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Prehospital Modified HEART Score Predictive of 30-Day Adverse Cardiac Events
- Jason P. Stopyra, William S. Harper, Tyson J. Higgins, Julia V. Prokesova, James E. Winslow, Robert D. Nelson, Roy L. Alson, Christopher A. Davis, Gregory B. Russell, Chadwick D. Miller, Simon A. Mahler
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- Journal:
- Prehospital and Disaster Medicine / Volume 33 / Issue 1 / February 2018
- Published online by Cambridge University Press:
- 10 January 2018, pp. 58-62
- Print publication:
- February 2018
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Introduction
The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it has yet to be evaluated in a prehospital setting.
HypothesisA prehospital modified HEART score can predict major adverse cardiac events (MACE) among undifferentiated chest pain patients transported to the ED.
MethodsA retrospective cohort study of patients with chest pain transported by two county-based Emergency Medical Service (EMS) agencies to a tertiary care center was conducted. Adults without ST-elevation myocardial infarction (STEMI) were included. Inter-facility transfers and those without a prehospital 12-lead ECG or an ED troponin measurement were excluded. Modified HEART scores were calculated by study investigators using a standardized data collection tool for each patient. All MACE (death, myocardial infarction [MI], or coronary revascularization) were determined by record review at 30 days. The sensitivity and negative predictive values (NPVs) for MACE at 30 days were calculated.
ResultsOver the study period, 794 patients met inclusion criteria. A MACE at 30 days was present in 10.7% (85/794) of patients with 12 deaths (1.5%), 66 MIs (8.3%), and 12 coronary revascularizations without MI (1.5%). The modified HEART score identified 33.2% (264/794) of patients as low risk. Among low-risk patients, 1.9% (5/264) had MACE (two MIs and three revascularizations without MI). The sensitivity and NPV for 30-day MACE was 94.1% (95% CI, 86.8-98.1) and 98.1% (95% CI, 95.6-99.4), respectively.
ConclusionsPrehospital modified HEART scores have a high NPV for MACE at 30 days. A study in which prehospital providers prospectively apply this decision aid is warranted.
,Stopyra JP ,Harper WS ,Higgins TJ ,Prokesova JV ,Winslow JE ,Nelson RD ,Alson RL ,Davis CA ,Russell GB ,Miller CD .Mahler SA Prehospital Modified HEART Score Predictive of 30-Day Adverse Cardiac Events . Prehosp Disaster Med.2018 ;33 (1 ):58 –62 .
Glyphosate-Resistant Giant Ragweed (Ambrosia trifida) and Waterhemp (Amaranthus rudis) Management in Dicamba-Resistant Soybean (Glycine max)
- Douglas J. Spaunhorst, Simone Siefert-Higgins, Kevin W. Bradley
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- Journal:
- Weed Technology / Volume 28 / Issue 1 / March 2014
- Published online by Cambridge University Press:
- 20 January 2017, pp. 131-141
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Field experiments were conducted across two locations during 2011 and 2012 to evaluate herbicide options for the control of glyphosate-resistant (GR) giant ragweed and GR waterhemp in dicamba-resistant (DR) soybean. All herbicide treatments provided 91 to 100% control of GR giant ragweed 3 wk after treatment (WAT). Flumioxazin plus dicamba plus glyphosate applied preplant provided greater control and density reduction of GR giant ragweed than flumioxazin plus 2,4-D plus glyphosate. When flumioxazin plus dicamba plus glyphosate were applied preplant, the addition of dicamba to glyphosate at either the early-postemergence (EPOST) or mid-postemergence (MPOST) timing provided greater control and density reduction of GR giant ragweed than glyphosate alone. Regardless of the preplant treatment, delay of EPOST dicamba to the MPOST timing did not influence GR giant ragweed control or density reduction. In the GR waterhemp experiment, dicamba plus glyphosate applied sequentially provided 88 to 89% control and 90% density reduction at the EPOST and MPOST timings compared to only 24% control and 42% density reduction in response to glyphosate applied sequentially. Control and GR waterhemp density reduction did not improve with the addition of acetochlor to either the EPOST or late-postemergence (LPOST) timings. Flumioxazin plus chlorimuron applied PRE followed by dicamba plus glyphosate or dicamba plus glyphosate plus acetochlor provided greater control of GR waterhemp than glyphosate plus fomesafen or glyphosate alone applied EPOST. Results from this research indicate that dicamba applied once or sequentially and when timed appropriately to match the biology of the weed species can be utilized as a component of an integrated program for the management of GR weeds like giant ragweed and waterhemp in DR soybean.
