WorldWideScience

Sample records for cams rationale design

  1. Child/Adolescent Anxiety Multimodal Study (CAMS: rationale, design, and methods

    Directory of Open Access Journals (Sweden)

    Waslick Bruce D

    2010-01-01

    Full Text Available Abstract Objective To present the design, methods, and rationale of the Child/Adolescent Anxiety Multimodal Study (CAMS, a recently completed federally-funded, multi-site, randomized placebo-controlled trial that examined the relative efficacy of cognitive-behavior therapy (CBT, sertraline (SRT, and their combination (COMB against pill placebo (PBO for the treatment of separation anxiety disorder (SAD, generalized anxiety disorder (GAD and social phobia (SoP in children and adolescents. Methods Following a brief review of the acute outcomes of the CAMS trial, as well as the psychosocial and pharmacologic treatment literature for pediatric anxiety disorders, the design and methods of the CAMS trial are described. Results CAMS was a six-year, six-site, randomized controlled trial. Four hundred eighty-eight (N = 488 children and adolescents (ages 7-17 years with DSM-IV-TR diagnoses of SAD, GAD, or SoP were randomly assigned to one of four treatment conditions: CBT, SRT, COMB, or PBO. Assessments of anxiety symptoms, safety, and functional outcomes, as well as putative mediators and moderators of treatment response were completed in a multi-measure, multi-informant fashion. Manual-based therapies, trained clinicians and independent evaluators were used to ensure treatment and assessment fidelity. A multi-layered administrative structure with representation from all sites facilitated cross-site coordination of the entire trial, study protocols and quality assurance. Conclusions CAMS offers a model for clinical trials methods applicable to psychosocial and psychopharmacological comparative treatment trials by using state-of-the-art methods and rigorous cross-site quality controls. CAMS also provided a large-scale examination of the relative and combined efficacy and safety of the best evidenced-based psychosocial (CBT and pharmacologic (SSRI treatments to date for the most commonly occurring pediatric anxiety disorders. Primary and secondary results

  2. Rationale for the Use of CAD/CAM Technology in Implant Prosthodontics

    Science.gov (United States)

    Abduo, Jaafar; Lyons, Karl

    2013-01-01

    Despite the predictable longevity of implant prosthesis, there is an ongoing interest to continue to improve implant prosthodontic treatment and outcomes. One of the developments is the application of computer-aided design and computer-aided manufacturing (CAD/CAM) to produce implant abutments and frameworks from metal or ceramic materials. The aim of this narrative review is to critically evaluate the rationale of CAD/CAM utilization for implant prosthodontics. To date, CAD/CAM allows simplified production of precise and durable implant components. The precision of fit has been proven in several laboratory experiments and has been attributed to the design of implants. Milling also facilitates component fabrication from durable and aesthetic materials. With further development, it is expected that the CAD/CAM protocol will be further simplified. Although compelling clinical evidence supporting the superiority of CAD/CAM implant restorations is still lacking, it is envisioned that CAD/CAM may become the main stream for implant component fabrication. PMID:23690778

  3. Rationale for the Use of CAD/CAM Technology in Implant Prosthodontics

    Directory of Open Access Journals (Sweden)

    Jaafar Abduo

    2013-01-01

    Full Text Available Despite the predictable longevity of implant prosthesis, there is an ongoing interest to continue to improve implant prosthodontic treatment and outcomes. One of the developments is the application of computer-aided design and computer-aided manufacturing (CAD/CAM to produce implant abutments and frameworks from metal or ceramic materials. The aim of this narrative review is to critically evaluate the rationale of CAD/CAM utilization for implant prosthodontics. To date, CAD/CAM allows simplified production of precise and durable implant components. The precision of fit has been proven in several laboratory experiments and has been attributed to the design of implants. Milling also facilitates component fabrication from durable and aesthetic materials. With further development, it is expected that the CAD/CAM protocol will be further simplified. Although compelling clinical evidence supporting the superiority of CAD/CAM implant restorations is still lacking, it is envisioned that CAD/CAM may become the main stream for implant component fabrication.

  4. Does Design Rationale Enhance Creativity?

    OpenAIRE

    Jing Wang; Umer Farooq; John M. Carroll

    2010-01-01

    Creativity and rationale are often viewed as two contrasting facets in software design. A lack in recognizing the facilitative relationship between creativity and rationale not only underestimates the benefits designers can obtain from rationale practices, but also confines the approaches that support creativity in software design. Our exploratory study provides empirical evidence of the positive correlation between rationale and creativity. Furthermore, we found that the feasibility of desig...

  5. Does Design Rationale Enhance Creativity?

    Directory of Open Access Journals (Sweden)

    Jing Wang

    2010-01-01

    Full Text Available Creativity and rationale are often viewed as two contrasting facets in software design. A lack in recognizing the facilitative relationship between creativity and rationale not only underestimates the benefits designers can obtain from rationale practices, but also confines the approaches that support creativity in software design. Our exploratory study provides empirical evidence of the positive correlation between rationale and creativity. Furthermore, we found that the feasibility of design alternatives and the comprehensiveness of tradeoff evaluation are critical to enhancing novelty, persuasiveness, and insightfulness. We also discuss future directions to further understand how these properties, or rationale quality in general, affects design creativity.

  6. CAM and stack air sampler design guide

    International Nuclear Information System (INIS)

    About 128 air samplers and CAMs presently in service to detect and document potential radioactive release from 'H' and 'F' area tank farm ventilation stacks are scheduled for replacement and/or upgrade by Projects S-5764, S-2081, S-3603, and S-4516. The seven CAMs scheduled to be upgraded by Project S-4516 during 1995 are expected to provide valuable experience for the three remaining projects. The attached document provides design guidance for the standardized High Level Waste air sampling system

  7. Integrated design of cam mechanisms and servo-control systems

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Traditionally, in a cam mechanism, the cam is driven by an actuator at a constant speed. The motion characteristics of the follower are determined once the cam profile is designed. This paper presents a novel theory named "integrated design of cam mechanisms and servo-control systems" whose basic idea is varying the input speed trajectory of the cam by a microcomputer-controlled servomotor to improve kinematic and dynamic characteristics of the follower system. The philosophy of the theory is developing superior machines by taking advantage of the flexibility of servo-control systems to compensate for disadvantages of rigid cam mechanisms. The systematic design criteria of the cam-servo-integrated system are developed and an approach based on optimal-control theory is presented for to select suitable cam speed functions, hence the basis of the theory is formed.

  8. A CAD/CAM interface for computer-aided design of cams

    OpenAIRE

    Gandhi, Ashit R.

    1985-01-01

    The purpose of this thesis is to provide a complete package for the design and three dimensional modeling display of cams. The software produced as a part of this work will operate as a module of CADAM to produce cam designs and enter the resulting cam as a CAD model and produce the graphical display of the cam. In addition to the introductory material, this thesis is divided into four sections. The section on the graphics packages used in this thesis includes a b...

  9. Rationale for reduced tornado design bases

    International Nuclear Information System (INIS)

    This paper provides a rationale for relaxing the present NRC tornado design requirements, which are based on a design basis tornado (DBT) whose frequency of exceedance is 10-7 per year. It is proposed that a reduced DBT frequency of 10-5 to 10-6 per year is acceptable. This change in the tornado design bases for LMFBRs (and possibly all types of nuclear plants) is justified based on (1) existing NRC regulations and guidelines, (2) probabilistic arguments, (3) consistency with NRC trial safety goals, and (4) cost-benefit analysis

  10. CAD/CAM at the design stage

    Energy Technology Data Exchange (ETDEWEB)

    Masur, W.

    1989-01-01

    The introduction of CAD/CAM requires a thorough analysis of the manufacturing process in order to be able to single out those operations and partial complexes which are found suited for CAD/CAM use and are also expected to bring about the streamlining effects desired. Further it has to be analysed what partial jobs can be done by existing and planned hardware and software as well as by the skilled labour available or to be made available yet. The organization of the relations between program developer and program user and the required training measures has to be fixed in time and clearly by the managerial staff.

  11. CamBAfx: workflow design, implementation and application for neuroimaging

    Directory of Open Access Journals (Sweden)

    Cinly Ooi

    2009-08-01

    Full Text Available CamBAfx is a workflow application designed for both researchers who use workflows to process data (consumers and those who design them (designers. It provides a front-end (user interface optimized for data processing designed in a way familiar to consumers. The back-end uses a pipeline model to represent workflows since this is a common and useful metaphor used by designers and is easy to manipulate compared to other representations like programming scripts. As an Eclipse Rich Client Platform application, CamBAfx's pipelines and functions can be bundled with the software or downloaded post-installation. The user interface contains all the workflow facilities expected by consumers. Using the Eclipse Extension Mechanism designers are encouraged to customize CamBAfx for their own pipelines. CamBAfx wraps a workflow facility around neuroinformatics software without modification. CamBAfx's design, licensing and Eclipse Branding Mechanism allow it to be used as the user interface for other software, facilitating exchange of innovative computational tools between originating labs.

  12. A framework for design rationale capture and use during geometry design

    OpenAIRE

    Van Schaik, Jeroen Robbert

    2014-01-01

    Despite broad agreement on the utility of design rationale use and capture, a review of the relevant literature shows that industrial usage remains limited, especially during geometry design. An initial field study confirmed low design rationale capture during the geometry design stage. The lack of linking between design rationale and geometry models is identified as a factor holding back design rationale capture. A toolset is presented to link entities in geometry models to design ra...

  13. CAD/CAM: improved design quality, increased productivity

    Energy Technology Data Exchange (ETDEWEB)

    Evans, D. E.; England, J.

    1980-01-01

    Maintaining productivity levels while assuring the quality of engineering products grows increasingly more difficult and costly for industries such as the energy industry which are heavily committed to product design. The man/machine interface made possible through the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology can be applied to the design process as a tool for increased control to assure the quality of the final engineering product. The quality-control aspects of CAD/CAM technology are addressed in this presentation.

  14. CamBAfx: workflow design, implementation and application for neuroimaging

    OpenAIRE

    Cinly Ooi; Bullmore, Edward T; Alle-Meije Wink; Levent Sendur; Anna Barnes; Sophie Achard; John Aspden; Sanja Abbott; Shigang Yue; Manfred Kitzbichler; David Meunier; Voichita Maxim; Raymond Salvador; Julian Henty; Roger Tait

    2009-01-01

    CamBAfx is a workflow application designed for both researchers who use workflows to process data (consumers) and those who design them (designers). It provides a front-end (user interface) optimized for data processing designed in a way familiar to consumers. The back-end uses a pipeline model to represent workflows since this is a common and useful metaphor used by designers and is easy to manipulate compared to other representations like programming scripts. As an Eclipse Rich Client Platf...

  15. CamBAfx: Workflow Design, Implementation and Application for Neuroimaging

    OpenAIRE

    Ooi, Cinly; Bullmore, Edward T; Wink, Alle-Meije; Sendur, Levent; Barnes, Anna; Achard, Sophie; Aspden, John; Abbott, Sanja; Yue, Shigang; Kitzbichler, Manfred; Meunier, David; Maxim, Voichita; Salvador, Raymond; Henty, Julian; Tait, Roger

    2009-01-01

    CamBAfx is a workflow application designed for both researchers who use workflows to process data (consumers) and those who design them (designers). It provides a front-end (user interface) optimized for data processing designed in a way familiar to consumers. The back-end uses a pipeline model to represent workflows since this is a common and useful metaphor used by designers and is easy to manipulate compared to other representations like programming scripts. As an Eclipse Rich Client Platf...

  16. CAD/CAM from the graphic-design perspective

    Energy Technology Data Exchange (ETDEWEB)

    Marcus, A.

    1982-11-01

    CAD/CAM systems have evolved elaborate human-computer interfaces in order to facilitate the creation of highly detailed and specialized schematic diagrams and texts. Although these systems have powerful capacities in terms of graphics editing, data manipulation, and data storage, insufficient attention has been given to making the online interface (together with supporting documentation) user-friendly, i.e., understandable, memorable, and appealing to the general user. Graphic-design considerations in particular have been routinely overlooked. Graphic design concerns typography, symbol design, color, spatial layout, and temporal sequencing. Graphic design can assist computer science by providing insight and expertise in designing effective communication between human being and machine.

  17. CAD-CAM printed circuit board design

    Science.gov (United States)

    Agy, W. E.

    A step-by-step procedure for a printed circuit design achieved by CAD is presented. The operator at the interactive CRT station moves a stylus across a graphics tablet and intersperses commands which result in computer-generated pictorial forms on the screen that were drawn on the pad. Standard symbols are used for commands allowing, for instance, connections to be made of specific types in certain locations, which can be automatically edited from a materials list. An entire network of drawn lines can be referenced by a signal name for recall, and a finished circuit schematic can be checked for designs rules compliance, including fault reporting in terms of designator/pin number. A map may be present delineating the boundaries of the circuitry area, and previously completed circuitry segments can be recalled for piece-by-piece assembly of the circuit board.

  18. Principles and Design Rationale of Composition Filters

    NARCIS (Netherlands)

    Bergmans, Lodewijk; Aksit, Mehmet; Filman, Robert E.; Elrad, Tzilla; Clarke, Siobhán; Akşit, Mehmet

    2004-01-01

    A wide range of aspect-oriented programming languages has appeared in the past years [7]. Current research on future generation AOP languages is addressing issues like flexibility, expressive power and safety. We think that it is important to understand the motivations and design decisions of the fi

  19. Hermeneutics framework: integration of design rationale and optimizing software modules

    OpenAIRE

    Aksit, Mehmet; Malakuti, Somayeh

    2015-01-01

    To tackle the evolution challenges of adaptive systems, this paper argues on the necessity of hermeneutic approaches that help to avoid too early elimination of design alternatives. This visionary paper proposes the Hermeneutics Framework, which computationally integrates a design rationale management system, an auto-adaptive control system and a reflective and modular event-driven language runtime together. The Hermeneutics Framework is, among others, suitable for implementing dynamic adapti...

  20. Supporting awareness in creative group work by exposing design rationale

    Directory of Open Access Journals (Sweden)

    Umer Farooq

    2011-01-01

    Full Text Available When creativity is taken as a long-term, complex, and collaborative activity, support for awareness is required for group members to monitor the development of ideas, track how these ideas became narrowed, and understand how alternatives are being implemented and integrated by colleagues. In this paper, we investigate the effects of exposing design rationale to convey awareness, specifically activity awareness, in group creativity. Through evaluating a prototype, we investigate status updates that convey design rationale, and to what consequences, in small groups in fully distributed collaboration. We found that status updates are used for a variety of purposes and that participants’ comments on their collaborators’ status updates provided feedback. Overall, results suggest that participants’ awareness about their collaborators’ future plans increased over time. Majority of participants found the status updates useful, particularly those with higher metacognitive knowledge. Based on our results, two design strategies for activity awareness are proposed.

  1. ON DESIGN METHOD OF THE PRECISION CAM PROFILE WITH RANDOM PROCESSING ERRORS

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Based on probability and statistic, a design method of precision cam profile concerning the influence of random processing errors is advanced. Combining the design with the process, which can be used to predict that cam profiles will be successfully processed or not in the design stage, design of the cam can be done by balancing the economization and reliability. In addition, an fuzzy deduction method based on Bayers formula is advanced to estimate processing reasonable of the designed precision cam profile, and it take few samples.

  2. Single Roller-to-Cam Indexing Mechanisms Providing Two Maximized Dwells: Determination of Cam Pitch Profile for Optimal Designs

    Science.gov (United States)

    Tripathi, K. S.

    2015-04-01

    The view point of present research paper is concentrated on a part of a systematic scientific investigation of the mechanical possibilities of generating non-uniform full-rotational output motion with intermittent motion as the most important special case. The paper develops a geometrical construction of the cam pitch profile for optimal designs for single roller-to-cam indexing mechanism providing either two unequal maximum extent dwells with equal indexing angles (and unequal indexing periods) or two equal maximized dwells with unequal indexing angles (and equal indexing periods). Placement of the two dwells in the same half of the motion cycle gives very small periods; very high accelerations; and poor radius of curvature in the transition portion. Hence this paper considers optimal motion diagrams for the case of two dwells placed in different halves of the motion cycle and using the principle of kinematic inversion with intuitive conviction very tactically determines the cam pitch profile.

  3. New Knowledge Network Evaluation Method for Design Rationale Management

    Institute of Scientific and Technical Information of China (English)

    JING Shikai; ZHAN Hongfei; LIU Jihong; WANG Kuan; JIANG Hao; ZHOU Jingtao

    2015-01-01

    Current design rationale (DR) systems have not demonstrated the value of the approach in practice since little attention is put to the evaluation method of DR knowledge. To systematize knowledge management process for future computer-aided DR applications, a prerequisite is to provide the measure for the DR knowledge. In this paper, a new knowledge network evaluation method for DR management is presented. The method characterizes the DR knowledge value from four perspectives, namely, the design rationale structure scale, association knowledge and reasoning ability, degree of design justification support and degree of knowledge representation conciseness. The DR knowledge comprehensive value is also measured by the proposed method. To validate the proposed method, different style of DR knowledge network and the performance of the proposed measure are discussed. The evaluation method has been applied in two realistic design cases and compared with the structural measures. The research proposes the DR knowledge evaluation method which can provide object metric and selection basis for the DR knowledge reuse during the product design process. In addition, the method is proved to be more effective guidance and support for the application and management of DR knowledge.

  4. Ethical Rationale for the Ebola "Ring Vaccination" Trial Design.

    Science.gov (United States)

    Rid, Annette; Miller, Franklin G

    2016-03-01

    The 2014 Ebola virus epidemic is the largest and most severe ever recorded. With no approved vaccines or specific treatments for Ebola, clinical trials were launched within months of the epidemic in an unprecedented show of global partnership. One of these trials used a highly innovative "ring vaccination" design. The design was chosen for operational, scientific, and ethical reasons--in particular, it was regarded as ethically superior to individually randomized placebo-controlled trials. We scrutinize the ethical rationale for the ring vaccination design. We argue that the ring vaccination design is ethical but fundamentally equivalent to placebo-controlled designs with respect to withholding a potentially effective intervention from the control group. We discuss the implications for the ongoing ring vaccination trial and future research. PMID:26794172

  5. Optimal Design of a Cam Mechanism with Translating Flat-Face Follower using Genetic Algorithm

    Directory of Open Access Journals (Sweden)

    I. Tsiafis

    2013-12-01

    Full Text Available The optimum design of a cam mechanism is a time consuming task, due to the numerous alternatives considerations. In the present work, the problem of design parameters optimization of a cam mechanism with translating flat - face follower is investigated from a multi - objective point of view. The design parameters, just like the cam base circle radius, the follower face width and the follower offset can be determined considering as the optimization criteria minimization of the cam size, of the input torque and of the contact stress. During the optimization procedure, a number of constraints regarding the pressure angle, the contact stress, etcare taken into account. The optimization approach, based on genetic algorithm, is applied to find the optimal solutions with respect to the a fore - mentioned objective function and to Ensure the kinematic requirements. Finally, the dynamic behavior of the designed cam mechanism is investigated considering the frictional forces.

  6. Design of Cylindrical Cam with Oscillating Follower Based on 3D Expansion of Planar Profile Model

    Institute of Scientific and Technical Information of China (English)

    CHEN Junhua; LIN Zuan; WU Yijie

    2009-01-01

    Cylindrical cam with oscillating follower is widely applicable and used in many mechanical devices and machines. However, a common error exists in the methods of designing planar profile for oscillating follower cylinder cam. In this study, we propose a new hypothesis to solve this design problem with the inclusion of deviation angle. On the basis of this new concept, equations for planar profile expansion and methods of calculating pressure angle are deduced by applying 3D expansion formula of the follower's motion orbit. When the pressure angle is less than allowable value, the minimum base radius can be determined by using MATLAB software. Accordingly, the planar profile of oscillating follower cylinder cam is generated by CAD software. This new method is practical and can be easily adopted for the design of oscillating follower cylindrical cam with desirable accuracy. We applied the method in the design of cylindrical cam for paper feeding mechanism used in high-speed printers. We calculated the planar profile and used it to direct the NC machine for the manufacture of the groove of cylindrical cam. The improved cylindrical cam met all of the requirements of speed and accuracy demanded by high-speed printers. Therefore, our new method has been validated by practical application.

  7. Nonlinear System Modeling, Optimal Cam Design, and Advanced System Control for an Electromechanical Engine Valve Drive

    OpenAIRE

    Qiu, Yihui; Perreault, David J.; Keim, Thomas A.; Kassakian, John G.

    2011-01-01

    A cam-based shear force-actuated electromechanical valve drive system offering variable valve timing in internal combustion engines was previously proposed and demonstrated. To transform this concept into a competitive commercial product, several major challenges need to addressed, including the reduction of power consumption, transition time, and size. As shown in this paper, by using nonlinear system modeling, optimizing cam design, and exploring different control strategies, the power cons...

  8. Design, Optimization and Development of Assemblies for Continuous Casting Facility using Techniques CAD, CAM and CAE

    Directory of Open Access Journals (Sweden)

    Marius Tufoi

    2011-10-01

    Full Text Available This work presents design methods, optimization and realization of mechanical for continuous casting plants using modern techniques: CAD,CAM and CAE. These current techniques refer to techniques CAD (Computer-Aided Design, CAE (Computer-Aided Engineering and CAM (Computer-Aided Manufacturing. Techniques mentioned above are areas of information technology aimed at helping engineering a variety of areas to be faster, more efficient and creative. A synthesis of the works published in the last 15 years shows that computer aided design and manufacturing are two areas which have developed simultaneously being treated in a common vision based on the natural links that exist between the activities of design and production or manufacturing. The paper will present a practical case application of techniques CAD, CAE and CAM.

  9. Design Alteration of Motor-Cycle Engine Cam for Pneumatic Operation

    Directory of Open Access Journals (Sweden)

    Jimil M. Shah

    2013-06-01

    Full Text Available Power produced by pressurized gases/air has been used in many applications since decades. The power produced by that means is pollution free too. Hence substitution of petrol/diesel in engines with compressed air will be a step towards pollution free engine. The 4-stroke IC engine is to be converted into a 2-stroke pneumatic engine. Various design changes in camshaft design were carried out. The valve timing diagram was derived for the same. The cam profile of a double lobed cam as required in the valve timing diagram was designed in Pro-e software and was cut on a wire cut machine. The cam and camshaft were manufactured separately and then assembled.

  10. Design and research of cam linked ATC%凸轮联动ATC的设计研究

    Institute of Scientific and Technical Information of China (English)

    聂应新

    2001-01-01

    Based on the analysis made on motions of linked cam action, design of cam curve and driving calculation are explained and the technical problems related to design of cam linked ATC are approached.%通过对凸轮联动的动作分析,对凸轮曲线的设计及驱动计算做了说明,探讨了凸轮联动ATC设计中的有关技术问题。

  11. Design Alteration of Motor-Cycle Engine Cam for Pneumatic Operation

    OpenAIRE

    Jimil M. Shah; Akash B. Pandey; Ujjwell Y. Trivedi

    2013-01-01

    Power produced by pressurized gases/air has been used in many applications since decades. The power produced by that means is pollution free too. Hence substitution of petrol/diesel in engines with compressed air will be a step towards pollution free engine. The 4-stroke IC engine is to be converted into a 2-stroke pneumatic engine. Various design changes in camshaft design were carried out. The valve timing diagram was derived for the same. The cam profile of a double lobed cam as required i...

  12. Design of a cam-form tool in precision reuse of a digital paper display

    International Nuclear Information System (INIS)

    A reuse fabrication module that uses micro electroremoving as a precision machining process with a new design of the cam-form tool to remove defective indium-tin-oxide (ITO) thin film from the optical PET surfaces of a digital paper display is presented. A small diameter of the cathode of the cam-form tool corresponds to a higher removal rate for the ITO nanostructure. A small edge radius of the anode and a small gap width between the cathode and the ITO surface takes less time for the same amount of ITO removal. A higher feed rate of the optical PET diaphragm combines with enough electric power to drive fast micro-electroremoving. The high rotational speed of the cam-form tool can improve the effect of dreg discharge and is advantageous to associate with the fast feed rate of the optical PET diaphragm.

  13. Benefits of using CAD/CAM for design, draughting and prototype production of automotive instrumentation parts

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, N.A.

    1982-01-01

    The paper will describe the work untertaken in the company over the last five years. This work now enables us to take a design concept through to volume production in about 12 months and delivery of prototypes 3-4 months from the start of design. This was not possible prior to the introduction of the CAD/CAM equipment. The C.A.D. graphics system will be described in terms of its method of use by designers, draughtsmen and part programmers. All these people use a common database to ensure validity of design. The C.A.M. operation on C.N.C.Milling machines will be described also, and indications given of future areas of work on this project. These will relate to tool manufacture using the same database.

  14. Design and manufacture of turbine runner blades using CAD/CAM technology

    Energy Technology Data Exchange (ETDEWEB)

    Strohmer, F.; Winkler, S.

    1986-05-01

    Advances in hydraulic and mechanical design and manufacture of hydraulic turbines have occured over the last years. The turbines have reached a high level of performance. This is especially a result of a proper design and accurate manufacture of the turbine runner due to the application of the computer aided design and computer aided manufacturing systems combined with new computerized analysis techniques. The various steps of the modular numerical system - hydraulic computation, interactive blade design, fluid flow analysis, stress analysis and CNC-manufacture of the model blade - are shown on the example of a runner blade for axial turbines. For optimizing the manufacturing of the prototype blade the CAD/CAM-technology is applied. The data flow from the model blade, measured on an electronic coordinate measurement machine, via the CAD/CAM-system, which represents the blade surface in a mathematical form and calculates the tool paths, to the five axis CNC-milling machine is demonstrated. Through the application of the CAD/CAM-technology to hydraulic blades the time frame for designing and manufacturing has been reduced while improving quality and accuracy of the blades.

  15. CAD/CAM interface design of excimer laser micro-processing system

    Science.gov (United States)

    Jing, Liang; Chen, Tao; Zuo, Tiechuan

    2005-12-01

    Recently CAD/CAM technology has been gradually used in the field of laser processing. The excimer laser micro-processing system just identified G instruction before CAD/CAM interface was designed. However the course of designing a part with G instruction for users is too hard. The efficiency is low and probability of making errors is high. By secondary development technology of AutoCAD with Visual Basic, an application was developed to pick-up each entity's information in graph and convert them to each entity's processing parameters. Also an additional function was added into former controlling software to identify these processing parameters of each entity and realize continue processing of graphic. Based on the above CAD/CAM interface, Users can design a part in AutoCAD instead of using G instruction. The period of designing a part is sharply shortened. This new way of design greatly guarantees the processing parameters of the part is right and exclusive. The processing of complex novel bio-chip has been realized by this new function.

  16. Tool application CAD / CAM for design and construction of a prototype of plastic injection mold

    Directory of Open Access Journals (Sweden)

    Albert Miyer Suárez Castrillón

    2015-11-01

    Full Text Available The study, development and production of injection molds comes with the implementation of CAD and CAM tools available on the market; using these tools, a prototype injection mold for thermoplastic materials was designed and built, based on a mold is injection in the laboratory of the University of Pamplona, in which a couple of modifications were made in order to experiment with its design. The prototype was manufactured through a 3D scan of the original mold to provide the CAD / CAM files with the simulated 3D printing technique for performing an experimental study with the prototype for adjusting temperature and pressure sensors and for coatings metallic materials for use in the injection molding process.

  17. Design Rationale for a Wide Spectrum Specification Language FGSPEC

    Institute of Scientific and Technical Information of China (English)

    吕建; 徐家福

    1993-01-01

    FGSPEC is a wide spectrum specification language intended to facilitate the software specification and the expression of transformation process from the functional specification whic describes “what to do ”to the corresponding design(perational)specification whic describer“how to do ”.The design emphasizes the coherence of multi-level specification mechanisms and a tree structure model is provided whic unifies the wide spectrum specification styles from“what”to“how”.

  18. Study on Approach for Computer-Aided Design and Machining of General Cylindrical Cam Using Relative Velocity and Inverse Kinematics

    Institute of Scientific and Technical Information of China (English)

    Se-Hwan; Park; Byong-Kook; Gu; Joong-Ho; Shin; Geun-Jong; Yoo

    2002-01-01

    Cylindrical Cam Mechanism which is one of the best eq uipments to accomplish an accurate motion transmission is widely used in the fie lds of industries, such as machine tool exchangers, textile machinery and automa tic transfer equipments. This paper proposes a new approach for the shape design and manufacturing of the cylindrical cam. The design approach uses the relative velocity concept and the manufacturing approach uses the inverse kinematics concept. For the shape desig n, the contact points betw...

  19. Rationale and Design of the Access Specification Language RASP

    Directory of Open Access Journals (Sweden)

    Mark Evered

    2014-05-01

    Full Text Available In this paper we describe the formal specification language RASP for expressing fine-grained access control constraints in information systems. The design of the language is motivated by a number of IS case studies which demonstrate the complexity of the access constraints which arise if minimal (need-to-know access is to be strictly enforced. RASP supports modularity, parameterization, role acquisition, constraint expressions and a symmetrical approach to role transitions and attribute transitions. No existing access control specification language supports all of these complex, realistic requirements.

  20. Design and development of a quad copter (UMAASK) using CAD/CAM/CAE

    Science.gov (United States)

    Manarvi, Irfan Anjum; Aqib, Muhammad; Ajmal, Muhammad; Usman, Muhammad; Khurshid, Saqib; Sikandar, Usman

    Micro flying vehicles1 (MFV) have become a popular area of research due to economy of production, flexibility of launch and variety of applications. A large number of techniques from pencil sketching to computer based software are being used for designing specific geometries and selection of materials to arrive at novel designs for specific requirements. Present research was focused on development of suitable design configuration using CAD/CAM/CAE tools and techniques. A number of designs were reviewed for this purpose. Finally, rotary wing Quadcopter flying vehicle design was considered appropriate for this research. Performance requirements were planned as approximately 10 meters ceiling, weight less than 500grams and ability to take videos and pictures. Parts were designed using Finite Element Analysis, manufactured using CNC machines and assembled to arrive at final design named as UMAASK. Flight tests were carried out which confirmed the design requirements.

  1. Activity in GEriatric acute CARe (AGECAR: rationale, design and methods

    Directory of Open Access Journals (Sweden)

    Fleck Steven J

    2012-06-01

    Full Text Available Abstract Background The Activity in GEriatric acute CARe (AGECAR is a randomised control trial to assess the effectiveness of an intrahospital strength and walk program during short hospital stays for improving functional capacity of patients aged 75 years or older. Methods/Design Patients aged 75 years or older admitted for a short hospital stay (≤14 days will be randomly assigned to either a usual care (control group or an intervention (training group. Participants allocated in the usual care group will receive normal hospital care and participants allocated in the intervention group will perform multiple sessions per day of lower limb strength training (standing from a seated position and walking (10 min bouts while hospitalized. The primary outcome to be assessed pre and post of the hospital stay will be functional capacity, using the Short Physical Performance Battery (SPPB, and time to walk 10 meters. Besides length of hospitalization, the secondary outcomes that will also be assessed at hospital admission and discharge will be pulmonary ventilation (forced expiratory volume in one second, FEV1 and peripheral oxygen saturation. The secondary outcomes that will be assessed by telephone interview three months after discharge will be mortality, number of falls since discharge, and ability to cope with activities of daily living (ADLs, using the Katz ADL score and Barthel ADL index. Discussion Results will help to better understand the potential of regular physical activity during a short hospital stay for improving functional capacity in old patients. The increase in life expectancy has resulted in a large segment of the population being over 75 years of age and an increase in hospitalization of this same age group. This calls attention to health care systems and public health policymakers to focus on promoting methods to improve the functional capacity of this population. Trial registration ClinicalTrials.gov ID: NCT01374893.

  2. Rationales, design and recruitment of the Taizhou Longitudinal Study

    Directory of Open Access Journals (Sweden)

    Lu Daru

    2009-07-01

    Full Text Available Background Rapid economic growth in China in the past decades has been accompanied by dramatic changes in lifestyle and environmental exposures. The burdens of non-communicable diseases, such as cardiovascular diseases, diabetes and cancer, have also increased substantially. Methods/design We initiated a large prospective cohort–the Taizhou Longitudinal Study–in Taizhou (a medium-size city in China to explore the environmental and genetic risk factors for common non-communicable diseases. The sample size of the cohort will be at least 100,000 adults aged 30–80 years drawn from the general residents of the districts of Hailin, Gaogang, and Taixing (sample frame, 1.8 million of Taizhou. A three-stage stratified sampling method will be applied. Baseline investigations include interviewer-administered questionnaire, anthropometric measurements, and collection of buccal mucosal cells and blood specimens. DNA will be extracted for genetic studies and serum samples will be used for biochemical examinations. A follow-up survey will be conducted every three years to obtain information on disease occurrence and information on selected lifestyle exposures. Study participants will be followed-up indefinitely by using a chronic disease register system for morbidity and cause-specific mortality. Information on non-fatal events will be obtained for certain major categories of disease (e.g., cancer, stroke, myocardial infarction through established registry systems. Discussion The Taizhou Longitudinal Study will provide a good basis for exploring the roles of many important environmental factors (especially those concomitant with the economic transformation in China for common chronic diseases, solely or via interaction with genetic factors.

  3. Preliminary design specification for Department of Energy standardized spent nuclear fuel canisters. Volume 2: Rationale document

    International Nuclear Information System (INIS)

    This document (Volume 2) is a companion document to a preliminary design specification for the design of canisters to be used during the handling, storage, transportation, and repository disposal of Department of Energy (DOE) spent nuclear fuel (SNF). This document contains no procurement information, such as the number of canisters to be fabricated, explicit timeframes for deliverables, etc. However, this rationale document does provide background information and design philosophy in order to help engineers better understand the established design criteria (contained in Volume 1 respectively) necessary to correctly design and fabricate these DOE SNF canisters

  4. Sildenafil in heart failure with reactive pulmonary hypertension (Sildenafil HF) clinical trial (rationale and design)

    OpenAIRE

    Guglin, Maya; Rajagopalan, Navin; Anaya, Paul; Charnigo, Richard

    2016-01-01

    In this article, we present the rationale and design of the Sildenafil HF trial (ClinicalTrials.gov identifier: NCT02304705). We will randomize patients with heart failure and reactive pulmonary hypertension (pulmonary capillary wedge pressure > 15 mmHg, pulmonary vascular resistance > 3 Wood units) into two groups: the treatment group receiving sildenafil 20 mg 3 times a day and a matching placebo group. The duration of intervention will be 3 months. The primary outcome is 6-minute walk dist...

  5. Implementing the World Mental Health Survey Initiative in Portugal – rationale, design and fieldwork procedures

    OpenAIRE

    XAVIER, MIGUEL; Baptista, Helena; Mendes, Jorge M; Magalhães, Pedro; Caldas-de-Almeida, José M.

    2013-01-01

    Background: The World Mental Health Survey Initiative was designed to evaluate the prevalence, the correlates, the impact and the treatment patterns of mental disorders. This paper describes the rationale and the methodological details regarding the implementation of the survey in Portugal, a country that still lacks representative epidemiological data about psychiatric disorders. Methods: The World Mental Health Survey is a cross-sectional study with a representative sample of th...

  6. Implementing the World Mental Health Survey Initiative in Portugal – rationale, design and fieldwork procedures

    OpenAIRE

    XAVIER, MIGUEL; Baptista, Helena; Mendes, Jorge M; Magalhães, Pedro; Caldas-de-Almeida, José M.

    2013-01-01

    Background The World Mental Health Survey Initiative was designed to evaluate the prevalence, the correlates, the impact and the treatment patterns of mental disorders. This paper describes the rationale and the methodological details regarding the implementation of the survey in Portugal, a country that still lacks representative epidemiological data about psychiatric disorders. Methods The World Mental Health Survey is a cross-sectional study with a representative sample of the Portuguese p...

  7. Rationale for human modelling in human in the loop systems design

    OpenAIRE

    Fass, Didier; Lieber, Romain

    2009-01-01

    Human modelling in human-in-the-loop systems (HITLS) design can be a complex and dynamic endeavour. Thereby it needs a theoretical framework for grounding methods and models on verified principals and an integrative approach that takes into consideration the specificity of biological organization of living systems, according to the principles of physics, and a coherent way to organize and integrate structural and functional artificial elements. This paper focuses on the rationale of human mod...

  8. Latin American Study of Nutrition and Health (ELANS): rationale and study design

    OpenAIRE

    M. Fisberg; Kovalskys, I.; Gómez, G.; Rigotti, A; Cortés, L. Y.; Herrera-Cuenca, M.; Yépez, M. C.; Pareja, R. G.; Guajardo, V.; I.Z. Zimberg; Chiavegatto Filho, A. D. P.; Pratt, M.; Koletzko, B; Tucker, K L; ,

    2016-01-01

    Background Obesity is growing at an alarming rate in Latin America. Lifestyle behaviours such as physical activity and dietary intake have been largely associated with obesity in many countries; however studies that combine nutrition and physical activity assessment in representative samples of Latin American countries are lacking. The aim of this study is to present the design rationale of the Latin American Study of Nutrition and Health/Estudio Latinoamericano de Nutrición y Salud (ELANS) w...

  9. Impact of SenseCam on memory, identity and mood in Korsakoff's syndrome: a single case experimental design study.

    Science.gov (United States)

    Svanberg, Jenny; Evans, Jonathan J

    2014-01-01

    This study aimed to investigate the impact of SenseCam, a wearable, automatic camera, on subjective mood and identity in a patient with severe memory impairment due to Korsakoff's syndrome. It was hypothesised that SenseCam would improve Ms A's mood and identity through enhancing recall of autobiographical memories of recent events, therefore supporting a coherent sense of self; the lack of which was contributing to Ms A's mood deterioration. An ABA single case experimental design investigated whether using SenseCam to record regular activities impacted on Ms A's mood and identity. Ms A experienced improved recall for events recorded using SenseCam, and showed improvement on subjective ratings of identity. However, a corresponding improvement in mood was not seen, and the study was ended early at Ms A's request. Qualitative information was gathered to explore Ms A's experience of the study, and investigate psychosocial factors that may have impacted on the use of SenseCam. SenseCam may be of significant use as a compensatory memory aid for people with Korsakoff's syndrome and other types of alcohol-related brain damage (ARBD), but acceptance of memory impairment and consistent support may be among the factors required to support the use of such assistive technologies in a community setting. PMID:24131241

  10. OPTIMAL DESIGNS AND CAPABILITY LIMITS OF SINGLE ROLLER-TO-CAM INDEXING MECHANISMS FOR THREE DWELLS

    Directory of Open Access Journals (Sweden)

    DR. K. S. TRIPATHI

    2010-12-01

    Full Text Available This paper aims to investigate the continuous contact single roller-to-cam indexing mechanism for optimal designs and capability limits, based on generic transmission and curvature constraint for three dwell periods. First of all, the paper determines the solutions of the problems associated with multiple dwells and then develops optimal designs for three maximum extent dwell periods with equal indexing angles with curvature and transmission constraints. Next, stipulating that the three dwell periods should be equal; iteration is done. This gives optimal designs for three equal maximized dwells with equal indexing periods with curvature and transmission constraints. Final information in the form of capability limits will be very helpful to those who search for various alternative indexing mechanisms for several applications of automatic and packaging industries.

  11. Criterios para Seleccionar Sistemas de Diseño y Manufactura Asistidos por Computadora (CAD/CAM Criteria for the Selection of Computer Aided Design and Manufacturing Systems (CAD/CAM

    Directory of Open Access Journals (Sweden)

    R.R. Martínez

    2004-01-01

    Full Text Available Este estudio tiene como objetivo presentar en forma clara los principios fundamentales que se requieren para tener un criterio sobre las bondades e inconvenientes de los sistemas Diseño y Manufactura Asistidos por Computadora (CAD/CAM. La inquietud nació por algunos problemas presentados en la primera adquisición de un sistema de CAD/CAM. Se adaptó a una máquina de Control Numérico por Computadora (CNC las dos modalidades de CAM, el primero con el sistema de CAD integrado y la otra con interacción en AutoCAD. Del análisis se determinó la indiferencia de usar un software de CAD desarrollado por la misma compañía del CAM. El resultado de estos experimentos y observaciones proporciona una herramienta fundamental para seleccionar un sistema de CAD/CAM eficienteThe objective of this study was to present in clear form the fundamental principles required to obtain a criterion of the advantages and disadvantages of computer aided design and manufacturing systems (CAD/CAM. The idea for setting these selection criteria were obtained during the initial acquisition of a CAD/CAM system. A Numerical Control by Computer (CNC machine was adapted to two modalities of CAM, the first with an integrated CAD system and another with AutoCAD interaction. From the analysis it was determined that it was immaterial whether or not the use of CAD software was from the same company that produced the CAM software. The results of these experiments and observations provide a fundamental tool for selecting an efficient CAD/CAM system

  12. Next-generation CAE/CAD/CAM system, CADDS5, featuring configurable design technology and intelligent user interfaces. Shinsedai CAE/CAD/CAM system CADDS5

    Energy Technology Data Exchange (ETDEWEB)

    Mizobe, K.; Suzuki, K.; Shimada, K. (Toshiba Corp., Tokyo (Japan))

    1992-12-01

    The next-generation CAE/CAD/CAM system (CADDS5) is outlined. It is featured by feature-based modeling capability which is possible to generate not only solid models of objects but also advanced models enhanced by material, finishing and machining information. Its software system is composed of (1) the main software package including a variational sketcher function, parametric solid one, feature-based modeling one and equation solver, (2) the software group for downsizing of software, and (3) the object-oriented programming tool to generate customized functions. In addition, CADDS5 provides some application software tools, (1) the plant piping design support tool including procedures from a piping layout to a cost estimation, (2) the structure design support tool for plants and buildings, and (3) the civil engineering design support tool to generate three-dimensional terrain models from terrain or surveying data. 2 refs., 2 figs.

  13. Some Aspects on Technological Design of a Cam Type Workpiece Using CATIA Software

    Directory of Open Access Journals (Sweden)

    Calin-Octavian Miclosina

    2013-09-01

    Full Text Available The paper presents the geometrical models of cam and of semi-finished piece, obtained with CATIA software. Two cam technological routes are shown and the optimal route is chosen. From the technological route, rough milling operation is simulated with CATIA software. By using different milling parameters, various machining time values are obtained.

  14. It is easier with CAD/CAM. Designing flow machines for air conditioning technique with computer-aided methods; Mit CAD/CAM geht`s besser. Stroemungsmaschinen fuer die Klimatechnik anwendungsspezifisch auslegen mit Hilfe computerunterstuetzter Methoden

    Energy Technology Data Exchange (ETDEWEB)

    Carolus, T. [Universitaet-Gesamthochschule Siegen (Germany). Inst. fuer Fluid- und Thermodynamik; Homrighausen, B. [Universitaet-Gesamthochschule Siegen (Germany). Inst. fuer Fluid- und Thermodynamik; Beiler, M. [Universitaet-Gesamthochschule Siegen (Germany). Inst. fuer Fluid- und Thermodynamik

    1994-08-08

    One requires many flow machines for circulation and delivery in air conditioning and ventilation technique. Computer-aided design and manufacture (CAD/CAM) and computational fluid dynamics (CFD) are now important aids for queck and reliable development of advanced flow machines. Conventional design processes supply the raw data of the generally very complicated geometry. (orig.) [Deutsch] In der Klima- und Lueftungstechnik benoetigt man zahlreiche Stroemungsmaschinen zum Umwaelzen und Foerdern. CAD/CAM (Computer aided design und manufacture) und CFD (Computational fluid dynamics) sind heute wichtige Hilfsmittel zur schnellen und zuverlaessigen Entwicklung fortschrittlicher Stroemungsmaschinen. Klassische Auslegeverfahren liefern die Rohdaten der allgemein sehr komplizierten Geometrie. (orig.)

  15. Computer Aided Design in Engineering Education.

    Science.gov (United States)

    Gobin, R.

    1986-01-01

    Discusses the use of Computer Aided Design (CAD) and Computer Aided Manufacturing (CAM) systems in an undergraduate engineering education program. Provides a rationale for CAD/CAM use in the already existing engineering program. Describes the methods used in choosing the systems, some initial results, and warnings for first-time users. (TW)

  16. Design of a radio telescope surface segment actuator based on a form-closed eccentric cam

    Science.gov (United States)

    Smith, David R.

    2014-07-01

    As radio telescopes have reached larger diameters and higher frequencies, it is typically not possible to meet their surface accuracy specifications using passive homology-based designs. The most common solution to this problem in the current generation of large, high-frequency radio telescopes is to employ a system of linear actuators to correct the surface shape of the primary reflector. The exact specifications of active surface actuators vary with the telescope. However, they have many common features, some of which drive their design. In general, these actuators must provide precise and repeatable positioning under significant loads during operation and they must withstand even higher loads for survival conditions. For general safety, they typically must hold position in the event of a power failure and must incorporate position limits, whether electrical, mechanical, or both. Because the number of actuators is generally high for large active surfaces (hundreds or even thousands of actuators), they must also be reliable and of reasonable individual cost. Finally, for maximum flexibility in their installation, they must be compact. This paper presents a concept for an active surface actuator based on a form-closed eccentric cam (kinematically, a Scotch Yoke mechanism). Such a design is limited in stroke, but offers potential advantages in terms of manufacture, compactness, measurement, and survival loading. The paper demonstrates that some of the expected advantages cannot be practically realized, due to dimensions that are driven by survival loading conditions. As a result, this concept is likely to offer an advantage over conventional screw-type actuators only for cases where actuator runaway and stall are the driving considerations.

  17. Male infertility after endoscopic Totally Extraperitoneal (Tep) hernia repair (Main): rationale and design of a prospective observational cohort study

    OpenAIRE

    Schouten Nelleke; van Dalen Thijs; Smakman Niels; Elias Sjoerd G; van de Water Cees; Spermon Roan J; Mulder Laurens; Burgmans Ine P J

    2012-01-01

    Abstract Background To describe the rationale and design of an observational cohort study analyzing the effects of endoscopic Totally Extraperitoneal (TEP) hernia repair on male fertility (MAIN study). Methods and design The MAIN study is an observational cohort study designed to assess fertility after endoscopic TEP hernia repair. The setting is a high-volume single center hospital, specialized in TEP hernia repair. Male patients of 18-60 years of age, with primary, reducible, bilateral ingu...

  18. Holonic Rationale and Bio-inspiration on Design of Complex Emergent and Evolvable Systems

    Science.gov (United States)

    Leitao, Paulo

    Traditional centralized and rigid control structures are becoming inflexible to face the requirements of reconfigurability, responsiveness and robustness, imposed by customer demands in the current global economy. The Holonic Manufacturing Systems (HMS) paradigm, which was pointed out as a suitable solution to face these requirements, translates the concepts inherited from social organizations and biology to the manufacturing world. It offers an alternative way of designing adaptive systems where the traditional centralized control is replaced by decentralization over distributed and autonomous entities organized in hierarchical structures formed by intermediate stable forms. In spite of its enormous potential, methods regarding the self-adaptation and self-organization of complex systems are still missing. This paper discusses how the insights from biology in connection with new fields of computer science can be useful to enhance the holonic design aiming to achieve more self-adaptive and evolvable systems. Special attention is devoted to the discussion of emergent behavior and self-organization concepts, and the way they can be combined with the holonic rationale.

  19. The Pediatric Obsessive-Compulsive Disorder Treatment Study II: rationale, design and methods

    Directory of Open Access Journals (Sweden)

    March John S

    2009-01-01

    Full Text Available Abstract This paper presents the rationale, design, and methods of the Pediatric Obsessive-Compulsive Disorder Treatment Study II (POTS II, which investigates two different cognitive-behavior therapy (CBT augmentation approaches in children and adolescents who have experienced a partial response to pharmacotherapy with a serotonin reuptake inhibitor for OCD. The two CBT approaches test a "single doctor" versus "dual doctor" model of service delivery. A specific goal was to develop and test an easily disseminated protocol whereby child psychiatrists would provide instructions in core CBT procedures recommended for pediatric OCD (e.g., hierarchy development, in vivo exposure homework during routine medical management of OCD (I-CBT. The conventional "dual doctor" CBT protocol consists of 14 visits over 12 weeks involving: (1 psychoeducation, (2, cognitive training, (3 mapping OCD, and (4 exposure with response prevention (EX/RP. I-CBT is a 7-session version of CBT that does not include imaginal exposure or therapist-assisted EX/RP. In this study, we compared 12 weeks of medication management (MM provided by a study psychiatrist (MM only with two types of CBT augmentation: (1 the dual doctor model (MM+CBT; and (2 the single doctor model (MM+I-CBT. The design balanced elements of an efficacy study (e.g., random assignment, independent ratings with effectiveness research aims (e.g., differences in specific SRI medications, dosages, treatment providers. The study is wrapping up recruitment of 140 youth ages 7–17 with a primary diagnosis of OCD. Independent evaluators (IEs rated participants at weeks 0,4,8, and 12 during acute treatment and at 3,6, and 12 month follow-up visits. Trial registration NCT00074815

  20. The Reversal Intervention for Metabolic Syndrome (TRIMS study: rationale, design, and baseline data

    Directory of Open Access Journals (Sweden)

    Troughton Jacqui

    2011-05-01

    Full Text Available Abstract Background Recent attention has focused on strategies to combat the forecast epidemic of type-2 diabetes (T2DM and its major vascular sequelae. Metabolic syndrome (MetS comprises a constellation of factors that increase the risk of cardiovascular disease (CVD and T2DM. Our study aims to develop a structured self-management education programme for people with MetS, which includes management of cardiovascular and diabetes risk factors, and to determine its impact. This paper describes the rationale and design of the TRIMS study, including intervention development, and presents baseline data. Methods Subjects recruited from a mixed-ethnic population with MetS were randomised to intervention or control arms. The intervention arm received structured group education based on robust psychological theories and current evidence. The control group received routine care. Follow-up data will be collected at 6 and 12 months. The primary outcome measure will be reversal of metabolic syndrome in the intervention group subjects compared to controls at 12 months follow-up. Results 82 participants (44% male, 22% South Asian were recruited between November 2009 and July 2010. Baseline characteristics were similar for both the intervention (n = 42 and control groups (n = 40. Median age was 63 years (IQR 57 - 67, mean waist size 106 cm (SD ± 11, and prescribing of statins and anti-hypertensives was 51% in each case. Conclusion Results will provide information on changes in diabetes and CVD risk factors and help to inform primary prevention strategies in people with MetS from varied ethnic backgrounds who are at high risk of developing T2DM and CVD. Information gathered in relation to the programme's acceptability and effectiveness in a multi-ethnic population would ensure that our results are widely applicable. Trial registration The study is registered at ClinicalTrials.gov, study identifier: NCT01043770.

  1. Canadian nuclear power principles for beyond design basis events - supporting rationale

    International Nuclear Information System (INIS)

    The development of the following principles and their rationale began during a special Chief Nuclear Engineers forum held on March 25th, 2013 in Toronto. These principles are intended to provide guidance to the Canadian Nuclear Power Industry in developing responses to the lessons learned from the Fukushima event of March 2011. These principles were accepted and signed off by the Chief Nuclear Officers of each of the three utilities in August 2013 and were presented to the CNSC at a public hearing on August 21, 2013. This document provides the underlying rationale for the principles. (author)

  2. Predicting asthma in preschool children with asthma symptoms: study rationale and design

    Directory of Open Access Journals (Sweden)

    Hafkamp-de Groen Esther

    2012-10-01

    Full Text Available Abstract Background In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. The aim of this study is to present the rationale and design of a study 1 to externally validate and update the PIAMA Risk Score, 2 to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of preschool children with asthma symptoms and 3 to test implementation of the Asthma Risk Appraisal Tool in well-child care. Methods and design The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth. The (updated PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. Discussion Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear. This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups

  3. SPLPKG WFCMPR WFAPPX, Wilson-Fowler Spline Generator for Computer Aided Design And Manufacturing (CAD/CAM) Systems

    International Nuclear Information System (INIS)

    1 - Description of program or function: The three programs SPLPKG, WFCMPR, and WFAPPX provide the capability for interactively generating, comparing and approximating Wilson-Fowler Splines. The Wilson-Fowler spline is widely used in Computer Aided Design and Manufacturing (CAD/CAM) systems. It is favored for many applications because it produces a smooth, low curvature fit to planar data points. Program SPLPKG generates a Wilson-Fowler spline passing through given nodes (with given end conditions) and also generates a piecewise linear approximation to that spline within a user-defined tolerance. The program may be used to generate a 'desired' spline against which to compare other Splines generated by CAD/CAM systems. It may also be used to generate an acceptable approximation to a desired spline in the event that an acceptable spline cannot be generated by the receiving CAD/CAM system. SPLPKG writes an IGES file of points evaluated on the spline and/or a file containing the spline description. Program WFCMPR computes the maximum difference between two Wilson-Fowler Splines and may be used to verify the spline recomputed by a receiving system. It compares two Wilson-Fowler Splines with common nodes and reports the maximum distance between curves (measured perpendicular to segments) and the maximum difference of their tangents (or normals), both computed along the entire length of the Splines. Program WFAPPX computes the maximum difference between a Wilson- Fowler spline and a piecewise linear curve. It may be used to accept or reject a proposed approximation to a desired Wilson-Fowler spline, even if the origin of the approximation is unknown. The maximum deviation between these two curves, and the parameter value on the spline where it occurs are reported. 2 - Restrictions on the complexity of the problem - Maxima of: 1600 evaluation points (SPLPKG), 1000 evaluation points (WFAPPX), 1000 linear curve breakpoints (WFAPPX), 100 spline Nodes

  4. Prospective Study of One Million Deaths in India: Rationale, Design, and Validation Results.

    Directory of Open Access Journals (Sweden)

    2005-12-01

    Full Text Available BACKGROUND: Over 75% of the annual estimated 9.5 million deaths in India occur in the home, and the large majority of these do not have a certified cause. India and other developing countries urgently need reliable quantification of the causes of death. They also need better epidemiological evidence about the relevance of physical (such as blood pressure and obesity, behavioral (such as smoking, alcohol, HIV-1 risk taking, and immunization history, and biological (such as blood lipids and gene polymorphisms measurements to the development of disease in individuals or disease rates in populations. We report here on the rationale, design, and implementation of the world's largest prospective study of the causes and correlates of mortality. METHODS AND FINDINGS: We will monitor nearly 14 million people in 2.4 million nationally representative Indian households (6.3 million people in 1.1 million households in the 1998-2003 sample frame and 7.6 million people in 1.3 million households in the 2004-2014 sample frame for vital status and, if dead, the causes of death through a well-validated verbal autopsy (VA instrument. About 300,000 deaths from 1998-2003 and some 700,000 deaths from 2004-2014 are expected; of these about 850,000 will be coded by two physicians to provide causes of death by gender, age, socioeconomic status, and geographical region. Pilot studies will evaluate the addition of physical and biological measurements, specifically dried blood spots. Preliminary results from over 35,000 deaths suggest that VA can ascertain the leading causes of death, reduce the misclassification of causes, and derive the probable underlying cause of death when it has not been reported. VA yields broad classification of the underlying causes in about 90% of deaths before age 70. In old age, however, the proportion of classifiable deaths is lower. By tracking underlying demographic denominators, the study permits quantification of absolute mortality rates

  5. Individual savings accounts for social insurance:rationale and alternative designs

    OpenAIRE

    Bovenberg, A.L.; Hansen, M.; Sorensen, P.B.

    2008-01-01

    Using Danish data, we find that about three-fourths of the taxes levied to finance public transfers actually finance benefits that redistribute income over the life cycle of individual taxpayers rather than redistribute resources across people. This finding and similar results for other countries provide a rationale for financing part of social insurance via mandatory individual savings accounts. We discuss the advantages and disadvantages of mandatory individual savings accounts for social i...

  6. CAMS achievements in 1995

    International Nuclear Information System (INIS)

    CAMS (Computerized Accident Management Support) is a system being developed as a joint research activity at the Halden Reactor Project with additional financing from the Swedish Nuclear Inspectorate (SKI) and the Nordic NKS/RAK-2 project. Three types of users are envisaged: the staff in the control room, the staff in the technical support centre and the staff at a national emergency centre. It is still an experimental system. The Swedish Nuclear Inspectorate kindly accepted to test CAMS at a safety exercise on the 4th of May, 1995. CAMS is designed assuming automatic data transfer from the plant. Missing the data link, a simulator running in the next room was updated now and then with data received by phone. As seen from CAMS, it did not matter if the data came from a fake plant or from a real plant, except that the data were delayed. Overall, it seemed that CAMS can be a very important tool for a national authority. A data link from the plant would increase its usefulness. Several comments on design features were collected and will be used to improve the system. The model needs more inputs to control the main parameters, and a larger repertoire of fault conditions should be put into the model. In the second half of 1995 the work on CAMS has concentrated upon designing new modules for signal validation, tracking simulation and state identification. This will provide better capabilities for on-line monitoring and assessment of the plant state. Further, it has been proposed to introduce Probabilistic Safety Assessment (PSA) to assist in risk monitoring. A first prototype has been made on a personal computer showing the main features of such a PSA module. (au)

  7. The CfAO's Astronomy Course in COSMOS: Curriculum Design, Rationale, and Application

    CERN Document Server

    Cooksey, Kathy L; Porter, Jason; Raschke, Lynne; Severson, Scott; Hinkley, Sasha

    2010-01-01

    From 2001 to 2007, COSMOS provided a teaching and outreach venue for the Center for Adaptive Optics Professional Development Program (CfAO PDP). COSMOS is a four-week residential mathematics and science summer program for high-school students organized by the University of California on four of its campuses. Two topical science courses comprised each COSMOS cluster. An astronomy course has always formed a basis for the CfAO PDP-affiliated cluster. The course included a variety of pedagogical techniques to address a diversity of learners and goals. We outline the astronomy course---lectures, activities, etc.---and provide the rationale for what was taught, how it was aught, and when it was taught.

  8. Rationale for the Design of a Web-based Programming Course for Adults

    DEFF Research Database (Denmark)

    Bennedsen, Jens; Caspersen, Michael Edelgaard

    2003-01-01

    assistant as well as the other students. Another serious drawback is the reduced bandwidth in communication among the different actors. Precautions have to be taken in order to compensate for these and other drawbacks. We describe a web-based introductory programming course for adults and the rationale...... for choosing technologies and organizing the course in order to compensate for the drawbacks inherent in this kind of teaching. Our conclusions, although presented in the context of an introductory programming course, holds for most other construction-based courses as well. In the first part we set the stage...... by describing the relevant context and identifying the special conditions stemming from the course being an introductory programming course. In the second part we present a thorough discussion of the consequences of converting to a webbased course. Based on these consequences, we discuss what is meant...

  9. Cam Design Projects in an Advanced CAD Course for Mechanical Engineers

    Science.gov (United States)

    Ault, H. K.

    2009-01-01

    The objective of this paper is to present applications of solid modeling aimed at modeling of complex geometries such as splines and blended surfaces in advanced CAD courses. These projects, in CAD-based Mechanical Engineering courses, are focused on the use of the CAD system to solve design problems for applications in machine design, namely the…

  10. Evaluation of biogeneric design techniques with CEREC CAD/CAM system

    OpenAIRE

    Arslan, Yeliz; Karakoca Nemli, Seçil; Bankoğlu Güngör, Merve; Tamam, Evşen; Yılmaz, Handan

    2015-01-01

    PURPOSE The aim of this study was to evaluate occlusal contacts generated by 3 different biogeneric design modes (individual (BI), copy (BC), reference (BR)) of CEREC software and to assess the designs subjectively. MATERIALS AND METHODS Ten pairs of maxillary and mandibular casts were obtained from full dentate individuals. Gypsum cast contacts were quantified with articulating paper and digital impressions were taken. Then, all ceramic crown preparation was performed on the left first molar...

  11. Alternative concepts for design of air monitoring instruments: In-line and open face reference samplers and a new method of demonstrating alpha CAM performance

    International Nuclear Information System (INIS)

    Over the past several years Los Alamos, Texas A ampersand M University and Canberra Instruments have been collaborating on the development of advanced continuous air monitoring and air sampling concepts and technology. We have successfully completed the design of an alpha CAM which embodies a number of innovations in the way radon progeny background interference is controlled and compensated, and in the way data processing, alarm generation, and data communication are handled

  12. The rationale, design, and implementation of a web-based inquiry learning environment

    OpenAIRE

    Kyza, Eleni A.; Michael, Georgia; Constantinou, Constantinos P.

    2007-01-01

    It is reported that, without appropriate support, students might face several difficulties when engaging in highlevel reasoning in science. This paper discusses the design of a software-based tool to support students’ inquiry. This scaffolding is provided through the use of STOCHASMOS, a web-based platform designed to support teachers’ authoring of inquiry-based learning environments and students’ reflective inquiry practices. In this paper, we present the theoretical background s...

  13. Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design

    OpenAIRE

    Jolly Kate; Duda Joan L; Daley Amanda; Eves Frank F; Mutrie Nanette; Ntoumanis Nikos; Rouse Peter C; Lodhia Rekha; Williams Geoffrey C

    2009-01-01

    Abstract Background The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation. Methods/Design Design: An exploratory cluster randomised controlled trial ...

  14. CAD/CAM and new design technologies in high energy physics electronics applications

    International Nuclear Information System (INIS)

    In the past few years, several significant new technologies related to electronics design, fabrication and testing, appear to have reached a level of maturity which makes them ripe for exploitation by high energy physics laboratories. This paper reviews recent developments and trends, and draws particularly from some examples at Stanford Linear Accelerator Center. Cost benefits as well as difficulties of implementing new technologies into relatively small laboratories will be examined

  15. CAD/CAM and new design technologies in high energy physics electronics applications

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, R.S.

