Set Of PCs Research Articles

Outpatient Rehabilitation Utilization Following Major Limb Loss in Adults Receiving Care in the Military Health System from 2001 to 2017

Objective: To investigate exposures associated with outpatient rehabilitation encounters among Military Health System (MHS) beneficiaries with major limb loss. Design: Retrospective, cohort study. Setting: American military treatment facilities and civilian healthcare facilities that accept TRICARE benefits. ParticipantsAdult MHS beneficiaries with major limb amputation(s) acquired between January 2001 and September 2017 (N=5,161). InterventionsNot applicable. Main Outcome Measure(s)This exploratory analysis investigated associations between outpatient rehabilitation care and demographic and amputation characteristics in MHS beneficiaries with major limb loss. Results: Of 5,161 military beneficiaries with major limb amputation(s), most were aged 55-64 (36%), male (73%), retirees/dependents (60%), with enlisted sponsor rank (88%), and single limb loss (89%). The active/reserve beneficiaries were younger, majority male, and more likely to be diagnosed with incident behavioral health conditions. Unadjusted negative binomial regression models revealed increased rates of outpatient rehabilitation encounters in ADSMs compared to retirees/dependents (rate ratio (RR): 10.02, 95% confidence interval (CI): 9.30, 10.80). The rate ratios for sex, sponsor rank, limb(s) lost, incident behavioral health condition, incident TBI, incident PTSD, and outpatient care setting were attenuated following stratification by beneficiary category. Enlisted ADSMs had increased rates of outpatient rehabilitation encounter days compared to officers, whereas retirees/dependents with enlisted sponsors had decreased rates compared to those with officer sponsors. ADSMs who accessed outpatient care in DC and PC settings demonstrated high rates of outpatient rehabilitation encounters compared to those who only sought care from PC settings (RR: 4.60, 95% CI: 2.95, 6.81). Conclusions: This study suggests that MHS beneficiaries with major limb loss utilize outpatient rehabilitation services differently, based on active/reserve duty or retiree/dependent status. This study is the first of its kind to quantify outpatient rehabilitation utilization for military beneficiaries with all cause major limb loss and may inform MHS policymakers on the rehabilitation needs for combat- and non-combat-related amputee populations.

Using Patient-Centered Dissemination and Implementation Frameworks and Strategies in Palliative Care Settings for Improved Quality of Life and Health Outcomes: A Scoping Review.

There is a need for patient-provider dissemination and implementation frameworks, strategies, and protocols in palliative care settings for a holistic approach when it comes to addressing pain and other distressing symptoms affecting the quality of life, function, and independence of patients with chronic illnesses. The purpose of this scoping review is to explore patient-centered D&I frameworks and strategies that have been adopted in PC settings to improve behavioral and environmental determinants influencing health outcomes through evidence-based programs and protocols. The five step Arksey and O'Malley's (2005) York methodology was adopted as a guiding framework: (1) identifying research questions; (2) searching for relevant studies; (3) selecting studies relevant to the research questions; (4) charting the data; and (5) collating, summarizing, and reporting results. Only 6 out of the 38 (16%) included studies applied a D&I theory and/or framework. The RE-AIM framework was the most prominently cited (n = 3), followed by the Diffusion of Innovation Model (n = 2), the CONNECT framework (n = 1), and the Transtheoretical Stages of Change Model (n = 1). The most frequently reported ERIC strategy was strategy #6 "Develop and organize quality monitoring systems", as it identified in all 38 of the included studies. This scoping review identifies D&I efforts to translate research into practice in U.S. palliative care settings. Results may contribute to enhancing future D&I initiatives for dissemination/adaptation, implementation, and sustainability efforts aiming to improve patient health outcomes and personal satisfaction with care received.