MON 37500 Soil Residues Affect Rotational Crops in the High Plains1
- Drew J. Lyon, Stephen D. Miller, Simone Seifert-Higgins
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- Journal:
- Weed Technology / Volume 17 / Issue 4 / December 2003
- Published online by Cambridge University Press:
- 20 January 2017, pp. 792-798
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MON 37500 is a sulfonylurea herbicide that selectively controls Bromus spp. in winter wheat. Field studies were conducted near Sidney, NE, and Archer, WY, to determine the sensitivity of corn, foxtail millet, grain sorghum, proso millet, and sunflower to soil residues of MON 37500. MON 37500 was applied to winter wheat at 0, 35, 69, and 139 g/ha in the autumn of 1997. Rotational crops were no-till seeded into the standing residues of the previous year's crop from 1999 through 2001. Grain yields for corn, foxtail millet, and proso millet planted 18 to 20 mo after herbicide application were not affected by soil residues of MON 37500. In contrast, average grain yields of grain sorghum were reduced from 1,760 to 30 kg/ha at Archer and from 4,480 to 390 kg/ha at Sidney as MON 37500 rates increased from 0 to 139 g/ha. Thirty to 32 mo after herbicide application, average grain yields of grain sorghum were reduced from 2,360 to 620 kg/ha at Sidney and average aboveground biomass was reduced from 4,000 to 1,800 kg/ha at Archer as MON 37500 rates increased from 0 to 139 g/ha. Nineteen to 20 mo after herbicide application, average sunflower seed yields were reduced from 1,450 to 20 kg/ha at Archer and from 1,830 to 540 kg/ha at Sidney as MON 37500 rates increased from 0 to 139 g/ha. Visual injury was observed 31 to 32 mo after herbicide application, but drought in 2000 prevented collection of seed yield data. In the High Plains, foxtail millet, proso millet, and corn may be successfully grown 18 to 20 mo after the application of MON 37500 to winter wheat. Successful production of grain sorghum and sunflower may require a minimum recrop interval between treatment and planting of >36 mo.
Contributors
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- By Mitchell Aboulafia, Frederick Adams, Marilyn McCord Adams, Robert M. Adams, Laird Addis, James W. Allard, David Allison, William P. Alston, Karl Ameriks, C. Anthony Anderson, David Leech Anderson, Lanier Anderson, Roger Ariew, David Armstrong, Denis G. Arnold, E. J. Ashworth, Margaret Atherton, Robin Attfield, Bruce Aune, Edward Wilson Averill, Jody Azzouni, Kent Bach, Andrew Bailey, Lynne Rudder Baker, Thomas R. Baldwin, Jon Barwise, George Bealer, William Bechtel, Lawrence C. Becker, Mark A. Bedau, Ernst Behler, José A. Benardete, Ermanno Bencivenga, Jan Berg, Michael Bergmann, Robert L. Bernasconi, Sven Bernecker, Bernard Berofsky, Rod Bertolet, Charles J. Beyer, Christian Beyer, Joseph Bien, Joseph Bien, Peg Birmingham, Ivan Boh, James Bohman, Daniel Bonevac, Laurence BonJour, William J. Bouwsma, Raymond D. Bradley, Myles Brand, Richard B. Brandt, Michael