Assessing medication adherence and healthcare utilization and cost patterns among hospital-discharged patients with schizoaffective disorder.

PubMed

Karve, Sudeep; Markowitz, Michael; Fu, Dong-Jing; Lindenmayer, Jean-Pierre; Wang, Chi-Chuan; Candrilli, Sean D; Alphs, Larry

2014-06-01

Hospital-discharged patients with schizoaffective disorder have a high risk of re-hospitalization. However, limited data exist evaluating critical post-discharge periods during which the risk of re-hospitalization is significant. Among hospital-discharged patients with schizoaffective disorder, we assessed pharmacotherapy adherence and healthcare utilization and costs during sequential 60-day clinical periods before schizoaffective disorder-related hospitalization and post-hospital discharge. From the MarketScan(®) Medicaid database (2004-2008), we identified patients (≥18 years) with a schizoaffective disorder-related inpatient admission. Study measures including medication adherence and healthcare utilization and costs were assessed during sequential preadmission and post-discharge periods. We conducted univariate and multivariable regression analyses to compare schizoaffective disorder-related and all-cause healthcare utilization and costs (in 2010 US dollars) between each adjacent 60-day post-discharge periods. No adjustment was made for multiplicity. We identified 1,193 hospital-discharged patients with a mean age of 41 years. The mean medication adherence rate was 46% during the 60-day period prior to index inpatient admission, which improved to 80% during the 60-day post-discharge period. Following hospital discharge, schizoaffective disorder-related healthcare costs were significantly greater during the initial 60-day period compared with the 61- to 120-day post-discharge period (mean US$2,370 vs US$1,765; p < 0.001), with rehospitalization (36%) and pharmacy (40%) accounting for over three-fourths of the initial 60-day period costs. Compared with the initial 60-day post-discharge period, both all-cause and schizoaffective disorder-related costs declined during the 61- to 120-day post-discharge period and remained stable for the remaining post-discharge periods (days 121-365). We observed considerably lower (46%) adherence during 60 days prior to the inpatient admission; in comparison, adherence for the overall 6-month period was 8% (54%) higher. Our study findings suggest that both short-term (e.g., 60 days) and long-term (e.g., 6-12 months) medication adherence likely are important characteristics to examine among patients with schizoaffective disorder and help provide a more holistic view of patients' adherence patterns. Furthermore, we observed a high rate of rehospitalization and greater healthcare costs during the initial 60-day period post-discharge among patients with schizoaffective disorder. Further research is required to better understand and manage transitional care after discharge (e.g., monitor adherence), which may help reduce the likelihood of rehospitalization and the associated downstream costs.

Maternal Education Is Associated with Disparities in Breastfeeding at Time of Discharge but Not at Initiation of Enteral Feeding in the Neonatal Intensive Care Unit.

PubMed

Herich, Lena Carolin; Cuttini, Marina; Croci, Ileana; Franco, Francesco; Di Lallo, Domenico; Baronciani, Dante; Fares, Katia; Gargano, Giancarlo; Raponi, Massimiliano; Zeitlin, Jennifer

2017-03-01

To investigate the relationship between maternal education and breastfeeding in very preterm infants admitted to neonatal intensive care units. This prospective, population-based cohort study analyzed the data of all very preterm infants admitted to neonatal care during 1 year in 3 regions in Italy (Lazio, Emilia-Romagna, and Marche). The use of mothers' own milk was recorded at initial enteral feedings and at hospital discharge. We used multilevel logistic analysis to model the association between maternal education and breastfeeding outcomes, adjusting for maternal age and country of birth. Region was included as random effect. There were 1047 very preterm infants who received enteral feeding, and 975 were discharged alive. At discharge, the use of mother's own milk, exclusively or not, and feeding directly at the breast were significantly more likely for mothers with an upper secondary education or higher. We found no relationship between maternal education and type of milk at initial enteral feedings. However, the exclusive early use of the mother's own milk at initial feedings was related significantly with receiving any maternal milk and feeding directly at the breast at discharge from hospital, and the association with feeding at the breast was stronger for the least educated mothers. In this population-based cohort of very preterm infants, we found a significant and positive association between maternal education and the likelihood of receiving their mother's own milk at the time of discharge. In light of the proven benefits of maternal milk, strategies to support breastfeeding should be targeted to mothers with less education. Copyright © 2016 Elsevier Inc. All rights reserved.

An experimental investigation of a hollow cathode discharge

NASA Technical Reports Server (NTRS)

Wilbur, P. J.

1971-01-01

An experimental study of the effects of various modifications to the hollow cathode discharge region of a 20 cm electron bombardment ion thruster is presented. The introduction of electrical insulation between the main and cathode discharge regions is shown to have no significant effect on thruster performance. Adjustment of both the diameter and length of the cathode discharge region from the design condition are examined and the reduced sizes are shown to effect large improvements in propellant utilization when the thruster is operating at about 30% of the design thrust level. Performance improvements are shown to be less significant at higher thrust levels. The feasibility of using a high voltage tickler electrode to initiate the cathode-keeper discharge is considered and results obtained suggest this mode of startup is unsatisfactory.

Functional outcomes following the prosthetic training phase of rehabilitation after dysvascular lower extremity amputation

PubMed Central

Christiansen, Cory; Fields, Thomas; Lev, Guy; Stephenson, Ryan O.; Stevens-Lapsley, Jennifer E.

2015-01-01

Objective To describe physical function outcomes and modes of physical therapy intervention for a cohort of patients with dysvascular lower extremity amputation (LEA) during the prosthetic training phase of rehabilitation. Design A retrospective cohort study. Setting Physical rehabilitation clinics at a Veterans Affairs Medical Center and a University Hospital. Patients Forty-two patients (38 men, 4 women, age 60.2±8.4 years) who completed outpatient physical therapy rehabilitation with prosthetic training after dysvascular LEA. Methods All patients underwent a prosthetic training phase of rehabilitation, with standardized outcome measures performed at initiation and discharge. Main Outcome Measures Performance-based physical function measures included: Two-Minute Walk (2MW), Timed-Up and Go (TUG), and 5-meter gait speed. Self-report physical function measures included: the Prosthesis Evaluation Questionnaire – Mobility Section (PEQ-MS) and the Patient-Specific Functional Scale (PSFS). Rehabilitation dose was tracked as total number of clinic visits, rehabilitation duration, and specific intervention modes. Results There were significant improvements in 2MW (mean±SD) [67.5±29.9 m (initial) and 103.3±45.8 m (discharge) (p<0.001)], gait speed [0.58±0.27 m/s (initial) and 0.88±0.39 m/s (discharge) (p<0.001)], TUG [34.8±21.3 s (initial) and 18.6±13.9 s (discharge) (p<0.001)], PEQ-MS [2.2±0.9 (initial) and 2.8±0.8 (discharge) (p<0.001)], and PSFS [3.2±2.0 (initial) and 5.9±2.3 (discharge) (p<0.001)]. Performance-based (TUG) and self-report (PEQ-MS) changes in functional mobility from initial exam to discharge had low or no correlations with rehabilitation dose measures. Number of clinic visits was 12.7±13.1 and rehabilitation duration was 13.7±16.8 weeks. Conclusions Significant improvements in performance-based and self-report measures of physical function occurred during the prosthetic training phase of physical rehabilitation following dysvascular major LEA. Despite improvements in function, gait speed and TUG outcomes remained below clinically important thresholds, indicating patients were limited in community ambulation and at risk for falls. Lack of moderate or higher correlation between rehabilitation dose and outcome measures may indicate need for more specific rehabilitation dose measures. PMID:25978948

Supersonic CO electric-discharge lasers

NASA Technical Reports Server (NTRS)

Hason, R. K.; Mitchner, M.; Stanton, A.

1975-01-01

Laser modeling activity is described which involved addition of an option allowing N2 as a second diatomic gas. This option is now operational and a few test cases involving N2/CO mixtures were run. Results from these initial test cases are summarized. In the laboratory, a CW double-discharge test facility was constructed and tested. Features include: water-cooled removable electrodes, O-ring construction to facilitate cleaning and design modifications, increased discharge length, and addition of a post-discharge observation section. Preliminary tests with this facility using N2 yielded higher power loadings than obtained in the first-generation facility. Another test-section modification, recently made and as yet untested, will permit injection of secondary gases into the cathode boundary layer. The objective will be to vary and enhance the UV emission spectrum from the auxiliary discharge, thereby influencing the level of photoionization in the main discharge region.

Modelling of streamer ignition and propagation in the system of two approaching hydrometeors

NASA Astrophysics Data System (ADS)

Jansky, J.; Pasko, V. P.

2017-12-01

The lightning initiation in low thundercloud fields represents an unsolved problem in lightning discharge physics. One of the initial conditions required for formation of a hot leader channel is initiation of non-thermal streamer discharges. Streamers can be initiated from electron avalanches, however, the problem of existence of an electric field strong enough for streamer initiation in thunderclouds is still open. The maximum electric field in thunderstorms measured by balloons is typically 3-4 kV cm-1 atm-1, that is significantly smaller than the breakdown electric field needed for avalanche multiplication of electrons Ek≃28.7 kV cm-1 atm-1. One of the possible explanations for the streamer corona initiation is that hydrometeors greatly intensify the local electric field by at least an order of magnitude to initiate an electron avalanche. It was suggested that a particle pair or chain create more favorable conditions for initiation of lightning discharge than a single precipitation particle in low electric fields. Recently Cai et al. [GRL, 44, 5758-5765, 2017] analyzed the ignition conditions for two hydrometeors of same radii. In the present work we use streamer fluid model to study streamer initiation scenarios in a system of two hydrometeors with different radii. When the hydrometeors are approaching the Townsend discharge may develop first between them. Then the Townsend discharge transforms to streamer and two hydrometeors connect electrically, which leads to increase of the electric field on the outside hemispheres of hydrometeors. This increase of field for two particles of same radii was analyzed by Cooray et al. [Proceedings of 24th International Conference on Lightning Protection, Birmingham, United Kingdom, 1998]. The combination of small and large hydrometeors leads to higher enhancement on the outside of small hydrometeor. Simulation results show that streamer ignites there and propagates away from two hydrometeors. The streamer ignites at fields below Meek criterion due to the effects of photoionization feedback [Naidis, JPD, 38, 2211-2214, 2005; Liu et al., JASTP, 80, 179-186, 2012].

Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction: a randomized controlled trial.

PubMed

Peixoto, Thatiana C A; Begot, Isis; Bolzan, Douglas W; Machado, Lais; Reis, Michel S; Papa, Valeria; Carvalho, Antonio C C; Arena, Ross; Gomes, Walter J; Guizilini, Solange

2015-03-01

The purpose of this study was to evaluate the influence of an early cardiac rehabilitation (CR) program on health-related quality of life (HRQL) and functional capacity in patients who recently experienced an acute myocardial infarction (AMI). This program was initiated in the inpatient setting and was followed by an unsupervised outpatient intervention. After the same inpatient care plan, low-risk patients who experienced an AMI were randomized into 2 groups: (1) a control group (CG) (n = 43) entailing usual care and (2) an intervention group (IG) (n = 45) entailing outpatient (unsupervised) CR primarily centered on a progressive walking program. Initially, all patients underwent a supervised exercise program with early mobilization beginning 12 hours after an AMI. On hospital discharge, all patients were classified according to cardiovascular risk. Quality of life was evaluated by the MacNew Heart Disease HRQL questionnaire 30 days after discharge. Functional capacity was determined by a 6-minute walk test (6MWT) distance on the day of inpatient discharge as well as 30 days afterward. The HRQL global score was higher in the IG compared with the CG 30 days after discharge (P < 0.001); physical and emotional domain scores were both significantly higher in the IG (P < 0.001). Furthermore, the IG showed a greater 6MWT distance compared with the CG (P < 0.001). A CR program based on early progressive exercises, initiated by supervised inpatient training and followed by an unsupervised outpatient program, improved HRQL and functional capacity in patients at low cardiovascular risk who recently experienced an AMI. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Correlation between charge input and cycle life of MgNi electrode for Ni-MH batteries

NASA Astrophysics Data System (ADS)

Ruggeri, Stéphane; Roué, Lionel

Amorphous MgNi material has been prepared by mechanically alloying magnesium and nickel powders for 10 h. Its cycle life as a negative electrode for nickel-metal hydride (Ni-MH) batteries has been studied with charge inputs varying from 0 to 600 mAh/g. For charge inputs lower than 400 mAh/g, the first cycle discharge capacity is superior to the charge input capacity. This surplus discharge capacity can be associated with the alloy oxidation to Mg(OH) 2 and Ni(OH) 2. For charge inputs higher than 400 mAh/g, the initial discharge capacity becomes inferior to the charge input capacity due to the progressive decrease of the charge efficiency related to the hydrogen evolution side reaction. From the second charge/discharge cycle, no additional discharge capacity appears and no discharge capacity degradation occurs for charge inputs inferior or equal to 233 mAh/g. In contrast, for higher charge input values, an important decay in the discharge capacity appears, which is accentuated with increasing charge input. The thresholds charge input of 233 mAh/g corresponds to an amount of hydrogen absorbed into the alloy of 0.8 wt.% (MgNiH 0.7). For higher absorbed hydrogen amounts, it is assumed that extended electrode pulverization occurs, which breaks the passive surface layer of Mg(OH) 2 formed during the first charge/discharge cycle. This creates unprotected fresh MgNi surfaces and consequently, leads to electrode capacity degradation. The stability of the MgNi electrode for absorbed hydrogen content lower than 0.8 wt.% may be related to its amorphous character, which favors a gradual volume expansion upon hydrogen absorption in contrast to crystalline compounds characterized by an abrupt α-to-β lattice expansion.

Cambridge community Optometry Glaucoma Scheme.

PubMed

Keenan, Jonathan; Shahid, Humma; Bourne, Rupert R; White, Andrew J; Martin, Keith R

2015-04-01

With a higher life expectancy, there is an increased demand for hospital glaucoma services in the United Kingdom. The Cambridge community Optometry Glaucoma Scheme (COGS) was initiated in 2010, where new referrals for suspected glaucoma are evaluated by community optometrists with a special interest in glaucoma, with virtual electronic review and validation by a consultant ophthalmologist with special interest in glaucoma. 1733 patients were evaluated by this scheme between 2010 and 2013. Clinical assessment is performed by the optometrist at a remote site. Goldmann applanation tonometry, pachymetry, monoscopic colour optic disc photographs and automated Humphrey visual field testing are performed. A clinical decision is made as to whether a patient has glaucoma or is a suspect, and referred on or discharged as a false positive referral. The clinical findings, optic disc photographs and visual field test results are transmitted electronically for virtual review by a consultant ophthalmologist. The number of false positive referrals from initial referral into the scheme. Of the patients, 46.6% were discharged at assessment and a further 5.7% were discharged following virtual review. Of the patients initially discharged, 2.8% were recalled following virtual review. Following assessment at the hospital, a further 10.5% were discharged after a single visit. The COGS community-based glaucoma screening programme is a safe and effective way of evaluating glaucoma referrals in the community and reducing false-positive referrals for glaucoma into the hospital system. © 2014 Royal Australian and New Zealand College of Ophthalmologists.

Process Performances of 2 ns Pulsed Discharge Plasma

NASA Astrophysics Data System (ADS)

Matsumoto, Takao; Wang, Douyan; Namihira, Takao; Akiyama, Hidenori

2011-08-01

Pulsed discharge plasmas have been used to treat exhaust gases. Since pulse duration and the rise time of applied voltage to the discharge electrode has a strong influence on the energy efficiency of pollutant removal, the development of a short-pulse generator is of paramount importance for practical applications. In this work, it is demonstrated that the non thermal plasma produced by the 2 ns pulsed discharge has a higher energy efficiency than the 5 ns pulsed discharge plasma for NO removal and ozone generation. Typically, the NO removal efficiency was 1.0 mol kW-1 h-1 for 70% NO removal (initial NO concentration = 200 ppm, gas flow = 10 L/min). Meanwhile, the ozone yield was 500 g kW-1 h-1 for 20 g/m3 ozone concentration in the case of oxygen feeding. These energy efficiencies are the highest in the literature.

Performance of a green propellant thruster with discharge plasma

NASA Astrophysics Data System (ADS)

Shindo, Takahiro; Wada, Asato; Maeda, Hiroshi; Watanabe, Hiroki; Takegahara, Haruki

2017-02-01

A discharge plasma was applied to initiate the combustion of a hydroxylammonium nitrate-based propellant as a substitute for the catalysts that are typically employed. The resulting thrust and thrust-to-power ratio during short interval firing tests as well as the chamber pressure with a single pulse discharge were evaluated. A 1.5-s firing test generated a maximum thrust of 322 mN along with a thrust-to-power ratio of 0.95 mN/W. During the single-pulse discharge trials, pulsed discharge capacitor energies of 5.4, 10.8, and 16.4 J were assessed, and the maximum chamber pressure was found to increase as the energy was raised. The maximum chamber pressures varied widely between experimental trials, and a 16.4-J energy value resulted in the highest chamber pressure of over 1 MPaG. The time spans between the pulsed discharge and the peak chamber pressure were in the range of 1-2 ms, representing a chamber pressure increase rate much higher than those obtained with standard catalysts.

Death after discharge: predictors of mortality in older brain-injured patients.

PubMed

Peck, Kimberly A; Calvo, Richard Y; Sise, C Beth; Johnson, Jeffrey; Yen, Jessica W; Sise, Michael J; Dunne, Casey E; Badiee, Jayraan; Shackford, Steven R; Lobatz, Michael A

2014-12-01

Older patients with traumatic brain injury (TBI) may be at high risk of death after hospitalization. The purpose of this study was to characterize long-term mortality of older TBI patients who survived to discharge. We hypothesized that predictors of postdischarge mortality differed from those of inpatient mortality. A retrospective cohort study was performed on TBI patients older than 55 years admitted to our Level I trauma center between July 1, 2006, and December 31, 2011. Postdischarge deaths were identified by matching patient data with local vital records up to December 31, 2011, when data collection was terminated (censoring). Patients were categorized by age, comorbidities, history of preinjury anticoagulant/prescription antiplatelet agent therapy, injury severity indices, initial TBI type, prehospital living status, discharge location, and discharge condition. The effect of risk factors on postdischarge mortality was evaluated by Cox proportional hazards modeling. Of 353 patients, 322 (91.2%) survived to discharge. Postdischarge mortality was 19.8% (n = 63) for the study period. Of the postdischarge deaths, 54.0% died within 6 months of discharge, and 68.3% died within 1 year. Median days to death after discharge or censoring were 149 and 410, respectively. Factors associated with death after discharge included age, preinjury anticoagulant use, higher number of Charlson comorbidities, discharge to a long-term care facility, and severe disability. Factors related to injury severity (i.e., Injury Severity Score [ISS], initial Glasgow Coma Scale [GCS] score) and preinjury prescription antiplatelet agent use, previously found to predict inpatient death, did not predict postdischarge mortality. Older TBI patients who survive to discharge have a significant risk of death within 1 year. Predictors of postdischarge mortality and inpatient death differ. Death after discharge is largely a function of overall health status. Monitoring health status and continued aggressive management of comorbidities after discharge may be essential in determining long-term outcomes. Epidemiologic study, level III.

Corona discharges from a windmill and its lightning protection tower in winter thunderstorms

NASA Astrophysics Data System (ADS)

Wu, Ting; Wang, Daohong; Rison, William; Thomas, Ronald J.; Edens, Harald E.; Takagi, Nobuyuki; Krehbiel, Paul R.

2017-05-01

This paper presents lightning mapping array (LMA) observations of corona discharges from a windmill and its lightning protection tower in winter thunderstorms in Japan. Corona discharges from the windmill, called windmill coronas, and those from the tower, called tower coronas, are distinctly different. Windmill coronas occur with periodic bursts, generally radiate larger power, and possibly develop to higher altitudes than tower coronas do. A strong negative electric field is necessary for the frequent production of tower coronas but is not apparently related with windmill coronas. These differences are due to the periodic rotation of the windmill and the moving blades which can escape space charges produced by corona discharges and sustain a large local electric field. The production period of windmill coronas is related with the rotation period of the windmill. Surprisingly, for one rotation of the windmill, only two out of the three blades produce detectable discharges and source powers of discharges from these two blades are different. The reason for this phenomenon is still unclear. For tower coronas, the source rate can get very high only when there is a strong negative electric field, and the source power can get very high only when the source rate is very low. The relationship between corona discharges and lightning flashes is investigated. There is no direct evidence that corona discharges can increase the chance of upward leader initiation, but nearby lightning flashes can increase the source rate of corona discharges right after the flashes. The peak of the source height distribution of corona discharges is about 100 m higher than the top of the windmill and the top of the tower. Possible reasons for this result are discussed.

Lightweight fibrous nickel electrodes for nickel-hydrogen batteries

NASA Technical Reports Server (NTRS)

Britton, Doris L.

1989-01-01

The NASA Lewis Research Center is currently developing nickel electrodes for nickel-hydrogen batteries. These electrodes are lighter in weight and have higher energy densities than the heavier state-of-the-art sintered nickel electrodes. Lightweight fibrous materials or plaques are used as conductive supports for the nickel hydroxide active material. These materials are commercial products that are fabricated into nickel electrodes by electrochemically impregnating them with active material. Evaluation is performed in half cells structured in the bipolar configuration. Initial performance tests include capacity measurements at five discharge levels, C/2, 1.0C, 1.37C, 2.0C, and 2.74C. The electrodes that pass the initial tests are life cycle-tested in a low Earth orbit regime at 80 percent depth of discharge.

Secondary health conditions in persons with spinal cord injury: a longitudinal study from one to five years post-discharge.

PubMed

Adriaansen, Jacinthe J E; Post, Marcel W M; de Groot, Sonja; van Asbeck, Floris W A; Stolwijk-Swüste, Janneke M; Tepper, Marga; Lindeman, Eline

2013-11-01

To assess the occurrence of secondary health conditions and their potential risk factors in persons with spinal cord injury from 1 to 5 years after discharge from initial inpatient rehabilitation. Multicentre longitudinal study. A total of 139 wheelchair-dependent persons with spinal cord injury. The occurrence of secondary health conditions and their potential risk factors were assessed in a clinical interview with a rehabilitation physician at 1 and 5 years after discharge from inpatient rehabilitation and by a telephone interview 2 years after discharge. Self-report questionnaires were used for the assessment of musculoskeletal and neuropathic pain. Neuropathic pain (83.7-92.1%), musculoskeletal pain (62.3-87.1%) and urinary tract infection (56.5-58.9%) were the most frequently reported secondary health conditions. The occurrence of several secondary health conditions was higher among women and individuals with a complete lesion, tetraplegia, and with a higher body mass index. Secondary health conditions are common in the first years post-discharge following spinal cord injury, and their course seems to be relatively stable. These results emphasize the number of health issues that must be considered during post-injury care of persons with spinal cord injury living in the community, and the importance of a well-coordinated interdisciplinary approach from specialized rehabilitation centres.

Electro-Hydrodynamics and Kinetic Modeling of Dry and Humid Air Flows Activated by Corona Discharges

NASA Astrophysics Data System (ADS)

P. Sarrette, J.; Eichwald, O.; Marchal, F.; Ducasse, O.; Yousfi, M.

2016-05-01

The present work is devoted to the 2D simulation of a point-to-plane Atmospheric Corona Discharge Reactor (ACDR) powered by a DC high voltage supply. The corona reactor is periodically crossed by thin mono filamentary streamers with a natural repetition frequency of some tens of kHz. The study compares the results obtained in dry air and in air mixed with a small amount of water vapour (humid air). The simulation involves the electro-dynamics, chemical kinetics and neutral gas hydrodynamics phenomena that influence the kinetics of the chemical species transformation. Each discharge lasts about one hundred of a nanosecond while the post-discharge occurring between two successive discharges lasts one hundred of a microsecond. The ACDR is crossed by a lateral dry or humid air flow initially polluted with 400 ppm of NO. After 5 ms, the time corresponding to the occurrence of 50 successive discharge/post-discharge phases, a higher NO removal rate and a lower ozone production rate are found in humid air. This change is due to the presence of the HO2 species formed from the H primary radical in the discharge zone.

The impact of discharge plan upon re-admission, satisfaction with nursing care and the ability to self-care for coronary artery bypass graft surgery patients.

PubMed

Negarandeh, Reza; Nayeri, Nahid Dehghan; Shirani, Farimah; Janani, Leila

2012-12-01

Grafting coronary arteries and post operative recovery has many challenges, which can be ameliorated through continues care and an appropriate discharge plan. Therefore, the current study was undertaken aiming to evaluate the impact of discharge plan on satisfaction with nursing care, ability to self-care, and incidence of re-admission. This is a quasi experimental study involving patients who were due to undergo coronary artery bypass graft in Chamran Hospital in 2010. In the intervention group, the discharge plan was initiated at the time of admission and continued for 2 weeks after discharge by home visit and telephone follow ups. Satisfaction with nursing care was assessed 2 days after discharge, whilst patients' ability for self-care was measured 6 weeks and 3 months post discharge and the incidence of re-admission was determined at the 3 months point. Satisfaction levels with nursing care and the ability to take self-care were higher in intervention group comparing with control group (p < 0.001). There was a significant difference for self-care ability between pre test and post test in both groups but the improvement was more pronounced for the intervention group (p = 0.04). There was no significant difference between the two groups in terms of re-admission incidence after 3 months (p = 0.15). The results indicate that the discharge plan, as a method of continual care plan, can lead to higher satisfaction levels and enhanced self-care abilities of patients. Such discharge plan can therefore be utilised as an effective method of continuous care for patients who are going to undergo coronary artery bypass graft.

Increased freshwater discharge shifts the trophic balance in the coastal zone of the northern Baltic Sea

PubMed Central

Wikner, Johan; Andersson, Agneta

2012-01-01

Increased precipitation is one projected outcome of climate change that may enhance the discharge of freshwater to the coastal zone. The resulting lower salinity, and associated discharge of both nutrients and dissolved organic carbon, may influence food web functioning. The scope of this study was to determine the net outcome of increased freshwater discharge on the balance between auto- and heterotrophic processes in the coastal zone. By using long-term ecological time series data covering 13 years, we show that increased river discharge suppresses phytoplankton biomass production and shifts the carbon flow towards microbial heterotrophy. A 76% increase in freshwater discharge resulted in a 2.2 times higher ratio of bacterio- to phytoplankton production (Pb:Pp). The level of Pb:Pp is a function of riverine total organic carbon supply to the coastal zone. This is mainly due to the negative effect of freshwater and total organic carbon discharge on phytoplankton growth, despite a concomitant increase in discharge of nitrogen and phosphorus. With a time lag of 2 years the bacterial production recovered after an initial decline, further synergistically elevating the microbial heterotrophy. Current climate change projections suggesting increased precipitation may therefore lead to increased microbial heterotrophy, thereby decreasing the transfer efficiency of biomass to higher trophic levels. This prognosis would suggest reduced fish production and lower sedimentation rates of phytoplankton, a factor of detriment to benthic fauna. Our findings show that discharge of freshwater and total organic carbon significantly contributes to the balance of coastal processes at large spatial and temporal scales, and that model's would be greatly augmented by the inclusion of these environmental drivers as regulators of coastal productivity.

Home Antibiotics at Discharge for Pediatric Complicated Appendicitis: Friend or Foe?

PubMed

Anderson, K Tinsley; Bartz-Kurycki, Marisa A; Kawaguchi, Akemi L; Austin, Mary T; Holzmann-Pazgal, Galit; Kao, Lillian S; Lally, Kevin P; Tsao, Kuojen

2018-04-20

The role of home antibiotics (HA) at discharge in children after perforated appendicitis is unclear. This study evaluates the outcomes of complicated appendicitis in patients being discharged with or without HA after initial operation and inpatient treatment. The 2015 and 2016 NSQIP-Pediatric database was queried for patients younger than 18 years of age with complicated appendicitis. Home antibiotics were prescribed or not (no home antibiotics [NHA]). Patients were stratified based on presence or absence of predischarge surgical site infection (SSI) and postoperative day of discharge (≤5 days or >5 days). The primary end point was 30-day postdischarge composite morbidity, including emergency department visit, readmission, postdischarge reoperation, and SSI. Multivariable logistic regression was used to adjust for baseline covariables. Of 6,412 patients with complicated appendicitis, the majority were discharged with HA (HA 56.4%; NHA 43.6%). Patients receiving HA had higher preoperative leukocytosis, longer procedures, higher incidence of sepsis, more predischarge SSIs, and longer length of stay than the NHA cohort (all p < 0.01), suggesting greater severity of illness. In adjusted multivariable models, HA patients without a predischarge SSI had higher postdischarge morbidity (adjusted odds ratio [aOR] 1.22; 95% CI 1.04 to 1.44), as did HA patients discharged ≤5 days post operation (aOR 1.28; 95% CI 1.04 to 1.57) compared with NHA patients. Composite morbidity was similar between NHA and HA patients with predischarge SSIs (aOR 1.06; 95% CI 0.56 to 2.00) or who were discharged >5 days post operation (aOR 1.14; 95% CI 0.89 to 1.46). Although the majority of pediatric patients with complicated appendicitis are discharged with HA, NSQIP-Pediatric data suggest there is no evidence of a significant benefit. There might be a cohort of patients with more severe disease who require continued antibiotics. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Xenon plasma sustained by pulse-periodic laser radiation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rudoy, I. G.; Solovyov, N. G.; Soroka, A. M.

2015-10-15

The possibility of sustaining a quasi-stationary pulse-periodic optical discharge (POD) in xenon at a pressure of p = 10–20 bar in a focused 1.07-μm Yb{sup 3+} laser beam with a pulse repetition rate of f{sub rep} ⩾ 2 kHz, pulse duration of τ ⩾ 200 μs, and power of P = 200–300 W has been demonstrated. In the plasma development phase, the POD pulse brightness is generally several times higher than the stationary brightness of a continuous optical discharge at the same laser power, which indicates a higher plasma temperature in the POD regime. Upon termination of the laser pulse,more » plasma recombines and is then reinitiated in the next pulse. The initial absorption of laser radiation in successive POD pulses is provided by 5p{sup 5}6s excited states of xenon atoms. This kind of discharge can be applied in plasma-based high-brightness broadband light sources.« less

Efficacy of Early Rehabilitation After Surgical Repair of Acute Aneurysmal Subarachnoid Hemorrhage: Outcomes After Verticalization on Days 2-5 Versus Day 12 Post-Bleeding.

PubMed

Milovanovic, Andjela; Grujicic, Danica; Bogosavljevic, Vojislav; Jokovic, Milos; Mujovic, Natasa; Markovic, Ivana Petronic

2017-01-01

To develop a specific rehabilitation protocol for patients who have undergone surgical repair of acute aneurysmal subarachnoid hemorrhage (aSAH), and to determine the time at which verticalization should be initiated after aSAH. Sixty-five patients who underwent acute-term surgery for aSAH and early rehabilitation were evaluated in groups: Group 1 (n=34) started verticalization on days 2-5 post-bleeding whereas Group 2 (n=31) started verticalization approximately day 12 post-bleeding. All patients were monitored for early complications, vasospasm and ischemia. Assessments of motor status, depression and anxiety (using Zung scales), and cognitive status (using the Mini-Mental State Examination (MMSE)) were conducted at discharge and at 1 and 3 months post-surgery. At discharge, Group 1 had a significantly higher proportion of patients with ischemia than Group 2 (p=0.004). Group 1 had a higher proportion of patients with hemiparesis than Group 2 three months post-surgery (p=0.015). Group 1 patients scored significantly higher on the Zung depression scale than Group 2 patients at 1 month (p=0.005) and 3 months post-surgery (p=0.001; the same applies to the Zung anxiety scale (p=0.006 and p=0.000, respectively). Group 2 patients scored significantly higher on the MMSE than those in Group 1 at discharge (p=0.040) and 1 month post-surgery (p=0.025). Early verticalization had no effect with respect to preventing early postoperative complications in this patient group. Once a patient has undergone acute surgical repair of aSAH, it is safe and preferred that rehabilitation be initiated immediately postsurgery. However, verticalization should not start prior to day 12 post-bleeding.

Television Image of a Large Upward Electrical Discharge Above a Thunderstorm System

NASA Astrophysics Data System (ADS)

Franz, R. C.; Nemzek, R. J.; Winckler, J. R.

1990-07-01

An image of an unusual luminous electrical discharge over a thunderstorm 250 kilometers from the observing site has been obtained with a low-light-level television camera. The discharge began at the cloud tops at 14 kilometers and extended into the clear air 20 kilometers higher. The image, which had a duration of less than 30 milliseconds, resembled two jets or fountains and was probably caused by two localized electric charge concentrations at the cloud tops. Large upward discharges may create a hazard for aircraft and rocket launches and, by penetrating into the ionosphere, may initiate whistler waves and other effects on a magnetospheric scale. Such upward electrical discharges may account for unexplained photometric observations of distant lightning events that showed a low rise rate of the luminous pulse and no electromagnetic sferic pulse of the type that accompanies cloud-to-earth lightning strokes. An unusually high rate of such photometric events was recorded during the night of 22 to 23 September 1989 during a storm associated with hurricane Hugo.

Television image of a large upward electrical discharge above a thunderstorm system.

PubMed

Franz, R C; Nemzek, R J; Winckler, J R

1990-07-06

An image of an unusual luminous electrical discharge over a thunderstorm 250 kilometers from the observing site has been obtained with a low-light-level television camera. The discharge began at the cloud tops at 14 kilometers and extended into the clear air 20 kilometers higher. The image, which had a duration of less than 30 milliseconds,resembled two jets or fountains and was probably caused by two localizd electric charge concentrations at the cloud tops. Large upward discharges may create a hazard for aircraft and rocket launches and, by penetrating into the ionosphere, may initiate whistler waves and other effects on a magnetospheric scale. Such upward electrical discharges may account for unexplained photometric observations of distant lightning events that showed a low rise rate of the luminous pulse and no electromagnetic sferic pulse of the type that accompanies cloud-to-earth lightning strokes. An unusually high rate of such photometric events was recorded during the night of 22 to 23 September 1989 during a storm associated with hurricane Hugo.

Water dissociation in a radio-frequency electromagnetic field with ex situ electrodes—modelling of discharge initiation

NASA Astrophysics Data System (ADS)

Schneider, Jens; Holzer, Frank; Rabe, Carsten; Häupl, Tilmann; Kopinke, Frank-Dieter; Roland, Ulf

2013-04-01

Applying a new experimental design with a capillary glass reactor and plate electrodes outside of the reactor allowed the initiation of discharges in aqueous electrolytes under the influence of a radio-frequency (RF) electromagnetic field. This study focused on the mechanism leading to the initiation of such discharges in the restriction of a glass tube. The light emission correlated with discharges was analysed with optical emission spectroscopy. Electrons with energies between 20 and 45 eV were responsible for the dissociation of water molecules into (excited) OH, H and O radicals. Current-voltage characteristics were measured before and under discharge conditions. Modelling of the experimental setup and simulation of electrical field strength distribution support the hypothesis of the origin of discharges in general and experimental findings such as ring-shaped discharges and a minimum solution conductivity of about 1 S m-1 required for discharge initiation with RF voltages of 2 kV.

Nontraditional Machining Guide, 26 Newcomers for Production

DTIC Science & Technology

1976-07-01

essential: Frequent coarse wheel dressing to maintain sharpness Lower wheel speeds (under 3500 sfpm) Lower infeed rates (0.0002 to 0.0005 inch per pass...Oil-base lubricants with good flow control Soft wheels (H, I or J grades) Higher table speeds (50 sfpm or more) Solid fixtures and well...the wheel and the workpiece as in ECG. Electrical discharges from the graphite wheel are initiated from the higher a-c voltage superimposed on

Treatment retention in a prison-based residential sex offender treatment program.

PubMed

Pelissier, Bernadette

2007-12-01

This study assessed the role of static factors, a dynamic factor (motivation to change sexually deviant behavior), and an administrative factor in predicting treatment retention within a prison-based sex offender treatment program. The analyses also included assessing differences in initial levels of motivation and differences in beginning-versus end-of-treatment motivation scores for various types of program discharges. The sample consisted of 251 individuals who were admitted to a residential prison-based sex offender treatment program where 46% completed the program. Paired comparison t-tests showed higher motivation scores at the end of treatment only among treatment completers. Multivariate analyses showed that treatment retention was associated with higher initial motivation scores, higher levels of education and admission to treatment within 3 months of initial commitment to prison. Implications for motivational enhancement programming as well as for changes in admission criteria are discussed.

Study on the characteristics of a two gap capillary discharge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, D.; Yang, L. J., E-mail: yanglj@mail.xjtu.edu.cn; Huo, P.

2015-02-15

The paper presents a new two-gap capillary (TGC) discharge structure. The prominent innovation is the introduction of the middle electrode, which divides the capillary into the trigger gap and the main gap. The discharge circuit of the TGC comprises the trigger circuit and the main circuit. The two circuits are used for the pre-ionization of the trigger gap and providing energy of 450 J for the main gap arc discharging, respectively. When the discharge initiates, the trigger gap is pre-ionized under high voltage pulse produced by trigger circuit, and meanwhile, the weakly ionized plasma is generated. The main circuit then maintainsmore » the expansion of the plasma, which is called soft capillary discharge. Afterwards, the main gap is shorted and discharges under a relatively low voltage. With the optimization of the circuit parameter, both the energy deposition ratio in main gap and the degree of plasma ionization are enhanced. The efficiency of the energy deposition is almost twice higher compared with that of the conventional capillary structure. The life performance test indicates that the erosion of the middle electrode and the trigger gap carbonization are the key factors that limit the life performance of the TGC.« less

Hemodilution after Initial Treatment in Patients with Acute Decompensated Heart Failure.

PubMed

Fujita, Teppei; Inomata, Takayuki; Yazaki, Mayu; Iida, Yuichiro; Kaida, Toyoji; Ikeda, Yuki; Nabeta, Takeru; Ishii, Shunsuke; Maekawa, Emi; Yanagisawa, Tomoyoshi; Koitabashi, Toshimi; Takeuchi, Ichiro; Ako, Junya

2018-05-09

Decongestion is an important goal of heart failure (HF) management. Blood cell concentration is a recognized indicator for guiding decongestive treatment for HF. We aimed to assess the clinical impact of hemodilution and hemoconcentration after initial treatment in acute decompensated HF (ADHF) patients. We retrospectively evaluated hemoglobin levels and body weight obtained before admission, on admission, 3 days after admission, and at discharge in 102 consecutive patients admitted with ADHF. Patients were then stratified into hemodilution (n = 55) and hemoconcentration (n = 47) groups based on whether their hemoglobin levels decreased or increased, respectively, during the first 3 days after admission. From before admission to admission, hemoglobin levels decreased less in the hemodilution group (-0.16 ± 0.98 g/dL) than in the hemoconcentration group (-0.88 ± 1.11 g/dL) (P < 0.001); however, there was no significant difference in body weight (P≥ 0.05). More patients in the hemodilution group (85%) had grade III/IV pulmonary edema (Turner's criteria) compared with the hemoconcentration group (63%) (P < 0.01). Rate of readmission for HF within 180 days of discharge was higher in the hemodilution group (34%) compared with the hemoconcentration group (9%) (P < 0.01). Hemodilution after initial treatment for ADHF was associated with severe pulmonary edema at admission and higher readmission rates.

The cloud-ionosphere discharge: a newly observed thunderstorm phenomenon.

PubMed

Winckler, J R

1997-09-30

This paper deals with a luminous electric discharge that forms in the mesospheric region between thundercloud tops and the ionosphere at 90-km altitude. These cloud-ionosphere discharges (CIs), following visual reports dating back to the 19th century, were finally imaged by a low-light TV camera as part of the "SKYFLASH" program at the University of Minnesota in 1989. Many observations were made by various groups in the period 1993-1996. The characteristics of CIs are that they have a wide range of sizes from a few kilometers up to 50 km horizontally; they extend from 40 km to nearly 90 km vertically, with an intense region near 60-70 km and streamers extending down toward cloud tops; the CIs are partly or entirely composed of vertical luminous filaments of kilometer size. The predominate color is red. The TV images show that the CIs usually have a duration less than one TV field (16.7 ms), but higher-speed photometric measurements show that they last about 3 ms, and are delayed 3 ms after an initiating cloud-ground lightning stroke; 95% of these initiating strokes are found to be "positive"-i.e., carry positive charges from clouds to ground. The preference for positive initiating strokes is not understood. Theories of the formation of CIs are briefly reviewed.

Hospitalist and Internal Medicine Leaders' Perspectives of Early Discharge Challenges at Academic Medical Centers.

PubMed

Patel, Hemali; Fang, Margaret C; Mourad, Michelle; Green, Adrienne; Wachter, Robert M; Murphy, Ryan D; Harrison, James D

2018-06-01

Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-based academic medical centers. We emailed each institutional representative a 30-item online survey regarding early-discharge initiatives. The survey included questions on discharge prioritization, the prevalence and effectiveness of early-discharge initiatives, and barriers to implementation. We received 61 responses from 115 institutions (53% response rate). Forty-seven (77%) "strongly agreed" or "agreed" that early discharge was a priority. "Discharge by noon" was the most cited goal (n = 23; 38%) followed by "no set time but overall goal for improvement" (n = 13; 21%). The majority of respondents reported early discharge as more important than obtaining translators for non-English-speaking patients and equally important as reducing 30-day readmissions and improving patient satisfaction. The most commonly reported factors delaying discharge were availability of postacute care beds (n = 48; 79%) and patient-related transport complications (n = 44; 72%). The most effective early discharge initiatives reported involved changes to the rounding process, such as preemptive identification and early preparation of discharge paperwork (n = 34; 56%) and communication with patients about anticipated discharge (n = 29; 48%). There is a strong interest in increasing early discharges in an effort to improve hospital throughput and patient flow. © 2017 Society of Hospital Medicine.

Towards Stable Lithium-Sulfur Batteries with a Low Self-Discharge Rate: Ion Diffusion Modulation and Anode Protection.

PubMed

Xu, Wen-Tao; Peng, Hong-Jie; Huang, Jia-Qi; Zhao, Chen-Zi; Cheng, Xin-Bing; Zhang, Qiang

2015-09-07

The self-discharge of a lithium-sulfur cell decreases the shelf-life of the battery and is one of the bottlenecks that hinders its practical applications. New insights into both the internal chemical reactions in a lithium-sulfur system and effective routes to retard self-discharge for highly stable batteries are crucial for the design of lithium-sulfur cells. Herein, a lithium-sulfur cell with a carbon nanotube/sulfur cathode and lithium-metal anode in lithium bis(trifluoromethanesulfonyl)imide/1,3-dioxolane/dimethyl ether electrolyte was selected as the model system to investigate the self-discharge behavior. Both lithium anode passivation and polysulfide anion diffusion suppression strategies are applied to reduce self-discharge of the lithium-sulfur cell. When the lithium-metal anode is protected by a high density passivation layer induced by LiNO3 , a very low shuttle constant of 0.017 h(-1) is achieved. The diffusion of the polysulfides is retarded by an ion-selective separator, and the shuttle constants decreased. The cell with LiNO3 additive maintained a discharge capacity of 97 % (961 mAh g(-1) ) of the initial capacity after 120 days at open circuit, which was around three times higher than the routine cell (32 % of initial capacity, corresponding to 320 mAh g(-1) ). It is expected that lithium-sulfur batteries with ultralow self-discharge rates may be fabricated through a combination of anode passivation and polysulfide shuttle control, as well as optimization of the lithium-sulfur cell configuration. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Effects of discharge parameters on the micro-hollow cathode sustained glow discharge

NASA Astrophysics Data System (ADS)

Shoujie, HE; Peng, WANG; Jing, HA; Baoming, ZHANG; Zhao, ZHANG; Qing, LI

2018-05-01

The effects of parameters such as pressure, first anode radius, and the cavity diameter on the micro-hollow cathode sustained glow discharge are investigated by using a two-dimensional self-consistent fluid model in pure argon. The results indicate that the three parameters influence the discharge in the regions inside and outside of the cavity. Under a fixed voltage on each electrode, a larger volume of high density plasma can be produced in the region between the first and the second anodes by selecting the appropriate pressure, the higher first anode, and the appropriate cavity diameter. As the pressure increases, the electron density inside the hollow cathode, the high density plasma volume between the first anode and second anodes, and the radial electric field in the cathode cavity initially increase and subsequently decrease. As the cavity diameter increases, the high-density plasma volume between the first and second anodes initially increases and subsequently decreases; whereas the electron density inside the hollow cathode decreases. As the first anode radius increases, the electron density increases both inside and outside of the cavity. Moreover, the increase of the electron density is more obvious in the microcathode sustained region than in the micro cavity region. The results reveal that the discharge inside the cavity interacts with that outside the cavity. The strong hollow cathode effect and the high-density plasma inside the cavity favor the formation of a sustained discharge between the first anode and the second anodes. Results also show that the radial boundary conditions exert a considerably weaker influence on the discharge except for a little change in the region close to the radial boundary.

Influence of Voltage Rise Time for Oxidation Treatment of NO in Simulated Exhausted Gas by Polarity-Reversed Pulse Discharge

NASA Astrophysics Data System (ADS)

Shinmoto, Kazuya; Kadowaki, Kazunori; Nishimoto, Sakae; Kitani, Isamu

This paper describes experimental study on NO removal from a simulated exhausted-gas using repetitive surface discharge on a glass barrier subjected to polarity-reversed voltage pulses. The very fast polarity-reversal with a rise time of 20ns is caused by direct grounding of a charged coaxial cable of 10m in length. Influence of voltage rise time on energy efficiency for NO removal is studied. Results of NO removal using a barrier-type plasma reactor with screw-plane electrode system indicates that the energy efficiency for the very fast polarity reversal caused by direct grounding becomes higher than that for the slower polarity reversal caused by grounding through an inductor at the cable end. The energy efficiency for the direct grounding is about 80g/kWh for 50% NO removal ratio and is about 60g/kWh for 100% NO removal ratio. Very intense discharge light is observed at the initial time of 10ns for the fast polarity reversal, whereas the intensity in the initial discharge light for the slower polarity reversal is relatively small. To confirm the effectiveness of the polarity-reversed pulse application, comparison of the energy efficiency between the polarity-reversed voltage pulse and ac 60Hz voltage will be presented.

A multi-electron redox mediator for redox-targeting lithium-sulfur flow batteries

NASA Astrophysics Data System (ADS)

Li, Guochun; Yang, Liuqing; Jiang, Xi; Zhang, Tianran; Lin, Haibin; Yao, Qiaofeng; Lee, Jim Yang

2018-02-01

The lithium-sulfur flow battery (LSFB) is a new addition to the rechargeable lithium flow batteries (LFBs) where sulfur or a sulfur compound is used as the cathode material against the lithium anode. We report here our evaluation of an organic sulfide - dimethyl trisulfide (DMTS), as 1) a catholyte of a LFB and 2) a multi-electron redox mediator for discharging and charging a solid sulfur cathode without any conductive additives. The latter configuration is also known as the redox-targeting lithium-sulfur flow battery (RTLSFB). The LFB provides an initial discharge capacity of 131.5 mAh g-1DMTS (1.66 A h L-1), which decreases to 59 mAh g-1DMTS (0.75 A h L-1) after 40 cycles. The RTLSFB delivers a significantly higher application performance - initial discharge capacity of 1225.3 mAh g-1sulfur (3.83 A h L-1), for which 1030.9 mAh g-1sulfur (3.23 A h L-1) is still available after 40 cycles. The significant increase in the discharge and charge duration of the LFB after sulfur addition indicates that DMTS is better used as a redox mediator in a RTLSFB than as a catholyte in a LFB.

The influence of gender on respiratory outcomes in children with bronchopulmonary dysplasia during the first 3 years of life.

PubMed

Collaco, Joseph M; Aherrera, Angela D; McGrath-Morrow, Sharon A

2017-02-01

Since premature males are more likely to be diagnosed with bronchopulmonary dysplasia we hypothesized that differences in respiratory outcomes after initial hospital discharge and during the first 3 years of life would exist between females and males diagnosed with BPD. Subjects with the diagnosis of BPD were recruited from the Johns Hopkins Bronchopulmonary Dysplasia Clinic between 2008 and 2014. Clinical features were assessed through chart review (n = 482). Respiratory morbidities were assessed by caregiver questionnaires at clinic visits (n = 429), including emergency department visits, hospital admissions, systemic steroid use, and antibiotic use for respiratory reasons since the last BPD clinic visit or after initial hospital discharge if assessed at the first visit. Male infants weighed significantly more at birth, had higher birth weight percentiles and were more likely to be non-white compared to female infants. The frequency of ever acute care use was 36.9% for emergency department visits, 27.4% for hospital admissions, 36.9% for systemic steroid use, and 40.5% for antibiotic use for a respiratory illness. No differences in respiratory morbidities were found between males and females. Females however, tended to be weaned from supplemental oxygen over 3 months later than males. Compared to females with BPD, males were more likely to weigh more, have higher birth weight percentiles and be non-white. After initial hospital discharge, there were no difference in respiratory morbidities between males and females with BPD. Female infants however were more likely to be weaned from supplemental oxygen at a later age than male infants. Pediatr Pulmonol. 2017;52:217-224. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Development and testing of a high cycle life 30 A-h sealed AgO-Zn battery

NASA Technical Reports Server (NTRS)

Bogner, R. S.

1972-01-01

A two-phase program was initiated to investigate design parameters and technology to develop an improved AgO-Zn battery. The basic performance goal was 100 charge/discharge cycles (22 h/2 h) at 50 percent depth of discharge following a six-month period of charged stand at room temperature. Phase 1, cell evaluation, involved testing 70 cells in five-cell groups. The major design variables were active material ratios, electrolyte concentrations, separator systems, and negative plate shape. Phase 1 testing showed that cycle life could be improved 10 percent to 20 percent by using greater ratios of zinc to silver oxide and higher electrolyte concentrations. Wedge-shaped negatives increased cycle life by nearly 100 percent. Phase 2 battery evaluation, which was initiated before the Phase 1 results were known completely, involved evaluation of six designs as 19-cell batteries. Only one battery exceeded 100 cycles following nine months charged stand.

Study on the mode-transition of nanosecond-pulsed dielectric barrier discharge between uniform and filamentary by controlling pressures and pulse repetition frequencies

NASA Astrophysics Data System (ADS)

Yu, S.; Pei, X.; Hasnain, Q.; Nie, L.; Lu, X.

2016-02-01

In this paper, we investigate the temporally resolved evolution of the nanosecond pulsed dielectric barrier discharge (DBD) in a moderate 6 mm discharge gap under various pressures and pulse repetition frequencies (PRFs) by intensified charge-coupled device (ICCD) images, using dry air and its components oxygen and nitrogen. It is found that the pressures are very different when the mode transits between uniform and filamentary in air, oxygen, and nitrogen. The PRFs can also obviously affect the mode-transition. The transition mechanism in the pulsed DBD is not Townsend-to-Streamer, which is dominant in the traditional alternating-voltage DBD. The pulsed DBD in a uniform mode develops in the form of plane ionization wave due to overlap of primary avalanches, while the increase in pressure disturbs the overlap and discharge develops in streamer, corresponding to the filamentary mode. Increasing the initial electron density by pre-ionization may contribute to discharge uniformity at higher pressures. We also found that the dependence of homogeneity upon PRF is a non-monotonic one.

Carbon with hierarchical pores from carbonized metal-organic frameworks for lithium sulphur batteries.

PubMed

Xi, Kai; Cao, Shuai; Peng, Xiaoyu; Ducati, Caterina; Kumar, R Vasant; Cheetham, Anthony K

2013-03-18

This paper presents a novel method and rationale for utilizing carbonized MOFs for sulphur loading to fabricate cathode structures for lithium-sulphur batteries. Unique carbon materials with differing hierarchical pore structures were synthesized from four types of zinc-containing metal-organic frameworks (MOFs). It is found that cathode materials made from MOFs-derived carbons with higher mesopore (2-50 nm) volumes exhibit increased initial discharge capacities, whereas carbons with higher micropore (<2 nm) volumes lead to cathode materials with better cycle stability.

Influence of early variables in traumatic brain injury on functional independence measure scores and rehabilitation length of stay and charges.

PubMed

Cowen, T D; Meythaler, J M; DeVivo, M J; Ivie, C S; Lebow, J; Novack, T A

1995-09-01

To determine the relationship between early variables (initial Glasgow Coma Scale [GCS] scores, computed tomography [CT] findings, presence of skeletal trauma, age, length of acute hospitalization) and outcome variables (Functional Independence Measure [FIM] scores, rehabilitation length of stay [LOS], rehabilitation charges) in traumatic brain injury (TBI). Inception cohort. University tertiary care rehabilitation center. 91 patients with TBI. Inpatient rehabilitation. FIM, rehabilitation LOS, and rehabilitation charges. Patients in the severely impaired (GCS = 3 to 7) group showed significantly lower (p = .01) mean admission and discharge motor scores (21.26, 39.83) than patients in the mildly impaired (GCS = 13 to 15) group (38.86, 55.29). Cognitive scores were also significantly lower (p < .01) in the severely impaired group on admission (26.73 vs 54.14) and discharge (42.28 vs 66.48). These findings continued to be statistically significant (p < .01) after regression analysis accounted for the other early variables previously listed. Regression analysis also illustrated that longer acute hospitalization LOS was independently associated with significantly lower admission motor (p < .01) and cognitive (p = .05) scores, and significantly higher (p = .01) rehabilitation charges. Patients with CT findings of intracranial bleed with skull fracture had longer total LOS (70.88 vs 43.08 days; p < .05), rehabilitation LOS (30.01 vs 19.68 days; p < .10), and higher rehabilitation charges ($43,346 vs $25,780; p < .05). Paradoxically, those patients in a motor vehicle crash with an extremity bone fracture had significantly higher (p = .002; p = .04 after regression analysis) FIM cognitive scores on admission (48.30 vs 27.28) and discharge (64.74 vs 45.78) than those without a fracture. Finally, data available on rehabilitation admission were used to predict discharge outcomes. The percentage of explained variance for each outcome variable is as follows: discharge FIM motor score, 69.5%; discharge FIM cognitive score, 71.2%; rehabilitation LOS, 54.1%; rehabilitation charges, 61.1%. The most powerful predictor of LOS and charges was the admission FIM motor score (p < .001), followed by CT findings (p = .02) and age (p = .04). Information readily available on rehabilitation admission, particularly the FIM motor score, may be useful in predicting discharge FIM scores as well as utilization of medical rehabilitation resources. Earlier transfer to rehabilitation may result in higher functional status and lower rehabilitation charges, as well as lower acute hospitalization charges. The presence of extremity fractures encountered during a motor vehicle crash is associated with a more favorable outcome in TBI as evidenced by higher discharge FIM cognitive scores.

Initiation of Positive Streamers near Uncharged Ice Hydrometeors in the Thundercloud Field

NASA Astrophysics Data System (ADS)

Babich, L. P.; Bochkov, E. I.

2018-05-01

Since the threshold electric field required for breakdown of air is much higher than the maximum field strength measured in thunderstorm clouds, the problem of lightning initiation still remains unsolved. According to the popular hypothesis, lightning can be initiated by a streamer discharge in the field enhanced near a hydrometeor. To verify the adequacy of this hypothesis, the development of a positive streamer propagating along the thunderstorm electric field in the vicinity of an ice needle at an air pressure corresponding to an altitude of 5 km (which is typical of the lightning initiation conditions) was simulated numerically. The hydrometeor dimensions are determined at which streamers can be initiated at different strengths of the thunderstorm electric field.

Potential ballast water transfer of organisms from the west to the east coast of India: Insights through on board sampling

NASA Astrophysics Data System (ADS)

Desai, Dattesh V.; Narale, Dhiraj; Khandeparker, Lidita; Anil, Arga Chandrashekar

2018-03-01

The possibility of translocation of organisms via ship's ballast water (BW) during a voyage from Hazira on the west coast to Visakhapatnam on the east coast of India was assessed. Samples of BW during the voyage and discharge and sediment collected subsequent to discharge of BW were collected and analyzed for different abiotic and biotic components. It was observed that the salinity did not change, whereas temperature and pH of BW increased marginally during the voyage. A marginal increase in the dissolved oxygen is observed during rough-very rough sea conditions. A sharp decline in the phytoplankton and zooplankton abundance observed in the initial ballast tank sample compared to natural seawater indicates the impact of ballast water pumping on the plankton community. Changes in the sea state during the voyage (slight-moderate to rough-very rough) resulted in a higher sediment suspension rate and suspended particulate matter and this coincided with higher bacterial abundance followed by increase in phytoplankton. An increase in the phytoplankton abundance in the discharge water could be attributed to the inoculum from the sediment. The abundance of zooplankton decreased from the start till the end of the voyage, with high numbers of dead zooplankton in the discharge sample.

Hyperoxia is Associated with Increased Mortality in Patients Treated with Mild Therapeutic Hypothermia after Sudden Cardiac Arrest

PubMed Central

Janz, David R.; Hollenbeck, Ryan D.; Pollock, Jeremy S.; McPherson, John A.; Rice, Todd W.

2012-01-01

Objective To determine if higher levels of partial pressure of arterial oxygen are associated with in-hospital mortality and poor neurologic status at hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. Design Retrospective analysis of a prospective cohort study Patients A total of 170 consecutive patients treated with therapeutic hypothermia in the cardiovascular care unit of an academic tertiary care hospital. Interventions None. Measurements and Main Results Of 170 patients, 77 (45.2%) survived to hospital discharge. Survivors had a significantly lower maximum partial pressure of arterial oxygen(198 mmHg, IQR 152.5–282) measured in the first 24 hours following cardiac arrest compared to nonsurvivors (254 mmHg, IQR 172–363, p = .022). A multivariable analysis including age, time to return of spontaneous circulation, the presence of shock, bystander CPR, and initial rhythm revealed that higher levels of the partial pressure of arterial oxygen were significantly associated with increased in-hospital mortality (odds ratio 1.439, 95% confidence interval 1.028–2.015, p = 0.034) and poor neurologic status at hospital discharge (odds ratio 1.485, 95% confidence interval 1.032–2.136, p = 0.033). Conclusions Higher levels of the maximum measured partial pressure of arterial oxygen are associated with increased in-hospital mortality and poor neurologic status on hospital discharge in patients treated with mild therapeutic hypothermia after sudden cardiac arrest. PMID:22971589

Design and development of a low cost, high current density power supply for streamer free atmospheric pressure DBD plasma generation in air.

PubMed

Jain, Vishal; Visani, Anand; Srinivasan, R; Agarwal, Vivek

2018-03-01

This paper presents a new power supply architecture for generating a uniform dielectric barrier discharge (DBD) plasma in air medium at atmospheric pressure. It is quite a challenge to generate atmospheric pressure uniform glow discharge plasma, especially in air. This is because air plasma needs very high voltage for initiation of discharge. If the high voltage is used along with high current density, it leads to the formation of streamers, which is undesirable for most applications like textile treatment, etc. Researchers have tried to generate high-density plasma using a RF source, nanosecond pulsed DC source, and medium frequency AC source. However, these solutions suffer from low current discharge and low efficiency due to the addition of an external resistor to control the discharge current. Moreover, they are relatively costly and bulky. This paper presents a new power supply configuration which is very compact and generates high average density (∼0.28 W/cm 2 ) uniform glow DBD plasma in air at atmospheric pressure. The efficiency is also higher as no external resistor is required to control the discharge current. An inherent feature of this topology is that it can drive higher current oscillations (∼50 A peak and 2-3 MHz frequency) into the plasma that damp out due to the plasma dissipation only. A newly proposed model has been used with experimental validation in this paper. Simulations and experimental validation of the proposed topology are included. Also, the application of the generated plasma for polymer film treatment is demonstrated.

Design and development of a low cost, high current density power supply for streamer free atmospheric pressure DBD plasma generation in air

NASA Astrophysics Data System (ADS)

Jain, Vishal; Visani, Anand; Srinivasan, R.; Agarwal, Vivek

2018-03-01

This paper presents a new power supply architecture for generating a uniform dielectric barrier discharge (DBD) plasma in air medium at atmospheric pressure. It is quite a challenge to generate atmospheric pressure uniform glow discharge plasma, especially in air. This is because air plasma needs very high voltage for initiation of discharge. If the high voltage is used along with high current density, it leads to the formation of streamers, which is undesirable for most applications like textile treatment, etc. Researchers have tried to generate high-density plasma using a RF source, nanosecond pulsed DC source, and medium frequency AC source. However, these solutions suffer from low current discharge and low efficiency due to the addition of an external resistor to control the discharge current. Moreover, they are relatively costly and bulky. This paper presents a new power supply configuration which is very compact and generates high average density (˜0.28 W/cm2) uniform glow DBD plasma in air at atmospheric pressure. The efficiency is also higher as no external resistor is required to control the discharge current. An inherent feature of this topology is that it can drive higher current oscillations (˜50 A peak and 2-3 MHz frequency) into the plasma that damp out due to the plasma dissipation only. A newly proposed model has been used with experimental validation in this paper. Simulations and experimental validation of the proposed topology are included. Also, the application of the generated plasma for polymer film treatment is demonstrated.

Glow discharge electrolysis plasma initiated preparation of temperature/pH dual sensitivity reed hemicellulose-based hydrogels.

PubMed

Zhang, Wenming; Zhu, Sha; Bai, Yunping; Xi, Ning; Wang, Shaoyang; Bian, Yang; Li, Xiaowei; Zhang, Yucang

2015-05-20

The temperature/pH dual sensitivity reed hemicellulose-based hydrogels have been prepared through glow discharge electrolysis plasma (GDEP). The effect of different discharge voltages on the temperature and pH response performance of reed hemicellulose-based hydrogels was inspected, and the formation mechanism, deswelling behaviors of reed hemicellulose-based hydrogels were also discussed. At the same time, infrared spectroscopy (FT-IR), scanning differential thermal analysis (DSC) and scanning electron microscope (SEM) were adopted to characterize the structure, phase transformation behaviors and microstructure of hydrogels. It turned out to be that all reed hemicellulose-based hydrogels had a double sensitivity to temperature and pH, and their phase transition temperatures were all approximately 33 °C, as well as the deswelling dynamics met the first model. In addition, the hydrogel (TPRH-3), under discharge voltage 600 V, was more sensitive to temperature and pH and had higher deswelling ratio. Copyright © 2015 Elsevier Ltd. All rights reserved.

Breakdown of methylene blue and methyl orange by pulsed corona discharge

NASA Astrophysics Data System (ADS)

Grabowski, L. R.; van Veldhuizen, E. M.; Pemen, A. J. M.; Rutgers, W. R.

2007-05-01

The recently developed corona above water technique is applied to water containing 10 mg l-1 methylene blue (MB) or methyl orange (MO). The corona discharge pulses are created with a spark gap switched capacitor followed by a transmission line transformer. The pulse amplitude is 40 kV; its duration is 50 ns. At a pulse repetition rate of 10 Hz this leads to an average power of 0.6 W into the discharge. MB and MO are completely decolourized in ~20 min. This corresponds to a yield of ~4.5 gr kW-1h-1, which is much higher than obtained with other discharge techniques or sonoluminescence. The high yield is reflected in the observed temperature increase of only ~1 K. Tests with additional chemicals show that the initial speed of the conversion can be influenced but the total time required for total decolourization is constant. Further, it follows that the main oxidation path of the dyes is by direct ozone attack and the conversion products are strong acids.

Discharge Chamber Plasma Structure of a 30-cm NSTAR-Type Ion Engine

NASA Technical Reports Server (NTRS)

Herman, Daniel A.; Gallimore, Alec D.

2006-01-01

Single Langmuir probe measurements are presented over a two-dimensional array of locations in the near Discharge Cathode Assembly (DCA) region of a 30-cm diameter ring cusp ion thruster over a range of thruster operating conditions encompassing the high-power half of the NASA throttling table. The Langmuir probe data were analyzed with two separate methods. All data were analyzed initially assuming an electron population consisting of Maxwellian electrons only. The on-axis data were then analyzed assuming both Maxwellian and primary electrons. Discharge plasma data taken with beam extraction exhibit a broadening of the higher electron temperature plume boundary compared to similar discharge conditions without beam extraction. The opposite effect is evident with the electron/ion number density as the data without began, extraction appears to be more collimated than the corresponding data with beam extraction. Primary electron energy and number densities are presented for one operating condition giving an order of magnitude of their value and the error associated with this calculation.

[Home care for the high-risk newborn infant].

PubMed

Puddu, M

2010-06-01

With increased survival of extremely low birth weigh (ELBW) and very ill infants, a lot of them are discharged with unresolved medical issues that complicate their subsequent care. Infants born preterm with low birth weight who require neonatal intensive care experience a much higher rate of hospital readmission and death during the first year after birth compared with healthy term infants. Despite initial hospital care which is one of the most expensive of all kind of hospitalization, home care services are sometimes still sparse though the high risk of this group for failure to thrive, respiratory problems, developmental delays, parenting problems. In addition, societal and economic forces have come to bear on the timing and process of discharge and home care. Moreover it takes time for the family of a high-risk infant to prepare to care for their infant in a home setting and to obtain the necessary support services and mobilize community resources. Careful preparation for discharge, good follow-up and medical home after discharge may reduce these risks.

Electrical treeing behaviors in silicone rubber under an impulse voltage considering high temperature

NASA Astrophysics Data System (ADS)

Yunxiao, ZHANG; Yuanxiang, ZHOU; Ling, ZHANG; Zhen, LIN; Jie, LIU; Zhongliu, ZHOU

2018-05-01

In this paper, work was conducted to reveal electrical tree behaviors (initiation and propagation) of silicone rubber (SIR) under an impulse voltage with high temperature. Impulse frequencies ranging from 10 Hz to 1 kHz were applied and the temperature was controlled between 30 °C and 90 °C. Experimental results show that tree initiation voltage decreases with increasing pulse frequency, and the descending amplitude is different in different frequency bands. As the pulse frequency increases, more frequent partial discharges occur in the channel, increasing the tree growth rate and the final shape intensity. As for temperature, the initiation voltage decreases and the tree shape becomes denser as the temperature gets higher. Based on differential scanning calorimetry results, we believe that partial segment relaxation of SIR at high temperature leads to a decrease in the initiation voltage. However, the tree growth rate decreases with increasing temperature. Carbonization deposition in the channel under high temperature was observed under microscope and proven by Raman analysis. Different tree growth models considering tree channel characteristics are proposed. It is believed that increasing the conductivity in the tree channel restrains the partial discharge, holding back the tree growth at high temperature.

Using the Electronic Medical Record to Enhance Physician-Nurse Communication Regarding Patients' Discharge Status.

PubMed

Driscoll, Molly; Gurka, David

2015-01-01

The fast-paced environment of hospitals contributes to communication failures between health care providers while impacting patient care and patient flow. An effective mechanism for sharing patients' discharge information with health care team members is required to improve patient throughput. The communication of a patient's discharge plan was identified as crucial in alleviating patient flow delays at a tertiary care, academic medical center. By identifying the patients who were expected to be discharged the following day, the health care team could initiate discharge preparations in advance to improve patient care and patient flow. The patients' electronic medical record served to convey dynamic information regarding the patients' discharge status to the health care team via conditional discharge orders. Two neurosciences units piloted a conditional discharge order initiative. Conditional discharge orders were designed in the electronic medical record so that the conditions for discharge were listed in a dropdown menu. The health care team was trained on the conditional discharge order protocol, including when to write them, how to find them in the patients' electronic medical record, and what actions should be prompted by these orders. On average, 24% of the patients discharged had conditional discharge orders written the day before discharge. The average discharge time for patients with conditional discharge orders decreased by 83 minutes (0.06 day) from baseline. Qualitatively, the health care team reported improved workflows with conditional orders. The conditional discharge orders allowed physicians to communicate pending discharges electronically to the multidisciplinary team. The initiative positively impacted patient discharge times and workflows.

The cloud–ionosphere discharge: A newly observed thunderstorm phenomenon

PubMed Central

Winckler, John R.

1997-01-01

This paper deals with a luminous electric discharge that forms in the mesospheric region between thundercloud tops and the ionosphere at 90-km altitude. These cloud–ionosphere discharges (CIs), following visual reports dating back to the 19th century, were finally imaged by a low-light TV camera as part of the “SKYFLASH” program at the University of Minnesota in 1989. Many observations were made by various groups in the period 1993–1996. The characteristics of CIs are that they have a wide range of sizes from a few kilometers up to 50 km horizontally; they extend from 40 km to nearly 90 km vertically, with an intense region near 60–70 km and streamers extending down toward cloud tops; the CIs are partly or entirely composed of vertical luminous filaments of kilometer size. The predominate color is red. The TV images show that the CIs usually have a duration less than one TV field (16.7 ms), but higher-speed photometric measurements show that they last about 3 ms, and are delayed 3 ms after an initiating cloud–ground lightning stroke; 95% of these initiating strokes are found to be “positive”—i.e., carry positive charges from clouds to ground. The preference for positive initiating strokes is not understood. Theories of the formation of CIs are briefly reviewed. PMID:11038577

Observations of narrow bipolar events reveal how lightning is initiated in thunderstorms

PubMed Central

Rison, William; Krehbiel, Paul R.; Stock, Michael G.; Edens, Harald E.; Shao, Xuan-Min; Thomas, Ronald J.; Stanley, Mark A.; Zhang, Yang

2016-01-01

A long-standing but fundamental question in lightning studies concerns how lightning is initiated inside storms, given the absence of physical conductors. The issue has revolved around the question of whether the discharges are initiated solely by conventional dielectric breakdown or involve relativistic runaway electron processes. Here we report observations of a relatively unknown type of discharge, called fast positive breakdown, that is the cause of high-power discharges known as narrow bipolar events. The breakdown is found to have a wide range of strengths and is the initiating event of numerous lightning discharges. It appears to be purely dielectric in nature and to consist of a system of positive streamers in a locally intense electric field region. It initiates negative breakdown at the starting location of the streamers, which leads to the ensuing flash. The observations show that many or possibly all lightning flashes are initiated by fast positive breakdown. PMID:26876654

Observations of narrow bipolar events reveal how lightning is initiated in thunderstorms.

PubMed

Rison, William; Krehbiel, Paul R; Stock, Michael G; Edens, Harald E; Shao, Xuan-Min; Thomas, Ronald J; Stanley, Mark A; Zhang, Yang

2016-02-15

A long-standing but fundamental question in lightning studies concerns how lightning is initiated inside storms, given the absence of physical conductors. The issue has revolved around the question of whether the discharges are initiated solely by conventional dielectric breakdown or involve relativistic runaway electron processes. Here we report observations of a relatively unknown type of discharge, called fast positive breakdown, that is the cause of high-power discharges known as narrow bipolar events. The breakdown is found to have a wide range of strengths and is the initiating event of numerous lightning discharges. It appears to be purely dielectric in nature and to consist of a system of positive streamers in a locally intense electric field region. It initiates negative breakdown at the starting location of the streamers, which leads to the ensuing flash. The observations show that many or possibly all lightning flashes are initiated by fast positive breakdown.

Post-Discharge Care Duration, Charges, and Outcomes Among Medicare Patients After Primary Total Hip and Knee Arthroplasty.

PubMed

Ponnusamy, Karthikeyan E; Naseer, Zan; El Dafrawy, Mostafa H; Okafor, Louis; Alexander, Clayton; Sterling, Robert S; Khanuja, Harpal S; Skolasky, Richard L

2017-06-07

In April 2016, the U.S. Centers for Medicare & Medicaid Services initiated mandatory 90-day bundled payments for total hip and knee arthroplasty for much of the country. Our goal was to determine duration of care, 90-day charges, and readmission rates by discharge disposition and U.S. region after hip or knee arthroplasty. Using the 2008 Medicare Provider Analysis and Review database 100% sample, we identified patients who had undergone elective primary total hip or knee arthroplasty. We collected data on patient age, sex, comorbidities, U.S. Census region, discharge disposition, duration of care, 90-day charges, and readmission. Multivariate regression was used to assess factors associated with readmission (logistic) and charges (linear). Significance was set at p < 0.01. Patients undergoing 138,842 total hip arthroplasties were discharged to home (18%), home health care (34%), extended-care facilities (35%), and inpatient rehabilitation (13%); patients undergoing 329,233 total knee arthroplasties were discharged to home (21%), home health care (38%), extended-care facilities (31%), and inpatient rehabilitation (10%). Patients in the Northeast were more likely to be discharged to extended-care facilities or inpatient rehabilitation than patients in other regions. Patients in the West had the highest 90-day charges. Approximately 70% of patients were discharged home from extended-care facilities, whereas after inpatient rehabilitation, >50% of patients received home health care. Among those discharged to home, 90-day readmission rates were highest in the South (9.6%) for patients undergoing total hip arthroplasty and in the Midwest (8.7%) and the South (8.5%) for patients undergoing total knee arthroplasty. Having ≥4 comorbidities, followed by discharge to inpatient rehabilitation or an extended-care facility, had the strongest associations with readmission, whereas the region of the West and the discharge disposition to inpatient rehabilitation had the strongest association with higher charges. Among Medicare patients, discharge disposition and number of comorbidities were most strongly associated with readmission. Inpatient rehabilitation and the West region had the strongest associations with higher charges. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Temperature and Nitric Oxide Generation in a Pulsed Arc Discharge Plasma

NASA Astrophysics Data System (ADS)

Namihira, T.; Sakai, S.; Matsuda, M.; D., Wang; Kiyan, T.; Akiyama, H.; Okamoto, K.; Toda, K.

2007-12-01

Nitric oxide (NO) is increasingly being used in medical treatments of high blood pressure, acute respiratory distress syndrome and other illnesses related to the lungs. Currently a NO inhalation system consists of a gas cylinder of N2 mixed with a high concentration of NO. This arrangement is potentially risky due to the possibility of an accidental leak of NO from the cylinder. The presence of NO in the air leads to the formation of nitric dioxide (NO2), which is toxic to the lungs. Therefore, an on-site generator of NO would be highly desirable for medical doctors to use with patients with lung disease. To develop the NO inhalation system without a gas cylinder, which would include a high concentration of NO, NAMIHIRA et al have recently reported on the production of NO from room air using a pulsed arc discharge. In the present work, the temperature of the pulsed arc discharge plasma used to generate NO was measured to optimize the discharge condition. The results of the temperature measurements showed the temperature of the pulsed arc discharge plasma reached about 10,000 K immediately after discharge initiation and gradually decreased over tens of microseconds. In addition, it was found that NO was formed in a discharge plasma having temperatures higher than 9,000 K and a smaller input energy into the discharge plasma generates NO more efficiently than a larger one.

Motivational stage of change in young patients undergoing day treatment for eating disorders.

PubMed

Bustin, Lisa A; Lane-Loney, Susan E; Hollenbeak, Christopher S; Ornstein, Rollyn M

2013-01-01

The objective was to determine whether motivation to change is significantly altered over the course of partial hospitalization in children and adolescents with eating disorders (EDs). This study was a retrospective chart review of 30 sets of adolescents and their parents who completed the Motivational Stage of Change for Adolescents Recovering from an Eating Disorder (MSCARED) at both intake and discharge from partial hospitalization. The main outcome variables included change in stage of change (SOC) for patients and their parents. Secondary outcomes included correlations between SOC and other baseline variables, as well as changes in SOC and psychological test scores. The SOC was significantly higher at discharge than at intake in both the patients and parents, but the two groups were not in agreement at discharge. The change in the SOC was correlated with change in Children's Eating Attitudes Test scores. Assessment of decisional balance showed correlations with SOC. Age, change in weight, and psychiatric diagnoses did not correlate with initial SOC. The MSCARED may be a useful tool for monitoring young ED patients' psychological improvements with day treatment. Initial SOC is not predictive of treatment outcomes.

Safe discharge and outpatient investigation of ureteric colic: a retrospective analysis.

PubMed

Stewart, Michael

2017-07-12

Computed tomography of the kidneys, ureters and bladder is the recommended imaging modality for suspected urolithiasis. Early scanning is advised in guidelines, but there is limited published evidence to support this recommendation. In a retrospective study, we reviewed patients managed according to a local guideline. Patients without high-risk features were either imaged during their initial visit (if in the daytime) or discharged for outpatient scans. Complications, unplanned returns, final diagnosis, and intervention rates were compared between groups. Fifty-four patients were scanned during their initial visit and 151 were scanned as an outpatient at a median interval of 10 days. Unplanned return rates were lower in those scanned as outpatients (7.3 vs. 24.1%), with no significant difference in complications (2.0 vs. 3.7%; none leading to permanent harm). Those scanned as outpatients were less likely to have a stone proven by imaging (39.7 vs. 64.8%), but did not have a significantly higher rate of proven alternative diagnosis (9.3 vs. 13.0%). There is no evidence in this cohort that discharging patients for outpatient imaging is associated with poorer outcomes, provided that an appropriate clinical risk assessment is carried out.

High-current discharge channel contraction in high density gas

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rutberg, Ph. G.; Bogomaz, A. A.; Pinchuk, M. E.

Research results for discharges at current amplitudes of 0.5-1.6 MA and current rise rate of {approx}10{sup 10} A/s are presented. The discharge is performed in the hydrogen environment at the initial pressure of 5-35 MPa. Initiation is implemented by a wire explosion. The time length of the first half-period of the discharge current is 70-150 {mu}s. Under such conditions, discharge channel contraction is observed; the contraction is followed by soft x-ray radiation. The phenomena are discussed, which are determined by high density of the gas surrounding the discharge channel. These phenomena are increase of the current critical value, where themore » channel contraction begins and growth of temperature in the axis region of the channel, where the initial density of the gas increases.« less

Early Results of Medicare's Bundled Payment Initiative for a 90-Day Total Joint Arthroplasty Episode of Care.

PubMed

Iorio, Richard; Clair, Andrew J; Inneh, Ifeoma A; Slover, James D; Bosco, Joseph A; Zuckerman, Joseph D

2016-02-01

In 2011 Medicare initiated a Bundled Payment for Care Improvement (BPCI) program with the goal of introducing a payment model that would "lead to higher quality, more coordinated care at a lower cost to Medicare." A Model 2 bundled payment initiative for Total Joint Replacement (TJR) was implemented at a large, tertiary, urban academic medical center. The episode of care includes all costs through 90 days following discharge. After one year, data on 721 Medicare primary TJR patients were available for analysis. Average length of stay (LOS) was decreased from 4.27 days to 3.58 days (Median LOS 3 days). Discharges to inpatient facilities decreased from 71% to 44%. Readmissions occurred in 80 patients (11%), which is slightly lower than before implementation. The hospital has seen cost reduction in the inpatient component over baseline. Early results from the implementation of a Medicare BPCI Model 2 primary TJR program at this medical center demonstrate cost-savings. IV economic and decision analyses-developing an economic or decision model. Copyright © 2016 Elsevier Inc. All rights reserved.

Modification of surface layers of copper under the action of the volumetric discharge initiated by an avalanche electron beam in nitrogen and CO2 at atmospheric pressure

NASA Astrophysics Data System (ADS)

Shulepov, M. A.; Akhmadeev, Yu. Kh.; Tarasenko, V. F.; Kolubaeva, Yu. A.; Krysina, O. V.; Kostyrya, I. D.

2011-05-01

The results of experimental investigations of the action of the volumetric discharge initiated by an avalanche electron beam on the surface of copper specimens are presented. The volumetric (diffuse) discharge in nitrogen and CO2 at atmospheric pressure was initiated by applying high voltage pulses of nanosecond duration to a tubular foil cathode. It has been found that the treatment of a copper surface by this type of discharge increases the hardness of the surface layer due to oxidation.

Relationship of initial hematocrit level to discharge destination and resource utilization after ischemic stroke: a pilot study.

