probably reflecting the conditions in the solar corona. We consider both linear and power law forms for the dependence and find that a simple linear fit of the form T_{i}/T_{p}=(1.35±.02)m_{i}/m_{p} describes the observations twice as well as the equivalent best fit power law of the form T_{i}/T_{p}=(m_{i}/m_{p})^{1.07±.01}. Most importantly we find that current model predictions based on turbulent transport and kinetic dissipation are in agreement with observed nonthermal heating in intermediate collisional age plasma for m/q<3...
June 24, 2016: Physical Review Letters
M Postma, W Vanderhaeghen, S Sarrazin, D Maes, J Dewulf
Antimicrobial usage (AMU) has been described to be high in pig production. Although farmers are aware of the high usage, little is known about intervention to improve the situation. This study evaluated the extent to which AMU could be reduced in pig production by the optimization of herd management, biosecurity status, vaccination strategy, anthelmintic therapy and advice on prudent AMU. Furthermore, the effects of these interventions on the herd production results were explored. This intervention study was conducted on 61 Flemish pig herds and included three visits per herd...
June 30, 2016: Zoonoses and Public Health
Maitreyee Nandy, P K Sarkar, T Sanami, M Takada, T Shibata
Measured neutron energy distribution emitted from a thick stopping target of natural carbon at 0°, 30°, 60° and 90° from nuclear reactions caused by 12 MeV amu(-1) incident (12)C(5+) ions were converted to energy differential and total neutron absorbed dose as well as ambient dose equivalent H (*)(10) using the fluence-to-dose conversion coefficients provided by the ICRP. Theoretical estimates were obtained using the Monte Carlo nuclear reaction model code PACE and a few existing empirical formulations for comparison...
June 29, 2016: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
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