Total Residence Research Articles

Water absorption and dripping of chicken breast and carcasses during pre-cooling in an industrial system

This study aimed to evaluate the parameters that influence the water absorption and drip of chicken carcasses due to the processing and pre-cooling of the meat in an industrial chiller. A total of 1,179 chickens were sampled during industrial processing to evaluate the influence of variables, validate the parameters, and conduct histological analysis. The best parameters for guaranteeing absorption levels and drip tests within acceptable limits on chicken carcasses were total residence time of 60min (in the pre-chiller, chiller 1, and chiller 2); air pressure of chillers at 0.5bar; the abdominal opening of carcasses at a maximum of 2cm. These parameters did not influence the protein content, moisture/protein ratio, pH, or lipid content. The validation of the parameters and the histological analysis performed after each cooling stage showed that the most significant structural changes occurred in the pre-chiller, where the temperature of carcasses and water was higher, which contributes to greater absorption.

Moonlighting by Psychiatry Residents: a Survey of Residents and Training Directors.

This study sought to assess the prevalence of moonlighting among psychiatry residents; the perceived effects of moonlighting on resident recruitment, education, and liability; and policies and practices governing oversight. In 2013, surveys were emailed to all general psychiatry residency programs that were accredited by the Accreditation Council for Graduate Medical Education and had available contact information (n = 183). Resident surveys were emailed to program coordinators with a request to forward the survey link to their residents. Responses were received from 63 program directors (34% response rate) and 238 residents (about 5% of total general psychiatry residents). Most psychiatry program directors (95%) indicated that their programs permit moonlighting. Moonlighting participation increased with each year of training, culminating with 67% of fourth year residents. Most residents and faculty (87%) agreed that moonlighting enhanced resident education. Thirty-seven percent of program directors reported having no oversight procedures in place to monitor moonlighting activities. Thirty-nine percent of resident survey responders reported having no supervision for at least one of their moonlighting activities and only 9% reported always having access to on-site supervision. Though limited by a low response rate, this study found that moonlighting seems to remain prevalent among psychiatry residents and widely accepted by psychiatry residency training programs. There appears to be relatively limited program oversight for moonlighting activities, many of which seem to lack close supervision.

Attrition rates in integrated vascular and cardiothoracic surgery residency and fellowship programs

BackgroundAttrition in surgical programs remains a significant problem resulting in trainee dissatisfaction and wasted time and educational dollars. Attrition rates in general surgery training programs approximate 5% per year (30% cumulative). Attrition rates in cardiovascular surgery training for the traditional vascular surgery fellowship (VSF), the vascular surgery residency (VSR), and the corresponding programs in cardiothoracic surgery have yet to be described, although they are assumed to be similar to those associated with general surgery training. MethodsA retrospective review of the Association of American Medical Colleges Annual Physician Specialty Data Book was performed. Data from consecutive academic years 2007-2008 to 2013-2014 were analyzed. The number of total residents, the number who did not complete their training, and those who successfully completed the program were recorded. Attrition rates were then calculated for VSF, VSR, general surgery residency (GSR), cardiothoracic surgery fellowship (CTF), and cardiothoracic surgery integrated residency (CTR). ResultsAnnually, between 2007-2008 and 2013-2014, there were zero to two vascular surgery residents who failed to complete the program (0%-5.9%). In the last 4 years of the study, whereas the absolute number of residents who failed to complete the program remained constant at 1 or 2 per year, the attrition rate decreased to 1 of 171 trainees (0.6%) in 2013-2014 as the total number of programs (and numbers of vascular surgery residents) significantly increased. During the same 7-year period, the number of vascular surgery fellows who did not complete their training ranged from one to six annually (0.4%-2.5%). Compared with the VSF, the VSR data show a relatively low and constant rate of attrition. In contrast, the number of general surgery residents who did not complete their program during the study period varied from 255 to 388 residents annually (3.3%-5.2%). During its first 3 years of inception, the CTR program had an attrition rate of 0%, and it was not until 2012-2013 that trainees failed to complete the program, resulting in an annual attrition rate of 1.2% to 3.2% from that point on. The annual attrition rate of CTF training programs ranged from 7 to 15 fellows (2.9%-6.8%) during the study period. ConclusionsThe inception of VSR and CTR programs dramatically changed the paradigms for training in these highly specialized surgical fields. Comparisons of attrition rates between these two programs and the traditional VSF and CTR as well as GSR suggests lesser rates of attrition in the integrated programs. These data may prove reassuring to VSR and CTR program directors, whose significantly smaller programs are more vulnerable to the loss of even a single trainee than general surgery training programs are. In addition, the VSF program has stable and lower attrition rates compared with the CTF and GSR programs.