Parsimonious sequences of finite sets and their applications to chord progressions and music composition

Parsimony is a broad concept with applications in music theory and composition. Two sets A and B of finite cardinality n (n-sets) are in parsimonious relation if there exists a (n–1)-set C that is included in both A and B. A sequence of n-sets is parsimonious if any two successive sets in the sequence are in parsimonious relation. This work demonstrates that for any set of finite cardinality p, there exist sequences of its n-subsets (n ≤ p) that are circular, non-redundant, exhaustive and parsimonious, and it describes the corresponding algorithm. The image of such a sequence by a bijection and the retrograde sequence keep the same four properties. The consequences of these results for the pitch class (pc) subsets of cardinality n (or n-chords) of a pc set of finite cardinality p (p-tonic scale) are derived and discussed in the context of music harmony, microtonality and composition.

A generic approach to construct pseudo components for oil weathering models

Oil weathering models are essential for predicting the behavior of spilled oil in the environment. Most models use a “Pseudo Component” (PC) approach to represent the wide range of compounds found in petroleum products. Within the approach, rather than modeling each individual compound in an oil, a manageable number of PCs are developed that represent whole classes of compounds. However, previous studies focused mainly on traditional crude oils and did not develop a generic approach to create an optimal set of PCs for a variety of oils. In developing the updates to the NOAA oil weathering model, we propose herein a generic approach to construct PCs using oil distillation data to capture the complexity of oil evaporative weathering. We validated our approach with 899 oils from the Automated Data Inquiry for Oil Spills (ADIOS) oil library and found that an optimal set of sixteen PCs should be used. These PCs include two with low boiling point (below 144 °C), one with a high boiling point (above 400 °C), and thirteen constructed within a middle range of boiling points with a temperature resolution of 20 °C. Our simulation tests suggested that this set of sixteen PCs adequately characterizes oil evaporation processes for a wide variety of oils.

Development and Initial Testing of a Brief, Integrated Intervention Aimed at Reducing Heavy Alcohol Use and PTSD among Military Veterans in Primary Care.

There is a need for integrated treatment approaches that address heavy alcohol use and posttraumatic stress disorder (PTSD) concurrently among Veterans as interactions between heavy drinking and PTSD are frequent. Veteran engagement in specialty mental health services after referral is limited with poorer outcomes following empirically-supported, exposure-based PTSD treatments that do not explicitly address alcohol use. The current project aimed to incorporate two evidenced-based interventions: Brief Motivational Intervention (BMI) with Prolonged Exposure for Primary Care (PE-PC) for Veterans with heavy drinking and PTSD. Delphi methodology was applied to adapt an intervention protocol using subject matter expert (SME) feedback to guide the refinement of a preliminary treatment manual. The newly developed brief intervention (PC-TIME) was then tested in an open trial (n=9) to gather Veteran participant feedback to modify the treatment manual.Two rounds of SME feedback resulted in 80% agreement that manual content was "acceptable as-is" across all intervention domains. The resulting protocol is a five-session, integrated intervention with session 1 primarily focused on alcohol use reduction and sessions 2-5 consisting of narrative exposure and in-vivo exercises for PTSD symptoms with brief alcohol use check-ins. Open trial results indicated high Veteran acceptance of PC-TIME structure and content, and reductions in heavy drinking and PTSD symptoms. Preliminary data suggest PC-TIME to be a promising approach for treatment of heavy alcohol use and PTSD. A pilot randomized controlled trial is necessary to demonstrate the intervention's efficacy with Veterans in a PC setting.

Assessment of the Influence of Performance Contracting on Teachers’ Professional Productivity in Primary Schools in Kilifi County

The drive of this study was to assess the influence of performance contracting on teachers’ professional productivity in primary schools in Kilifi North Sub-County. The study was guided by four theories, goal setting, management, expectancy and Two- factor. The goal-setting theory was proposed by John Locke [1]. The study used a mixed-methods approach to research in order to produce both quantitative and qualitative data while also reducing bias. A triangulation design was used to permit the complementarity of both descriptive and numerical data. Using the Krejcie and Morgan Table, a sample size of 181 was achieved out of the intended population of 346. After descriptive and inferential statistics were used to analyse the data, frequency tables, percentages, charts, and graphs were used to illustrate the results. The study adhered rigorously to research ethics. The findings showed that PC settings had a substantial impact on instructors' professional output. The study suggested making digital gadgets available and accessible to support learning and improve instructors' professional readiness in lesson planning, strategizing, and record keeping, hence enhancing professional productivity toward vision 2030. Similar to this, ICT should be incorporated and adopted from the start of creating goals, implementing changes, and monitoring data; doing so would increase production efficiency and effectiveness and improve school monitoring. The study suggested that there should be one CSO for every ten schools, and that CSO offices should be capitated to promote movements.

