1
|
Floyd N, Hassan MT, Tang Z, Krivoš M, Blatnik M, Cude-Woods C, Clayton SM, Holley AT, Ito TM, Johnson BA, Liu CY, Makela M, Morris CL, Navazo ASC, O'Shaughnessy CM, Renner EL, Pattie RW, Young AR. Scintillation characteristics of the EJ-299-02H scintillator. Rev Sci Instrum 2024; 95:045108. [PMID: 38573050 DOI: 10.1063/5.0179451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 03/04/2024] [Indexed: 04/05/2024]
Abstract
A study of the dead layer thickness and quenching factor of a plastic scintillator for use in ultracold neutron (UCN) experiments is described. Alpha spectroscopy was used to determine the thickness of a thin surface dead layer to be 630 ± 110 nm. The relative light outputs from the decay of 241Am and Compton scattering of electrons were used to extract Birks' law coefficient, yielding a kB value of 0.087 ± 0.003 mm/MeV, consistent with some previous reports for other polystyrene-based scintillators. The results from these measurements are incorporated into the simulation to show that an energy threshold of (∼9 keV) can be achieved for the UCNProBe experiment. This low threshold enables high beta particle detection efficiency and the indirect measurement of UCN. The ability to make the scintillator deuterated, accompanied by its relatively thin dead layer, gives rise to unique applications in a wide range of UCN experiments, where it can be used to trap UCN and detect charged particles in situ.
Collapse
Affiliation(s)
- N Floyd
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
- University of Kentucky, Lexington, Kentucky 40506, USA
| | - Md T Hassan
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - Z Tang
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Krivoš
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - M Blatnik
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
- W. K. Kellogg Radiation Laboratory, California Institute of Technology, Pasadena, California 91125, USA
| | - C Cude-Woods
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
- North Carolina State University, Raleigh, North Carolina 27695, USA
| | - S M Clayton
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A T Holley
- Tennessee Technological University, Cookeville, Tennessee 38505, USA
| | - T M Ito
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - B A Johnson
- Indiana University, Bloomington, Indiana 47405, USA
| | - C-Y Liu
- University of Illinois, Champaign, Illinois 61820, USA
| | - M Makela
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - C L Morris
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - A S C Navazo
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | | | - E L Renner
- Los Alamos National Laboratory, Los Alamos, New Mexico 87545, USA
| | - R W Pattie
- East Tennessee State University, Johnson City, Tennessee 37614, USA
| | - A R Young
- North Carolina State University, Raleigh, North Carolina 27695, USA
| |
Collapse
|
2
|
Kilbourne AM, Braganza MZ, Bowersox NW, Goodrich DE, Miake-Lye I, Floyd N, Garrido MM, Frakt AB, Bever CT, Vega R, Ramoni R. Research Lifecycle to Increase the Substantial Real-world Impact of Research: Accelerating Innovations to Application. Med Care 2019; 57 Suppl 10 Suppl 3:S206-S212. [PMID: 31517789 PMCID: PMC6750195 DOI: 10.1097/mlr.0000000000001146] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND US health care systems face a growing demand to incorporate innovations that improve patient outcomes at a lower cost. Funding agencies increasingly must demonstrate the impact of research investments on public health. The Learning Health System promotes continuous institutional innovation, yet specific processes to develop innovations for further research and implementation into real-world health care settings to maximize health impacts have not been specified. OBJECTIVE We describe the Research Lifecycle and how it leverages institutional priorities to support the translation of research discoveries to clinical application, serving as a broader operational approach to enhance the Learning Health System. METHODS Developed by the US Department of Veterans Affairs Office of Research and Development Research-to-Real-World Workgroup, the Research Lifecycle incorporates frameworks from product development, translational science, and implementation science methods. The Lifecycle is based on Workgroup recommendations to overcome barriers to more direct translation of innovations to clinical application and support practice implementation and sustainability. RESULTS The Research Lifecycle posits 5 phases which support a seamless pathway from discovery to implementation: prioritization (leadership priority alignment), discovery (innovation development), validation (clinical, operational feasibility), scale-up and spread (implementation strategies, performance monitoring), and sustainability (business case, workforce training). An example of how the Research Lifecycle has been applied within a health system is provided. CONCLUSIONS The Research Lifecycle aligns research and health system investments to maximize real-world practice impact via a feasible pathway, where priority-driven innovations are adapted for effective clinical use and supported through implementation strategies, leading to continuous improvement in real-world health care.