Indirect assessment of the maximum empirical activity (250 mCi) with respect to dosimetry concepts in radioiodine therapy of metastatic differentiated thyroid cancer.

The development of reliable dosimetry models promotes the individualized therapy concept toward more success and less complications. This paper evaluates the traditional maximum empirical activity (250 mCi) and the benefit of joining two dosimetry approaches to optimize the therapeutic activity and radioiodine efficacy in metastatic differentiated thyroid cancer. Nineteen (12 females and seven males) patients with metastatic differentiated thyroid cancer were included in the present study. The mean age of the patients was 46±16 years. The mean height and weight were 1.67±0.11 m and 76±18 kg, respectively. Radioiodine treatment was given by recombinant human thyrotropin stimulation in seven patients, and thyroxine withdrawal was successful for the rest 12 patients. The mean thyroid-stimulating hormone value was 68±34 μIU/ml, and the mean thyroglobulin value was 408±356 ng/ml before therapy. After radiotracer administration, lesion-absorbed dose was calculated in addition to red marrow dose estimation via two different models. Total body and blood residence time was found to be 30±17 and 4.5±1.9 h, respectively. Red marrow absorbed dose was 0.535±0.262 Gy/100 mCi using the model accounts for red marrow dose surrogated by blood, and it was 0.398±0.212 Gy/100 mCi using a modified model with mean deviation of -24% (range: -19 to -31%). Red marrow absorbed dose was found to be 0.50±0.15 Gy/100 mCi in the levothyroxine withdrawal group, whereas it was 0.46±0.2 Gy/100 mCi for the patients who received recombinant human thyrotropin. Mean lesion-absorbed dose was 0.16±0.14 Gy/g/mCi. The speculated dose from 250 mCi iodine-131 was evaluated, as 65% of all lesions (n=27) would receive at least 100 Gy, whereas the percentage of bone lesions that would receive at least 100 Gy was only 55%. Upon to this study, red marrow dose varies with type of preparation as that of medication withdrawal cases was slightly higher than exogenous thyroid-stimulating hormone. Involvement of lesion and red marrow dose assessment through dosimetry protocol seems indeed valuable to optimize safe and effective activity compared with the conventional regime with 250 mCi as maximum empirical activity.

Measuring sparingly-soluble, aqueous salt crystallization kinetics using CSTRs-in-series: Methodology development and CaCO3 studies

We present a methodology and results for measuring crystallization kinetics of sparingly soluble salt mixtures typical of reject/concentrate streams from membrane-based, inland water supply processes. More usable water can be recovered (and lower disposal costs incurred) from these concentrate streams through efficient crystallization. In this work, we present a steady state, continuous stirred tank reactors (CSTRs)-in-series approach to study crystallization kinetics of a model solution mixture that is supersaturated in CaCO3. We have used pH, conductivity and turbidity changes in the system to monitor crystallization using six CSTRs with individual residence times of nominally 3, 5, and 11 min. This system operates in a steady state mode with total crystallization times from ∼15–68 min and was capable of handling up to ∼0.59 L/min of hard water for the shortest residence time studied. The supersaturation was depleted ∼25% and over 50% with total reactor system residence times of ∼15 and 68 min, respectively, without any added chemicals. Using the metric of 5 NTU turbidity as being the point of discernible crystal formation, we examined how mixing energy dissipation affects the induction times for crystallization. Notably, discernible crystallization could only be advanced to the 1st CSTR by using a recirculation loop to “fine-tune” the effect of surface area exposure-to-volume ratio, as well as, mixing energy dissipation. A rudimentary, semi-empirical model was used to capture the parametric trends of our experimental results, using the Kolmogorov mixing lengths, surface area-to-volume ratios, flow rates, and nominal diffusion coefficients. This parameterization may be tested further for design scale-up guidance.

