Improving the non-structural preparedness of the selected hospital based on the FOCUS-PDCA1 model: action research.

INTRODUCTION: With the intensification of the country's development process, the expansion of cities and population, and the inclusion of Iran in the accident-prone category, reducing the vulnerability of non-structures has received more attention from the organizations involved. In addition to damage to communities and infrastructure, accidents can affect hospitals and their non-organizational components. Hospitals, as the front line of providing medical services after accidents, must maintain their stability, ensure the safety of their patients and employees, and continue to operate without interruption as in normal conditions. Therefore, it is necessary to evaluate the non-structural safety and their preparedness to ensure they can perform acceptable in critical conditions. METHODS: This applied research was conducted in 2023 (September to December) using the participatory action research method in all selected hospital departments. The level of non-structural preparedness of the hospital was checked using the valid "Hospital Safety Index" questionnaire and the non-structural weaknesses of the hospital were identified. Then, in action research using the FOCUS-PDCA model, a program was implemented to improve the non-structural preparedness of different departments of hospitals in the face of accidents and disasters. The non-structural readiness level of the hospital was compared before and after the implementation of the change. RESULTS: Based on the evaluation conducted in the present study, the lowest level of safety was observed in the water supply system, office furniture and appliances, and fuel storage. The waste management systems, the fire protection system, and the long-distance communication systems were at a desirable performance level. Although in the evaluation before the change, the overall score of the hospital was 71.01%, and it had a desirable performance level in non-structural factors, in all the involved parts of the hospital, the sensitive, critical, and practical parts in the operation of the hospital had an average and sometimes low safety level. According to the obtained safety score, the safety level of the selected hospital before the change was 7 out of 10 (level seven of safety evaluation = medium). After the change and corrective measures, the non-structural safety assessment score was 76.93, and the hospital's safety level was raised by one step to 8 out of 10 (8th level of safety assessment = relatively favorable). CONCLUSION: The present study showed that the application of Total Quality Management (TQM), primarily its application tool FOCUS-PDCA, is efficient and helpful in improving the non-structural preparedness of hospitals. Using action research in the health field in accidents and disasters can open blind knots in different dimensions of preparedness (structural, non-structural, and functional).

Two vacuolar invertase inhibitors PpINHa and PpINH3 display opposite effects on fruit sugar accumulation in peach.

Soluble sugars are an important determinant of fruit taste, but their accumulation mechanisms remain elusive. In this study, we report two vacuolar invertase inhibitor genes involved in sugar accumulation in peach, PpINHa and PpINH3. Transient overexpression of PpINH3 in peach fruits resulted in an increase in sugar content, while the opposite trend was detected for PpINHa. Unexpectedly, PpINH3 and PpINHa both had no physical interaction with vacuolar invertase (VIN). Moreover, the PpVIN genes had no or extremely low expression in fruits at the ripening stage. These results suggested that the regulatory role of PpINHa and PpINH3 in sugar accumulation is unlikely due to their interaction with PpVINs. Additionally, overexpression of PpINHa and PpINH3 had an impact on transcription of genes related to fruit sugar metabolism and transport, which is likely responsible for their regulatory role in fruit sugar accumulation. Altogether, these results indicated an important role of PpINHs in fruit accumulation in peach. Our study provides new insights into molecular mechanisms underlying sugar accumulation, which could be useful for genetic improvement of fruit taste in breeding programs of peach and other fruit crops.

Efficient extraction of high pulse energy from partly quenched highly Er3+-doped fiber amplifiers.

We demonstrate efficient pulse-energy extraction from a partly quenched erbium-doped aluminosilicate fiber amplifier. This has a high erbium concentration that allows for short devices with reduced nonlinear distortions but also results in partial quenching and thus significant unsaturable absorption, even though the fiber is still able to amplify. Although the quenching degrades the average-power efficiency, the pulse energy remains high, and our results point to an increasingly promising outcome for short pulses. Furthermore, unlike unquenched fibers, the conversion efficiency improves at low repetition rates, which we attribute to smaller relative energy loss to quenched ions at higher pulse energy. A short (2.6 m) cladding-pumped partly quenched Er-doped fiber with 95-dB/m 1530-nm peak absorption and saturation energy estimated to 85 µJ reached 0.8 mJ of output energy when seeded by 0.2-µs, 23-µJ pulses. Thus, according to our results, pulses can be amplified to high energy in short highly Er-doped fibers designed to reduce nonlinear distortions at the expense of average-power efficiency.