E. Bratman, Stephen E. Braude, Daniel Breazeale, Angela Breitenbach, Jason Bridges, David O. Brink, Gordon G. Brittan, Justin Broackes, Dan W. Brock, Aaron Bronfman, Jeffrey E. Brower, Bartosz Brozek, Anthony Brueckner, Jeffrey Bub, Lara Buchak, Otavio Bueno, Ann E. Bumpus, Robert W. Burch, John Burgess, Arthur W. Burks, Panayot Butchvarov, Robert E. Butts, Marina Bykova, Patrick Byrne, David Carr, Noël Carroll, Edward S. Casey, Victor Caston, Victor Caston, Albert Casullo, Robert L. Causey, Alan K. L. Chan, Ruth Chang, Deen K. Chatterjee, Andrew Chignell, Roderick M. Chisholm, Kelly J. Clark, E. J. Coffman, Robin Collins, Brian P. Copenhaver, John Corcoran, John Cottingham, Roger Crisp, Frederick J. Crosson, Antonio S. Cua, Phillip D. Cummins, Martin Curd, Adam Cureton, Andrew Cutrofello, Stephen Darwall, Paul Sheldon Davies, Wayne A. Davis, Timothy Joseph Day, Claudio de Almeida, Mario De Caro, Mario De Caro, John Deigh, C. F. Delaney, Daniel C. Dennett, Michael R. DePaul, Michael Detlefsen, Daniel Trent Devereux, Philip E. Devine, John M. Dillon, Martin C. Dillon, Robert DiSalle, Mary Domski, Alan Donagan, Paul Draper, Fred Dretske, Mircea Dumitru, Wilhelm Dupré, Gerald Dworkin, John Earman, Ellery Eells, Catherine Z. Elgin, Berent Enç, Ronald P. Endicott, Edward Erwin, John Etchemendy, C. Stephen Evans, Susan L. Feagin, Solomon Feferman, Richard Feldman, Arthur Fine, Maurice A. Finocchiaro, William FitzPatrick, Richard E. Flathman, Gvozden Flego, Richard Foley, Graeme Forbes, Rainer Forst, Malcolm R. Forster, Daniel Fouke, Patrick Francken, Samuel Freeman, Elizabeth Fricker, Miranda Fricker, Michael Friedman, Michael Fuerstein, Richard A. Fumerton, Alan Gabbey, Pieranna Garavaso, Daniel Garber, Jorge L. A. Garcia, Robert K. Garcia, Don Garrett, Philip Gasper, Gerald Gaus, Berys Gaut, Bernard Gert, Roger F. Gibson, Cody Gilmore, Carl Ginet, Alan H. Goldman, Alvin I. Goldman, Alfonso Gömez-Lobo, Lenn E. Goodman, Robert M. Gordon, Stefan Gosepath, Jorge J. E. Gracia, Daniel W. Graham, George A. Graham, Peter J. Graham, Richard E. Grandy, I. Grattan-Guinness, John Greco, Philip T. Grier, Nicholas Griffin, Nicholas Griffin, David A. Griffiths, Paul J. Griffiths, Stephen R. Grimm, Charles L. Griswold, Charles B. Guignon, Pete A. Y. Gunter, Dimitri Gutas, Gary Gutting, Paul Guyer, Kwame Gyekye, Oscar A. Haac, Raul Hakli, Raul Hakli, Michael Hallett, Edward C. Halper, Jean Hampton, R. James Hankinson, K. R. Hanley, Russell Hardin, Robert M. Harnish, William Harper, David Harrah, Kevin Hart, Ali Hasan, William Hasker, John Haugeland, Roger Hausheer, William Heald, Peter Heath, Richard Heck, John F. Heil, Vincent F. Hendricks, Stephen Hetherington, Francis Heylighen, Kathleen Marie Higgins, Risto Hilpinen, Harold T. Hodes, Joshua Hoffman, Alan Holland, Robert L. Holmes, Richard Holton, Brad W. Hooker, Terence E. Horgan, Tamara Horowitz, Paul Horwich, Vittorio Hösle, Paul Hoβfeld, Daniel Howard-Snyder, Frances Howard-Snyder, Anne Hudson, Deal W. Hudson, Carl A. Huffman, David L. Hull, Patricia