The importance of user memory in understanding housing quality

PurposeHousing quality is determined by both objective and subjective dynamics. This research was conducted to explore the importance of users’ memory as a tool for assessing housing quality. While objective features of the surroundings generally require physical measurements, subjective features can be supported by residents’ memories. Memory studies can therefore be used as a research tool to understand the housing environment as they provide important references to the past, present, and future. The purpose of this paper is to explore the relationship between users’ (residents) memory and housing quality.Design/methodology/approachThe methodology comprised a literature review of spatial quality studies and a field study of a modern housing estate in Istanbul. For the field study, housing quality was examined through the memories of residents in the neighbourhood, buildings, and units. With the research, site observations were made, a questionnaire was issued to residents, and in-depth interviews were conducted with residents who had lived there the longest. New dimensions of housing quality problems were then discussed in the conclusion with reference to residents’ memories.FindingsMemory studies can be used as a research tool to understand the housing environment, as they provide important references to the past, present and future. In the conclusion, new dimensions of the housing quality problems were discussed with the help of the residents’ memories. It was seen that different dimensions of housing quality can be revealed with the help of user memory.Research limitations/implicationsIn all, 40 of the total residents (101) accepted to make questionnaires. In-depth interviews were conducted with three long-term residents that are the only ones still alive and had lived the area since the beginning of the life after construction.Originality/valueWith the aim of developing new tools and methods to analyse housing quality, this research presents a new perspective by utilising users’ memories to evaluate spatial quality.

Two-step processing of refractory gold-containing sulfidic concentrate via biooxidation at two temperatures

A practical problem in the biohydrometallurgical processing of sulfide raw materials is the need to increase the efficiency and stability. The heating of pulp in bioreactors causes exothermic lysis of microorganisms and cessation of the production process. To find solutions to these problems, the present study examines the biooxidation of a gold-bearing sulfidic concentrate in a two-step (ferric leaching + biooxidation) process with different temperatures in the bioreactors at the biological step: 50 °C in the first bioreactor and 39 °C in the second. The main minerals of the flotation concentrate were pyrrhotite, pyrite, arsenopyrite, and stibnite. The preliminary ferric leaching of the concentrate for 5 h at 80 °C and pH 1.15–1.35 allowed oxidization of 26.8% of arsenopyrite and 54.4% of sulfur in the sulfides. At the biological step, a moderately thermophilic culture of acidophilic microorganisms dominated by representatives of the genus Sulfobacillus was used. The residence time of the pulp in each bioreactor was 2 days with a total residence time of 4 days. This study indicated that the efficiency of two-step process with the use of a two-temperature mode is comparable with the constant temperature mode and much higher than that of the one-step process. The final oxidation levels of arsenopyrite and sulfidic sulfur for the two-step process with elevated temperature in the primary bioreactor were 73.1 and 65.9%, respectively, with 82% gold recovery.

Understanding of two-stage continuous microreaction technology for in-situ generation and consecutive conversion of diazomethane

Abstract Microreaction technology (MRT) offers a safe way to deliver useful, highly active but hazardous diazomethane on demand within a closed system and then realize in-situ conversion to the desired product. In this work, the two-stage MRT is employed for the integrated synthesis of diazomethane and its consecutive conversion with benzoic acid, and the key factors resulting in the low product yield are investigated in depth. Extensive optimization of reaction conditions (e.g., the total flow rate, residence time, temperature and reactants ratio), solvent selection as well as heat management are performed. Special attention has to be devoted to the significantly detrimental effect of water solvent on the product yield. These results provide some fundamental understanding of the interlinked reaction chemistry and engineering, which could guide the MRT development for continuous operation when using hazardous compounds.