A Principal Component Informed Approach to Address Polygenic Risk Score Transferability Across European Cohorts.

One important confounder in genome-wide association studies (GWASs) is population genetic structure, which may generate spurious associations if not properly accounted for. This may ultimately result in a biased polygenic risk score (PRS) prediction, especially when applied to another population. To explore this matter, we focused on principal component analysis (PCA) and asked whether a population genetics informed strategy focused on PCs derived from an external reference population helps in mitigating this PRS transferability issue. Throughout the study, we used two complex model traits, height and body mass index, and samples from UK and Estonian Biobanks. We aimed to investigate 1) whether using a reference population (1000G) for computation of the PCs adjusted for in the discovery cohort improves the resulting PRS performance in a target set from another population and 2) whether adjusting the validation model for PCs is required at all. Our results showed that any other set of PCs performed worse than the one computed on samples from the same population as the discovery dataset. Furthermore, we show that PC correction in GWAS cannot prevent residual population structure information in the PRS, also for non-structured traits. Therefore, we confirm the utility of PC correction in the validation model when the investigated trait shows an actual correlation with population genetic structure, to account for the residual confounding effect when evaluating the predictive value of PRS.

Patients and family members´ perceptions of interprofessional teamwork in palliative care: A qualitative descriptive study.

AimsTo describe patients and family members’ perceptions of interprofessional teamwork in specialised palliative care.BackgroundInterprofessional teamwork is essential when delivering high‐quality palliative care. Little attention has been paid to patients and family members’ perceptions.DesignA qualitative descriptive design.MethodsSemi‐structured individual interviews were conducted with 20 palliative patients and family members (n = 19) in four palliative wards, which were collected from May 2019 to November 2019. Data were analysed using inductive content analysis. COREQ guidelines were followed.ResultsPatients’ perceptions of interprofessional teamwork were described as the nature of interprofessional teamwork, a sense of community and patient participation. Family members’ perceptions of interprofessional teamwork were described as the nature of interprofessional teamwork, the diverse expertise and the sense of community. Patients and family members’ perceptions of interprofessional teamwork were nearly identical and were based on observed social situations or their assumptions. They trust that professionals are working interprofessionally, even if the teamwork cannot be observed. In palliative care, the nature of interprofessional care changes together with patients’ condition and family members progressively need more professional support.ConclusionsConducting interprofessional care more openly could benefit the availability of different professionals’ competence to patients and family members. In palliative care, the nature of interprofessional teamwork changes together with the patients’ health condition. More information is needed about what constitutes an interprofessional framework and the required interprofessional competencies in palliative care.Relevance to clinical practice.The findings show the importance of considering the patient's health status when interprofessional care is planned. However, professionals should recognise that a patient's weakening condition changes the focus more to the needs of the family members. It is acknowledged that IP teamwork requires time, but in PC settings, spending time on collaborative practices is not always possible.

Clinical Presentation of the SARS-CoV-2 Virus Infection and Predictive Validity of the PCR Test in Primary Health Care Worker Patients of the Spanish National Health System.

Background: Despite the impact that the SARS-CoV-2 virus infection has presented in Spain, data on the diagnostic capacity of the symptoms associated with this infection are limited, especially among patients with mild symptoms and who are detected in the primary care field (PC). The objective of the present study was to know the associated symptoms and their predictive criterial validity in SARS-CoV-2 infection among professionals working in PC. Methods: A cross-sectional, multicenter study was carried out in the Spanish National Health System, through an epidemiological survey directed to patients who underwent the PCR test for SARS-CoV-2 in the PC setting. Results: A total of 1612 patients participated, of which 86.6% were PC healthcare professionals, and of these, 67.4% family doctors. Hyposmia, with a sensitivity of 42.69% (95% CI: 37.30–48.08) and a specificity of 95.91% (95% CI: 94.78–97.03), and ageusia with a sensitivity of 39.47% (34.15–44.80) and a specificity of 95.20% (93.98–96.41) were the symptoms with the highest criteria validity indexes. Conclusions: This study identifies the specific symptoms of loss of smell or taste as the most frequently associated with SARS-CoV-2 infection, essential in the detection of COVID-19 given its high frequency and predictive capacity.