Huntington, Thomas Hurka, Paul Hurley, Rosalind Hursthouse, Guillermo Hurtado, Ronald E. Hustwit, Sarah Hutton, Jonathan Jenkins Ichikawa, Harry A. Ide, David Ingram, Philip J. Ivanhoe, Alfred L. Ivry, Frank Jackson, Dale Jacquette, Joseph Jedwab, Richard Jeffrey, David Alan Johnson, Edward Johnson, Mark D. Jordan, Richard Joyce, Hwa Yol Jung, Robert Hillary Kane, Tomis Kapitan, Jacquelyn Ann K. Kegley, James A. Keller, Ralph Kennedy, Sergei Khoruzhii, Jaegwon Kim, Yersu Kim, Nathan L. King, Patricia Kitcher, Peter D. Klein, E. D. Klemke, Virginia Klenk, George L. Kline, Christian Klotz, Simo Knuuttila, Joseph J. Kockelmans, Konstantin Kolenda, Sebastian Tomasz Kołodziejczyk, Isaac Kramnick, Richard Kraut, Fred Kroon, Manfred Kuehn, Steven T. Kuhn, Henry E. Kyburg, John Lachs, Jennifer Lackey, Stephen E. Lahey, Andrea Lavazza, Thomas H. Leahey, Joo Heung Lee, Keith Lehrer, Dorothy Leland, Noah M. Lemos, Ernest LePore, Sarah-Jane Leslie, Isaac Levi, Andrew Levine, Alan E. Lewis, Daniel E. Little, Shu-hsien Liu, Shu-hsien Liu, Alan K. L. Chan, Brian Loar, Lawrence B. Lombard, John Longeway, Dominic McIver Lopes, Michael J. Loux, E. J. Lowe, Steven Luper, Eugene C. Luschei, William G. Lycan, David Lyons, David Macarthur, Danielle Macbeth, Scott MacDonald, Jacob L. Mackey, Louis H. Mackey, Penelope Mackie, Edward H. Madden, Penelope Maddy, G. B. Madison, Bernd Magnus, Pekka Mäkelä, Rudolf A. Makkreel, David Manley, William E. Mann (W.E.M.), Vladimir Marchenkov, Peter Markie, Jean-Pierre Marquis, Ausonio Marras, Mike W. Martin, A. P. Martinich, William L. McBride, David McCabe, Storrs McCall, Hugh J. McCann, Robert N. McCauley, John J. McDermott, Sarah McGrath, Ralph McInerny, Daniel J. McKaughan, Thomas McKay, Michael McKinsey, Brian P. McLaughlin, Ernan McMullin, Anthonie Meijers, Jack W. Meiland, William Jason Melanson, Alfred R. Mele, Joseph R. Mendola, Christopher Menzel, Michael J. Meyer, Christian B. Miller, David W. Miller, Peter Millican, Robert N. Minor, Phillip Mitsis, James A. Montmarquet, Michael S. Moore, Tim Moore, Benjamin Morison, Donald R. Morrison, Stephen J. Morse, Paul K. Moser, Alexander P. D. Mourelatos, Ian Mueller, James Bernard Murphy, Mark C. Murphy, Steven Nadler, Jan Narveson, Alan Nelson, Jerome Neu, Samuel Newlands, Kai Nielsen, Ilkka Niiniluoto, Carlos G. Noreña, Calvin G. Normore, David Fate Norton, Nikolaj Nottelmann, Donald Nute, David S. Oderberg, Steve Odin, Michael O’Rourke, Willard G. Oxtoby, Heinz Paetzold, George S. Pappas, Anthony J. Parel, Lydia Patton, R. P. Peerenboom, Francis Jeffry Pelletier, Adriaan T. Peperzak, Derk Pereboom, Jaroslav Peregrin, Glen Pettigrove, Philip Pettit, Edmund L. Pincoffs, Andrew Pinsent, Robert B. Pippin, Alvin Plantinga, Louis P. Pojman, Richard H. Popkin, John F. Post, Carl J. Posy, William J. Prior, Richard Purtill, Michael Quante, Philip L. Quinn, Philip L. Quinn, Elizabeth S. Radcliffe, Diana Raffman, Gerard Raulet, Stephen L. Read, Andrews Reath, Andrew Reisner, Nicholas Rescher, Henry