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Background: Hyperacute stroke care demands rapid, coordinated care. Traditional metrics like Door-to-Needle time are pivotal but insufficient for capturing the complexity of endovascular stroke interventions. The SMILES collaboration aims to standardize and optimize protocols for door-to-intervention times, incorporating Crew Resource Management (CRM). Methods: The multidisciplinary initiative integrates both hospitals, ED, neurology, and QI teams. We employed a comprehensive approach: stakeholder engagement, simulation-based learning, process mapping, and literature review. Emphasis was placed on enhancing situational awareness, triage and prioritization, cognitive load management, role clarity, effective communication, and debriefing. Results: The collaboration led to PDSA cycles and development of refined stroke protocols. Interventions included: 1) A ’zero point survey’ for team pre-arrival briefings, enhancing situational awareness and role clarity; 2) Streamlined patient registration to reduce cognitive load and improve triage efficiency; 3) Direct transfer of patients to imaging. Additionally, digital tools were implemented to facilitate communication. Simulation sessions reinforced CRM principles, leading to improved team cohesion and operational performance. Conclusions: The SMILES initiative is grounded in CRM principles by standardizing protocols and emphasizing non-technical skills crucial for high-stakes environments. This improves outcomes but also fosters a culture of safety and efficiency. Future directions include an evaluation of these protocols’ impact on patient factors.
Three inbred strains of male laboratory rat (BN/HsdCpb, BDIX/Or1Ico and LEW/Mol) were provided with nest boxes and nest materials, and were observed for nest-building activity. After 7 days, each cage and nest box was examined. Each nest was weighed and scored for complexity, and returned to the cage. This was repeated after a further 7 days and the nest removed completely. This routine was repeated three times. All three strains of rat built nests inside the nest box and showed the same stages of construction. There was a significant increase in nest complexity between day 7 and day 14 in the strains BN and BDIX. Furthermore, BDIX rats used significantly more material for the nests, compared with the BN and LEW rats. In a second experiment, using the same rats, nest material was offered in four different ways. LEW rats used nesting material irrespective of where it was placed; BN rats only used straw placed on the top of the cage when no alternative was provided in the cage, and would not use the nest box roof when it was covered with bedding; whereas BDIX rats would only use nest material placed within the cage and would not use straw placed on the cage lid. BN rats also used nest material to cover the entrance to the nest box, a practice not carried out by the other strains. This study demonstrates that these rat strains have retained their natural nest-building behaviour. We suggest that the correct stimuli must be provided in order for this behaviour to be exhibited; in addition, the way in which the nest materials are provided must be in accordance with strain-specific characteristics.
We distinguish between the experience and expectation of subjective status decline in relation to electoral behaviour. Studies often link support for radical parties, especially radical right ones, to voters’ experience of status decline. A few other studies argue that voters’ expectation of status decline also triggers radical right support. Without precise measures of both perceptions, it has been difficult to distinguish which (or both) is most relevant for radical right support in Western Europe and the USA. Using survey data from 2018 (n = 4,076) and 2020 (n = 2,106) in Finland, we could precisely measure and distinguish between voters’ experience and expectation of status decline. Descriptively, voters who have experienced status decline have low income, whereas voters who expect status decline have (lower)middle income. Using multivariate analyses, we find that voters who expect status decline consistently prefer radical right parties more than voters who expect status improvement. However, there is no robust evidence of radical right support among voters who have experienced status decline. These findings suggest that the expectation, not experience, of status decline drives radical right support. If these expectations trigger radical right support in Nordic welfare states, they may be even more pertinent in less comprehensive welfare states.
In the Midwestern United States, winter hilling, consisting of two tillage
activities per year, is required in vinifera-grape vineyards for winter
protection. However, this practice often leads to severe soil erosion and
pesticide offsite movement. The effectiveness of wheat straw mulch as a
replacement for soil mounding was investigated as a way of providing winter
protection and to mitigate pesticide leaching and runoff. A laboratory
experiment was conducted where simazine was applied to wheat straw or bare
soil and then followed by simulated rainfalls. When compared with bare soil,
straw reduced simazine leaching and runoff by 40 and 68%, respectively.