Protocol conception for safe selection of mechanical ventilation settings for respiratory failure Patients

Background and ObjectiveMechanical ventilation is the primary form of care provided to respiratory failure patients. Limited guidelines and conflicting results from major clinical trials means selection of mechanical ventilation settings relies heavily on clinician experience and intuition. Determining optimal mechanical ventilation settings is therefore difficult, where non-optimal mechanical ventilation can be deleterious. To overcome these difficulties, this research proposes a model-based method to manage the wide range of possible mechanical ventilation settings, while also considering patient-specific conditions and responses. MethodsThis study shows the design and development of the “VENT” protocol, which integrates the single compartment linear lung model with clinical recommendations from landmark studies, to aid clinical decision-making in selecting mechanical ventilation settings. Using retrospective breath data from a cohort of 24 patients, 3,566 and 2,447 clinically implemented VC and PC settings were extracted respectively. Using this data, a VENT protocol application case study and clinical comparison is performed, and the prediction accuracy of the VENT protocol is validated against actual measured outcomes of pressure and volume. ResultsThe study shows the VENT protocols’ potential use in narrowing an overwhelming number of possible mechanical ventilation setting combinations by up to 99.9%. The comparison with retrospective clinical data showed that only 33% and 45% of clinician settings were approved by the VENT protocol. The unapproved settings were mainly due to exceeding clinical recommended settings. When utilising the single compartment model in the VENT protocol for forecasting peak pressures and tidal volumes, median [IQR] prediction error values of 0.75 [0.31 – 1.83] cmH2O and 0.55 [0.19 – 1.20] mL/kg were obtained. ConclusionsComparing the proposed protocol with retrospective clinically implemented settings shows the protocol can prevent harmful mechanical ventilation setting combinations for which clinicians would be otherwise unaware. The VENT protocol warrants a more detailed clinical study to validate its potential usefulness in a clinical setting.

Groups unite on collaborative care model for BH patients in PC settings

In a show of support for investments in collaborative care, more than a dozen organizations have united behind new bipartisan legislation aimed at a care delivery model that integrates behavioral health care within the primary care setting for treating mental health and substance use disorders that require regular follow‐up, such as depression, anxiety and substance abuse.

A Qualitative Study on Nudging and Palliative Care: "An Attractive but Misleading Concept".

The debate about the ethical decision-making process in the healthcare context has been enriched with a theory called “nudging”, which has been defined as the framing of information that can significantly influence behaviour without restricting choice. The literature shows very limited data on the opinion and experience of palliative care healthcare professionals on the use of nudging techniques in their care setting. The aim of this study is to explore the beliefs of experienced palliative care professionals towards nudging. We performed a qualitative study using textual data collected through a focus group. It was audio-recorded, and the transcripts were subjected to a thematic analysis. It was performed within an oncological research hospital with a small and multidisciplinary group of healthcare professionals specialised in PC. Participants reported two overarching positions grounded in two main themes: (1) translating nudging in the PC setting and (2) towards a neutral space. The participants found few justifications for the use of nudging in the PC field, even if it can be very attractive and reassuring. Participants also expressed concerns about the excessive risk of developing pure paternalism.