    1984-10-01

    In the past few years, several significant new technologies related to electronics design, fabrication and testing, appear to have reached a level of maturity which makes them ripe for exploitation by high energy physics laboratories. This paper reviews recent developments and trends and draws particularly from some examples at Stanford Linear Accelerator Center. Cost benefits as well as difficulties of implementing new technologies into relatively small laboratories are examined. 3 references, 11 figures, 2 tables.

  16. CAD/CAM and new design technologies in high energy physics electronics applications

    International Nuclear Information System (INIS)

    In the past few years, several significant new technologies related to electronics design, fabrication and testing, appear to have reached a level of maturity which makes them ripe for exploitation by high energy physics laboratories. This paper reviews recent developments and trends and draws particularly from some examples at Stanford Linear Accelerator Center. Cost benefits as well as difficulties of implementing new technologies into relatively small laboratories are examined. 3 references, 11 figures, 2 tables

  17. CAD/CAM and new design technologies in high energy physics electronics applications

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, R.S.

    1985-02-01

    In the past few years, several significant new technologies related to electronics design, fabrication and testing, appear to have reached a level of maturity which makes them ripe for exploitation by high energy physics laboratories. This paper reviews recent developments and trends, and draws particularly from some examples at Stanford Linear Accelerator Center. Cost benefits as well as difficulties of implementing new technologies into relatively small laboratories will be examined.

  18. Designing HTML5 2D platformer for web cam based motion games

    OpenAIRE

    Ziegenbein, Tim

    2015-01-01

    Movement interaction in games has over the last years been a main subject in the area of game design and recent motion based interaction systems provide many improvements over earlier systems. Research has proven that motion based games provide several benefits over general games, they increase the players’ engagement level and may induce both mental and physical health benefits. Still, not much research has been conducted in the area of motion based platform games, even though the platform g...

  19. [Digital smile design and anterior monolithic restorations chair side fabrication with Cerec Cad/Cam system].

    Science.gov (United States)

    Perez-Davidi, M

    2015-10-01

    Digital dentistry and digital smile design are both components of modern dentistry. The combination of the two enables the dentist to simulate the desired outcome, share the mock up with the patient and coordinate his or her expectations with the probable esthetic outcome. In this article a case is presented of anterior restorations performed to improve the smile and esthetics of the patient, combining the digital smile design (by Christian Coachman) and the Avatar Digital smile aide of the Cerec SW4 (sirona Germany) software for designing and the MCxI inlab milling unit for the fabrication. The patients picture was imported into the software and the model of the teeth was super imposed into the 3d picture of the face enabling positioning the incisal edge and midline in the desired place and sharing the virtual demo with the patient. All this procedure was performed after the patient had a mockup session in the mouth done according to the wax up procedure. The mockup can be scanned in the mouth and added as a protocol to the patient's digital models, to be used later in the biogeneric copy option. Using this option the software uses the outline of the mockup as guide lins for the final restoration computerized proposal. It is still an aide tool to be improved and simplified but definitely it is the present and future of chair side prosthodontics. PMID:26727845

  20. Study rationale and design of the CIMT trial: the Copenhagen Insulin and Metformin Therapy trial

    DEFF Research Database (Denmark)

    Lundby Christensen, L; Almdal, T; Boesgaard, T;

    2009-01-01

    combination with one of three insulin analogue regimens, the primary outcome measure being carotid intima-media thickness (CIMT) in T2DM patients. DESIGN: A randomized, stratified, multicentre trial having a 2 x 3 factorial design. The metformin part is double masked and placebo controlled. The insulin...... composition, progression of microvascular complications and quality of life will be assessed as tertiary outcome measures. TIME SCHEDULE: Patient enrolment started May 2008. Follow-up is expected to finish in March 2011. CONCLUSION: CIMT is designed to provide evidence as to whether metformin is advantageous...... even during insulin treatment and to provide evidence regarding which insulin analogue regimen is most advantageous with regard to cardiovascular disease....

  1. FENG SHUI IN MODERN HOUSE DESIGN SEARCHING FOR THE RATIONALE AND POSSIBLE IMPACTS ASSESSMENT

    Directory of Open Access Journals (Sweden)

    OCTAVIA Linda

    2014-01-01

    Full Text Available The Feng Shui, the "wind-water", is a Chinese system of geomancy using the laws of both Heaven and Earth for harmony and balance of life with the positive qi. Feng Shui is widely used to orient temples, palaces, shops, houses, and other structures, with the reference to local features such as bodies of water, stars, or a compass. The Feng Shui also informs the physical arrangements for manipulation and channeling the qi (positive or negative energy. Although Feng Shui is related to traditional believe and propitious manner, but some of its principles are rational. The current research is conducted to investigate any positive impacts of the Feng Shui application in modern house design. A house in Jakarta designed with Feng Shui was analyzed. The strategies were later examined based on the sustainable architectural design principles, especially its impact on the house functionality.

  2. A new design of CAD/CAM surgical template system for two-piece narrowing genioplasty.

    Science.gov (United States)

    Li, B; Shen, S G; Yu, H; Li, J; Xia, J J; Wang, X

    2016-05-01

    The purpose of this study was to develop and validate a new chin template system for a two-piece narrowing genioplasty. Nine patients with wide chin deformities were enrolled. Surgeries were planned with the computer-aided surgical simulation (CASS) planning method. Surgical splints and chin templates were designed in a computer and fabricated using a three-dimensional printing technique. The chin template system included a cutting guide and a repositioning guide for a two-piece narrowing genioplasty. These guides were also designed to avoid the mental foramen area and inferior alveolar nerve loops during the osteotomy, for nerve protection. After surgery, the outcome evaluation was completed by first superimposing the postoperative computed tomography model onto the planned model, and then measuring the differences between the planned and actual outcomes. All surgeries were completed successfully using the chin template system. No inferior alveolar nerve damage was seen in this study. With the use of the chin templates, the largest linear root mean square deviation (RMSD) between the planned and the postoperative chin segments was 0.7mm and the largest angular RMSD was 4.5°. The results showed that the chin template system provides a reliable method of transfer for two-piece osseous narrowing genioplasty planning. PMID:26725914

  3. A Birth Cohort Study: Conceptual and Design Considerations and Rationale. Working Paper Series.

    Science.gov (United States)

    Moore, Kristin; Manlove, Jennifer; Richter, Kerry; Halle, Tamara; Le Menestrel, Suzanne; Zaslow, Martha; Greene, Angela Dungee; Mariner, Carrie; Romano, Angela; Bridges, Lisa

    The Early Childhood Longitudinal Study, Birth Cohort 2000 (ECLS-B) is a study that will assess children's health status and their growth and development in domains that are critical for later school readiness and academic achievement. This paper is one of several that have been prepared in support of ECLS-B design efforts. It is anticipated that…

  4. Designing the Professional Writing Major: A Rationale for Multiplicity versus Specialization.

    Science.gov (United States)

    Brooks, Randy M.

    Reform of undergraduate education is sweeping the United States and the design of the writing major at Millikin University (Decatur, Illinois), is an example of this movement. The writing major was in need of reform because, in addition to the English major core of literature surveys, Shakespeare, and a course in the history of grammar and the…

  5. Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA: Design and rationale

    Directory of Open Access Journals (Sweden)

    Bossuyt Patrick MM

    2007-08-01

    Full Text Available Abstract Background The acute abdomen is a frequent entity at the Emergency Department (ED, which usually needs rapid and accurate diagnostic work-up. Diagnostic work-up with imaging can consist of plain X-ray, ultrasonography (US, computed tomography (CT and even diagnostic laparoscopy. However, no evidence-based guidelines exist in current literature. The actual diagnostic work-up of a patient with acute abdominal pain presenting to the ED varies greatly between hospitals and physicians. The OPTIMA study was designed to provide the evidence base for constructing an optimal diagnostic imaging guideline for patients with acute abdominal pain at the ED. Methods/design Thousand consecutive patients with abdominal pain > 2 hours and Discussion This study aims to provide the evidence base for the development of a diagnostic algorithm that can act as a guideline for ED physicians to evaluate patients with acute abdominal pain.

  6. Transaortic transcatheter aortic valve implantation - rationale and design of the multicenter, multinational prospective ROUTE registry

    OpenAIRE

    Bramlage, Peter; Romano, Mauro; Bonaros, Nikolaos; Cocchieri, Ricardo; Jagielak, Dariusz; Frank, Derk; Bapat, Vinayak

    2014-01-01

    Background Transaortic transcatheter aortic valve implantation (TAo-TAVI) is a recently developed approach that provides an alternative delivery route for valve replacement in patients with vascular abnormalities or existing comorbidities. While initial studies have shown the principal efficacy and safety, the real world effectiveness and safety of this approach remains to be fully assessed. Methods/Design In this regard, the Registry Of the Utilization of the TAo-TAVI approach using the Edwa...

  7. Design, rationale, and baseline characteristics of a cluster randomized controlled trial of pay for performance for hypertension treatment: study protocol

    Directory of Open Access Journals (Sweden)

    Lutschg Meghan Z

    2011-10-01

    Full Text Available Abstract Background Despite compelling evidence of the benefits of treatment and well-accepted guidelines for treatment, hypertension is controlled in less than one-half of United States citizens. Methods/design This randomized controlled trial tests whether explicit financial incentives promote the translation of guideline-recommended care for hypertension into clinical practice and improve blood pressure (BP control in the primary care setting. Using constrained randomization, we assigned 12 Veterans Affairs hospital outpatient clinics to four study arms: physician-level incentive; group-level incentive; combination of physician and group incentives; and no incentives (control. All participants at the hospital (cluster were assigned to the same study arm. We enrolled 83 full-time primary care physicians and 42 non-physician personnel. The intervention consisted of an educational session about guideline-recommended care for hypertension, five audit and feedback reports, and five disbursements of incentive payments. Incentive payments rewarded participants for chart-documented use of guideline-recommended antihypertensive medications, BP control, and appropriate responses to uncontrolled BP during a prior four-month performance period over the 20-month intervention. To identify potential unintended consequences of the incentives, the study team interviewed study participants, as well as non-participant primary care personnel and leadership at study sites. Chart reviews included data collection on quality measures not related to hypertension. To evaluate the persistence of the effect of the incentives, the study design includes a washout period. Discussion We briefly describe the rationale for the interventions being studied, as well as the major design choices. Rigorous research designs such as the one described here are necessary to determine whether performance-based payment arrangements such as financial incentives result in meaningful

  8. “ASUKI Step” pedometer intervention in university staff: rationale and design

    Directory of Open Access Journals (Sweden)

    Ainsworth Barbara E

    2012-08-01

    Full Text Available Abstract Background We describe the study design and methods used in a 9-month pedometer-based worksite intervention called “ASUKI Step” conducted at the Karolinska Institutet (KI in Stockholm, Sweden and Arizona State University (ASU in the greater Phoenix area, Arizona. Methods/design “ASUKI Step” was based on the theory of social support and a quasi-experimental design was used for evaluation. Participants included 2,118 faculty, staff, and graduate students from ASU (n = 712 and KI (n = 1,406 who participated in teams of 3–4 persons. The intervention required participants to accumulate 10,000 steps each day for six months, with a 3-month follow-up period. Steps were recorded onto a study-specific website. Participants completed a website-delivered questionnaire four times to identify socio-demographic, health, psychosocial and environmental correlates of study participation. One person from each team at each university location was randomly selected to complete physical fitness testing to determine their anthropometric and cardiovascular health and to wear an accelerometer for one week. Study aims were: 1 to have a minimum of 400 employee participants from each university site reach a level of 10, 000 steps per day on at least 100 days (3.5 months during the trial period; 2 to have 70% of the employee participants from each university site maintain two or fewer inactive days per week, defined as a level of less than 3,000 steps per day; 3 to describe the socio-demographic, psychosocial, environmental and health-related determinants of success in the intervention; and 4 to evaluate the effects of a pedometer-based walking intervention in a university setting on changes in self-perceived health and stress level, sleep patterns, anthropometric measures and fitness. Incentives were given for compliance to the study protocol that included weekly raffles for participation prizes and a grand finale trip to Arizona or Sweden

  9. European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics

    DEFF Research Database (Denmark)

    Slimani, N.; Kaaks, R.; Ferrari, P.;

    2002-01-01

    a large multi-centre European study. These studies showed that, despite certain inherent methodological and logistic constraints, a study design such as this one works relatively well in practice. The average response in the calibration study was 78.3% and ranged from 46.5% to 92.5%. The calibration...... population differed slightly from the overall cohort but the differences were small for most characteristics and centres. The overall results suggest that, after adjustment for age, dietary intakes estimated from calibration samples can reasonably be interpreted as representative of the main cohorts in most...

  10. Tai Chi for osteopenic women: design and rationale of a pragmatic randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fischer Mary

    2010-03-01

    Full Text Available Abstract Background Post-menopausal osteopenic women are at increased risk for skeletal fractures. Current osteopenia treatment guidelines include exercise, however, optimal exercise regimens for attenuating bone mineral density (BMD loss, or for addressing other fracture-related risk factors (e.g. poor balance, decreased muscle strength are not well-defined. Tai Chi is an increasingly popular weight bearing mind-body exercise that has been reported to positively impact BMD dynamics and improve postural control, however, current evidence is inconclusive. This study will determine the effectiveness of Tai Chi in reducing rates of bone turnover in post-menopausal osteopenic women, compared with standard care, and will preliminarily explore biomechanical processes that might inform how Tai Chi impacts BMD and associated fracture risks. Methods/Design A total of 86 post-menopausal women, aged 45-70y, T-score of the hip and/or spine -1.0 and -2.5, have been recruited from primary care clinics of a large healthcare system based in Boston. They have been randomized to a group-based 9-month Tai Chi program plus standard care or to standard care only. A unique aspect of this trial is its pragmatic design, which allows participants randomized to Tai Chi to choose from a pre-screened list of community-based Tai Chi programs. Interviewers masked to participants' treatment group assess outcomes at baseline and 3 and 9 months after randomization. Primary outcomes are serum markers of bone resorption (C-terminal cross linking telopeptide of type I collagen, bone formation (osteocalcin, and BMD of the lumbar spine and proximal femur (dual-energy X-ray absorptiometry. Secondary outcomes include health-related quality-of-life, exercise behavior, and psychological well-being. In addition, kinetic and kinematic characterization of gait, standing, and rising from a chair are assessed in subset of participants (n = 16 to explore the feasibility of modeling skeletal

  11. ACCISS study rationale and design: activating collaborative cancer information service support for cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Bullard Emily

    2009-12-01

    Full Text Available Abstract Background High-quality cancer information resources are available but underutilized by the public. Despite greater awareness of the National Cancer Institute's Cancer Information Service among low-income African Americans and Hispanics compared with Caucasians, actual Cancer Information Service usage is lower than expected, paralleling excess cancer-related morbidity and mortality for these subgroups. The proposed research examines how to connect the Cancer Information Service to low-income African-American and Hispanic women and their health care providers. The study will examine whether targeted physician mailing to women scheduled for colposcopy to follow up an abnormal Pap test can increase calls to the Cancer Information Service, enhance appropriate medical follow-up, and improve satisfaction with provider-patient communication. Methods/Design The study will be conducted in two clinics in ethnically diverse low-income communities in Chicago. During the formative phase, patients and providers will provide input regarding materials planned for use in the experimental phase of the study. The experimental phase will use a two-group prospective randomized controlled trial design. African American and Hispanic women with an abnormal Pap test will be randomized to Usual Care (routine colposcopy reminder letter or Intervention (reminder plus provider recommendation to call the Cancer Information Service and sample questions to ask. Primary outcomes will be: 1 calls to the Cancer Information Service; 2 timely medical follow-up, operationalized by whether the patient keeps her colposcopy appointment within six months of the abnormal Pap; and 3 patient satisfaction with provider-patient communication at follow-up. Discussion The study examines the effectiveness of a feasible, sustainable, and culturally sensitive strategy to increase awareness and use of the Cancer Information Service among an underserved population. The goal of linking a

  12. Rationale and design: telephone-delivered behavioral skills interventions for Blacks with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Strom Joni L

    2010-03-01

    Full Text Available Abstract Background African Americans with Type 2 diabetes (T2DM have higher prevalence of diabetes, poorer metabolic control, and greater risk for complications and death compared to American Whites. Poor outcomes in African Americans with T2DM can be attributed to patient, provider, and health systems level factors. Provider and health system factors account for Methods/Design We describe an ongoing four-year randomized clinical trial, using a 2 × 2 factorial design, which will test the efficacy of separate and combined telephone-delivered, diabetes knowledge/information and motivation/behavioral skills training interventions in high risk African Americans with poorly controlled T2DM (HbA1c ≥ 9%. Two-hundred thirty-two (232 male and female African-American participants, 18 years of age or older and with an HbA1c ≥ 9%, will be randomized into one of four groups for 12-weeks of phone interventions: (1 an education group, (2 a motivation/skills group, (3 a combined group or (4 a usual care/general health education group. Participants will be followed for 12-months to ascertain the effect of the interventions on glycemic control. Our primary hypothesis is that among African Americans with poorly controlled T2DM, patients randomized to the combined diabetes knowledge/information and motivation/behavioral skills training intervention will have significantly greater reduction in HbA1c at 12 months of follow-up compared to the usual care/general health education group. Discussion Results from this study will provide important insight into how best to deliver diabetes education and skills training in ethnic minorities and whether combined knowledge/information and motivation/behavioral skills training is superior to the usual method of delivering diabetes education for African Americans with poorly controlled T2DM. Trial registration National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00929838.

  13. 产品设计原理语义表达%Semantic Representation for Design Rationale of Product

    Institute of Scientific and Technical Information of China (English)

    张应中; 罗晓芳; 陈钎

    2012-01-01

    Design rationale (DR.) is crucial information in product design analysis, design reuse, design reasoning and design evaluation. Based on the foundation of issue-based information system (IBIS) model, a new ontology-based semantic representation model for DR information-ISAA model is proposed. ISAA model introduces the ontology-based semantic representation mode to the DR representation and expands the concept elements of IBIS. The ontology definitions of issue concept, solution concept, and argument concept as well as other four concepts of DR are given. The semantic relationships between concept elements are also defined. The axioms and rules which are used to restrict and constraint the existed relations and create new relations by reasoning are analyzed and defined. The defined rules also rich the semantic relations of DR representation defined by web ontology language (OWL). The ISAA model represents the directed graph of IBIS to resource description framework (RDF) graph and serializes to RDF / XML document which lays foundation for retrieving and reasoning semantic information of DR. A semantic annotation interface integrating with the product CAD model is developed, which captures and abstracts the discrete information of DR thinking to conceptual information of ISAA model. An example of representing DR of spring charge for high-voltage circuit breaker is taken to embody and validate the ISAA model.%设计原理(Design rationale,DR)信息对于产品设计重用、设计推理和设计评价等有非常重要的作用.在基于问题信息系统(Issue-based information system,IBIS)模型基础上,提出一个新的基于本体的产品DR语义表达模型——ISAA模型.ISAA模型将基于本体的语义表达模式引入到DR信息表达中,并扩充IBIS表达的概念元素;基于本体定义问题、解决方案、论据等七个DR概念和概念间的语义关系;给出对关系限定、约束和创建的公理规则,丰富Web本体语言(Web ontology

  14. Dose timing of D-cycloserine to augment cognitive behavioral therapy for social anxiety: Study design and rationale.

    Science.gov (United States)

    Hofmann, Stefan G; Carpenter, Joseph K; Otto, Michael W; Rosenfield, David; Smits, Jasper A J; Pollack, Mark H

    2015-07-01

    The use of D-cycloserine (DCS) as a cognitive enhancer to augment exposure-based cognitive-behavioral therapy (CBT) represents a promising new translational research direction with the goal to accelerate and optimize treatment response for anxiety disorders. Some studies suggest that DCS may not only augment extinction learning but could also facilitate fear memory reconsolidation. Therefore, the effect of DCS may depend on fear levels reported at the end of exposure sessions. This paper presents the rationale and design for a randomized controlled trial examining the relative efficacy of tailoring DCS administration based on exposure success (i.e. end fear levels) during a 5-session group CBT protocol for social anxiety disorder (n = 156). Specifically, tailored post-session DCS administration will be compared against untailored post-session DCS, untailored pre-session DCS, and pill placebo in terms of reduction in social anxiety symptoms and responder status. In addition, a subset of participants (n = 96) will undergo a fear extinction retention experiment prior to the clinical trial in which they will be randomly assigned to receive either DCS or placebo prior to extinguishing a conditioned fear. The results from this experimental paradigm will clarify the mechanism of the effects of DCS on exposure procedures. This study aims to serve as the first step toward developing an algorithm for the personalized use of DCS during CBT for social anxiety disorder, with the ultimate goal of optimizing treatment outcome for anxiety disorders. PMID:26111923

  15. The intervention composed of aerobic training and non-exercise physical activity (I-CAN) study: Rationale, design and methods.

    Science.gov (United States)

    Swift, Damon L; Dover, Sara E; Nevels, Tyara R; Solar, Chelsey A; Brophy, Patricia M; Hall, Tyler R; Houmard, Joseph A; Lutes, Lesley D

    2015-11-01

    Recent data has suggested that prolonged sedentary behavior is independent risk factor for cardiovascular and all-cause mortality independent of adequate amounts of moderate to vigorous physical activity. However, few studies have prospectively evaluated if exercise training and increasing non-exercise physical activity leads to greater reduction in cardiometabolic risk compared to aerobic training alone. The purpose of the Intervention Composed of Aerobic Training and Non-Exercise Physical Activity (I-CAN) study is to determine whether a physical activity program composed of both aerobic training (consistent with public health recommendations) and increasing non-exercise physical activity (3000 steps above baseline levels) leads to enhanced improvements in waist circumference, oral glucose tolerance, systemic inflammation, body composition, and fitness compared to aerobic training alone in obese adults (N=45). Commercially available accelerometers (Fitbits) will be used to monitor physical activity levels and behavioral coaching will be used to develop strategies of how to increase non-exercise physical activity levels. In this manuscript, we describe the design, rationale, and methodology associated with the I-CAN study. PMID:26542389

  16. The Rationale, Design, and Initial Efficacy of SystemCHANGE™ -HIV: A Systems-Based Intervention to Improve Physical Activity in People Living with HIV

    OpenAIRE

    Webel, Allison R; Moore, Shirley M.; Hanson, Jan E.; Salata, Robert A.

    2013-01-01

    The purpose of this paper was to describe SystemCHANGE™-HIV, a novel self-management intervention for people living with HIV (PLWH) and provide evidence of its initial efficacy to improve physical activity. The rationale and design of the SystemCHANGE™-HIV intervention were reviewed. Intervention detail, including its historical use, learning exercises and content, were provided. Forty PLWH participated in this pilot study, using a randomized clinical trial design. Intervention participants i...

  17. Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): study protocol for a randomized controlled trial

    OpenAIRE

    Cavalcanti, AB; Suzumura, ÉA; Amato, MB; Tallo, FS; Rezende, AC; Telles, MM; Takahashi, LN; Carvalho, VO; Díaz-Quijano, FA; Berwanger, O; Kodama, AA; Ribeiro, GF; Abreu, MO; Oliveira, IM; Guyatt, G

    2012-01-01

    Background Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design ART is a pragmatic, multicenter...

  18. Nurse Forecasting in Europe (RN4CAST): Rationale, design and methodology

    LENUS (Irish Health Repository)

    Sermeus, Walter

    2011-04-18

    Abstract Background Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. Methods\\/Design A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data). All staff nurses of a random selection of medical and surgical units (at least 2 per hospital) were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout) as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status) is collected to control the analyses for institutional differences. This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate the impact of

  19. Nurse forecasting in Europe (RN4CAST: Rationale, design and methodology

    Directory of Open Access Journals (Sweden)

    Brzostek Tomasz

    2011-04-01

    Full Text Available Abstract Background Current human resources planning models in nursing are unreliable and ineffective as they consider volumes, but ignore effects on quality in patient care. The project RN4CAST aims innovative forecasting methods by addressing not only volumes, but quality of nursing staff as well as quality of patient care. Methods/Design A multi-country, multilevel cross-sectional design is used to obtain important unmeasured factors in forecasting models including how features of hospital work environments impact on nurse recruitment, retention and patient outcomes. In each of the 12 participating European countries, at least 30 general acute hospitals were sampled. Data are gathered via four data sources (nurse, patient and organizational surveys and via routinely collected hospital discharge data. All staff nurses of a random selection of medical and surgical units (at least 2 per hospital were surveyed. The nurse survey has the purpose to measure the experiences of nurses on their job (e.g. job satisfaction, burnout as well as to allow the creation of aggregated hospital level measures of staffing and working conditions. The patient survey is organized in a sub-sample of countries and hospitals using a one-day census approach to measure the patient experiences with medical and nursing care. In addition to conducting a patient survey, hospital discharge abstract datasets will be used to calculate additional patient outcomes like in-hospital mortality and failure-to-rescue. Via the organizational survey, information about the organizational profile (e.g. bed size, types of technology available, teaching status is collected to control the analyses for institutional differences. This information will be linked via common identifiers and the relationships between different aspects of the nursing work environment and patient and nurse outcomes will be studied by using multilevel regression type analyses. These results will be used to simulate

  20. Rationale and design considerations for a semantic mediator in health information systems.

    Science.gov (United States)

    Degoulet, P; Sauquet, D; Jaulent, M C; Zapletal, E; Lavril, M

    1998-11-01

    Rapid development of community health information networks raises the issue of semantic interoperability between distributed and heterogeneous systems. Indeed, operational health information systems originate from heterogeneous teams of independent developers and have to cooperate in order to exchange data and services. A good cooperation is based on a good understanding of the messages exchanged between the systems. The main issue of semantic interoperability is to ensure that the exchange is not only possible but also meaningful. The main objective of this paper is to analyze semantic interoperability from a software engineering point of view. It describes the principles for the design of a semantic mediator (SM) in the framework of a distributed object manager (DOM). The mediator is itself a component that should allow the exchange of messages independently of languages and platforms. The functional architecture of such a SM is detailed. These principles have been partly applied in the context of the HELIOS object-oriented software engineering environment. The resulting service components are presented with their current state of achievement. PMID:9865050

  1. Learning from failure - rationale and design for a study about discontinuation of randomized trials (DISCO study

    Directory of Open Access Journals (Sweden)

    Kasenda Benjamin

    2012-08-01

    Full Text Available Abstract Background Randomized controlled trials (RCTs may be discontinued because of apparent harm, benefit, or futility. Other RCTs are discontinued early because of insufficient recruitment. Trial discontinuation has ethical implications, because participants consent on the premise of contributing to new medical knowledge, Research Ethics Committees (RECs spend considerable effort reviewing study protocols, and limited resources for conducting research are wasted. Currently, little is known regarding the frequency and characteristics of discontinued RCTs. Methods/Design Our aims are, first, to determine the prevalence of RCT discontinuation for specific reasons; second, to determine whether the risk of RCT discontinuation for specific reasons differs between investigator- and industry-initiated RCTs; third, to identify risk factors for RCT discontinuation due to insufficient recruitment; fourth, to determine at what stage RCTs are discontinued; and fifth, to examine the publication history of discontinued RCTs. We are currently assembling a multicenter cohort of RCTs based on protocols approved between 2000 and 2002/3 by 6 RECs in Switzerland, Germany, and Canada. We are extracting data on RCT characteristics and planned recruitment for all included protocols. Completion and publication status is determined using information from correspondence between investigators and RECs, publications identified through literature searches, or by contacting the investigators. We will use multivariable regression models to identify risk factors for trial discontinuation due to insufficient recruitment. We aim to include over 1000 RCTs of which an anticipated 150 will have been discontinued due to insufficient recruitment. Discussion Our study will provide insights into the prevalence and characteristics of RCTs that were discontinued. Effective recruitment strategies and the anticipation of problems are key issues in the planning and evaluation of trials

  2. The Intensive Diet and Exercise for Arthritis (IDEA trial: design and rationale

    Directory of Open Access Journals (Sweden)

    Eckstein Felix

    2009-07-01

    Full Text Available Abstract Background Obesity is the most modifiable risk factor, and dietary induced weight loss potentially the best nonpharmacologic intervention to prevent or to slow osteoarthritis (OA disease progression. We are currently conducting a study to test the hypothesis that intensive weight loss will reduce inflammation and joint loads sufficiently to alter disease progression, either with or without exercise. This article describes the intervention, the empirical evidence to support it, and test-retest reliability data. Methods/Design This is a prospective, single-blind, randomized controlled trial. The study population consists of 450 overweight and obese (BMI = 27–40.5 kg/m2 older (age ≥ 55 yrs adults with tibiofemoral osteoarthritis. Participants are randomized to one of three 18-month interventions: intensive dietary restriction-plus-exercise; exercise-only; or intensive dietary restriction-only. The primary aims are to compare the effects of these interventions on inflammatory biomarkers and knee joint loads. Secondary aims will examine the effects of these interventions on function, pain, and mobility; the dose response to weight loss on disease progression; if inflammatory biomarkers and knee joint loads are mediators of the interventions; and the association between quadriceps strength and disease progression. Results Test-retest reliability results indicated that the ICCs for knee joint load variables were excellent, ranging from 0.86 – 0.98. Knee flexion/extension moments were most affected by BMI, with lower reliability with the highest tertile of BMI. The reliability of the semi-quantitative scoring of the knee joint using MRI exceeded previously reported results, ranging from a low of 0.66 for synovitis to a high of 0.99 for bone marrow lesion size. Discussion The IDEA trial has the potential to enhance our understanding of the OA disease process, refine weight loss and exercise recommendations in this prevalent disease, and

  3. Learning environments’ activity potential for preschoolers (LEAPP: study rationale and design

    Directory of Open Access Journals (Sweden)

    Patricia Tucker

    2013-09-01

    Full Text Available Background. The purpose of this paper is to provide an overview of the study protocol for the Learning Environments’ Activity Potential for Preschoolers (LEAPP study, the goal of which is to describe the activity levels of preschoolers attending various early learning venues and explore which attributes of these facilities (e.g. curriculum, policies, equipment, etc. support activity participation.Design and Methods. This cross-sectional study aimed to recruit approximately 30 early learning environments requesting participation from preschoolers aged 2.5-5 years. Data collection included: Actical accelerometers (MiniMitter, Oregon, USA to measure the activity levels of children for five consecutive days (15-second epoch length while in care; the Environment and Policy Assessment and Observation tool to explore the early learning environment’s impact on activity; anthropometric data; the Child Temperament Questionnaire to assess the influence of preschoolers’ temperament on physical activity; and demographic information from parents/guardians and early learning staff. ANOVA and linear regression analyses will be conducted to assess variances in activity levels among preschoolers attending different early learning types and to explore the impact of early learning environments on their activity levels. Independent sample t-tests will be used to examine differences in activity levels based on sex and weight status.Expected impact of the study for public health. This research will provide the first Canadian data to address environmental influences on preschoolers’ activity levels in differing early learning environments. Additionally, this work will highlight the extent to which activity levels vary among preschoolers enrolled in full-day kindergarten, centre-, and home-based childcare.

  4. Living with diabetes: rationale, study design and baseline characteristics for an Australian prospective cohort study

    Directory of Open Access Journals (Sweden)

    Donald Maria

    2012-01-01

    Full Text Available Abstract Background Diabetes mellitus is a major global public health threat. In Australia, as elsewhere, it is responsible for a sizeable portion of the overall burden of disease, and significant costs. The psychological and social impact of diabetes on individuals with the disease can be severe, and if not adequately addressed, can lead to the worsening of the overall disease picture. The Living With Diabetes Study aims to contribute to a holistic understanding of the psychological and social aspects of diabetes mellitus. Methods/Design The Living With Diabetes Study is a 5-year prospective cohort study, based in Queensland, Australia. The first wave of data, which was collected via a mailed self-report survey, was gathered in 2008, with annual collections thereafter. Measurements include: demographic, lifestyle, health and disease characteristics; quality of life (EQ-5D, ADDQoL; emotional well-being (CES-D, LOT-R, ESSI; disease self-management (PAM; and health-care utilisation and patient-assessed quality of care (PACIC. 29% of the 14,439 adults who were invited to participate in the study agreed to do so, yielding a sample size of 3,951 people. Discussion The data collected by the Living With Diabetes Study provides a good representation of Australians with diabetes to follow over time in order to better understand the natural course of the illness. The study has potential to further illuminate, and give a comprehensive picture of the psychosocial implications of living with diabetes. Data collection is ongoing.

  5. Rationale, design, and analysis of combined Brazilian household budget survey and food intake individual data

    Directory of Open Access Journals (Sweden)

    Vasconcellos ABPA

    2008-03-01

    Full Text Available Abstract Background Data on food intake at the individual level and its statistical distribution in population groups defined by age, gender, or geographic areas are important in planning public health and nutrition programs. However, individual-based surveys in representative population samples are expensive to perform. Methods/Design In Brazil, an individual based survey is under consideration to be conducted alongside the household budget survey (HBS, which will be carried out in 2008–2009. This paper presents the methodological framework of dietary data collection and indicates the directions to combining both sources of data. The 2008–2009 Brazilian HBS sample will include 60,000 households. Of the selected HBS households, 30% will be randomly sampled to gather data on individual food intake. Therefore, individual dietary intake data is expected to be gathered for 70,000 individuals. Data collection procedures will comprise: completion of a diary with information regarding food purchases during a seven-day period; registration of all items consumed during two non-consecutive days for all 10 year-old or older members of the household. The sample will be large enough to capture the variation between individuals, and the two records will assure the estimation of the variation within individuals for food groups, energy and nutrients. Data on individual dietary intake and food family budget will be stratified by the five regions of the country and by rural or urban. A pilot study has been conducted in two states, and it indicated that combining individual and budgetary data in a survey is feasible. Discussion This kind of study will allow us to estimate correlations between individual intake and household purchases, overcoming the limitations of individual dietary surveys, and enhancing the HBS with information on eating out and intra-familiar distribution of food.

  6. Maxillary implant-supported bar overdenture and mandibular implant-retained fixed denture using CAD/CAM technology and 3-D design software: a clinical report.

    Science.gov (United States)

    Spyropoulou, Panagiota-Eirini; Razzoog, Michael E; Duff, Renée E; Chronaios, Dimitrios; Saglik, Berna; Tarrazzi, Daler E

    2011-06-01

    The implant-supported bar overdenture and the implant-retained fixed complete denture are appropriate treatment choices for patients with inadequate bone volume in the posterior maxilla and mandible, respectively. Computer-aided design/computer-aided manufacturing (CAD/CAM) technology has broadened the scope and application of those treatment options, allowing for prosthodontically-driven implant placement and ideal substructure design for optimal esthetics and biomechanics. This report describes the fabrication of a maxillary implant-supported milled titanium bar with attachments and an overdenture, and a mandibular implant-retained fixed complete denture with milled titanium substructure. PMID:21640235

  7. Design and fabrication of uncemented femoral prosthesis using CAD/CAM/Robotic integration method%CAD/CAM/Robotic集成方法设计与制作生物型股骨柄假体

    Institute of Scientific and Technical Information of China (English)

    韩文龙; 朱建非; 吴琪; 刘昌华; 王爱民; 席文明

    2014-01-01

    BACKGROUND:In total hip replacements, aseptic loosening of uncemented femoral hip prosthesis is the main reason for the failure of artificial hip replacement, the prerequisite of reducing aseptic loosening of prosthesis is to increase fil ing area of femoral prosthesis in femoral cavity. OBJECTIVE:To obtain the fil ing rate of customized femoral prosthesis in femoral cavity and verify the validity of the methods of CAD/CAM/Robotic integration and the robot grind. METHODIn this paper, the CT data of femur were used to reconstruct three-dimensional model of femoral cavity. According to this model, a custom uncemented femoral hip prosthesis was designed, then the model of this custom prosthesis was imported into the CAD/CAM/Robotic software to generate cut path. After the cut path was imported into the robotic control er, the custom prosthesis can be fabricated, then this custom prosthesis was inserted into the femoral cavity, and the fil ing result of the custom prosthesis in femoral cavity was analyzed. RESULTS AND CONCLUSION:The experiment results showed that the customized prosthesis in femoral cavity achieved good fil ing result, the structure of femoral cavity resisted the rotation of the customized prosthesis in femoral cavity, and the customized prosthesis obtained stable fixation in the femoral cavity.%背景:生物型股骨柄假体无菌松动是全髋关节置换失败的主要因素,减少无菌松动的先决条件是增加股骨柄假体在股骨髓腔中的填充率。  目的:得到定制式股骨柄假体在髓腔中的填充率,验证计算机辅助设计/计算机辅助制造/工业机器人加工(CAD/CAM/Robotic)集成方法和机器人磨削的有效性。  方法:利用 CT 数据重建股骨髓腔三维模型,在此三维模型基础上设计股骨柄假体的柄体,依据标准直柄股骨柄假体近端模型设计股骨柄假体的其余部分。将设计的股骨柄假体模型导入CAD/CAM/Robotic集成系统生成机

  8. Child abuse inventory at emergency rooms: CHAIN-ER rationale and design

    Directory of Open Access Journals (Sweden)

    Nieuwenhuis Edward ES

    2011-10-01

    Full Text Available Abstract Background Child abuse and neglect is an important international health problem with unacceptable levels of morbidity and mortality. Although maltreatment as a cause of injury is estimated to be only 1% or less of the injured children attending the emergency room, the consequences of both missed child abuse cases and wrong suspicions are substantial. Therefore, the accuracy of ongoing detection at emergency rooms by health care professionals is highly important. Internationally, several diagnostic instruments or strategies for child abuse detection are used at emergency rooms, but their diagnostic value is still unknown. The aim of the study 'Child Abuse Inventory at Emergency Rooms' (CHAIN-ER is to assess if active structured inquiry by emergency room staff can accurately detect physical maltreatment in children presenting at emergency rooms with physical injury. Methods/design CHAIN-ER is a multi-centre, cross-sectional study with 6 months diagnostic follow-up. Five thousand children aged 0-7 presenting with injury at an emergency room will be included. The index test - the SPUTOVAMO-R questionnaire- is to be tested for its diagnostic value against the decision of an expert panel. All SPUTOVAMO-R positives and a 15% random sample of the SPUTOVAMO-R negatives will undergo the same systematic diagnostic work up, which consists of an adequate history being taken by a pediatrician, inquiry with other health care providers by structured questionnaires in order to obtain child abuse predictors, and by additional follow-up information. Eventually, an expert panel (reference test determines the true presence or absence of child abuse. Discussion CHAIN-ER will determine both positive and negative predictive value of a child abuse detection instrument used in the emergency room. We mention a benefit of the use of an expert panel and of the use of complete data. Conducting a diagnostic accuracy study on a child abuse detection instrument is also

  9. Children, parents, and pets exercising together (CPET randomised controlled trial: study rationale, design, and methods

    Directory of Open Access Journals (Sweden)

    Yam Philippa S

    2012-03-01

    Full Text Available Abstract Background Objectively measured physical activity is low in British children, and declines as childhood progresses. Observational studies suggest that dog-walking might be a useful approach to physical activity promotion in children and adults, but there are no published public health interventions based on dog-walking with children. The Children, Parents, and Pets Exercising Together Study aims to develop and evaluate a theory driven, generalisable, family-based, dog walking intervention for 9-11 year olds. Methods/design The Children, Parents, and Pets Exercising Together Study is an exploratory, assessor-blinded, randomised controlled trial as defined in the UK MRC Framework on the development and evaluation of complex interventions in public health. The trial will follow CONSORT guidance. Approximately 40 dog-owning families will be allocated randomly in a ratio of 1.5:1 to receive a simple behavioural intervention lasting for 10 weeks or to a 'waiting list' control group. The primary outcome is change in objectively measured child physical activity using Actigraph accelerometry. Secondary outcomes in the child, included in part to shape a future more definitive randomised controlled trial, are: total time spent sedentary and patterning of sedentary behaviour (Actigraph accelerometry; body composition and bone health from dual energy x-ray absorptiometry; body weight, height and BMI; and finally, health-related quality of life using the PedsQL. Secondary outcomes in parents and dogs are: changes in body weight; changes in Actigraph accelerometry measured physical activity and sedentary behaviour. Process evaluation will consist of assessment of simultaneous child, parent, and dog accelerometry data and brief interviews with participating families. Discussion The Children, Parents, and Pets Exercising Together trial should be the first randomised controlled study to establish and evaluate an intervention aimed at dog-based physical

  10. Prevalence of Work-Related Asthma in Primary Health Care: Study Rationale and Design

    Science.gov (United States)

    Rabell-Santacana, Ventura; Panadès-Valls, Rafael; Vila-Rigat, Rosa; Hernandez-Huet, Enric; Sivecas-Maristany, Joan; Blanché-Prat, Xavier; Prieto, Gemma; Muñoz, Laura; Torán, Pere

    2015-01-01

    Background : Occupational Asthma (OA) is the most frequent origin of occupational respiratory diseases in industrialized countries and accounts for between 5% and 25% of asthmatic patients. The correct and early diagnosis of OA is of great preventive and socio-economic importance. However, few studies exist on OA’s prevalence in Catalonia and in Spain and those affected are mainly treated by the public health services and not by the occupational health services, which are private. Objective : To determine the prevalence of OA in patients diagnosed with asthma in the Primary Healthcare system and to evaluate the socio-economic impact of OA in the Primary Healthcare system. Methods/Design : We will carry out an observational, transversal and multi-center study in the Primary Healthcare Service in the Barcelona region (Catalonia, Spain), with 385 asthmatic workers aged between 16 and 64 who are currently working or have been working in the past. We will confirm the asthma diagnosis in each patient, and those meeting the inclusion criteria will be asked to answer a questionnaire that aims to link asthma to the patient’s past employment history. The resulting diagnosis will be of either occupational asthma, work-aggravated asthma or common asthma. We will also collect socio-demographic information about the patients, about their smoking status, their exposure outside of the workplace, their work situation at the onset of the symptoms, their employment history, their symptoms of asthma, their present and past medical asthma treatment, and, in order to estimate the economic impact in the Primary Healthcare system, where they have been attended to and treated. Prevalence will link OA or work-aggravated asthma to the total of patients participating in the study with a asthma diagnosis. Discussion : The results will show the prevalence of OA and work-aggravated asthma, and shall provide valuable information to set out and apply the necessary personal and technical

  11. DFM/CAPP/CAM System in a Concurrent Engineering Environment

    Institute of Scientific and Technical Information of China (English)

    1999-01-01

    In this paper the importance of DFM/CAPP/CAM system in Concurrent Engineering (CE) is discussed. Based on the analyses of the character of concurrent product design and manufacturing process design, the workflow of DFM/CAPP/CAM system in CE is given. DFM/CAPP/CAM theories, methods and functions are investigated in a delicate and all-round way, and are implemented in the developed DFM/CAPP/CAM system.

  12. RESEARCH ON STRAIGHTENING TECHNOLOGY CAM SYSTEM

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    Automatic straightening process is a nonlinear process, and affected by many factors.The straightening technology CAM system has been designed and built up to straighten shafts, which mainly consists of the straightening technology's database and the model of stroke-controlled precise straightening calculation model.The operational test of the CAM system has been passed.

  13. Impact of the cam and follower cooperation and of lubrication on the cam wear

    Directory of Open Access Journals (Sweden)

    P. Folęga

    2012-12-01

    Full Text Available Purpose: The paper provides an analysis of the reasons for excessive wear of the cam/follower system components based on physical and mathematical models developed to describe the impact of selected material, technological and operational factors. Owing to the comparison between the calculation results obtained and the actual cam wear values, it was possible to asses the correctness of the wear models taken into consideration.Design/methodology/approach: The research in question included preparation of a mathematical cam wear model developed by way of dimensional analysis as well as finite element (FEM based structural models for a cam/follower system. The aforementioned FEM models were noted in a parametrical form using macro commands of the COSMOS/M system, and hence it was possible to analyse contact problems in various cam positions and change the selected analytical parameters (e.g. dimensions, material parameters.Findings: The main reasons for excessive cam wear include inferior quality of the cam and follower frictional couple lubrication as well as edge-type cooperation between the cam and the cam follower. At the same time, a significant impact on the wear is exerted by hardness of the cam and its follower.Research limitations/implications: Wear of cams and cam followers operating in timing gear systems of vehicle combustion engines takes place as an effect of friction occurring in presence of lubricant. During standard operation, components of the cam/follower system may be subject to an excessive or accelerated wear process. This study is an attempt to establish the reasons for this phenomenon to occur in order to control such cases.Originality/value: In order to counteract the phenomenon of accelerated wear of cams, one should consider increasing the required hardness of their working surfaces.

  14. Aspirin for the prevention of cognitive decline in the elderly: rationale and design of a neuro-vascular imaging study (ENVIS-ion)

    OpenAIRE

    Reid Christopher M; Storey Elsdon; Wong Tien Y; Woods Robyn; Tonkin Andrew; Wang Jie; Kam Anthony; Janke Andrew; Essex Rowan; Abhayaratna Walter P; Budge Marc M

    2012-01-01

    Abstract Background This paper describes the rationale and design of the ENVIS-ion Study, which aims to determine whether low-dose aspirin reduces the development of white matter hyper-intense (WMH) lesions and silent brain infarction (SBI). Additional aims include determining whether a) changes in retinal vascular imaging (RVI) parameters parallel changes in brain magnetic resonance imaging (MRI); b) changes in RVI parameters are observed with aspirin therapy; c) baseline cognitive function ...

  15. The “House Calls” Trial: A Randomized Controlled Trial to Reduce Racial Disparities in Live Donor Kidney Transplantation: Rationale and Design

    OpenAIRE

    Rodrigue, James R.; Pavlakis, Martha; Egbuna, Ogo; Paek, Mathew; Waterman, Amy D; Mandelbrot, Didier A.

    2012-01-01

    Despite a substantially lower rate of live donor kidney transplantation among Black Americans compared to White Americans, there are few systematic efforts to reduce this racial disparity. This paper describes the rationale and design of a randomized controlled trial aims evaluating the comparative effectiveness of three different educational interventions for increasing live donor kidney transplantation in Black Americans. This trial is a single-site, urn-randomized controlled trial with a p...

  16. Male infertility after endoscopic Totally Extraperitoneal (Tep hernia repair (Main: rationale and design of a prospective observational cohort study

    Directory of Open Access Journals (Sweden)

    Schouten Nelleke

    2012-05-01

    Full Text Available Abstract Background To describe the rationale and design of an observational cohort study analyzing the effects of endoscopic Totally Extraperitoneal (TEP hernia repair on male fertility (MAIN study. Methods and design The MAIN study is an observational cohort study designed to assess fertility after endoscopic TEP hernia repair. The setting is a high-volume single center hospital, specialized in TEP hernia repair. Male patients of 18-60 years of age, with primary, reducible, bilateral inguinal hernias and no contraindications for endoscopic TEP repair are eligible for inclusion in this study. Patients with an ASA-classification ≥ III and patients with recurrent and/or scrotal hernias and/or a medical history of pelvic surgery and/or radiotherapy, known fertility problems, diabetes and/or other diseases associated with a risk of fertility problems, will be excluded. The primary outcome is the testicular perfusion before and 6 months after TEP hernia repair (assessed by means of a scrotal ultrasonography. Secondary endpoints are the testicular volume (Ultrasound, semen quality and quantity and the endocrinological status, based on serum levels of the sexual hormones follicle-stimulating hormone (FSH, luteinizing hormone (LSH, testosterone and inhibin B before and 6 months after TEP hernia repair. Discussion The use of polypropylene mesh is associated with a strong foreign body reaction which could play a role in chronic groin pain development. Since the mesh in (endoscopic inguinal hernia repair is placed in close contact to the vas deferens and spermatic vessels, the mesh-induced inflammatory reaction could lead to a dysfunction of these structures. Relevant large and prospective clinical studies on the problem are limited. This study will provide a complete assessment of fertility in male patients who undergo simultaneous bilateral endoscopic TEP hernia repair, by analyzing testicular perfusion and volume, semen quantity and quality

  17. LCoMotion – Learning, Cognition and Motion; a multicomponent cluster randomized school-based intervention aimed at increasing learning and cognition - rationale, design and methods

    OpenAIRE

    Bugge, Anna; Tarp, Jakob; Østergaard, Lars; Domazet, Sidsel Louise; Andersen, Lars Bo; Froberg, Karsten

    2014-01-01

    Background The aim of the study; LCoMotion – Learning, Cognition and Motion was to develop, document, and evaluate a multi-component physical activity (PA) intervention in public schools in Denmark. The primary outcome was cognitive function. Secondary outcomes were academic skills, body composition, aerobic fitness and PA. The primary aim of the present paper was to describe the rationale, design and methods of the LCoMotion study. Methods/Design LCoMotion was designed as a cluster-randomize...

  18. The Effect of Preparation Design on the Fracture Resistance of Zir-Conia Crown Copings (Computer Associated Design/Computer Associated Machine, CAD/CAM System

    Directory of Open Access Journals (Sweden)

    B. Atashkar

    2011-09-01

    Full Text Available Objective: One of the major problems of all ceramic restorations is their probable fracture against the occlusal force. The aim of the present in-vitro study is was to compare the effect of two marginal designs (chamfer & shoulder on the fracture resistance of zirconia copings, CERCON (CAD/CAM.MATERIALS AND METHODS: This in vitro study was done with single blind experimental technique. One stainless steel dye with 50’ chamfer finish line design (0.8 mm depth was prepared using milling machine. Ten epoxy resin dyes were made, The same dye was retrieved and 50' chamfer was converted into shoulder (1 mm.again ten epoxy resin dyes were made from shoulder dyes. Zirconia cores with 0.4 mm thickness and 35 µm cement Space fabricated on the20 epoxy resin dyes (10 samples chamfer and 10 samples shoulder in a dental laboratory. Then the zirconia cores were cemented on the epoxy resin dyes and underwent a fracture test with a universal testing machine (GOTECH AI-700LAC, Arson, USA and samples were investigated from the point of view of the origin of the failure.RESULT: The mean value of fracture resistance for shoulder margins were 788.90±99.56 N and for the chamfer margins were 991.75±112.00 N. The student’s T-test revealed a statistically significant difference between groups (P=0.001.CONCLUSION: The result of this study indicates that marginal design of the zirconia cores effects on their fracture resistance. A chamfer margin could improve the biomechanical performance of posterior single zirconia crown restorations. This may be because of strong unity and round internal angle in chamfer margin.

  19. The Effect of Preparation Design on the Fracture Resistance of Zirconia Crown Copings (Computer Associated Design/Computer Associated Machine, CAD/CAM System)

    Science.gov (United States)

    Jalalian, E.; Atashkar, B.; Rostami, R.

    2011-01-01

    Objective One of the major problems of all ceramic restorations is their probable fracture against the occlusal force. The aim of the present in-vitro study is was to compare the effect of two marginal designs (chamfer & shoulder) on the fracture resistance of zirconia copings, CERCON (CAD/CAM). MATERIALS AND METHODS This in vitro study was done with single blind experimental technique. One stainless steel dye with 50′ chamfer finish line design (0.8 mm depth) was prepared using milling machine. Ten epoxy resin dyes were made, The same dye was retrieved and 50′ chamfer was converted into shoulder (1 mm).again ten epoxy resin dyes were made from shoulder dyes. Zirconia cores with 0.4 mm thickness and 35 μm cement Space fabricated on the 20 epoxy resin dyes (10 samples chamfer and 10 samples shoulder) in a dental laboratory. Then the zirconia cores were cemented on the epoxy resin dyes and underwent a fracture test with a universal testing machine (GOTECH AI-700LAC, Arson, USA) and samples were investigated from the point of view of the origin of the failure. RESULT The mean value of fracture resistance for shoulder margins were 788.90±99.56 N and for the chamfer margins were 991.75±112.00 N. The student’s T-test revealed a statistically significant difference between groups (P=0.001). CONCLUSION The result of this study indicates that marginal design of the zirconia cores effects on their fracture resistance. A chamfer margin could improve the biomechanical performance of posterior single zirconia crown restorations. This may be because of strong unity and round internal angle in chamfer margin. PMID:22457839

  20. CAD/CAM. High-Technology Training Module.

    Science.gov (United States)

    Zuleger, Robert

    This high technology training module is an advanced course on computer-assisted design/computer-assisted manufacturing (CAD/CAM) for grades 11 and 12. This unit, to be used with students in advanced drafting courses, introduces the concept of CAD/CAM. The content outline includes the following seven sections: (1) CAD/CAM software; (2) computer…

  1. Parametric Modeling for Globoidal Cam Based and NC Machining

    OpenAIRE

    Haitao Liu; Zhibin Chang; Lei Zhang; Wei Jiang; Guangguo Zhang

    2013-01-01

    The design and machining of globoidal cam is difficult, because the shape of working surface is complex,and the curved surface of its space is undevelopable. Based on the above reasons,we proposed the parametric Modeling method for globoidal cam based. Through the secondary development, we realized the parameterized modeling of globoidal cam. Base on using of globular indexing cam NC milling machine existing in the lab,research the programming technology,analyses the defects of conventional p...

  2. Introduction to Analytical Methods for Internal Combustion Engine Cam Mechanisms

    CERN Document Server

    Williams, J J

    2013-01-01

    Modern design methods of Automotive Cam Design require the computation of a range of parameters. This book provides a logical sequence of steps for the derivation of the relevant equations from first principles, for the more widely used cam mechanisms. Although originally derived for use in high performance engines, this work is equally applicable to the design of mass produced automotive and other internal combustion engines.   Introduction to Analytical Methods for Internal Combustion Engine Cam Mechanisms provides the equations necessary for the design of cam lift curves with an associated smooth acceleration curve. The equations are derived for the kinematics and kinetics of all the mechanisms considered, together with those for cam curvature and oil entrainment velocity. This permits the cam shape, all loads, and contact stresses to be evaluated, and the relevant tribology to be assessed. The effects of asymmetry on the manufacture of cams for finger follower and offset translating curved followers is ...

  3. VARIABLE-THROW CAM

    Science.gov (United States)

    Godsil, E.C.; Robinson, E.Y.

    1963-07-16

    A variable-throw cam comprising inner and outer eccentric sleeves which are adjustably locked together is described. The cam throw is varied by unlocking the inner and outer sleeves, rotating the outer sleeve relative to the inner one until the desired throw is obtained, and locking the sleeves together again. The cam is useful in applications wherein a continuously-variable throw is required, e.g., ram-and-die pressing operations, cyclic fatigue testing of materials, etc. (AEC)

  4. Academic doctors' views of complementary and alternative medicine (CAM and its role within the NHS: an exploratory qualitative study

    Directory of Open Access Journals (Sweden)

    Shaw Alison

    2007-05-01

    Full Text Available Abstract Background There has been a marked increase in the use of complementary and alternative medicine (CAM in the UK population in recent years. Surveys of doctors' perspectives on CAM have identified a variety of views and potential information needs. While these are useful for describing the proportions of doctors who hold particular attitudes towards CAM, they are less helpful for understanding why. In addition, while the views of non-academic doctors have begun to be studied, the perspective and rationales of academic doctors remains under-researched. It seems important to investigate the views of those with a research-orientation, given the emphasis on the need for more scientific evidence in recent debates on CAM. Methods This exploratory study used qualitative methods to explore academic doctors' views of CAM and the rationales they provided for their views. A purposeful sampling strategy was used to identify doctors with a dual clinical and academic role in the Bristol area, with an anticipated variety of views on CAM. Semi-structured interviews were conducted with nine doctors. The data were analysed thematically, drawing on the Framework Approach. Results The doctors expressed a spectrum of views on CAM, falling into three broad groups: the 'enthusiasts', the 'sceptics' and the 'undecided'. Scepticism or uncertainty about the value of CAM was prominent, except among those practising a form of CAM. A variety of rationales underpinned their perspectives on CAM, a key recurring rationale being their perspective on the scientific evidence base. The main themes arising included: the role of doctors' professional experiences of conventional medicine and CAM in shaping their attitudes towards CAM, doctor-patient communication about CAM and patient disclosure, whether there is a need for training and education in CAM for doctors, a hierarchy of acceptability of CAM and the nature of evidence; and the role of CAM within the NHS. Conclusion

  5. The ExStroke Pilot Trial: rationale, design, and baseline data of a randomized multicenter trial comparing physical training versus usual care after an ischemic stroke

    DEFF Research Database (Denmark)

    Krarup, L.H.; Gluud, C.; Truelsen, T.;

    2008-01-01

    increasing stroke patients' level of physical activity and secondarily to associate the level of physical activity to the risk of recurrent stroke, myocardial infarction, and all-cause mortality in the two groups. We describe the rationale, design, and baseline data of the ExStroke Pilot Trial. METHODS......: Patients with ischemic stroke above 39 years were randomized to intervention or control group. The intervention group will, over a 2-year period, receive information on and verbal instruction to exercise by a physiotherapist or a physician. The control group will receive the department's usual care...

  6. Study to prospectively evaluate reamed intramedually nails in patients with tibial fractures (S.P.R.I.N.T.): Study rationale and design

    OpenAIRE

    ,

    2008-01-01

    Background Surgeons agree on the benefits of operative treatment of tibial fractures – the most common of long bone fractures – with an intramedullary rod or nail. Rates of re-operation remain high – between 23% and 60% in prior trials – and the two alternative nailing approaches, reamed or non-reamed, each have a compelling biological rationale and strong proponents, resulting in ongoing controversy regarding which is better. Methods/Design The objective of this trial was to assess the impac...

  7. Bendix CAD-CAM site plan

    Energy Technology Data Exchange (ETDEWEB)

    Smith, M.L.

    1982-12-01

    The Bendix Site Plan for CAD-CAM encompasses the development and integration of interactive graphics systems, factory data management systems, robotics, direct numerical control, automated inspection, factory automation, and shared data bases to achieve significant plant-wide gains in productivity. This plan does not address all current or planned computerization projects within our facility. A summary of planning proposals and rationale is presented in the following paragraphs. Interactive Graphics System (IGS) capability presently consists of two Applicon CAD systems and the CD-2000 software program processing on a time-shared CYBER 174 computer and a dedicated CYBER 173. Proposed plans include phased procurment through FY85 of additional computers and sufficient graphics terminals to support projected needs in drafting, tool/gage design, N/C programming, and process engineering. Planned procurement of additional computer equipment in FY86 and FY87 will provide the capacity necessary for a comprehensive graphics data base management system, computer-aided process planning graphics, and special graphics requirements in facilities and test equipment design. The overall IGS plan, designated BICAM (Bendix Integrated Computer Aided Manufacturing), will provide the capability and capacity to integrate manufacturing activities through a shared product data base and standardized data exchange format. Planned efforts in robotics will result in productive applications of low to medium technology robots beginning in FY82, and extending by FY85 to work cell capabilities utilizing higher technology robots with sensors such as vision and instrumented remote compliance devices. A number of robots are projected to be in service by 1990.

  8. Virtually designed and CAD/CAM-fabricated lithium disilicate prostheses for an esthetic maxillary rehabilitation: a senior dental student clinical report.

    Science.gov (United States)

    Zandinejad, Amirali; Metz, Michael; Stevens, Paul; Lin, Wei-Shao; Morton, Dean

    2015-04-01

    During their education, dental students seek to be involved in comprehensive esthetic treatment for the rehabilitation of lost, damaged, or discolored tooth structure. Due to technological advances and patient exposure to dental advertising, recent dental school graduates can find themselves under great expectations with limited clinical experience. With the implementation of an oral health and rehabilitation department at the University of Louisville Dental School, dental students have the opportunity to plan treatment and treat such patients under the supervision of faculty with advanced training in prosthodontics and restorative dentistry. The work flow of multiple consecutive lithium disilicate ceramic prostheses using a digital impression, virtual CAD/CAM design, and milled fabrication as planned and executed by a senior dental student is presented. PMID:25682528

  9. CYCLE TIME REDUCTION FROM DESIGN TO MANUFACTURING BY INTEGRATING CAD-CAM AND PROCESS PLANNING ACTIVITIES IN SMALL SCALE DIE MANUFACTURING COMPANY

    Directory of Open Access Journals (Sweden)

    Yogesh G. Jangale

    2015-04-01

    Full Text Available In small scale industry the current environment tends to force employee to work in isolation also it observed that they works on conventional machines when CNC or VMC machines are available, this is because of some certain problems which are not analyzed properly or failure to find root cause by system. To eliminate this mentality of workers there should be close neat observation of supervisory control is essential, also it is necessary to built an error proof system which lead to develop a system which focuses on productivity & quality control. This paper deals with design of low budget system for CAD-CAM-CAPP integration for a small scale die manufacturing industry to reduce lead time during production.

  10. Model Documentation for the MiniCAM

    Energy Technology Data Exchange (ETDEWEB)

    Brenkert, Antoinette L.; Smith, Steven J.; Kim, Son H.; Pitcher, Hugh M.

    2003-07-17

    The MiniCAM, short for the Mini-Climate Assessment Model, is an integrated assessment model of moderate complexity focused on energy and agriculture sectors. The model produces emissions of greenhouse gases (carbon dioxide, methane and nitrous oxide) and other radiatively important substances such as sulfur dioxide. Through incorporation of the simple climate model MAGICC, the consequences of these emissions for climate change and sea-level rise can be examined. The MiniCAM is designed to be fast and flexible.

  11. A pragmatic randomised controlled trial on routine iron prophylaxis during pregnancy in Maputo, Mozambique (PROFEG): rationale, design, and success.

