976 resultados para Clinical evolution


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The phase transition of single layer molybdenum disulphide (MoS2) from semi-conducting 2H to metallic 1T and then to 1T' phases, and the effect of the phase transition on hydrogen evolution reaction (HER) are investigated within this work by density functional theory. Experimentally, 2H-MoS2 has been widely used as an excellent electrode for HER and can get charged easily. Here we find that the negative charge has a significant impact on the structural phase transition in a MoS2 monolayer. The thermodynamic stability of 1T-MoS2 increases with the negative charge state, comparing with the 2H-MoS2 structure before phase transition and the kinetic energy barrier for a phase transition from 2H to 1T decreases from 1.59 eV to 0.27 eV when 4 e- are injected per MoS2 unit. Additionally, 1T phase is found to transform into the distorted structure (1T' phase) spontaneously. On their activity toward hydrogen evolution reaction, 1T'-MoS2 structure hydrogen coverage shows comparable hydrogen evolution reaction activity to the 2H-MoS2 structure. If the charge transfer kinetics is taken into account, the catalytic activity of 1T'-MoS2 is superior to that of 2H-MoS2. Our finding provides a possible novel method for phase transition of MoS2, and enriches understanding of the catalytic properties of MoS2 for HER.

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Background Assessing hand injury is of great interest given the level of involvement of the hand with the environment. Knowing different assessment systems and their limitations generates new perspectives. The integration of digital systems (accelerometry and electromyography) as a tool to supplement functional assessment allows the clinician to know more about the motor component and its relation to movement. Therefore, the purpose of this study was the kinematic and electromyography analysis during functional hand movements. Method Ten subjects carried out six functional movements (terminal pinch, termino-lateral pinch, tripod pinch, power grip, extension grip and ball grip). Muscle activity (hand and forearm) was measured in real time using electromyograms, acquired with the Mega ME 6000, whilst acceleration was measured using the AcceleGlove. Results Electrical activity and acceleration variables were recorded simultaneously during the carrying out of the functional movements. The acceleration outcome variables were the modular vectors of each finger of the hand and the palm. In the electromyography, the main variables were normalized by the mean and by the maximum muscle activity of the thenar region, hypothenar, first interosseous dorsal, wrist flexors, carpal flexors and wrist extensors. Conclusions Knowing muscle behavior allows the clinician to take a more direct approach in the treatment. Based on the results, the tripod grip shows greater kinetic activity and the middle finger is the most relevant in this regard. Ball grip involves most muscle activity, with the thenar region playing a fundamental role in hand activity. Clinical relevance Relating muscle activation, movements, individual load and displacement offers the possibility to proceed with rehabilitation by individual component.

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Clinical Data Warehousing: A Business Analytic approach for managing health data

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Secondary ionization mass spectrometry (SIMS) U–Pb dating of zircons from the Åreskutan Nappe in the central part of the Seve Nappe Complex of western central Jämtland provides new constraints on the timing of granulite–amphibolite-facies metamorphism and tectonic stacking of the nappe during the Caledonian orogeny. Peak-temperature metamorphism in garnet migmatites is constrained to c. 442 ± 4 Ma, very similar to the ages of leucogranites at 442 ± 3 and 441 ± 4 Ma. Within a migmatitic amphibolite, felsic segregations crystallized at 436 ± 2 Ma. Pegmatites, cross-cutting the dominant Caledonian foliation in the Nappe, yield 428 ± 4 and 430 ± 3 Ma ages. The detrital zircon cores in the migmatites and leucogranites provide evidence of Late Palaeoproterozoic, Mesoproterozoic to Early Neoproterozoic source terranes for the metasedimentary rocks. The formation of the ductile and hot Seve migmatites, with their inverted metamorphism and thinning towards the hinterland, can be explained by an extrusion model in which the allochthon stayed ductile for a period of at least 10 million years during cooling from peak-temperature metamorphism early in the Silurian. In our model, Baltica–Laurentia collision occurred in the Late Ordovician–earliest Silurian, with emplacement of the nappes far on to the Baltoscandian platform during the Silurian and early Devonian, Scandian Orogeny lasting until c. 390 Ma.

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Emotion researchers have grappled with challenging methodological issues in capturing emotions of participants in naturalistic settings such as school or university classrooms. Self-reporting methods have been used frequently, yet these methods are inadequate when used alone. We argue that the self-reporting methods of emotion diaries and cogenerative dialogues can be helpful in identifying in-the-moment emotions when used in conjunction with the microanalysis of video recordings of classroom events. We trace the evolution of our use of innovative self-reporting methods through three cases from our research projects, and propose new directions for our ongoing development and application of these methods in both school and university classrooms.

