Elkhart Clinic

Abstract The global quest for greater value from wells achieved success through well construction improvements contributing to economic production. The stage is set to unlock further value through a well lifecycle approach. Well Lifecycle applications need to solve two interconnected challenges: ability to uniformly quantify all the constituent factors contributing to the long-term outcome of a well, and ability to connect multiple static, transient, and in motion data in a meaningful manner across multiple disciplines. Increased value from wells requires a shift from siloed behaviors to full lifecycle unhindered workflow. A system of systems framework can create a context-driven federation for linkage of sub systems and multiple data sources for their intended use. Fully leveraged value can only be achieved when the well's data is comprehensively managed, contains context and is accessible in time to all involved for comprehensive lifecycle asset value while safeguarding against risk. This paper proposes an approach to well lifecycle workflow and data management that maximizes the well value contribution to enhance field development value. Data is an asset that must be competently managed and utilized to maximize the impact it has on business value. Currently, the two-way flow of information across the well lifecycle is broken or stifled. For example, the final user has limited input and access to the initial design. This failure to flow accurate data drives up risk across multiple aspects of the well lifecycle. The System of Systems approach has been successfully applied to both the defense and space exploration sectors as they evolved over the last decade. This approach offers an opportunity to deliver a framework onto which robust modern data management and utilization methods can be constructed. In time, access to all well data regardless of the stage in the lifecycle in a manner that is efficient and communicates the data context can be achieved with modern data management systems. This will enable significantly greater value realization from the operation of the wells and the associated subsurface modelling. Currently this is not practiced in wells lifecycle, for example, through the poor management of wellbore survey data routinely leading to greater uncertainty in subsurface models negatively impacting field development decisions. This paper furthers the application of a System of Systems methodology and workflow to manage the inherent complexity of interconnected interactions throughout a wells lifecycle. It also introduces industry best practices for managing data in this environment. These best practices will include data attributes (frequency, latency, …), context (data set description and changes made over time), uncertainty (deviations from the intended source value or derived parameters), various industry data standards, etc.

Myrrh was used anciently in difficult cultures as in embalming fluids by Egyptians, in Chinese and other traditional medicine. However, research about activity of myrrh till now is not very convincing. Compendial description of myrrh wasn't helpful nor convenient in fully describing the composition as well as the attributes of the nature of myrrh, which put a burden on healthcare providers to appropriately prescribe it as it lacks the adequate validation tool in its healing properties or practices. Methods used were descriptive parameters, such as color and particle size. Furthermore, we enforced chemical instrumental procedures, such as near infrared spectra, Thin layer chromatography and ultraviolet spectroscopy profiling. In conclusion, in vitro biological αglucosidase activity of myrrh was assigned. Impartially, NIR spectra of Myrrh were recorded and attempt to assign peaks of myrrh's chemical composition, this is the first study to use this approach for myrrh. Particle size and color-PLS models with low RMSEC and RMSECV was useful to estimate alphaglucosidase inhibitory activity with acceptable accuracy. In the absence of evidence based therapeutic indication for myrrh chemistry we must accurately study the composition of myrrh and agree upon species.

In diesem Jahr trat die ASV-Regelung für Sarkoidose mit dem Ziel einer besseren Versorgung der Patienten mittels gut vernetzter ärztlicher Kompetenz-Teams in Kraft. Innerhalb der letzten 5 Jahre wurden 247 Patienten wegen einer Sarkoidose an der Evangelischen Lungenklinik stationär behandelt. Gründe für die Zuweisung waren histologische Diagnosesicherung und Therapieoptimierung bei Unverträglichkeit, Progression oder Rezidiven.

Occurrence variance reporting (OVR) may be very critical for making sure affected person and body of workers safety, nice of care and threat management. Variance is any occasion or condition now no longer regular with the usual habitual operations of the medical institution and its body of workers or the habitual care of a affected person/visitor. OVR trending and analysis. Result: prevalence variance reporting machine considerably stepped forward after implementation of an academic software on OVR to medical institution body of workers and directors than before. Recommendations: Continues month-to-month and quarterly tracking and collecting of information to keep the performance, Continuous -Occurrence variance reporting (OVR) may be very critical for making sure affected person and body of workers safety, nice of care and threat management. Variance is any occasion or condition now no longer regular with the usual habitual operations of the medical institution and its body of workers or the habitual care of a affected person/visitor. OVR trending and analysis. Result: prevalence variance reporting machine considerably stepped forward after implementation of an academic software on OVR to medical institution body of workers and directors than before. Recommendations: Continues month-to-month and quarterly tracking and collecting of information to keep the performance, Continuous

This paper analyzes the nature and determinants of product innovation for food and agribusiness firms in India. The study is based on the World Bank’s Enterprise Survey and the India Innovation Follow-up Survey from 2014. These surveys included 294 Indian food and agribusiness firms operating in different regions of the country. Simple statistical tools, such as chi-square test and logistic regression, are used for analyzing the raw data. It is evident from the analysis that there is a significant difference in the adoption of product innovations across enterprise sizes. Product innovation is more prominent in large enterprises than small and medium scale enterprises (SMEs). Results of regression analysis indicate that product innovation in SMEs is more likely to be influenced by a variety of internal, collaborative, and external factors. The findings of the study suggest that SMEs should diversify their product innovations to include new inputs, improved product features, and enhanced technologies to strengthen their place in the market. This research is valuable because there is limited evidence on the nature and determinants of product innovation in food and agribusiness SMEs of emerging economies like India.

The purpose of this research was to study night shift work and its health effects on nurses. This was a quantitative study using descriptive design; it also incorporated three qualitative open-ended questions to complement the study. The data were collected using Survey Monkey, with an Internet based confidential data collection tool. The population of relevance to this study was nurses employed in hospital settings in the United States. E-mail addresses and Facebook were used to recruit participants. Results indicated that there is an increased risk of sleep deprivation, family stressors, and mood changes because of working the night shift. Rotating shifts were mentioned as a major concern for night shift nurses. Respondents agreed that complaints about fatigue and fatigue related illnesses in night shift workers were ignored. There was also a general perception among nurses working the night shift that sleep deprivation leads to negative health consequences including obesity; however, they were not as high a concern as rotating shifts or fatigue.

College students who participate in semester abroad programs have diverse but positive experiences. Variables such as the educational institution attended by the students and the location of the study abroad can affect the experiences of the students. There is minimal research concerning students from Christian colleges who study abroad. The purpose of this study was to investigate the lived experiences of college students participating in a semester abroad program in a developing country. Seven college students were interviewed regarding their experiences by three senior nursing students who also participated in the study abroad program. Results indicated that major factors influencing students' experiences were related to cultural immersion, role relationships, challenges encountered, and personal growth. Students reported that relationships with people and faith in Christ were strengthened through the experience.