Continuous process for biodiesel production from palm fatty acid distillate (PFAD) using helical static mixers as reactors

Abstract Three-step continuous process for producing biodiesel from palm fatty acid distillate (PFAD) was optimized by response surface methodology (RSM). PFAD has high content of free fatty acids (FFA) and is not suited for human consumption: normally it is used in soap or in animal feed. The key parts of the three-step continuous process took place in helical static mixers (HSMs) used as continuous reactors. The three-step process was optimized by RSM with 5 levels for each of three factors in central composite design (CCD). First step was esterification, then second step was esterification, and third was transesterification. Methyl ester purities of 71.01 wt.% from first step, 95.94 wt.% from second step, and 99.96 wt.% from third step were achieved with total chemical consumption of (115.1 wt.% MeOH, 13.5 wt.% H2SO4, and 5.0 g/L KOH), and total residence time 147 s in the 3 HSMs. In continuous processing the maximum yields were 109.5 wt.% first-esterified oil, 117.0 wt.% second-esterified oil, and 129.0 wt.% crude biodiesel, and purified biodiesel 86.4 wt.%, in the separated phases from first, second, and third steps, and after purification, respectively. Ester purity from three-step process meets the standard specifications for commercial biodiesel in Thailand, US, and Europe.

A four-year simulation of soil aquifer treatment using columns filled with San Gabriel Valley sand

Two column pairs filled with 3.05-m of a sandy soil from the Upper San Gabriel Valley were operated for a period of four and ½ years on municipal effluent from the San Jose Creek Water Reclamation Plant operated by the Sanitation Districts of Los Angeles County (LACSD). One column pair was fed filtered, chlorinated effluent (tertiary effluent) for the entire period. The other pair was fed ozonated secondary effluent for 8-mo, ozonated secondary effluent filtered through biological activated carbon (O3/BAC) for 7-mo and tertiary effluent for 38-mo. Each column pair was operated in series, where the first column was operated for a shorter residence time and the second column for a longer residence time. Residence times tested were 5-d, 28-d, 30-d, 58-d, 60-d, 150-d and 180-d. For the last 38-mo, both pairs of columns had a residence time of 30-d in the first column and the total residence time of the two pairs was 150 and 180-d, respectively. Testing showed both of these pairs had the same long-term performance. The column pairs with a 150 to 180-d residence time, which were both fed tertiary effluent, reached an effluent total organic carbon (TOC) of 1.8 mg/L. Column pairs with a 28 to 30-d residence time, which were fed tertiary, ozonated, and O3/BAC effluent, reached effluent TOCs of 2.3, 2.1 and 1.8 mg/L respectively. In the latter, some TOC removal was shifted from the soil columns to the BAC. During the last 38 months of testing, using tertiary effluent as the source water, a series of sampling events was performed throughout the soil column system for N-nitrosodimethylamine (NDMA) and chemicals of emerging concern (CECs). NDMA was substantially reduced in all the columns, with a median value of 3 ng/L after 30-d and <2 ng/L after both 150 and 180-d. Twenty-one CECs were found in the majority of tertiary effluent samples, twelve of which were attenuated by the soil columns and the remaining were not. Chemicals found to be recalcitrant were 4-nonylphenol, acesulfame-k, carbamazepine, lidocaine, primidone, simazine, sucralose, sulfamethoxazole, and TCEP. Using excitation-emission matrix (EEM) techniques, soluble microbial products (SMP) peak characteristic of effluent organic matter (EfOM) is nearly eliminated after a 30-d hydraulic retention time (HRT) and completely eliminated in the 150/180-d samples. The intensity of the other peaks is significantly reduced as well, resulting in an EEM much like that of natural groundwater.

A kinetic study of xylose recovery from a hemicellulose-rich biomass for xylitol fermentative production

Hemicellulose in the complex structure of lignocellulosic substances is mainly composed of xylan which is a polymer based on monosaccharide xylose. Using acidic or enzymatic hydrolysis, hemicellulose can be depolymerized into its constituent monomer. The kinetics of hemicellulose depolymerization and decomposition in oat hull was investigated under moderate pressures with catalyst (H2SO4) concentration up to 0.55 N and temperatures of up to 130 °C for a total residence time of 150 min. Different trends of recovery or generation and kinetic mechanisms obtained for the components in the hydrolysate which could be described by different kinetic models, that is, a single-phase kinetic mechanism with product decomposition (two-step sequential reaction) could describe xylose generation. However, generation of arabinose, furfural, and acetic acid followed a single-phase mechanism with no decomposition (one-step reaction). Generation of glucose in the hydrolysate followed a biphasic mechanism due to the fast- and slow-releasing fractions into the liquid phase which was apparently with no decomposition. A pentose recovery of almost 80% was achieved under optimal conditions. Parameters of xylitol bioproduction indicated that a xylitol/xylose conversion yield of 0.80 g/g is achievable from the concentrated hydrolysate with no complementary treatment proving its low toxicity compared to other hemicellulose resources.