Milton Babbitt’s E-type All-Combinatorial Hexachord and its Applications to Jazz

Many of Babbitt's ideas have relevance to jazz, to which I can attest from having spent many years exploring that connection, which I illuminate in this article. I had the wonderful experience of studying with Babbitt as an undergraduate at Princeton; he was a huge inspiration to me. In particular I worked extensively on applying integer pitch-class notation (IPC) to jazz, and Babbitt was extremely helpful as I developed my approach. I retrace the unlikely route that led a jazz musician into the heart of Babbitt's world and, in doing so, I hope to show why my jazz development of IPC has taken its own particular turns. Then, building on that foundation, I focus on a particular pc set that Babbitt used and discussed: the E-type all-combinatorial hexachord, also called the augmented scale, and I discuss its applications to jazz. To date, this hexachord is seldom used in jazz, yet it seems tailor-made for jazz composition and improvisation. I discuss a few rare examples where it has already been used in jazz. Then I examine its structure, paying particular attention to those aspects that seem most applicable to jazz. I examine its relationship to pitch class sets (chords and scales) commonly in use in jazz and, using set operations such as intersection, disjunction, and union, I develop a network of related harmonies involving the hexachord. This network serves as a foundation for a harmonic vocabulary for jazz that is novel, yet compatible with existing practice. Finally, I demonstrate how these structures can serve as compositional determinants.

Voice Leading Among Pitch-Class Sets: Revisiting Allen Forte’s Genera

The theory of PC-set class genera by Allen Forte was an important contribution to the understanding of similarity relations among PC sets within the tempered system. The growing interaction between the universes of PC-sets and transformational theories has been explored the space between sets of the same or distinct cardinality, by means of voice-leading procedures. This paper intends to demonstrate Forte’s method along with proposals by other authors like Morris, Parks, Straus, Cohn, and Coelho de Souza. Some analysis demonstrates such operations in passages picked from Heitor Villa-Lobos’s works, like the Seventh String Quartet and the First Symphony.

Homage to Schoenberg and Bartók: Symmetry, Transpositional Combination and Octatonicism in the First Movement of Roberto Gerhard's Quartetto No. 3

ABSTRACTThe first movement of Roberto Gerhard's Quartetto No. 3 (ca. 1927), his final assignment under Schoenberg, represents a direct homage to the teacher. Gerhard finished the movement with a clearly identifiable allusion to the minor and major chords that close Schoenberg's String Quartet in F♯ minor No. 2, Op. 10 (1907–8). Furthermore, he employed the four‐note set resulting from the fusion of these chords (pc set 4–17) as the movement's generative idea, expanding its main structural properties, namely inversional symmetry and transpositional combination, to inform the movement's large‐scale sonata layout and a number of configurations of key structural importance throughout the movement. In the development, he elaborated Schoenberg's materials by implementing a technique used extensively by Bartók at the time, namely the combination of dyads with one or more transpositions of themselves for generating larger (often octatonic) structures. Gerhard's compositional method in the movement shows not only the decisive impact of Schoenberg's principles but also his indebtedness to the music of Bartók, to whom the composition seems to pay tribute as equally as to Schoenberg. This article utilises these perspectives to offer an analysis of the first movement of Gerhard's Quartetto No. 3/Concertino.

Virtual MRTD – an indirect method to measure MRTD of thermal imagers using computer simulation

Minimum resolvable temperature difference (MRTD) is considered as the most important parameter of thermal imagers. A new method of MRTD measurement without drawbacks of other methods is presented in this paper. Proposed MRTD measurement method coded as virtual MRTD is based on a three steps measurement concept using semi-automatic objective measurements and computer simulation. First, objective parameters of the tested thermal imager are measured. Second, software simulates this tested thermal imager and generates the image of 4-bar target of specified spatial frequency (size) and contrast (temperature difference). Third, a human observer analyses the images of the 4-bar target generated by the software on the screen of PC set and measures MRTD of the simulated thermal imager at specified set of spatial frequencies. The proposed method offers higher measurement speed, lower cost and typically better accuracy in comparison with the typical MRTD measurement method.

