Yes / The purpose of this paper is to identify current UK screening practices prior to contrast-enhanced CT. To determine the patient management strategies to minimize the risk of contrast-induced acute kidney injury (CI-AKI) risk in outpatients. An invitation to complete an electronic survey was distributed to the CT managers of 174 UK adult National Health Service hospital trusts. The survey included questions related to local protocols and national guidance on which these are based. Details of the assessment of renal function prior to imaging and thresholds for contrast contraindication and patient management were also sought. A response rate of 47.1% was received. Almost all sites had a policy in place for contrast administration (n = 80/82; 97.6%). The majority of sites require a blood test on outpatients undergoing a contrast-enhanced CT scan (n = 75/82; 91.5%); however, some (15/75; 20.0%) sites only check the result in patients at high risk and a small number (7/82; 8.5%) of sites indicated that it was a referrer responsibility. The estimated glomerular filtration rate (eGFR) or serum creatinine (SCr) result threshold at which i.v. contrast was contraindicated varied and 19 different threshold levels of eGFR or SCr were identified, each leading to different prophylactic strategies. Inconsistency was noted in the provision of follow-up blood tests after contrast administration. The wide variation in practice reflects inconsistencies in published guidance. Evidence-based consensuses of which patients to test and subsequent risk thresholds will aid clinicians identify those patients in which the risk of CI-AKI is clinically significant but manageable. There is also a need to determine the value of the various prophylactic strategies, follow-up regimen and efficient service delivery pathways. This survey has identified that further work is required to define which patients are high risk, confirm those which require renal function testing prior to contrast administration and how best to manage patients at risk of CI-AKI. The role of new technologies within this service delivery pathway requires further investigation.

Thesis (Ed.D.)--Boston University / PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you. / Internet access and the increased use of course management systems to supplement classroom instruction in higher education in the last decade (Green, 1996; 2006) present instructors with opportunities to combine online and classroom instruction to enhance student learning. Computer-mediated communication tools like e-mail, discussion forums, and chat rooms available in course Web sites make it possible to continue course discussions beyond the time and space of the classroom. The interactions resulting from instructor use of the discussion board - an asynchronous communication tool available in most course management systems - in two web-enhanced courses that used Blackboard TM are investigated in this study. The most important finding of this study was the interaction and synergy between online and classroom discussions that resulted in several benefits for the professors and students. Semi-structured interviews with the professors and 26 students as well as classroom observations indicated that online and classroom discussions influence each other in web-enhanced courses, and that combining online discussions with classroom discussions can benefit both instructors and students. High student participation in classroom as well as online discussions, additional opportunities for engagement with course content, high instructor-student and student-student interaction, reflection on course readings, and exposure to multiple student perspectives were some benefits cited by both students and professors in the study. The professors reported additional benefits such as insight into students' understanding of readings and time saved planning, structuring, and grading course discussions. Based on the findings, two models for the integration of online discussions in the classroom are presented and the role played by instructional design, instructor participation, instructor feedback, and instructor use of online discussions in crafting a comprehensive learning experience are highlighted in this research. The findings of this study reinforce the importance of choices that instructors make when using technology to achieve their goals and learning objectives. The report concludes with recommendations for instructors wishing to integrate online discussions into the classroom in higher education and directions for future research. / 2999-01-01

Diffraction Enhanced Imaging (DEI) is an X-ray imaging technique providing specific information about the molecular structure of a tissue by means of coherently scattered photons. A Controlled Drift Detector (CDD) is a novel 2D silicon imager developed to be used in X-ray imaging techniques. In this work a final (complete and detailed) analysis of DEI data taken with the CDD in the ELETTRA synchrotron light source facility in Trieste (Italy) in 2005, is presented and the applicability of both this new technique and the novel detector are discussed.

