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Introduction: High-fidelity simulation is frequently utilized in medical education. Its use in the neurosciences is limited by the inherent limitations of the manikin to simulate neurological changes. We report here the use of a hybrid simulation – a combination of lecture and high-fidelity manikin – in the education of neurosciences nurses, involved in care of neurocritical care patients. Methods: Neurosciences nurses from at the University of Missouri, Columbia, MO, USA, which is an academic, tertiary-care medical center participated in the simulation during Spring of 2016. The simulation involved a patient presenting with acute intracerebral hemorrhage (ICH) who neurologically deteriorated to brain death. Pre- and post-simulation questionnaires were administered using a questionnaire with five-point Liker scale. Results: Seventy-two responses were returned. The majority had 0-5 years of nursing experience with 83.8% having prior critical care experience. Pre-simulation, the majority of nurses (85.7%) agreed or strongly agreed with managing patients with ICH. When the responses of “agree” were compared to “strongly agree”, a significant improvement (p

Introduction. Central hyperthermia is common in patients with brain injury. It typically has a rapid onset with high temperatures and marked fluctuations and responds poorly to antibiotics and antipyretics. It is also associated with worse outcomes in the brain injured patient. Recognizing this, it is important to aggressively manage it. Case Report. We report a 34-year-old male with a right thalamic hemorrhage extending to the midbrain and into the ventricles. During his admission, he developed intractable fevers with core temperatures as high as 39.3°C. Infectious workup was unremarkable. The fever persisted despite empiric antibiotics, antipyretics, and cooling wraps. Bromocriptine was started resulting in control of the central hyperthermia. The fever spikes were reduced to minor fluctuations that significantly worsened with any attempt to wean off the bromocriptine. Conclusion. Diagnosing and managing central hyperthermia can be challenging. The use of bromocriptine can be beneficial as we have reported.

Introduction. Management of postoperative central diabetes insipidus (DI) can be challenging from changes in volume status and serum sodium levels. We report a case successfully using a dilute vasopressin bolus protocol in managing hypovolemic shock in acute, postoperative, central DI. Case Report. Patient presented after bifrontal decompressive craniotomy for severe traumatic brain injury. He developed increased urine output resulting in hypovolemia and hypernatremia. He was resuscitated with intravenous fluids including a dilute vasopressin bolus protocol. This protocol consisted of 1 unit of vasopressin in 1 liter of 0.45% normal saline. This protocol was given in boluses based on the formula: urine output minus one hundred. Initial serum sodium was 148 mmol/L, and one-hour urine output was 1 liter. After 48 hours, he transitioned to 1-desamino-8-D-arginine vasopressin (DDAVP). Pre-DDAVP serum sodium was 149 mmol/L and one-hour urine output 320 cc. Comparing the bolus protocol to the DDAVP protocol, the average sodium was 143.8 ± 3.2 and 149.6 ± 3.2 mmol/L (p=0.0001), average urine output was 433.2 ± 354.4 and 422.3 ± 276.0 cc/hr (p=0.90), and average specific gravity was 1.019 ± 0.009 and 1.016 ± 0.01 (p=0.42), respectively. Conclusion. A protocol using dilute vasopressin bolus can be an alternative for managing acute, central DI postoperatively, particularly in setting of hypovolemic shock resulting in a consistent control of serum sodium.

Introduction. Dedicated neurointensivists have been shown to improve outcome measurements in the neurosciences intensive care unit (NSICU). Quality outcome data in relation to patient and family satisfaction is lacking. This study evaluated the impact of newly appointed neurointensivists and creation of a neurocritical care team on quality outcome measures including patient satisfaction in a NSICU. Methods. This is a retrospective study of data over 36 months from a 14-bed NSICU evaluating quality outcome measures and anonymous patient satisfaction questionnaires before and after neurointensivists appointment. Results. After appointment of neurointensivists, patient acuity of the NSICU increased by 33.4% while LOS decreased by 3.5%. There was a decrease in neurosciences mortality (35.8%), catheter-associated urinary tract infection (50%), central line associated bloodstream infection (100%), and ventilator-associated pneumonia (50%). During the same time, patient satisfaction increased by 28.3% on physicians/nurses consistency (p=0.025), by 69.5% in confidence/trust in physicians (p<0.0001), by 78.3% on physicians treated me with courtesy/respect (p<0.0001), and by 46.4% on physicians’ attentiveness (p<0.0001). Ultimately, patients recommending the hospital to others increased by 67.5% (p<0.0001). Conclusion. Dedicated neurointensivists and the subsequent development of a neurocritical care team positively impacted quality outcome metrics, particularly significantly improving patient satisfaction.