Evolutionary rate variation among genes involved in galactomannan biosynthesis in Coffea canephora.

The endosperm cell walls of mature coffee seeds accumulate large amounts of mannan storage polysaccharides, which serve as nutrient reserve for embryo and contribute to beverage quality. Our study investigated the evolutionary patterns of key galactomannan (GM) biosynthesis genes using d N/d S ratio, synteny, and phylogenetic analysis and detected heterogeneity in rate of evolution among gene copies. Selection ratio index revealed evidence of positive selection in the branch editing gene Coffea canephora alpha (α) galactosidase (Cc-alpha Gal) at Cc11_g15950 copy (ω = 1.12), whereas strong purifying selection on deleterious mutations was observed in the Coffea canephora uridine diphosphate (UDP)-glucose 4'-epimerase (Cc-UG4E) and Coffea canephora mannose-1P guanylytransferase (Cc-MGT) genes controlling the crucial nucleotide carbon sugar building blocks flux in the pathway. Relatively low sequence diversity and strong syntenic linkages were detected in all GM pathway genes except in Cc-alpha Gal, which suggests a correlation between selection pressure and nucleotide diversity or synteny analysis. In addition, phylogenetic analysis revealed independent evolution or expansion of GM pathway genes in different plant species, with no obvious inferable clustering patterns according to either gene family or congruent with evolutionary plants lineages tested due to high dynamic nature and specific biochemical cell wall modification requirements. Altogether, our study shows a significant high rate of evolutionary variation among GM pathway genes in the diploid C. canephora and demonstrates the inherent variation in evolution of gene copies and their potential role in understanding selection rates in a homogenously connected metabolic pathway.

Broadband telecom to mid-infrared supercontinuum generation in a dispersion-engineered silicon germanium waveguide.

We demonstrate broadband supercontinuum generation (SCG) in a dispersion-engineered silicon-germanium waveguide. The 3 cm long waveguide is pumped by femtosecond pulses at 2.4 µm, and the generated supercontinuum extends from 1.45 to 2.79 µm (at the -30 dB point). The broadening is mainly driven by the generation of a dispersive wave in the 1.5-1.8 µm region and soliton fission. The SCG was modeled numerically, and excellent agreement with the experimental results was obtained.

Distributed dynamic large strain optical fiber sensor based on the detection of spontaneous Brillouin scattering.

A Brillouin-based distributed optical fiber dynamic strain sensor is described which converts strain-induced Brillouin frequency shift into optical intensity variations by using an imbalanced Mach-Zhender interferometer. A 3×3 coupler is used at the output of this interferometer to permit differentiate and cross multiply demodulation. The demonstrated sensor is capable of probing dynamic strain disturbances over 2 km of sensing length every 0.5 s up to a strain of 10 mε with an accuracy of ±50 µÎµ and spatial resolution of 1.3 m.

An interferometric current sensor based on optical fiber micro wires.

In this paper we demonstrate a compact current sensor using the optic fiber micro wire, based on the idea of interferometrically measuring the thermally induced optical phase shifts as a result of heat produced due to the flow of electric current over short transit lengths. A responsivity of 1.28 x 10(-4) rad/I(2) at 50 Hz of current signal has been shown, with capability of measuring alternating current signals up to 500 Hz.

Granular congenital cell tumor in the newborn: a case report.

This report represents a case of unusual large size congenital granular cell tumor appearing on the maxillary alveolar ridge in a newborn. Positive staining was found for S-100 protein. The authors discuss the clinical picture, histological findings, etiology and treatment of this rare lesion.