PubMed

Diamond, Paul T; Gale, Shawn D; Evans, Brent A

2003-07-01

To examine the association between initial hematocrit level at the time of ischemic stroke, discharge destination, and resource utilization. Case series. University hospital. A total of 1012 consecutive patients with ischemic stroke admitted to a university health system between August 3, 1995, and June 24, 1999. Not applicable. Length of stay, hospital cost, and discharge disposition. Of 1012 patients presenting with ischemic stroke, 58% were discharged home, 10% were discharged home with home care services, 15% were discharged to a rehabilitation hospital, 11% were discharged to a skilled or intermediate care facility, and 6% died. After adjusting for age, sex, race, and comorbidities, a significant association (P=.009) existed between discharge outcome and initial hematocrit level. The probability of achieving an equivalent or less favorable outcome increased at both high and low hematocrit levels, with a minimum probability at a hematocrit level of approximately 45%. An association exists between hematocrit level at the time of ischemic stroke and discharge outcome. Midrange hematocrit levels appear to be associated with discharge to home rather than to an inpatient rehabilitation unit or to a nursing facility. Further study is indicated to examine the relationship among hematocrit level, stroke severity, and outcome.

Vastus Lateralis Motor Unit Firing Rate Is Higher in Women With Patellofemoral Pain.

PubMed

Gallina, Alessio; Hunt, Michael A; Hodges, Paul W; Garland, S Jayne

2018-05-01

To compare neural drive, determined from motor unit firing rate, in the vastus medialis and lateralis in women with and without patellofemoral pain. Cross-sectional study. University research laboratory. Women (N=56) 19 to 35 years of age, including 36 with patellofemoral pain and 20 controls. Not applicable. Participants sustained an isometric knee extension contraction at 10% of their maximal voluntary effort for 70 seconds. Motor units (N=414) were identified using high-density surface electromyography. Average firing rate was calculated between 5 and 35 seconds after recruitment for each motor unit. Initial firing rate was the inverse of the first 3 motor unit interspike intervals. In control participants, vastus medialis motor units discharged at higher rates than vastus lateralis motor units (P=.001). This was not observed in women with patellofemoral pain (P=.78) because of a higher discharge rate of vastus lateralis compared with control participants (P=.002). No between-group differences were observed for vastus medialis (P=.93). Similar results were obtained for the initial motor unit firing rate. These findings suggest that women with patellofemoral pain have a higher neural drive to vastus lateralis but not vastus medialis, which may be a contributor of the altered patellar kinematics observed in some studies. The different neural drive may be an adaptation to patellofemoral pain, possibly to compensate for decreased quadriceps force production, or a precursor of patellofemoral pain. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Role of the Axon Initial Segment in the Control of Spontaneous Frequency of Nigral Dopaminergic Neurons In Vivo.

PubMed

Meza, Rodrigo C; López-Jury, Luciana; Canavier, Carmen C; Henny, Pablo

2018-01-17

The spontaneous tonic discharge activity of nigral dopamine neurons plays a fundamental role in dopaminergic signaling. To investigate the role of neuronal morphology and architecture with respect to spontaneous activity in this population, we visualized the 3D structure of the axon initial segment (AIS) along with the entire somatodendritic domain of adult male mouse dopaminergic neurons, previously recorded in vivo We observed a positive correlation of the firing rate with both proximity and size of the AIS. Computational modeling showed that the size of the AIS, but not its position within the somatodendritic domain, is the major causal determinant of the tonic firing rate in the intact model, by virtue of the higher intrinsic frequency of the isolated AIS. Further mechanistic analysis of the relationship between neuronal morphology and firing rate showed that dopaminergic neurons function as a coupled oscillator whose frequency of discharge results from a compromise between AIS and somatodendritic oscillators. Thus, morphology plays a critical role in setting the basal tonic firing rate, which in turn could control striatal dopaminergic signaling that mediates motivation and movement. SIGNIFICANCE STATEMENT The frequency at which nigral dopamine neurons discharge action potentials sets baseline dopamine levels in the brain, which enables activity in motor, cognitive, and motivational systems. Here, we demonstrate that the size of the axon initial segment, a subcellular compartment responsible for initiating action potentials, is a key determinant of the firing rate in these neurons. The axon initial segment and all the molecular components that underlie its critical function may provide a novel target for the regulation of dopamine levels in the brain. Copyright © 2018 the authors 0270-6474/18/380733-12$15.00/0.

Initiation of long, free-standing z discharges by CO2 laser gas heating

NASA Astrophysics Data System (ADS)

Niemann, C.; Tauschwitz, A.; Penache, D.; Neff, S.; Knobloch, R.; Birkner, R.; Presura, R.; Hoffmann, D. H. H.; Yu, S. S.; Sharp, W. M.

2002-01-01

High current discharge channels can neutralize both current and space charge of very intense ion beams. Therefore, they are considered an interesting solution for final focus and beam transport in a heavy ion beam fusion reactor. At the Gesellschaft für Schwerionenforschung accelerator facility, 50 cm long, free-standing discharge channels were created in a 60 cm diameter metallic chamber. Discharges with currents of 45 kA in 2 to 25 mbar ammonia (NH3) gas are initiated by a CO2 laser pulse along the channel axis before the capacitor bank is triggered. Resonant absorption of the laser, tuned to the v2 vibration of the ammonia molecule, causes strong gas heating. Subsequent expansion and rarefaction of the gas prepare the conditions for a stable discharge to fulfill the requirements for ion beam transport. The influence of an electric prepulse on the high current discharge was investigated. This article describes the laser-gas interaction and the discharge initiation mechanism. We found that channels are magnetohydrodynamic stable up to currents of 45 kA, measured by fast shutter and streak imaging techniques. The rarefaction of the laser heated gas is studied by means of a one-dimensional Lagrangian fluid code (CYCLOPS) and is identified as the dominant initiation mechanism of the discharge.

Adult emergency department patients with sickle cell pain crisis: a learning collaborative model to improve analgesic management.

PubMed

Tanabe, Paula; Artz, Nicole; Mark Courtney, D; Martinovich, Zoran; Weiss, Kevin B; Zvirbulis, Elena; Hafner, John W

2010-04-01

The objectives were to report the baseline (prior to quality improvement interventions) patient and visit characteristics and analgesic management practices for each site participating in an emergency department (ED) sickle cell learning collaborative. A prospective, multisite longitudinal cohort study in the context of a learning-collaborative model was performed in three midwestern EDs. Each site formed a multidisciplinary team charged with improving analgesic management for patients with sickle cell disease (SCD). Each team developed a nurse-initiated analgesic protocol for SCD patients (implemented after a baseline data collection period of 3.5 months at one site and 10 months at the other two sites). All sites prospectively enrolled adults with an acute pain crisis and SCD. All medical records for patients meeting study criteria were reviewed. Demographic, health services, and analgesic management data were abstracted, including ED visit frequency data, ED disposition, arrival and discharge pain score, and name and route of initial analgesic administered. Ten interviews per quarter per site were conducted with patients within 14 days of their ED discharge, and subjects were queried about the highest level of pain acceptable at discharge. The primary outcome variable was the time to initial analgesic administration. Variable data were described as means and standard deviations (SDs) or medians and interquartile ranges (IQR) for nonnormal data. A total of 155 patients met study criteria (median age = 32 years, IQR = 24-40 years) with a total of 701 ED visits. Eighty-six interviews were conducted. Most patients (71.6%) had between one and three visits to the ED during the study period. However, after removing Site 3 from the analysis because of the short data enrollment period (3.5 months), which influenced the mean number of visits for the entire cohort, 52% of patients had between one and three ED visits over 10 months, 21% had four to nine visits, and 27% had between 10 and 67 visits. Fifty-nine percent of patients were discharged home. The median time to initial analgesic for the cohort was 74 minutes (IQR = 48-135 minutes). Differences between choice of analgesic agent and route selected were evident between sites. For the cohort, 680 initial analgesic doses were given (morphine sulfate, 42%; hydromorphone, 46%; meperidine, 4%; morphine sulfate and ibuprofen or ketorolac, 7%) using the following routes: oral (2%), intravenous (67%), subcutaneous (3%), and intramuscular (28%). Patients reported a significantly lower targeted discharge pain score (mean +/- SD = 4.19 +/- 1.18) compared to the actual documented discharge pain score within 45 minutes of discharge (mean +/- SD = 5.77 +/- 2.45; mean difference = 1.58, 95% confidence interval = .723 to 2.44, n = 43). While half of the patients had one to three ED visits during the study period, many patients had more frequent visits. Delays to receiving an initial analgesic were common, and post-ED interviews reveal that sickle cell pain patients are discharged from the ED with higher pain scores than what they perceive as desirable.

Weekend Effect in Children With Stroke in the Nationwide Inpatient Sample.

PubMed

Adil, Malik M; Vidal, Gabriel; Beslow, Lauren A

2016-06-01

Studies have demonstrated differences in clinical outcomes in adult patients with stroke admitted on weekdays versus weekends. The study's objective was to determine whether a weekend impacts clinical outcomes in children with ischemic stroke and hemorrhagic stroke. Children aged 1 to 18 years admitted to US hospitals from 2002 to 2011 with a primary discharge diagnosis of ischemic stroke or hemorrhagic stroke were identified by International Classification of Disease, 9th Revision, codes. Logistic regression estimated odds ratios and 95% confidence intervals for in-hospital mortality and discharge to a nursing facility among children admitted on weekends (Saturday and Sunday) versus weekdays (Monday to Friday), adjusting for potential confounders. Of 8467 children with ischemic stroke, 28% were admitted on a weekend. Although children admitted on weekends did not have a higher in-hospital mortality rate than those admitted on weekdays (4.1% versus 3.3%; P=0.4), children admitted on weekends had a higher rate of discharge to a nursing facility (25.5% versus 18.6%; P=0.003). After adjusting for age, sex, and confounders, the odds of discharge to a nursing facility remained increased among children admitted on weekends (odds ratio, 1.5; 95% confidence interval, 1.1-1.9; P=0.006). Of 10 919 children with hemorrhagic stroke, 25.3% were admitted on a weekend. Children admitted on weekends had a higher rate of in-hospital mortality (12% versus 8%; P=0.006). After adjusting for age, sex, and confounders, the odds of in-hospital mortality remained higher among children admitted on weekends (odds ratio, 1.4; 95% confidence interval, 1.1-1.9; P=0.04). There seems to be a weekend effect for children with ischemic and hemorrhagic strokes. Quality improvement initiatives should examine this phenomenon prospectively. © 2016 American Heart Association, Inc.

Parental Understanding of Hospital Course and Discharge Plan.

PubMed

Bhansali, Priti; Washofsky, Anne; Romrell, Evan; Birch, Sarah; Winer, Jeffrey C; Hoffner, Wendy

2016-08-01

Hospital discharge marks an important transition in care from the inpatient team to the family and primary care provider. Parents must know the hospital course and discharge plan to care for their child at home and provide background for future providers. Our study aimed to determine parental knowledge of key aspects of their child's hospital course and discharge plan and to identify markers of increased risk for incomplete or incorrect knowledge among participants. We conducted a descriptive prospective cohort study of parents within 24 hours of hospital discharge. The primary outcome was concordance of parent responses to verbal interview questions about their child's hospital treatment, laboratory testing, imaging, procedures and discharge plan with the medical record. Of 174 participants, 15% felt less than "completely prepared" to explain the hospital course to their primary care provider or to provide care after discharge. There was >83% overall concordance with interview responses and the medical record, with concordance higher for hospital course events than discharge plan. There were few significant differences in understanding between trainee-based teams and the attending physician-run unit. No patient or family characteristics were consistently associated with poor understanding of hospital course or discharge plan. Although parents were generally knowledgeable about hospital course and discharge plan, areas for improved communication were identified. Individualized counseling about hospital course and discharge plan should be initiated for all parents early during hospitalization. Methods that assess and bolster caregiver comprehension and minimize dependence on written instructions may help with transition to outpatient care. Copyright © 2016 by the American Academy of Pediatrics.

[Short, medium and long-term benefits of human milk intake in very-low-birth-weight infants].

PubMed

Chinea Jiménez, Bibiana; Awad Parada, Yumana; Villarino Marín, Antonio; Sáenz de Pipaón Marcos, Miguel

2017-10-24

The aim of the present study is to evaluate the effect of human milk feeding during the first weeks of life in very low birth weight infants on weight gain at discharge, length of hospitalization, postmenstrual age at discharge and nutritional assessment, growth and neurodevelopment at two and five years. Longitudinal study of very-low-birth-weight infants (< 1,500 grams) admitted to the Neonatal Intensive Care Unit of La Paz University Hospital, from January 1st 2009 to December 31st 2009, followed in the follow-up clinic. Their parents agreed to perform a more exhaustive anthropometric study at five years, classified according to the type of feeding at the time of discharge (exclusive human milk, formula milk or mixed). Initial hospital duration and anthropometry at discharge were evaluated. At two years of age, anthropometric data (weight, height and head circumference) were collected and neurodevelopment was assessed according to the Bayley scale of child development. Data at five years were collected prospectively. Measurements of weight, height and head circumference, waist circumference, hip, relaxed and contracted arm, thigh and middle leg, bicipital, triceps, subscapular, suprailiac and leg skin folds were performed. For patients older than five years, the Kaufman test battery for children was used. The effect of human milk on the variables of interest was investigated using a multivariate analysis correcting for gestational age and weight at birth. One hundred and fifty-two infants born in 2009 were discharged from our unit: exclusive breast milk (59), formula (55) or mixed milk (38). More detailed follow-up was carried out for 61 of them. Human milk during the first admission decreases the initial hospital stay, and is associated with a higher head circumference at two and five years, and a better score in the global and verbal cognitive area at five years. Our results suggest that maternal milk feeding during initial admission should be encouraged because it can improve neurodevelopment at five years of age.

Estimating initial contaminant mass based on fitting mass-depletion functions to contaminant mass discharge data: Testing method efficacy with SVE operations data

NASA Astrophysics Data System (ADS)

Mainhagu, J.; Brusseau, M. L.

2016-09-01

The mass of contaminant present at a site, particularly in the source zones, is one of the key parameters for assessing the risk posed by contaminated sites, and for setting and evaluating remediation goals and objectives. This quantity is rarely known and is challenging to estimate accurately. This work investigated the efficacy of fitting mass-depletion functions to temporal contaminant mass discharge (CMD) data as a means of estimating initial mass. Two common mass-depletion functions, exponential and power functions, were applied to historic soil vapor extraction (SVE) CMD data collected from 11 contaminated sites for which the SVE operations are considered to be at or close to essentially complete mass removal. The functions were applied to the entire available data set for each site, as well as to the early-time data (the initial 1/3 of the data available). Additionally, a complete differential-time analysis was conducted. The latter two analyses were conducted to investigate the impact of limited data on method performance, given that the primary mode of application would be to use the method during the early stages of a remediation effort. The estimated initial masses were compared to the total masses removed for the SVE operations. The mass estimates obtained from application to the full data sets were reasonably similar to the measured masses removed for both functions (13 and 15% mean error). The use of the early-time data resulted in a minimally higher variation for the exponential function (17%) but a much higher error (51%) for the power function. These results suggest that the method can produce reasonable estimates of initial mass useful for planning and assessing remediation efforts.

Investigation of heavy current discharges with high initial gas density

NASA Astrophysics Data System (ADS)

Budin, A.; Bogomaz, A.; Kolikov, V.; Kuprin, A.; Leontiev, V.; Rutberg, Ph.; Shirokov, N.

1996-05-01

Piezoelectric pressure transducers, with noise immunity and time resolution of 0,5 μs were used to measure pulse pressures of 430 MPa along the axis of an electrical discharge channel. Initial concentration of He was 2,7ṡ1021cm-3, dI/dt=6ṡ1011 A/s, and Imax=560 kA. Shock waves with amplitudes exceeding the pressure along the axis, were detected by a pressure transducer on the wall of the discharge chamber. Typical shock velocities were 2ṡ4 km/s. Average pressure measurements along the discharge axis at different radii were used to estimate the current density distribution along the canal radius. The presence of the shock waves, promoting the additional hydrogen heating in the discharge chamber, has been registered during the discharge in hydrogen for Imax˜1 MA and an initial concentration of 1021cm-3.

Study on moisture absorption and sweat discharge of honeycomb polyester fiber

NASA Astrophysics Data System (ADS)

Feng, Aifen; Zhang, Yongjiu

2015-07-01

The moisture absorption and liberation properties of honeycomb polyester fiber were studied in order to understand its moisture absorption and sweat discharge. Through testing moisture absorption and liberation regains of honeycomb polyester fiber and normal polyester fiber in standard atmospheric conditions, their moisture absorption and liberation curves were depicted, and the regression equations of moisture regains to time during their reaching the balance of moisture absorption and moisture liberation were obtained according to the curves. Their moisture absorption and liberation rate curves were analyzed and the regression equations of the rates to time were obtained. The results shows that the moisture regain of honeycomb polyester fiber is much bigger than the normal polyester fiber's, and the initial moisture absorption and moisture liberation rates of the former are much higher than the latter's, so that the moisture absorbance and sweat discharge of honeycomb polyester fiber are excellent.

Effectiveness of a Model Bundle Payment Initiative for Femur Fracture Patients.

PubMed

Lott, Ariana; Belayneh, Rebekah; Haglin, Jack; Konda, Sanjit; Egol, Kenneth A

2018-05-28

Analyze the effectiveness of a BPCI (Bundle Payments for Care Improvement) initiative for patients who would be included in a future potential Surgical Hip and Femur Fracture Treatment (SHFFT) bundle. Retrospective cohort SETTING:: Single Academic Institution PATIENTS/PARTICIPANTS:: Patients discharged with operative fixation of a hip or femur fracture (DRG codes 480-482) between 1/2015-10/2016 were included. A BPCI initiative based upon an established program for BPCI Total Joint Arthroplasty (TJA) was initiated for patients with hip and femur fractures in January 2016. Patients were divided into non-bundle (care before initiative) and bundle (care with initiative) cohorts. Application of BPCI principles MAIN OUTCOME MEASURES:: Length of stay, location of discharge, readmissions RESULTS:: 116 patients participated in the "institutional bundle," and 126 received care prior to the initiative. There was a trend towards decreased mean length of stay, (7.3 ± 6.3 days vs. 6.8 ± 4.0 days, p=0.457) and decreased readmission within 90 days (22.2% vs. 18.1%, p=0.426). The number of patients discharged home doubled (30.2% vs. 14.3%, p=0.008). There was no difference in readmission rates in bundle vs. non-bundle patients based on discharged home status; however, bundle patients discharged to SNF trended towards less readmissions than non-bundle patients discharged to SNF (37.3% vs. 50.6%, p=0.402). Mean episode cost reduction due to initiative was estimated to be $6,450 using Medicare reimbursement data. This study demonstrates the potential success of a BPCI initiative at one institution in decreasing post-acute care facility utilization and cost of care when used for a hip and femur fracture population. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Rationale and design of TRANSITION: a randomized trial of pre‐discharge vs. post‐discharge initiation of sacubitril/valsartan

PubMed Central

Wachter, Rolf; Senni, Michele; Belohlavek, Jan; Noè, Adele; Carr, David; Butylin, Dmytro

2017-01-01

Abstract Aims The prognosis after hospitalization for acute decompensated heart failure (ADHF) remains poor, especially <30 days post‐discharge. Evidence‐based medications with prognostic impact administered at discharge improve survival and hospital readmission, but robust studies comparing pre‐discharge with post‐discharge initiation are rare. The PARADIGM‐HF trial established sacubitril/valsartan as a new evidence‐based therapy in patients with heart failure (HF) and reduced left ventricular ejection fraction (<40%) (rEF). In common with other landmark studies, it enrolled patients who were ambulatory at the time of inclusion. In addition, there is also still limited knowledge of initiation and up‐titration of sacubitril/valsartan in ACEi/ARB‐ naïve patients and in de novo HF with rEF patients. Methods and results TRANSITION is a multicentre, open‐label study in which ~1000 adults hospitalized for ADHF with rEF are randomized to start sacubitril/valsartan in a pre‐discharge arm (initiated ≥24 h after haemodynamic stabilization) or a post‐discharge arm (initiated within Days 1–14 after discharge). The protocol allows investigators to select the appropriate starting dose and dose adjustments according to clinical circumstances. Over a 10 week treatment period, the primary and secondary objectives assess the feasibility and safety of starting sacubitril/valsartan in‐hospital, early after haemodynamic stabilization. Exploratory objectives also include assessment of HF signs and symptoms, readmissions, N‐terminal pro‐B‐type natriuretic peptide and high‐sensitivity troponin T levels, and health resource utilization parameters. Conclusions TRANSITION will provide new evidence about initiating sacubitril/valsartan following hospitalization for ADHF, occurring either as de novo ADHF or as deterioration of chronic HF, and in patients with or without prior ACEI/ARB therapy. The results of TRANSITION will thus be highly relevant to the management of patients hospitalized for ADHF with rEF. PMID:29239515

Rationale and design of TRANSITION: a randomized trial of pre-discharge vs. post-discharge initiation of sacubitril/valsartan.

PubMed

Pascual-Figal, Domingo; Wachter, Rolf; Senni, Michele; Belohlavek, Jan; Noè, Adele; Carr, David; Butylin, Dmytro

2018-04-01

The prognosis after hospitalization for acute decompensated heart failure (ADHF) remains poor, especially <30 days post-discharge. Evidence-based medications with prognostic impact administered at discharge improve survival and hospital readmission, but robust studies comparing pre-discharge with post-discharge initiation are rare. The PARADIGM-HF trial established sacubitril/valsartan as a new evidence-based therapy in patients with heart failure (HF) and reduced left ventricular ejection fraction (<40%) (rEF). In common with other landmark studies, it enrolled patients who were ambulatory at the time of inclusion. In addition, there is also still limited knowledge of initiation and up-titration of sacubitril/valsartan in ACEi/ARB- naïve patients and in de novo HF with rEF patients. TRANSITION is a multicentre, open-label study in which ~1000 adults hospitalized for ADHF with rEF are randomized to start sacubitril/valsartan in a pre-discharge arm (initiated ≥24 h after haemodynamic stabilization) or a post-discharge arm (initiated within Days 1-14 after discharge). The protocol allows investigators to select the appropriate starting dose and dose adjustments according to clinical circumstances. Over a 10 week treatment period, the primary and secondary objectives assess the feasibility and safety of starting sacubitril/valsartan in-hospital, early after haemodynamic stabilization. Exploratory objectives also include assessment of HF signs and symptoms, readmissions, N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T levels, and health resource utilization parameters. TRANSITION will provide new evidence about initiating sacubitril/valsartan following hospitalization for ADHF, occurring either as de novo ADHF or as deterioration of chronic HF, and in patients with or without prior ACEI/ARB therapy. The results of TRANSITION will thus be highly relevant to the management of patients hospitalized for ADHF with rEF. © 2017 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.

Fast repetition rate (FRR) flasher

DOEpatents

Kolber, Zbigniew; Falkowski, Paul

1997-02-11

A fast repetition rate (FRR) flasher suitable for high flash photolysis including kinetic chemical and biological analysis. The flasher includes a power supply, a discharge capacitor operably connected to be charged by the power supply, and a flash lamp for producing a series of flashes in response to discharge of the discharge capacitor. A triggering circuit operably connected to the flash lamp initially ionizes the flash lamp. A current switch is operably connected between the flash lamp and the discharge capacitor. The current switch has at least one insulated gate bipolar transistor for switching current that is operable to initiate a controllable discharge of the discharge capacitor through the flash lamp. Control means connected to the current switch for controlling the rate of discharge of the discharge capacitor thereby to effectively keep the flash lamp in an ionized state between Successive discharges of the discharge capacitor. Advantageously, the control means is operable to discharge the discharge capacitor at a rate greater than 10,000 Hz and even up to a rate greater than about 250,000 Hz.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rison, William; Krehbiel, Paul R.; Stock, Michael G.

A long-standing but fundamental question in lightning studies concerns how lightning is initiated inside storms, given the absence of physical conductors. The issue has revolved around the question of whether the discharges are initiated solely by conventional dielectric breakdown or involve relativistic runaway electron processes. Here we report observations of a relatively unknown type of discharge, called fast positive breakdown, that is the cause of high-power discharges known as narrow bipolar events. We find that the breakdown has a wide range of strengths and is the initiating event of numerous lightning discharges. It appears to be purely dielectric in naturemore » and to consist of a system of positive streamers in a locally intense electric field region. It initiates negative breakdown at the starting location of the streamers, which leads to the ensuing flash. The observations show that many or possibly all lightning flashes are initiated by fast positive breakdown.« less

Multipoint Ignition of a Gas Mixture by a Microwave Subcritical Discharge with an Extended Streamer Structure

NASA Astrophysics Data System (ADS)

Aleksandrov, K. V.; Busleev, N. I.; Grachev, L. P.; Esakov, I. I.; Ravaev, A. A.

2018-02-01

The results of experimental studies on using an electrical discharge with an extended streamer structure in a quasioptical microwave beam in the multipoint ignition of a propane-air mixture have been reported. The pulsed microwave discharge was initiated at the interior surface of a quartz tube that was filled with the mentioned flammable mixture and introduced into a microwave beam with a subbreakdown initial field. Gas breakdown was initiated by an electromagnetic vibrator. The dependence of the type of discharge on the microwave field strength was examined, the lower concentration threshold of ignition of the propane-air mixture by the studied discharge was determined, and the dynamics of combustion of the flammable mixture with local and multipoint ignition were compared.

Observations of narrow bipolar events reveal how lightning is initiated in thunderstorms

DOE PAGES

Rison, William; Krehbiel, Paul R.; Stock, Michael G.; ...

2016-02-15

A long-standing but fundamental question in lightning studies concerns how lightning is initiated inside storms, given the absence of physical conductors. The issue has revolved around the question of whether the discharges are initiated solely by conventional dielectric breakdown or involve relativistic runaway electron processes. Here we report observations of a relatively unknown type of discharge, called fast positive breakdown, that is the cause of high-power discharges known as narrow bipolar events. We find that the breakdown has a wide range of strengths and is the initiating event of numerous lightning discharges. It appears to be purely dielectric in naturemore » and to consist of a system of positive streamers in a locally intense electric field region. It initiates negative breakdown at the starting location of the streamers, which leads to the ensuing flash. The observations show that many or possibly all lightning flashes are initiated by fast positive breakdown.« less

The Influence of the Shape of Model Hydrometeors on the Formation of Discharge between an Artificial-Thunderstorm Cell and the Ground

NASA Astrophysics Data System (ADS)

Temnikov, A. G.; Chernenskii, L. L.; Orlov, A. V.; Lysov, N. Yu.; Belova, O. S.; Gerastenok, T. K.; Zhuravkova, D. S.

2017-12-01

We have experimentally studied how arrays of model coarse hydrometeors influence the initiation and propagation of discharge between an artificial-thunderstorm cell of negative or positive polarity and the ground. It is established for the first time that the probability of initiation and stimulation of a channeled discharge between negatively or positively charged cloud and the ground significantly depends on the shape and size of coarse hydrometeors occurring near the thunderstorm cell boundaries. The obtained results can be used in developing methods for the artificial initiation of the cloud-ground type lightning of both polarities and targeted discharge of thunderstorm clouds.

Selective fibronectin adsorption against albumin and enhanced stem cell attachment on helium atmospheric pressure glow discharge treated titanium

NASA Astrophysics Data System (ADS)

Han, Inho; Vagaska, Barbora; Joo Park, Bong; Lee, Mi Hee; Jin Lee, Seung; Park, Jong-Chul

2011-06-01

Successful tissue integration of implanted medical devices depends on appropriate initial cellular response. In this study, the effect of helium atmospheric pressure glow discharge (He-APGD) treatment of titanium on selective protein adsorption and the initial attachment processes and focal adhesion formation of osteoprogenitor cells and stem cells were examined. Titanium disks were treated in a self-designed He-APGD system. Initial attachment of MC3T3-E1 mouse pre-osteoblasts and human mesenchymal stem cells (MSCs) was evaluated by MTT assay and plasma membrane staining followed by morphometric analysis. Fibronectin adsorption was investigated by Enzyme-Linked ImmunoSorbant Assay. MSCs cell attachment to treated and non-treated titanium disks coated with different proteins was verified also in serum-free culture. Organization of actin cytoskeleton and focal adhesions was evaluated microscopically. He-APGD treatment effectively modified the titanium surfaces by creating a super-hydrophilic surface, which promoted selectively higher adsorption of fibronectin, a protein of critical importance for cell/biomaterial interaction. In two different types of cells, the He-APGD treatment enhanced the number of attaching cells as well as their attachment area. Moreover, cells had higher organization of actin cytoskeleton and focal adhesions. Faster acceptance of the material by the progenitor cells in the early phases of tissue integration after the implantation may significantly reduce the overall healing time; therefore, titanium treatment with He-APGD seems to be an effective method of surface modification of titanium for improving its tissue inductive properties.

In-hospital switching between adenosine diphosphate receptor inhibitors in patients with acute myocardial infarction treated with percutaneous coronary intervention: Insights into contemporary practice from the TRANSLATE-ACS study.

PubMed

Bagai, Akshay; Peterson, Eric D; Honeycutt, Emily; Effron, Mark B; Cohen, David J; Goodman, Shaun G; Anstrom, Kevin J; Gupta, Anjan; Messenger, John C; Wang, Tracy Y

2015-12-01

While randomized clinical trials have compared clopidogrel with higher potency adenosine diphosphate (ADP) receptor inhibitors among patients with acute myocardial infarction, little is known about the frequency, effectiveness and safety of switching between ADP receptor inhibitors in routine clinical practice. We studied 11,999 myocardial infarction patients treated with percutaneous coronary intervention at 230 hospitals from April 2010 to October 2012 in the TRANSLATE-ACS study. Multivariable Cox regression was used to compare six-month post-discharge risks of major adverse cardiovascular events (MACE: death, myocardial infarction, stroke, or unplanned revascularization) and Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO)-defined bleeding between in-hospital ADP receptor inhibitor switching versus continuation of the initially selected therapy. Among 8715 patients treated initially with clopidogrel, 994 (11.4%) were switched to prasugrel or ticagrelor; switching occurred primarily after percutaneous coronary intervention (60.9%) and at the time of hospital discharge (26.7%). Among 3284 patients treated initially with prasugrel or ticagrelor, 448 (13.6%) were switched to clopidogrel; 48.2% of switches occurred after percutaneous coronary intervention and 48.0% at hospital discharge. Switching to prasugrel or ticagrelor was not associated with increased bleeding when compared with continuation on clopidogrel (2.7% vs. 3.3%, adjusted hazard ratio 0.96, 95% confidence interval 0.64-1.42, p=0.82). Switching from prasugrel or ticagrelor to clopidogrel was not associated with increased MACE (8.9% vs. 7.7%, adjusted hazard ratio 1.06, 95% confidence interval 0.75-1.49, p=0.76) when compared with continuation on the higher potency agent. In-hospital ADP receptor inhibitor switching occurs in more than one in 10 myocardial infarction patients in contemporary practice. In this observational study, ADP receptor inhibitor switching does not appear to be significantly associated with increased hazard of MACE or bleeding. © The European Society of Cardiology 2014.

The Spatial Expansion of a Discharge in the Generation and the Channel Structure (in German)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schlumbohm, H.

1962-02-01

The spatial expansion of a discharge was investigated under homogeneous field conditions, using an anode with a small central area separated from the remainder and wide band double beam oscillographic techniques. The discharge currents were initiated by electrons released along traces of single alpha particles in the gas between the electrodes. The k particles enter the gap volume through a small hole in the middle of the separated center of the anode. The measurements have shown that a secondary photon emission from the cathode causes a spreading over the total gap volume within the first few electron generations (N 2,more » air, and CO 2 at lower pressures). If a streamer mechanism occurs (O 2 and CO 2 at higher pressures), the discharge remains localized to the trace of the alpha particle, in which the avalanches yielded by the primary electrons have produced a high density of positive ions. New details of steamer mechanism are revealed by analyzing the rapid increase of the current during streamer formation.« less

Experimental investigation on the effect of plasma jet in the triggered discharge process of a gas switch

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tie, W., E-mail: twh.110.666@163.com, E-mail: 84470220@qq.com; Xi'an Jiaotong University, Xi'an 710049; Liu, S.

The temporal and spatial evolution of a plasma jet generated by a spark discharge was observed. The electron temperature and density were obtained under different time and gas pressures by optical emission spectroscopy. Moreover, the discharge process of the plasma-jet triggered gas switch was recorded and analyzed at the lowest working coefficient. The results showed that the plasma jet moved forward in a bullet mode, and the advancing velocity increased with the decrease of pressure, and decreased with time growing. At initial time, the maximum velocity of a plasma jet could reach 3.68 × 10{sup 6 }cm/s. The electron temperature decreased from 2.0 eVmore » to 1.3 eV, and the electron density increased from 3.1 × 10{sup 15}/cm{sup 3} to 6.3 × 10{sup 15}/cm{sup 3} at the initial moment as the gas pressure increases from 0.1 MPa to 0.32 MPa. For a two-gap gas switch, the discharge performances were more depended on the second discharge spark gap (gap 2). Because plasma jet promoted the discharge in Gap 2, the gas switch operating in mode II had better triggered discharge characteristics. In the discharge process, the plasma-jet triggering had the effect of non-penetrating inducing, which not only provided initial electrons for reducing statistical lag but also enhanced the local electric field. The discharge was initiated and accelerated from electron avalanche to streamer. Therefore, a fast discharge was occurred in the gas switch.« less

Factors associated with exclusive breastfeeding at hospital discharge in rural Western Australia.

PubMed

Cox, Kylee; Giglia, Roslyn; Zhao, Yun; Binns, Colin W

2014-11-01

Breastfeeding is accepted as the best way of feeding infants, and health authorities recommend exclusive breastfeeding to around 6 months of age, but despite the evidence of its benefits, few mothers meet this goal. Infants who are exclusively breastfed in the early postpartum period are more likely to continue breastfeeding at 6 and 12 months, reinforcing the role that Baby-Friendly hospital practices play in supporting exclusive breastfeeding. This study aimed to determine the rate of breastfeeding initiation and identify the factors associated with exclusive breastfeeding at discharge from hospital for rural mothers. The prospective cohort study recruited 489 women from hospitals in regional Western Australia following the birth of their infant. Breastfeeding exclusivity at discharge was assessed based on mothers' self-reported infant feeding behavior during her hospital stay. The self-administered baseline questionnaire was completed by 427 mothers. Breastfeeding was initiated by 97.7% of the mothers in this cohort, with 82.7% exclusively breastfeeding at hospital discharge. The odds of exclusive breastfeeding at discharge were more than 4 times higher for women whose infants did not require admission to the special care nursery (adjusted odds ratio [aOR] = 4.43; 95% confidence interval [CI], 1.98-9.99). Demand feeding (aOR = 3.33; 95% CI, 1.59-6.95) and 24-hour rooming-in (aOR = 2.31; 95% CI, 1.15-4.62) were also significant positive factors. The findings suggest that hospital practices are strong predictors of exclusive breastfeeding. Greater emphasis on Baby-Friendly hospital practices in the early postpartum period may help the establishment of exclusive breastfeeding, assisting rural mothers to reach established international breastfeeding recommendations. © The Author(s) 2014.

Fast repetition rate (FRR) flasher

DOEpatents

Kolber, Z.; Falkowski, P.

1997-02-11

A fast repetition rate (FRR) flasher is described suitable for high flash photolysis including kinetic chemical and biological analysis. The flasher includes a power supply, a discharge capacitor operably connected to be charged by the power supply, and a flash lamp for producing a series of flashes in response to discharge of the discharge capacitor. A triggering circuit operably connected to the flash lamp initially ionizes the flash lamp. A current switch is operably connected between the flash lamp and the discharge capacitor. The current switch has at least one insulated gate bipolar transistor for switching current that is operable to initiate a controllable discharge of the discharge capacitor through the flash lamp. Control means connected to the current switch for controlling the rate of discharge of the discharge capacitor thereby to effectively keep the flash lamp in an ionized state between successive discharges of the discharge capacitor. Advantageously, the control means is operable to discharge the discharge capacitor at a rate greater than 10,000 Hz and even up to a rate greater than about 250,000 Hz. 14 figs.

Plasma Assisted Combustion

DTIC Science & Technology

2007-02-28

these pulses was uniform. Dependence of the energy contribution on pressure is showed in the Figure 3.5. It is clearly seen that for the pressure of...note that water–ions kinetics is more important than kinetics of initial substances– ions because water has higher proton affinity energy than... pulsed discharge. 4.3.2 Kinetic model To calculate the densities of active particles, one has to determine electron energy dis- tribution function (EEDF

Advanced Concepts Research Initiative

EPA Science Inventory

This initiative is investigating various approaches to controlling and treating wet-weather flow (WWF) discharges in the urban watershed. WWF, including combined sewer overflow (CSO), sanitary sewer overflow (SSO) and stormwater discharges are leading causes of receiving water q...

A Multidisciplinary Quality Improvement Approach Increases Breastmilk Availability at Discharge from the Neonatal Intensive Care Unit for the Very-Low-Birth-Weight Infant.

PubMed

Bixby, Christine; Baker-Fox, Cindy; Deming, Crystal; Dhar, Vijay; Steele, Caroline

2016-03-01

Mothers of very-low-birth-weight (VLBW) infants often struggle to establish and maintain a milk supply. Children's Hospital of Orange County (CHOC Children's) data from 2005 to 2011 showed that while the total percentage of all neonatal intensive care unit (NICU) babies being discharged on breastmilk had remained stable, the percentage of VLBW babies with breastmilk at discharge had declined. This information resulted in a quality improvement initiative to remove barriers and implement programs shown to have the greatest impact on initiating and sustaining lactation in this patient subset. The objective of this initiative was to increase breastmilk availability at discharge for the VLBW population. A multidisciplinary program was initiated, which included NICU parent and staff education, clarification of roles, and improved access to pumping supplies. Physicians and nurses completed online education. An algorithm defining roles in lactation support was developed, and a resource team of trained bedside nurses was formed. Lactation consultant time was then refocused on the VLBW population. In addition, "Lactation Support" was added to the physician daily documentation to bring the topic to daily bedside rounds. Twice weekly lactation rounds between the lactation consultant and neonatologist addressed lactation concerns for each dyad. To address pumping issues, the loaner pump program was enhanced. To assess the effectiveness of the initiative, breastmilk availability at discharge for the VLBW population at CHOC Children's was compared from baseline (2011) to the end of June 2015. VLBW breastmilk availability at discharge upon project initiation was 58.7% and increased by 36% to a final rate of 80% by 2013--a rate sustained through the first 6 months of 2015. The results of this initiative suggest that a multidisciplinary approach, including education, changes in workflow, and redefinition of roles, is effective in improving breastmilk rates at discharge in the VLBW patient population.

Improving Human Milk and Breastfeeding Practices in the NICU.

PubMed

Fugate, Karen; Hernandez, Ivonne; Ashmeade, Terri; Miladinovic, Branko; Spatz, Diane L

2015-01-01

To determine if systematic implementation of the Spatz Ten Steps for Promoting and Protecting Breastfeeding for Vulnerable Infants (Ten Steps) would result in an improvement in the percentage of infants receiving mother's own milk (MOM) at initiation of feedings and at hospital discharge. Continuous quality improvement (QI) process. Urban, 82-bed, Level-III NICU. Very- low-birth-weight (VLBW) infants weighing fewer than 1500 grams. The Ten Step method was implemented during a 3-year period. Process measurements included percentage of VLBW infants receiving MOM at initiation of feeds, number of mothers of VLBW infants with hospital-grade electric breast pump at hospital discharge, and number of mothers of VLBW infants initiating pumping within 6 hours of delivery. Outcome measurements included percentage of VLBW infants with any human milk at discharge to home and parent satisfaction with nurses' support of mother's efforts to breastfeed. Balancing measurements included percentage of VLBW infants at less than the third percentile for growth on the Fenton growth chart at discharge and receiving pasteurized donor milk (PDM). Significant improvements were achieved in the percentages of mothers expressing their milk within 6 hours of delivery, infants receiving MOM at initiation of feeds, and mothers with a hospital-grade pump at discharge. Improvements in these processes resulted in increased parent satisfaction with nurses' support of breastfeeding and a 3.1-fold greater odds of the VLBW infant receiving MOM at discharge in 2013 compared to 2010 (odds ratio [OR]= 3.01, 95% confidence interval [CI] [1.75, 5.17], p < .001). Despite an increase in the use of MOM, there was not a significant increase in VLBW infants discharged at less than the third percentile for growth, and initiation of PDM did not negatively affect the percentage of VLBW infants with any human milk at discharge. Implementation of the Ten Steps method using QI methodology resulted in significantly improved rates of use of MOM at initiation of feeds and at hospital discharge. © 2015 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses.

Nanodisperse transition metal electrodes (NTME) for electrochemical cells

DOEpatents

Striebel, Kathryn A.; Wen, Shi-Jie

2000-01-01

Disclosed are transition metal electrodes for electrochemical cells using gel-state and solid-state polymers. The electrodes are suitable for use in primary and secondary cells. The electrodes (either negative electrode or positive electrode) are characterized by uniform dispersion of the transition metal at the nanoscale in the polymer. The transition metal moiety is structurally amorphous, so no capacity fade should occur due to lattice expansion/contraction mechanisms. The small grain size, amorphous structure and homogeneous distribution provide improved charge/discharge cycling performance, and a higher initial discharge rate capability. The cells can be cycled at high current densities, limited only by the electrolyte conductivity. A method of making the electrodes (positive and negative), and their usage in electrochemical cells are disclosed.

Radiative Characteristics of the Pulse-Periodic Discharge Plasma Initiated by Runaway Electrons

NASA Astrophysics Data System (ADS)

Lomaev, M. I.; Beloplotov, D. V.; Tarasenko, V. F.; Sorokin, D. A.

2016-07-01

Results of experimental investigations of amplitude-temporal and spectral characteristics of radiation of a pulse-periodic discharge plasma initiated in nitrogen by runaway electrons are presented. The discharge was initiated by high-voltage nanosecond voltage pulses with repetition frequency of 60 Hz in a sharply inhomogeneous electric field in a gap between the conic potential cathode and the planar grounded aluminum anode. It is established that intensive lines of Al I atoms and Al II atomic ions, lines of N I atoms and N II ions, bands of the first (1+) and second positive (2+) nitrogen systems, as well as bands of cyanogen CN are observed in the emission spectrum of the discharge plasma under the given excitation conditions.

Does Wilson's cloud chamber offer clues on lightning initiation in thunderclouds?

NASA Astrophysics Data System (ADS)

Cooray, V.; Rakov, V.

2007-12-01

The experimental evidence indicates that the large scale electric field in the cloud at the time of lightning initiation is about 100 kV/m [1], which is an order of magnitude lower than the expected conventional breakdown field. One important problem in atmospheric physics is to understand how lightning flashes are initiated in such low fields. Some scientists suggest that the electric field could reach higher values momentarily in small regions and this combined with the field enhancing action of hydrometeors in the cloud could provide trigger for lightning initiation [2, 3]. Others suggest that energetic electrons produced by cosmic rays could give rise to runaway electron avalanches generating the initial ionization necessary for lightning initiation [4]. Nguyen and Michnowski [2] suggested that in small cloud regions the electric field may exceed 200 to 400 kV/m and in these locations the discharges between hydrometeors could facilitate lightning initiation. This mechanism was further investigated by Cooray et al. [3] who showed that interaction between adjacent hydrometeors cannot produce a streamer discharge, a prerequisite for electric breakdown, unless the field exceeds about 830 kV/m. They also found that long chains of hydrometeors could initiate streamer discharges in relatively low electric fields. For example, in order to generate a streamer discharge in 100 kV/m electric field the length of the chain of hydrometeors of 0.1 mm radius should be about 65 mm with more than 100 particles constituting the chain. However, the question remains on how such long chains of hydrometeors can be produced in the cloud. We suggest the following possibility. Consider an energetic particle passing through the cloud producing ionization in its wake. The passage of such a particle will lead to a stream of positive ions and electrons with the latter being captured within a few tens of nanoseconds by oxygen molecules to form negative ions. If the water vapor in the region under consideration is supersaturated, water molecules will condense on the ions and the resulting droplets can grow to tens of micrometers in a fraction of a second. This is the mechanism utilized in Wilson's cloud chamber to visualize the tracks of ionizing particles. If the track of ionizing particle is aligned with the direction of the electric field in the cloud, the resultant drift of the oppositely charged particles in opposite directions will facilitate collisions among them leading to production of larger droplets. This process can potentially generate long chains of droplets in the cloud which may provide the trigger necessary for the initiation of lightning flashes. [1] Marshall, T. C., M. P. McCarthy and W. D. Rust, Electric field magnitudes and lightning initiation in thunderstorms, J. Geophys. Res., vol. 100, pp. 7097 - 7103, 1995. [2] Nguyen, M. D. and S. Michnowski, On the initiation of lightning discharges in a cloud, 2. The lightning initiation on precipitation particles, J. Geophys. Res., vol. 101, pp. 26 675 - 26 680, 1996. [3] Cooray, V., M. Berg, M. Akyuz and A. Larsson, Initiation of ground flashes: some microscopic electrical processes associated with precipitation particles, Proc. International Conference on Lightning Protection, Birmingham, UK, 2002. [4] Gurevich, A. V., G. M. Milikh and J. A. Valdivia, Model of X-ray emission and fast preconditioning during a thunderstorm, Phys. Lett., A 231, pp. 402 - 408, 1997.

Application of Artificial Thunderstorm Cells for the Investigation of Lightning Initiation Problems between a Thundercloud and the Ground

NASA Astrophysics Data System (ADS)

Temnikov, A. G.; Chernensky, L. L.; Orlov, A. V.; Lysov, N. Y.; Zhuravkova, D. S.; Belova, O. S.; Gerastenok, T. K.

2017-12-01

The results of the experimental application of artificial thunderstorm cells of negative and positive polarities for the investigation of the lightning initiation problems between the thundercloud and the ground using model hydrometeor arrays are presented. Possible options of the initiation and development of a discharge between the charged cloud and the ground in the presence of model hydrometeors are established. It is experimentally shown that groups of large hydrometeors of various shapes significantly increase the probability of channel discharge initiation between the artificial thunderstorm cell and the ground, especially in the case of positive polarity of the cloud. The authors assume that large hail arrays in the thundercloud can initiate the preliminary breakdown stage in the lower part of the thundercloud or initiate and stimulate the propagation of positive lightning from its upper part. A significant effect of the shape of model hydrometeors and the way they are grouped on the processes of initiation and stimulation of the channel discharge propagation in the artificial thunderstorm cell of negative or positive polarity-ground gap is experimentally established. It is found that, in the case of negative polarity of a charged cloud, the group of conductive cylindrical hydrometeors connected by a dielectric string more effectively initiates the channel discharge between the artificial thunderstorm cell and the ground. In the case of positive polarity of the artificial thunderstorm cell, the best effect of the channel discharge initiation is achieved for model hydrometeors grouped together by the dielectric tape. The obtained results can be used in the development of the method for the directed artificial lightning initiation between the thundercloud and the ground.

Lightning Mapping Observations of Volume-Filling Small Discharges in Thunderstorms

NASA Astrophysics Data System (ADS)

Rison, W.; Krehbiel, P. R.; Thomas, R. J.; Rodeheffer, D.

2013-12-01

Lightning is usually considered to be a large-scale electrical discharge in the atmosphere. For example, the American Meteorological Society's Glossary of Meteorology defines lightning as "a transient, high-current electric discharge with pathlengths measured in kilometers" (http://glossary.ametsoc.org/wiki/Lightning). There have been several reported examples of short-duration discharges in thunderstorms, which have a duration of a few microseconds to less than a millisecond, and have a small spatial extent These short-duration discharges were located at high altitudes (> 14 km), altitudes consistent with being located between the upper positive charge and the negative screening layer. At these altitudes, the electric field needed to initiate an electrical discharge is much lower than it is at the altitudes of initiation for IC (~8 km) or CG (~5 km) flashes. We have recently reported on short-duration "precursor" discharges with durations of a few microseconds to a few milliseconds, which occur in the high-fields between the mid-level negative and upper positive charge regions. These "precursor" discharges are discrete in both time and space, being separated in time by hundreds of milliseconds to several seconds, and localized in space, usually very close to the initiation location of a subsequent IC discharge. We have recently observed nearly continuous, volume filling short-duration discharges in several thunderstorms. These discharges have durations of much less than a millisecond, spatial extents of less than a few hundred meters, and occur randomly in the volume between the mid-level negative and upper positive charge regions. During an active period, these discharges occur every few milliseconds. The rates of these discharges decreases dramatically to a few per second following an IC discharge, then increases to several hundred per second until the next discharge. In a storm just off the Florida coast, one cell was producing a large number of these small discharges, while a contemporaneous cell a few kilometers west produced no detectable small discharges. Short-duration discharges occur at altitudes between 10 km and 14 km in the intervals between lightning discharges. The rates of short-duration discharges decreases dramatically after a lightning discharge.

Improving the reliability of verbal communication between primary care physicians and pediatric hospitalists at hospital discharge.

PubMed

Mussman, Grant M; Vossmeyer, Michael T; Brady, Patrick W; Warrick, Denise M; Simmons, Jeffrey M; White, Christine M

2015-09-01

Timely and reliable verbal communication between hospitalists and primary care physicians (PCPs) is critical for prevention of medical adverse events but difficult in practice. Our aim was to increase the proportion of completed verbal handoffs from on-call residents or attendings to PCPs within 24 hours of patient discharge from a hospital medicine service to ≥90% within 18 months. A multidisciplinary team collaborated to redesign the process by which PCPs were contacted following patient discharge. Interventions focused on the key drivers of obtaining stakeholder buy-in, standardization of the communication process, including assigning primary responsibility for discharge communication to a single resident on each team and batching calls during times of maximum resident availability, reliable automated process initiation through leveraging the electronic health record (EHR), and transparency of data. A run chart assessed the impact of interventions over time. The percentage of calls initiated within 24 hours of discharge improved from 52% to 97%, and the percentage of calls completed improved to 93%. Results were sustained for 18 months. Standardization of the communication process through hospital telephone operators, use of the discharge order to ensure initiation of discharge communication, and batching of phone calls were associated with improvements in our measures. Reliable verbal discharge communication can be achieved through the use of a standardized discharge communication process coupled with the EHR. © 2015 Society of Hospital Medicine.

Electron Temperature Evolution During Local Helicity Injection on the Pegasus Toroidal Experiment

NASA Astrophysics Data System (ADS)

Schlossberg, D. J.; Barr, J. L.; Bodner, G. M.; Bongard, M. W.; Fonck, R. J.; Perry, J. M.; Reusch, J. A.; Rodriguez Sanchez, C.

2016-10-01

Understanding the electron temperature (Te) evolution during local helicity injection (LHI) is critical for scaling up this non-solenoidal startup technique to MA-class devices. The first comprehensive Te measurements during LHI reveal centrally-peaked profiles with Te > 100 eV for plasma current Ip > 120 kA, toroidal field 0.15 T, and electron density ne 1019 m-3. Te rises and is sustained from just after magnetic relaxation through the plasma decoupling from edge-localized injectors. Results are presented for two injector edge locations: outboard midplane and inboard divertor. Outboard midplane injection couples LHI with inductive drive from poloidal field ramps and radial compression during inward plasma growth. Comparisons of Te at different LHI-to-inductive drive ratios show some profile flattening for higher LHI drive fraction. The latter, constant-shape discharges were necessarily lower performance, with Ip 50 kA and reduced Te , max. Inboard divertor injection achieves higher Ip using minimal inductive drive and thus isolates effects of LHI drive on Te. Initial results in this configuration show Te rising rapidly at the injector location as the discharge grows, settling to a roughly flat profile 100 eV. Thus far, both scenarios provide relatively stable discharges with moderate ne and high-Te, suitable for coupling to auxiliary current drive. Detailed studies of confinement dynamics and discharge optimization are planned for the near future. Work supported by US DOE Grant DE-FG02-96ER54375.

42 CFR 412.4 - Discharges and transfers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES General Provisions § 412.4 Discharges... hospital inpatient is considered discharged from a hospital paid under the prospective payment system when... the initial discharge) to another hospital that is— (1) Paid under the prospective payment system...

42 CFR 412.4 - Discharges and transfers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES General Provisions § 412.4 Discharges... hospital inpatient is considered discharged from a hospital paid under the prospective payment system when... the initial discharge) to another hospital that is— (1) Paid under the prospective payment system...

42 CFR 412.4 - Discharges and transfers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES General Provisions § 412.4 Discharges... hospital inpatient is considered discharged from a hospital paid under the prospective payment system when... the initial discharge) to another hospital that is— (1) Paid under the prospective payment system...

42 CFR 412.4 - Discharges and transfers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES General Provisions § 412.4 Discharges... hospital inpatient is considered discharged from a hospital paid under the prospective payment system when... the initial discharge) to another hospital that is— (1) Paid under the prospective payment system...

42 CFR 412.4 - Discharges and transfers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES General Provisions § 412.4 Discharges... hospital inpatient is considered discharged from a hospital paid under the prospective payment system when... the initial discharge) to another hospital that is— (1) Paid under the prospective payment system...

Microelectrode-assisted low-voltage atmospheric pressure glow discharge in air

NASA Astrophysics Data System (ADS)

Liu, Wenzheng; Zhao, Shuai; Niu, Jiangqi; Chai, Maolin

2017-09-01

During the process of discharge, appropriately changing the paths corresponding to electric field lines and the field strength distribution along these paths, as well as increasing the number of initial electrons, can effectively enhance the uniformity of discharge and inhibit the formation of filamentary discharge. A method is proposed that uses a microelectrode to initiate the macroscopic discharge phenomenon. An asymmetric structure was designed comprising a single electrode of carbon fiber; this electrode structure is of helical-contact type. Benefitting from the special electric field distribution and the microdischarge process, a three-dimensional atmospheric pressure glow discharge was achieved in air, characterized by low discharge voltage, low energy consumption, good diffusion performance, and less ozone generation. The plasma studied is uniform and stable with good diffusion characteristics and low levels of contaminants and hence has potential applications in the field of air purification.

Comparative effectiveness of coronary CT angiography vs stress cardiac imaging in patients following hospital admission for chest pain work-up: The Prospective First Evaluation in Chest Pain (PERFECT) Trial.

PubMed

Uretsky, Seth; Argulian, Edgar; Supariwala, Azhar; Agarwal, Shiv K; El-Hayek, Georges; Chavez, Patricia; Awan, Hira; Jagarlamudi, Ashadevi; Puppala, Siva P; Cohen, Randy; Rozanski, Alan

2017-08-01

Because the frequency of cardiac event rates is low among chest pain patients following either performance of coronary CT angiography (CCTA) or stress testing, there is a need to better assess how these tests influence the central management decisions that follow from cardiac testing. The present study was performed to assess the relative impact of CCTA vs stress testing on medical therapies and downstream resource utilization among patients admitted for the work-up of chest pain. The admitted patients were randomized in a 1:1 ratio to either cardiac imaging stress test or CCTA. Primary outcomes were time to discharge, change in medication usage, and frequency of downstream testing, cardiac interventions, and cardiovascular re-hospitalizations. We randomized 411 patients, 205 to stress testing, and 206 to CCTA. There were no differences in time to discharge or initiation of new cardiac medications at discharge. At 1 year follow-up, there was no difference in the number of patients who underwent cardiovascular downstream tests in the CCTA vs stress test patients (21% vs 15%, P = .1) or cardiovascular hospitalizations (14% vs 16%, P = .5). However, there was a higher frequency of invasive angiography in the CCTA group (11% vs 2%, P = .001) and percutaneous coronary interventions (6% vs 0%, P < .001). Randomization of hospitalized patients admitted for chest pain work-up to either CCTA or to stress testing resulted in similar discharge times, change in medical therapies at discharge, frequency of downstream noninvasive testing, and repeat hospitalizations. However, a higher frequency of invasive coronary angiography and revascularization procedures were performed in the CCTA arm. (ClinicalTrials.gov number, NCT01604655.).

77 FR 66087 - Federal Perkins Loan Program, Federal Family Education Loan Program, and William D. Ford Federal...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-01

...The Secretary amends the Federal Perkins Loan (Perkins Loan) program, Federal Family Education Loan (FFEL) program, and William D. Ford Federal Direct Loan (Direct Loan) program regulations. These final regulations implement a new Income-Contingent Repayment (ICR) plan in the Direct Loan program based on the President's ``Pay As You Earn'' repayment initiative, incorporate recent statutory changes to the Income-Based Repayment (IBR) plan in the Direct Loan and FFEL programs, and streamline and add clarity to the total and permanent disability (TPD) discharge process for borrowers in loan programs under title IV of the Higher Education Act of 1965, as amended (HEA). These final regulations implementing a new ICR plan and the statutory changes to the IBR plan will assist borrowers in repaying their loans while the changes to the TPD discharge process will reduce burden for borrowers who are disabled and seeking a discharge of their title IV debt.

Short Haul Civil Tiltrotor Contingency Power System Preliminary Design

NASA Technical Reports Server (NTRS)

Eames, David J. H.

2006-01-01

Single Langmuir probe measurements are presented over a two-dimensional array of locations in the near Discharge Cathode Assembly (DCA) region of a 30-cm diameter ring cusp ion thruster over a range of thruster operating conditions encompassing the high-power half of the NASA throttling table. The Langmuir probe data were analyzed with two separate methods. All data were analyzed initially assuming an electron population consisting of Maxwellian electrons only. The on-axis data were then analyzed assuming both Maxwellian and primary electrons. Discharge plasma data taken with beam extraction exhibit a broadening of the higher electron temperature plume boundary compared to similar discharge conditions without beam extraction. The opposite effect is evident with the electron/ion number density as the data without began, extraction appears to be more collimated than the corresponding data with beam extraction. Primary electron energy and number densities are presented for one operating condition giving an order of magnitude of their value and the error associated with this calculation.

Evaluation of Cycle Life and Characterization of YTP 45 Ah Li-Ion Battery for EMU

NASA Technical Reports Server (NTRS)

Deng, Yi; Jeevarajan, Judith; Rehm, Raymond; Bragg, Bobby; Strangways, Brad

2002-01-01

Li-ion batteries, with longer cycle life and higher energy density features, are now more and more attractive and applied in multiple fields. The YTP 45 Ah Li-ion battery has been evaluated here and may be employed in EMU in the future. Evaluations were on: (1) Cycle life tests - 500 cycles total (completed 40 cycles in simulated shuttle use mode and 460 cycles in an accelerated use mode, and recorded differential voltage of individual cell in battery); (2) Characterization test - discharge capacity measurement in environment temperature of -10, 25, 50 C before and after 500 cycles; and (3) Thermal testing - charge and discharge at 50 C and -10 C before and after 500 cycles. The battery showed less than a 9% drop of initial discharge capacity and energy within 500 cycles with 475 cycles 59% DOD plus 25 cycles 100% DOD. The EOD voltage ranged from 16.0 to 18.0 V, which fits the requirement for operating the EMU.

Effect of turbulent flow on an atmospheric-pressure AC powered gliding arc discharge

NASA Astrophysics Data System (ADS)

Kong, Chengdong; Gao, Jinlong; Zhu, Jiajian; Ehn, Andreas; Aldén, Marcus; Li, Zhongshan

2018-06-01

A high-power gliding arc (GA) discharge was generated in a turbulent air flow driven by a 35 kHz alternating current electric power supply. The effects of the flow rate on the characteristics of the GA discharge were investigated using combined optical and electrical diagnostics. Phenomenologically, the GA discharge exhibits two types of discharge, i.e., glow type and spark type, depending on the flow rates and input powers. The glow-type discharge, which has peak currents of hundreds of milliamperes, is sustained at low flow rates. The spark-type discharge, which is characterized by a sharp current spike of several amperes with duration of less than 1 μs, occurs more frequently as the flow rate increases. Higher input power can suppress spark-type discharges in moderate turbulence, but this effect becomes weak under high turbulent conditions. Physically, the transition between glow- and spark-type is initiated by the short cutting events and the local re-ignition events. Short cutting events occur owing to the twisting, wrinkling, and stretching of the plasma columns that are governed by the relatively large vortexes in the flow. Local re-ignition events, which are defined as re-ignition along plasma columns, are detected in strong turbulence due to increment of the impedance of the plasma column and consequently the internal electric field strength. It is suggested that the vortexes with length scales smaller than the size of the plasma can penetrate into the plasma column and promote mixing with surroundings to accelerate the energy dissipation. Therefore, the turbulent flow influences the GA discharges by ruling the short cutting events with relatively large vortexes and the local re-ignition events with small vortexes.

Readmission after Gastrointestinal Bleeding in Children: A Retrospective Cohort Study.

PubMed

Attard, Thomas M; Miller, Mikaela; Pant, Chaitanya; Thomson, Mike

2017-05-01

To compare the demographic, clinical, and therapeutic characteristics in a cohort of patients discharged following acute gastrointestinal bleeding, representing to the emergency department (ED) and readmitted within 30 days of discharge with the characteristics of non-readmitted patients. Hospitalization data was obtained from the Pediatric Hospital Information System including 49 tertiary children's hospitals in the US. Children 1-21 years of age diagnosed with acute gastrointestinal bleeding, admitted between January 2007 and September 2015 were included. The primary outcomes in this study were 30-day inpatient readmission through the ED and 30-day return to the ED only. Unadjusted, univariate followed by multivariable analysis of the associations between patient characteristics and treatment course at the index encounter using the R statistical package, v. 3.2.3. During the study period, 9902 patients were admitted with acute gastrointestinal bleeding; in the following month, 1460 (16.1%) represented to the ED and 932 (9%) were readmitted; 68.7% within 14 days from discharge. Readmission was most frequently associated with portal hypertension or esophageal variceal hemorrhage. There was a decreased likelihood of readmission with endoscopy (OR 0.77, 95% CI, 0.661, 0.906) and with Meckel scan (OR 0.513, 95% CI 0.362, 0.727) during the initial admission. Multiple comorbidities, longer initial stay and the early proton pump inhibitor therapy were associated with higher likelihood of readmission. Readmission following acute gastrointestinal bleeding is common and is more likely following variceal hemorrhage, long initial admission, and chronic comorbidities. Copyright © 2017 Elsevier Inc. All rights reserved.

Nanosecond repetitively pulsed discharges in air at atmospheric pressure—the spark regime

NASA Astrophysics Data System (ADS)

Pai, David Z.; Lacoste, Deanna A.; Laux, Christophe O.

2010-12-01

Nanosecond repetitively pulsed (NRP) spark discharges have been studied in atmospheric pressure air preheated to 1000 K. Measurements of spark initiation and stability, plasma dynamics, gas temperature and current-voltage characteristics of the spark regime are presented. Using 10 ns pulses applied repetitively at 30 kHz, we find that 2-400 pulses are required to initiate the spark, depending on the applied voltage. Furthermore, about 30-50 pulses are required for the spark discharge to reach steady state, following initiation. Based on space- and time-resolved optical emission spectroscopy, the spark discharge in steady state is found to ignite homogeneously in the discharge gap, without evidence of an initial streamer. Using measured emission from the N2 (C-B) 0-0 band, it is found that the gas temperature rises by several thousand Kelvin in the span of about 30 ns following the application of the high-voltage pulse. Current-voltage measurements show that up to 20-40 A of conduction current is generated, which corresponds to an electron number density of up to 1015 cm-3 towards the end of the high-voltage pulse. The discharge dynamics, gas temperature and electron number density are consistent with a streamer-less spark that develops homogeneously through avalanche ionization in volume. This occurs because the pre-ionization electron number density of about 1011 cm-3 produced by the high frequency train of pulses is above the critical density for streamer-less discharge development, which is shown to be about 108 cm-3.

Modification of the Steel Surface Treated by a Volume Discharge Plasma in Nitrogen at Atmospheric Pressure

NASA Astrophysics Data System (ADS)

Erofeev, M. V.; Shulepov, M. A.; Ivanov, Yu. F.; Oskomov, K. V.; Tarasenko, V. F.

2016-03-01

Effect of volume discharge plasma initiated by an avalanche electron beam on the composition, structure, and properties of the surface steel layer is investigated. Voltage pulses with incident wave amplitude up to 30 kV, full width at half maximum of about 4 ns, and wave front of about 2.5 ns were applied to the gap with an inhomogeneous electric field. Changes indicating the hardening effect of the volume discharge initiated by an avalanche electron beam are revealed in St3-grade steel specimens treated by the discharge of this type.

Theoretical Investigations of Dielectric Breakdown in CO2: Implications for Atmospheric Discharges on Mars (and Venus)

NASA Astrophysics Data System (ADS)

Riousset, J. A.

2017-12-01

The detection of an atmospheric discharge in the Martian atmosphere by Ruf et al. [GRL, 36, L13202, 2009] supports the idea of a Martian atmospheric electric circuit [Farrell and Desch, JGR, 106, E4, 2001]. However, the lack of subsequent detection of similar events raises the question of the conditions of their initiation, and the existence of Martian lightning remains a controversial question. On Earth, atmospheric electricity manifests itself in the form of glow, corona, streamer, and leader discharges observed as Saint Elmo's fire, sprites, lightning and jets discharges, and other Transient Luminous Events (TLEs). All of these are dielectric breakdown governed by different physics. Their initiation is associated with the crossing of specific electric field thresholds: relativistic runaway, streamer propagation, conventional breakdown, or thermal runaway thresholds, some better understood than others. For example, the initiation of a lightning discharge is known to occur when the local electric field exceeds a value similar to relativistic runaway field, but the exact threshold, as well as the physical mechanisms at work, remain unclear to date. Scaling laws for electric fields (and other quantities) have been established by Pasko et al. [GRL, 25(12), 2123-2126, 1998] and Pasko [NATO Sci. Series, Springer, 253-311, 2006]. In this work, we develop profiles for initiation criteria in air and in other atmospheric environments. We further calculate their associated scaling laws to determine the ability to trigger lightning flashes and TLEs on Mars. This lets us predict the likelihood of electrical discharges and calculate the expected electric field conditions, under which discharges could be observed. We develop the analogy between Earth sand storm [Nicoll et al., Env. Res. Lett., 6, 014001, 2001] and Martian dust storms [Melnik and Parrot, JGR, 103(A12), 1998] to investigate the charge structure and resulting electric fields necessary to initiate dielectric breakdown in the Martian atmosphere. Initiation of electric discharges will be susceptible to local pressure, density, atmospheric composition, and charge structure, and will impact charge moment variations detectable by remote sensing.

Documenting stress in caregivers of transplantation patients: initial evidence of HPA dysregulation.

PubMed

Bevans, Margaret F; Ross, Alyson; Wehrlen, Leslie; Klagholz, Stephen D; Yang, Li; Childs, Richard; Flynn, Sharon L; Remaley, Alan T; Krumlauf, Michael; Reger, Robert N; Wallen, Gwenyth R; Shamburek, Robert; Pacak, Karel

2016-01-01

There is growing evidence linking caregiver stress with an increased risk for morbidity and mortality. While the emotional and practical burden experienced by caregivers is well established, the physiological changes that may affect the caregiver's health are less understood. This study sought to compare self-reported stress, anxiety and depression along with neuroendocrine and immune markers of stress among adult caregivers of allogeneic hematopoietic stem cell transplantation patients during the acute transplant recovery period to matched non-caregivers controls. Biomarkers and self-reported data were collected at three points during the patient's HSCT: (1) before transplant, (2) after initial transplantation discharge (±7 days) and (3) 6 weeks after initial transplantation discharge. Mixed linear modeling was used to examine differences by group and time. Twenty-one caregivers and 20 controls completed all study procedures. The majority of caregivers were female (57% or 57.1%) and married (95.2%), with a mean age of 52 ± 11.4 years. Caregiver perceived stress, anxiety and depression scores were significantly higher than controls (p < 0.001) with effect sizes (ES) ranging from 1.37 to 1.80 and they did not change over time (p > 0.05) for either group. Caregivers had significantly lower serum cortisol levels than controls at both discharge (p = 0.013; ES = 0.81) and 6 weeks after discharge (p = 0.028; ES = 0.72) but exhibited no significant relationship between self-reported stress and serum cortisol. In addition, caregivers showed a significant inverse relationship between stress and epinephrine levels (r(s)=-0.654, p = 0.021). These findings support the evidence of the caregiving experience being stressful. The counter-intuitive relationship between cortisol and epinephrine might suggest dysregulation of the HPA axis and central nervous system but additional research on the physiological impact of caregiving is warranted.

Muscle vibration sustains motor unit firing rate during submaximal isometric fatigue in humans

PubMed Central

Griffin, L; Garland, S J; Ivanova, T; Gossen, E R

2001-01-01

In keeping with the ‘muscular wisdom hypothesis’, many studies have documented that the firing rate of the majority of motor units decreased during fatiguing isometric contractions. The present study investigated whether the application of periodic muscle vibration, which strongly activates muscle spindles, would alter the modulation of motor unit firing rate during submaximal fatiguing isometric contractions. Thirty-three motor units from the lateral head of the triceps brachii muscle were recorded from 10 subjects during a sustained isometric 20 % maximal voluntary contraction (MVC) of the elbow extensors. Vibration was interposed on the contraction for 2 s every 10 s. Twenty-two motor units were recorded from the beginning of the fatigue task. The discharge rate of the majority of motor units remained constant (12/22) or increased (4/22) with fatigue. Six motor units demonstrated a reduction in discharge rate that later returned toward initial values; these motor units had higher initial discharge rates than the other 16 motor units. In a second series of experiments, four subjects held a sustained isometric 20 % MVC for 2 min and then vibration was applied as above for the remainder of the contraction. In this case, motor units initially demonstrated a decrease in firing rate that increased after the vibration was applied. Thus muscle spindle disfacilitation of the motoneurone pool may be associated with the decline of motor unit discharge rate observed during the first 2 min of the contraction. In a third set of experiments, seven subjects performed the main experiment on one occasion and repeated the fatigue task without vibration on a second occasion. Neither the endurance time of the fatiguing contraction nor the MVC torque following fatigue was affected by the application of vibration. This finding calls into question the applicability of the muscular wisdom hypothesis to submaximal contractions. PMID:11559785

Muscle vibration sustains motor unit firing rate during submaximal isometric fatigue in humans.

PubMed

Griffin, L; Garland, S J; Ivanova, T; Gossen, E R

2001-09-15

1. In keeping with the 'muscular wisdom hypothesis', many studies have documented that the firing rate of the majority of motor units decreased during fatiguing isometric contractions. The present study investigated whether the application of periodic muscle vibration, which strongly activates muscle spindles, would alter the modulation of motor unit firing rate during submaximal fatiguing isometric contractions. 2. Thirty-three motor units from the lateral head of the triceps brachii muscle were recorded from 10 subjects during a sustained isometric 20 % maximal voluntary contraction (MVC) of the elbow extensors. Vibration was interposed on the contraction for 2 s every 10 s. Twenty-two motor units were recorded from the beginning of the fatigue task. The discharge rate of the majority of motor units remained constant (12/22) or increased (4/22) with fatigue. Six motor units demonstrated a reduction in discharge rate that later returned toward initial values; these motor units had higher initial discharge rates than the other 16 motor units. 3. In a second series of experiments, four subjects held a sustained isometric 20 % MVC for 2 min and then vibration was applied as above for the remainder of the contraction. In this case, motor units initially demonstrated a decrease in firing rate that increased after the vibration was applied. Thus muscle spindle disfacilitation of the motoneurone pool may be associated with the decline of motor unit discharge rate observed during the first 2 min of the contraction. 4. In a third set of experiments, seven subjects performed the main experiment on one occasion and repeated the fatigue task without vibration on a second occasion. Neither the endurance time of the fatiguing contraction nor the MVC torque following fatigue was affected by the application of vibration. This finding calls into question the applicability of the muscular wisdom hypothesis to submaximal contractions.

Implementation of a clinical pharmacy specialist-managed telephonic hospital discharge follow-up program in a patient-centered medical home.

PubMed

Anderson, Sarah L; Marrs, Joel C; Vande Griend, Joseph P; Hanratty, Rebecca

2013-08-01

The objectives of this retrospective study were to examine the feasibility and characteristics that define successful implementation of a Clinical Pharmacy Specialist (CPS) telephonic hospital discharge follow-up quality improvement initiative, as well as the impact of this initiative. Adult patients who were discharged from a safety-net hospital between July 1, 2010 and June 30, 2011 and who were part of a patient-centered medical home were included in this quality improvement initiative. CPSs attempted to contact 470 patients; of those, 207 received the intervention and 263 did not. Patients in the contacted group were more likely to attend a hospital discharge follow-up appointment (66.2% vs. 44.5%, P<0.01) and had lower rates of 30-day readmission (22 vs. 52, P<0.01) compared to those who were not contacted. Institutions should consider allocating resources for pharmacist-managed posthospital discharge follow-up services because of the potential for positive clinical and financial impact.

Readmission and late mortality after critical illness in childhood

PubMed Central

Hartman, Mary E.; Saeed, Mohammed J.; Bennett, Tellen; Typpo, Katri; Matos, Renee; Olsen, Margaret A.

2016-01-01

Objectives Little is known about the ongoing mortality risk and healthcare utilization among U.S. children after discharge from a hospitalization involving ICU care. We sought to understand risks for hospital readmission and trends in mortality during the year following ICU discharge. Design We performed a retrospective observational cohort study using administrative claims data from the years 2006–2013 obtained from the Truven Health Analytics MarketScan® Database. Subjects We included all children in the dataset admitted to a U.S. ICU ≤18 years old. Interventions The primary outcome was non-elective readmission in the year following discharge. Risk of rehospitalization was determined using a Cox proportional hazards model. Measurements and Main Results We identified 109,130 children with at least one ICU admission in the dataset. Over three-quarters of the index ICU admissions (78.6%) had an ICU length of stay ≤ 3 days and the overall index hospitalization mortality rate was 1.4%. In multivariate analysis, risk of non-elective readmission for children without cancer was higher with longer index ICU admission LOS, younger age, and several chronic and acute conditions. By the end of the one year observation period, 36.0% of children with an index ICU LOS ≥ 14 days had been readmitted, compared to only 13.9% of children who had an index ICU LOS = 1 day. Mortality in the year after ICU discharge was low overall (106 deaths per 10,000 person-years of observation), but was highest among children with an initial index ICU admission LOS ≥ 14 days (599 deaths per 10,000 person-years). Conclusions Readmission after ICU care is common. Further research is needed to investigate the potentially modifiable factors affecting likelihood of readmissions after discharge from the ICU. While late mortality was relatively uncommon overall, it was ten-fold higher in the year after ICU discharge than in the general U.S. pediatric population. PMID:28107264

Utilization of psychiatric inpatient care in Greece: a nationwide study (1984-1996).

PubMed

Madianos, M G; Zacharakis, C; Tsitsa, C

2000-01-01

This report examines the trends in the utilization of psychiatric inpatient care for the period 1984-1996, when the implementation of the psychiatric reform programme was initiated in Greece. Admissions in public mental hospitals declined by 7.2%. However discharges have been increased by 30.6% with a parallel decrease of the length of stay by 53.7% followed by an increase in discharges of patients diagnosed as suffering from schizophrenia and affective psychoses by 61.1% and 123.8% respectively. In the private sector a remarkable reduction in both admissions and discharges was noticed. Admissions in psychiatric departments of general hospitals for the same years have been increased by 1054.1%. It seems that the recent deinstitutionalization process resulted in increasing trends in the discharges of patients suffering from psychoses. Additionally, a substantial increase in the number of extramural psychiatric services and rehabilitation places between 1994-1996 was observed. The demand for the mental health care services expressed as the urbanization index was found to be related with mental health professionals and the extramural units ratios. The higher degree of urbanism is, the greater the number of extramural services exist. The models explained variance reached 50.6%.

Payments for acute myocardial infarction episodes-of-care initiated at hospitals with and without interventional capabilities.

PubMed

Ben-Josef, Gal; Ott, Lesli S; Spivack, Steven B; Wang, Changqin; Ross, Joseph S; Shah, Sachin J; Curtis, Jeptha P; Kim, Nancy; Krumholz, Harlan M; Bernheim, Susannah M

2014-11-01

It is unknown whether hospitals with percutaneous coronary intervention (PCI) capability provide costlier care than hospitals without PCI capability for patients with acute myocardial infarction. The growing number of PCI hospitals and higher rate of PCI use may result in higher costs for episodes-of-care initiated at PCI hospitals. However, higher rates of transfers and postacute care procedures may result in higher costs for episodes-of-care initiated at non-PCI hospitals. We identified all 2008 acute myocardial infarction admissions among Medicare fee-for-service beneficiaries by principal discharge diagnosis and classified hospitals as PCI- or non-PCI-capable on the basis of hospitals' 2007 PCI performance. We added all payments from admission through 30 days postadmission, including payments to hospitals other than the admitting hospital. We calculated and compared risk-standardized payment for PCI and non-PCI hospitals using 2-level hierarchical generalized linear models, adjusting for patient demographics and clinical characteristics. PCI hospitals had a higher mean 30-day risk-standardized payment than non-PCI hospitals (PCI, $20 340; non-PCI, $19 713; P<0.001). Patients presenting to PCI hospitals had higher PCI rates (39.2% versus 13.2%; P<0.001) and higher coronary artery bypass graft rates (9.5% versus 4.4%; P<0.001) during index admissions, lower transfer rates (2.2% versus 25.4%; P<0.001), and lower revascularization rates within 30 days (0.15% versus 0.27%; P<0.0001) than those presenting to non-PCI hospitals. Despite higher PCI and coronary artery bypass graft rates for Medicare patients initially presenting to PCI hospitals, PCI hospitals were only $627 costlier than non-PCI hospitals for the treatment of patients with acute myocardial infarction in 2008. © 2014 American Heart Association, Inc.

Temporally resolved plasma spectroscopy for analyzing natural gas components

NASA Astrophysics Data System (ADS)

Kobayashi, Kazunobu; Tsumaki, Naomasa; Ito, Tsuyohito

2016-09-01

Temporally resolved plasma spectroscopy has been carried out in two different hydrocarbon gas mixtures (CH4/Ar and C2H6/Ar) to explore the possibility of a new gas sensor using plasma emission spectral analysis. In this experiment, a nanosecond-pulsed plasma discharge was applied to observe optical emissions representing the initial molecular structure. It is found that a CH emission intensity in CH4/Ar is higher than that in C2H6/Ar. On the other hand, C2 intensities are almost the same degree between CH4/Ar and C2H6/Ar. This finding indicates that the emission intensity ratio of CH to C2 might be an effective index for a gas analysis. In addition, a time for the highest emission intensities of CH and C2 is several nanoseconds later than that of Ar. This result suggests that spectra from the initial molecular structure may be observed at the early stage of the discharge before molecules are fully dissociated, and this is currently in progress.

Lightweight nickel electrode for nickel hydrogen cells and batteries

NASA Technical Reports Server (NTRS)

Britton, D. L.

1986-01-01

The nickel electrode was identified as the heaviest component of the nickel hydrogen (NiH2) battery. The NASA Lewis Research Center is developing nickel electrodes for NiH2 battery devices which will be lighter in weight and have higher energy densities when cycled under a low Earth orbit regime at deep depths of discharge. Lightweight plaques are first exposed to 31 percent potassium hydroxide for 3 months to determine their suitability for use as electrode substrates from a chemical corrosion standpoint. Pore size distribution and porosity of the plaques are then measured. The lightweight plaques examined are nickel foam, nickel felt, nickel plastic and nickel plated graphite. Plaques are then electrochemically impregnated in an aqueous solution. Initial characterization tests of the impregnated plaques are performed at five discharge levels, C/2, 1.0 C, 1.37 C, 2.0C, and 2.74 C rates. Electrodes that passed the initial characterization screening test will be life cycle tested. Lightweight electrodes are approximately 30 to 50 percent lighter in weight than the sintered nickel electrode.

Lithium-sulfur batteries based on nitrogen-doped carbon and an ionic-liquid electrolyte.