Title: Optical Responses of Biomolecules on Regular Metal Plasmonic Nanostructures Author: Martin Šubr Department: Institute of Physics of Charles University Supervisor of the doctoral thesis: prof. RNDr. Marek Procházka, Dr., Institute of Physics of Charles University Abstract: Adsorption of molecules on metal plasmonic nanostructures leads to significant enhancement of many optical processes, such as Raman scattering (surface-enhanced Raman scattering - SERS) or fluorescence (surface-enhanced fluorescence - SEF). Two groups of substrates were tested within this thesis: (i) Silver nanorods prepared by oblique angle vapor deposition, and (ii) silver and gold nanoislands growing on magnetron-sputtered polytetrafluoroethylene film. Step-by- step optimization process was performed on the nanoislands in order to obtain optimum SERS sensitivity and reproducibility. Detailed SERS intensity profiles were obtained using gradient nanostructures with the localized surface plasmon resonance (LSPR) condition varying across the sample and three different excitation wavelengths. It was also found that spectral position and height of the LSPR band can be controlled simultaneously using mixed gold/silver nanoislands. Detailed investigation of polarization- and angular- dependences of anisotropic silver nanorods was...

[Truncated abstract] This study investigates the thermal stability of Plasma Enhanced Chemical Vapor Deposited (PECVD) silicon nitride thin films. Effects of heat-treatment in air on the chemical composition, atomic bonding structure, crystallinity, mechanical properties, morphological and physical integrity are investigated. The chemical composition, bonding structures and crystallinity are studied by means of X-ray Photoelectron Spectroscopy (XPS), Fourier Transform Infrared (FTIR) Spectroscopy and Transmission Electron Microscopy (TEM). The mechanical properties, such as hardness and Young’s modulus, are determined by means of nanoindentation. The morphological and physical integrity are analyzed using Scanning Electron Microscopy (SEM) . . . The Young’s modulus (E) and hardness (H) of the film deposited at 448 K were measured to have E=121±1.8 GPa and H=11.7±0.25 GPa. The film deposited at 573 K has E=150±3.6 GPa and H=14.7±0.6 GPa. For the film deposited at 573 K, the Young’s modulus is not affected by heating up to 1148 K. Heating at 1373 K caused significant increase in Young’s modulus to 180∼199 GPa. This is attributed to the crystallization of the film. For the film deposited at 448 K, the Young’s modulus showed a moderate increase, by ∼10%, after heating to above 673 K. This is consistent with the much lower level of crystallization in this film as compared to the film deposited at 573 K. In summary, low temperature deposited PECVD SiNx films are chemically and structurally unstable when heated in air to above 673 K. The main changes include oxidation to SiO2, crystallization of Si3N4 and physical cracking. The film deposited at 573 K is more stable and damage and oxidation resistant than the film deposited at 448 K.

Even in times of renewable energy revolution fossil fuels will play a major role in energy supply, transportation, and chemical industry. Therefore, increasing demand for crude oil will still have to be met in the next decades by developing new oil re-serves. To cope with this challenge, companies and researchers are constantly seeking for new methods to increase the recovery factor of oil fields. For that reason, many enhanced oil recovery (EOR) methods have been developed and applied in the field. EOR methods alter the physico-chemical conditions inside the reservoir. One possibility to achieve this is to inject an aqueous solution containing special chemicals into the oil-bearing zone. Polymers, for example, increase the viscosity of the injected water and hence improve the displacement of the oil to the production well. The injection of surfactant solutions results in reduced capillary forces, which retain the oil in the pores of the reservoir. Some surfactants form viscoelastic solutions under certain conditions. The possibil-ity to apply those solutions for enhanced oil recovery has been investigated by some authors in the last years in low salinity brines. Reservoir brines, however, often contain high salt concentrations, which have detrimental effects on the properties of many chemical solutions applied for EOR operations. The Triphenoxymethane derivatives, which were the subject of study in this thesis, form viscoelastic solutions even in highly saline brines. The aim of this thesis was to investigate the efficiency and the mode-of-action of this new class of chemical EOR molecules with respect to oil mobilization in porous media.