Simple Frameworks for Daily Work: Innovative Strategies to Coach Residents Struggling With Time Management, Organization, and Efficiency.

Organization and efficiency are central to success on busy inpatient services and may be relevant to demonstrating certain milestones. Most residents adopt these skills by observing supervisors and peers. For some, this method of emulation and adaptation does not occur, with the potential for a negative effect on patient care and team morale. Information on effective strategies for remediating organization and efficiency deficits is lacking. We explored the major themes of organization and efficiency referred to the University of Pennsylvania Department of Medicine Early Intervention and Remediation Committee (EIRC), and developed tools for their remediation. Assessments of residents and fellows referred to the EIRC between July 2014 and October 2016 were reviewed for organization and efficiency deficits. Common areas were identified, and an iterative process of learner observations and expert input was used to develop remediation tools. Over a 2-year period, the EIRC developed remediation plans for 4% of residents (13 of 342 total residents), and for 1 internal medicine subspecialty fellow. Organization and efficiency was the primary or secondary deficit in more than half of those assessed. Most common deficiencies involved admitting a patient efficiently, performing effective prerounding, and composing daily progress notes/presentations. Remediation tools that provided deconstruction of tasks to their most granular and reproducible components were effective in improving performance. Deficits in organization and efficiency can disproportionately affect resident performance and delay milestone achievement. Many residents would benefit from detailed frameworks and assistance with new approaches to basic elements of daily work.

Enhanced chalcopyrite dissolution in stirred tank reactors by temperature increase during bioleaching

Primary copper sulfides, such as chalcopyrite, represent the most important copper resource and are currently mainly exploited by pyrometallurgy. Bioleaching is considered as environmental-friendly and economic alternative, and the technical feasibility of stirred tank reactor (STR) bioleaching of copper ore concentrates using acidophilic, iron- /sulfur-oxidizing microorganisms was proven. In case of copper concentrates from Kupferschiefer-type ore the copper recovery at temperatures suitable for moderately thermophilic acidophiles was, however, incomplete due to inefficient chalcopyrite dissolution.The presented study therefore aimed to enhance chalcopyrite dissolution by decoupling of growth and bioleaching activity of the acidophiles. This was achieved by a controlled temperature increase in laboratory bioreactor experiments with copper concentrate from Kupferschiefer-type ore. Total cell number and microbial activity monitoring allowed to define three stages of the bioleaching process: (i) growth phase, (ii) bioleaching phase and (iii) resting phase. The total residence time was close to seven days, according to copper recovery and iron oxidation activity. Experiments at constant temperatures (42 °C, 48 °C, 50 °C) and a controlled temperature increase at the end of the growth phase of 42/46 °C, 44/48 °C and 46/50 °C, showed that metal recovery was enhanced by incremental temperature increase and resulted in a lower redox potential. Copper recovery was improved from originally 86% to 97% by only 4–8 °C temperature increase. Mineralogical analysis confirmed an almost complete absence of chalcopyrite in the residues after the 46/50 °C bioleaching experiments. These results indicate a distinct temperature effect on copper recovery. The study defines parameters to make STR bioleaching of chalcopyrite-rich ores more efficient and economically feasible and ensures an optimal control of the process for upscaling.