    Science.gov (United States)

    Nwaru, Bright I; Parkkali, Saara; Abacassamo, Fatima; Salomé, Graca; Chilundo, Baltazar; Augusto, Orvalho; Cliff, Julie; Dgedge, Martinho; Regushevskaya, Elena; Nikula, Minna; Hemminki, Elina

    2015-04-01

    The effects of prophylactic iron during pregnancy on maternal and child health in developing settings with endemic malaria and high prevalence of HIV remain unclear. This paper describes the rationale, implementation and success of a pragmatic randomised controlled trial comparing routine iron supplementation vs. screening and treatment for anaemia during pregnancy. The setting was two health centres in Maputo, Mozambique. Pregnant women (≥ 12-week gestation; ≥ 18 years old; and not with a high-risk pregnancy, n=4326) were recruited. The main outcomes are preterm delivery and low birthweight. The women were randomly assigned to one of two iron administration policies: a routine iron group (n=2184) received 60 mg of ferrous sulphate plus 400 μg of folic acid daily while a selective iron group (n=2142) had screening and treatment for anaemia and a daily intake of 1 mg of folic acid. The recruitment, follow-up, and collection of follow-up data were successful; both groups were similar to each other in all the trial stages. Collection of delivery data was challenging and data on about 40% of births is missing. These are currently being traced through different hospitals and health centres. The compliance of the study personnel and the women with regard to regular measurement of haemoglobin and intake of the iron and folic acid tablets was high and similar in both trial arms. Taking into account the various constraints encountered, the stages of the present trial prior to delivery were carried out well. PMID:23020829

  12. CAM and NK Cells

    Directory of Open Access Journals (Sweden)

    Kazuyoshi Takeda

    2004-01-01

    Full Text Available It is believed that tumor development, outgrowth and metastasis are under the surveillance of the immune system. Although both innate and acquired immune systems play roles, innate immunity is the spearhead against tumors. Recent studies have revealed the critical role of natural killer (NK cells in immune surveillance and that NK cell activity is considerably influenced by various agents, such as environmental factors, stress, foods and drugs. Some of these NK cell stimulants have been used in complementary and alternative medicine (CAM since ancient times. Therefore, the value of CAM should be re-evaluated from this point of view. In this review, we overview the intimate correlation between NK cell functions and CAM agents, and discuss possible underlying mechanisms mediating this. In particular, neuro-immune crosstalk and receptors for CAM agents are the most important and interesting candidates for such mechanisms.

  13. Resin-composite Blocks for Dental CAD/CAM Applications

    OpenAIRE

    Ruse, N.D.; Sadoun, M.J.

    2014-01-01

    Advances in digital impression technology and manufacturing processes have led to a dramatic paradigm shift in dentistry and to the widespread use of computer-aided design/computer-aided manufacturing (CAD/CAM) in the fabrication of indirect dental restorations. Research and development in materials suitable for CAD/CAM applications are currently the most active field in dental materials. Two classes of materials are used in the production of CAD/CAM restorations: glass-ceramics/ceramics and ...

  14. Application of CAD/CAPP/CAM in design & manufacture process of mould%CAD/CAPP/CAM在模具设计制造中的应用

    Institute of Scientific and Technical Information of China (English)

    任玉珠

    2011-01-01

    模具设计与制造是一个集设计、绘图、制订工艺路线、加工制造等为一体的系列工作过程.阐述了在模具设计制造中应用CAD软件进行模具的特征三维造型设计、应用CAPP软件制订模具加工工艺规程,利用CAM软件模拟模具辅助制造"用二维代替三维""特殊工艺造型""使用混合模型""化整为零"过程,同时自动生成刀具加工时的运动轨迹(刀位文件)和数控程序的技术路线,为模具设计制造提供了先进的方法和手段,给企业模具设计制造以借鉴.%Design and manufacture of mould is a series of work flow integrating designing, drafting,formulating process routes and machining as a whole.lt elaborated on the features of three-dimensional model design of mould by applying CAD software in the process of mould design and manufacture as well as the mould processing procedure by applying CAPP software.Furthermore CAM software is utilized to simulate aided mould manufacturing process of“replacing 2D by 3D”“unique process model”“hybrid model breaking up the whole into parts” ,and motion trail (cutter location files )and technical routes of numerical control program are generated automatically during machining knife tools ,which provides advanced ways and means for design and manufacture of mould,for the reference of enterprises accordingly.

  15. Ethical and policy issues in cluster randomized trials: rationale and design of a mixed methods research study

    Directory of Open Access Journals (Sweden)

    Chaudhry Shazia H

    2009-07-01

    Full Text Available Abstract Background Cluster randomized trials are an increasingly important methodological tool in health research. In cluster randomized trials, intact social units or groups of individuals, such as medical practices, schools, or entire communities – rather than individual themselves – are randomly allocated to intervention or control conditions, while outcomes are then observed on individual cluster members. The substantial methodological differences between cluster randomized trials and conventional randomized trials pose serious challenges to the current conceptual framework for research ethics. The ethical implications of randomizing groups rather than individuals are not addressed in current research ethics guidelines, nor have they even been thoroughly explored. The main objectives of this research are to: (1 identify ethical issues arising in cluster trials and learn how they are currently being addressed; (2 understand how ethics reviews of cluster trials are carried out in different countries (Canada, the USA and the UK; (3 elicit the views and experiences of trial participants and cluster representatives; (4 develop well-grounded guidelines for the ethical conduct and review of cluster trials by conducting an extensive ethical analysis and organizing a consensus process; (5 disseminate the guidelines to researchers, research ethics boards (REBs, journal editors, and research funders. Methods We will use a mixed-methods (qualitative and quantitative approach incorporating both empirical and conceptual work. Empirical work will include a systematic review of a random sample of published trials, a survey and in-depth interviews with trialists, a survey of REBs, and in-depth interviews and focus group discussions with trial participants and gatekeepers. The empirical work will inform the concurrent ethical analysis which will lead to a guidance document laying out principles, policy options, and rationale for proposed guidelines. An

  16. A randomized controlled trial investigation of a non-stimulant in attention deficit hyperactivity disorder (ACTION: Rationale and design

    Directory of Open Access Journals (Sweden)

    Clarke Simon D

    2011-03-01

    Full Text Available Abstract Background The ACTION study (Attention deficit hyperactivity disorder Controlled Trial Investigation Of a Non-stimulant is a multi-center, double-blind, randomized cross-over trial of the non-stimulant medication, Atomoxetine, in children and adolescents with attention deficit hyperactivity disorder (ADHD. The primary aims are to examine the efficacy of atomoxetine for improving cognition and emotional function in ADHD and whether any improvements in these outcomes are more pronounced in participants with comorbid anxiety; and to determine if changes in these outcomes after atomoxetine are more reliable than changes in diagnostic symptoms of ADHD. This manuscript will describe the methodology and rationale for the ACTION study. Methods Children and adolescents aged 6 - 17 y with ADHD will be enrolled. Clinical interview and validated scales will be used to confirm diagnosis and screen for exclusion criteria, which include concurrent stimulant use, and comorbid psychiatric or neurological conditions other than anxiety. Three assessment sessions will be conducted over the 13-week study period: Session 1 (Baseline, pre-treatment, Session 2 (six weeks, atomoxetine or placebo, and Session 3 (13 weeks, cross-over after one-week washout period. The standardized touch-screen battery, "IntegNeuro™", will be used to assess cognitive and emotional function. The primary measure of response will be symptom ratings, while quality of life will be a secondary outcome. Logistic regression will be used to determine predictors of treatment response, while repeated measures of analysis will determine any differences in effect of atomoxetine and placebo. Results The methodology for the ACTION study has been detailed. Conclusions The ACTION study is the first controlled trial to investigate the efficacy of atomoxetine using objective cognitive and emotional function markers, and whether these objective measures predict outcomes with atomoxetine in ADHD

  17. Parametric Modeling for Globoidal Cam Based and NC Machining

    Directory of Open Access Journals (Sweden)

    Haitao Liu

    2013-02-01

    Full Text Available The design and machining of globoidal cam is difficult, because the shape of working surface is complex,and the curved surface of its space is undevelopable. Based on the above reasons,we proposed the parametric Modeling method for globoidal cam based. Through the secondary development, we realized the parameterized modeling of globoidal cam. Base on using of globular indexing cam NC milling machine existing in the lab,research the programming technology,analyses the defects of conventional programming method,raise improvement measures,control the programming error,modify the feeding speed,develop the special purpose programming software, creat globular indexing cam NC machining program automaticly ,improve the machining precision and efficiency of globular indexing cam.  

  18. TFTR Bumper Limiter and Protective Plate (BL/PP) graphite tile computer aided design and manufacture (CAD/CAM)

    International Nuclear Information System (INIS)

    The Bumper Limiter/Protective Plate (BL/PP) project was part of McDonnell Douglas Astronautics Company's (MDAC's) diversification effort into Fusion Energy. MDAC planned to layout and fabricate protective liners for the inside walls of the Tokamak Fusion Test Reactor (TFTR). The conceptual design was given: water-cooled Inconel backing plates covered with high purity graphite tiles. This paper describes how the computer was used to design, fabricate, and inspect the liners and, in particular, the tiles

  19. CAD/CAM of braided preforms for advanced composites

    Science.gov (United States)

    Yang, Gui; Pastore, Christopher; Tsai, Yung Jia; Soebroto, Heru; Ko, Frank

    A CAD/CAM system for braiding to produce preforms for advanced textile structural composites is presented in this paper. The CAD and CAM systems are illustrated in detail. The CAD system identifies the fiber placement and orientation needed to fabricate a braided structure over a mandrel, for subsequent composite formation. The CAM system uses the design parameters generated by the CAD system to control the braiding machine. Experimental evidence demonstrating the success of combining these two technologies to form a unified CAD/CAM system for the manufacture of braided fabric preforms with complex structural shapes is presented.

  20. CAD/CAM Helps Build Better Bots: High-Tech Design and Manufacture Draws Engineering-Oriented Students

    Science.gov (United States)

    Van Name, Barry

    2012-01-01

    There is a battlefield where no quarter is given, no mercy shown, but not a single drop of blood is spilled. It is an arena that witnesses the bringing together of high-tech design and manufacture with the outpouring of brute force, under the remotely accessed command of some of today's brightest students. This is the world of battling robots, or…

  1. CAD/CAM (Computer Aided Design/Computer Aided Manufacture). A Brief Guide to Materials in the Library of Congress.

    Science.gov (United States)

    Havas, George D.

    This brief guide to materials in the Library of Congress (LC) on computer aided design and/or computer aided manufacturing lists reference materials and other information sources under 13 headings: (1) brief introductions; (2) LC subject headings used for such materials; (3) textbooks; (4) additional titles; (5) glossaries and handbooks; (6)…

  2. Rationale and design of a randomized controlled trial examining the effect of classroom-based physical activity on math achievement

    OpenAIRE

    Have, Mona; Nielsen, Jacob Have; Gejl, Anne Kær; Thomsen Ernst, Martin; Fredens, Kjeld; Støckel, Jan Toftegaard; Wedderkopp, Niels; Domazet, Sidsel Louise; Gudex, Claire; Grøntved, Anders; Kristensen, Peter Lund

    2016-01-01

    Background Integration of physical activity (PA) into the classroom may be an effective way of promoting the learning and academic achievement of children at elementary school. This paper describes the research design and methodology of an intervention study examining the effect of classroom-based PA on mathematical achievement, creativity, executive function, body mass index and aerobic fitness. Methods The study was designed as a school-based cluster-randomized controlled trial targeting sc...

  3. Evaluation of a standard provision versus an autonomy promotive exercise referral programme:rationale and study design

    OpenAIRE

    Jolly, Kate; Joan L. Duda; Daley, Amanda; Eves, Frank F.; Mutrie, Nanette; Ntoumanis, Nikos; Rouse, Peter C; Lodhia, Rekha; Williams, Geoffrey C

    2009-01-01

    Background: The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT)-based exercise referral consultation.Methods/Design: Design: An exploratory cluster randomised controlled trial comparin...

  4. PreCam

    Energy Technology Data Exchange (ETDEWEB)

    Allam, Sahar S. [Fermilab; Tucker, Douglas L. [Fermilab

    2015-01-01

    The Dark Energy Survey (DES) will be taking the next step in probing the properties of Dark Energy and in understanding the physics of cosmic acceleration. A step towards the photometric calibration of DES is to have a quick, bright survey in the DES footprint (PreCam), using a pre-production set of the Dark Energy Camera (DECam) CCDs and a set of 100 mm×100 mm DES filters. The objective of the PreCam Survey is to create a network of calibrated DES grizY standard stars that will be used for DES nightly calibrations and to improve the DES global relative calibrations. Here, we describe the first year of PreCam observation, results, and photometric calibrations.

  5. Retrievability; rationale, measures, impacts

    International Nuclear Information System (INIS)

    The concept of deep geological disposal was developed in order to permanently remove radioactive wastes from the human environment. Retrieval of wastes was reckoned to be a scenario of such low probability that little effort was initially devoted to its study. In recent years, however, there has been an increasingly active debate on whether fully passive (and safe) systems provide a sufficient level of practicability of retrievability. This debate is linked directly to practical, technical matters, such as the design of the facility, the operating procedures and also the institutional programs throughout the lifetime of a repository. But there are also philosophical issues involved in addition to these purely technical issues. For retrievability, the questions are: How easy does retrieval have to be in the different stages of repository development? What is the rationale for requiring retrievability? What technical measures and methods are feasible? Should specific features facilitating retrievability be introduced into the repository design? How do such measures impact on other aspects of system performance and on other issues (such as safeguards)? This paper addresses the questions raised and presents a subjective set of conclusions, as a means to stimulate further debate on this topical issue. Copyright (2001) Material Research Society

  6. CAD/CAM: Practical and Persuasive in Canadian Schools

    Science.gov (United States)

    Willms, Ed

    2007-01-01

    Chances are that many high school students would not know how to use drafting instruments, but some might want to gain competence in computer-assisted design (CAD) and possibly computer-assisted manufacturing (CAM). These students are often attracted to tech courses by the availability of CAD/CAM instructions, and many go on to impress employers…

  7. The VA augmentation and switching treatments for improving depression outcomes (VAST-D) study: Rationale and design considerations.

    Science.gov (United States)

    Mohamed, Somaia; Johnson, Gary R; Vertrees, Julia E; Guarino, Peter D; Weingart, Kimberly; Young, Ilanit Tal; Yoon, Jean; Gleason, Theresa C; Kirkwood, Katherine A; Kilbourne, Amy M; Gerrity, Martha; Marder, Stephen; Biswas, Kousick; Hicks, Paul; Davis, Lori L; Chen, Peijun; Kelada, AlexandraMary; Huang, Grant D; Lawrence, David D; LeGwin, Mary; Zisook, Sidney

    2015-10-30

    Because two-thirds of patients with Major Depressive Disorder do not achieve remission with their first antidepressant, we designed a trial of three "next-step" strategies: switching to another antidepressant (bupropion-SR) or augmenting the current antidepressant with either another antidepressant (bupropion-SR) or with an atypical antipsychotic (aripiprazole). The study will compare 12-week remission rates and, among those who have at least a partial response, relapse rates for up to 6 months of additional treatment. We review seven key efficacy/effectiveness design decisions in this mixed "efficacy-effectiveness" trial. PMID:26279130

  8. Rationale and design of the plate or pin (pop study for dislocated midshaft clavicular fractures: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Meylaerts Sven AG

    2011-07-01

    Full Text Available Abstract Background To describe the rationale and design of a future study comparing results of plate fixation and Elastic Stable Intramedullary Nailing (ESIN with a Titanium Elastic Nail (TEN for adults with a dislocated midshaft clavicular fracture. Methods/Design Prospective randomized multicenter clinical trial in two level 1 and one level 2 trauma centers. 120 patients between 18 and 65 years of age will be included. They are randomized to either plate fixation or ESIN with a TEN with a one year follow-up. Sixty patients will be treated with plate fixation and 60 patients will be treated with ESIN. Primary outcome parameter is the Disabilities of the Arm, Shoulder and Hand score after 6 months. Secondary outcome parameters are Constant Shoulder Score, complications, experienced pain, radiologic consolidation and cosmetics after both procedures. Discussion Prospective randomized studies comparing operative techniques for treatment of dislocated midshaft clavicular fracture are lacking. By studying shoulder function, complications, quality of life, radiographic union, cosmetics as well as experienced pain, a complete efficacy assessment of both procedures will be performed. Trial registration The POP study is registered in the Dutch Trial Register (NTR NTR2438.

  9. HEALTHY study rationale, design and methods: Moderating risk of type 2 diabetes in multi-ethnic middle school students

    Science.gov (United States)

    The HEALTHY primary prevention trial was designed and implemented in response to the growing numbers of children and adolescents being diagnosed with type 2 diabetes. The objective was to moderate risk factors for type 2 diabetes. Modifiable risk factors measured were indicators of adiposity and gly...

  10. Community health workers assisting Latinos manage stress and diabetes (CALMS-D): rationale, intervention design, implementation, and process outcomes.

    Science.gov (United States)

    Wagner, Julie; Bermudez-Millan, Angela; Damio, Grace; Segura-Perez, Sofia; Chhabra, Jyoti; Vergara, Cunegundo; Perez-Escamilla, Rafael

    2015-12-01

    Latinos have high rates of diabetes and mental distress, but lack appropriate services. A study was designed to compare enhanced standard diabetes care with enhanced standard care plus community health worker (CHW) delivered stress management for Latinos with type 2 diabetes. This paper reports intervention design and process outcomes. A formative process was used to develop and implement an eight-session, group stress management intervention. One hundred twenty-one participants completed baseline assessments; n = 107 attended diabetes education and were then randomized. Recruits reported high credibility and treatment expectancies. Treatment fidelity was high. Participants reported high treatment satisfaction and therapeutic alliance and their diabetes knowledge and affect improved over the short term. Retention and attendance at group sessions was challenging but successful relative to similar trials. This comprehensive and culturally sensitive stress management intervention, delivered by a well-trained CHW, was successfully implemented. PMID:26622914

  11. Weight management for individuals with intellectual and developmental disabilities: Rationale and design for an 18 month randomized trial

    OpenAIRE

    Donnelly, JE; Saunders, RR; Saunders, M.; Washburn, RA; Sullivan, DK; Gibson, CA; Ptomey, LT; Goetz, JR; Honas, JJ; Betts, JL; Rondon, MR; Smith, BK; Mayo, MS

    2013-01-01

    Weight management for individuals with intellectual and developmental disabilities (IDD) has received limited attention. Studies on weight management in this population have been conducted over short time frames, in small samples with inadequate statistical power, infrequently used a randomized design, and have not evaluated the use of emerging effective dietary strategies such as pre-packaged meals (PMs). Low energy/fat PMs may be useful in individuals with IDD as they simplify meal planning...

  12. CAD/CAM-designed 3D-printed electroanalytical cell for the evaluation of nanostructured gas-diffusion electrodes

    Science.gov (United States)

    Chervin, Christopher N.; Parker, Joseph F.; Nelson, Eric S.; Rolison, Debra R.; Long, Jeffrey W.

    2016-04-01

    The ability to effectively screen and validate gas-diffusion electrodes is critical to the development of next-generation metal-air batteries and regenerative fuel cells. The limiting electrode in a classic two-terminal device such as a battery or fuel cell is difficult to discern without an internal reference electrode, but the flooded electrolyte characteristic of three-electrode electroanalytical cells negates the prime function of an air electrode—a void volume freely accessible to gases. The nanostructured catalysts that drive the energy-conversion reactions (e.g., oxygen reduction and evolution in the air electrode of metal-air batteries) are best evaluated in the electrode structure as-used in the practical device. We have designed, 3D-printed, and characterized an air-breathing, thermodynamically referenced electroanalytical cell that allows us to mimic the Janus arrangement of the gas-diffusion electrode in a metal-air cell: one face freely exposed to gases, the other wetted by electrolyte.

  13. Rationale, design, methodology and sample characteristics for the Vietnam pre-conceptual micronutrient supplementation trial (PRECONCEPT: a randomized controlled study

    Directory of Open Access Journals (Sweden)

    Nguyen Phuong H

    2012-10-01

    Full Text Available Abstract Background Low birth weight and maternal anemia remain intractable problems in many developing countries. The adequacy of the current strategy of providing iron-folic acid (IFA supplements only during pregnancy has been questioned given many women enter pregnancy with poor iron stores, the substantial micronutrient demand by maternal and fetal tissues, and programmatic issues related to timing and coverage of prenatal care. Weekly IFA supplementation for women of reproductive age (WRA improves iron status and reduces the burden of anemia in the short term, but few studies have evaluated subsequent pregnancy and birth outcomes. The Preconcept trial aims to determine whether pre-pregnancy weekly IFA or multiple micronutrient (MM supplementation will improve birth outcomes and maternal and infant iron status compared to the current practice of prenatal IFA supplementation only. This paper provides an overview of study design, methodology and sample characteristics from baseline survey data and key lessons learned. Methods/design We have recruited 5011 WRA in a double-blind stratified randomized controlled trial in rural Vietnam and randomly assigned them to receive weekly supplements containing either: 1 2800 μg folic acid 2 60 mg iron and 2800 μg folic acid or 3 MM. Women who become pregnant receive daily IFA, and are being followed through pregnancy, delivery, and up to three months post-partum. Study outcomes include birth outcomes and maternal and infant iron status. Data are being collected on household characteristics, maternal diet and mental health, anthropometry, infant feeding practices, morbidity and compliance. Discussion The study is timely and responds to the WHO Global Expert Consultation which identified the need to evaluate the long term benefits of weekly IFA and MM supplementation in WRA. Findings will generate new information to help guide policy and programs designed to reduce the burden of anemia in women and

  14. High-dose N-acetylcysteine in the prevention of COPD exacerbations: rationale and design of the PANTHEON Study.

    Science.gov (United States)

    Zheng, Jin-Ping; Wen, Fu-Qiang; Bai, Chun-Xue; Wan, Huan-Ying; Kang, Jian; Chen, Ping; Yao, Wan-Zhen; Ma, Li-Jun; Xia, Qi-Kui; Gao, Yi; Zhong, Nan-Shan

    2013-04-01

    Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation; from a pathophysiological point of view it involves many components, including mucus hypersecretion, oxidative stress and inflammation. N-acetylcysteine (NAC) is a mucolytic agent with antioxidant and anti-inflammatory properties. Long-term efficacy of NAC 600mg/d in COPD is controversial; a dose-effect relationship has been demonstrated, but at present it is not known whether a higher dose provides clinical benefits. The PANTHEON Study is a prospective, ICS stratified, randomized, double-blind, placebo-controlled, parallel-group, multi-center trial designed to assess the efficacy and safety of high-dose (1200 mg/daily) NAC treatment for one year in moderate-to-severe COPD patients. The primary endpoint is the annual exacerbation rate. Secondary endpoints include recurrent exacerbations hazard ratio, time to first exacerbation, as well as quality of life and pulmonary function. The hypothesis, design and methodology are described and baseline characteristics of recruited patients are presented. 1006 COPD patients (444 treated with maintenance ICS, 562 ICS naive, aged 66.27±8.76 yrs, average post-bronchodilator FEV1 48.95±11.80 of predicted) have been randomized at 34 hospitals in China. Final results of this study will provide objective data on the effects of high-dose (1200 mg/daily) long-term NAC treatment in the prevention of COPD exacerbations and other outcome variables. PMID:23061828

  15. Rationale and Design of the Reduce Elevated Left Atrial Pressure in Patients With Heart Failure (Reduce LAP-HF) Trial

    DEFF Research Database (Denmark)

    Hasenfuss, Gerd; Gustafsson, Finn; Kaye, David; Shah, Sanjiv J; Burkhoff, Dan; Reymond, Marie-Christine; Komtebedde, Jan; Hünlich, Mark

    2015-01-01

    OBJECTIVE: Heart failure with preserved ejection fraction (HFpEF) is characterized by elevated left atrial pressure during rest and/or exercise. The Reduce LAP-HF (Reduce Elevated Left Atrial Pressure in Patients With Heart Failure) trial will evaluate the safety and performance of the Interatria...... the trial is primarily designed to study safety and device performance, we also test the pathophysiologic hypothesis that reduction of left atrial pressure will improve symptoms and quality of life in patients with HFpEF.......OBJECTIVE: Heart failure with preserved ejection fraction (HFpEF) is characterized by elevated left atrial pressure during rest and/or exercise. The Reduce LAP-HF (Reduce Elevated Left Atrial Pressure in Patients With Heart Failure) trial will evaluate the safety and performance of the Interatrial...... Shunt Device (IASD) System II, designed to directly reduce elevated left atrial pressure, in patients with HFpEF. METHODS: The Reduce LAP-HF Trial is a prospective, nonrandomized, open-label trial to evaluate a novel device that creates a small permanent shunt at the level of the atria. A minimum of 60...

  16. Stroke risk associated with balloon based catheter ablation for atrial fibrillation: Rationale and design of the MACPAF Study

    Directory of Open Access Journals (Sweden)

    Schultheiss Heinz-Peter

    2010-07-01

    Full Text Available Abstract Background Catheter ablation of the pulmonary veins has become accepted as a standard therapeutic approach for symptomatic paroxysmal atrial fibrillation (AF. However, there is some evidence for an ablation associated (silent stroke risk, lowering the hope to limit the stroke risk by restoration of rhythm over rate control in AF. The purpose of the prospective randomized single-center study "Mesh Ablator versus Cryoballoon Pulmonary Vein Ablation of Symptomatic Paroxysmal Atrial Fibrillation" (MACPAF is to compare the efficacy and safety of two balloon based pulmonary vein ablation systems in patients with symptomatic paroxysmal AF. Methods/Design Patients are randomized 1:1 for the Arctic Front® or the HD Mesh Ablator® catheter for left atrial catheter ablation (LACA. The predefined endpoints will be assessed by brain magnetic resonance imaging (MRI, neuro(psychological tests and a subcutaneously implanted reveal recorder for AF detection. According to statistics 108 patients will be enrolled. Discussion Findings from the MACPAF trial will help to balance the benefits and risks of LACA for symptomatic paroxysmal AF. Using serial brain MRIs might help to identify patients at risk for LACA-associated cerebral thromboembolism. Potential limitations of the study are the single-center design, the existence of a variety of LACA-catheters, the missing placebo-group and the impossibility to assess the primary endpoint in a blinded fashion. Trial registration clinicaltrials.gov NCT01061931

  17. Artificial intelligence and CAD/CAM

    Energy Technology Data Exchange (ETDEWEB)

    Iwata, K.

    1983-10-01

    In recent years CAD/CAM technology has improved industrial productivity. It is a significant step towards the design of the factory of the future. CAD/CAM in conjunction with artificial intelligence will become paramount. Workers in this field are attempting to produce systems of ever-increasing intelligence and independence for everyday use in factories, schools and elsewhere. A computer system which could understand natural language in both spoken and handwritten form and communicate in natural language would have considerable advantage in practical situations over one of the present generation of computers and computer programs. 2 references.

  18. Patients’ views of CAM as spiritual practice

    DEFF Research Database (Denmark)

    Ulrich, Anita; Evron, Lotte; Ostenfeld-Rosenthal, Ann

    2011-01-01

    Objectives: This paper explores Danish cancer patients’ narratives on spiritual beliefs, practices and the relationship these practices may have to complementary and alternative medicine (CAM). Design: Narrative inquiry was used to understand how spiritual beliefs and practices might be related...... to CAM. Thirty-two cancer patients, family, friends and alternative practitioners were followed up over a two year period by face to face interview, telephone and focus groups. Results: Although religious and spiritual issues were not manifestly expressed by many of the subjects, these issues were...... significantly elaborated upon in narratives by four female participants to warrant more detailed consideration and analysis. Conclusion: It is suggested that for some cancer patients CAM may function, not just as a treatment for cancer related symptoms and side effects, but also as a form of spiritual practice...

  19. Hazmat Cam Wireless Video System

    Energy Technology Data Exchange (ETDEWEB)

    Kevin L. Young

    2006-02-01

    This paper describes the Hazmat Cam Wireless Video System and its application to emergency response involving chemical, biological or radiological contamination. The Idaho National Laboratory designed the Hazmat Cam Wireless Video System to assist the National Guard Weapons of Mass Destruction - Civil Support Teams during their mission of emergency response to incidents involving weapons of mass destruction. The lightweight, handheld camera transmits encrypted, real-time video from inside a contaminated area, or hot-zone, to a command post located a safe distance away. The system includes a small wireless video camera, a true-diversity receiver, viewing console, and an optional extension link that allows the command post to be placed up to five miles from danger. It can be fully deployed by one person in a standalone configuration in less than 10 minutes. The complete system is battery powered. Each rechargeable camera battery powers the camera for 3 hours with the receiver and video monitor battery lasting 22 hours on a single charge. The camera transmits encrypted, low frequency analog video signals to a true-diversity receiver with three antennas. This unique combination of encryption and transmission technologies delivers encrypted, interference-free images to the command post under conditions where other wireless systems fail. The lightweight camera is completely waterproof for quick and easy decontamination after use. The Hazmat Cam Wireless Video System is currently being used by several National Guard Teams, the US Army, and by fire fighters. The system has been proven to greatly enhance situational awareness during the crucial, initial phase of a hazardous response allowing commanders to make better, faster, safer decisions.

  20. Controlled study of myocardial recovery after interval training in heart failure: SMARTEX-HF - rationale and design

    DEFF Research Database (Denmark)

    Støylen, Asbjørn; Conraads, Viviane; Halle, Martin;

    2011-01-01

    comprising interval training at high relative intensity would yield significantly larger effects in terms of left ventricular remodelling compared to moderate continuous exercise training. Study design: In a three-armed randomized multicentre study of stable heart failure patients with left ventricular...... ejection fraction =35%, the effects of a 12-week programme of high-intensity interval training (HIT; 85-90% of peak oxygen uptake, VO(2peak)) will be compared to actual practice in Europe, represented by either an isocaloric programme of moderate continuous training (MCT; 50-60% of VO(2peak)) and a......Background: The large randomized controlled multicentre clinical trial, HF-ACTION, recently demonstrated that a programme of recommendation of regular exercise training at moderate intensity is safe, improves quality of life, and reduces the combined endpoint of all-cause death and hospitalization...

  1. Design Rationale and Preclinical Evaluation of the HeartMate 3 Left Ventricular Assist System for Hemocompatibility.

    Science.gov (United States)

    Bourque, Kevin; Cotter, Christopher; Dague, Charles; Harjes, Daniel; Dur, Onur; Duhamel, Julien; Spink, Kaitlyn; Walsh, Kelly; Burke, Edward

    2016-01-01

    The HeartMate 3 (HM3) left ventricular assist device (LVAD) is designed to support advanced heart failure patients. This centrifugal flow pump has a magnetically levitated rotor, artificial pulse, textured blood-contacting surfaces, optimized fluid dynamics, large blood-flow gaps, and low shear stress. Preclinical tests were conducted to assess hemocompatibility. A computational fluid dynamics (CFD) model guided design for low shear stress and sufficient washing. Hemolysis testing was conducted on six pumps. Plasma-free hemoglobin (PfHb) and modified index of hemolysis (MIH) were compared with HeartMate II (HMII). CFD showed secondary flow path residence times between 27 and 798 min, comparable with main flow residence times between 118 and 587 min; HM3 vs. HMII shear stress exposure above 150 Pa was 3.3 vs. 11 mm within the pump volume and 134 vs. 604 mm on surfaces. In in vitro hemolysis tests at 2, 5, and 10 L/min, average pfHb 6 hours after test initiation was 58, 74, and 157 mg/dl, compared with 112, 123, and 353 mg/dl for HMII. The HM3/HMII ratio of average MIH at 2, 5, and 10 L/min was 0.29, 0.36, and 0.22. Eight 60 day bovine implants were tested with average flow rates from 5.6 to 6.4 L/min with no device failures, thrombosis, or hemolysis. Results support advancing HM3 to clinical trials. PMID:27195742

  2. Clinical Evaluation of Effects of Chronic Resveratrol Supplementation on Cerebrovascular Function, Cognition, Mood, Physical Function and General Well-Being in Postmenopausal Women—Rationale and Study Design

    Directory of Open Access Journals (Sweden)

    Hamish Michael Evans

    2016-03-01

    Full Text Available Background: This methodological paper presents both a scientific rationale and a methodological approach for investigating the effects of resveratrol supplementation on mood and cognitive performance in postmenopausal women. Postmenopausal women have an increased risk of cognitive decline and dementia, which may be at least partly due to loss of beneficial effects of estrogen on the cerebrovasculature. We hypothesise that resveratrol, a phytoestrogen, may counteract this risk by enhancing cerebrovascular function and improving regional blood flow in response to cognitive demands. A clinical trial was designed to test this hypothesis. Method: Healthy postmenopausal women were recruited to participate in a randomised, double-blind, placebo-controlled (parallel comparison dietary intervention trial to evaluate the effects of resveratrol supplementation (75 mg twice daily on cognition, cerebrovascular responsiveness to cognitive tasks and overall well-being. They performed the following tests at baseline and after 14 weeks of supplementation: Rey Auditory Verbal Learning Test, Cambridge Semantic Memory Battery, the Double Span and the Trail Making Task. Cerebrovascular function was assessed simultaneously by monitoring blood flow velocity in the middle cerebral arteries using transcranial Doppler ultrasound. Conclusion: This trial provides a model approach to demonstrate that, by optimising circulatory function in the brain, resveratrol and other vasoactive nutrients may enhance mood and cognition and ameliorate the risk of developing dementia in postmenopausal women and other at-risk populations.

  3. Study rationale and design of OPTIMISE, a randomised controlled trial on the effect of benchmarking on quality of care in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Hermans Michel P

    2011-09-01

    Full Text Available Abstract Background To investigate the effect of physician- and patient-specific feedback with benchmarking on the quality of care in adults with type 2 diabetes mellitus (T2DM. Methods Study centres in six European countries were randomised to either a benchmarking or control group. Physicians in both groups received feedback on modifiable outcome indicators (glycated haemoglobin [HbA1c], glycaemia, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein [LDL]-cholesterol and triglycerides for each patient at 0, 4, 8 and 12 months, based on the four times yearly control visits recommended by international guidelines. The benchmarking group also received comparative results on three critical quality indicators of vascular risk (HbA1c, LDL-cholesterol and systolic blood pressure [SBP], checked against the results of their colleagues from the same country, and versus pre-set targets. After 12 months of follow up, the percentage of patients achieving the pre-determined targets for the three critical quality indicators will be assessed in the two groups. Results Recruitment was completed in December 2008 with 3994 evaluable patients. Conclusions This paper discusses the study rationale and design of OPTIMISE, a randomised controlled study, that will help assess whether benchmarking is a useful clinical tool for improving outcomes in T2DM in primary care. Trial registration NCT00681850

  4. Some Workplace Effects of CAD and CAM.

    Science.gov (United States)

    Ebel, Karl-H.; Ulrich, Erhard

    1987-01-01

    Examines the impact of computer-aided design (CAD) and computer-aided manufacturing (CAM) on employment, work organization, working conditions, job content, training, and industrial relations in several countries. Finds little evidence of negative employment effects since productivity gains are offset by various compensatory factors. (Author/CH)

  5. CAD/CAM ceramic restorations in the operatory and laboratory.

    Science.gov (United States)

    Fasbinder, Dennis J

    2003-08-01

    Computer assisted design/computer assisted machining (CAD/CAM) technology has received considerable clinical and research interest from modern dental practices as a means of delivering all-ceramic restorations. The CEREC, System offers CAD/CAM dental technology designed for clinical use by dentists, as well as a separate system designed for dental laboratory technicians. The CEREC 3 system is indicated for dental operatory applications, and the CEREC inLab, system is indicated for dental laboratory applications. Although both systems rely on similar CAD/CAM technology, several significant differences exist in the processing techniques involved, restorative materials used, and types of restoration provided. PMID:14692164

  6. Rationale, design, and protocol for the prevention of low back pain in the military (POLM trial (NCT00373009

    Directory of Open Access Journals (Sweden)

    Dugan Jessica L

    2007-09-01

    Full Text Available Abstract Background There are few effective strategies reported for the primary prevention of low back pain (LBP. Core stabilization exercises targeting the deep abdominal and trunk musculature and psychosocial education programs addressing patient beliefs and coping styles represent the current best evidence for secondary prevention of low back pain. However, these programs have not been widely tested to determine if they are effective at preventing the primary onset and/or severity of LBP. The purpose of this cluster randomized clinical trial is to determine if a combined core stabilization exercise and education program is effective in preventing the onset and/or severity of LBP. The effect of the combined program will be compared to three other standard programs. Methods/Design Consecutive Soldiers participating in advanced individual training (AIT will be screened for eligibility requirements and consented to study participation, as appropriate. Companies of Soldiers will be randomly assigned to receive the following standard prevention programs; a core stabilization exercise program (CSEP alone, a CSEP with a psychosocial education (PSEP, a traditional exercise (TEP, or a TEP with a PSEP. Proximal outcome measures will be assessed at the conclusion of AIT (a 12 week training period and include imaging of deep lumbar musculature using real-time ultrasound imaging and beliefs about LBP by self-report questionnaire. We are hypothesizing that Soldiers receiving the CSEP will have improved thickness of selected deep lumbar musculature (transversus abdominus, multifidi, and erector spinae muscles. We are also hypothesizing that Soldiers receiving the PSEP will have improved beliefs about the management of LBP. After AIT, Soldiers will be followed monthly to measure the distal outcomes of LBP occurrence and severity. This information will be collected during the subsequent 2 years following completion of AIT using a web-based data entry system

  7. A new approach to physical activity maintenance: Rationale, design, and baseline data from the Keep Active Minnesota trial

    Directory of Open Access Journals (Sweden)

    Crain A Lauren

    2008-07-01

    Full Text Available Abstract Background Since many individuals who initiate physical activity programs are highly likely to return to a sedentary lifestyle, innovative strategies to efforts to increase the number of physically active older adults who successfully maintain beneficial levels of PA for a substantial length of time are needed. Methods/Design The Keep Active Minnesota Trial is a randomized controlled trial of an interactive phone- and mail-based intervention to help 50–70 year old adults who have recently increased their physical activity level, maintain that activity level over a 24-month period in comparison to usual care. Baseline, 6, 12, and 24 month measurement occurred via phone surveys with kilocalories expended per week in total and moderate-to-vigorous physical activity (CHAMPS Questionnaire as the primary outcome measures. Secondary outcomes include hypothesized mediators of physical activity change (e.g., physical activity enjoyment, self-efficacy, physical activity self-concept, body mass index, and depression. Seven day accelerometry data were collected on a sub-sample of participants at baseline and 24-month follow-up. Discussion The Keep Active Minnesota study offers an innovative approach to the perennial problem of physical activity relapse; by focusing explicitly on physical activity maintenance, the intervention holds considerable promise for modifying the typical relapse curve. Moreover, if shown to be efficacious, the use of phone- and mail-based intervention delivery offers potential for widespread dissemination. Trial registration ClinicalTrials.gov Identifier: NCT00283452.

  8. A virtual reality intervention (Second Life) to improve weight maintenance: Rationale and design for an 18-month randomized trial.

    Science.gov (United States)

    Sullivan, D K; Goetz, J R; Gibson, C A; Mayo, M S; Washburn, R A; Lee, Y; Ptomey, L T; Donnelly, J E

    2016-01-01

    Despite the plethora of weight loss programs available in the US, the prevalence of overweight and obesity (BMI≥25kg/m(2)) among US adults continues to rise at least, in part, due to the high probability of weight regain following weight loss. Thus, the development and evaluation of novel interventions designed to improve weight maintenance are clearly needed. Virtual reality environments offer a promising platform for delivering weight maintenance interventions as they provide rapid feedback, learner experimentation, real-time personalized task selection and exploration. Utilizing virtual reality during weight maintenance allows individuals to engage in repeated experiential learning, practice skills, and participate in real-life scenarios without real-life repercussions, which may diminish weight regain. We will conduct an 18-month effectiveness trial (6 months weight loss, 12 months weight maintenance) in 202 overweight/obese adults (BMI 25-44.9kg/m(2)). Participants who achieve ≥5% weight loss following a 6month weight loss intervention delivered by phone conference call will be randomized to weight maintenance interventions delivered by conference call or conducted in a virtual environment (Second Life®). The primary aim of the study is to compare weight change during maintenance between the phone conference call and virtual groups. Secondarily, potential mediators of weight change including energy and macronutrient intake, physical activity, consumption of fruits and vegetables, self-efficacy for both physical activity and diet, and attendance and completion of experiential learning assignments will also be assessed. PMID:26616535

  9. Rationale and design of the Leipzig (LIFE Heart Study: phenotyping and cardiovascular characteristics of patients with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Frank Beutner

    Full Text Available OBJECTIVE: We established the Leipzig (LIFE Heart Study, a biobank and database of patients with different stages of coronary artery disease (CAD for studies of clinical, metabolic, cellular and genetic factors of cardiovascular diseases. DESIGN: The Leipzig (LIFE Heart Study (NCT00497887 is an ongoing observational angiographic study including subjects with different entities of CAD. Cohort 1, patients undergoing first-time diagnostic coronary angiography due to suspected stable CAD with previously untreated coronary arteries. Cohort 2, patients with acute myocardial infarction (MI requiring percutaneous revascularization. Cohort 3, patients with known left main coronary artery disease (LMCAD. RESULTS: We present preliminary results of demographics and phenotyping based on a 4-years analysis of a total of 3,165 subjects. Cohort 1 (n=2,274 shows the typical distribution of elective coronary angiography cohorts with 43% cases with obstructive CAD and 37% normal angiograms. Cohorts 2 and 3 consist of 590 and 301 subjects, respectively, adding patients with severe forms of CAD. The suitability of the database and biobank to perform association studies was confirmed by replication of the CAD susceptibility locus on chromosome 9p21 (OR per allele: 1.55 (any CAD, 1.54 (MI, 1.74 (LMCAD, p<10(-6, respectively. A novel finding was that patients with LMCAD had a stronger association with 9p21 than patients with obstructive CAD without LMCAD (OR 1.22, p=0.042. In contrast, 9p21 did not associate with myocardial infarction in excess of stable CAD. CONCLUSION: The Leipzig (LIFE Heart Study provides a basis to identify molecular targets related to atherogenesis and associated metabolic disorders. The study may contribute to an improvement of individual prediction, prevention, and treatment of CAD.

  10. Studying variability in human brain aging in a population-based German cohort – Rationale and design of 1000BRAINS

    Directory of Open Access Journals (Sweden)

    Svenja eCaspers

    2014-07-01

    Full Text Available The ongoing 1000 brains study (1000BRAINS is an epidemiological and neuroscientific investigation of structural and functional variability in the human brain during aging. The two recruitment sources are the 10-year follow-up cohort of the German Heinz Nixdorf Recall (HNR Study, and the HNR MultiGeneration Study cohort, which comprises spouses and offspring of HNR subjects. The HNR is a longitudinal epidemiological investigation of cardiovascular risk factors, with a comprehensive collection of clinical, laboratory, socioeconomic, and environmental data from population-based subjects aged 45-75 years on inclusion. HNR subjects underwent detailed assessments in 2000, 2006, and 2011, and completed annual postal questionnaires on health status. 1000BRAINS accesses these HNR data and applies a separate protocol comprising: neuropsychological tests of attention, memory, executive functions & language; examination of motor skills; ratings of personality, life quality, mood & daily activities; analysis of laboratory and genetic data; and state-of-the-art magnetic resonance imaging (MRI, 3 Tesla of the brain. The latter includes (i 3D-T1- and 3D-T2-weighted scans for structural analyses and myelin mapping; (ii three diffusion imaging sequences optimized for diffusion tensor imaging, high-angular resolution diffusion imaging for detailed fibre tracking and for diffusion kurtosis imaging; (iii resting-state and task-based functional MRI; and (iv fluid-attenuated inversion recovery and MR angiography for the detection of vascular lesions and the mapping of white matter lesions. The unique design of 1000BRAINS allows: (i comprehensive investigation of various influences including genetics, environment and health status on variability in brain structure and function during aging; and (ii identification of the impact of selected influencing factors on specific cognitive subsystems and their anatomical correlates.

  11. Diet and lifestyle interventions in postpartum women in China: study design and rationale of a multicenter randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Fu Juan

    2010-02-01

    Full Text Available Abstract Background "Doing the month", or "sitting month", is a traditional practice for postpartum women in China and other Asian countries, which includes some taboos against well-accepted healthy diet and lifestyles in general population. Previous studies have shown this practice may be associated with higher prevalence of postpartum problems. The current multicenter randomized controlled trial (RCT aims to evaluate outcomes of diet and lifestyle interventions in Chinese postpartum women. Methods/Design The current multicenter RCT will be conducted in three representative areas in China, Shandong province, Hubei province and Guangdong province, which locate in northern, central and southern parts of China, respectively. Women who attend routine pregnancy diagnosis in hospitals or maternal healthcare centers will be invited to take part in this study. At least 800 women who meet our eligibility criteria will be recruited and randomly assigned to the intervention group (n > = 400 and the control group (n > = 400. A three-dimension comprehensive intervention strategy, which incorporates intervention measures simultaneously to individual postpartum woman, their family members and community environment, will be utilized to maximize the effectiveness of intervention. Regular visiting and follow-up will be done in both group; nutrition and health-related measurements will be assessed both before and after the intervention. Discussion To our knowledge, this current study is the first and largest multicenter RCT which focus on the effectiveness of diet and lifestyle intervention on reducing the incidence rate of postpartum diseases and improving health status in postpartum women. We hypothesize that the intervention will reduce the incidence rates of postpartum diseases and improve nutrition and health status due to a balanced diet and reasonable lifestyle in comparison with the control condition. If so, the results of our study will provide

  12. Studying variability in human brain aging in a population-based German cohort-rationale and design of 1000BRAINS.

    Science.gov (United States)

    Caspers, Svenja; Moebus, Susanne; Lux, Silke; Pundt, Noreen; Schütz, Holger; Mühleisen, Thomas W; Gras, Vincent; Eickhoff, Simon B; Romanzetti, Sandro; Stöcker, Tony; Stirnberg, Rüdiger; Kirlangic, Mehmet E; Minnerop, Martina; Pieperhoff, Peter; Mödder, Ulrich; Das, Samir; Evans, Alan C; Jöckel, Karl-Heinz; Erbel, Raimund; Cichon, Sven; Nöthen, Markus M; Sturma, Dieter; Bauer, Andreas; Jon Shah, N; Zilles, Karl; Amunts, Katrin

    2014-01-01

    The ongoing 1000 brains study (1000BRAINS) is an epidemiological and neuroscientific investigation of structural and functional variability in the human brain during aging. The two recruitment sources are the 10-year follow-up cohort of the German Heinz Nixdorf Recall (HNR) Study, and the HNR MultiGeneration Study cohort, which comprises spouses and offspring of HNR subjects. The HNR is a longitudinal epidemiological investigation of cardiovascular risk factors, with a comprehensive collection of clinical, laboratory, socioeconomic, and environmental data from population-based subjects aged 45-75 years on inclusion. HNR subjects underwent detailed assessments in 2000, 2006, and 2011, and completed annual postal questionnaires on health status. 1000BRAINS accesses these HNR data and applies a separate protocol comprising: neuropsychological tests of attention, memory, executive functions and language; examination of motor skills; ratings of personality, life quality, mood and daily activities; analysis of laboratory and genetic data; and state-of-the-art magnetic resonance imaging (MRI, 3 Tesla) of the brain. The latter includes (i) 3D-T1- and 3D-T2-weighted scans for structural analyses and myelin mapping; (ii) three diffusion imaging sequences optimized for diffusion tensor imaging, high-angular resolution diffusion imaging for detailed fiber tracking and for diffusion kurtosis imaging; (iii) resting-state and task-based functional MRI; and (iv) fluid-attenuated inversion recovery and MR angiography for the detection of vascular lesions and the mapping of white matter lesions. The unique design of 1000BRAINS allows: (i) comprehensive investigation of various influences including genetics, environment and health status on variability in brain structure and function during aging; and (ii) identification of the impact of selected influencing factors on specific cognitive subsystems and their anatomical correlates. PMID:25071558

  13. Design and rationale of a randomized controlled trial of melatonin supplementation in men and women with the metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Terry PD

    2013-03-01

    Full Text Available Paul D Terry,1 Abhinav Goyal,2,3 Lawrence S Phillips,3 Hillary M Superak,4 Michael H Kutner4 1Departments of Public Health and Surgery, University of Tennessee, Knoxville, TN, 2Department of Epidemiology, Emory Rollins School of Public Health, 3Department of Medicine, Emory School of Medicine, 4Department of Biostatistics and Bioinformatics, Emory Rollins School of Public Health, Atlanta, GA, USA Background: The metabolic syndrome is a constellation of interrelated metabolic risk factors that appear to increase the risk of atherosclerotic cardiovascular disease, type 2 diabetes mellitus, and possibly some cancers. Animal studies and observational clinical data in humans suggest that supplemental melatonin may ameliorate a number of components of the metabolic syndrome, including elevated glucose, elevated blood pressure, dyslipidemia, and obesity. The primary objective of this clinical trial was to determine the feasibility, efficacy, and safety of melatonin supplementation in men and women with the metabolic syndrome. Methods: Thirty-nine men and women of mixed race/ethnicity were enrolled into a randomized, double-blind, placebo-controlled clinical trial with two arms: placebo for 10 weeks followed by melatonin for 10 weeks, or vice versa, with an interval 6-week washout period, in a crossover trial design. Outcome measures include metabolic syndrome components (blood pressure, glucose, triglycerides, high-density lipoprotein cholesterol, waist circumference, oxidative stress, and inflammation biomarkers. These biomarkers, along with sleep duration and quality and pretreatment endogenous melatonin levels, were measured to explore possible underlying biologic mechanisms. Discussion: This trial will provide knowledge of the effects of melatonin in metabolic syndrome subjects, and lay the groundwork for future clinical trials of melatonin in metabolic syndrome subjects. Keywords: melatonin, metabolic syndrome, diabetes, blood pressure, sleep

  14. Prevalence of peripheral arterial disease in patients at non-high cardiovascular risk. Rationale and design of the PANDORA study

    Directory of Open Access Journals (Sweden)

    Cimminiello Claudio

    2010-08-01

    Full Text Available Abstract Background Lower extremity peripheral arterial disease (PAD is a marker of widespread atherosclerosis. Individuals with PAD, most of whom do not show typical PAD symptoms ('asymptomatic' patients, are at increased risk of cardiovascular ischaemic events. American College of Cardiology/American Heart Association guidelines recommend that individuals with asymptomatic lower extremity PAD should be identified by measurement of ankle-brachial index (ABI. However, despite its associated risk, PAD remains under-recognised by clinicians and the general population and office-based ABI detection is still poorly-known and under-used in clinical practice. The Prevalence of peripheral Arterial disease in patients with a non-high cardiovascular disease risk, with No overt vascular Diseases nOR diAbetes mellitus (PANDORA study has a primary aim of assessing the prevalence of lower extremity PAD through ABI measurement, in patients at non-high cardiovascular risk, with no overt cardiovascular diseases (including symptomatic PAD, or diabetes mellitus. Secondary objectives include documenting the prevalence and treatment of cardiovascular risk factors and the characteristics of both patients and physicians as possible determinants for PAD under-diagnosis. Methods/Design PANDORA is a non-interventional, cross-sectional, pan-European study. It includes approximately 1,000 primary care participating sites, across six European countries (Belgium, France, Greece, Italy, The Netherlands, Switzerland. Investigator and patient questionnaires will be used to collect both right and left ABI values at rest, presence of cardiovascular disease risk factors, current pharmacological treatment, and determinants for PAD under-diagnosis. Discussion The PANDORA study will provide important data to estimate the prevalence of asymptomatic PAD in a population otherwise classified at low or intermediate risk on the basis of current risk scores in a primary care setting. Trial

  15. Aspirin for the prevention of cognitive decline in the elderly: rationale and design of a neuro-vascular imaging study (ENVIS-ion

    Directory of Open Access Journals (Sweden)

    Reid Christopher M

    2012-02-01

    Full Text Available Abstract Background This paper describes the rationale and design of the ENVIS-ion Study, which aims to determine whether low-dose aspirin reduces the development of white matter hyper-intense (WMH lesions and silent brain infarction (SBI. Additional aims include determining whether a changes in retinal vascular imaging (RVI parameters parallel changes in brain magnetic resonance imaging (MRI; b changes in RVI parameters are observed with aspirin therapy; c baseline cognitive function correlates with MRI and RVI parameters; d changes in cognitive function correlate with changes in brain MRI and RVI and e whether factors such as age, gender or blood pressure influence the above associations. Methods/Design Double-blind, placebo-controlled trial of three years duration set in two Australian academic medical centre outpatient clinics. This study will enrol 600 adults aged 70 years and over with normal cognitive function and without overt cardiovascular disease. Subjects will undergo cognitive testing, brain MRI and RVI at baseline and after 3 years of study treatment. All subjects will be recruited from a 19,000-patient clinical outcome trial conducted in Australia and the United States that will evaluate the effects of aspirin in maintaining disability-free longevity over 5 years. The intervention will be aspirin 100 mg daily versus matching placebo, randomized on a 1:1 basis. Discussion This study will improve understanding of the mechanisms at the level of brain and vascular structure that underlie the effects of aspirin on cognitive function. Given the limited access and high cost of MRI, RVI may prove useful as a tool for the identification of individuals at high risk for the development of cerebrovascular disease and cognitive decline. Trial Registration clinicaltrials.gov Identifier: NCT01038583

  16. Efficacy and safety of oral strontium ranelate for the treatment of knee osteoarthritis: rationale and design of randomised, double-blind, placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Cyrus Cooper

    2013-12-01

    Full Text Available Objective: The osteoporosis drug strontium ranelate dissociates bone remodelling processes. It also inhibits subchondral bone resorption and stimulates cartilage matrix formation in vitro. Exploratory studies in the osteoporosis trialsreport that strontium ranelate reduces biomarkers of cartilage degradation, and attenuates the progression and clinical symptoms of spinal osteoarthritis, suggesting symptom- and structure-modifying activity in osteoarthritis. We describethe rationale and design of a randomised trial evaluating the efficacy and safety of strontium ranelate in knee osteoarthritis.Research design, methods, and results: This double-blind, placebo-controlled trial (98 centres, 18 countries includes ambulatory Caucasian men and women aged ≥50 years with primary knee osteoarthritis of the medial tibiofemoralcompartment (Kellgren and Lawrence grade 2 or 3, joint space width (JSW 2.5 to 5 mm, and knee pain on most days in the previous month (intensity ≥40 mm on a visual analogue scale. Patients are randomly allocated to three groups (strontium ranelate 1 or 2g/day, or placebo. Follow-up is expected to last 3 years. The primary endpoint is radiographic change in JSW from baseline in each group versus placebo. The main clinical secondary endpoint is WOMAC score at the knee. Safety is assessed at every visit. It is estimated that 1600 patients are required to establish statistical significance with power >90% (0.2 mm ±10% between-group difference in change in JSW over 3 years. Recruitment started in April 2006. The results are expected in spring 2012.Clinical trial registration: The trial is registered on www.controlled-trials.com (number ISRCTN41323372.Conclusions: This randomised, double blind, placebo-controlled study will establish the potential of strontium ranelate in improving structure and symptoms in patients with knee osteoarthritis.

  17. SWITCH: rationale, design, and implementation of a community, school, and family-based intervention to modify behaviors related to childhood obesity

    Directory of Open Access Journals (Sweden)

    Callahan Randi

    2008-06-01

    Full Text Available Abstract Background Although several previous projects have attempted to address the issue of child obesity through school-based interventions, the overall effectiveness of school-based programs on health-related outcomes in youth has been poor. Thus, it has been suggested that multi-level interventions that aim to influence healthy lifestyle behaviors at the community, school and family levels may prove more successful in the prevention of childhood obesity. Methods/Design This paper describes the rationale, design, and implementation of a community-, school-, and family-based intervention aimed at modifying key behaviors (physical activity, screen time (Internet, television, video games, and nutrition related to childhood obesity among third through fifth graders in two mid-western cities. The intervention involves a randomized study of 10 schools (5 intervention and 5 control schools. The intervention is being conducted during the duration of the academic year – approximately 9 months – and includes baseline and post-intervention measurements of physical activity, dietary intake, screen time and body composition. Discussion We hope this report will be useful to researchers, public health professionals, and school administrators and health professionals (nurses and physical/health educators seeking to develop similar prevention programs. It is obvious that more collaborative, inter-disciplinary, multi-level work is needed before a proven, effective intervention package to modify behaviors related to childhood obesity can be generally recommended. It is our hope that SWITCH is a step in that direction. Trial Registration ClinicalTrials.gov NCT00685555

  18. CAD/CAM approach to improving industry productivity gathers momentum

    Science.gov (United States)

    Fulton, R. E.

    1982-01-01

    Recent results and planning for the NASA/industry Integrated Programs for Aerospace-Vehicle Design (IPAD) program for improving productivity with CAD/CAM methods are outlined. The industrial group work is being mainly done by Boeing, and progress has been made in defining the designer work environment, developing requirements and a preliminary design for a future CAD/CAM system, and developing CAD/CAM technology. The work environment was defined by conducting a detailed study of a reference design process, and key software elements for a CAD/CAM system have been defined, specifically for interactive design or experiment control processes. Further work is proceeding on executive, data management, geometry and graphics, and general utility software, and dynamic aspects of the programs being developed are outlined

  19. Cam Drive Step Mechanism of a Quadruped Robot

    Directory of Open Access Journals (Sweden)

    Qun Sun

    2014-01-01

    Full Text Available Bionic quadruped robots received considerable worldwide research attention. For a quadruped robot walking with steady paces on a flat terrain, using a cam drive control mechanism instead of servomotors provides theoretical and practical benefits as it reduces the system weight, cost, and control complexities; thus it may be more cost beneficial for some recreational or household applications. This study explores the robot step mechanism including the leg and cam drive control systems based on studying the bone structure and the kinematic step sequences of dog. The design requirements for the cam drive robot legs have been raised, and the mechanical principles of the leg operating mechanism as well as the control parameters have been analyzed. A cam drive control system was constructed using three cams to control each leg. Finally, a four-leg demo robot was manufactured for experiments and it showed stable walking patterns on a flat floor.

  20. Rationale and design of XAMOS

    DEFF Research Database (Denmark)

    Turpie, Alexander G G; Schmidt, André C; Kreutz, Reinhold; Rud-Lassen, Michael; Jamal, Waheed; Mantovani, Lorenzo; Haas, Sylvia

    2012-01-01

    Venous thromboembolism is a frequent and potentially life-threatening complication of orthopedic surgery. Rivaroxaban is an oral direct factor Xa inhibitor, which was shown to be effective for the prevention of venous thromboembolism after elective hip and knee arthroplasty in the RECORD study...... program. Rivaroxaban has the potential to overcome the limitations of the current standards of care in the prevention of venous thromboembolism. XAMOS (Xarelto(®) in the prophylaxis of post-surgical venous thromboembolism after elective major orthopedic surgery of hip or knee) is an international......, noninterventional, parallel-group study to gain insight into the safety (major bleeding, side effects) and effectiveness (prevention of symptomatic thromboembolic events) of rivaroxaban in daily clinical practice. XAMOS will follow 15,000 patients after major orthopedic surgery in approximately 200 centers...

  1. Rationale and design of ARTS

    DEFF Research Database (Denmark)

    Pitt, Bertram; Filippatos, Gerasimos; Gheorghiade, Mihai; Kober, Lars; Krum, Henry; Ponikowski, Piotr; Nowack, Christina; Kolkhof, Peter; Kim, So-Young; Zannad, Faiez

    2012-01-01

    AIMS: BAY 94-8862 is a novel, non-steroidal, mineralocorticoid receptor antagonist with greater selectivity than spironolactone and stronger mineralocorticoid receptor binding affinity than eplerenone. The aims of the MinerAlocorticoid Receptor Antagonist Tolerability Study (ARTS; NCT01345656) ar...... expected to provide a wealth of information on BAY 94-8862 in patients with HFREF and CKD, including the optimal dose range for further studies....

  2. Today's CAD/CAM: flexible digital technologies expanding workflow options.

    Science.gov (United States)

    Ferencz, Jonathan L

    2015-03-01

    CAD/CAM and digital scanning technologies have become essential components of dentistry. Digital impression scanning, restoration design, and manufacturing techniques yield greater treatment predictability, high-level esthetics, and functional accuracy using a variety of materials. PMID:25822749

  3. Rationale and study design of a three-period, 58-week trial of ferric citrate as a phosphate binder in patients with ESRD on dialysis.