Degree of control of patients with chronic obstructive pulmonary disease in Spain: SINCON study

BackgroundDisease control is an important objective of COPD management. The SINCON study evaluated the level of control in terms of respiratory symptoms and exacerbations in Spanish patients with COPD for ≥2 years.MethodsSINCON was a descriptive, cross-sectional, multicenter study that assessed degree of control using a combined index comprising COPD assessment test (CAT), modified Medical Research Council dyspnea scale (mMRC), and number of moderate/severe exacerbations in the last year. Based on this score, patients were categorized as “well controlled” or “poorly controlled”. Degree of control was also assessed relative to patient phenotype, setting (primary care [PC] vs respiratory care [RC]), and impact of treatment on morning symptoms.ResultsOf the 481 patients (PC: 307, RC: 174) analyzed, COPD was poorly controlled in 63.2%. Some differences were found between clinical settings: PC patients were more poorly controlled (PC: 66.4% vs RC: 57.5%; P = 0.06) and had higher CAT score (PC: 17.9 vs RC: 15.5; P < 0.05), and higher rate of moderate/severe exacerbations during previous year (PC: 1.5 vs RC: 1.1; P < 0.05), while dyspnea degree was similar in both settings. Regarding phenotypes, non-exacerbators demonstrated better control vs exacerbators. Morning symptoms score improved between waking and 3 h after bronchodilator treatment (P < 0.05), with greater improvements in PC patients (PC: − 6.5 vs RC: − 5.0 points; P < 0.05).ConclusionsMost COPD patients were poorly controlled with some differences observed between PC and RC settings and between patient phenotypes. Our index may be easily used in PC settings to optimize COPD treatment.

Bill to integrate BH into PC settings for vets includes peers

Bill to integrate BH into PC settings for vets includes peers

Advantages and Disadvantages of an Innovative Tablet Technology Learning Activity: A Ten Year Case Study in Small Tertiary Mathematics Classrooms

Aim/Purpose: To identify positive and negative aspects for learning of interactive tablet technology learning activities that promote student engagement and learning. Background: Engaging students in mathematics classes is an on-going challenge for teachers. In 2008 we were offered the opportunity to run interactive activities with a class set of tablet PCs that had just been released on to the market. Since then, we have run these interactive activities continuously with mathematics classes for computing students, albeit with two changes in hardware. Methodology: In the interactive activities, students submit full worked solutions to various problem types (classified as table, text, open or multi-choice) which can then be displayed to the class anonymously, discussed and annotated by the teacher. We surveyed student and staff perceptions and monitored academic performance. Contribution: We have over 10 years of results, observations, and experience from 2008, when tablet technologies were new and expensive, to the current time, when modern tablets with styli are now affordable. Findings: There was a significant increase in higher grades although pass rates did not increase significantly. Over the ten year period of the study, perceptions of students and staff about how this technology impacted on student learning were consistently positive. The majority of students found all problem types useful for learning even those they rated “too hard” or “too easy”. Benefits included increased feedback, peer learning and engagement. Recommendations for Practitioners: We recommend using tablet learning activities to engage students and teachers and to contribute to learning. Impact on Society: This study shows how using tablet technologies for interactive classroom activities can enable and enhance known pedagogies of feedback, peer instruction, and student engagement for mathematics classes. Future Research: We recommend extending this study to include larger classes, and other technical subjects that use symbols and diagrams. In addition, we suggest considering control groups.

Autoignition study of binary blends of n-dodecane/1-methylnaphthalene and iso-cetane/1-methylnaphthalene

An experimental study on autoignition of two binary blends, n-dodecane/1-methylnaphthalene and iso-cetane/1-methylnaphthalene, has been conducted using a rapid compression machine. Specifically, the ignition delays of the stoichiometric blend+air mixtures were measured at elevated pressures of PC = 15 bar and 30 bar, compressed temperatures of TC = 626–944 K, and varying blending ratios of the constituents. For a given set of PC and TC, a nonlinear response of the blend reactivity with respect to the relative amount of the constituents was observed. Since a comprehensive chemical kinetic model for the blends investigated here is under development, the current ignition delay datasets serve as the needed targets for model validation. For selected conditions, ignition delay simulations were conducted to highlight and discuss the deficiencies of the literature models and the potential areas for model improvements, especially at low temperatures. Further chemical kinetic analyses were conducted to gain understanding of the blending behavior predicted by the available model.