Even in times of renewable energy revolution fossil fuels will play a major role in energy supply, transportation, and chemical industry. Therefore, increasing demand for crude oil will still have to be met in the next decades by developing new oil re-serves. To cope with this challenge, companies and researchers are constantly seeking for new methods to increase the recovery factor of oil fields. For that reason, many enhanced oil recovery (EOR) methods have been developed and applied in the field. EOR methods alter the physico-chemical conditions inside the reservoir. One possibility to achieve this is to inject an aqueous solution containing special chemicals into the oil-bearing zone. Polymers, for example, increase the viscosity of the injected water and hence improve the displacement of the oil to the production well. The injection of surfactant solutions results in reduced capillary forces, which retain the oil in the pores of the reservoir. Some surfactants form viscoelastic solutions under certain conditions. The possibil-ity to apply those solutions for enhanced oil recovery has been investigated by some authors in the last years in low salinity brines. Reservoir brines, however, often contain high salt concentrations, which have detrimental effects on the properties of many chemical solutions applied for EOR operations. The Triphenoxymethane derivatives, which were the subject of study in this thesis, form viscoelastic solutions even in highly saline brines. The aim of this thesis was to investigate the efficiency and the mode-of-action of this new class of chemical EOR molecules with respect to oil mobilization in porous media.

Bakgrund: Inom kolorektalkirurgi är ”Enhanced Recovery After Surgery” (ERAS) ett standardiserat koncept pre-, intra- och postoperativt som syftar till snabb återhämtning efter operation. För att nå goda resultat i den postoperativa vården, där tidigt nutritionsintag och tidig mobilisering är viktiga faktorer, har patientens delaktighet visat sig vara viktig. För att utveckla omvårdnaden postoperativt och bland annat förbättra tidig mobilisering och tidigt nutritionsintag behöver de faktorer som påverkar patientdelaktigheten identifieras. Syfte: Att beskriva patienternas erfarenheter av den postoperativa vården efter genomgången kolorektalkirurgi enligt ”Enhanced Recovery After Surgery” med fokus på patientdelaktighet. Metod: Semistrukturerade intervjuer genomfördes med personer som genomgått kirurgi enligt ERAS (tio deltagare). Kvalitativ innehållsanalys användes som analysmetod. Resultat: Personerna ansåg sig vara välinformerade före operation och tyckte att de fått förståelse för konceptet, dock upplevdes loggbokens funktion vara otydlig. Alla patienter var nöjda med tiden på vårdavdelningen och resultatet visade att relationen mellan patient och vårdpersonal hade stor betydelse för återhämtningen postoperativt. Att upprätthålla god nutrition var dock en utmaning då många patienter upplevde illamående och hade svårt att äta samt dricka näringsdrycker.  Slutsats: ERAS-konceptet bidrar till trygghet för patienten genom kontinuitet och tydliga riktlinjer vilket möjliggör delaktighet och stimulerar till återhämtning efter operation. Personer med ett försvagat fysiskt utgångsläge har dock ett större behov av personalens stöttning och ett personcentrerat förhållningssätt skulle möjliggöra en individuellt anpassad vård utifrån ERAS-konceptet. Majoriteten av patienterna besväras dock av illamående postoperativt vilket har negativ påverkan på patientens återhämtning men också på upplevelsen som helhet, detta problem behöver ses över närmre för att om möjligt förbättras. / Background: In colorectal surgery ”Enhanced Recovery After Surgery” (ERAS) is a standardized pre-, intra- and postoperative concept aiming to enhance recovery after surgery. To achieve good outcome in postoperative care, early nutritional intake and early mobilisation has been identified as important factors as well as the patient´s involvement in their care. In order to develop postoperative nursing care and improve early mobilisation and early nutritional intake, factors affecting patient participation need to be identified. Aim: To describe patients experiences of the postoperative care after colorectal cancer surgery according to ”Enhanced Recovery After Surgery” with a specific focus on patient participation.   Method: Semi structured interviews were conducted with individuals undergoing surgery according to ERAS (ten participants). The interviews were analysed using a qualitative content analyze method. Result: The individuals considered themselves well informed before surgery and thought they understood the concept, but the logbook´s function was found to be unclear. All patients were satisfied with the time in the surgical care department and the results showed that the relationship between the patient and healthcare staff are of great importance for postoperative recovery. Maintaining good nutrition postoperatively, however, is a challenge when many patients experienced nausea and had difficulty eating and drinking nutritional beverages.  Conclusion: The ERAS concept contributes patient safety through continuity and clear guidelines, enabling participation and stimulating postoperative recovery. People with a weakened physical starting position, however, have a greater need for staff support and a person-centred approach would enable that, based on the ERAS concept. However the majority of patients suffer from postoperative nausea which has a negative impact on patient recovery but also on the experience as a whole, this problem has to be reviewed closer, but also improved if possible.