    Science.gov (United States)

    Umanath, Kausik; Sika, Mohammed; Niecestro, Robert; Connelly, Carolyn; Schulman, Gerald; Koury, Mark J; Lewis, Julia B; Dwyer, Jamie P

    2013-01-01

    Chronic kidney disease associated mineral and bone disorders arise as a result of aberrant bone mineral metabolism in patients with advancing levels of renal dysfunction and end-stage renal disease. One of the cornerstones of treatment is the use of phosphate-binding agents. We describe the rationale and study design for a clinical trial to assess the safety and efficacy of ferric citrate as a phosphate binder. This trial is a three-period, international, multicenter, randomized, controlled clinical trial to assess the safety and efficacy of ferric citrate as a phosphate binder, consisting of a 2-week washout period, a 52-week safety assessment period in which subjects are randomized to ferric citrate or active control, and a 4-week efficacy assessment period in which subjects randomized to ferric citrate in the safety assessment period are randomized to ferric citrate or placebo. Eligible subjects include end-stage renal disease patients who have been treated with thrice-weekly hemodialysis or peritoneal dialysis for at least 3 months in dialysis clinics in the United States and Israel. Primary outcome measure will be the effect of ferric citrate vs. placebo on the change in serum phosphorus. Safety assessments will be performed by monitoring adverse events, concomitant medication use, and sequential blood chemistries (including iron parameters, phosphorus, and calcium). This three-period trial will assess the efficacy of ferric citrate as a phosphate binder. If proven safe and efficacious, ferric citrate will likely provide an additional phosphate binder to treat chronic kidney disease associated mineral and bone disorders. PMID:22702490

  4. Endoscopic totally extraperitoneal (TEP) hernia repair for inguinal disruption (Sportsman's hernia): rationale and design of a prospective observational cohort study (TEP-ID-study)

    Science.gov (United States)

    Voorbrood, C E H; Goedhart, E; Verleisdonk, E J M M; Sanders, F; Naafs, D; Burgmans, J P J

    2016-01-01

    Introduction Chronic inguinal pain is a frequently occurring problem in athletes. A diagnosis of inguinal disruption is performed by exclusion of other conditions causing groin pain. Up to now, conservative medical management is considered to be the primary treatment for this condition. Relevant large and prospective clinical studies regarding the treatment of inguinal disruption are limited; however, recent studies have shown the benefits of the totally extraperitoneal patch (TEP) technique. This study provides a complete assessment of the inguinal area in athletes with chronic inguinal pain before and after treatment with the TEP hernia repair technique. Methods and analysis We describe the rationale and design of an observational cohort study for surgical treatment with the endoscopic TEP hernia repair technique in athletes with a painful groin (inguinal disruption). The study is being conducted in a high-volume, single centre hospital with specialty in TEP hernia repair. Patients over 18 years, suffering from inguinal pain for at least 3 months during or after playing sports, and whom have not undergone previous inguinal surgery and have received no benefit from physiotherapy are eligible for inclusion. Patients with any another cause of inguinal pain, proven by physical examination, inguinal ultrasound, X-pelvis/hip or MRI are excluded. Primary outcome is reduction in pain after 3 months. Secondary outcomes are pain reduction, physical functioning, and resumption of sport (in frequency and intensity). Ethics and dissemination An unrestricted research grant for general study purposes was assigned to the Hernia Centre. This study itself is not directly subject to the above mentioned research grant or any other financial sponsorship. We intend to publish the outcome of the study, regardless of the findings. All authors will give final approval of the manuscript version to be published. PMID:26739740

  5. Early markers of airways inflammation and occupational asthma: Rationale, study design and follow-up rates among bakery, pastry and hairdressing apprentices

    Directory of Open Access Journals (Sweden)

    Hannhart Bernard

    2009-04-01

    Full Text Available Abstract Background Occupational asthma is a common type of asthma caused by a specific agent in the workplace. The basic alteration of occupational asthma is airways inflammation. Although most patients with occupational asthma are mature adults, there is evidence that airways inflammation starts soon after inception of exposure, including during apprenticeship. Airways hyper responsiveness to methacholine is a valid surrogate marker of airways inflammation, which has proved useful in occupational epidemiology. But it is time-consuming, requires active subject's cooperation and is not readily feasible. Other non-invasive and potentially more useful tests include the forced oscillation technique, measurement of fraction exhaled nitric oxide, and eosinophils count in nasal lavage fluid. Methods and design This study aims to investigate early development of airways inflammation and asthma-like symptoms in apprentice bakers, pastry-makers and hairdressers, three populations at risk of occupational asthma whose work-related exposures involve agents of different nature. The objectives are to (i examine the performance of the non-invasive tests cited above in detecting early airways inflammation that might eventually develop into occupational asthma; and (ii evaluate whether, and how, constitutional (e.g. atopy and behavioural (e.g. smoking risk factors for occupational asthma modulate the effects of allergenic and/or irritative substances involved in these occupations. This paper presents the study rationale and detailed protocol. Discussion Among 441 volunteers included at the first visit, 354 attended the fourth one. Drop outs were investigated and showed unrelated to the study outcome. Sample size and follow-up participation rates suggest that the data collected in this study will allow it to meet its objectives.

  6. Enhancing physical and social environments to reduce obesity among public housing residents: rationale, trial design, and baseline data for the Healthy Families study.

    Science.gov (United States)

    Quintiliani, Lisa M; DeBiasse, Michele A; Branco, Jamie M; Bhosrekar, Sarah Gees; Rorie, Jo-Anna L; Bowen, Deborah J

    2014-11-01

    Intervention programs that change environments have the potential for greater population impact on obesity compared to individual-level programs. We began a cluster randomized, multi-component multi-level intervention to improve weight, diet, and physical activity among low-socioeconomic status public housing residents. Here we describe the rationale, intervention design, and baseline survey data. After approaching 12 developments, ten were randomized to intervention (n=5) or assessment-only control (n=5). All residents in intervention developments are welcome to attend any intervention component: health screenings, mobile food bus, walking groups, cooking demonstrations, and a social media campaign; all of which are facilitated by community health workers who are residents trained in health outreach. To evaluate weight and behavioral outcomes, a subgroup of female residents and their daughters age 8-15 were recruited into an evaluation cohort. In total, 211 households completed the survey (RR=46.44%). Respondents were Latino (63%), Black (24%), and had ≤ high school education (64%). Respondents reported ≤2 servings of fruits & vegetables/day (62%), visiting fast food restaurants 1+ times/week (32%), and drinking soft drinks daily or more (27%). The only difference between randomized groups was race/ethnicity, with more Black residents in the intervention vs. control group (28% vs. 19%, p=0.0146). Among low-socioeconomic status urban public housing residents, we successfully recruited and randomized families into a multi-level intervention targeting obesity. If successful, this intervention model could be adopted in other public housing developments or entities that also employ community health workers, such as food assistance programs or hospitals. PMID:25139728

  7. Effect of genetic testing for risk of type 2 diabetes mellitus on health behaviors and outcomes: study rationale, development and design

    Directory of Open Access Journals (Sweden)

    Cho Alex H

    2012-01-01

    Full Text Available Abstract Background Type 2 diabetes is a prevalent chronic condition globally that results in extensive morbidity, decreased quality of life, and increased health services utilization. Lifestyle changes can prevent the development of diabetes, but require patient engagement. Genetic risk testing might represent a new tool to increase patients' motivation for lifestyle changes. Here we describe the rationale, development, and design of a randomized controlled trial (RCT assessing the clinical and personal utility of incorporating type 2 diabetes genetic risk testing into comprehensive diabetes risk assessments performed in a primary care setting. Methods/Design Patients are recruited in the laboratory waiting areas of two primary care clinics and enrolled into one of three study arms. Those interested in genetic risk testing are randomized to receive either a standard risk assessment (SRA for type 2 diabetes incorporating conventional risk factors plus upfront disclosure of the results of genetic risk testing ("SRA+G" arm, or the SRA alone ("SRA" arm. Participants not interested in genetic risk testing will not receive the test, but will receive SRA (forming a third, "no-test" arm. Risk counseling is provided by clinic staff (not study staff external to the clinic. Fasting plasma glucose, insulin levels, body mass index (BMI, and waist circumference are measured at baseline and 12 months, as are patients' self-reported behavioral and emotional responses to diabetes risk information. Primary outcomes are changes in insulin resistance and BMI after 12 months; secondary outcomes include changes in diet patterns, physical activity, waist circumference, and perceived risk of developing diabetes. Discussion The utility, feasibility, and efficacy of providing patients with genetic risk information for common chronic diseases in primary care remain unknown. The study described here will help to establish whether providing type 2 diabetes genetic risk

  8. Deterministic mathematical morphology for CAD/CAM

    OpenAIRE

    Sarabia Pérez, Rubén; Jimeno Morenilla, Antonio; Molina Carmona, Rafael

    2014-01-01

    Purpose – The purpose of this paper is to present a new geometric model based on the mathematical morphology paradigm, specialized to provide determinism to the classic morphological operations. The determinism is needed to model dynamic processes that require an order of application, as is the case for designing and manufacturing objects in CAD/CAM environments. Design/methodology/approach – The basic trajectory-based operation is the basis of the proposed morphological specialization. This ...

  9. Selecting a CAD/CAM system for the first time

    Energy Technology Data Exchange (ETDEWEB)

    Link, C.H.

    1984-01-01

    A good percentage of manufacturing companies with gross sales exceeding $100 million already use some form of computer-aided design and manufacturing (CAD/CAM). More recently, however, a new, larger group with annual gross sales between $10 million and $100 million have entered the CAD/CAM marketplace. Interested because the technology has proven itself to be economical, beneficial, and relatively easy to implement without prior computer experience, these companies are actively investigating and applying CAD and CAD/CAM. Many are subcontractors to large companies with low design requirements. Others may design and/or manufacture a proprietary product line. Yet, while resembling one another, the needs of these companies vary widely. Applying the proper kind and level of CAD/CAM, therefore, requires a careful analysis of each user's needs.

  10. Italian survey on cardiac rehabilitation and secondary prevention after cardiac revascularization: ICAROS study. A survey from the Italian cardiac rehabilitation network: rationale and design.

    Science.gov (United States)

    Griffo, Raffaele; Fattirolli, Francesco; Temporelli, Pier Luigi; Tramarin, Roberto

    2008-09-01

    In this paper, the Italian Association for Cardiac Prevention and Rehabilitation (GICR) presents the rationale and design of the "Italian survey on CArdiac RehabilitatiOn and Secondary prevention after cardiac revascularization (ICAROS)". The survey is a prospective, longitudinal, multicentric survey, with a on-line web-based data collection. Its design corresponds to the survey's goal, i.e. to describe accurately in the Italian cardiological setting, through a representative number of cardiac rehabilitation centers belonging to the GICR national network, the characteristics, content and effects in the medium term of cardiac rehabilitation (CRP) inpatient or outpatient programs offered to patients after coronary artery bypass (CABG) or percutaneous revascularization (PTCA). The primary aims of the study are: a) to define the principal clinical characteristics of patients who have undergone PTCA or CABG and have been admitted to a CRP program; b) to identify the components of the CRP programs in terms of diagnostic procedures and assessment tests performed, treatments administered, educational programs and physical exercise interventions employed; c) to identify and analyze drug treatments prescribed at discharge from the acute facility and those prescribed at the end of the CRP program; d) to verify the clinical outcome during the course of the CRP program and at 6 months and 1 year after the end of the post-acute CRP program, as well as patients' adherence to the prescribed pharmacological therapy and to the recommended life styles, and the achievement and maintenance of the targets in relation to the modifiable risk factors; e) to define the consumption of major healthcare resources (major cardiac events, hospital re-admission, emergency care access, specialist visits) during the first year following a CRP program. The survey population will consist of all patients consecutively discharged in the period November 3-30, 2008 at the end of an inpatient, day

  11. Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART: Study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    2012-08-01

    Full Text Available Abstract Background Acute respiratory distress syndrome (ARDS is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART. Methods/Design ART is a pragmatic, multicenter, randomized (concealed, controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy. We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH2O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet. In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight and targeting plateau pressure ≤30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion If the ART strategy with maximum recruitment and PEEP titration improves

  12. A school-based intervention to promote physical activity among adolescent girls: Rationale, design, and baseline data from the Girls in Sport group randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Puglisi Lauren

    2011-08-01

    Full Text Available Abstract Background Physical activity levels decline markedly among girls during adolescence. School-based interventions that are multi-component in nature, simultaneously targeting curricular, school environment and policy, and community links, are a promising approach for promoting physical activity. This report describes the rationale, design and baseline data from the Girls in Sport group randomised trial, which aims to prevent the decline in moderate-to-vigorous intensity physical activity (MVPA among adolescent girls. Methods/Design A community-based participatory research approach and action learning framework are used with measurements at baseline and 18-month follow-up. Within each intervention school, a committee develops an action plan aimed at meeting the primary objective (preventing the decline in accelerometer-derived MVPA. Academic partners and the State Department of Education and Training act as critical friends. Control schools continue with their usual school programming. 24 schools were matched then randomized into intervention (n = 12 and control (n = 12 groups. A total of 1518 girls (771 intervention and 747 control completed baseline assessments (86% response rate. Useable accelerometer data (≥10 hrs/day on at least 3 days were obtained from 79% of this sample (n = 1199. Randomisation resulted in no differences between intervention and control groups on any of the outcomes. The mean age (SE of the sample was 13.6 (± 0.02 years and they spent less than 5% of their waking hours in MVPA (4.85 ± 0.06. Discussion Girls in Sport will test the effectiveness of schools working towards the same goal, but developing individual, targeted interventions that bring about changes in curriculum, school environment and policy, and community links. By using community-based participatory research and an action learning framework in a secondary school setting, it aims to add to the body of literature on effective school

  13. Formal Management of CAD/CAM Processes

    Science.gov (United States)

    Kohlhase, Michael; Lemburg, Johannes; Schröder, Lutz; Schulz, Ewaryst

    Systematic engineering design processes have many aspects in common with software engineering, with CAD/CAM objects replacing program code as the implementation stage of the development. They are, however, currently considerably less formal. We propose to draw on the mentioned similarities and transfer methods from software engineering to engineering design in order to enhance in particular the reliability and reusability of engineering processes. We lay out a vision of a document-oriented design process that integrates CAD/CAM documents with requirement specifications; as a first step towards supporting such a process, we present a tool that interfaces a CAD system with program verification workflows, thus allowing for completely formalised development strands within a semi-formal methodology.

  14. Hydraulic involute cam actuator

    Science.gov (United States)

    Love, Lonnie J.; Lind, Randall F.

    2011-11-01

    Mechanical joints are provided in which the angle between a first coupled member and a second coupled member may be varied by mechanical actuators. In some embodiments the angle may be varied around a pivot axis in one plane and in some embodiments the angle may be varied around two pivot axes in two orthogonal planes. The joints typically utilize a cam assembly having two lobes with an involute surface. Actuators are configured to push against the lobes to vary the rotation angle between the first and second coupled member.

  15. Cam Profile Grinding CNC System Based on Open Architecture

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    This paper studies some key technologies of CNC system for cam grinding. Themathematical motion model for cam grinding is established according to the harmony of re-ciprocating motion of the grinding wheel and the rotating motion of the woorkpiece. Themethod of using the linear servomotor to accomplish the grinding wheel tracking is devel-oped and the dynamic model of the system is analyzed. Then the cross-coupled biaxial errorcompensation model is proposed. Finally,the hardware and software of the control systemare designed based on open architecture. Some algorithms, such as spline fitting and inter-polation for cam contour, velocity control and feed control, are presented to improvegrinding precision.

  16. West End Walkers 65+: A randomised controlled trial of a primary care-based walking intervention for older adults: Study rationale and design

    Directory of Open Access Journals (Sweden)

    Rowe David A

    2011-02-01

    Full Text Available Abstract Background In Scotland, older adults are a key target group for physical activity intervention due to the large proportion who are inactive. The health benefits of an active lifestyle are well established but more research is required on the most effective interventions to increase activity in older adults. The 'West End Walkers 65+' randomised controlled trial aims to examine the feasibility of delivering a pedometer-based walking intervention to adults aged ≥65 years through a primary care setting and to determine the efficacy of this pilot. The study rationale, protocol and recruitment process are discussed in this paper. Methods/Design The intervention consisted of a 12-week pedometer-based graduated walking programme and physical activity consultations. Participants were randomised into an immediate intervention group (immediate group or a 12-week waiting list control group (delayed group who then received the intervention. For the pilot element of this study, the primary outcome measure was pedometer step counts. Secondary outcome measures of sedentary time and physical activity (time spent lying/sitting, standing or walking; activPAL™ monitor, mood (Positive and Negative Affect Schedule, functional ability (Perceived Motor-Efficacy Scale for Older Adults, quality of life (Short-Form (36 Health Survey version 2 and loneliness (UCLA Loneliness Scale were assessed. Focus groups with participants and semi-structured interviews with the research team captured their experiences of the intervention. The feasibility component of this trial examined recruitment via primary care and retention of participants, appropriateness of the intervention for older adults and the delivery of the intervention by a practice nurse. Discussion West End Walkers 65+ will determine the feasibility and pilot the efficacy of delivering a pedometer-based walking intervention through primary care to Scottish adults aged ≥65 years. The study will also

  17. Study to prospectively evaluate reamed intramedually nails in patients with tibial fractures (S.P.R.I.N.T.: Study rationale and design

    Directory of Open Access Journals (Sweden)

    2008-06-01

    Full Text Available Abstract Background Surgeons agree on the benefits of operative treatment of tibial fractures – the most common of long bone fractures – with an intramedullary rod or nail. Rates of re-operation remain high – between 23% and 60% in prior trials – and the two alternative nailing approaches, reamed or non-reamed, each have a compelling biological rationale and strong proponents, resulting in ongoing controversy regarding which is better. Methods/Design The objective of this trial was to assess the impact of reamed versus non-reamed intramedullary nailing on rates of re-operation in patients with open and closed fractures of the tibial shaft. The study to prospectively evaluate reamed intramedullary nails in tibial fractures (S.P.R.I.N.T was a multi-center, randomized trial including 29 clinical sites in Canada, the United States and the Netherlands which enrolled 1200 skeletally mature patients with open (Gustilo Types I-IIIB or closed (Tscherne Types 0–3 fractures of the tibial shaft amenable to surgical treatment with an intramedullary nail. Patients received a statically locked intramedullary nail with either reamed or non-reamed insertion. The first strategy involved fixation of the fracture with an intramedullary nail following reaming to enlarge the intramedullary canal (Reamed Group. The second treatment strategy involved fixation of the fracture with an intramedullary nail without prior reaming of the intramedullary canal (Non-Reamed Group. Patients, outcome assessors, and data analysts were blinded to treatment allocation. Peri-operative care was standardized, and re-operations before 6 months were proscribed. Patients were followed at discharge, 2 weeks post-discharge, and at 6 weeks, 3, 6, 9, and 12 months post surgery. A committee, blinded to allocation, adjudicated all outcomes. Discussion The primary outcome was re-operation to promote healing, treat infection, or preserve the limb (fasciotomy for compartment syndrome after

  18. CAD/CAM data management

    Science.gov (United States)

    Bray, O. H.

    1984-01-01

    The role of data base management in CAD/CAM, particularly for geometric data is described. First, long term and short term objectives for CAD/CAM data management are identified. Second, the benefits of the data base management approach are explained. Third, some of the additional work needed in the data base area is discussed.

  19. IGES data exchange between dissimilar CAD-CAM systems

    Energy Technology Data Exchange (ETDEWEB)

    Theilen, D.F.

    1982-06-01

    Sandia National Laboratories and Bendix Kansas City have successfully transferred geometrical model data by using a neutral graphics format, Initial Graphics Exchange Specification (IGES). Data was exchanged between two dissimilar CAD-CAM systems without the need for special translators. The exchanged data was used to fabricate a mechanical part. Design information developed on a CAD-CAM system was translated to IGES with a commercial preprocessor at Sandia. A second vendor's postprocessor translated the design information from IGES to the CAD-CAM system at Bendix. The Bendix CAD-CAM system was used to generate the numerical control tape from the exchange data. The tape was used to fabricate the part. A production print from Sandia was used during final inspection to verify part accuracy. Project results indicated that both vendor-furnished translators correctly transferred the geometric model of points, lines and arcs.

  20. Optimisation Methods for Cam Mechanisms

    Directory of Open Access Journals (Sweden)

    Claudia–Mari Popa

    2010-01-01

    Full Text Available In this paper we present the criteria which represent the base of optimizing the cam mechanisms and also we perform the calculations for several types of mechanisms. We study the influence of the constructive parameters in case of the simple machines with rotation cam and follower (flat or curve of translation on the curvature radius and that of the transmission angle. As it follows, we present the optimization calculations of the cam and flat rotation follower mechanisms, as well as the calculations for optimizing the cam mechanisms by circular groove followers’ help. For an easier interpretation of the results, we have visualized the obtained cam in AutoCAD according to the script files generated by a calculation program.

  1. Geometric Distortion Analysis Using CAD/CAM Based Manufacturing Simulation

    OpenAIRE

    Werke, Mats; Hedlind, Mikael; Nicolescu, Mihai

    2014-01-01

    Machining of components may cause geometric distortions and thereby quality issues and increased costs. This paper presents an engineering approach of CAD/CAM based manufacturing simulation in order to be in control of geometric distortions after machining. The method utilises STEP AP209 for communication of CAD/CAM simulation data. The method improves the ability to optimise process parameters, geometry, and material, in order to fulfil the design requirements. The method supports concurrent...

  2. The Walking Interventions Through Texting (WalkIT) Trial: Rationale, Design, and Protocol for a Factorial Randomized Controlled Trial of Adaptive Interventions for Overweight and Obese, Inactive Adults

    OpenAIRE

    Hurley, Jane C; Hollingshead, Kevin E; Todd, Michael; Jarrett, Catherine L; Tucker, Wesley J; Angadi, Siddhartha S; Adams, Marc A

    2015-01-01

    Background Walking is a widely accepted and frequently targeted health promotion approach to increase physical activity (PA). Interventions to increase PA have produced only small improvements. Stronger and more potent behavioral intervention components are needed to increase time spent in PA, improve cardiometabolic risk markers, and optimize health. Objective Our aim is to present the rationale and methods from the WalkIT Trial, a 4-month factorial randomized controlled trial (RCT) in inact...

  3. CAD/CAM at Gullick Dobson Ltd

    Energy Technology Data Exchange (ETDEWEB)

    1985-11-01

    Gullick Dobson introduced computer-aided design systems more than four years ago, and those have improved the standard of technical presentation for tendering as well as saving time and the repetitive mundane work involved in incorporating standard plants onto several drawings. Computer-aided manufacture has also helped to reduce costs and in future interactive CAD/CAM will be developed where total engineering will result in the best product.

  4. Rad Pole Cam Development

    International Nuclear Information System (INIS)

    The RadPoleCam was developed to provide Department Of Energy (DOE) first responders the capability to assess the radiological and visual condition of remote or inaccessible locations. Real time gamma isotopic identification is provided to the first responder in the form of audio feedback (i.e. spoken through head phones) from a gamma detector mounted on a collapsible pole that can extend from 1 to 9 meters (6 to 29 feet). Simultaneously, selectable direct and side looking visual images are provided from the 5cm (2in) diameter, waterproof probe tip. The lightweight, self contained, ruggedized, system will provide a rapidly deployable field system for visual and radiological search and assessment of confined spaces and extended reach locations

  5. Bilgisayar destekli diş hekimliği ve güncel CAD/CAM sistemleri

    OpenAIRE

    Gözde Çelik; Tuğrul Sarı; Aslıhan Üşümez

    2013-01-01

    CAD/CAM systems (computer aided design/computer aided manufacturing) has been used in dentistry since 1987. In the past 25 years, development of various high quality chairside and laboratory CAD/CAM systems has been continued with the progress of technology. This article describes currently used CAD/CAM systems.

    Keywords: Dental, CAD/CAM systems.

     

    ÖZET

  6. Rationale, design and methods for a randomised and controlled trial to evaluate "Animal Fun" - a program designed to enhance physical and mental health in young children

    Directory of Open Access Journals (Sweden)

    McLaren Sue

    2010-11-01

    Full Text Available Abstract Background Children with poor motor ability have been found to engage less in physical activities than other children, and a lack of physical activity has been linked to problems such as obesity, lowered bone mineral density and cardiovascular risk factors. Furthermore, if children are confident with their fine and gross motor skills, they are more likely to engage in physical activities such as sports, crafts, dancing and other physical activity programs outside of the school curriculum which are important activities for psychosocial development. The primary objective of this project is to comprehensively evaluate a whole of class physical activity program called Animal Fun designed for Pre-Primary children. This program was designed to improve the child's movement skills, both fine and gross, and their perceptions of their movement ability, promote appropriate social skills and improve social-emotional development. Methods The proposed randomized and controlled trial uses a multivariate nested cohort design to examine the physical (motor coordination and psychosocial (self perceptions, anxiety, social competence outcomes of the program. The Animal Fun program is a teacher delivered universal program incorporating animal actions to facilitate motor skill and social skill acquisition and practice. Pre-intervention scores on motor and psychosocial variables for six control schools and six intervention schools will be compared with post-intervention scores (end of Pre-Primary year and scores taken 12 months later after the children's transition to primary school Year 1. 520 children aged 4.5 to 6 years will be recruited and it is anticipated that 360 children will be retained to the 1 year follow-up. There will be equal numbers of boys and girls. Discussion If this program is found to improve the child's motor and psychosocial skills, this will assist in the child's transition into the first year of school. As a result of these changes

  7. Resin-composite Blocks for Dental CAD/CAM Applications

    Science.gov (United States)

    Ruse, N.D.; Sadoun, M.J.

    2014-01-01

    Advances in digital impression technology and manufacturing processes have led to a dramatic paradigm shift in dentistry and to the widespread use of computer-aided design/computer-aided manufacturing (CAD/CAM) in the fabrication of indirect dental restorations. Research and development in materials suitable for CAD/CAM applications are currently the most active field in dental materials. Two classes of materials are used in the production of CAD/CAM restorations: glass-ceramics/ceramics and resin composites. While glass-ceramics/ceramics have overall superior mechanical and esthetic properties, resin-composite materials may offer significant advantages related to their machinability and intra-oral reparability. This review summarizes recent developments in resin-composite materials for CAD/CAM applications, focusing on both commercial and experimental materials. PMID:25344335

  8. Engine testing of ceramic cam-roller followers

    Energy Technology Data Exchange (ETDEWEB)

    Kalish, Y. (Detroit Diesel Corp., MI (United States))

    1992-04-01

    For several years, DDC has been developing monolithic ceramic heat engine components. One of the components, developed for an application in our state-of-the-art on-highway, heavy-duty diesel engine, the Series 60, is a silicon nitride cam-roller follower. Prior to starting this program, each valve train component in the Series 60 was considered for conversion to a ceramic material. Many advantages and disadvantages (benefits and risks) were considered. From this effort, one component was selected, the cam-roller follower. Using a system design approach, a ceramic cam-roller follower offered functional improvement at a reasonable cost. The purpose of the project was to inspect and test 100 domestically produced silicon nitride cam-roller followers built to the requirements of the DDC series 60 engine.

  9. Engine testing of ceramic cam-roller followers. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Kalish, Y. [Detroit Diesel Corp., MI (United States)

    1992-04-01

    For several years, DDC has been developing monolithic ceramic heat engine components. One of the components, developed for an application in our state-of-the-art on-highway, heavy-duty diesel engine, the Series 60, is a silicon nitride cam-roller follower. Prior to starting this program, each valve train component in the Series 60 was considered for conversion to a ceramic material. Many advantages and disadvantages (benefits and risks) were considered. From this effort, one component was selected, the cam-roller follower. Using a system design approach, a ceramic cam-roller follower offered functional improvement at a reasonable cost. The purpose of the project was to inspect and test 100 domestically produced silicon nitride cam-roller followers built to the requirements of the DDC series 60 engine.

  10. CAD/CAM-assisted breast reconstruction

    International Nuclear Information System (INIS)

    The application of computer-aided design and manufacturing (CAD/CAM) techniques in the clinic is growing slowly but steadily. The ability to build patient-specific models based on medical imaging data offers major potential. In this work we report on the feasibility of employing laser scanning with CAD/CAM techniques to aid in breast reconstruction. A patient was imaged with laser scanning, an economical and facile method for creating an accurate digital representation of the breasts and surrounding tissues. The obtained model was used to fabricate a customized mould that was employed as an intra-operative aid for the surgeon performing autologous tissue reconstruction of the breast removed due to cancer. Furthermore, a solid breast model was derived from the imaged data and digitally processed for the fabrication of customized scaffolds for breast tissue engineering. To this end, a novel generic algorithm for creating porosity within a solid model was developed, using a finite element model as intermediate.

  11. CAD/CAM-assisted breast reconstruction

    Energy Technology Data Exchange (ETDEWEB)

    Melchels, Ferry; Hutmacher, Dietmar Werner [Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059 (Australia); Wiggenhauser, Paul Severin; Schantz, Jan-Thorsten [Department of Plastic and Hand Surgery, Klinikum rechts der Isar, Technische Universitaet Muenchen, Ismaninger Strasse 22, 81675 Munich (Germany); Warne, David; Barry, Mark [High Performance Computing and Research Support, Queensland University of Technology, Gardens Point Road, Brisbane, QLD 4000 (Australia); Ong, Fook Rhu; Chong, Woon Shin, E-mail: Dietmar.Hutmacher@qut.edu.au, E-mail: jtschantz@lrz.tu-muenchen.de [Singapore Polytechnic, 500 Dover Road, 139651 Singapore (Singapore)

    2011-09-15

    The application of computer-aided design and manufacturing (CAD/CAM) techniques in the clinic is growing slowly but steadily. The ability to build patient-specific models based on medical imaging data offers major potential. In this work we report on the feasibility of employing laser scanning with CAD/CAM techniques to aid in breast reconstruction. A patient was imaged with laser scanning, an economical and facile method for creating an accurate digital representation of the breasts and surrounding tissues. The obtained model was used to fabricate a customized mould that was employed as an intra-operative aid for the surgeon performing autologous tissue reconstruction of the breast removed due to cancer. Furthermore, a solid breast model was derived from the imaged data and digitally processed for the fabrication of customized scaffolds for breast tissue engineering. To this end, a novel generic algorithm for creating porosity within a solid model was developed, using a finite element model as intermediate.

  12. Update on CAD/CAM activities at Sandia Laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Oliver, D.A.

    1977-09-01

    Development of systems for Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) has been underway at Sandia Laboratories for several years. These include systems for circuit design and analysis, systems for design and fabrication of printed circuit boards and hybrid microcircuits, and systems for mechanical applications, such as mass properties calculations and stress analysis. CAD/CAM operations have proved successful for electronic applications. Current emphasis is on development of mechanical support software, and with putting into production a machine-aided design and definition system (MADDS) utilizing Applicon Graphics Systems (AGS). 14 figures. (RWR)

  13. Understanding dental CAD/CAM for restorations--the digital workflow from a mechanical engineering viewpoint.

    Science.gov (United States)

    Tapie, L; Lebon, N; Mawussi, B; Fron Chabouis, H; Duret, F; Attal, J-P

    2015-01-01

    As digital technology infiltrates every area of daily life, including the field of medicine, so it is increasingly being introduced into dental practice. Apart from chairside practice, computer-aided design/computer-aided manufacturing (CAD/CAM) solutions are available for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental solutions can be considered a chain of digital devices and software for the almost automatic design and creation of dental restorations. However, dentists who want to use the technology often do not have the time or knowledge to understand it. A basic knowledge of the CAD/CAM digital workflow for dental restorations can help dentists to grasp the technology and purchase a CAM/CAM system that meets the needs of their office. This article provides a computer-science and mechanical-engineering approach to the CAD/CAM digital workflow to help dentists understand the technology. PMID:25911827

  14. Time to Talk about CAM

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section CAM Time to Talk Past Issues / Winter 2009 Table of ... helps to ensure your coordinated, safe care. NCCAM's Time to Talk program is just right for talking ...

  15. Hyper Suprime-Cam

    Science.gov (United States)

    Miyazaki, Satoshi; Komiyama, Yutaka; Nakaya, Hidehiko; Kamata, Yukiko; Doi, Yoshi; Hamana, Takashi; Karoji, Hiroshi; Furusawa, Hisanori; Kawanomoto, Satoshi; Morokuma, Tomoki; Ishizuka, Yuki; Nariai, Kyoji; Tanaka, Yoko; Uraguchi, Fumihiro; Utsumi, Yousuke; Obuchi, Yoshiyuki; Okura, Yuki; Oguri, Masamune; Takata, Tadafumi; Tomono, Daigo; Kurakami, Tomio; Namikawa, Kazuhito; Usuda, Tomonori; Yamanoi, Hitomi; Terai, Tsuyoshi; Uekiyo, Hatsue; Yamada, Yoshihiko; Koike, Michitaro; Aihara, Hiro; Fujimori, Yuki; Mineo, Sogo; Miyatake, Hironao; Yasuda, Naoki; Nishizawa, Jun; Saito, Tomoki; Tanaka, Manobu; Uchida, Tomohisa; Katayama, Nobu; Wang, Shiang-Yu; Chen, Hsin-Yo; Lupton, Robert; Loomis, Craig; Bickerton, Steve; Price, Paul; Gunn, Jim; Suzuki, Hisanori; Miyazaki, Yasuhito; Muramatsu, Masaharu; Yamamoto, Koei; Endo, Makoto; Ezaki, Yutaka; Itoh, Noboru; Miwa, Yoshinori; Yokota, Hideo; Matsuda, Toru; Ebinuma, Ryuichi; Takeshi, Kunio

    2012-09-01

    Hyper Suprime-Cam (HSC) is an 870 Mega pixel prime focus camera for the 8.2 m Subaru telescope. The wide field corrector delivers sharp image of 0.25 arc-sec FWHM in r-band over the entire 1.5 degree (in diameter) field of view. The collimation of the camera with respect to the optical axis of the primary mirror is realized by hexapod actuators whose mechanical accuracy is few microns. As a result, we expect to have seeing limited image most of the time. Expected median seeing is 0.67 arc-sec FWHM in i-band. The sensor is a p-ch fully depleted CCD of 200 micron thickness (2048 x 4096 15 μm square pixel) and we employ 116 of them to pave the 50 cm focal plane. Minimum interval between exposures is roughly 30 seconds including reading out arrays, transferring data to the control computer and saving them to the hard drive. HSC uniquely features the combination of large primary mirror, wide field of view, sharp image and high sensitivity especially in red. This enables accurate shape measurement of faint galaxies which is critical for planned weak lensing survey to probe the nature of dark energy. The system is being assembled now and will see the first light in August 2012.

  16. The NectarCAM camera project

    CERN Document Server

    Glicenstein, J-F; Barrio, J-A; Blanch, O; Boix, J; Bolmont, J; Boutonnet, C; Cazaux, S; Chabanne, E; Champion, C; Chateau, F; Colonges, S; Corona, P; Couturier, S; Courty, B; Delagnes, E; Delgado, C; Ernenwein, J-P; Fegan, S; Ferreira, O; Fesquet, M; Fontaine, G; Fouque, N; Henault, F; Gascón, D; Herranz, D; Hermel, R; Hoffmann, D; Houles, J; Karkar, S; Khelifi, B; Knödlseder, J; Martinez, G; Lacombe, K; Lamanna, G; LeFlour, T; Lopez-Coto, R; Louis, F; Mathieu, A; Moulin, E; Nayman, P; Nunio, F; Olive, J-F; Panazol, J-L; Petrucci, P-O; Punch, M; Prast, J; Ramon, P; Riallot, M; Ribó, M; Rosier-Lees, S; Sanuy, A; Siero, J; Tavernet, J-P; Tejedor, L A; Toussenel, F; Vasileiadis, G; Voisin, V; Waegebert, V; Zurbach, C

    2013-01-01

    In the framework of the next generation of Cherenkov telescopes, the Cherenkov Telescope Array (CTA), NectarCAM is a camera designed for the medium size telescopes covering the central energy range of 100 GeV to 30 TeV. NectarCAM will be finely pixelated (~ 1800 pixels for a 8 degree field of view, FoV) in order to image atmospheric Cherenkov showers by measuring the charge deposited within a few nanoseconds time-window. It will have additional features like the capacity to record the full waveform with GHz sampling for every pixel and to measure event times with nanosecond accuracy. An array of a few tens of medium size telescopes, equipped with NectarCAMs, will achieve up to a factor of ten improvement in sensitivity over existing instruments in the energy range of 100 GeV to 10 TeV. The camera is made of roughly 250 independent read-out modules, each composed of seven photo-multipliers, with their associated high voltage base and control, a read-out board and a multi-service backplane board. The read-out b...

  17. CAD-CAM at Bendix Kansas city: the BICAM system

    Energy Technology Data Exchange (ETDEWEB)

    Witte, D.R.

    1983-04-01

    Bendix Kansas City Division (BEKC) has been involved in Computer Aided Manufacturing (CAM) technology since the late 1950's when the numerical control (N/C) analysts installed computers to aid in N/C tape preparation for numerically controlled machines. Computer Aided Design (CAD) technology was introduced in 1976, when a number of 2D turnkey drafting stations were procured for printed wiring board (PWB) drawing definition and maintenance. In June, 1980, CAD-CAM Operations was formed to incorporate an integrated CAD-CAM capability into Bendix operations. In March 1982, a ninth division was added to the existing eight divisions at Bendix. Computer Integrated Manufacturing (CIM) is a small organization, reporting directly to the general manager, who has responsibility to coordinate the overall integration of computer aided systems at Bendix. As a long range plan, CIM has adopted a National Bureau of Standards (NBS) architecture titled Factory of the Future. Conceptually, the Bendix CAD-CAM system has a centrally located data base which can be accessed by both CAD and CAM tools, processes, and personnel thus forming an integrated Computer Aided Engineering (CAE) System. This is a key requirement of the Bendix CAD-CAM system that will be presented in more detail.

  18. Special Section: Complementary and Alternative Medicine (CAM): Low Back Pain and CAM

    Science.gov (United States)

    ... Current Issue Past Issues Special Section CAM Low Back Pain and CAM Past Issues / Winter 2009 Table of ... from CAM treatment for conditions such as low back pain. Photo courtesy of Glenn Scimonelli "Oh, my aching ...

  19. A Space Cam Mechanism for Power Transmission of an Opposite-cylinder Piston Engine

    OpenAIRE

    Zhang Haoyue; Xu Xiaojun; Zhang Lei; Zhou Faliang

    2015-01-01

    For the purpose of improving the engine’s power density, we put forward a new type of power transmission mechanism which is used for opposed-cylinder engine. The gas pressure acts on the cam through the piston and push rod, and the spindle rotation of external is driven by the cam. The design of spatial cam work surface is completed by using the enveloping theory of a family of space curves, the force between roller and cam is analyzed using dynamic analysis software. Under the condition of e...

  20. Fundamento e desenho do teste randomizado PAINT Fundamento y diseño del test randomizado PAINT Rationale and design for the PAINT randomized trial

    Directory of Open Access Journals (Sweden)

    Pedro A. Lemos

    2009-12-01

    óricas y el formato del "Estudio PAINT - Intervención percutánea con stents recubiertos de paclitaxel o sirolimus en polímero biodegradable comparados con stents no recubiertos en el tratamiento de lesiones coronarias de novo". OBJETIVO: Evaluar dos nuevas formulaciones de stents con liberación de paclitaxel o sirolimus en comparación con un stent de estructura metálica idéntica, pero sin recubierto polimérico o liberación de droga. MÉTODOS: El PAINT es un estudio randomizado, multicéntrico, de 3 brazos, llevado a cabo en centros terciaros brasileños, que incluyó a 275 pacientes destinados a tratamiento con los stents InfinniumR (paclitaxel, the SupralimusR (sirolimus o Milennium MatrixR (no recubierto en la proporción 2:2:1. Los pacientes presentaban lesiones coronarias de novo en vasos nativos con un diámetro entre 2,5 y 3,5 mm, pasibles de tratamiento con un único stent de hasta 29 mm de longitud. El objetivo primario era comparar la pérdida luminal tardía a los nueve meses de ambos stents con paclitaxel- o sirolimus versus la pérdida luminal de los stents convencionales de control. Los objetivos secundarios importantes incluían la comparación angiográfica entre los dos tipos de stents farmacológicos, así como el análisis de la ocurrencia de eventos clínicos adversos. RESULTADOS Y CONCLUSIONES: El estudio PAINT presenta un formato peculiar y único que permitió la evaluación de la seguridad y eficacia de dos nuevas formulaciones de stents farmacológicos, con transportador polimérico biodegradable, y liberación de paclitaxel o sirolimus, los que fueron comparados con un stent metálico convencional (objetivo primario. Dado que los stents farmacológicos diferían entre sí solamente por la droga, pero eran idénticos en sus otras características, el estudio también permitió la comparación del efecto antireestenótico entre sirolimus y paclitaxel (objetivo secundario.BACKGROUND: We describe the rationale and design for the "Percut

  1. CAD/CAM in the Brazilian aeronautical industry

    Science.gov (United States)

    Lampi, L. H.; Embraer, S. A.

    Features, applications and progress in the usage of CAD/CAM since 1980 by an aircraft manufacturer in Brazil are described. The system comprises 34 graphics work stations dedicated to structural design, lofting, electrical cable routing, finite element modeling and quality control. Standardized work methods have been devised to enhance productivity. Programs have been defined for finite element stress analysis and generating wiring diagrams. The computerized design capabilities have increased productivity for hole boring accuracy through work on digitized controllers. Psychological testing has been initiated to identify users who can adapt more easily to CAD/CAM utilization.

  2. IGES data exchange between dissimilar CAD-CAM systems

    Energy Technology Data Exchange (ETDEWEB)

    Theilen, D.F.; Jones, J.F.

    1982-04-01

    Sandia National Laboratories, Livermore (SNLL), and Bendix Kansas City have successfully transferred geometric model data by using a neutral graphics format, Initial Graphics Exchange Specification (IGES). Data was exchanged between two dissimilar CAD-CAM systems without the need for special translators. The exchanged data was used to fabricate a mechanical part. Design information developed on a CAD-CAM system was translated to IGES with a commercial preprocessor at Sandia. A second vendor's postprocessor translated the design information from IGES to the CAD-CAM system at Bendix. The Bendix system was used to generate the numerical control tape from the exchanged data. The tape was used to fabricate the part. A production print from Sandia was used during final inspection to verify part accuracy. Project results indicated that both vendor-furnished translators correctly transferred the three-dimensional geometric model of points, lines, and arcs.

  3. IBD and Complementary and Alternative Medicine (CAM)

    Science.gov (United States)

    ... Alternative Medicine (CAM) Go Back Complementary and Alternative Medicine (CAM) Email Print + Share Crohn’s disease and ulcerative ... Energy Medicine, and Biologically-Based Practices. Mind-Body Medicine Mind-body medicine is a set of interventions ...

  4. The detection of EpCAM(+) and EpCAM(-) circulating tumor cells

    NARCIS (Netherlands)

    de Wit, Sanne; van Dalum, Guus; Lenferink, Aufried T. M.; Tibbe, Arjan G. J.; Hiltermann, T. Jeroen N.; Groen, Harry J. M.; van Rijn, Cees J. M.; Terstappen, Leon W. M. M.

    2015-01-01

    EpCAM expressing circulating tumor cells, detected by CellSearch, are predictive of short survival in several cancers and may serve as a liquid biopsy to guide therapy. Here we investigate the presence of EpCAM(+) CTC detected by CellSearch and EpCAM(-) CTC discarded by CellSearch, after EpCAM based

  5. The Z CamPaign: Year Five

    CERN Document Server

    Simonsen, Mike

    2014-01-01

    Entering into the fifth year of the Z CamPaign, the author has developed a website summarizing our findings which will also act as a living catalog of bona fide Z Cam stars, suspected Z Cams and Z Cam impostors. In this paper we summarize the findings of the first four years of research, introduce the website and its contents to the public and discuss the way forward into year five and beyond.

  6. The detection of EpCAM

    NARCIS (Netherlands)

    Wit, De Sanne; Dalum, Van Guus; Lenferink, Aufried T.M.; Tibbe, Arjan G.J.; Hiltermann, T.J.N.; Groen, Harry J.M.; Rijn, Van C.J.M.; Terstappen, Leon W.M.M.

    2015-01-01

    EpCAM expressing circulating tumor cells, detected by CellSearch, are predictive of short survival in several cancers and may serve as a liquid biopsy to guide therapy. Here we investigate the presence of EpCAM+ CTC detected by CellSearch and EpCAM- CTC discarded by CellSear

  7. CAMS: Computerized Accident Management Support

    International Nuclear Information System (INIS)

    The OECD Halden Reactor Project has initiated a new research programme on computerised accident management support, the so-called CAMS project (CAMS = Computerized Accident Management Support). This work will investigate the possibilities for developing systems which provide more extensive support to the control room staff and technical support centre than the existing SPDS (Safety Parameter Display System) type of systems. The CAMS project will utilize available simulator codes and the capabilities of computerized tools to assist the plant staff during the various accident stages including: identification of the accident state, assessment of the future development of the accident, and planning accident mitigation strategies. This research programme aims at establishing a prototype system which can be used for experimental testing of the concept and serve as a tool for training and education in accident management. The CAMS prototype should provide support to the staff when the plant is in a normal state, in a disturbance sate, and in an accident state. Even though better support in an accident state is the main goal of the project, it is felt to be important that the staff is familiar with the use of the system during normal operation, when they utilize the system during transients

  8. An approach towards fully integration of CAD and CAM technologies

    OpenAIRE

    M. Tolouei-Rad

    2006-01-01

    Purpose: An integrated CAD/CAM system for milling operations has been developed which helps designers tosolve machining problems at the design stage.Design/methodology/approach: A methodology has been employed which provides all necessary informationfor machining products automatically. Use of these system results in reduced machining leadtimes and costthrough designing machinable components; using available cutting tools; improving machining efficiency. Thesystem is menu driven with a user f...

  9. Marginal Integrity of CAD/CAM Fixed Partial Dentures

    OpenAIRE

    Rosentritt, Martin; Behr, Michael; Kolbeck, Carola; Handel, Gerhard

    2007-01-01

    Objectives Computer-aided design (CAD) and manufacturing (CAM) allows the milling of high strength zirconia fixed partial dentures (FPD), however bonding to an inert ZrO2 ceramic surface may effect the marginal integrity of the FPDs. The aim of this investigation was to evaluate the marginal adaptation of zirconia FPDs at the interfaces between zirconia, cement, and tooth. Methods 32 3-unit FPDs were fabricated of the CAD/CAM Y-TZP zirconia (Lava, 3M Espe, Germany) according to the manufactur...

  10. Illness narratives in cancer: CAM and spiritual practices

    DEFF Research Database (Denmark)

    Ulrich, Anita; Evron, Lotte; Ostenfeld-Rosenthal, Ann

    2011-01-01

    be related to CAM. The analysis is based on empirical findings from a recent PhD project. During a two-year period first author followed 32 cancer patients, family, friends and alternative practitioners through interviews, telephone conversations, treatments and in focus groups. Results: As a general pattern......Objectives: In this paper,we investigate Danish cancer patients’ narratives on spiritual beliefs and practices and the relationship these practices may have to complementary and alternative medicine (CAM). Design: Narrative inquiry is used to uncover how spiritual beliefs and practices may......, religious and spiritual issues were not extensively unfolded in participants’ illness narratives. However, these issues were significantly elaborated on in narratives by four female participants. Conclusion: We propose that for some cancer patients CAM may function, not only or primarily as a treatment...

  11. Xi-CAM v1.2.3

    Energy Technology Data Exchange (ETDEWEB)

    2016-09-06

    Xi-CAM aims to provide a community driven platform for multimodal analysis in synchrotron science. The platform core provides a robust plugin infrastructure for extensibility, allowing continuing development to simply add further functionality. Current modules include tools for characterization with (GI)SAXS, Tomography, and XAS. This will continue to serve as a development base as algorithms for multimodal analysis develop. Seamless remote data access, visualization and analysis are key elements of Xi-CAM, and will become critical to synchrotron data infrastructure as expectations for future data volume and acquisition rates rise with continuously increasing throughputs. The highly interactive design elements of Xi-cam will similarly support a generation of users which depend on immediate data quality feedback during high-throughput or burst acquisition modes.

  12. Prolonged conservative treatment or 'early' surgery in sciatica caused by a lumbar disc herniation: Rationale and design of a randomized trial [ISRCT 26872154

    NARCIS (Netherlands)

    W.C. Peul (Wilco); H.C. van Houwelingen (Hans); W.B. van den Hout (Wilbert); R. Brand (René); J.A.H. Eekhof (Just); J.T.J. Tans (Th); R.T.W.M. Thomeer (Raph); B.W. Koes (Bart)

    2005-01-01

    textabstractBackground: The design of a randomized multicenter trial is presented on the effectiveness of a prolonged conservative treatment strategy compared with surgery in patients with persisting intense sciatica (lumbosacral radicular syndrome). Methods/design: Patients presenting themselves to

  13. Schools (Students) Exchanging CAD/CAM Files over the Internet.

    Science.gov (United States)

    Mahoney, Gary S.; Smallwood, James E.

    This document discusses how students and schools can benefit from exchanging computer-aided design/computer-aided manufacturing (CAD/CAM) files over the Internet, explains how files are exchanged, and examines the problem of selected hardware/software incompatibility. Key terms associated with information search services are defined, and several…

  14. An approach towards fully integration of CAD and CAM technologies

    Directory of Open Access Journals (Sweden)

    M. Tolouei-Rad

    2006-08-01

    Full Text Available Purpose: An integrated CAD/CAM system for milling operations has been developed which helps designers tosolve machining problems at the design stage.Design/methodology/approach: A methodology has been employed which provides all necessary informationfor machining products automatically. Use of these system results in reduced machining leadtimes and costthrough designing machinable components; using available cutting tools; improving machining efficiency. Thesystem is menu driven with a user friendly interface.Findings: Different components for developing such a system have been identified and various problems thatarose in the development of this system have been dealt with The system developed leads to an adequate basisfor fully integration of CAD and CAM technologies in one system. It allows simultaneous generation of allinformation required to satisfy machining requirements of the design such as its machinability and availabilityof the required tooling resources.Research limitations/implications: Different components required for developing such systems have beenidentified and various problems that arose in the development of these systems have been dealt with, leadingto an adequate basis for complete integration of CAD and CAM technologies. Although much of the workdescribed here goes beyond the scope of published literature, however, it should be noted that the systemdeveloped couldn’t be considered as a complete solution to the CAD/CAM integration problem. Further workrequires including other manufacturing activities that are considered in concurrent engineering concept. In thisdirection, further integration of the system developed with systems such as MRP, MRP II and assembly sequenceplanning packages are highly desirable.Originality/value: CAD/CAM integration is regarded as a solution for bridging the gap between design andmanufacturing, one of the ultimate goals for concurrent engineering. Since the advent of CAD and CAMnumerous

  15. Facultative crassulacean acid metabolism (CAM) plants: powerful tools for unravelling the functional elements of CAM photosynthesis.

    Science.gov (United States)

    Winter, Klaus; Holtum, Joseph A M

    2014-07-01

    Facultative crassulacean acid metabolism (CAM) describes the optional use of CAM photosynthesis, typically under conditions of drought stress, in plants that otherwise employ C3 or C4 photosynthesis. In its cleanest form, the upregulation of CAM is fully reversible upon removal of stress. Reversibility distinguishes facultative CAM from ontogenetically programmed unidirectional C3-to-CAM shifts inherent in constitutive CAM plants. Using mainly measurements of 24h CO2 exchange, defining features of facultative CAM are highlighted in five terrestrial species, Clusia pratensis, Calandrinia polyandra, Mesembryanthemum crystallinum, Portulaca oleracea and Talinum triangulare. For these, we provide detailed chronologies of the shifts between photosynthetic modes and comment on their usefulness as experimental systems. Photosynthetic flexibility is also reviewed in an aquatic CAM plant, Isoetes howellii. Through comparisons of C3 and CAM states in facultative CAM species, many fundamental biochemical principles of the CAM pathway have been uncovered. Facultative CAM species will be of even greater relevance now that new sequencing technologies facilitate the mapping of genomes and tracking of the expression patterns of multiple genes. These technologies and facultative CAM systems, when joined, are expected to contribute in a major way towards our goal of understanding the essence of CAM. PMID:24642847

  16. Feed Cam Mechanism Design of Cut-off Saws Based on ANSYS%基于ANSYS的林间锯段机进料凸轮机构设计

    Institute of Scientific and Technical Information of China (English)

    战丽; 宫乙帅; 王毅亮

    2012-01-01

    A feeding mechanism is one of the main components of forest self-propelled small-scale cut-off saws, and its rational design determines the efficiency of the entire cutting process. The exact cutting speed is determined through the comparative analysis of theoretical calculation and actual processing empirical value, based on which feed speed is calculated. In order to ensure steady processing, a feed cam is designed and finite element analysis of it is made using ANSYS software to verify the stiffness and strength of the feed mechanism. The mechanism is rationally optimized in order to provide a theoretical basis for the design of the feed mechanism of sawing operation.%进料机构是林间自走式小型锯段机的主要部件之一,其设计的合理与否影响整个锯切加工过程。通过理论计算值与实际加工经验值的对比分析确定切削速度,进而计算出进料速度。为保证加工平稳设计了进料凸轮机构,并利用ANSYS软件对其进行有限元分析,验证凸轮机构的刚度与强度。对该结构进行合理优化,为锯切进料机构的设计提供理论依据。

  17. CAD/CAM-assisted breast reconstruction.

    Science.gov (United States)

    Melchels, Ferry; Wiggenhauser, Paul Severin; Warne, David; Barry, Mark; Ong, Fook Rhu; Chong, Woon Shin; Hutmacher, Dietmar Werner; Schantz, Jan-Thorsten

    2011-09-01

    The application of computer-aided design and manufacturing (CAD/CAM) techniques in the clinic is growing slowly but steadily. The ability to build patient-specific models based on medical imaging data offers major potential. In this work we report on the feasibility of employing laser scanning with CAD/CAM techniques to aid in breast reconstruction. A patient was imaged with laser scanning, an economical and facile method for creating an accurate digital representation of the breasts and surrounding tissues. The obtained model was used to fabricate a customized mould that was employed as an intra-operative aid for the surgeon performing autologous tissue reconstruction of the breast removed due to cancer. Furthermore, a solid breast model was derived from the imaged data and digitally processed for the fabrication of customized scaffolds for breast tissue engineering. To this end, a novel generic algorithm for creating porosity within a solid model was developed, using a finite element model as intermediate. PMID:21900731

  18. Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns

    Science.gov (United States)

    Kwon, Taek-Ka; Pak, Hyun-Soon; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun

    2013-01-01

    PURPOSE All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. MATERIALS AND METHODS Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also duplicated from the original prepared tooth for fracture testing. A universal testing machine was used to determine the fracture strength of the crowns. RESULTS The mean fracture strengths were as follows: 54.9 ± 15.6 N for the Lava CAD/CAM zirconia crowns and 87.0 ± 16.0 N for the Digident CAD/CAM zirconia crowns. The difference between the mean fracture strengths of the Lava and Digident crowns was statistically significant (P<.001). Lava CAD/CAM zirconia crowns showed a complete fracture of both the veneering porcelain and the core whereas the Digident CAD/CAM zirconia crowns showed fracture only of the veneering porcelain. CONCLUSION The fracture strengths of CAD/CAM zirconia crowns differ depending on the compatibility of the core material and the veneering porcelain. PMID:23755332

  19. A national school-based health lifestyles interventions among Chinese children and adolescents against obesity: rationale, design and methodology of a randomized controlled trial in China

    OpenAIRE

    Chen, Yajun; Ma, Lu; Ma, Yinghua; Wang, Haijun; Luo, Jiayou; Xin ZHANG; Luo, Chunyan; Wang, Hong; Zhao, Haiping; Pan, Dehong; Zhu, Yanna; Cai, Li; Zou, Zhiyong; Yang, Wenhan; Ma, Jun

    2015-01-01

    Background The prevalence of obesity among children and adolescents has been rapidly rising in Mainland China in recent decades, both in urban and rural areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited rigid data regarding children and adolescent overweight prevention in China are available. A national random controlled school-based obesity intervention program was developed in the mainland of China. Methods/Design The study was designed ...

  20. CAD/CAM/CAI Application for High-Precision Machining of Internal Combustion Engine Pistons

    Directory of Open Access Journals (Sweden)

    V. V. Postnov

    2014-07-01

    Full Text Available CAD/CAM/CAI application solutions for internal combustion engine pistons machining was analyzed. Low-volume technology of internal combustion engine pistons production was proposed. Fixture for CNC turning center was designed.

  1. Study on glass infiltrated alumina(GIA) ceramic for CAD/CAM

    Institute of Scientific and Technical Information of China (English)

    LI Mingzhe; LI Hong; WANG Wei; Zhao Yunfeng

    2001-01-01

    @@ With the rapid development of computer technique , Computer aided design(CAD) and computer aided manufacturing(CAM) or computer integrated manufacturing(CIM) has became an alternative to the conventional technique for producingdental restorations.

  2. The effectiveness and cost-evaluation of manual therapy and physical therapy in patients with sub-acute and chronic non specific neck pain. Rationale and design of a Randomized Controlled Trial (RCT

    Directory of Open Access Journals (Sweden)

    van Assen Luite

    2010-01-01

    Full Text Available Abstract Background Manual Therapy applied to patients with non specific neck pain has been investigated several times. In the Netherlands, manual therapy as applied according to the Utrecht School of Manual Therapy (MTU has not been the subject of a randomized controlled trial. MTU differs in diagnoses and treatment from other forms of manual therapy. Methods/Design This is a single blind randomized controlled trial in patients with sub-acute and chronic non specific neck pain. Patients with neck complaints existing for two weeks (minimum till one year (maximum will participate in the trial. 180 participants will be recruited in thirteen primary health care centres in the Netherlands. The experimental group will be treated with MTU during a six week period. The control group will be treated with physical therapy (standard care, mainly active exercise therapy, also for a period of six weeks. Primary outcomes are Global Perceived Effect (GPE and functional status (Neck Disability Index (NDI-DV. Secondary outcomes are neck pain (Numeric Rating Scale (NRS, Eurocol, costs and quality of life (SF36. Discussion This paper presents details on the rationale of MTU, design, methods and operational aspects of the trial. Trial registration ClinicalTrials.gov Identifier: NCT00713843

  3. Rationale and design of the dal-OUTCOMES trial: efficacy and safety of dalcetrapib in patients with recent acute coronary syndrome

    DEFF Research Database (Denmark)

    Schwartz, Gregory G; Olsson, Anders G; Ballantyne, Christie M;

    2009-01-01

    BACKGROUND: Despite contemporary therapies for acute coronary syndrome (ACS), morbidity and mortality remain high. Low levels of high-density lipoprotein (HDL) cholesterol are common among patients with ACS and may contribute to ongoing risk. Strategies that raise levels of HDL cholesterol, such as...... inhibition of cholesterol ester transfer protein (CETP), might reduce risk after ACS. Dal-OUTCOMES is a multicenter, randomized, double-blind, placebo-controlled trial designed to test the hypothesis that CETP inhibition with dalcetrapib reduces cardiovascular morbidity and mortality in patients with recent...... ACS. DESIGN: The study will randomize approximately 15,600 patients to receive daily doses of dalcetrapib 600 mg or matching placebo, beginning 4 to 12 weeks after an index ACS event. There are no prespecified boundaries for HDL cholesterol levels at entry. Other elements of care, including management...

  4. A randomized controlled trial to evaluate an educational strategy involving community health volunteers in improving self-care in patients with chronic heart failure: Rationale, design and methodology

    OpenAIRE

    Siabani, Soraya; Driscoll, Tim; Davidson, Patricia M; Leeder, Stephen R

    2014-01-01

    Background Chronic heart failure (CHF) is an increasingly important health problem worldwide. Effective self-care can improve the outcomes and quality of life in patients with CHF. Acknowledging the important role of educational interventions for improving self-care, we sought to assess a new educational strategy involving community health volunteers (CHVs) that could reduce the cost and, hypothetically, increase the effectiveness of self-care education in patients with CHF. Methods/Design In...

  5. A school-based comprehensive lifestyle intervention among chinese kids against obesity (CLICK-Obesity: rationale, design and methodology of a randomized controlled trial in Nanjing city, China

    Directory of Open Access Journals (Sweden)

    Xu Fei

    2012-06-01

    Full Text Available Abstract Background The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China in recent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus, we developed a school-based intervention with the aim of reducing excess body weight in children. This report described the study design. Methods/design We designed a cluster randomized controlled trial in 8 randomly selected urban primary schools between May 2010 and December 2013. Each school was randomly assigned to either the intervention or control group (four schools in each group. Participants were the 4th graders in each participating school. The multi-component program was implemented within the intervention group, while students in the control group followed their usual health and physical education curriculum with no additional intervention program. The intervention consisted of four components: a classroom curriculum, (including physical education and healthy diet education, b school environment support, c family involvement, and d fun programs/events. The primary study outcome was body composition, and secondary outcomes were behaviour and behavioural determinants. Discussion The intervention was designed with due consideration of Chinese cultural and familial tradition, social convention, and current primary education and exam system in Mainland China. We did our best to gain good support from educational authorities, school administrators, teachers and parents, and to integrate intervention components into schools’ regular academic programs. The results of and lesson learned from this study will help guide future school-based childhood obesity prevention programs in Mainland China. Trial registration Registration number: ChiCTR-ERC-11001819

  6. A randomized controlled trial on the effectiveness of strength training on clinical and muscle cellular outcomes in patients with prostate cancer during androgen deprivation therapy: rationale and design

    OpenAIRE

    Thorsen, Lene; Nilsen, Tormod S; Raastad, Truls; Courneya, Kerry S.; Skovlund, Eva; Fosså, Sophie D

    2012-01-01

    Background Studies indicate that strength training has beneficial effects on clinical health outcomes in prostate cancer patients during androgen deprivation therapy. However, randomized controlled trials are needed to scientifically determine the effectiveness of strength training on the muscle cell level. Furthermore, close examination of the feasibility of a high-load strength training program is warranted. The Physical Exercise and Prostate Cancer (PEPC) trial is design...

  7. A randomized controlled trial on the effectiveness of strength training on clinical and muscle cellular outcomes in patients with prostate cancer during androgen deprivation therapy: rationale and design

    OpenAIRE

    Thorsen Lene; Nilsen Tormod S; Raastad Truls; Courneya Kerry S; Skovlund Eva; Fosså Sophie D

    2012-01-01

    Abstract Background Studies indicate that strength training has beneficial effects on clinical health outcomes in prostate cancer patients during androgen deprivation therapy. However, randomized controlled trials are needed to scientifically determine the effectiveness of strength training on the muscle cell level. Furthermore, close examination of the feasibility of a high-load strength training program is warranted. The Physical Exercise and Prostate Cancer (PEPC) trial is designed to dete...

  8. A randomized controlled trial on the effectiveness of strength training on clinical and muscle cellular outcomes in patients with prostate cancer during androgen deprivation therapy: rationale and design

    OpenAIRE

    Thorsen, Lene; Nilsen, Tormod Skogstad; Raastad, Truls; Courneya, Kerry S.; Skovlund, Eva; Fosså, Sophie Dorothea

    2012-01-01

    Background Studies indicate that strength training has beneficial effects on clinical health outcomes in prostate cancer patients during androgen deprivation therapy. However, randomized controlled trials are needed to scientifically determine the effectiveness of strength training on the muscle cell level. Furthermore, close examination of the feasibility of a high-load strength training program is warranted. The Physical Exercise and Prostate Cancer (PEPC) trial is designed to determine...

