ABSTRACT
We describe a quality improvement initiative aimed at achieving interdisciplinary consensus about the appropriate delivery of extracorporeal membrane oxygenation (ECMO). Interdisciplinary rounds were implemented for all patients on ECMO and addressed whether care was consistent with a patient's minimally acceptable outcome, maximally acceptable burden, and relative likelihood of achieving either. The rounding process was associated with decreased days on venoarterial ECMO, from a median of 6 days in 2014 (first quartile [Q1]-third quartile [Q3], 3-10) to 5 days in 2015 (Q1-Q3, 2.5-8) and in 2016 (Q1-Q3, 1-8). Our statistical methods do not allow us to conclude that this change was due to our intervention, and it is possible that the observed decreases would have occurred whether or not the rounding process was implemented.
Subject(s)
Consensus , Extracorporeal Membrane Oxygenation/standards , Length of Stay , Patient Care Team/standards , Quality Improvement/standards , Extracorporeal Membrane Oxygenation/methods , Humans , Respiratory Insufficiency/diagnosis , Respiratory Insufficiency/therapy , Retrospective StudiesABSTRACT
Fate and transport analysis has been performed to evaluate potential exposures to cadmium (Cd) from cadmium telluride (CdTe) photovoltaics (PV) for rainwater leaching from broken modules in a commercial building scenario. Leaching from broken modules is modeled using the worst-case scenario of total release of Cd, and residential screening levels are used to evaluate potential health impacts to on-site workers and off-site residents. A rooftop installation was considered rather than a ground-mount installation because rainwater runoff is concentrated via building downspouts in a rooftop installation rather than being dispersed across large areas in a ground-mount installation. Fate and transport of Cd from leachate to soil are modeled using equilibrium soil/soil-water partitioning. Subsequent migration to ambient air as windblown dust is evaluated with a screening Gaussian plume dispersion model, and migration to groundwater is evaluated with a dilution-attenuation factor approach. Exposure point concentrations in soil, air, and groundwater are one to six orders of magnitude below conservative (residential soil, residential air, drinking water) human health screening levels in both a California and southern Germany (Baden-Württemberg) exposure scenario. Potential exposures to Cd from rainwater leaching of broken modules in a commercial building scenario are highly unlikely to pose a potential health risk to on-site workers or off-site residents.
Subject(s)
Air Pollutants/analysis , Cadmium Compounds/analysis , Soil Pollutants/analysis , Tellurium/analysis , Water Pollutants, Chemical/analysis , California , Environmental Exposure , Germany , Humans , Models, Chemical , Risk Assessment , Soil/analysis , Solar Energy , Water MovementsABSTRACT
Tooth whitening has become a very popular procedure. Advertisements for whitening products imply that whiter teeth are more attractive than yellower teeth. We tested this idea empirically by manipulating the tooth color of pictures of male and female targets. Participants' ratings of attractiveness were not influenced by tooth color. Exp. 2 yielded a negative correlation between attractiveness and age ratings: targets judged to be older were rated as less attractive. Unless whiter teeth help in some other way, e.g., improved self-esteem or confidence, it seems that tooth whitening procedures or products are not associated with increased attractiveness to others.
Subject(s)
Attitude , Beauty , Esthetics, Dental , Tooth Bleaching/psychology , Tooth Discoloration/psychology , Adult , Aging/psychology , Female , Humans , Male , Middle Aged , Sex Factors , Social PerceptionABSTRACT
Chicken frankfurter emulsions were challenged with ca. 1000 C. bolulinum spores/g and incubated at 27°C. Botulinal toxin formation was delayed by the addition of nisin or nitrite, either singly or in combination. In the absence of nisin or nitrite, samples became toxic within 1 wk. A 4-wk extension of shelf-life was achieved by addition of 156 ppm nitrite. The addition of 500 ppm nisin allowed only a 1-wk extension of shelf-life. The addition of 100 or 250 ppm nisin together with 120 ppm nitrite was superior to addition of 156 ppm nitrite, whereas the addition of 100 or 250 ppm nisin together with 80 ppm nitrite was somewhat less effective than 156 ppm nitrite. In TPYG broth, an adjuvant effect was observed between nisin and nitrite. Levels of nisin and nitrite that were not effective in TPYG broth when used alone did prevent spore outgrowth when used in combination.