Esta pesquisa teve como objetivo principal propor um panorama de integração entre repositórios de dados de pesquisa e publicações científicas baseado no modelo de publicações ampliadas. Do ponto de vista de sua natureza, é básica. Segundo a abordagem é considerada qualitativa, e caracteriza-se por ser uma pesquisa exploratória e bibliográfica. O modelo de análise deste estudo foi composto por três fases. Na primeira fase de análise, foram coletadas literaturas específicas da área por meio da revisão sistemática e, a partir das literaturas, foram extraídos os requisitos indicados e sugeridos para um modelo de publicação ampliada. Na segunda fase de análise, foram selecionados os repositórios de dados de pesquisa através do diretório re3data.org e averiguadas as informações disponibilizadas por meio dos filtros que demonstrassem a utilização de ligações baseadas no modelo de publicação ampliada. Na terceira fase de análise, foi realizada a inspeção das interfaces e identificados os elementos que cada repositório contempla para posteriormente iniciar as análises, observações e comparações dos elementos utilizados nos repositórios com os requisitos estabelecidos por meio da revisão sistemática. Percebeu-se na literatura que há uma tentativa de adicionar uma estrutura utilizando-se requisitos relacionados a metadados, relacionamentos semânticos, entre outros. Verificou-se que parte dessa estrutura indicada na literatura já encontra-se nas interfaces de alguns repositórios identificados no diretório re3data.org. No entanto estes repositórios que contemplam parte da estrutura indicada foram caracterizados como uma minoria. Desta forma, verificou-se uma necessidade crescente, de uma infraestrutura compatível com as publicações ampliadas, tornando-se de extrema importância a utilização de requisitos para as interfaces dos repositórios de dados de pesquisa O cruzamento de informações realizado neste estudo permitiu um maior entendimento do quanto é importante o uso de cada um dos requisitos estipulados, como também foi possível compreender as consequências caso estes requisitos não estejam contemplados nas interfaces de repositórios. Os repositórios de dados de pesquisa deveriam fornecer em suas interfaces as ligações e o acesso às respectivas publicações científicas dos dados registrados para que fosse possível compreender os estudos realizados a partir destes dados. Foi comprovado que esse processo não ocorre na grande parte dos repositórios, o que dificulta a compreensão sobre a origem e o contexto em que foram utilizados esses dados. Percebe-se que os repositórios que não estavam de acordo com os principais requisitos estabelecidos apresentavam características de publicações convencionais como, por exemplo, documentos em PDF, textos em HTML e que não estavam de acordo com padrões da web semântica. Esta proposta de um panorama de integração de dados de pesquisa baseado em publicações ampliadas visa sugerir uma interface que contemple todos os requisitos especificados nesta pesquisa para que se tenha uma infraestrutura compatível com as publicações ampliadas. A partir da investigação e do aprofundamento sobre o tema, foi possível ampliar o conhecimento e detectar os elementos apropriados para propor um panorama de integração entre um repositório de dados de pesquisas e publicações científicas baseando-se em um modelo de publicação ampliada, como também destacar as vantagens da utilização deste modelo. Considera-se que um conjunto de dados disponíveis em um repositório digital, que contemple os requisitos, melhora a recuperação da informação e, consequentemente, aumenta a visibilidade da publicação e de autores. / This research had the main objective to propose an integration landscape between research data repositories and scientific publications based on the model for enhanced publications. From its nature`s point of view, it is basic. According to the approach it is considered a qualitative, is characterized as an exploratory, bibliographic research and a case study as well. The analysis model of this study was constituted of three phases. In first phase of the analyses, specific literatures were colected through the systematic review and from literatures, in addition the suggested requirements and indicated for a model for enhanced publications were extracted, in addition the suggested requirements and indicated for an enhanced publication model were extract. In second phase of the analyses, research data repositories were select through the re3data.org directory and were verified the information provided through the filters which demonstrated the application of links based on the model for enhanced publications. In the third and last phase of the analyses, an inspection of interfaces were realized, and also elements that each repository comprehend were identified to subsequently initiate the analyses, observations and comparisions of the elements used on repositories with the estabilished requirements through systematic review. It was perceived in the literature, that there are an attempt to add a structure by using related requirements to metadata, semantic relationship, among others. Also verified that part of this estructure indicated on literature is available on interfaces of some identified repositories on re3data.org. Although these repositories which comprehend part of the indicated structure were characterized as a minority.( Continue) Therefore, there has been a growing need for an infrastructure compatible with the enhanced publications, aware of the importance for the application of requirements to the interfaces of research data repositories. The crossover of informations realized in this study allowed a greater understanding about the importance to use each one of the stipulated requirements, as well as was possible to understand the consequences in case of these requirements are not be included in the repositories interfaces. Research data repositories should provide on their interfaces the links and access to their respective scientific publications of the recorded data in order to be able to understand the studies carried out from this data. It has been proven that this process does not occur in most repositories, which difficults to understand the origin and context in which these data were used. It was noticed that repositories not in agreement with the main presented established requirements characteristics of conventional publications, as for example PDF documents, HTML texts and which was not in accordance to patterns for semantic web. This proposal for a research data integration model based on enhanced publications aims to suggest an interface that that fulfills all the specified requirements in this research to obtain an infrastructure compatible to enhanced publications. From the investigation and deepening the theme, it was possible to increase the knowledge and to detect the appropriate elements to propose an integration model between a researches data repository and scientific publications based on a model for enhanced publication as well as highlighting the advantages of applying this model. Thus, it is concluded that a set of available data into a digital repository that comprehend the requirements improves the information recovery and, therefore, increases the visibility of publication and authors.

