In‐center hemodialysis attendance: Patient perceptions of risks,barriers, and recommendations

Missed hemodialysis treatments lead to increased morbidity and mortality in the end‐stage renal disease population. Little is known about why patients have difficulty attending their scheduled in‐center dialysis treatments. Semistructured interviews with 15 adherent and 15 nonadherent hemodialysis patients were conducted to determine patients' attitudes about dialysis, health beliefs and risk perception regarding missed treatments, barriers and facilitators to hemodialysis attendance, and recommendations to improve the system to facilitate dialysis attendance. Average time on dialysis was 2.5 years for the nonadherent group and 7.3 years in the adherent group. In both groups, patients felt that dialysis is life‐saving and a necessity. A substantial number of patients in both groups understood that missing hemodialysis treatments is dangerous and several patients could clearly communicate the risk of skipping. The most common barriers to hemodialysis were inadequate or unreliable transportation (mentioned in both groups) and a lack of motivation to get to dialysis or that dialysis is not a priority (typically mentioned by the nonadherent group). Facilitators to hemodialysis attendance included explanations from the health care team regarding the risk of skipping and relationships with other dialysis patients. Patient recommendations to improve dialysis attendance included continued education about the risk of poor attendance and more accessible transportation. Patients did not feel that home dialysis would improve adherence. Hemodialysis patients must adhere to a complex and burdensome regimen. Through the elucidation of barriers and facilitators to hemodialysis attendance and through specific patient recommendations, at least three interventions may be further investigated to improve hemodialysis attendance: Improvement of the transportation system, education and supportive encouragement from the health care team, and peer support mentorship.     

Anthropogenic forcing of estuarine hypoxic events in sub-tropical catchments: landscape drivers and biogeochemical processes

Episodic hypoxic events can occur following summer floods in sub-tropical estuaries of eastern Australia. These events can cause deoxygenation of waterways and extensive fish mortality. Here, we present a conceptual model that links key landscape drivers and biogeochemical processes which contribute to post-flood hypoxic events. The model provides a framework for examining the nature of anthropogenic forcing. Modification of estuarine floodplain surface hydrology through the construction of extensive drainage networks emerges as a major contributing factor to increasing the frequency, magnitude and duration of hypoxic events. Forcing occurs in two main ways. Firstly, artificial drainage of backswamp wetlands initiates drier conditions which cause a shift in vegetation assemblages from wetland-dominant species to dryland-dominant species. These species, which currently dominate the floodplain, are largely intolerant of inundation and provide abundant labile substrate for decomposition following flood events. Decomposition of this labile carbon pool consumes oxygen in the overlying floodwaters, and results in anoxic conditions and waters with excess deoxygenation potential (DOP). Carbon metabolism can be strongly coupled with microbially-mediated reduction of accumulated Fe and Mn oxides, phases which are common on these coastal floodplain landscapes. Secondly, artificial drainage enhances discharge rates during the flood recession phase. Drains transport deoxygenated high DOP floodwaters rapidly from backswamp wetlands to the main river channel to further consume oxygen. This process effectively displaces the natural carbon metabolism processes from floodplain wetlands to the main channel. Management options to reduce the impacts of post-flood hypoxia include i) remodifying drainage on the floodplain to promote wetter conditions, thereby shifting vegetation assemblages towards inundation-tolerant species, and ii) strategic retention of floodwaters in the backswamp wetlands to reduce the volume and rate during the critical post-flood recession phase.     

最大化利用老化的输电和配电设施

正输电和配电设施已成为美国电力公用事业的高管们最关注的事情。电力企业在对待输电设施时,应从基于设备年龄的模式转变为基于设备性能的模式,不仅要关注故障概率,还要关注保养和维修的费用。截至2010年,美国70%的输电线路和电力变压器至少已经服役超过25年,60%的断路器服役已经超过30年。Brattle Group预计美国需要在2010年到2030年间投资8793亿美元用于电力传输设施,其中的5815亿美元将用于配电设施,1134亿美元将用于主输电网(230kV及以上),1844亿美元将用于低压输电设施。     

Folate intake of older adults before and after fortification of grain products.

PURPOSE: To determine whether fortification allowed older adults in the Kingston, Frontenac, and Lennox & Addington (KFL&A) Public Health area to obtain adequate amounts of food folate, and the proportion at risk of consuming more than the upper limit (UL) of folic acid (1,000 mcg). METHODS: Dietary intake of a convenience sample of 103 healthy, active older adults (age range: 65 to 95 years) was measured using three 24-hour recalls. Dietary folate pre- and post-fortification was estimated. RESULTS: Mean dietary folate increased from pre- to post-fortification, but 43.4% of women and 20% of men still consumed less than the Estimated Average Requirement of 320 mcg dietary folate equivalent. No intakes exceeded the UL. Participants whose diet met grain products and vegetable and fruit recommendations of Canada's Food Guide to Healthy Eating consumed significantly more folate. CONCLUSIONS: Despite fortification, some older adults in the KFL&A area may not be obtaining enough folate to meet their nutritional needs, and may be at risk for health problems associated with folate deficiency. However, without concomitant serum folate measurements, the proportion is not known. Dietitians need to continue promoting foods naturally rich in folate, along with folic acid-fortified foods. While none of the older adults consumed more than the UL, some could exceed this amount if folic acid supplements were added to a folic acid-rich diet.     