PubMed

Sun, Xiao-Guang; Wang, Xiqing; Mayes, Richard T; Dai, Sheng

2012-10-01

Nitrogen-doped mesoporous carbon (NC) and sulfur were used to prepare an NC/S composite cathode, which was evaluated in an ionic-liquid electrolyte of 0.5 M lithium bis(trifluoromethane sulfonyl)imide (LiTFSI) in methylpropylpyrrolidinium bis(trifluoromethane sulfonyl)imide ([MPPY][TFSI]) by cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), and cycle testing. To facilitate the comparison, a C/S composite based on activated carbon (AC) without nitrogen doping was also fabricated under the same conditions. Compared with the AC/S composite, the NC/S composite showed enhanced activity toward sulfur reduction, as evidenced by the lower onset sulfur reduction potential, higher redox current density in the CV test, and faster charge-transfer kinetics, as indicated by EIS measurements. At room temperature under a current density of 84 mA g(-1) (C/20), the battery based on the NC/S composite exhibited a higher discharge potential and an initial capacity of 1420 mAh g(-1), whereas the battery based on the AC/S composite showed a lower discharge potential and an initial capacity of 1120 mAh g(-1). Both batteries showed similar capacity fading with cycling due to the intrinsic polysulfide solubility and the polysulfide shuttle mechanism; capacity fading can be improved by further cathode modification. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Implementing Kangaroo mother care in a resource-limited setting in rural Bangladesh.

PubMed

Pervin, Jesmin; Gustafsson, Frida E; Moran, Allisyn C; Roy, Suchismita; Persson, Lars Åke; Rahman, Anisur

2015-05-01

This study evaluated stable and unstable low birthweight infants admitted to a Kangaroo mother care (KMC) unit at a resource-limited rural hospital in Bangladesh. This was a descriptive consecutive patient series study of 423 low birthweight neonates <2500 g enrolled from July 2007 to December 2010. KMC was initiated as soon as possible after birth, regardless of health, and we monitored skin-to-skin contact, weight gain, exclusive breastfeeding, length of hospital stay and death rates. Mean birthweight was 1796 g, and mean gestational age was 34.9 weeks. Mean (median, 90th percentile) time of skin-to-skin initiation for stable and unstable neonates was 1.1 h (0.3-2.5) and 1.7 h (0.3-3.0), respectively. Adjusted mean daily skin-to-skin contact duration was significantly higher for unstable infants. About 99% of neonates were exclusively breastfed. The death rate was 8.3% (stable 1.9%, unstable 19%) at discharge. Neonatal mortality rate was 90 per 1000 live births (stable: 23 per 1000; unstable: 203 per 1000). Skin-to-skin duration was higher for unstable than stable low birthweight infants, and exclusive breastfeeding was almost universal at discharge. KMC was suitable for unstable infants and may be successfully implemented in resource-limited hospitals. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Initial Assessment of the Risk Assessment and Prediction Tool in a Heterogeneous Neurosurgical Patient Population.

PubMed

Piazza, Matthew; Sharma, Nikhil; Osiemo, Benjamin; McClintock, Scott; Missimer, Emily; Gardiner, Diana; Maloney, Eileen; Callahan, Danielle; Smith, J Lachlan; Welch, William; Schuster, James; Grady, M Sean; Malhotra, Neil R

2018-05-21

Bundled care payments are increasingly being explored for neurosurgical interventions. In this setting, skilled nursing facility (SNF) is less desirable from a cost perspective than discharge to home, underscoring the need for better preoperative prediction of postoperative disposition. To assess the capability of the Risk Assessment and Prediction Tool (RAPT) and other preoperative variables to determine expected disposition prior to surgery in a heterogeneous neurosurgical cohort, through observational study. Patients aged 50 yr or more undergoing elective neurosurgery were enrolled from June 2016 to February 2017 (n = 623). Logistic regression was used to identify preoperative characteristics predictive of discharge disposition. Results from multivariate analysis were used to create novel grading scales for the prediction of discharge disposition that were subsequently compared to the RAPT Score using Receiver Operating Characteristic analysis. Higher RAPT Score significantly predicted home disposition (P < .001). Age 65 and greater, dichotomized RAPT walk score, and spinal surgery below L2 were independent predictors of SNF discharge in multivariate analysis. A grading scale utilizing these variables had superior discriminatory power between SNF and home/rehab discharge when compared with RAPT score alone (P = .004). Our analysis identified age, lower lumbar/lumbosacral surgery, and RAPT walk score as independent predictors of discharge to SNF, and demonstrated superior predictive power compared with the total RAPT Score when combined in a novel grading scale. These tools may identify patients who may benefit from expedited discharge to subacute care facilities and decrease inpatient hospital resource utilization following surgery.

Sessile multidroplets and salt droplets under high tangential electric fields

PubMed Central

Xie, Guoxin; He, Feng; Liu, Xiang; Si, Lina; Guo, Dan

2016-01-01

Understanding the interaction behaviors between sessile droplets under imposed high voltages is very important in many practical situations, e.g., microfluidic devices and the degradation/aging problems of outdoor high-power applications. In the present work, the droplet coalescence, the discharge activity and the surface thermal distribution response between sessile multidroplets and chloride salt droplets under high tangential electric fields have been investigated with infrared thermography, high-speed photography and pulse current measurement. Obvious polarity effects on the discharge path direction and the temperature change in the droplets in the initial stage after discharge initiation were observed due to the anodic dissolution of metal ions from the electrode. In the case of sessile aligned multidroplets, the discharge path direction could affect the location of initial droplet coalescence. The smaller unmerged droplet would be drained into the merged large droplet as a result from the pressure difference inside the droplets rather than the asymmetric temperature change due to discharge. The discharge inception voltages and the temperature variations for two salt droplets closely correlated with the ionization degree of the salt, as well as the interfacial electrochemical reactions near the electrodes. Mechanisms of these observed phenomena were discussed. PMID:27121926

The impact of healthcare-associated methicillin-resistant Staphylococcus aureus infections on post-discharge healthcare costs and utilization.

PubMed

Nelson, Richard E; Jones, Makoto; Liu, Chuan-Fen; Samore, Matthew H; Evans, Martin E; Graves, Nicholas; Lee, Bruce; Rubin, Michael A

2015-05-01

Healthcare-associated methicillin-resistant Staphylococcus aureus (MRSA) infections are a major cause of morbidity, mortality, and cost among hospitalized patients. Little is known about their impact on post-discharge resource utilization. The purpose of this study was to estimate post-discharge healthcare costs and utilization attributable to positive MRSA cultures during a hospitalization. Our study cohort consisted of patients with an inpatient admission lasting longer than 48 hours within the US Department of Veterans Affairs (VA) system between October 1, 2007, and November 30, 2010. Of these patients, we identified those with a positive MRSA culture from microbiology reports in the VA electronic medical record. We used propensity score matching and multivariable regression models to assess the impact of positive culture on post-discharge outpatient, inpatient, and pharmacy costs and utilization in the 365 days following discharge. Our full cohort included 369,743 inpatients, of whom, 3,599 (1.0%) had positive MRSA cultures. Our final analysis sample included 3,592 matched patients with and without positive cultures. We found that, in the 12 months following hospital discharge, having a positive culture resulted in increases in post-discharge pharmacy costs ($776, P<.0001) and inpatient costs ($12,167, P<.0001). Likewise, having a positive culture increased the risk of a readmission (odds ratio [OR]=1.396, P<.0001), the number of prescriptions (incidence rate ratio [IRR], 1.138; P<.0001) and the number of inpatient days (IRR, 1.204; P<.0001,) but decreased the number of subsequent outpatient encounters (IRR, 0.941; P<.008). The results of this study indicate that MRSA infections are associated with higher levels of post-discharge healthcare cost and utilization. These findings indicate that financial benefits resulting from infection prevention efforts may extend beyond the initial hospital stay.

Preliminary Results From a Laboratory Study of Positive Streamer Discharges on Simulated Ice Hydrometeors

NASA Astrophysics Data System (ADS)

Petersen, D.; Bailey, M.; Hallett, J.; Beasley, W.

2007-12-01

The initiation of lightning remains an open question, due in large part to a deficit of in-situ observational evidence. Recent theoretical descriptions of lightning initiation have focused on runaway breakdown and related secondary processes, but have not convincingly explained the details of onset of the embryonic lightning leader channel. Among possible mechanisms contributing to the initial leader formation are positive streamer discharges from ice hydrometeors, themselves once favored as the primary explanation of lightning initiation. We present preliminary results from a new laboratory study of positive streamer discharges on simulated ice hydrometeors. Emphasis is given to precisely defining the minimum electric field strength required for onset of positive streamer generation, with variables of interest being ice crystal size, habit and environmental temperature.

Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest.

PubMed

Kudenchuk, Peter J; Brown, Siobhan P; Daya, Mohamud; Rea, Thomas; Nichol, Graham; Morrison, Laurie J; Leroux, Brian; Vaillancourt, Christian; Wittwer, Lynn; Callaway, Clifton W; Christenson, James; Egan, Debra; Ornato, Joseph P; Weisfeldt, Myron L; Stiell, Ian G; Idris, Ahamed H; Aufderheide, Tom P; Dunford, James V; Colella, M Riccardo; Vilke, Gary M; Brienza, Ashley M; Desvigne-Nickens, Patrice; Gray, Pamela C; Gray, Randal; Seals, Norman; Straight, Ron; Dorian, Paul

2016-05-05

Antiarrhythmic drugs are used commonly in out-of-hospital cardiac arrest for shock-refractory ventricular fibrillation or pulseless ventricular tachycardia, but without proven survival benefit. In this randomized, double-blind trial, we compared parenteral amiodarone, lidocaine, and saline placebo, along with standard care, in adults who had nontraumatic out-of-hospital cardiac arrest, shock-refractory ventricular fibrillation or pulseless ventricular tachycardia after at least one shock, and vascular access. Paramedics enrolled patients at 10 North American sites. The primary outcome was survival to hospital discharge; the secondary outcome was favorable neurologic function at discharge. The per-protocol (primary analysis) population included all randomly assigned participants who met eligibility criteria and received any dose of a trial drug and whose initial cardiac-arrest rhythm of ventricular fibrillation or pulseless ventricular tachycardia was refractory to shock. In the per-protocol population, 3026 patients were randomly assigned to amiodarone (974), lidocaine (993), or placebo (1059); of those, 24.4%, 23.7%, and 21.0%, respectively, survived to hospital discharge. The difference in survival rate for amiodarone versus placebo was 3.2 percentage points (95% confidence interval [CI], -0.4 to 7.0; P=0.08); for lidocaine versus placebo, 2.6 percentage points (95% CI, -1.0 to 6.3; P=0.16); and for amiodarone versus lidocaine, 0.7 percentage points (95% CI, -3.2 to 4.7; P=0.70). Neurologic outcome at discharge was similar in the three groups. There was heterogeneity of treatment effect with respect to whether the arrest was witnessed (P=0.05); active drugs were associated with a survival rate that was significantly higher than the rate with placebo among patients with bystander-witnessed arrest but not among those with unwitnessed arrest. More amiodarone recipients required temporary cardiac pacing than did recipients of lidocaine or placebo. Overall, neither amiodarone nor lidocaine resulted in a significantly higher rate of survival or favorable neurologic outcome than the rate with placebo among patients with out-of-hospital cardiac arrest due to initial shock-refractory ventricular fibrillation or pulseless ventricular tachycardia. (Funded by the National Heart, Lung, and Blood Institute and others; ClinicalTrials.gov number, NCT01401647.).

Hospital readmission risks in older adults following inpatient subacute care: A six-month follow-up study.

PubMed

Lee, Den-Ching A; Williams, Cylie; Lalor, Aislinn F; Brown, Ted; Haines, Terry P

2018-05-09

High rates of unplanned hospital readmissions are a burden on healthcare systems and individuals. This study examined factors at, and after initial hospital discharge and their associations with unplanned hospital readmission for older adults up to six months post-discharge from subacute care. Older subacute care patients were surveyed prior to discharge, and assessed monthly post-discharge for six months. Data included the Geriatric Depression Scale, Phone-Fitt sub-scales, Friendship Scale, modified Lubben Social Network Scale, unplanned hospital readmission, self-reported physical capacity and falls in the last month were collected. Regression analyses were used to examine relationships between unplanned hospital readmission and variables that may predispose this outcome. Participants (n = 311) completed the baseline assessment. N = 218 (70%) completed all at six-month post-discharge. Eighty-nine (29%) participants shared 143 readmissions. Those with cancer history (adjusted OR [95% CI]) (1.97 [1.15, 3.39]), neurological disease other than stroke (2.95 [1.32, 6.57]) and dependence on others to assist in bending tasks (1.94 [1.14, 3.29]) at initial discharge were associated with readmission within six months post-discharge. Those who fell in the last month (adjusted OR [robust 95% CI]) (2.28 [1.43, 3.64]), being less physical active (0.98 [0.96, 0.99]), and dependence on others in moving around residence (2.63 [1.37, 5.06]) after initial discharge were associated with a readmission in the next month within six months post-discharge. Trials investigating the effectiveness of strategies to reduce falls, build physical capacity, increase physical activity level, and connection with health care services after discharge to prevent readmission are warranted. Copyright © 2018 Elsevier B.V. All rights reserved.

Correlated Lightning Mapping Array (LMA) and Radar Observations of the Initial Stages of Florida Triggered Lightning Discharges

NASA Technical Reports Server (NTRS)

Hill, J. D.; Pilkey, J.; Uman, M, A.; Jordan, D. M.; Biggerstaff, M. I.; Rison, W.; Blakeslee, R.

2012-01-01

We characterize the geometrical and electrical characteristics of the initial stages of nine Florida triggered lightning discharges using a Lightning Mapping Array (LMA), a C-band SMART radar, and measured channel-base currents. We determine initial channel and subsequent branch lengths, average initial channel and branch propagation speeds, and channel-base current at the time of each branch initiation. The channel-base current is found to not change significantly when branching occurs, an unexpected result. The initial stage of Florida triggered lightning typically transitions from vertical to horizontal propagation at altitudes of 3-6 km, near the typical 0 C level of 4-5 km and several kilometers below the expected center of the negative cloud-charge region at 7-8 km. The data presented potentially provide information on thunderstorm electrical and hydrometeor structure and discharge propagation physics. LMA source locations were obtained from VHF sources of positive impulsive currents as small as 10 A, in contrast to expectations found in the literature.

Neutral-depletion-induced axially asymmetric density in a helicon source and imparted thrust

NASA Astrophysics Data System (ADS)

Takahashi, Kazunori; Takao, Yoshinori; Ando, Akira

2016-02-01

The high plasma density downstream of the source is observed to be sustained only for a few hundreds of microsecond at the initial phase of the discharge, when pulsing the radiofrequency power of a helicon plasma thruster. Measured relative density of argon neutrals inside the source implies that the neutrals are significantly depleted there. A position giving a maximum plasma density temporally moves to the upstream side of the source due to the neutral depletion and then the exhausted plasma density significantly decreases. The direct thrust measurement demonstrates that the higher thrust-to-power ratio is obtained by using only the initial phase of the high density plasma, compared with the steady-state operation.

Discharge prescribing of enteral opioids after initiation as a weaning strategy from continuous opioid infusions in the Intensive Care Unit.

PubMed

Kram, Bridgette; Weigel, Kylie M; Kuhrt, Michelle; Gilstrap, Daniel L

To evaluate the proportion of patients receiving a hospital discharge prescription for a scheduled enteral opioid following initiation as a weaning strategy from a continuous opioid infusion in the Intensive Care Unit (ICU). Retrospective, observational study. Five adult ICUs at a large, quaternary care academic medical center. Endotracheally intubated, opioid-naive adults receiving a continuous opioid infusion with a concomitant scheduled enteral opioid initiated. Exclusion criteria were receipt of fewer than two enteral opioid doses, documentation of a long-acting opioid as a home medication, the indication for the enteral opioid was not a weaning strategy, death during hospital admission or discharge to hospice. None. The proportion of ICU and hospital survivors who received a discharge prescription for a scheduled enteral opioid, total duration of continuous opioid infusion, duration of continuous opioid infusion after initiation of an enteral opioid therapy, total duration of enteral therapy, ICU and hospital length of stay. Of 62 included patients, 19 patients (30.6 percent) received a new prescription for a scheduled enteral opioid at hospital discharge. The median duration of enteral opioid therapy was longer for patients who received a discharge prescription compared to those who did not (20.09 vs 8.89 days, p = 0.02), though the remaining endpoints were not different. Utilizing scheduled enteral opioids as a weaning strategy from continuous opioid infusions may place patients at risk of ICU-acquired physical dependence on opioids.

Operando Synchrotron XRD Investigation of Silver Metal Formation upon Electrochemical Reduction of Silver Iron Pyrophosphate (Ag 7Fe 3(P 2O 7) 4)

DOE PAGES

Zhang, Yiman; Kirshenbaum, Kevin C.; Marschilok, Amy C.; ...

2017-05-11

The formation of conductive metallic silver upon electrochemical reduction and lithiation of Ag 7Fe 3(P 2O 7) 4 is investigated. Alternating current impedance spectroscopy measurements show a 34% decrease in charge transfer resistance upon one electron equivalent (ee) of reduction, which is coincident with the formation of a Ag metal conductive network evidenced by both ex situ and operando X-ray diffraction. Quantitative assessment of Ag metal formation derived from operando XRD shows that only Ag + ions are reduced during the first 3ee, followed by simultaneous reduction of Ag + and Fe 3+ reduction for the next 5ee (3ee tomore » 8ee), culminating in reduction of the remaining Ag +. Scanning electron microscopy images show smaller Ag metal crystallite size and shorter nearest neighbor distance between and among Ag particles with higher depth of discharge. A high rate intermittent pulsatile discharge test is conducted where the cell delivers 12 total pulses during full discharge to probe the effect of Ag metal formation on the Li/Ag 7Fe 3(P 2O 7) 4 cell electrochemistry. The Ohmic resistance is derived from the voltage drop of each pulse. The resistance is 65 Ω initially, reaches its minimum of 26 Ω at 4.5 ee discharge, and levels off at 35 Ω after 7.0 ee reduction. In conclusion, the initial Ag reduction is more significant for the conductive network formation indicated by the decrease of both R ct and Ohmic resistance, which facilitates the high power output of the cell.« less

[Acute complicated and uncomplicated pyelonephritis in the emergency department: process-of-care indicators and outcomes].

PubMed

Delgado Vicente, Miriam; Lecaroz Agara, Mª Concepción; Barrios Andrés, José Luis; Canut Blasco, Andrés

2017-02-01

To assess process-of-care indicators and outcomes in acute pyelonephritis (APN) in a general hospital emergency department, and compare them between uncomplicaed and complicated APN. Retrospective study of consecutive patients discharged with a diagnosis of APN. We studied health processof- care indicators (percentage admitted, avoidable hospitalization, appropriate initial antibiotic therapy, urine and blood cultures) and outcomes (hospital length of stay [LOS], discharge from the emergency department, revisits, mortality, yields of microbiological tests ordered). A total of 529 cases (59% of them complicated) were included. Patients with uncomplicated APN were significantly younger on average (mean, 39 years) than patients with complicated APN (56 years). Escherichia coli was the most common pathogen identified, although the percentage of E coli infection was lower in patients with complicated APN (78%) than in patients with uncomplicated APN (95%). The rates of admission and orders for urine and blood cultures were significantly higher and hospital LOS was longer in the group with complicated APN. Moreover, these patients had even longer stays if the initial antibiotic therapy was inappropriate. Significantly more patients with uncomplicated APN were discharged from the emergency department. Sixty-one percent of patients with uncomplicated APN were admitted; 9% of these cases were considered avoidable hospitalizations. Complicated APN is diagnosed more often in older patients, and E coli infection causes a smaller proportion of these cases. Hospital LOS is longer in complicated APN and more urine and blood cultures are ordered. Patients with uncomplicated APN are more often discharged from the emergency department, although the number of avoidable hospitalizations seems high based on the rate found in this study.

Early hospital discharge of infants born to group B streptococci-positive mothers: a decision analysis.

PubMed

Berger, M B; Xu, X; Williams, J A; Van de Ven, C J M; Mozurkewich, E L

2012-03-01

To compare the cost-effectiveness of an additional 24-hour inpatient observation for asymptomatic term neonates born to group B streptococcus (GBS)-colonised mothers with adequate intrapartum antibiotic prophylaxis (IAP) after an initial 24-hour in-hospital observation. Cost-effectiveness analysis from a societal perspective. United States. Asymptomatic term neonates born to GBS-colonised mothers with IAP after an initial 24-hour in-hospital observation. Monte Carlo simulation for a decision tree model incorporating the following chance events: development of GBS sepsis during the second 24 hours of life, development of GBS sepsis between 48 hours and 7 days of life, prompt versus delayed treatment for sepsis, neonatal mortality and long-term health sequelae. Expected cost and quality-adjusted life years (QALYs), Incremental cost-effectiveness ratio (ICER). Delayed, versus early, hospital discharge results in similar mean expected QALYs, but substantially higher expected cost. The mean difference in QALY is 0.00016 (95% CI 0.00005-0.00040), whereas the mean difference in cost is $1170.96 (95% CI $750.13-1584.32). The ICER is estimated to be $9,771,520.87 per QALY (95% CI $2,573,139.89-24,407,017.82). The proportion of early-onset GBS that develops during the second 24 hours of life, the cost of 24 hours of inpatient observation, and the probability of long-term sequelae following prompt versus delayed treatment play important roles in determining the cost-effectiveness of delayed hospital discharge. Cost-effectiveness analysis suggests that with adequate IAP, discharging asymptomatic term neonates to home after 24 hours is the preferred approach compared with 48 hours inpatient observation. © 2012 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2012 RCOG.

Operando Synchrotron XRD Investigation of Silver Metal Formation upon Electrochemical Reduction of Silver Iron Pyrophosphate (Ag 7Fe 3(P 2O 7) 4)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Yiman; Kirshenbaum, Kevin C.; Marschilok, Amy C.

The formation of conductive metallic silver upon electrochemical reduction and lithiation of Ag 7Fe 3(P 2O 7) 4 is investigated. Alternating current impedance spectroscopy measurements show a 34% decrease in charge transfer resistance upon one electron equivalent (ee) of reduction, which is coincident with the formation of a Ag metal conductive network evidenced by both ex situ and operando X-ray diffraction. Quantitative assessment of Ag metal formation derived from operando XRD shows that only Ag + ions are reduced during the first 3ee, followed by simultaneous reduction of Ag + and Fe 3+ reduction for the next 5ee (3ee tomore » 8ee), culminating in reduction of the remaining Ag +. Scanning electron microscopy images show smaller Ag metal crystallite size and shorter nearest neighbor distance between and among Ag particles with higher depth of discharge. A high rate intermittent pulsatile discharge test is conducted where the cell delivers 12 total pulses during full discharge to probe the effect of Ag metal formation on the Li/Ag 7Fe 3(P 2O 7) 4 cell electrochemistry. The Ohmic resistance is derived from the voltage drop of each pulse. The resistance is 65 Ω initially, reaches its minimum of 26 Ω at 4.5 ee discharge, and levels off at 35 Ω after 7.0 ee reduction. In conclusion, the initial Ag reduction is more significant for the conductive network formation indicated by the decrease of both R ct and Ohmic resistance, which facilitates the high power output of the cell.« less

Exploring the cell: Sodium (beta-alumina) cupric chloride - Aluminum chloride - Sodium chloride between 136 and 200 C

NASA Technical Reports Server (NTRS)

Miller, R. O.

1975-01-01

Experiments were done with a molten-salt catholyte (initially CuCl2 in AlCl3-NaCl) separated from molten Na by beta alumina. The open-circuit reduction potentials were 4.3 and 3 volts for Cu++ and Cu+, respectively. High polarization and nonrechargeability characterized the cell's operation. The cell's ohmic resistance during discharge was higher than what would be expected from only the ionic resistance of the beta-alumina.

High-discharge-rate lithium ion battery

DOEpatents

Liu, Gao; Battaglia, Vincent S; Zheng, Honghe

2014-04-22

The present invention provides for a lithium ion battery and process for creating such, comprising higher binder to carbon conductor ratios than presently used in the industry. The battery is characterized by much lower interfacial resistances at the anode and cathode as a result of initially mixing a carbon conductor with a binder, then with the active material. Further improvements in cycleability can also be realized by first mixing the carbon conductor with the active material first and then adding the binder.

Surface-initiated graft polymerization on multiwalled carbon nanotubes pretreated by corona discharge at atmospheric pressure.

PubMed

Xu, Lihua; Fang, Zhengping; Song, Ping'an; Peng, Mao

2010-03-01

Surface-initiated graft polymerization on multi-walled carbon nanotubes pretreated with a corona discharge at atmospheric pressure was explored. The mechanism of the corona-discharge-induced graft polymerization is discussed. The results indicate that MWCNTs were encapsulated by poly(glycidyl methacrylate) (PGMA), demonstrating the formation of PGMA-grafted MWCNTs (PGMA-g-MWCNTs), with a grafting ratio of about 22 wt%. The solubility of PGMA-g-MWCNTs in ethanol was dramatically improved compared to pristine MWCNTs, which could contribute to fabricating high-performance polymer/MWCNTs nanocomposites in the future. Compared with most plasma processes, which operate at low pressures, corona discharge has the merit of working at atmospheric pressure.

Pediatric extracorporeal cardiopulmonary resuscitation during nights and weekends.

PubMed

Burke, Christopher R; Chan, Titus; Brogan, Thomas V; McMullan, D Michael

2017-05-01

Extracorporeal cardiopulmonary resuscitation (ECPR) is a lifesaving rescue therapy for patients with refractory cardiac arrest. Previous studies suggest that maintaining a 24/7 in-house surgical team may reduce ECPR initiation time and improve survival in adult patients. However, an association between cardiac arrest occurring during off-hours and ECPR outcome has not been established in children. This is a single institution, retrospective review of all pediatric patients who received ECPR from December 2008 to August 2015. During the study period, ECPR was performed 54 times in 53 patients (20 weekday, 34 night/weekend). Interval from ECPR activation to initiation of extracorporeal life support was significantly longer during night/weekends (49min night/weekend vs. 33min weekday, p<0.001) as was the interval from ECPR activation to incision for cannulation (26min night/weekend vs. 14min Weekday, p<0.001). Rate of central nervous system (CNS) injury was higher in the night/weekend group (43% night/weekend vs. 15% weekday, p=0.04), with associated 75% mortality prior to hospital discharge. Time of arrest did not impact survival to hospital discharge (44% night/weekend vs. 55% weekday, p=0.57), one-year survival (33% night/weekend vs. 44% weekday, p=0.44), or neurologic outcome (Pediatric Cerebral Performance Score at 1-year post-ECPR, 1.45 weekday vs. 1.50 night/weekend, p=0.82). Cardiac arrest occurring at night or during weekend hours is associated with a longer ECPR initiation time and higher rates of CNS injury. However, prolonged pre-ECPR support associated with off-hours cardiac arrest does not appear to impact survival or functional outcome in pediatric patients. Copyright © 2017 Elsevier B.V. All rights reserved.

L-lactic acid and sodium p-toluenesulfonate co-doped polypyrrole for high performance cathode in sodium ion battery

NASA Astrophysics Data System (ADS)

Liao, Qishu; Hou, Hongying; Liu, Xianxi; Yao, Yuan; Dai, Zhipeng; Yu, Chengyi; Li, Dongdong

2018-04-01

In this work, polypyrrole (PPy) was co-doped with L-lactic acid (LA) and sodium p-toluenesulfonate (TsONa) for high performance cathode in sodium ion battery (SIB) via facile one-step electropolymerization on Fe foil. The as-synthesized LA/TsONa co-doped PPy cathode was investigated in terms of scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR), galvanostatic charge/discharge and cyclic voltammetry (CV). The results suggested that some oval-bud-like LA/TsONa co-doped PPy particles did form and tightly combine with the surface of Fe foil; furthermore, LA/TsONa co-doped PPy cathode also delivered higher electrochemical performances than TsONa mono-doped PPy cathode. For example, the initial specific discharge capacity was as high as about 124 mAh/g, and the reversible specific capacity still maintained at about 110 mAh/g even after 50 cycles, higher than those of TsONa mono-doped PPy cathode. The synergy effect of multi components of LA/TsONa co-doped PPy cathode should be responsible for high electrochemical performances.

Analysis of a gas-liquid film plasma reactor for organic compound oxidation.

PubMed

Hsieh, Kevin; Wang, Huijuan; Locke, Bruce R

2016-11-05

A pulsed electrical discharge plasma formed in a tubular reactor with flowing argon carrier gas and a liquid water film was analyzed using methylene blue as a liquid phase hydroxyl radical scavenger and simultaneous measurements of hydrogen peroxide formation. The effects of liquid flow rate, liquid conductivity, concentration of dye, and the addition of ferrous ion on dye decoloration and degradation were determined. Higher liquid flow rates and concentrations of dye resulted in less decoloration percentages and hydrogen peroxide formation due to initial liquid conductivity effects and lower residence times in the reactor. The highest decoloration energy yield of dye found in these studies was 5.2g/kWh when using the higher liquid flow rate and adding the catalyst. The non-homogeneous nature of the plasma discharge favors the production of hydrogen peroxide in the plasma-liquid interface over the chemical oxidation of the organic in the bulk liquid phase and post-plasma reactions with the Fenton catalyst lead to complete utilization of the plasma-formed hydrogen peroxide. Copyright © 2016 Elsevier B.V. All rights reserved.

Microplasma discharge vacuum ultraviolet photoionization source for atmospheric pressure ionization mass spectrometry.

PubMed

Symonds, Joshua M; Gann, Reuben N; Fernández, Facundo M; Orlando, Thomas M

2014-09-01

In this paper, we demonstrate the first use of an atmospheric pressure microplasma-based vacuum ultraviolet (VUV) photoionization source in atmospheric pressure mass spectrometry applications. The device is a robust, easy-to-operate microhollow cathode discharge (MHCD) that enables generation of VUV photons from Ne and Ne/H(2) gas mixtures. Photons were detected by excitation of a microchannel plate detector and by analysis of diagnostic sample ions using a mass spectrometer. Reactive ions, charged particles, and metastables produced in the discharge were blocked from entering the ionization region by means of a lithium fluoride window, and photoionization was performed in a nitrogen-purged environment. By reducing the output pressure of the MHCD, we observed heightened production of higher-energy photons, making the photoionization source more effective. The initial performance of the MHCD VUV source has been evaluated by ionizing model analytes such as acetone, azulene, benzene, dimethylaniline, and glycine, which were introduced in solid or liquid phase. These molecules represent species with both high and low proton affinities, and ionization energies ranging from 7.12 to 9.7 eV.

Average discharge, perennial flow initiation, and channel initiation - small southern Appalachian basins

Treesearch

B. Lane Rivenbark; C. Rhett Jackson

2004-01-01

Regional average evapotranspiration estimates developed by water balance techniques are frequently used to estimate average discharge in ungaged strttams. However, the lower stream size range for the validity of these techniques has not been explored. Flow records were collected and evaluated for 16 small streams in the Southern Appalachians to test whether the...

Internal erosion rates of a 10-kW xenon ion thruster

NASA Technical Reports Server (NTRS)

Rawlin, Vincent K.

1988-01-01

A 30 cm diameter divergent magnetic field ion thruster, developed for mercury operation at 2.7 kW, was modified and operated with xenon propellant at a power level of 10 kW for 567 h to evaluate thruster performance and lifetime. The major differences between this thruster and its baseline configuration were elimination of the three mercury vaporizers, use of a main discharge cathode with a larger orifice, reduction in discharge baffle diameter, and use of an ion accelerating system with larger acceleration grid holes. Grid thickness measurement uncertainties, combined with estimates of the effects of reactive residual facility background gases gave a minimum screen grid lifetime of 7000 h. Discharge cathode orifice erosion rates were measured with three different cathodes with different initial orifice diameters. Three potential problems were identified during the wear test: the upstream side of the discharge baffle eroded at an unacceptable rate; two of the main cathode tubes experienced oxidation, deformation, and failure; and the accelerator grid impingement current was more than an order of magnitude higher than that of the baseline mercury thruster. The charge exchange ion erosion was not quantified in this test. There were no measurable changes in the accelerator grid thickness or the accelerator grid hole diameters.

Development of non-flammable lithium secondary battery with room-temperature ionic liquid electrolyte: Performance of electroplated Al film negative electrode

NASA Astrophysics Data System (ADS)

Ui, Koichi; Yamamoto, Keigo; Ishikawa, Kohei; Minami, Takuto; Takeuchi, Ken; Itagaki, Masayuki; Watanabe, Kunihiro; Koura, Nobuyuki

The negative electrode performance of the electroplated Al film electrode in the LiCl saturated AlCl 3-1-ethyl-3-methylimizadolium chloride (EMIC) + SOCl 2 melt as the electrolyte for use in non-flammable lithium secondary batteries was evaluated. In the cyclic voltammogram of the electroplated Al film electrode in the melt, the oxidation and reduction waves corresponding to the electrochemical insertion/extraction reactions of the Li + ion were observed at 0-0.80 V vs. Li +/Li, which suggested that the electroplated Al film electrode operated well in the electrolyte. The almost flat potential profiles at about 0.40 V vs. Li +/Li on discharging were shown. The discharge capacity and charge-discharge efficiency was 236 mAh g -1 and 79.2% for the 1st cycle and it maintained 232 mAh g -1 and 77.9% after the 10th cycle. In addition, the initial charge-discharge efficiencies of the electroplated Al film electrode were higher than that of carbon electrodes. The main cathodic polarization reaction was the insertion of Li + ions, and side reactions hardly occurred due to the decomposition reaction of the melt because the Li content corresponding to the electricity was almost totally inserted into the film after charging.

Trajectories of Risk for Specific Readmission Diagnoses after Hospitalization for Heart Failure, Acute Myocardial Infarction, or Pneumonia.

PubMed

Krumholz, Harlan M; Hsieh, Angela; Dreyer, Rachel P; Welsh, John; Desai, Nihar R; Dharmarajan, Kumar

2016-01-01

The risk of rehospitalization is elevated in the immediate post-discharge period and declines over time. It is not known if the extent and timing of risk vary across readmission diagnoses, suggesting that recovery and vulnerability after discharge differ by physiologic system. We compared risk trajectories for major readmission diagnoses in the year after discharge among all Medicare fee-for-service beneficiaries hospitalized with heart failure (HF), acute myocardial infarction (AMI), or pneumonia from 2008-2010. We estimated the daily risk of rehospitalization for 12 major readmission diagnostic categories after accounting for the competing risk of death after discharge. For each diagnostic category, we identified (1) the time required for readmission risk to peak and then decline 50% from maximum values after discharge; (2) the time required for readmission risk to approach plateau periods of minimal day-to-day change; and (3) the extent to which hospitalization risks are higher among patients recently discharged from the hospital compared with the general elderly population. Among >3,000,000 hospitalizations, the yearly rate of rehospitalization was 67.0%, 49.5%, and 55.3% after hospitalization for HF, AMI, and pneumonia, respectively. The extent and timing of risk varied by readmission diagnosis and initial admitting condition. Risk of readmission for gastrointestinal bleeding/anemia peaked particularly late after hospital discharge, occurring 10, 6, and 7 days after hospitalization for HF, AMI, and pneumonia, respectively. Risk of readmission for trauma/injury declined particularly slowly, requiring 38, 20, and 38 days to decline by 50% after hospitalization for HF, AMI, and pneumonia, respectively. Patterns of vulnerability to different conditions that cause rehospitalization vary by time after hospital discharge. This finding suggests that recovery of various physiologic systems occurs at different rates and that post-discharge interventions to minimize vulnerability to specific conditions should be tailored to their underlying risks.

Women undergoing aortic surgery are at higher risk for unplanned readmissions compared with men especially when discharged home.

PubMed

Flink, Benjamin J; Long, Chandler A; Duwayri, Yazan; Brewster, Luke P; Veeraswamy, Ravi; Gallagher, Katherine; Arya, Shipra

2016-06-01

Women undergoing vascular surgery have higher morbidity and mortality. Our study explores gender-based differences in patient-centered outcomes such as readmission, length of stay (LOS), and discharge destination (home vs nonhome facility) in aortic aneurysm surgery. Patients were identified from the American College of Surgeons National Surgical Quality Improvement Project database (2011-2013) undergoing abdominal, thoracic, and thoracoabdominal aortic aneurysms (N = 17,763), who were discharged and survived their index hospitalization. The primary outcome was unplanned readmission, and secondary outcomes were discharge to a nonhome facility, LOS, and reasons for unplanned readmission. Univariate, multivariate, and stratified analyses based on gender and discharge destination were used. Overall, 1541 patients (8.7%) experienced an unplanned readmission, with a significantly higher risk in women vs men (10.8% vs 8%; P < .001) overall (Procedure subtypes: abdominal aortic aneurysm [10.1% vs 7.7%; P < .001], thoracic aortic aneurysm [14.1% vs 13.5%; P = .8], and thoracoabdominal aortic aneurysm [14.8% vs 10%; P = .051]). The higher odds of readmission in women compared with men persisted in multivariate analysis after controlling for covariates (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.05-1.4). Similarly, the rate of discharge to a nonhome facility was nearly double in women compared with men (20.6% vs 10.7%; P < .001), but discharge to a nonhome facility was not a significant predictor of unplanned readmission. Upon stratification by discharge destination, the higher odds of readmissions in women compared with men occurred in patients who were discharged home (OR, 1.2; 95% CI, 1.02-1.4) but not in those who were discharged to a nonhome facility (OR, 1.06; 95% CI, 0.8-1.4). Significant differences in LOS were seen in patients who were discharged home. No gender differences were found in reasons for readmission with the three most common reasons being thromboembolic events, wound infections, and pneumonia. Gender disparity exists in the risk of unplanned readmission among aortic aneurysm surgery patients. Women who were discharged home have a higher likelihood of unplanned readmission despite longer LOS than men. These data suggest that further study into the discharge planning processes, social factors, and use of rehabilitation services is needed for women undergoing aortic procedures to decrease readmissions. Published by Elsevier Inc.

Puncture discharges in surface dielectrics as contaminant sources in spacecraft environments

NASA Technical Reports Server (NTRS)

Yadlowsky, E. J.; Hazelton, R. C.; Churchill, R. J.

1978-01-01

Spacecraft in geosynchronous orbits are known to become charged to large negative potentials during the local midnight region of the satellite orbit. Such discharges have been studied by the electron beam irradiation of dielectric samples in a vacuum environment. In addition to static measurements and photographic examination of the puncture discharges in Teflon samples, the transient characteristics of the electrical discharges are determined from oscillographs of voltage and current and by charged particle measurements employing a biased Faraday cup and a retarding potential analyzer. Using these latter techniques, studies of angular and energy distributions of charged particles have indicated an initial burst of high energy electrons (5 x 10 to the 13th power per discharge at energies greater than 300 eV) followed by a less intense burst of lower energy negative particles. Positive ions are emitted from the discharge site in an initial high velocity burst followed by a lower velocity burst tentatively identified as carbon.

Observations of the initial stage of a rocket-and-wire-triggered lightning discharge

NASA Astrophysics Data System (ADS)

Zhang, Yang; Krehbiel, Paul R.; Zhang, Yijun; Lu, Weitao; Zheng, Dong; Xu, Liangtao; Huang, Zhigang

2017-05-01

Observations have been obtained of the initial stage of a rocket-and-wire-triggered lightning flash with a high-resolution broadband VHF interferometer. The discharge produced 54 precursor current pulses (PCPs) over 883 ms during the rocket's ascent. The interferometer observations show that the PCPs were produced by breakdown at the ascending tip of the rocket, and that individual PCPs were produced by weak upward positive breakdown over meters-scale distances, followed by more energetic, fast downward negative breakdown over several tens of meters distance. The average propagation speeds were 5 × 106 m s-1 and 3 × 107 m s-1, respectively. The sustained upward positive leader (UPL) was initiated by a rapid, repetitive burst of 14 precursor pulses. Upon initiation, the VHF radiation abruptly became continuous with time. Significantly, breakdown during the UPL appeared to extend the discharge in a similar manner to that of the precursor pulses.

Admission Systolic Blood Pressure Predicts the Number of Blood Pressure Medications at Discharge in Patients With Primary Intracerebral Hemorrhage.

PubMed

Khawaja, Ayaz M; Shiue, Harn; Boehme, Amelia K; Albright, Karen C; Venkatraman, Anand; Kumar, Gyanendra; Lyerly, Michael J; Hays-Shapshak, Angela; Mirza, Maira; Gropen, Toby I; Harrigan, Mark R

2018-03-01

Control of systolic blood pressure (SBP) after primary intracerebral hemorrhage improves outcomes. Factors determining the number of blood pressure medications (BPM) required for goal SBP<160 mm Hg at discharge are unknown. We hypothesized that higher admission-SBPs require a greater number of BPM for goal discharge-SBP<160 mm Hg, and investigated factors influencing this goal. We conducted a retrospective review of 288 patients who presented with primary intracerebral hemorrhage. Admission-SBP was obtained. Primary outcome was the number of BPM at discharge. Comparison was made between patients presenting with and without a history of hypertension, and patients discharged on <3 and ≥3 BPM. Patients with hypertension history had a higher median admission-SBP compared with those without (180 vs. 157 mm Hg, P=0.0001). In total, 133 of 288 (46.2%) patients were discharged on <3 BPM; 155/288 (53.8%) were discharged on ≥3 BPM. Hypertension history (P<0.0001) and admission-SBP (P<0.0001) predicted the number of BPM at discharge. In patients without hypertension history, every 10 mm Hg increase in SBP resulted in an absolute increase of 0.5 BPM at discharge (P=0.0011), whereas in those with hypertension, the absolute increase was 1.3 BPM (P=0.0012). In comparison with patients discharged on <3 BPM, patients discharged on ≥3 BPM were more likely to have a higher median admission-SBP, be younger in age, belong to the African-American race, have a history of diabetes, have higher median admission-National Institutes of Health Stroke Scale and modified Rankin Scale of 4 to 5 at discharge. An understanding of the factors influencing BPM at discharge may help clinicians better optimize blood pressure control both before and after discharge.

Effect of Risk Acceptance for Bundled Care Payments on Clinical Outcomes in a High-Volume Total Joint Arthroplasty Practice After Implementation of a Standardized Clinical Pathway.

PubMed

Kee, James R; Edwards, Paul K; Barnes, Charles L

2017-08-01

The Bundled Payments for Care Improvement (BPCI) initiative and the Arkansas Payment Improvement (API) initiative seek to incentivize reduced costs and improved outcomes compared with the previous fee-for-service model. Before participation, our practice initiated a standardized clinical pathway (CP) to reduce length of stay (LOS), readmissions, and discharge to postacute care facilities. This practice implemented a standardized CP focused on patient education, managing patient expectations, and maximizing cost outcomes. We retrospectively reviewed all primary total joint arthroplasty patients during the initial 2-year "at risk" period for both BPCI and API and determined discharge disposition, LOS, and readmission rate. During the "at risk" period, the average LOS decreased in our total joint arthroplasty patients and our patients discharged home >94%. Patients within the BPCI group had a decreased discharge to home and decreased readmission rates after total hip arthroplasty, but also tended to be older than both API and nonbundled payment patients. While participating in the BPCI and API, continued use of a standardized CP in a high-performing, high-volume total joint practice resulted in maintenance of a low-average LOS. In addition, BPCI patients had similar outcomes after total knee arthroplasty, but had decreased rates of discharge to home and readmission after total hip arthroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

Role of electric discharges in the generation of atmospheric vortices

NASA Astrophysics Data System (ADS)

Sinkevich, O. A.; Maslov, S. A.; Gusein-zade, N. G.

2017-02-01

The existing thermohydrodynamic and hydroelectromagnetic models of tornado are considered. The potentialities of the humid atmosphere as a heat engine generating air vortices are analyzed in detail. The ability of long-term atmospheric electric discharges to form a tornado funnel and create an initial twist of up to 10-3-10-2 s-1 in it are estimated. The possible effect of a lightning discharge on the initiation and evolution of the tornado is discussed. It is shown that the electric current flowing along the lightning channel can lead to helical instability and generation of a weak primary vortex. The channel formed in the atmosphere by a lightning discharge and the vortex motion of the parent thundercloud can enhance the primary vortex and promote its transformation into a tornado. Possible mechanisms of enhancement of the primary vortex created by a lightning discharge and the possibility of its transformation into a tornado in the postdischarge stage are discussed.

The channel radius and energy of cloud-to-ground lightning discharge plasma with multiple return strokes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, Xuejuan; Yuan, Ping; Cen, Jianyong

2014-03-15

Using the spectra of a cloud-to-ground (CG) lightning flash with multiple return strokes and combining with the synchronous radiated electrical field information, the linear charge density, the channel radius, the energy per unit length, the thermal energy, and the energy of dissociation and ionization in discharge channel are calculated with the aid of an electrodynamic model of lightning. The conclusion that the initial radius of discharge channel is determined by the duration of the discharge current is confirmed. Moreover, the correlativity of several parameters has been analyzed first. The results indicate that the total intensity of spectra is positive correlatedmore » to the channel initial radius. The ionization and thermal energies have a linear relationship, and the dissociation energy is correlated positively to the ionization and thermal energies, the energy per unit length is in direct proportion to the square of initial radius in different strokes of one CG lightning.« less

EXPERT SYSTEMS FOR MIXING-ZONE ANALYSIS AND DESIGN OF POLLUTANT DISCHARGES

EPA Science Inventory

Water-quality policy in the United States includes the concept of a mixing zone, a limited area or volume of water where initial dilution of an aqueous pollutant discharge occurs. iven a myriad of possible discharge configurations, ambient environments, and mixing zone definition...

Do comorbid fibromyalgia diagnoses change after a functional restoration program in patients with chronic disabling occupational musculoskeletal disorders?

PubMed

Hartzell, Meredith M; Neblett, Randy; Perez, Yoheli; Brede, Emily; Mayer, Tom G; Gatchel, Robert J

2014-08-01

A retrospective study of prospectively collected data. To determine whether comorbid fibromyalgia, identified in patients with chronic disabling occupational musculoskeletal disorders (CDOMDs), resolves with a functional restoration program (FRP). Fibromyalgia involves widespread bodily pain and tenderness to palpation. In recent studies, 23% to 41% of patients with CDOMDs entering an FRP had comorbid fibromyalgia, compared with population averages of 2% to 5%. Few studies have examined whether fibromyalgia diagnoses resolve with any treatment, and none have investigated diagnosis responsiveness to an FRP. A consecutive cohort of patients with CDOMDs (82% with spinal disorders and all reporting chronic spinal pain) and comorbid fibromyalgia (N = 117) completed an FRP, which included quantitatively directed exercise progression and multimodal disability management. Diagnosis responsiveness, evaluated at discharge, created 2 groups: those who retained fibromyalgia and those who did not. These groups were compared with chronic regional lumbar pain only patients (LO group, n = 87), lacking widespread pain and fibromyalgia. Of the patients with comorbid fibromyalgia, 59% (n = 69) retained the fibromyalgia diagnosis (RFM group) and 41% (n = 48) lost the fibromyalgia diagnosis (LFM group) at discharge. Although all 3 groups reported decreased pain intensity, disability, and depressive symptoms from admission to discharge, RFM patients reported higher symptom levels than the LFM and LO groups at discharge. The LFM and LO groups were statistically similar. At 1-year follow-up, LO patients demonstrated higher work retention than both fibromyalgia groups (P < 0.03). Despite a significant comorbid fibromyalgia prevalence in a cohort of patients with CDOMDs entering an FRP, 41% of patients with an initial fibromyalgia diagnosis no longer met diagnostic criteria for fibromyalgia at discharge and were indistinguishable from LO patients on pain, disability, and depression symptoms. However, both fibromyalgia groups (LFM and RFM) had lower work retention than LO patients 1 year later, suggesting that an FRP may suppress symptoms of fibromyalgia in a subset of patients, but prolonged fibromyalgia-related disability may be more difficult to overcome. 2.

Wastewater discharge impact on drinking water sources along the Yangtze River (China).

PubMed

Wang, Zhuomin; Shao, Dongguo; Westerhoff, Paul

2017-12-01

Unplanned indirect (de facto) wastewater reuse occurs when wastewater is discharged into surface waters upstream of potable drinking water treatment plant intakes. This paper aims to predict percentages and trends of de facto reuse throughout the Yangtze River watershed in order to understand the relative contribution of wastewater discharges into the river and its tributaries towards averting water scarcity concerns. The Yangtze River is the third longest in the world and supports more than 1/15 of the world's population, yet the importance of wastewater on the river remains ill-defined. Municipal wastewater produced in the Yangtze River Basin increased by 41% between 1998 and 2014, from 2580m 3 /s to 3646m 3 /s. Under low flow conditions in the Yangtze River near Shanghai, treated wastewater contributions to river flows increased from 8% in 1998 to 14% in 2014. The highest levels of de facto reuse appeared along a major tributary (Han River) of the Yangtze River, where de facto reuse can exceed 20%. While this initial analysis of de facto reuse used water supply and wastewater data from 110 cities in the basin and 11 gauging stations with >50years of historic streamflow data, the outcome was limited by the lack of gauging stations at more locations (i.e., data had to be predicted using digital elevation mapping) and lack of precise geospatial location of drinking water intakes or wastewater discharges. This limited the predictive capability of the model relative to larger datasets available in other countries (e.g., USA). This assessment is the first analysis of de facto wastewater reuse in the Yangtze River Basin. It will help identify sections of the river at higher risk for wastewater-related pollutants due to presence of-and reliance on-wastewater discharge that could be the focus of field studies and model predictions of higher spatial and temporal resolution. Copyright © 2017 Elsevier B.V. All rights reserved.

On the shape of the glow discharge channel

NASA Astrophysics Data System (ADS)

Dmitriev, A. L.; Nikushchenko, E. M.

2017-05-01

Examples of the shapes of the glow discharge channel are presented. The discharge has been initiated in air at a pressure of 0.1 atm. The effective value and frequency of the discharge current are 30-70 mA and 50 Hz, respectively. It has been shown that, for these values of the current and pressure, thermal convection in a vacuum chamber and buoyancy (Archimedes force) are not major reasons for the specific parabolic shape of glow discharge.

Motor unit recruitment in human biceps brachii during sustained voluntary contractions.

PubMed

Riley, Zachary A; Maerz, Adam H; Litsey, Jane C; Enoka, Roger M

2008-04-15

The purpose of the study was to examine the influence of the difference between the recruitment threshold of a motor unit and the target force of the sustained contraction on the discharge of the motor unit at recruitment. The discharge characteristics of 53 motor units in biceps brachii were recorded after being recruited during a sustained contraction. Some motor units (n = 22) discharged action potentials tonically after being recruited, whereas others (n = 31) discharged intermittent trains of action potentials. The two groups of motor units were distinguished by the difference between the recruitment threshold of the motor unit and the target force for the sustained contraction: tonic, 5.9 +/- 2.5%; intermittent, 10.7 +/- 2.9%. Discharge rate for the tonic units decreased progressively (13.9 +/- 2.7 to 11.7 +/- 2.6 pulses s(-1); P = 0.04) during the 99 +/- 111 s contraction. Train rate, train duration and average discharge rate for the intermittent motor units did not change across 211 +/- 153 s of intermittent discharge. The initial discharge rate at recruitment during the sustained contraction was lower for the intermittent motor units (11.0 +/- 3.3 pulses s(-1)) than the tonic motor units (13.7 +/- 3.3 pulses s(-1); P = 0.005), and the coefficient of variation for interspike interval was higher for the intermittent motor units (34.6 +/- 12.3%) than the tonic motor units (21.2 +/- 9.4%) at recruitment (P = 0.001) and remained elevated for discharge duration (34.6 +/- 9.2% versus 19.1 +/- 11.7%, P < 0.001). In an additional experiment, 12 motor units were recorded at two different target forces below recruitment threshold (5.7 +/- 1.9% and 10.5 +/- 2.4%). Each motor unit exhibited the two discharge patterns (tonic and intermittent) as observed for the 53 motor units. The results suggest that newly recruited motor units with recruitment thresholds closer to the target force experienced less synaptic noise at the time of recruitment that resulted in them discharging action potentials at more regular and greater rates than motor units with recruitment thresholds further from the target force.

Comparison of Canadian versus American emergency department visits for acute asthma

PubMed Central

Rowe, Brian H; Bota, Gary W; Clark, Sunday; Camargo, Carlos A

2007-01-01

BACKGROUND: Acute asthma is a common emergency department (ED) presentation in both Canada and the United States. OBJECTIVE: To compare ED asthma management and outcomes between Canada and the United States. MEHODS: A prospective cohort study of 69 American and eight Canadian EDs was conducted. Patients aged two to 54 years who presented with acute asthma underwent a structured ED interview and telephone follow-up two weeks later. RESULTS: A total of 3031 patients were enrolled. Canadian patients were more likely to be white (89% versus 22%; P<0.001), have health insurance (100% versus 69%; P<0.001) and identify a primary care provider (89% versus 64%; P<0.001) than American patients. In addition, Canadian patients were more likely to be using inhaled corticosteroids (63% versus 44%; P<0.001) and had higher initial peak expiratory flow (61% versus 48%; P<0.001). In the ED, Canadians received fewer beta-agonist (one versus two; P<0.001) and more anticholinergic (two versus one; P<0.001) treatments in the first hour; use of systemic corticosteroids was similar (60% versus 68%; P=0.13). Canadians were less likely to be hospitalized (11% versus 21%; P=0.02). Corticosteroids were prescribed similarly at discharge (60% versus 69%; P=0.13); however, Canadians were discharged more commonly on inhaled corticosteroids (63% versus 11%; P<0.001) and relapses were similar. CONCLUSIONS: Canadian patients with acute asthma have fewer barriers to primary care and are more likely to be on preventive medications, both before the ED visit and following discharge. Admissions rates are higher in the United States; however, relapse after discharge is similar between countries. These findings highlight the influences of preventive practices and heath care systems on ED visits for asthma. PMID:17885692

Association Between Facility Type During Pediatric Inpatient Rehabilitation and Functional Outcomes

PubMed Central

Fuentes, Molly M.; Apkon, Susan; Jimenez, Nathalia; Rivara, Frederick P.

2017-01-01

Objective To compare functional outcomes between children receiving inpatient rehabilitation at children’s hospitals and those at other facilities. Design Retrospective cohort study. Setting Inpatient rehabilitation facilities. Participants Children (N=28,793) aged 6 months to 18 years who received initial inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures Total, cognitive, and motor developmental functional quotients (DFQs; which is the WeeFIM score divided by age-adjusted norms and multiplied by 100) at discharge from inpatient rehabilitation and WeeFIM efficiency (the change in WeeFIM score from admission to discharge divided by the length of the rehabilitation stay), adjusting for age, sex, race, insurance, region, admission function, impairment type, discharge year, and length of stay. Results A total of 12,732 children received rehabilitation at 25 children’s hospitals and 16,061 at 36 other facilities (general hospitals or freestanding rehabilitation hospitals). Adjusting for clustering by facility, patients at children’s hospitals had a lower cognitive DFQ at admission (difference between children’s hospitals and other facility types, −3.8; 95% confidence interval [CI], −7.7 to −0.1), a shorter length of stay (median, 16d vs 22d; P<.001), and a higher WeeFIM efficiency (difference, 0.63; 95% CI, 0.25–1.00) than did children at other facility types. Rehabilitation in a children’s hospital was independently associated with a higher discharge cognitive DFQ (regression coefficient, 2.3; 95% CI, 0.3–4.2) and more efficient rehabilitation admissions (regression coefficient, 0.3; 95% CI, 0.1–0.6). Conclusions Children who receive inpatient rehabilitation at children’s hospitals have more efficient inpatient rehabilitation admissions, a shorter median length of stay, and a slight improvement in cognitive function than do children at other facility types. PMID:27026580

Performance of lightweight nickel electrodes

NASA Technical Reports Server (NTRS)

Britton, Doris L.

1988-01-01

The NASA Lewis Research Center is currently developing nickel electrodes for nickel-hydrogen (Ni-H2) batteries. These electrodes are lighter in weight and have higher energy densities than the heavier state-of-the-art (SOA) sintered nickel electrodes. In the present approach, lightweight materials or plaques are used as conductive supports for the nickel hydroxide active material. These plaques (fiber and felt, nickel plated plastic and graphite) are commercial products that are fabricated into nickel electrodes by electrochemically impregnating them with active material. Evaluation is performed in half cells structured in the bipolar configuration. Initial performance tests include capacity measurements at five discharge levels, C/2, 1.0C 1.37C, 2.0C and 2.74C. The electrodes that pass the initial tests are life cycle tested in a low Earth orbit regime at 80 percent depth of discharge. Different formulations of nickel fiber materials obtained from several manufacturers are currently being tested as possible candidates for nickel electrodes. One particular lightweight fiber mat electrode has accumulated over 3000 cycles to date, with stable capacity and voltage. Life and performance data of this electrode were investigated and presented. Good dimensional stability and active material adherence have been demonstrated in electrodes made from this lightweight plaque.

Silicon hollow sphere anode with enhanced cycling stability by a template-free method

NASA Astrophysics Data System (ADS)

Chen, Song; Chen, Zhuo; Luo, Yunjun; Xia, Min; Cao, Chuanbao

2017-04-01

Silicon is a promising alternative anode material since it has a ten times higher theoretical specific capacity than that of a traditional graphite anode. However, the poor cycling stability due to the huge volume change of Si during charge/discharge processes has seriously hampered its widespread application. To address this challenge, we design a silicon hollow sphere nanostructure by selective etching and a subsequent magnesiothermic reduction. The Si hollow spheres exhibit enhanced electrochemical properties compared to the commercial Si nanoparticles. The initial discharge and charge capacities of the Si hollow sphere anode are 2215.8 mAh g-1 and 1615.1 mAh g-1 with a high initial coulombic efficiency (72%) at a current density of 200 mA g-1, respectively. In particular, the reversible capacity is 1534.5 mAh g-1 with a remarkable 88% capacity retention against the second cycle after 100 cycles, over four times the theoretical capacity of the traditional graphite electrode. Therefore, our work demonstrates the considerable potential of silicon structures for displacing commercial graphite, and might open up new opportunities to rationally design various nanostructured materials for lithium ion batteries.

LiMn2O4–yBryNanoparticles Synthesized by a Room Temperature Solid-State Coordination Method

PubMed Central

2009-01-01

LiMn2O4–yBrynanoparticles were synthesized successfully for the first time by a room temperature solid-state coordination method. X-ray diffractometry patterns indicated that the LiMn2O4–yBrypowders were well-crystallized pure spinel phase. Transmission electron microscopy images showed that the LiMn2O4–yBrypowders consisted of small and uniform nanosized particles. Synthesis conditions such as the calcination temperature and the content of Br−were investigated to optimize the ideal condition for preparing LiMn2O4–yBrywith the best electrochemical performances. The optimized synthesis condition was found in this work; the calcination temperature is 800 °C and the content of Br−is 0.05. The initial discharge capacity of LiMn2O3.95Br0.05obtained from the optimized synthesis condition was 134 mAh/g, which is far higher than that of pure LiMn2O4, indicating introduction of Br−in LiMn2O4is quite effective in improving the initial discharge capacity. PMID:20628635

Algebraic method for parameter identification of circuit models for batteries under non-zero initial condition

NASA Astrophysics Data System (ADS)

Devarakonda, Lalitha; Hu, Tingshu

2014-12-01

This paper presents an algebraic method for parameter identification of Thevenin's equivalent circuit models for batteries under non-zero initial condition. In traditional methods, it was assumed that all capacitor voltages have zero initial conditions at the beginning of each charging/discharging test. This would require a long rest time between two tests, leading to very lengthy tests for a charging/discharging cycle. In this paper, we propose an algebraic method which can extract the circuit parameters together with initial conditions. This would theoretically reduce the rest time to 0 and substantially accelerate the testing cycles.

Deflagration-to-Detonation Transition Control by Nanosecond Gas Discharges

DTIC Science & Technology

2008-04-07

Report 3. DATES COVERED (From – To) 1 April 2007 - 18 August 09 4. TITLE AND SUBTITLE Deflagration-To- Detonation Transition Control By Nanosecond...SUPPLEMENTARY NOTES 14. ABSTRACT During the current project, an extensive experimental study of detonation initiation by high{voltage...nanosecond gas discharges has been performed in a smooth detonation tube with different discharge chambers and various discharge cell numbers. The chambers

Readability of patient discharge instructions with and without the use of electronically available disease-specific templates.

PubMed

Mueller, Stephanie K; Giannelli, Kyla; Boxer, Robert; Schnipper, Jeffrey L

2015-07-01

Low health literacy is common, leading to patient vulnerability during hospital discharge, when patients rely on written health instructions. We aimed to examine the impact of the use of electronic, patient-friendly, templated discharge instructions on the readability of discharge instructions provided to patients at discharge. We performed a retrospective cohort study of 233 patients discharged from a large tertiary care hospital to their homes following the implementation of a web-based "discharge module," which included the optional use of diagnosis-specific templated discharge instructions. We compared the readability of discharge instructions, as measured by the Flesch Reading Ease Level test (FREL, on a 0-100 scale, with higher scores indicating greater readability) and the Flesch-Kincaid Grade Level test (FKGL, measured in grade levels), between discharges that used templated instructions (with or without modification) versus discharges that used clinician-generated instructions (with or without available templated instructions for the specific discharge diagnosis). Templated discharge instructions were provided to patients in 45% of discharges. Of the 55% of patients that received clinician-generated discharge instructions, the majority (78.1%) had no available templated instruction for the specific discharge diagnosis. Templated discharge instructions had higher FREL scores (71 vs. 57, P < .001) and lower FKGL scores (5.6 vs. 7.6, P < .001), compared to clinician-generated discharge instructions. The use of electronically available templated discharge instructions was associated with better readability (a higher FREL score and a lower FKGL score) than the use of clinician-generated discharge instructions. The main reason for clinicians to create discharge instructions was the lack of available templates for the patient's specific discharge diagnosis. Use of electronically available templated discharge instructions may be a viable option to improve the readability of written material provided to patients at discharge, although the library of available templates requires expansion. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Fundamentals of undervoltage breakdown through the Townsend mechanism

NASA Astrophysics Data System (ADS)

Cooley, James E.

The conditions under which an externally supplied pulse of electrons will induce breakdown in an undervoltaged, low-gain, DC discharge gap are experimentally and theoretically explored. The phenomenon is relevant to fundamental understanding of breakdown physics, to switching applications such as triggered spark gaps and discharge initiation in pulsed-plasma thrusters, and to gas-avalanche particle counters. A dimensionless theoretical description of the phenomenon is formulated and solved numerically. It is found that a significant fraction of the charge on the plates must be injected for breakdown to be achieved at low avalanche-ionization gain, when an electron undergoes fewer than approximately 10 ionizing collisions during one gap transit. It is also found that fewer injected electrons are required as the gain due to electron-impact ionization (alpha process) is increased, or as the sensitivity of the alpha process to electric field is enhanced by decreasing the reduced electric field (electric field divided by pressure, E/p). A predicted insensitivity to ion mobility implies that breakdown is determined during the first electron avalanche when space charge distortion is greatest. A dimensionless, theoretical study of the development of this avalanche reveals a critical value of the reduced electric field to be the value at the Paschen curve minimum divided by 1.6. Below this value, the net result of the electric field distortion is to increase ionization for subsequent avalanches, making undervoltage breakdown possible. Above this value, ionization for subsequent avalanches will be suppressed and undervoltage breakdown is not possible. Using an experimental apparatus in which ultraviolet laser pulses are directed onto a photo-emissive cathode of a parallel-plate discharge gap, it is found that undervoltage breakdown can occur through a Townsend-like mechanism through the buildup of successively larger avalanche generations. The minimum number of injected electrons required to achieve breakdown is measured in argon at pd values of 3-10 Torr-m. The required electron pulse magnitude was found to scale inversely with pressure and voltage in this parameter range. When higher-power infrared laser pulses were used to heat the cathode surface, a faster, streamer-like breakdown mechanism was occasionally observed. As an example application, an investigation into the requirements for initiating discharges in Gas-fed Pulsed Plasma Thrusters (GFPPTs) is conducted. Theoretical investigations based on order-of-magnitude characterizations of previous GFPPT designs reveal that high-conductivity arc discharges are required for critically-damped matching of circuit components, and that relatively fast streamer breakdown is preferable to minimize delay between triggering and current sheet formation. The faster breakdown mechanism observed in the experiments demonstrates that such a discharge process can occur. However, in the parameter space occupied by most thrusters, achieving the phenomenon by way of a space charge distortion caused purely by an electron pulse should not be possible. Either a transient change in the distribution of gas density, through ablation or desorption, or a thruster design that occupies a different parameter space, such as one that uses higher mass bits, higher voltages, or smaller electrode spacing, is required for undervoltage breakdown to occur.

77 FR 18963 - Energy Conservation Program: Public Meeting and Availability of the Framework Document for High...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-29

... the Framework Document for High-Intensity Discharge Lamps AGENCY: Office of Energy Efficiency and... availability of framework document for high-intensity discharge (HID) lamps, initiating the rulemaking and data... Availability of Framework Document Regarding Energy Conservation Standards for High-Intensity Discharge (HID...

Arcing in Leo and Geo Simulated Environments: Comparative Analysis

NASA Technical Reports Server (NTRS)

Vayner, Boris V.; Ferguson, Dale C.; Galofaro, Joel TY.

2006-01-01

Comprehensive tests of two solar array samples in simulated Low Earth Orbit (LEO) and Geosynchronous Orbit (GEO) environments have demonstrated that the arc inception voltage was 2-3 times lower in the LEO plasma than in the GEO vacuum. Arc current pulse wave forms are also essentially different in these environments. Moreover, the wide variations of pulse forms do not allow introducing the definition of a "standard arc wave form" even in GEO conditions. Visual inspection of the samples after testing in a GEO environment revealed considerable damage on coverglass surfaces and interconnects. These harmful consequences can be explained by the discharge energy being one order of magnitude higher in vacuum than in background plasma. The tests also revealed a potential danger of powerful electrostatic discharges that could be initiated on the solar array surface of a satellite in GEO during the ignition of an arcjet thruster.

Memory and decision making in the frontal cortex during visual motion processing for smooth pursuit eye movements.

PubMed

Shichinohe, Natsuko; Akao, Teppei; Kurkin, Sergei; Fukushima, Junko; Kaneko, Chris R S; Fukushima, Kikuro

2009-06-11

Cortical motor areas are thought to contribute "higher-order processing," but what that processing might include is unknown. Previous studies of the smooth pursuit-related discharge of supplementary eye field (SEF) neurons have not distinguished activity associated with the preparation for pursuit from discharge related to processing or memory of the target motion signals. Using a memory-based task designed to separate these components, we show that the SEF contains signals coding retinal image-slip-velocity, memory, and assessment of visual motion direction, the decision of whether to pursue, and the preparation for pursuit eye movements. Bilateral muscimol injection into SEF resulted in directional errors in smooth pursuit, errors of whether to pursue, and impairment of initial correct eye movements. These results suggest an important role for the SEF in memory and assessment of visual motion direction and the programming of appropriate pursuit eye movements.

Performance of large area xenon ion thrusters for orbit transfer missions

NASA Technical Reports Server (NTRS)

Rawlin, Vincent K.

1989-01-01

Studies have indicated that xenon ion propulsion systems can enable the use of smaller Earth-launch vehicles for satellite placement which results in significant cost savings. These analyses have assumed the availability of advanced, high power ion thrusters operating at about 10 kW or higher. A program was initiated to explore the viability of operating 50 cm diameter ion thrusters at this power level. Operation with several discharge chamber and ion extraction grid set combinations has been demonstrated and data were obtained at power levels to 16 kW. Fifty cm diameter thrusters using state of the art 30 cm diameter grids or advanced technology 50 cm diameter grids allow discharge power and beam current densities commensurate with long life at power levels up to 10 kW. In addition, 50 cm diameter thrusters are shown to have the potential for growth in thrust and power levels beyond 10 KW.

Antiarrhythmic Drugs for Nonshockable-Turned-Shockable Out-of-Hospital Cardiac Arrest: The ALPS Study (Amiodarone, Lidocaine, or Placebo).

PubMed

Kudenchuk, Peter J; Leroux, Brian G; Daya, Mohamud; Rea, Thomas; Vaillancourt, Christian; Morrison, Laurie J; Callaway, Clifton W; Christenson, James; Ornato, Joseph P; Dunford, James V; Wittwer, Lynn; Weisfeldt, Myron L; Aufderheide, Tom P; Vilke, Gary M; Idris, Ahamed H; Stiell, Ian G; Colella, M Riccardo; Kayea, Tami; Egan, Debra; Desvigne-Nickens, Patrice; Gray, Pamela; Gray, Randal; Straight, Ron; Dorian, Paul

2017-11-28

Out-of-hospital cardiac arrest (OHCA) commonly presents with nonshockable rhythms (asystole and pulseless electric activity). It is unknown whether antiarrhythmic drugs are safe and effective when nonshockable rhythms evolve to shockable rhythms (ventricular fibrillation/pulseless ventricular tachycardia [VF/VT]) during resuscitation. Adults with nontraumatic OHCA, vascular access, and VF/VT anytime after ≥1 shock(s) were prospectively randomized, double-blind, to receive amiodarone, lidocaine, or placebo by paramedics. Patients presenting with initial shock-refractory VF/VT were previously reported. The current study was a prespecified analysis in a separate cohort that initially presented with nonshockable OHCA and was randomized on subsequently developing shock-refractory VF/VT. The primary outcome was survival to hospital discharge. Secondary outcomes included discharge functional status and adverse drug-related effects. Of 37 889 patients with OHCA, 3026 with initial VF/VT and 1063 with initial nonshockable-turned-shockable rhythms were treatment-eligible, were randomized, and received their assigned drug. Baseline characteristics among patients with nonshockable-turned-shockable rhythms were balanced across treatment arms, except that recipients of a placebo included fewer men and were less likely to receive bystander cardiopulmonary resuscitation. Active-drug recipients in this cohort required fewer shocks, supplemental doses of their assigned drug, and ancillary antiarrhythmic drugs than recipients of a placebo ( P <0.05). In all, 16 (4.1%) amiodarone, 11 (3.1%) lidocaine, and 6 (1.9%) placebo-treated patients survived to hospital discharge ( P =0.24). No significant interaction between treatment assignment and discharge survival occurred with the initiating OHCA rhythm (asystole, pulseless electric activity, or VF/VT). Survival in each of these categories was consistently higher with active drugs, although the trends were not statistically significant. Adjusted absolute differences (95% confidence interval) in survival from nonshockable-turned-shockable arrhythmias with amiodarone versus placebo were 2.3% (-0.3, 4.8), P =0.08, and for lidocaine versus placebo 1.2% (-1.1, 3.6), P =0.30. More than 50% of these survivors were functionally independent or required minimal assistance. Drug-related adverse effects were infrequent. Outcome from nonshockable-turned-shockable OHCA is poor but not invariably fatal. Although not statistically significant, point estimates for survival were greater after amiodarone or lidocaine than placebo, without increased risk of adverse effects or disability and consistent with previously observed favorable trends from treatment of initial shock-refractory VF/VT with these drugs. Together the findings may signal a clinical benefit that invites further investigation. URL: https://www.clinicaltrials.gov. Unique identifier: NCT01401647. © 2017 American Heart Association, Inc.

Numerical study of nonequilibrium plasma assisted detonation initiation in detonation tube

NASA Astrophysics Data System (ADS)

Zhou, Siyin; Wang, Fang; Che, Xueke; Nie, Wansheng

2016-12-01

Nonequilibrium plasma has shown great merits in ignition and combustion nowadays, which should be especially useful for hypersonic propulsion. A coaxial electrodes configuration was established to investigate the effect of alternating current (AC) dielectric barrier discharge nonequilibrium plasma on the detonation initiation process in a hydrogen-oxygen mixture. A discharge simulation-combustion simulation loosely coupled method was used to simulate plasma assisted detonation initiation. First, the dielectric barrier discharge in the hydrogen-oxygen mixture driven by an AC voltage was simulated, which takes 17 kinds of particles (including positively charged particles, negatively charged particles, and neutral particles) and 47 reactions into account. The temporal and spatial characteristics of the discharge products were obtained. Then, the discharge products were incorporated into the combustion model of a detonation combustor as the initial conditions for the later detonation initiation simulation. Results showed that the number density distributions of plasma species are different in space and time, and develop highly nonuniformly from high voltage electrode to grounded electrode at certain times. All the active species reach their highest concentration at approximately 0.6T (T denotes a discharge cycle). Compared with the no plasma case, the differences of flowfield shape mainly appear in the early stage of the deflagration to detonation transition process. None of the sub-processes (including the very slow combustion, deflagration, over-driven detonation, detonation decay, and propagation of a self-sustained stable detonation wave) have been removed by the plasma. After the formation of a C-J detonation wave, the whole flowfield remains unchanged. With the help of plasma, the deflagration to detonation transition (DDT) time and distance are reduced by about 11.6% and 12.9%, respectively, which should be attributed to the active particles effect of nonequilibrium plasma and the local turbulent enhancing effect by the spatial characteristics of discharge. In addition, as the duration of forming a shock wave in the combustor is shortened by approximately 8.1%, it can be inferred that the plasma accelerates the DDT process more significantly before the flow becomes supersonic.

A relationship between a level of hemoglobin after delivery and exclusive breastfeeding initiation at a baby friendly hospital in Japan.

PubMed

Horie, Saki; Nomura, Kyoko; Takenoshita, Shinichi; Nakagawa, Junko; Kido, Michiko; Sugimoto, Mitsuhiro

2017-04-20

The recent National Nutrition Survey of 2013 demonstrated that 16.7% of women in childbearing age are underweight, and 5.0-10.0% of these women manifested a Hemoglobin (Hb) level less than 11.0 g/dl. The purpose of this study was to investigate if such maternal nutritional status affects success of exclusive breastfeeding (EBF) practice. This cross-sectional study investigated 1532 dyads of mothers and infants with full-term singleton pregnancies delivered during 2011 at a perinatal center in Tokyo. Outcome is EBF initiation defined as the successful practice at discharge and 1 month after discharge. A logistic regression model was applied to investigate the impact of Hb levels (<9.0, 9.0-10.9, and ≥11.0 g/dl) measured within 2-3 days after delivery on successful EBF initiation adjusting for covariates including bleeding at delivery. Mean age was 34 years, 23.0% were underweight and 63.0% were nulliparous. The success rate for EBF initiation at discharge and at 1 month after discharge was 72.7 and 63.0% for a Hb level <9.0 g/dl, 81.9 and 68.9% for a Hb level of 9.0-10.9 g/dl, and 85.7 and 75.9% for a Hb level ≥11.0 g/dl, respectively. A logistic regression model showed that risk factors of unsuccessful EBF practice at discharge and 1 month after discharge included lower level Hb categories (P < 0.001 and P < 0.001), postpartum hemorrhage > 500 ml (P = 0.089 and P = 0.011), maternal age (P < 0.001 and P < 0.001), nulliparity (P < 0.0001 and P < 0.001), pregnancy-induced hypertension (P = 0.002 and P = 0.012), gestational week (P = 0.006 and P = 0.002), Low Birth Weight (LBW) (P < 0.001 and P < 0.001), and immediate separation (P < 0.001 and P = 0.020). After adjusting for the covariates, compared with a Hb level ≥11.0 g/dl, a Hb level <9.0 g/dl was significantly associated with unsuccessful EBF initiation at discharge [odds ratio (OR): 2.15; 95% confidence interval (CI): 1.37-3.39] and at 1 month after discharge (OR: 1.63; 95% CI: 1.10-2.42), and a Hb level of 9.0-10.9 g/dl also was significant at 1 month after discharge (OR: 1.35; 95% CI: 1.04-1.75). Pre-pregnancy underweight was not associated with success of EBF practice both at hospital discharge and 1 month after discharge. Maternal severe anemia after delivery was associated with the risk of unsuccessful initiation of EBF even after adjusting for bleeding at delivery, suggesting the importance of dietary management especially in the later trimester.

Electromagnetic emission from terrestrial lightning in the 0.1-30 MHz frequency range

NASA Astrophysics Data System (ADS)

Karashtin, A. N.; Gurevich, A. V.

Results of measurements carried out at SURA facility of Radiophisical Research Institute and at Tien-Shan Mountain Scientific Station of Lebedev Physical Institute using specially designed installations for short electromagnetic pulse observation in the frequency range from 0.1 to 30 MHz are presented. Specific attention is paid to initial stage of the lightning discharge. It is shown that lightning can be initiated by extensive atmospheric showers caused by high energy cosmic ray particles. Analysis of emission of few thousand lightning discharges showed that • Short wave radio emission of lightning consists of a series of short pulses with duration from less than 100 nanoseconds to several microseconds separated well longer gaps. • Background noise between lightning discharges is not differ from one observed without thunderstorm activity (at given sensitivity). Usually it is the same between lightning pulses at least at the initial stage. • Each lightning discharge radio emission starts with a number of very short (less than 100 nanoseconds at 0.7 level) bi-polar pulses. Gaps between initial pulses vary from several microseconds to few hundreds of microseconds. No radio emission was observed before the first pulse during at least 500 milliseconds. Both positive and negative polarity of the first pulses occur in approximately equal proportion in different lightning discharges while the polarity was the same in any individual lightning. • First pulse amplitude, width and waveform are consistent with predicted by the theory of combined action of runaway breakdown and extensive atmospheric shower caused by cosmic ray particle of 1016 eV energy. Lightning discharges at other planets can be initiated by cosmic ray particles as well. This work was partly supported by ISTC grant # 2236p. The work of one of the authors (A. N. Karashtin) was also partly supported by INTAS grant # 03-51-5727.

Numerical simulation of narrow bipolar electromagnetic pulses generated by thunderstorm discharges

NASA Astrophysics Data System (ADS)

Bochkov, E. I.; Babich, L. P.; Kutsyk, I. M.

2013-07-01

Using the concept of avalanche relativistic runaway electrons (REs), we perform numerical simulations of compact intracloud discharge (CID) as a generator of powerful natural electromagnetic pulses (EMPs) in the HF-VHF range, called narrow bipolar pulses (NBPs). For several values of the field overvoltage and altitude at which the discharge develops, the numbers of seed electrons initiating the avalanche are evaluated, with which the calculated EMP characteristics are consistent with the measured NBP parameters. We note shortcomings in the hypothesis assuming participation of cosmic ray air showers in avalanche initiation. The discharge capable of generating NBPs produces REs in numbers close to those in the source of terrestrial γ-ray flashes (TGFs), which can be an argument in favor of a unified NBP and TGF source.

Atmospheric-pressure electric discharge as an instrument of chemical activation of water solutions

NASA Astrophysics Data System (ADS)

Rybkin, V. V.; Shutov, D. A.

2017-11-01

Results of experimental studies and numerical simulations of physicochemical characteristics of plasmas generated in different types of atmospheric-pressure discharges (pulsed streamer corona, gliding electric arc, dielectric barrier discharge, glow-discharge electrolysis, diaphragmatic discharge, and dc glow discharge) used to initiate various chemical processes in water solutions are analyzed. Typical reactor designs are considered. Data on the power supply characteristics, plasma electron parameters, gas temperatures, and densities of active particles in different types of discharges excited in different gases and their dependences on the external parameters of discharges are presented. The chemical composition of active particles formed in water is described. Possible mechanisms of production and loss of plasma particles are discussed.

Plasma Discharge Process in a Pulsed Diaphragm Discharge System

NASA Astrophysics Data System (ADS)

Duan, Jianjin; Hu, Jue; Zhang, Chao; Wen, Yuanbin; Meng, Yuedong; Zhang, Chengxu

2014-12-01

As one of the most important steps in wastewater treatment, limited study on plasma discharge process is a key challenge in the development of plasma applications. In this study, we focus on the plasma discharge process of a pulsed diaphragm discharge system. According to the analysis, the pulsed diaphragm discharge proceeds in seven stages: (1) Joule heating and heat exchange stage; (2) nucleated site formation; (3) plasma generation (initiation of the breakdown stage); (4) avalanche growth and plasma expansion; (5) plasma contraction; (6) termination of the plasma discharge; and (7) heat exchange stage. From this analysis, a critical voltage criterion for breakdown is obtained. We anticipate this finding will provide guidance for a better application of plasma discharges, especially diaphragm plasma discharges.

