157 research outputs found
Use of child death review to inform sudden unexplained infant deaths occurring in a large urban setting
No full textHealthcare queueing models.
No full textHealthcare systems differ intrinsically from manufacturing systems. As such, they require a distinct modeling approach. In this article, we show how to construct a queueing model of a general class of healthcare systems. We develop new expressions to assess the impact of service outages and use the resulting model to approximate patient flow times and to evaluate a number of practical applications. We illustrate the devastating impact of service interruptions on patient flow times and show the potential gains obtained by pooling hospital resources. In addition, we present an optimization model to determine the optimal number of patients to be treated during a service session.Operations research; Health care evaluation mechanisms; Organizational efficiency; Management decision support systems; Time management; Queueing theory;
Mid-season prediction of wheat-grain yield potential using plant, soil, and sensor measurements
No full textThe components that define cereal-grain yield potential have not been well defined. The objective of this study was to collect many differing biological measurements from a long-term winter wheat (Triticum aestivum L.) study in an attempt to better define yield potential. Four treatments were sampled that annually received 0, 45, 90, and 135 kg N ha-1 at fixed rates of phosphorus (P) (30 kg ha-1) and potassium (K) (37 kg ha -1). Mid-season measurements of leaf color, chlorophyll, normalized difference vegetative index (NDVI), plant height, canopy temperature, tiller density, plant density, soil moisture, soil NH4-N, NO3-N, organic carbon (C), total nitrogen (N), pH, and N mineralization potential were collected. In addition, soil texture and bulk density were determined to characterize each plot. Correlations and multiple linear-regression analyses were used to determine those variables that can predict final winter wheat grain yield. Both the correlation and regression analyses suggested mid-season NDVI, chlorophyll content, plant height, and total N uptake to be good predictors of final winter wheat grain yield. Copyright © Taylor & Francis Group, LLC
Documents originaux et copies concernant la noblesse de Lorraine, les Assises et les États généraux.
No full textContient : « Chevalerie de Lorraine » ; Renvois et notice historique sur les privilèges de la noblesse lorraine ; Traité d'alliance entre Conrad évêque de Metz et Louis évêque de Verdun, Badewin de Flueville abbé de Gorze, Simon comte de Salm, Jean de Fenestranges, Pierre seigneur de Beauffremont et de Ruppes, Jean de Hassonville sénéchal et maître d'hôtel, Ferry de Parroie bailli de Nancy, Ferry de Savigny maréchal de Bar et Lorraine, Werry de Fléville bailli d'Allemagne, Charles d'Haraucourt, Gérard d'Haraucourt, Ferry de Luddres, Errard du Châtelet, Philibert de Brixey, Thiedry Bayer, Philippe de Noeroy, Willeme de Dommertin, Jean de Saulx bailli de Clermont, Amé du Fay bailli du Bassigny, Jean de Bassompierre, Jaiques de Hassonville, Simon de Saint-Menge et Willame de Savigny, chevaliers, Jean seigneur de Sainte-Marie, Arnoul de Ville bailli des Vosges, Jaiquet de Haraucourt, Hanri Hause, Philippe de Lenoncourt, Jaiquet de Savigny, Jean de Chambley, Philebert du Châtelet, Colard des Armoises, Arnoul de Sampigny et Henri de Commeney, écuyers, tous conseillers de René d'Anjou, Ferry de Ligneville, Willaume de Ligneville, Jean de Lucey, Jean de Pulligny, Jean de Commeney, Jean seigneur de Darnielle et Philippe d'Abocourt chevaliers, Erard de Ville, Thierry de Lenoncourt, Colard de Lenoncourt, François de Chamble, Gérard d'Assey, Louis du Fay, Jean de Pulligny le Jeune, Renequin de Gadekonen, Henri Haienges, Jacquet de Juxey, Godefroy de Bajemont, Nicolas Wisse, jean Wisse et Waltrin Wisse, Wautrin de Theullières, Wautrin de Bousey, Bougnat de Bouzey, Liebal de Bousey, Henri de Bousey, Durant de Marches, Didier de Marches, Jean de Herbeviller, Henri de Lucey, Simonin de Jalue, Jean de Jaulney, Jean d'Epinal, Barnaud de Felin, Georges d'Alye, Abert de Chastel, Ferry de Lye, Rodolph Bayer, Louis de Florenville, Jorge de Craincourt, Jean de Tequestain, Jean bâtard de Parroie, Henri Denvile, Franque de Weheicourt, Philibert de Weheicourt, Milet d'Autrey, Jean d'Autrey et Ancel de Molinet, le Conseil et les vassaux de Bar et de Lorraine réunis avec les Etats de Lorraine : ils jurent de tenir et de faire respecter la paix entre eux ; Copie pour le Conseil de Lorraine d'un traité du 1er février 1468 n. s. à Charmes de nobles de Bar et Lorraine au service de Jean II d'Anjou duc de Lorraine contre Neufchâtel, jurant de servir le duc et de se soutenir mutuellement. Les compagnons porteront pour enseigne un lion, d'or pour les chevaliers, d'argent pour les écuyers ; Analyse de l'acte ; Copie moderne de la pièce f. 8-9 ; Copie moderne d'une lettre du 22 avril 1477 à Mirecourt de René II duc de Lorraine, donnant à Henri de Ligneville les biens confisqués d'Isabelle de Ligneville, femme de Nicolas de Baudemont (ou de