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"Using the nursing process as a framework for practice, the fourth edition has been extensively revised to reflect the rapid changing nature of nursing practice and the increasing focus on key nursing care priorities. Building on the strengths of the third Australian and New Zealand edition and incorporating relevant global nursing research and practice from the prominent US title Medical-Surgical Nursing, 9Th Edition, Lewis’s Medical-Surgical Nursing, 4th Edition is an essential resource for students seeking to understand the role of the professional nurse in the contemporary health environment."--Publisher website

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Background Family caregivers provide invaluable support to stroke survivors during their recovery, rehabilitation, and community re-integration. Unfortunately, it is not standard clinical practice to prepare and support caregivers in this role and, as a result, many experience stress and poor health that can compromise stroke survivor recovery and threaten the sustainability of keeping the stroke survivor at home. We developed the Timing it Right Stroke Family Support Program (TIRSFSP) to guide the timing of delivering specific types of education and support to meet caregivers' evolving needs. The objective of this multi-site randomized controlled trial is to determine if delivering the TIRSFSP across the stroke care continuum improves caregivers' sense of being supported and emotional well-being. Methods/design Our multi-site single-blinded randomized controlled trial will recruit 300 family caregivers of stroke survivors from urban and rural acute care hospitals. After completing a baseline assessment, participants will be randomly allocated to one of three groups: 1) TIRSFSP guided by a stroke support person (health care professional with stroke care experience), delivered in-person during acute care and by telephone for approximately the first six to 12 months post-stroke; 2) caregiver self-directed TIRSFSP with an initial introduction to the program by a stroke support person, or; 3) standard care receiving the educational resource "Let's Talk about Stroke" prepared by the Heart and Stroke Foundation. Participants will complete three follow-up quantitative assessments 3, 6, and 12-months post-stroke. These include assessments of depression, social support, psychological well-being, stroke knowledge, mastery (sense of control over life), caregiving assistance provided, caregiving impact on everyday life, and indicators of stroke severity and disability. Qualitative methods will also be used to obtain information about caregivers' experiences with the education and support received and the impact on caregivers' perception of being supported and emotional well-being. Discussion This research will determine if the TIRSFSP benefits family caregivers by improving their perception of being supported and emotional well-being. If proven effective, it could be recommended as a model of stroke family education and support that meets the Canadian Stroke Best Practice Guideline recommendation for providing timely education and support to families through transitions.

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The phase transition of single layer molybdenum disulfide (MoS2) from semiconducting 2H to metallic 1T and then to 1T′ phases, and the effect of the phase transition on hydrogen evolution reaction (HER) are investigated within this work by density functional theory. Experimentally, 2H-MoS2 has been widely used as an excellent electrode for HER and can get charged easily. Here we find that the negative charge has a significant impact on the structural phase transition in a MoS2 monolayer. The thermodynamic stability of 1T-MoS2 increases with the negative charge state, comparing with the 2H-MoS2 structure before phase transition and the kinetic energy barrier for a phase transition from 2H to 1T decreases from 1.59 to 0.27 eV when 4e– are injected per MoS2 unit. Additionally, 1T phase is found to transform into the distorted structure (1T′ phase) spontaneously. On their activity toward hydrogen evolution reaction, 1T′-MoS2 structure shows comparable hydrogen evolution reaction activity to the 2H-MoS2 structure. If the charge transfer kinetics is taken into account, the catalytic activity of 1T′-MoS2 is superior to that of 2H-MoS2. Our finding provides a possible novel method for phase transition of MoS2 and enriches understanding of the catalytic properties of MoS2 for HER.

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Background Comparison of a multimodal intervention WE CALL (study initiated phone support/information provision) versus a passive intervention YOU CALL (participant can contact a resource person) in individuals with first mild stroke. Methods and Results This study is a single-blinded randomized clinical trial. Primary outcome includes unplanned use of health services (participant diaries) for adverse events and quality of life (Euroquol-5D, Quality of Life Index). Secondary outcomes include planned use of health services (diaries), mood (Beck Depression Inventory II), and participation (Assessment of Life Habits [LIFE-H]). Blind assessments were done at baseline, 6, and 12 months. A mixed model approach for statistical analysis on an intention-to-treat basis was used where the group factor was intervention type and occasion factor time, with a significance level of 0.01. We enrolled 186 patients (WE=92; YOU=94) with a mean age of 62.5±12.5 years, and 42.5% were women. No significant differences were seen between groups at 6 months for any outcomes with both groups improving from baseline on all measures (effect sizes ranged from 0.25 to 0.7). The only significant change for both groups from 6 months to 1 year (n=139) was in the social domains of the LIFE-H (increment in score, 0.4/9±1.3 [95% confidence interval, 0.1–0.7]; effect size, 0.3). Qualitatively, the WE CALL intervention was perceived as reassuring, increased insight, and problem solving while decreasing anxiety. Only 6 of 94 (6.4%) YOU CALL participants availed themselves of the intervention. Conclusions Although the 2 groups improved equally over time, WE CALL intervention was perceived as helpful, whereas YOU CALL intervention was not used.