S. Richardson, Robert C. Richardson, Thomas Ricketts, Wayne D. Riggs, Mark Roberts, Robert C. Roberts, Luke Robinson, Alexander Rosenberg, Gary Rosenkranz, Bernice Glatzer Rosenthal, Adina L. Roskies, William L. Rowe, T. M. Rudavsky, Michael Ruse, Bruce Russell, Lilly-Marlene Russow, Dan Ryder, R. M. Sainsbury, Joseph Salerno, Nathan Salmon, Wesley C. Salmon, Constantine Sandis, David H. Sanford, Marco Santambrogio, David Sapire, Ruth A. Saunders, Geoffrey Sayre-McCord, Charles Sayward, James P. Scanlan, Richard Schacht, Tamar Schapiro, Frederick F. Schmitt, Jerome B. Schneewind, Calvin O. Schrag, Alan D. Schrift, George F. Schumm, Jean-Loup Seban, David N. Sedley, Kenneth Seeskin, Krister Segerberg, Charlene Haddock Seigfried, Dennis M. Senchuk, James F. Sennett, William Lad Sessions, Stewart Shapiro, Tommie Shelby, Donald W. Sherburne, Christopher Shields, Roger A. Shiner, Sydney Shoemaker, Robert K. Shope, Kwong-loi Shun, Wilfried Sieg, A. John Simmons, Robert L. Simon, Marcus G. Singer, Georgette Sinkler, Walter Sinnott-Armstrong, Matti T. Sintonen, Lawrence Sklar, Brian Skyrms, Robert C. Sleigh, Michael Anthony Slote, Hans Sluga, Barry Smith, Michael Smith, Robin Smith, Robert Sokolowski, Robert C. Solomon, Marta Soniewicka, Philip Soper, Ernest Sosa, Nicholas Southwood, Paul Vincent Spade, T. L. S. Sprigge, Eric O. Springsted, George J. Stack, Rebecca Stangl, Jason Stanley, Florian Steinberger, Sören Stenlund, Christopher Stephens, James P. Sterba, Josef Stern, Matthias Steup, M. A. Stewart, Leopold Stubenberg, Edith Dudley Sulla, Frederick Suppe, Jere Paul Surber, David George Sussman, Sigrún Svavarsdóttir, Zeno G. Swijtink, Richard Swinburne, Charles C. Taliaferro, Robert B. Talisse, John Tasioulas, Paul Teller, Larry S. Temkin, Mark Textor, H. S. Thayer, Peter Thielke, Alan Thomas, Amie L. Thomasson, Katherine Thomson-Jones, Joshua C. Thurow, Vzalerie Tiberius, Terrence N. Tice, Paul Tidman, Mark C. Timmons, William Tolhurst, James E. Tomberlin, Rosemarie Tong, Lawrence Torcello, Kelly Trogdon, J. D. Trout, Robert E. Tully, Raimo Tuomela, John Turri, Martin M. Tweedale, Thomas Uebel, Jennifer Uleman, James Van Cleve, Harry van der Linden, Peter van Inwagen, Bryan W. Van Norden, René van Woudenberg, Donald Phillip Verene, Samantha Vice, Thomas Vinci, Donald Wayne Viney, Barbara Von Eckardt, Peter B. M. Vranas, Steven J. Wagner, William J. Wainwright, Paul E. Walker, Robert E. Wall, Craig Walton, Douglas Walton, Eric Watkins, Richard A. Watson, Michael V. Wedin, Rudolph H. Weingartner, Paul Weirich, Paul J. Weithman, Carl Wellman, Howard Wettstein, Samuel C. Wheeler, Stephen A. White, Jennifer Whiting, Edward R. Wierenga, Michael Williams, Fred Wilson, W. Kent Wilson, Kenneth P. Winkler, John F. Wippel, Jan Woleński, Allan B. Wolter, Nicholas P. Wolterstorff, Rega Wood, W. Jay Wood, Paul Woodruff, Alison Wylie, Gideon Yaffe, Takashi Yagisawa, Yutaka Yamamoto, Keith E. Yandell, Xiaomei Yang, Dean Zimmerman, Günter Zoller, Catherine Zuckert, Michael Zuckert, Jack A. Zupko (J.A.Z.)