Evolution and Initial Experience of a Statewide Care Transitions Quality Improvement Collaborative: Preventing Avoidable Readmissions Together.

PubMed

Axon, R Neal; Cole, Laura; Moonan, Aunyika; Foster, Richard; Cawley, Patrick; Long, Laura; Turley, Christine B

2016-02-01

Increasing scrutiny of hospital readmission rates has spurred a wide variety of quality improvement initiatives. The Preventing Avoidable Readmissions Together (PART) initiative is a statewide quality improvement learning collaborative organized by stakeholder organizations in South Carolina. This descriptive report focused on initial interventions with hospitals. Eligible participants included all acute care hospitals plus home health organizations, nursing facilities, hospices, and other health care organizations. Measures were degree of statewide participation, curricular engagement, adoption of evidence-based improvement strategies, and readmission rate changes. Fifty-nine of 64 (92%) acute care hospitals and 9 of 10 (90%) hospital systems participated in collaborative events. Curricular engagement included: webinars and coaching calls (49/59, 83%), statewide in-person meetings (35/59, 59%), regional in-person meetings (44/59, 75%), and individualized consultations (46/59, 78%). Among 34 (58%) participating hospitals completing a survey at the completion of Year 1, respondents indicated complete implementation of multidisciplinary rounding (58%), post-discharge telephone calls (58%), and teach-back (32%), and implementation in process of high-quality transition records (52%), improved discharge summaries (45%), and timely follow-up appointments (39%). A higher proportion of hospitals had significant decreases (≥10% relative change) in all-cause readmission rates for acute myocardial infarction (55.6% vs. 30.4%, P=0.01), heart failure (54.2% vs. 31.7%, P=0.09), and chronic obstructive pulmonary disease (41.7% vs. 33.3%, P=0.83) between 2011-2013 compared to earlier (2009-2011) trends. Focus on reducing readmissions is driving numerous, sometimes competing, quality improvement initiatives. PART successfully engaged the majority of acute care facilities in one state to harmonize and accelerate adoption of evidence-based care transitions strategies.

Effectiveness of granisetron in controlling pediatric gastroenteritis-related vomiting after discharge from the ED.

PubMed

Qazi, Khajista; BinSalleeh, Hashim M; Shah, Ubaid H; AlGhamedi, Najwa; Tamim, Hani; Mubasher, Mohamed; Alrasheed, Faris; Alkanhal, Abdulrahman; AlTamimi, Saleh A

2014-09-01

The objective of the study is to determine the efficacy of oral granisetron (a long-acting 5-HT3 receptor antagonist) in stopping vomiting subsequent to discharge from emergency department (ED), in 6-month-old to 8-year-old patients with gastroenteritis-related vomiting and dehydration, who had failed an initial trial of oral rehydration (ORT). Eligible patients were offered ORT on a slowly advancing schedule. Patients who tolerated the initial ORT were discharged home. Patients who vomited were randomized to receive either 40 μg/kg of granisetron or placebo, and ORT was resumed. Patients who tolerated the postrandomization ORT were discharged home with another dose of the study drug. Parents were contacted by telephone every 24 hours until complete resolution of symptoms. The primary outcome was the proportion of patients with vomiting at 24 hours. Of the 900 eligible patients, 537 (60%) tolerated the initial ORT and were discharged home. Of the patients who vomited during the initial ORT, 165 were included in the final study sample (placebo, n = 82; granisetron, n = 83). There was no statistically significant difference in the proportion of patients with vomiting at 24 hours (granisetron, n = 38; placebo, n = 45; odds ratio, 0.64; 95% confidence interval, 0.34-1.19; P = .16). A similar trend in the proportion of patients with vomiting was noted for the entire follow-up period (granisetron, n = 43; placebo, n = 47; odds ratio, 0.73; P = .33; 95% confidence interval, 0.39-1.36). Granisetron was not effective in controlling gastroenteritis-related vomiting subsequent to discharge from ED. It did not change the expected course of the illness. Copyright © 2014 Elsevier Inc. All rights reserved.

Plasma Discharge Initiation of Explosives in Rock Blasting Application: A Case Study

NASA Astrophysics Data System (ADS)

Jae-Ou, Chae; Young-Jun, Jeong; V, M. Shmelev; A, A. Denicaev; V, M. Poutchkov; V, Ravi

2006-07-01

A plasma discharge initiation system for the explosive volumetric combustion charge was designed, investigated and developed for practical application. Laboratory scale experiments were carried out before conducting the large scale field tests. The resultant explosions gave rise to less noise, insignificant seismic vibrations and good specific explosive consumption for rock blasting. Importantly, the technique was found to be safe and environmentally friendly.

Factors associated with initiation and exclusive breastfeeding at hospital discharge: late preterm compared to 37 week gestation mother and infant cohort.

PubMed

Ayton, Jennifer; Hansen, Emily; Quinn, Stephen; Nelson, Mark

2012-11-26

To investigate and examine the factors associated with initiation of, and exclusive breastfeeding at hospital discharge of, late preterm (34 0/7 - 36 6/7 weeks) compared to 37 week gestation (37 0/7 - 37 6/7 week) mother and baby pairs. A retrospective population-based cohort study using a Perinatal National Minimum Data Set and clinical medical records review, at the Royal Hobart Hospital, Tasmania, Australia in 2006. Late preterm and 37 week gestation infants had low rates of initiation of breastfeeding within one hour of birth, 31 (21.1%) and 61 (41.5%) respectively. After multiple regression analysis, late preterm infants were less likely to initiate breastfeeding within one hour of birth (OR 0.3 95% CI 0.1, 0.7 p = 0.009) and were less likely to be discharged exclusively breastfeeding from hospital (OR 0.4 95% CI 0.1, 1.0 p = 0.04) compared to 37 week gestation infants. A late preterm birth is predictive of breastfeeding failure, with late preterm infants at greater risk of not initiating breastfeeding and/or exclusively breastfeeding at hospital discharge, compared with those infants born at 37 weeks gestation. Stratifying breastfeeding outcomes by gestational age groups may help to identify those sub-populations at greatest risk of premature cessation of breastfeeding.

Influence of shock waves from plasma actuators on transonic and supersonic airflow

NASA Astrophysics Data System (ADS)

Mursenkova, I. V.; Znamenskaya, I. A.; Lutsky, A. E.

2018-03-01

This paper presents experimental and numerical investigations of high-current sliding surface discharges of nanosecond duration and their effect on high-speed flow as plasma actuators in a shock tube. This study deals with the effectiveness of a sliding surface discharge at low and medium air pressure. Results cover the electrical characteristics of the discharge and optical visualization of the discharge and high-speed post-discharge flow. A sliding surface discharge is first studied in quiescent air conditions and then in high-speed flow, being initiated in the boundary layer at a transverse flow velocity of 50-950 m s-1 behind a flat shock wave in air of density 0.04-0.45 kg m-3. The discharge is powered by a pulse voltage of 25-30 kV and the electric current is ~0.5 kA. Shadow imaging and particle image velocimetry (PIV) are used to measure the flow field parameters after the pulse surface discharge. Shadow imaging reveals shock waves originating from the channels of the discharge configurations. PIV is used to measure the velocity field resulting from the discharge in quiescent air and to determine the homogeneity of energy release along the sliding discharge channel. Semicylindrical shock waves from the channels of the sliding discharge have an initial velocity of more than 600 m s-1. The shock-wave configuration floats in the flow along the streamlined surface. Numerical simulation based on the equations of hydrodynamics matched with the experiment showed that 25%-50% of the discharge energy is instantly transformed into heat energy in a high-speed airflow, leading to the formation of shock waves. This energy is comparable to the flow enthalpy and can result in significant modification of the boundary layer and the entire flow.

Lightning discharges produced by wind turbines

NASA Astrophysics Data System (ADS)

Montanyà, Joan; van der Velde, Oscar; Williams, Earle R.

2014-02-01

New observations with a 3-D Lightning Mapping Array and high-speed video are presented and discussed. The first set of observations shows that under certain thunderstorm conditions, wind turbine blades can produce electric discharges at regular intervals of 3 s in relation to its rotation, over periods of time that range from a few minutes up to hours. This periodic effect has not been observed in static towers indicating that the effect of rotation is playing a critical role. The repeated discharges can occur tens of kilometers away from electrically active thunderstorm areas and may or may not precede a fully developed upward lightning discharge from the turbine. Similar to rockets used for triggering lightning, the fast movement of the blade tip plays an important role on the initiation of the discharge. The movement of the rotor blades allows the tip to "runaway" from the generated corona charge. The second observation is an uncommon upward/downward flash triggered by a wind turbine. In that flash, a negative upward leader was initiated from a wind turbine without preceding lightning activity. The flash produced a negative cloud-to-ground stroke several kilometers from the initiation point. The third observation corresponds to a high-speed video record showing simultaneous upward positive leaders from a group of wind turbines triggered by a preceding intracloud flash. The fact that multiple leaders develop simultaneously indicates a poor shielding effect among them. All these observations provide some special features on the initiation of lightning by nonstatic and complex tall structures.

Partial pressure of arterial carbon dioxide and survival to hospital discharge among patients requiring acute mechanical ventilation: A cohort study.

PubMed

Fuller, Brian M; Mohr, Nicholas M; Drewry, Anne M; Ferguson, Ian T; Trzeciak, Stephen; Kollef, Marin H; Roberts, Brian W

2017-10-01

To describe the prevalence of hypocapnia and hypercapnia during the earliest period of mechanical ventilation, and determine the association between P a CO 2 and mortality. A cohort study using an emergency department registry of mechanically ventilated patients. P a CO 2 was categorized: hypocapnia (<35mmHg), normocapnia (35-45mmHg), and hypercapnia (>45mmHg). The primary outcome was survival to hospital discharge. A total of 1,491 patients were included. Hypocapnia occurred in 375 (25%) patients and hypercapnia in 569 (38%). Hypercapnia (85%) had higher survival rate compared to normocapnia (74%) and hypocapnia (66%), P<0.001. P a CO 2 was an independent predictor of survival to hospital discharge [hypocapnia (aOR 0.65 (95% confidence interval [CI] 0.48-0.89), normocapnia (reference category), hypercapnia (aOR 1.83 (95% CI 1.32-2.54)]. Over ascending ranges of P a CO 2 , there was a linear trend of increasing survival up to a P a CO 2 range of 66-75mmHg, which had the strongest survival association, aOR 3.18 (95% CI 1.35-7.50). Hypocapnia and hypercapnia occurred frequently after initiation of mechanical ventilation. Higher P a CO 2 levels were associated with increased survival. These data provide rationale for a trial examining the optimal P a CO 2 in the critically ill. Copyright © 2017 Elsevier Inc. All rights reserved.

Continued Inpatient Care After Primary Total Knee Arthroplasty Increases 30-Day Post-Discharge Complications: A Propensity Score-Adjusted Analysis.

PubMed

McLawhorn, Alexander S; Fu, Michael C; Schairer, William W; Sculco, Peter K; MacLean, Catherine H; Padgett, Douglas E

2017-09-01

Discharge destination, either home or skilled care facility, after total knee arthroplasty (TKA) may be associated with significant variation in postacute care outcomes. The purpose of this study was to characterize the 30-day postdischarge outcomes after primary TKA relative to discharge destination. All primary unilateral TKAs performed for osteoarthritis from 2011-2014 were identified in the National Surgical Quality Improvement Program database. Propensity scores based on predischarge characteristics were used to adjust for selection bias in discharge destination. Propensity-adjusted multivariable logistic regressions were used to examine associations between discharge destination and postdischarge complications. Among 101,256 primary TKAs identified, 70,628 were discharged home and 30,628 to skilled care facilities. Patients discharged to facilities were more frequently were female, older, higher body mass index class, higher Charlson comorbidity index and American Society of Anesthesiologists scores, had predischarge complications, received general anesthesia, and classified as nonindependent preoperatively. Propensity adjustment accounted for this selection bias. Patients discharged to skilled care facilities after TKA had higher odds of any major complication (odds ratio = 1.25; 95% confidence interval, 1.13-1.37) and readmission (odds ratio = 1.81; 95% confidence interval, 1.50-2.18). Skilled care was associated with increased odds for respiratory, septic, thromboembolic, and urinary complications. Associations with death, cardiac, and wound complications were not significant. After controlling for predischarge characteristics, discharge to skilled care facilities vs home after primary TKA is associated with higher odds of numerous complications and unplanned readmission. These results support coordination of care pathways to facilitate home discharge after hospitalization for TKA whenever possible. Copyright © 2017 Elsevier Inc. All rights reserved.

Coccidioidomycosis-associated hospitalizations, California, USA, 2000-2011.

PubMed

Sondermeyer, Gail; Lee, Lauren; Gilliss, Debra; Tabnak, Farzaneh; Vugia, Duc

2013-10-01

In the past decade, state-specific increases in the number of reported cases of coccidioidomycosis have been observed in areas of California and Arizona where the disease is endemic. Although most coccidioidomycosis is asymptomatic or mild, infection can lead to severe pulmonary or disseminated disease requiring hospitalization and costly disease management. To determine the epidemiology of cases and toll of coccidioidomycosis-associated hospitalizations in California, we reviewed hospital discharge data for 2000-2011. During this period, there were 25,217 coccidioidomycosis-associated hospitalizations for 15,747 patients and >$2 billion US in total hospital charges. Annual initial hospitalization rates increased from 2.3 initial hospitalizations/100,000 population in 2000 to 5.0 initial hospitalizations/100,000 population in 2011. During this period, initial hospitalization rates were higher for men than women, African Americans and Hispanics than Whites, and older persons than younger persons. In California, the increasing health- and cost-related effects of coccidioidomycosis-associated hospitalizations are a major public health challenge.

Microwave-induced electrostatic etching: generation of highly reactive magnesium for application in Grignard reagent formation.

PubMed

van de Kruijs, Bastiaan H P; Dressen, Mark H C L; Meuldijk, Jan; Vekemans, Jef A J M; Hulshof, Lumbertus A

2010-04-07

A detailed study regarding the influence of microwave irradiation on the formation of a series of Grignard reagents in terms of rates and selectivities has revealed that these heterogeneous reactions may display a beneficial microwave effect. The interaction between microwaves and magnesium turnings generates violent electrostatic discharges. These discharges on magnesium lead to melting of the magnesium surface, thus generating highly active magnesium particles. As compared to conventional operation the microwave-induced discharges on the magnesium surface lead to considerably shorter initiation times for the insertion of magnesium in selected substrates (i.e. halothiophenes, halopyridines, octyl halides, and halobenzenes). Thermographic imaging and surface characterization by scanning electron microscopy showed that neither selective heating nor a "specific" microwave effect was causing the reduction in initiation times. This novel and straightforward initiation method eliminates the use of toxic and environmentally adverse initiators. Thus, this initiation method limits the formation of by-products. We clearly demonstrated that microwave irradiation enables fast Grignard reagent formation. Therefore, microwave technology is promising for process intensification of Grignard based coupling reactions.

Social Factors Associated with Non-initiation and Cessation of Predominant Breastfeeding in a Mother-Child Cohort in Spain.

PubMed

Villar, Maria; Santa-Marina, Loreto; Murcia, Mario; Amiano, Pilar; Gimeno, Silvia; Ballester, Ferran; Julvez, Jordi; Romaguera, Dora; Fernández-Somoano, Ana; Tardón, Adonina; Ibarluzea, Jesús

2018-05-01

Objective The aim of the study was to identify factors associated with non-initiation and cessation of predominant breastfeeding (PBF) in a mother-child cohort from Spain. Materials and Methods The analysis included 2195 mother-infant from birth to 14 months post- delivery recruited between 2004 and 2008. Maternal characteristics were collected during the pregnancy. Lactation data were obtained at 6 and 14 months after delivery. PBF was defined as intake of breast milk plus liquids like juices or water. The PBF cessation was calculated using the date that women started PBF and the date that she reported to start giving infant formula and/or food. The relationship between maternal variables and PBF initiation and cessation was modeled using logistic and Cox proportional hazards regression analysis. Results The prevalence of PBF at hospital discharge was 85.3, 53.4% at 3 months, 46.1% at 4 months and 7.2% at 6 month. Only two women continued PBF at 12 months and none at 14 months. The initiating of PBF was associated with higher levels of maternal education, being a first-time mother and worked in a non-manual occupation. Higher level of physical activity, not smoking and having a healthy BMI, were also positively associated with PBF initiation. PBF cessation was higher in young, obese women, who had had complications during the pregnancy, and who had lower levels of education and smoked. The employment status of women, in week 32 of pregnancy and also in month 14 post-delivery, determined likelihood of PBF cessation. Conclusions Healthier habits and education positively influenced PBF initiation and duration. Decrease in PBF duration rates in Spain can be interpreted in part as a consequence of women returning to work.

From ENSEMBLES to CORDEX: exploring the progress for hydrological impact research for the upper Danube basin

NASA Astrophysics Data System (ADS)

Stanzel, Philipp; Kling, Harald

2017-04-01

EURO-CORDEX Regional Climate Model (RCM) data are available as result of the latest initiative of the climate modelling community to provide ever improved simulations of past and future climate in Europe. The spatial resolution of the climate models increased from 25 x 25 km in the previous coordinated initiative, ENSEMBLES, to 12 x 12 km in the CORDEX EUR-11 simulations. This higher spatial resolution might yield improved representation of the historic climate, especially in complex mountainous terrain, improving applicability in impact studies. CORDEX scenario simulations are based on Representative Concentration Pathways, while ENSEMBLES applied the SRES greenhouse gas emission scenarios. The new emission scenarios might lead to different projections of future climate. In this contribution we explore these two dimensions of development from ENSEMBLES to CORDEX - representation of the past and projections for the future - in the context of a hydrological climate change impact study for the Danube River. We replicated previous hydrological simulations that used ENSEMBLES data of 21 RCM simulations under SRES A1B emission scenario as meteorological input data (Kling et al. 2012), and now applied CORDEX EUR-11 data of 16 RCM simulations under RCP4.5 and RCP8.5 emission scenarios. The climate variables precipitation and temperature were used to drive a monthly hydrological model of the upper Danube basin upstream of Vienna (100,000 km2). RCM data was bias corrected and downscaled to the scale of hydrological model units. Results with CORDEX data were compared with results with ENSEMBLES data, analysing both the driving meteorological input and the resulting discharge projections. Results with CORDEX data show no general improvement in the accuracy of representing historic climatic features, despite the increase in spatial model resolution. The tendency of ENSEMBLES scenario projections of increasing precipitation in winter and decreasing precipitation in summer is reproduced with the CORDEX RCMs, albeit with slightly higher precipitation in the CORDEX data. The distinct pattern of future change in discharge seasonality - increasing winter discharge and decreasing summer discharge - is confirmed with the new CORDEX data, with a range of projections very similar to the range projected by the ENSEMBLES RCMs. References: Kling, H., Fuchs, M., Paulin, M. 2012. Runoff conditions in the upper Danube basin under an ensemble of climate change scenarios. Journal of Hydrology 424-425, 264-277.

Prediction of initiation and cessation of breastfeeding from late pregnancy to 16 weeks: the Feeding Your Baby (FYB) cohort study

PubMed Central

Donnan, Peter T; Dalzell, Janet; Symon, Andrew; Rauchhaus, Petra; Monteith-Hodge, Ewa; Kellett, Gillian; Wyatt, Jeremy C; Whitford, Heather M

2013-01-01

Objective To derive prediction models for both initiation and cessation of breastfeeding using demographic, psychological and obstetric variables. Design A prospective cohort study. Setting Women delivering at Ninewells Hospital, Dundee, UK. Data sources Demographic data and psychological measures were obtained during pregnancy by questionnaire. Birth details, feeding method at birth and at hospital discharge were obtained from the Ninewells hospital database, Dundee, UK. Breastfeeding women were followed up by text messages every 2 weeks until 16 weeks or until breastfeeding was discontinued to ascertain feeding method and feeding intentions. Participants Pregnant women over 30 weeks gestation aged 16 years and above, living in Dundee, booked to deliver at Ninewells Hospital, Dundee, and able to speak English. Main outcome measure Initiation and cessation of breastfeeding. Results From the total cohort of women at delivery (n=344) 68% (95% CI 63% to 73%) of women had started breastfeeding at discharge. Significant predictors of initiating breastfeeding were older age, parity, greater intention to breastfeed from a Theory of Planned Behaviour (TPB)-based questionnaire, higher Iowa Infant Feeding Assessment Scale (IIFAS) score as well as living with a husband or partner. For the final model, the AUROC was 0.967. For those who initiated breastfeeding (n=233), the strongest predictors of stopping were low intention to breastfeed from TPB, low IIFAS score and non-managerial/professional occupations. Conclusions The findings from this study will be used to inform the protocol for an intervention study to encourage and support prolonged breastfeeding as intentions appear to be a key intervention focus for initiation. The predictive models could be used to identify women at high risk of not initiating and also women at high risk of stopping for interventions to improve the longevity of breastfeeding. PMID:23906958

Increased Risk of Vascular Events in Emergency Room Patients Discharged Home with Diagnosis of Dizziness or Vertigo: A 3-Year Follow-Up Study

PubMed Central

Lee, Ching-Chih; Ho, Hsu-Chueh; Su, Yu-Chieh; Chiu, Brian C-H; Su, Yung-Cheng; Lee, Yi-Da; Chou, Pesus

2012-01-01

Background Dizziness and vertigo symptoms are commonly seen in emergency room (ER). However, these patients are often discharged without a definite diagnosis. Conflicting data regarding the vascular event risk among the dizziness or vertigo patients have been reported. This study aims to determine the risk of developing stroke or cardiovascular events in ER patients discharged home with a diagnosis of dizziness or vertigo. Methodology A total of 25,757 subjects with at least one ER visit in 2004 were identified. Of those, 1,118 patients were discharged home with a diagnosis of vertigo or dizziness. A Cox proportional hazard model was performed to compare the three-year vascular event-free survival rates between the dizziness/vertigo patients and those without dizziness/vertigo after adjusting for confounding and risk factors. Results We identified 52 (4.7%) vascular events in patients with dizziness/vertigo and 454 (1.8%) vascular events in patients without dizziness/vertigo. ER patients discharged home with a diagnosis of vertigo or dizziness had 2-fold (95% confidence interval [CI], 1.35–2.96; p<0.001) higher risk of stroke or cardiovascular events after adjusting for patient characteristics, co-morbidities, urbanization level of residence, individual socio-economic status, and initially taking medications after the onset of dizziness or vertigo during the first year. Conclusions ER patients discharged home with a diagnosis of dizziness or vertigo were at a increased risk of developing subsequent vascular events than those without dizziness/vertigo after the onset of dizziness or vertigo. Further studies are warranted for developing better diagnostic and follow-up strategies in increased risk patients. PMID:22558272

Smoking Behavior Change During Compulsory Military Service in Israel, 1987-2011.

PubMed

Zarka, Salman; Levine, Hagai; Rozhavski, Vladislav; Sela, Tamar; Bar-Ze'ev, Yael; Molina-Hazan, Vered; Rosen, Laura J

2017-11-01

Smoking in military settings is of major concern. We aimed to assess the association between personal, family, and military factors and smoking behavior change during compulsory military service in Israel. Participants were soldiers recruited between 1987 and 2008 who were interviewed at recruitment and reinterviewed at discharge (1987-2011) (total: 29 189; males:15 136; females:14 053). The primary outcome variables were smoking initiation during service among nonsmokers at recruitment, and cessation during service among smokers at recruitment. We examined potential predictors of change, and trends by calendar year. Smoking prevalence increased by 39.4% during military service (recruitment: 26.2%, discharge: 36.5%). 18.4% of nonsmoking recruits initiated smoking, and 12.4% of smoking recruits quit smoking between recruitment and discharge. There was no observed trend in initiation between 1987 and 2011. The strongest predictor of smoking initiation among nonsmokers at recruitment was smoking history (former vs. never-smoker, odds ratio (OR) [95% confidence interval [CI

Nano-Enabled Technologies for Naval Aviation Applications

DTIC Science & Technology

2015-06-05

4. Reduced self- discharge DEW 1. Active materials (silicon based/anode only); 2. Active materials coated on CNTs surface; 3...polymer film capacitors have the potential to provide higher energy density, higher power density, reduce weight, improve duty cycles (fast discharge and...dependent excess of 200C) 4. Nano-particle dispersion 5. Understanding discharge rate 6. Design and control of the interface 1. Increased

Medication reconciliation in acute care: ensuring an accurate drug regimen on admission and discharge.

PubMed

Rodehaver, Claire; Fearing, Deb

2005-07-01

Several factors contribute to the potential for patient confusion regarding his or her medication regimen, including multiple names for a single drug and formulary variations when the patient receives medications from more than one pharmacy. A 68-year-old woman was discharged from the hospital on a HMG-CoA reductase inhibitor (statin) and resumed her home statin. Eleven days later she returned to the hospital with a diagnosis of severe rhabdomyolysis due to statin overdose. IMPLEMENTING SOLUTIONS: Miami Valley Hospital, Dayton, Ohio, implemented a reconciliation process and order form at admission and discharge to reduce the likelihood that this miscommunication would recur. Initial efforts were trialed on a 44-bed orthopedic unit, with spread of the initiative to the cardiac units and finally to the remaining 22 nursing units. The team successfully implemented initiation of the order sheet, yet audits indicated the need for improvement in reconciling the medications within 24 hours of admission and in reconciling the home medications at the point of discharge. Successful implementation of the order sheet to drive reconciliation takes communication, perseverance, and a multidisciplinary team approach.

A thermally regenerative ammonia battery with carbon-silver electrodes for converting low-grade waste heat to electricity

NASA Astrophysics Data System (ADS)

Rahimi, Mohammad; Kim, Taeyoung; Gorski, Christopher A.; Logan, Bruce E.

2018-01-01

Thermally regenerative ammonia batteries (TRABs) have shown great promise as a method to convert low-grade waste heat into electrical power, with power densities an order of magnitude higher than other approaches. However, previous TRABs based on copper electrodes suffered from unbalanced anode dissolution and cathode deposition rates during discharging cycles, limiting practical applications. To produce a TRAB with stable and reversible electrode reactions over many cycles, inert carbon electrodes were used with silver salts. In continuous flow tests, power production was stable over 100 discharging cycles, demonstrating excellent reversibility. Power densities were 23 W m-2-electrode area in batch tests, which was 64% higher than that produced in parallel tests using copper electrodes, and 30 W m-2 (net energy density of 490 Wh m-3-anolyte) in continuous flow tests. While this battery requires the use a precious metal, an initial economic analysis of the system showed that the cost of the materials relative to energy production was 220 per MWh, which is competitive with energy production from other non-fossil fuel sources. A substantial reduction in costs could be obtained by developing less expensive anion exchange membranes.

Role of electric discharges in the generation of atmospheric vortices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sinkevich, O. A., E-mail: oleg.sinkevich@itf.mpei.ac.ru; Maslov, S. A., E-mail: sergm90@mail.ru; Gusein-zade, N. G., E-mail: ngus@mail.ru

The existing thermohydrodynamic and hydroelectromagnetic models of tornado are considered. The potentialities of the humid atmosphere as a heat engine generating air vortices are analyzed in detail. The ability of long-term atmospheric electric discharges to form a tornado funnel and create an initial twist of up to 10{sup –3}–10{sup –2} s{sup –1} in it are estimated. The possible effect of a lightning discharge on the initiation and evolution of the tornado is discussed. It is shown that the electric current flowing along the lightning channel can lead to helical instability and generation of a weak primary vortex. The channel formedmore » in the atmosphere by a lightning discharge and the vortex motion of the parent thundercloud can enhance the primary vortex and promote its transformation into a tornado. Possible mechanisms of enhancement of the primary vortex created by a lightning discharge and the possibility of its transformation into a tornado in the postdischarge stage are discussed.« less

Wire-chamber radiation detector with discharge control

DOEpatents

Perez-Mendez, V.; Mulera, T.A.

1982-03-29

A wire chamber; radiation detector has spaced apart parallel electrodes and grids defining an ignition region in which charged particles or other ionizing radiations initiate brief localized avalanche discharges and defining an adjacent memory region in which sustained glow discharges are initiated by the primary discharges. Conductors of the grids at each side of the memory section extend in orthogonal directions enabling readout of the X-Y coordinates of locations at which charged particles were detected by sequentially transmitting pulses to the conductors of one grid while detecting transmissions of the pulses to the orthogonal conductors of the other grid through glow discharges. One of the grids bounding the memory region is defined by an array of conductive elements each of which is connected to the associated readout conductor through a separate resistance. The wire chamber avoids ambiguities and imprecisions in the readout of coordinates when large numbers of simultaneous or; near simultaneous charged particles have been detected. Down time between detection periods and the generation of radio frequency noise are also reduced.

Dependence of Initial Oxygen Concentration on Ozone Yield Using Inductive Energy Storage System Pulsed Power Generator

NASA Astrophysics Data System (ADS)

Go, Tomio; Tanaka, Yasushi; Yamazaki, Nobuyuki; Mukaigawa, Seiji; Takaki, Koichi; Fujiwara, Tamiya

Dependence of initial oxygen concentration on ozone yield using streamer discharge reactor driven by an inductive energy storage system pulsed power generator is described in this paper. Fast recovery type diodes were employed as semiconductor opening switch to interrupt a circuit current within 100 ns. This rapid current change produced high-voltage short pulse between a secondary energy storage inductor. The repetitive high-voltage short pulse was applied to a 1 mm diameter center wire electrode placed in a cylindrical pulse corona reactor. The streamer discharge successfully occurred between the center wire electrode and an outer cylinder ground electrode of 2 cm inner diameter. The ozone was produced with the streamer discharge and increased with increasing pulse repetition rate. The ozone yield changed in proportion to initial oxygen concentration contained in the injected gas mixture at 800 ns forward pumping time of the current. However, the decrease of the ozone yield by decreasing oxygen concentration in the gas mixture at 180 ns forward pumping time of the current was lower than the decrease at 800 ns forward pumping time of the current. This dependence of the initial oxygen concentration on ozone yield at 180 ns forward pumping time is similar to that of dielectric barrier discharge reactor.

Factors affecting return to oral intake in inpatient rehabilitation after acquired brain injury.

PubMed

Kjaersgaard, Annette; Nielsen, Lars Hedemann; Sjölund, Bengt H

2015-01-01

To extend previous observations by investigating if differences exist in time to initiation or to recovery of total oral intake in patients with acquired brain injury assessed by either Facial-Oral Tract Therapy (F.O.T.T.) or Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and to investigate whether other factors influence these outcomes. Randomized controlled trial. One hundred and nineteen patients with dysphagia in inpatient neurorehabilitation were randomized. The main outcome was time to maximum on the Functional Oral Intake Scale. There was no difference in time to initiation or recovery of total oral intake using F.O.T.T. or FEES. Oral intake was initiated for 42% on admission and 92% at discharge; 2.5% of the patients were on total oral intake within 24 hours of admission and 37% at discharge. The likelihood of recovery to total oral intake before discharge was found to depend on age, Functional Independence Measure score, length of stay and number of dysphagia interventions. There was no significant difference in time to initiation and recovery of total oral intake before discharge, whether assessed by F.O.T.T. or FEES, indicating that an instrumental assessment is unnecessary for standard evaluation. Age, functional independence and length of stay had a significant influence.

Modeling the sediment transport induced by deep sea mining in the Pacific Ocean

NASA Astrophysics Data System (ADS)

Purkiani, Kaveh; Paul, André; Schulz, Michael; Vink, Annemiek; Walter, Maren

2017-04-01

A numerical modeling study is conducted in the German license area in northeastern Pacific Ocean to investigate the sediment dispersal of mining exploitation. A sediment transport module is implemented in a hydrodynamic model. All differently sized particles can aggregate and break up until equilibrium floc sizes are obtained. A nested model approach using the MITgcm (Massachusetts Institute of Technology general circulation model) is applied and validated against hydrographic and hydrodynamic measurements obtained in this region. Two different sediment discharge scenarios have been examined to investigate the effect of flocculation on sediment transport distribution in the deep ocean. The suspended sediment is mainly influenced by a dominant SW current far away from the sediment discharge location. Independent of initial particle size all initial particles larger than 30 μm attain similar floc size equilibrium. In contrast to coastal seas and estuaries where floc size equilibrium can be obtained in a few hours, due to low shear rate (G) the flocculation process at deep ocean is completed within 1˜2 days. Considering temporal evolution of the floc size in the model, an increase in floc sinking velocity consequently enhances the sediment deposition at seafloor. The analysis of different sediment concentration scenarios suggests that floc sinking velocity increases at higher suspended sediment concentration (SSC). The presence of a dominant current in this region induces a fine sediment plume in SW direction. The dispersed SSC plume at 20 km downstream the discharge location is able to form the flocculation process and induces a spatial variation of floc size and floc sinking velocity.

Virtual Telemedicine Visits in Pediatric Home Parenteral Nutrition Patients: A Quality Improvement Initiative.

PubMed

Raphael, Bram P; Schumann, Caitlin; Garrity-Gentille, Sara; McClelland, Jennifer; Rosa, Carolyn; Tascione, Christina; Gallotto, Mary; Takvorian-Bené, Melissa; Carey, Alexandra N; McCarthy, Patrick; Duggan, Christopher; Ozonoff, Al

2018-05-04

Despite being less costly than prolonged hospitalization, home parenteral nutrition (HPN) is associated with high rates of post-discharge complications, including frequent readmissions and central line-associated bloodstream infections (CLABSIs). Telemedicine has been associated with improved outcomes and reduced healthcare utilization in other high-risk populations, but no studies to date have supported effectiveness of telemedicine in pediatric HPN. We prospectively collected data on pediatric patients managed at a single HPN program who participated in postdischarge telemedicine visits from March 1, 2014 to March 30, 2016. We excluded patients with a history of HPN and strictly palliative care goals. Univariate analysis was performed for primary outcomes: Community-acquired CLABSI and 30-day readmission rate. Twenty-six families participated in the pilot initiative with median (interquartile range) patient age 1.5 (5.7) years old, diagnosis of short bowel syndrome in 16 (62%), and in-state residence in 17 (55%). Ishikawa (fishbone) diagram identified causes of post-discharge HPN complications. Areas of focus during telemedicine visit included central venous catheter care methods, materials, clinical concerns, and equipment. Compared to historical comparison group, the telemedicine group experienced CLABSI rates of 1.0 versus 2.7 per 1,000 line days and readmission rates of 38% versus 17% (p = 0.03, 0.02, respectively). Telemedicine visits identified opportunities for improvement for families newly discharged on HPN. In a small cohort of patients who experienced telemedicine visits, we found lower CLABSI rates alongside higher readmission rates compared with a historical comparison group. Further studies are needed to optimize telemedicine in delivering care to this high-risk population.

Implications of DRG Classification in a Bundled Payment Initiative for COPD.

PubMed

Parekh, Trisha M; Bhatt, Surya P; Westfall, Andrew O; Wells, James M; Kirkpatrick, Denay; Iyer, Anand S; Mugavero, Michael; Willig, James H; Dransfield, Mark T

2017-12-01

Institutions participating in the Medicare Bundled Payments for Care Improvement (BPCI) initiative invest significantly in efforts to reduce readmissions and costs for patients who are included in the program. Eligibility for the BPCI initiative is determined by diagnosis-related group (DRG) classification. The implications of this methodology for chronic diseases are not known. We hypothesized that patients included in a BPCI initiative for chronic obstructive pulmonary disease (COPD) would have less severe illness and decreased hospital utilization compared with those excluded from the bundled payment initiative. Retrospective observational study. We sought to determine the clinical characteristics and outcomes of Medicare patients admitted to the University of Alabama at Birmingham Hospital with acute exacerbations of COPD between 2012 and 2014 who were included and excluded in a BPCI initiative. Patients were included in the analysis if they were discharged with a COPD DRG or with a non-COPD DRG but with an International Classification of Diseases, Ninth Revision code for COPD exacerbation. Six hundred and ninety-eight unique patients were discharged for an acute exacerbation of COPD; 239 (34.2%) were not classified into a COPD DRG and thus were excluded from the BPCI initiative. These patients were more likely to have intensive care unit (ICU) admissions (63.2% vs 4.4%, respectively; P <.001) and require noninvasive (46.9% vs 6.5%; P <.001) and invasive mechanical ventilation (41.4% vs 0.7%; P <.001) during their hospitalization than those in the initiative. They also had a longer ICU length of stay (5.2 vs 1.8 days; P = .011), longer hospital length of stay (10.3 days vs 3.9 days; P <.001), higher in-hospital mortality (14.6% vs 0.7%; P <.001), and greater hospitalization costs (median = $13,677 [interquartile range = $7489-$23,054] vs $4281 [$2718-$6537]; P <.001). The use of DRGs to identify patients with COPD for inclusion in the BPCI initiative led to the exclusion of more than one-third of patients with acute exacerbations who had more severe illness and worse outcomes and who may benefit most from the additional interventions provided by the initiative.

Implications of DRG Classification in a Bundled Payment Initiative for COPD

PubMed Central

PAREKH, TRISHA M.; BHATT, SURYA P.; WESTFALL, ANDREW O.; WELLS, JAMES M.; KIRKPATRICK, DENAY; IYER, ANAND S.; MUGAVERO, MICHAEL; WILLIG, JAMES H.; DRANSFIELD, MARK T.

2018-01-01

OBJECTIVES Institutions participating in the Medicare Bundled Payments for Care Improvement (BPCI) initiative invest significantly in efforts to reduce readmissions and costs for patients who are included in the program. Eligibility for the BPCI initiative is determined by diagnosis-related group (DRG) classification. The implications of this methodology for chronic diseases are not known. We hypothesized that patients included in a BPCI initiative for chronic obstructive pulmonary disease (COPD) would have less severe illness and decreased hospital utilization compared with those excluded from the bundled payment initiative. STUDY DESIGN Retrospective observational study. METHODS We sought to determine the clinical characteristics and outcomes of Medicare patients admitted to the University of Alabama at Birmingham Hospital with acute exacerbations of COPD between 2012 and 2014 who were included and excluded in a BPCI initiative. Patients were included in the analysis if they were discharged with a COPD DRG or with a non-COPD DRG but with an International Classification of Diseases, Ninth Revision code for COPD exacerbation. RESULTS Six hundred and ninety-eight unique patients were discharged for an acute exacerbation of COPD; 239 (34.2%) were not classified into a COPD DRG and thus were excluded from the BPCI initiative. These patients were more likely to have intensive care unit (ICU) admissions (63.2% vs 4.4%, respectively; P <.001) and require noninvasive (46.9% vs 6.5%; P <.001) and invasive mechanical ventilation (41.4% vs 0.7%; P <.001) during their hospitalization than those in the initiative. They also had a longer ICU length of stay (5.2 vs 1.8 days; P = .011), longer hospital length of stay (10.3 days vs 3.9 days; P <.001), higher in-hospital mortality (14.6% vs 0.7%; P <.001), and greater hospitalization costs (median = $13,677 [interquartile range = $7489-$23,054] vs $4281 [$2718-$6537]; P <.001). CONCLUSIONS The use of DRGs to identify patients with COPD for inclusion in the BPCI initiative led to the exclusion of more than one-third of patients with acute exacerbations who had more severe illness and worse outcomes and who may benefit most from the additional interventions provided by the initiative. PMID:29623307

A power-balance model for local helicity injection startup in a spherical tokamak

DOE Office of Scientific and Technical Information (OSTI.GOV)

Barr, Jayson L.; Bongard, Michael W.; Burke, Marcus G.

A 0D circuit model for predicting I p( t) in Local Helicity Injection (LHI) discharges is developed. Analytic formulas for estimating the surface flux of finite-A plasmas developed are modified and expanded to treat highly shaped, ultralow-A tokamak geometry using a database of representative equilibria. Model predictions are compared to sample LHI discharges in the A ~ 1 Pegasus spherical tokamak, and are found to agree within 15% of experimental I p( t). High performance LHI discharges are found to follow the Taylor relaxation current limit for approximately the first half of the current ramp, or I p ≲ 75more » kA. The second half of the current ramp follows a limit imposed by power-balance as plasmas expand from high- A to ultralow- A. Here, this shape evolution generates a significant drop in external plasma inductance, effectively using the plasma’s initially high inductance to drive the current ramp and provide > 70% of the current drive V-s. Projections using this model indicate the relative influences of higher helicity input rate and injector current on the attainable total plasma current.« less

Hurricanes, submarine groundwater discharge, and Florida's red tides

NASA Astrophysics Data System (ADS)

Hu, Chuanmin; Muller-Karger, Frank E.; Swarzenski, Peter W.

2006-06-01

A Karenia brevis Harmful Algal Bloom affected coastal waters shallower than 50 m off west-central Florida from January 2005 through January 2006, showing a sustained anomaly of ~1 mg chlorophyll m-3 over an area of up to 67,500 km2. Red tides occur in the same area (approximately 26-29°N, 82-83°W) almost every year, but the intense 2005 bloom led to a widespread hypoxic zone (dissolved oxygen <2 mg L-1) that caused mortalities of benthic communities, fish, turtles, birds, and marine mammals. Runoff alone provided insufficient nitrogen to support this bloom. We pose the hypothesis that submarine groundwater discharge (SGD) provides the missing nutrients, and indeed can trigger and support the recurrent red tides off west-central Florida. SGD inputs of dissolved inorganic nitrogen (DIN) in Tampa Bay alone are ~35% of that discharged by all central Florida rivers draining west combined. We propose that the unusual number of hurricanes in 2004 resulted in high runoff, and in higher than normal SGD emerging along the west Florida coast throughout 2005, initiating and fueling the persistent HAB. This mechanism may also explain recurrent red tides in other coastal regions of the Gulf of Mexico.

Hurricanes, submarine groundwater discharge, and Florida's red tides

USGS Publications Warehouse

Hu, C.; Muller-Karger, F. E.; Swarzenski, P.W.

2006-01-01

A Karenia brevis Harmful Algal Bloom affected coastal waters shallower than 50 m off west-central Florida from January 2005 through January 2006, showing a sustained anomaly of ???1 mg chlorophyll m-3 over an area of up to 67,500 km2. Red tides occur in the same area (approximately 26-29??N, 82-83??W) almost every year, but the intense 2005 bloom led to a widespread hypoxic zone (dissolved oxygen <2 mg L-1) that caused mortalities of benthic communities, fish, turtles, birds, and marine mammals. Runoff alone provided insufficient nitrogen to support this bloom. We pose the hypothesis that submarine groundwater discharge (SGD) provides the missing nutrients, and indeed can trigger and support the recurrent red tides off west-central Florida. SGD inputs of dissolved inorganic nitrogen (DIN) in Tampa Bay alone are ???35% of that discharged by all central Florida rivers draining west combined. We propose that the unusual number of hurricanes in 2004 resulted in high runoff, and in higher than normal SGD emerging along the west Florida coast throughout 2005, initiating and fueling the persistent HAB. This mechanism may also explain recurrent red tides in other coastal regions of the Gulf of Mexico. Copyright 2006 by the American Geophysical Union.

Super-atmospheric pressure chemical ionization mass spectrometry.

PubMed

Chen, Lee Chuin; Rahman, Md Matiur; Hiraoka, Kenzo

2013-03-01

Super-atmospheric pressure chemical ionization (APCI) mass spectrometry was performed using a commercial mass spectrometer by pressurizing the ion source with compressed air up to 7 atm. Similar to typical APCI source, reactant ions in the experiment were generated with corona discharge using a needle electrode. Although a higher needle potential was necessary to initiate the corona discharge, discharge current and detected ion signal were stable at all tested pressures. A Roots booster pump with variable pumping speed was installed between the evacuation port of the mass spectrometer and the original rough pumps to maintain a same pressure in the first pumping stage of the mass spectrometer regardless of ion source pressure. Measurement of gaseous methamphetamine and research department explosive showed an increase in ion intensity with the ion source pressure until an optimum pressure at around 4-5 atm. Beyond 5 atm, the ion intensity decreased with further increase of pressure, likely due to greater ion losses inside the ion transport capillary. For benzene, it was found that besides molecular ion and protonated species, ion due to [M + 2H](+) which was not so common in APCI, was also observed with high ion abundance under super-atmospheric pressure condition. Copyright © 2013 John Wiley & Sons, Ltd.

A power-balance model for local helicity injection startup in a spherical tokamak

DOE PAGES

Barr, Jayson L.; Bongard, Michael W.; Burke, Marcus G.; ...

2018-05-15

A 0D circuit model for predicting I p( t) in Local Helicity Injection (LHI) discharges is developed. Analytic formulas for estimating the surface flux of finite-A plasmas developed are modified and expanded to treat highly shaped, ultralow-A tokamak geometry using a database of representative equilibria. Model predictions are compared to sample LHI discharges in the A ~ 1 Pegasus spherical tokamak, and are found to agree within 15% of experimental I p( t). High performance LHI discharges are found to follow the Taylor relaxation current limit for approximately the first half of the current ramp, or I p ≲ 75more » kA. The second half of the current ramp follows a limit imposed by power-balance as plasmas expand from high- A to ultralow- A. Here, this shape evolution generates a significant drop in external plasma inductance, effectively using the plasma’s initially high inductance to drive the current ramp and provide > 70% of the current drive V-s. Projections using this model indicate the relative influences of higher helicity input rate and injector current on the attainable total plasma current.« less

46 CFR 108.437 - Pipe sizes and discharge rates for enclosed ventilation systems for rotating electrical equipment.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Pipe sizes and discharge rates for enclosed ventilation... Systems Fixed Carbon Dioxide Fire Extinguishing Systems § 108.437 Pipe sizes and discharge rates for enclosed ventilation systems for rotating electrical equipment. (a) The minimum pipe size for the initial...

Sediment motion and velocity in a glacier-fed stream

NASA Astrophysics Data System (ADS)

Mao, L.; Dell'Agnese, A.; Comiti, F.

2017-08-01

Current understanding of coarse sediment transport (e.g. threshold for motion, travel length and virtual velocity) in mountain rivers is still quite limited, and even less is known about glacial streams. However, the hydrological characteristics of these systems (strong daily discharge fluctuations, high water turbidity) pose challenges to the use of tracers to monitor bed sediment dynamics, as tagged clasts are usually located after bedload events when flow stage has receded, e.g. by means of portable antennas in the case of Passive Integrated Transponders (PIT). The use of stationary antennas, still scarcely in use worldwide, to detect PIT-tagged particles has potential advantages in glacier-fed streams. If water discharge is monitored continuously, a stationary antenna provides real time data on the actual discharge at the moment of tracer particles passage. This study focuses on incipient motion and virtual velocity of bed particles measured by a stationary antennas system in a steep mountain channel (Saldur River, drainage area 18.6 km2, Italian Alps) where significant daily discharge fluctuations and bedload transport occur as a result of a nivo-glacial regime. Four stationary antennas were installed 50-m apart in the study reach. A total of 629 PIT-tagged clasts were inserted in the studied reach between 2011 and 2014, ranging in size from 35 mm to 580 mm, with an overall recovery rate of around 44%. Critical discharge for sediment entrainment was obtained by detecting the movement of tracers placed immediately upstream of antennas. Virtual velocity was derived by knowing distances between the antennas and travel time of tracers. Results on initiation of motion show that the relationship between the size of transported tracers and the discharge measured at the time clasts were passing the stationary antenna is very weak. The influence of antecedent flows on incipient motion was thus investigated by dividing the highest discharge recorded between each PIT deployment and the subsequent entrainment by the actual critical discharge at the time of movement (ratio Qmax/Qc). Results show that approximately 50% of tracers moved at Qmax/Qc ≤ 1.2, and that 73% of tracers moved at Qmax/Qc < 1.5. Therefore, about 30% of tracers had to previously experience a discharge substantially greater than the one that actually mobilized them. Also, coarser particles moved at higher Qmax/Qc ratios, suggesting that higher antecedent flows may be needed to destabilize bed clustering. Results on the virtual velocity of the PIT-tagged clasts employed in the field show that the virtual velocity turned out to be highly variable (ranging from 101 to 10- 5 m min- 1) and weakly related to either particle size or flow discharge. However, virtual velocity was well correlated with the highest flow discharge experienced by each tracer normalized by a percentile of the flow duration curve. This evidence further stresses the importance of flow history on sediment entrainment and transport. Finally, the pros and cons of the deployed monitoring technology are discussed.

Sex Disparities in Post-Acute Myocardial Infarction Pharmacologic Treatment Initiation and Adherence: Problem for Young Women.

PubMed

Smolina, Kate; Ball, Laura; Humphries, Karin H; Khan, Nadia; Morgan, Steven G

2015-11-01

The prevalence of the use of secondary prevention cardiovascular medications is lower among women than men, but it is unclear if this is a result of lower treatment initiation among women or lower treatment adherence. We aimed to map the treatment pathway for survivors of acute myocardial infarction (AMI) by sex and age. This retrospective population-based cohort study used linked administrative data sets in British Columbia (2004-2011), which include health care, prescription drugs, sociodemographic, and mortality information. The study cohort included all individuals admitted to hospital for AMI in 2007-2009 and survived for 1 year after hospital discharge. Patients were evaluated for whether they initiated and then subsequently filled prescriptions angiotensin-converting enzyme inhibitors, β-blockers, and statins. More than two thirds of AMI survivors initiated treatment on all appropriate medications, given their contraindications, within 2 months of discharge. Younger men were significantly more likely than younger women to initiate appropriate treatment (adjusted odds ratio, 1.38; 95% confidence interval, 1.10-1.75). By the end of 1 year after discharge, only one third of all AMI survivors filled all appropriate prescriptions for at least 80% of the year. There was no significant difference in adherence to medication therapy between women and men. The majority of AMI survivors either discontinue treatment or do not refill their prescriptions consistently. Women <55 years are significantly less likely to be on optimal therapy by the end of 1 year after discharge, which is driven by a sex disparity in treatment initiation and not treatment adherence. © 2015 American Heart Association, Inc.

Controllable transition from positive space charge to negative space charge in an inverted cylindrical magnetron

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rane, R., E-mail: ramu@ipr.res.in; Ranjan, M.; Mukherjee, S.

2016-01-15

The combined effect of magnetic field (B), gas pressure (P), and the corresponding discharge voltage on the discharge properties of argon in inverted cylindrical magnetron has been investigated. In the experiment, anode is biased with continuous 10 ms sinusoidal half wave. It is observed that at a comparatively higher magnetic field (i.e., >200 gauss) and lower operating pressure (i.e., <1 × 10{sup −3} mbar), the discharge extinguishes and demands a high voltage to reignite. Discharge current increases with increase in magnetic field and starts reducing at sufficiently higher magnetic field for a particular discharge voltage due to restricted electron diffusion towards the anode.more » It is observed that B/P ratio plays an important role in sustaining the discharge and is constant for a discharge voltage. The discharge is transformed to negative space charge regime from positive space charge regime at certain B/P ratio and this ratio varies linearly with the discharge voltage. The space charge reversal is indicated by the radial profile of the floating potential and plasma potential in between two electrodes for different magnetic fields. At a particular higher magnetic field (beyond 100 gauss), the floating potential increases gradually with the radial distance from cathode, whereas it remains almost constant at lower magnetic field.« less

Discharge Characteristics of DC Arc Water Plasma for Environmental Applications

NASA Astrophysics Data System (ADS)

Li, Tianming; Sooseok, Choi; Takayuki, Watanabe

2012-12-01

A water plasma was generated by DC arc discharge with a hafnium embedded rod-type cathode and a nozzle-type anode. The discharge characteristics were examined by changing the operation parameter of the arc current. The dynamic behavior of the arc discharge led to significant fluctuations in the arc voltage and its frequency. Analyses of the high speed image and the arc voltage waveform showed that the arc discharge was in the restrike mode and its frequency varied within several tens of kilohertz according to the operating conditions. The larger thermal plasma volume was generated by the higher flow from the forming steam with a higher restrike frequency in the higher arc current conditions. In addition, the characteristics of the water plasma jet were investigated by means of optical emission spectroscopy to identify the abundant radicals required in an efficient waste treatment process.

Surface charge dynamics and OH and H number density distributions in near-surface nanosecond pulse discharges at a liquid / vapor interface

NASA Astrophysics Data System (ADS)

Winters, Caroline; Petrishchev, Vitaly; Yin, Zhiyao; Lempert, Walter R.; Adamovich, Igor V.

2015-10-01

The present work provides insight into surface charge dynamics and kinetics of radical species reactions in nanosecond pulse discharges sustained at a liquid-vapor interface, above a distilled water surface. The near-surface plasma is sustained using two different discharge configurations, a surface ionization wave discharge between two exposed metal electrodes and a double dielectric barrier discharge. At low discharge pulse repetition rates (~100 Hz), residual surface charge deposition after the discharge pulse is a minor effect. At high pulse repetition rates (~10 kHz), significant negative surface charge accumulation over multiple discharge pulses is detected, both during alternating polarity and negative polarity pulse trains. Laser induced fluorescence (LIF) and two-photon absorption LIF (TALIF) line imaging are used for in situ measurements of spatial distributions of absolute OH and H atom number densities in near-surface, repetitive nanosecond pulse discharge plasmas. Both in a surface ionization wave discharge and in a double dielectric barrier discharge, peak measured H atom number density, [H] is much higher compared to peak OH number density, due to more rapid OH decay in the afterglow between the discharge pulses. Higher OH number density was measured near the regions with higher plasma emission intensity. Both OH and especially H atoms diffuse out of the surface ionization wave plasma volume, up to several mm from the liquid surface. Kinetic modeling calculations using a quasi-zero-dimensional H2O vapor / Ar plasma model are in qualitative agreement with the experimental data. The results demonstrate the experimental capability of in situ radical species number density distribution measurements in liquid-vapor interface plasmas, in a simple canonical geometry that lends itself to the validation of kinetic models.

Plasma-panel based detectors

NASA Astrophysics Data System (ADS)

Friedman, Peter

2017-09-01

The plasma panel sensor (PPS) is a novel micropattern gas detector inspired by plasma display panels (PDPs), the core component of plasma-TVs. A PDP comprises millions of discrete cells per square meter, each of which, when provided with a signal pulse, can initiate and sustain a plasma discharge. Configured as a detector, a pixel or cell is biased to discharge when a free-electron is generated in the gas. The PPS consists of an array of small plasma discharge pixels, and can be configured to have either an ``open-cell'' or ``closed-cell'' structure, operating with high gain in the Geiger region. We describe both configurations and their application to particle physics. The open-cell PPS lends itself to ultra-low-mass, ultrathin structures, whereas the closed-cell microhexcavity PPS is capable of higher performance. For the ultrathin-PPS, we are fabricating 3-inch devices based on two types of extremely thin, inorganic, transparent, substrate materials: one being 8-10 µm thick, and the other 25-27 µm thick. These gas-filled ultrathin devices are designed to operate in a beam-line vacuum environment, yet must be hermetically-sealed and gas-filled in an ambient environment at atmospheric pressure. We have successfully fabricated high resolution, submillimeter pixel electrodes on both types of ultrathin substrates. We will also report on the fabrication, staging and operation of the first microhexcavity detectors (µH-PPS). The first µH-PPS prototype devices have a 16 by 16 matrix of closed packed hexagon pixels, each having a 2 mm width. Initial tests of these detectors, conducted with Ne based gases at atmospheric pressure, indicate that each pixel responds independent of its neighboring cells, producing volt level pulse amplitudes in response to ionizing radiation. Results will include the hit rate response to a radioactive beta source, cosmic ray muons, the background from spontaneous discharge, pixel isolation and uniformity, and efficiency measurements. This work was funded in part by a DOE Office of Nuclear Physics SBIR Phase-II Grant.

Heart failure diagnosis in acute conditions has high agreement with inpatient diagnosis.

PubMed

Seronde, Marie-France; Laribi, Said; Collins, Sean P; Deye, Nicolas; Logeart, Damien; Plaisance, Patrick; Cohen-Solal, Alain; Mebazaa, Alexandre

2016-06-01

Acute heart failure (AHF) is frequently encountered in the emergency department (ED) or in the cardiac care unit (CCU)/ICU. Discrimination between cardiac and noncardiac cause of dyspnea by clinical means and standard testing is sometimes inadequate. The aim of our study was to assess AHF diagnosis agreement as determined by: (a) the attending physician, (b) the hospital discharge diagnosis, and (c) an adjudication committee. Between 2010 and 2011, consecutive patients arriving for dyspnea in our hospital were prospectively included. A convenience sample of patients was enrolled in this analysis. Patients were admitted through the ED (280 patients) or through CCU/ICU (112 patients) for undifferentiated dyspnea. Overall, few differences were observed between the initial diagnosis and the hospital discharge diagnosis or the adjudicated diagnosis. Among the 200 patients with an initial diagnosis of AHF, hospital discharge diagnosis confirmed AHF (alone or combined) in 191 (95.5%) patients and the adjudication committee confirmed AHF (alone or combined) in 196 (98%) patients. Our study showed considerable agreement between different AHF diagnostic standards. An initial AHF diagnosis on the basis of clinical signs and biological parameters utilizing B-type natriuretic peptide testing has high agreement and accuracy with the hospital discharge and adjudicated diagnosis of AHF. The present study also shows that the accuracy of the initial AHF diagnosis allows rapid inclusion in AHF trials. These results, if confirmed in a broader cohort of patients, suggest that the initial ED diagnosis is highly accurate and reliable to guide further inpatient management.

Medication review and patient counselling at discharge from the hospital by community pharmacists.

PubMed

Hugtenburg, J G; Borgsteede, S D; Beckeringh, J J

2009-12-01

In 2001, the Association of Amsterdam Community Pharmacists adopted a programme to improve the pharmaceutical care of patients who were discharged from hospital with five or more drug prescriptions. A comprehensive protocol for pharmaceutical care at discharge (IBOM-1) was developed. The aim of the study was to evaluate the initial IBOM protocol and to study the effects of the protocol on drug therapy and patient satisfaction as well as on drug use compliance and mortality. A controlled intervention study involving 37 community pharmacies and 715 of their registered patients who were discharged from a hospital and using at least five prescribed drugs in the years 2001-2003. The intervention included an extensive medication review and drug counselling at the patient's home. Pharmacy intervention activities, changes in medication, discontinuation of drugs prescribed at discharge, mortality, time spent on the intervention activities, and medication cost savings were all evaluated. Patient satisfaction was measured by means of a questionnaire. 379 and 336 patients were enrolled in the intervention and control groups, respectively. The mean number of drugs per patient not dispensed, concomitantly dispensed, or of which the quantity was changed was higher in the intervention group than in the control group (0.70 +/- 1.74 vs. 0.40 +/- 1.43, 0.11 +/- 0.40 vs. 0.038 +/- 0.26, and 0.29 +/- 1.05 vs. 0.097 +/- 0.52, respectively). The mean number of drugs for which the dose or dosage form was changed was similar in both groups. Substitution of brand for generic or vice versa was greater in the intervention group. Changes resulting from a PAIS signal were similar in both groups. The mean number of drugs per patient for which contact was required with the physician or the Pharmacy Hospital Service Desk was higher in the intervention group (0.35 +/- 0.51 vs. 0.16 +/- 0.38). About 40% of home visits resulted in the clearing of redundant drug supplies. The IBOM-1 intervention did not influence discontinuation of drugs prescribed at discharge, nor did it influence mortality. Medication costs were slightly reduced. More patients of intervention pharmacies than of control pharmacies indicated that they were (very) satisfied with the drug counselling by their community pharmacist upon delivery of their discharge medication (87% vs. 50%; chi(2) < 0.001). Structured pharmaceutical care according to the IBOM-1 protocol led to more changes in drug therapy. Home visits resulted in the clearing of redundant home drug supplies. In addition, patients were highly satisfied with the counselling at discharge from hospital by their community pharmacist. Patient counselling at discharge from hospital by pharmacists, therefore, appears to be a meaningful pharmaceutical care activity.

Overview of Initial NSTX-U Experimental Operations

NASA Astrophysics Data System (ADS)

Battaglia, Devon; the NSTX-U Team

2016-10-01

Initial operation of the National Spherical Torus Experiment Upgrade (NSTX-U) has satisfied a number of commissioning milestones, including demonstration of discharges that exceed the field and pulse length of NSTX. ELMy H-mode operation at the no-wall βN limit is obtained with Boronized wall conditioning. Peak H-mode parameters include: Ip = 1 MA, BT0 = 0.63 T, WMHD = 330 kJ, βN = 4, βN/li = 6, κ = 2.3, τE , tot >50 ms. Access to high-performance H-mode scenarios with long MHD-quiescent periods is enabled by the resilient timing of the L-H transition via feedback control of the diverting time and shape, and correction of the dominant n =1 error fields during the Ip ramp. Stationary L-mode discharges have been realized up to 1 MA with 2 s discharges achieved at Ip = 650 kA. The long-pulse L-mode discharges enabled by the new central solenoid supported initial experiments on error field measurements and correction, plasma shape control, controlled discharge ramp-down, L-mode transport and fast ion physics. Increased off-axis current drive and reduction of fast ion instabilities has been observed with the new, more tangential neutral beamline. The initial results support that access to increased field, current and heating at low-aspect-ratio expands the regimes available to develop scenarios, diagnostics and predictive models that inform the design and optimization of future burning plasma tokamak devices, including ITER. Work Supported by U.S. DOE Contract No. DE-AC02-09CH11466.

Study of Survival Rate After Cardiopulmonary Resuscitation (CPR) in Hospitals of Kermanshah in 2013

PubMed Central

Goodarzi, Afshin; Jalali, Amir; Almasi, Afshin; Naderipour, Arsalan; Kalhori, Reza Pourmirza; Khodadadi, Amineh

2015-01-01

Background: After CPR, the follow-up of survival rate and caused complications are the most important practices of the medical group. This study was performed aimed at determining the follow-up results after CPR in patients of university hospitals in Kermanshah in 2014. Methods: In this prospective study, 320 samples were examined. A purposive sampling method was used, and data was collected using a researcher-made information form with content and face validity and reliability of r= 0.79. Data was analyzed with STATA9 software and statistical tests, including calculation of the success rate, relative risk (RR), chi-square and Fisher at significance level of P < 0.05. Results: The initial success rate of cardiopulmonary resuscitation was equal to 15.3%, while the ultimate success rate (discharged alive from the hospital) was as 10.6%. The six-month success rate after resuscitation was 8.78% than those who were discharged alive. There were no significant statistical differences between different age groups regarding the initial success rate of resuscitation (P = 0.14), and the initial resuscitation success rate was higher in patients in morning shift (P = 0.02). Conclusion: By the results of study, it is recommended to increase the medical - nursing knowledge and techniques for personnel in the evening and night shifts. Also, an appropriate dissemination of health care staff in working shifts should be done to increase the success rate of CPR procedure. PMID:25560341

Under Voltage Lock-Out Design Rules for Proper Start-Up of Energy Autonomous Systems Powered by Supercapacitors

NASA Astrophysics Data System (ADS)

Boitier, V.; Durand Estèbe, P.; Monthéard, R.; Bafleur, M.; Dilhac, J. M.

2013-12-01

This paper deals with the issue of the initial start-up of an autonomous and battery-free system powered by an energy harvester associated with a storage subsystem based on supercapacitors initially discharged. A review of different low power Under Voltage Lock-Out (UVLO) solutions used to delay the load start-up and to avoid a useless discharge of supercapacitors is presented and discussed.

Runaway breakdown and hydrometeors in lightning initiation.

PubMed

Gurevich, A V; Karashtin, A N

2013-05-03

The particular electric pulse discharges are observed in thunderclouds during the initiation stage of negative cloud-to-ground lightning. The discharges are quite different from conventional streamers or leaders. A detailed analysis reveals that the shape of the pulses is determined by the runaway breakdown of air in the thundercloud electric field initiated by extensive atmospheric showers (RB-EAS). The high amplitude of the pulse electric current is due to the multiple microdischarges at hydrometeors stimulated and synchronized by the low-energy electrons generated in the RB-EAS process. The series of specific pulse discharges leads to charge reset from hydrometeors to the free ions and creates numerous stretched ion clusters, both positive and negative. As a result, a wide region in the thundercloud with a sufficiently high fractal ion conductivity is formed. The charge transport by ions plays a decisive role in the lightning leader preconditioning.

Dual-protection of a graphene-sulfur composite by a compact graphene skin and an atomic layer deposited oxide coating for a lithium-sulfur battery

NASA Astrophysics Data System (ADS)

Yu, Mingpeng; Wang, Aiji; Tian, Fuyang; Song, Hongquan; Wang, Yinshu; Li, Chun; Hong, Jong-Dal; Shi, Gaoquan

2015-03-01

A reduced graphene oxide (rGO)-sulfur composite aerogel with a compact self-assembled rGO skin was further modified by an atomic layer deposition (ALD) of ZnO or MgO layer, and used as a free-standing electrode material of a lithium-sulfur (Li-S) battery. The rGO skin and ALD-oxide coating worked as natural and artificial barriers to constrain the polysulfides within the cathode region. As a result, the Li-S battery based on this electrode material exhibited superior cycling stability, good rate capability and high coulombic efficiency. Furthermore, ALD-ZnO coating was tested for performance improvement and found to be more effective than ALD-MgO coating. The ZnO modified G-S electrode with 55 wt% sulfur loading delivered a maximum discharge capacity of 998 mA h g-1 at a current density of 0.2 C. A high capacity of 846 mA h g-1 was achieved after charging/discharging for 100 cycles with a coulombic efficiency of over 92%. In the case of using LiNO3 as a shuttle inhibitor, this electrode showed an initial discharge capacity of 796 mA h g-1 and a capacity retention of 81% after 250 cycles at a current density of 1 C with an average coulombic efficiency higher than 99.7%.A reduced graphene oxide (rGO)-sulfur composite aerogel with a compact self-assembled rGO skin was further modified by an atomic layer deposition (ALD) of ZnO or MgO layer, and used as a free-standing electrode material of a lithium-sulfur (Li-S) battery. The rGO skin and ALD-oxide coating worked as natural and artificial barriers to constrain the polysulfides within the cathode region. As a result, the Li-S battery based on this electrode material exhibited superior cycling stability, good rate capability and high coulombic efficiency. Furthermore, ALD-ZnO coating was tested for performance improvement and found to be more effective than ALD-MgO coating. The ZnO modified G-S electrode with 55 wt% sulfur loading delivered a maximum discharge capacity of 998 mA h g-1 at a current density of 0.2 C. A high capacity of 846 mA h g-1 was achieved after charging/discharging for 100 cycles with a coulombic efficiency of over 92%. In the case of using LiNO3 as a shuttle inhibitor, this electrode showed an initial discharge capacity of 796 mA h g-1 and a capacity retention of 81% after 250 cycles at a current density of 1 C with an average coulombic efficiency higher than 99.7%. Electronic supplementary information (ESI) available: Procedures of ALD operation, supplementary figures and details of theoretical simulations. See DOI: 10.1039/c5nr00166h

Hypothermia and rapid rewarming is associated with worse outcome following traumatic brain injury.

PubMed

Thompson, Hilaire J; Kirkness, Catherine J; Mitchell, Pamela H

2010-01-01

The purpose of the present study was to determine (1) the prevalence and degree of hypothermia in patients on emergency department admission and (2) the effect of hypothermia and rate of rewarming on patient outcomes. Secondary data analysis was conducted on patients admitted to a level I trauma center following severe traumatic brain injury (n = 147). Patients were grouped according to temperature on admission according to hypothermia status and rate of rewarming (rapid or slow). Regression analyses were performed. Hypothermic patients were more likely to have lower postresuscitation Glasgow Coma Scale scores and a higher initial injury severity score. Hypothermia on admission was correlated with longer intensive care unit stays, a lower Glasgow Coma Scale score at discharge, higher mortality rate, and lower Glasgow outcome score-extended scores up to 6 months postinjury (P < .05). When controlling for other factors, rewarming rates more than 0.25°C/h were associated with lower Glasgow Coma Scale scores at discharge, longer intensive care unit length of stay, and higher mortality rate than patients rewarmed more slowly although these did not reach statistical significance. Hypothermia on admission is correlated with worse outcomes in brain-injured patients. Patients with traumatic brain injury who are rapidly rewarmed may be more likely to have worse outcomes. Trauma protocols may need to be reexamined to include controlled rewarming at rates 0.25°C/h or less.

Triggered lightning strikes to aircraft and natural intracloud discharges

NASA Technical Reports Server (NTRS)

Mazur, Vladislav

1989-01-01

The physical model of Mazur (1989) for triggering lightning strikes by aircraft was used to interpret the initiation of intracloud flashes observed by the French UHF-VHF interferometric system. It is shown that both the intracloud discharges and airplane-triggered lightning strikes were initiated by simultaneous bidirectional development of the negative stepped leader and the positive leader-continous current process. However, the negative stepped leader phase in triggered flashes is of shorter duration (tens of milliseconds), than that in intracloud flashes (usually hundreds of milliseconds). This is considered to be due to the fact that, on the aircraft there is a single initiation process, versus the numerous initiation processes that occur inside the cloud.

On nuclear DD synthesis at the initial stage of nanosecond vacuum discharge with deuterium-loaded Pd anode

NASA Astrophysics Data System (ADS)

Kurilenkov, Yu K.; Gus'kov, S. Yu; Karpukhin, V. T.; Oginov, A. V.; Samoylov, I. S.

2018-01-01

Earlier, there was demonstrated generation of DD neutrons in an interelectrode medium of a low-energy (˜ 1 J) nanosecond vacuum discharge with a hollow cathode and a deuterium-loaded Pd anode. There was revealed essential role of formation of a virtual cathode and a potential well corresponding thereto in the processes of collisional DD synthesis in the interelectrode space. In this work, we have obtained as a result of an experiment and discussed the neutron yield at the very initial stage of the discharge, when the beam of auto-electrons just starts to irradiate the non-ideal surface of the deuterium-loaded Pd anode.

Behavior of motor units in human biceps brachii during a submaximal fatiguing contraction.

PubMed

Garland, S J; Enoka, R M; Serrano, L P; Robinson, G A

1994-06-01

The activity of 50 single motor units was recorded in the biceps brachii muscle of human subjects while they performed submaximal isometric elbow flexion contractions that were sustained to induce fatigue. The purposes of this study were to examine the influence of fatigue on motor unit threshold force and to determine the relationship between the threshold force of recruitment and the initial interimpulse interval on the discharge rates of single motor units during a fatiguing contraction. The discharge rate of most motor units that were active from the beginning of the contraction declined during the fatiguing contraction, whereas the discharge rates of most newly recruited units were either constant or increased slightly. The absolute threshold forces of recruitment and derecruitment decreased, and the variability of interimpulse intervals increased after the fatigue task. The change in motor unit discharge rate during the fatigue task was related to the initial rate, but the direction of the change in discharge rate could not be predicted from the threshold force of recruitment or the variability in the interimpulse intervals. The discharge rate of most motor units declined despite an increase in the excitatory drive to the motoneuron pool during the fatigue task.

Centennial-scale records of total organic carbon in sediment cores from the South Yellow Sea, China

NASA Astrophysics Data System (ADS)

Zhu, Qing; Lin, Jia; Hong, Yuehui; Yuan, Lirong; Liu, Jinzhong; Xu, Xiaoming; Wang, Jianghai

2018-01-01

Global carbon cycling is a significant factor that controls climate change. The centennial-scale variations in total organic carbon (TOC) contents and its sources in marginal sea sediments may reflect the influence of human activities on global climate change. In this study, two fine-grained sediment cores from the Yellow Sea Cold Water Mass of the South Yellow Sea were used to systematically determine TOC contents and stable carbon isotope ratios. These results were combined with previous data of black carbon and 210Pb dating from which we reconstructed the centennial-scale initial sequences of TOC, terrigenous TOC (TOCter) and marine autogenous TOC (TOCmar) after selecting suitable models to correct the measured TOC (TOCcor). These sequences showed that the TOCter decreased with time in the both cores while the TOCmar increased, particularly the rapid growth in core H43 since the late 1960s. According to the correlation between the Huanghe (Yellow) River discharge and the TOCcor, TOCter, or TOCmar, we found that the TOCter in the two cores mainly derived from the Huanghe River and was transported by it, and that higher Huanghe River discharge could strengthen the decomposition of TOCmar. The newly obtained initial TOC sequences provide important insights into the interaction between human activities and natural processes.

The Role of Medicare's Inpatient Cost-Sharing in Medicaid Entry.

PubMed

Keohane, Laura M; Trivedi, Amal N; Mor, Vincent

2018-04-01

To isolate the effect of greater inpatient cost-sharing on Medicaid entry among Medicare beneficiaries. Medicare administrative data (years 2007-2010) were linked to nursing home assessments and area-level socioeconomic indicators. Medicare beneficiaries who are readmitted to a hospital must pay an additional deductible ($1,100 in 2010) if their readmission occurs more than 59 days following discharge. In a regression discontinuity analysis, we take advantage of this Medicare benefit feature to test whether beneficiaries with greater cost-sharing have higher rates of Medicaid enrollment. We identified 221,248 Medicare beneficiaries with an initial hospital stay and a readmission 53-59 days later (no deductible) or 60-66 days later (charged a deductible). Among beneficiaries in low-socioeconomic areas with two hospitalizations, those readmitted 60-66 days after discharge were 21 percent more likely to join Medicaid compared with those readmitted 53-59 days following their initial hospitalization (absolute difference in adjusted risk of Medicaid entry: 3.7 percent vs. 3.1 percent, p = .01). Increasing Medicare cost-sharing requirements may promote Medicaid enrollment among low-income beneficiaries. Potential savings from an increased cost-sharing in the Medicare program may be offset by increased Medicaid participation. © Health Research and Educational Trust.

Efficient mineralization of antibiotic ciprofloxacin in acid aqueous medium by a novel photoelectro-Fenton process using a microwave discharge electrodeless lamp irradiation.

PubMed

Wang, Aimin; Zhang, Yanyu; Zhong, Huihui; Chen, Yu; Tian, Xiujun; Li, Desheng; Li, Jiuyi

2018-01-15

In this study, a novel photoelectro-Fenton (PEF) process using microwave discharge electrodeless lamp (MDEL) as a UV irradiation source was developed for the removal of antibiotic ciprofloxacin (CIP) in water. Comparative degradation of 200mgL -1 CIP was studied by direct MDEL photolysis, anodic oxidation (AO), AO in presence of electrogenerated H 2 O 2 (AO-H 2 O 2 ), AO-H 2 O 2 under MDEL irradiation (MDEL-AO-H 2 O 2 ), electro-Fenton (EF) and MDEL-PEF processes. Higher oxidation power was found in the sequence: MDEL photolysis < AO < AO-H 2 O 2 < MDEL-AO-H 2 O 2 < EF < MDEL-PEF. Effects of current density, pH, initial Fe 2+ concentration and initial CIP concentration on TOC removal in MDEL-PEF process were examined, and the optimal conditions were ascertained. The releases of three inorganic ions (F - , NH 4 + and NO 3 - ) and two carboxylic acids (oxalic and formic acids) were qualified. Seven aromatic intermediates mainly generated from hydroxylation, dealkylation and defluorination of CIP were detected by UPLC-QTOF-MS/MS technology. Therefore, plausible degradation sequences for CIP degradation in MDEL-PEF process including all detected products were proposed. Copyright © 2017 Elsevier B.V. All rights reserved.

Schlieren optical visualization for transient EHD induced flow in a stratified dielectric liquid under gas-phase ac corona discharges

NASA Astrophysics Data System (ADS)

Ohyama, R.; Inoue, K.; Chang, J. S.

2007-01-01

A flow pattern characterization of electrohydrodynamically (EHD) induced flow phenomena of a stratified dielectric fluid situated in an ac corona discharge field is conducted by a Schlieren optical system. A high voltage application to a needle-plate electrode arrangement in gas-phase normally initiates a conductive type EHD gas flow. Although the EHD gas flow motion initiated from the corona discharge electrode has been well known as corona wind, no comprehensive study has been conducted for an EHD fluid flow motion of the stratified dielectric liquid that is exposed to the gas-phase ac corona discharge. The experimentally observed result clearly presents the liquid-phase EHD flow phenomenon induced from the gas-phase EHD flow via an interfacial momentum transfer. The flow phenomenon is also discussed in terms of the gas-phase EHD number under the reduced gas pressure (reduced interfacial momentum transfer) conditions.

A mathematical approach for evaluating nickel-hydrogen cells

NASA Technical Reports Server (NTRS)

Leibecki, H. F.

1986-01-01

A mathematical equation is presented which gives a quantitative relationship between time-voltage discharge curves, when a cell's ampere-hour capacity is determined at a constant discharge current. In particular the equation quantifies the initial exponential voltage decay; the rate of voltage decay; the overall voltage shift of the curve and the total capacity of the cell at the given discharge current. The results of 12 nickel-hydrogen boiler plate cells cycled to 80 percent depth-of-discharge (DOD) are discussed in association with these equations.

Low current plasmatron fuel converter having enlarged volume discharges

DOEpatents

Rabinovich, Alexander; Alexeev, Nikolai; Bromberg, Leslie; Cohn, Daniel R.; Samokhin, Andrei

2005-04-19

A novel apparatus and method is disclosed for a plasmatron fuel converter (""plasmatron"") that efficiently uses electrical energy to produce hydrogen rich gas. The volume and shape of the plasma discharge is controlled by a fluid flow established in a plasma discharge volume. A plasmatron according to this invention produces a substantially large effective plasma discharge volume allowing for substantially greater volumetric efficiency in the initiation of chemical reactions within a volume of bulk fluid reactant flowing through the plasmatron.

Low current plasmatron fuel converter having enlarged volume discharges

DOEpatents

Rabinovich, Alexander [Swampscott, MA; Alexeev, Nikolai [Moscow, RU; Bromberg, Leslie [Sharon, MA; Cohn, Daniel R [Chestnut Hill, MA; Samokhin, Andrei [Moscow, RU

2009-10-06

A novel apparatus and method is disclosed for a plasmatron fuel converter ("plasmatron") that efficiently uses electrical energy to produce hydrogen rich gas. The volume and shape of the plasma discharge is controlled by a fluid flow established in a plasma discharge volume. A plasmatron according to this invention produces a substantially large effective plasma discharge volume allowing for substantially greater volumetric efficiency in the initiation of chemical reactions within a volume of bulk fluid reactant flowing through the plasmatron.

Lightning and middle atmospheric discharges in the atmosphere

NASA Astrophysics Data System (ADS)

Siingh, Devendraa; Singh, R. P.; Kumar, Sarvan; Dharmaraj, T.; Singh, Abhay K.; Singh, Ashok K.; Patil, M. N.; Singh, Shubha

2015-11-01

Recent development in lightning discharges including transient luminous events (TLEs) and global electric circuit are discussed. Role of solar activity, convective available potential energy, surface temperature and difference of land-ocean surfaces on convection process are discussed. Different processes of discharge initiation are discussed. Events like sprites and halos are caused by the upward quasi-electrostatic fields associated with intense cloud-to-ground discharges while jets (blue starter, blue jet, gigantic jet) are caused by charge imbalance in thunderstorm during lightning discharges but they are not associated with a particular discharge flash. Elves are generated by the electromagnetic pulse radiated during lightning discharges. The present understanding of global electric circuit is also reviewed. Relation between lightning activity/global electric circuit and climate is discussed.

Application of surface electrical discharges to the study of lightning strikes on aircraft

NASA Technical Reports Server (NTRS)

Boulay, J. L.; Larigaldie, S.

1991-01-01

Considered here is the characterization of surface discharges which provide a facility complementary to that of artificially triggered lightning. General characteristics of a simplified surface discharge, including current waveforms and the constitution of a surface discharge are outlined, and the application of this approach to the study of aircraft lightning strikes is considered. Representations of leader-streamer and return-stroke phases are discussed, and the application to the two-dimensional discharge phase is covered. It is noted that the fact that the initiation times of surface discharges could be controlled, and the path followed by the discharge channels could be predetermined, indicates that it is possible to produce a highly dedicated high performance instrumentation system.