Collapse
Affiliation(s)
- Amy M. Kilbourne
- Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
- Department of Psychiatry, University of Michigan Medical School
| | - Melissa Z. Braganza
- Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
| | - Nicholas W. Bowersox
- Department of Psychiatry, University of Michigan Medical School
- Center for Evaluation and Implementation Resources, VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI
| | - David E. Goodrich
- Center for Evaluation and Implementation Resources, VA Ann Arbor Center for Clinical Management Research, Ann Arbor, MI
| | - Isomi Miake-Lye
- Center for the Study of Healthcare Innovation, Implementation & Policy, VA Greater Los Angles Healthcare System, Los Angeles, CA
| | - Nicole Floyd
- Evidence Synthesis Program Coordinating Center, Portland VA Health Care System, Portland, OR
| | - Melissa M. Garrido
- Partnered Evidence-based Policy Resource Center, Boston VA Healthcare System
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA
| | - Austin B. Frakt
- Partnered Evidence-based Policy Resource Center, Boston VA Healthcare System
- Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA
| | - Christopher T. Bever
- Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
| | - Ryan Vega
- Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
| | - Rachel Ramoni
- Veterans Health Administration, US Department of Veterans Affairs, Washington, DC
| |
Collapse
|
3
|
Floyd N, Peterson K, Christensen V, Anderson J. "Implementation Is so Difficult": Survey of National Learning Health System Decision-makers Identifies Need For Implementation Information in Evidence Reviews. Med Care 2019; 57 Suppl 10 Suppl 3:S233-S238. [PMID: 31517793 PMCID: PMC6750151 DOI: 10.1097/mlr.0000000000001192] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Evidence use within learning health care systems can improve patient health outcomes. Embedded in the Veterans Health Administration (VHA) since 2007, the Veterans Affairs Evidence Synthesis Program (ESP) provides tailored evidence synthesis services to support VHA's learning health care system goals. As part of the ESP's ongoing quality improvement efforts, we have been surveying our users since 2016. METHODS We reviewed data from a survey of end-users received between September 5, 2016, and June 10, 2019. The survey assessed: (1) nature of decision-making needs; (2) actions resulting from the report's findings; (3) implementation timeframe; and (4) overall perception of report content. RESULTS Feedback was received from 66 of the 138 operational partners requesting ESP products during the fiscal year 2015 through 2018. Requests commonly informed clinical guidance (58%), identified future research needs (58%), and determined VHA-specific implementation strategy (47%). A total of 91% of responders used reports, typically within 3 months after completion (82%). Use was typically for VHA publications and/or presentations to inform VHA policy or guidance (26%), to inform intervention/strategy adoption decisions (23%) and for medical device and therapy procurement decisions (21%). Over half (53%) of respondents indicated that it would be useful for ESP reports to include more guidance on implementing findings. CONCLUSION Our survey of learning health system decision-makers' actual patterns and timing of evidence use provides valuable new information that can further support development of other health system and evidence producer partnerships and identifies key needs for better supporting health systems' uptake of evidence.
Collapse
Affiliation(s)
- Nicole Floyd
- Evidence Synthesis Program Coordinating Center, Portland VA Medical Center, Portland, OR
| | | | | | | |
Collapse
|
4
|
Peterson K, Floyd N, Ferguson L, Christensen V, Helfand M. User survey finds rapid evidence reviews increased uptake of evidence by Veterans Health Administration leadership to inform fast-paced health-system decision-making. Syst Rev 2016; 5:132. [PMID: 27491354 PMCID: PMC4974754 DOI: 10.1186/s13643-016-0306-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 06/20/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To provide evidence synthesis for faster-paced healthcare decision-making, rapid reviews have emerged as a streamlined alternative to standard systematic reviews. In 2012, the Veterans Affairs Evidence-based Synthesis Program (VA ESP) added rapid reviews to support Veterans Health Administration (VHA) operational partners' more urgent decision-making needs. VHA operational partners play a substantial role in dissemination of ESP rapid reviews through a variety of routes, including posting on the VA ESP's public website ( http://www.hsrd. RESEARCH va.gov/publications/esp/ ). As demand for rapid reviews rises, much progress has been made in characterizing methods and practices. However, evidence synthesis organizations still seek to better understand how and when rapid reviews are being used. METHODS The VA ESP administered an online survey to rapid review operational partners. The survey assessed the nature of decision-making needs, overall perception of review content, resulting actions, and implementation timeframe. We use descriptive statistics and narrative methods to summarize findings. RESULTS Between October 2011 and April 2015, we completed 12 rapid reviews for 35 operational partners. Operational partners were primarily non-academic subject matter experts with VA operations' decision-making authority. The most common topic categories reviewed were policy or system (50 %) or process of care (42 %) initiatives. Median report completion time was 14.5 weeks. Survey response rate was 46 %, with at least one operational partner responding for 92 % of reports. Reviews served multiple purposes including policy directive or regulation (72 %), supporting program development and evaluation (55 %), identifying future research needs (45 %), and determining implementation strategy (45 %). Overall, operational partners' perception of report content was positive. A majority of rapid reviews were used immediately and informed actions ranking high on the Institute of Medicine's Degrees of Impact framework: 45.4 % effected change, 18.2 % inspired action, 18.2 % informed the field, 9.1 % received recognition, and 9.1 % spread a message. CONCLUSIONS VA ESP rapid reviews have increased the VHA's uptake of evidence to inform time-sensitive system-level decision-making. Key areas of interest for future evaluation include assessing user perception of our streamlined methods and the quality of our efforts to inform users of these methods, as well as comparing the usability and impact of our rapid and standard systematic reviews.