  9. Active video games as a tool to prevent excessive weight gain in adolescents : rationale, design and methods of a randomized controlled trial

    OpenAIRE

    Simons, Monique; Mai J M Chinapaw; van de Bovenkamp, Maaike; de Boer, Michiel R; Jacob C Seidell; Brug, Johannes; Vet, Emely

    2014-01-01

    Background: Excessive body weight, low physical activity and excessive sedentary time in youth are major public health concerns. A new generation of video games, the ones that require physical activity to play the games -i.e. active games- may be a promising alternative to traditional non-active games to promote physical activity and reduce sedentary behaviors in youth. The aim of this manuscript is to describe the design of a study evaluating the effects of a family oriented active game inte...

  10. A school-based comprehensive lifestyle intervention among chinese kids against obesity (CLICK-Obesity): rationale, design and methodology of a randomized controlled trial in Nanjing city, China

    OpenAIRE

    Xu Fei; Ware Robert S; Tse Lap; Wang Zhiyong; Hong Xin; Song Aiju; Li Jiequan; Wang Youfa

    2012-01-01

    Abstract Background The prevalence of childhood obesity among adolescents has been rapidly rising in Mainland China in recent decades, especially in urban and rich areas. There is an urgent need to develop effective interventions to prevent childhood obesity. Limited data regarding adolescent overweight prevention in China are available. Thus, we developed a school-based intervention with the aim of reducing excess body weight in children. This report described the study design. Methods/desig...

  11. Trial design: Computer guided normal-low versus normal-high potassium control in critically ill patients: Rationale of the GRIP-COMPASS study

    OpenAIRE

    van der Maaten Joost MAA; Lansink Annemieke; van der Horst Iwan CC; Vogelzang Mathijs; Hoekstra Miriam; Ismael Farouq; Zijlstra Felix; Nijsten Maarten WN

    2010-01-01

    Abstract Background Potassium depletion is common in hospitalized patients and can cause serious complications such as cardiac arrhythmias. In the intensive care unit (ICU) the majority of patients require potassium suppletion. However, there are no data regarding the optimal control target in critically ill patients. After open-heart surgery, patients have a strongly increased risk of atrial fibrillation or atrial flutter (AFF). In a novel trial design, we examined if in these patients diffe...

  12. The Multidomain Intervention to preveNt disability in ElDers (MINDED) project: rationale and study design of a pilot study.

    Science.gov (United States)

    Cesari, Matteo; Demougeot, Laurent; Boccalon, Henri; Guyonnet, Sophie; Vellas, Bruno; Andrieu, Sandrine

    2014-05-01

    Disability is hardly reversible at old age, negatively impacts on the elders' quality of life, and significantly threatens the sustainability of public health services. Therefore, preventive interventions become necessary for successfully avoiding its onset. The translation of the successful clinical approach represented by the geriatric comprehensive assessment at the community-level and the specific targeting of frailty (a well-established geriatric syndrome) might represent a promising possibility. This approach may allow the implementation of preventive interventions before the irreversible features of disability onset. Unfortunately, there is a lack of evidence on the effectiveness of primary prevention programs against disability in community-dwelling elders. Moreover, the novelty of the topic makes it difficult for the immediate design and conduction of a full-scale trial. For these reasons, a pilot project aimed at obtaining the preliminary information for the design of a subsequent definitive trial is required. In the present article, we describe the objectives, design, and methods of the Multidomain Intervention to preveNt Disability in ElDers (MINDED) project. MINDED is articulated into three sequential phases. First, a screening tool for indentifying non-disabled frail older persons in the community (ideal target population for preventive interventions against disability) will be validated. Then, the organization of a multidisciplinary team in the development and design of a multidomain preventive plan against disability will be verified/optimized. Finally, a randomized controlled trial measuring the effect size of a multicomponent intervention (based on physical exercise, nutrition, and cognitive training) against incident mobility disability versus usual care in community-dwelling frail elders will be conducted. PMID:24768939

  13. The impact of care pathways for patients with proximal femur fracture: rationale and design of a cluster-randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Vanhaecht Kris

    2012-05-01

    Full Text Available Abstract Background Proximal femur fracture (PFF is associated with considerable morbidity and mortality. The European Quality of Care Pathway (EQCP study on PFF (NCT00962910 was designed to determine how care pathways (CP for hospital treatment of PFF affect consistency of care, adherence to evidence-based key interventions, and clinical outcome. Methods/Design An international cluster-randomized controlled trial (cRCT will be performed in Belgium, Ireland, Italy and Portugal. Based on power analyses, a sample of 44 hospital teams and 437 patients per arm will be included in the study. In the control arm, usual care will be provided. Experimental teams will implement a care pathway which will include three active components: a formative evaluation of quality and organization of the care setting, a set of evidence-based key interventions, and support of the development and implementation of the CP. Main outcome will be the six-month mortality rate. Discussion The EQCP study constitutes the first international cRCT on care pathways. The EQCP project was designed as both a research and a quality improvement project and will provide a real-world framework for process evaluation to improve our understanding of why and when CP can really work. Trial registration number NCT00962910

  14. Yoga as a complementary treatment for smoking cessation: rationale, study design and participant characteristics of the Quitting-in-Balance study

    Directory of Open Access Journals (Sweden)

    Jennings Ernestine

    2010-04-01

    Full Text Available Abstract Background Tobacco smoking remains the leading preventable cause of death among American women. Exercise has shown promise as an aid to smoking cessation because it reduces weight gain and weight concerns, improves affect, and reduces nicotine withdrawal symptoms and cigarette craving. Studies have shown that the practice of yoga improves weight control, and reduces perceived stress and negative affect. Yoga practice also includes regulation of breathing and focused attention, both of which may enhance stress reduction and improve mood and well-being and may improve cessation outcomes. Methods/Design This pilot efficacy study is designed to examine the rates of cessation among women randomized to either a novel, 8-week Yoga plus Cognitive Behavioral Therapy (CBT smoking cessation intervention versus a Wellness program plus the same CBT smoking cessation intervention. Outcome measures include 7-day point prevalence abstinence at end of treatment, 3 and 6 months follow up and potential mediating variables (e.g., confidence in quitting smoking, self-efficacy. Other assessments include measures of mindfulness, spirituality, depressive symptoms, anxiety and perceived health (SF-36. Discussion Innovative treatments are needed that address barriers to successful smoking cessation among men and women. The design chosen for this study will allow us to explore potential mediators of intervention efficacy so that we may better understand the mechanism(s by which yoga may act as an effective complementary treatment for smoking cessation. If shown to be effective, yoga can offer an alternative to traditional exercise for reducing negative symptoms that often accompany smoking cessation and predict relapse to smoking among recent quitters. Trial Registration ClinicalTrials NCT00492310

  15. Kelston Beverages Pilot Study: Rationale, design and implementation of a community and school based intervention to reduce sugary drink consumption among children and youth.

    Science.gov (United States)

    Sundborn, G; Ni Mhurchu, C; Ness, C; Latu, H; Jackson, R

    2014-03-01

    The Kelston Beverages Study was designed to increase awareness of the sugar content of sugary drinks, the poor health consequences that high intake of these drinks have, and inform on ways to reduce intake of students. The aims of this pilot study were to refine interventions and processes designed to raise awareness of the harms that sugar sweetened beverages (SSBs) have on health, and to reduce their consumption among the youth of a small West Auckland suburb. There were three arms to this interventional study, one in schools, another in community organisations (churches, sports clubs and community groups), and the final arm is in the local retail sector. The school arm was the most extensive component and initially involved a survey of children's knowledge and consumption of sugar sweetened beverages (SSBs) using a brief questionnaire. The study evaluated any SSB policies in schools and for schools that did not have policies, opportunities were scoped to develop and implement them; a canteen AUDIT focussed particularly on beverages was carried out; and finally a student partnered social marketing exercise was undertaken that comprised 2 competitions, one to design a poster, and another to write and perform a rap. Children were re-surveyed at the completion of the intervention (7 months later) to determine change in knowledge and self-reported consumption of SSBs. Both the community organisations and retail arms of this study focussed on raising awareness into the harmful effects of SSBs and establishing healthy beverage policy in the respective organisations. Promising results with regards to acceptability, feasibility, and recruitment as well as valuable learnings with regard to process support the development of a proposal to conduct a cluster randomised trial of the interventions successfully tested in this pilot study. PMID:25929003

  16. Rationale for development of constitutive models of a basalt rock mass for design of a nuclear waste repository at the Hanford Site

    International Nuclear Information System (INIS)

    The Cohassett basalt flow underlying the Hanford Site in Eastern Washington is being investigated by the U.S. Department of Energy to assess the feasibility of constructing the nation's first nuclear waste repository in the flow. Development of constitutive laws of the basalt is necessary for modeling studies used to evaluate the repository design and to evaluate the ability of the repository to contain radioactive waste for several thousands of years. This paper evaluates four analytical approaches that have been used in previous analyses of the repository in basalt and presents a strategy for further development of constitutive models

  17. Rationale, design, and method of the Diabetes & Women's Health study – a study of long-term health implications of glucose intolerance in pregnancy and their determinants

    DEFF Research Database (Denmark)

    Zhang, Cuilin; Hu, Frank B; Olsen, Sjurdur F;

    2014-01-01

    diabetes mellitus in two existing prospective cohorts, the Nurses' Health Study II and the Danish National Birth Cohort. Women who had a medical history of gestational diabetes mellitus in one or more of their pregnancies are eligible for the present study. After enrollment, we follow study participants...... public health interventions in relation to the transition of gestational diabetes mellitus to type 2 diabetes mellitus. To achieve the goal efficiently, we are applying a hybrid design enrolling and collecting data longitudinally from approximately 4000 women with a medical history of gestational...

  18. Preventing AVF thrombosis: the rationale and design of the Omega-3 fatty acids (Fish Oils and Aspirin in Vascular access OUtcomes in REnal Disease (FAVOURED study

    Directory of Open Access Journals (Sweden)

    Rosman Johan

    2009-01-01

    Full Text Available Abstract Background Haemodialysis (HD is critically dependent on the availability of adequate access to the systemic circulation, ideally via a native arteriovenous fistula (AVF. The Primary failure rate of an AVF ranges between 20–54%, due to thrombosis or failure of maturation. There remains limited evidence for the use of anti-platelet agents and uncertainty as to choice of agent(s for the prevention of AVF thrombosis. We present the study protocol for a randomised, double-blind, placebo-controlled, clinical trial examining whether the use of the anti-platelet agents, aspirin and omega-3 fatty acids, either alone or in combination, will effectively reduce the risk of early thrombosis in de novo AVF. Methods/Design The study population is adult patients with stage IV or V chronic kidney disease (CKD currently on HD or where HD is planned to start within 6 months in whom a planned upper or lower arm AVF is to be the primary HD access. Using a factorial-design trial, patients will be randomised to aspirin or matching placebo, and also to omega-3 fatty acids or matching placebo, resulting in four treatment groups (aspirin placebo/omega-3 fatty acid placebo, aspirin/omega-3 fatty acid placebo, aspirin placebo/omega-3 fatty acid, aspirin/omega-3 fatty acid. Randomisation will be achieved using a dynamic balancing method over the two stratification factors of study site and upper versus lower arm AVF. The medication will be commenced pre-operatively and continued for 3 months post surgery. The primary outcome is patency of the AVF at three months after randomisation. Secondary outcome measures will include functional patency at six and twelve months, primary patency time, secondary (assisted patency time, and adverse events, particularly bleeding. Discussion This multicentre Australian and New Zealand study has been designed to determine whether the outcome of surgery to create de novo AVF can be improved by the use of aspirin and/or omega-3 fatty

  19. Development of CAD/CAM System for Cross Section’s Changing Hole Electrical Discharge Machining

    Science.gov (United States)

    Ishida, Tohru; Ishiguro, Eiki; Kita, Masahiko; Nakamoto, Keiichi; Takeuchi, Yoshimi

    This study deals with the development of a new CAD/CAM system for fabricating holes whose cross sections change variously. The cross sections of machined holes are generally constant. The limitations in the shapes of holes that can be machined make obstacles in the design stage of industrial products. A new device that utilizes electrical discharge machining has been developed that can create holes with various cross sections to solve this problem. However, it has been impossible to put the device into practical use since there has been no software that has enabled the designed shapes to be easily machined. Therefore, we aimed at developing a new CAD/CAM system for machining the beforehand designed holes with changing cross sections by using the device. As the first step in developing the CAD/CAM system, the post processor in the CAM system is formulated in this paper.

  20. VERTOS II: Percutaneous vertebroplasty versus conservative therapy in patients with painful osteoporotic vertebral compression fractures; rationale, objectives and design of a multicenter randomized controlled trial

    Directory of Open Access Journals (Sweden)

    van der Graaf Y

    2007-10-01

    Full Text Available Abstract Background The standard care in patients with a painful osteoporotic vertebral compression fracture (VCF is conservative therapy. Percutaneous vertebroplasty (PV, a minimally invasive technique, is gaining popularity as a new treatment option. Many prospective and retrospective studies have reported on the effectiveness and safety of PV, but no large randomized controlled trial (RCT has been published. Objective To estimate cost-effectiveness of PV compared to conservative therapy in terms of: pain reduction, quality of life, complications, secondary fractures and mortality. Materials and methods The VERTOS II study is designed as a prospective, multicenter RCT. Patients with a painful VCF with bone edema on MR imaging, local back pain for 6 weeks or less, osteopenia and aged 50 years or older, after obtaining informed consent are included and randomized for PV or conservative therapy. In total 200 patients will be enrolled. Follow-up is at regular intervals during a 1-year period with standard questionnaires, addressing: clinical symptoms, pain medication, Visual Analogue Scale (VAS score, quality of life and cost-effectiveness. Secondary fractures, necessary additional therapies and complications are recorded. Conclusion The VERTOS II study is the first methodologically sound RCT designed to assess the cost-effectiveness of PV compared to conservative therapy in patients with an acute osteoporotic VCF. Trial registration http://www.clinicaltrials.gov, NCT00232466

  1. Pancreatitis, very early compared with normal start of enteral feeding (PYTHON trial: design and rationale of a randomised controlled multicenter trial

    Directory of Open Access Journals (Sweden)

    Schaapherder Alexander F

    2011-03-01

    Full Text Available Abstract Background In predicted severe acute pancreatitis, infections have a negative effect on clinical outcome. A start of enteral nutrition (EN within 24 hours of onset may reduce the number of infections as compared to the current practice of starting an oral diet and EN if necessary at 3-4 days after admission. Methods/Design The PYTHON trial is a randomised controlled, parallel-group, superiority multicenter trial. Patients with predicted severe acute pancreatitis (Imrie-score ≥ 3 or APACHE-II score ≥ 8 or CRP > 150 mg/L will be randomised to EN within 24 hours or an oral diet and EN if necessary, after 72 hours after hospital admission. During a 3-year period, 208 patients will be enrolled from 20 hospitals of the Dutch Pancreatitis Study Group. The primary endpoint is a composite of mortality or infections (bacteraemia, infected pancreatic or peripancreatic necrosis, pneumonia during hospital stay or within 6 months following randomisation. Secondary endpoints include other major morbidity (e.g. new onset organ failure, need for intervention, intolerance of enteral feeding and total costs from a societal perspective. Discussion The PYTHON trial is designed to show that a very early ( Trial Registration ISRCTN: ISRCTN18170985

  2. Potential worker risk as a function of CAM airflow rate

    Energy Technology Data Exchange (ETDEWEB)

    Whicker, J.J.

    1994-03-21

    The goal of the continuous air monitor (CAM) system at the Los Alamos National Laboratory`s Plutonium Facility (PF-4) is to have a flow rate of 1 cubic feet per minute (cfm) drawn through the CAMs. However, design limitations in the house vacuum result in many CAMs having less than 1 cfm being drawn through them. Reduced flow rates through CAMs present a compromise in worker protection. Laboratory Health and Safety personnel and DOE officials established a flow rate of 0.5 cfm or less as operationally unacceptable. This report quantitatively estimated the difference in risk to workers from a reduced flow rate of 0.5 cfm relative to the risk inherent with a flow rate of 1 cfm. I calculated risk in terms of Committed Effective Dose Equivalent (CEDE) and used units of rem. Estimates for the increase in risk for 0.5 cfm compared to 1 cfm ranged from 0.32 rem to 3.3 rem. The difference in the minimum alarm concentration between 0.5 cfm and I cfm was also compared and was estimated to range from 0.4 rem to 4 rem.

  3. CAD/CAM-prosessin kuvaus

    OpenAIRE

    Aho, Arto

    2014-01-01

    Työssä selvitettiin CAD/CAM-prosessin toiminta ja datan liikkuminen eri järjestelmien välillä. Teoriassa perehdyttiin tuotetietojen ja muutostenhallintaan sekä järjestelmien integrointiin. Siemens PLM -järjestelmästä esitellään valmistusprosessin suunnitteluun ja hallintaan tarkoitettuja sovelluksia. Työssä käsitellään muutoksenhallintaa järjestelmien välillä sekä nopeiden muutosten aikaansaamat hyödyt prosessissa ja integraation tuomat edut virheiden ja kustannusten vähentämisessä. Työssä...

  4. CAD/CAM-ohjelmiston valinta

    OpenAIRE

    Heino, Sanna

    2011-01-01

    Opinnäytetyön toimeksianto tuli Helasteel Oy:ltä. Työn sisältö koostuu sopivan CAM-ohjelmiston etsimisestä Helasteelille sekä niiden perusteiden selvittämisestä, jotka vaikuttavat ohjelmiston valintaan. Kolmea eri ohjelmistotoimittajaa pyydettiin esittelemään tuotteitaan Helasteelille. Näistä ohjelmistoista valittiin sopivin yrityksen työstämät kappaleet ja tuotanto huomioon ottaen. Prosessin jälkeen päädyttiin Wincam-ohjelmistoon, joka vastasi parhaiten Helasteelin vaatimuksiin niin omina...

  5. Alberta Diabetes and Physical Activity Trial (ADAPT: A randomized theory-based efficacy trial for adults with type 2 diabetes - rationale, design, recruitment, evaluation, and dissemination

    Directory of Open Access Journals (Sweden)

    Birkett Nicholas

    2010-01-01

    Full Text Available Abstract Background The primary aim of this study was to compare the efficacy of three physical activity (PA behavioural intervention strategies in a sample of adults with type 2 diabetes. Method/Design Participants (N = 287 were randomly assigned to one of three groups consisting of the following intervention strategies: (1 standard printed PA educational materials provided by the Canadian Diabetes Association [i.e., Group 1/control group]; (2 standard printed PA educational materials as in Group 1, pedometers, a log book and printed PA information matched to individuals' PA stage of readiness provided every 3 months (i.e., Group 2; and (3 PA telephone counseling protocol matched to PA stage of readiness and tailored to personal characteristics, in addition to the materials provided in Groups 1 and 2 (i.e., Group 3. PA behaviour measured by the Godin Leisure Time Exercise Questionnaire and related social-cognitive measures were assessed at baseline, 3, 6, 9, 12 and 18-months (i.e., 6-month follow-up. Clinical (biomarkers and health-related quality of life assessments were conducted at baseline, 12-months, and 18-months. Linear Mixed Model (LMM analyses will be used to examine time-dependent changes from baseline across study time points for Groups 2 and 3 relative to Group 1. Discussion ADAPT will determine whether tailored but low-cost interventions can lead to sustainable increases in PA behaviours. The results may have implications for practitioners in designing and implementing theory-based physical activity promotion programs for this population. Clinical Trials Registration ClinicalTrials.gov identifier: NCT00221234

  6. Dutch randomized trial comparing standard catheter-directed thrombolysis versus Ultrasound-accElerated Thrombolysis for thromboembolic infrainguinal disease (DUET: design and rationale

    Directory of Open Access Journals (Sweden)

    Fioole Bram

    2011-01-01

    Full Text Available Abstract Background The use of thrombolytic therapy in the treatment of thrombosed infrainguinal native arteries and bypass grafts has increased over the years. Main limitation of this treatment modality, however, is the occurrence of bleeding complications. Low intensity ultrasound (US has been shown to accelerate enzymatic thrombolysis, thereby reducing therapy time. So far, no randomized trials have investigated the application of US-accelerated thrombolysis in the treatment of thrombosed infra-inguinal native arteries or bypass grafts. The DUET study (Dutch randomized trial comparing standard catheter-directed thrombolysis versus Ultrasound-accElerated Thrombolysis for thrombo-embolic infrainguinal disease is designed to assess whether US-accelerated thrombolysis will reduce therapy time significantly compared with standard catheter-directed thrombolysis. Methods/design Sixty adult patients with recently (between 1 and 7 weeks thrombosed infrainguinal native arteries or bypass grafts with acute limb ischemia class I or IIa, according to the Rutherford classification for acute ischemia, will be randomly allocated to either standard thrombolysis (group A or US-accelerated thrombolysis (group B. Patients will be recruited from 5 teaching hospitals in the Netherlands during a 2-year period. The primary endpoint is the duration of catheter-directed thrombolysis needed for uninterrupted flow in the thrombosed infrainguinal native artery or bypass graft, with outflow through at least 1 crural artery. Discussion The DUET study is a randomized controlled trial that will provide evidence of whether US-accelerated thrombolysis will significantly reduce therapy time in patients with recently thrombosed infrainguinal native arteries or bypass grafts, without an increase in complications. Trial registration Current Controlled Trials ISRCTN72676102

  7. PRevalence of Abuse and Intimate Partner Violence Surgical Evaluation (P.R.A.I.S.E.: rationale and design of a multi-center cross-sectional study.

    Directory of Open Access Journals (Sweden)

    2010-04-01

    Full Text Available Abstract Background Intimate partner violence (IPV is described by the American Medical Association as "a pattern of coercive behaviors that may include repeated battering and injury, psychological abuse, sexual assault, progressive social isolation, deprivation, and intimidation." The long-term consequences of IPV include health risks, posttraumatic stress disorder, depression, and staggering economic costs for health care of victims. Intimate partner violence is often underreported among women who seek medical attention. The current study seeks to address the issue of possible underreporting of IPV in orthopaedic fracture clinics by establishing prevalence rates of IPV among women seeking treatment for musculoskeletal injuries. Methods/Design We propose a cross-sectional multicenter study wherein 3,600 women will complete a self-reported written questionnaire across clinical sites in North America, Europe, and Australia. Recruitment of participants will take place at orthopaedic fracture clinics at each clinical site. The questionnaire will contain a validated set of questions used to screen for IPV, as well as questions that pertain to the participant's demographic, injury characteristics, and experiences with health care utilization. Female patients presenting to the orthopaedic fracture clinics will complete two validated self-reported written questionnaires (Woman Abuse Screening Tool (WAST and the Partner Violence Screen (PVS to determine the prevalence of IPV in the past 12 months and in their lifetime. The two questionnaires were designed for rapid assessment of IPV status in emergency departments, family practice, and women's health clinics that we believe are similar to our intended setting of an orthopaedic clinic. Discussion If the prevalence of IPV among women attending orthopaedic clinics is greater than the current perceptions of orthopaedic surgeons, this study will serve to advocate for the continued education of medical

  8. Prolonged conservative treatment or 'early' surgery in sciatica caused by a lumbar disc herniation: rationale and design of a randomized trial [ISRCT 26872154

    Directory of Open Access Journals (Sweden)

    Tans Joseph

    2005-02-01

    Full Text Available Abstract Background The design of a randomized multicenter trial is presented on the effectiveness of a prolonged conservative treatment strategy compared with surgery in patients with persisting intense sciatica (lumbosacral radicular syndrome. Methods/design Patients presenting themselves to their general practitioner with disabling sciatica lasting less than twelve weeks are referred to the neurology outpatient department of one of the participating hospitals. After confirmation of the diagnosis and surgical indication MRI scanning is performed. If a distinct disc herniation is discerned which in addition covers the clinically expected site the patient is eligible for randomization. Depending on the outcome of the randomization scheme the patient will either be submitted to prolonged conservative care or surgery. Surgery will be carried out according to the guidelines and between six and twelve weeks after onset of complaints. The experimental therapy consists of a prolonged conservative treatment under supervision of the general practitioner, which may be followed by surgical intervention in case of persisting or progressive disability. The main primary outcome measure is the disease specific disability of daily functioning. Other primary outcome measures are perceived recovery and intensity of legpain. Secondary outcome measures encompass severity of complaints, quality of life, medical consumption, absenteeism, costs and preference. The main research question will be answered at 12 months after randomization. The total follow-up period covers two years. Discussion Evidence is lacking concerning the optimal treatment of lumbar disc induced sciatica. This pragmatic randomized trial, focusses on the 'timing' of intervention, and will contribute to the decision of the general practictioner and neurologist, regarding referral of patients for surgery.

  9. Active video games as a tool to prevent excessive weight gain in adolescents: rationale, design and methods of a randomized controlled trial

    Science.gov (United States)

    2014-01-01

    Background Excessive body weight, low physical activity and excessive sedentary time in youth are major public health concerns. A new generation of video games, the ones that require physical activity to play the games –i.e. active games- may be a promising alternative to traditional non-active games to promote physical activity and reduce sedentary behaviors in youth. The aim of this manuscript is to describe the design of a study evaluating the effects of a family oriented active game intervention, incorporating several motivational elements, on anthropometrics and health behaviors in adolescents. Methods/Design The study is a randomized controlled trial (RCT), with non-active gaming adolescents aged 12 – 16 years old randomly allocated to a ten month intervention (receiving active games, as well as an encouragement to play) or a waiting-list control group (receiving active games after the intervention period). Primary outcomes are adolescents’ measured BMI-SDS (SDS = adjusted for mean standard deviation score), waist circumference-SDS, hip circumference and sum of skinfolds. Secondary outcomes are adolescents’ self-reported time spent playing active and non-active games, other sedentary activities and consumption of sugar-sweetened beverages. In addition, a process evaluation is conducted, assessing the sustainability of the active games, enjoyment, perceived competence, perceived barriers for active game play, game context, injuries from active game play, activity replacement and intention to continue playing the active games. Discussion This is the first adequately powered RCT including normal weight adolescents, evaluating a reasonably long period of provision of and exposure to active games. Next, strong elements are the incorporating motivational elements for active game play and a comprehensive process evaluation. This trial will provide evidence regarding the potential contribution of active games in prevention of excessive weight gain in

  10. Determinants of cardiovascular disease and other non-communicable diseases in Central and Eastern Europe: Rationale and design of the HAPIEE study

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    Pikhart Hynek

    2006-10-01

    Full Text Available Abstract Background Over the last five decades, a wide gap in mortality opened between western and eastern Europe; this gap increased further after the dramatic fluctuations in mortality in the former Soviet Union (FSU in the 1990s. Recent rapid increases in mortality among lower socioeconomic groups in eastern Europe suggests that socioeconomic factors are powerful determinants of mortality in these populations but the more proximal factors linking the social conditions with health remain unclear. The HAPIEE (Health, Alcohol and Psychosocial factors In Eastern Europe study is a prospective cohort study designed to investigate the effect of classical and non-conventional risk factors and social and psychosocial factors on cardiovascular and other non-communicable diseases in eastern Europe and the FSU. The main hypotheses of the HAPIEE study relate to the role of alcohol, nutrition and psychosocial factors. Methods and design The HAPIEE study comprises four cohorts in Russia, Poland, the Czech Republic and Lithuania; each consists of a random sample of men and women aged 45–69 years old at baseline, stratified by gender and 5 year age groups, and selected from population registers. The total planned sample size is 36,500 individuals. Baseline information from the Czech Republic, Russia and Poland was collected in 2002–2005 and includes data on health, lifestyle, diet (food frequency, socioeconomic circumstances and psychosocial factors. A short examination included measurement of anthropometric parameters, blood pressure, lung function and cognitive function, and a fasting venous blood sample. Re-examination of the cohorts in 2006–2008 focuses on healthy ageing and economic well-being using face-to-face computer assisted personal interviews. Recruitment of the Lithuanian cohort is ongoing, with baseline and re-examination data being collected simultaneously. All cohorts are being followed up for mortality and non-fatal cardiovascular

  11. Comparative efficacy of the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for early onset chronic depression: design and rationale of a multisite randomized controlled trial

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    Berger Mathias

    2011-08-01

    Full Text Available Abstract Background Effective treatment strategies for chronic depression are urgently needed since it is not only a common and particularly disabling disorder, but is also considered treatment resistant by most clinicians. There are only a few studies on chronic depression indicating that traditional psycho- and pharmacological interventions are not as effective as in acute, episodic depression. Current medications are no more effective than those introduced 50 years ago whereas the only psychotherapy developed specifically for the subgroup of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP, faired well in one large trial. However, CBASP has never been directly compared to a non-specific control treatment. Methods/Design The present article describes the study protocol of a multisite parallel-group randomized controlled trial in Germany. The purpose of the study is to estimate the efficacy of CBASP compared to supportive psychotherapy in 268 non-medicated early-onset chronically depressed outpatients. The intervention includes 20 weeks of acute treatment with 24 individual sessions followed by 28 weeks of continuation treatment with another 8 sessions. Depressive symptoms are evaluated 20 weeks after randomisation by means of the 24-item Hamilton Rating Scale of Depression (HRSD. Secondary endpoints are depressive symptoms after 12 and 48 weeks, and remission after 12, 20, and 48 weeks. Primary outcome will be analysed using analysis of covariance (ANCOVA controlled for pre-treatment scores and site. Analyses of continuous secondary variables will be performed using linear mixed models. For remission rates, chi-squared tests and logistic regression will be applied. Discussion The study evaluates the comparative effects of a disorder-specific psychotherapy and a well designed non-specific psychological approach in the acute and continuation treatment phase in a large sample of early-onset chronically

  12. Comparative fracture strength analysis of Lava and Digident CAD/CAM zirconia ceramic crowns

    OpenAIRE

    Kwon, Taek-Ka; Pak, Hyun-Soon; Yang, Jae-Ho; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun; Yeo, In-Sung

    2013-01-01

    PURPOSE All-ceramic crowns are subject to fracture during function. To minimize this common clinical complication, zirconium oxide has been used as the framework for all-ceramic crowns. The aim of this study was to compare the fracture strengths of two computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crown systems: Lava and Digident. MATERIALS AND METHODS Twenty Lava CAD/CAM zirconia crowns and twenty Digident CAD/CAM zirconia crowns were fabricated. A metal die was also ...

  13. DYNAMIC ANALYSIS OF A CRIMPING DEVICE WITH MULTIPLE CAMS USING MSC ADAMS II

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    Gheorghe Popescu

    2012-05-01

    Full Text Available Through the present paper, the author presents the results of the dynamic analysis with MSC ADAMS of the mechanism with a crimping device with 12 tightening cams, designed and used in the technological process of assembly of the indigenous electrical detonators. In this sense, the mechanism with multiple cams is considered a mechanical system and is treated as an assembly of rigid bodies connected by mechanical connections and elastic elements. For shaping and simulation of the mechanism with multiple cams using ADAMS program, the author got through the following stages: construction of the pattern, its testing and simulation, validation, finishing, parametrization, optimization of the pattern.

  14. Thyroid Disease and Complementary and Alternative Medicine (CAM)

    Science.gov (United States)

    ... to Donate Thyroid Disease and Complementary and Alternative Medicine (CAM) WHAT IS A THYROID NODULE? The term ... type of evaluation. WHAT IS COMPLEMENTARY AND ALTERNATIVE MEDICINE (CAM)? Complementary and Alternative Medicine (CAM) is defined ...

  15. Non-invasive cardiac assessment in high risk patients (The GROUND study: rationale, objectives and design of a multi-center randomized controlled clinical trial

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    Moll Frans L

    2008-08-01

    Full Text Available Abstract Background Peripheral arterial disease (PAD is a common disease associated with a considerably increased risk of future cardiovascular events and most of these patients will die from coronary artery disease (CAD. Screening for silent CAD has become an option with recent non-invasive developments in CT (computed tomography-angiography and MR (magnetic resonance stress testing. Screening in combination with more aggressive treatment may improve prognosis. Therefore we propose to study whether a cardiac imaging algorithm, using non-invasive imaging techniques followed by treatment will reduce the risk of cardiovascular disease in PAD patients free from cardiac symptoms. Design The GROUND study is designed as a prospective, multi-center, randomized clinical trial. Patients with peripheral arterial disease, but without symptomatic cardiac disease will be asked to participate. All patients receive a proper risk factor management before randomization. Half of the recruited patients will enter the 'control group' and only undergo CT calcium scoring. The other half of the recruited patients (index group will undergo the non invasive cardiac imaging algorithm followed by evidence-based treatment. First, patients are submitted to CT calcium scoring and CT angiography. Patients with a left main (or equivalent coronary artery stenosis of > 50% on CT will be referred to a cardiologist without further imaging. All other patients in this group will undergo dobutamine stress magnetic resonance (DSMR testing. Patients with a DSMR positive for ischemia will also be referred to a cardiologist. These patients are candidates for conventional coronary angiography and cardiac interventions (coronary artery bypass grafting (CABG or percutaneous cardiac interventions (PCI, if indicated. All participants of the trial will enter a 5 year follow up period for the occurrence of cardiovascular events. Sequential interim analysis will take place. Based on sample size

  16. Effectiveness and cost-effectiveness of an educational intervention for practice teams to deliver problem focused therapy for insomnia: rationale and design of a pilot cluster randomised trial

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    Ørner Roderick

    2009-01-01

    Full Text Available Abstract Background Sleep problems are common, affecting over a third of adults in the United Kingdom and leading to reduced productivity and impaired health-related quality of life. Many of those whose lives are affected seek medical help from primary care. Drug treatment is ineffective long term. Psychological methods for managing sleep problems, including cognitive behavioural therapy for insomnia (CBTi have been shown to be effective and cost effective but have not been widely implemented or evaluated in a general practice setting where they are most likely to be needed and most appropriately delivered. This paper outlines the protocol for a pilot study designed to evaluate the effectiveness and cost-effectiveness of an educational intervention for general practitioners, primary care nurses and other members of the primary care team to deliver problem focused therapy to adult patients presenting with sleep problems due to lifestyle causes, pain or mild to moderate depression or anxiety. Methods and design This will be a pilot cluster randomised controlled trial of a complex intervention. General practices will be randomised to an educational intervention for problem focused therapy which includes a consultation approach comprising careful assessment (using assessment of secondary causes, sleep diaries and severity and use of modified CBTi for insomnia in the consultation compared with usual care (general advice on sleep hygiene and pharmacotherapy with hypnotic drugs. Clinicians randomised to the intervention will receive an educational intervention (2 × 2 hours to implement a complex intervention of problem focused therapy. Clinicians randomised to the control group will receive reinforcement of usual care with sleep hygiene advice. Outcomes will be assessed via self-completion questionnaires and telephone interviews of patients and staff as well as clinical records for interventions and prescribing. Discussion Previous studies in adults

  17. Rationale, design, and implementation protocol of an electronic health record integrated clinical prediction rule (iCPR randomized trial in primary care

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    Wisnivesky Juan

    2011-09-01

    Full Text Available Abstract Background Clinical prediction rules (CPRs represent well-validated but underutilized evidence-based medicine tools at the point-of-care. To date, an inability to integrate these rules into an electronic health record (EHR has been a major limitation and we are not aware of a study demonstrating the use of CPR's in an ambulatory EHR setting. The integrated clinical prediction rule (iCPR trial integrates two CPR's in an EHR and assesses both the usability and the effect on evidence-based practice in the primary care setting. Methods A multi-disciplinary design team was assembled to develop a prototype iCPR for validated streptococcal pharyngitis and bacterial pneumonia CPRs. The iCPR tool was built as an active Clinical Decision Support (CDS tool that can be triggered by user action during typical workflow. Using the EHR CDS toolkit, the iCPR risk score calculator was linked to tailored ordered sets, documentation, and patient instructions. The team subsequently conducted two levels of 'real world' usability testing with eight providers per group. Usability data were used to refine and create a production tool. Participating primary care providers (n = 149 were randomized and intervention providers were trained in the use of the new iCPR tool. Rates of iCPR tool triggering in the intervention and control (simulated groups are monitored and subsequent use of the various components of the iCPR tool among intervention encounters is also tracked. The primary outcome is the difference in antibiotic prescribing rates (strep and pneumonia iCPR's encounters and chest x-rays (pneumonia iCPR only between intervention and control providers. Discussion Using iterative usability testing and development paired with provider training, the iCPR CDS tool leverages user-centered design principles to overcome pervasive underutilization of EBM and support evidence-based practice at the point-of-care. The ongoing trial will determine if this collaborative

  18. A randomized controlled trial on the effectiveness of strength training on clinical and muscle cellular outcomes in patients with prostate cancer during androgen deprivation therapy: rationale and design

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    Thorsen Lene

    2012-03-01

    Full Text Available Abstract Background Studies indicate that strength training has beneficial effects on clinical health outcomes in prostate cancer patients during androgen deprivation therapy. However, randomized controlled trials are needed to scientifically determine the effectiveness of strength training on the muscle cell level. Furthermore, close examination of the feasibility of a high-load strength training program is warranted. The Physical Exercise and Prostate Cancer (PEPC trial is designed to determine the effectiveness of strength training on clinical and muscle cellular outcomes in non-metastatic prostate cancer patients after high-dose radiotherapy and during ongoing androgen deprivation therapy. Methods/design Patients receiving androgen deprivation therapy for 9-36 months combined with external high-dose radiotherapy for locally advanced prostate cancer are randomized to an exercise intervention group that receives a 16 week high-load strength training program or a control group that is encouraged to maintain their habitual activity level. In both arms, androgen deprivation therapy is continued until the end of the intervention period. Clinical outcomes are body composition (lean body mass, bone mineral density and fat mass measured by Dual-energy X-ray Absorptiometry, serological outcomes, physical functioning (muscle strength and cardio-respiratory fitness assessed with physical tests and psycho-social functioning (mental health, fatigue and health-related quality of life assessed by questionnaires. Muscle cellular outcomes are a muscle fiber size b regulators of muscle fiber size (number of myonuclei per muscle fiber, number of satellite cells per muscle fiber, number of satellite cells and myonuclei positive for androgen receptors and proteins involved in muscle protein degradation and muscle hypertrophy and c regulators of muscle fiber function such as proteins involved in cellular stress and mitochondrial function. Muscle cellular outcomes

  19. Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial

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    Ambresin Gilles

    2012-10-01

    Full Text Available Abstract Background A few recent studies have found indications of the effectiveness of inpatient psychotherapy for depression, usually of an extended duration. However, there is a lack of controlled studies in this area and to date no study of adequate quality on brief psychodynamic psychotherapy for depression during short inpatient stay exists. The present article describes the protocol of a study that will examine the relative efficacy, the cost-effectiveness and the cost-utility of adding an Inpatient Brief Psychodynamic Psychotherapy to pharmacotherapy and treatment-as-usual for inpatients with unipolar depression. Methods/Design The study is a one-month randomized controlled trial with a two parallel group design and a 12-month naturalistic follow-up. A sample of 130 consecutive adult inpatients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited. The study is carried out in the university hospital section for mood disorders in Lausanne, Switzerland. Patients are assessed upon admission, and at 1-, 3- and 12- month follow-ups. Inpatient therapy is a manualized brief intervention, combining the virtues of inpatient setting and of time-limited dynamic therapies (focal orientation, fixed duration, resource-oriented interventions. Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to inpatients. Final analyses will follow an intention–to-treat strategy. Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology, psychosocial role functioning, and psychodynamic-emotional functioning. The mediating role of the therapeutic alliance is also examined. Allocation to treatment groups uses a stratified block randomization method with permuted block. To guarantee allocation concealment, randomization is done by an independent researcher. Discussion Despite the large number of studies

  20. Predicting the outcome of chronic kidney disease by the estimated nephron number: The rationale and design of PRONEP, a prospective, multicenter, observational cohort study

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    Imasawa Toshiyuki

    2012-03-01

    Full Text Available Abstract Background The nephron number is thought to be associated with the outcome of chronic kidney disease (CKD. If the nephron number can be estimated in the clinical setting, it could become a strong tool to predict renal outcome. This study was designed to estimate the nephron number in CKD patients and to establish a method to predict the outcome by using the estimated nephron number. Methods/Design The hypothesis of this study is that the estimated nephron number can predict the outcome of a CKD patient. This will be a multicenter, prospective (minimum 3 and maximum 5 years follow-up study. The subjects will comprise CKD patients aged over 14 years who have undergone a kidney biopsy. From January 2011 to March 2013, we will recruit 600 CKD patients from 10 hospitals belonging to the National Hospital Organization of Japan. The primary parameter for assessment is the composite of total mortality, renal death, cerebro-cardiovascular events, and a 50% reduction in the eGFR. The secondary parameter is the rate of eGFR decline per year. The nephron number will be estimated by the glomerular density in biopsy specimens and the renal cortex volume. This study includes one sub-cohort study to establish the equation to calculate the renal cortex volume. Enrollment will be performed at the time of the kidney biopsy, and the data will consist of a medical interview, ultrasound for measurement of the kidney size, blood or urine test, and the pathological findings of the kidney biopsy. Patients will continue to have medical consultations and receive examinations and/or treatment as usual. The data from the patients will be collected once a year after the kidney biopsy until March 2016. All data using this study are easily obtained in routine clinical practice. Discussion This study includes the first trials to estimate the renal cortex volume and nephron number in the general clinical setting. Furthermore, this is the first prospective study to

  1. The lung cancer exercise training study: a randomized trial of aerobic training, resistance training, or both in postsurgical lung cancer patients: rationale and design

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    Crawford Jeffrey

    2010-04-01

    Full Text Available Abstract Background The Lung Cancer Exercise Training Study (LUNGEVITY is a randomized trial to investigate the efficacy of different types of exercise training on cardiorespiratory fitness (VO2peak, patient-reported outcomes, and the organ components that govern VO2peak in post-operative non-small cell lung cancer (NSCLC patients. Methods/Design Using a single-center, randomized design, 160 subjects (40 patients/study arm with histologically confirmed stage I-IIIA NSCLC following curative-intent complete surgical resection at Duke University Medical Center (DUMC will be potentially eligible for this trial. Following baseline assessments, eligible participants will be randomly assigned to one of four conditions: (1 aerobic training alone, (2 resistance training alone, (3 the combination of aerobic and resistance training, or (4 attention-control (progressive stretching. The ultimate goal for all exercise training groups will be 3 supervised exercise sessions per week an intensity above 70% of the individually determined VO2peak for aerobic training and an intensity between 60 and 80% of one-repetition maximum for resistance training, for 30-45 minutes/session. Progressive stretching will be matched to the exercise groups in terms of program length (i.e., 16 weeks, social interaction (participants will receive one-on-one instruction, and duration (30-45 mins/session. The primary study endpoint is VO2peak. Secondary endpoints include: patient-reported outcomes (PROs (e.g., quality of life, fatigue, depression, etc. and organ components of the oxygen cascade (i.e., pulmonary function, cardiac function, skeletal muscle function. All endpoints will be assessed at baseline and postintervention (16 weeks. Substudies will include genetic studies regarding individual responses to an exercise stimulus, theoretical determinants of exercise adherence, examination of the psychological mediators of the exercise - PRO relationship, and exercise-induced changes

  2. Controlled trial of a collaborative primary care team model for patients with diabetes and depression: Rationale and design for a comprehensive evaluation

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    Johnson Jeffrey A

    2012-08-01

    Full Text Available Abstract Background When depression accompanies diabetes, it complicates treatment, portends worse outcomes and increases health care costs. A collaborative care case-management model, previously tested in an urban managed care organization in the US, achieved significant reduction of depressive symptoms, improved diabetes disease control and patient-reported outcomes, and saved money. While impressive, these findings need to be replicated and extended to other healthcare settings. Our objective is to comprehensively evaluate a collaborative care model for comorbid depression and type 2 diabetes within a Canadian primary care setting. Methods/design We initiated the TeamCare model in four Primary Care Networks in Northern Alberta. The intervention involves a nurse care manager guiding patient-centered care with family physicians and consultant physician specialists to monitor progress and develop tailored care plans. Patients eligible for the intervention will be identified using the Patient Health Questionnaire-9 as a screen for depressive symptoms. Care managers will then guide patients through three phases: 1 improving depressive symptoms, 2 improving blood glucose, blood pressure and cholesterol, and 3 improving lifestyle behaviors. We will employ the RE-AIM framework for a comprehensive and mixed-methods approach to our evaluation. Effectiveness will be assessed using a controlled “on-off” trial design, whereby eligible patients would be alternately enrolled in the TeamCare intervention or usual care on a monthly basis. All patients will be assessed at baseline, 6 and 12 months. Our primary analyses will be based on changes in two outcomes: depressive symptoms, and a multivariable, scaled marginal model for the combined outcome of global disease control (i.e., A1c, systolic blood pressure, LDL cholesterol. Our planned enrolment of 168 patients will provide greater than 80% power to observe clinically important improvements in all

  3. [Atherosclerosis of the lower extremities as a linked comorbidity in Patients Admitted for cardiac rehabilitation (THINKPAD): rationale, design, and study group].

    Science.gov (United States)

    Ambrosetti, Marco; Diaco, Tommaso; Febo, Oreste; Calisi, Pasqualina; Favretto, Giuseppe; Carlon, Roberto; Temporelli, Pier Luigi

    2012-03-01

    Peripheral arterial disease (PAD) is a frequent comorbidity among patients entering cardiac rehabilitation (CR) programmes and an important source of disability and impaired prognosis. The prevalence of PAD across the wide range of conditions for CR is poorly understood, as far as its impact on drug optimization and intervention delivered. The "ATHerosclerosis of the lower extremities as a liNKed comorbidity in Patients Admitted for carDiac rehabilitation" (THINKPAD) study was carried out by the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) in order to explore PAD both as a comorbidity and a primary indication at the entry of CR. The study was a retrospective case series. In the study period (from May 1, 2012 to June 30, 2012), data on consecutive patients discharged from 17 CR units in Northern Italy were collected. Web-based electronic case report forms (e-CRF), accessible in a dedicated section of the IACPR website (www.iacpr.it), were used for data entry, and data were transferred via web to a central database. The data collection instrument was designed with a multiple choice format, with jump menus or select boxes and obligatory items. A sample size of 1,300 subjects is expected, with first data available by the end of 2012. PMID:22928398

  4. Rationale, design and methodology of a double-blind, randomized, placebo-controlled study of escitalopram in prevention of Depression in Acute Coronary Syndrome (DECARD

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    Hansen Jørgen

    2009-04-01

    Full Text Available Abstract Background The prevalence of depression in patients with acute coronary syndrome, i.e. myocardial infarction and unstable angina, is higher than in the general population. The prevalence of anxiety is higher as well. Both depression and anxiety are associated with poor cardiac outcomes and higher mortality. Comorbid depression in patients with acute coronary syndrome often goes undiagnosed, and it is therefore a challenging task to prevent this risk factor. The study of DEpression in Coronary ARtery Disease (DECARD is designed to examine if it is possible to prevent depression in patients with acute coronary syndrome. Methods Two hundred forty non-depressed patients with acute coronary syndrome are randomized to treatment with either escitalopram or placebo for 1 year. Psychiatric and cardiac assessment of patients is performed to evaluate the possibility of preventing depression. Diagnosis of depression and Hamilton Depression Scale are the primary outcome measures. Discussion This is the first study of prevention of depression in patients after acute coronary syndrome with a selective serotonin reuptake inhibitor. Trial Registration http://www.ClinicalTrials.gov. Identifier: NCT00140257

  5. Conceptual framework and rationale

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    Voigt Gabriella

    2009-11-01

    Full Text Available Abstract The sterile insect technique (SIT has been shown to be an effective and sustainable genetic approach to control populations of selected major pest insects, when part of area-wide integrated pest management (AW-IPM programmes. The technique introduces genetic sterility in females of the target population in the field following their mating with released sterile males. This process results in population reduction or elimination via embryo lethality caused by dominant lethal mutations induced in sperm of the released males. In the past, several field trials have been carried out for mosquitoes with varying degrees of success. New technology and experience gained with other species of insect pests has encouraged a reassessment of the use of the sterility principle as part of integrated control of malaria vectors. Significant technical and logistic hurdles will need to be overcome to develop the technology and make it effective to suppress selected vector populations, and its application will probably be limited to specific ecological situations. Using sterile males to control mosquito vector populations can only be effective as part of an AW-IPM programme. The area-wide concept entails the targeting of the total mosquito population within a defined area. It requires, therefore, a thorough understanding of the target pest population biology especially as regards mating behaviour, population dynamics, dispersal and level of reproductive isolation. The key challenges for success are: 1 devising methods to monitor vector populations and measuring competitiveness of sterile males in the field, 2 designing mass rearing, sterilization and release strategies that maintain competitiveness of the sterile male mosquitoes, 3 developing methods to separate sexes in order to release only male mosquitoes and 4 adapting suppression measures and release rates to take into account the high reproductive rate of mosquitoes. Finally, success in area

  6. The ADOPT trial (Assessment of Efficacies of Cardiac Resynchronization Therapies (CRT-P/D for Heart Failure Patients in China: rationale, design, and end-points

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    Liu B

    2011-06-01

    Full Text Available Bing Liu1*, Fu Yi1*, Hongwei Cai2, Wenyi Guo1, Weijie Li1, Min Shen1, Jielai Xia3, Liwen Liu4, Haichang Wang1, on behalf of The ADOPT Study Steering Committee and Investigators1Department of Cardiology, Xijing Hospital, FMMU, Xi’an, China; 2Department of Information, School of Stomatology, FMMU, Xi’an, China; 3Department of Statistics, FMMU, Xi’an, China; 4Department of Ultrasound, Xijing Hospital, FMMU, Xi’an, ChinaClinicalTrials.gov number, NCT01018667*Both authors contributed equally to this workBackground: Cardiac resynchronization therapy (CRT is a novel nonpharmacological treatment for patients with chronic heart failure (CHF. Some clinical trials conducted in Western countries have demonstrated that CRT could improve CHF patients’ symptoms and reduce mortality. However, due to the differences in economic and social conditions as well as inconsistencies in CHF etiologies between China and Western countries, there is an urgent need to conduct a large-scale CRT clinical study in Chinese patients with CHF. The ADOPT Trial (Assessment of Efficacies of Cardiac Resynchronization Therapies (CRT-P/D for Heart Failure Patients in China is designed to observe whether CRT can further improve syptoms and reduce mortality in Chinese patients in addition to optimal pharmalogical therapy.Methods: The ADOPT study is a prospective, nested, case-controlled, open-label clinical trial. About 40 centers across China participate in this study with a planned 800 Chinese cases to be enrolled. All patients will receive optimal medical treatment. Patients who have successful CRT-P/D implant will be assigned to the CRT group. According to the baseline evaluation, matched cases will be selected from the enrolled optimal pharmaceutical therapy alone group (Group for Selection. After successful match, the cases in Group for Selection enter into follow-up and become the control group. The unmatched cases in the Group for Selection will be removed. If patients

  7. Ultrasound enhanced prehospital thrombolysis using microbubbles infusion in patients with acute ST elevation myocardial infarction: Rationale and design of the Sonolysis study

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    van Dijk Arie PJ

    2008-12-01

    Full Text Available Abstract Background - Experimental studies have shown that ultrasound contrast agents enhance the effectiveness of thrombolytic agents in the presence of ultrasound in vitro and in vivo. Recently, we have launched a clinical pilot study, called "Sonolysis", to study this effect in patients with ST-elevation myocardial infarction based on proximal lesions of the infarct-related artery. Methods/design - In our multicenter, randomized, placebo controlled clinical trial we will include patients between 18 and 80 years of age with their first ST-elevation myocardial infarction based on a proximal lesion of the infarct-related artery. After receiving a single bolus alteplase 50 mg IV (Actilyse® Boehringer Ingelheim GmbH, a loading dose of aspirin 500 mg, and heparin 5000 IU in the ambulance according to the prehospital thrombolysis protocol, patients, following oral informed consent, are randomized to undergo 15 minutes of pulsatile ultrasound with intravenous administration of ultrasound contrast agent or placebo without ultrasound. Afterwards coronary angiography and, if indicated, percutaneous coronary intervention will take place. A total of 60 patients will be enrolled in approximately 1 year. The primary endpoints are based on the coronary angiogram and consist of TIMI flow, corrected TIMI frame count, and myocardial blush grade. Follow-up includes 12-lead ECG, 2D-echocardiography, cardiac MRI, and enzyme markers to obtain our secondary endpoints, including the infarct size, wall motion abnormalities, and the global left ventricular function. Discussion - The Sonolysis study is the first multicenter, randomized, placebo controlled clinical trial investigating the therapeutic application of ultrasound and microbubbles in acute ST-elevation myocardial infarction patients. A positive finding may stimulate further research and technical innovations to implement the treatment in the ambulance and maybe obtain even more patency at an earlier stage

  8. Depression in Primary care: Interpersonal Counseling vs Selective serotonin reuptake inhibitors. The DEPICS Study. A multicenter randomized controlled trial. Rationale and design

    Directory of Open Access Journals (Sweden)

    Scocco Paolo

    2010-11-01

    Full Text Available Abstract Background Depression is a frequently observed and disabling condition in primary care, mainly treated by Primary Care Physicians with antidepressant drugs. Psychological interventions are recommended as first-line treatment by the most authoritative international guidelines but few evidences are available on their efficacy and effectiveness for mild depression. Methods/Design This multi-center randomized controlled trial was conducted in 9 Italian centres with the aim to compare the efficacy of Inter-Personal Counseling, a brief structured psychological intervention, to that of Selective Serotonin Reuptake Inhibitors. Patients with depressive symptoms referred by Primary Care Physicians to psychiatric consultation-liaison services were eligible for the study if they met the DSM-IV criteria for major depression, had a score ≥13 on the 21-item Hamilton Depression Rating Scale, and were at their first or second depressive episode. The primary outcome was remission of depressive symptoms at 2-months, defined as a HDRS score ≤ 7. Secondary outcome measures were improvement in global functioning and recurrence of depressive symptoms at 12-months. Patients who did not respond to Inter-Personal Counseling or Selective Serotonin Reuptake Inhibitors at 2-months received augmentation with the other treatment. Discussion This trial addresses some of the shortcomings of existing trials targeting major depression in primary care by evaluating the comparative efficacy of a brief psychological intervention that could be easily disseminated, by including a sample of patients with mild/moderate depression and by using different outcome measures. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12608000479303

  9. Probiotic prophylaxis in patients with predicted severe acute pancreatitis (PROPATRIA: design and rationale of a double-blind, placebo-controlled randomised multicenter trial [ISRCTN38327949

    Directory of Open Access Journals (Sweden)

    Akkermans Louis MA

    2004-09-01

    Full Text Available Abstract Background Infectious complications are the major cause of death in acute pancreatitis. Small bowel bacterial overgrowth and subsequent bacterial translocation are held responsible for the vast majority of these infections. Goal of this study is to determine whether selected probiotics are capable of preventing infectious complications without the disadvantages of antibiotic prophylaxis; antibiotic resistance and fungal overgrowth. Methods/design PROPATRIA is a double-blind, placebo-controlled randomised multicenter trial in which 200 patients will be randomly allocated to a multispecies probiotic preparation (Ecologic 641 or placebo. The study is performed in all 8 Dutch University Hospitals and 7 non-University hospitals. The study-product is administered twice daily through a nasojejunal tube for 28 days or until discharge. Patients eligible for randomisation are adult patients with a first onset of predicted severe acute pancreatitis: Imrie criteria 3 or more, CRP 150 mg/L or more, APACHE II score 8 or more. Exclusion criteria are post-ERCP pancreatitis, malignancy, infection/sepsis caused by a second disease, intra-operative diagnosis of pancreatitis and use of probiotics during the study. Administration of the study product is started within 72 hours after onset of abdominal pain. The primary endpoint is the total number of infectious complications. Secondary endpoints are mortality, necrosectomy, antibiotic resistance, hospital stay and adverse events. To demonstrate that probiotic prophylaxis reduces the proportion of patients with infectious complications from 50% to 30%, with alpha 0,05 and power 80%, a total sample size of 200 patients was calculated. Conclusion The PROPATRIA study is aimed to show a reduction in infectious complications due to early enteral use of multispecies probiotics in severe acute pancreatitis.

  10. Rationale and design of an independent randomised controlled trial evaluating the effectiveness of aripiprazole or haloperidol in combination with clozapine for treatment-resistant schizophrenia

    Directory of Open Access Journals (Sweden)

    Piantato Ennio

    2009-05-01

    Full Text Available Abstract Background One third to two thirds of people with schizophrenia have persistent psychotic symptoms despite clozapine treatment. Under real-world circumstances, the need to provide effective therapeutic interventions to patients who do not have an optimal response to clozapine has been cited as the most common reason for simultaneously prescribing a second antipsychotic drug in combination treatment strategies. In a clinical area where the pressing need of providing therapeutic answers has progressively increased the occurrence of antipsychotic polypharmacy, despite the lack of robust evidence of its efficacy, we sought to implement a pre-planned protocol where two alternative therapeutic answers are systematically provided and evaluated within the context of a pragmatic, multicentre, independent randomised study. Methods/Design The principal clinical question to be answered by the present project is the relative efficacy and tolerability of combination treatment with clozapine plus aripiprazole compared with combination treatment with clozapine plus haloperidol in patients with an incomplete response to treatment with clozapine over an appropriate period of time. This project is a prospective, multicentre, randomized, parallel-group, superiority trial that follow patients over a period of 12 months. Withdrawal from allocated treatment within 3 months is the primary outcome. Discussion The implementation of the protocol presented here shows that it is possible to create a network of community psychiatric services that accept the idea of using their everyday clinical practice to produce randomised knowledge. The employed pragmatic attitude allowed to randomly allocate more than 100 individuals, which means that this study is the largest antipsychotic combination trial conducted so far in Western countries. We expect that the current project, by generating evidence on whether it is clinically useful to combine clozapine with aripiprazole

  11. The MARINER trial of rivaroxaban after hospital discharge for medical patients at high risk of VTE. Design, rationale, and clinical implications.