- Edited by Robert Audi, University of Notre Dame, Indiana
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- The Cambridge Dictionary of Philosophy
- Published online:
- 05 August 2015
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- 27 April 2015, pp ix-xxx
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Single Dose versus Fractionated Stereotactic Radiotherapy for Meningiomas
- Simon S. Lo, Kwan H. Cho, Walter A. Hall, Ronald J. Kossow, Wilson L. Hernandez, Kim K. McCollow, Bruce J. Gerbi, Patrick D. Higgins, Chung K. Lee, Kathryn E. Dusenbery
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 29 / Issue 3 / August 2002
- Published online by Cambridge University Press:
- 02 December 2014, pp. 240-248
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Objective:
To evaluate the safety and efficacy of stereotactic radiosurgery (SRS) compared to fractionated stereotactic radiation therapy (FSRT) for meningiomas treated over a seven year period.
Methods and materials:Of the 53 patients (15 male and 38 female) with 63 meningiomas, 35 were treated with SRS and the 18 patients with tumors adjacent to critical structures or with large tumors were treated with FSRT. The median doses for the SRS and the FSRT groups were 1400 cGy (500- 4500 cGy) and 5400 cGy (4000-6000 cGy) respectively. Median target volumes for SRS and FSRT were 6.8 ml and 8.8 ml respectively. The median follow-up for the SRS and FSRT groups were 38 months (4.1-97 months) and 30.5 months (6.0-63 months) respectively.
Results:The five-year tumor control probability (TC) for benign versus atypical meningiomas were 92.7% vs. 31% (P=.006). The three-year TC were 92.7% vs. 93.3% for SRS vs. FSRT groups respectively (P=.62). For benign meningiomas, the three-year TC were 92.9% vs. 92.3% for the SRS group (29 patients) vs. FSRT group (14 patients) respectively (P=.77). Two patients in the SRS group and one in the FSRT group developed late complications.
Conclusion:Preliminary data suggest that SRS is a safe and effective treatment for patients with benign meningiomas. Fractionated stereotactic radiation therapy with conventional fractionation appeared to be an effective and safe treatment alternative for patients not appropriate for SRS. A longer follow-up is required to determine the long-term efficacy and the toxicity of these treatment modalities.
Environmental Effects on the Single Molecule Conductance of bis(thiahexyl)oligothiophenes
- Edmund Leary, Horst Höbenreich, Simon J. Higgins, Harm van Zalinge, Wolfgang Haiss, Richard J. Nichols, Christopher Finch, Iain Grace, Colin J. Lambert
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- Journal:
- MRS Online Proceedings Library Archive / Volume 1154 / 2009
- Published online by Cambridge University Press:
- 31 January 2011, 1154-B04-02
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- 2009
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Simple alkanedithiols exhibit the same molecular conductance whether measured in air, under vacuum or under liquids of different polarity. Here, we show that the presence of water ‘gates’ the conductance of a family of oligothiophene–containing molecular wires, and that the longer the oligothiophene, the larger is the effect; for the longest example studied, the molecular conductance is over two orders of magnitude larger in the presence of water, an unprecedented result suggesting that ambient water is a crucial factor to be taken into account when measuring single molecule conductances (SMC), or in the design of future molecular electronic devices. Theoretical investigation of electron transport through the molecules, using the ab initio non-equilibrium Green's function (SMEAGOL) method, shows that water molecules interact with the thiophene rings, shifting the transport resonances enough to increase greatly the SMC of the longer, more conjugated examples.