Adsorption or interception, or both, of simazine by straw were responsible
for this effect. Additionally, straw reduced soil erosion by 95% and would
largely reduce simazine runoff associated with sediment displacement. The
first simulated rainfall contributed 70 and 34% of total simazine runoff
from bare soil and straw, respectively. In conclusion, mulching with straw
during winter months to provide winter protection could be an effective
practice for controlling simazine offsite movement and soil erosion in
vinifera vineyards.
We have investigated the solidified microstructure of nucleation-generated grains obtained via complete melting of Si films on SiO2 at high nucleation temperatures. This was achieved using a high-temperature-capable hot stage in conjunction with excimer laser irradiation. As predicted by the direct-growth model that considers (1) the evolution in the temperature of the solidifying interface and (2) the subsequent modes of growth (consisting of amorphous, defective, and epitaxial) as key factors, we were able to observe the appearance of “normal” grains that possess a single-crystal core area. These grains, which are in contrast to previously reported flower-shaped grains that fully make up the microstructure of the solidified films obtained via irradiation at lower preheating temperatures (and amongst which these “normal” grains emerge), indicate that epitaxial growth of nucleated crystals must have taken place within the grains. We discuss the implications of our findings regarding (1) the validity of the direct-growth model, (2) the nature of the heterogeneous nucleation mechanism, and (3) the alternative explanations and assumptions that have been previously employed in order to explain the microstructure of Si films obtained via nucleation and growth within the complete melting regime.
We have experimentally investigated the anisotropy of Si-SiO2 interfacial energy by leveraging the mixed-phase solidification (MPS) method. By examining the microstructure evolution resulting from partial-melting-and-solidification cycles, and interpreting the changes in the surface-orientation distribution of the grains in terms of the thermodynamic model, we have identified the orientation-dependent hierarchical order of Si-SiO2 interfacial energies, σ{hkl}, as: σ{100} < σ{310} < σ{113} < σ{112} < σ{221} < σ{210}∼σ{331} < σ{111}, σ{110}.
To modify the rigid structure of alginate, polyvinyl alcohol was mixed. Rheological properties and viscoelastic properties of the polymer blend solution were investigated. Complex and shear viscosity and tangent delta of the solution were obtained to find optimum condition of spinning dope. Effect of blend ratio on morphology and property change was investigated.
We investigated the connection between AGN and star formation (SF) activities of various kinds of AGNs and their host galaxies. In order to probe SF activity, we measured the 3.3 μm PAH emission luminosity utilizing the slitless spectroscopic capability of AKARI space telescope. We present the results from two missions, ASCSG and LQSONG.
We have investigated the effect of varying the film thickness on the surface orientation texturing in polycrystalline Si films obtained via mixed-phase solidification (MPS) of initially a-Si precursor films on SiO2. It is found that, for a given number of MPS exposure cycles, the degree of (100)-surface texturing is reduced as the film thickness is increased. We discuss how this trend can be accounted for by the previously proposed thermodynamic model of MPS, wherein a decreasing local solid/liquid interface curvature with increasing film thickness is identified as the primary cause for decreasing the influence which anisotropic solid-Si/SiO2 interfacial energies have on the survivability of the grains. This, in turn, leads to other factors becoming more significant in determining the grains that survive the MPS cycle, thereby reducing the degree of (100)-surface texturing in the resulting films.
This chapter reviews the spectrum of inflammatory, infectious, metabolic, and neurodegenerative disorders that can overlap or simulate the phenotype of demyelinating disorders in children, including its relapsing-remitting nature. Careful clinical documentation, serum and cerebrospinal fluid (CSF) testing and neuroimaging will likely provide the diagnostic specificity desired to differentiate between acquired demyelinating disorders of the CNS in children and the other disorders. Careful but preliminary studies looking at MRI characteristics are attempting to identify reliable findings to differentiate between pediatric multiple sclerosis and other, clinically relapsing neurologic disorders. Validation of these early findings as well as studies to define additional risk factors, clinical features and biomarkers are needed to further improve our ability to recognize acquired CNS demyelinating disease and to differentiate it from other types of CNS lesions in children. Newer imaging modalities such as diffusion tensor imaging, magnetization transfer ratios, and volumetric analysis will likely play a future role.