Numerical modelling of ozone production in a wire-cylinder corona discharge and comparison with a wire-plate corona discharge

NASA Astrophysics Data System (ADS)

Wang, Pengxiang; Chen, Junhong

2009-02-01

The effect of electrode configuration on ozone production in the direct-current corona discharge of dry and humid air is studied by a numerical model that combines the electron distribution in the corona plasma, plasma chemistry and transport phenomena. Two electrode configurations are considered: wire-cylinder discharge with air flowing along the wire axis and wire-plate discharge with air flowing transverse to the wire. The ozone distributions in both types of discharges are compared. For both electrode configurations, the ozone production rate is higher in the negative corona than in the positive corona and it decreases with an increase in relative humidity. More importantly, the detailed ozone distribution in the neighbourhood of the discharge wire, together with the ozone kinetics, reveals the possible difference in the ozone production from the two discharges. With the same operating conditions and sufficiently short flow residence time, the ozone production rate is nearly the same for both electrode configurations. When the flow residence time is longer than the characteristic time for homogeneous ozone destruction, the net ozone production is higher in the wire-cylinder discharge than in the wire-plate discharge due to relatively less ozone destruction.

Predictors of the discharge dosage of an atypical antipsychotic agent among hospitalized, treatment-naive, first-episode psychosis patients in naturalistic, public-sector settings.

PubMed

Compton, Michael T; Kelley, Mary E; Lloyd, Robert Brett; McClam, Tamela; Ramsay, Claire E; Haggard, Patrick J; Augustin, Sara

2011-02-01

Little is known about determinants of second-generation antipsychotic dosages during initial hospitalization of first-episode psychosis. This study examined potential predictors of dosage of an atypical antipsychotic agent, risperidone, at hospital discharge after initial evaluation and treatment of first-episode nonaffective psychosis in 3 naturalistic, public-sector treatment settings. The number of psychotropic agents prescribed and discharge antipsychotic dosage were abstracted from the medical record. Demographic and extensive clinical characteristics were assessed through a clinical research study conducted at the 3 sites. One-way analyses of variance, trend tests using specific linear combinations of estimates, and χ² tests assessed for associations between atypical antipsychotic dosage and 5 hypothesized predictors, as well as 12 exploratory variables. Among 155 hospitalized first-episode patients, 121 (78.1%) were discharged on risperidone, and subsequent analyses focused on that subset. The mean risperidone dosage among those 121 patients was 4.26 mg; 31 received 1 to 2 mg, 45 received 3 to 4 mg, 37 received 5 to 6 mg, and 8 received more than 6 mg. Analyses suggested that older age at hospitalization, the number of psychotropic agents prescribed, excited symptoms, and premorbid social functioning may be predictors of the discharge dosage. Although several factors emerged, in general, predictors of discharge dosages of second-generation agents, here exemplified by risperidone, in real-world practice settings remain to be clarified. Given the importance of antipsychotic initiation during first hospitalization, future research should test an even broader array of potential predictors.

Laser-initiated channels for ion transport: breakdown and channel evolution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Olsen, J.N.; Baker, L.

1981-05-01

The electrical breakdown and discharge evolution in CO/sub 2/ laser-heated molecular gases has been studied. With the laser tuned to a vibrational mode of NH/sub 3/, C/sub 2/H/sub 4/, CH/sub 2/CHCN, or CH/sub 3/OH the breakdown potential decreases as much as 10-fold for laser pulse energies up to 35 J/cm/sup 2/. The subsequent 50--142-cm discharges are straight, stable, and reproducible. Analogous tests in D/sub 2/ and air yield only a small alteration of breakdown potential and do not cause a straight discharge. The expansion of the initial laser-heated gas has been modeled by the CHARTB hydrocode with the addition ofmore » the NH/sub 3/ equation of state in tabular and analytic form to that code. The breakdown characteristics and initial expansion stage confirm the earlier calculation of laser heating to 1900--2100 /sup 0/K. Experimental observations of the discharge evolution in NH/sub 3/ have measured (1) the radial expansion velocity by streak-camera photography of the H/sub ..beta../ emission zone, (2) the plasma temperature by the Niv/Niii line-ratio method, and (3) the electron-density profile by holographic interferometry. The central zone of the channel is heated to 5.5 eV and expands with a radial velocity of 1.0--1.2 mm/..mu..s for the case of a 27-kA discharge in 20 Torr of NH/sub 3/. Preliminary hydrocode simulations of the discharge show qualitative agreement with observations.« less

Plasma Assisted Ignition and Combustion at Low Initial Gas Temperatures: Development of Kinetic Mechanism

DTIC Science & Technology

2016-10-05

describes physics of a nanosecond surface dielectric barrier discharge (SDBD) at ambient gas temperature and high pressures (1-6 bar) in air. Details about...the ignition by a nanosecond discharge. Chapter 7 presents the high pressure high temperature reactor built recently at Laboratory for Plasma Physics ...livelink.ebs.afrl.af.mil/livelink/llisapi.dll Laboratory for Physics of Plasma, Ecole Polytechnique Plasma Assisted Ignition and Combustion at Low Initial Gas

[Predictors of the therapeutic discharge in patients with dual pathology admitted to a therapeutic community with a psychiatric unit].

PubMed

Madoz-Gúrpide, Agustín; García Vicent, Vicente; Luque Fuentes, Encarnación; Ochoa Mangado, Enriqueta

2013-01-01

This study aims to analyze the variables on which depends therapeutic discharge, in patients with a severe dual diagnosis admitted to a professional therapeutic community where their pathology is treated. 325 patients admitted between June 2000 and June 2009 to the therapeutic community. This is a retrospective, cross-sectional study with no control group, based on the detailed analysis of the information collected in a model of semi-structured clinical interview designed in the therapeutic community. The 29.5% of the individuals included in the sample were therapeutically discharged. Of all the variables introduced in this analysis the most significant ones were gender, age at the beginning of treatment, education level, opiate dependence, polidrug abuse, and the presence of psychotic disorders and borderline personality disorder. In our study, gender determines the type of discharge, being therapeutic discharge more frequent among women. A higher educational also increases a better prognosis with a higher rate of therapeutic discharge among individuals with higher education level. A later age at the beginning of the treatment reduces the likelihood of therapeutic discharge. Likewise, polidrug abuse, diagnosis of psychotic disorders and borderline personality disorder are associated to a lower rate of therapeutic discharge. Recognizing these characteristics will allow the early identification of those patients more at risk of dropping treatment hastily, while trying to prevent it by increasing the therapeutic intensity.

Statistical considerations in estimating organism concentrations in ballast water discharges

EPA Science Inventory

Sampling probabilities may affect the practical use of different ballast water performance standards which establish the acceptable concentration of organisms in ballast discharges. The International Maritime Organization (IMO) has initiated a ballast water standard of <10 viabl...

A Corona Discharge Initiated Electrochemical Electrospray Ionization Technique

PubMed Central

Lloyd, John R.; Hess, Sonja

2009-01-01

We report here the development of a corona discharge (CD) initiated electrochemical (EC) electrospray ionization (ESI) technique using a standard electrospray ion source. This is a new ionization technique distinct from ESI, electrochemistry inherent to ESI, APCI, and techniques using hydroxyl radicals produced under atmospheric pressure conditions. By maximizing the observable CD at the tip of a stainless steel ESI capillary, efficient electrochemical oxidation of electrochemically active compounds is observed. For electrochemical oxidation to be observed, the ionization potential of the analyte must be lower than Fe. Ferrocene labeled compounds were chosen as the electrochemically active moiety. The electrochemical cell in the ESI source was robust and generated ions with selectivity according to the ionization potential of the analytes and up to zeptomolar sensitivity. Our results indicate that CD initiated electrochemical ionization has the potential to become a powerful technique to increase the dynamic range, sensitivity and selectivity of ESI experiments. Synopsis Using a standard ESI source a corona discharge initiated electrochemical ionization technique was established resulting from the electrochemistry occurring at the CD electrode surface. PMID:19747843

Pore structures in an implantable sol gel titania ceramic device used in controlled drug release applications: A modeling study

NASA Astrophysics Data System (ADS)

Peterson, Aaron; Lopez, Tessy; Islas, Emma Ortiz; Gonzalez, Richard D.

2007-04-01

Several process variables, which may be helpful in optimizing the rate at which drugs are released from implantable, sol-gel titania devices have been identified in this study. The controlled rate of drug release is compared for two different anticonvulsant drugs, valproic acid and sodic phenytoin. Contrary to what one might expect, when the concentration is increased in the titania reservoir the rate of initial drug delivery decreases. This is a desirable result, because it may reduce the danger of a high initial discharge, which may harm the epileptic rat. The structure of the porous structure within the titania network has been studied using a generalized form of the BET equation which considers only n layers. In general, following an initial discharge, the rate at which the drug is released will increase with the increasing concentration. Pore mouth blocking can present a problem. However, this problem tends to disappear following the initial discharge. The extent of drug loading is a useful variable parameter, which can be adjusted in order to deliver the amount of drug required in a given application.

GAS DISCHARGE DEVICES

DOEpatents

Jefferson, S.

1958-11-11

An apparatus utilized in introducing tritium gas into envelope of a gas discharge device for the purpose f maintaining the discharge path in ionized condition is described. ln addition to the cathode and anode, the ischarge device contains a zirconium or tantalum ilament arranged for external excitation and a metallic seed containing tritium, and also arranged to have a current passed through it. Initially, the zirconium or tantalum filament is vaporized to deposit its material adjacent the main discharge region. Then the tritium gas is released and, due to its affinity for the first released material, it deposits in the region of the main discharge where it is most effective in maintaining the discharge path in an ionized condition.

Impacts of urban wastewater discharge on seagrass meadows ( Zostera noltii)

NASA Astrophysics Data System (ADS)

Cabaço, Susana; Machás, Raquel; Vieira, Vasco; Santos, Rui

2008-06-01

The abiotic disturbance of urban wastewater discharge and its effects in the population structure, plant morphology, leaf nutrient content, epiphyte load and macroalgae abundance of Zostera noltii meadows were investigated in Ria Formosa coastal lagoon, southern Portugal using both univariate and multivariate analysis. Four sites were assessed, on a seasonal basis, along a gradient from a major Waste Water Treatment Works (WWTW) discharge to a main navigation channel. The wastewater discharge caused an evident environmental disturbance through the nutrient enrichment of the water and sediment, particularly of ammonium. Zostera noltii of the sites closest to the nutrient source showed higher leaf N content, clearly reflecting the nitrogen load. The anthropogenic nutrient enrichment resulted in higher biomass, and higher leaf and internode length, except for the meadow closest to the wastewater discharge (270 m). The high ammonium concentration (158-663 μM) in the water at this site resulted in the decrease of biomass, and both the leaf and internode length, suggesting a toxic effect on Z. noltii. The higher abundance of macroalgae and epiphytes found in the meadow closest to the nutrient source may also affect the species negatively. Shoot density was higher at the nutrient-undisturbed site. Two of the three abiotic processes revealed by Principal Component Analysis were clearly related to the WWTW discharge, a contrast between water column salinity and nutrient concentration and a sediment contrast between both porewater nutrients and temperature and redox potential. A multiple regression analysis showed that these abiotic processes had a significant effect on the biomass-density dynamics of meadows and on the overall size of Z. noltii plants, respectively. Results show that the wastewater discharge is an important source of environmental disturbance and nutrients availability in Ria Formosa lagoon affecting the population structure, morphology and N content of Z. noltii. This impact is spatially restricted to areas up to 600 m distant from the WWTW discharge, probably due to the high water renewal of the lagoon.

Modeling of non-thermal plasma in flammable gas mixtures

NASA Astrophysics Data System (ADS)

Napartovich, A. P.; Kochetov, I. V.; Leonov, S. B.

2008-07-01

An idea of using plasma-assisted methods of fuel ignition is based on non-equilibrium generation of chemically active species that speed up the combustion process. It is believed that gain in energy consumed for combustion acceleration by plasmas is due to the non-equilibrium nature of discharge plasma, which allows radicals to be produced in an above-equilibrium amount. Evidently, the size of the effect is strongly dependent on the initial temperature, pressure, and composition of the mixture. Of particular interest is comparison between thermal ignition of a fuel-air mixture and non-thermal plasma initiation of the combustion. Mechanisms of thermal ignition in various fuel-air mixtures have been studied for years, and a number of different mechanisms are known providing an agreement with experiments at various conditions. The problem is -- how to conform thermal chemistry approach to essentially non-equilibrium plasma description. The electric discharge produces much above-equilibrium amounts of chemically active species: atoms, radicals and ions. The point is that despite excess concentrations of a number of species, total concentration of these species is far below concentrations of the initial gas mixture. Therefore, rate coefficients for reactions of these discharge produced species with other gas mixture components are well known quantities controlled by the translational temperature, which can be calculated from the energy balance equation taking into account numerous processes initiated by plasma. A numerical model was developed combining traditional approach of thermal combustion chemistry with advanced description of the plasma kinetics based on solution of electron Boltzmann equation. This approach allows us to describe self-consistently strongly non-equilibrium electric discharge in chemically unstable (ignited) gas. Equations of pseudo-one-dimensional gas dynamics were solved in parallel with a system of thermal chemistry equations, kinetic equations for charged particles (electrons, positive and negative ions), and with the electric circuit equation. The electric circuit comprises power supply, ballast resistor connected in series with the discharge and capacity. Rate coefficients for electron-assisted reactions were calculated from solving the two-term spherical harmonic expansion of the Boltzmann equation. Such an approach allows us to describe influence of thermal chemistry reactions (burning) on the discharge characteristics. Results of comparison between the discharge and thermal ignition effects for mixtures of hydrogen or ethylene with dry air will be reported. Effects of acceleration of ignition by discharge plasma will be analyzed. In particular, the role of singlet oxygen produced effectively in the discharge in ignition speeding up will be discussed.

Association of heart rate at hospital discharge with mortality and hospitalizations in patients with heart failure.

PubMed

Habal, Marlena V; Liu, Peter P; Austin, Peter C; Ross, Heather J; Newton, Gary E; Wang, Xuesong; Tu, Jack V; Lee, Douglas S

2014-01-01

Heart failure (HF) is associated with a high burden of morbidity and mortality. Hospital discharge is an opportunity for identification of modifiable prognostic factors in the transition to chronic HF. We examined the association of discharge heart rate with 30-day and 1-year mortality and hospitalization outcomes in a cohort of 9097 patients with HF discharged from hospital. Discharge heart rate was categorized into predefined groups: 40 to 60 (n=1333), 61 to 70 (n=2170), 71 to 80 (n=2631), 81 to 90 (n=1700), and >90 bpm (n=1263). There was a significant increase in all-cause 30-day mortality with adjusted odds ratios of 1.59 (95% confidence interval [CI], 1.18-2.14; P=0.003) for discharge heart rates 81 to 90 bpm and 1.56 (95% CI, 1.13-2.16; P=0.007) for heart rates>90 bpm when compared with the reference group (heart rates, 61-70 bpm). Cardiovascular death risk at 30 days was also higher with adjusted odds ratio 1.59 (discharge heart rates, 81-90 bpm; 95% CI, 1.09-2.33; P=0.017) and 1.65 (discharge heart rates, >90 bpm; 95% CI, 1.09-2.48; P=0.017). One-year all-cause mortality (adjusted odds ratio, 1.41; 95% CI, 1.16-1.72; P<0.001) and cardiovascular death (adjusted odds ratio, 1.47; 95% CI, 1.12-1.92; P=0.005) were higher with discharge heart rates>90 bpm when compared with the reference group (heart rates, 40-60 bpm). Readmissions for HF (adjusted hazard ratio, 1.26; 95% CI, 1.04-1.54; P=0.021) and cardiovascular disease (adjusted hazard ratio, 1.29; 95% CI, 1.08-1.54; P=0.004) within 30 days were also higher with discharge heart rates>90 bpm. Higher discharge heart rates were associated with greater risk of all-cause and cardiovascular mortality≤1-year follow-up and an elevated risk of 30-day readmission for HF and cardiovascular disease.

On the road to self-sputtering in high power impulse magnetron sputtering: particle balance and discharge characteristics

NASA Astrophysics Data System (ADS)

Huo, Chunqing; Lundin, Daniel; Raadu, Michael A.; Anders, André; Tomas Gudmundsson, Jon; Brenning, Nils

2014-04-01

The onset and development of self-sputtering (SS) in a high power impulse magnetron sputtering (HiPIMS) discharge have been studied using a plasma chemical model and a set of experimental data, taken with an aluminum target and argon gas. The model is tailored to duplicate the discharge in which the data are taken. The pulses are long enough to include both an initial transient and a following steady state. The model is used to unravel how the internal discharge physics evolves with pulse power and time, and how it is related to features in the discharge current-voltage-time characteristics such as current densities, maxima, kinks and slopes. The connection between the self-sputter process and the discharge characteristics is quantified and discussed in terms of three parameters: a critical target current density Jcrit based on the maximum refill rate of process (argon) gas above the target, an SS recycling factor ΠSS-recycle, and an approximation \\tilde{\\alpha} of the probabilities of ionization of species that come from the target (both sputtered metal and embedded argon atoms). For low power pulses, discharge voltages UD ⩽ 380 V with peak current densities below ≈ 0.2 A cm-2, the discharge is found to be dominated by process gas sputtering. In these pulses there is an initial current peak in time, associated with partial gas rarefaction, which is followed by a steady-state-like plateau in all parameters similar to direct current magnetron sputtering. In contrast, high power pulses, with UD ⩾ 500 V and peak current densities above JD ≈ 1.6 A cm-2, make a transition to a discharge mode where SS dominates. The transition is found not to be driven by process gas rarefaction which is only about 10% at this time. Maximum gas rarefaction is found later in time and always after the initial peak in the discharge current. With increasing voltage, and pulse power, the discharge can be described as following a route where the role of SS increases in four steps: process gas sputtering, gas-sustained SS, self-sustained SS and SS runaway. At the highest voltage, 1000 V, the discharge is very close to, but does not go into, the SS runaway mode. This absence of runaway is proposed to be connected to an unexpected finding: that twice ionized ions of the target species play almost no role in this discharge, not even at the highest powers. This reduces ionization by secondary-emitted energetic electrons almost to zero in the highest power range of the discharge.

Urinary Tract Infections in Hospitalized Ischemic Stroke Patients: Source and Impact on Outcome

PubMed Central

Bogason, Einar; Morrison, Kathy; Zalatimo, Omar; Ermak, David M; Lehman, Erik; Markley, Eric

2017-01-01

Background: Urinary tract infections (UTIs) in ischemic stroke patients are a common occurrence and the frequent focus of quality improvement initiatives. However, many UTIs are community-acquired and the impact of such infections on patient outcomes remains controversial. Methods: We conducted a retrospective analysis of our Stroke Center Database and electronic medical records to determine the incidence of both community-acquired UTI (CA-UTI) and hospital-acquired UTI (HA-UTI) in hospitalized ischemic stroke patients. We assessed risk factors for UTI, as well as clinical outcome, the length of stay (LOS), and hospital charges. Results: In our study sample of 395 patients, UTIs were found in 11.7% and the majority of these (65%) were found on admission. Patients admitted from another hospital were more likely to be diagnosed with a UTI of any type compared to those arriving from home (odds ratio (OR) 2.42 95%, confidence interval (CI) 1.18, 4.95) and were considerably more likely to have an HA-UTI than a CA-UTI (OR 12.06 95% CI 2.14, 95.32). Those with a Foley catheter were also more likely to have a UTI (OR 2.65 95% CI 1.41, 4.98). In the multivariable analysis, we did not find a statistically significant relationship between any UTI or a specific UTI subtype and discharge modified Rankin Score (mRS), LOS, or hospital charges. Admission stroke severity remained associated with higher odds of discharge in poor condition (adjusted odds ratio (aOR) 6.23 95% CI2.33, 16.62), an extended LOS (6.84 vs 5.07, p = 0.006), and higher hospital charges ($18,305 vs $12,162, p = 0.001).  Conclusions: Urinary tract infections remain a common occurrence in stroke patients. However, the majority of UTIs are present on admission and may have little impact on discharge clinical condition, LOS, or hospital charges. These results may have implications for quality improvement (QI) initiatives that focus on the prevention and treatment of hospital-acquired UTIs. PMID:28331776

Extracorporeal membrane oxygenation for refractory septic shock in adults.

PubMed

Park, Taek Kyu; Yang, Jeong Hoon; Jeon, Kyeongman; Choi, Seung-Hyuk; Choi, Jin-Ho; Gwon, Hyeon-Cheol; Chung, Chi Ryang; Park, Chi Min; Cho, Yang Hyun; Sung, Kiick; Suh, Gee Young

2015-02-01

The role of extracorporeal membrane oxygenation (ECMO) remains controversial in adult patients with refractory septic shock. We sought to describe the clinical outcomes of adult patients supported by ECMO during septic shock refractory to conventional treatment. We analysed consecutive adult patients with refractory septic shock, assisted by an ECMO system between January 2005 and December 2013 in a single-centre registry. The primary outcome was survival to hospital discharge. A total of 32 patients (21 males) received ECMO support for refractory septic shock. Of these, 14 patients (43.8%) had undergone cardiopulmonary resuscitation (CPR) and 7 patients (21.9%) did not achieve the return of spontaneous circulation until initiation of ECMO flow. ECMO was weaned off successfully in 13 patients (40.6%) and 7 patients (21.9%) survived to hospital discharge. The survivors had lower peak lactate (4.5 vs 15.1 mmol/l, P = 0.03), lower Sepsis-related Organ Failure Assessment day 3 score (15 vs 18, P = 0.01) and higher peak troponin I (32.8 vs 3.7 ng/ml, P = 0.02) than the non-survivors. None of the patients (31.3%) in whom ECMO was initiated more than 30.5 h after onset of septic shock, survived. In multivariable-adjusted models, CPR [adjusted hazard ratio (HR), 4.61; 95% confidence interval (CI), 1.55-13.69; P = 0.006] was an independent predictor of in-hospital mortality after ECMO in patients with refractory septic shock. Higher peak troponin I > 15 ng/ml (adjusted HR, 0.34; 95% CI, 0.12-0.97; P = 0.04) was associated with a lower risk of in-hospital mortality. Survival to hospital discharge remained low in adult patients with refractory septic shock despite ECMO support. Our findings suggest that implantation of ECMO during refractory septic shock could be considered in patients with severe myocardial injury but should be avoided in patients who have received CPR. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

The effect of time to defibrillation and targeted temperature management on functional survival after out-of-hospital cardiac arrest.

PubMed

Drennan, Ian R; Lin, Steve; Thorpe, Kevin E; Morrison, Laurie J

2014-11-01

Cardiac arrest physiology has been proposed to occur in three distinct phases: electrical, circulatory and metabolic. There is limited research evaluating the relationship of the 3-phase model of cardiac arrest to functional survival at hospital discharge. Furthermore, the effect of post-cardiac arrest targeted temperature management (TTM) on functional survival during each phase is unknown. To determine the effect of TTM on the relationship between the time of initial defibrillation during each phase of cardiac arrest and functional survival at hospital discharge. This was a retrospective observational study of consecutive adult (≥18 years) out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythms. Included patients obtained a return of spontaneous circulation (ROSC) and were eligible for TTM. Multivariable logistic regression was used to determine predictors of functional survival at hospital discharge. There were 20,165 OHCA treated by EMS and 871 patients were eligible for TTM. Of these patients, 622 (71.4%) survived to hospital discharge and 487 (55.9%) had good functional survival. Good functional survival was associated with younger age (OR 0.94; 95% CI 0.93-0.95), shorter times from collapse to initial defibrillation (OR 0.73; 95% CI 0.65-0.82), and use of post-cardiac arrest TTM (OR 1.49; 95% CI 1.07-2.30). Functional survival decreased during each phase of the model (65.3% vs. 61.7% vs. 50.2%, P<0.001). Functional survival at hospital discharge was associated with shorter times to initial defibrillation and was decreased during each successive phase of the 3-phase model. Post-cardiac arrest TTM was associated with improved functional survival. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Post-discharge supplementation of vitamins and minerals for preterm neonates.

PubMed

Dall'Agnola, Alberto; Beghini, Lorenzo

2009-10-01

Ninety percent of premature babies has nutritional deficiency at discharge. It is very important that not only carbohydrates, proteins, fats, but also mineral salts, and vitamins are in quantities and adequate quality according to the needs of the various scientific neonatal and nutrition programs so as to avoid any shortcomings or excess. The growth, neurodevelopmental outcome and quality of life depend on, among other factors, an adequate nutritional supply with essential nutrients including minerals. It is now recommended that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth. The standard initial dose of vitamin K1 for full term infants (1.0 mg) may be too high for premature infants. The addition of folate and especially vitamin B-12 with formula feedings, provided an effective and nontoxic means of reducing anemia of prematurity. Several investigators have reported higher plasma concentrations of selenium and glutathione peroxidase in preterm infants fed with selenium-supplemented formula than in infants fed with unsupplemented formula.

A descriptive study of urethral discharge among men in Fiji.

PubMed

Gaunavinaka, Lavenia; Balak, Dashika; Varman, Sumanthla; Ram, Sharan; Graham, Stephen M

2014-10-17

Urethral discharge is a common presentation of sexually transmitted infection (STI) in men and known pathogens include Neisseria gonorrhoeae and Chlamydia trachomatis. There are no published data of the burden of urethral discharge among men in Fiji. To evaluate urethral discharge among men to determine the incidence, the frequency of recurrence and reported at-risk behaviour. We conducted a retrospective, descriptive study of clinical records of all men presenting with urethral discharge to two major reproductive health clinics. Data collected included self-reported at-risk behaviours, results of abnormal syphilis serology and antibiotics prescribed. The frequency of recurrence in the following 1-2 years of initial presentation was determined along with microbiological findings from urethral swab in this group. A total of 748 males presented with urethral discharge to the clinic in one year. This represents an incidence rate of at least 295 per 100,000 adult males per year in the study population. Within the next 1-2 years of the initial presentation, 102 (14%) of these re-presented out of which 42 had urethral swab taken for etiological diagnosis. The commonest isolate was Neisseria gonorrhoeae. Results of syphilis tests were available for 560 (75%) of patients and 29 (5%) were positive. Recurrence was not associated with self-reported at-risk behaviours. The incidence of urethral discharge among males in Fiji is very high and prevention strategies are urgently needed.

Three-electrode low pressure discharge apparatus and method for uniform ionization of gaseous media

DOEpatents

McLellan, Edward J.

1983-01-01

Uniform, transverse electrical discharges are produced in gaseous media without the necessity of switching the main discharge voltage with an external device which carries the entire discharge current. A three-electrode low pressure discharge tube is charged across its anode (1) and cathode (2) to below breakdown voltage using a dc voltage source (3). An array of resistors (4) or capacitors can be made to discharge to the wire screen anode by means of a low energy high voltage pulse circuit (5) producing sufficient preionization in the region between the anode and cathode to initiate and control the main discharge. The invention has been demonstrated to be useful as a CO.sub.2 laser oscillator and pulse-smoother. It can be reliably operated in the sealed-off mode.

Yield of H2O2 in Gas-Liquid Phase with Pulsed DBD

NASA Astrophysics Data System (ADS)

Jiang, Song; Wen, Yiyong; Liu, Kefu

2014-01-01

Electric discharge in water can generate a large number of oxidants such as ozone, hydrogen peroxide and hydroxyl radicals. In this paper, a non-thermal plasma processing system was established by means of pulsed dielectric barrier discharge in gas-liquid phase. The electrodes of discharge reactor were staggered. The yield of H2O2 was enhanced after discharge. The effects of discharge time, discharge voltage, frequency, initial pH value, and feed gas were investigated. The concentration of hydrogen peroxide and ozone was measured after discharge. The experimental results were fully analyzed. The chemical reaction equations in water were given as much as possible. At last, the water containing Rhodamine B was tested in this system. The degradation rate came to 94.22% in 30 min.

Saltstone SDU6 Modeling Study

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Si Y.; Hyun, Sinjae

2013-01-10

A new disposal unit, designated as Saltstone Disposal Unit 6 (SDU6), is being designed for support of site accelerated closure goals and salt waste projections identified in the new Liquid Waste System Plan. The unit is a cylindrical disposal cell of 375 ft in diameter and 43 ft in height, and it has a minimum 30 million gallons of capacity. SRNL was requested to evaluate the impact of an increased grout placement height on the flow patterns radially spread on the floor and to determine whether grout quality is impacted by the height. The primary goals of the work aremore » to develop the baseline Computational Fluid Dynamics (CFD) model and to perform the evaluations for the flow patterns of grout material in SDU6 as a function of elevation of grout discharge port and grout rheology. Two transient grout models have been developed by taking a three-dimensional multiphase CFD approach to estimate the domain size of the grout materials radially spread on the facility floor and to perform the sensitivity analysis with respect to the baseline design and operating conditions such as elevation height of the discharge port and fresh grout properties. For the CFD modeling calculations, air-grout Volume of Fluid (VOF) method combined with Bingham plastic and time-dependent grout models were used for examining the impact of fluid spread performance for the initial baseline configurations and to evaluate the impact of grout pouring height on grout quality. The grout quality was estimated in terms of the air volume fraction for the grout layer formed on the SDU6 floor, resulting in the change of grout density. The study results should be considered as preliminary scoping analyses since benchmarking analysis is not included in this task scope. Transient analyses with the Bingham plastic model were performed with the FLUENTTM code on the high performance parallel computing platform in SRNL. The analysis coupled with a transient grout aging model was performed by using ANSYS-CFX code in the parallel computing platform in Mercer University. Recommended operational guidance was developed assuming that local shear rates and flow patterns related to radial spread along the SDU floor can be used as a measure of grout performance and spatial dispersion affected by the grout height and viscosity. The 5 ft height baseline results show that when the 150 gpm grout flow with a 5 Pa yield stress and a 60 cp viscosity is poured down through a 3 inch discharge port, the grout is spread radially up to about 64 ft distance from the pouring center after 2 hours' pouring time. The air volume fraction of the grout layer is about 29% at 5 minutes' transient time, and it is reduced by about 9% in 2 hours' pouring time, resulting in the grout density consisting of about 80% grout and 20% air volume fractions. The sensitivity results show that when the discharge port is located at a higher position, a larger amount of air is trapped inside the layer formed below the discharge port at the early transient time of less than 30 minutes because of the higher impinging momentum of the grout flow on the floor, resulting in the formation of less smooth layer. The results clearly indicate that the radial spread for the 43 ft discharge port is about 10% faster than that of the 5 ft discharge port for the early transient period of 5 minutes. However, for the pouring time longer than half an hour, the discharge port height does not affect the radial distance spread on the disposal floor. When grout quality is related to grout volume fraction, the grout volume fraction for the 43 ft discharge port has lower volume fraction than the 5 ft discharge port for the transient period of the first 5 minutes. However, for the pouring time longer than half an hour, the discharge port height does not affect the grout volume fraction for the layer accumulated on the disposal floor. A modified Bingham plastic model coupled with time-dependent viscosity behavior was developed for conducting the initial scoping calculations to assess the impact of fluid residence time on radial spreading and basic flow patterns. The results for the transient viscosity model show that when grout material becomes more viscous, the thickness of the grout layer accumulated on the floor becomes higher, but the radial distance spread on the horizontal floor becomes smaller. The early transient results for the grout density with about 32% air volume fractions are in reasonable agreement with those of the idealized Bingham plastic model. It is recommended that the current models developed here be benchmarked against the experimental results for critical applications of the modeling results.« less

Modeling carbonaceous particle formation in an argon graphite cathode dc discharge

NASA Astrophysics Data System (ADS)

Michau, A.; Lombardi, G.; Colina Delacqua, L.; Redolfi, M.; Arnas, C.; Bonnin, X.; Hassouni, K.

2010-12-01

We develop a model for the nucleation, growth and transport of carbonaceous dust particles in a non-reactive gas dc discharge where the carbon source is provided by cathode sputtering. We consider only the initial phase of the discharge when the dust charge density remains small with respect to the electron density. We find that an electric field reversal at the entrance of the negative glow region promotes trapping of negatively charged clusters and dust particles, confining them for long times in the plasma and favoring molecular growth. An essential ingredient for this process is electron attachment, which negatively charges the initially neutral clusters. We perform sensitivity studies on several number parameters: size of the largest molecular edifice, sticking coefficient, etc.

A prospective evaluation of missed injuries in trauma patients, before and after formalising the trauma tertiary survey.

PubMed

Keijzers, Gerben B; Campbell, Don; Hooper, Jeffrey; Bost, Nerolie; Crilly, Julia; Steele, Michael Craig; Del Mar, Chris; Geeraedts, Leo M G

2014-01-01

This study prospectively evaluated in-hospital and postdischarge missed injury rates in admitted trauma patients, before and after the formalisation of a trauma tertiary survey (TTS) procedure. Prospective before-and-after cohort study. TTS were formalised in a single regional level II trauma hospital in November 2009. All multitrauma patients admitted between March-October 2009 (preformalisation of TTS) and December 2009-September 2010 (post-) were assessed for missed injury, classified into three types: Type I, in-hospital, (injury missed at initial assessment, detected within 24 h); Type II, in-hospital (detected in hospital after 24 h, missed at initial assessment and by TTS); Type III, postdischarge (detected after hospital discharge). Secondary outcome measures included TTS performance rates and functional outcomes at 1 and 6 months. A total of 487 trauma patients were included (pre-: n = 235; post-: n = 252). In-hospital missed injury rate (Types I and II combined) was similar for both groups (3.8 vs. 4.8 %, P = 0.61), as were postdischarge missed injury rates (Type III) at 1 month (13.7 vs. 11.5 %, P = 0.43), and 6 months (3.8 vs. 3.3 %, P = 0.84) after discharge. TTS performance was substantially higher in the post-group (27 vs. 42 %, P < 0.001). Functional outcomes for both cohorts were similar at 1 and 6 months follow-up. This is the first study to evaluate missed injury rates after hospital discharge and demonstrated cumulative missed injury rates >15 %. Some of these injuries were clinically relevant. Although TTS performance was significantly improved by formalising the process (from 27 to 42 %), this did not decrease missed injury rates.

Impact of case volume on outcome and performance of targeted temperature management in out-of-hospital cardiac arrest survivors.

PubMed

Lee, Seung Joon; Jeung, Kyung Woon; Lee, Byung Kook; Min, Yong Il; Park, Kyu Nam; Suh, Gil Joon; Kim, Kyung Su; Kang, Gu Hyun

2015-01-01

This study aimed to determine the effect of case volume on targeted temperature management (TTM) performance, incidence of adverse events, and neurologic outcome in comatose out-of-hospital cardiac arrest (OHCA) survivors treated with TTM. We used a Web-based, multicenter registry (Korean Hypothermia Network registry), to which 24 hospitals throughout the Republic of Korea participated to study adult (≥18 years) comatose out-of-hospital cardiac arrest patients treated with TTM between 2007 and 2012. The primary outcome was neurologic outcome at hospital discharge. The secondary outcomes were inhospital mortality, TTM performance, and adverse events. We extracted propensity-matched cohorts to control for bias. Multivariate logistic regression analysis was performed to assess independent risk factors for neurologic outcome. A total of 901 patients were included in this study; 544 (60.4%) survived to hospital discharge, and 248 (27.5%) were discharged with good neurologic outcome. The high-volume hospitals initiated TTM significantly earlier and had lower rates of hyperglycemia, bleeding, hypotension, and rebound hyperthermia. However, neurologic outcome and inhospital mortality were comparable between high-volume (27.7% and 44.6%, respectively) and low-volume hospitals (21.1% and 40.5%) in the propensity-matched cohorts. The adjusted odds ratio for the high-volume hospitals compared with low-volume hospitals was 1.506 (95% confidence interval, 0.875-2.592) for poor neurologic outcome. Higher TTM case volume was significantly associated with early initiation of TTM and lower incidence of adverse events. However, case volume had no association with neurologic outcome and inhospital mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

Implementation and Initial Validation of a 100-Kilowatt Class Nested-Channel Hall Thruster

NASA Technical Reports Server (NTRS)

Hall, Scott J.; Florenz, Roland E.; Gallimore, Alec D.; Kamhawi, Hani; Brown, Daniel L.; Polk, James E.; Goebel, Dan; Hofer, Richard R.

2014-01-01

The X3 is a 100-kilowatt class nested-channel Hall thruster developed by the Plasmadynamics and Electric Propulsion Laboratory at the University of Michigan in collaboration with the Air Force Research Laboratory and NASA. The cathode, magnetic circuit, boron nitride channel rings, and anodes all required specific design considerations during thruster development, and thermal modeling was used to properly account for thermal growth in material selection and component design. A number of facility upgrades were required at the University of Michigan to facilitate operation of the X3. These upgrades included a re-worked propellant feed system, a completely redesigned power and telemetry break-out box, and numerous updates to thruster handling equipment. The X3 was tested on xenon propellant at two current densities, 37% and 73% of the nominal design value. It was operated to a maximum steady-state discharge power of 60.8 kilowatts. The tests presented here served as an initial validation of thruster operation. Thruster behavior was monitored with telemetry, photography and high-speed current probes. The photography showed a uniform plume throughout testing. At constant current density, reductions in mass flow rate of 18% and 26% were observed in the three-channel operating configuration as compared to the superposition of each channel running individually. The high-speed current probes showed that the thruster was stable at all operating points and that the channels influence each other when more than one is operating simultaneously. Additionally, the ratio of peak-to-peak AC-coupled discharge current oscillations to mean discharge current did not exceed 51% for any operating points reported here, and did not exceed 17% at the higher current density.

Acceleration Modes and Transitions in Pulsed Plasma Accelerators

NASA Technical Reports Server (NTRS)

Polzin, Kurt A.; Greve, Christine M.

2018-01-01

Pulsed plasma accelerators typically operate by storing energy in a capacitor bank and then discharging this energy through a gas, ionizing and accelerating it through the Lorentz body force. Two plasma accelerator types employing this general scheme have typically been studied: the gas-fed pulsed plasma thruster and the quasi-steady magnetoplasmadynamic (MPD) accelerator. The gas-fed pulsed plasma accelerator is generally represented as a completely transient device discharging in approximately 1-10 microseconds. When the capacitor bank is discharged through the gas, a current sheet forms at the breech of the thruster and propagates forward under a j (current density) by B (magnetic field) body force, entraining propellant it encounters. This process is sometimes referred to as detonation-mode acceleration because the current sheet representation approximates that of a strong shock propagating through the gas. Acceleration of the initial current sheet ceases when either the current sheet reaches the end of the device and is ejected or when the current in the circuit reverses, striking a new current sheet at the breech and depriving the initial sheet of additional acceleration. In the quasi-steady MPD accelerator, the pulse is lengthened to approximately 1 millisecond or longer and maintained at an approximately constant level during discharge. The time over which the transient phenomena experienced during startup typically occur is short relative to the overall discharge time, which is now long enough for the plasma to assume a relatively steady-state configuration. The ionized gas flows through a stationary current channel in a manner that is sometimes referred to as the deflagration-mode of operation. The plasma experiences electromagnetic acceleration as it flows through the current channel towards the exit of the device. A device that had a short pulse length but appeared to operate in a plasma acceleration regime different from the gas-fed pulsed plasma accelerators was developed by Cheng, et al. The Coaxial High ENerGy (CHENG) thruster operated on the 10-microseconds timescales of pulsed plasma thrusters, but claimed high thrust density, high efficiency and low electrode erosion rates, which are more consistent with the deflagration mode of acceleration. Separate work on gas-fed pulsed plasma thrusters (PPTs) by Ziemer, et al. identified two separate regimes of performance. The regime at higher mass bits (termed Mode I in that work) possessed relatively constant thrust efficiency (ratio of jet kinetic energy to input electrical energy) as a function of mass bit. In the second regime at very low mass bits (termed Mode II), the efficiency increased with decreasing mass bit. Work by Poehlmann et al. and by Sitaraman and Raja sought to understand the performance of the CHENG thruster and the Mode I / Mode II performance in PPTs by modeling the acceleration using the Hugoniot Relation, with the detonation and deflagration modes representing two distinct sets of solutions to the relevant conservation laws. These works studied the proposal that, depending upon the values of the various controllable parameters, the accelerator would operate in either the detonation or deflagration mode. In the present work, we propose a variation on the explanation for the differences in performance between the various pulsed plasma accelerators. Instead of treating the accelerator as if it were only operating in one mode or the other during a pulse, we model the initial stage of the discharge in all cases as an accelerating current sheet (detonation mode). If the current sheet reaches the exit of the accelerator before the discharge is completed, the acceleration mode transitions to the deflagration mode type found in the quasi-steady MPD thrusters. This modeling method is used to demonstrate that standard gas-fed pulsed plasma accelerators, the CHENG thruster, and the quasi-steady MPD accelerator are variations of the same device, with the overall acceleration of the plasma depending upon the behavior of the plasma discharge during initial transient phase and the relative lengths of the detonation and deflagration modes of operation.

Plasma Assisted Ignition and Combustion at Low Initial Gas Temperatures: Development of Kinetic Mechanism

DTIC Science & Technology

2016-10-05

of these species experimentally challenging. In these cases , TALIF is a good alternative. The energy levels used in this study are shown in Fig. 2.1...flame velocities achieved in lean mixtures (ER=0.5 in our experimental case ) can be an interesting issue for industrial applications. One of the possible...dielectric barrier discharge (nSDBD) was studied experimentally at high initial pressures P = 3 − 6 bar. The discharge was studied in different gas mixtures

Fundamental studies on initiation and evolution of multi-channel discharges and their application to next generation pulsed power machines.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schwarz, Jens; Savage, Mark E.; Lucero, Diego Jose

Future pulsed power systems may rely on linear transformer driver (LTD) technology. The LTD's will be the building blocks for a driver that can deliver higher current than the Z-Machine. The LTD's would require tens of thousands of low inductance ( %3C 85nH), high voltage (200 kV DC) switches with high reliability and long lifetime ( 10 4 shots). Sandia's Z-Machine employs 36 megavolt class switches that are laser triggered by a single channel discharge. This is feasible for tens of switches but the high inductance and short switch life- time associated with the single channel discharge are undesirable formore » future machines. Thus the fundamental problem is how to lower inductance and losses while increasing switch life- time and reliability. These goals can be achieved by increasing the number of current-carrying channels. The rail gap switch is ideal for this purpose. Although those switches have been extensively studied during the past decades, each effort has only characterized a particular switch. There is no comprehensive understanding of the underlying physics that would allow predictive capability for arbitrary switch geometry. We have studied rail gap switches via an extensive suite of advanced diagnostics in synergy with theoretical physics and advanced modeling capability. Design and topology of multichannel switches as they relate to discharge dynamics are investigated. This involves electrically and optically triggered rail gaps, as well as discrete multi-site switch concepts.« less

Improvement in Total Joint Replacement Quality Metrics: Year One Versus Year Three of the Bundled Payments for Care Improvement Initiative.

PubMed

Dundon, John M; Bosco, Joseph; Slover, James; Yu, Stephen; Sayeed, Yousuf; Iorio, Richard

2016-12-07

In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge. The goal for this initiative is to improve patient care and quality through a patient-centered approach with increased care coordination supported through payment innovation. Length of stay (LOS), readmissions, discharge disposition, and cost per episode of care were analyzed for year 3 compared with year 1 of the initiative. Multiple programs were implemented after the first year to improve performance metrics: a surgeon-directed preoperative risk-factor optimization program, enhanced care coordination and home services, a change in venous thromboembolic disease (VTED) prophylaxis to a risk-stratified protocol, infection-prevention measures, a continued emphasis on discharge to home rather than to an inpatient facility, and a quality-dependent gain-sharing program among surgeons. There were 721 Medicare primary total joint arthroplasty patients in year 1 and 785 in year 3; their data were compared. The average hospital LOS decreased from 3.58 to 2.96 days. The rate of discharge to an inpatient facility decreased from 44% to 28%. The 30-day all-cause readmission rate decreased from 7% to 5%; the 60-day all-cause readmission rate decreased from 11% to 6%; and the 90-day all-cause readmission rate decreased from 13% to 8%. The average 90-day cost per episode decreased by 20%. Mid-term results from the implementation of Medicare BPCI Model 2 for primary total joint arthroplasty demonstrated decreased LOS, decreased discharges to inpatient facilities, decreased readmissions, and decreased cost of the episode of care in year 3 compared with year 1, resulting in increased value to all stakeholders involved in this initiative and suggesting that continued improvement over initial gains is possible.

Implications of arcing due to spacecraft charging on spacecraft EMI margins of immunity

NASA Technical Reports Server (NTRS)

Inouye, G. T.

1981-01-01

Arcing due to spacecraft charging on spacecraft EMI margins of immunity was determined. The configuration of the P78-2 spacecraft of the SCATHA program was analyzed. A brushfire arc discharge model was developed, and a technique for initiating discharges with a spark plug trigger was for data configuration. A set of best estimate arc discharge parameters was defined. The effects of spacecraft potentials in limiting the discharge current blowout component are included. Arc discharge source models were incorporated into a SEMCAP EMI coupling analysis code for the DSP spacecraft. It is shown that with no mission critical circuits will be affected.

Alternate charging and discharging of capacitor to enhance the electron production of bioelectrochemical systems.

PubMed

Liang, Peng; Wu, Wenlong; Wei, Jincheng; Yuan, Lulu; Xia, Xue; Huang, Xia

2011-08-01

A bioelectrochemical system (BES) can be operated in both "microbial fuel cell" (MFC) and "microbial electrolysis cell" (MEC) modes, in which power is delivered and invested respectively. To enhance the electric current production, a BES was operated in MFC mode first and a capacitor was used to collect power from the system. Then the charged capacitor discharged electrons to the system itself, switching into MEC mode. This alternate charging and discharging (ACD) mode helped the system produce 22-32% higher average current compared to an intermittent charging (IC) mode, in which the capacitor was first charged from an MFC and then discharged to a resistor, at 21.6 Ω external resistance, 3.3 F capacitance and 300 mV charging voltage. The effects of external resistance, capacitance and charging voltage on average current were studied. The average current reduced as the external resistance and charging voltage increased and was slightly affected by the capacitance. Acquisition of higher average current in the ACD mode was attributed to the shorter discharging time compared to the charging time, as well as a higher anode potential caused by discharging the capacitor. Results from circuit analysis and quantitatively calculation were consistent with the experimental observations.

Distinct Facets of Impulsivity Exhibit Differential Associations with Substance Use Disorder Treatment Processes: A Cross-Sectional and Prospective Investigation Among Military Veterans

PubMed Central

Heinz, Adrienne J.; Bui, Leena; Thomas, Katherine M.; Blonigen, Daniel M.

2015-01-01

Impulsivity, a multi-faceted construct characterized by rash, unplanned actions and a disregard for long-term consequences, is associated with poor substance use disorder (SUD) treatment outcomes. Little is known though about the influence of impulsivity on treatment process variables critical for initiating and maintaining behavioral change. This knowledge gap is important as different aspects of impulsivity may be susceptible to diverse cognitive, behavioral and pharmacological influences. The present study examined two distinct facets of impulsivity (lack of planning and immoderation - a proxy of urgency) as predictors of processes that impact SUD treatment success (active coping, avoidant coping, self-efficacy, and interpersonal problems). Participants were 200 Veterans who completed impulsivity and treatment process assessments upon entering a SUD treatment program and treatment process assessments at treatment discharge. Results from multivariate models revealed that lack of planning was associated with lower active coping and higher avoidant coping and interpersonal problems at intake, though not with lower self-efficacy to abstain from substances. Immoderation was associated with higher avoidant coping and lower self-efficacy to abstain from substances at intake, but not with lower active coping or higher interpersonal problems. Higher immoderation, but not lack of planning, predicted lower self-efficacy to abstain from substances at treatment discharge. These findings suggest that different facets of impulsivity confer risk for different SUD treatment process indicators and that clinicians should consider the behavioral expression of patients’ impulse control problems in treatment planning and delivery. PMID:25770869

Modes of Ignition of Powder Layers of Nanocomposite Thermites by Electrostatic Discharge

NASA Astrophysics Data System (ADS)

Monk, I.; Schoenitz, M.; Dreizin, E. L.

2017-01-01

Nanocomposite powders with aluminum as a fuel and oxides of molybdenum, copper, bismuth, and iron as oxidizers were prepared by arrested reactive milling. The powders were placed in 0.5-mm-thick layers and ignited by electrostatic discharge (ESD) in air. In different tests, time-resolved light emission was recorded at 568 nm or in the range of 373-641 nm. The amount of material consumed was recorded as well. Time-resolved temperatures were determined. Two distinct ignition regimes were observed. Prompt ignition occurred within 10 µs of the electric discharge, comparable to what had previously been observed for corresponding powder monolayers. This ignition mode was observed for composites with Bi2O3 and Fe2O3 ignited with a 12-kV discharge, whereas it only occurred at higher spark voltage (20 kV) and energy for CuO and MoO3 composites. Delayed ignition, occurring after 0.1-1 ms following the discharge, was observed for all composites with consistently stronger light emission. Analysis of quenched, partially burned particles showed that the original nanostructure was preserved after prompt ignition but not after delayed ignition. It is proposed that prompt ignition represents direct ESD initiation of composite particles rapidly and adiabatically preheated to high temperatures while keeping the nanostructure intact, resulting in a heterogeneous reaction consuming most of the aluminum. Delayed ignition occurs when particles preheated to lower temperatures start oxidizing at much lower rates, leading to cloud combustion, in which thermal interaction between individual aerosolized burning particles is substantial. During this process, the nanostructure may be lost. Temperature measurements show that nanocomposites with CuO and MoO3 burned superadiabatically with flame temperatures exceeding thermodynamic predictions.

Phenomena of oscillations in atmospheric pressure direct current glow discharges

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Fu-cheng; Yan, Wen; Wang, De-zhen

2013-12-15

Self-sustained oscillations in a dc glow discharge with a semiconductor layer at atmospheric pressure were investigated by means of a one-dimensional fluid model. It is found that the dc glow discharge initially becomes unstable in the subnormal glow region and gives rise to oscillations of plasma parameters. A variety of oscillations with one or more frequencies have been observed under different conditions. The discharge oscillates between the glow discharge mode and the Townsend discharge mode in the oscillations with large amplitude while operates in the subnormal glow discharge mode all the while in the oscillations with small amplitude. Fourier Transformmore » spectra of oscillations reveal the transition mechanism between different oscillations. The effects of semiconductor conductivity on the oscillation frequency of the dominant mode, gas voltage, as well as the discharge current have also been analyzed.« less

Synthesis and Electrochemical Properties of LiFePO4/C for Lithium Ion Batteries.

PubMed

Gao, Hong; Wang, Jiazhao; Yin, Shengyu; Zheng, Hao; Wang, Shengfu; Feng, Chuanqi; Wang, Shiquan

2015-03-01

LiFePO4/C was prepared through a facile rheological phase reaction method by using Fe3(PO4)2, Li3PO4 · 8H2O, and glucose as reactants. The LiFePO4/C samples were characterized by X-ray diffraction, scanning electron microscopy, and thermogravimetric analysis. The electrochemical properties of the samples were investigated. The results show that the LiFePO4/C samples have single-phase olivine-type structure, and their particles feature a spherical shape. The carbon coating on the particles of LiFePO4 is about 1.8% of the LiFePO4/C by weight. The particle size was distributed from 0.2 to 1 µm. The initial discharge capacity of LiFePO4/C reached 154 mA h/g at 0.1 C. The retained discharge capacity of LiFePO4/C was 152.9 mA h g(-1) after 50 cycles. The LiFePO4/C also showed better cycling performance than that of the bare LiPeO4 at a higher charge/discharge rate (1 C). The LIFePO4/C prepared in this way could be a promising cathode material for lithium ion battery application.

Enteral Feeding With Human Milk Decreases Time to Discharge in Infants Following Gastroschisis Repair

PubMed Central

Gulack, Brian C.; Laughon, Matthew M.; Clark, Reese H.; Burgess, Terrance; Robinson, Sybil; Muhammad, Abdurrauf; Zhang, Angela; Davis, Adrienne; Morton, Robert; Chu, Vivian H.; Arnold, Christopher J.; Hornik, Christoph P.; Smith, P. Brian

2015-01-01

Objective We reviewed a multi-institutional database to assess the effect of enteral feeding with human milk on duration from initiation of feeds to discharge after gastroschisis repair. Study design Infants who had gastroschisis repair between 1997 and 2012 with data recorded in the Pediatrix Medical Group Clinical Data Warehouse were categorized into 4 groups based on the percentage of days they were fed human milk out of the number of days they were fed enterally. Cox proportional hazards regression modeling was performed to determine the adjusted effect of human milk on duration from initiation of feeds to discharge. Results Of 3082 infants, 659 (21%) were fed human milk on 0% of enteral feeding days, 766 (25%) on 1–50% of enteral feeding days, 725 (24%) on 51–99% of enteral feeding days, and 932 (30%) on 100% of enteral feeding days. Following adjustment, being fed human milk on 0% of enteral feeding days was associated with a significantly increased time to discharge compared with being fed human milk on 100% of enteral feeding days (HR for discharge per day: 0.46, 95% CI: 0.40–0.52). The same was found for infants fed human milk on 1–50% of enteral feeding days (HR: 0.37, 95% CI: 0.32–0.41) and for infants fed human milk on 51–99% of enteral feeding days (HR: 0.51, 95% CI: 0.46–0.57). Conclusion The use of human milk for enteral feeding of infants following repair of gastroschisis significantly reduces the time to discharge from initiation of feeds. PMID:26703875

Enteral Feeding with Human Milk Decreases Time to Discharge in Infants following Gastroschisis Repair.

PubMed

Gulack, Brian C; Laughon, Matthew M; Clark, Reese H; Burgess, Terrance; Robinson, Sybil; Muhammad, Abdurrauf; Zhang, Angela; Davis, Adrienne; Morton, Robert; Chu, Vivian H; Arnold, Christopher J; Hornik, Christoph P; Smith, P Brian

2016-03-01

To assess the effect of enteral feeding with human milk on the time from initiation of feeds to discharge after gastroschisis repair through review of a multi-institutional database. Infants who underwent gastroschisis repair between 1997 and 2012 with data recorded in the Pediatrix Medical Group Clinical Data Warehouse were categorized into 4 groups based on the percentage of days fed human milk out of the number of days fed enterally. Cox proportional hazards regression modeling was performed to determine the adjusted effect of human milk on the time from initiation of feeds to discharge. Among 3082 infants, 659 (21%) were fed human milk on 0% of enteral feeding days, 766 (25%) were fed human milk on 1%-50% of enteral feeding days, 725 (24%) were fed human milk on 51%-99% of enteral feeding days, and 932 (30%) were fed human milk on 100% of enteral feeding days. Following adjustment, being fed human milk on 0% of enteral feeding days was associated with a significantly increased time to discharge compared with being fed human milk on 100% of enteral feeding days (hazard ratio [HR] for discharge per day, 0.46; 95% CI, 0.40-0.52). The same was found for infants fed human milk on 1%-50% of enteral feeding days (HR, 0.37; 95% CI, 0.32-0.41) and for infants fed human milk on 51%-99% of enteral feeding days (HR, 0.51; 95% CI, 0.46-0.57). The use of human milk for enteral feeding of infants following repair of gastroschisis significantly reduces the time to discharge from initiation of feeds. Copyright © 2016 Elsevier Inc. All rights reserved.

Predictors and outcome of discharge against medical advice from the psychiatric units of a general hospital.

PubMed

Pages, K P; Russo, J E; Wingerson, D K; Ries, R K; Roy-Byrne, P P; Cowley, D S

1998-09-01

The study examined predictors of discharge against medical advice (AMA) and outcomes of psychiatric patients with AMA discharges, as measured by poorer symptom ratings at discharge and higher rates of rehospitalization. A total of 195 patients discharged AMA from general hospital psychiatric units were compared retrospectively with 2,230 regularly discharged patients. AMA status was defined as signing out against medical advice, being absent without leave, or being administratively discharged. All patients received standardized assessments within 24 hours of admission and at discharge. Demographic characteristics, psychiatric history, DSA-IV psychiatric and substance use diagnoses, and scores on an expanded 32-item version of the Psychiatric Symptom Assessment Scale were compared. The groups did not differ in primary psychiatric diagnoses. Patients discharged AMA were significantly less likely to be Caucasian or to be functionally impaired due to physical illness. They were more likely to live alone, have a substance use diagnosis, use more psychoactive substances, and have more previous hospitalizations. Patients discharged AMA had significantly shorter lengths of stay, higher rehospitalization rates, and more severe symptoms at discharge, even when length of stay was taken into account. The differences between the groups in male gender and young age were better accounted for by a greater likelihood of substance abuse in these groups. The results suggest a profile of patients who may be discharged AMA. Such patients have worse outcomes and are more likely to be high utilizers of inpatient resources. Aggressive identification of patients likely to be discharged AMA and early discharge planning for appropriate outpatient treatment are recommended.

The Role of Climatic Conditions in Controlling Observed Variability of Timing and Peak Discharge of Glacial Lake Outburst Floods: Lago Cachet Dos, Chile

NASA Astrophysics Data System (ADS)

Jacquet, J.; McCoy, S. W.; McGrath, D.; Nimick, D.; Friesen, B.; Fahey, M. J.; Leidich, J.; Okuinghttons, J.

2016-12-01

The sudden release of water from an ice-dammed lake poses substantial hazard to the downstream environment, but predicting the timing and magnitude of such an event is difficult. We use a series of high-resolution discharge measurements from a glacier-dammed lake, Lago Cachet Dos (LC2), during outburst events to evaluate the environmental conditions that influence the timing of initiation and peak discharge of observed glacial lake outburst floods (GLOFs). Since April 2008, 20 GLOFs have initiated out of LC2, located on the eastern edge of the Northern Patagonia Icefield, Chile and flooded areas along the Rio Colonia- Rio Baker system. GLOF frequency has averaged 2-3 events annually and peak discharges exiting LC2 have ranged widely from 2,000 to >15,000 m3 s-1. Although some LC2 GLOFs are consistent with global compilations relating peak discharge to lake volume, large deviations from the global trend and large intra-event variability are striking and call into question the predictive ability of simple empirical scaling equations. To evaluate the environmental conditions that lead to variability in observed peak discharge, we use a variation of the theoretical model of Nye (1976), which describes the process of englacial conduit evolution as a competition between thermally induced conduit growth and viscous flow of ice causing conduit collapse. We show that, consistent with theory, initial lake volume, lake temperature, and the rate of meltwater input into the glacially dammed lake all influence the peak discharge of measured GLOFs. Consequently, evolving climatic conditions of a region can greatly influence the potential hazard of GLOFs. Our results suggest that more accurate predictions of GLOF timing and magnitude from ice dammed lakes can be made by incorporating additional measurements of environmental conditions.

Some Factors Affecting the Reproducibility of Penetration and the Cut-Off of Oil Sprays for Fuel-injection Engines

NASA Technical Reports Server (NTRS)

Beardsley, E G

1928-01-01

This investigation was undertaken at the Langley Memorial Aeronautical Laboratory in connection with a general research on fuel-injection for aircraft. The purpose of the investigation was to determine the factors controlling the reproducibility of spray penetration and secondary discharges after cut-off. The development of single sprays from automatic injection valves was recorded by means of special high-speed photographic apparatus capable of taking 25 consecutive pictures of the moving spray at a rate of 4,000 per second. The effect of two types of injection valves, injection-valve tube length, initial pressure in the injection-valve tube, speed of the injection control mechanism, and time of spray cut-off, on the reproducibility of spray penetration, and on secondary discharges were investigated. It was found that neither type of injection valve materially affected spray reproducibility. The initial pressure in the injection-valve tube controlled the reproducibility of spray penetrations. An increase in the initial pressure or in the length of the injection-valve tube slightly increased the spray penetration within the limits of this investigation. The speed of the injection-control mechanism did not affect the penetration. Analysis of the results indicates that secondary discharges were caused in this apparatus by pressure waves initiated by the rapid opening of the cut-off valve. The secondary discharges were eliminated in this investigation by increasing the length of the injection-valve tube. (author)

Simulation of Soil Wetting Patterns in Drip and Subsurface Irrigation. Effects in Design and Irrigation Management Variables.

NASA Astrophysics Data System (ADS)

Rodríguez-Sinobas, L.; Gil-Rodríguez, M.; Sánchez, R.; Losada, A.; Castañón, G.; Juana, L.; Laguna, F. V.; Benítez, J.

2010-05-01

Conventional drip irrigation is considered one of the most efficient irrigation systems. Alternatively to traditional surface drip irrigation systems (DI), laterals are deployed underneath the soil surface, as in subsurface drip irrigation (SDI), leading to a higher potential efficiency, which is of especial interest in places where water is a limited source. The design and management of DI and SDI systems involve selection of an appropriate combination of emitter discharge rate and spacing between emitters and the inlet pressure and irrigation time for any given set of soil, crop, and climatic conditions, as well as understanding the wetted zone pattern around the emitter. Likewise, water distribution is affected by soil hydraulic properties, initial water content, emitter discharge, irrigation frequency, evapotranspiration and root characteristics. However, complexity arousing of soil water properties and soil profile characteristics means that these are often not properly considered in the design and management of those systems. A better understanding of the infiltration process around the discharge point source should contribute to increase water use efficiency and thus to reduce the risk of environmental impact of irrigation. In this regard, numerical models have been proved to be a powerful tool to analyze the evolution of the wetting pattern during the distribution and redistribution processes, in order to explore irrigation management strategies, to set up the duration of irrigation, and finally to optimize water use efficiency. Also, irrigation design variables such as emitter spacing and discharge could also be assessed. In this study the suitability of the HYDRUS-2D to simulate infiltration process around an emitter during irrigation of a loamy soil with drip and SDI laterals has been addressed. The model was then applied in order to evaluate the main dimensions of the wetted soil volume surrounding the emitter during irrigation. Irrigation uniformity with DI and SDI laterals were determined by field evaluations at different inlet head pressures. Results were related with estimations made on water distribution within the soil that were simulated taking into account the emitter discharge at different lateral locations, initial soil water content, soil hydraulic properties and time of irrigation. Conclusions highlight the effect of emitter discharge, emitter spacing, and irrigation time on wetting patterns, and thus solute transport, in both drip and subsurface drip irrigation. The effect of emitter depth was also considered in SDI. Some recommendations for the design and management of these irrigation systems are also provided.

Performance, Facility Pressure Effects, and Stability Characterization Tests of NASA's Hall Effect Rocket with Magnetic Shielding Thruster

NASA Technical Reports Server (NTRS)

Kamhawi, Hani; Huang, Wensheng; Haag, Thomas; Yim, John; Herman, Daniel; Peterson, Peter Y.; Williams, George J.; Gilland, James; Hofer, Richard; Mikellides, Ioannis

2016-01-01

NASA's Hall Effect Rocket with Magnetic Shielding (HERMeS) 12.5 kW Technology Demonstration Unit-1 (TDU-1) has been the subject of extensive technology maturation in preparation for flight system development. Part of the technology maturation effort included experimental evaluation of the TDU-1 thruster with conducting and dielectric front pole cover materials in two different electrical configurations. A graphite front magnetic pole cover thruster configuration with the thruster body electrically tied to cathode, and an alumina front pole cover thruster configuration with the thruster body floating were evaluated. Both configurations were also evaluated at different facility background pressure conditions to evaluate background pressure effects on thruster operation. Performance characterization tests found that higher thruster performance was attained with the graphite front pole cover configuration with the thruster electrically tied to cathode. A total thrust efficiency of 68% and a total specific impulse of 2,820 s was demonstrated at a discharge voltage of 600 V and a discharge power of 12.5 kW. Thruster stability regimes were characterized with respect to the thruster discharge current oscillations and with maps of the discharge current-voltage-magnetic field (IVB). Analysis of TDU-1 discharge current waveforms found that lower normalized discharge current peak-to-peak and root mean square magnitudes were attained when the thruster was electrically floated with alumina front pole covers. Background pressure effects characterization tests indicated that the thruster performance and stability were mostly invariant to changes in the facility background pressure for vacuum chamber pressure below 1×10-5 Torr-Xe (for thruster flow rates of 20.5 mg/s). Power spectral density analysis of the discharge current waveforms showed that increasing the vacuum chamber background pressure resulted in a higher discharge current dominant breathing mode frequency. Finally, IVB maps of the TDU-1 thruster indicated that the discharge current became more oscillatory with higher discharge current peak-to-peak and RMS values with increased facility background pressure at lower thruster mass flow rates; thruster operation at higher flow rates resulted in less change to the thruster's IVB characteristics with elevated background pressure.

Three-electrode low pressure discharge apparatus and method for uniform ionization of gaseous media. [CO/sub 2/ laser oscillator and pulse smoother

DOEpatents

McLellan, E.J.

1980-10-17

Uniform, transverse electrical discharges are produced in gaseous media without the necessity of switching the main discharge voltage with an external device which carries the entire discharge current. A three-electrode low pressure discharge tube is charged across its anode and cathode to below breakdown voltage using a dc voltage source. An array of resistors or capacitors can be made to discharge to the wire screen anode by means of a low energy high voltage pulse circuit producing sufficient preionization in the region between the anode and cathode to initiate and control the main discharge. The invention has been demonstrated to be useful as a CO/sub 2/ laser oscillator and pulse-smoother. It can be reliably operated in the sealed-off mode.

Modeling the Influence of Early Skin-to-Skin Contact on Exclusive Breastfeeding in a Sample of Hispanic Immigrant Women.

PubMed

Linares, Ana M; Wambach, Karen; Rayens, Mary K; Wiggins, Amanda; Coleman, Elizabeth; Dignan, Mark B

2017-10-01

Using data from a longitudinal study of breastfeeding in Hispanics, this study evaluated the influence of early skin-to-skin contact (SSC) on initiation and sustained exclusive breastfeeding (EBF) at 1 month postpartum. Two-thirds of the women in the sample participated in early SSC. At discharge, over half of the women were EBF; this proportion decreased to one-third at 1 month postpartum. Controlling for demographic and clinical variables in the model, participation in early SSC was associated with a greater than sevenfold increase in the odds of EBF at discharge (p = .005) but was not predictive of EBF at 1 month post-discharge (p = .7). Younger maternal age and increased prenatal infant feeding intention were associated with an increased likelihood of EBF across both timepoints. Promoting early SSC may help with initiation of EBF, while further breastfeeding support may be needed to maintain EBF following discharge for this vulnerable population.

Simulation studies of vestibular macular afferent-discharge patterns using a new, quasi-3-D finite volume method

NASA Technical Reports Server (NTRS)

Ross, M. D.; Linton, S. W.; Parnas, B. R.

2000-01-01

A quasi-three-dimensional finite-volume numerical simulator was developed to study passive voltage spread in vestibular macular afferents. The method, borrowed from computational fluid dynamics, discretizes events transpiring in small volumes over time. The afferent simulated had three calyces with processes. The number of processes and synapses, and direction and timing of synapse activation, were varied. Simultaneous synapse activation resulted in shortest latency, while directional activation (proximal to distal and distal to proximal) yielded most regular discharges. Color-coded visualizations showed that the simulator discretized events and demonstrated that discharge produced a distal spread of voltage from the spike initiator into the ending. The simulations indicate that directional input, morphology, and timing of synapse activation can affect discharge properties, as must also distal spread of voltage from the spike initiator. The finite volume method has generality and can be applied to more complex neurons to explore discrete synaptic effects in four dimensions.

WIC-based interventions to promote breastfeeding among African-American Women in Baltimore: effects on breastfeeding initiation and continuation.

PubMed

Caulfield, L E; Gross, S M; Bentley, M E; Bronner, Y; Kessler, L; Jensen, J; Weathers, B; Paige, D M

1998-03-01

We evaluated the single and combined effects of introducing a motivational video and peer counseling into four matched WIC clinics on breastfeeding initiation and continuation at 7-10 days among African-American WIC participants. Of the 242 women with complete data, 48% initiated breastfeeding, but only 31% were still breastfeeding at 7-10 days. Initiation was associated with cesarean delivery, infant feeding instruction, no artificial milk discharge pack, attending the peer counselor only-intervention site, and intention to breastfeed. Continuation was influenced by infant feeding instruction, no artificial milk discharge pack, and intention to breastfeed. Overall, trends toward a positive impact of the breastfeeding promotion activities were evident but weak, and largely gone by 7-10 days postpartum.

Alcohol craving as a predictor of relapse.

PubMed

Schneekloth, Terry D; Biernacka, Joanna M; Hall-Flavin, Daniel K; Karpyak, Victor M; Frye, Mark A; Loukianova, Larissa L; Stevens, Susanna R; Drews, Maureen S; Geske, Jennifer R; Mrazek, David A

2012-11-01

Alcoholism treatment interventions, both psychosocial and pharmacologic, aim to reduce cravings to drink. Yet, the role of craving in treatment outcomes remains unclear. This study evaluated craving intensity measured with the Penn Alcohol Craving Scale (PACS) at admission and discharge from residential treatment as a predictive factor of relapse after treatment. The study cohort included 314 alcohol-dependent subjects. Associations between relapse after discharge, PACS score, and clinical variables were investigated using time-to-event analyses. The primary analysis, based on the intent-to-treat principle, presumed relapse in those declining follow-up or not responding to contact attempts. Secondary analysis utilized data from 226 subjects successfully contacted after discharge with a median follow-up time of 365 days. The intent-to-treat analysis demonstrated that relapse was associated with higher level of craving at admission (p= .002) and discharge (p < .001). The analysis of data from patients successfully contacted after discharge led to similar results. A multivariable analysis indicated that relapse rates increased as PACS scores increased, and a higher discharge PACS score was significantly associated with relapse (p= .006) even after adjusting for covariates. This study demonstrates that higher PACS scores at the time of admission and discharge are associated with relapse following residential addiction treatment. These data support the role of craving in relapse and the utility of craving measurement as a clinical guide in assessing relapse risk. Copyright © American Academy of Addiction Psychiatry.

Local changes in neocortical circuit dynamics coincide with the spread of seizures to thalamus in a model of epilepsy.

PubMed

Neubauer, Florian B; Sederberg, Audrey; MacLean, Jason N

2014-01-01

During the generalization of epileptic seizures, pathological activity in one brain area recruits distant brain structures into joint synchronous discharges. However, it remains unknown whether specific changes in local circuit activity are related to the aberrant recruitment of anatomically distant structures into epileptiform discharges. Further, it is not known whether aberrant areas recruit or entrain healthy ones into pathological activity. Here we study the dynamics of local circuit activity during the spread of epileptiform discharges in the zero-magnesium in vitro model of epilepsy. We employ high-speed multi-photon imaging in combination with dual whole-cell recordings in acute thalamocortical (TC) slices of the juvenile mouse to characterize the generalization of epileptic activity between neocortex and thalamus. We find that, although both structures are exposed to zero-magnesium, the initial onset of focal epileptiform discharge occurs in cortex. This suggests that local recurrent connectivity that is particularly prevalent in cortex is important for the initiation of seizure activity. Subsequent recruitment of thalamus into joint, generalized discharges is coincident with an increase in the coherence of local cortical circuit activity that itself does not depend on thalamus. Finally, the intensity of population discharges is positively correlated between both brain areas. This suggests that during and after seizure generalization not only the timing but also the amplitude of epileptiform discharges in thalamus is entrained by cortex. Together these results suggest a central role of neocortical activity for the onset and the structure of pathological recruitment of thalamus into joint synchronous epileptiform discharges.

Local changes in neocortical circuit dynamics coincide with the spread of seizures to thalamus in a model of epilepsy

PubMed Central

Neubauer, Florian B.; Sederberg, Audrey; MacLean, Jason N.

2014-01-01

During the generalization of epileptic seizures, pathological activity in one brain area recruits distant brain structures into joint synchronous discharges. However, it remains unknown whether specific changes in local circuit activity are related to the aberrant recruitment of anatomically distant structures into epileptiform discharges. Further, it is not known whether aberrant areas recruit or entrain healthy ones into pathological activity. Here we study the dynamics of local circuit activity during the spread of epileptiform discharges in the zero-magnesium in vitro model of epilepsy. We employ high-speed multi-photon imaging in combination with dual whole-cell recordings in acute thalamocortical (TC) slices of the juvenile mouse to characterize the generalization of epileptic activity between neocortex and thalamus. We find that, although both structures are exposed to zero-magnesium, the initial onset of focal epileptiform discharge occurs in cortex. This suggests that local recurrent connectivity that is particularly prevalent in cortex is important for the initiation of seizure activity. Subsequent recruitment of thalamus into joint, generalized discharges is coincident with an increase in the coherence of local cortical circuit activity that itself does not depend on thalamus. Finally, the intensity of population discharges is positively correlated between both brain areas. This suggests that during and after seizure generalization not only the timing but also the amplitude of epileptiform discharges in thalamus is entrained by cortex. Together these results suggest a central role of neocortical activity for the onset and the structure of pathological recruitment of thalamus into joint synchronous epileptiform discharges. PMID:25232306

Clinical pharmacy services that influence prescribing in the Western Pacific Region based on the FIP Basel Statements.

PubMed

Penm, Jonathan; Chaar, Betty; Moles, Rebekah

2015-06-01

Clinical pharmacy services have been associated with decreased mortality rates, length of stay, medication errors, adverse drug reactions and total cost of care. Such services have recently been introduced to the Western Pacific Region (WPR), particularly in Asia. A survey to measure clinical pharmacy services that influence prescribing has been validated in the WPR and can be used to explore the implementation of such services. To explore the implementation of clinical pharmacy services that influence prescribing in the WPR and the barriers and facilitators involved in their implementation. Hospital pharmacies in the WPR. Hospital pharmacy directors in the WPR were emailed a link to the validated survey. Surveys were available in English, Japanese, Chinese, Vietnamese, Lao, Khmer, French and Mongolian. (1) Percentage of hospitals offering clinical pharmacy services. (2) Percentage of in-patients receiving a medication history, review or discharge counselling by a pharmacist. In total, 726 responses were received from 31 countries and nations. Nearly all hospitals, 90.6 % (658/726), stated they provided clinical pharmacy services. On average 28 % of their clinical pharmacists attended medical rounds regularly. The median percentage of inpatients receiving a medication history and discharge counselling by a pharmacist was 40 and 30 % respectively. Higher internal facilitator factor scores significantly increased the likelihood of offering clinical services and having pharmacists attend medical rounds regularly. Internal facilitators included individual pharmacist traits and pharmacy departmental structure/resources. Higher environmental facilitator factor scores and having a higher percentage of pharmacists attend medical rounds regularly significantly increased the likelihood of inpatients receiving a medication history, a medication review and discharge counselling by a pharmacist. Environment facilitators included government support, patient and physician expectations. A large proportion of hospitals in the WPR have implemented clinical pharmacy services. Although internal facilitators were shown to be important for initiating such services, the addition of environmental facilitators and ward round participation by pharmacists allowed clinical services to be integrated throughout the hospitals.

Soil aggregate stability and size-selective sediment transport with surface runoff as affected by organic residue amendment.

PubMed

Shi, Pu; Arter, Christian; Liu, Xingyu; Keller, Martin; Schulin, Rainer

2017-12-31

Aggregate breakdown influences the availability of soil particles for size-selective sediment transport with surface runoff during erosive rainfall events. Organic matter management is known to affect aggregate stability against breakdown, but little is known about how this translates into rainfall-induced aggregate fragmentation and sediment transport under field conditions. In this study, we performed field experiments in which artificial rainfall was applied after pre-wetting on three pairs of arable soil plots (1.5×0.75m) six weeks after incorporating a mixture of grass and wheat straw into the topsoil of one plot in each pair (OI treatment) but not on the other plot (NI treatment). Artificial rainfall was applied for approximately 2h on each pair at an intensity of 49.1mmh -1 . In both treatments, discharge and sediment concentration in the discharge were correlated and followed a similar temporal pattern after the onset of surface runoff: After a sharp increase at the beginning both approached a steady state. But the onset of runoff was more delayed on the OI plots, and the discharge and sediment concentration were in average only roughly half as high on the OI as on the NI plots. With increasing discharge the fraction of coarse sediment increased. This relationship did not differ between the two treatments. Thus, due to the lower discharge, the fraction of fine particles in the exported sediment was larger in the runoff from the OI plots than from the NI plots. The later runoff onset and lower discharge rate was related to a higher initial aggregate stability on the OI plots. Terrestrial laser scanning proved to be a very valuable method to map changes in the micro-topography of the soil surfaces. It revealed a much less profound decrease in surface roughness on the OI than on the NI plots. Copyright © 2017 Elsevier B.V. All rights reserved.

Hollow cathode startup using a microplasma discharge

NASA Technical Reports Server (NTRS)

Aston, G.

1981-01-01

Attention is given to a microplasma discharge to initiate a hollow cathode discharge for such applications as plasma flow experiments, the electric propulsion of space vehicles, and as a replacement for filament cathodes in neutral beam injector ion sources. The technique results in a cathode that is easy to start, simple in design, and which does not require external RF exciters, inserts or heating elements. Future applications may include ion beam milling and ion implantation.

Bottle-feeding histories of preterm infants.

PubMed

Pickler, R H; Mauck, A G; Geldmaker, B

1997-01-01

To describe the bottle-feeding histories of preterm infants and determine physical indices related to and predictive of bottle-feeding initiation and progression. Ex post facto. Academic medical center. A convenience sample of 40 preterm infants without concomitant cardiac, gastrointestinal, or cognitive impairment. Postconceptional age at first bottle-feeding, full bottle-feeding, and discharge. The morbidity rating, using the Neonatal Medical Index (NMI), was most strongly correlated with postconceptional age at first bottle-feeding (r = .34, p < .05), full bottle-feeding (r = .65, p < .01), and discharge (r = .55, p < .05). The morbidity rating also accounted for 12%, 42%, and 30% of the variance in postconceptional age at first bottle-feeding, full bottle-feeding, and discharge, respectively. The NMI may be a useful tool for predicting the initiation and progression of bottle-feeding in preterm infants.

Lightning-Discharge Initiation as a Noise-Induced Kinetic Transition

NASA Astrophysics Data System (ADS)

Iudin, D. I.

2017-10-01

The electric fields observed in thunderclouds have the peak values one order of magnitude smaller than the electric strength of air. This fact renders the issue of the lightning-discharge initiation one of the most intriguing problems of thunderstorm electricity. In this work, the lightning initiation in a thundercloud is considered as a noise-induced kinetic transition. The stochastic electric field of the charged hydrometeors is the noise source. The considered kinetic transition has some features which distinguish it from other lightning-initiation mechanisms. First, the dynamic realization of this transition, which is due to interaction of the electron and ion components, is extended for a time significantly exceeding the spark-discharge development time. In this case, the fast attachment of electrons generated by supercritical bursts of the electric field of hydrometeors is balanced during long-term time intervals by the electron-release processes when the negative ions are destroyed. Second, an important role in the transition kinetics is played by the stochastic drift of electrons and ions caused by the small-scale fluctuations of the field of charged hydrometeors. From the formal mathematical viewpoint, this stochastic drift is indistinguishable from the scalar-impurity advection in a turbulent flow. In this work, it is shown that the efficiency of "advective mixing" is several orders of magnitude greater than that of the ordinary diffusion. Third, the considered transition leads to a sharp increase in the conductivity in the exponentially rare compact regions of space against the background of the vanishingly small variations in the average conductivity of the medium. In turn, the spots with increased conductivity are polarized in the mean field followed by the streamer initiation and discharge contraction.

Wire chamber radiation detector with discharge control

DOEpatents

Perez-Mendez, Victor; Mulera, Terrence A.

1984-01-01

A wire chamber radiation detector (11) has spaced apart parallel electrodes (16) and grids (17, 18, 19) defining an ignition region (21) in which charged particles (12) or other ionizing radiations initiate brief localized avalanche discharges (93) and defining an adjacent memory region (22) in which sustained glow discharges (94) are initiated by the primary discharges (93). Conductors (29, 32) of the grids (18, 19) at each side of the memory section (22) extend in orthogonal directions enabling readout of the X-Y coordinates of locations at which charged particles (12) were detected by sequentially transmitting pulses to the conductors (29) of one grid (18) while detecting transmissions of the pulses to the orthogonal conductors (36) of the other grid (19) through glow discharges (94). One of the grids (19) bounding the memory region (22) is defined by an array of conductive elements (32) each of which is connected to the associated readout conductor (36) through a separate resistance (37). The wire chamber (11) avoids ambiguities and imprecisions in the readout of coordinates when large numbers of simultaneous or near simultaneous charged particles (12) have been detected. Down time between detection periods and the generation of radio frequency noise are also reduced.