Can social prescribing provide the missing link?
- Jane South, Tracy J. Higgins, James Woodall, Simon M. White
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- Journal:
- Primary Health Care Research & Development / Volume 9 / Issue 4 / October 2008
- Published online by Cambridge University Press:
- 01 October 2008, pp. 310-318
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Background
The voluntary sector has long been recognised as making an important contribution to individual and community health. In the UK, however, the links between primary health care services and the voluntary and community sector are often underdeveloped. Social prescribing is an innovative approach, which aims to promote the use of the voluntary sector within primary health care. Social prescribing involves the creation of referral pathways that allow primary health care patients with non-clinical needs to be directed to local voluntary services and community groups. Such schemes typically use community development workers with local knowledge who are linked to primary health care settings. Social prescribing therefore has the potential to assist individual patients presenting with social needs to access health resources and social support outside of the National Health Service.
AimThe aim of this paper is to explore the concept of social prescribing and discuss its value as a public health initiative embedded within general practice.
MethodsThe rationale for social prescribing and existing evidence are briefly reviewed. The paper draws on a case study of a pilot social prescribing scheme based in general practice. Data collected during the development, implementation and evaluation of the scheme are used to illustrate the opportunities and limitations for development in UK primary health care.
FindingsThe potential for social prescribing to provide a mediating mechanism between different sectors and address social need is discussed. The paper argues that social prescribing can successfully extend the boundaries of traditional general practice through bridging the gap between primary health care and the voluntary sector. The potential for wider health gain is critically examined. The paper concludes that social prescribing not only provides a means to alternative support but also acts as a mechanism to strengthen community–professional partnerships. More research is needed on the benefits to patients and professionals.
Variable Temperature Capacitance-Voltage Measurements to Investigate the Density of Localized Trapping Levels in Organic Semiconductors
- Naser Sedghi, David Donaghy, Munira Raja, Samer Badriya, Simon J. Higgins, Bill Eccleston
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- Journal:
- MRS Online Proceedings Library Archive / Volume 905 / 2005
- Published online by Cambridge University Press:
- 26 February 2011, 0905-DD06-02
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- 2005
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We have approximated the tail of the Gaussian distribution of states of organic semiconduc-tors with an exponential function. We have used this approach to calculate the carrier concentra-tion in organic materials, and subsequently the charge distribution in the accumulation region of a field effect device and the space-charge capacitance in accumulation mode. Small signal high frequency capacitance-voltage measurements performed at various temperatures show good agreement with this model and the characteristic temperature of the exponential function has been estimated from these measurements based on the theory developed.
Functionalized Regioregular Polyalkylthiophenes for Biosensing Applications
- Simon J. Higgins, Fouzi Mouffouk, Stewart J. Brown, Naser Sedghi, Bill Eccleston, Stuart Reeman
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- Journal:
- MRS Online Proceedings Library Archive / Volume 871 / 2005
- Published online by Cambridge University Press:
- 01 February 2011, I1.3
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- 2005
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A regioregular copolymer of 3–hexylthiophene and 3–(6–hydroxyhexan–1yl)thiophene has been functionalised with biotin hydrazide; binding of avidin to the biotin moieties causes drastic changes to the absorption spectrum of the polymer in solution, and to the electrochemistry and conductivity of the polymer in thin films.