Rice Husk Char-Clay Composite for the Adsorption of Methylene Blue Dye

Contamination of water bodies due to the release of wastewater containing dyes is a worldwide environmental problem and hence treatment before discharging is particularly important. In this study, adsorption of Methylene Blue dye from aqueous solutions onto a novel adsorbent; rice husk char-clay composite; was studied. Rice husk was burnt at 300° C at a heating rate of 100 C increase per minute with the total residence time of 45 minutes. Rice husk char thus obtained was grounded and the composite was prepared by mixing rice husk char and clay to the weight ratio of 9:16 and extruding to approximately 0.5 cm diameter pellets. Two types of adsorbents were prepared with clay burnt at 450° C for 1 hour and with unburnt clay. A series of batch adsorption experiments were performed to determine the factors affecting adsorption. For both types of composites, maximum removal of dye was observed at an initial dye concentration of 20 mg/l. In particular, an extensive analysis was made on solution pH variation during the adsorption process. Batch experiments at various initial pH values were carried out, and solution pH profiles with the adsorption time were also evaluated. The pH values considered for the experiment were 6, 7, 8, 9 and 10. Optimum pH values for the maximum dye removal were obtained for burnt clay at 7 and for the unburnt clay at 10. Composite made of burnt clay showed higher dye removal compared to unburnt clay composite. Experimental data were fitted to pseudo first order and second order kinetic models and related parameters, initial adsorption rate (h) and rate constant (k2) were estimated. The results showed that kinetic data of the system best fits the pseudo second order model for burnt clay composite with initial adsorption rate (h) as 12.937 mg g-1 min-1 and rate constant (k2) 0.136 g mg-1 min-1. The highest initial dye uptake of 12.9 mg/g was observed for burnt clay composite. Langmuir and Freundlich isotherms were used to fit the equilibrium data successfully and constants were calculated. Accordingly, for burnt clay these values were obtained adsorption coefficient (b) as 1.28, constant related to adsorption capacity (k) as 4.96, constant related to adsorption intensity (n) as 2.42 and amount of solute adsorbed per unit weight of adsorbent corresponding to complete coverage of available sites (𝑞𝑜) as 10.21 mg g-1. Results revealed that Freundlich isotherm fits the burnt clay composite and Langmuir model fits the unburnt clay composite. Based on these experimental results, application of rice husk char burnt clay composite in removal of dye from wastewater is suggested. Keywords: Rice husk char, Adsorption, Methylene-blue

The fate of polar trace organic compounds in the hyporheic zone

The hyporheic zone (HZ) is often considered to efficiently remove polar trace organic compounds (TrOCs) from lotic systems, mitigating potential adverse effects of TrOCs on ecosystem functioning and drinking water production. Predicting the fate of TrOCs in the hyporheic zone (HZ) is difficult as the in-situ removal rate constants are not known and the biogeochemical factors as well as hydrological conditions controlling the removal efficiency are not fully understood. To determine the in-situ removal efficiency of the HZ for a variety of TrOCs as a function of the biogeochemical milieu, we conducted a field study in an urban river near Berlin, Germany. Subsurface flow was studied by time series of temperature depth profiles and the biogeochemical milieu of the HZ by concentration depth profiles. These results, in conjunction with a 1D advection-dispersion transport model, were used to calculate first-order removal rate constants of several polar TrOCs in the HZ. For the majority of TrOCs investigated, removal rate constants were strongly dependent on redox conditions, with significantly higher removal rates observed under predominantly suboxic (i.e. denitrifying) compared to anoxic (i.e. Fe and Mn reducing) conditions. Compared to previous studies on the fate of TrOCs in saturated sediments, half-lives within oxic/suboxic sections of the HZ were relatively low, attributable to the site-specific characteristics of the HZ in a stream dominated by wastewater treatment plant effluent. For nine out of thirteen investigated TrOCs, concentrations decreased significantly in the HZ with relative removal percentages ranging from 32% for primidone to 77% for gabapentin. For many TrOCs, removal efficiency decreased drastically as redox conditions became anoxic. For the majority of compounds investigated here, the HZ indeed acts as an efficient bioreactor that is capable of removing TrOCs along relatively short flow paths. Depending on the TrOC, removal capacity may be enhanced by either increasing the magnitude of groundwater-surface exchange fluxes, by increasing the total residence time in the HZ or the exposure time to suboxic zones, respectively.