With advancement of infrared space telescopes during the past decade, infrared wavelengthregime has been a focal point to study various properties of galaxies with respect toevolution of galaxies. Polycyclic Aromatic Hydrocarbons (PAHs) have emerged as one of themost important features since these features dominate the mid-infrared spectra ofgalaxies. These PAH features provide a great handle to calibrate star formation rates anddiagnose ionized states of grains. However, the PAH 3.3 μm feature hasnot been studied as much as other PAH features since it is weaker than others and residesoutside of Spitzer capability, although it will be the only PAH feature accessible by JWSTfor high-z galaxies. AKARI mJy Unbiased Survey of Extragalactic Sources in 5MUSES (AMUSES)intends to take advantage of AKARI capability of spectroscopy in the2 ~ 5 μm to provide an unbiased library of 44 samplegalaxies selected from a parent sample of 5MUSES, one of Spitzer legacy projects. Forthese 3.6 μm flux limited sample galaxies whose redshifts range between0 < z < 1, AMUSES will calibrate PAH 3.3μm as a star formation rate (SFR) indicator while measuring ratiosbetween PAH features. We present preliminary results of AMUSES.
This paper reports on new experimental findings and conclusions regarding the pulsed-laser-induced melting-and-solidification behavior of PECVD a-Si films. The experimental findings reveal that, within the partial-melting regime, these a-Si films can melt and solidify in ways that are distinct from, and more complex than, those encountered in microcrystalline-cluster-rich LPCVD a-Si films. Specifically (1) spatially dispersed and temporally stochastic nucleation of crystalline solids occurring relatively effectively at the moving liquid-amorphous interface, (2) very defective crystal growth that leads to the formation of fine-grained Si proceeding, at least initially after the nucleation, at a sufficiently rapidly moving crystal solidification front, and (3) the propensity for local preferential remelting of the defective regions and grain boundaries (while the beam is still on) are identified as being some of the fundamental factors that can participate and affect how these PECVD films melt and solidify.
Transition from a low-fat vegetable-rich rural diet to a high-fat Westernised diet is considered a factor in the escalating occurrence of vascular-related diseases and type 2 diabetes in urban black South Africans. Consumption of morogo is a distinguishing feature of rural African diets.
Objective
To determine fatty acid profiles and folate contents of three widely consumed, wild-growing, African dark green leafy vegetables (morogo).
Design
GC–MS was applied for analysis of fatty acid composition and a validated microbiological assay conducted to determine folic acid contents of wild-growing morogo sampled from deep rural villages in three different geographical regions of South Africa.
Results
Measured fatty acids ranged from 1610·2 to 2941·6 mg/100 g dry mass, with PUFA concentrations 1·4 to 2·8 times those of SFA. Calculated from the relative percentages of linoleic acid (18:2n-6) and linolenic acid (18:3n-3), the ratio of 18:2n-6 to 18:3n-3 PUFA was 1·0:3·4 to 1·0:8·9. The only MUFA was palmitoleic acid (16:1), measured at 34·7 (sd 0·3) to 79·0 (sd 9·3) mg/100 g dry mass, and the predominant SFA was palmitic acid (16:0), measured at 420·6 (sd 83·3) to 662·0 (sd 21·2) mg/100 g dry mass. Folic acid concentration varied from 72 to 217 μg/100 g fresh sample.
Conclusion
Morogo is low-fat food item high in folate and with 18:3n-3 in excess of 18:2n-6, the proposed anti-inflammatory effects of which may lower risks of vascular-related chronic diseases and type 2 diabetes.