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Use of hydroponics is increasing because of its ability to be used for year round vegetable production using an environmentally sustainable system. Management of solution pH is an important challenge in hydroponics systems. Our objective was to quantify the effects of various pH modifiers on growth and nutrient uptake of leafy greens and stability of nutrient solution’s pH. Lettuce, basil, and Swiss chard were transplanted into an Ebb and flow system, and nutrient solution pH was maintained using three different pH modifiers (pH Down, lime juice, or vinegar). The nutrient solution’s pH was maintained between 5.5 and 6.5. pH Down resulted in the most stable solution pH and required the least amount of product used when compared to lime juice and vinegar. The cost of using phosphoric acid or lime juice was greater than that of using vinegar. Vinegar reduced the yield of all crops in comparison to pH Down. When compared to pH Down, lime juice reduced the yield of basil and Swiss chard but not that of lettuce. Therefore, growers can use lime juice as an alternative to pH Down in lettuce production but not for basil and Swiss chard, while vinegar would not be recommended for any of the crops studied.

BackgroundAlthough misdiagnosis in the outpatient setting leads to significant patient harm and wasted resources, it is not well studied. The authors surveyed primary care physicians (PCPs) about barriers to timely diagnosis in the outpatient setting and assessed their perceptions of diagnostic difficulty.MethodsSurveys of PCPs practicing in an integrated health system across 10 geographically dispersed states in 2005. The survey elicited information on key cognitive failures (including in clinical knowledge or judgement) for a specific case, and solicited strategies for reducing diagnostic delays. Content analysis was used to categorise cognitive failures and strategies for improvement. The authors examined the extent and predictors of diagnostic difficulty, defined as reporting >5% patients difficult to diagnose.ResultsOf 1817 physicians surveyed, 1054 (58%) responded; 848 (80%) respondents primarily practiced in outpatient settings and had an assigned patient panel (inclusion sample). Inadequate knowledge (19.9%) was the most commonly reported cognitive factor. Half reported >5% of their patients were difficult to diagnose; more experienced physicians reported less diagnostic difficulty. In adjusted analyses, problems with information processing (information availability and time to review it) and the referral process were associated with greater diagnostic difficulty. Strategies for improvement most commonly involved workload issues (panel size, non-visit tasks).ConclusionsPCPs report a variety of reasons for diagnostic difficulties in primary care practice. In this study, knowledge gaps appear to be a prominent concern. Interventions that address these gaps as well as practice level issues such as time to process diagnostic information and better subspecialty input may reduce diagnostic difficulties in primary care.

Byline: Rajat. Verma, Chhitij. Srivastava, Bal. Ojha, Anil. Chandra, R. Garg, Monica. Kohli, Hardeep. Singh, Anit. Parihar, Shalini. Tripathi Background: Hydrocephalus is an abnormal excessive accumulation of cerebrospinal fluid (CSF) [...]

The wind turbine power curve model is critical to a wind turbine's power prediction and performance analysis. However, abnormal data in the training set decrease the prediction accuracy of trained models. This paper proposes a sample average approach-based method to construct an interval model of a wind turbine, which increases robustness against abnormal data and further improves the model accuracy. We compare our proposed methods with the traditional neural network-based and Bayesian neural network-based models in experimental data-based validations. Our model shows better performance in both accuracy and computational time. [ABSTRACT FROM AUTHOR]

In this paper, we propose an all-optical integrated 2-to-4 decoder and a 1-to-4 demultiplexer circuit using SOA based MZI (Mach–Zehnder Interferometer) architecture. The proposed device has been applied an enable signal along with two data input signals at the same wavelength. Four output signals from 2-to-4 decoder and 1-to-4 demultiplexer have been attained at the same wavelength. The output timing diagrams of 2-to-4 decoder and 1-to-4 demultiplexer for different input data conditions with clear eye opening patterns confirms the operation of the proposed logic device at 10 Gb/s. Maximum value of extinction ratio, contrast ratio and minimum value of amplitude modulation achieved for the different output waveforms are 12, 9.5 and 0.1 dB respectively. Easy integration with active and passive devices and simple architecture makes this device suitable for all-optical processing. [ABSTRACT FROM AUTHOR]

Background: After testing, ensuring test results are communicated and actioned is important for patient safety, with failure or delay in diagnosis the most common cause of malpractice claims in primary care worldwide. Identifying interventions to improve test communication from the decision to test through to sharing of results has important implications for patient safety, GP workload, and patient engagement. Aim: To assess the factors around communication of blood test results between primary care providers (for example GPs, nurses, reception staff) and their patients and carers. Design & setting: A mixed methods systematic review including primary studies involving communication of blood test results in primary care. Method: The review will use a segregated convergent synthesis method. Qualitative information will be synthesised using a meta-aggregative approach, and quantitative data will be meta-analysed or synthesised if pooling of studies is appropriate and data are available. If not, data will be presented in tabular and descriptive summary form. Conclusion: This review has the potential to provide conclusions about blood test result communication interventions and factors important to stakeholders, including barriers and facilitators to improved communication. [ABSTRACT FROM AUTHOR]

Acute encephalopathies or acute confusional states are among the commonest causes of hospital admissions especially among the elderly population. A treating physician needs to have a thorough knowledge of the various etiologies, clinical presentations and associations of acute encephalopathy in order to manage these patients in a timely and efficient manner. The present study was a prospective cross sectional study conducted over a period of one year aimed to know the dynamics of encephalopathy patients attending the medical emergency. Patients who met the inclusion and exclusion criteria were included after taking consent from the attendants. The mean age of the patients was 60 years for males and 61.8 years for females. About 19.7% patients admitted in emergency department had acute confusional state. The most common etiologies in the study were strokes (25.6%), metabolic (24.9%) and septic (18.5%) encephalopathies followed by seizures (13%) and intracranial infections (5%). About 35.5% cases had multiples factors responsible for encephalopathy. The most frequent symptoms besides encephalopathy included weakness on one side of the body (15.8 %), headache (14.1%), cough (12.6%), incontinence (10.7), breathlessness (10.1%) and fever (10.2%). The overall mortality in the study was 16.5%. Mortality was significantly higher in patients with weak or non-palpable pulses, hypotensive patients, patients with aberrant pupillary responses, patients admitted in winter period and obese patients. Also low mean arterial PH, oxygen saturation and mean diastolic BP and high total leukocyte count and potassium were significantly associated with mortality. [ABSTRACT FROM AUTHOR]