Plasma sterilization of polyethylene terephthalate bottles by pulsed corona discharge at atmospheric pressure.

PubMed

Masaoka, Satoshi

2007-06-01

A pulsed power supply was used to generate a corona discharge on a polyethylene terephthalate bottle, to conduct plasma sterilization at atmospheric pressure. Before generating such a discharge, minute quantities of water were attached to the inner surface of the bottle and to the surface of a high voltage (HV) electrode inserted into the bottle. Next, high-voltage pulses of electricity were discharged between electrodes for 6.0s, while rotating the bottle. The resulting spore log reduction values of Bacillus subtilis and Aspergillus niger on the inner surface of the bottle were 5.5 and 6 or higher, respectively, and those on the HV electrode surface were each 6 or higher for both strains. The presence of the by-products gaseous ozone, hydrogen peroxide, and nitric ions resulting from the electrical discharge was confirmed.

Large scale Tesla coil guided discharges initiated by femtosecond laser filamentation in air

NASA Astrophysics Data System (ADS)

Arantchouk, L.; Point, G.; Brelet, Y.; Prade, B.; Carbonnel, J.; André, Y.-B.; Mysyrowicz, A.; Houard, A.

2014-07-01

The guiding of meter scale electric discharges produced in air by a Tesla coil is realized in laboratory using a focused terawatt laser pulse undergoing filamentation. The influence of the focus position, the laser arrival time, or the gap length is studied to determine the best conditions for efficient laser guiding. Discharge parameters such as delay, jitter, and resistance are characterized. An increase of the discharge length by a factor 5 has been achieved with the laser filaments, corresponding to a mean breakdown field of 2 kV/cm for a 1.8 m gap length. Consecutive guided discharges at a repetition rate of 10 Hz are also reported.

NASCAP modelling of environmental-charging-induced discharges in satellites

NASA Technical Reports Server (NTRS)

Stevens, N. J.; Roche, J. C.

1979-01-01

The charging and discharging characteristics of a typical geosynchronous satellite experiencing time-varying geomagnetic substorms, in sunlight, were studied utilizing the NASA Charging Analyzer Program (NASCAP). An electric field criteria of 150,000 volts/cm to initiate discharges and transfer of 67 percent of the stored charge was used based on ground test results. The substorm characteristics were arbitrarily chosen to evaluate effects of electron temperature and particle density (which is equivalent to current density). It was found that while there is a minimum electron temperature for discharges to occur, the rate of discharges is dependent on particle density and duration times of the encounter. Hence, it is important to define the temporal variations in the substorm environments.

CORMIX: AN EXPERT SYSTEM FOR MIXING ZONE ANALYSIS

EPA Science Inventory

United States water quality policy includes the concept of a fixing zone, a limited area where initial dilution of a discharge occurs. urrent practice in mixing zone analysis is plagued by a number of problems--mixing zone definitions vary widely, there is a diversity of discharg...

76 FR 24874 - Initiation of Scoping for an Environmental Assessment (EA)

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-03

...) General Permit for Discharges from Construction Activities. The EA will evaluate the potential environmental impacts from the discharge of pollutants associated with stormwater runoff from construction... days of the date of the publication of the Proposed Construction General Permit in the Federal Register...

The formation of diffuse discharge by short-front nanosecond voltage pulses and the modification of dielectrics in this discharge

NASA Astrophysics Data System (ADS)

Orlovskii, V. M.; Panarin, V. A.; Shulepov, M. A.

2014-07-01

The dynamics of diffuse discharge formation under the action of nanosecond voltage pulses with short fronts (below 1 ns) in the absence of a source of additional preionization and the influence of a dielectric film on this process have been studied. It is established that the diffuse discharge is induced by the avalanche multiplication of charge initiated by high-energy electrons and then maintained due to secondary breakdowns propagating via ionized gas channels. If a dielectric film (polyethylene, Lavsan, etc.) is placed on the anode, then multiply repeated discharge will lead to surface and bulk modification of the film material. Discharge-treated polyethylene film exhibits a change in the optical absorption spectrum in the near-IR range.

Framework and components for effective discharge planning system: a delphi methodology

PubMed Central

2012-01-01

Background To reduce avoidable hospital readmissions, effective discharge planning and appropriate post discharge support care are key requirements. This study is a 3-staged process to develop, pretest and pilot a framework for an effective discharge planning system in Hong Kong. This paper reports on the methodology of Delphi approach and findings of the second stage on pre-testing the framework developed so as to validate and attest to its applicability and practicability in which consensus was sought on the key components of discharge planning. Methods Delphi methodology was adopted to engage a group of experienced healthcare professionals to rate and discuss the framework and components of an effective discharge planning. The framework was consisted 36 statements under 5 major themes: initial screening, discharge planning process, coordination of discharge, implementation of discharge, and post discharge follow-up. Each statement was rated independently based on 3 aspects including clarity, validity and applicability on a 5-point Likert-scale. Statement with 75% or above of participants scoring 4–5 on all 3 aspects would be included in the discharge planning framework. For those statements not reaching 75% of consensus in any one of the aspect, it would be revised or discarded following the group discussion, and be re-rated in another round. Results A total of 24 participants participated in the consensus-building process. In round one rating, consensus was achieved in 25 out of 36 statements. Among those 11 statements not reaching consensus, the major concern was related to the “applicability” of the statements. The participants expressed a lack of manpower, skills and time in particular during weekends and long holidays in carrying out assessment and care plans within 24 h after admission. There were also timeliness and availability issue in providing transportation and necessary equipment to the patients. To make the statements more applicable, the wordings of some of the statements were revised to provide greater flexibility. Due to the lack of a statement in clarifying the role of the members of the healthcare professional team, one additional statement on the role and responsibility of the multidisciplinary team members was added. The first theme on “initial screening” was further revised to “initial screening and assessment” to better reflect the first stage of discharge planning process. After two rounds of rating process, all the 36 statements and the newly added statement reached consensus Conclusions A structured, systematic and coordinated system of hospital discharge system is required to facilitate the discharge process to ensure a smooth patient transition from the hospital to the community and improve patient health outcome in both clinical and social aspect. The findings of this paper provide a reference framework helping policymakers and hospital managers to facilitate the development of a coherent and systematized discharge planning process. Adopting a Delphi approach also demonstrates the values of the method as a pre-test (before the clinical run) of the components and requirements of a discharge planning system taking into account of the local context and system constraints, which would lead to improvements to its applicability and practicability. To confirm the applicability and practicability of this consensus framework for discharge planning system, the third stage of process of development of the discharge planning framework is to apply and pilot the framework in a hospital setting to evaluate its feasibility, applicability and impact in hospital including satisfaction from both the perspectives of staff and patients. PMID:23151173

Improved outcomes of feeding low birth weight infants with predominantly raw human milk versus donor banked milk and formula.

PubMed

Dritsakou, Kalliopi; Liosis, Georgios; Valsami, Georgia; Polychronopoulos, Evangelos; Skouroliakou, Maria

2016-01-01

To investigate the benefits of treating low birth weight infants predominantly with mother's own raw milk and early initiation of breastfeeding (raw human milk/breast-fed infants), in comparison to feeding only with donor banked milk (until the third week of life) and afterwards a preterm formula until hospital discharge (donor banked/formula-fed infants). One hundred and ninety-two predominantly raw human milk-fed infants (70% of raw and 30% of donor milk) were matched to 192 donor/formula-fed ones (on 1:1 ratio). Aggressive nutrition policy and targeted fortification of human milk were implemented in both groups. The two groups show similar demographic and perinatal characteristics. Predominantly raw milk-fed infants regained earlier their birth weight, suffered less episodes of feeding intolerance and presented a higher body length and head circumference at discharge (p < 0.001). Those treated mainly with their mothers' milk were able to initiate breastfeeding almost 2 weeks earlier compared to those fed with donor milk who achieved to be bottle-fed later on post-conceptual age (p < 0.001). Infants being breastfed until the 8th month of life conducted less visits for a viral infection to a pediatrician compared to those in the other group (p < 0.001). Feeding predominantly with mother's raw milk seems to result in optimal neonatal outcomes.

Evaluating Riparian and Agricultural Systems as Sinks for Surface Water Nutrients in the Upper Rio Grande

NASA Astrophysics Data System (ADS)

Oelsner, G. P.; Brooks, P. D.; Hogan, J. F.; Phillips, F. M.; Villinski, J. E.

2005-12-01

We have performed five years of biannual synoptic sampling along a 1200km reach of the Rio Grande to develop relationships between discharge, land use, and major water quality parameters. Both total dissolved nitrogen (TDN) and dissolved organic carbon (DOC) concentrations gradually increase with distance downstream, however for TDN and phosphate this trend is punctuated by large, localized inputs primarily from urban wastewater. Somewhat surprisingly, surface water draining from areas of intensive, irrigated agriculture during the growing season often had lower nutrient and DOC concentrations than the river. To better quantify the effects of urban and agricultural systems on water quality we conducted three years of higher spatial resolution sampling of a 250km reach (between Cochiti Dam and Elephant Butte Reservoir) that contains both major agricultural and urban water users. During the higher flow years of 2001 and 2005 TDN concentrations in the river were higher (x = 1.19mg/L, SD = 0.21) than in the drier years 2002-2004 (x = 0.52mg/L, SD = 0.42). TDN concentrations decreased from 1.97mg/L to 0.78 mg/L in a 5km reach below the Albuquerque wastewater treatment plant during the low discharge year of 2004, but there was little to no decrease in TDN concentrations over the 180km below the wastewater treatment plant in years with higher river discharge. In contrast, water diverted to agricultural fields and returned to the river in drains experienced a 60% reduction in TDN concentrations in dry years and a 30% reduction in wet years compared to initial river water. During the dry years, water in the conveyance channel appears to be a mixture of river and drain water whereas in wetter years the conveyance channel has a lower average TDN concentration than either the river or the drains. These data suggest that the river-riparian-hyporheic system of the Rio Grande can serve at best as a weak N sink, while the combination of agricultural fields and drains serve as a strong nutrient sink. Ongoing research is quantifying the locations and potential rates of N transformation in both the river and agricultural drain systems.

Patients discharged against medical advice from a psychiatric hospital in Iran: a prospective study.

PubMed

Sheikhmoonesi, Fatemeh; Khademloo, Mohammad; Pazhuheshgar, Samaneh

2014-03-30

Self- discharged patients are at high risk for readmission and ultimately higher cost for care.We intended to find the proportion of patients who leave hospital against medical advice and explore some of their characteristics. This prospective study of discharge against medical advice was conducted in psychiatric wards of Zare hospital in Iran, 2011. A psychologist recorded some information on a checklist based on the documented information about the patient who wanted to leave against medical advice. The psychologist interviewed these patients and recorded the reasons for discharge against medical advice. Descriptive statistics were calculated for the variables. The rate of premature discharge was 34.4%. Compared to patients with regular discharges, patients with premature discharge were significantly more likely to be male, self-employed, to have co morbid substance abuse and first admission and positive family history of psychiatric disorder. Disappearance of symptoms was the most frequent reason for premature discharge. The 34.4% rate of premature discharge observed in our study is higher than rate reported in other studies. One possible explanation is our teaching hospital serves a low-income urban area and most patients had low socioeconomic status. Further studies are needed to compare teaching and non-teaching hospital about the rate of premature discharge and the reasons of patients who want to leave against medical advice.

NOx formation in apokamp-type atmospheric pressure plasma jets in air initiated by a pulse-repetitive discharge

NASA Astrophysics Data System (ADS)

Sosnin, Eduard A.; Didenko, Maria V.; Panarin, Victor A.; Skakun, Victor S.; Tarasenko, Victor F.; Liu, Dongping P.; Song, Ying

2018-04-01

The decomposition products of atmospheric pressure plasma of repetitive pulsed discharge in apokamp and corona modes were determined by optical and chemical methods. It is shown, that the decomposition products contain mainly nitrogen oxides NOx. A brief review of the plasma- and thermochemical reactions in the pulsed discharges was made. The review and experimental data allow us to explain the reactive oxygen species formation mechanisms in a potential discharge channel with apokamp. The possible applications of this plasma source for treatment of seeds of agricultural crops are discussed.

Experimental research on medium-frequency discharge cleaning in the HT-6M tokamak

NASA Astrophysics Data System (ADS)

Li, Chengfu; Guo, Wenkang; Gu, Xuemao; Luo, Nanchang; Hu, Wanfen; Cheng, Shanhua; Qian, Chao

1989-04-01

Surface cleaning experiments of the wall of HT-6M tokamak chamber by medium-frequency discharge (MFD) in hydrogen has been monitored and analysed by. QMS and AES. After 300 min discharge, the signals with mass number 12 and 18 were 100 times less than their initial values. The concentration of C and O on the wall surface decreased to 26% and 5.8%, respectively. The cleaning efficiency of MFD has been compared with that of DC glow discharge. The results showed that the former was superior to the later in ability of water release.

INTENSE ENERGETIC GAS DISCHARGE

DOEpatents

Luce, J.S.

1960-03-01

A method and apparatus for initiating and sustaining an energetic gas arc discharge are described. A hollow cathode and a hollow anode are provided. By regulating the rate of gas flow into the interior of the cathode, the arc discharge is caused to run from the inner surface of the cathode with the result that adequate space-charge neutralization is provided inside the cathode but not in the main arc volume. Thus, the gas fed to the cathode is substantially completely ionized before it leaves the cathode, with the result that an energetic arc discharge can be maintained at lower operating pressures.

Purification of inkjet ink from water using liquid phase, electric discharge polymerization and cellulosic membrane filtration.

PubMed

Jordan, Alexander T; Hsieh, Jeffery S; Lee, Daniel T

2013-01-01

A method to separate inkjet ink from water was developed using a liquid phase, electric discharge process. The liquid phase, electric discharge process with filtration or sedimentation was shown to remove 97% of inkjet ink from solutions containing between 0.1-0.8 g/L and was consistent over a range of treatment conditions. Additionally, particle size analysis of treated allyl alcohol and treated propanol confirmed the electric discharge treatment has a polymerization mechanism, and small molecule analysis of treated methanol using gas chromatography and mass spectroscopy confirmed the mechanism was free radical initiated polymerization.

Formation of a spark discharge in an inhomogeneous electric field with current limitation by a large ballast Resistance

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baldanov, B. B., E-mail: baibat@mail.ru

2016-01-15

Results of studies of a spark discharge initiated in argon in a point–plane electrode gap with limitation of the discharge current by a large ballast resistance are presented. It is shown that the current flowing through the plasma channel of such a low-current spark has the form of periodic pulses. It is experimentally demonstrated that, when a low-current spark transforms into a constricted glow discharge, current pulses disappear, the spatial structure of the cathode glow changes abruptly, and a brightly glowing positive plasma column forms in the gap.

Forecasting the Value of Podiatric Medical Care in Newly Insured Diabetic Patients During Implementation of the Affordable Care Act in California.

PubMed

Labovitz, Jonathan M; Kominski, Gerald F

2016-05-01

Because value-based care is critical to the Affordable Care Act success, we forecasted inpatient costs and the potential impact of podiatric medical care on savings in the diabetic population through improved care quality and decreased resource use during implementation of the health reform initiatives in California. We forecasted enrollment of diabetic adults into Medicaid and subsidized health benefit exchange programs using the California Simulation of Insurance Markets (CalSIM) base model. Amputations and admissions per 1,000 diabetic patients and inpatient costs were based on the California Office of Statewide Health Planning and Development 2009-2011 inpatient discharge files. We evaluated cost in three categories: uncomplicated admissions, amputations during admissions, and discharges to a skilled nursing facility. Total costs and projected savings were calculated by applying the metrics and cost to the projected enrollment. Diabetic patients accounted for 6.6% of those newly eligible for Medicaid or health benefit exchange subsidies, with a 60.8% take-up rate. We project costs to be $24.2 million in the diabetic take-up population from 2014 to 2019. Inpatient costs were 94.3% higher when amputations occurred during the admission and 46.7% higher when discharged to a skilled nursing facility. Meanwhile, 61.0% of costs were attributed to uncomplicated admissions. Podiatric medical services saved 4.1% with a 10% reduction in admissions and amputations and an additional 1% for every 10% improvement in access to podiatric medical care. When implementing the Affordable Care Act, inclusion of podiatric medical services on multidisciplinary teams and in chronic-care models featuring prevention helps shift care to ambulatory settings to realize the greatest cost savings.

Are the argon metastables important in high power impulse magnetron sputtering discharges?

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gudmundsson, J. T., E-mail: tumi@hi.is; Science Institute, University of Iceland, Dunhaga 3, IS-107 Reykjavik; Lundin, D.

2015-11-15

We use an ionization region model to explore the ionization processes in the high power impulse magnetron sputtering (HiPIMS) discharge in argon with a titanium target. In conventional dc magnetron sputtering (dcMS), stepwise ionization can be an important route for ionization of the argon gas. However, in the HiPIMS discharge stepwise ionization is found to be negligible during the breakdown phase of the HiPIMS pulse and becomes significant (but never dominating) only later in the pulse. For the sputtered species, Penning ionization can be a significant ionization mechanism in the dcMS discharges, while in the HiPIMS discharge Penning ionization ismore » always negligible as compared to electron impact ionization. The main reasons for these differences are a higher plasma density in the HiPIMS discharge, and a higher electron temperature. Furthermore, we explore the ionization fraction and the ionized flux fraction of the sputtered vapor and compare with recent experimental work.« less

Facility and market factors affecting transitions from nursing home to community.

PubMed

Arling, Greg; Abrahamson, Kathleen A; Cooke, Valerie; Kane, Robert L; Lewis, Teresa

2011-09-01

Research into nursing home transitions has given limited attention to the facility or community contexts. To identify facility and market factors affecting transitions of nursing home residents back to the community. Multilevel models were used to estimate effects of facility and market factors on facility-level community discharge rates after controlling for resident demographic, health, and functional conditions. Facility discharge rates were adjusted using Empirical Bayes estimation. Annual cohort of first-time admissions (N=24,648) to 378 Minnesota nursing facilities in 75 nursing home markets from July 2005 to June 2006. Community discharge within 90 days of admission; facility occupancy, payer mix, ownership, case-mix acuity, size, admissions from hospitals, nurse staffing level, and proportion of admissions preferring or having support to return to the community; and nursing market population size, average occupancy, market concentration, and availability of home and community-based services. Rates of community discharge (Empirical Bayes residual) were highest in facilities with more residents preferring community discharge, more Medicare days, higher nurse staffing levels, and higher occupancy. In addition, facilities had higher community discharge rates if they were located in markets with a greater ratio of home and community-based services recipients to nursing home residents and with larger populations. State Medicaid programs should undertake system-level interventions that encourage nursing facilities to reduce unused bed capacity, balance the mix of payers, invest in nurse staffing, and take other steps to promote community discharges. In addition, states should increase home and community-based services, particularly in markets with low community discharge rates.

Hospital-level care coordination strategies associated with better patient experience.

PubMed

Figueroa, Jose F; Feyman, Yevgeniy; Zhou, Xiner; Joynt Maddox, Karen

2018-04-04

Patient experience is a key measure of hospital quality and is increasingly contained in value-based payment programmes. Understanding whether strategies aimed at improving care transitions are associated with better patient experience could help clinical leaders and policymakers seeking to improve care across multiple dimensions. To determine the association of specific hospital care coordination and transition strategies with patient experience. We surveyed leadership at 1600 acute care hospitals and categorised respondents into three groups based on the strategies used: low-strategy (bottom quartile of number of strategies), mid-strategy (quartiles 2 and 3) and high-strategy (highest quartile). We used linear regression models to examine the association between use of these strategies and performance on measures of patient experience from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. We achieved a 62% response rate. High-strategy hospitals reported using 7.7 strategies on average usually or always on their patient populations, while mid-strategy and low-strategy hospitals reported using 5.0 and 2.3 strategies, respectively. Compared with low-strategy hospitals, high-strategy hospitals had a higher overall rating (+2.23 percentage points (pp), P<0.001), higher recommendation score (+2.5 pp, P<0.001), and higher satisfaction with discharge process (+1.35 pp, P=0.01) and medication communication (+1.44 pp, P=0.002). Mid-strategy hospitals had higher scores than low-strategy hospitals except for discharge satisfaction. Patient-facing strategies, like sharing discharge summaries with patients prior to discharge, using discharge coordinators and calling patients 48 hours after discharge, were each individually associated with a higher overall hospital rating, and higher satisfaction with discharge process and medication communication. Hospitals with greater reported use of care coordination and transition strategies have better patient experience than hospitals with fewer reported strategies. Strategies that most directly involve patients have the strongest association with better experience. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Time evolution of nanosecond runaway discharges in air and helium at atmospheric pressure

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yatom, S.; Vekselman, V.; Krasik, Ya. E.

2012-12-15

Time- and space-resolved fast framing photography was employed to study the discharge initiated by runaway electrons in air and He gas at atmospheric pressure. Whereas in the both cases, the discharge occurs in a nanosecond time scale and its front propagates with a similar velocity along the cathode-anode gap, the later stages of the discharge differ significantly. In air, the main discharge channels develop and remain in the locations with the strongest field enhancement. In He gas, the first, diode 'gap bridging' stage, is similar to that obtained in air; however, the development of the discharge that follows is dictatedmore » by an explosive electron emission from micro-protrusions on the edge of the cathode. These results allow us to draw conclusions regarding the different conductivity of the plasma produced in He and air discharges.« less

Application of Fenton oxidation to cosmetic wastewaters treatment.

PubMed

Bautista, P; Mohedano, A F; Gilarranz, M A; Casas, J A; Rodriguez, J J

2007-05-08

The removal of organic matter (TOC and COD) from a cosmetic wastewater by Fenton oxidation treatment has been evaluated. The operating conditions (temperature as well as ferrous ion and hydrogen peroxide dosage) have been optimized. Working at an initial pH equal to 3.0, a Fe(2+) concentration of 200 mg/L and a H(2)O(2) concentration to COD initial weight ratio corresponding to the theoretical stoichiometric value (2.12), a TOC conversion higher than 45% at 25 degrees C and 60% at 50 degrees C was achieved. Application of the Fenton oxidation process allows to reach the COD regional limit for industrial wastewaters discharges to the municipal sewer system. A simple kinetic analysis based on TOC was carried out. A second-order equation describes well the overall kinetics of the process within a wide TOC conversion range covering up to the 80-90% of the maximum achievable conversion.

40 CFR 60.103 - Standard for carbon monoxide.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Refineries § 60.103 Standard for carbon monoxide. Each owner or operator of any fluid catalytic cracking unit... the fluid catalytic cracking unit catalyst regenerator will be operated, or 180 days after initial... discharge or cause the discharge into the atmosphere from any fluid catalytic cracking unit catalyst...

40 CFR 60.103 - Standard for carbon monoxide.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Refineries § 60.103 Standard for carbon monoxide. Each owner or operator of any fluid catalytic cracking unit... the fluid catalytic cracking unit catalyst regenerator will be operated, or 180 days after initial... discharge or cause the discharge into the atmosphere from any fluid catalytic cracking unit catalyst...

CORMIX2: AN EXPERT SYSTEM FOR HYDRODYNAMIC MIXING ZONE ANALYSIS OF CONVENTIONAL AND TOXIC MULTIPORT DIFFUSER DISCHARGES

EPA Science Inventory

CORMIX is a series of software systems for the analysis, prediction, and design of aqueous toxic or conventional pollutant discharges into watercourses, with emphasis on the geometry and dilution characteristics of the initial mixing zone. ubsystem CORMIX1 deals with submerged si...

Modelling mortality and discharge of hospitalized stroke patients using a phase-type recovery model.

PubMed

Jones, Bruce; McClean, Sally; Stanford, David

2018-05-01

We model the length of in-patient hospital stays due to stroke and the mode of discharge using a phase-type stroke recovery model. The model allows for three different types of stroke: haemorrhagic (the most severe, caused by ruptured blood vessels that cause brain bleeding), cerebral infarction (less severe, caused by blood clots) and transient ischemic attack or TIA (the least severe, a mini-stroke caused by a temporary blood clot). A four-phase recovery process is used, where the initial phase depends on the type of stroke, and transition from one phase to the next depends on the age of the patient. There are three differing modes of absorption for this phase-type model: from a typical recovery phase, a patient may die (mode 1), be transferred to a nursing home (mode 2) or be discharged to the individual's usual residence (mode 3). The first recovery phase is characterized by a very high rate of mortality and very low rates of discharge by the other two modes. The next two recovery phases have progressively lower mortality rates and higher mode 2 and 3 discharge rates. The fourth recovery phase is visited only by those who experience a very mild TIA, and they are discharged to home after a short stay. The novelty of our approach to phase representation is two-fold: first, it aligns the phases with labelled diagnosis states, representing stages of illness severity; second, the model allows us to obtain expressions for Key Performance Indicators that are of use to healthcare professionals. This allows us to use a backward estimation process where we leverage the fact that we know the phase of admission (the diagnosis), but not which phases are subsequently entered or when this happens; this strategy improves both computational efficiency and accuracy. The model has clear practical value as it yields length of stay distributions by age and type of stroke, which are useful in resource planning. Also, inclusion of the three modes of discharge permits analyses of outcomes.

Crack growth and fracture toughness of amorphous Li-Si anodes: Mechanisms and role of charging/discharging studied by atomistic simulations

NASA Astrophysics Data System (ADS)

Khosrownejad, S. M.; Curtin, W. A.

2017-10-01

Fracture is the main cause of degradation and capacity fading in lithiated silicon during cycling. Experiments on the fracture of lithiated silicon show conflicting results, and so mechanistic models can help interpret experiments and guide component design. Here, large-scale K-controlled atomistic simulations of crack propagation (R-curve KI vs. Δa) are performed at LixSi compositions x = 0.5 , 1.0 , 1.5 for as-quenched/relaxed samples and at x = 0.5 , 1.0 for samples created by discharging from higher Li compositions. In all cases, the fracture mechanism is void nucleation, growth, and coalescence. In as-quenched materials, with increasing Li content the plastic flow stress and elastic moduli decrease but void nucleation and growth happen at smaller stress, so that the initial fracture toughness KIc ≈ 1.0 MPa√{ m} decreases slightly but the initial fracture energy JIc ≈ 10.5J/m2 is similar. After 10 nm of crack growth, the fracture toughnesses increase and become similar at KIc ≈ 1.9 MPa√{ m} across all compositions. Plane-strain equi-biaxial expansion simulations of uncracked samples provide complementary information on void nucleation and growth. The simulations are interpreted within the framework of Gurson model for ductile fracture, which predicts JIc = ασy D where α ≃ 1 and D is the void spacing, and good agreement is found. In spite of flowing plastically, the fracture toughness of LixSi is low because voids nucleate within nano-sized distances ahead of the crack (D ≈ 1nm). Scaling simulation results to experimental conditions, reasonable agreement with experimentally-estimated fracture toughnesses is obtained. The discharging process facilitates void nucleation but decreases the flow stress (as shown previously), leading to enhanced fracture toughness at all levels of crack growth. Therefore, the fracture behavior of lithiated silicon at a given composition is not a material property but instead depends on the history of charging/discharging. These findings indicate that the mechanical behavior (flow and fracture) of lithiated Si must be interpreted within a fully rate- and history-dependent framework.

Neonates and Infants Discharged Home Dependent on Medical Technology: Characteristics and Outcomes.

PubMed

Toly, Valerie Boebel; Musil, Carol M; Bieda, Amy; Barnett, Kimberly; Dowling, Donna A; Sattar, Abdus

2016-10-01

Preterm neonates and neonates with complex conditions admitted to a neonatal intensive care unit (NICU) may require medical technology (eg, supplemental oxygen, feeding tubes) for their continued survival at hospital discharge. Medical technology introduces another layer of complexity for parents, including specialized education about neonatal assessment and operation of technology. The transition home presents a challenge for parents and has been linked with greater healthcare utilization. To determine incidence, characteristics, and healthcare utilization outcomes (emergency room visits, rehospitalizations) of technology-dependent neonates and infants following initial discharge from the hospital. This descriptive, correlational study used retrospective medical record review to examine technology-dependent neonates (N = 71) upon discharge home. Study variables included demographic characteristics, hospital length of stay, and type of medical technology used. Analysis of neonates (n = 22) with 1-year postdischarge data was conducted to identify relationships with healthcare utilization. Descriptive and regression analyses were performed. Approximately 40% of the technology-dependent neonates were between 23 and 26 weeks' gestation, with birth weight of less than 1000 g. Technologies used most frequently were supplemental oxygen (66%) and feeding tubes (46.5%). The mean total hospital length of stay for technology-dependent versus nontechnology-dependent neonates was 108.6 and 25.7 days, respectively. Technology-dependent neonates who were female, with a gastrostomy tube, or with longer initial hospital length of stay were at greater risk for rehospitalization. Assessment and support of families, particularly mothers of technology-dependent neonates following initial hospital discharge, are vital. Longitudinal studies to determine factors affecting long-term outcomes of technology-dependent infants are needed.

Absence of early epileptiform abnormalities predicts lack of seizures on continuous EEG.

PubMed

Shafi, Mouhsin M; Westover, M Brandon; Cole, Andrew J; Kilbride, Ronan D; Hoch, Daniel B; Cash, Sydney S

2012-10-23

To determine whether the absence of early epileptiform abnormalities predicts absence of later seizures on continuous EEG monitoring of hospitalized patients. We retrospectively reviewed 242 consecutive patients without a prior generalized convulsive seizure or active epilepsy who underwent continuous EEG monitoring lasting at least 18 hours for detection of nonconvulsive seizures or evaluation of unexplained altered mental status. The findings on the initial 30-minute screening EEG, subsequent continuous EEG recordings, and baseline clinical data were analyzed. We identified early EEG findings associated with absence of seizures on subsequent continuous EEG. Seizures were detected in 70 (29%) patients. A total of 52 patients had their first seizure in the initial 30 minutes of continuous EEG monitoring. Of the remaining 190 patients, 63 had epileptiform discharges on their initial EEG, 24 had triphasic waves, while 103 had no epileptiform abnormalities. Seizures were later detected in 22% (n = 14) of studies with epileptiform discharges on their initial EEG, vs 3% (n = 3) of the studies without epileptiform abnormalities on initial EEG (p < 0.001). In the 3 patients without epileptiform abnormalities on initial EEG but with subsequent seizures, the first epileptiform discharge or electrographic seizure occurred within the first 4 hours of recording. In patients without epileptiform abnormalities during the first 4 hours of recording, no seizures were subsequently detected. Therefore, EEG features early in the recording may indicate a low risk for seizures, and help determine whether extended monitoring is necessary.

Absence of early epileptiform abnormalities predicts lack of seizures on continuous EEG

PubMed Central

Westover, M. Brandon; Cole, Andrew J.; Kilbride, Ronan D.; Hoch, Daniel B.; Cash, Sydney S.

2012-01-01

Objective: To determine whether the absence of early epileptiform abnormalities predicts absence of later seizures on continuous EEG monitoring of hospitalized patients. Methods: We retrospectively reviewed 242 consecutive patients without a prior generalized convulsive seizure or active epilepsy who underwent continuous EEG monitoring lasting at least 18 hours for detection of nonconvulsive seizures or evaluation of unexplained altered mental status. The findings on the initial 30-minute screening EEG, subsequent continuous EEG recordings, and baseline clinical data were analyzed. We identified early EEG findings associated with absence of seizures on subsequent continuous EEG. Results: Seizures were detected in 70 (29%) patients. A total of 52 patients had their first seizure in the initial 30 minutes of continuous EEG monitoring. Of the remaining 190 patients, 63 had epileptiform discharges on their initial EEG, 24 had triphasic waves, while 103 had no epileptiform abnormalities. Seizures were later detected in 22% (n = 14) of studies with epileptiform discharges on their initial EEG, vs 3% (n = 3) of the studies without epileptiform abnormalities on initial EEG (p < 0.001). In the 3 patients without epileptiform abnormalities on initial EEG but with subsequent seizures, the first epileptiform discharge or electrographic seizure occurred within the first 4 hours of recording. Conclusions: In patients without epileptiform abnormalities during the first 4 hours of recording, no seizures were subsequently detected. Therefore, EEG features early in the recording may indicate a low risk for seizures, and help determine whether extended monitoring is necessary. PMID:23054233

A study to examine the relationship between metritis severity and depletion of oxytetracycline in plasma and milk after intrauterine infusion.

PubMed

Gorden, P J; Ydstie, J A; Kleinhenz, M D; Wulf, L W; Gehring, R; Lee, C J; Wang, C; Coetzee, J F

2016-10-01

Metritis is a frequent problem in postpartum dairy cows. Intrauterine therapy with the antimicrobial oxytetracycline (OTC) is often used, although this therapy has not been shown to be superior to systemic therapy. The objectives of this study were to (1) determine the plasma and milk concentrations of OTC following intrauterine infusion in postpartum dairy cows with varying degrees of metritis severity; (2) determine the depletion time of OTC in an attempt to provide veterinarians withdrawal guidelines, should they use this therapy; and (3) correlate metritis severity scores with OTC concentrations in plasma and milk. Our hypothesis was that cows with more severe metritis would have higher OTC concentrations in milk following intrauterine therapy. Thirty-two cows were selected to participate in the study after farm personnel had determined that they had metritis based on evaluation of vaginal discharge between 4 and 14 DIM, in accordance with the farm's treatment protocols. Metritis scores (1-4) were assigned based on a published scheme: 1 represented yellow-to-orange thick discharge or translucent mucus with no fetid smell; 2 represented blood-tinged vaginal mucus, slightly watery, with little or no fetid smell; 3 represented red to red/brown watery discharge with moderate fetid smell; and 4 represented red to red/brown watery discharge containing pieces of placenta and an intense fetid smell. Trial cows received a single treatment of 4g of OTC (approximately 6.7mg/kg) via intrauterine infusion. Blood samples were collected over 96h, and milk samples were collected before intrauterine therapy and 3 times a day for 4 d following infusion. Following treatment, OTC rapidly diffused to plasma and subsequently to milk. Maximum OTC concentrations in plasma and milk occurred within the first 24h following intrauterine infusion, and 25 of the 32 cows had detectable OTC concentrations in milk at 4 d after intrauterine infusion. Cows with clinical metritis (metritis severity scores of 3 or 4) at the initiation of treatment were significantly and positively correlated with higher milk OTC concentrations at the second [time (T)9 h; r=0.43], fourth (T25 h; r=0.42), and fifth milking following treatment (T33 h; r=0.38) compared with cows with normal vaginal discharge. We also observed a positive correlation between initial metritis score and milk maximum concentration (r=0.36) and milk area under the concentration curve (r=0.36). Given that intrauterine administration of OTC is an extra-label therapy, dairy producers should consult with their veterinarian to ensure that milk is being tested at or below the established tolerance for OTC. This will ensure that violative drug residues do not enter the human food supply. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Seasonal changes in particulate and dissolved organic matter composition and quality in the Lena River Delta

NASA Astrophysics Data System (ADS)

Mollenhauer, G.; Winterfeld, M.; Hefter, J.; Bodenstab, L.; Morgenstern, A.; Eulenburg, A.; Heim, B.; Koch, B.; Schefuss, E.; Moerth, C. M.; Rethemeyer, J.

2016-12-01

Arctic rivers are known to export large quantities of carbon by discharge of dissolved and particulate organic carbon (DOC, POC), and in a warming and progressively moister Arctic, these exports may increase resulting in a reduction of arctic continental carbon stocks. These rivers have highly variable discharge rates with a pronounced maximum during the spring freshet associated with highest concentrations of DOC and POC. Most studies investigating the isotopic composition and quality of carbon exported by Arctic rivers rely on samples taken in summer during base flow, which is due to the logistical challenges associated with sampling in the remote Arctic permafrost regions. Here we present a record of δ13C and Δ14C of DOC and POC collected between late May during the freshet and late August 2014 in the Lena River Delta. POC Δ14C shows an initial trend towards older values in the spring samples, which is reversed in summer, associated with a shift towards more depleted δ13C values. We interpret this aging trend as reflecting progressive thawing throughout the ice-free season, resulting in mobilization of progressively older carbon from deeper thawed layers. The summer reversal indicates admixture of aquatic organic matter. DOC Δ14C, in contrast, remains at relatively modern levels with rather constant δ13C values throughout the sampling period. We furthermore analysed the biomarker composition of Lena Delta particulate OM collected in spring and summer. From spring to summer, we observe trends in abundance of individual leaf-wax derived biomarkers indicating higher abundance of algal biomass in the summer particles. Trends in soil microbial biomarkers and compound-specific δD of leaf-wax lipids suggest a shift in sources towards higher contributions from the southern catchment in summer. DOC composition investigated with FT-ICR-MS changes from spring with higher abundances of compounds with high H/C and low O/C ratios to late summer, when fewer compounds were found. Our results illustrate the seasonal variability in composition and sources of organic matter discharged by the Lena River. Paired with the strong seassonality of the hydrograph, this implies that total annual discharge of organic matter contains a disproportionally high contribution from the northern part of the catchment.

Patterns of beta-blocker intensification in ambulatory heart failure patients and short-term association with hospitalization

PubMed Central

2012-01-01

Background In response to the short-term negative inotropic and chronotropic effects of β-blockers, heart failure (HF) guidelines recommend initiating β-blockers at low dose with gradual uptitration as tolerated to doses used in clinical trials. However, patterns and safety of β-blocker intensification in routine practice are poorly described. Methods We described β-blocker intensification among Kaiser Colorado enrollees with a primary discharge diagnosis of HF between 2001–2009. We then assessed β-blocker intensification in the 30 days prior to first hospital readmission for cases compared to the same time period following index hospitalization for non-rehospitalized matched controls. In separate analysis of the subgroup initiated on β-blocker after index hospital discharge, we compared adjusted rates of 30-day hospitalization following initiation of high versus low dose β-blocker. Results Among 3,227 patients, median age was 76 years and 37% had ejection fraction ≤40% (LVSD). During a median follow up of 669 days, 14% were never on β-blocker, 21% were initiated on β-blocker, 43% were discharged on β-blocker but never uptitrated, and 22% had discharge β-blocker uptitrated; 63% were readmitted and 49% died. β-blocker intensification occurred in the 30 days preceding readmission for 39 of 1,674 (2.3%) readmitted cases compared to 27 (1.6%) of matched controls (adjusted OR 1.36, 95% CI 0.81-2.27). Among patients initiated on therapy, readmission over the subsequent 30 days occurred in 6 of 155 (3.9%) prescribed high dose and 9 of 513 (1.8%) prescribed low dose β-blocker (adjusted OR 3.10, 95% CI 1.02-9.40). For the subgroup with LVSD, findings were not significantly different. Conclusion While β-blockers were intensified in nearly half of patients following hospital discharge and high starting dose was associated with increased readmission risk, the prevailing finding was that readmission events were rarely preceded by β-blocker intensification. These data suggest that β-blocker intensification is not a major precipitant of hospitalization, provided recommended dosing is followed. PMID:22709128

Performance-based Outcomes of Inpatient Rehabilitation Facilities Treating Hip Fracture Patients in the United States

PubMed Central

Baernholdt, Marianne; Anderson, Ruth A.; Merwin, Elizabeth I.

2015-01-01

Objective To examine the influence of facility and aggregate patient characteristics of inpatient rehabilitation facilities (IRFs) on performance-based rehabilitation outcomes in a national sample of IRFs treating Medicare beneficiaries with hip fracture. Design Secondary data analysis. Setting U.S. Medicare-certified IRFs (N=983). Participants 983 US Medicare-certified IRFs. Data included 34,364 patient records of Medicare beneficiaries admitted in 2009 for rehabilitation after hip fracture. Main Outcome Measures Performance-based outcomes included mean motor function on discharge, mean motor change (mean motor score on discharge minus mean motor score on admission) and percentage discharged to the community. Results Higher mean motor function on discharge was explained by aggregate characteristics of hip fracture patients (lower age [p=0.009], lower percentage of Blacks [p<0.001] and Hispanics [p<0.001], higher percentage of females [p<0.030], higher motor function on admission [p<0.001], longer length of stay [p<0.001]) and facility characteristics (freestanding [p<0.001], rural [p<0.001], for-profit [p=0.048], and smaller IRFs [p=0.041]). The findings were similar for motor change, but motor change was also associated with lower mean cognitive function on admission (0.008). Higher percentage discharged to the community was associated with aggregate patient characteristics (lower age [p<0.001], lower percentage of Hispanics [p=0.009], higher percentage of patients living with others [p<0.001], and higher motor function on admission [p<0.001]). No facility characteristics were associated with percentage discharged to the community. Conclusion Performance-based measurement offers health policymakers, administrators, clinicians, and consumers a major opportunity for securing health system improvement by benchmarking or comparing their outcomes to other similar facilities. These results might serve as the basis for benchmarking and quality-based reimbursement to IRFs for one impairment group: hip fracture. PMID:25596000

The synthesis of higher oxides of alkali and alkaline earth metals in an electric discharge: Theoretical and experimental studies

NASA Technical Reports Server (NTRS)

Bell, A. T.; Sadhukhan, P.

1974-01-01

Potassium hydroxide was subjected to the products of an electrical discharge sustained in oxygen and produced both potassium peroxide and superoxide. The conversion to higher oxides was shown to strongly depend upon the particle size of KOH, the position of KOH in the discharge zone, and the operating conditions of the discharge. Similar experiments were performed with hydroxides of lithium and calcium which do not form superoxides, but are converted to peroxides. The yields of peroxides were shown to strongly depend upon the operating conditions of the discharge. The absence of superoxides and the presence of peroxides of lithium and calcium was explained from the consideration of relative thermodynamic stability of the oxides of lithium and calcium. Thermogravimetric analysis was shown to provide a more accurate means for determining the amount of KO2 than previous methods.

Hydrologic variability, water chemistry, and phytoplankton biomass in a large flood plain of the Sacramento River, CA, U.S.A.

USGS Publications Warehouse

Schemel, L.E.; Sommer, T.R.; Muller-Solger, A. B.; Harrell, W.C.

2004-01-01

The Yolo Bypass, a large, managed floodplain that discharges to the headwaters of the San Francisco Estuary, was studied before, during, and after a single, month-long inundation by the Sacramento River in winter and spring 2000. The primary objective was to identify hydrologic conditions and other factors that enhance production of phytoplankton biomass in the floodplain waters. Recent reductions in phytoplankton have limited secondary production in the river and estuary, and increased phytoplankton biomass is a restoration objective for this system. Chlorophyll a was used as a measure of phytoplankton biomass in this study. Chlorophyll a concentrations were low (<4 ??g l -1) during inundation by the river when flow through the floodplain was high, but concentrations rapidly increased as river inflow decreased and the floodplain drained. Therefore, hydrologic conditions in the weeks following inundation by river inflow appeared most important for producing phytoplankton biomass in the floodplain. Discharges from local streams were important sources of water to the floodplain before and after inundation by the river, and they supplied dissolved inorganic nutrients while chlorophyll a was increasing. Discharge from the floodplain was enriched in chlorophyll a relative to downstream locations in the river and estuary during the initial draining and later when local stream inflows produced brief discharge pulses. Based on the observation that phytoplankton biomass peaks during drainage events, we suggest that phytoplankton production in the floodplain and biomass transport to downstream locations would be higher in years with multiple inundation and draining sequences.

Low levels of serum total antioxidant capacity and presence at admission and absence at discharge of a day/night change as a marker of acute paranoid schizophrenia relapse.

PubMed

Morera-Fumero, Armando L; Díaz-Mesa, Estefanía; Abreu-Gonzalez, Pedro; Fernandez-Lopez, Lourdes; Cejas-Mendez, Maria Del Rosario

2017-03-01

An oxidant-antioxidant system dysregulation has been described as a schizophrenia pathophysiological base. The total antioxidant capacity (TAC) is one measure of the antioxidant capacity of a system. Day/night concentration changes is a biological characteristic of hormones such as melatonin or cortisol. There is no information about TAC day/night changes in schizophrenia. Studying the existence of a day/night TAC change in schizophrenia. Forty-three DSM-IV paranoid schizophrenia inpatients participated in the study. Thirty healthy subjects matched by age and gender acted as control group. Blood was sampled at 12:00 and 00:00h the day after admission and the day before discharge. Serum TAC was measured by the ABTS radical cation technique and expressed in Trolox mmol/L. Patients had significantly lower TAC levels at admission and discharge (12:00 and 00:00) than controls. At admission patients had a TAC day/night change, with higher day-time than night-time levels (0.66±0.14 vs 0.60±0.15) as well as healthy subjects (0.83±0.07 vs 0.77±0.11). At discharge patients had a similar TAC level at 12:00 and 00:00 (0.64±0.15 vs 0.63±0.14). Schizophrenic patients present a deficit of the antioxidant system. The initial presence and the later absence of a day/night change deserves future studies. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Efficient synthesis of tungsten oxide hydrate-based nanocomposites for applications in bifunctional electrochromic-energy storage devices

NASA Astrophysics Data System (ADS)

Chang, Xueting; Hu, Ruirui; Sun, Shibin; Lu, Tong; Liu, Tao; Lei, Yanhua; Dong, Lihua; Yin, Yansheng; Zhu, Yanqiu

2018-05-01

In this work, we realized the large-scale synthesis of WO3 · H2O nanoflakes (NFs), g-C3N4/WO3 · H2O nanocomposite (NC) and graphene (G)/WO3 · H2O NC via a sonochemical process with tungsten salt as the precursor, g-C3N4 or G sheets as the supports, and distilled water as the solvent. Both the g-C3N4/WO3 · H2O NC and G/WO3 · H2O NC exhibited much better electrochromic (EC) performance (higher coloration efficiencies and faster response times) than that of the WO3 · H2O NFs. Using the WO3 · H2O-based materials as electrode materials, EC batteries that integrate the energy storage and EC functions in one device have been assembled. The energy status of the EC batteries could be visually indicated by the reversible color variations. Compared with the plain WO3 · H2O-based EC batteries, the NC-based EC batteries possessed a lower color contrast between the charged and discharged conditions but much longer discharge durations. The EC batteries could be quickly charged in a few seconds by adding H2O2, and the charged batteries exhibited significantly-enhanced discharging durations in comparison with the initial ones. The g-C3N4/WO3 · H2O NC-EC batteries charged by a small amount of H2O2 could produce a long discharging duration up to 760 min.

Influence of gas conditions on electron temperature inside a pinch column of plasma-focus discharge

NASA Astrophysics Data System (ADS)

Zaloga, D. R.; Sadowski, M. J.; Skladnik-Sadowska, E.; Paduch, M.; Zielinska, E.; Tomaszewski, K.

2018-01-01

The paper reports on soft x-ray emission from high-current discharges in PF-1000U facility operated at 170 kJ. The discharges at static conditions were performed with pure deuterium (D2) and a mixture of D2 and neon (Ne). In shots with the gas-puffing 1 cm3 of D2 or a (D2+Ne) mixture was injected 2 ms before the discharge initiation. Time-integrated x-ray images from a Be-filtered pinhole camera showed that the pinch microstructure depends strongly on gas conditions. In shots with the D2-, (D2+Ne)- or He-puffing distinct “filaments” and “hot-spots” were observed. Time-resolved x-ray pulses were recorded with 4 filtered PIN-diodes which recorded signals from 2 regions of 3 cm in diameter (at z = 3 cm and 6 cm from the anode). From a ratio of x-ray pulses, measured behind different filters, it was estimated that at the static D2-filling electron temperatures (Te ) were from 90 eV to 200 eV. At the D2-filling and -puffing additional x-ray spikes were emitted from “hot-spots” with Te twice higher. In shots at the (D2+10%Ne)-filling Te was 4 keV. In shots with the (D2+Ne)-mixture puffing intense “hot-spots” were formed, and Te reached 2.2-7.5 keV. At the same conditions “filaments” were reproducible macroscopically, but “hot-spots” were irreproducible.

Semi-idealized modeling of lightning initiation related to vertical air motion and cloud microphysics

NASA Astrophysics Data System (ADS)

Wang, Fei; Zhang, Yijun; Zheng, Dong; Xu, Liangtao; Zhang, Wenjuan; Meng, Qing

2017-10-01

A three-dimensional charge-discharge numerical model is used, in a semi-idealized mode, to simulate a thunder-storm cell. Characteristics of the graupel microphysics and vertical air motion associated with the lightning initiation are revealed, which could be useful in retrieving charge strength during lightning when no charge-discharge model is available. The results show that the vertical air motion at the lightning initiation sites ( W ini) has a cubic polynomial correlation with the maximum updraft of the storm cell ( W cell-max), with the adjusted regression coefficient R 2 of approximately 0.97. Meanwhile, the graupel mixing ratio at the lightning initiation sites ( q g-ini) has a linear correlation with the maximum graupel mixing ratio of the storm cell ( q g-cell-max) and the initiation height ( z ini), with the coefficients being 0.86 and 0.85, respectively. These linear correlations are more significant during the middle and late stages of lightning activity. A zero-charge zone, namely, the area with very low net charge density between the main positive and negative charge layers, appears above the area of q g-cell-max and below the upper edge of the graupel region, and is found to be an important area for lightning initiation. Inside the zero-charge zone, large electric intensity forms, and the ratio of q ice (ice crystal mixing ratio) to q g (graupel mixing ratio) illustrates an exponential relationship to q g-ini. These relationships provide valuable clues to more accurately locating the high-risk area of lightning initiation in thunderstorms when only dual-polarization radar data or outputs from numerical models without charging/discharging schemes are available. The results can also help understand the environmental conditions at lightning initiation sites.

Same-Day Discharge after Laparoscopic Roux-en-Y Gastric Bypass: An Analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Database.

PubMed

Inaba, Colette S; Koh, Christina Y; Sujatha-Bhaskar, Sarath; Zhang, Lishi; Nguyen, Ninh T

2018-05-01

Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been performed with successful discharge on postoperative day 1 (POD1). There are limited studies on same-day discharge after LRYGB. The objective of this study was to examine the frequency and outcomes of same-day discharge after LRYGB. The 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was analyzed for adult patients who underwent elective LRYGB cases with same-day vs POD1 discharge. Open and revisional cases were excluded. Multivariate analysis was performed to compare risk-adjusted 30-day mortality, overall morbidity, readmission, and reoperation. There were 354 (0.9%) patients who were discharged on the same day as surgery after LRYGB. After exclusion criteria, 319 patients with same-day discharge and 9,402 patients with POD1 discharge were examined. For same-day vs POD1 discharge groups, mean ages were 45.0 and 44.5 years, respectively, and mean BMIs were 47.3 kg/m 2 and 45.9 kg/m 2 , respectively. The unadjusted mortality rate was significantly higher for same-day compared with POD1 discharge (0.94% vs. 0.05%, respectively; p = 0.0017). Compared with POD1 discharge, same-day discharge had higher overall morbidity (3.76% vs 1.54%; adjusted odds ratio [AOR] 2.41; p = 0.0216), but no statistically significant differences for readmissions (3.45% vs. 3.66%; AOR 0.85; p = 0.9999) or reoperations (1.88% vs. 0.89%; AOR 2.33; p = 0.2428). Same-day discharge after LRYGB is associated with increased morbidity and mortality compared with POD1 discharge. The practice of same-day discharge after LRYGB should be considered experimental until further studies confirm which patient characteristics will ensure safe same-day discharge. Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Underwater spark discharge with long transmission line for cleaning horizontal wells

NASA Astrophysics Data System (ADS)

Lee, Kern; Chung, Kyoung-Jae; Hwang, Y. S.; Kim, C. Y.

2017-06-01

A transmission line is discussed for application in an underwater spark-discharge technique in the cleaning of a horizontal well by incorporating a power-transmission model into the simulation. The pulsed-spark-discharge technique has been proposed for clogged-well rehabilitation, because it removes incrustations that are attached to well screens by using strong pressure waves that are generated by the rapid expansion of a spark channel. To apply the pulsed-spark-discharge technique to the cleaning of horizontal wells, the coaxial cable between the pulsed power supply and the spark gap as a load needs to be extended to a few hundred meters. Prior to field application, pulsed-spark-discharge experiments were conducted and the role of the transmission line was examined using an improved simulation model. In the model, a non-linear interaction of the spark channel and the capacitor bank is described by the pulse-forming action of the coaxial cable. Based on the accurate physical properties of the water plasma, such as the equation of state and electrical conductivity within the region of interest, the amount of energy contributed to the development of a shock wave was evaluated. The simulation shows that if the initial conditions of the spark channel are the same, no further reduction in strength of the pressure wave occurs, even if the cable length is increased above 50 m. Hence, the degraded peak pressure that was observed in the experiments using the longer cable is attributed to a change in the initial condition of the spark channel. The parametric study suggests that the low initial charging voltage, the high ambient water pressure, and the long cable length yield the low initial spark-channel density, which results in a reduced peak pressure. The simulation of line charging is presented to discuss the principle of disturbing the pre-breakdown process by an extended cable.

Improving transition of care for veterans after total joint replacement.

PubMed

Green, Uthona R; Dearmon, Valorie; Taggart, Helen

2015-01-01

Patients transitioning from hospital to home are at risk for readmission to the hospital. Readmissions are costly and occur too often. Standardized discharge education processes have shown to decrease readmissions. The purpose of this quality improvement project was to utilize evidence-based practice changes to decrease 30-day all-cause readmissions after total joint replacement. Review of literature revealed that improved discharge education can decrease unnecessary readmissions after discharge. A quality improvement project was developed including standardized total joint replacement discharge education, teach-back education methodology, and improved postdischarge telephone follow-up. The quality improvement project was initiated and outcomes were evaluated. Improving coordination of the discharge process, enhanced education for patients/caregivers, and postdischarge follow-up decreased total joint replacement readmissions.

Reversing-counterpulse repetitive-pulse inductive storage circuit

DOEpatents

Honig, Emanuel M.

1987-01-01

A high-power reversing-counterpulse repetitive-pulse inductive storage and transfer circuit includes an opening switch, a main energy storage coil, a counterpulse capacitor and a small inductor. After counterpulsing the opening switch off, the counterpulse capacitor is recharged by the main energy storage coil before the load pulse is initiated. This gives the counterpulse capacitor sufficient energy for the next counterpulse operation, although the polarity of the capacitor's voltage must be reversed before that can occur. By using a current-zero switch as the counterpulse start switch, the capacitor is disconnected from the circuit (with a full charge) when the load pulse is initiated, preventing the capacitor from depleting its energy store by discharging through the load. After the load pulse is terminated by reclosing the main opening switch, the polarity of the counterpulse capacitor voltage is reversed by discharging the capacitor through a small inductor and interrupting the discharge current oscillation at zero current and peak reversed voltage. The circuit enables high-power, high-repetition-rate operation with reusable switches and features total control (pulse-to-pulse) over output pulse initiation, duration, repetition rate, and, to some extent, risetime.

Reversing-counterpulse repetitive-pulse inductive storage circuit

DOEpatents

Honig, E.M.

1984-06-05

A high power reversing-counterpulse repetitive-pulse inductive storage and transfer circuit includes an opening switch, a main energy storage coil, a counterpulse capacitor and a small inductor. After counterpulsing the opening switch off, the counterpulse capacitor is recharged by the main energy storage coil before the load pulse is initiated. This gives the counterpulse capacitor sufficient energy for the next counterpulse operation, although the polarity of the capacitor's voltage must be reversed before that can occur. By using a current-zero switch as the counterpulse start switch, the capacitor is disconnected from the circuit (with a full charge) when the load pulse is initiated, preventing the capacitor from depleting its energy store by discharging through the load. After the load pulse is terminated by reclosing the main opening switch, the polarity of the counterpulse capacitor voltage is reversed by discharging the capacitor through a small inductor and interrupting the discharge current oscillation at zero current and peak reversed voltage. The circuit enables high-power, high-repetition-rate operation with reusable switches and features total control (pulse-to-pulse) over output pulse initiation, duration, repetition rate, and, to some extent, risetime.

Initial results from the NASA Lewis Bumpy Torus experiment. [of steady-state ion heating method based on modified Penning discharge

NASA Technical Reports Server (NTRS)

Roth, J. R.; Richardson, R. W.; Gerdin, G. A.

1973-01-01

Initial results were obtained from low power operation of the NASA Lewis Bumpy Torus experiment, in which a steady-state ion heating method based on the modified Penning discharge is applied in a bumpy torus confinement geometry. The magnet facility consists of 12 superconducting coils, each 19 cm i.d. and capable of 3.0 T, equally spaced in a toroidal array 1.52 m in major diameter. A 18 cm i.d. anode ring is located at each of the 12 midplanes and is maintained at high positive potentials by a dc power supply. Initial observations indicate electron temperatures from 10 to 150 eV, and ion kinetic temperatures from 200 eV to 1200 eV. Two modes of operation were observed, which depend on background pressure, and have different radial density profiles. Steady state neutron production was observed. The ion heating process in the bumpy torus appears to parallel closely the mechanism observed when the modified Penning discharge was operated in a simple magnetic mirror field.

Annual peak discharges from small drainage areas in Montana for stations discontinued before 1978

USGS Publications Warehouse

Omang, R.J.; Hull, J.A.; Parrett, Charles

1979-01-01

Annual peak stage and discharge data have been tabulated for crest-stage gage sites in Montana. The crest-stage program was begun in July 1955 to investigate the magnitude and frequency of floods from samll drainage areas. The program has expanded from 45 crest-stage gaging stations initially to 172 stations maintained in 1978. From 1955 to 1978, 156 stations have been discontinued. This report is a tabulation of the stage and discharge data for the discontinued stations. (Woodard-USGS)

Nanoscale discharge electrode for minimizing ozone emission from indoor corona devices.

PubMed

Bo, Zheng; Yu, Kehan; Lu, Ganhua; Mao, Shun; Chen, Junhong; Fan, Fa-Gung

2010-08-15

Ground-level ozone emitted from indoor corona devices poses serious health risks to the human respiratory system and the lung function. Federal regulations call for effective techniques to minimize the indoor ozone production. In this work, stable atmospheric corona discharges from nanomaterials are demonstrated using horizontally suspended carbon nanotubes (CNTs) as the discharge electrode. Compared with the conventional discharges employing micro- or macroscale electrodes, the corona discharge from CNTs could initiate and operate at a much lower voltage due to the small electrode diameter, and is thus energy-efficient. Most importantly, the reported discharge is environmentally friendly since no ozone (below the detection limit of 0.5 ppb) was detected for area current densities up to 0.744 A/m(2) due to the significantly reduced number of electrons and plasma volume generated by CNT discharges. The resulting discharge current density depends on the CNT loading. Contrary to the conventional wisdom, negative CNT discharges should be used to enhance the current density owing to the efficient field emission of electrons from the CNT surface.

Geospatial database of estimates of groundwater discharge to streams in the Upper Colorado River Basin

USGS Publications Warehouse

Garcia, Adriana; Masbruch, Melissa D.; Susong, David D.

2014-01-01

The U.S. Geological Survey, as part of the Department of the Interior’s WaterSMART (Sustain and Manage America’s Resources for Tomorrow) initiative, compiled published estimates of groundwater discharge to streams in the Upper Colorado River Basin as a geospatial database. For the purpose of this report, groundwater discharge to streams is the baseflow portion of streamflow that includes contributions of groundwater from various flow paths. Reported estimates of groundwater discharge were assigned as attributes to stream reaches derived from the high-resolution National Hydrography Dataset. A total of 235 estimates of groundwater discharge to streams were compiled and included in the dataset. Feature class attributes of the geospatial database include groundwater discharge (acre-feet per year), method of estimation, citation abbreviation, defined reach, and 8-digit hydrologic unit code(s). Baseflow index (BFI) estimates of groundwater discharge were calculated using an existing streamflow characteristics dataset and were included as an attribute in the geospatial database. A comparison of the BFI estimates to the compiled estimates of groundwater discharge found that the BFI estimates were greater than the reported groundwater discharge estimates.

Psychiatric Inpatient Discharge Planning Practices and Attendance at Aftercare Appointments.

PubMed

Smith, Thomas E; Abraham, Maria; Bolotnikova, Natalia V; Donahue, Sheila A; Essock, Susan M; Olfson, Mark; Shao, Wenjun S; Wall, Melanie M; Radigan, Marleen

2017-01-01

This study examined discharge planning practices by hospital providers for 17,053 psychiatric discharges in New York's statewide Medicaid program. Claims data were linked to information reported to New York State by managed behavioral health care organizations (MBHOs) conducting inpatient utilization reviews. MBHOs documented hospital providers' reports of the presence of three discharge planning practices for each discharge: communicating with an outpatient provider prior to discharge, scheduling an aftercare appointment, and forwarding a discharge summary. Hospital providers reported completing at least one of the three discharge planning practices for 85% of discharges. Individuals who received all three discharge planning practices had a higher likelihood of follow-up and kept their first outpatient follow-up visit at almost twice the speed compared with individuals who received none of the practices (hazard ratio=1.96, p<.001). This study provided baseline information concerning routine discharge planning practices and their relationship to timeliness of care transitions.

Stackelberg Game Model of Wind Farm and Electric Vehicle Battery Switch Station

NASA Astrophysics Data System (ADS)

Jiang, Zhe; Li, Zhimin; Li, Wenbo; Wang, Mingqiang; Wang, Mengxia

2017-05-01

In this paper, a cooperation method between wind farm and Electric vehicle battery switch station (EVBSS) was proposed. In the pursuit of maximizing their own benefits, the cooperation between wind farm and EVBSS was formulated as a Stackelberg game model by treating them as decision makers in different status. As the leader, wind farm will determine the charging/discharging price to induce the charging and discharging behavior of EVBSS reasonably. Through peak load shifting, wind farm could increase its profits by selling more wind power to the power grid during time interval with a higher purchase price. As the follower, EVBSS will charge or discharge according to the price determined by wind farm. Through optimizing the charging /discharging strategy, EVBSS will try to charge with a lower price and discharge with a higher price in order to increase its profits. Since the possible charging /discharging strategy of EVBSS is known, the wind farm will take the strategy into consideration while deciding the charging /discharging price, and will adjust the price accordingly to increase its profits. The case study proved that the proposed cooperation method and model were feasible and effective.

Development of ambient temperature secondary lithium cells

NASA Technical Reports Server (NTRS)

Subbarao, S.; Shen, D. H.; Dawson, S.; Deligiannis, F.; Taraszkiewicz, J.; Halpert, G.

1988-01-01

JPL is developing ambient temperature secondary lithium cells for future spacecraft applications. Prior studies on experimental laboratory type Li-TiS2 cells yielded promising results in terms of cycle life and rate capability. To further assess the performance of this cell, 5 Ah engineering model cells were developed. Initially baseline cells were designed and fabricated. Each cell had 15 cathodes and 16 anodes and the ratio of anode to cathode capacity is 6:1. A solution of 1.5 molar LiAsF6 in 2Me-THF was used as the electrolyte. Cells were evaluated for their cycle life at C/1 and C/5 discharge rates and 100 percent depth of discharge. The cells were cycled between voltage limits 1.7 and 2.8 volts. The rate of charge in all cases is C/10. The results obtained indicate that cells can operate at C/10 to C/2 discharge rates and have an initial energy density of 70 Wh/kg. Cells delivered more than 100 cycles at C/2 discharge rate. The details of cell design, the test program, and the results obtained are described.

Development of ambient temperature secondary lithium cells

NASA Technical Reports Server (NTRS)

Subbarao, S.; Shen, D. H.; Dawson, S.; Deligiannis, F.; Taraszkiewicz, J.; Halpert, Gerald

1987-01-01

JPL is developing ambient temperature secondary lithium cells for future spacecraft applications. Prior studies on experimental laboratory type Li-TiS2 cells yielded promising results in terms of cycle life and rate capability. To further assess the performance of this cell, 5 Ah engineering model cells were developed. Initially baseline cells were designed and fabricated. Each cell had 15 cathodes and 16 anodes and the ratio of anode to cathode capacity is 6:1. A solution of 1.5 molar LiAsF6 in 2Me-THF was used as the electrolyte. Cells were evaluated for their cycle life at C/1 and C/5 discharge rates and 100 percent depth of discharge. The cells were cycled between voltage limits 1.7 and 2.8 volts. The rate of charge in all cases is C/10. The results obtained indicate that cells can operate at C/10 to C/2 discharge rates and have an initial energy density of 70 Wh/kg. Cells delivered more than 100 cycles at C/2 discharge rate. The details of cell design, the test program, and the results obtained are described.

Effect of component compression on the initial performance of an IPV nickel-hydrogen cell

NASA Technical Reports Server (NTRS)

Gahn, Randall F.

1987-01-01

An experimental method was developed for evaluating the effect of component compression on the charge and discharge voltage characteristics of a 3 1/2 in. diameter boiler plate cell. A standard boiler plate pressure vessel was modified by the addition of a mechanical feedthrough on the bottom of the vessel which permitted different compressions to be applied to the components without disturbing the integrity of the stack. Compression loadings from 0.94 to 27.4 psi were applied by suspending weights from the feedthrough rod. Cell voltages were measured for 0.96-C, 55-min charge and for 1.37-C, 35-min and 2-C, 24-min discharges. An initial change in voltage performance on both charge and discharge as the loading increased was attributed to seating of the components. Subsequent variation of the compression from 2.97 to 27.4 psi caused only minor changes in either the charge or the discharge voltages. Several one month open-circuit voltage stands and 1100 cycles under LEO conditions at the maximum loading have produced no change in performance.

Effect of component compression on the initial performance of an IPV nickel-hydrogen cell. [Individual Pressure Vessel

NASA Technical Reports Server (NTRS)

Gahn, Randall F.

1987-01-01

An experimental method was developed for evaluating the effect of component compression on the charge and discharge voltage characteristics of a 3 1/2 in. diameter boiler plate cell. A standard boiler plate pressure vessel was modified by the addition of a mechanical feedthrough on the bottom of the vessel which permitted different compressions to be applied to the components without disturbing the integrity of the stack. Compression loadings from 0.94 to 27.4 psi were applied by suspending weights from the feedthrough rod. Cell voltages were measured for 0.96-C, 55-min charge and for 1.37-C, 35-min and 2-C, 24-min discharges. An initial change in voltage performance on both charge and discharge as the loading increased was attributed to seating of the components. Subsequent variation of the compression from 2.97 to 27.4 psi caused only minor changes in either the charge or the discharge voltages. Several one month open-circuit voltage stands and 1100 cycles under LEO conditions at the maximum loading have produced no change in performance.

Investigation of the relevant kinetic processes in the initial stage of a double-arcing instability in oxygen plasmas

NASA Astrophysics Data System (ADS)

Mancinelli, B.; Prevosto, L.; Chamorro, J. C.; Minotti, F. O.; Kelly, H.

2018-05-01

A numerical investigation of the kinetic processes in the initial (nanosecond range) stage of the double-arcing instability was developed. The plasma-sheath boundary region of an oxygen-operated cutting torch was considered. The energy balance and chemistry processes in the discharge were described. It is shown that the double-arcing instability is a sudden transition from a diffuse (glow-like) discharge to a constricted (arc-like) discharge in the plasma-sheath boundary region arising from a field-emission instability. A critical electric field value of ˜107 V/m was found at the cathodic part of the nozzle wall under the conditions considered. The field-emission instability drives in turn a fast electronic-to-translational energy relaxation mechanism, giving rise to a very fast gas heating rate of at least ˜109 K/s, mainly due to reactions of preliminary dissociation of oxygen molecules via the highly excited electronic state O2(B3Σu-) populated by electron impact. It is expected that this fast oxygen heating rate further stimulates the discharge contraction through the thermal instability mechanism.

Reporting of Sepsis Cases for Performance Measurement Versus for Reimbursement in New York State.

PubMed

Prescott, Hallie C; Cope, Tara M; Gesten, Foster C; Ledneva, Tatiana A; Friedrich, Marcus E; Iwashyna, Theodore J; Osborn, Tiffany M; Seymour, Christopher W; Levy, Mitchell M

2018-05-01

Under "Rory's Regulations," New York State Article 28 acute care hospitals were mandated to implement sepsis protocols and report patient-level data. This study sought to determine how well cases reported under state mandate align with discharge records in a statewide administrative database. Observational cohort study. First 27 months of mandated sepsis reporting (April 1, 2014, to June 30, 2016). Hospitalizations with sepsis at New York State Article 28 acute care hospitals. Sepsis regulations with mandated reporting. We compared cases reported to the New York State Department of Health Sepsis Clinical Database with discharge records in the Statewide Planning and Research Cooperative System database. We classified discharges as 1) "coded sepsis discharges"-a diagnosis code for severe sepsis or septic shock and 2) "possible sepsis discharges," using Dombrovskiy and Angus criteria. Of 111,816 sepsis cases reported to the New York State Department of Health Sepsis Clinical Database, 105,722 (94.5%) were matched to discharge records in Statewide Planning and Research Cooperative System. The percentage of coded sepsis discharges reported increased from 67.5% in the first quarter to 81.3% in the final quarter of the study period (mean, 77.7%). Accounting for unmatched cases, as many as 82.7% of coded sepsis discharges were potentially reported, whereas at least 17.3% were unreported. Compared with unreported discharges, reported discharges had higher rates of acute organ dysfunction (e.g., cardiovascular dysfunction 63.0% vs 51.8%; p < 0.001) and higher in-hospital mortality (30.2% vs 26.1%; p < 0.001). Hospital characteristics (e.g., number of beds, teaching status, volume of sepsis cases) were similar between hospitals with a higher versus lower percent of discharges reported, p values greater than 0.05 for all. Hospitals' percent of discharges reported was not correlated with risk-adjusted mortality of their submitted cases (Pearson correlation coefficient 0.11; p = 0.17). Approximately four of five discharges with a diagnosis code of severe sepsis or septic shock in the Statewide Planning and Research Cooperative System data were reported in the New York State Department of Health Sepsis Clinical Database. Incomplete reporting appears to be driven more by underrecognition than attempts to game the system, with minimal bias to risk-adjusted hospital performance measurement.

Clinical outcomes, health resource use, and cost in patients with early versus late dual or triple anti-platelet treatment for acute coronary syndrome.

PubMed

Friedman, Howard; Mollon, Patrick; Lian, Jean; Navaratnam, Prakash

2013-08-01

Acute coronary syndrome (ACS) guidelines recommend early dual anti-platelet therapy (thienopyridines + acetylsalicylic acid [aspirin]). However, triple therapy (thienopyridines + aspirin + glycoprotein IIb/IIIa receptor inhibitors [GRIs]) has shown benefit in clinical trials. This study assessed real-world ACS treatment patterns and outcomes in the acute care setting. A retrospective analysis of patients admitted to hospital with ACS (index event) from January 2007 to December 2009 was conducted (Thomson's MarketScan Hospital Drug Database). Eligible patients were ≥18 years of age, of either sex, and had primary admission and discharge diagnoses of ACS. Cohorts were defined by anti-platelet treatment and then by the timing of treatment initiation (early initiation: within ≤2 days of admission; late initiation: ≥2 days post-admission). Patient characteristics, clinical outcomes, resource utilization, and costs were assessed using descriptive statistics. A total of 249,907 eligible patients were placed into four treatment cohorts (aspirin assumed for all patients): aspirin only; clopidogrel only (dual therapy); GRI only (dual therapy); and clopidogrel + GRI (triple therapy). Patients in the 'clopidogrel-only' cohort were more likely to be older, female, and have more co-morbidities than those in other cohorts; stroke (6.2 %) and re-hospitalization (15.4 %) rates were higher than in the 'GRI-only' and 'triple therapy' cohorts. The GRI-only cohort had higher major bleeding rates (3.3 %), mortality (7.6 %), and costs ($US21,975 [year 2010 values]) than the clopidogrel-only and triple-therapy cohorts. Late initiation cohorts were more likely to be older, female, and have more co-morbidities than early initiation cohorts. Major bleeding was more likely with GRI-only patients (regardless of initiation timing) than with other cohorts. Late-treated clopidogrel-only patients had higher rates of stroke (6.9 %), ACS-related re-admissions (6.1 %), and all-cause re-admissions (15.9 %) than other cohorts. Late treatment was associated with longer length of stay and significantly higher costs. Real-world anti-platelet treatment patterns are consistent with ACS guidelines recommending early initiation and selective GRI use. In contrast to recommendations, some outcomes were improved with triple therapy compared with dual therapy.

Evaluation of a community based childhood injury prevention program.

PubMed Central

Bablouzian, L.; Freedman, E. S.; Wolski, K. E.; Fried, L. E.

1997-01-01

OBJECTIVES: This pilot study evaluates the effectiveness of a community based childhood injury prevention program on the reduction of home hazards. METHODS: High risk pregnant women, who were enrolled in a home visiting program that augments existing health and human services, received initial home safety assessments. Clients received education about injury prevention practices, in addition to receiving selected home safety supplies. Fourteen questions from the initial assessment tool were repeated upon discharge from the program. Matched analyses were conducted to evaluate differences from initial assessment to discharge. RESULTS: A significantly larger proportion of homes were assessed as safe at discharge, compared with the initial assessment, for the following hazards: children riding unbuckled in all auto travel, Massachusetts Poison Center sticker on the telephone, outlet plugs in all unused electrical outlets, safety latches on cabinets and drawers, and syrup of ipecac in the home. CONCLUSIONS: A community based childhood injury prevention program providing education and safety supplies to clients significantly reduced four home hazards for which safety supplies were provided. Education and promotion of the proper use of child restraint systems in automobiles significantly reduced a fifth hazard, children riding unbuckled in auto travel. This program appears to reduce the prevalence of home hazards and, therefore, to increase home safety. PMID:9113841

Exploration to generate atmospheric pressure glow discharge plasma in air

NASA Astrophysics Data System (ADS)

Wenzheng, LIU; Chuanlong, MA; Shuai, ZHAO; Xiaozhong, CHEN; Tahan, WANG; Luxiang, ZHAO; Zhiyi, LI; Jiangqi, NIU; Liying, ZHU; Maolin, CHAI

2018-03-01

Atmospheric pressure glow discharge (APGD) plasma in air has high application value. In this paper, the methods of generating APGD plasma in air are discussed, and the characteristics of dielectric barrier discharge (DBD) in non-uniform electric field are studied. It makes sure that APGD in air is formed by DBD in alternating current electric field with using the absorbing electron capacity of electret materials to provide initial electrons and to end the discharge progress. Through designing electric field to form two-dimensional space varying electric field and three-dimensional space varying electric field, the development of electron avalanches in air-gap is suppressed effectively and a large space of APGD plasma in air is generated. Further, through combining electrode structures, a large area of APGD plasma in air is generated. On the other hand, by using the method of increasing the density of initial electrons, millimeter-gap glow discharge in atmospheric pressure air is formed, and a maximum gap distance between electrodes is 8 mm. By using the APGD plasma surface treatment device composed of contact electrodes, the surface modification of high polymer materials such as aramid fiber and polyester are studied and good effect of modifications is obtained. The present paper provides references for the researchers of industrial applications of plasma.

Submerged Glow-Discharge Plasma: An Economical Approach to Convert Construction Scrap Metal into Nanomaterials

NASA Astrophysics Data System (ADS)

Yek, Peter Nai Yuh; Rafiq Mirza Julaihi, Muhammad; Shahril Osman, Mohammad; Tiong, Tung Chuan; Lee, Wak Ha; Leing Lee, Chern

2018-03-01

Submerged glow-discharge plasma (SGDP) is relatively new among the various methods available for nanomaterials synthesis (NMs) techniques. This method allows great control over the production cost of nanomaterials synthesis. A lab-scale batch type SDGP technology has been constructed to produce nanomaterials and investigate the inter-relationship between plasma excitation voltages, electrodes submerged areas and electrolyte concentration. Metal oxide nanospheres has been synthesised from different electrolyte concentrations (1M-0.001M) and characterized by Scanning Electron Microscopy (SEM) and Energy Dispersive Spectroscopy (EDS). As the major results showed that the nanospheres are uniformly spherical with diameter size distribution are between 100 nm - 2μm. EDS analysis shown the nano-Iron Oxide have been formed. Scrap metal initially showed around 6.45% and 93.55% of Carbon and Iron composition respectively. After SGDP process to the scrap metal, Carbon content has increased to 34-35% and Iron content has reduced to around 15-40%. EDS results also shown the higher percentage of Iron amount has remained with lower electrolyte concentration and Current is proportionally related to submersion area of cathode.

Low power arcjet thruster pulse ignition

NASA Technical Reports Server (NTRS)

Sarmiento, Charles J.; Gruber, Robert P.

1987-01-01

An investigation of the pulse ignition characteristics of a 1 kW class arcjet using an inductive energy storage pulse generator with a pulse width modulated power converter identified several thruster and pulse generator parameters that influence breakdown voltage including pulse generator rate of voltage rise. This work was conducted with an arcjet tested on hydrogen-nitrogen gas mixtures to simulate fully decomposed hydrazine. Over all ranges of thruster and pulser parameters investigated, the mean breakdown voltages varied from 1.4 to 2.7 kV. Ignition tests at elevated thruster temperatures under certain conditions revealed occasional breakdowns to thruster voltages higher than the power converter output voltage. These post breakdown discharges sometimes failed to transition to the lower voltage arc discharge mode and the thruster would not ignite. Under the same conditions, a transition to the arc mode would occur for a subsequent pulse and the thruster would ignite. An automated 11 600 cycle starting and transition to steady state test demonstrated ignition on the first pulse and required application of a second pulse only two times to initiate breakdown.

The behaviour of arcs in carbon mixed-mode high-power impulse magnetron sputtering

NASA Astrophysics Data System (ADS)

Tucker, M. D.; Putman, K. J.; Ganesan, R.; Lattemann, M.; Stueber, M.; Ulrich, S.; Bilek, M. M. M.; McKenzie, D. R.; Marks, N. A.

2017-04-01

Mixed-mode deposition of carbon is an extension of high-power impulse magnetron sputtering in which a short-lived arc is deliberately allowed to ignite on the target surface to increase the ionised fraction of carbon in the deposition flux. Here we investigate the ignition and evolution of these arcs and examine their behaviour for different conditions of argon pressure, power supply voltage, and current. We find that mixed-mode deposition is sensitive to the condition of the target surface, and changing the operating parameters causes changes in the target surface condition which themselves affect the discharge in a process of negative feedback. Initially the arcs are evenly distributed on the target racetrack, but after a long period of operation the mode of erosion changes and arcs become localised in a small region, resulting in a pronounced nodular structure. We also quantify macroparticle generation and observe a power-law size distribution typical of arc discharges. Fewer particles are generated for operation at lower Ar pressure when the arc spot velocity is higher.

Advanced nickel-metal hydride cell development. Final report, September 1993--March 1996

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lim, Hong S.

1996-03-01

Inert gas atomization using metal hydride alloys for a Ni/MH{sub x}cell was studied. Atomization of the alloys was demonstrated on a small production scale up to batch size of several kg. Relative performance of the atomized and nonatomized alloys was investigated for the electrode material in a Ni/MH{sub x} cell. The study included effects of charge-discharge rates, temperature, and particle size on cell voltage (polarization) and specific capacity. Results show that the specific capacity of the present atomized alloys was apprecialy smaller than that of the nonatomized powder, especially for initial cycles. Full activation of the atomized alloys oftentook severalmore » hundreds of cycles. However, no appreciable difference in discharge rate capability was observed with R10 and R12 alloys. Chemical compositions were indistinguishable, although the oxygen contents of the atomized alloys were always higher. Effects of Ni and Cu coating on alloy performance were studied after electroless coating; the coatings noticeably improved the electrode rate capability for all the alloys. The electrode polarization was esecially improved, but not the cycle life. Further studies are needed.« less

Treatment of simulated wastewater containing Reactive Red 195 by zero-valent iron/activated carbon combined with microwave discharge electrodeless lamp/sodium hypochlorite.