Previous literature on student employment within campus recreation departments has focused on a variety of work-related factors, but has been limited by examining single institutions. The current study extended this area of research by examining 290 recreation student employees at 11 institutions located throughout the United States to determine how important five work-related variables were to student employment. Results indicated all variables were rated high in importance, but ability to work around class schedules was most important. Results also indicated that females believe pay rate is more important than males, first year employees do not desire supervisory roles as much as students with more work experience, and students who have supervisory responsibilities find these roles more important than students without such roles. These results can be used by recreation administrators to better understand the priorities of their employees, which ultimately could impact quality of work.

An across-subjects multiple-baseline design was used to evaluate the effects of solution-focused guided imagery (SFGI) on putting yips (e.g., jerk in the putting stroke) in three experienced (24 years or more), accomplished (handicap less than 7), male golfers located in the Southeastern United States. Each golfer participated in at least five SFGI sessions designed to guide him to create vivid images of thinking, feeling, and behaving in ways devoid of the problem (i.e., putting with a smooth continuous stroke). Data collected during participants’ regularly scheduled weekly golf rounds showed an immediate and sustained decrease in yips after SFGI sessions. Maintenance data collected three weeks after the last sessions showed that these decreases were maintained. Discussion focuses on future research and practice related to treatment of the yips and similar focal hand dystonia.

Lanthanum Strontium Manganate (LSM) powders were synthesised by six different routes, namely solid state reaction, drip pyrolysis, citrate, sol–gel, carbonate and oxalate co-precipitation. The LSM samples, produced by firing to 1000°C for 5 h were then characterised by way of XRD, TPD’s of oxygen, TPR and catalytic activity for a simple oxidation reaction, that of carbon monoxide to carbon dioxide. It was found that although the six samples had similar compositions and surface areas they performed quite differently during catalytic characterisation. These observed differences correlated more closely to the mode of synthesis, than to the physical properties of the powders, or their impurity levels, indicating that the surface structures created by the different syntheses perform very differently under catalysis conditions. Co-precipitation and drip pyrolysis produced structures that were most efficient at facilitating oxidation type reactions.

This paper applies to individuals charged with maintaining the reliability of shell and tube heat exchangers. These persons typically specify and/or retain the services of others to examine heat exchangers with nondestructive test methods, such as eddy current and are responsible for submitting run-repair-replace recommendations to management. Electromagnetic Testing (ET) uses the electromagnetic characteristics of components made of conductive materials to determine their condition. Eddy Current Testing (ECT), an electromagnetic method that utilizes induced electrical currents, is usually used to examine non-ferromagnetic materials. ECT’s high rate of examination, relatively good accuracy with thin wall components, repeatability and volumetric measurement make it an ideal method for examining nonmagnetic heat exchanger tubes. This paper will provide a brief description of the method, concentrating on ECT because most power generation industry heat exchanger tubing is non-ferromagnetic in nature. This paper will also address the following: • Training and Certification of Technicians. • ET signal analysis, an exacting science? • ASME Section V, Appendix II vs. Appendix VIII for in-situ ECT of all heat exchanger tubing. • Signal analysis variables and limitations. • A need to know the potential degradation mechanisms. • Condition assessment vs. eddy current testing.

FT Raman spectroscopy has been used to characterise the composition of the oxalate precursor to YBCO superconductors. By comparison to spectra of barium, copper and yttrium oxalate it is concluded that the co-precipitate incorporates not only the individual oxalate species but also a species ascribed to a mixed oxalate system. Significantly, Raman spectroscopy demonstrated that the precursor was not amorphous as previously deduced from XRD studies. In contrast, it is hypothesised that the sample consists of very small crystalline particles.

The complex indices of refraction for crystalline gypsum and calcite were determined from reflectance measurements for both single crystals and pressed powder pellets. These optical constants were determined from a classical dispersive analysis (DA) of the reflectance data to facilitate comparisons between the crystal and powdered data. This study was done to show the usefulness and the limitations of using pressed pellets for determining the complex refractive index of materials unavailable in single crystals.

Reflectance speculaire de pastilles de montmorillonite preparees sous differentes pressions et pour differentes rugosites de surface

This paper describes outbreaks of Salmonella Typhimurium phage type 197 (STm197) linked to eggs from the farm of a single egg producer. Epidemiological and microbiological investigations (genotyping by multiple locus variable number tandem repeats analysis [MLVA]) identified outbreaks of STm197 with the same or closely-related MLVA profiles in a series of restaurants across Brisbane over 2 months. Environmental health investigations revealed that these restaurants were supplied with eggs from the same egg producer and that cross-contamination may have contributed to the outbreak. Environmental swabs taken from restaurant kitchens and the farm of the egg producer identified a number of salmonellas including STm197, many with MLVA profiles matching or closely related to the human strains from outbreak cases. A case-to-case comparison study showed a significant association between illness with 1 MLVA type and attending a restaurant during the 5 days before onset of illness (odds ratio [OR] 8.1, 95% confidence interval [CI] 1.8, 35.4). MLVA has become a valuable tool for S. Typhimurium surveillance and outbreak investigation. This outbreak further justifies the Commonwealth Government's decision to develop a draft national primary production and processing standard for eggs and egg products to address food safety risks posed by cracked and dirty eggs.