A TFT Strategy for Polymer Circuits
- Naser Sedghi, Munira Raja, Giles C. R. Lloyd, Iain Liversedge, Simon J. Higgins, Bill Eccleston
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- Journal:
- MRS Online Proceedings Library Archive / Volume 734 / 2002
- Published online by Cambridge University Press:
- 11 February 2011, B9.59
- Print publication:
- 2002
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Although integrated circuit design principles are well understood, they lead to the possibility of radically new modes of device operation when applied to conjugated polymers. Design for speed is very important, even when this is not a primary requirement for a particular application, since supply voltage can be reduced and with it power dissipation. For all-polymer circuits, on thermally insulating plastic substrates, device operating temperature will also be reduced. This has implications for device stability. There are a number of factors that are important in increasing circuit speed. Reduction of channel length must be accompanied by a reduction of gate overlap capacitance and this makes the conventional versions of bottom gate TFT perform badly. Vertical devices are a particularly attractive proposition providing that off-currents can be maintained at a low level. One approach is to use Schottky barriers as the source and drain. Examples will be explained, as will the very unusual mode of operation of such devices. Optimum load structures will also be defined.
Critical Considerations in Polymer Thin-Film Transistor (TFT) Dielectrics
- Munira Raja, Giles Lloyd, Naser Sedghi, Simon J. Higgins, William Eccleston
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- Journal:
- MRS Online Proceedings Library Archive / Volume 725 / 2002
- Published online by Cambridge University Press:
- 01 February 2011, P6.5
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- 2002
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We present a study of aqueous and plasma anodised aluminium oxide (Al2O3) and its performance in thin film transistors (TFTs). The current through the oxide was measured with aluminium electrodes and with one of the electrode replaced by poly(3-hexylthiophene)(P3HT). The current increased by up to 2 orders of magnitude with P3HT. The current increased further when the polymer was doped with different percentages of 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ). It was also found to be dependent on the thickness of the polymer film. Surprisingly, the oxide current fell to its initial value when the polymer film was removed. Two mechanisms may explain the behaviour in these devices: charge injection and/or displacement. C-V plots were obtained from the MOS capacitors and were frequency dependent. They also showed substantial hysteresis, with a lateral shift along the voltage axis. This indicates the presence of a mobile species that increases with the concentration of dopant. We deduce that much of the increased gate current is associated with displacement currents induced by ion motion.
The Benefits of High-K dielectrics for Polymer TFTs
- Munira Raja, Naser Sedghi, Simon J. Higgins, W. Eccleston
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- Journal:
- MRS Online Proceedings Library Archive / Volume 734 / 2002
- Published online by Cambridge University Press:
- 11 February 2011, B9.1
- Print publication:
- 2002
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An increasing range of high-K dielectric is becoming available and it is very worth considering incorporating them into polymer TFTs. One of the benefits is that if metal gates are used then aqueous anodisation provides a very simple approach that is compatible with solution based processing. The details of this process are described. High-K dielectrics reduce threshold voltage and, therefore, increase switching speed. Of particular importance is the problem of bias instability. All the results involve the fractionation and controlled doping of poly-3-hexylthiophene.
Improved Thin Film Transistor (TFT) performance using fractionated Poly-3-hexylthiophene (P3HT)
- Munira Raja, Giles Lloyd, Naser Sedghi, Rafaella di Lucrezia, Simon J. Higgins, W. Eccleston
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- Journal:
- MRS Online Proceedings Library Archive / Volume 708 / 2001
- Published online by Cambridge University Press:
- 15 March 2011, BB10.56
- Print publication:
- 2001
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By using the Trznadel method, it has been possible to increase molecular weight, the regio-regularity, and probably to decrease the residual catalyst of poly-3-hexylthiophene thin films. The drift mobility of holes, normal to the surface of cast films, in air, has been found using Schottky diodes, and field-effect mobility has been measured with Thin-Film Transistors. Three types of film have been studied using the two methods of assessing mobility. The as-synthesised films are compared with those that have been fractionated. The third set of films involves doping with 2,3-dichloro-5,6-dicyano-1,4-benzoquinone (DDQ). The doped films show a field effect mobility of 0.2 cm2V-1s-1: all others being lower. Field effect mobility is approximately two orders of magnitude greater than that in the bulk normal to the plane of the film. Doping levels in the films are found to be similar, probably because of the process conditions.