PubMed

Fu, Jie; Xu, Zhen; Li, Qing-Shan; Chen, Song; An, Shu-Qing; Zeng, Qing-Fu; Zhu, Hai-Liang

2010-01-01

A comparative study of treatment of simulated wastewater containing Reactive Red 195 using zero-valent iron/activated carbon (ZVI/AC), microwave discharge electrodeless lamp/sodium hypochlorite (MDEL/NaClO) and the combination of ZVI/AC-MDEL/NaClO was conducted. The preliminary results showed the two steps method of ZVI/AC-MDEL/NaClO had much higher degradation efficiency than both single steps. The final color removal percentage was nearly up to 100% and the chemical oxygen demand reduction percentage was up to approximately 82%. The effects of operational parameters, including initial pH value of simulated wastewater, ZVI/AC ratio and particle size of ZVI were also investigated. In addition, from the discussion of synergistic effect between ZVI/AC and MEDL/NaClO, we found that in the ZVI/AC-MEDL/NaClO process, ZVI/AC could break the azo bond firstly and then MEDL/NaClO degraded the aromatic amine products effectively. Reversing the order would reduce the degradation efficiency.

Structural and Electrochemical Characterization of Zn1-xFexO-Effect of Aliovalent Doping on the Li⁺ Storage Mechanism.

PubMed

Giuli, Gabriele; Eisenmann, Tobias; Bresser, Dominic; Trapananti, Angela; Asenbauer, Jakob; Mueller, Franziska; Passerini, Stefano

2017-12-29

In order to further improve the energy and power density of state-of-the-art lithium-ion batteries (LIBs), new cell chemistries and, therefore, new active materials with alternative storage mechanisms are needed. Herein, we report on the structural and electrochemical characterization of Fe-doped ZnO samples with varying dopant concentrations, potentially serving as anode for LIBs (Rechargeable lithium-ion batteries). The wurtzite structure of the Zn 1-x Fe x O samples (with x ranging from 0 to 0.12) has been refined via the Rietveld method. Cell parameters change only slightly with the Fe content, whereas the crystallinity is strongly affected, presumably due to the presence of defects induced by the Fe 3+ substitution for Zn 2+ . XANES (X-ray absorption near edge structure) data recorded ex situ for Zn 0.9 Fe 0.1 O electrodes at different states of charge indicated that Fe, dominantly trivalent in the pristine anode, partially reduces to Fe 2+ upon discharge. This finding was supported by a detailed galvanostatic and potentiodynamic investigation of Zn 1-x Fe x O-based electrodes, confirming such an initial reduction of Fe 3+ to Fe 2+ at potentials higher than 1.2 V (vs. Li⁺/Li) upon the initial lithiation, i.e., discharge. Both structural and electrochemical data strongly suggest the presence of cationic vacancies at the tetrahedral sites, induced by the presence of Fe 3+ (i.e., one cationic vacancy for every two Fe 3+ present in the sample), allowing for the initial Li⁺ insertion into the ZnO lattice prior to the subsequent conversion and alloying reaction.

Dual-protection of a graphene-sulfur composite by a compact graphene skin and an atomic layer deposited oxide coating for a lithium-sulfur battery.

PubMed

Yu, Mingpeng; Wang, Aiji; Tian, Fuyang; Song, Hongquan; Wang, Yinshu; Li, Chun; Hong, Jong-Dal; Shi, Gaoquan

2015-03-12

A reduced graphene oxide (rGO)-sulfur composite aerogel with a compact self-assembled rGO skin was further modified by an atomic layer deposition (ALD) of ZnO or MgO layer, and used as a free-standing electrode material of a lithium-sulfur (Li-S) battery. The rGO skin and ALD-oxide coating worked as natural and artificial barriers to constrain the polysulfides within the cathode region. As a result, the Li-S battery based on this electrode material exhibited superior cycling stability, good rate capability and high coulombic efficiency. Furthermore, ALD-ZnO coating was tested for performance improvement and found to be more effective than ALD-MgO coating. The ZnO modified G-S electrode with 55 wt% sulfur loading delivered a maximum discharge capacity of 998 mA h g(-1) at a current density of 0.2 C. A high capacity of 846 mA h g(-1) was achieved after charging/discharging for 100 cycles with a coulombic efficiency of over 92%. In the case of using LiNO3 as a shuttle inhibitor, this electrode showed an initial discharge capacity of 796 mA h g(-1) and a capacity retention of 81% after 250 cycles at a current density of 1 C with an average coulombic efficiency higher than 99.7%.

Initial home health outcomes under prospective payment.

PubMed

Schlenker, Robert E; Powell, Martha C; Goodrich, Glenn K

2005-02-01

To assess initial changes in home health patient outcomes under Medicare's home health Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services (CMS) in October 2000. Pre-PPS and early PPS data were obtained from CMS Outcome and Assessment Information Set (OASIS) and Medicare claims files. Regression analysis was applied to national random samples (n=164,810) to estimate pre-PPS/PPS outcome and visit-per-episode changes. Outcome episodes were constructed from OASIS data and linked with Medicare claims data on visits. Outcome changes (risk adjusted) were mixed and generally modest. Favorable changes included higher improvement rates under PPS for functioning and dyspnea, higher community discharge rates, and lower hospitalization and emergent care rates. Most stabilization (nonworsening) outcome rates also increased. However, improvement rates were lower under PPS for wounds, incontinence, and cognitive and emotional/behavioral outcomes. Total visits per episode (case-mix adjusted) declined 16.6 percent although therapy visits increased by 8.4 percent. The outcome and visit results suggest improved system efficiency under PPS (fewer visits, similar outcomes). However, declines in several improvement rates merit ongoing monitoring, as do subsequent (posthome health) hospitalization and emergent care use. Since only the early PPS period was examined, longer-term analyses are needed.

The influence of superimposed DC current on electrical and spectroscopic characteristics of HiPIMS discharge

NASA Astrophysics Data System (ADS)

Zuo, Xiao; Chen, Rende; Liu, Jingzhou; Ke, Peiling; Wang, Aiying

2018-01-01

The electrical characteristics and spectroscopic properties have been comprehensively investigated in a DC superimposed high power impulse magnetron sputtering (DC-HiPIMS) deposition system in this paper. The influence of superimposed DC current on the variation of target and substrate current waveforms, active species and electron temperatures with pulse voltages are focused. The peak target currents in DC-HiPIMS are lower than in HiPIMS. The time scales of the two main discharge processes like ionization and gas rarefaction in DC-HiPIMS are analyzed. When the pulse voltage is higher than 600 V, the gas rarefaction effect becomes apparent. Overall, the ionization process is found to be dominant in the initial ˜100 μs during each pulse. The active species of Ar and Cr in DC-HiPIMS are higher than in HiPIMS unless that the pulse voltage reaches 900 V. However, the ionization degree in HiPIMS exceeds that in DC-HiPIMS at around 600 V. The electron temperature calculated by modified Boltzmann plot method based on corona model has a precipitous increase from 0.87 to 25.0 eV in HiPIMS, but varies mildly after the introduction of the superimposed DC current. Additionally, the current from plasma flowing to the substrate is improved when a DC current is superimposed with HiPIMS.

Scaling of Dielectric Breakdown Thresholds in Earth's and CO2-rich atmospheres: Impact for Predictions of Extraterrestrial Transient Luminous Events and Lightning Discharges

NASA Astrophysics Data System (ADS)

Riousset, J. A.

2016-12-01

Earth's atmospheric electricity manifests itself in the form of glow, corona, streamer, and leader discharges observed as Saint Elmo's fire, sprites, lightning and jets discharges, and other Transient Luminous Events (TLEs). All of these are types of dielectric breakdown, but are governed by different physics. In particular, their initiation is associated with the crossing of specific electric field thresholds: relativistic runaway, streamer propagation, conventional breakdown, or thermal runaway thresholds, some better understood than others. For example, the initiation of a lightning discharge is known to occur when the local electric field exceeds a value similar to relativistic runaway field, but the exact threshold, as well as the physical mechanisms at work, remain rather unclear to date. Scaling laws for electric fields (and other quantities) have been established by Pasko et al. [GRL, 25(12), 2123-2126, 1998] and Pasko [NATO Sci. Series, Springer, 253-311, 2006]. In this work, we develop profiles for initiation criteria in air and in other atmospheric environments. We further calculate their associated scaling laws to determine the ability to trigger lightning flashes and TLEs in our solar system. This lets us predict the likelihood of electrical discharges on, e.g., Mars, Venus and Titan, and calculate the expected electric field conditions, under which discharges have been observed on Jupiter, Saturn, Uranus, and Neptune [Leblanc et al., ISSI Spa. Sci. Series, Springer, 2008, Yair, Adv. Space Res., 50(3), 293-310, 2012]. Our results anticipate the arrival of ExoMars 2016's Schiaparelli module, which will provide the first records of electric field at the surface of the planet [Déprez et al., EGU GA, 16, 16613, 2014]. This research is also motived by the increasing probability of manned missions to Mars and the potential electrostatic hazards it may face [Yair, 2012], and by the role of electrical discharges in the creation of active radicals, some of which may be of biological importance [Miller, Science, 117, 528-529, 1953; Biochem. Biophys. Acta, 23, 480-489, 1957].

GAS DISCHARGE SWITCH EVALUATION FOR RHIC BEAM ABORT KICKER APPLICATION.

DOE Office of Scientific and Technical Information (OSTI.GOV)

ZHANG,W.; SANDBERG,J.; SHELDRAKE,R.

2002-06-30

A gas discharge switch EEV HX3002 is being evaluated at Brookhaven National Laboratory as a possible candidate of RHIC Beam Abort Kicker modulator main switch. At higher beam energy and higher beam intensity, the switch stability becomes very crucial. The hollow anode thyratron used in the existing system is not rated for long reverse current conduction. The reverse voltage arcing caused thyratron hold-off voltage de-rating has been the main limitation of the system operation. To improve the system reliability, a new type of gas discharge switch has been suggested by Marconi Applied Technology for its reverse conducting capability.

[Secondary Splenic Rupture after Initially Inconspicuous CAT Scan].

PubMed

Prokop, A; Koll, S; Chmielnicki, M

2016-04-01

Splenic injuries occur in 1-5 % of blunt abdominal trauma cases. After initial haemorrhagic compression, secondary delayed spleen rupture can occur with a latency of one day to a month or longer. Mortality is then up to 15 %. The spleen injury is almost always recognisable on CT or ultrasound. In one case from our clinic, secondary splenic rupture occurred in a patient after discharge from hospitalisation, even though the initial CT and ultrasound were unremarkable. The patient survived, and underwent emergent splenectomy 8 days after the trauma. An expert review of the case identified no errors in treatment. No case of secondary splenic rupture after initially unremarkable diagnostic studies and clinical course has previously been published. Secondary splenic rupture has a high mortality rate. Patients should be advised of potential complications after hospital discharge, and should return to the hospital immediately in case of symptoms. Georg Thieme Verlag KG Stuttgart · New York.

A novel two-level dielectric barrier discharge reactor for methyl orange degradation.

PubMed

Tao, Xumei; Wang, Guowei; Huang, Liang; Ye, Qingguo; Xu, Dongyan

2016-12-15

A novel pilot two-level dielectric barrier discharge (DBD) reactor has been proposed and applied for degradation of continuous model wastewater. The two-level DBD reactor was skillfully realized with high space utilization efficiency and large contact area between plasma and wastewater. Various conditions such as applied voltage, initial concentration and initial pH value on methyl orange (MO) model wastewater degradation were investigated. The results showed that the appropriate applied voltage was 13.4 kV; low initial concentration and low initial pH value were conducive for MO degradation. The percentage removal of 4 L MO with concentration of 80 mg/L reached 94.1% after plasma treatment for 80min. Based on ultraviolet spectrum (UV), Infrared spectrum (IR), liquid chromatography-mass spectrometry (LC-MS) analysis of degradation intermediates and products, insights in the degradation pathway of MO were proposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Influence of surface emission processes on a fast-pulsed dielectric barrier discharge in air at atmospheric pressure

NASA Astrophysics Data System (ADS)

Pechereau, François; Bonaventura, Zdeněk; Bourdon, Anne

2016-08-01

This paper presents simulations of an atmospheric pressure air discharge in a point-to-plane geometry with a dielectric layer parallel to the cathode plane. Experimentally, a discharge reignition in the air gap below the dielectrics has been observed. With a 2D fluid model, it is shown that due to the fast rise of the high voltage applied and the sharp point used, a first positive spherical discharge forms around the point. Then this discharge propagates axially and impacts the dielectrics. As the first discharge starts spreading on the upper dielectric surface, in the second air gap with a low preionization density of {{10}4}~\\text{c}{{\\text{m}}-3} , the 2D fluid model predicts a rapid reignition of a positive discharge. As in experiments, the discharge reignition is much slower, a discussion on physical processes to be considered in the model to increase the reignition delay is presented. The limit case with no initial seed charges in the second air gap has been studied. First, we have calculated the time to release an electron from the cathode surface by thermionic and field emission processes for a work function φ \\in ≤ft[3,4\\right] eV and an amplification factor β \\in ≤ft[100,220\\right] . Then a 3D Monte Carlo model has been used to follow the dynamics of formation of an avalanche starting from a single electron emitted at the cathode. Due to the high electric field in the second air gap, we have shown that in a few nanoseconds, a Gaussian cloud of seed charges is formed at a small distance from the cathode plane. This Gaussian cloud has been used as the initial condition of the 2D fluid model in the second air gap. In this case, the propagation of a double headed discharge in the second air gap has been observed and the reignition delay is in rather good agreement with experiments.

Modeling Peak Discharge within the Marengo River Watershed: Lessons for Restoration in the Saint Louis River Watershed

EPA Science Inventory

To more fully understand the hydrologic condition of the Marengo River Watershed, and to map specific locations most likely to have increased discharge and flow velocity (leading to more erosion and higher sediment loads) we modeled peak discharge for 35 different sub-watersheds ...

Method and apparatus for charged particle propagation

DOEpatents

Hershcovitch, A.

1996-11-26

A method and apparatus are provided for propagating charged particles from a vacuum to a higher pressure region. A generator includes an evacuated chamber having a gun for discharging a beam of charged particles such as an electron beam or ion beam. The beam is discharged through a beam exit in the chamber into a higher pressure region. A plasma interface is disposed at the beam exit and includes a plasma channel for bounding a plasma maintainable between a cathode and an anode disposed at opposite ends thereof. The plasma channel is coaxially aligned with the beam exit for propagating the beam from the chamber, through the plasma, and into the higher pressure region. The plasma is effective for pumping down the beam exit for preventing pressure increase in the chamber and provides magnetic focusing of the beam discharged into the higher pressure region 24. 7 figs.

Repeat neuroimaging of mild traumatic brain-injured patients with acute traumatic intracranial hemorrhage: clinical outcomes and radiographic features.

PubMed

Kreitzer, Natalie; Lyons, Michael S; Hart, Kim; Lindsell, Cristopher J; Chung, Sora; Yick, Andrew; Bonomo, Jordan

2014-10-01

Emergency department (ED) management of mild traumatic brain injury (TBI) patients with any form of traumatic intracranial hemorrhage (ICH) is variable. Since 2000, our center's standard practice has been to obtain a repeat head computed tomography (CT) at least 6 hours after initial imaging. Patients are eligible for discharge if clinical and CT findings are stable. Whether this practice is safe is unknown. This study characterized clinical outcomes in mild TBI patients with acute traumatic ICH seen on initial ED neuroimaging. This retrospective cohort study included patients presenting to the ED with blunt mild TBI with Glasgow Coma Scale (GCS) scores of 14 or 15 and stable vital signs, during the period from January 2001 to January 2010. Patients with any ICH on initial head CT and repeat head CT within 24 hours were eligible. Cases were excluded for initial GCS < 14, injury > 24 hours old, pregnancy, concomitant nonminor injuries, and coagulopathy. A single investigator abstracted data from records using a standardized case report form and data dictionary. Primary endpoints included death, neurosurgical procedures, and for discharged patients, return to the ED within 7 days. Differences in proportions were computed with 95% confidence intervals (CIs). Of 1,011 patients who presented to the ED and had two head CTs within 24 hours, 323 (32%) met inclusion criteria. The median time between CT scans was 6 hours (interquartile range = 5 to 7 hours). A total of 153 (47%) patients had subarachnoid hemorrhage, 132 (41%) patients had subdural hemorrhage, 11 (3%) patients had epidural hemorrhage, 78 (24%) patients had cerebral contusions, and 59 (18%) patients had intraparenchymal hemorrhage. Four of 323 (1.2%, 95% CI = 0.3% to 3.2%) patients died within 2 weeks of injury. Three of the patients who died had been admitted from the ED on their initial visits, and one had been discharged home. There were 206 patients (64%) discharged from the ED, 28 (13.6%) of whom returned to the ED within 1 week. Of the 92 who were hospitalized, three (0.9%, 95% CI = 0.2% to 2.7%) required neurosurgical intervention. Discharge after a repeat head CT and brief period of observation in the ED allowed early discharge of a cohort of mild TBI patients with traumatic ICH without delayed adverse outcomes. Whether this justifies the cost and radiation exposure involved with this pattern of practice requires further study. © 2014 by the Society for Academic Emergency Medicine.

Effects of well discharges on hydraulic heads in and spring discharges from the Geothermal Aquifer System in the Bruneau area, Owyhee County, southwestern Idaho

USGS Publications Warehouse

Berenbrock, Charles

1993-01-01

substantially less in late summer than in the spring. A hydraulic head/spring discharge relation was developed for two sites at Indian Bathtub Spring and a nearby test hole. The relation for Indian Bathtub Spring indicated that a spring discharge of 2,400 gallons per minute would relate to a hydraulic head of about 2,708 feet at the spring, which is about 34 feet higher than the head at zero spring discharge.

ARC DISCHARGE AND METHOD OF PRODUCING THE SAME

DOEpatents

Neidigh, R.V.

1960-03-15

A device for producing an energetic gas arc discharge between spaced electrodes in an evacuated chamber and within a magnetic field is described. Gas is fed into the arc in a direction normal to a refluxing stream of electrons and at a pressure higher than the pressure within the chamber to establish a pressure gradient along the arc discharge formed between the electrodes. This pressure gradient establishes rotating, time varying, radial electrical fields in the volume surroundimg the discharge, causing the discharge to rotate about the arc center line.

Three dimensional thermal pollution models. Volume 3: Free surface models. [waste heat discharge from power plants and effects on ecosystems

NASA Technical Reports Server (NTRS)

Lee, S. S.; Sengupta, S.

1978-01-01

Two sets of programs, named Nasum 2 and Nasum 3 are presented in detail. Nasum 2 is a far field formulation and is used without including the plant thermal discharge. Nasum 3 uses horizontal stretching to provide higher resolution at thermal discharge joints; and includes far field influences such as varying tides and ambient currents far from point of discharge.

Investigation of the Discharge Characteristics of the T6 Hollow Cathode Operating on Several Inert Gases and a Kr/Xe Mixture

NASA Astrophysics Data System (ADS)

Ahmed Rudwan, M.; Gabriel, S. B.

2002-01-01

Investigation of the discharge characteristics of the T6 hollow cathode operating on several inert Xenon is currently the propellant of choice for gridded ion thrusters. But in order to make deep space missions feasible, an increase in the Specific Impulse (SI) that these thrusters can achieve is necessary. One method of achieving this is to use a propellant with a lower atomic mass (e.g. argon), as the propellant exhaust velocity is inversely proportional to the square root of the propellant mass. However, the feasibility of operating the hollow cathode using these alternative propellants has to be demonstrated. Moreover, interest in decreasing the propellant cost in missions and ground testing (especially life tests) have led to the comprehensive discharge characterisation of several gases that will be presented in this paper. A Kr/Xe mixture in the naturally occurring ratio, for example, could offer a 15 times cost saving when compared to pure xenon and 2-3 times cost saving when compared to pure krypton. The T6 hollow cathode discharge behaviour as well as its initiation characteristics have been studied. The tests were carried out in diode configuration using a T6 hollow cathode with an enclosed keeper design employing xenon, krypton, argon and a Kr/Xe mix. The discharge initiation tests were undertaken with a view to investigate some of the factors thought to influence the starting potential such as mass flow rate and tip temperature. It was found that, for mass flow rates ranging from 0.2-1.1 mg/s and cathode tip temperatures ranging from 900-1300oC, the breakdown potential was less than 50V for argon, less than 25V for krypton, less than 21V for xenon and less than 35V for the Kr/Xe mix. The discharge initiation results were then compared to those obtained by Fearn et al. with a T5 cathode operating on mercury and with a T6 cathode utilising an open keeper design using xenon propellant. The xenon breakdown potentials were found to be lower than those obtained with an open keeper design by as much as 4V. Steady state discharge behaviour was also investigated in a range of operating conditions. Spot to plume mode transitions were observed in argon, krypton and Kr/Xe discharges for the first time.

Intergranular Cracking as a Major Cause of Long-Term Capacity Fading of Layered Cathodes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Liu, Hao; Wolf, Mark; Karki, Khim

Capacity fading has limited commercial layered Li-ion battery electrodes to <70% of their theoretical capacity. Higher capacities can be achieved initially by charging to higher voltages, however, these gains are quickly eroded by a faster fade in capacity. In-creasing lifetimes and reversible capacity is contingent on identifying the origin of this capacity fade to inform electrode design and synthesis. We must understand how the battery reactions change following capacity loss after long-term cycling. Using operando X-ray diffraction, we followed the reaction of a LiNi 0.8Co 0.15Al 0.05O 2 (NCA) electrode after months of charge-discharge cycles. Furthermore, the heterogeneous reaction kineticsmore » observed during extended cycles quantitatively explain the capacity loss, which is ultimately attributed to inter-granular fracturing that degrades the connectivity of sub-surface grains within the polycrystalline NCA aggregate.« less

Intergranular Cracking as a Major Cause of Long-Term Capacity Fading of Layered Cathodes

DOE PAGES

Liu, Hao; Wolf, Mark; Karki, Khim; ...

2017-05-26

Capacity fading has limited commercial layered Li-ion battery electrodes to <70% of their theoretical capacity. Higher capacities can be achieved initially by charging to higher voltages, however, these gains are quickly eroded by a faster fade in capacity. In-creasing lifetimes and reversible capacity is contingent on identifying the origin of this capacity fade to inform electrode design and synthesis. We must understand how the battery reactions change following capacity loss after long-term cycling. Using operando X-ray diffraction, we followed the reaction of a LiNi 0.8Co 0.15Al 0.05O 2 (NCA) electrode after months of charge-discharge cycles. Furthermore, the heterogeneous reaction kineticsmore » observed during extended cycles quantitatively explain the capacity loss, which is ultimately attributed to inter-granular fracturing that degrades the connectivity of sub-surface grains within the polycrystalline NCA aggregate.« less

Observation of enhanced radial transport of energetic ion due to energetic particle mode destabilized by helically-trapped energetic ion in the Large Helical Device

NASA Astrophysics Data System (ADS)

Ogawa, K.; Isobe, M.; Kawase, H.; Nishitani, T.; Seki, R.; Osakabe, M.; LHD Experiment Group

2018-04-01

A deuterium experiment was initiated to achieve higher-temperature and higher-density plasmas in March 2017 in the Large Helical Device (LHD). The central ion temperature notably increases compared with that in hydrogen experiments. However, an energetic particle mode called the helically-trapped energetic-ion-driven resistive interchange (EIC) mode is often excited by intensive perpendicular neutral beam injections on high ion-temperature discharges. The mode leads to significant decrease of the ion temperature or to limiting the sustainment of the high ion-temperature state. To understand the effect of EIC on the energetic ion confinement, the radial transport of energetic ions is studied by means of the neutron flux monitor and vertical neutron camera newly installed on the LHD. Decreases of the line-integrated neutron profile in core channels show that helically-trapped energetic ions are lost from the plasma.

Intergranular Cracking as a Major Cause of Long-Term Capacity Fading of Layered Cathodes.

PubMed

Liu, Hao; Wolf, Mark; Karki, Khim; Yu, Young-Sang; Stach, Eric A; Cabana, Jordi; Chapman, Karena W; Chupas, Peter J

2017-06-14

Capacity fading has limited commercial layered Li-ion battery electrodes to <70% of their theoretical capacity. Higher capacities can be achieved initially by charging to higher voltages, however, these gains are eroded by a faster fade in capacity. Increasing lifetimes and reversible capacity are contingent on identifying the origin of this capacity fade to inform electrode design and synthesis. We used operando X-ray diffraction to observe how the lithiation-delithiation reactions within a LiNi 0.8 Co 0.15 Al 0.05 O 2 (NCA) electrode change after capacity fade following months of slow charge-discharge. The changes in the reactions that underpin energy storage after long-term cycling directly correlate to the capacity loss; heterogeneous reaction kinetics observed during extended cycles quantitatively account for the capacity loss. This reaction heterogeneity is ultimately attributed to intergranular fracturing that degrades the connectivity of subsurface grains within the polycrystalline NCA aggregate.

Effect of electronegative additives on physical properties and chemical activity of gas discharge plasma

NASA Astrophysics Data System (ADS)

Kuznetsov, D. L.; Filatov, I. E.; Uvarin, V. V.

2018-01-01

Effect of electronegative additives (oxygen O2, sulfur dioxide SO2, carbon disulfide CS2, and carbon tetrachloride CCl4) on physical properties and chemical activity of plasma formed by pulsed corona discharge and by non-self-sustained discharge supported by pulsed electron beam in atmospheric pressure gas mixtures was investigated. It is shown that a decrease in discharge current depends on a sort of the additive and on its concentration. The reason is the difference in rate constants of electron attachment processes for the above molecules. In experiments on volatile organic compounds (VOCs) conversion in air by streamer corona it is obtained that an addition of CCl4 both decreases the discharge current amplitude and increases the VOCs conversion degree. An installation for investigation of electron attachment processes and for study of toxic impurities conversion in plasma formed by non-self-sustained discharge initiated by pulsed nanosecond electron beam is created.

Ecton processes in the generation of pulsed runaway electron beams in a gas discharge

NASA Astrophysics Data System (ADS)

Mesyats, G. A.

2017-09-01

As was shown earlier for pulsed discharges that occur in electric fields rising with extremely high rates (1018 V/(cm s)) during the pulse rise time, the electron current in a vacuum discharge is lower than the current of runaway electrons in an atmospheric air discharge in a 1-cm-long gap. In this paper, this is explained by that the field emission current from cathode microprotrusions in a gas discharge is enhanced due to gas ionization. This hastens the initiation of explosive electron emission, which occurs within 10-11 s at a current density of up to 1010 A/cm2. Thereafter, a first-type cathode spot starts forming. The temperature of the cathode spot decreases due to heat conduction, and the explosive emission current ceases. Thus, the runaway electron current pulse is similar in nature to the ecton phenomenon in a vacuum discharge.

Soft chemical synthesis and electrochemical properties of calcium ferrite-type LixMn2O4

NASA Astrophysics Data System (ADS)

Mamiya, Mikito; Tokiwa, Kazuyasu; Akimoto, Junji

2016-04-01

Calcium ferrite (CaFe2O4)-type LixMn2O4 was prepared via high-pressure and soft chemical synthesis method. The framework structure of CaFe2O4-type NaMn2O4 was synthesized from the stoichiometric mixture of Na2CO3 and MnO2 annealed by 1273 K for 1 h under 4.5 GPa. Na/Li ion-exchange of the CaFe2O4-type NaMn2O4 was carried out by soaking molten LiNO3 at 633 K for 12 h. The electrochemical properties of the ion-exchanged CaFe2O4-type LixMn2O4 were measured. The initial discharge profile in the voltage range from 4.0 to 1.0 V showed 458 mAh g-1 of the discharge capacity with two plateaus near 3.7 V and 2.7 V (vs. Li/Li+). The discharge capacity was decreased with increasing the cycle number. After 30 cycles, the capacity was decreased to 375 mAh g-1. When the range was set between 4.8 and 3.0 V, the discharge capacity was 113 mAh g-1 in initial, and 111 mAh g-1 after 50th cycle. The reference CaFe2O4-type LiMn2O4 was prepared via one-step high-pressure synthesis and compared the electrochemical properties with the ion-exchanged sample. The initial discharge capacity of the one-step synthesized one was 108 mAh g-1 at 1.0 V (vs. Li/Li+), which was 73% lower than the value of the ion-exchanged one.

Management of minor head injury in patients receiving oral anticoagulant therapy: a prospective study of a 24-hour observation protocol.

PubMed

Menditto, Vincenzo G; Lucci, Moira; Polonara, Stefano; Pomponio, Giovanni; Gabrielli, Armando

2012-06-01

Patients receiving warfarin who experience minor head injury are at risk of intracranial hemorrhage, and optimal management after a single head computed tomography (CT) scan is unclear. We evaluate a protocol of 24-hour observation followed by a second head CT scan. In this prospective case series, we enrolled consecutive patients receiving warfarin and showing no intracranial lesions on a first CT scan after minor head injury treated at a Level II trauma center. We implemented a structured clinical pathway, including 24-hour observation and a CT scan performed before discharge. We then evaluated the frequency of death, admission, neurosurgery, and delayed intracranial hemorrhage. We enrolled and observed 97 consecutive patients. Ten refused the second CT scan and were well during 30-day follow-up. Repeated CT scanning in the remaining 87 patients revealed a new hemorrhage lesion in 5 (6%), with 3 subsequently hospitalized and 1 receiving craniotomy. Two patients discharged after completing the study protocol with 2 negative CT scan results were admitted 2 and 8 days later with symptomatic subdural hematomas; neither received surgery. Two of the 5 patients with delayed bleeding at 24 hours had an initial international normalized ratio greater than 3.0, as did both patients with delayed bleeding beyond 24 hours. The relative risk of delayed hemorrhage with an initial international normalized ratio greater than 3.0 was 14 (95% confidence interval 4 to 49). For patients receiving warfarin who experience minor head injury and have a negative initial head CT scan result, a protocol of 24-hour observation followed by a second CT scan will identify most occurrences of delayed bleeding. An initial international normalized ratio greater than 3 suggests higher risk. Copyright © 2011 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.

Impacts of effluent from Carlsbad Desalination Plant on the coastal biology and chemistry in a in-situ study of pre- and post-discharge

NASA Astrophysics Data System (ADS)

Petersen, K. L.; Heck, N.; Paytan, A.; Potts, D. C.

2016-12-01

Ongoing droughts throughout the world and increasing water demand are creating critical water shortage in arid and semi-arid regions. Desalination of seawater is a powerful source of potable water, however the effects of the brine discharge on coastal areas are insufficiently studied. Here we report results from in-situ measurements of the effects of brine discharge from a desalination plant in Carlsbad, in Southern California before and after operation began. Operation as of December 2015. Pre-discharge samples were collected in December 2014 and September 2015. Post-discharge samples were collected in May 2016 and November 2016. Water samples are collected at the mount of the discharge channel and out to 1000 m offshore. Both surface and bottom water samples were collected and analyzed for salinity, temperature, Chl a concentration, nutrients (NO3, PO4 and silica), δ13C and δ15N of suspended matter, DOC and organic contaminants. Samples are also collected for phytoplankton cell count and sediment grain size. A biological swath was done by SCUBA divers to verify abundance and diversity of benthic organisms. The pre-discharge measurements show a homogenous water column for salinity, Chl a and nutrients. There is a slight temperature difference between the discharge channel and the intake channel due to activities of a power plant around the discharge channel. There are significantly fewer species and a lower abundance of benthic organism by the discharge channel than by the intake. This is possibly due to a higher flow rate at the discharge channel. The preliminary post-discharge analyses show a stratified water column at the discharge area. The salinity was higher by 2 to 3 salinity units at the discharge site. This trend is evident to 600 m offshore. How this affects the benthic organisms and the phytoplankton will be reported.

A Multidisciplinary Initiative to Increase Inpatient Discharges Before Noon.

PubMed

Kane, Marlena; Weinacker, Ann; Arthofer, Rudolph; Seay-Morrison, Timothy; Elfman, Wesley; Ramirez, Mark; Ahuja, Neera; Pickham, David; Hereford, James; Welton, Mark

2016-12-01

The aim of this study is to evaluate the effect of 2 hospital-wide interventions on achieving a discharge-before-noon rate of 40%. A multidisciplinary team led by administrative and physician leadership developed a plan to diminish capacity constraints by minimizing late afternoon hospital discharges using 2 patient flow management techniques. The study was a preintervention/postintervention retrospective analysis observing all inpatients discharged across 19 inpatient units in a 484-bed, academic teaching hospital measuring calendar month discharge-before-noon percentage, patient satisfaction, and readmission rates. Patient satisfaction and readmission rates were used as baseline metrics. The discharge-before-noon percentage increased from 14% in the 11-month preintervention period to an average of 24% over the 11-month postintervention period, whereas patient satisfaction scores and readmission rates remained stable. Implementation of the 2 interventions successfully increased the percentage of discharges before noon yet did not achieve the goal of 40%. Patient satisfaction and readmission rates were not negatively impacted by the program.

Observations of Blue Discharges Associated With Negative Narrow Bipolar Events in Active Deep Convection

NASA Astrophysics Data System (ADS)

Liu, Feifan; Zhu, Baoyou; Lu, Gaopeng; Qin, Zilong; Lei, Jiuhou; Peng, Kang-Ming; Chen, Alfred B.; Huang, Anjing; Cummer, Steven A.; Chen, Mingli; Ma, Ming; Lyu, Fanchao; Zhou, Helin

2018-03-01

On 19 August 2012, the Imager of Sprites and Upper Atmospheric Lightning on board the FORMOSAT-2 satellite captured a sequence of seven blue discharges within 1 min that emanated from a parent thunderstorm over Lake Taihu in East China. The analysis of lightning activity produced in the thunderstorm indicates that at least six of these events occurred in association with negative narrow bipolar events (NBEs) that were concurrent with the blue discharge by less than 1 ms, and negative cloud-to-ground occurred within 6 s before each blue discharge, which is in agreement with the modeling presented by Krehbiel et al. (2008). Therefore, the frequent occurrence of negative cloud-to-ground could provide the favorable condition for the production of blue discharges, and negative NBEs are probably the initial event of blue discharges. The detection of negative NBEs might provide a convenient approach to detect the occurrence of blue discharges as lightning bolt shooting upward from the top of energetic thunderstorms.

Psychiatric Discharge Process

PubMed Central

Alghzawi, Hamzah M.

2012-01-01

Background. Integration of research evidence into clinical nursing practice is essential for the delivery of high-quality nursing care. Discharge planning is an essential process in psychiatric nursing field, in order to prevent recurrent readmission to psychiatric units. Objective. The purpose of this paper is to perform literature overview on psychiatric discharge planning, in order to develop evidence-based practice guideline of psychiatric discharge plan. Methods. A search of electronic databases was conducted. The search process aimed to locate different levels of evidence. Inclusion criteria were studies including outcomes related to prevention of readmission as stability in the community, studies investigating the discharge planning process in acute psychiatric wards, and studies that included factors that impede discharge planning and factors that aid timely discharge. On the other hand, exclusion criteria were studies in which discharge planning was discussed as part of a multi faceted intervention and was not the main focus of the review. Result. Studies met inclusion criteria were mainly literature reviews, consensus statements, and descriptive studies. All of these studies are considered at the lower levels of evidence. Conclusion. This review demonstrated that discharge planning based on general principles (evidence based principles) should be applied during psychiatric discharge planning to make this discharge more effective. Depending on this review, it could be concluded that effective discharge planning includes main three stages; initial discharge meeting, regular discharge meeting(s), and leaving from hospital and discharge day. Each stage of them has requirements should be accomplished be go to the next stage. PMID:23762767

Acute Ischemic Stroke Infarct Topology: Association with Lesion Volume and Severity of Symptoms at Admission and Discharge.

PubMed

Payabvash, S; Taleb, S; Benson, J C; McKinney, A M

2017-01-01

Acute stroke presentation and outcome depend on both ischemic infarct volume and location. We aimed to determine the association between acute ischemic infarct topology and lesion volume and stroke severity at presentation and discharge. Patients with acute ischemic stroke who underwent MR imaging within 24 hours of symptom onset or last seen well were included. Infarcts were segmented and coregistered on the Montreal Neurological Institute-152 brain map. Voxel-based analyses were performed to determine the distribution of infarct lesions associated with larger volumes, higher NIHSS scores at admission and discharge, and greater NIHSS/volume ratios. A total of 238 patients were included. Ischemic infarcts involving the bilateral lentiform nuclei, insular ribbons, middle corona radiata, and right precentral gyrus were associated with larger infarct volumes (average, 76.7 ± 125.6 mL versus 16.4 ± 24.0 mL, P < .001) and higher admission NIHSS scores. Meanwhile, brain stem and thalami infarctions were associated with higher admission NIHSS/volume ratios. The discharge NIHSS scores were available in 218 patients, in whom voxel-based analysis demonstrated that ischemic infarcts of the bilateral posterior insular ribbons, middle corona radiata, and right precentral gyrus were associated with more severe symptoms at discharge, whereas ischemic lesions of the brain stem, bilateral thalami, and, to a lesser extent, the middle corona radiata were associated with higher ratios of discharge NIHSS score/infarct volume. Acute ischemic infarcts of the insulae, lentiform nuclei, and middle corona radiata tend to have larger volumes, more severe presentations, and worse outcomes, whereas brain stem and thalamic infarcts have greater symptom severity relative to smaller lesion volumes. © 2017 by American Journal of Neuroradiology.

Physician Board Certification and the Care and Outcomes of Elderly Patients with Acute Myocardial Infarction

PubMed Central

Chen, Jersey; Rathore, Saif S; Wang, Yongfei; Radford, Martha J; Krumholz, Harlan M

2006-01-01

BACKGROUND Patients and purchasers prefer board-certified physicians, but whether these physicians provide better quality of care and outcomes for hospitalized patients is unclear. OBJECTIVE We evaluated whether care by board-certified physicians after acute myocardial infarction (AMI) was associated with higher use of clinical guideline recommended therapies and lower 30-day mortality. SUBJECTS AND METHODS We examined 101,251 Medicare patients hospitalized for AMI in the United States and compared use of aspirin, β-blockers, and 30-day mortality according to the attending physicians' board certification in family practice, internal medicine, or cardiology. RESULTS Board-certified family practitioners had slightly higher use of aspirin (admission: 51.1% vs 46.0%; discharge: 72.2% vs 63.9%) and β-blockers (admission: 44.1% vs 37.1%; discharge: 46.2% vs 38.7%) than nonboard-certified family practitioners. There was a similar pattern in board-certified Internists for aspirin (admission: 53.7% vs 49.6%; discharge: 78.2% vs 68.8%) and β-blockers (admission: 48.9% vs 44.1%; discharge: 51.2% vs 47.1). Board-certified cardiologists had higher use of aspirin compared with cardiologists certified in internal medicine only or without any board certification (admission: 61.3% vs 53.1% vs 52.1%; discharge: 82.2% vs 71.8% vs 71.5%) and β-blockers (admission: 52.9% vs 49.6% vs 41.5%; discharge: 54.7% vs 50.6% vs 42.5%). In multivariate regression analyses, board certification was not associated with differences in 30-day mortality. CONCLUSIONS Treatment by a board-certified physician was associated with modestly higher quality of care for AMI, but not differences in mortality. Regardless of board certification, all physicians had opportunities to improve quality of care for AMI. PMID:16637823

40 CFR 63.9520 - What procedures must I use to demonstrate initial compliance?

Code of Federal Regulations, 2013 CFR

2013-07-01

... must determine the percent of HAP solvent discharged to the atmosphere for each mix batch according to... to the atmosphere for each mix batch, percent; Srec = Weight of HAP solvent recovered for each mix... discharged to the atmosphere for that mix batch (Pb). (7) Determine the 7-day block average percent of HAP...

40 CFR 63.9520 - What procedures must I use to demonstrate initial compliance?

Code of Federal Regulations, 2011 CFR

2011-07-01

... must determine the percent of HAP solvent discharged to the atmosphere for each mix batch according to... to the atmosphere for each mix batch, percent; Srec = Weight of HAP solvent recovered for each mix... discharged to the atmosphere for that mix batch (Pb). (7) Determine the 7-day block average percent of HAP...

40 CFR 63.9520 - What procedures must I use to demonstrate initial compliance?

Code of Federal Regulations, 2012 CFR

2012-07-01

... must determine the percent of HAP solvent discharged to the atmosphere for each mix batch according to... to the atmosphere for each mix batch, percent; Srec = Weight of HAP solvent recovered for each mix... discharged to the atmosphere for that mix batch (Pb). (7) Determine the 7-day block average percent of HAP...

40 CFR 63.9520 - What procedures must I use to demonstrate initial compliance?

Code of Federal Regulations, 2014 CFR

2014-07-01

... must determine the percent of HAP solvent discharged to the atmosphere for each mix batch according to... to the atmosphere for each mix batch, percent; Srec = Weight of HAP solvent recovered for each mix... discharged to the atmosphere for that mix batch (Pb). (7) Determine the 7-day block average percent of HAP...

Utilizing Four Dimensional Lightning and Dual-Polarization Radar to Develop Lightning Initiation Forecast Guidance

DTIC Science & Technology

2015-03-26

Electrification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 2.3 Lightning Discharge ...charge is caused by falling graupel that is positively charged (Wallace and Hobbs 2006). 2.3 Lightning Discharge Lightning occurs when the electric...emission of positive corona from the surface of precipitation particles, causing the electric field to become locally enhanced and supporting the

AN EXPERT SYSTEM FOR HYDRODYNAMIC MIXING ZONE ANAYLSIS OF CONVENTIONAL AND TOXIC SUBMERGED SINGLE PORT DISCHARGES (CORMIX1)

EPA Science Inventory

U.S. water quality policy includes the concept of a mixing zone, a limited area or volume of water where the initial dilution of a discharge occurs. he Cornell Mixing Zone Expert System (CORMIX1) was developed to predict the dilution and trajectory of a submerged single port disc...

Physical mechanism of initial breakdown pulses and narrow bipolar events in lightning discharges

NASA Astrophysics Data System (ADS)

da Silva, Caitano L.; Pasko, Victor P.

2015-05-01

To date the true nature of initial breakdown pulses (IBPs) and narrow bipolar events (NBEs) in lightning discharges remains a mystery. Recent experimental evidence has correlated IBPs to the initial development of lightning leaders inside the thundercloud. NBE wideband waveforms resemble classic IBPs in both amplitude and duration. Most NBEs are quite peculiar in the sense that very frequently they occur in isolation from other lightning processes. The remaining fraction, 16% of positive polarity NBEs, according to Wu et al. (2014), happens as the first event in an otherwise regular intracloud lightning discharge. These authors point out that the initiator type of NBEs has no difference with other NBEs that did not start lightning, except for the fact that they occur deeper inside the thunderstorm (i.e., at lower altitudes). In this paper, we propose a new physical mechanism to explain the source of both IBPs and NBEs. We propose that IBPs and NBEs are the electromagnetic transients associated with the sudden (i.e., stepwise) elongation of the initial negative leader extremity in the thunderstorm electric field. To demonstrate our hypothesis a novel computational/numerical model of the bidirectional lightning leader tree is developed, consisting of a generalization of electrostatic and transmission line approximations found in the literature. Finally, we show how the IBP and NBE waveform characteristics directly reflect the properties of the bidirectional lightning leader (such as step length, for example) and amplitude of the thunderstorm electric field.

Factors influencing warfarin response in hospitalized patients

PubMed Central

Abdel-Aziz, Mahmoud I.; Ali, Mostafa A. Sayed; Hassan, Ayman K.M.; Elfaham, Tahani H.

2015-01-01

The objective of this study was to investigate the influence of simultaneous factors that potentially keep patients far from achieving target INR range at discharge in hospitalized patients. Prospective cross-sectional observational study conducted at the Cardiology Department and Intensive Care Unit (ICU) of the Assiut University Hospitals. One-hundred and twenty patients were enrolled in the study from July 2013 to January 2014. Outcome measures were discharge INRs, bleeding and thromboembolic episodes. Bivariate analysis and multinomial logistic regression were conducted to determine independent risk factors that can keep patients outside target INR range. Patients who were newly initiated warfarin on hospital admission were given low initiation dose (2.8 mg ± 0.9). They were more likely to have INR values below 1.5 during hospital stay, 13 (27.7%) patients compared with 9 (12.3%) previously treated patients, respectively (p = .034). We found that the best predictors of achieving below target INR range relative to within target INR range were; shorter hospital stay periods (OR, 0.82 for every day increase [95% CI, 0.72–0.94]), being a male patient (OR, 2.86 [95% CI, 1.05–7.69]), concurrent infection (OR, 0.21 [95% CI, 0.07–0.59]) and new initiation of warfarin therapy on hospital admission (OR, 3.73 [95% CI, 1.28–10.9]). Gender, new initiation of warfarin therapy on hospital admission, shorter hospital stay periods and concurrent infection can have a significant effect on discharge INRs. Initiation of warfarin without giving loading doses increases the risk of having INRs below 1.5 during hospital stay and increases the likelihood of a patient to be discharged with INR below target range. Following warfarin dosing nomograms and careful monitoring of the effect of various factors on warfarin response should be greatly considered. PMID:26702259

New type side weir discharge coefficient simulation using three novel hybrid adaptive neuro-fuzzy inference systems

NASA Astrophysics Data System (ADS)

Bonakdari, Hossein; Zaji, Amir Hossein

2018-03-01

In many hydraulic structures, side weirs have a critical role. Accurately predicting the discharge coefficient is one of the most important stages in the side weir design process. In the present paper, a new high efficient side weir is investigated. To simulate the discharge coefficient of these side weirs, three novel soft computing methods are used. The process includes modeling the discharge coefficient with the hybrid Adaptive Neuro-Fuzzy Interface System (ANFIS) and three optimization algorithms, namely Differential Evaluation (ANFIS-DE), Genetic Algorithm (ANFIS-GA) and Particle Swarm Optimization (ANFIS-PSO). In addition, sensitivity analysis is done to find the most efficient input variables for modeling the discharge coefficient of these types of side weirs. According to the results, the ANFIS method has higher performance when using simpler input variables. In addition, the ANFIS-DE with RMSE of 0.077 has higher performance than the ANFIS-GA and ANFIS-PSO methods with RMSE of 0.079 and 0.096, respectively.

An Analysis of Two Thunderstorms Producing Five Negative Sprites on 12 September 2014

NASA Astrophysics Data System (ADS)

Boggs, L.; Liu, N.; Splitt, M. E.; Lazarus, S. M.; Cummer, S. A.; Rassoul, H.

2015-12-01

We present a detailed analysis of the thunderstorms and the parent lightning discharge morphologies of five confirmed negative sprites taking place in two different thunderstorms. These two thunderstorms took place in east-central and south Florida on 12 September 2014. We utilized several lightning location networks, remote magnetic field measurements, dual polarization radar, and balloon borne soundings in our analysis. Each parent discharge was immediately preceded by intra-cloud (IC) discharges between the mid-level negative and upper positive charge regions. This either allowed a second upward negative leader to escape the upper positive charge region, or encouraged a downward negative leader to be initiated and connect with ground. The discharges found in this study support the findings of Lu et al., 2012 [JGR,117, D04212, 2012] that negative sprite-parent lightning consists primarily of hybrid intra-cloud negative cloud-to-ground (IC-NCG) and bolt-from-the-blue (BFB) lightning. Our work finds these unique discharges form in thunderstorms that have an excess of mid-level negative charge and weakened upper positive charge. Due to this charge structure, these unusual discharges transfer more charge to the ground than typical negative cloud-to-ground discharges. Our study suggests that the key difference separating bolt-from-the-blue and gigantic jet discharges is an asymmetric charge structure. This acts to bring the negative leader exiting the thundercloud closer to the lateral positive screening layer, encouraging the negative leader to turn towards ground. This investigation reveals IC discharges that involve multiple convective cells and come to ground as a negative CG discharge, a breed of hybrid IC-NCG discharges, also transfer more negative charge to ground than typical negative CG discharges and are able to initiate negative sprites. From this work, the charge structures mentioned above resulted from tall, intense convective cells with low CG flash rates with high wind shear in the mid to upper regions of the cloud. This acted to create a large reservoir of mid-level negative charge and create a general asymmetry to the charge structure. The wind shear in the upper regions also acted to weaken the upper positive charge by turbulent mixing with the upper negative screening charge layer.

Triggering regime of oil-filled trigatron dischargers

NASA Astrophysics Data System (ADS)

Kapishnikov, N. K.; Muratov, V. M.

1986-11-01

A comparative analysis made in [1, 2] of different types of regulable high-voltage dischargers with liquid insulation showed that trigatrons are currently the most promising for use in high-voltage pulse-operated devices due to their simplicity and reliability. Two basic mechanisms of discharge initiation can be realized in trigatrons — initiation by intensification of the field in the region of the control electrode [2, 3], and triggering by a spark in the ignition gap [4, 5]. The first type of trigatron has been studied sufficiently only for short voltage periods [3, 6, 7], so it is used mainly in switching the pulse-shaping lines of powerful nanosecond pulse generators with “rapid” (0.5 1.5 μsec) charging [8, 9]. Almost no use is now made of the second type of trigatron switch in high-voltage pulse technology due to its unsatisfactory time characteristics. Here we report results of a study of the time characteristics of both types of oil-filled trigatrons operating in a regime whereby they form the leading edge of rectangular voltage pulses with amplitudes up to 800 kV and durations of 1 100 μsec. The goal is to find the optimum conditions for triggering of trigatron dischargers with liquid insulation in the region of microsecond voltage discharges. Experiments were conducted on the unit in [10]. The test discharger was placed in a cylindrical chamber 45 cm in diameter and 27 cm in length. The high-voltage electrode of the discharger was in the form of a cylinder 20 cm in diameter positioned coaxially inside the chamber. The 10-mm-diameter ground electrode was positioned radially in a branch pipe 8 cm long. The control electrode was placed in a 2-cm-diameter hole in the center of the ground electrode. The chamber with the test discharge was filled with transformer oil with a breakdown voltage of about 50 kV. The oil was not replaced or cleaned during the experiment. We did not find that contamination of the oil by discharge products had any effect on the time characteristics of either type of discharger. The results were analyzed by the least squares method, with 50 measurements to a point (it was found that time lag of the discharger triggering conforms approximately to a normal distribution law for both types of discharger).

Two-dimensional simulation of argon dielectric barrier discharge excited by a Gaussian voltage at atmospheric pressure

NASA Astrophysics Data System (ADS)

Xu, Yonggang; Wang, Jing; Li, Jing; Lei, Bingying; Tang, Jie; Wang, Yishan; Li, Yongfang; Zhao, Wei; Duan, Yixiang

2017-04-01

A two-dimensional self-consistent fluid model was employed to investigate the spatiotemporal characteristics of discharges in atmospheric pressure argon (Ar) dielectric barrier discharge driven by a Gaussian voltage. The simulation results show that a discharge with multiple current pulses occurs each half-cycle in the gas gap. A transition from the Townsend mode to the glow mode is observed with the increasing applied voltage each half-cycle at a lower driving frequency (7.5 kHz). It is also found that the glow mode survives all the discharge phases at a higher driving frequency (12.5 kHz and 40 kHz). The change in the discharge mode with the driving frequency mainly lies in the fact that a lot of charged particles created in the discharge gap have no enough time to drift and diffuse around, and then these particles are assembled in the discharge space at higher frequency. Additionally, the spatial distributions of the electron density indicate that a center-advantage discharge is ignited at the driving frequencies of interest, resulting in the radial non-uniformity of discharge because of the edge effects. However, this overall non-uniformity is weakened with the driving frequency increased to 40 kHz, at which concentric ring patterns are observed. These distinct behaviors are mainly attributed to the fact that many charged particles generated are trapped in the gas gap and then accumulated to make the extension along the radial direction due to the charged particles transport and diffusion, and that the effective overlapping of a large number of avalanches induced by the increased "seed" electron density with the driving frequency. Meanwhile, the surface charged particles accumulated on the dielectric barriers are also shown to play a role in the formation of the discharge structure.

Factors associated with discharge to home versus discharge to institutional care after inpatient stroke rehabilitation.

PubMed

Nguyen, Vu Q C; PrvuBettger, Janet; Guerrier, Tami; Hirsch, Mark A; Thomas, J George; Pugh, Terrence M; Rhoads, Charles F

2015-07-01

To examine sociodemographic and clinical characteristics independently associated with discharge home compared with discharge to a skilled nursing facility (SNF) after acute inpatient rehabilitation. Retrospective cohort study. Three tertiary accredited acute care rehabilitation facilities. Adult patients with stroke (N=2085). Not applicable. Not applicable. Of 2085 patients with stroke treated at 3 centers over a 4-year period, 78.2% (n=1631) were discharged home and 21.8% (n=454) discharged to an SNF. Findings from a multivariable logistic regression analysis indicated that patients were less likely to be discharged home if they were older (odds ratio [OR], .98; 95% confidence interval [CI], .96-.99), separated or divorced (compared with married; OR, .61; 95% CI, .48-.79), or with Medicare health insurance (compared with private insurance; OR, .69; 95% CI, .55-.88), or had dysphagia (OR, .83; 95% CI, .71-.98) or cognitive deficits (OR, .79; 95% CI, .77-.81). The odds of being discharged home were higher for those admitted with a higher motor FIM score (OR, 1.10; 95% CI, 1.09-1.11). The following were not associated with discharge disposition: sex, race, prestroke vocational status, availability of secondary health insurance, number of days from stroke onset to rehabilitation facility admission, stroke type, impairment group, cognitive FIM on admission, other stroke deficits (aphasia, ataxia, neglect, or speech disturbance), stroke complications of hyponatremia or urinary tract infection, or comorbid conditions. One in 5 patients with stroke were discharged to an SNF after inpatient rehabilitation. On admission, several sociodemographic and clinical characteristics were identified that could be considered as important factors in early discussions for discharge planning. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Method of inducing differential etch rates in glow discharge produced amorphous silicon

DOEpatents

Staebler, David L.; Zanzucchi, Peter J.

1980-01-01

A method of inducing differential etch rates in glow discharge produced amorphous silicon by heating a portion of the glow discharge produced amorphous silicon to a temperature of about 365.degree. C. higher than the deposition temperature prior to etching. The etch rate of the exposed amorphous silicon is less than the unheated amorphous silicon.

Characteristics of radiocesium runoff between five river basins near to the Fukushima Daiichi Nuclear Power Plant over heavy rainfall events

NASA Astrophysics Data System (ADS)

Sakuma, Kazuyuki; Malins, Alex; Kurikami, Hiroshi; Kitamura, Akihiro

2017-04-01

Due to the Fukushima Daiichi Nuclear Power Plant accident triggered by the earthquake and subsequent tsunami on 11 March 2011, many radionuclides were released into environments such as forests, rivers, dam reservoirs, and the ocean. 137Cs is one of the most important radio-contaminants. In order to investigate 137Cs transport and discharge from contaminated basins, in this study we developed a three dimensional model of five river basins near to the Fukushima Daiichi Nuclear Power Plant. We applied the General-purpose Terrestrial fluid-Flow Simulator (GETFLOWS) watershed code to the Odaka, Ukedo, Maeda, Kuma, and Tomioka River basins. The main land uses in these areas are forests, rice paddy fields, crop fields and urban. The Ukedo, Kuma and Tomioka Rivers have relatively large dam reservoirs (>106 m3) in the upper basins. The radiocesium distribution was initiated based on the Second Airborne Monitoring Survey. The simulation periods were 2011 Typhoon Roke, nine heavy rainfall events in 2013, Typhoons Man-yi and Wipha, and tropical storm Etau in 2015. Water, sediment, and radiocesium discharge from the basins was calculated for these events. The characteristics of 137Cs runoff between the different basins were evaluated in terms of land use, the effect of dam reservoirs, geology, and the fraction of the initial radiocesium inventory discharged. The absolute 137Cs discharge from the Ukedo River basin was highest, however the 137Cs discharge ratio was lowest due to the Ogaki Dam and the inventory being mainly concentrated in upstream forests. The results for the water, suspended sediment and radiocesium discharge as a function of total precipitation over the various rainfall events can be used to predict discharges for other typhoons.

An Excitatory Loop with Astrocytes Contributes to Drive Neurons to Seizure Threshold

PubMed Central

Chiavegato, Angela; Zonta, Micaela; Cammarota, Mario; Brondi, Marco; Vetri, Francesco; Uva, Laura; Pozzan, Tullio; de Curtis, Marco; Ratto, Gian Michele; Carmignoto, Giorgio

2010-01-01

Seizures in focal epilepsies are sustained by a highly synchronous neuronal discharge that arises at restricted brain sites and subsequently spreads to large portions of the brain. Despite intense experimental research in this field, the earlier cellular events that initiate and sustain a focal seizure are still not well defined. Their identification is central to understand the pathophysiology of focal epilepsies and to develop new pharmacological therapies for drug-resistant forms of epilepsy. The prominent involvement of astrocytes in ictogenesis was recently proposed. We test here whether a cooperation between astrocytes and neurons is a prerequisite to support ictal (seizure-like) and interictal epileptiform events. Simultaneous patch-clamp recording and Ca2+ imaging techniques were performed in a new in vitro model of focal seizures induced by local applications of N-methyl-D-aspartic acid (NMDA) in rat entorhinal cortex slices. We found that a Ca2+ elevation in astrocytes correlates with both the initial development and the maintenance of a focal, seizure-like discharge. A delayed astrocyte activation during ictal discharges was also observed in other models (including the whole in vitro isolated guinea pig brain) in which the site of generation of seizure activity cannot be precisely monitored. In contrast, interictal discharges were not associated with Ca2+ changes in astrocytes. Selective inhibition or stimulation of astrocyte Ca2+ signalling blocked or enhanced, respectively, ictal discharges, but did not affect interictal discharge generation. Our data reveal that neurons engage astrocytes in a recurrent excitatory loop (possibly involving gliotransmission) that promotes seizure ignition and sustains the ictal discharge. This neuron–astrocyte interaction may represent a novel target to develop effective therapeutic strategies to control seizures. PMID:20405049

Ion cyclotron resonance heating for tungsten control in various JET H-mode scenarios

NASA Astrophysics Data System (ADS)

Goniche, M.; Dumont, R. J.; Bobkov, V.; Buratti, P.; Brezinsek, S.; Challis, C.; Colas, L.; Czarnecka, A.; Drewelow, P.; Fedorczak, N.; Garcia, J.; Giroud, C.; Graham, M.; Graves, J. P.; Hobirk, J.; Jacquet, P.; Lerche, E.; Mantica, P.; Monakhov, I.; Monier-Garbet, P.; Nave, M. F. F.; Noble, C.; Nunes, I.; Pütterich, T.; Rimini, F.; Sertoli, M.; Valisa, M.; Van Eester, D.; Contributors, JET

2017-05-01

Ion cyclotron resonance heating (ICRH) in the hydrogen minority scheme provides central ion heating and acts favorably on the core tungsten transport. Full wave modeling shows that, at medium power level (4 MW), after collisional redistribution, the ratio of power transferred to the ions and the electrons vary little with the minority (hydrogen) concentration n H/n e but the high-Z impurity screening provided by the fast ions temperature increases with the concentration. The power radiated by tungsten in the core of the JET discharges has been analyzed on a large database covering the 2013-2014 campaign. In the baseline scenario with moderate plasma current (I p = 2.5 MA) ICRH modifies efficiently tungsten transport to avoid its accumulation in the plasma centre and, when the ICRH power is increased, the tungsten radiation peaking evolves as predicted by the neo-classical theory. At higher current (3-4 MA), tungsten accumulation can be only avoided with 5 MW of ICRH power with high gas injection rate. For discharges in the hybrid scenario, the strong initial peaking of the density leads to strong tungsten accumulation. When this initial density peaking is slightly reduced, with an ICRH power in excess of 4 MW,very low tungsten concentration in the core (˜10-5) is maintained for 3 s. MHD activity plays a key role in tungsten transport and modulation of the tungsten radiation during a sawtooth cycle is correlated to the fishbone activity triggered by the fast ion pressure gradient.

Surface modification of cathode material 0.5Li2MnO3·0.5LiMn1/3Ni1/3Co1/3O2 by alumina for lithium-ion batteries

NASA Astrophysics Data System (ADS)

Li, Yonghu; Chang, Xingping; Xu, Qunjie; Lai, Chunyan; Liu, Xinnuan; Yuan, Xiaolei; Liu, Haimei; Min, Yulin

2018-02-01

In an attempt to overcome the irreversible capacity loss occurred during the first cycle and stabilize the surface structure, an alumina coating layer has been triumphantly prepared on the surface of 0.5Li2MnO3·0.5LiMn1/3Ni1/3Co1/3O2 cathode material with different amounts (1, 2, and 3 wt%) through a simple hydrolysis reaction, followed by an annealing process. The results reveal that the coated materials have a higher crystallinity and the particles are evenly distributed. As a cathode material for lithium-ion batteries, the 2-wt% coated sample delivers initial discharge specific capacity of 211.7 mAh g-1 at a rate of 1 C between 2.0 and 4.8 V with an initial columbic efficiency of 73.2%. Meanwhile, it exhibits the highest discharge specific capacity of 206.2 mAh g-1 with 97.4% capacity retention after 100 cycles at and much elevated rate capability compared to uncoated material. The excellent cycling stability and more superior rate property can be ascribed to alumina coating layer, which has a surface stabilization effect on these cathode materials, lessening the dissolution of metal ions. The electrochemical impedance and cyclic voltammetry studies indicate that coated by alumina improved the kinetic performance for lithium-rich layered materials, showing a prospect for practical lithium battery application.

Characterizing Long-term Contaminant Mass Discharge and the Relationship Between Reductions in Discharge and Reductions in Mass for DNAPL Source Areas

PubMed Central

Matthieu, D.E.; Carroll, K.C.; Mainhagu, J.; Morrison, C.; McMillan, A.; Russo, A.; Plaschke, M.

2013-01-01

The objective of this study was to characterize the temporal behavior of contaminant mass discharge, and the relationship between reductions in contaminant mass discharge and reductions in contaminant mass, for a very heterogeneous, highly contaminated source-zone field site. Trichloroethene is the primary contaminant of concern, and several lines of evidence indicate the presence of organic liquid in the subsurface. The site is undergoing groundwater extraction for source control, and contaminant mass discharge has been monitored since system startup. The results show a significant reduction in contaminant mass discharge with time, decreasing from approximately 1 to 0.15 kg/d. Two methods were used to estimate the mass of contaminant present in the source area at the initiation of the remediation project. One was based on a comparison of two sets of core data, collected 3.5 years apart, which suggests that a significant (~80%) reduction in aggregate sediment-phase TCE concentrations occurred between sampling events. The second method was based on fitting the temporal contaminant mass discharge data with a simple exponential source-depletion function. Relatively similar estimates, 784 and 993 kg, respectively, were obtained with the two methods. These data were used to characterize the relationship between reductions in contaminant mass discharge (CMDR) and reductions in contaminant mass (MR). The observed curvilinear relationship exhibits a reduction in contaminant mass discharge essentially immediately upon initiation of mass reduction. This behavior is consistent with a system wherein significant quantities of mass are present in hydraulically poorly accessible domains for which mass removal is influenced by rate-limited mass transfer. The results obtained from the present study are compared to those obtained from other field studies to evaluate the impact of system properties and conditions on mass-discharge and mass-removal behavior. The results indicated that factors such as domain scale, hydraulic-gradient status (induced or natural), and flushing-solution composition had insignificant impact on the CMDR-MR profiles and thus on underlying mass-removal behavior. Conversely, source-zone age, through its impact on contaminant distribution and accessibility, was implicated as a critical factor influencing the nature of the CMDR-MR relationship. PMID:23528743

Discharge Planning in Chronic Conditions

PubMed Central

McMartin, K

2013-01-01

Background Chronically ill people experience frequent changes in health status accompanied by multiple transitions between care settings and care providers. Discharge planning provides support services, follow-up activities, and other interventions that span pre-hospital discharge to post-hospital settings. Objective To determine if discharge planning is effective at reducing health resource utilization and improving patient outcomes compared with standard care alone. Data Sources A standard systematic literature search was conducted for studies published from January 1, 2004, until December 13, 2011. Review Methods Reports, randomized controlled trials, systematic reviews, and meta-analyses with 1 month or more of follow-up and limited to specified chronic conditions were examined. Outcomes included mortality/survival, readmissions and emergency department (ED) visits, hospital length of stay (LOS), health-related quality of life (HRQOL), and patient satisfaction. Results One meta-analysis compared individualized discharge planning to usual care and found a significant reduction in readmissions favouring individualized discharge planning. A second meta-analysis compared comprehensive discharge planning with postdischarge support to usual care. There was a significant reduction in readmissions favouring discharge planning with postdischarge support. However, there was significant statistical heterogeneity. For both meta-analyses there was a nonsignificant reduction in mortality between the study arms. Limitations There was difficulty in distinguishing the relative contribution of each element within the terms “discharge planning” and “postdischarge support.” For most studies, “usual care” was not explicitly described. Conclusions Compared with usual care, there was moderate quality evidence that individualized discharge planning is more effective at reducing readmissions or hospital LOS but not mortality, and very low quality evidence that it is more effective at improving HRQOL or patient satisfaction. Compared with usual care, there was low quality evidence that the discharge planning plus postdischarge support is more effective at reducing readmissions but not more effective at reducing hospital LOS or mortality. There was very low quality evidence that it is more effective at improving HRQOL or patient satisfaction. Plain Language Summary Chronically ill people experience frequent changes in their health status and multiple transitions between care settings and care providers (e.g., hospital to home). Discharge planning provides support services, follow-up activities and other interventions that span pre-hospital discharge to post-hospital settings. A review of the effects of different discharge plans was conducted. After searching for relevant studies, 11 studies were found that compared discharge planning with routine discharge care. This review indicates that: Individualized discharge planning reduces initial hospital length of stay and subsequent readmission to hospital but does not reduce mortality. The effect on health-related quality of life (HRQOL) or patient satisfaction is uncertain. Discharge planning plus postdischarge support reduces readmissions but does not reduce the initial hospital length of stay or mortality after discharge. The effect on HRQOL or patient satisfaction is uncertain. PMID:24167538

Numerical simulation of compact intracloud discharge and generated electromagnetic pulse

NASA Astrophysics Data System (ADS)

Babich, L. P.; Bochkov, E. I.; Kutsyk, I. M.

2015-06-01

Using the concept of the relativistic runaway electron avalanche, numerical simulation of compact intracloud discharge as a generator of powerful natural electromagnetic pulses (EMPs) in the HF-UHF range was conducted. We evaluated the numbers of electrons initiating the avalanche, with which the calculated EMP characteristics are consistent with measured ones. The discharge capable of generating EMPs produces runaway electrons in numbers close to those in the source of terrestrial γ-flashes (TGF) registered in the nearest space, which may be an argument for a joint EMP and TGF source.

Simulating the inception of pulsed discharges near positive electrodes

NASA Astrophysics Data System (ADS)

Teunissen, Jannis; Ebert, Ute

2013-09-01

With 3D particle simulations we study the inception of pulsed discharges near positive electrodes. In different geometries, we first determine the breakdown voltage. Then we study the probability of inception for a fast voltage pulse. This probability mostly depends on the availability of seed electrons to generate the initial electron avalanches. These results are compared with experimental observations. Then we investigate how the shape of a starting discharge affects its further development. In particular, we discuss the formation of so-called ``inception clouds.'' JT was supported by STW-project 10755.

Feasibility, safety and cost of outpatient management of acute minor ischaemic stroke: a population-based study.

PubMed

Paul, Nicola L M; Koton, Silvia; Simoni, Michela; Geraghty, Olivia C; Luengo-Fernandez, Ramon; Rothwell, Peter M

2013-03-01

Outpatient management safely and effectively prevents early recurrent stroke after transient ischaemic attack (TIA), but this approach may not be safe in patients with acute minor stroke. To study outcomes of clinic and hospital-referred patients with TIA or minor stroke (National Institute of Health Stroke Scale score ≤3) in a prospective, population-based study (Oxford Vascular Study). Of 845 patients with TIA/stroke, 587 (69%) were referred directly to outpatient clinics and 258 (31%) directly to inpatient services. Of the 250 clinic-referred minor strokes (mean age 72.7 years), 237 (95%) were investigated, treated and discharged on the same day, of whom 16 (6.8%) were subsequently admitted to hospital within 30 days for recurrent stroke (n=6), sepsis (n=3), falls (n=3), bleeding (n=2), angina (n=1) and nursing care (n=1). The 150 patients (mean age 74.8 years) with minor stroke referred directly to hospital (median length-of-stay 9 days) had a similar 30-day readmission rate (9/150; 6.3%; p=0.83) after initial discharge and a similar 30-day risk of recurrent stroke (9/237 in clinic patients vs 8/150, OR=0.70, 0.27-1.80, p=0.61). Rates of prescription of secondary prevention medication after initial clinic/hospital discharge were higher in clinic-referred than in hospital-referred patients for antiplatelets/anticoagulants (p<0.05) and lipid-lowering agents (p<0.001) and were maintained at 1-year follow-up. The mean (SD) secondary care cost was £8323 (13 133) for hospital-referred minor stroke versus £743 (1794) for clinic-referred cases. Outpatient management of clinic-referred minor stroke is feasible and may be as safe as inpatient care. Rates of early hospital admission and recurrent stroke were low and uptake and maintenance of secondary prevention was high.

Generation of anomalously energetic suprathermal electrons by an electron beam interacting with a nonuniform plasma

NASA Astrophysics Data System (ADS)

Sydorenko, Dmytro

2015-11-01

Electrons emitted by electrodes surrounding or immersed in the plasma are accelerated by the sheath electric field and become electron beams penetrating the plasma. In plasma applications where controlling the electron velocity distribution function (EVDF) is crucial, these beams are an important factor capable of modifying the EVDF and affecting the discharge properties. Recently, it was reported that an EVDF measured in a dc-rf discharge with 800 V dc voltage has not only a peak of 800 eV electrons emitted from the dc-biased electrode, but also a peak of suprathermal electrons with energy up to several hundred eV. Initial explanation of the suprathermal peak suggested that the fast long plasma waves excited by the beam decay parametrically into ion acoustic waves and short plasma waves with much lower phase velocity which accelerate bulk electrons to suprathermal energies. Particle-in-cell simulation of a dc beam-plasma system, however, reveals that the short waves appear not due to the parametric instability, but due to the plasma nonuniformity. Moreover, the acceleration may occur in two stages. Plasma waves excited by the beam in the middle of the system propagate towards the anode and enter the density gradient area where their wavelength and phase speed rapidly decrease. Acceleration of thermal electrons by these waves is the first stage. Some of the accelerated electrons reflect from the anode sheath, travel through the plasma, reflect near the cathode, and enter the accelerating area again but with the energy higher than before. The acceleration that occurs now is the second stage. The energy of a particle after the second acceleration exceeds the initial thermal energy by an order of magnitude. This two-stage mechanism plays a role in explaining previous observations of energetic suprathermal electrons in similar discharges. The study is performed in collaboration with I. D. Kaganovich (PPPL), P. L. G. Ventzek and L. Chen (Tokyo Electron America).

Impact of cardiopulmonary resuscitation duration on survival from paramedic witnessed out-of-hospital cardiac arrests: An observational study.

PubMed

Nehme, Z; Andrew, E; Bernard, S; Smith, K

2016-03-01

Resuscitation guidelines often recommend ongoing cardiopulmonary resuscitation (CPR) efforts to hospital for out-of-hospital cardiac arrests (OHCA) witnessed by emergency medical service (EMS) personnel. In this study, we examine the relationship between EMS CPR duration and survival to hospital discharge in EMS witnessed OHCA patients. Between January 2003 and December 2011, 1035 adult EMS witnessed arrests of presumed cardiac aetiology were included from the Victorian Ambulance Cardiac Arrest Registry. CPR duration was defined as the total sum of prehospital CPR time in minutes. Adjusted logistic regression analyses were used to assess the impact of EMS CPR duration on survival to hospital discharge. 382 (37.3%) patients were discharged alive. The median CPR duration was 12 min (95% CI: 11-13) overall, but was higher in non-survivors compared to survivors (24 min vs. 2 min, p<0.001). The 99th percentile CPR duration in patients surviving to hospital discharge differed by the initial rhythm of arrest: 32 min (95% CI: 27-44) overall, 32 min (95% CI: 23-44) for ventricular fibrillation and pulseless ventricular tachycardia (VF/VT), 34 min (95% CI: 30-34) for pulseless electrical activity (PEA), and 28 min (95% CI: 21-28) for asystole. There were no survivors after 44 min for all rhythms. After adjusting for prehospital confounders, every minute increase in CPR duration was associated with a 13% reduction in the odds of survival to hospital discharge (OR 0.87, 95% CI: 0.84-0.89, p<0.001). The multivariable model predicted no chance of survival at or after a CPR duration of 48 min for VF/VT patients, 47 min for PEA patients and 45 min for asystole patients. Resuscitation efforts exceeding 32 min yielded less than 1% of survivors from EMS witnessed OHCA. On the basis of this data, EMS witnessed OHCA patients may benefit from ongoing CPR efforts up to 48 min in duration. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Post-discharge kidney function is associated with subsequent ten-year renal progression risk among survivors of acute kidney injury.

PubMed

Sawhney, Simon; Marks, Angharad; Fluck, Nick; Levin, Adeera; McLernon, David; Prescott, Gordon; Black, Corri

2017-08-01

The extent to which renal progression after acute kidney injury (AKI) arises from an initial step drop in kidney function (incomplete recovery), or from a long-term trajectory of subsequent decline, is unclear. This makes it challenging to plan or time post-discharge follow-up. This study of 14651 hospital survivors in 2003 (1966 with AKI, 12685 no AKI) separates incomplete recovery from subsequent renal decline by using the post-discharge estimated glomerular filtration rate (eGFR) rather than the pre-admission as a new reference point for determining subsequent renal outcomes. Outcomes were sustained 30% renal decline and de novo CKD stage 4, followed from 2003-2013. Death was a competing risk. Overall, death was more common than subsequent renal decline (37.5% vs 11.3%) and CKD stage 4 (4.5%). Overall, 25.7% of AKI patients had non-recovery. Subsequent renal decline was greater after AKI (vs no AKI) (14.8% vs 10.8%). Renal decline after AKI (vs no AKI) was greatest among those with higher post-discharge eGFRs with multivariable hazard ratios of 2.29 (1.88-2.78); 1.50 (1.13-2.00); 0.94 (0.68-1.32) and 0.95 (0.64-1.41) at eGFRs of 60 or more; 45-59; 30-44 and under 30, respectively. The excess risk after AKI persisted over ten years of study, irrespective of AKI severity, or post-episode proteinuria. Thus, even if post-discharge kidney function returns to normal, hospital admission with AKI is associated with increased renal progression that persists for up to ten years. Follow-up plans should avoid false reassurance when eGFR after AKI returns to normal. Copyright © 2017 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.

Detecting seasonal flood changes in the Upper Danube River basin

NASA Astrophysics Data System (ADS)

Kohnová, Silvia; Jeneiová, Katarína; Parajka, Juraj; Hall, Julia; Marková, Romana

2017-04-01

Due to a number of large-scale floods observed worldwide in recent years, the analysis of changes in long-term hydrological time series is becoming increasingly important. This study focuses on the Upper Danube region, which was struck by many flood events in the past decade. The flood seasonality of the study region, defined as the area of Germany, the Czech Republic, Switzerland, Austria and Slovakia, is examined to interpret the dominant flood processes. A spatial assessment of the seasonality indices of the annual maximum discharges and the seasonal discharges (derived from daily average discharges) was conducted for 117 gauging stations. Hot spots for potential changes in the mean dates of occurrence of the discharges were identified, and the results were linked with derived spatial characteristics for the catchments. The first results of the study of the seasonal discharges revealed that the variability of occurrence of summer floods is higher than winter floods in lowlands of the upper Danube catchment. In high Alpine catchments the winter floods variability of occurrence is the same or higher than for the summer floods. The summer season floods tend to appear for all catchment sizes in the same time period. With increased magnitude of floods in the summer season, the variability of occurrence of the floods is higher.

Hydrogen and Ethene Plasma Assisted Ignition by NS discharge at Elevated Temperatures

NASA Astrophysics Data System (ADS)

Starikovskiy, Andrey

2015-09-01

The kinetics of ignition in lean H2:O2:Ar and C2H4:O2:Ar mixtures has been studied experimentally and numerically after a high-voltage nanosecond discharge. The ignition delay time behind a reflected shock wave was measured with and without the discharge. It was shown that the initiation of the discharge with a specific deposited energy of 10 - 30 mJ/cm3 leads to an order of magnitude decrease in the ignition delay time. Discharge processes and following chain chemical reactions with energy release were simulated. The generation of atoms, radicals and excited and charged particles was numerically simulated using the measured time - resolved discharge current and electric field in the discharge phase. The calculated densities of the active particles were used as input data to simulate plasma-assisted ignition. Good agreement was obtained between the calculated ignition delay times and the experimental data. It follows from the analysis of the calculated results that the main mechanism of the effect of gas discharge on the ignition of hydrocarbons is the electron impact dissociation of O2 molecules in the discharge phase. Detailed kinetic mechanism for plasma assisted ignition of hydrogen and ethene is elaborated and verified.

Static current-voltage characteristics for radio-frequency induction discharge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Budyansky, A.; Zykov, A.

1995-12-31

The aim of this work was to obtain experimentally such characteristic of Radio-Frequency Induction Discharge (RFID) that can play the role of its current-voltage characteristic (CVC) and to explain the nature of current and voltage jumps arising in RF coils at exciting of discharge. Experiments were made in quartz 5.5, 11, 20 cm diam tubes with outer RF coil at pressures 10--100 mTorr, at frequency 13.56 MHz and discharge power to 500 W. In case of outer coil as analogue of discharge voltage it`s convenient to use the value of the RF voltage U{sub R}, induced around outer perimeter ofmore » discharge tube. It is evident that current and voltage jumps arising at exciting of discharge are due to low output resistance of standard generators and negative slope of initial part of CVC. Three sets of such dependencies for different pressures were obtained for each diameter of tubes. The influence of different metal electrodes placed into discharge volume on CVC`s shape has been studied also. Experimental results can explain the behavior of HFI discharge as a load of RF generator and give data for calculation of RF circuit.« less

Efficient Radio Frequency Inductive Discharges in Near Atmospheric Pressure Using Immittance Conversion Topology

NASA Astrophysics Data System (ADS)

Razzak, M. Abdur; Takamura, Shuichi; Uesugi, Yoshihiko; Ohno, Noriyasu

A radio frequency (rf) inductive discharge in atmospheric pressure range requires high voltage in the initial startup phase and high power during the steady state sustainment phase. It is, therefore, necessary to inject high rf power into the plasma ensuring the maximum use of the power source, especially where the rf power is limited. In order to inject the maximum possible rf power into the plasma with a moderate rf power source of few kilowatts range, we employ the immittance conversion topology by converting a constant voltage source into a constant current source to generate efficient rf discharge by inductively coupled plasma (ICP) technique at a gas pressure with up to one atmosphere in argon. A novel T-LCL immittance circuit is designed for constant-current high-power operation, which is practically very important in the high-frequency range, to provide high effective rf power to the plasma. The immittance conversion system combines the static induction transistor (SIT)-based radio frequency (rf) high-power inverter circuit and the immittance conversion elements including the rf induction coil. The basic properties of the immittance circuit are studied by numerical analysis and verified the results by experimental measurements with the inductive plasma as a load at a relatively high rf power of about 4 kW. The performances of the immittance circuit are also evaluated and compared with that of the conventional series resonance circuit in high-pressure induction plasma generation. The experimental results reveal that the immittance conversion circuit confirms injecting higher effective rf power into the plasma as much as three times than that of the series resonance circuit under the same operating conditions and same dc supply voltage to the inverter, thereby enhancing the plasma heating efficiency to generate efficient rf inductive discharges.