This thesis describes the development a new swarm-enhanced sampling methodology and its application to the exploration of biologically relevant molecules. First, the development of a new multi-dimensional swarm-enhanced sampling molecular dynamics (msesMD) approach is detailed. Relative to the original swarm-enhanced sampling molecular dynamics (sesMD) methodology, the msesMD method demonstrates improved parameter transferability, resulting in more extensive sampling when scaling to larger systems such as alanine heptapeptide. The implementation and optimisation of the swarm-enhanced sampling algorithms in the AMBER software suite are also described. Through the use of the newer pmemd molecular dynamics (MD) engine and asynchronous MPI routines, speedups of up to three times the original sesMD implementation were achieved. The msesMD method is then applied to the investigation of carbohydrates, first looking at rare conformational changes in Lewis oligosaccharides. Validating against multi-microsecond unbiased MD trajectories and other enhanced sampling methods, the msesMD simulations identified rare conformational changes leading to the adoption of non-canonical unstacked core trisaccharide structures. Next, the use of msesMD as a tool to probe pyranose ring pucker events is explored. Evaluating against four benchmark monosaccharide systems, msesMD simulations accurately recover puckering details not easily obtained via multi-microsecond unbiased MD. This was followed by an exploration of the impact of ring substituents on conformation in glycosaminoglycan monosaccharides: through msesMD simulations, the influence of specific sulfation patterns were explored, finding that in some cases, such as 4-O-sulfation in N-acetyl-galactosamine, large changes in the relative stability of ring conformers can arise. Finally, the msesMD method was coupled with a thermodynamic integration scheme and used to evaluate solvation free energies for small molecule systems. Comparing against independent trajectory TI simulations, it was found that although the correct solvation free energies were obtained, the msesMD based method did not offer an advantage over unbiased MD for these small molecule systems. However, interesting discrepancies in free energy estimates arising from the use of hydrogen mass repartitioning were found.