Rapid mixing and short storage timescale in the magma dynamics of a steady-state volcano

Steady-state volcanic activity implies equilibrium between the rate of magma replenishment and eruption of compositionally homogeneous magmas, lasting for tens to thousands of years in an open conduit system. The Present-day activity of Stromboli volcano (Aeolian Islands, Southern Italy) has long been recognised as typical of a steady-state volcano, with a shallow magmatic reservoir (highly porphyritic or hp-magma) continuously refilled by more mafic magma (with low phenocryst content or lp-magma) at a constant rate and accompanied by mixing, crystallisation and eruption. Our aim is to clarify the timescale and dynamics of the plumbing system at the establishment of the Present-day steady-state activity (<1.2 ka) to pinpoint the onset of the steady-state regime. We investigated the Post-Pizzo (PP) pyroclastic sequence (∼1.7–1.5 ka) and one of the Early Paroxysms (EP) of the Present-day activity, focusing on the clinopyroxene population.Whole rock and clinopyroxene compositional variation among the PP and EP magmas is consistent with the time progression of the Stromboli system towards more mafic and lower 87Sr/86Sr compositions, pointing to the chemical and isotopic signature of the Present-day activity. Clinopyroxenes from both PP and EP record a complex history with compositional zoning that reflects growth in three different melt domains: a high-Mg# proto-lp recharging magma, a low-Mg# proto-hp resident magma, and a transient intermediate-Mg# magma. These are the result of complex turbulent flow fields and mixing regimes produced by repeated injections of the proto-lp magma in the shallow proto-hp magma reservoir. During the PP period the magmatic system was already able to regain the pre-input proto-hp composition, gradually changing toward a less evolved signature after the injection(s) of the more mafic proto-lp magma, owing to efficient (days to a few years) stirring and melt homogenisation (i.e., homogenisation time < residence time).Based upon Fe–Mg diffusion in clinopyroxene the total residence time during PP and EP periods, from the arrival of the mafic magma in the shallow system until the eruption, ranges from 1 to ∼50 years. Longer residence times (up to 150 years) have been recorded in the initial phase of the PP sequence, possibly testifying to the transition from a closed- to the open-conduit, steady-state regime of the Present-day activity.Some clinopyroxenes from the PP recorded the mafic triggering event of the feeding proto-lp magma occurring within few months to a few days before eruption. Remarkably, other clinopyroxene portions crystallised and captured the rapid timescales (a few days) of the on-going mixing and homogenisation process between the proto-lp and the proto-hp magmas leading to the eruption.The modelling of clinopyroxene zoning events at Stromboli provides evidence for growth and storage in three different melt domains, and sets robust constraints on their residence time from lp-magma recharge(s) to eruption, along with the timescales of melt homogenisation and triggering events. The lifetime history captured by Fe–Mg zoning of Stromboli clinopyroxenes suggests that the interplay between rapid mixing and short storage timescales can be a key parameter controlling the dynamics of the plumbing system of steady-state volcanoes.

Resident Wellness and Social Support: Development and Cognitive Validation of a Resident Social Capital Assessment Tool

The purpose of this study is to develop and generate validity evidence for an instrument to measure social capital in residents. Mixed-methods, phased approach utilizing a modified Delphi technique, focus groups, and cognitive interviews. Four residency training institutions in Washington state between February 2016 and March 2017. General surgery, anesthesia, and internal medicine residents ranging from PGY-1 to PGY-6. The initial resident-focused instrument underwent revision via Delphi process with 6 experts; 100% expert consensus was achieved after 4 cycles. Three focus groups were conducted with 19 total residents. Focus groups identified 6 of 11 instrument items with mean quality ratings ≤4.0 on a 1-5 scale. The composite instrument rating of the draft version was 4.1 ± 0.5. After refining the instrument, cognitive interviews with the final version were completed with 22 residents. All items in the final version had quality ratings >4.0; the composite instrument rating was 4.8 ± 0.1. Social capital may be an important factor in resident wellness as residents rely upon each other and external social support to withstand fatigue, burnout, and other negative sequelae of rigorous training. This instrument for assessment of social capital in residents may provide an avenue for data collection and potentially, identification of residents at-risk for wellness degradation.