Two-dimensional optical effects were observed for surface electromagnetic waves (SEW) on metals at lambda = 3.55 cm. Refractive processes with prisms and lenses established Snell's law experimentally. Reflection with prisms and metal sheets established the law of reflection and indicated that radiative losses were small and that Fresnel's equations hold to a good approximation for the reflectivities of SEW. A two-dimensional SEW grating was made and first-order diffraction observed. Although the experiments were performed at microwave frequencies, the principles are usable for two-dimensional SEW optics at least as far as the near ir. It was shown that the propagation constant of the SEW with an overlayer material is as though the SEW propagates entirely in the overlayer material. That is, losses in the metal substrate were negligible.

The important parameters governing the propagation of surface electromagnetic waves (SEW) on metals or polar insulators have been theoretically investigated. General approximations for the propagation distance, decay distance, and penetration depth are presented in summary tables. It is found that the propagation distance of SEW can be used to study overlayer materials on metals, that the penetration depth of SEW fields into a metal is governed by the classical skin depth at low frequencies and by the plasma frequency in the visible wavelength region, that surface phonons can propagate over a centimeter on PbS, PbTe, and ferroelectrics, and that the propagation distances of SEW increase with decreasing temperature.

The theory of multielement grid filters is derived and compared with experiment. The properties of the filters can be predicted from a knowledge of the characteristics of the individual grids. The filters are treated as asymmetric Fabry-Perot interferometers coupled and in series. Room temperature and low temperature data for combination filters are presented. The fabrication techniques and materials are described for filters in a dielectric.

The propagation distances, L x , of surface electromagnetic waves on metal-air and semiconductor-metal-air systems were measured using the two prism technique in the far infrared (84.2 cm −1 ). Copper, gold, palladium, tungsten, nickel, steel, and platinum metal-air interfaces were studied. Also semiconductor-metal-air systems consisting of Pt films of varying thickness deposited on single crystal GaAs substrates were examined. The experimental values for L x were found to be orders of magnitude lower than theoretical values for these metals.

The propagation distances, L x , of surface electromagnetic waves (SEW) on Ni, Pd, Pt, and W were measured using the two-prism coupling technique at wavelengths from 9.3 to 10.6 microm. Metal samples consisted of films, deposited on glass substrates by electron beam deposition, and metal foils. The measured L x values for the Pd and Pt firms and Pt foil agree to within 20% of the calculated values from the two-media dispersion relation. The measured values of the propagation distance for the Ni film and foil and the W foil agree to within 50% of the calculated L x . Scanning electron microscope (SEM) photographs and Auger analysis indicate that film imperfections and foil surface roughness contributed to the lower propagation distances observed for Pt and Pd while imperfections, roughness, and oxidation contributed to the disagreement between measured and calculated propagation distance for Ni and W.

Surface-electromagnetic-wave dispersion curves are usually calculated using a simple equation derived from Maxwell's equations and boundary conditions. When complex dielectric functions are used for the two media, the component of the propagation vector along the surface, ${k}_{x}$, becomes infinite as the frequency approaches the surface polariton frequency ${\ensuremath{\omega}}_{s}$ if $\ensuremath{\omega}$ is considered complex and ${k}_{x}$ is real. On the other hand, if ${k}_{x}$ is considered complex and $\ensuremath{\omega}$ real, the dispersion curves bend back toward smaller ${k}_{x}$ as $\ensuremath{\omega}$ approaches ${\ensuremath{\omega}}_{s}$. We have previously demonstrated that both types of behavior can be obtained from attenuated-total-reflection measurements of silver. We now extend this result to other materials and show that dispersion curves alone present an inadequate summary of the data.

The propagation distance of surface electromagnetic waves on a copper-cuprous oxide-air system was measured using two prism couplers, for oxide thickness between 20 A and 2000 A, and wavelengths from 9.2 μm to 10.8 μm. The copper sample consisted of an evaporated copper film on glass, with an oxide film overlayer grown by heating in air. The measured values of propagation distance agree well with computer-calculated solutions of the three-media dispersion relation. Similar measurements made on a polished surface of rolled titanium, oxidized by heating in air, give agreement only to within 50%. Auger analysis indicated that a carbide impurity on the highly reactive titanium surface and a variation of the titanium oxide composition with thickness both contributed to the disagreement between measured and calculated values of propagation distance.