The effect of polymer coatings on proton transverse relaxivities of aqueous suspensions of magnetic nanoparticles

Iron oxide magnetic nanoparticles are good candidates for magnetic resonance imaging (MRI) contrast agents due to their high magnetic susceptibilities. Here we investigate 19 polyether-coated magnetite nanoparticle systems comprising three series. All systems were synthesized from the same batch of magnetite nanoparticles. A different polyether was used for each series. Each series comprised systems with systematically varied polyether loadings per particle. A highly significant (p < 0.0001) linear correlation (r = 0.956) was found between the proton relaxivity and the intensity-weighted average diameter measured by dynamic light scattering in the 19 particle systems studied. The intensity-weighted average diameter measured by dynamic light scattering is sensitive to small number fractions of larger particles/aggregates. We conclude that the primary effect leading to differences in proton relaxivity between systems arises from the small degree of aggregation within the samples, which appears to be determined by the nature of the polymer and, for one system, the degree of polymer loading of the particles. For the polyether coatings used in this study, any changes in relaxivity from differences in water exclusion or diffusion rates caused by the polymer are minor in comparison with the changes in relaxivity resulting from variations in the degree of aggregation.     

Performance of lactating dairy cows fed tall fescue forage

Two trials were conducted during consecutive summers to compare performance of lactating cows fed four varieties of tall fescue soilage. The first trial was conducted in 1983 and the second in 1984 using 25 midlactation Holsteins. Treatments included endophyte-free Kenhy; 8.1% endophyte-infected Johnstone (a prevarietal release); endophyte-free Kentucky 31; 63% endophyte-infected Kentucky 31; and orchardgrass or alfalfa as controls. In 1983, concentrate was fed twice each day at the rate of 4.1 kg per feeding, and in 1984, 4.5 kg were fed twice daily for first 4 wk and 4.1 kg per feeding thereafter. Intake of Kenhy was higher than all other tall fescue treatments when data for both trials were combined. Means of the high endophyte Kentucky 31 group were lower than all other treatments during both trials for milk yield, dry matter intake, body weight change, and serum prolactin in 1984 while higher for rectal temperature. Improved intake and performance of the cows consuming Kenhy compared with those consuming endophyte-free Kentucky 31 indicated the improved forage quality of this variety. Decreased performance of dairy cows consuming endophyte-infected tall fescue, even at a relatively low infection, was evident.     

Get the picture? The effects of iconicity on toddlers' reenactment from picture books.

What do toddlers learn from everyday picture-book reading interactions? To date, there has been scant research exploring this question. In this study, the authors adapted a standard imitation procedure to examine 18- to 30-month-olds' ability to learn how to reenact a novel action sequence from a picture book. The results provide evidence that toddlers can imitate specific target actions on novel real-world objects on the basis of a picture-book interaction. Children's imitative performance after the reading interaction varied both as a function of age and the level of iconicity of the pictures in the book. These findings are discussed in terms of children's emerging symbolic capacity and the flexibility of the cognitive representation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Interlayer Transition in a vdW Heterostructure toward Ultrahigh Detectivity Shortwave Infrared Photodetectors

Van der Waals (vdW) heterostructures of 2D atomically thin layered materials (2DLMs) provide a unique platform for constructing optoelectronic devices by staking 2D atomic sheets with unprecedented functionality and performance. A particular advantage of these vdW heterostructures is the energy band engineering of 2DLMs to achieve interlayer excitons through type‐II band alignment, enabling spectral range exceeding the cutoff wavelengths of the individual atomic sheets in the 2DLM. Herein, the high performance of GaTe/InSe vdW heterostructures device is reported. Unexpectedly, this GaTe/InSe vdWs p–n junction exhibits extraordinary detectivity in a new shortwave infrared (SWIR) spectrum, which is forbidden by the respective bandgap limits for the constituent GaTe (bandgap of ≈1.70 eV in both the bulk and monolayer) and InSe (bandgap of ≈1.20–1.80 eV depending on thickness reduction from bulk to monolayer). Specifically, the uncooled SWIR detectivity is up to ≈10¹⁴ Jones at 1064 nm and ≈10¹² Jones at 1550 nm, respectively. This result indicates that the 2DLM vdW heterostructures with type‐II band alignment produce an interlayer exciton transition, and this advantage can offer a viable strategy for devising high‐performance optoelectronics in SWIR or even longer wavelengths beyond the individual limitations of the bandgaps and heteroepitaxy of the constituent atomic layers.     

Comparison of the magnetic recording performance of medium-scale ring, double-sided pole, metal-in-gap heads on high-coercivity longitudinal media

The magnetic recording performance of medium-scale ring, double-sided pole, and metal-in-gap (MIG) heads were investigated on standard longitudinal high-coercivity floppy, video tape, and isotropic floppy media using a stretched-surface multi-head magnetic recording tester. The isolated pulses for the ring and MIG heads exhibited sharp peaks near tbe edges of the gap for a head-medium separation of less than 0.1 um. Low density maximum output voltage was independent of the type of the write head. The largest output voltage was achieved from the MIG head. The isolated outputs on video media agreed with calculated values for the ring head efficiency set to 52% and the pole head efficiency set to 33% using the Karlqvist head field approximation.