It appears that the most important contributing factors to active CQI implementation in Korean hospitals were the use of scientific skills in decision-making and the adoption of a quality information system capable of producing precise and valid information.
This study deals with (a) the development of a prototype 3D printer for concrete structures having a bed size of 1 × 1 × 1 m for a laboratory testing and (b) laboratory testing of cementitious materials with different design mixes to find their suitability and efficacy for the developed 3D printer. In this printer, a program with the concept of computer numerical controlled milling was adopted to control the nozzle motion using an easy graphic user interface program. The experiment was carried out to test mechanical control and proper material properties of the printer. Thus, the optimum values of water-cement ratio of cementitious materials for the 3D concrete printer were determined by experimental trials. Also, the adequate viscosity of the material for layering and dispensing is determined by a slump-flow test. The suitable size of sands for the dispensing system was found through the trials. However, shrinkage cracks occurred during the hardening process for the paste and mortar that polyvinyl alcohol fibers are added to prevent the cracking and build an improved quality 3D printed structure. After suitable and efficient mix ratio is found, compressive strength is measured for the mechanical property. The experiments demonstrated possibility of printing concrete structure using the 3D printer.
PURPOSE: To assess the value of laser in situ keratomileusis (LASIK) by patient-reported outcomes using quality of life assessment.
METHOD: This study included 288 consecutive patients treated by LASIK between July and December 2001 at two eye clinics. A Myopia-specific Quality of Life Questionnaire was developed in this study. The baseline quality of life corresponding to the situation where refractive error was corrected by glasses or contact lenses before LASIK treatment was evaluated by self-administered questionnaire. The evaluation was repeated at 4 days, and 1, 3, and 6 months after LASIK treatment. All question items were rated on a scale ranging from 1 (maximal dysfunction) to 5 (minimal dysfunction).
RESULTS: Factor analysis identified 34 questions in 4 subscales-visual function, visual symptoms, social role function, and psychological well-being. The Myopia-specific Quality of Life Questionnaire subscales proved to be internally consistent (Cronbach alpha = 0.70-0.95). Criterion validity was assessed by evaluating Spearman correlation between the overall or domain-specific quality of life and traditional measures of patient status. Overall Myopia -specific Quality of Life Questionnaire score changed from 3.21 preoperatively to 3.76, 4.00, 4.07, and 4.11 at 4 days, and 1, 3, and 6 months after surgery, respectively. Social role function showed the biggest improvement (score change: 1.51, P<.05), followed by psychological well-being (0.90, P<.05), visual function (0.72, P<.05), and visual symptoms (0.49, P<.05). Regression analysis results showed that the degree of uncorrected visual acuity, discomfort associated with myopia preoperatively, and location of eye center were significant factors affecting the magnitude of changes in quality of life after LASIK.
CONCLUSIONS: This study confirms that the value of LASIK went beyond the clinical achievement of refractive correction and extended to the improvement of quality of life. [J Refract Surg, 2005;21:59-71.]
The DNA-binding protein PU.1 is a myeloid lineage–determining and pioneering transcription factor due to its ability to bind “closed” genomic sites and maintain “open” chromatin state for myeloid lineage–specific genes. The precise mechanism of PU.1 in cell type–specific programming is yet to be elucidated. The melanoma cell line B16BL6, although it is nonmyeloid lineage, expressed Toll-like receptors and activated the transcription factor NF-κB upon stimulation by the bacterial cell wall component lipopolysaccharide. However, it did not produce cytokines, such as IL-1β mRNA. Ectopic PU.1 expression induced remodeling of a novel distal enhancer (located ∼10 kbp upstream of the IL-1β transcription start site), marked by nucleosome depletion, enhancer-promoter looping, and histone H3 lysine 27 acetylation (H3K27ac). PU.1 induced enhancer-promoter looping and H3K27ac through two distinct PU.1 regions. These PU.1-dependent events were independently required for subsequent signal-dependent and co-dependent events: NF-κB recruitment and further H3K27ac, both of which were required for enhancer RNA (eRNA) transcription. In murine macrophage RAW264.7 cells, these PU.1-dependent events were constitutively established and readily expressed eRNA and subsequently IL-1β mRNA by lipopolysaccharide stimulation. In summary, this study showed a sequence of epigenetic events in programming IL-1β transcription by the distal enhancer priming and eRNA production mediated by PU.1 and the signal-dependent transcription factor NF-κB.
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