    Science.gov (United States)

    Raskob, Gary E; Spyropoulos, Alex C; Zrubek, Julie; Ageno, Walter; Albers, Gregory; Elliott, C Gregory; Halperin, Jonathan; Haskell, Lloyd; Hiatt, William R; Maynard, Gregory A; Peters, Gary; Spiro, Theodore; Steg, Philippe Gabriel; Suh, Eun Young; Weitz, Jeffrey I

    2016-06-01

    Hospital-associated venous thromboembolism (VTE) is a leading cause of premature death and disability worldwide. Evidence-based guidelines recommend that anticoagulant thromboprophylaxis be given to hospitalised medical patients at risk of VTE, but suggest against routine use of thromboprophylaxis beyond the hospital stay. The MARINER study is a randomised, double-blind, placebo-controlled trial to evaluate the efficacy and safety of thromboprophylaxis using rivaroxaban, begun at hospital discharge and continued for 45 days, for preventing symptomatic VTE in high-risk medical patients. Eligible patients are identified using the International Medical Prevention Registry on Venous Thromboembolism (IMPROVE VTE) risk score, combined with a laboratory test, D-dimer. The rivaroxaban regimen is 10 mg once daily for patients with CrCl ≥ 50 ml/min, or 7.5 mg once daily for patients with CrCl ≥ 30 ml/min and thrombosis and non-fatal pulmonary embolism) and VTE-related death. The principal safety outcome is major bleeding. A blinded clinical events committee adjudicates all suspected outcome events. The sample size is event-driven with an estimated total of 8,000 patients to acquire 161 primary outcome events. Study design features that distinguish MARINER from previous and ongoing thromboprophylaxis trials in medically ill patients are: (i) use of a validated risk assessment model (IMPROVE VTE) and D-dimer determination for identifying eligible patients at high risk of VTE, (ii) randomisation at the time of hospital discharge, (iii) a 45-day treatment period and (iv) restriction of the primary efficacy outcome to symptomatic VTE events. PMID:26842902

  12. A randomized controlled trial on the effectiveness of strength training on clinical and muscle cellular outcomes in patients with prostate cancer during androgen deprivation therapy: rationale and design

    International Nuclear Information System (INIS)

    Studies indicate that strength training has beneficial effects on clinical health outcomes in prostate cancer patients during androgen deprivation therapy. However, randomized controlled trials are needed to scientifically determine the effectiveness of strength training on the muscle cell level. Furthermore, close examination of the feasibility of a high-load strength training program is warranted. The Physical Exercise and Prostate Cancer (PEPC) trial is designed to determine the effectiveness of strength training on clinical and muscle cellular outcomes in non-metastatic prostate cancer patients after high-dose radiotherapy and during ongoing androgen deprivation therapy. Patients receiving androgen deprivation therapy for 9-36 months combined with external high-dose radiotherapy for locally advanced prostate cancer are randomized to an exercise intervention group that receives a 16 week high-load strength training program or a control group that is encouraged to maintain their habitual activity level. In both arms, androgen deprivation therapy is continued until the end of the intervention period. Clinical outcomes are body composition (lean body mass, bone mineral density and fat mass) measured by Dual-energy X-ray Absorptiometry, serological outcomes, physical functioning (muscle strength and cardio-respiratory fitness) assessed with physical tests and psycho-social functioning (mental health, fatigue and health-related quality of life) assessed by questionnaires. Muscle cellular outcomes are a) muscle fiber size b) regulators of muscle fiber size (number of myonuclei per muscle fiber, number of satellite cells per muscle fiber, number of satellite cells and myonuclei positive for androgen receptors and proteins involved in muscle protein degradation and muscle hypertrophy) and c) regulators of muscle fiber function such as proteins involved in cellular stress and mitochondrial function. Muscle cellular outcomes are measured on muscle cross sections and

  13. Effectiveness and cost-effectiveness of 'BeweegKuur', a combined lifestyle intervention in the Netherlands: Rationale, design and methods of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Kremers Stef PJ

    2011-10-01

    Full Text Available Abstract Background Improving the lifestyle of overweight and obese adults is of increasing interest in view of its role in several chronic diseases. Interventions aiming at overweight or weight-related chronic diseases suffer from high drop-out rates. It has been suggested that Motivational Interviewing and more frequent and more patient-specific coaching could decrease the drop-out rate. 'BeweegKuur' is a multidisciplinary lifestyle intervention which offers three programmes for overweight persons. The effectiveness and the cost-effectiveness of intensively guided programmes, such as the 'supervised exercise programme' of 'BeweegKuur', for patients with high weight-related health risk, remain to be assessed. Our randomized controlled trial compares the expenses and effects of the 'supervised exercise programme' with those of the less intensively supervised 'start-up exercise programme'. Methods/Design The one-year intervention period involves coaching by a lifestyle advisor, a physiotherapist and a dietician, coordinated by general practitioners (GPs. The participating GP practices have been allocated to the interventions, which differ only in terms of the amount of coaching offered by the physiotherapist. Whereas the 'start-up exercise programme' includes several consultations with physiotherapists to identify barriers hampering independent exercising, the 'supervised exercise programme' includes more sessions with a physiotherapist, involving exercise under supervision. The main goal is transfer to local exercise facilities. The main outcome of the study will be the participants' physical activity at the end of the one-year intervention period and after one year of follow-up. Secondary outcomes are dietary habits, health risk, physical fitness and functional capacity. The economic evaluation will consist of a cost-effectiveness analysis and a cost-utility analysis. The primary outcome measures for the economic evaluation will be the physical

  14. Hand-suture versus stapling for closure of loop ileostomy: HASTA-Trial: a study rationale and design for a randomized controlled trial

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    Krüger Matthias

    2011-02-01

    Full Text Available Abstract Background Colorectal cancer is the second most common tumor in developed countries, with a lifetime prevalence of 5%. About one third of these tumors are located in the rectum. Surgery in terms of low anterior resection with mesorectal excision is the central element in the treatment of rectal cancer being the only option for definite cure. Creating a protective diverting stoma prevents complications like anastomotic failure and meanwhile is the standard procedure. Bowel obstruction is one of the main and the clinically and economically most relevant complication following closure of loop ileostomy. The best surgical technique for closure of loop ileostomy has not been defined yet. Methods/Design A study protocol was developed on the basis of the only randomized controlled mono-center trial to solve clinical equipoise concerning the optimal surgical technique for closure of loop ileostomy after low anterior resection due to rectal cancer. The HASTA trial is a multi-center pragmatic randomized controlled surgical trial with two parallel groups to compare hand-suture versus stapling for closure of loop ileostomy. It will include 334 randomized patients undergoing closure of loop ileostomy after low anterior resection with protective ileostomy due to rectal cancer in approximately 20 centers consisting of German hospitals of all level of health care. The primary endpoint is the rate of bowel obstruction within 30 days after ileostomy closure. In addition, a set of surgical and general variables including quality of life will be analyzed with a follow-up of 12 months. An investigators meeting with a practical session will help to minimize performance bias and enforce protocol adherence. Centers are monitored centrally as well as on-site before and during recruitment phase to assure inclusion, treatment and follow up according to the protocol. Discussion Aim of the HASTA trial is to evaluate the efficacy of hand-suture versus stapling for

  15. Breast ductal lavage for biomarker assessment in high risk women: rationale, design and methodology of a randomized phase II clinical trial with nimesulide, simvastatin and placebo

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    Lazzeroni Matteo

    2012-12-01

    Full Text Available Abstract Background Despite positive results from large phase III clinical trials proved that it is possible to prevent estrogen-responsive breast cancers with selective estrogen receptor modulators and aromatase inhibitors, no significant results have been reached so far to prevent hormone non-responsive tumors. The Ductal Lavage (DL procedure offers a minimally invasive method to obtain breast epithelial cells from the ductal system for cytopathologic analysis. Several studies with long-term follow-up have shown that women with atypical hyperplasia have an elevated risk of developing breast cancer. The objective of the proposed trial is to assess the efficacy and safety of a daily administration of nimesulide or simvastatin in women at higher risk for breast cancer, focused particularly on hormone non-responsive tumor risk. The primary endpoint is the change in prevalence of atypical cells and cell proliferation (measured by Ki67 in DL or fine needle aspirate samples, after 12 months of treatment and 12 months after treatment cessation. Methods-Design From 2005 to 2011, 150 women with a history of estrogen receptor negative ductal intraepithelial neoplasia or lobular intraepithelial neoplasia or atypical hyperplasia, or unaffected subjects carrying a mutation of BRCA1 or with a probability of mutation >10% (according to BRCAPRO were randomized to receive nimesulide 100mg/day versus simvastatin 20mg/day versus placebo for one year followed by a second year of follow-up. Discussion This is the first randomized placebo controlled trial to evaluate the role of DL to study surrogate endpoints biomarkers and the effects of these drugs on breast carcinogenesis. In 2007 the European Medicines Agency limited the use of systemic formulations of nimesulide to 15 days. According to the European Institute of Oncology Ethics Committee communication, we are now performing an even more careful monitoring of the study participants. Preliminary results showed

  16. A prospective study of symptoms, function, and medication use during acute illness in nursing home residents: design, rationale and cohort description

    Directory of Open Access Journals (Sweden)

    Liu Sophia

    2010-07-01

    incidence of 1.5 (SD 2.0 episodes per resident per year; 74% were managed in the nursing home and 26% managed in the acute care setting. Conclusion In this report, we describe the conceptual model and methods of designing a longitudinal cohort to measure acute illness patterns and symptoms among nursing home residents, and describe the characteristics of our cohort at baseline. In our planned analysis, we will further estimate the effect of the use and interruption of medications on withdrawal and relapse symptoms and illness outcomes.

  17. A randomized controlled trial of long term effect of BCM guided fluid management in MHD patients (BOCOMO study: rationales and study design

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    Liu Li

    2012-09-01

    that aim, the study was designed with very careful important considerations related to the endpoints, sample size, inclusion criteria, exclusion criteria and so on. For example, annual mortality of Beijing MHD patients was around 10%. To reach statistical significance, the sample size will be very large. By using composite endpoint, the sample size becomes reasonable and feasible. Limiting inclusion to patients with urine volume less than 800 ml/day the day before dialysis session will limit confounding due to residual renal function effects on the measured parameters. Patients who had received BIS measurement within 3 months prior to enrolment are excluded as data from such measurements might lead to protocol violation. Although not all patients enrolled will be incident patients, we will record the vintage of dialysis in the multivariable analysis. Trial registration Current Controlled Trials NCT01509937

  18. A randomized controlled trial of tai chi for long-term low back pain (TAI CHI: Study rationale, design, and methods

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    Hall Amanda M

    2009-05-01

    Full Text Available Abstract Background Low back pain persisting for longer than 3 months is a common and costly condition for which many current treatments have low-moderate success rates at best. Exercise is among the more successful treatments for this condition, however, the type and dosage of exercise that elicits the best results is not clearly defined. Tai chi is a gentle form of low intensity exercise that uses controlled movements in combination with relaxation techniques and is currently used as a safe form of exercise for people suffering from other chronic pain conditions such as arthritis. To date, there has been no scientific evaluation of tai chi as an intervention for people with back pain. Thus the aim of this study will be to examine the effects of a tai chi exercise program on pain and disability in people with long-term low back pain. Methods and design The study will recruit 160 healthy individuals from the community setting to be randomised to either a tai chi intervention group or a wait-list control group. Individuals in the tai chi group will attend 2 tai chi sessions (40 minutes/week for 8 weeks followed by 1 tai chi session/week for 2 weeks. The wait-list control will continue their usual health care practices and have the opportunity to participate in the tai chi program once they have completed the follow-up assessments. The primary outcome will be bothersomeness of back symptoms measured with a 0–10 numerical rating scale. Secondary outcomes include, self-reports of pain-related disability, health-related quality of life and global perceived effect of treatment. Statistical analysis of primary and secondary outcomes will be based on the intention to treat principle. Linear mixed models will be used to test for the effect of treatment on outcome at 10 weeks follow up. This trial has received ethics approval from The University of Sydney Human Research Ethics Committee. HREC Approval No.10452 Discussion This study will be the first

  19. Enhancing field GP engagement in hospital-based studies. Rationale, design, main results and participation in the diagest 3-GP motivation study

    Directory of Open Access Journals (Sweden)

    Berkhout Christophe

    2012-06-01

    explores issues in primary care, its design must anticipate GP participation early in the trial. Based on our questionnaire response rates, we found that one in two GPs were willing to participate in our hospital-led study, regardless of their initial attitudes.

  20. Biological mechanisms of disease and death in Moscow: rationale and design of the survey on Stress Aging and Health in Russia (SAHR

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    Deev Alexander

    2009-08-01

    Full Text Available Abstract Background Prior research has revealed large differences in health and mortality across countries, socioeconomic groups, and individuals. Russia experiences one of the world's highest levels of all-cause and cardiovascular mortality, great mortality differences within the population, and a heavy burden of ill health. Psychological stress has been suggested as a likely explanation of health loss and premature death in Russia and Eastern Europe. However, physiological mechanisms connecting stress with health in Russia remain unclear since existing epidemiological data are scarce and limited to conventional risk factors. Method and Design The survey on Stress Aging and Health in Russia (SAHR is addressing this knowledge gap by collecting an unusually rich database that includes a wide range of reported information, physical and cognitive health outcomes, and biomarkers in a sample of Muscovite men and women aged 55 and older. The total planned sample size is 2,000 individuals. The sample was randomly selected from epidemiological cohorts formed in Moscow between the mid-1970s and the 1990s and from medical population registers. The baseline data collection was carried out from December 2006 to June 2009. Interviews and medical tests were administered at hospital or at home according to standardized protocol. Questionnaire information includes health, socio-demographic characteristics, economic well-being, cognitive functioning, and batteries on stress and depression. Biomarkers include anthropometry, grip strength, resting ECG, conventional cardiovascular factors of risk such as lipid profile and blood pressure, and other biochemical parameters such as those related to inflammation, glucose and insulin resistance, coagulation, fibrinolysis, and stress hormones. In addition to these measurements, SAHR includes dynamic biomarkers provided by 24-hour ECG (Holter monitoring. This method continuously registers the beat-to-beat heart rate in

  1. Referral from primary care to a physical activity programme: establishing long-term adherence? A randomized controlled trial. Rationale and study design

    Directory of Open Access Journals (Sweden)

    Puig-Ribera Anna

    2009-01-01

    Full Text Available Abstract Background Declining physical activity is associated with a rising burden of global disease. There is little evidence about effective ways to increase adherence to physical activity. Therefore, interventions are needed that produce sustained increases in adherence to physical activity and are cost-effective. The purpose is to assess the effectiveness of a primary care physical activity intervention in increasing adherence to physical activity in the general population seen in primary care. Method and design Randomized controlled trial with systematic random sampling. A total of 424 subjects of both sexes will participate; all will be over the age of 18 with a low level of physical activity (according to the International Physical Activity Questionnaire, IPAQ, self-employed and from 9 Primary Healthcare Centres (PHC. They will volunteer to participate in a physical activity programme during 3 months (24 sessions; 2 sessions a week, 60 minutes per session. Participants from each PHC will be randomly allocated to an intervention (IG and control group (CG. The following parameters will be assessed pre and post intervention in both groups: (1 health-related quality of life (SF-12, (2 physical activity stage of change (Prochaska's stages of change, (3 level of physical activity (IPAQ-short version, (4 change in perception of health (vignettes from the Cooperative World Organization of National Colleges, Academies, and Academic Associations of Family Physicians, COOP/WONCA, (5 level of social support for the physical activity practice (Social Support for Physical Activity Scale, SSPAS, and (6 control based on analysis (HDL, LDL and glycated haemoglobin. Participants' frequency of visits to the PHC will be registered over the six months before and after the programme. There will be a follow up in a face to face interview three, six and twelve months after the programme, with the reduced version of IPAQ, SF-12, SSPAS, and Prochaska's stages

  2. Three-dimensional mapping of mechanical activation patterns, contractile dyssynchrony and dyscoordination by two-dimensional strain echocardiography: Rationale and design of a novel software toolbox

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    Cramer Maarten J

    2008-05-01

    Full Text Available Abstract Background Dyssynchrony of myocardial deformation is usually described in terms of variability only (e.g. standard deviations SD's. A description in terms of the spatio-temporal distribution pattern (vector-analysis of dyssynchrony or by indices estimating its impact by expressing dyscoordination of shortening in relation to the global ventricular shortening may be preferential. Strain echocardiography by speckle tracking is a new non-invasive, albeit 2-D imaging modality to study myocardial deformation. Methods A post-processing toolbox was designed to incorporate local, speckle tracking-derived deformation data into a 36 segment 3-D model of the left ventricle. Global left ventricular shortening, standard deviations and vectors of timing of shortening were calculated. The impact of dyssynchrony was estimated by comparing the end-systolic values with either early peak values only (early shortening reserve ESR or with all peak values (virtual shortening reserve VSR, and by the internal strain fraction (ISF expressing dyscoordination as the fraction of deformation lost internally due to simultaneous shortening and stretching. These dyssynchrony parameters were compared in 8 volunteers (NL, 8 patients with Wolff-Parkinson-White syndrome (WPW, and 7 patients before (LBBB and after cardiac resynchronization therapy (CRT. Results Dyssynchrony indices merely based on variability failed to detect differences between WPW and NL and failed to demonstrate the effect of CRT. Only the 3-D vector of onset of shortening could distinguish WPW from NL, while at peak shortening and by VSR, ESR and ISF no differences were found. All tested dyssynchrony parameters yielded higher values in LBBB compared to both NL and WPW. CRT reduced the spatial divergence of shortening (both vector magnitude and direction, and improved global ventricular shortening along with reductions in ESR and dyscoordination of shortening expressed by ISF. Conclusion Incorporation

  3. The Alberta population-based prospective evaluation of the quality of life outcomes and economic impact of bariatric surgery (APPLES study: background, design and rationale

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    McCargar Linda

    2010-10-01

    Full Text Available Abstract Background Extreme obesity affects nearly 8% of Canadians, and is debilitating, costly and ultimately lethal. Bariatric surgery is currently the most effective treatment available; is associated with reductions in morbidity/mortality, improvements in quality of life; and appears cost-effective. However, current demand for surgery in Canada outstrips capacity by at least 1000-fold, causing exponential increases in already protracted, multi-year wait-times. The objectives and hypotheses of this study were as follows: 1. To serially assess the clinical, economic and humanistic outcomes in patients wait-listed for bariatric care over a 2-year period. We hypothesize deterioration in these outcomes over time; 2. To determine the clinical effectiveness and changes in quality of life associated with modern bariatric procedures compared with medically treated and wait-listed controls over 2 years. We hypothesize that surgery will markedly reduce weight, decrease the need for unplanned medical care, and increase quality of life; 3. To conduct a 3-year (1 year retrospective and 2 year prospective economic assessment of bariatric surgery compared to medical and wait-listed controls from the societal, public payor, and health-care payor perspectives. We hypothesize that lower indirect, out of pocket and productivity costs will offset increased direct health-care costs resulting in lower total costs for bariatric surgery. Methods/design Population-based prospective cohort study of 500 consecutive, consenting adults, including 150 surgically treated patients, 200 medically treated patients and 150 wait-listed patients. Subjects will be enrolled from the Edmonton Weight Wise Regional Obesity Program (Edmonton, Alberta, Canada, with prospective bi-annual follow-up for 2 years. Mixed methods data collection, linking primary data to provincial administrative databases will be employed. Major outcomes include generic, obesity-specific and preference

  4. Increasing efficacy of primary care-based counseling for diabetes prevention: Rationale and design of the ADAPT (Avoiding Diabetes Thru Action Plan Targeting trial

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    Mann Devin M

    2012-01-01

    Full Text Available Abstract Background Studies have shown that lifestyle behavior changes are most effective to prevent onset of diabetes in high-risk patients. Primary care providers are charged with encouraging behavior change among their patients at risk for diabetes, yet the practice environment and training in primary care often do not support effective provider counseling. The goal of this study is to develop an electronic health record-embedded tool to facilitate shared patient-provider goal setting to promote behavioral change and prevent diabetes. Methods The ADAPT (Avoiding Diabetes Thru Action Plan Targeting trial leverages an innovative system that integrates evidence-based interventions for behavioral change with already-existing technology to enhance primary care providers' effectiveness to counsel about lifestyle behavior changes. Using principles of behavior change theory, the multidisciplinary design team utilized in-depth interviews and in vivo usability testing to produce a prototype diabetes prevention counseling system embedded in the electronic health record. Results The core element of the tool is a streamlined, shared goal-setting module within the electronic health record system. The team then conducted a series of innovative, "near-live" usability testing simulations to refine the tool and enhance workflow integration. The system also incorporates a pre-encounter survey to elicit patients' behavior-change goals to help tailor patient-provider goal setting during the clinical encounter and to encourage shared decision making. Lastly, the patients interact with a website that collects their longitudinal behavior data and allows them to visualize their progress over time and compare their progress with other study members. The finalized ADAPT system is now being piloted in a small randomized control trial of providers using the system with prediabetes patients over a six-month period. Conclusions The ADAPT system combines the influential

  5. Rate of cardiac arrhythmias and silent brain lesions in experienced marathon runners: rationale, design and baseline data of the Berlin Beat of Running study

    Directory of Open Access Journals (Sweden)

    Haeusler Karl

    2012-08-01

    Full Text Available Abstract Background Regular exercise is beneficial for cardiovascular health but a recent meta-analysis indicated a relationship between extensive endurance sport and a higher risk of atrial fibrillation, an independent risk factor for stroke. However, data on the frequency of cardiac arrhythmias or (clinically silent brain lesions during and after marathon running are missing. Methods/ Design In the prospective observational “Berlin Beat of Running” study experienced endurance athletes underwent clinical examination (CE, 3 Tesla brain magnetic resonance imaging (MRI, carotid ultrasound imaging (CUI and serial blood sampling (BS within 2-3 days prior (CE, MRI, CUI, BS, directly after (CE, BS and within 2 days after (CE, MRI, BS the 38th BMW BERLIN-MARATHON 2011. All participants wore a portable electrocardiogram (ECG-recorder throughout the 4 to 5 days baseline study period. Participants with pathological MRI findings after the marathon, troponin elevations or detected cardiac arrhythmias will be asked to undergo cardiac MRI to rule out structural abnormalities. A follow-up is scheduled after one year. Results Here we report the baseline data of the enrolled 110 athletes aged 36-61 years. Their mean age was 48.8 ± 6.0 years, 24.5% were female, 8.2% had hypertension and 2.7% had hyperlipidaemia. Participants have attended a mean of 7.5 ± 6.6 marathon races within the last 5 years and a mean of 16 ± 36 marathon races in total. Their weekly running distance prior to the 38th BMW BERLIN-MARATHON was 65 ± 17 km. Finally, 108 (98.2% Berlin Beat-Study participants successfully completed the 38th BMW BERLIN-MARATHON 2011. Discussion Findings from the “Berlin Beats of Running” study will help to balance the benefits and risks of extensive endurance sport. ECG-recording during the marathon might contribute to identify athletes at risk for cardiovascular events. MRI results will give new insights into the link

  6. Atraumatic extractions: a biomechanical rationale.

    Science.gov (United States)

    Misch, Carl E; Perez, Helena M

    2008-08-01

    Biomechanical aspects of force have been applied to tooth extraction for centuries. However, the mechanical advantages available to extract the teeth were primarily applied to hold the crown of the tooth, rather than help extract it. An extraction device (Physics Forceps) has been developed to apply a biomechanical rationale to the extraction process of a tooth using a class 1 lever, creep, and shear components of force. PMID:18717405

  7. Immediate CAD/ CAM Custom Fabricated Dental Implants

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    Jafar Kolahi

    2010-11-01

    Full Text Available Introduction: There will almost always be gaps between cylin-drical or screw shaped prefabricated implant surface and funnel-shaped tooth socket when an implant is placed immediately after tooth extraction. Hence expensive and difficult bone grafting is re-quired. A custom fabricated implant will be a pragmatic solution for this limitation.The hypothesis: First step following extraction of a tooth is data capture or scanning via a 3D scan method e.g. coordinate measuring machine or non-contact laser scanners such as triangulation range finder. Second step is reconstruction or modeling via editable CAD (computer-aided design model, allowing us to add retentive holes and correction of implant angle. Third step is fabrication via CAM (computer aided manufacturing followed by plasma cleaning process. Fourth step is insertion of the CAD/CAM custom fabricated one-stage implant in the fresh tooth socket. Optimal time for this step is 24-48 hours after extraction. The custom fabricated implant should not load 3-4 months. Usage of chlorhexidine mouth-rinse or chewing gum twice daily for 2 weeks and, in some cases oral antibiotic is recommended. Evaluation of the hypothesis: Contemporary dental implant system faced with several clinical and anatomical limitations such is low sinuses or nerve bundles. Complex and expensive surgical procedures such as nerve repositioning and sinus lift are frequently required. With custom fabricated implant we can overcome several of these limitations because insertion of custom fabricated implant will perform before alveolar bone recession.

  8. Comparative evaluation of RetCam vs. gonioscopy images in congenital glaucoma

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    Raj V Azad

    2014-01-01

    Full Text Available Purpose: To compare clarity, exposure and quality of anterior chamber angle visualization in congenital glaucoma patients, using RetCam and indirect gonioscopy images. Design: Cross-sectional study Participants. Congenital glaucoma patients over age of 5 years. Materials and Methods: A prospective consecutive pilot study was done in congenital glaucoma patients who were older than 5 years. Methods used are indirect gonioscopy and RetCam imaging. Clarity of the image, extent of angle visible and details of angle structures seen were graded for both methods, on digitally recorded images, in each eye, by two masked observers. Outcome Measures: Image clarity, interobserver agreement. Results: 40 eyes of 25 congenital glaucoma patients were studied. RetCam image had excellent clarity in 77.5% of patients versus 47.5% by gonioscopy. The extent of angle seen was similar by both methods. Agreement between RetCam and gonioscopy images regarding details of angle structures was 72.50% by observer 1 and 65.00% by observer 2. Conclusions: There was good agreement between RetCam and indirect gonioscopy images in detecting angle structures of congenital glaucoma patients. However, RetCam provided greater clarity, with better quality, and higher magnification images. RetCam can be a useful alternative to gonioscopy in infants and small children without the need for general anesthesia.

  9. Combination therapy with dutasteride and tamsulosin in men with moderate-to-severe benign prostatic hyperplasia and prostate enlargement: the CombAT (Combination of Avodart and Tamsulosin) trial rationale and study design.

    Science.gov (United States)

    Siami, Paul; Roehrborn, Claus G; Barkin, Jack; Damiao, Ronaldo; Wyczolkowski, Marek; Duggan, Annette; Major-Walker, Kim; Morrill, Betsy B

    2007-11-01

    Benign prostatic hyperplasia (BPH) is a highly prevalent condition in aging men, which can be progressive and lead to acute urinary retention (AUR) and the need for surgery. It is commonly treated with alpha-blockers and 5alpha-reductase inhibitors (5ARIs), both of which improve the symptoms of BPH. Long-term treatment with 5ARIs can also reduce the risk of developing AUR and the need for surgery. The landmark Medical Therapy of Prostatic Symptoms (MTOPS) trial demonstrated that over 4 years the combination of the type 2-specific 5ARI, finasteride and the alpha-blocker doxazosin was more effective than either agent alone in reducing overall clinical progression. Since the initiation of MTOPS, it has been shown that patients with larger prostates and higher prostate-specific antigen (PSA) levels are at greater risk of BPH progression, and are therefore arguably more likely to benefit from combination therapy. The Combination of Avodart and Tamsulosin (CombAT) trial is a 4-year, global, multicenter, randomized, double-blind, parallel-group study designed to investigate the benefits of combination therapy with the dual 5ARI dutasteride and the alpha-blocker tamsulosin compared with each monotherapy in improving symptoms and long-term outcomes in men with moderate-to-severe symptoms of BPH and prostate enlargement. Symptoms and long-term outcomes (AUR and surgery) will be assessed as separate primary endpoints at 2 and 4 years, respectively. Eligible patients were at least 50 years old with prostate volume > or =30 cm(3) and PSA level > or =1.5 ng/mL. A total of 4838 subjects have been enrolled. This paper describes the rationale, design and baseline data of the CombAT study. PMID:17761460

  10. Accuracy and safety of second-generation PillCam COLON capsule for colorectal polyp detection

    OpenAIRE

    Spada, Cristiano; De Vincentis, Fabio; Cesaro, Paola; Hassan, Cesare; Riccioni, Maria Elena; Minelli Grazioli, Leonardo; Bolivar, Santiago; Zurita, Andrade; Costamagna, Guido

    2012-01-01

    PillCam COLON capsule endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) is one of the most recent diagnostic, endoscopic technologies designed to explore the colon. CCE is a noninvasive, patient-friendly technique that is able to explore the colon without requiring sedation and air insufflation. The first generation of CCE was released onto the market in 2006 and although it generated great enthusiasm, it showed suboptimal accuracy. Recently, a second-generation system (PillCam COLON 2) (C...

  11. Complete denture fabrication supported by CAD/CAM.

    Science.gov (United States)

    Wimmer, Timea; Gallus, Korbinian; Eichberger, Marlis; Stawarczyk, Bogna

    2016-05-01

    The inclusion of computer-aided design/computer-aided manufacturing (CAD/CAM) technology into complete denture fabrication facilitates the procedures. The presented workflow for complete denture fabrication combines conventional and digitally supported treatment steps for improving dental care. With the presented technique, the registration of the occlusal plane, the determination of the ideal lip support, and the verification of the maxillomandibular relationship record are considered. PMID:26774323

  12. Development of a Feature Based CAM System for Rotational Parts

    OpenAIRE

    Yakup YILDIZ; İhsan KORKUT; ŞEKER, Ulvi

    2010-01-01

    Computer Aided Process Planning (CAPP) plays an  important role in the development of Computer Integrated Manufacturing systems (CIM) and provides a vital link  between Computer Aided Design (CAD) and Computer Aided Manufacturing (CAM). Automatic extraction and recognition of part features directly from a CAD database also strengthen the link between CAD and CAPP. In this study, an automatic feature recognition and CNC code generation (AFR/ACCG) system  was developed for rotati...

  13. Rationale of Early Adopters of Fossil Fuel Divestment

    Science.gov (United States)

    Beer, Christopher Todd

    2016-01-01

    Purpose: This research uses the social science perspectives of institutions, ecological modernization and social movements to analyze the rationale used by the early-adopting universities of fossil fuel divestment in the USA. Design/methodology/approach: Through analysis of qualitative data from interviews with key actors at the universities that…

  14. Rationale and Design of the 'MITOCARE' Study

    DEFF Research Database (Denmark)

    Jensen, Svend Eggert

    2012-01-01

    Treatment of acute ST-elevation myocardial infarction (STEMI) by reperfusion using percutaneous coronary intervention (PCI) or thrombolysis has provided clinical benefits; however, it also induces considerable cell death. This process is called reperfusion injury. The continuing high rates of...... resonance). The study is being financed under an EU-FP7 grant and conducted under the auspices of the MITOCARE research consortium, which includes experts from clinical and basic research centers, as well as commercial enterprises, throughout Europe. Results from this study will contribute to a better...

  15. Design and rationale for the PREVAIL study

    DEFF Research Database (Denmark)

    Klausen, Susanne Hwiid; Mikkelsen, Ulla Ramer; Hirth, Asle;

    2012-01-01

    Intensive exercise may be an important part of rehabilitation in patients with congenital heart disease (CHD). However, performing regular physical exercise is challenging for many adolescent patients. Consequently, effective exercise encouragements may be needed. Little is known on the effect of e......:1 randomized to an intervention group or a control group. Individually fully automated tailored e-Health encouragements--SMS, Internet, and mobile applications--aimed at increasing physical activity are delivered to the participants in the intervention group once a week. The Bandura's Social Cognitive Theory......-Health encouragements on physical fitness, physical activity, and health-related quality of life in adolescents. This trial is a nationwide interactive e-Health rehabilitation study lasting 1 year, centered on interactive use of mobile phone and Internet technology. We hypothesize that e-Health encouragements and...

  16. CAD/CAM-mathematical models and information processing. CAD/CAM-sugaku model to joho shori

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, F. (The Univ. of Tokyo, Tokyo (Japan). Research center for advanced Science and Technology)

    1990-09-05

    Works concerning industrial product design and production design are comprehensive works and it is said that its technique has not been systematized and there are many aspects of relying on human creativity and experience in the past. On the other hand, technological theories are the works of analysis and have well been developed based upon scientific academic systems. In the field of designing, standardized design procedures, etc. have been enciphered and its computerized automation has been progressed, but in normal design works including new design to a certain extent, its design procedures cannot be made as mathematical models, consequently its automation is obliged to base on an information processing model. The models which can express comprehensively all technical information concerning products necessary for design and production of industrial products are called product models. In this article, product modelling is roughly explained and the features of numerical models in CAD/CAM (computer assisted automation of mechanical design and production) are discussed taking geometrical modelling as a subject for discussion. 5 refs., 4 figs.

  17. CAM Photosynthesis in Submerged Aquatic Plants

    Science.gov (United States)

    Keeley, J.E.

    1998-01-01

    Crassulacean acid metabolism (CAM) is a CO2-concentrating mechanism selected in response to aridity in terrestrial habitats, and, in aquatic environments, to ambient limitations of carbon. Evidence is reviewed for its presence in five genera of aquatic vascular plants, including Isoe??tes, Sagittaria, Vallisneria, Crassula, and Littorella. Initially, aquatic CAM was considered by some to be an oxymoron, but some aquatic species have been studied in sufficient detail to say definitively that they possess CAM photosynthesis. CO2-concentrating mechanisms in photosynthetic organs require a barrier to leakage; e.g., terrestrial C4 plants have suberized bundle sheath cells and terrestrial CAM plants high stomatal resistance. In aquatic CAM plants the primary barrier to CO2 leakage is the extremely high diffusional resistance of water. This, coupled with the sink provided by extensive intercellular gas space, generates daytime CO2(Pi) comparable to terrestrial CAM plants. CAM contributes to the carbon budget by both net carbon gain and carbon recycling, and the magnitude of each is environmentally influenced. Aquatic CAM plants inhabit sites where photosynthesis is potentially limited by carbon. Many occupy moderately fertile shallow temporary pools that experience extreme diel fluctuations in carbon availability. CAM plants are able to take advantage of elevated nighttime CO2 levels in these habitats. This gives them a competitive advantage over non-CAM species that are carbon starved during the day and an advantage over species that expend energy in membrane transport of bicarbonate. Some aquatic CAM plants are distributed in highly infertile lakes, where extreme carbon limitation and light are important selective factors. Compilation of reports on diel changes in titratable acidity and malate show 69 out of 180 species have significant overnight accumulation, although evidence is presented discounting CAM in some. It is concluded that similar proportions of the aquatic

  18. Study design and rationale for investigating phosphodiesterase type 5 inhibition for the treatment of pulmonary hypertension due to chronic obstructive lung disease: the TADA-PHiLD (TADAlafil for Pulmonary Hypertension associated with chronic obstructive Lung Disease) trial.

    Science.gov (United States)

    Maron, Bradley A; Goldstein, Ronald H; Rounds, Sharon I; Shapiro, Shelley; Jankowich, Matthew; Garshick, Eric; Moy, Marilyn L; Gagnon, David; Choudhary, Gaurav

    2013-12-01

    In patients with chronic obstructive pulmonary disease (COPD), moderate or severe pulmonary hypertension (COPD-PH) is associated with increased rates of morbidity and mortality. Despite this, approaches to treatment and the efficacy of phosphodiesterase type 5 inhibition (PDE-5i) in COPD-PH are unresolved. We present the clinical rationale and study design to assess the effect of oral tadalafil on exercise capacity, cardiopulmonary hemodynamics, and clinical outcome measures in COPD-PH patients. Male and female patients 40-85 years old with GOLD stage 2 COPD or higher and pulmonary hypertension diagnosed on the basis of invasive cardiac hemodynamic assessment (mean pulmonary artery pressure [mPAP] >30 mmHg, pulmonary vascular resistance [PVR] >2.5 Wood units, and pulmonary capillary wedge pressure ≤18 mmHg at rest) will be randomized at a 1∶1 ratio to receive placebo or oral PDE-5i with tadalafil (40 mg daily for 12 months). The primary end point is change from baseline in 6-minute walk distance at 12 months. The secondary end points are change from baseline in PVR and mPAP at 6 months and change from baseline in peak volume of oxygen consumption ([Formula: see text]) during exercise at 12 months. Changes in systemic blood pressure and/or oxyhemoglobin saturation (Sao2) at rest and during exercise will function as safety outcome measures. TADA-PHiLD (TADAlafil for Pulmonary Hypertension assocIated with chronic obstructive Lung Disease) is the first sufficiently powered randomized clinical trial testing the effect of PDE-5i on key clinical and drug safety outcome measures in patients with at least moderate PH due to COPD. PMID:25006405

  19. Rationale, design, and baseline findings from HIPP: A randomized controlled trial testing a home-based, individually-tailored physical activity print intervention for African American women in the Deep South.

    Science.gov (United States)

    Pekmezi, Dori; Ainsworth, Cole; Joseph, Rodney; Bray, Molly S; Kvale, Elizabeth; Isaac, Shiney; Desmond, Renee; Meneses, Karen; Marcus, Bess; Demark-Wahnefried, Wendy

    2016-03-01

    African American women report high rates of physical inactivity and related health disparities. In our previous formative research, we conducted a series of qualitative assessments to examine physical activity barriers and intervention preferences among African American women in the Deep South. These data were used to inform a 12-month Home-based, Individually-tailored Physical activity Print (HIPP) intervention, which is currently being evaluated against a wellness contact control condition among 84 post-menopausal African American women residing in the metropolitan area of Birmingham, Alabama. This paper reports the rationale, design and baseline findings of the HIPP trial. The accrued participants had an average age of 57 (SD=4.7), a BMI of 32.1kg/m(2) (SD=5.16) with more than half (55%) having a college education and an annual household income under $50,000 (53.6%). At baseline, participants reported an average of 41.5min/week (SD=49.7) of moderate intensity physical activity, and 94.1% were in the contemplation or preparation stages of readiness for physical activity. While social support for exercise from friends and family was low, baseline levels of self-efficacy, cognitive and behavioral processes of change, decisional balance, outcome expectations, and enjoyment appeared promising. Baseline data indicated high rates of obesity and low levels of physical activity, providing strong evidence of need for intervention. Moreover, scores on psychosocial measures suggested that such efforts may be well received. This line of research in technology-based approaches for promoting physical activity in African American women in the Deep South has great potential to address health disparities and impact public health. PMID:26944022

  20. A Space Cam Mechanism for Power Transmission of an Opposite-cylinder Piston Engine

    Directory of Open Access Journals (Sweden)

    Zhang Haoyue

    2015-01-01

    Full Text Available For the purpose of improving the engine’s power density, we put forward a new type of power transmission mechanism which is used for opposed-cylinder engine. The gas pressure acts on the cam through the piston and push rod, and the spindle rotation of external is driven by the cam. The design of spatial cam work surface is completed by using the enveloping theory of a family of space curves, the force between roller and cam is analyzed using dynamic analysis software. Under the condition of equal number, size and stroke of piston, the new one with larger power density is more compact in structure than the traditional power transmission mechanism, and the reaction force on either side of the main shaft and the acting force between pistons and cylinders are smaller than those in traditional one, which prolongs the service life of the pistons.

  1. A Unique Opportunity for an Intercultural Discussion on CAM and Liver Disease

    Directory of Open Access Journals (Sweden)

    Francesco Marotta

    2005-01-01

    Full Text Available The meeting of the APASL, Asian Pacific Association for the Study of the Liver, was held in December 2004, in New Delhi, India. The meeting was held under the patronage of the APASL Committee and Board of Presidents of the National Liver Association and in conjunction with the annual conference of the Indian Association for the Study of Liver (INASL. The congress was designed to have a core meeting with three parallel sessions running throughout, dedicated research workshops and intensive breakfast sessions. This report concentrates on the two sessions devoted to complementary and alternative medicine (CAM and shows the latest research in CAM for liver disease and the concerns of doctors about integrating CAM with more traditional treatments. With researchers and practitioners gathering from all over the world, it was a unique opportunity for an intercultural discussion on CAM and liver disease.

  2. Commissioning and First Observations with Wide FastCam at the Telescopio Carlos S\\'anchez

    CERN Document Server

    Velasco, Sergio; Oscoz, Alejandro; López, Roberto L; Puga, Marta; Murga, Gaizka; Pérez-Garrido, Antonio; Pallé, Enric; Ricci, Davide; Ayuso, Ismael; Hernández-Sánchez, Mónica; Truant, Nicola

    2016-01-01

    The FastCam instrument platform, jointly developed by the IAC and the UPCT, allows, in real-time, acquisition, selection and storage of images with a resolution that reaches the diffraction limit of medium-sized telescopes. FastCam incorporates a specially designed software package to analyse series of tens of thousands of images in parallel with the data acquisition at the telescope. Wide FastCam is a new instrument that, using the same software for data acquisition, does not look for lucky imaging but fast observations in a much larger field of view. Here we describe the commissioning process and first observations with Wide FastCam at the Telescopio Carlos S\\'anchez (TCS) in the Observatorio del Teide.

  3. A pragmatic cluster randomised controlled trial to evaluate the safety, clinical effectiveness, cost effectiveness and satisfaction with point of care testing in a general practice setting – rationale, design and baseline characteristics

    Directory of Open Access Journals (Sweden)

    Glastonbury Briony

    2008-08-01

    Full Text Available Abstract Background Point of care testing (PoCT may be a useful adjunct in the management of chronic conditions in general practice (GP. The provision of pathology test results at the time of the consultation could lead to enhanced clinical management, better health outcomes, greater convenience and satisfaction for patients and general practitioners (GPs, and savings in costs and time. It could also result in inappropriate testing, increased consultations and poor health outcomes resulting from inaccurate results. Currently there are very few randomised controlled trials (RCTs in GP that have investigated these aspects of PoCT. Design/Methods The Point of Care Testing in General Practice Trial (PoCT Trial was an Australian Government funded multi-centre, cluster randomised controlled trial to determine the safety, clinical effectiveness, cost effectiveness and satisfaction of PoCT in a GP setting. The PoCT Trial covered an 18 month period with the intervention consisting of the use of PoCT for seven tests used in the management of patients with diabetes, hyperlipidaemia and patients on anticoagulant therapy. The primary outcome measure was the proportion of patients within target range, a measure of therapeutic control. In addition, the PoCT Trial investigated the safety of PoCT, impact of PoCT on patient compliance to medication, stakeholder satisfaction, cost effectiveness of PoCT versus laboratory testing, and influence of geographic location. Discussion The paper provides an overview of the Trial Design, the rationale for the research methodology chosen and how the Trial was implemented in a GP environment. The evaluation protocol and data collection processes took into account the large number of patients, the broad range of practice types distributed over a large geographic area, and the inclusion of pathology test results from multiple pathology laboratories. The evaluation protocol developed reflects the complexity of the Trial setting

  4. Cad/cam-tekniikan kannattavuus hammastekniikassa

    OpenAIRE

    Kinnunen, Vilho

    2012-01-01

    Hammaslaboratorioissa tehdään cad/cam-tekniikalla kiinteän protetiikan töitä. Opinnäytetyössäni tarkastelen, kuinka kannattavaa on valmistaa jyrsintekniikalla kiinteän protetiikan valmisteita. Selvitän millainen cad/cam-tekniikkaa käyttävä yritys pitää olla, jotta se on kannattava. Opinnäytetyöni aineiston keruun tein haastattelemalla cad/cam tekniikkaa ja perinteistä tekniikkaa käyttävien hammaslaboratorioiden omistajia. Haastattelun toteutin teemahaastatteluna. Kehitin laajuuskäsitteen,...

  5. CAM Stochastic Volatility Model for Option Pricing

    Directory of Open Access Journals (Sweden)

    Wanwan Huang

    2016-01-01

    Full Text Available The coupled additive and multiplicative (CAM noises model is a stochastic volatility model for derivative pricing. Unlike the other stochastic volatility models in the literature, the CAM model uses two Brownian motions, one multiplicative and one additive, to model the volatility process. We provide empirical evidence that suggests a nontrivial relationship between the kurtosis and skewness of asset prices and that the CAM model is able to capture this relationship, whereas the traditional stochastic volatility models cannot. We introduce a control variate method and Monte Carlo estimators for some of the sensitivities (Greeks of the model. We also derive an approximation for the characteristic function of the model.

  6. Tooth-colored CAD/CAM monolithic restorations.

    Science.gov (United States)

    Reich, S

    2015-01-01

    A monolithic restoration (also known as a full contour restoration) is one that is manufactured from a single material for the fully anatomic replacement of lost tooth structure. Additional staining (followed by glaze firing if ceramic materials are used) may be performed to enhance the appearance of the restoration. For decades, monolithic restoration has been the standard for inlay and partial crown restorations manufactured by both pressing and computer-aided design and manufacturing (CAD/CAM) techniques. A limited selection of monolithic materials is now available for dental crown and bridge restorations. The IDS (2015) provided an opportunity to learn about and evaluate current trends in this field. In addition to new developments, established materials are also mentioned in this article to complete the picture. In line with the strategic focus of the IJCD, the focus here is naturally on CAD/CAM materials. PMID:26110926

  7. Understanding dental CAD/CAM for restorations--accuracy from a mechanical engineering viewpoint.

    Science.gov (United States)

    Tapie, Laurent; Lebon, Nicolas; Mawussi, Bernardin; Fron-Chabouis, Hélène; Duret, Francois; Attal, Jean-Pierre

    2015-01-01

    As is the case in the field of medicine, as well as in most areas of daily life, digital technology is increasingly being introduced into dental practice. Computer-aided design/ computer-aided manufacturing (CAD/CAM) solutions are available not only for chairside practice but also for creating inlays, crowns, fixed partial dentures (FPDs), implant abutments, and other dental prostheses. CAD/CAM dental practice can be considered as the handling of devices and software processing for the almost automatic design and creation of dental restorations. However, dentists who want to use dental CAD/CAM systems often do not have enough information to understand the variations offered by such technology practice. Knowledge of the random and systematic errors in accuracy with CAD/CAM systems can help to achieve successful restorations with this technology, and help with the purchasing of a CAD/CAM system that meets the clinical needs of restoration. This article provides a mechanical engineering viewpoint of the accuracy of CAD/ CAM systems, to help dentists understand the impact of this technology on restoration accuracy. PMID:26734668

  8. A computer-aided software engineering toolkit for the integration of CAD/CAM application software in a network environment

    OpenAIRE

    Grieshaber, Michele Marie

    1991-01-01

    Much progress has been made in recent years in the development of Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM) tools for engineering design, analysis, and manufacturing. Unfortunately, most of these CAD/CAM applications were constructed independently and without standardization. In essence, they automate a single aspect of design, analysis, or manufacturing and cannot be combined to form a cohesive environment, since integration among applications was not addressed during ...

  9. Development and some applications of general purpose CAD/CAM/CAE system -IMAGE-

    International Nuclear Information System (INIS)

    General purpose CAD/CAM/CAE system, named IMAGE (Interactive Modeling Aids for Graphics in Engineering), has been developed. This system is composed of several subsystems. Two modeling types are available, one is a wire frame model and the other is a surface model. CAD subsystems for drawings, piping and preliminary design, CAM subsystems for NC programming/nesting and CAE subsystems for FEM preprocessing are described. Three applications are described. The first application field is the boiler plant design, the second one the nuclear equipment engineering design and the third one the industrial machinery design. (author)

  10. CYP2C19 genotype-guided antiplatelet therapy in ST-segment elevation myocardial infarction patients-Rationale and design of the Patient Outcome after primary PCI (POPular) Genetics study

    NARCIS (Netherlands)

    Bergmeijer, Thomas O.; Janssen, Paul W.A.; Schipper, Jurjan C.; Qaderdan, Khalid; Ishak, Maycel; Ruitenbeek, Rianne S.; Asselbergs, Folkert W.; van 't Hof, Arnoud W.J.; Dewilde, Willem J.M.; Spanó, Fabrizio; Herrman, Jean-Paul R.; Kelder, Johannes C.; Postma, Maarten J.; de Boer, Anthonius; Deneer, Vera H.M.; ten Berg, Jurriën M.

    2014-01-01

    RATIONALE: In patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (pPCI), the use of dual antiplatelet therapy is essential to prevent atherothrombotic complications. Therefore, patients are treated with acetylsalicylic acid and clo

  11. Ticagrelor or prasugrel versus clopidogrel in elderly patients with an acute coronary syndrome: Optimization of antiplatelet treatment in patients 70years and older-rationale and design of the POPular AGE study

    NARCIS (Netherlands)

    Qaderdan, K.; Ishak, M.; Heestermans, A.A.; Vrey, E. de; Jukema, J.W.; Voskuil, M.; Boer, M.J. de; Hof, A.W.J.; Groenemeijer, B.E.; Vos, G.J.; Janssen, P.W.; Bergmeijer, T.O.; Kelder, J.C.; Deneer, V.H.; Berg, J.M. van den

    2015-01-01

    RATIONALE: Dual antiplatelet therapy with acetylsalicylic acid in combination with a more potent P2Y12- inhibitor (ticagrelor or prasugrel) is recommended in patients with acute coronary syndrome without ST-segment elevation (NSTE-ACS) to prevent atherothrombotic complications. The evidence on which

  12. Ticagrelor or prasugrel versus clopidogrel in elderly patients with an acute coronary syndrome : Optimization of antiplatelet treatment in patients 70years and older-rationale and design of the POPular AGE study

    NARCIS (Netherlands)

    Qaderdan, Khalid; Ishak, Maycel; Heestermans, Antonius A C M; de Vrey, Evelyn; Jukema, J Wouter; Voskuil, Michiel; de Boer, Menko-Jan; Van't Hof, Arnoud W J; Groenemeijer, Björn E; Vos, Gerrit-Jan A; Janssen, Paul W A; Bergmeijer, Thomas O; Kelder, Johannes C; Deneer, Vera H M; Ten Berg, Jurriën M

    2015-01-01

    RATIONALE: Dual antiplatelet therapy with acetylsalicylic acid in combination with a more potent P2Y12- inhibitor (ticagrelor or prasugrel) is recommended in patients with acute coronary syndrome without ST-segment elevation (NSTE-ACS) to prevent atherothrombotic complications. The evidence on which

  13. Firms' Rationales for Interaction with Research Universities

    OpenAIRE

    Broström, Anders

    2008-01-01

    R&D managers at 50 firms randomly selected from all firms who have formal relations with two research universities in Stockholm are being interviewed about their rationales for collaboration. Drawing on this material, a distinctive typology of rationales and the therewith associated effects from cooperative relations is presented. As expected, rationales related to innovation, in terms of invented or improved products or processes, are found to be the main drivers for interaction. As regards ...

  14. AFSC/FMA/CAMS Data Objects

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The CAMS system consists of a set of tables and packages that provide authentication services to all other North Pacific Groundfish and Halibut Observing Program...

  15. Radiometric Calibration for AgCam

    OpenAIRE

    Edward Hildum; Lianbo Hu; Hojin Kim; Xiaodong Zhang; Changyong Dou; Doug Olsen

    2010-01-01

    The student-built Agricultural Camera (AgCam) now onboard the International Space Station observes the Earth surface through two linescan cameras with Charge-Coupled Device (CCD) arrays sensitive to visible and near-infrared wavelengths, respectively. The electro-optical components of the AgCam were characterized using precision calibration equipment; a method for modeling and applying these measurements was derived. Correction coefficients to minimize effects of optical vignetting, CCD non-u...

  16. Physics rationale for the engineering specifications for ZTH

    International Nuclear Information System (INIS)

    This report presents the physics rationale that established the engineering design of ZTH. The physics criteria are given and the implications regarding the engineering design are presented. Experimental and theoretical background evidence is given in support of the criteria but the justification is left to other reports and peer reviews. The physics criteria discussed here are limited to the ones deemed to be of highest engineering priority. 32 refs., 9 figs

  17. CAD/CAM at a Distance: Assessing the Effectiveness of Web-Based Instruction To Meet Workforce Development Needs. AIR 2000 Annual Forum Paper.

    Science.gov (United States)

    Wilkerson, Joyce A.; Elkins, Susan A.

    This qualitative case study assessed web-based instruction in a computer-aided design/computer-assisted manufacturing (CAD/CAM) course designed for workforce development. The study examined students' and instructors' experience in a CAD/CAM course delivered exclusively on the Internet, evaluating course content and delivery, clarity of…

  18. Statistical Shape Modeling of Cam Femoroacetabular Impingement

    Energy Technology Data Exchange (ETDEWEB)

    Harris, Michael D.; Dater, Manasi; Whitaker, Ross; Jurrus, Elizabeth R.; Peters, Christopher L.; Anderson, Andrew E.

    2013-10-01

    In this study, statistical shape modeling (SSM) was used to quantify three-dimensional (3D) variation and morphologic differences between femurs with and without cam femoroacetabular impingement (FAI). 3D surfaces were generated from CT scans of femurs from 41 controls and 30 cam FAI patients. SSM correspondence particles were optimally positioned on each surface using a gradient descent energy function. Mean shapes for control and patient groups were defined from the resulting particle configurations. Morphological differences between group mean shapes and between the control mean and individual patients were calculated. Principal component analysis was used to describe anatomical variation present in both groups. The first 6 modes (or principal components) captured statistically significant shape variations, which comprised 84% of cumulative variation among the femurs. Shape variation was greatest in femoral offset, greater trochanter height, and the head-neck junction. The mean cam femur shape protruded above the control mean by a maximum of 3.3 mm with sustained protrusions of 2.5-3.0 mm along the anterolateral head-neck junction and distally along the anterior neck, corresponding well with reported cam lesion locations and soft-tissue damage. This study provides initial evidence that SSM can describe variations in femoral morphology in both controls and cam FAI patients and may be useful for developing new measurements of pathological anatomy. SSM may also be applied to characterize cam FAI severity and provide templates to guide patient-specific surgical resection of bone.

  19. Chiropractic and CAM Utilization: A Descriptive Review

    Directory of Open Access Journals (Sweden)

    Meeker William C

    2007-01-01

    Full Text Available Abstract Objective To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Sources A literature of PubMed and MANTIS was performed using the key terms Chiropractic; Low Back Pain; Utilization Rate; Use Rate; Complementary and Alternative Medicine; and Health Services in various combinations. Data Selection A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form. Results Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

  20. Morphing Mechanisms Part 1: Using Iterative Learning Control to Morph Cam Follower Motion

    Directory of Open Access Journals (Sweden)

    Nonglak Phetkong

    2005-01-01

    Full Text Available This study introduces the concept of morphing mechanisms. Mechanisms are normally designed for specific operating conditions and once they are built one may wish to use them under different operating conditions. In some cases, a mechanism may be imperfectly fabricated and one would like to get the intended ideal performance. In these cases, instead of designing, fabricating and replacing the original mechanism, the behavior of the existing hardware can be morphed to make it function as if it was the redesigned or re-fabricated system. This concept is illustrated in both simulation and experiments for cam mechanisms. Iterative learning control is used on a cam designed and built using a 2-3 polynomial profile and it is made to function like a cam designed with a 3-4-5 polynomial. Eight cycles of learning are seen to be sufficient to effectively accomplish this morphing of the calm behavior.

  1. Integration of CAM and CNC operation through code editing and manipulation

    International Nuclear Information System (INIS)

    The IT technology for engineering design and manufacturing has gone through significant advancement for the last 30 years. It is widely acknowledged that IT would provide competitive advantage for engineering company in term of production cycle, productivity and efficiency. The recent development in this area is on the total system integration. While standard off-shelf CAD/CAM/CNC software and hardware packages would provide solution for system integration, more often than not users will stumble upon compatibility problems. Moreover, most of the integration deals with CAD and CAM systems. CNC integration has not been fully developed. Users always found problems in the integration of CAM and CNC machine due to the different level of technological development. CNC codes have not fundamentally progressed in the last 50 years, while CAD/CAM software packages have undergone massive evolution and improvement. This paper discusses a practical solution of CAM and CNC integration through code editing and manipulation within the CAM system in order to comply with the CNC machine requirements. (Author)

  2. Status of the NectarCAM camera project

    OpenAIRE

    Barrio Uña, Juan Abel; Herranz, D.; Tejedor, L. A.

    2014-01-01

    NectarCAM is a camera designed for the medium-sized telescopes of the Cherenkov Telescope Array (CTA) covering the central energy range 100 GeV to 30 TeV. It has a modular design based on the NECTAr chip, at the heart of which is a GHz sampling Switched Capacitor Array and 12-bit Analog to Digital converter. The camera will be equipped with 265 7-photomultiplier modules, covering a field of view of 7 to 8 degrees. Each module includes the photomultiplier bases, High Voltage supply, pre-amplif...

  3. Design and rationale of FOCUS (PX-171-011: A randomized, open-label, phase 3 study of carfilzomib versus best supportive care regimen in patients with relapsed and refractory multiple myeloma (R/R MM

    Directory of Open Access Journals (Sweden)

    Hájek Roman

    2012-09-01

    Full Text Available Abstract Background Carfilzomib is a next-generation proteasome inhibitor with single-agent activity in patients with relapsed and refractory multiple myeloma (R/R MM. In PX-171-003-A1, a single-arm phase 2 study of carfilzomib monotherapy in heavily pretreated patients, the overall response rate was 23.7%, 37% of patients achieved ≥ minimal response and median overall survival (OS was 15.6 months. Based on this study, carfilzomib was recently approved by the US Food and Drug Administration for the treatment of R/R MM. Herein we describe the trial design and rationale for a phase 3 randomized study, FOCUS (CarFilzOmib for AdvanCed Refractory MUltiple Myeloma European Study, being conducted to compare OS after treatment with single-agent carfilzomib to best supportive care (BSC regimen in R/R MM. Methods Patients must have received ≥3 prior regimens, must be responsive to at least 1 line of therapy, and be refractory to their most recent therapy. Eligible patients are randomized 1:1 to receive either carfilzomib (28-day cycles at 20 mg/m2 IV on Days 1–2 of Cycle 1, escalating to 27 mg/m2 IV on Days 8, 9, 15, and 16 and continuing at 27 mg/m2 through Cycle 9 and Days 1, 2, 15, and 16 ≥ Cycle 10 or an active BSC regimen (corticosteroid treatment of prednisolone 30 mg, dexamethasone 6 mg, or equivalent every other day with optional cyclophosphamide 50 mg PO once daily. Patients will continue treatment until disease progression, unacceptable toxicity, or treatment discontinuation and will then enter long-term follow-up for survival. The primary endpoint is OS and secondary endpoints include progression-free survival, overall response rate, and safety. Disease assessments will be determined according to the International Myeloma Working Group Uniform Response Criteria with minimal response per European Blood and Marrow Transplantation Group criteria. Conclusions This phase 3 trial will provide more rigorous data for carfilzomib, as

  4. Design and rationale of FOCUS (PX-171-011): A randomized, open-label, phase 3 study of carfilzomib versus best supportive care regimen in patients with relapsed and refractory multiple myeloma (R/R MM)

    International Nuclear Information System (INIS)

    Carfilzomib is a next-generation proteasome inhibitor with single-agent activity in patients with relapsed and refractory multiple myeloma (R/R MM). In PX-171-003-A1, a single-arm phase 2 study of carfilzomib monotherapy in heavily pretreated patients, the overall response rate was 23.7%, 37% of patients achieved ≥ minimal response and median overall survival (OS) was 15.6 months. Based on this study, carfilzomib was recently approved by the US Food and Drug Administration for the treatment of R/R MM. Herein we describe the trial design and rationale for a phase 3 randomized study, FOCUS (CarFilzOmib for AdvanCed Refractory MUltiple Myeloma European Study), being conducted to compare OS after treatment with single-agent carfilzomib to best supportive care (BSC) regimen in R/R MM. Patients must have received ≥3 prior regimens, must be responsive to at least 1 line of therapy, and be refractory to their most recent therapy. Eligible patients are randomized 1:1 to receive either carfilzomib (28-day cycles at 20 mg/m2 IV on Days 1–2 of Cycle 1, escalating to 27 mg/m2 IV on Days 8, 9, 15, and 16 and continuing at 27 mg/m2 through Cycle 9 and Days 1, 2, 15, and 16 ≥ Cycle 10) or an active BSC regimen (corticosteroid treatment of prednisolone 30 mg, dexamethasone 6 mg, or equivalent every other day with optional cyclophosphamide 50 mg PO once daily). Patients will continue treatment until disease progression, unacceptable toxicity, or treatment discontinuation and will then enter long-term follow-up for survival. The primary endpoint is OS and secondary endpoints include progression-free survival, overall response rate, and safety. Disease assessments will be determined according to the International Myeloma Working Group Uniform Response Criteria with minimal response per European Blood and Marrow Transplantation Group criteria. This phase 3 trial will provide more rigorous data for carfilzomib, as this is the first carfilzomib study with OS as the primary

  5. Proposal for providing integrated CAD/CAM in the DOE/NWC

    Energy Technology Data Exchange (ETDEWEB)

    Crowe, R.A.; Elliott, R.L.; Jones, J.F.; Kelly, J.C.

    1982-08-01

    This is a proposal for providing integrated Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) in the Department of Energy/Nuclear Weapons Complex (DOE/NWC). This plan was developed under the premise that commitment to this CAD/CAM Integration Plan will lead to improved use of DOE/NWC's limited resources. The Integration Plan consists of the development of a Design with recommended action, followed by implementation and maintenance plans. This report proposes a methodology for the development of the design.

  6. Safety and efficacy of intensive vs. guideline antiplatelet therapy in high‐risk patients with recent ischemic stroke or transient ischemic attack: rationale and design of the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial (ISRCTN47823388)

    OpenAIRE

    ,

    2015-01-01

    Rationale The risk of recurrence following a stroke or transient ischemic attack is high, especially immediately after the event. Hypothesis Because two antiplatelet agents are superior to one in patients with non‐cardioembolic events, more intensive treatment might be even more effective. Sample size estimates The sample size of 4100 patients will allow a shift to less recurrence, and less severe recurrence, to be detected (odds ratio 0·68) with 90% power at 5% significance. Methods and desi...

  7. Characterization of SynCAM surface trafficking using a SynCAM derived ligand with high homophilic binding affinity

    International Nuclear Information System (INIS)

    In order to better probe SynCAM function in neurons, we produced a fusion protein between the extracellular domain of SynCAM1 and the constant fragment of human IgG (SynCAM-Fc). Whether in soluble form or immobilized on latex microspheres, the chimera bound specifically to the surface of hippocampal neurons and recruited endogenous SynCAM molecules. SynCAM-Fc was also used in combination with Quantum Dots to follow the mobility of transfected SynCAM receptors at the neuronal surface. Both immobile and highly mobile SynCAM were found. Thus, SynCAM-Fc behaves as a high affinity ligand that can be used to study the function of SynCAM at the neuronal membrane

  8. An accelerated technique for a ceramic-pressed-to-metal restoration with CAD/CAM technology.

    Science.gov (United States)

    Lee, Ju-Hyoung

    2014-11-01

    The conventional fabrication of metal ceramic restorations depends on an experienced dental technician and requires a long processing time. However, complete-contour digital waxing and digital cutback with computer-aided design and computer-aided manufacturing (CAD/CAM) technology can overcome these disadvantages and provide a correct metal framework design and space for the ceramic material. PMID:24952883

  9. Research on A Parallel CAM-based Hardware System for Parallel Information Detection and Its Applications

    OpenAIRE

    Van Le, Duc

    2013-01-01

    Information Detection Hardware System plays an important role in search engines or matching systems such as text search, pattern match-ing, image matching, face detection and many others. The objective of this dissertation is to design an ultra-fast parallel information de-tector for search systems employing CAM and SHIFT circuits to en-hance search performance of the systems. This structure has not been proposed by other research works. CAM is designed basing on 2-port RAM blocks on FPGA. Th...

  10. Exploring the rationale of the process behind corporate sponsorships

    OpenAIRE

    Ystad, Sunniva G. Marchioro; Nygaard, Kaja Gjersem

    2012-01-01

    The purpose of this thesis was to examine and identify the process behind the delegation of corporate sponsorships in a Norwegian context. Corporate sponsorships are presently the third largest corporate communication channel in Norway. However, there is limited research on sponsorship management. The thesis seeks to identify the process and investigate the rationale behind it. To be able to research this, an explorative study was conducted, by means of a grounded theory design. First, a m...