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This is an ongoing research investigating the use of health information technologies (HIT) to improve clinical decision-making processes. Effective and timely clinical decision-making can lead to positive improvements in patient’s health outcome...

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This study greatly enhanced our knowledge of the potential for geothermal energy development in Queensland as a viable clean energy source in the coming decades. Key outcomes of the project were understanding the first-order controls on the concentration of the heat-producing elements: uranium, thorium and potassium in granitic rocks, and constraining where rocks with the greatest heat-producing potential lie at depth in Queensland. Importantly, new temperature and heat flow maps for southwest Queensland were developed that will greatly assist future exploration efforts.

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Study Design Cross-sectional study. Objectives To compare erector spinae (ES) muscle fatigue between chronic non-specific lower back pain (CNLBP) sufferers and healthy subjects from a biomechanical perspective during fatiguing isometric lumbar extensions. Background Paraspinal muscle maximal contraction and fatigue are used as a functional predictor for disabilities. The simplest method to determine muscle fatigue is by evaluating the evolution during specific contractions, such as isometric contractions. There are no studies that evaluate the evolution of the ES muscle during fatiguing isometric lumbar extensions and analyse functional and architectural variables. Methods In a pre-calibrated system, participants performed a maximal isometric extension of the lumbar spine for 5 and 30 seconds. Functional variables (torque and muscle activation) and architecture (pennation angle and muscle thickness) were measured using a load cell, surface electromyography and ultrasound, respectively. The results were normalised and a reliability study of the ultrasound measurement was made. Results: The ultrasound measurements were highly reliable, with Cronbach’s alpha values ranging from 0.951 0.981. All measured variables shown significant differences before and after fatiguing isometric lumbar extension. Conclusion During a lumbar isometric extension test, architecture and functional variables of the ES muscle could be analised using ultrasound, surface EMG and load cell. In adition, during an endurance test, ES muscle suffers an acute effect on architectural and functional variables.

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There is a growing need for measures assessing technological changes in systemic contexts as business ecosystems replace standalone products. In these ecosystem contexts, organizations are required to manage their innovation processes in increasingly networked and complex environments. In this paper, we introduce the technology and ecosystem clockspeed measures that can be used to assess the temporal nature of technological changes in a business ecosystem. We analyze systemic changes in the personal computer (PC) ecosystem, explicitly focusing on subindustries central to the delivery of PC gaming value to the end user. Our results show that the time-based intensity of technological competition in intertwined subindustries of a business ecosystem may follow various trajectories during the evolution of the ecosystem. Hence, the technology and ecosystem clockspeed measures are able to pinpoint alternating dynamics in technological changes among the subindustries in the business ecosystem. We subsequently discuss organizational considerations and theoretical implications of the proposed measures.

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This paper presents a new active learning query strategy for information extraction, called Domain Knowledge Informativeness (DKI). Active learning is often used to reduce the amount of annotation effort required to obtain training data for machine learning algorithms. A key component of an active learning approach is the query strategy, which is used to iteratively select samples for annotation. Knowledge resources have been used in information extraction as a means to derive additional features for sample representation. DKI is, however, the first query strategy that exploits such resources to inform sample selection. To evaluate the merits of DKI, in particular with respect to the reduction in annotation effort that the new query strategy allows to achieve, we conduct a comprehensive empirical comparison of active learning query strategies for information extraction within the clinical domain. The clinical domain was chosen for this work because of the availability of extensive structured knowledge resources which have often been exploited for feature generation. In addition, the clinical domain offers a compelling use case for active learning because of the necessary high costs and hurdles associated with obtaining annotations in this domain. Our experimental findings demonstrated that 1) amongst existing query strategies, the ones based on the classification model’s confidence are a better choice for clinical data as they perform equally well with a much lighter computational load, and 2) significant reductions in annotation effort are achievable by exploiting knowledge resources within active learning query strategies, with up to 14% less tokens and concepts to manually annotate than with state-of-the-art query strategies.

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Based on the construction industry of 27 province over the period of 1995-2008,this paper analyzes the evolution of regional structure of foreign engineering consultation industry.It is found that this industry translates weak overall strength,unbalanced regional structure to a more developed and balanced status,keeps pushing this change can improve the strength of our country’s engineering consultation industry,improve the international competition of construction.