Therapeutic temperature modulation for fever after intracerebral hemorrhage.

PubMed

Lord, Aaron S; Karinja, Sarah; Lantigua, Hector; Carpenter, Amanda; Schmidt, J Michael; Claassen, Jan; Agarwal, Sachin; Connolly, E Sander; Mayer, Stephan A; Badjatia, Neeraj

2014-10-01

We sought to determine whether therapeutic temperature modulation (TTM) to treat fever after intracerebral hemorrhage (ICH) is associated with improved hospital complications and discharge outcomes. We performed a retrospective case-control study of patients admitted with spontaneous ICH having two consecutive fevers ≥38.3 °C despite acetaminophen administration. Cases were enrolled from a prospective database of patients receiving TTM from 2006 to 2010. All cases received TTM for fever control with goal temperature of 37 °C with a shiver-control protocol. Controls were matched in severity by ICH score and retrospectively obtained from 2001 to 2004, before routine use of TTM for ICH. Primary outcome was discharge-modified Rankin score. Forty patients were enrolled in each group. Median admission ICH Score, ICH volume, and GCS were similar. TTM was initiated with a median of 3 days after ICH onset and for a median duration of 7 days. Mean daily T max was significantly higher in the control group over the first 12 days (38.1 vs. 38.7 °C, p ≤ 0.001). The TTM group had more days of IV sedation (median 8 vs. 1, p < 0.001) and mechanical ventilation (18 vs. 9, p = 0.003), and more frequently underwent tracheostomy (55 vs. 23 %, p = 0.005). Mean NICU length of stay was longer for TTM patients (15 vs. 11 days, p = 0.007). There was no difference in discharge outcomes between the two groups (overall mortality 33 %, moderate or severe disability 67 %). Therapeutic normothermia is associated with increased duration of sedation, mechanical ventilation, and NICU stay, but is not clearly associated with improved discharge outcome.

Effect of Al substitution on the enhanced electrochemical performance and strong structure stability of Na3V2(PO4)3/C composite cathode for sodium-ion batteries

NASA Astrophysics Data System (ADS)

Chen, Yanjun; Xu, Youlong; Sun, Xiaofei; Wang, Chao

2018-01-01

In this study, a promising cathode material in Na-ion batteries, Al-doped NASICON-type Na3V2-xAlx(PO4)3/C (0 ≤ × ≤0.03) samples are synthesized and characterized. The doping effects on the crystal structure are investigated by XRD and XPS, indicating that low dose of Al3+ doping generates no damage on the structure of the material, and aluminum is substituted for the vanadium site successfully. Electron microscopy and Raman data show that amorphous carbon coated on the matrix can enhance the electron conductivity. The electrochemical kinetic response of Al3+ doping are tested based on "slow-charge and rapid-discharge" electrochemical mode, results from before and after the cycles show that the doping samples have strong structure stability and excellent electrochemical performance because of low internal resistances and high ion conductivity. Thus, Na3V1.98Al0.02(PO4)3/C exhibits an initial reversible capacity of 102.7 mAh g-1 at 10 mA g-1 in the potential range between 2.3 and 3.8 V and delivers a discharge value of 95 mAh g-1vs. 59.9 mAh g-1 of NVP/C at current density of 70 mA g-1 discharge after 50 cycles. The ionic conductivity of Na3V1.98Al0.02(PO4)3/C sample at 3.4 V after 50 cycles at 10 mA g-1 charge 200 mA g-1 discharge is 1.31 × 10-12 cm2s-1, four orders of magnitude higher than the undoped one(7.79 × 10-17 cm2s-1).

[Does improvement of symptoms four weeks after the begin of psychodynamic inpatient psychotherapy correspond to long term outcome?].

PubMed

Franke, Gabriele Helga; Hoffmann, Thilo; Frommer, Jörg

2005-01-01

This study was conducted to explore differentiated aspects of outcome throughout and one year after psychodynamic inpatient psychotherapy with special regard to symptomatic distress and interpersonal behaviour. Sixty-four patients of the Department of Psychotherapeutic Medicine of the Jerichow Hospital (Saxonia-Anhaltina) were investigated with the SCL-90-R and the IIP-D four times: at the beginning of inpatient psychotherapy (t0), four weeks after (t1), at the end (t2), and one year after discharge (t3). The improvement of symptoms four weeks after the beginning of psychodynamic inpatient psychotherapy is equivalent with long term outcome. The Global Severity Index of SCL-90-R demonstrated a statistically significant change from markedly psychological distress to lack of distress after four weeks psychodynamic inpatient psychotherapy (effect-size d(GSI) = 0.82). At the end of psychotherapy, three weeks later, the effect-size was d = 1.11, and one year after discharge the effect-size decreased again to d = 0.85. Major improvements demonstrated the SCL-90-R subscales Depression, Anxiety, and Obsessive/Compulsive. Regarding interpersonal problems, the subscales Dominance, and Competitive demonstrated statistically significant changes from low Stanine-scores at t0 to higher scores one year after discharge. The subscales Socially avoidant, Nonassertive, and Exploitable demonstrated statistical significant changes from high levels at t0 to lower scores after one year. In conclusion the first four weeks of psychodynamic psychotherapy are not sufficient to demonstrate an optimum level of low psychological distress as well as an optimum change in interpersonal problems. Regarding stability of the effects of psychodynamic inpatient psychotherapy it was demonstrated that the first four weeks initiated changes which improved at the end of psychotherapy until one year after discharge.

Self-discharge mechanism of sealed-type nickel/metal-hydride battery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ikoma, Munehisa; Hoshina, Yasuko; Matsumoto, Isao

1996-06-01

Factors affecting the self-discharge rate of a nickel/metal-hydride (Ni-MH) battery, generally much higher than that of nickel/cadmium (Ni-Cd) battery, are investigated, and the self-discharge mechanism is discussed. Ammonia and amine participate in the shuttle reaction like nitrate ion in the Ni-Cd battery, resulting in acceleration of the self-discharge. When nonwoven fabric made of sulfonated-polypropylene is used as a separator instead of conventional polyamide separator, the self-discharge rate of the Ni-MH battery is strongly depressed, to the same level as that of Ni-Cd battery.

A trial of ignition innovation of gasoline engine by nanosecond pulsed low temperature plasma ignition

NASA Astrophysics Data System (ADS)

Shiraishi, Taisuke; Urushihara, Tomonori; Gundersen, Martin

2009-07-01

Application of nanosecond pulsed low temperature plasma as an ignition technique for automotive gasoline engines, which require a discharge under conditions of high back pressure, has been studied experimentally using a single-cylinder engine. The nanosecond pulsed plasma refers to the transient (non-equilibrated) phase of a plasma before the formation of an arc discharge; it was obtained by applying a high voltage with a nanosecond pulse (FWHM of approximately 80 or 25 ns) between coaxial cylindrical electrodes. It was confirmed that nanosecond pulsed plasma can form a volumetric multi-channel streamer discharge at an energy consumption of 60 mJ cycle-1 under a high back pressure of 1400 kPa. It was found that the initial combustion period was shortened compared with the conventional spark ignition. The initial flame visualization suggested that the nanosecond pulsed plasma ignition results in the formation of a spatially dispersed initial flame kernel at a position of high electric field strength around the central electrode. It was observed that the electric field strength in the air gap between the coaxial cylindrical electrodes was increased further by applying a shorter pulse. It was also clarified that the shorter pulse improved ignitability even further.

Spatially and Temporally Resolved Atomic Oxygen Measurements in Short Pulse Discharges by Two Photon Laser Induced Fluorescence

NASA Astrophysics Data System (ADS)

Lempert, Walter; Uddi, Mruthunjaya; Mintusov, Eugene; Jiang, Naibo; Adamovich, Igor

2007-10-01

Two Photon Laser Induced Fluorescence (TALIF) is used to measure time-dependent absolute oxygen atom concentrations in O2/He, O2/N2, and CH4/air plasmas produced with a 20 nanosecond duration, 20 kV pulsed discharge at 10 Hz repetition rate. Xenon calibrated spectra show that a single discharge pulse creates initial oxygen dissociation fraction of ˜0.0005 for air like mixtures at 40-60 torr total pressure. Peak O atom concentration is a factor of approximately two lower in fuel lean (φ=0.5) methane/air mixtures. In helium buffer, the initially formed atomic oxygen decays monotonically, with decay time consistent with formation of ozone. In all nitrogen containing mixtures, atomic oxygen concentrations are found to initially increase, for time scales on the order of 10-100 microseconds, due presumably to additional O2 dissociation caused by collisions with electronically excited nitrogen. Further evidence of the role of metastable N2 is demonstrated from time-dependent N2 2^nd Positive and NO Gamma band emission spectroscopy. Comparisons with modeling predictions show qualitative, but not quantitative, agreement with the experimental data.

Reversing-counterpulse repetitive-pulse inductive storage circuit

DOEpatents

Honig, E.M.

1987-02-10

A high-power reversing-counterpulse repetitive-pulse inductive storage and transfer circuit includes an opening switch, a main energy storage coil, a counterpulse capacitor and a small inductor. After counterpulsing the opening switch off, the counterpulse capacitor is recharged by the main energy storage coil before the load pulse is initiated. This gives the counterpulse capacitor sufficient energy for the next counterpulse operation, although the polarity of the capacitor's voltage must be reversed before that can occur. By using a current-zero switch as the counterpulse start switch, the capacitor is disconnected from the circuit (with a full charge) when the load pulse is initiated, preventing the capacitor from depleting its energy store by discharging through the load. After the load pulse is terminated by reclosing the main opening switch, the polarity of the counterpulse capacitor voltage is reversed by discharging the capacitor through a small inductor and interrupting the discharge current oscillation at zero current and peak reversed voltage. The circuit enables high-power, high-repetition-rate operation with reusable switches and features total control (pulse-to-pulse) over output pulse initiation, duration, repetition rate, and, to some extent, risetime. 10 figs.

Quasi-perpetual discharge behaviour in p-type Ge-air batteries.

PubMed

Ocon, Joey D; Kim, Jin Won; Abrenica, Graniel Harne A; Lee, Jae Kwang; Lee, Jaeyoung

2014-11-07

Metal-air batteries continue to become attractive energy storage and conversion systems due to their high energy and power densities, safer chemistries, and economic viability. Semiconductor-air batteries - a term we first define here as metal-air batteries that use semiconductor anodes such as silicon (Si) and germanium (Ge) - have been introduced in recent years as new high-energy battery chemistries. In this paper, we describe the excellent doping-dependent discharge kinetics of p-type Ge anodes in a semiconductor-air cell employing a gelled KOH electrolyte. Owing to its Fermi level, n-type Ge is expected to have lower redox potential and better electronic conductivity, which could potentially lead to a higher operating voltage and better discharge kinetics. Nonetheless, discharge measurements demonstrated that this prediction is only valid at the low current regime and breaks down at the high current density region. The p-type Ge behaves extremely better at elevated currents, evident from the higher voltage, more power available, and larger practical energy density from a very long discharge time, possibly arising from the high overpotential for surface passivation. A primary semiconductor-air battery, powered by a flat p-type Ge as a multi-electron anode, exhibited an unprecedented full discharge capacity of 1302.5 mA h gGe(-1) (88% anode utilization efficiency), the highest among semiconductor-air cells, notably better than new metal-air cells with three-dimensional and nanostructured anodes, and at least two folds higher than commercial Zn-air and Al-air cells. We therefore suggest that this study be extended to doped-Si anodes, in order to pave the way for a deeper understanding on the discharge phenomena in alkaline metal-air conversion cells with semiconductor anodes for specific niche applications in the future.

Influence of the electrode gap separation on the pseudospark-sourced electron beam generation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhao, J., E-mail: junping.zhao@qq.com; State Key Laboratory of Electrical Insulation and Power Equipment, West Xianning Road, Xi'an 710049; Department of Physics, SUPA, University of Strathclyde, Glasgow, G4 0NG Scotland

Pseudospark-sourced electron beam is a self-focused intense electron beam which can propagate without any external focusing magnetic field. This electron beam can drive a beam-wave interaction directly or after being post-accelerated. It is especially suitable for terahertz radiation generation due to the ability of a pseudospark discharge to produce small size in the micron range and very high current density and bright electron beams. In this paper, a single-gap pseudospark discharge chamber has been built and tested with several electrode gap separations to explore the dependence of the pseudospark-sourced electron beam current on the discharge voltage and the electrode gapmore » separation. Experimental results show that the beam pulses have similar pulse width and delay time from the distinct drop of the applied voltage for smaller electrode gap separations but longer delay time for the largest gap separation used in the experiment. It has been found that the electron beam only starts to occur when the charging voltage is above a certain value, which is defined as the starting voltage of the electron beam. The starting voltage is different for different electrode gap separations and decreases with increasing electrode gap separation in our pseudospark discharge configuration. The electron beam current increases with the increasing discharge voltage following two tendencies. Under the same discharge voltage, the configuration with the larger electrode gap separation will generate higher electron beam current. When the discharge voltage is higher than 10 kV, the beam current generated at the electrode gap separation of 17.0 mm, is much higher than that generated at smaller gap separations. The ionization of the neutral gas in the main gap is inferred to contribute more to the current increase with increasing electrode gap separation.« less

Generation of low-temperature air plasma for food processing

NASA Astrophysics Data System (ADS)

Stepanova, Olga; Demidova, Maria; Astafiev, Alexander; Pinchuk, Mikhail; Balkir, Pinar; Turantas, Fulya

2015-11-01

The project is aimed at developing a physical and technical foundation of generating plasma with low gas temperature at atmospheric pressure for food industry needs. As known, plasma has an antimicrobial effect on the numerous types of microorganisms, including those that cause food spoilage. In this work an original experimental setup has been developed for the treatment of different foods. It is based on initiating corona or dielectric-barrier discharge in a chamber filled with ambient air in combination with a certain helium admixture. The experimental setup provides various conditions of discharge generation (including discharge gap geometry, supply voltage, velocity of gas flow, content of helium admixture in air and working pressure) and allows for the measurement of the electrical discharge parameters. Some recommendations on choosing optimal conditions of discharge generation for experiments on plasma food processing are developed.

Prediction of initiation and duration of breast-feeding for neonates admitted to the neonatal intensive care unit.

PubMed

Lessen, Rachelle; Crivelli-Kovach, Andrea

2007-01-01

Women who desire to breast-feed their sick newborns often encounter obstacles, including insufficient support and education as well as unsupportive hospital practices. The purpose of this study was to describe maternal, neonatal, and outside influences associated with the intention, initiation, and duration of breast-feeding for women whose newborns were admitted to the neonatal intensive care unit. One hundred mothers were interviewed. Most mothers (67%) intended to breast-feed exclusively and this was significantly related to maternal characteristics such as age, education, parity, smoking and marital status, pre-breast-feeding experience, and the influences of the neonate's father and prenatal education. Seventy-eight mothers initiated pumping. Initiation was significantly related to maternal education, smoking, parity, previous breast-feeding experience, the neonate's physician, the neonate's father, and postpartum breast-feeding education. Fifty-four mothers were followed up by telephone after discharge until weaning. Thirty percent were exclusively breast-feeding at 2 weeks after discharge, and 15% were breast-feeding at 1 year. Duration of breast-feeding was significantly associated with education, marital status, ethnicity, income, assistance from nurses and lactation consultants, and feeding method along with milk type and milk volume at discharge. Increased family support, timely breast-feeding information, and a supportive neonatal intensive care unit environment are needed for women to succeed in breast-feeding their hospitalized newborns.

One-dimensional numerical modeling of Blue Jet and its impact on stratospheric chemistry

NASA Astrophysics Data System (ADS)

Duruisseau, F.; Thiéblemont, R.; Huret, N.

2011-12-01

In the stratosphere the ozone layer is very sensitive to the NOx abundance. The ionisation of N2 and O2 molecules by TLE's (Transient Luminous Events) is a source of NOx which is currently not well quantified and could act as a loss of ozone. In this study a one dimensional explicit parameterization of a Blue-Jet propagation based on that proposed by Raizer et al. (2006 and 2007) has been developed. This parameterization considers Blue-Jet as a streamer initiated by a bidirectional leader discharge, emerging from the anvil and sustained by moderate cloud charge. The streamer growth varies with the electrical field induced by initial cloud charge and the initial altitude. This electrical parameterization and the chemical mechanisms associated with the discharge have been implemented into a detailed chemical model of stratospheric ozone including evolution of nitrogen, chlorine and bromine species. We will present several tests performed to validate the electrical code and evaluate the propagation velocity and the maximum altitude attains by the blue jet as a function of electrical parameters. The results obtained giving the spatiotemporal evolution of the electron density are then used to initiate the specific chemistry associated with the Blue Jet. Preliminary results on the impact of such discharge on the ozone content and the whole stratospheric system will be presented.

Discharge Chamber Primary Electron Modeling Activities in Three-Dimensions

NASA Technical Reports Server (NTRS)

Steuber, Thomas J.

2004-01-01

Designing discharge chambers for ion thrusters involves many geometric configuration decisions. Various decisions will impact discharge chamber performance with respect to propellant utilization efficiency, ion production costs, and grid lifetime. These hardware design decisions can benefit from the assistance of computational modeling. Computational modeling for discharge chambers has been limited to two-dimensional codes that leveraged symmetry for interpretation into three-dimensional analysis. This paper presents model development activities towards a three-dimensional discharge chamber simulation to aid discharge chamber design decisions. Specifically, of the many geometric configuration decisions toward attainment of a worthy discharge chamber, this paper focuses on addressing magnetic circuit considerations with a three-dimensional discharge chamber simulation as a tool. With this tool, candidate discharge chamber magnetic circuit designs can be analyzed computationally to gain insight into factors that may influence discharge chamber performance such as: primary electron loss width in magnetic cusps, cathode tip position with respect to the low magnetic field volume, definition of a low magnetic field region, and maintenance of a low magnetic field region across the grid span. Corroborating experimental data will be obtained from mockup hardware tests. Initially, simulated candidate magnetic circuit designs will resemble previous successful thruster designs. To provide opportunity to improve beyond previous performance benchmarks, off-design modifications will be simulated and experimentally tested.

Electron beam switched discharge for rapidly pulsed lasers

DOEpatents

Pleasance, Lyn D.; Murray, John R.; Goldhar, Julius; Bradley, Laird P.

1981-01-01

Method and apparatus for electrical excitation of a laser gas by application of a pulsed voltage across the gas, followed by passage of a pulsed, high energy electron beam through the gas to initiate a discharge suitable for laser excitation. This method improves upon current power conditioning techniques and is especially useful for driving rare gas halide lasers at high repetition rates.

A Safe and Interactive Method of Illuminating Discharge Tubes for Studying Emission Spectra

ERIC Educational Resources Information Center

Lu, Zhe

2012-01-01

Discharge tubes are useful tools for teaching emission spectra and the discrete energy levels of the Bohr model. A new setup uses a plasma globe to illuminate the discharge tube and allows a higher degree of interactivity owing to the omission of a traditional, high-voltage power source. The decreased power consumption also reduces the heating of…

Impeller tandem blade study with grid embedding for local grid refinement

NASA Technical Reports Server (NTRS)

Bache, George

1992-01-01

Flow non-uniformity at the discharge of high power density impellers can result in significant unsteady interactions between impeller blades and downstream diffuser vanes. These interactions result in degradation of both performance and pump reliability. The MSFC Pump Technology Team has recognized the importance of resolving this problem and has thus initiated the development and testing of a high head coefficient impeller. One of the primary goals of this program is to improve impeller performance and discharge flow uniformity. The objective of the present work is complimentary. Flow uniformity and performance gains were sought through the application of a tandem blade arrangement. The approach adopted was to numerically establish flow characteristics at the impeller discharge for the baseline MSFC impeller and then parametrically evaluate tandem blade configurations. A tandem design was sought that improves both impeller performance and discharge uniformity. The Navier-Stokes solver AEROVISC was used to conduct the study. Grid embedding is used to resolve local gradients while attempting to minimize model size. Initial results indicate that significant gains in flow uniformity can be achieved through the tandem blade concept and that blade clocking rather than slot location is the primary driver for flow uniformity.

Laser flash-photolysis and gas discharge in N2O-containing mixture: kinetic mechanism

NASA Astrophysics Data System (ADS)

Kosarev, Ilya; Popov, Nikolay; Starikovskaia, Svetlana; Starikovskiy, Andrey; mipt Team

2011-10-01

The paper is devoted to further experimental and theoretical analysis of ignition by ArF laser flash-photolysis and nanosecond discharge in N2O-containing mixture has been done. Additional experiments have been made to assure that laser emission is distributed uniformly throughout the cross-section. The series of experiments was proposed and carried out to check validity of O(1D) determination in experiments on plasma assisted ignition initiated by flash-photolysis. In these experiments, ozone density in the given mixture (mixture composition and kinetics has been preliminary analyzed) was measured using UV light absorption in Hartley band. Good coincidence between experimental data and results of calculations have been obtained Temporal behavior of energy input, electric field and electric current has been measured and analyzed. These data are considered as initial conditions for numerical modeling of the discharge in O2:N2O:H2:Ar = 0.3:1:3:5 mixture. Ion-molecular reactions and reactions of active species production in Ar:H2:O2:N2O mixture were analyzed. The set of reactions to describe chemical transformation in the system due to the discharge action has been selected.

Addressing the business of discharge: building a case for an electronic discharge summary.

PubMed

Mourad, Michelle; Cucina, Russell; Ramanathan, Rajiv; Vidyarthi, Arpana R

2011-01-01

Hospitalists are increasingly involved in implementing quality improvement initiatives around patient safety, clinical informatics, and transitions of care, but may lack expertise in promoting these important interventions. Developing a sound business case is essential to garnering support and resources for any quality improvement initiative. We present a framework for developing a business case using a structured approach to exploring qualitative and quantitative costs and benefits and describe its application in the experience of developing an electronic discharge summary at the University of California San Francisco (UCSF). At our institution, we found that the primary financial benefits are the cost reductions in eliminating transcription needs and decreasing billing delays, as well as reducing the cost of tracking completion of and dissemination of discharge summaries. Costs incurred from a new information technology (IT) infrastructure, programmer time, maintenance and training must also be accounted for. While benefits may be apparent to front line providers (improved communication, efficiency of data transfer, and increased referring physician satisfaction), implementing and sustaining such an innovation depends on articulating a sound business case with a detailed cost-benefit analysis to institutional decision making. Copyright © 2010 Society of Hospital Medicine.

DIVERSE MODELS FOR SOLVING CONTRASTING OUTFALL PROBLEMS

EPA Science Inventory

Mixing zone initial dilution and far-field models are useful for assuring that water quality criteria will be met when specific outfall discharge criteria are applied. Presented here is a selective review of mixing zone initial dilution models and relatively simple far-field tran...

[Shortened hospital stay for elective cesarean section after initiation of a fast-track program and midwifery home-care].

PubMed

Gunnarsdottir, Johanna; Bjornsdottir, Thorbjörg Edda; Halldorsson, Thorhallur Ingi; Halldorsdottir, Gudrun; Geirsson, Reynir Tomas

2011-07-01

To audit whether hospital stay shortened without increasing readmissions after implementation of fast-track methodology for elective cesarean section and characterize what influences length of stay. A fast-track program was initiated in November 2008, with a one year clinical audit and satisfaction survey. Discharge criteria were predefined and midwife home visits included if discharge was within 48 hours. Hospital stay by parity for women with elective section for singleton pregnancy between 1.11. 2008 - 31.10. 2009 (n=213, fast-track 182) was compared to 2003 (n=199) and 2007 (n=183). Readmissions and outpatient visits 2007 and 2008-9 were counted. Reasons for longer stay were recorded in fast-track, and body mass index. Median hospital stay decreased significantly from 81 to 52 hours between 2007 and 2008-9. Readmissions were four in each period and outpatient visit rates similar. In 2008-9, 66% of all women were discharged within 48 hours. Women in the fast-track program were satisfied with early discharge. Hospital stay for parous women was shorter in 2007 compared to 2003, but unchanged for nulliparas. Parity had a minimal influence on length of stay in 2008-9, although nulliparous women ≤ 25 years were more likely to stay >48 hours. Body mass index did not correlate with length of stay. Pain was rarely the reason for a longer stay in the fast-track program and 90% were satisfied with pain-medication after discharge. Most healthy women can be discharged early after singleton birth by elective cesarean, without increasing readmissions.

Discharges to prison from medium secure psychiatric units in England and Wales.

PubMed

Doyle, Michael; Coid, Jeremy; Archer-Power, Laura; Dewa, Lindsay; Hunter-Didrichsen, Alice; Stevenson, Rachel; Wainwright, Verity; Kallis, Costas; Ullrich, Simone; Shaw, Jenny

2014-09-01

Early findings from a national study of discharges from 32 National Health Service medium secure units revealed that nearly twice as many patients than expected were discharged back to prison. To compare the characteristics of those discharged back to prison with those discharged to the community, and consider the implications for ongoing care and risk. Prospective cohort follow-up design. All forensic patients discharged from 32 medium secure units across England and Wales over a 12-month period were identified. Those discharged to prison were compared with those who were discharged to the community. Nearly half of the individuals discharged to prison were diagnosed with a serious mental illness and over a third with schizophrenia. They were a higher risk, more likely to have a personality disorder, more symptomatic and less motivated than those discharged to the community. Findings suggest that alternative models of prison mental healthcare should be considered to reduce risks to the patient and the public. Royal College of Psychiatrists.

Using the red/yellow/green discharge tool to improve the timeliness of hospital discharges.

PubMed

Mathews, Kusum S; Corso, Philip; Bacon, Sandra; Jenq, Grace Y

2014-06-01

As part of Yale-New Haven Hospital (Connecticut)'s Safe Patient Flow Initiative, the physician leadership developed the Red/Yellow/Green (RYG) Discharge Tool, an electronic medical record-based prompt to identify likelihood of patients' next-day discharge: green (very likely), yellow (possibly), and red (unlikely). The tool's purpose was to enhance communication with nursing/care coordination and trigger earlier discharge steps for patients identified as "green" or "yellow." Data on discharge assignments, discharge dates/ times, and team designation were collected for all adult medicine patients discharged in October-December 2009 (Study Period 1) and October-December 2011 (Study Period 2), between which the tool's placement changed from the sign-out note to the daily progress note. In Study Period 1, 75.9% of the patients had discharge assignments, compared with 90.8% in Period 2 (p < .001). The overall 11 A.M. discharge rate improved from 10.4% to 21.2% from 2007 to 2011. "Green" patients were more likely to be discharged before 11 A.M. than "yellow" or "red" patients (p < .001). Patients with RYG assignments discharged by 11 A.M. had a lower length of stay than those without assignments and did not have an associated increased risk of readmission. Discharge prediction accuracy worsened after the change in placement, decreasing from 75.1% to 59.1% for "green" patients (p < .001), and from 34.5% to 29.2% (p < .001) for "yellow" patients. In both periods, hospitalists were more accurate than house staff in discharge predictions, suggesting that education and/or experience may contribute to discharge assignment. The RYG Discharge Tool helped facilitate earlier discharges, but accuracy depends on placement in daily work flow and experience.

Using the Red/Yellow/Green Discharge Tool to Improve the Timeliness of Hospital Discharges

PubMed Central

Mathews, Kusum S.; Corso, Philip; Bacon, Sandra; Jenq, Grace Y.

2015-01-01

Background As part of Yale-New Haven Hospital (Connecticut)’s Safe Patient Flow Initiative, the physician leadership developed the Red/Yellow/Green (RYG) Discharge Tool, an electronic medical record–based prompt to identify likelihood of patients’ next-day discharge: green (very likely), yellow (possibly), and red (unlikely). The tool’s purpose was to enhance communication with nursing/care coordination and trigger earlier discharge steps for patients identified as “green” or “yellow”. Methods Data on discharge assignments, discharge dates/times, and team designation were collected for all adult medicine patients discharged from October – December 2009 (Study Period 1) and October – December 2011 (Study Period 2), between which the tool’s placement changed from the sign-out note to the daily progress note. Results In Study Period 1, 75.9% of the patients had discharge assignments, compared with 90.8% in Period 2 (p < .001). The overall 11 A.M. discharge rate improved from 10.4% to 21.2% from 2007 to 2011. “Green” patients were more likely to be discharged before 11 A.M. than “yellow” or “red” patients (p < .001). Patients with RYG assignments discharged by 11 A.M. had a lower length of stay than those without assignments and did not have an associated increased risk of readmission. Discharge prediction accuracy worsened after the change in placement, decreasing from 75.1% to 59.1% for “green” patients (p < .001), and from 34.5% to 29.2% (p < .001) for “yellow” patients. In both periods, hospitalists were more accurate than housestaff in discharge predictions, suggesting that education and/or experience may contribute to discharge assignment. Conclusions The RYG Discharge Tool helped facilitate earlier discharges, but accuracy depends on placement in daily work flow and experience. PMID:25016672

Under Pressure: Financial Effect of the Hospital-Acquired Conditions Initiative-A Statewide Analysis of Pressure Ulcer Development and Payment.

PubMed

Meddings, Jennifer; Reichert, Heidi; Rogers, Mary A M; Hofer, Timothy P; McMahon, Laurence F; Grazier, Kyle L

2015-07-01

To assess the financial effect of the 2008 Hospital-Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals. Retrospective before-and-after study of all-payer statewide administrative data for more than 2.4 million annual adult discharges in 2007 and 2009 using the Healthcare Cost and Utilization Project State Inpatient Datasets for California. How often and by how much the 2008 payment changes for pressure ulcers affected hospital payment was assessed. Nonfederal acute care California hospitals (N = 311). Adults discharged from acute-care hospitals. Pressure ulcer rates and hospital payment changes. Hospital-acquired pressure ulcer rates were low in 2007 (0.28%) and 2009 (0.27%); present-on-admission pressure ulcer rates increased from 2.3% in 2007 to 3.0% in 2009. According to clinical stage of pressure ulcer (available in 2009), hospital-acquired Stage III and IV ulcers occurred in 603 discharges (0.02%); 60,244 discharges (2.42%) contained other pressure ulcer diagnoses. Payment removal for Stage III and IV hospital-acquired ulcers reduced payment in 75 (0.003%) discharges, for a statewide payment decrease of $310,444 (0.001%) for all payers and $199,238 (0.001%) for Medicare. For all other pressure ulcers, the Hospital-Acquired Conditions Initiative reduced hospital payment in 20,246 (0.81%) cases (including 18,953 cases with present-on-admission ulcers), reducing statewide payment by $62,538,586 (0.21%) for all payers and $47,237,984 (0.32%) for Medicare. The total financial effect of the 2008 payment changes for pressure ulcers was negligible. Most payment decreases occurred by removal of comorbidity payments for present-on-admission pressure ulcers other than Stages III and IV. The removal of payment for hospital-acquired Stage III and IV ulcers by implementation of the HACI policy was 1/200th that of the removal of payment for other types of pressure ulcers that occurred in implementation of the Hospital-Acquired Conditions Initiative. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

Association of hospitalist care with medical utilization after discharge: evidence of cost shift from a cohort study.

PubMed

Kuo, Yong-Fang; Goodwin, James S

2011-08-02

Hospitalist care has grown rapidly, in part because it is associated with decreased length of stay and hospital costs. No national studies examining the effect of hospitalist care on hospital costs or on medical utilization and costs after discharge have been done. To assess the relationship of hospitalist care with hospital length of stay, hospital charges, and medical utilization and Medicare costs after discharge. Population-based national cohort study. Hospital care of Medicare patients. A 5% national sample of enrollees in Medicare parts A and B with a primary care physician who were cared for by their primary care physician or a hospitalist during medical hospitalizations from 2001 to 2006. Length of stay, hospital charges, discharge location and physician visits, emergency department visits, rehospitalization, and Medicare spending within 30 days after discharge. In propensity score analysis, hospital length of stay was 0.64 day less among patients receiving hospitalist care. Hospital charges were $282 lower, whereas Medicare costs in the 30 days after discharge were $332 higher (P < 0.001 for both). Patients cared for by hospitalists were less likely to be discharged to home (odds ratio, 0.82 [95% CI, 0.78 to 0.86]) and were more likely to have emergency department visits (odds ratio, 1.18 [CI, 1.12 to 1.24]) and readmissions (odds ratio, 1.08 [CI, 1.02 to 1.14]) after discharge. They also had fewer visits with their primary care physician and more nursing facility visits after discharge. Observational studies are subject to selection bias. Decreased length of stay and hospital costs associated with hospitalist care are offset by higher medical utilization and costs after discharge. National Institute on Aging and National Cancer Institute.

Outcomes of an inpatient medical nutritional rehabilitation protocol in children and adolescents with eating disorders.

PubMed

Peebles, Rebecka; Lesser, Andrew; Park, Courtney Cheek; Heckert, Kerri; Timko, C Alix; Lantzouni, Eleni; Liebman, Ronald; Weaver, Laurel

2017-01-01

Medical stabilization through inpatient nutritional rehabilitation is often necessary for patients with eating disorders (EDs) but includes the inherent risk of refeeding syndrome. Here we describe our experience of implementing and sustaining an inpatient nutritional rehabilitation protocol designed to strategically prepare patients with EDs and their families for discharge to a home setting in an efficient and effective manner from a general adolescent medicine unit. We report outcomes at admission, discharge, and 4-weeks follow-up. Protocol development, implementation, and unique features of the protocol, are described. Data were collected retrospectively as part of a continuous quality improvement (QI) initiative. Safety outcomes were the clinical need for phosphorus, potassium, and magnesium supplementation, other evidence of refeeding syndrome, and unexpected readmissions within one month of discharge. The value outcome was length of stay (LOS). Treatment outcomes were the percentage median BMI (MBMI) change from admission to discharge, and from discharge to 4-weeks follow-up visit. A total of 215 patients (88% F, 12% M) were included. Patients averaged 15.3 years old (5.8-23.2y); 64% had AN, 18% had atypical anorexia (AtAN), 6% bulimia nervosa (BN), 5% purging disorder (PD), 4% avoidant-restrictive food intake disorder (ARFID), and 3% had an unspecified food and eating disorder (UFED). Average LOS was 11 days. Initial mean calorie level for patients at admission was 1466 and at discharge 3800 kcals/day. Phosphorus supplementation for refeeding hypophosphatemia (RH) was needed in 14% of inpatients; full-threshold refeeding syndrome did not occur. Only 3.8% were rehospitalized in the thirty days after discharge. Patients averaged 86.1% of a median MBMI for age and gender, 91.4% MBMI at discharge, and 100.9% MBMI at 4-weeks follow-up. Mean percentage MBMI differences between time points were significantly different (admission-discharge: 5.3%, p  <0.001; discharge-follow-up: 9.2%, p  <0.001). Implementation of the CHOP inpatient nutritional rehabilitation protocol aimed at rapid, efficient, and safe weight gain and integration of caregivers in treatment of patients with diverse ED diagnoses led to excellent QI outcomes in percentage MBMI at discharge and 4-weeks follow-up, while maintaining a short LOS and low rates of RH phosphorus supplementation.

Process for preparing higher oxides of the alkali and alkaline earth metals

NASA Technical Reports Server (NTRS)

Sadhukhan, P.; Bell, A. (Inventor)

1978-01-01

High purity inorganic higher oxides of the alkali and alkaline earth metals are prepared by subjecting the hydroxide of the alkali and alkaline earth metal to a radio frequency discharge sustained in oxygen. The process is particulary adaptable to the production of high purity potassium superoxide by subjecting potassium hydroxide to glow discharge sustained in oxygen under the pressure of about 0.75 to 1.00 torr.

Coherence between coastal and river flooding along the California coast

USGS Publications Warehouse

Odigie, Kingsley O.; Warrick, Jonathan

2018-01-01

Water levels around river mouths are intrinsically determined by sea level and river discharge. If storm-associated coastal water-level anomalies coincide with extreme river discharge, landscapes near river mouths will be flooded by the hydrodynamic interactions of these two water masses. Unfortunately, the temporal relationships between ocean and river water masses are not well understood. The coherence between extreme river discharge and coastal water levels at six California river mouths across different climatic and geographic regions was examined. Data from river gauges, wave buoys, and tide gauges from 2007 to 2014 were integrated to investigate the relationships between extreme river discharge and coastal water levels near the mouths of the Eel, Russian, San Lorenzo, Ventura, Arroyo Trabuco, and San Diego rivers. Results indicate that mean and extreme coastal water levels during extreme river discharge are significantly higher compared with background conditions. Elevated coastal water levels result from the combination of nontidal residuals (NTRs) and wave setups. Mean and extreme (>99th percentile of observations) NTRs are 3–20 cm and ∼30 cm higher during extreme river discharge conditions, respectively. Mean and extreme wave setups are up to 40 cm and ∼20–90 cm higher during extreme river discharge than typical conditions, respectively. These water-level anomalies were generally greatest for the northern rivers and least for the southern rivers. Time-series comparisons suggest that increases in NTRs are largely coherent with extreme river discharge, owing to the low atmospheric pressure systems associated with storms. The potential flooding risks of the concurrent timing of these water masses are tempered by the mixed, semidiurnal tides of the region that have amplitudes of 2–2.5 m. In summary, flooding hazard assessments for floodplains near California river mouths for current or future conditions with sea-level rise should include the temporal coherence of fluvial and oceanic water levels.

The Utility of Therapeutic Hypothermia for Post-Cardiac Arrest Syndrome Patients With an Initial Nonshockable Rhythm.

PubMed

Perman, Sarah M; Grossestreuer, Anne V; Wiebe, Douglas J; Carr, Brendan G; Abella, Benjamin S; Gaieski, David F

2015-12-01

Therapeutic hypothermia (TH) attenuates reperfusion injury in comatose survivors of cardiac arrest. The utility of TH in patients with nonshockable initial rhythms has not been widely accepted. We sought to determine whether TH improved neurological outcome and survival in postarrest patients with nonshockable rhythms. We identified 519 patients after in- and out-of-hospital cardiac arrest with nonshockable initial rhythms from the Penn Alliance for Therapeutic Hypothermia (PATH) registry between 2000 and 2013. Propensity score matching was used. Patient and arrest characteristics used to estimate the propensity to receive TH were age, sex, location of arrest, witnessed arrest, and duration of arrest. To determine the association between TH and outcomes, we created 2 multivariable logistic models controlling for confounders. Of 201 propensity score-matched pairs, mean age was 63 ± 17 years, 51% were male, and 60% had an initial rhythm of pulseless electric activity. Survival to hospital discharge was greater in patients who received TH (17.6% versus 28.9%; P < 0.01), as was a discharge Cerebral Performance Category of 1 to 2 (13.7% versus 21.4%; P = 0.04). In adjusted analyses, patients who received TH were more likely to survive (odds ratio, 2.8; 95% confidence interval, 1.6-4.7) and to have better neurological outcome (odds ratio, 3.5; 95% confidence interval, 1.8-6.6) than those that did not receive TH. Using propensity score matching, we found that patients with nonshockable initial rhythms treated with TH had better survival and neurological outcome at hospital discharge than those who did not receive TH. Our findings further support the use of TH in patients with initial nonshockable arrest rhythms. © 2015 American Heart Association, Inc.

Sediment yield during typhoon events in relation to landslides, rainfall, and catchment areas in Taiwan

NASA Astrophysics Data System (ADS)

Chen, Chi-Wen; Oguchi, Takashi; Hayakawa, Yuichi S.; Saito, Hitoshi; Chen, Hongey; Lin, Guan-Wei; Wei, Lun-Wei; Chao, Yi-Chiung

2018-02-01

Debris sourced from landslides will result in environmental problems such as increased sediment discharge in rivers. This study analyzed the sediment discharge of 17 main rivers in Taiwan during 14 typhoon events, selected from the catchment area and river length, that caused landslides according to government reports. The measured suspended sediment and water discharge, collected from hydrometric stations of the Water Resources Agency of Taiwan, were used to establish rating-curve relationships, a power-law relation between them. Then sediment discharge during typhoon events was estimated using the rating-curve method and the measured data of daily water discharge. Positive correlations between sediment discharge and rainfall conditions for each river indicate that sediment discharge increases when a greater amount of rainfall or a higher intensity of rainfall falls during a typhoon event. In addition, the amount of sediment discharge during a typhoon event is mainly controlled by the total amount of rainfall, not by peak rainfall. Differences in correlation equations among the rivers suggest that catchments with larger areas produce more sediment. Catchments with relatively low sediment discharge show more distinct increases in sediment discharge in response to increases in rainfall, owing to the little opportunity for deposition in small catchments with high connectivity to rivers and the transportation of the majority of landslide debris to rivers during typhoon events. Also, differences in geomorphic and geologic conditions among catchments around Taiwan lead to a variety of suspended sediment dynamics and the sediment budget. Positive correlation between average sediment discharge and average area of landslides during typhoon events indicates that when larger landslides are caused by heavier rainfall during a typhoon event, more loose materials from the most recent landslide debris are flushed into rivers, resulting in higher sediment discharge. The high proportion of large landslides in Taiwan contributes significantly to the high annual sediment yield, which is among the world's highest despite the small area of Taiwan.

Plasma induced degradation of Indigo Carmine by bipolar pulsed dielectric barrier discharge(DBD) in the water-air mixture.

PubMed

Zhang, Ruo-Bing; Wu, Yan; Li, Guo-Feng; Wang, Ning-Hui; Li, Jie

2004-01-01

Degradation of the Indigo Carmine (IC) by the bipolar pulsed DBD in water-air mixture was studied. Effects of various parameters such as gas flow rate, solution conductivity, pulse repetitive rate and ect., on color removal efficiency of dying wastewater were investigated. Concentrations of gas phase o3 and aqueous phase H2O2 under various conditions were measured. Experimental results showed that air bubbling facilitates the breakdown of water and promotes generation of chemically active species. Color removal efficiency of IC solution can be greatly improved by the air aeration under various solution conductivities. Decolorization efficiency increases with the increase of the gas flow rate, and decreases with the increase of the initial solution conductivity. A higher pulse repetitive rate and a larger pulse capacitor C(p) are favorable for the decolorization process. Ozone and hydrogen peroxide formed decreases with the increase of initial solution conductivity. In addition, preliminary analysis of the decolorization mechanisms is given.

Self-discharge analysis and characterization of supercapacitors for environmentally powered wireless sensor network applications

NASA Astrophysics Data System (ADS)

Yang, Hengzhao; Zhang, Ying

2011-10-01

A new approach is presented to characterize the variable leakage resistance, a parameter in the variable leakage resistance model we developed to model supercapacitors used in environmentally powered wireless sensor network applications. Based on an analysis of the supercapacitor terminal behavior during the self-discharge, the variable leakage resistance is modeled as a function of the supercapacitor terminal voltage instead of the self-discharge time, which is more practical for an environmentally powered wireless sensor node. The new characterization approach is implemented and validated using MATLAB Simulink with a 10 F supercapacitor as an example. In addition, effects of initial voltages and temperatures on the supercapacitor self-discharge rate and the variable leakage resistance value are explored.

Correlation of the neutron yield from the plasma focus upon variations in the magnetic field energy of the discharge circuit

NASA Astrophysics Data System (ADS)

Ablesimov, V. E.; Dolin, Yu. N.; Kalinychev, A. E.; Tsibikov, Z. S.

2017-10-01

The relation between neutron yield Y and magnetic field energy variations Δ W in the discharge circuit has been studied for a Mather-type plasma-focus camera. The activation technique (activation of silver isotopes) has been used to measure the integral yield of DD neutrons from the source. The time dependence of the neutron yield has been recorded by scintillation detectors. For the device used in the investigations, the neutron yield exhibits a linear dependence on variations in the magnetic field energy Δ W in the discharge circuit at the instant of neutron generation. It is also found that this dependence is related to the initial deuteron pressure in the discharge chamber.

Dynamic model based on voltage transfer curve for pattern formation in dielectric barrier glow discharge

DOE Office of Scientific and Technical Information (OSTI.GOV)

Li, Ben; He, Feng; Ouyang, Jiting, E-mail: jtouyang@bit.edu.cn

2015-12-15

Simulation work is very important for understanding the formation of self-organized discharge patterns. Previous works have witnessed different models derived from other systems for simulation of discharge pattern, but most of these models are complicated and time-consuming. In this paper, we introduce a convenient phenomenological dynamic model based on the basic dynamic process of glow discharge and the voltage transfer curve (VTC) to study the dielectric barrier glow discharge (DBGD) pattern. VTC is an important characteristic of DBGD, which plots the change of wall voltage after a discharge as a function of the initial total gap voltage. In the modeling,more » the combined effect of the discharge conditions is included in VTC, and the activation-inhibition effect is expressed by a spatial interaction term. Besides, the model reduces the dimensionality of the system by just considering the integration effect of current flow. All these greatly facilitate the construction of this model. Numerical simulations turn out to be in good accordance with our previous fluid modeling and experimental result.« less

Particulate and aerosol detector

NASA Technical Reports Server (NTRS)

Wortman, J. J.; Donovan, R. P.; Brooks, A. D.; Monteith, L. K.; Kinard, W. H.; Oneil, R. L. (Inventor)

1976-01-01

A device is described for counting aerosols and sorting them according to either size, mass or energy. The component parts are an accelerator, a capacitor sensor and a readout. The accelerator is a means for accelerating the aerosols toward the face of the capacitor sensor with such force that they partially penetrate the capacitor sensor, momentarily discharging it. The readout device is a means for counting the number of discharges of the capacitor sensor and measuring the amplitudes of these different discharges. The aerosols are accelerated by the accelerator in the direction of the metal layer with such force that they penetrate the metal and damage the oxide layers, thereby allowing the electrical charge on the capacitor to discharge through the damaged region. Each incident aerosol initiates a discharge path through the capacitor in such a fashion as to vaporize the conducting path. Once the discharge action is complete, the low resistance path no longer exists between the two capacitor plates and the capacitor is again able to accept a charge. The active area of the capacitor is reduced in size by the damaged area each time a discharge occurs.

Higher Quality and Lower Cost from Improving Hospital Discharge Decision Making*

PubMed Central

Cox, James C.; Sadiraj, Vjollca; Schnier, Kurt E.; Sweeney, John F.

2015-01-01

This paper reports research on improving decisions about hospital discharges – decisions that are now made by physicians based on mainly subjective evaluations of patients’ discharge status. We report an experiment on uptake of our clinical decision support software (CDSS) which presents physicians with evidence-based discharge criteria that can be effectively utilized at the point of care where the discharge decision is made. One experimental treatment we report prompts physician attentiveness to the CDSS by replacing the default option of universal “opt in” to patient discharge with the alternative default option of “opt out” from the CDSS recommendations to discharge or not to discharge the patient on each day of hospital stay. We also report results from experimental treatments that implement the CDSS under varying conditions of time pressure on the subjects. The experiment was conducted using resident physicians and fourth-year medical students at a university medical school as subjects. PMID:28239219

Upward electrical discharges observed above Tropical Depression Dorian

PubMed Central

Liu, Ningyu; Spiva, Nicholas; Dwyer, Joseph R.; Rassoul, Hamid K.; Free, Dwayne; Cummer, Steven A.

2015-01-01

Observation of upward electrical discharges from thunderstorms has been sporadically reported in the scientific literature. According to their terminal altitudes, they are classified as starters (20–30 km), jets (40–50 km) and gigantic jets (70–90 km). They not only have a significant impact on the occupied atmospheric volumes but also electrically couple different atmospheric regions. However, as they are rare and unpredictable, our knowledge of them has been built on observations that typically record only one type of such discharges. Here we report a close-distance observation of seven upward discharges including one starter, two jets and four gigantic jets above Tropical Depression Dorian. Our optical and electromagnetic data indicate that all events are of negative polarity, suggesting they are initiated in the same thundercloud charge region. The data also indicate that the lightning-like discharge channel can extend above thunderclouds by about 30 km, but the discharge does not emit low-frequency electromagnetic radiation as normal lightning. PMID:25607345

Arcing in LEO: Does the Whole Array Discharge?

NASA Technical Reports Server (NTRS)

Ferguson, Dale C.; Vayner, Boris V.; Galofaro, Joel T.; Hillard, G. Barry

2005-01-01

The conventional wisdom about solar array arcing in LEO is that only the parts of the solar array that are swept over by the arc-generated plasma front are discharged in the initial arc. This limits the amount of energy that can be discharged. Recent work done at the NASA Glenn Research Center has shown that this idea is mistaken. In fact, the capacitance of the entire solar array may be discharged, which for large arrays leads to very large and possibly debilitating arcs, even if no sustained arc occurs. We present the laboratory work that conclusively demonstrates this fact by using a grounded plate that prevents the arc-plasma front from reaching certain array strings. Finally, we discuss the dependence of arc strength and arc pulse width on the capacitance that is discharged, and provide a physical mechanism for discharge of the entire array, even when parts of the array are not accessible to the arc-plasma front. Mitigation techniques are also presented.

Feasibility of rapid discharge after transoral robotic surgery of the oropharynx.

PubMed

Richmon, Jeremy D; Feng, Allen L; Yang, Wuyang; Starmer, Heather; Quon, Harry; Gourin, Christine G

2014-11-01

To investigate the use of an algorithm for rapid discharge after transoral robotic surgery (TORS) and its effect on postoperative complications. Retrospective cohort study. A retrospective analysis of TORS cases from September 2009 to February 2013 was conducted. The effect of patient and tumor characteristics on postoperative length of stay (LOS) and complications were analyzed. A total of 91 patients were included; 79 underwent TORS for malignancy and 12 for a benign process. The mean LOS was 1.51 days (range, 1-5 days) with a median of 1 day. The mean time to initiation of oral diet was 1.26 days (range, 1-7 days) with a median of 1 day. Eleven (12%) patients experienced one or more complications during their postoperative course. Multivariate analysis demonstrated a significant association between patient and procedure variables and postoperative complications. TORS base of tongue reduction for obstructive sleep apnea (OSA) was associated with a significantly greater mean incremental time to initiation of oral diet (1.0 days, 95% confidence interval [CI]: 0.4 to 1.7, P < .001). A significantly greater mean incremental LOS was observed for patients with advanced comorbidity and a delay in initiation of oral diet beyond 24 hours. Rapid initiation of oral diet and rapid discharge home is feasible and not associated with postoperative complications. Similarly, the performance of a concurrent neck dissection does not contribute to LOS or the development of postoperative complications. Patients undergoing TORS for OSA are at greater risk of delay in initiation of oral diet and increased LOS. 4 © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

Studies of oxygen-helium discharges for use in electric oxygen-iodine lasers

NASA Astrophysics Data System (ADS)

Zimmerman, Joseph William

In recent work, the performance of the Electric Oxygen-Iodine Laser (ElectricOIL), developed in partnership by researchers at the University of Illinois and CU Aerospace, has been greatly improved through systematic study of various components of this new laser technology. One major contribution to the advancement of ElectricOIL technology has been the development of electric discharges capable of producing significant flow rates of the precursor electronically-excited molecular oxygen, O2(a1Delta). O2(a 1Delta) serves as an energy reservoir in the laser system, pumping atomic iodine by near-resonant energy transfer producing gain and laser on the I(2P1/2) → I(2P3/2 ) transition at 1315 nm. Initial experimental work with radio-frequency discharges showed the importance of controlling O-atom flow rates to reduce quenching losses of energy stored in O2(a1Delta), and determined proper selection of the helium diluent ratio and specific power deposition (power per O2 flow rate). Further experimental investigations with transverse capacitive radio-frequency discharges in O2/He/NO mixtures in the pressure range of 1-100 Torr and power range of 0.1-1.2 kW have indicated that O2(a1Delta) production is a strong function of geometry (transverse gap), excitation frequency, and pressure. These parameters along with gas flow mixture dictate the current density at which the discharge operates, and its modal characteristics (normal vs. abnormal, homogeneous vs. inhomogeneous). A key result is that to encourage efficient O2(a1Delta) production these parameters should be selected in order to promote a homogeneous (low current density) discharge. The discharge behavior is characterized using terminal current-voltage-characteristics, microwave interferometer measurements, and plasma emission intensity measurements. Numerous spectroscopic measurements of O2(a1Delta), oxygen atoms, and discharge excited states are made in order to describe the discharge performance dependent on various parameters. The influence of NO on O-atom flow rates and O2(a1Delta) production is investigated. Progress of laser power extraction since initial reports in 2005 is overviewed.

33 CFR 155.1050 - Response plan development and evaluation criteria for vessels carrying groups I through IV...

Code of Federal Regulations, 2012 CFR

2012-07-01

... the discovery of a discharge in higher volume port areas and the Great Lakes; (ii) 24 hours of the discovery of a discharge in all rivers and canals, inland, nearshore and offshore areas; and (iii) 24 hours of the discovery of a discharge plus travel time from shore for open ocean areas. (2) The necessary...

33 CFR 155.1050 - Response plan development and evaluation criteria for vessels carrying groups I through IV...

Code of Federal Regulations, 2013 CFR

2013-07-01

... the discovery of a discharge in higher volume port areas and the Great Lakes; (ii) 24 hours of the discovery of a discharge in all rivers and canals, inland, nearshore and offshore areas; and (iii) 24 hours of the discovery of a discharge plus travel time from shore for open ocean areas. (2) The necessary...

33 CFR 155.1050 - Response plan development and evaluation criteria for vessels carrying groups I through IV...

Code of Federal Regulations, 2014 CFR

2014-07-01

... the discovery of a discharge in higher volume port areas and the Great Lakes; (ii) 24 hours of the discovery of a discharge in all rivers and canals, inland, nearshore and offshore areas; and (iii) 24 hours of the discovery of a discharge plus travel time from shore for open ocean areas. (2) The necessary...

Individualized follow up programme and early discharge in term neonates.

PubMed

De Carolis, Maria Pia; Cocca, Carmen; Valente, Elisabetta; Lacerenza, Serafina; Rubortone, Serena Antonia; Zuppa, Antonio Alberto; Romagnoli, Costantino

2014-07-15

Early discharge of mother/neonate dyad has become a common practice, and its effects are measured by readmission rates. We evaluated the safety of early discharge followed by an individualized Follow-up programme and the efficacy in promoting breastfeeding initiation and duration. During a nine-month period early discharge followed by an early targeted Follow-up was carried out in term neonates in the absence of weight loss <10% or hyperbilirubinaemia at risk of treatment. Follow-up visits were performed at different timepoints with a specific flow-chart according to both bilirubin levels and weight loss at discharge. During the study period early discharge was performed in 419 neonates and Follow-up was carried out in 408 neonates (97.4%). No neonates required readmission for hyperbilirubinaemia and dehydration during the first 28 days of life. Breastfeeding rate was 90.6%, 75.2%, 41.5% at 30, 90 and 180 days of life, respectively. A six-month phone interview was performed for 383 neonates (93.8%) and satisfaction of parents about early discharge was high in 345 cases (90.1%). Early discharge in association with an individualized Follow-up programme resulted safe for the neonate and effective for breastfeeding initation and duration.

Laser-guided, intersecting discharge channels for the final beam transport in heavy-ion fusion

NASA Astrophysics Data System (ADS)

Niemann, C.; Neff, S.; Tauschwitz, A.; Penache, D.; Birkner, R.; Constantin, C.; Knobloch, R.; Presura, R.; Rosmej, F. B.; Hoffmann, D. H. H.; Yu, S. S.

2003-06-01

Ion-beam transport in space charge neutralizing discharge channels has been proposed for the final focus and chamber transport in a heavy-ion fusion reactor. A driver scenario with two-sided target illumination requires a system of two intersecting discharges to transport beams of the same charge from opposite sides towards the fusion target. In this article we report on experiments on the creation of free-standing, intersecting high-current discharge channels. The discharges are initiated in ammonia gas (NH3) in a metallic chamber by two perpendicular CO2-laser beams, which resonantly heat and subsequently rarefy the gas along the laser paths before the breakdown. These low density channels guide the discharges along the predefined paths and also around the 90° angles without any mechanical guiding structures. In this way stable X-, T-, and L-shaped discharges with currents in excess of 40 kA, at pressures of a few mbar were created with a total length of 110 cm. An 11.4 A MeV 58Ni+12 beam from the UNILAC (Universal Linear Accelerator) linear accelerator was used to probe the line-integrated ion-optical properties of the central channel in a T-shaped discharge.

Experimental study and simulation of space charge stimulated discharge

NASA Astrophysics Data System (ADS)

Noskov, M. D.; Malinovski, A. S.; Cooke, C. M.; Wright, K. A.; Schwab, A. J.

2002-11-01

The electrical discharge of volume distributed space charge in poly(methylmethacrylate) (PMMA) has been investigated both experimentally and by computer simulation. The experimental space charge was implanted in dielectric samples by exposure to a monoenergetic electron beam of 3 MeV. Electrical breakdown through the implanted space charge region within the sample was initiated by a local electric field enhancement applied to the sample surface. A stochastic-deterministic dynamic model for electrical discharge was developed and used in a computer simulation of these breakdowns. The model employs stochastic rules to describe the physical growth of the discharge channels, and deterministic laws to describe the electric field, the charge, and energy dynamics within the discharge channels and the dielectric. Simulated spatial-temporal and current characteristics of the expanding discharge structure during physical growth are quantitatively compared with the experimental data to confirm the discharge model. It was found that a single fixed set of physically based dielectric parameter values was adequate to simulate the complete family of experimental space charge discharges in PMMA. It is proposed that such a set of parameters also provides a useful means to quantify the breakdown properties of other dielectrics.

Health related quality of life in patients with community-acquired pneumococcal pneumonia in France.

PubMed

Andrade, Luiz Flavio; Saba, Grèce; Ricard, Jean-Damien; Messika, Jonathan; Gaillat, Jacques; Bonnin, Pierre; Chidiac, Christian; Illes, Hajnal-Gabriela; Laurichesse, Henri; Detournay, Bruno; Petitpretz, Patrick; de Pouvourville, Gérard

2018-02-02

Community Acquired Pneumococcal Pneumonia is a lung infection that causes serious health problems and can lead to complications and death. The aim of this study was to observe and analyze health related quality of life after a hospital episode for patients with community acquired pneumococcal pneumonia in France. A total of 524 individuals were enrolled prospectively in the study and were followed for 12 months after hospital discharge. Presence of streptococcus pneumoniae was confirmed by microbiological sampling. Quality of life was reported at four different points of time with the EQ-5D-3 L health states using the French reference tariff. Complete data on all four periods was available for 269 patients. We used descriptive and econometric analysis to assess quality of life over time during follow-up, and to identify factors that impact the utility indexes and their evolution through time. We used Tobit panel data estimators to deal with the bounded nature of utility values. Average age of patients was 63 and 55% of patients were men. Negative predictors of quality of life were the severity of the initial event, history of pneumonia, smokers, age and being male. On average, quality of life improved in the first 6 months after discharge and stabilized beyond. At month 1, mean utility index was 0.53 (SD: 0.34) for men and 0.45 (SD: 0.34) for women, versus mean of 0.69 (SD: 0.33) and 0.70 (SD: 0.35) at Month 12. "Usual activities" was the dimension the most impacted by the disease episode. Utilities for men were significantly higher than for women, although male patients were more severe. Individuals over 85 years old did not improve quality of life during follow-up, and quality of life did not improve or deteriorated for 34% of patients. We found that length of hospital stay was negatively correlated with quality of life immediately after discharge. This study provides with evidence that quality of life after an episode of community acquired pneumococcal pneumonia improves overall until the sixth month after hospital discharge, but older patients with previous history of pneumonia may not experience health gains after the initial episode.

Incidence and types of speech disorders in stroke patients.

PubMed

Vidović, Mirjana; Sinanović, Osman; Sabaskić, Lejla; Haticić, Adisa; Brkić, Ensala

2011-12-01

The aim of the study was to determine the incidence and types of speech disorders in patients with acute stroke. The study was performed in 936 acute stroke patients admitted to University Department of Neurology, Tuzla University Clinical Center, in the period from January 1, 2007 through December 31, 2008. Out of 936 study patients, speech disorders were verified on admission in 771 (82.37%) patients. Dysarthria was present in 540 (57.69%) and aphasia in 231 (24.67%) patients. In the group with speech disturbances, dysarthria was present in 70.04% and aphasia in 29.96% of patients. During hospital stay, lethal outcome was recorded in 51 patients, significantly higher in the group with speech disorders (P = 0.004). At discharge from the hospital, speech disorders persisted in 671 (75.81%), dysarthria in 468 (69.75%), and different types of aphasia in 203 (30.25%) of 885 surviving patients. Among patients with aphasia at both admission and discharge, global aphasia was most common, followed by motor aphasia (Broca's aphasia) and nominal aphasia. Although the rate of patients with speech disorders was lower at discharge, the difference was not statistically significant. On admission, 82.37% of patients were considered to have a speech-language disorder, dysarthria being most common. Concerning the type of aphasia, global aphasia was most frequent. Study results suggested the importance and need of speech-language therapy in the early rehabilitation of post-stroke patients; it should be initiated during their hospital stay and continued at long-term.

Investigation of the Cause of Readmission to the Intensive Care Unit for Patients with Lung Edema or Atelectasis

PubMed Central

Zaitsu, Akinori; Hashizume, Makoto

2008-01-01

Purpose For patients with acute respiratory failure due to lung edema or atelectasis, Surplus lung water that is not removed during an initial stay in the Intensive Care Unit (ICU) may be related to early ICU readmission. Therefore, we performed a retrospective study of patient management during the first ICU stay for such patients. Materials and Methods Of 1,835 patients who were admitted to the ICU in the 36 months from January, 2003 to December, 2005, 141 were patients readmitted, and the reason for readmission was lung edema or atelectasis in 21 patients. For these 21 patients, correlations were investigated between body weight gain at the time of initial ICU discharge (weight upon discharge from the ICU ÷ weight when entering the ICU) and the time to ICU readmission, between body weight gain and the P/F ratio at ICU readmission, between the R/E ratio (the period using a respirator (R) ÷ the length of the ICU stay after extubation (E)) and the time to ICU readmission, between the R/E ratio and body weight gain, and between body weight gain until extubation and the time to extubation. Results A negative linear relationship was found between body weight gain at the time of initial ICU discharge and the time to ICU readmission, and between body weight gain at the time of ICU discharge and the P/F ratio at ICU readmission. If body weight had increased by more than 10% at ICU discharge or the P/F ratio was below 150, readmission to the ICU within three days was likely. Patients with a large R/E ratio, a large body weight gain, and a worsening P/F ratio immediately after ICU discharge were likely to be readmitted soon to the ICU. Loss of body weight during the period of respirator support led to early extubation, since a positive correlation was found between the time to extubation and body weight gain. Conclusion Fluid management failure during the first ICU stay might cause ICU readmission for patients who had lung edema or atelectasis. Therefore, a key to the prevention of ICU readmission is to ensure complete recovery from lung failure before the initial ICU discharge. Strict water management is crucial based on body weight measurement and removal of excess lung water is essential. In addition, an apparent improvement in respiratory state may be due to respiratory support, and such an improvement should be viewed cautiously. Loss of weight at the refilling stage of transfusion prevents ICU readmission and may decrease the length of the ICU stay. PMID:18581592

High-order harmonic generation in a capillary discharge

DOEpatents

Rocca, Jorge J.; Kapteyn, Henry C.; Mumane, Margaret M.; Gaudiosi, David; Grisham, Michael E.; Popmintchev, Tenio V.; Reagan, Brendan A.

2010-06-01

A pre-ionized medium created by a capillary discharge results in more efficient use of laser energy in high-order harmonic generation (HHG) from ions. It extends the cutoff photon energy, and reduces the distortion of the laser pulse as it propagates down the waveguide. The observed enhancements result from a combination of reduced ionization energy loss and reduced ionization-induced defocusing of the driving laser as well as waveguiding of the driving laser pulse. The discharge plasma also provides a means to spectrally tune the harmonics by tailoring the initial level of ionization of the medium.

Hypergolic ignitor

NASA Technical Reports Server (NTRS)

Taylor, Eric S. (Inventor); Myers, W. Neill (Inventor); Martin, Michael A. (Inventor)

2005-01-01

An ignitor for use with the MC-1 rocket engine has a cartridge bounded by two end caps with rupture disc assemblies connected thereto. A piston assembly within the cartridge moves from one end of the cartridge during the ignition process. The inlet of the ignitor communicates with a supply taken from the discharge of the fuel pump. When the pump is initially started, the pressure differential bursts the first rupture disc to begin the movement of the piston assembly toward the discharge end. The pressurization of the cartridge causes the second rupture disc to rupture and hypergolic fluid contained within the cartridge is discharged out the ignitor outlet.

Insulator edge voltage gradient effects in spacecraft charging phenomena

NASA Technical Reports Server (NTRS)

Stevens, N. J.; Purvis, C. K.; Staskus, J. V.

1978-01-01

Insulating surfaces on geosynchronous satellites were charged by geomagnetic substorms to a point where discharges occur. The electromagnetic pulses from these discharges couple into satellite electronic systems disrupting operations are examined. Laboratory tests conducted on insulator charging have indicated that discharges appear to be initiated at insulator edges where voltage gradients can exist. An experimental investigation was conducted to measure edge voltage gradients on silvered Teflon samples as they are charged by monoenergetic electron beams. It was found that the surface voltage at insulator edges can be approximated by an exponential expression based on an electron current density balance.

Pulsed Gas Lasers Pumped by a Runaway Electron Initiated Discharge

NASA Astrophysics Data System (ADS)

Panchenko, A. N.; Tarasenko, V. F.; Panchenko, N. A.

2017-12-01

The generation parameters are investigated in a runaway electron preionized diffuse discharge (REP DD). Laser generation is produced in different spectral bands from the IR to VUV range. New modes of the nitrogen laser operation are obtained. Ultimate efficiencies of N2- and nonchain HF(DF)-lasers are achieved. A possibility of increasing the pulse durations of XeF-, KrF-, ArF- and VUV F2- lasers (157 nm) in an oscillating REP DD is shown. The efficiencies of VUV- and UV-generation comparable with that of a laser pumped by a self-sustained volume discharge with preionization are gained.

Radio frequency observations of lightning discharges by the forte satellite.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Shao, X.; Jacobson, A. R.; Light, T.

2002-01-01

FORTE-observed VHF signatures for different lightning discharges are presented. For in-cloud discharges, a pulse pair is typically recorded and is named a 'transionospheric pulse pair' (TIPP). Many intense TIPPs are coherent and polarized, whereas initial and dart leaders do not show a recognizable degree of polarization. TIPPs are optically weaker than cloud-to-ground (CG) strokes, and stronger VHF TIPPs are optically darker. About 10% of CG strokes, mostly over seawater, produce extremely narrow, powerful VHF pulses at the very beginning of the return strokes. These narrow pulses are found to form an upward beam pattern.

Innovative approach for benzene degradation using hybrid surface/packed-bed discharge plasmas.

PubMed

Jiang, Nan; Lu, Na; Shang, Kefeng; Li, Jie; Wu, Yan

2013-09-03

An innovative plasma reactor, which generates hybrid surface/packed-bed discharge (HSPBD) plasmas, was employed for the degradation of benzene. The HSPBD reactor was found to display remarkably better benzene degradation, mineralization, and energy performance than surface or packed-bed discharge reactors alone. The degradation efficiency, CO2 selectivity, and energy yield in the HSPBD reactor were 21%, 11%, and 3.9 g kWh-1 higher, respectively, than in a surface discharge reactor and 30%, 21%, and 5.5 g kWh-1 higher, respectively, than in a packed-bed discharge reactor operated at 280 J L-1. Particularly, the benzene degradation in the HSPBD reactor exhibited an unambiguous synergistic enhancement rather than a simple additive effect using the surface discharge and packed-bed discharge reactors. Moreover, in the HSPBD reactor, the formation of byproducts, such as NO2, was suppressed, while O3 was promoted. The use of N2 as the carrier gas was found to be effective for benzene degradation because of the fast reaction rate of N2(A3∑u+) with benzene, and oxygen species derived from the dissociation of O2 were found to be significant in the mineralization process. Thus, the addition of O2 to N2 allows for efficient degradation of benzene, and the optimized amount of O2 was determined to be 3%.

Relations of Water Quality to Streamflow, Season, and Land Use for Four Tributaries to the Toms River, Ocean County, New Jersey, 1994-99

USGS Publications Warehouse

Baker, Ronald J.; Hunchak-Kariouk, Kathryn

2006-01-01

The effects of nonpoint-source contamination on the water quality of four tributaries to the Toms River in Ocean County, New Jersey, have been investigated in a 5-year study by the U.S. Geological Survey (USGS), in cooperation with the New Jersey Department of Environmental Protection (NJDEP). The purpose of the study was to relate the extent of land development to loads of nutrients and other contaminants to these streams, and ultimately to Barnegat Bay. Volumetric streamflow (discharge) was measured at 6 monitoring sites during 37 stormflow and base-flow sampling events over a 5-year period (May 1994-September 1999). Concentrations and yields (area-normalized instantaneous load values) of nitrogen and phosphorus species, total suspended solids, and fecal coliform bacteria were quantified, and pH, dissolved oxygen, and stream stage were monitored during base-flow conditions and storms. Sufficient data were collected to allow for a statistical evaluation of differences in water quality among streams in subbasins with high, medium, and low levels of land development. Long Swamp Creek, in a highly developed subbasin (64.2 percent developed); Wrangle Brook, in a moderately developed subbasin (34.5 percent); Davenport Branch, in a slightly developed subbasin (22.8 percent); and Jakes Branch, in an undeveloped subbasin (0 percent) are the subbasins selected for this study. No point-source discharges are known to be present on these streams. Water samples were collected and analyzed by the NJDEP, and discharge measurements and data analysis were conducted by the USGS. Total nitrogen concentrations were lower in Davenport Branch than in Long Swamp Creek and Wrangle Brook during base flow and stormflow. Concentrations of total nitrogen and nitrate were highest in Wrangle Brook (as high as 3.0 mg/L and 1.6 mg/L, respectively) as a result of high concentrations of nitrate in samples collected during base flow; nitrate loading from ground-water discharge is much higher in Wrangle Brook than in any of the other streams, possibly as a result of an experimental wastewater-(secondary effluent) disposal site that was in operation during the 1980's. Ammonia concentrations were higher in samples from Long Swamp Creek than in those from the other two monitoring sites under all flow conditions, and ammonia yields were higher during stormflow than base flow at all monitoring sites. Concentrations and yields of fecal coliform bacteria and total suspended solids were higher during stormflow than during base flow at all monitoring sites. Concentrations and yields were significantly higher in Long Swamp Creek, a highly developed subbasin and Wrangle Brook, a moderately developed subbasin than in Davenport Branch, a slightly developed subbasin. Concentrations and yields of phosphate species, which also are strongly related to stormflow, were higher during stormflow in Long Swamp Creek than in the other subbasins. Base-flow separation techniques were used on hydrographs generated for storms to distinguish the fraction of discharge and constituent loading attributable to storm runoff (overland flow) from the fraction contributed by ground-water discharge. Precipitation records were used to determine the total annual volumes of ground-water discharge and runoff at each monitoring site. These volumes were used in conjunction with water-quality data to calculate total annual loads of each constituent at each monitoring site, separated into ground-water discharge and runoff fractions. It was determined that loads of ammonia, nitrate, organic nitrogen, total nitrogen, and orthophosphate in ground-water discharge were significantly higher in the moderately developed Wrangle Brook subbasin than in the highly developed Long Swamp Creek subbasin, and that no relation was apparent between the percent of land development and constituent loads from ground-water discharge. The loading of each constituent contributed by ground-water discharge is specific

Managing severe mental illness in the community using the Mental Health Act 1983: a comparison of Supervised Discharge and Guardianship in England.

PubMed

Hatfield, B; Shaw, J; Pinfold, V; Bindman, J; Evans, S; Huxley, P; Thornicroft, G

2001-10-01

Two measures in the English Mental Health Act allow requirements to be imposed upon patients living in the community. These are Guardianship (Section 7) and Supervised Discharge (Section 25A). The paper aims to compare patients with mental illnesses, made subject to Guardianship or Supervised Discharge. Data on patient characteristics, impairment, needs and interventions were collected from keyworkers in a random national sample of Trusts and local authorities. Ratings were obtained on standardised measures of disability, impairment and needs. Patients placed on Supervised Discharge were more likely to have problems of treatment compliance and drug misuse, whilst those on Guardianship were more likely to have problems of social welfare and higher ratings of disability and impairment. Supervised Discharge has a higher proportion of African-Caribbean patients. Interventions delivered are rated as effective for both measures. Legal changes proposed in England include a single power for supervision in the community. This should not mean a focus on risk management to the neglect of social welfare interventions.

Anomalous cross-B field transport and spokes in HiPIMS plasma

NASA Astrophysics Data System (ADS)

Hecimovic, Ante; Maszl, Christian; Schulz-von der Gathen, Volker; von Keudell, Achim

2016-09-01

The rotation of localised ionisation zones, i.e. spokes, in magnetron discharge is investigated as a function of discharge current, ranging from 10 mA (current density 0.5 mA cm-2) to 140 A (7 A cm-2) . The presence of spokes throughout the complete discharge current range indicates that the spokes are an intrinsic property of a magnetron sputtering plasma discharge. Up to discharge currents of several amperes, the spokes rotate in a retrograde ExB direction and beyond the spokes rotate in a ExB direction. In this contribution we present experimental evidence that anomalous diffusion is triggered by the appearance of spokes rotating in the ExB direction. The Hall parameter ωceτc , product of the electron cyclotron frequency and the classical collision time, reduces from Bohm diffusion values (16 and higher) down to the value of 3 as spokes appear, indicating anomalous cross-B field transport. The ion diffusion coefficients calculated from a sideways image of the spoke is six times higher than Bohm diffusion coefficients, which is consistent with the reduction of the Hall parameter.

Development summary of a sympathetic discharge CO2 laser for lidar use

NASA Technical Reports Server (NTRS)

Jaenisch, Holger M.; Johnson, R. Barry

1991-01-01

A commercial pulsed sympathetic discharge laser has been characterized and modified for use as a potential lidar. This report summarizes the initial findings and modifications made to the baseline system. The new laser performance is then checked with theory and operational results are presented. The laser has inherent mode instability and high chirp. Several solutions were tried and their results are presented.

Electron beam-switched discharge for rapidly pulsed lasers

DOEpatents

Pleasance, L.D.; Murray, J.R.; Goldhar, J.; Bradley, L.P.

1979-12-11

A method and apparatus are designed for electrical excitation of a laser gas by application of a pulsed voltage across the gas, followed by passage of a pulsed, high energy electron beam through the gas to initiate a discharge suitable for laser excitation. This method improves upon current power conditioning techniques and is especially useful for driving rare gas halide lasers at high repetition rates.

Cumulative effective dose associated with radiography and CT of adolescents with spinal injuries.

PubMed

Lemburg, Stefan P; Peters, Soeren A; Roggenland, Daniela; Nicolas, Volkmar; Heyer, Christoph M

2010-12-01

The purpose of this study was to analyze the quantity and distribution of cumulative effective doses in diagnostic imaging of adolescents with spinal injuries. At a level 1 trauma center from July 2003 through June 2009, imaging procedures during initial evaluation and hospitalization and after discharge of all patients 10-20 years old with spinal fractures were retrospectively analyzed. The cumulative effective doses for all imaging studies were calculated, and the doses to patients with spinal injuries who had multiple traumatic injuries were compared with the doses to patients with spinal injuries but without multiple injuries. The significance level was set at 5%. Imaging studies of 72 patients (32 with multiple injuries; average age, 17.5 years) entailed a median cumulative effective dose of 18.89 mSv. Patients with multiple injuries had a significantly higher total cumulative effective dose (29.70 versus 10.86 mSv, p < 0.001) mainly owing to the significantly higher CT-related cumulative effective dose to multiple injury patients during the initial evaluation (18.39 versus 2.83 mSv, p < 0.001). Overall, CT accounted for 86% of the total cumulative effective dose. Adolescents with spinal injuries receive a cumulative effective dose equal to that of adult trauma patients and nearly three times that of pediatric trauma patients. Areas of focus in lowering cumulative effective dose should be appropriate initial estimation of trauma severity and careful selection of CT scan parameters.

High-altitude electrical discharges associated with thunderstorms and lightning

NASA Astrophysics Data System (ADS)

Liu, Ningyu; McHarg, Matthew G.; Stenbaek-Nielsen, Hans C.

2015-12-01

The purpose of this paper is to introduce electrical discharge phenomena known as transient luminous events above thunderstorms to the lightning protection community. Transient luminous events include the upward electrical discharges from thunderstorms known as starters, jets, and gigantic jets, and electrical discharges initiated in the lower ionosphere such as sprites, halos, and elves. We give an overview of these phenomena with a focus on starters, jets, gigantic jets, and sprites, because similar to ordinary lightning, streamers and leaders are basic components of these four types of transient luminous events. We present a few recent observations to illustrate their main properties and briefly review the theories. The research in transient luminous events has not only advanced our understanding of the effects of thunderstorms and lightning in the middle and upper atmosphere, but also improved our knowledge of basic electrical discharge processes critical for sparks and lightning.

Mass analysis of neutral particles and ions released during electrical breakdowns on spacecraft surfaces

NASA Technical Reports Server (NTRS)

Kendall, B. R. F.

1983-01-01

A specialized spectrometer was designed and developed to measure the mass and velocity distributions of neutral particles (molecules and molecular clusters) released from metal-backed Teflon and Kapton films. Promising results were obtained with an insulation breakdown initiation system based on a moveable contact touching the insulated surfaces. A variable energy, high voltage pulse is applied to the contact. The resulting surface damage sites can be made similar in size and shape to those produced by a high voltage electron beam system operating at similar discharge energies. The point discharge apparatus was used for final development of several high speed recording systems and for measurements of the composition of the materials given off by the discharge. Results with this apparatus show evolution of large amounts of fluorocarbon fragments from discharge through Teflon FEP, while discharges through Kapton produce mainly very light hydrocarbon fragments at masses below about 80 a.m.u.

Global helium particle balance in LHD

NASA Astrophysics Data System (ADS)

Motojima, G.; Masuzaki, S.; Tokitani, M.; Kasahara, H.; Yoshimura, Y.; Kobayashi, M.; Sakamoto, R.; Morisaki, T.; Miyazawa, J.; Akiyama, T.; Ohno, N.; Mutoh, T.; Yamada, H.; LHD Experiment Group

2015-08-01

Global helium particle balance in long-pulse discharges is analyzed for the first time in the Large Helical Device (LHD) with the plasma-facing components of the first wall and the divertor tiles composed of stainless steel and carbon, respectively. During the 2-min discharge sustained by ion cyclotron resonance heating (ICRH) and electron cyclotron heating (ECH), helium is observed to be highly retained in the wall (regarded as both the first wall and the divertor tiles). Almost all (about 96%) puffed helium particles (1.3 × 1022 He) are absorbed in the wall near the end of the discharge. Even though a dynamic retention is eliminated, 56% is still absorbed. The analysis is also applied to longer pulse discharges over 40 min by ICRH and ECH, indicating that the helium wall retention is dynamically changed in time. At the initial phase of the discharge, a mechanism for adsorbing helium other than dynamical retention is invoked.

Effects of a brine discharge over soft bottom Polychaeta assemblage.

PubMed

Del-Pilar-Ruso, Yoana; De-la-Ossa-Carretero, Jose Antonio; Giménez-Casalduero, Francisca; Sánchez-Lizaso, Jose Luis

2008-11-01

Desalination is a growing activity that has introduced a new impact, brine discharge, which may affect benthic communities. Although the role of polychaetes as indicators to assess organic pollution is well known, their tolerance to salinity changes has not been examined to such a great extent. The aim of this study was to examine the effect of brine discharge over soft bottom polychaete assemblage along the Alicante coast (Southeast Spain) over a two year period. Changes in the polychaete assemblage was analysed using univariate and multivariate techniques. We compared a transect in front of the discharge with two controls. At each transect we sampled at three depths (4, 10 and 15 m) during winter and summer. We have observed different sensitivity of polychaete families to brine discharges, Ampharetidae being the most sensitive, followed by Nephtyidae and Spionidae. Syllidae and Capitellidae showed some resistance initially, while Paraonidae proved to be a tolerant family.