  11. CAM practitioners in the Australian health workforce: an underutilized resource

    Directory of Open Access Journals (Sweden)

    Grace Sandra

    2012-11-01

    Full Text Available Abstract Background CAM practitioners are a valuable but underutilizes resource in Australian health care. Despite increasing public support for complementary and alternative medicine (CAM little is known about the CAM workforce. Apart from the registered professions of chiropractic, osteopathy and Chinese medicine, accurate information about the number of CAM practitioners in the workforce has been difficult to obtain. It appears that many non-registered CAM practitioners, although highly qualified, are not working to their full capacity. Discussion Increasing public endorsement of CAM stands in contrast to the negative attitude toward the CAM workforce by some members of the medical and other health professions and by government policy makers. The marginalisation of the CAM workforce is evident in prejudicial attitudes held by some members of the medical and other health professions and its exclusion from government policy making. Inconsistent educational standards has meant that non-registered CAM practitioners, including highly qualified and competent ones, are frequently overlooked. Legitimising their contribution to the health workforce could alleviate workforce shortages and provide opportunities for redesigned job roles and new multidisciplinary teams. Priorities for better utilisation of the CAM workforce include establishing a guaranteed minimum education standard for more CAM occupation groups through national registration, providing interprofessional education that includes CAM practitioners, developing courses to upgrade CAM practitioners' professional skills in areas of indentified need, and increasing support for CAM research. Summary Marginalisation of the CAM workforce has disadvantaged those qualified and competent CAM practitioners who practise evidence-informed medicine on the basis of many years of university training. Legitimising and expanding the important contribution of CAM practitioners could alleviate projected health

  12. Integrating conventional and CAD/CAM digital techniques for establishing canine protected articulation: A clinical report.

    Science.gov (United States)

    El Kerdani, Tarek; Nimmo, Arthur

    2016-05-01

    Canine protected articulation is widely accepted for patients requiring extensive oral rehabilitation. Computer-aided design and computer-aided manufacturing (CAD/CAM) restorations have been primarily designed in occlusion at the maximum intercuspal position. Designing a virtual articulator that is capable of accepting excursive occlusal records and duplicating the mandibular movements is a challenge for CAD/CAM technology. Modifying tooth shape using composite resin trial restorations to produce esthetic results and later scanning the modified teeth to create milled crowns is becoming a popular use of the CAD/CAM technology. This report describes a technique that combines conventional and CAD/CAM prosthodontic techniques for milling crowns for canine teeth that are designed to establish or improve canine protected articulation. This technique involves designing and fabricating interim restorations based on diagnostic waxing, scanning the designs intraorally, and storing them in software as pretreatment digital records. The scanned designs are then applied to the digital representation of the prepared teeth to fabricate the definitive restorations. PMID:26774319

  13. Paper-Less CAD/CAM For Accelerator Components

    Energy Technology Data Exchange (ETDEWEB)

    Franks, R M; Alford, O; Bertolini, L R

    2001-01-12

    Computer-aided design and manufacture (CAD/CAM) have enabled advances in the design and manufacture of many accelerator components, though government procurement rules tend to inhibit its use. We developed and executed a method that provides adequate documentation for the procurement process, industrial vendor manufacturing processes, and laboratory installation activities. We detail our experiences in the design and manufacture of 60 separate and unique PEP-II Low Energy Ring Interaction Region vacuum chambers totaling {approx} 140m in length as an example of how we used this technique, reducing design effort and manufacturing risk while streamlining the production process. We provide ''lessons learned'' to better implement and execute the process in subsequent iterations. We present our study to determine the estimated savings in the design and production of the Spallation Neutron Source room temperature linac if this process were utilized.

  14. Paper-Less CAD/CAM For Accelerator Components

    International Nuclear Information System (INIS)

    Computer-aided design and manufacture (CAD/CAM) have enabled advances in the design and manufacture of many accelerator components, though government procurement rules tend to inhibit its use. We developed and executed a method that provides adequate documentation for the procurement process, industrial vendor manufacturing processes, and laboratory installation activities. We detail our experiences in the design and manufacture of 60 separate and unique PEP-II Low Energy Ring Interaction Region vacuum chambers totaling ∼ 140m in length as an example of how we used this technique, reducing design effort and manufacturing risk while streamlining the production process. We provide ''lessons learned'' to better implement and execute the process in subsequent iterations. We present our study to determine the estimated savings in the design and production of the Spallation Neutron Source room temperature linac if this process were utilized

  15. FEAT-REP : representing features in CAD/CAM

    OpenAIRE

    Klauck, Christoph; Bernardi, Ansgar; Legleitner, Ralf

    1991-01-01

    When CAD/CAM experts view a workpiece, they perceive it in terms of their own expertise. These terms, called features, which are build upon a syntax (geometry) and a semantic (e.g. skeletal plans in manufacturing or functional relations in design), provide an abstraction mechanism to facilitate the creation, manufacturing and analysis of workpieces. Our goal is to enable experts to represent their own feature-language via a feature-grammar in the computer to build feature-based systems e.g. C...

  16. Cooling Tests of the NectarCAM camera for the Cherenkov Telescope Array

    CERN Document Server

    Moulin, E; Durand, D; Feirreira, O; Fesquet, M; Giebels, B; Glicenstein, J -F; Loiseau, D; Louis, F; Nunio, F; Rateau, S; consortia, CTA

    2015-01-01

    The NectarCAM is a camera proposed for the medium-sized telescopes in the framework of the Cherenkov Telescope Array (CTA), the next-generation observatory for very-high-energy gamma-ray astronomy. The cameras are designed to operate in an open environment and their mechanics must provide protection for all their components under the conditions defined for the CTA observatory. In order to operate in a stable environment and ensure the best physics performance, each NectarCAM will be enclosed in a slightly overpressurized, nearly air-tight, camera body, to prevent dust and water from entering. The total power dissipation will be ~7.7 kW for a 1855-pixel camera. The largest fraction is dissipated by the readout electronics in the modules. We present the design and implementation of the cooling system together with the test bench results obtained on the NectarCAM thermal demonstrator.

  17. Bilgisayar destekli diş hekimliği ve güncel CAD/CAM sistemleri

    Directory of Open Access Journals (Sweden)

    Gözde Çelik

    2013-01-01

    Full Text Available

    CAD/CAM systems (computer aided design/computer aided manufacturing has been used in dentistry since 1987. In the past 25 years, development of various high quality chairside and laboratory CAD/CAM systems has been continued with the progress of technology. This article describes currently used CAD/CAM systems.

    Keywords: Dental, CAD/CAM systems.

     

    ÖZET

    CAD/CAM sistemleri (bilgisayar destekli tasarım/bilgisayar destekli üretim diş hekimliğinde 1987 yılından beri kullanılmaktadır. Son 25 yılda teknolojinin de ilerlemesiyle üstün özellikte çeşitli klinik ve laboratuvar CAD/CAM sistemleri geliştirilmeye devam etmektedir. Bu makalede günümüzde kullanılan CAD/CAM sistemleri anlatılmaktadır.

  18. Who Should Benefit from REDD+? Rationales and Realities

    Directory of Open Access Journals (Sweden)

    Cecilia Luttrell

    2013-12-01

    Full Text Available Benefit-sharing mechanisms are a central design aspect of REDD+ because they help to create the necessary incentives to reduce carbon emissions. However, if stakeholders do not perceive the benefit sharing as fair, the legitimacy of REDD+, and support for the mechanism, will be weakened. In this paper, drawing on data from CIFOR's Global Comparative Study on REDD+, we analyze national policy processes in 6 countries and incipient benefit-sharing arrangements in 21 REDD+ project sites. Through our analysis of current practices and debates, we identify six rationales that have been put forward to justify how benefits should be distributed and to whom. These rationales encompass a range of perspectives. Some hold that benefit sharing should be related to actual carbon emission reductions or to costs incurred in achieving the reduction of emissions; others emphasize the importance of a legal right to benefit, the need to consider aspects such as poverty reduction or the appropriateness of rewarding those with a history of protecting the forest. Each rationale has implications for the design of benefit-sharing mechanisms and the equity of their outcomes. We point out that, given the wide range of rationales and interests at play, the objectives of REDD+ and benefit sharing must be clearly established and the term "benefit" defined before effective benefit-sharing mechanisms can be designed. For stakeholders to support REDD+, the legitimacy of decision-making institutions, consideration of context, and attention to process are critical. Building legitimacy requires attention not only to fair distributional outcomes but also to consensus on relevant institutions' authority to make decisions and to procedural equity.

  19. Bioethics: A Rationale and a Model

    Science.gov (United States)

    Barman, Charles R.; Rusch, John J.

    1978-01-01

    Discusses the rationale for and development of an undergraduate bioethics course. Based on experiences with the course, general suggestions are offered to instructors planning to add bioethics to existing curricula. (MA)

  20. Teachers’ Attitude towards Integration of Computer Assisted Instructions in Teaching and Learning Process in CAD/CAM/CNC Module

    OpenAIRE

    Abdulrasool, Salah Mahdi; Mishra, Rakesh

    2010-01-01

    The purpose of this study was to understand the effects of teachers’ attitudes, effectiveness of various teaching methods employed as well as teachers’ perceptions of the teaching experience on effectiveness of teaching-learning processes in computer-aided design/computer-aided manufacturing and computer numerical control (CAD/CAM/CNC) module used in vocational education department in Bahrain. Previous studies suggested that a part of the problem in CAD/CAM/CNC subject area is the use of inap...

  1. Forced orthodontic extrusion and use of CAD/CAM for reconstruction of grossly destructed crown: A multidisciplinary approach

    OpenAIRE

    Rahul Kumar; Suvarna Patil

    2012-01-01

    The aim of this study is to present a report of a case where forced orthodontic extrusion and computer-aided design and computer-aided manufacturing (CAD/CAM) technique was used for reconstruction of right maxillary central incisor with grossly destructed crown. Aesthetic rehabilitation of a fractured maxillary right central incisor was performed employing a multidisciplinary approach i.e. conventional endodontic treatment followed by orthodontic extrusion and final restoration using CAD-CAM ...

  2. Therapeutic Uses of the WebCam in Child Psychiatry

    Science.gov (United States)

    Chlebowski, Susan; Fremont, Wanda

    2011-01-01

    Objective: The authors provide examples for the use of the WebCam as a therapeutic tool in child psychiatry, discussing cases to demonstrate the application of the WebCam, which is most often used in psychiatry training programs during resident supervision and for case presentations. Method: Six cases illustrate the use of the WebCam in individual…

  3. The factors that influence CAD/CAM/CAE

    International Nuclear Information System (INIS)

    CAD/CAM/CAE usage has grown and expanded significantly due to its many applications relating to the productivity of an organization. It is important for an organization to have planning and strategy in using CAD/CAM/CAE to ensure sustained efficiency. This paper will discuss the factors that can influence the implementation and success of CAD/CAM/CAE. (Author)

  4. CAD-CAM data exchange pilot project

    Energy Technology Data Exchange (ETDEWEB)

    Hintz, J.; Williams, D.

    1986-03-01

    CAD-CAM data were exchanged between dissimilar CAD systems and the information was used to fabricate three parts. Problems were identified and solutions were proposed or implemented in the area of translation methods, data verification, CAD drawing conventions, and data handling. Additional software needed for productive data exchange has been identified.

  5. Patients’ views of CAM as spiritual practice

    DEFF Research Database (Denmark)

    Ulrich, Anita; Evron, Lotte; Ostenfeld-Rosenthal, Ann

    2011-01-01

    CAM. Thirty-two cancer patients, family, friends and alternative practitioners were followed up over a two year period by face to face interview, telephone and focus groups. Results: Although religious and spiritual issues were not manifestly expressed by many of the subjects, these issues were...

  6. Marginal fit of anterior 3-unit fixed partial zirconia restorations using different CAD/CAM systems

    OpenAIRE

    Song, Tae-Jin; Kwon, Taek-Ka; Yang, Jae-Ho; Han, Jung-Suk; Lee, Jai-Bong; Kim, Sung-Hun; Yeo, In-Sung

    2013-01-01

    PURPOSE Few studies have investigated the marginal accuracy of 3-unit zirconia fixed partial dentures (FPDs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM) system. The purpose of this study was to compare the marginal fit of zirconia FPDs made using two CAD/CAM systems with that of metal-ceramic FPDs. MATERIALS AND METHODS Artificial resin maxillary central and lateral incisors were prepared for 3-unit FPDs and fixed in yellow stone. This model was duplicated to ep...

  7. Remote Geochemical and Mineralogical Analysis with SuperCam on the Mars 2020 Rover and on Earth

    Science.gov (United States)

    Clegg, S. M.; Wiens, R. C.; Maurice, S.; Gasnault, O.; Forni, O.; Sharma, S. K.; Misra, A. K.; Rull, F.; Johnson, J. R.

    2014-12-01

    The SuperCam instrument selected for the Mars 2020 rover is the integration of remote Laser-Induced Breakdown Spectroscopy (LIBS), Raman spectroscopy, Time-Resolved Fluorescence, Visible and Infrared (VISIR) Reflectance Spectroscopy, and a color Remote Micro-Imager (RMI). The SuperCam instrument is based on the ChemCam architecture that includes a 1064 nm Nd:YAG laser and telescope in the mast and a suite of three spectrometers in the body connected by an optical fiber. The telescope on the mast will be used to focus the 1064 nm laser and generate a LIBS plasma from which the elemental composition will be determined up to a 7 m standoff distance. Some of the 1064 nm laser will be directed through a doubling crystal to produce 532 nm light for Raman mineralogical analysis out to 12 m from the mast. The ChemCam visible and near infrared (VNIR) spectrometer will be replaced with a transmission spectrometer and intensified charge coupled device (ICCD) that is designed to maximize the Raman mineralogical sensitivity. This transmission spectrometer and ICCD was also designed to collect time-resolved fluorescence spectra that can distinguish short lived organic fluorescence from long lived inorganic signatures. The SuperCam instrument also includes a Visible and Infrared (VISIR) Reflectance Spectrometer (400 - 900 nm, 1.3 - 2.6 µm) designed to remotely detect minerals. Finally, the ChemCam black and white RMI that is integrated into the telescope will be replaced with a color RMI with the same spatial resolution to provide context images of the samples probed with the SuperCam spectrometers. In this paper, some of the geochemical and mineralogical laboratory tests will be presented to highlight the SuperCam capabilities under both terrestrial and Mars conditions.

  8. Complementary and alternative medicine use of women with breast cancer : Self-help CAM attracts other women than guided CAM therapies

    NARCIS (Netherlands)

    Lo-Fo-Wong, Deborah N. N.; Ranchor, Adelita V.; de Haes, Hanneke C. J. M.; Sprangers, Mirjam A. G.; Henselmans, Inge

    2012-01-01

    Objective: Examine stability of use of complementary and alternative medicine (CAM) of breast cancer patients, reasons for CAM use, and sociodemographic, clinical, and psychological predictors of CAM use. Methods: CAM use was assessed after adjuvant therapy and six months later. Following the CAM He

  9. Application of CAD/CAE/CAM in forging process: a review

    International Nuclear Information System (INIS)

    Forging can be described as the process in which metal is plastically deformed with application of huge pressure. The process not only changes the shape but also improves the properties of the forged parts due to grain size refinement. Conventionally, the empirical trial and error method has been applied, but recently there are various tools are employed to improved product quality and economic of the process. For example, Computer Aided Design (CAD) is widely used in modeling of the process, while Computer Aided Engineering (CAE) tools have been utilized in analyzing the process. To physically demonstrate the process, Computer Aided Manufacturing (CAM) such as CNC machine has been exploited. In order to improve forging process efficiency, an integrated system that combines all advantages of CAD, CAM and CAE need to be developed. This paper presents an overview of computer aided simulation such as CAD, CAE and CAM application in forging process. (Author)

  10. Sulphation requirement for GlyCAM-1, an endothelial ligand for L-selectin.

    Science.gov (United States)

    Imai, Y; Lasky, L A; Rosen, S D

    1993-02-11

    L-selectin participates in the initial attachment of leukocytes to the vascular endothelium. On lymphocytes, it mediates binding to high endothelial venules of lymph nodes. As a selectin it functions as a calcium-dependent lectin recognizing carbohydrate-bearing ligands on endothelial cells. Two lymph node ligands for L-selectin have been identified as sulphated glycoproteins of M(r) approximately 50K and approximately 90K, called Sgp50 and Sgp90 (ref. 10). The recently cloned Sgp50 (ref. 12), now designated GlyCAM-1, is a high endothelial venule-associated, mucin-like glycoprotein containing predominantly O-linked carbohydrate chains. Sialylation of GlyCAM-1 is necessary for its ligand activity and a role for fucosylation is suspected. We have used chlorate as a metabolic inhibitor of sulphation, and report here that GlyCAM-1 has an additional requirement for sulphate. PMID:7679207

  11. ChemCam Passive Spectroscopy of the Martian Atmosphere

    Science.gov (United States)

    McConnochie, T. H.; Smith, M. D.; Wolff, M. J.; Bender, S. C.; Johnson, J. R.; Wiens, R. C.; Maurice, S.; Gasnault, O.; Barraclough, B. L.; Blaney, D. L.; DeFlores, L.; Team, M.

    2013-12-01

    The design priority of the Laser-Induced Breakdown Spectrometer (LIBS) portion of the ChemCam instrument (Wiens et al. 2012, Space Sci, Rev. 170) on the Mars Science Laboratory (MSL) Curiosity rover is its active mode, which acquires spectra of a laser induced plasma using three spectrometers. However these same spectrometers have excellent sensitivity to ambient light and so are also used independent of the laser in 'passive' mode to acquire spectra of the Martian surface (Johnson et al., 2013, LPSC #1372) and, as we will describe here, the Martian sky. Using ChemCam passive sky observations, we have successfully measured the column abundance of water vapor, molecular oxygen, and carbon dioxide gas, and with further analysis will likely be able to constrain the column abundance of ozone as well as aerosol and cloud particle properties. Although data analysis is ongoing, we currently estimate a 2 sigma precision of oxygen, and < +/- 4 % for carbon dioxide. The three ChemCam spectrometers span 240-342 nm, 382-469 nm, and 474-906 nm, respectively, with a resolution of 0.6 nm FWHM or better. Passive sky observations were obtained on sols 131, 230, and then at regular ~7 sol intervals starting on sol 278. The observation consists of acquiring spectra of light scattered by the atmosphere at two elevation angles so that the ratio of the two resulting radiance spectra yields (after removing the continuum) an extremely precise absorption spectrum with both the solar spectrum and instrument response uncertainties removed. To yield column abundances, the spectra are modeled with a discrete ordinates multiple scattering radiative transfer code that incorporates gas absorption via the correlated-k method.

  12. Education & Training for CAD/CAM: Results of a National Probability Survey. Krannert Institute Paper Series.

    Science.gov (United States)

    Majchrzak, Ann

    A study was conducted of the training programs used by plants with Computer Automated Design/Computer Automated Manufacturing (CAD/CAM) to help their employees adapt to automated manufacturing. The study sought to determine the relative priorities of manufacturing establishments for training certain workers in certain skills; the status of…

  13. Implementation and operating experience with a centralized multi-disciplinary CAD CAM System

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, R.S.; Steffani, J.P.

    1985-09-01

    The Stanford Linear Accelerator Center (SLAC) has installed a centralized CAD CAM System to support Electronics, Mechanical, Mechanical Fabrication and Architectural Engineering and Design. The various phases of implementing this system are described, including problems of selection, system software support, maintenance, training, performance evaluation, and future expansion. Some emphasis will be given to the experience with the Electronics disciplines.

  14. 21 CFR 872.3661 - Optical Impression Systems for CAD/CAM.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3661 Optical Impression Systems for CAD... (CAD/CAM) is a device used to record the topographical characteristics of teeth, dental impressions, or stone models by analog or digital methods for use in the computer-assisted design and manufacturing...

  15. Development of Integrated ASR Model Forcing Data and Their Applications to Improve CAM

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Minghua [Research Foundation of the State University of New York, Albany, NY (United States)

    2016-01-01

    In this project, we have (1) improved the constrained variational analysis algorithm of ARM model forcing data, and (2) used the ARM forcing data to identify systematic biases in clouds and radiation in the CAM5 and design new physical parameterizations to improve it.

  16. FlashCam: a fully-digital camera for the medium-sized telescopes of the Cherenkov Telescope Array

    CERN Document Server

    Pühlhofer, G; Bernhard, S; Capasso, M; Diebold, S; Eisenkolb, F; Florin, D; Föhr, C; Funk, S; Gadola, A; Garrecht, F; Hermann, G; Jung, I; Kalekin, O; Kalkuhl, C; Kasperek, J; Kihm, T; Lahmann, R; Manalaysay, A; Marszalek, A; Pfeifer, M; Rajda, P J; Reimer, O; Santangelo, A; Schanz, T; Schwab, T; Steiner, S; Straumann, U; Tenzer, C; Vollhardt, A; Weitzel, Q; Werner, F; Wolf, D; Zietara, K

    2015-01-01

    The FlashCam group is currently preparing photomultiplier-tube based cameras proposed for the medium-sized telescopes (MST) of the Cherenkov Telescope Array (CTA). The cameras are designed around the FlashCam readout concept which is the first fully-digital readout system for Cherenkov cameras, based on commercial FADCs and FPGAs as key components for the front-end electronics modules and a high performance camera server as back-end. This contribution describes the progress of the full-scale FlashCam camera prototype currently under construction, as well as performance results also obtained with earlier demonstrator setups. Plans towards the production and implementation of FlashCams on site are also briefly presented.

  17. The PanCam Calibration Target (PCT) and multispectral image processing for the ExoMars 2018 mission

    Science.gov (United States)

    Barnes, D.; Wilding, M.; Gunn, M.; Tyler, L.; Pugh, S.; Coates, A.; Griffiths, A.; Cousins, C.; Schmitz, N.; Paar, G.

    2011-10-01

    The Panoramic Camera (PanCam) instrument for the ESA/NASA 2018 ExoMars mission is designed to be the 'eyes' of the Mars rover and is equipped with two wide angle multispectral cameras (WACs) from MSSL, and a focusable High Resolution Camera (HRC) from DLR. To achieve its science role within the ExoMars mission, the PanCam will generate terrain reflectance spectra to help identify the mineralogy of the Martian surface, and generate true-colour images of the Martian environment. The PanCam Calibration Target (PCT) is an essential component for the science operations of the PanCam instrument. Its purpose is to allow radiometric calibration and to support geometric calibration check-out of the PanCam instrument during the mission. Unlike other camera calibration targets flown to Mars, the PCT target regions are being made from stained glass. The paper describes the work undertaken during the early build and testing of the PCT, together with results from the baseline algorithms that have been designed and implemented to process the multispectral PanCam images.

  18. mHealth to Improve the Diet Among Low-Income Populations Enrolled in an Established U.S. Nutrition Program: Design and Rationale of a Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Heather Noel Fedesco

    2015-10-01

    the limitations with current SMS interventions is that most have relied on providing reminder texts at the conclusion of an education/counseling session(s − either reinforcing previous educational material or providing basic motivational messages. Very few have focused on incorporating effective counseling techniques to promote behavior change through interactions with participants during these educational sessions. The aim of our study is to explore what types of SMS behavior change techniques are most effective at helping individuals make challenging behavior change regarding diet and nutrition − Counseling vs. personalized Coaching vs. Reminding text messages. Method: To describe the design and rationale of an SMS randomized four-arm control trial that compares the dietary changes of an intervention using: 1 a standardized Counseling SMS group; 2 a personalized Coaching SMS group; 3 an educational information Reminding SMS group; each of which are compared to 4 the usual care control condition of a No SMS group. The Counseling and Coaching SMS groups were developed based on constructs of social cognitive theory (self-efficacy, motivation and outcome expectations and the theory of planned behavior (barriers, social support, and action plans. Reminding SMS was the attention-control group and No SMS was the true control. A total of up to 300 SNAP recipients enrolled in the Small Steps to Health program in the state of Indiana will be randomized into one of four groups for three months to determine the efficacy of text-based behavioral interventions focusing on diet and nutrition. Every two weeks, participants will focus on a specific dietary behavior corresponding with the first four lessons taught in the Small Steps class. Behavior Change 1 (weeks 1 & 2: drink water instead of sugary beverages. Behavior Change 2 (weeks 3 & 4: eat breakfast every day. Behavior Change 3 (weeks 5 & 6: choose fruit as snacks and dessert instead of calorie-laden sweet and high

  19. The detection of EpCAM+ and EpCAM- circulating tumor cells

    OpenAIRE

    Wit, de, J.; Dalum, van, G.; Lenferink, Aufried T. M.; Arjan G. J. Tibbe; Hiltermann, T.J.N.; Groen, Harry J. M.; Rijn, van, Michela; Terstappen, Leon W.M.M.

    2015-01-01

    EpCAM expressing circulating tumor cells, detected by CellSearch, are predictive of short survival in several cancers and may serve as a liquid biopsy to guide therapy. Here we investigate the presence of EpCAM+ CTC detected by CellSearch and EpCAM- CTC discarded by CellSearch, after EpCAM based enrichment. EpCAM- CTC were identified by filtration and fluorescent labelling. This approach was validated using different cell lines spiked into blood and evaluated on blood samples of 27 metastatic...

  20. Methodology for benefit analysis of CAD/CAM in USN shipyards.

    OpenAIRE

    Grahlman, Richard B.

    1984-01-01

    Approved for public release; distribution in unlimited. This thesis expands the concept of Computer-Aided Design/Computer-Aided Manufacturing (CAD/CAM) in naval shipbuilding to include maintenance. This inclusion is coupled with the integration of the design and manufacturing processes in the acronym CIDMM, which stands for Computer-Integrated Design, Manufacture and Maintenance. http://archive.org/details/methodologyforbe00grah Lieutenant Commander, United States Navy

  1. Radiation transport analysis with the aid of CAD/CAM

    International Nuclear Information System (INIS)

    The determination of radiation exposure to sensitive parts in spacecraft involves complex shielding configurations and multi-directional exposures. Ray tracing is commonly used to determine shielding along different directions for transport calculations and dose conversions. Ray tracing requires geometric modeling of the spacecraft, structures, equipment and enclosures. Modeling by manual procedures is inefficient and slow. Combinatorial geometry codes are a substantial improvement over manual procedures but modeling a spacecraft and its contents can take many man months; and still involves many approximations. The increasing use of CAD/CAM in engineering and design results in the convenient accessibility of geometric modeling data. A CAD/CAM system, CADAM, was used to develop an ancillary program which provides one-dimensional ray trace information from CADAM models. The resultant ray trace information is used in subsequent transport analysis on a DEC computer. The result is a timesavings of man-months, by utilizing an existing data base and an increase in accuracy by using up-to-date geometrical information

  2. Characterization and performance of hyper Suprime-Cam CCD

    Science.gov (United States)

    Kamata, Yukiko; Miyazaki, Satoshi; Nakaya, Hidehiko; Suzuki, Hisanori; Miyazaki, Yasuhito; Muramatsu, Masaharu

    2010-07-01

    Hyper Suprime-Cam (HSC) is a second-generation wide field imaging camera for Subaru telescope with 10 times wider field of view (FOV) compared with Suprime-Cam (SC) currently being used. HSC makes the survey speed considerably faster than SC, while maintaining the high image quality of SC. The 1.5 degrees in diameter FOV is covered with 116 of 2K × 4K fully depleted back-illuminated CCDs with 15 μm pixels developed by HAMAMATSU Photonics K. K. and National Astronomical Observatory of Japan (NAOJ). The CCDs for HSC are designed to have higher quantum efficiency than those for SC in a wider range in the visible wavelengths, especially in the blue region. We at NAOJ have started acceptance inspection of the CCDs being delivered from HAMAMATSU. We used the X-ray source of 55Fe and the LED to measure charge transfer efficiency, readout noise, linearity, and full-well capacity of 33 CCDs. In addition, we measured the quantum efficiency of 7 CCDs. We confirmed all the CCDs have good performances and quality. In this paper, we report the results from the acceptance inspection and characterization of these CCDs.

  3. Rational redesign of the biodegradative enzyme cytochrome P450 cam:

    International Nuclear Information System (INIS)

    Cytochromes P450, a superfamily of monooxygenase enzymes present in all kingdoms of living organisms, are very versatile with respect to substrate range and catalytic functionality. Many recalcitrant halogenated hydrocarbons, on DOE sites and throughout the nation, result in serious environmental impact. Cytochromes P450 have been shown to be catalytically capable of, at least partial, dehalogenation of some such compounds. Clearly, however, their active site stereochemistry and related functional components are not well suited for this role because the rates of dehalogenation are generally rather modest. The evolution of modified active site and access channel structures may proceed very slowly if multiple genetic changes are simultaneously required for enzyme adaptation. Since each mutational event is by itself a rare event, a basic premise of our research is that designing multiple changes into an enzyme may be more timely than waiting for them to occur biologically either via natural selection or under laboratory-controlled conditions. Starting with available high-resolution x-ray crystal structures, molecular modeling and molecular dynamics simulations have been used to probe the basic structure/function principles and conformational fluctuations of the biodegradative enzyme, cytochrome P450cam (camphor hydroxylase from Pseudomonas putida) and active site mutants, to provide the fundamental understanding necessary for rational engineering of the enzyme for modified substrate specificity. In the present paper, we review our progress to data, in the area of molecular dynamics simulations and active site redesign of P450cam. 36 refs., 2 figs

  4. Off-line programming: key to CAD/CAM (robots)

    Energy Technology Data Exchange (ETDEWEB)

    Durham, T.

    1983-06-23

    Off-line programming is essential if robots are to be fully integrated into the computer-aided design/computer-aided manufacturing (CAD/CAM) process. It is also fundamental to the use of robots with touch and vision sensors, since the movements of such a robot depend on real-world data and cannot be taught in advance. Edinburgh (UK) University's Department of Artificial Intelligence is developing a high-level language called Rapt, for the programming of assembly robots. Rapt is described as an object-level language. Its statements refer to material objects and their physical relationships and motions. It uses higher level descriptions than those of commercially available robot languages such as unimation's val. The developments in off-line programming which are crucial to the successful integration of industrial robots into computer-aided design and manufacturing processes are discussed.

  5. CAD/CAM: influencing the skilled trades

    Energy Technology Data Exchange (ETDEWEB)

    Plomp, P.W.

    1983-01-01

    CAD/CAM is influencing many of the skilled trades. Computers are permitting an increase in productivity with a resulting need for people with greater mental rather than motor skills. Computers are used for the control of a wide variety of manufacturing operations and the trend is accelerating rapidly. The net result is a smaller need for semi-skilled jobs but an increasing demand for skilled craftsmen.

  6. Development of optimal cam contours; Entwicklung von optimalen Nockenkonturen

    Energy Technology Data Exchange (ETDEWEB)

    Grosse-Loescher, Hendrik; Haberland, Heiner [MAN-Diesel SE, Augsburg (Germany)

    2011-07-01

    A closed-loop method for the development of an optimal shape of an injection cam for a common rail injection system of a large-bore Diesel engine is presented. Due to the demanded fuel flow rate of the engine, a three-loop cam is necessary. The optimal shape of the cam results of a multitude of criteria, constaints and optimization aims. A stepwise resolution of 0.5 rotation angle of the cam shape is required due to manufacturing demands. One single cam shape consists of 120 rotation angles. Thus, the calculation of the optimal cam shape comprises 241 nodes. The method described aims to develop an optimal cam shape depending on all criteria and constaints. Due to the huge number of constraints as well as the complex calculations, the application of a particle swarm optimization (PSA) algorithm is proposed. An optimal cam shape complies to all demands required at each single node. Therefore, a loose lifting curve without any additional conditions applying, such as e.g. linear velocity profiles, is created. Following this procedure, all potentials are best exploited. Each node of the cam shape is basically independent of all other nodes within the chosen demands and constaints. The nodes are thus treated as independent parameters. The procedure described generates optimal cam shapes. (orig.)

  7. Three-dimensional CAE/CAD/CAM system, ANVIL-5000, and examples of application. Sanjigen CAE/CAD/CAM system ANVIL-5000 to tekiyo jirei

    Energy Technology Data Exchange (ETDEWEB)

    Kanno, M.; Miyata, M. (Toshiba Corp., Tokyo (Japan))

    1992-12-01

    Several functions of the three-dimensional CAE/CAD/CAM system (ANVIL-5000) are outlined and some applications are also illustrated. The system is composed of four main functions, the CAD function for three-dimensional design/drafting, CAM function to generate NC data for 2-5 axis machining, OMNISOLIDS function to generate solid models, and OMNIFEM function to generate FEM meshes from solid models. The following new functions have been added to the system recently: (1) the dynamic rotation function to rotate solid models around every axis along with their shading, (2) the draft line function for drafting using draft lines erasable after completion of drawings, and (3) the multi-part access function to copy needed graphic forms from a reference drawing to a drawing under working. Its applications to the design and manufacturing are illustrated of IC lead frame dies in a semiconductor factory and molds in an AV appliance factory. 1 ref., 7 figs.

  8. Screening for retinopathy of prematurity-a comparison between binocular indirect ophthalmoscopy and RetCam 120

    Directory of Open Access Journals (Sweden)

    Shah Parag

    2006-01-01

    Full Text Available Aim: To compare the photographic screening for retinopathy of prematurity (ROP using RetCam 120 with binocular indirect ophthalmoscope (BIO, which is the current gold standard. Setting and Design: Prospective, comparative study. Materials and Methods: A total of 87 RetCam examinations were performed on 27 premature babies. They were stored in a separate file after deleting the identifying information. At the same visit using the BIO with scleral depression, an experienced vitreoretinal surgeon evaluated the fundus in detail. A masked examiner then evaluated the RetCam photographs for presence or absence of ROP, the stage and zone of the disease, and the presence or absence of plus disease. These data were then compared with the BIO findings to determine the sensitivity, specificity, and the positive and negative predictive values of the method. Results: ROP was detected in 63 of 87 examinations by BIO and in 56 of 87 RetCam examinations. Nine RetCam examinations were false-negative and two were false-positive. Sensitivity of RetCam was 85.71% (54/63 and specificity was 91.66% (22/24. The positive and negative predictive values were 96.43% and 70.97% respectively. Conclusion: Nine cases having ROP were missed by the RetCam. All these cases were either in zone 3 or the outer part of zone 2, which later regressed. These were missed mostly because of the restricted mobility of the camera head caused by its size and the barrier caused by the lid speculum arms. No case of threshold ROP was missed. RetCam may replace BIO for screening of ROP.

  9. Development of the pipe machining CAD/CAM system; Kankako CAD/CAM system no kaihatsu

    Energy Technology Data Exchange (ETDEWEB)

    Taketomi, Y.; Teshima, H.; Suzuki, T.; Yoshida, A.

    1997-11-05

    The pipe machining CAD/CAM system was developed which can use previously prepared CAD input data for piping work diagrams. This system can automatically prepare diagrams and information necessary for machining, packaging, handling/lifting planning and assembly of pipes from previously inputted data. Output contents are as follows: parts machining diagram, piping work diagram, piping parts table, label, parts packaging/loading indication, transport program, assembly diagram (isometric diagram, plan). Since all data are transmitted to CAM system in automatic machining, these outputs are unnecessary. A reliable pipe machining system (automatic screwing/cutting machine) was prepared by improving recognized existing machines. The new mechanism (pipe automatic warehouse) which can certainly take out a desired pipe from randomly stacked pipes by an originally developed `rotation disk.` A precise measurement equipment was also developed by using a stopper arm and encoder. The CAD/CAM system achieved labor saving requiring only 1-2 operators. 3 figs.

  10. Availability Analysis of the Ventilation Stack CAM Interlock System

    International Nuclear Information System (INIS)

    Ventilation Stack Continuous Air Monitor (CAM) Interlock System failure modes, failure frequencies and system availability have been evaluated for the RPP. The evaluation concludes that CAM availability is as high as assumed in the safety analysis and that the current routine system surveillance is adequate to maintain this availability. Further, requiring an alarm to actuate upon CAM failure is not necessary to maintain the availability credited in the safety analysis, nor is such an arrangement predicted to significantly improve system availability. However, if CAM failures were only detected by the 92-day functional tests required in the Authorization Basis (AB), CAM availability would be much less than that credited in the safety analysis. Therefore it is recommended that the current surveillance practice of daily simple system checks, 30-day source checks and 92-day functional tests be continued in order to maintain CAM availability

  11. Advanced control room evaluation: General approach and rationale

    International Nuclear Information System (INIS)

    Advanced control rooms (ACRs) for future nuclear power plants (NPPs) are being designed utilizing computer-based technologies. The US Nuclear Regulatory Commission reviews the human engineering aspects of such control rooms to ensure that they are designed to good human factors engineering principles and that operator performance and reliability are appropriately supported in order to protect public health and safety. This paper describes the rationale and general approach to the development of a human factors review guideline for ACRs. The factors influencing the guideline development are discussed, including the review environment, the types of advanced technologies being addressed, the human factors issues associated with advanced technology, and the current state-of-the-art of human factors guidelines for advanced human-system interfaces (HSIs). The proposed approach to ACR review would track the design and implementation process through the application of review guidelines reflecting four review modules: planning, design process analysis, human factors engineering review, and dynamic performance evaluation. 21 refs

  12. The ExoMars PanCam Instrument

    Science.gov (United States)

    Griffiths, Andrew; Coates, Andrew; Muller, Jan-Peter; Jaumann, Ralf; Josset, Jean-Luc; Paar, Gerhard; Barnes, David

    2010-05-01

    The ExoMars mission has evolved into a joint European-US mission to deliver a trace gas orbiter and a pair of rovers to Mars in 2016 and 2018 respectively. The European rover will carry the Pasteur exobiology payload including the 1.56 kg Panoramic Camera. PanCam will provide multispectral stereo images with 34 deg horizontal field-of-view (580 microrad/pixel) Wide-Angle Cameras (WAC) and (83 microrad/pixel) colour monoscopic "zoom" images with 5 deg horizontal field-of-view High Resolution Camera (HRC). The stereo Wide Angle Cameras (WAC) are based on Beagle 2 Stereo Camera System heritage [1]. Integrated with the WACs and HRC into the PanCam optical bench (which helps the instrument meet its planetary protection requirements) is the PanCam interface unit (PIU); which provides image storage, a Spacewire interface to the rover and DC-DC power conversion. The Panoramic Camera instrument is designed to fulfil the digital terrain mapping requirements of the mission [2] as well as providing multispectral geological imaging, colour and stereo panoramic images and solar images for water vapour abundance and dust optical depth measurements. The High Resolution Camera (HRC) can be used for high resolution imaging of interesting targets detected in the WAC panoramas and of inaccessible locations on crater or valley walls. Additionally HRC will be used to observe retrieved subsurface samples before ingestion into the rest of the Pasteur payload. In short, PanCam provides the overview and context for the ExoMars experiment locations, required to enable the exobiology aims of the mission. In addition to these baseline capabilities further enhancements are possible to PanCam to enhance it's effectiveness for astrobiology and planetary exploration: 1. Rover Inspection Mirror (RIM) 2. Organics Detection by Fluorescence Excitation (ODFE) LEDs [3-6] 3. UVIS broadband UV Flux and Opacity Determination (UVFOD) photodiode This paper will discuss the scientific objectives and resource

  13. Treatment Preferences for CAM in Children with Chronic Pain

    OpenAIRE

    Tsao, Jennie C. I.; Marcia Meldrum; Kim, Su C.; Jacob, Margaret C.; Zeltzer, Lonnie K

    2006-01-01

    CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years ± 2.4; range = 8–18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examin...

  14. Compression Testing Using a CAM-Driven Electromagnetic Machine

    OpenAIRE

    Martins, Paulo; Rosa, Pedro; Silva, Carlos

    2012-01-01

    This paper presents new equipment for the compression testing of materials under high rates of loading. The equipment consists of an electromagnetic actuator, a fixed housing containing two flat compression platens, a translating cam and a follower. The electromagnetic actuator makes possible reaching high strain rates with a very precise control of the impact velocity and of the energy transmitted to the translating cam. The cam profile enables compression testing to be perfor...

  15. New Conception of Waving Machine CamEl Drive

    Science.gov (United States)

    Bílkovský, A.; Marek, O.; Jirásko, P.; Volanský, Z.

    New mechatronic conception of waving machine CamEl drive is realized by two electronic cams Yaskawa and planetary gears. The first servo motor is used to slay and shedding motion in position mode and the second servo motor is used in automatic weaving mode. Moment of inertia of kinematic chain was reduced that it was possible used a smaller servo motor of electronic cam Yaskawa.

  16. Rationale and design of ATHENA: A placebo-controlled, double-blind, parallel arm trial to assess the efficacy of dronedarone 400 mg bid for the prevention of cardiovascular hospitalization or death from any cause in PatiENts with atrial fibrillation/atrial flutter

    DEFF Research Database (Denmark)

    Hohnloser, S.H.; Connolly, S.J.; Crijns, H.J.G.M.;

    2008-01-01

    Rationale and Design of ATHENA. Background: Atrial fibrillation (AF) is the most commonly encountered clinical arrhythmia, predominantly affecting elderly patients. There is a continued need for new antiarrhythmic drugs to treat the ever-increasing number of patients with this arrhythmia......ENts with Atrial fibrillation/atrial flutter) is the largest single antiarrhythmic drug trial ever conducted. More than 4,600 patients with a history of AF or atrial flutter (AFL) have been randomized to receive dronedarone 400 mg bid or matching placebo. The primary study endpoint is time to first....... Dronedarone is a new antiarrhythmic compound currently being developed for treatment of AF. Methods: The ATHENA trial (A placebo-controlled, double-blind, parallel arm Trial to assess the efficacy of dronedarone 400 mg bid for the prevention of cardiovascular Hospitalization or death from any cause in pati...

  17. Intelligent gateway processors as integrators of CAD/CAM networks

    Energy Technology Data Exchange (ETDEWEB)

    Hampel, V.E.; Garner, B.L.; Matthews, J.R.

    1985-07-01

    The integration of dissimilar CAD/CAM hardware and software on local and geographically distributed networks is the major problem faced by large organizations today. We begin by examining the existing system for storage, retrieval, control, and distribution of design information at Lawrence Livermore National Laboratory (LLNL) and describe a new prototype Engineering Information System (EIS). We then discuss the Department of Energy neutral Data Exchange Format (DOE/DEF) for the sharing of mechanical drawings among DOE installations. Finally, we describe the potential role of the Intelligent Gateway Processor (IGP) as a transaction controller for engineering resources among contractors of the Air Force Logistics Command (AFLC). IGP capabilities include a unique interpreter-driven user interface which permits the installation and modification of resources and the translation of dissimilar data formats, commands, and protocols, in a unified manner while running non-stop.

  18. Hyper Suprime-Cam: filter exchange unit and shutter

    Science.gov (United States)

    Uraguchi, Fumihiro; Wang, Shiang-Yu; Komiyama, Yutaka; Liaw, Eric J. Y.; Chiu, Chi-Fang; Chen, Hsin-Yo; Ho, Cheng-Lin; Lai, Tsang-Chih; Lee, Yao-Cheng; Jeng, Dun-Zen; Iwamura, Satoru; Kamata, Yukiko; Kawanomoto, Satoshi; Miyazaki, Satoshi; Morokuma, Tomoki; Nakaya, Hidehiko; Utsumi, Yousuke

    2012-09-01

    We have developed a filter exchange unit (FEU) and a shutter of Hyper Suprime-Cam (HSC). FEU consists of two parts; the alignment mechanism of the filter in the optical path and a jukebox of the filters. The alignment mechanism can guarantee 10 μm position stability with respect to the focal plane CCDs. On the exchange sequence, a motorized cart grabs and pushes the filter from the jukebox. Each jukebox has 3 slots and we have two identical jukeboxes. The operation is fully automated and the entire exchange sequence takes 16 minutes. Also, we developed the focal-plane shutter with 1,030 mm diameter envelope and 60 mm thickness while having 600 mm aperture. We report the detail of design and implementation of the shutter and FEU, and installation procedure of FEU.

  19. THE FOURIER SERIES USED IN ANALYSE OF THE CAM MECHANISMS FOR THE SHOEMAKING MACHINES (PART I

    Directory of Open Access Journals (Sweden)

    IOVAN-DRAGOMIR Alina

    2016-05-01

    Full Text Available A computer assisted procedure for the cinematic analysis of the mechanism of a cam is essential in making a certain type of research operations. They mainly refer to the optimization of operations running on specific machinery, or to the re-design of the mechanism, in order to make the mechanism digital. This analysis seems even more important, when we consider the fact that most of the machines used in shoe industry nowadays use a cam mechanism. The paper is devided in two parts. In first part, it is elaborated a method of finding of a function G(x, belonging to a Fourier series, which approximates the numerical values {xi, yi}, with the biggest accuracy. Finding the function that approximates the most accurately the data set, for the position parameters of the follower S(ω, ( will lead to a complete kinematic and dynamic analysis of the cam mechanism. These values repeat with T = 2π period. In second part, the method is tasted using MatCAD work sessions which allow a numerical and graphical analysis of the mathematical relations involved, in order to test the reability of the method. The set of experimental data are resulted after measuring a cam mechanism of a machine used in shoemaking.

  20. CAD/CAM method application for ear shell auto-manufacturing

    Science.gov (United States)

    Jarng, Soon Suck; Ting, Gao

    2010-01-01

    This paper presents the engineering technique of the rapid hearing aid production with a rapid shell modelling (RSM) Computer Aided Design/Manufacturing (CAD/CAM). It will be worthwhile to describe how the virtual ear shell designed with RSM from an ear impression. And the virtual ear shell model is then used as the template to manufacture the actual ear shell by a Rapid Production (RP) machine. Some detailed description of the whole processing will be given in this thesis. The CAD/CAM method processing will enhance and provide outstanding, high-quality hearing aid shell production capabilities to customers. It reduces the time and the cost of designing products and facilitates direct and indirect manufacturing by creating actual parts directly from digital input. It determines that this technique has made a large impact on hearing aid processing and fitting.

  1. Konepajan siirtyminen CAD-CAM-ohjelmointiin

    OpenAIRE

    Moisanen, Sari

    2011-01-01

    Sandvik Mining and Construction Köping AB Haparanda aloitti konepajauudistusprojektin kesällä 2008. Uudistuksen tavoitteena oli kasvattaa konepajan tuotantokapasiteettia ja muuttaa tuotantotapa funktionaalisesta solumuotoiseksi. Uudistuksen myötä konepajalle hankittiin keväällä 2009 kolme uutta NC-sorvia ja tietokoneavusteiseen ohjelmointiin soveltuva WinCAM-ohjelmisto. Osa konepajan tuotantohenkilöstöstä koulutettiin käyttämään NC-ohjelmointia ja tekemään NC-ohjelmia Fanucin käyttöjärjestelm...

  2. Compartilhando protocolos: maquina CMM / CAD / CAM

    OpenAIRE

    Pinheiro Beck, Joao Carlos; Lima da Silva, Isaac Newton; Baroni, Alexandre; Mazin Dias, Gilver

    2007-01-01

    A meta desta contribuição é a descrição da metodologia utilizada para compartilhar um software comercial de CAD/CAM, orientado à indústria mecânica, com um equipamento industrial de controle de qualidade tridimensional (CMM). As etapas necessárias a esta integração são apresentadas, passo a passo, para facilitar o entendimento e a visualização progressiva de cada uma das fases de estudo e análise. Tomando-se como referência este compartilhamento, efetuouse, como aplicação do proce...

  3. Model-Based Engineering and Manufacturing CAD/CAM Benchmark

    Energy Technology Data Exchange (ETDEWEB)

    Domm, T.D.; Underwood, R.S.

    1999-04-26

    than a single computer-aided manufacturing (CAM) system. The Inteznet was a technology that all companies were considering to either transport information more easily throughout the corporation or as a conduit for business, as the small firm was doing Successfully. Because PrdEngineer is the de facto CAD standard fbr the NWC, the Benchmark Team targeted companies using Parametric Technology Corporation (PTC) software tools. Most of the companies used Pm'Engineer for design to some degree, but found the PTC CAM product, PdManufacture lacking as compared to alternate CAM solutions. All of the companies visited fOund the data exchange between CAD/CAM systems problematic. It was apparent that these companies were trying to consolidate their software tools to reduce translation but had not been able to do so because no single solution had all the needed capabilities. In regard to organizational slructure and human resoukes, two companies were found to be using product or program teams. These teams consisted of the technical staff capable of completing the entire task and were xmintained throughout the project. This same strategy was evident at another of the companies but with more mobility of members. For all eornpanies visited except the small ~ work structure breakdown and responsibility were essentially the same as Y-12's at this time. The functions of numerical control (NC), desi~ and process planning were separate and distinct. The team made numerous recommendations that are detailed in the report.

  4. Model-Based Engineering and Manufacturing CAD/CAM Benchmark

    International Nuclear Information System (INIS)

    than a single computer-aided manufacturing (CAM) system. The Inteznet was a technology that all companies were considering to either transport information more easily throughout the corporation or as a conduit for business, as the small firm was doing Successfully. Because PrdEngineer is the de facto CAD standard fbr the NWC, the Benchmark Team targeted companies using Parametric Technology Corporation (PTC) software tools. Most of the companies used Pm'Engineer for design to some degree, but found the PTC CAM product, PdManufacture lacking as compared to alternate CAM solutions. All of the companies visited found the data exchange between CAD/CAM systems problematic. It was apparent that these companies were trying to consolidate their software tools to reduce translation but had not been able to do so because no single solution had all the needed capabilities. In regard to organizational structure and human resources, two companies were found to be using product or program teams. These teams consisted of the technical staff capable of completing the entire task and were xmintained throughout the project. This same strategy was evident at another of the companies but with more mobility of members. For all companies visited except the small work structure breakdown and responsibility were essentially the same as Y-12's at this time. The functions of numerical control (NC), desi and process planning were separate and distinct. The team made numerous recommendations that are detailed in the report

  5. The rationale behind the development of an airline operations control centre using Gaia-based methodology.

    OpenAIRE

    Castro, Antonio J.M.; Eugenio Oliveira

    2008-01-01

    In this paper, we report how we complemented Gaia methodology to analyse and design a multi-agent system for an airline company operations control centre. Besides showing the rationale behind the analysis, design and implementation of our system, we also present how we mapped the abstractions used in agent-oriented design to specific constructs in JADE. The advantages of using a goal-oriented early requirements analysis and its influence on subsequent phases of analysis and design are also pr...

  6. CAMS confirmation of previously reported meteor showers

    Science.gov (United States)

    Jenniskens, P.; Nénon, Q.; Gural, P. S.; Albers, J.; Haberman, B.; Johnson, B.; Holman, D.; Morales, R.; Grigsby, B. J.; Samuels, D.; Johannink, C.

    2016-03-01

    Leading up to the 2015 IAU General Assembly, the International Astronomical Union's Working List of Meteor Showers included 486 unconfirmed showers, showers that are not certain to exist. If confirmed, each shower would provide a record of past comet or asteroid activity. Now, we report that 41 of these are detected in the Cameras for Allsky Meteor Surveillance (CAMS) video-based meteor shower survey. They manifest as meteoroids arriving at Earth from a similar direction and orbit, after removing the daily radiant drift due to Earth's motion around the Sun. These showers do exist and, therefore, can be moved to the IAU List of Established Meteor Showers. This adds to 31 previously confirmed showers from CAMS data. For each shower, finding charts are presented based on 230,000 meteors observed up to March of 2015, calculated by re-projecting the drift-corrected Sun-centered ecliptic coordinates into more familiar equatorial coordinates. Showers that are not detected, but should have, and duplicate showers that project to the same Sun-centered ecliptic coordinates, are recommended for removal from the Working List.

  7. Application of CAM in online measurement of mechanical parameters

    OpenAIRE

    Xiaokang, Gao

    2013-01-01

    Online Measurement of mechanical parameters by using CAM (Computer Aided Measurement) is a new advanced technique in the field of measurement. Taking special measurement software DASYLab as an example, this paper describes the basic principles and unique advantages of this technique. The application of CAM is explained through an example of measurements of temperature, flow rate and pressure.

  8. From Artisanal to CAD-CAM Blocks: State of the Art of Indirect Composites.

    Science.gov (United States)

    Mainjot, A K; Dupont, N M; Oudkerk, J C; Dewael, T Y; Sadoun, M J

    2016-05-01

    Indirect composites have been undergoing an impressive evolution over the last few years. Specifically, recent developments in computer-aided design-computer-aided manufacturing (CAD-CAM) blocks have been associated with new polymerization modes, innovative microstructures, and different compositions. All these recent breakthroughs have introduced important gaps among the properties of the different materials. This critical state-of-the-art review analyzes the strengths and weaknesses of the different varieties of CAD-CAM composite materials, especially as compared with direct and artisanal indirect composites. Indeed, new polymerization modes used for CAD-CAM blocks-especially high temperature (HT) and, most of all, high temperature-high pressure (HT-HP)-are shown to significantly increase the degree of conversion in comparison with light-cured composites. Industrial processes also allow for the augmentation of the filler content and for the realization of more homogeneous structures with fewer flaws. In addition, due to their increased degree of conversion and their different monomer composition, some CAD-CAM blocks are more advantageous in terms of toxicity and monomer release. Finally, materials with a polymer-infiltrated ceramic network (PICN) microstructure exhibit higher flexural strength and a more favorable elasticity modulus than materials with a dispersed filler microstructure. Consequently, some high-performance composite CAD-CAM blocks-particularly experimental PICNs-can now rival glass-ceramics, such as lithium-disilicate glass-ceramics, for use as bonded partial restorations and crowns on natural teeth and implants. Being able to be manufactured in very low thicknesses, they offer the possibility of developing innovative minimally invasive treatment strategies, such as "no prep" treatment of worn dentition. Current issues are related to the study of bonding and wear properties of the different varieties of CAD-CAM composites. There is also a crucial

  9. Marginal Integrity of CAD/CAM Fixed Partial Dentures

    Science.gov (United States)

    Rosentritt, Martin; Behr, Michael; Kolbeck, Carola; Handel, Gerhard

    2007-01-01

    Objectives Computer-aided design (CAD) and manufacturing (CAM) allows the milling of high strength zirconia fixed partial dentures (FPD), however bonding to an inert ZrO2 ceramic surface may effect the marginal integrity of the FPDs. The aim of this investigation was to evaluate the marginal adaptation of zirconia FPDs at the interfaces between zirconia, cement, and tooth. Methods 32 3-unit FPDs were fabricated of the CAD/CAM Y-TZP zirconia (Lava, 3M Espe, Germany) according to the manufacturers’ instructions. Resin cements with corresponding primer and bonding systems were used to lute the FPDs: Compolute/EBS multi (3M Espe, Germany), Panavia F/ED (Kuraray, Japan), Variolink 2/Syntac classic (Ivoclar-Vivadent, FL) and RelyX Unicem/without treatment (3M Espe, Germany). Aualloy FPDs (BioPontostar, Bego, Germany) were cemented with RelyX Unicem and Harvard (Harvard, Germany) as the control. Marginal adaptation was evaluated with scanning electron microscopy using replica specimen before and after artificial aging. After aging, microleakage tests were performed with fuchsine solution. The interfaces between cement-tooth and cement-FPD were examined. Results At the interfaces (cement-tooth and cement-FPD), the systems showed a 95% or higher perfect margin before and after aging. Only Variolink2/Syntac had a marginal adaptation, lower than a 70% perfect margin. Generally, the fuchsine penetration was below 20%, only BioPontstar/Harvard andLava/Variolink2 showed penetration results between 80% and 100%. Conclusion The success of the adhesive cementation of zirconia FPDs depends on the cement system. Under the conditions of this study, zirconia FPDs showed good to sufficient marginal integrity in combination with Panavia/ED, Compolute/EBS and RelyX Unicem. PMID:19212494

  10. CAD/CAM Application Examples in the Mechanical Manufacturing Industry%CAD/CAM在机械制造业中应用实例

    Institute of Scientific and Technical Information of China (English)

    张玲峻

    2015-01-01

    The mechanical equipment is commonly used in cam mechanism to convey movement, more complex motion can be obtained. Because of cam curve precision directly affects the operation of the machine precision and smooth degree, so the cam design must be accuracy. With computer aided design and manufacture (CAD/CAM) technology design and machining cam, greatly improving the production efficiency and machining accuracy, better solve the cam design and processing problems in manufacturing enterprises.%在机械设备中常用凸轮机构来传递运动,可以获得较复杂的运动规律。因凸轮曲线精度直接影响机器的运行精度和平稳度,因此要求凸轮的设计要准确。用计算机辅助设计与制造(CAD/CAM)技术设计和加工凸轮,大大提高了生产效率和加工精度,较好地解决了制造企业中凸轮设计与加工的问题。

  11. Knowledge and training needs among Danish nurses about CAM

    DEFF Research Database (Denmark)

    Lunde, Anita

    2010-01-01

    Background: The increased use of CAM among the Danish population is well documented as are patient’s requests to discuss CAM with a healthcare professional. It is suggested that among different groups of healthcare professionals nurses are the most “open minded” about CAM. This makes it important...... to explore nurses’ knowledge about CAM and their needs for training. Methods: Similar to international investigations a Danish “CAM-knowledge” questionnaire was developed that included multiple choice, yes/no and 5 points scale answers. Validity was established through initial pilot testing. Contacts...... to a randomized sample of 2500 nurses were established through the Danish Nurses Foundation. The questionnaires were mailed by post with the possibility of anonymous return. The data material was analyzed using non-parametic methods. Results: The response rate was 67 % and 1458 completed...

  12. CAD/CAM fabricated single-unit all-ceramic post-core-crown restoration

    Directory of Open Access Journals (Sweden)

    Thilla Sekar Vinothkumar

    2011-01-01

    Full Text Available This case report explains about an innovative treatment strategy for the management of damaged anterior teeth with reduced incisal clearance by means of a single-unit all-ceramic post-core-crown zirconia ceramic restoration fabricated by Computer-aided designing and computer-aided manufacturing (CAD/CAM technology. The reinforced zirconia ceramics allow fabrication of durable esthetic restorations in cases with high functional loading and the unification of the post, core, and crown in a single unit decreases the frequency of failure by creating a monobloc effect. In addition, the use of CAD/CAM technology for designing and fabricating ceramic restorations offers the option of expeditiously preparing these high-strength all-ceramic restorations.

  13. CAD/CAM fabricated single-unit all-ceramic post–core–crown restoration

    Science.gov (United States)

    Vinothkumar, Thilla Sekar; Kandaswamy, Deivanayagam; Chanana, Pallavi

    2011-01-01

    This case report explains about an innovative treatment strategy for the management of damaged anterior teeth with reduced incisal clearance by means of a single-unit all-ceramic post–core–crown zirconia ceramic restoration fabricated by Computer-aided designing and computer-aided manufacturing (CAD/CAM) technology. The reinforced zirconia ceramics allow fabrication of durable esthetic restorations in cases with high functional loading and the unification of the post, core, and crown in a single unit decreases the frequency of failure by creating a monobloc effect. In addition, the use of CAD/CAM technology for designing and fabricating ceramic restorations offers the option of expeditiously preparing these high-strength all-ceramic restorations. PMID:21691515

  14. Modeling the corrosion of high-level waste containers: CAM-CRM interface

    International Nuclear Information System (INIS)

    A key component of the Engineered Barrier System (EBS) being designed for containment of spent-fuel and high-level waste at the proposed geological respository at Yucca Mountain, Nevada is a two-layer canister. In this particular design, the inner barrier is made of a corrosion resistant material (CRM) such as Alloy 825, 625 or C-22, while the outer barrier is made of a corrosion-allowance material (CAM) such as A516 or Monel 400. At the present time, Alloy C-22 and A516 are favored. This publication addresses the development of models to account for corrosion of Alloy C-22 surfaces exposed directly to the Near Field Environmental (NFE), as well as to the exacerbated conditions in the CAM-CRM crevice

  15. IPAD 2: Advances in Distributed Data Base Management for CAD/CAM

    Science.gov (United States)

    Bostic, S. W. (Compiler)

    1984-01-01

    The Integrated Programs for Aerospace-Vehicle Design (IPAD) Project objective is to improve engineering productivity through better use of computer-aided design and manufacturing (CAD/CAM) technology. The focus is on development of technology and associated software for integrated company-wide management of engineering information. The objectives of this conference are as follows: to provide a greater awareness of the critical need by U.S. industry for advancements in distributed CAD/CAM data management capability; to present industry experiences and current and planned research in distributed data base management; and to summarize IPAD data management contributions and their impact on U.S. industry and computer hardware and software vendors.

  16. Treatment Preferences for CAM in children with chronic pain.

    Science.gov (United States)

    Tsao, Jennie C I; Meldrum, Marcia; Kim, Su C; Jacob, Margaret C; Zeltzer, Lonnie K

    2007-09-01

    CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls) (mean age = 14.5 years +/- 2.4; range = 8-18 years) presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80%) were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy), pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities. PMID:17965769

  17. Treatment Preferences for CAM in Children with Chronic Pain

    Directory of Open Access Journals (Sweden)

    Jennie C. I. Tsao

    2007-01-01

    Full Text Available CAM therapies have become increasingly popular in pediatric populations. Yet, little is known about children's preferences for CAM. This study examined treatment preferences in chronic pediatric pain patients offered a choice of CAM therapies for their pain. Participants were 129 children (94 girls (mean age = 14.5 years ± 2.4; range = 8–18 years presenting at a multidisciplinary, tertiary clinic specializing in pediatric chronic pain. Bivariate and multivariate analyses were used to examine the relationships between CAM treatment preferences and patient's sociodemographic and clinical characteristics, as well as their self-reported level of functioning. Over 60% of patients elected to try at least one CAM approach for pain. The most popular CAM therapies were biofeedback, yoga and hypnosis; the least popular were art therapy and energy healing, with craniosacral, acupuncture and massage being intermediate. Patients with a diagnosis of fibromyalgia (80% were the most likely to try CAM versus those with other pain diagnoses. In multivariate analyses, pain duration emerged as a significant predictor of CAM preferences. For mind-based approaches (i.e. hypnosis, biofeedback and art therapy, pain duration and limitations in family activities were both significant predictors. When given a choice of CAM therapies, this sample of children with chronic pain, irrespective of pain diagnosis, preferred non-invasive approaches that enhanced relaxation and increased somatic control. Longer duration of pain and greater impairment in functioning, particularly during family activities increased the likelihood that such patients agreed to engage in CAM treatments, especially those that were categorized as mind-based modalities.

  18. Complete-mouth rehabilitation using a 3D printing technique and the CAD/CAM double scanning method: A clinical report.