Collapse
Affiliation(s)
- Kim Peterson
- VA Portland Health Care System, Veterans Affairs Evidence-Based Synthesis Program, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239 USA
- Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239 USA
| | - Nicole Floyd
- VA Portland Health Care System, Veterans Affairs Evidence-Based Synthesis Program, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239 USA
| | - Lauren Ferguson
- VA Portland Health Care System, Veterans Affairs Evidence-Based Synthesis Program, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239 USA
- Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239 USA
| | - Vivian Christensen
- VA Portland Health Care System, Veterans Affairs Evidence-Based Synthesis Program, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239 USA
| | - Mark Helfand
- VA Portland Health Care System, Veterans Affairs Evidence-Based Synthesis Program, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239 USA
- Oregon Health and Science University, 3181 S.W. Sam Jackson Park Rd., Portland, OR 97239 USA
| |
Collapse
|
5
|
Affiliation(s)
- G Medes
- The Lankenau Hospital Research Institute, Philadelphia, Pa
| | | |
Collapse
|
6
|
Medes G, Floyd N. Metabolism of sulphur: Further investigation of the enzymic oxidation of sulphur-containing amino-acids. Biochem J 2006; 36:259-70. [PMID: 16747486 PMCID: PMC1265681 DOI: 10.1042/bj0360259] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G Medes
- The Lankenau Hospital Research Institute, Philadelphia
| | | |
Collapse
|
7
|
Abstract
Animals, including humans, react with distinct emotional coping strategies to different sets of environmental demands. These strategies include the capacity to affect appropriate responses to "escapable" or "inescapable" stressors. Active emotional coping strategies--fight or flight--are particularly adaptive if the stress is escapable. On the other hand, passive emotional coping strategies-quiescence, immobility, decreased responsiveness to the environment-are useful when the stress is inescapable. Passive strategies contribute also to facilitating recovery and healing once the stressful event is over. Active vs. passive emotional coping strategies are characterised further by distinct patterns of autonomic change. Active strategies are associated with sympathoexcitation (hypertension, tachycardia), whereas passive strategies are associated with sympathoinhibitory patterns (hypotension, bradycardia). Distinct neural substrates mediating active vs. passive emotional coping have been identified within the longitudinal neuronal columns of the midbrain periaqueductal gray region (PAG). The PAG offers then a potentially useful point of entry for delineating neural circuits mediating the different forms of emotional coping and their associated patterns of autonomic activity. As one example, recent studies of the connections of orbital and medial prefrontal cortical (PFC) fields with specific PAG longitudinal neuronal columns are reviewed. Findings of discrete orbital and medial PFC projections to different PAG columns, and related PFC and PAG columnar connections with specific subregions of the hypothalamus, suggest that distinct but parallel circuits mediate the behavioural strategies and patterns of autonomic activity characteristic of emotional "engagement with" or "disengagement from" the external environment.
Collapse
Affiliation(s)
- R Bandler
- Department of Anatomy and Histology, University of Sydney, NSW, Sydney, Australia.
| | | | | | | |
Collapse
|
8
|
Abstract
Contusive spinal cord injury (SCI) may result in central neuropathic pain marked by allodynia-like features in the dermatomes close to the level of injury. The aim of this study was to compare the laminar distribution of activated neurons (as determined by c-fos immediate early gene expression) in the spinal cord immediately above the level of a SCI in rats with or without allodynia-like features. Non-noxious mechanical stimulation was applied to half the animals in the dermatomes corresponding to the level of injury prior to perfusion. Stimulation resulted in a significant increase in c-fos labelling in all laminae of the spinal dorsal horn in the segment immediately above the level of injury only in allodynia animals. Animals that had allodynia also demonstrated a significant increase in the level of c-fos labelling in lamina III, IV and V of the dorsal horn without stimulation. Thus, allodynia following SCI is associated with significant increases in basal and evoked c-fos expression ("neuronal activity") in response to non-noxious mechanical stimulation. The data also suggest that allodynia-like behaviour following SCI cannot be accounted for solely by changes occurring at a spinal level.
Collapse
Affiliation(s)
- P J Siddall
- Pain Management and Research Centre, University of Sydney, Royal North Shore Hospital, St. Leonards, NSW, Australia.
| | | | | | | |
Collapse
|