Baudoncourt) qui a suivi le parti de Charles le Téméraire contre le duc ; Copie de lettre patentes du 20 mars 1632 de Charles IV duc de Lorraine confirmant les privilèges de la noblesse de Lorraine, contenant une lettre du 10 décembre 1614 d'Henri duc de Lorraine, contenant une lettre du 6 août 1569 de Charles III duc de Lorraine, contenant une lettre du 28 mars 1532 d'Antoine duc de Lorraine, contenant une lettre du 22 février 1478 n. s. de René II duc de Lorraine, contenant une lettre du 22 novembre 1464 de Jean II duc de Lorraine, contenant une lettre du 30 janvier 1431 n. s. de René d'Anjou et d'Isabelle de Lorraine ; États de Lorraine ; « Du ressort des appellations de Marsal » ; Mémoires sur la chevalerie ; Listes des vassaux du bailliage d'Allemagne « de l'ancienne chevalerie » ; Liste de genthillommes présents aux assises de Nancy en 1608-1613 ; Notice sur les anciennes familles lorraines ; Notice sur les « maisons originaires de France » ; Notice sur les entrées solennelles à Nancy ; Assises ; états généraux ; Arrêt du conseil du duc René II, portant renvoi devant le bailli au change de Nancy d'un procès engagé entre Jean de Savoie et les maire et échevins de Raon ; Copie ? d'une ordonnance d'Antoine duc de Lorraine sur le fait de la justice ; Requête de la noblesse du bailliage de Saint-Mihiel à Antoine duc de Lorraine, concernant la justice ; États de Saint-Mihiel ; Remontrances de la noblesse du bailliage de Saint-Mihiel au duc Charles III ; Remontrances de la noblesse du bailliage de Saint-Mihiel au duc Charles IIINumérisation effectuée à partir d'un document original
Optimising stabilisation of the critical ill child in the medical emergency unit at the Red Cross War Memorial Children's Hospital : an enthnographic study
No full textIncludes abstract.
Includes bibliographical references
Gadd45 gamma and Map3k4 Interactions Regulate Mouse Testis Determination via p38 MAPK-Mediated Control of Sry Expression
No full textSafety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): a multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study
No full textBackground: Direct-acting oral anticoagulant use for stroke prevention in atrial fibrillation is limited by bleeding concerns. Asundexian, a novel, oral small molecule activated coagulation factor XIa (FXIa) inhibitor, might reduce thrombosis with minimal effect on haemostasis. We aimed to determine the optimal dose of asundexian and to compare the incidence of bleeding with that of apixaban in patients with atrial fibrillation. Methods: In this randomised, double-blind, phase 2 dose-finding study, we compared asundexian 20 mg or 50 mg once daily with apixaban 5 mg twice daily in patients aged 45 years or older with atrial fibrillation, a CHA2DS2-VASc score of at least 2 if male or at least 3 if female, and increased bleeding risk. The study was conducted at 93 sites in 14 countries, including 12 European countries, Canada, and Japan. Participants were randomly assigned (1:1:1) to a treatment group using an interactive web response system, with randomisation stratified by whether patients were receiving a direct-acting oral anticoagulant before the study start. Masking was achieved using a double-dummy design, with participants receiving both the assigned treatment and a placebo that resembled the non-assigned treatment. The primary endpoint was the composite of major or clinically relevant non-major bleeding according to International Society on Thrombosis and Haemostasis criteria, assessed in all patients who took at least one dose of study medication. This trial is registered with ClinicalTrials.gov, NCT04218266, and EudraCT, 2019-002365-35. Findings: Between Jan 30, 2020, and June 21, 2021, 862 patients were enrolled. 755 patients were randomly assigned to treatment. Two patients (assigned to asundexian 20 mg) never took any study medication, resulting in 753 patients being included in the analysis (249 received asundexian 20 mg, 254 received asundexian 50 g, and 250 received apixaban). The mean age of participants was 73·7 years (SD 8·3), 309 (41%) were women, 216 (29%) had chronic kidney disease, and mean CHA2DS2-VASc score was 3·9 (1·3). Asundexian 20 mg resulted in 81% inhibition of FXIa activity at trough concentrations and 90% inhibition at peak concentrations; asundexian 50 mg resulted in 92% inhibition at trough concentrations and 94% inhibition at peak concentrations. Ratios of incidence proportions for the primary endpoint were 0·50 (90% CI 0·14–1·68) for asundexian 20 mg (three events), 0·16 (0·01–0·99) for asundexian 50 mg (one event), and 0·33 (0·09–0·97) for pooled asundexian (four events) versus apixaban (six events). The rate of any adverse event occurring was similar in the three treatment groups: 118 (47%) with asundexian 20 mg, 120 (47%) with asundexian 50 mg, and 122 (49%) with apixaban. Interpretation: The FXIa inhibitor asundexian at doses of 20 mg and 50 mg once daily resulted in lower rates of bleeding compared with standard dosing of apixaban, with near-complete in-vivo FXIa inhibition, in patients with atrial fibrillation. Funding: Bayer
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