In the infrared surface electromagnetic waves (SEW) can propagate several centimeters over a metal and some ferroelectrics. Therefore SEW can be used to integrate overlayer surface absorption over very much larger path lengths than in the usual transmission and reflection surface studies. Using a continuum model, we have calculated the surface electromagnetic wave modes for a dielectric slab on a metal against a third (weakly absorbing) medium. Unlike previous treatments, absorption has been included and the absorption expected using the two prism SEW technique has been calculated. For a thick slab (1 mm or more), we show that the absorption coefficient of the slab material can be obtained very simply. For very thin slabs both surface-plasmon-like modes and surface-phonon-like modes (including Fuchs-Kliewer modes) are found. A new parameter Δ1 + iΔ2 is introduced to describe the thin film absorption. It has the physical significance of an effective susceptibility for the metal-coating-overlayer system. Further, its experimental significance is that for the normalized transmission of SEW between two prisms, Δ2 is a dominating parameter which can be measured. For the two prism experiments, numerical examples show 50 percent absorption at peak for a monolayer of CO on Pt and a 4 percent absorption for CuO on copper. Applications to the study of thin films, catalysis, corrosion and other surface problems are anticipated.

The spectral response of an n-type InSb bolometer and a Golay detector were compared between about 10 and 100 cm−1. The optical systems were held nearly constant and major wave number dependent deviations were removed from the data. The relative responsivities are given with the detector, cathode followers, and preamplifiers treated as a single component with the detector.

The far infrared (84.2 cm −1 ) propagation distance of surface electromagnetic waves on samples of single crystal GaAs with varied carrier concentrations has been measured using the twoprism technique. The experimental propagation distances agree well with theoretical values obtained from computer calculations using the exact two media dispersion relation. It was found that the propagation of the SEW is strongly dependent upon the free carrier concentration of the GaAs sample as expected. It is demonstrated that a simple classical theory of SEW works for GaAs-air interfaces in the far infrared.

We assume complex magnetic and dielectric properties of two adjacent, isotropic, semi-infinite media and examine surface electromagnetic waves (SEW) at their plane interface. The dispersion curves and non-radiative conditions are derived and compared with other results. Comments are made about which materials will allow surface electromagnetic waves. The importances of the dielectric constants of the sample and the overlayer materials are emphasized with an example, Si and NiO.

The d ±1 levels are numerically located for the shallow donor impurity when the impurity is at the semiconductor surface for both silicon and germanium. d 0 , d ±2 , and for high n the s, p 0 , and p ±1 levels are found for the case of the impurity somewhere in the bulk material. Generalized energy equations, trial wave functions, effective Bohr radii, and some relative electric-dipole transition probabilities are given.

Exact propagation constants and Poynting vectors are calculated for surface excitations at an interface between two media with complex dielectric functions. It is found that the electric fields associated with the surface excitations decay as damped oscillating exponentials. It is also found that the mean-free-paths can be of the order of meters, even in the presence of damping. At intermediate frequencies, the surface plasmon mean-free-paths are proportional to the free carrier lifetime.

The longitudinal optical phonon‐plasmon interaction theory of Varga is shown to be applicable to Gadoped CdS through the region of the first reflectivity minumum (2.5 to about 30 μ). The theoretical reflectivity vs wavelength for several concentrations of Ga‐doped CdS are compared with experiment. The agreement between theory and experiment is particularly good for high dopant concentrations. A plot of the wavelength at minimum reflectivity vs impurity concentrations shows that the Varga theory does well in explaining the data. When phonon damping is introduced into the Varga dielectric function, the reflectivity over the whole region of resonance is more realistic. Finite plasmon lifetime is not considered since no data are available for CdS.

The reflectivity of $n$-type InSb has been measured in the far infrared. The doping of the samples was such that the free-carrier plasma frequency was near the LO mode frequency. The results suggest that samples with a sufficiently thick damage layer show effects due to surface plasmons. Use of a simple model indicates that the surface-plasma excitations are coupled to the phonons.

Pour caracteriser les proprietes optiques des materiaux on utilise: l'indice de refraction complexe, la fonction dielectrique complexe, l'impedance complexe normalisee et la conductivite complexe. On presente les relations entre ces quatre quantites dans le modele de Drude pour les metaux

Infrared optical constants collected from the literature are tabulated. The data for the noble metals and Al, Pb, and W can be reasonably fit using the Drude model. It is shown that -epsilon1(omega) = epsilon2(omega) approximately omega(2)(p)/(2omega(2)(tau)) at the damping frequency omega = omega(tau). Also -epsilon1(omega(tau)) approximately - (1/2) epsilon1(0), where the plasma frequency is omega(p).