Effect of tsunami drill experience on evacuation behavior after the onset of the Great East Japan Earthquake

The effectiveness of tsunami drills in guiding evacuation behavior remains uninvestigated. Accumulation of evidence regarding the effectiveness of tsunami drills would be beneficial for improving survival and health of communities to be inundated by a tsunami. A questionnaire to inquire participants' location at the onset of the Great East Japan Earthquake and experience of the tsunami was issued as part of a survey of total adult residents of Shichigahama town whose houses were significantly damaged by the disaster. Along with the location information, self-reported information on participation in tsunami disaster drills and attendance of a lecture about tsunamis before the disaster and whether the participants evacuated after the earthquake was subjected to multiple logistic regression analyses adjusted for potential confounding factors. Amongst the 2314 participants who were present in the town at the onset of the disaster and completed the questionnaires, 1560 (67%) evacuated after the earthquake. The rate of evacuation was significantly higher amongst the population who participated in tsunami disaster drills before the event than amongst those who did not participate (multivariate-adjusted odds ratio [MOR] = 1.99, 95% confidence interval [CI] = 1.53–2.61, p < 0.01). However, other experience of earthquake and tsunami disaster prevention before the event did not affect evacuation behavior (MOR = 0.86–1.16). A survey of the population who survived the catastrophe provides initial evidence to advocate the administration of tsunami drills in seaside communities to enhance the evacuation behavior immediately after the disaster onset.

KNOWLEDGE AND ATTITUDES OF PUBLIC TOWARD MENTAL DISORDERS AT OUTPATIENT CLINICS IN ASSIUT UNIVERSITY HOSPITAL

Background: Mental disorders are more common in developed world than in developing world. Community, attitude and beliefs play a role in determining behavior of seeking help and successful treatment of patient with mental disorder. It is worth noting that ignorance and stigma prevent the mentally disordered patient from seeking appropriate help. The study aimed to investigate knowledge and attitudes of public toward mental disorders in outpatient clinics at Assiut university general hospital. This study was conducted in outpatient clinics at Assiut university general hospitals. Descriptive study was performed and multi stage sample (first, clinic choose by Random and second, patient’s relatives choose by Convenience sampling was used for sex month. The total sample of this study was 1000 person from those attending to outpatient clinics with their relative patients, aged from 18 or more. The present study shows that the majority (84.7% and 83.9%) respectively of the studied sample had unsatisfactory total knowledge scores, and negative attitudes about mental disorders. Also, there is a highly statistical significant difference between total knowledge scores and age, residence, education level and occupation of study participants with P=0.000. Also, between total attitudes level, residence and educational level (P= 0.000 as well as between attitudes toward mental disorders and family history of mental disorders (P= 0.000). The study recommended that we must increase awareness and improve public’s knowledge and attitude towards mental disorders through, health education for public in every health care setting that provides care for mentally disordered patients.

Psychometric characteristics of Clinical Reasoning Problems (CRPs) and its correlation with routine multiple choice question (MCQ) in Cardiology department.

Clinical reasoning is one of the most important skills in the process of training a medical student to become an efficient physician. Assessment of the reasoning skills in a medical school program is important to direct students' learning. One of the tests for measuring the clinical reasoning ability is Clinical Reasoning Problems (CRPs). The major aim of this study is to measure psychometric qualities of CRPs and define correlation between this test and routine MCQ in cardiology department of Shiraz medical school. This study was a descriptive study conducted on total cardiology residents of Shiraz Medical School. The study population consists of 40 residents in 2014. The routine CRPs and the MCQ tests was designed based on similar objectives and were carried out simultaneously. Reliability, item difficulty, item discrimination, and correlation between each item and the total score of CRPs were all measured by Excel and SPSS software for checking psycometeric CRPs test. Furthermore, we calculated the correlation between CRPs test and MCQ test. The mean differences of CRPs test score between residents' academic year [second, third and fourth year] were also evaluated by Analysis of variances test (One Way ANOVA) using SPSS software (version 20)(α=0.05). The mean and standard deviation of score in CRPs was 10.19 ±3.39 out of 20; in MCQ, it was 13.15±3.81 out of 20. Item difficulty was in the range of 0.27-0.72; item discrimination was 0.30-0.75 with question No.3 being the exception (that was 0.24). The correlation between each item and the total score of CRP was 0.26-0.87; the correlation between CRPs test and MCQ test was 0.68 (p<0.001). The reliability of the CRPs was 0.72 as calculated by using Cronbach's alpha. The mean score of CRPs was different among residents based on their academic year and this difference was statistically significant (p<0.001). The results of this present investigation revealed that CRPs could be reliable test for measuring clinical reasoning in residents. It can be included in cardiology residency assessment programs.