    Science.gov (United States)

    Joo, Han-Sung; Park, Sang-Won; Yun, Kwi-Dug; Lim, Hyun-Pil

    2016-07-01

    According to evolving computer-aided design/computer-aided manufacturing (CAD/CAM) technology, ceramic materials such as zirconia can be used to create fixed dental prostheses for partial removable dental prostheses. Since 3D printing technology was introduced a few years ago, dental applications of this technique have gradually increased. This clinical report presents a complete-mouth rehabilitation using 3D printing and the CAD/CAM double-scanning method. PMID:26946918

  19. Complementary and alternative medicine (CAM providers’ views of chronic low back pain patients’ expectations of CAM therapies: a qualitative study

    Directory of Open Access Journals (Sweden)

    Schafer Lisa M

    2012-11-01

    Full Text Available Abstract Background Some researchers think that patients with higher expectations for CAM therapies experience better outcomes and that enthusiastic providers can enhance treatment outcomes. This is in contrast to evidence suggesting conventional medical providers often reorient patient expectations to better match what providers believe to be realistic. However, there is a paucity of research on CAM providers’ views of their patients’ expectations regarding CAM therapy and the role of these expectations in patient outcomes. Methods To better understand how CAM providers view and respond to their patients’ expectations of a particular therapy, we conducted 32 semi-structured, qualitative interviews with acupuncturists, chiropractors, massage therapists and yoga instructors identified through convenience sampling. Interviews were recorded, transcribed and analyzed thematically using Atlas ti version 6.1. Results CAM providers reported that they attempt to ensure that their patients’ expectations are realistic. Providers indicated they manage their patients’ expectations in a number of domains— roles and responsibilities of providers and patients, treatment outcomes, timeframe for improvement, and treatment experience. Providers reported that patients’ expectations change over time and that they need to continually manage these expectations to enhance patient engagement and satisfaction with treatment. Conclusions Providers of four types of CAM therapies viewed patients’ expectations as an important component of their experiences with CAM therapy and indicated that they try to align patient expectations with reality. These findings suggest that CAM providers are similar in this respect to conventional medical providers.

  20. Surface Roughness and Microhardness of Two Recent CAD/CAM-Materials After Storage

    OpenAIRE

    Flury, Simon; Diebold, Elisabeth; Peutzfeldt, Anne; Lussi, Adrian

    2014-01-01

    Objectives: To investigate surface roughness and microhardness of two recent resin-ceramic materials for computer-aided design/computer-aided manufacturing (CAD/CAM) after polishing with three polishing systems. Surface roughness and microhardness were measured immediately after polishing and after six months storage including monthly artificial toothbrushing. Methods: Sixty specimens of Lava Ultimate (3M ESPE) and 60 specimens of VITA ENAMIC (VITA Zahnfabrik) were roughened in a standardi...

  1. Adult Lifespan Cognitive Variability in the Cross-Sectional Cam-CAN Cohort

    OpenAIRE

    Emma Green; Shafto, Meredith A.; Fiona E Matthews; Cam-CAN,; White, Simon R.

    2015-01-01

    This study examines variability across the age span in cognitive performance in a cross-sectional, population-based, adult lifespan cohort from the Cambridge Centre for Ageing and Neuroscience (Cam-CAN) study (n = 2680). A key question we highlight is whether using measures that are designed to detect age-related cognitive pathology may not be sensitive to, or reflective of, individual variability among younger adults. We present three issues that contribute to the debate for and against age-...

  2. CAD/CAM fabricated single-unit all-ceramic post–core–crown restoration

    OpenAIRE

    Thilla Sekar Vinothkumar; Deivanayagam Kandaswamy; Pallavi Chanana

    2011-01-01

    This case report explains about an innovative treatment strategy for the management of damaged anterior teeth with reduced incisal clearance by means of a single-unit all-ceramic post-core-crown zirconia ceramic restoration fabricated by Computer-aided designing and computer-aided manufacturing (CAD/CAM) technology. The reinforced zirconia ceramics allow fabrication of durable esthetic restorations in cases with high functional loading and the unification of the post, core, and crown in a sin...

  3. A 3-dimensional accuracy analysis of chairside CAD/CAM milling processes

    OpenAIRE

    Bosch, Gabriel; Ender, Andreas; Mehl, Albert

    2014-01-01

    STATEMENT OF PROBLEM Milling is a central and important aspect of computer-aided design and computer-aided manufacturing (CAD/CAM) technology. High milling accuracy reduces the time needed to adapt the workpiece and provides restorations with better longevity and esthetic appeal. The influence of different milling processes on the accuracy of milled restorations has not yet been reviewed. PURPOSE The purpose of this study was to investigate the influence of different milling processes on t...

  4. Glucocorticoid augmentation of prolonged exposure therapy: rationale and case report

    Directory of Open Access Journals (Sweden)

    Laura Pratchett

    2010-12-01

    Full Text Available Rationale: Prolonged exposure (PE therapy has been found to reduce symptoms of posttraumatic stress disorder (PTSD; however, it is difficult for many patients to engage fully in the obligatory retelling of their traumatic experiences. This problem is compounded by the fact that habituation and cognitive restructuring – the main mechanisms through which PE is hypothesized to work – are not instantaneous processes, and often require several weeks before the distress associated with imaginal exposure abates. Case reports: Two cases are described that respectively illustrate the use of hydrocortisone and placebo, in combination with PE, for the treatment of combat-related PTSD. Based on known effects of glucocorticoids on learning and memory performance, we hypothesized that augmentation with hydrocortisone would improve the therapeutic effects of PE by hastening “new” learning and facilitating decreases in the emotional impact of fear memories during the course of treatment. The veteran receiving hydrocortisone augmentation of PE displayed an accelerated and ultimately greater decline in PTSD symptoms than the veteran receiving placebo. Conclusions: While no general conclusion can be derived from comparison of two patients, the findings are consistent with the rationale for augmentation. These case reports support the potential for an appropriately designed and powered clinical trial to examine the efficacy of glucocorticoids in augmenting the effects of psychotherapy for PTSD.

  5. Netherlands research programme weight gain prevention (NHF-NRG): rationale, objectives and strategies

    NARCIS (Netherlands)

    Kremers, S.P.; Schouten, E.G.; Kok, F.J.; Visscher, T.L.S.; Brug, J.; Kromhout, D.

    2005-01-01

    OBJECTIVE: To outline the rationale, objectives and strategies used in a systematically designed research programmme to study specific weight gain-inducing behaviours, their social-psychological as well as environmental determinants, and the effects of interventions aimed at the prevention of weight

  6. Rationale for Students' Participation in University Governance and Organizational Effectiveness in Ekiti and Ondo States, Nigeria

    Science.gov (United States)

    Akomolafe, C. O.; Ibijola, E. Y.

    2012-01-01

    The study investigated the rationale for students' participation in university governance and organizational effectiveness. A descriptive research of survey design was adopted. The population consisted of all staff and students of Ekiti State University, Ado Ekiti, Ekiti State and Adekunle Ajasin University, Akungba-Akoko, Ondo State. 700 subjects…

  7. Advanced water-cooled reactor technologies. Rationale, state of progress and outlook

    International Nuclear Information System (INIS)

    Eighty per cent of the world's power reactors are water cooled and moderated. Many improvements in their design and operation have been implemented since the first such reactor started commercial operation in 1957. This report addresses the safety, environmental and economic rationales for further improvements, as well as their relevance to currently operating water reactors

  8. 带冠涡轮盘电火花加工专用CAD/CAM软件开发%A special CAD/CAM software for electro-discharge machining of shrouded turbine blisks

    Institute of Scientific and Technical Information of China (English)

    李刚; 赵万生; 王振龙; 吴湘

    2007-01-01

    In this paper, a special-purpose CAD/CAM software package, BliskCad/Cam, based on a commercial CAD/CAM software Unigraphics is developed to reduce difficulties in CNC-EDM of the shrouded turbine blisks. The software package consists of five modules such as electrode design, path searching, and machining simulation module. Functions of BliskCad/Cam include parametrical reconstruction of 3-D model of the blisk, intelligent design of complex shaped electrode, automatic generation of NC codes, search of interference-free tool path for multi-axis NC-EDM and machining simulation, etc. Experimental verification is conducted by using BliskCad/Cam and the results show that it satisfies the requirements, and can realize precision machining and reduce accessorial time remarkably.

  9. FlashCam: a fully-digital camera for the medium-sized telescopes of the Cherenkov Telescope Array

    OpenAIRE

    Pühlhofer, G.; Bauer, C.; Bernhard, S.; Capasso, M.; Diebold, S; Eisenkolb, F.; Florin, D.; Föhr, C.; S Funk; Gadola, A.; Garrecht, F.; Hermann, G.; Jung, I.; Kalekin, O.(Erlangen Centre for Astroparticle Physics, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany); Kalkuhl, C.

    2015-01-01

    The FlashCam group is currently preparing photomultiplier-tube based cameras proposed for the medium-sized telescopes (MST) of the Cherenkov Telescope Array (CTA). The cameras are designed around the FlashCam readout concept which is the first fully-digital readout system for Cherenkov cameras, based on commercial FADCs and FPGAs as key components for the front-end electronics modules and a high performance camera server as back-end. This contribution describes the progress of the full-scale ...

  10. New solid modeling system for CAD/CAM integration through engineering drawing understanding

    Energy Technology Data Exchange (ETDEWEB)

    Yu, Yuanchen.

    1987-01-01

    A solid model is crucial for CAD/CAM integration. However, for supporting downstream CAD/CAM applications, a solid model should be able to represent not only the basic shape of a mechanical part but also all the design intentions designers may have. In this research, a framework of a new solid-modeling system that can represent some design intentions and can be constructed through the scheme of engineering drawing is proposed. This framework includes three parts: a variational solid model, V-SOLID, an engineering drawing-based design model, ED-DESIGN, and a knowledge-based computer understanding system. The V-SOLID is an augmented version of the existing boundary representation which is able to represent dimension, tolerance, datum structure, surface attributes and geometric relationships among surfaces. The ED-DESIGN is an input scheme which allows the designer to input the V-SOLID through the scheme of engineering drawing. Also, in this ED-DESIGN, an engineering drawing is represented in a drawing space instead of a drawing plane, so that engineering drawing can be interpreted as a pseudo-3D design scheme. The computer understanding system is developed to construct the V-SOLID from the ED-DESIGN using a knowledge-based approach.

  11. Pilot Aircraft Interface Objectives/Rationale

    Science.gov (United States)

    Shively, Jay

    2010-01-01

    Objective: Database and proof of concept for guidelines for GCS compliance a) Rationale: 1) Provide research test-bed to develop guidelines. 2) Modify GCS for NAS Compliance to provide proof of concept. b) Approach: 1) Assess current state of GCS technology. 2) Information Requirements Definition. 3) SME Workshop. 4) Modify an Existing GCS for NAS Compliance. 5) Define exemplar UAS (choose system to develop prototype). 6) Define Candidate Displays & Controls. 7) Evaluate/ refine in Simulations. 8) Demonstrate in flight. c) Deliverables: 1) Information Requirements Report. 2) Workshop Proceedings. 3) Technical Reports/ papers on Simulations & Flight Demo. 4) Database for guidelines.

  12. Rationales of Verse: Poe and Other Critics

    OpenAIRE

    Barragão, Fernando Pedro Cleto Rodrigues

    2010-01-01

    “The Rationale of Verse” is probably among the less widely known theoretic/critical essays by Edgar Allan Poe. Nevertheless, it is a text whose rediscovery matters due to the pertinence of most of Poe’s conceptions regarding topics such as prosody and the correct scansion of a poem (if there is such a thing). Poe’s essay is also surprising because of the author’s proposal of a new method for scanning verse based on a musical notation. In this context, other authors such as Gerard Manley Hopki...

  13. Rationale, Design, and Baseline Data of the Insulin Glargine (Lantus) Versus Insulin Detemir (Levemir) Treat-To-Target (L2T3) Study: A Multinational, Randomized Noninferiority Trial of Basal Insulin Initiation in Type 2 Diabetes

    NARCIS (Netherlands)

    S.G.H.A. Swinnen; F.J. Snoek; M.P. Dain; J.H. DeVries; J.B.L. Hoekstra; F. Holleman

    2009-01-01

    Objective: To discuss the design and baseline data of the Lantus (R) (sanofi-aventis, Paris, France) versus Levemir (R) (Novo Nordisk A/S, Bagsvaerd, Denmark) Treat-To-Target (L2T3) study, a multinational, randomized comparison between the basal insulin analogs insulin glargine and insulin detemir.

  14. UVAJANJE PROGRAMSKIH ORODIJ CAD/CAM V PODJETJU

    OpenAIRE

    Gjerkeš, Srečko

    2010-01-01

    V diplomskem delu je prikazan postopek uvedbe CAD/CAM programskega orodja v podjetje. Cilj diplomskega dela je primerjava med ročnim programiranjem in programiranjem s pomočjo CAM sistema ter povečanje produktivnosti proizvodnje pri izdelavi serijskih izdelkov. Z uvedbo programskega orodja bi predvsem skrajšali obdelovalne čase izdelkov, ki se izdelujejo v različnih serijah. Diplomsko delo opisuje osnovne značilnosti CAD/CAM sistemov, podjetje Medicop d.o.o, programska orodja in njihovo p...

  15. SODOBNA RAČUNALNIŠKA TEHNOLOGIJA ZA CAD/CAM

    OpenAIRE

    Herženjak, Eric

    2011-01-01

    Sodobna računalniška tehnologija CAD/CAM se čedalje pogosteje uporablja v naprednih podjetjih v tujini in tudi v Sloveniji. Pomembno je vedeti kakšna aparaturna oprema za CAD/CAM je danes na voljo, saj omogoča uspešno konstruiranje, modeliranje in simulacije. V prvem delu diplomske naloge sem zato preučil sodobno programsko in aparaturno opremo za CAD/CAM, ki je namenjena za konstruiranje, modeliranje in simulacije. Prav tako sem na kratko opisal najpomembnejše vidike dodajanih tehnologij, ki...

  16. Technical engineering in mines on the basis of an integrated CAD/CAM/CAE system

    Energy Technology Data Exchange (ETDEWEB)

    Gritsko, G.J.; Vylegzhanin, V.N.; Vitovsky, E.J.; Potapov, V.P.; Zvikina, L.S. (Academy of Sciences of the USSR, Kemerevo (USSR))

    1990-01-01

    A concept of an integrated technical engineering system for the design, planning and managment phases is decribed. The system's structure includes international CAD/CAM/CAE system standards and is based on a mathematical hybrid model of a coal mining technology system, including safety of mining work regarding geomechanical aspects. Basic relations of mining parameters are discussed by means of models. The system operates on the basis of logic-linguistic programs, verbal and graphic analysis models for mining situation, organization of frame models to describe properties and structures of objects in the geological system, and developing technological algorithms. The technology decision structure of the CAD/CAM/CAE system is compatible with expert systems. (orig.).

  17. CAD/CAM Solutions for Minimally Invasive All-Ceramic Rehabilitation of Extended Erosive Lesions.

    Science.gov (United States)

    Guess Gierthmuehlen, Petra C; Steger, Enrico

    2016-05-01

    Dental erosion is a global oral health problem that can lead to significant functional and esthetic impairments of the affected patients. Treatment of severe cases with augmented loss of the vertical dimension of occlusion (VDO) represents a challenge for both the dental team and the patient. CAD/CAM technology was used in the presented case to analyze the interocclusal space. Based on a virtual wax-up of the final restorations, CAD/CAM-fabricated preparation splints served as a guide and ensured a most minimally invasive preparation design. Milled polymer provisionals enabled the patient to visualize the final treatment outcome and served as a fracture-resistant temporary restoration to test the increased VDO. Monolithic lithium-disilicate ceramic, defect-oriented restorations with reduced ceramic thickness enabled a functional and reliable reconstruction of the severely compromised dentition. This case report documents a practical, digital approach and discusses the advantages related to treatment time, ease of treatment, and predictability. PMID:27419357

  18. Clinical and Laboratory Steps for Fabricating a Complete-Arch Fixed Prosthesis Using CAD/CAM.

    Science.gov (United States)

    Keerthi, Senthil; Proussaefs, Periklis; Lozada, Jaime

    2015-01-01

    The fabrication of a full-arch maxillary prosthesis has been associated with several prosthetic complications and difficulties. Even though it has been reported that phonetics, esthetics, and proper lip support are difficult to achieve, there is a scarcity in the literature regarding the clinical and laboratory procedures necessary to minimize these complications. This article provides clinical and laboratory steps that may enable the clinician to achieve more predictable restorative results when using computer-aided design/computer-assisted manufacture (CAD/CAM) to fabricate a full-arch maxillary implant-supported prosthesis. The technique presented here describes the use of an implant-retained diagnostic wax-up that is subsequently duplicated to an interim polymethylmethacrylate prosthesis using CAD/CAM before fabricating the definitive restoration. PMID:26133136

  19. Full-mouth rehabilitation with monolithic CAD/CAM-fabricated hybrid and all-ceramic materials: A case report and 3-year follow up.

    Science.gov (United States)

    Selz, Christian F; Vuck, Alexander; Guess, Petra C

    2016-02-01

    Esthetic full-mouth rehabilitation represents a great challenge for clinicians and dental technicians. Computer-aided design/ computer-assisted manufacture (CAD/CAM) technology and novel ceramic materials in combination with adhesive cementation provide a reliable, predictable, and economic workflow. Polychromatic feldspathic CAD/CAM ceramics that are specifically designed for anterior indications result in superior esthetics, whereas novel CAD/CAM hybrid ceramics provide sufficient fracture resistance and adsorption of the occlusal load in posterior areas. Screw-retained monolithic CAD/CAM lithium disilicate crowns (ie, hybrid abutment crowns) represent a reliable and time- and cost-efficient prosthetic implant solution. This case report details a CAD/CAM approach to the full-arch rehabilitation of a 65-year-old patient with toothand implant-supported restorations and provides an overview of the applied CAD/CAM materials and the utilized chairside intraoral scanner. The esthetics, functional occlusion, and gingival and peri-implant tissues remained stable over a follow-up period of 3 years. No signs of fractures within the restorations were observed. PMID:26417616

  20. Description and Rationale for the Planning, Monitoring, and Implementation (PMI) Model: Rationale.

    Science.gov (United States)

    Cort, H. Russell

    The rationale for the Planning, Monitoring, and Implementation Model (PMI) is the subject of this paper. The Superintendent of the District of Columbia Public Schools requested a model for systematic evaluation of educational programs to determine their effectiveness. The school system's emphasis on objective-referenced instruction and testing,…

  1. Clinical trial design and rationale of the Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) investigational device exemption clinical study protocol.

    Science.gov (United States)

    Heatley, Gerald; Sood, Poornima; Goldstein, Daniel; Uriel, Nir; Cleveland, Joseph; Middlebrook, Don; Mehra, Mandeep R

    2016-04-01

    The HeartMate 3 left ventricular assist system (LVAS; St. Jude Medical, Inc., formerly Thoratec Corporation, Pleasanton, CA) was recently introduced into clinical trials for durable circulatory support in patients with medically refractory advanced-stage heart failure. This centrifugal, fully magnetically levitated, continuous-flow pump is engineered with the intent to enhance hemocompatibility and reduce shear stress on blood elements, while also possessing intrinsic pulsatility. Although bridge-to-transplant (BTT) and destination therapy (DT) are established dichotomous indications for durable left ventricular assist device (LVAD) support, clinical practice has challenged the appropriateness of these designations. The introduction of novel LVAD technology allows for the development of clinical trial designs to keep pace with current practices. The prospective, randomized Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy With HeartMate 3 (MOMENTUM 3) clinical trial aims to evaluate the safety and effectiveness of the HeartMate 3 LVAS by demonstrating non-inferiority to the HeartMate II LVAS (also St. Jude Medical, Inc.). The innovative trial design includes patients enrolled under a single inclusion and exclusion criteria , regardless of the intended use of the device, with outcomes ascertained in the short term (ST, at 6 months) and long term (LT, at 2 years). This adaptive trial design includes a pre-specified safety phase (n = 30) analysis. The ST cohort includes the first 294 patients and the LT cohort includes the first 366 patients for evaluation of the composite primary end-point of survival to transplant, recovery or LVAD support free of debilitating stroke (modified Rankin score >3), or re-operation to replace the pump. As part of the adaptive design, an analysis by an independent statistician will determine whether sample size adjustment is required at pre-specified times during the study. A further 662

  2. CAD-CAM database management at Bendix Kansas City

    Energy Technology Data Exchange (ETDEWEB)

    Witte, D.R.

    1985-05-01

    The Bendix Kansas City Division of Allied Corporation began integrating mechanical CAD-CAM capabilities into its operations in June 1980. The primary capabilities include a wireframe modeling application, a solid modeling application, and the Bendix Integrated Computer Aided Manufacturing (BICAM) System application, a set of software programs and procedures which provides user-friendly access to graphic applications and data, and user-friendly sharing of data between applications and users. BICAM also provides for enforcement of corporate/enterprise policies. Three access categories, private, local, and global, are realized through the implementation of data-management metaphors: the desk, reading rack, file cabinet, and library are for the storage, retrieval, and sharing of drawings and models. Access is provided through menu selections; searching for designs is done by a paging method or a search-by-attribute-value method. The sharing of designs between all users of Part Data is key. The BICAM System supports 375 unique users per quarter and manages over 7500 drawings and models. The BICAM System demonstrates the need for generalized models, a high-level system framework, prototyping, information-modeling methods, and an understanding of the entire enterprise. Future BICAM System implementations are planned to take advantage of this knowledge.

  3. Rationale and Roadmap for Moon Exploration

    Science.gov (United States)

    Foing, B. H.; ILEWG Team

    We discuss the different rationale for Moon exploration. This starts with areas of scientific investigations: clues on the formation and evolution of rocky planets, accretion and bombardment in the inner solar system, comparative planetology processes (tectonic, volcanic, impact cratering, volatile delivery), records astrobiology, survival of organics; past, present and future life. The rationale includes also the advancement of instrumentation: Remote sensing miniaturised instruments; Surface geophysical and geochemistry package; Instrument deployment and robotic arm, nano-rover, sampling, drilling; Sample finder and collector. There are technologies in robotic and human exploration that are a drive for the creativity and economical competitivity of our industries: Mecha-electronics-sensors; Tele control, telepresence, virtual reality; Regional mobility rover; Autonomy and Navigation; Artificially intelligent robots, Complex systems, Man-Machine interface and performances. Moon-Mars Exploration can inspire solutions to global Earth sustained development: In-Situ Utilisation of resources; Establishment of permanent robotic infrastructures, Environmental protection aspects; Life sciences laboratories; Support to human exploration. We also report on the IAA Cosmic Study on Next Steps In Exploring Deep Space, and ongoing IAA Cosmic Studies, ILEWG/IMEWG ongoing activities, and we finally discuss possible roadmaps for robotic and human exploration, starting with the Moon-Mars missions for the coming decade, and building effectively on joint technology developments.

  4. The SuperCam Remote-Sensing Instrument Suite for the Mars 2020 Rover Mission

    Science.gov (United States)

    Wiens, R. C.; Maurice, S.; Clegg, S. M.; Rull, F.; Sharma, S. K.; Anderson, R. B.; Beyssac, O.; Bonal, L.; DeFlores, L. P.; Dromart, G.; Fischer, W. W.; Forni, O.; Gasnault, O.; Grotzinger, J. P.; Johnson, J. R.; Martinez-Frias, J.; Mangold, N.; McLennan, S. M.; Montmessin, F.

    2015-12-01

    The SuperCam remote-sensing instrument suite in development for the Mars 2020 rover represents a significant advance from its precursor, ChemCam, by adding Raman spectroscopy (to 12 m distance) and visible and near-infrared (VISIR) reflectance spectroscopy. For Raman spectroscopy the LIBS Nd:YAG laser is frequency-doubled to 532 nm (green Raman). A transmission spectrometer with an intensified CCD covers 150-4400 cm-1 spectral range at a resolution of 10 cm-1. The system is adjustably time-gated, removing much of the mineral fluorescence from the Raman spectra and also facilitating time-resolved fluorescence studies. The infrared range covers 1.3-2.6 microns in addition to the existing 400-840 nm range on ChemCam. Additional upgrades include doubling the LIBS resolution in the 535-860 nm range and adding color to the Remote Micro-Imager (RMI), which is the highest resolution remote imager on the rover. A large-scale effort is being applied to the on-board standards, being led by U. Valladolid in Spain, with targets contributed by many institutions. The number of geological targets will be increased from 8 (on ChemCam) to 22, planned to include end-member plagioclase feldspars, hi- and low-Ca pyroxene, olivines, several fine-grained basalts, hematite, jarosite, carbonates, apatite, and several synthetic targets doped with trace elements. Three Spectralon targets are planned for IR calibration and several color bands for the RMI. All but the Spectralon and color bands should be available for LIBS calibration, and many are also being designed for Raman and VISIR calibration. For LIBS this collection of standards will significantly improve the accuracy relative to ChemCam; other precision improvements are anticipated to come from correcting for variable plasma temperature. The presentation will illustrate how Mars datasets will be significantly improved via this multi-technique approach and will give a first look at prototype SuperCam spectra.

  5. A prospective randomised cross-over study of the effect of insulin analogues and human insulin on the frequency of severe hypoglycaemia in patients with type 1 diabetes and recurrent hypoglycaemia (the HypoAna trial): study rationale and design

    Science.gov (United States)

    2012-01-01

    Background Severe hypoglycaemia still represents a significant problem in insulin-treated diabetes. Most patients do not experience severe hypoglycaemia often. However, 20% of patients with type 1 diabetes experience recurrent severe hypoglycaemia corresponding to at least two episodes per year. The effect of insulin analogues on glycaemic control has been documented in large trials, while their effect on the frequency of severe hypoglycaemia is less clear, especially in patients with recurrent severe hypoglycaemia. The HypoAna Trial is designed to investigate whether short-acting and long-acting insulin analogues in comparison with human insulin are superior in reducing the occurrence of severe hypoglycaemic episodes in patients with recurrent hypoglycaemia. This paper reports the study design of the HypoAna Trial. Methods/design The study is a Danish two-year investigator-initiated, prospective, randomised, open, blinded endpoint (PROBE), multicentre, cross-over trial investigating the effect of insulin analogues versus human insulin on the frequency of severe hypoglycaemia in subjects with type 1 diabetes. Patients are randomised to treatment with basal-bolus therapy with insulin detemir / insulin aspart or human NPH insulin / human regular insulin in random order. The major inclusion criterion is history of two or more episodes of severe hypoglycaemia in the preceding year. Discussion In contrast to almost all other studies in this field the HypoAna Trial includes only patients with major problems with hypoglycaemia. The HypoAna Trial will elucidate whether basal-bolus regimen with short-acting and long-acting insulin analogues in comparison with human insulin are superior in reducing occurrence of severe hypoglycaemic episodes in hypoglycaemia prone patients with type 1 diabetes. http://www.clinicaltrials.gov: NCT00346996. PMID:22727048

  6. A prospective randomised cross-over study of the effect of insulin analogues and human insulin on the frequency of severe hypoglycaemia in patients with type 1 diabetes and recurrent hypoglycaemia (the HypoAna trial: study rationale and design

    Directory of Open Access Journals (Sweden)

    Kristensen Peter

    2012-06-01

    Full Text Available Abstract Background Severe hypoglycaemia still represents a significant problem in insulin-treated diabetes. Most patients do not experience severe hypoglycaemia often. However, 20% of patients with type 1 diabetes experience recurrent severe hypoglycaemia corresponding to at least two episodes per year. The effect of insulin analogues on glycaemic control has been documented in large trials, while their effect on the frequency of severe hypoglycaemia is less clear, especially in patients with recurrent severe hypoglycaemia. The HypoAna Trial is designed to investigate whether short-acting and long-acting insulin analogues in comparison with human insulin are superior in reducing the occurrence of severe hypoglycaemic episodes in patients with recurrent hypoglycaemia. This paper reports the study design of the HypoAna Trial. Methods/design The study is a Danish two-year investigator-initiated, prospective, randomised, open, blinded endpoint (PROBE, multicentre, cross-over trial investigating the effect of insulin analogues versus human insulin on the frequency of severe hypoglycaemia in subjects with type 1 diabetes. Patients are randomised to treatment with basal-bolus therapy with insulin detemir / insulin aspart or human NPH insulin / human regular insulin in random order. The major inclusion criterion is history of two or more episodes of severe hypoglycaemia in the preceding year. Discussion In contrast to almost all other studies in this field the HypoAna Trial includes only patients with major problems with hypoglycaemia. The HypoAna Trial will elucidate whether basal-bolus regimen with short-acting and long-acting insulin analogues in comparison with human insulin are superior in reducing occurrence of severe hypoglycaemic episodes in hypoglycaemia prone patients with type 1 diabetes. http://www.clinicaltrials.gov: NCT00346996.

  7. Rationale and design of the HEALTHY-CATH trial: A randomised controlled trial of Heparin versus EthAnol Lock THerapY for the prevention of Catheter Associated infecTion in Haemodialysis patients

    Directory of Open Access Journals (Sweden)

    Broom Jennifer K

    2009-08-01

    Full Text Available Abstract Background Catheter-related bacteraemias (CRBs contribute significantly to morbidity, mortality and health care costs in dialysis populations. Despite international guidelines recommending avoidance of catheters for haemodialysis access, hospital admissions for CRBs have doubled in the last decade. The primary aim of the study is to determine whether weekly instillation of 70% ethanol prevents CRBs compared with standard heparin saline. Methods/design The study will follow a prospective, open-label, randomized controlled design. Inclusion criteria are adult patients with incident or prevalent tunneled intravenous dialysis catheters on three times weekly haemodialysis, with no current evidence of catheter infection and no personal, cultural or religious objection to ethanol use, who are on adequate contraception and are able to give informed consent. Patients will be randomized 1:1 to receive 3 mL of intravenous-grade 70% ethanol into each lumen of the catheter once a week and standard heparin locks for other dialysis days, or to receive heparin locks only. The primary outcome measure will be time to the first episode of CRB, which will be defined using standard objective criteria. Secondary outcomes will include adverse reactions, incidence of CRB caused by different pathogens, time to infection-related catheter removal, time to exit site infections and costs. Prospective power calculations indicate that the study will have 80% statistical power to detect a clinically significant increase in median infection-free survival from 200 days to 400 days if 56 patients are recruited into each arm. Discussion This investigator-initiated study has been designed to provide evidence to help nephrologists reduce the incidence of CRBs in haemodialysis patients with tunnelled intravenous catheters. Trial Registration Australian New Zealand Clinical Trials Registry Number: ACTRN12609000493246

  8. Rationale and design of the balANZ trial: A randomised controlled trial of low GDP, neutral pH versus standard peritoneal dialysis solution for the preservation of residual renal function

    Directory of Open Access Journals (Sweden)

    Clarke Margaret

    2010-09-01

    Full Text Available Abstract Background The main hypothesis of this study is that neutral pH, low glucose degradation product (GDP peritoneal dialysis (PD fluid better preserves residual renal function in PD patients over time compared with conventional dialysate. Methods/Design Inclusion criteria are adult PD patients (CAPD or APD aged 18-81 years whose first dialysis was within 90 days prior to or following enrolment and who have a residual GFR ≥ 5 ml/min/1.73 m2, a urine output ≥ 400 ml/day and an ability to understand the nature and requirements of this trial. Pregnant or lactating patients or individuals with an active infection at the time of enrolment, a contra-indication to PD or participation in any other clinical trial where an intervention is designed to moderate rate of change of residual renal function are excluded. Patients will be randomized 1:1 to receive either neutral pH, low GDP dialysis solution (Balance® or conventional dialysis solution (Stay.safe® for a period of 2 years. During this 2 year study period, urinary urea and clearance measurements will be performed at 0, 3, 6, 9, 12, 18 and 24 months. The primary outcome measure will be the slope of residual renal function decline, adjusted for centre and presence of diabetic nephropathy. Secondary outcome measures will include time from initiation of peritoneal dialysis to anuria, peritoneal small solute clearance, peritoneal transport status, peritoneal ultrafiltration, technique survival, patient survival, peritonitis rates and adverse events. A total of 185 patients has been recruited into the trial. Discussion This investigator-initiated study has been designed to provide evidence to help nephrologists determine the optimal dialysis solution for preserving residual renal function in PD patients. Trial Registration Australian New Zealand Clinical Trials Registry Number: ACTRN12606000044527

  9. A cluster randomized trial to assess the impact of opinion leader endorsed evidence summaries on improving quality of prescribing for patients with chronic cardiovascular disease: rationale and design [ISRCTN26365328

    Directory of Open Access Journals (Sweden)

    Tsuyuki Ross T

    2005-06-01

    Full Text Available Abstract Background Although much has been written about the influence of local opinion leaders on clinical practice, there have been few controlled studies of their effect, and almost none have attempted to change prescribing in the community for chronic conditions such as heart failure (HF or ischemic heart disease (IHD. These two conditions are common and there is very good evidence about how to best prevent morbidity and mortality – and good evidence that quality of care is, in general, suboptimal. Practice audits have demonstrated that about one-half of eligible HF patients are prescribed ACE inhibitors (with fewer still reaching appropriate target doses and less than one-third of patients with established IHD are prescribed statins (with many fewer reaching recommended cholesterol targets. It is apparent that interventions to improve quality of prescribing are urgently needed. We hypothesized that an intervention that consisted of patient-specific one-page evidence summaries, generated and then endorsed by local opinion leaders, would be able to change prescribing practices of community-based primary care physicians. Methods (study design A pragmatic single-centre cluster randomized controlled trial comparing an opinion leader-based intervention to usual care for patients with HF or IHD. Randomization will be clustered at the level of the primary care physician; as the design effect is anticipated to be negligible, the unit of analysis will be the patient. Patients with HF or IHD (not receiving ACE inhibitors or statins, respectively will be recruited from community pharmacies and allocated to intervention or usual care based on the randomization status of their primary care physician. The primary outcome is improvement in prescription of proven efficacious therapies for HF (ACE inhibitors or IHD (statins within 6 months of the intervention. Conclusion If the methods used in this intervention are found to improve prescribing practices

  10. Study design and rationale of "Synergistic Effect of Combination Therapy with Cilostazol and ProbUcol on Plaque Stabilization and Lesion REgression (SECURE" study: a double-blind randomised controlled multicenter clinical trial

    Directory of Open Access Journals (Sweden)

    Lee Myoungsook

    2011-01-01

    Full Text Available Abstract Background Probucol, a cholesterol-lowering agent that paradoxically also lowers high-density lipoprotein cholesterol has been shown to prevent progression of atherosclerosis. The antiplatelet agent cilostazol, which has diverse antiatherogenic properties, has also been shown to reduce restenosis in previous clinical trials. Recent experimental studies have suggested potential synergy between probucol and cilostazol in preventing atherosclerosis, possibly by suppressing inflammatory reactions and promoting cholesterol efflux. Methods/design The Synergistic Effect of combination therapy with Cilostazol and probUcol on plaque stabilization and lesion REgression (SECURE study is designed as a double-blind, randomised, controlled, multicenter clinical trial to investigate the effect of cilostazol and probucol combination therapy on plaque volume and composition in comparison with cilostazol monotherapy using intravascular ultrasound and Virtual Histology. The primary end point is the change in the plaque volume of index intermediate lesions between baseline and 9-month follow-up. Secondary endpoints include change in plaque composition, neointimal growth after implantation of stents at percutaneous coronary intervention target lesions, and serum levels of lipid components and biomarkers related to atherosclerosis and inflammation. A total of 118 patients will be included in the study. Discussion The SECURE study will deliver important information on the effects of combination therapy on lipid composition and biomarkers related to atherosclerosis, thereby providing insight into the mechanisms underlying the prevention of atherosclerosis progression by cilostazol and probucol. Trial registration number ClinicalTrials (NCT: NCT01031667

  11. Surgical hip dislocation for treatment of cam femoroacetabular impingement

    Directory of Open Access Journals (Sweden)

    Milind M Chaudhary

    2015-01-01

    Conclusion: Cam femoroacetabular Impingement causing pain and limitation of hip movements was treated by open osteochondroplasty after surgical hip dislocation. This reduced pain, improved hip motion and gave good to excellent results in the short term.

  12. Rationale, design and conduct of a comprehensive evaluation of a school-based peer-led anti-smoking intervention in the UK: the ASSIST cluster randomised trial [ISRCTN55572965

    Directory of Open Access Journals (Sweden)

    Sidaway Mark

    2005-04-01

    Full Text Available Abstract Background To date, no school-based intervention has been proven to be effective in preventing adolescent smoking, despite continuing concern about smoking levels amongst young people in the United Kingdom. Although formal teacher-led smoking prevention interventions are considered unlikely to be effective, peer-led approaches to reducing smoking have been proposed as potentially valuable. Methods/design ASSIST (A Stop Smoking in Schools Trial is a comprehensive, large-scale evaluation to rigorously test whether peer supporters in Year 8 (age 11–12 can be recruited and trained to effect a reduction in smoking uptake among their fellow students. The evaluation is employing a cluster randomised controlled trial (RCT design with secondary school as the unit of randomisation, and is being undertaken in 59 schools in South East Wales and the West of England. Embedded within the trial are an economic evaluation of the intervention costs, a process evaluation to provide detailed information on how the intervention was delivered and received, and an analysis of social networks to consider whether such a peer group intervention could work amongst schoolchildren in this age group. Schools were randomised to either continue with normal smoking education (n = 29 schools, 5562 students, or to do so and additionally receive the ASSIST intervention (n = 30 schools, 5481 students. No schools withdrew once the trial had started, and the intervention was successfully implemented in all 30 schools, with excellent participation rates from the peer supporters. The primary outcome is regular (weekly smoking, validated by salivary cotinine, and this outcome has been obtained for 94.4%, 91.0% and 95.6% of eligible students at baseline, immediate post-intervention, and one-year follow-up respectively. Discussion Comprehensive evaluations of complex public health interventions of this scale and nature are rare in the United Kingdom. This paper demonstrates the

  13. Rationale and design of decision: a double-blind, randomized, placebo-controlled phase III trial evaluating the efficacy and safety of sorafenib in patients with locally advanced or metastatic radioactive iodine (RAI-refractory, differentiated thyroid cancer

    Directory of Open Access Journals (Sweden)

    Brose Marcia S

    2011-08-01

    Full Text Available Abstract Background The incidence of thyroid cancer and the number of patients who die from this disease are increasing globally. Differentiated thyroid cancer (DTC is the histologic subtype present in most patients and is primarily responsible for the increased overall incidence of thyroid cancer. Sorafenib is a multikinase inhibitor that targets several molecular signals believed to be involved in the pathogenesis of thyroid cancer, including those implicated in DTC. In phase II studies of patients with DTC, sorafenib treatment has yielded a median progression-free survival (PFS of 58 to 84 weeks and disease control rates of 59% to 100%. The DECISION trial was designed to assess the ability of sorafenib to improve PFS in patients with locally advanced or metastatic, radioactive iodine (RAI-refractory DTC. Methods/design DECISION is a multicenter, double-blind, randomized, placebo-controlled phase III study in patients with locally advanced/metastatic RAI-refractory DTC. Study treatment will continue until radiographically documented disease progression, unacceptable toxicity, noncompliance, or withdrawal of consent. Efficacy will be evaluated every 56 days (2 cycles, whereas safety will be evaluated every 28 days (1 cycle for the first 8 months and every 56 days thereafter. Following disease progression, patients may continue or start sorafenib, depending on whether they were randomized to receive sorafenib or placebo, at investigator discretion. Patients originally randomized to receive sorafenib will be followed up every 3 months for overall survival (OS; patients originally randomized to receive placebo will be followed up every month for 8 months after cross-over to sorafenib. The duration of the trial is expected to be 30 months from the time the first patient is randomized until the planned number of PFS events is attained. The primary endpoint is PFS; secondary endpoints include OS, time to disease progression, disease control rate

  14. Population Study of Urban, Rural, and Semiurban Regions for the Detection of Endovascular Disease and Prevalence of Risk Factors and Holistic Intervention Study: Rationale, Study Design, and Baseline Characteristics of PURSE-HIS.

    Science.gov (United States)

    Thanikachalam, Sadagopan; Harivanzan, Vijayakumar; Mahadevan, Murugappapillai V; Murthy, J S N; Anbarasi, Chandrasekar; Saravanababu, Chidambaram S; Must, Aviva; Baliga, Ragavendra R; Abraham, William T; Thanikachalam, Mohan

    2015-12-01

    We designed and implemented the PURSE-HIS (Population Study of Urban, Rural and Semiurban Regions for the Detection of Endovascular Disease and Prevalence of Risk Factors and Holistic Intervention Study) to understand the prevalence and progression of subclinical and overt endovascular disease (EVD) and its risk factors in urban, semiurban, and rural communities in South India. The study is also designed to generate clinical evidence for effective, affordable, and sustainable community-specific intervention strategies to control risks factors for EVD. As of June 2012, 8,080 (urban: 2,221; semiurban: 2,821; rural: 3,038) participants >20 years of age were recruited using 2-stage cluster sampling. Baseline measurements included standard cardiovascular disease risk factors, sociodemographic factors, lifestyle habits, psychosocial factors, and nutritional assessment. Fasting blood samples were assayed for putative biochemical risk factors and urine samples for microalbuminuria. All nondiabetic participants underwent oral glucose tolerance test with blood and urine samples collected every 30 min for 2 h. Additional baseline measurements included flow-mediated brachial artery endothelial vasodilation, assessment of carotid intimal medial wall thickness using ultrasonography, screening for peripheral vascular disease using ankle and brachial blood pressures, hemodynamic screening using a high-fidelity applanation tonometry to measure central blood pressure parameters, and aortic pulse wave velocity. To assess prevalence of coronary artery disease, all participants underwent surface electrocardiography and documentation of ventricular wall motion abnormality and function using echocardiography imaging. To detect subclinical lesions, all eligible participants completed an exercise treadmill test. Prospectively, the study will assess progression of subclinical and overt EVD, including risk factor-outcome relation differences across communities. The study will also evaluate

  15. The rationale and design of the antihypertensives and vascular, endothelial, and cognitive function (AVEC trial in elderly hypertensives with early cognitive impairment: Role of the renin angiotensin system inhibition

    Directory of Open Access Journals (Sweden)

    Hart Meaghan

    2009-11-01

    Full Text Available Abstract Background Prior evidence suggests that the renin angiotensin system and antihypertensives that inhibit this system play a role in cognitive, central vascular, and endothelial function. Our objective is to conduct a double-blind randomized controlled clinical trial, the antihypertensives and vascular, endothelial, and cognitive function (AVEC, to compare 1 year treatment of 3 antihypertensives (lisinopril, candesartan, or hydrochlorothiazide in their effect on memory and executive function, cerebral blood flow, and central endothelial function of seniors with hypertension and early objective evidence of executive or memory impairments. Methods/Design The overall experimental design of the AVEC trial is a 3-arm double blind randomized controlled clinical trial. A total of 100 community eligible individuals (60 years or older with hypertension and early cognitive impairment are being recruited from the greater Boston area and randomized to lisinopril, candesartan, or hydrochlorothiazide ("active control" for 12 months. The goal of the intervention is to achieve blood pressure control defined as SBP 20 and without clinical diagnosis of dementia or Alzheimer's disease. Individuals who are currently receiving antihypertensives are eligible to participate if the participants and the primary care providers are willing to taper their antihypertensives. Participants undergo cognitive assessment, measurements of cerebral blood flow using Transcranial Doppler, and central endothelial function by measuring changes in cerebral blood flow in response to changes in end tidal carbon dioxide at baseline (off antihypertensives, 6, and 12 months. Our outcomes are change in cognitive function score (executive and memory, cerebral blood flow, and carbon dioxide cerebral vasoreactivity. Discussion The AVEC trial is the first study to explore impact of antihypertensives in those who are showing early evidence of cognitive difficulties that did not reach the

  16. Home-based versus hospital-based cardiac rehabilitation after myocardial infarction or revascularisation: design and rationale of the Birmingham Rehabilitation Uptake Maximisation Study (BRUM: a randomised controlled trial [ISRCTN72884263

    Directory of Open Access Journals (Sweden)

    Lane Deirdre

    2003-09-01

    Full Text Available Abstract Background Cardiac rehabilitation following myocardial infarction reduces subsequent mortality, but uptake and adherence to rehabilitation programmes remains poor, particularly among women, the elderly and ethnic minority groups. Evidence of the effectiveness of home-based cardiac rehabilitation remains limited. This trial evaluates the effectiveness and cost-effectiveness of home-based compared to hospital-based cardiac rehabilitation. Methods/design A pragmatic randomised controlled trial of home-based compared with hospital-based cardiac rehabilitation in four hospitals serving a multi-ethnic inner city population in the United Kingdom was designed. The home programme is nurse-facilitated, manual-based using the Heart Manual. The hospital programmes offer comprehensive cardiac rehabilitation in an out-patient setting. Patients We will randomise 650 adult, English or Punjabi-speaking patients of low-medium risk following myocardial infarction, coronary angioplasty or coronary artery bypass graft who have been referred for cardiac rehabilitation. Main outcome measures Serum cholesterol, smoking cessation, blood pressure, Hospital Anxiety and Depression Score, distance walked on Shuttle walk-test measured at 6, 12 and 24 months. Adherence to the programmes will be estimated using patient self-reports of activity. In-depth interviews with non-attendees and non-adherers will ascertain patient views and the acceptability of the programmes and provide insights about non-attendance and aims to generate a theory of attendance at cardiac rehabilitation. The economic analysis will measure National Health Service costs using resource inputs. Patient costs will be established from the qualitative research, in particular how they affect adherence. Discussion More data are needed on the role of home-based versus hospital-based cardiac rehabilitation for patients following myocardial infarction and revascularisation, which would be provided by the

  17. Cancer Health Empowerment for Living without Pain (Ca-HELP: study design and rationale for a tailored education and coaching intervention to enhance care of cancer-related pain

    Directory of Open Access Journals (Sweden)

    Slee Christina

    2009-09-01

    Full Text Available Abstract Background Cancer-related pain is common and under-treated. This article describes a study designed to test the effectiveness of a theory-driven, patient-centered coaching intervention to improve cancer pain processes and outcomes. Methods/Design The Cancer Health Empowerment for Living without Pain (Ca-HELP Study is an American Cancer Society sponsored randomized trial conducted in Sacramento, California. A total of 265 cancer patients with at least moderate pain severity (Worst Pain Numerical Analog Score >=4 out of 10 or pain-related impairment (Likert score >= 3 out of 5 were randomly assigned to receive tailored education and coaching (TEC or educationally-enhanced usual care (EUC; 258 received at least one follow-up assessment. The TEC intervention is based on social-cognitive theory and consists of 6 components (assess, correct, teach, prepare, rehearse, portray. Both interventions were delivered over approximately 30 minutes just prior to a scheduled oncology visit. The majority of visits (56% were audio-recorded for later communication coding. Follow-up data including outcomes related to pain severity and impairment, self-efficacy for pain control and for patient-physician communication, functional status and well-being, and anxiety were collected at 2, 6, and 12 weeks. Discussion Building on social cognitive theory and pilot work, this study aims to test the hypothesis that a brief, tailored patient activation intervention will promote better cancer pain care and outcomes. Analyses will focus on the effects of the experimental intervention on pain severity and impairment (primary outcomes; self-efficacy and quality of life (secondary outcomes; and relationships among processes and outcomes of cancer pain care. If this model of coaching by lay health educators proves successful, it could potentially be implemented widely at modest cost. Trial Registration [Clinical Trials Identifier: NCT00283166

  18. Rationale and design of the oral HEMe iron polypeptide Against Treatment with Oral Controlled Release Iron Tablets trial for the correction of anaemia in peritoneal dialysis patients (HEMATOCRIT trial

    Directory of Open Access Journals (Sweden)

    Isbel Nicole M

    2009-07-01

    Full Text Available Abstract Background The main hypothesis of this study is that oral heme iron polypeptide (HIP; Proferrin® ES administration will more effectively augment iron stores in erythropoietic stimulatory agent (ESA-treated peritoneal dialysis (PD patients than conventional oral iron supplementation (Ferrogradumet®. Methods Inclusion criteria are peritoneal dialysis patients treated with darbepoietin alpha (DPO; Aranesp®, Amgen for ≥ 1 month. Patients will be randomized 1:1 to receive either slow-release ferrous sulphate (1 tablet twice daily; control or HIP (1 tablet twice daily for a period of 6 months. The study will follow an open-label design but outcome assessors will be blinded to study treatment. During the 6-month study period, haemoglobin levels will be measured monthly and iron studies (including transferring saturation [TSAT] measurements will be performed bi-monthly. The primary outcome measure will be the difference in TSAT levels between the 2 groups at the end of the 6 month study period, adjusted for baseline values using analysis of covariance (ANCOVA. Secondary outcome measures will include serum ferritin concentration, haemoglobin level, DPO dosage, Key's index (DPO dosage divided by haemoglobin concentration, and occurrence of adverse events (especially gastrointestinal adverse events. Discussion This investigator-initiated multicentre study has been designed to provide evidence to help nephrologists and their peritoneal dialysis patients determine whether HIP administration more effectively augments iron stores in ESP-treated PD patients than conventional oral iron supplementation. Trial Registration Australia New Zealand Clinical Trials Registry number ACTRN12609000432213.

  19. CAD-CAM Implants in Esthetic and Reconstructive Craniofacial Surgery

    OpenAIRE

    Hendricks, Jörg; Hemprich, Alexander; Schulze, Fritz Peter; Berti, Guntram; Schmidt, Jens-Georg; Scholz, Eckhard; Wollny, Gerd; Hierl, Thomas

    2006-01-01

    In the reconstruction of complex craniofacial malformations CAD-CAM procedures could help generating alloplastic implants to achieve almost optimal esthetic results. Complementary to the existing CAD-CAM techniques in the cranial vault region or modeling procedures in unilateral defects, these techniques are introduced to bilaterally affected skulls in esthetic reconstructive surgery. Surgery could thus become less invasive and results more predictable. A tool chain is shown to generate such ...

  20. The pineapple genome and the evolution of CAM photosynthesis

    Science.gov (United States)

    Ming, Ray; VanBuren, Robert; Wai, Ching Man; Tang, Haibao; Schatz, Michael C.; Bowers, John E.; Lyons, Eric; Wang, Ming-Li; Chen, Jung; Biggers, Eric; Zhang, Jisen; Huang, Lixian; Zhang, Lingmao; Miao, Wenjing; Zhang, Jian; Ye, Zhangyao; Miao, Chenyong; Lin, Zhicong; Wang, Hao; Zhou, Hongye; Yim, Won C.; Priest, Henry D.; Zheng, Chunfang; Woodhouse, Margaret; Edger, Patrick P.; Guyot, Romain; Guo, Hao-Bo; Guo, Hong; Zheng, Guangyong; Singh, Ratnesh; Sharma, Anupma; Min, Xiangjia; Zheng, Yun; Lee, Hayan; Gurtowski, James; Sedlazeck, Fritz J.; Harkess, Alex; McKain, Michael R.; Liao, Zhenyang; Fang, Jingping; Liu, Juan; Zhang, Xiaodan; Zhang, Qing; Hu, Weichang; Qin, Yuan; Wang, Kai; Chen, Li-Yu; Shirley, Neil; Lin, Yann-Rong; Liu, Li-Yu; Hernandez, Alvaro G.; Wright, Chris L.; Bulone, Vincent; Tuskan, Gerald A.; Heath, Katy; Zee, Francis; Moore, Paul H.; Sunkar, Ramanjulu; Leebens-Mack, James H.; Mockler, Todd; Bennetzen, Jeffrey L.; Freeling, Michael; Sankoff, David; Paterson, Andrew H.; Zhu, Xinguang; Yang, Xiaohan; Smith, J. Andrew C.; Cushman, John C.; Paull, Robert E.; Yu, Qingyi

    2016-01-01

    Pineapple (Ananas comosus (L.) Merr.) is the most economically valuable crop possessing crassulacean acid metabolism (CAM), a photosynthetic carbon assimilation pathway with high water use efficiency, and the second most important tropical fruit after banana in terms of international trade. We sequenced the genomes of pineapple varieties ‘F153’ and ‘MD2’, and a wild pineapple relative A. bracteatus accession CB5. The pineapple genome has one fewer ancient whole genome duplications than sequenced grass genomes and, therefore, provides an important reference for elucidating gene content and structure in the last common ancestor of extant members of the grass family (Poaceae). Pineapple has a conserved karyotype with seven pre rho duplication chromosomes that are ancestral to extant grass karyotypes. The pineapple lineage has transitioned from C3 photosynthesis to CAM with CAM-related genes exhibiting a diel expression pattern in photosynthetic tissues using beta-carbonic anhydrase (βCA) for initial capture of CO2. Promoter regions of all three βCA genes contain a CCA1 binding site that can bind circadian core oscillators. CAM pathway genes were enriched with cis-regulatory elements including the morning (CCACAC) and evening (AAAATATC) elements associated with regulation of circadian-clock genes, providing the first link between CAM and the circadian clock regulation. Gene-interaction network analysis revealed both activation and repression of regulatory elements that control key enzymes in CAM photosynthesis, indicating that CAM evolved by reconfiguration of pathways preexisting in C3 plants. Pineapple CAM photosynthesis is the result of regulatory neofunctionalization of preexisting gene copies and not acquisition of neofunctionalized genes via whole genome or tandem gene duplication. PMID:26523774

  1. Availability Analysis of the Ventilation Stack CAM Interlock System

    International Nuclear Information System (INIS)

    Ventilation Stack Continuous Air Monitor (CAM) Interlock System failure modes, failure frequencies, and system availability have been evaluated for the RPP. The evaluation concludes that CAM availability is as high as assumed in the safety analysis and that the current routine system surveillance is adequate to maintain this availability credited in the safety analysis, nor is such an arrangement predicted to significantly improve system availability

  2. A systematic review of CAD/CAM fit restoration evaluations.

    Science.gov (United States)

    Boitelle, P; Mawussi, B; Tapie, L; Fromentin, O

    2014-11-01

    The evolution and development of CAD/CAM systems have led to the production of prosthetic reconstructions by going beyond the use of traditional techniques. Precision adjustment of prosthetic elements is considered essential to ensure sustainable restoration and dental preparation. The purpose of this article was to summarise the current literature on the fitting quality of fixed prostheses obtained by CAD/CAM technology. PMID:24952991

  3. Aquatic CAM photosynthesis: a brief history of its discovery

    Science.gov (United States)

    Keeley, Jon E.

    2014-01-01

    Aquatic CAM (Crassulacean Acid Metabolism) photosynthesis was discovered while investigating an unrelated biochemical pathway concerned with anaerobic metabolism. George Bowes was a significant contributor to this project early in its infancy. Not only did he provide me with some valuable perspectives on peer review rejections, but by working with his gas exchange system I was able to take our initial observations of diel fluctuations in malic acid to the next level, showing this aquatic plant exhibited dark CO2 uptake. CAM is universal in all aquatic species of the worldwide Lycophyta genus Isoetes and non-existent in terrestrial Isoetes. Outside of this genus aquatic CAM has a limited occurrence in three other families, including the Crassulaceae. This discovery led to fascinating adventures in the highlands of the Peruvian Andes in search of Stylites, a terrestrial relative of Isoetes. Stylites is a plant that is hermetically sealed from the atmosphere and obtains all of its carbon from terrestrial sources and recycles carbon through CAM. Considering the Mesozoic origin of Isoetes in shallow pools, coupled with the fact that aquatic Isoetes universally possess CAM, suggests the earliest evolution of CAM photosynthesis was most likely not in terrestrial plants.

  4. Rationale and design of the PREDICE project: cost-effectiveness of type 2 diabetes prevention among high-risk Spanish individuals following lifestyle intervention in real-life primary care setting

    Directory of Open Access Journals (Sweden)

    Bolíbar Bonaventura

    2011-08-01

    Full Text Available Abstract Background Type 2 diabetes is an important preventable disease and a growing public health problem. Based on information provided by clinical trials, we know that Type 2 diabetes can be prevented or delayed by lifestyle intervention. In view of translating the findings of diabetes prevention research into real-life it is necessary to carry out community-based evaluations so as to learn about the feasibility and effectiveness of locally designed and implemented programmes. The aim of this project was to assess the effectiveness of an active real-life primary care strategy in high-risk individuals for developing diabetes, and then evaluate its efficiency. Methods/Design Cost-Effectiveness analysis of the DE-PLAN (Diabetes in Europe - Prevention using Lifestyle, physical Activity and Nutritional intervention project when applied to a Mediterranean population in Catalonia (DE-PLAN-CAT. Multicenter, longitudinal cohort assessment (4 years conducted in 18 primary health-care centres (Catalan Health Institute. Individuals without diabetes aged 45-75 years were screened using the Finnish Diabetes Risk Score - FINDRISC - questionnaire and a 2-h oral glucose tolerance test. All high risk tested individuals were invited to participate in either a usual care intervention (information on diet and cardiovascular health without individualized programme, or the intensive DE-PLAN educational program (individualized or group periodically reinforced. Oral glucose tolerance test was repeated yearly to determine diabetes incidence. Besides measuring the accumulated incidence of diabetes, information was collected on economic impact of the interventions in both cohorts (using direct and indirect cost questionnaires and information on utility measures (Quality Adjusted Life Years. A cost-utility and a cost-effectiveness analysis will be performed and data will be modelled to predict long-term cost-effectiveness. Discussion The project was intended to evidence

  5. The REFER (REFer for EchocaRdiogram protocol: a prospective validation of a clinical decision rule, NT-proBNP, or their combination, in the diagnosis of heart failure in primary care. Rationale and design

    Directory of Open Access Journals (Sweden)

    Tait Lynda

    2012-10-01

    Full Text Available Abstract Background Heart failure is a major cause of mortality and morbidity. As mortality rates are high, it is important that patients seen by general practitioners with symptoms suggestive of heart failure are identified quickly and treated appropriately. Identifying patients with heart failure or deciding which patients need further tests is a challenge. All patients with suspected heart failure should be diagnosed using objective tests such as echocardiography, but it is expensive, often delayed, and limited by the significant skill shortage of trained echocardiographers. Alternative approaches for diagnosing heart failure are currently limited. Clinical decision tools that combine clinical signs, symptoms or patient characteristics are designed to be used to support clinical decision-making and validated according to strict methodological procedures. The REFER Study aims to determine the accuracy and cost-effectiveness of our previously derived novel, simple clinical decision rule, a natriuretic peptide assay, or their combination, in the triage for referral for echocardiography of symptomatic adult patients who present in general practice with symptoms suggestive of heart failure. Methods/design This is a prospective, Phase II observational, diagnostic validation study of a clinical decision rule, natriuretic peptides or their combination, for diagnosing heart failure in primary care. Consecutive adult primary care patients 55 years of age or over presenting to their general practitioner with a chief complaint of recent new onset shortness of breath, lethargy or peripheral ankle oedema of over 48 hours duration, with no obvious recurrent, acute or self-limiting cause will be enrolled. Our reference standard is based upon a three step expert specialist consensus using echocardiography and clinical variables and tests. Discussion Our clinical decision rule offers a potential solution to the diagnostic challenge of providing a timely and

  6. Use of behavioral economics and social psychology to improve treatment of acute respiratory infections (BEARI): rationale and design of a cluster randomized controlled trial [1RC4AG039115-01] - study protocol and baseline practice and provider characteristics

    Science.gov (United States)

    2013-01-01

    Background Inappropriate antibiotic prescribing for nonbacterial infections leads to increases in the costs of care, antibiotic resistance among bacteria, and adverse drug events. Acute respiratory infections (ARIs) are the most common reason for inappropriate antibiotic use. Most prior efforts to decrease inappropriate antibiotic prescribing for ARIs (e.g., educational or informational interventions) have relied on the implicit assumption that clinicians inappropriately prescribe antibiotics because they are unaware of guideline recommendations for ARIs. If lack of guideline awareness is not the reason for inappropriate prescribing, educational interventions may have limited impact on prescribing rates. Instead, interventions that apply social psychological and behavioral economic principles may be more effective in deterring inappropriate antibiotic prescribing for ARIs by well-informed clinicians. Methods/design The Application of Behavioral Economics to Improve the Treatment of Acute Respiratory Infections (BEARI) Trial is a multisite, cluster-randomized controlled trial with practice as the unit of randomization. The primary aim is to test the ability of three interventions based on behavioral economic principles to reduce the rate of inappropriate antibiotic prescribing for ARIs. We randomized practices in a 2 × 2 × 2 factorial design to receive up to three interventions for non-antibiotic-appropriate diagnoses: 1) Accountable Justifications: When prescribing an antibiotic for an ARI, clinicians are prompted to record an explicit justification that appears in the patient electronic health record; 2) Suggested Alternatives: Through computerized clinical decision support, clinicians prescribing an antibiotic for an ARI receive a list of non-antibiotic treatment choices (including prescription options) prior to completing the antibiotic prescription; and 3) Peer Comparison: Each provider’s rate of inappropriate antibiotic prescribing relative to top

  7. Rationale and design of a multicenter prospective cohort study for the eVALuation and monitoring of HPV infections and relATEd cervical diseases in high-risk women (VALHIDATE study

    Directory of Open Access Journals (Sweden)

    Orlando Giovanna

    2012-05-01

    Full Text Available Abstract Background Pap screening, an effective method for cervical cancer prevention, is now supported by molecular human papillomavirus (HPV testing. Recently commercialised preventive vaccines also provide new tools for the primary prevention of cervical cancer. To determine appropriate prevention strategies, the Health General Direction, Lombardy Region, funded a project that aims to characterize and monitor HPV infections and related cervical diseases in high-risk women. Methods/design VALHIDATE is a 5-year multicentre open prospective cohort study. It will recruit 7000 consenting women aged 13–65 years to provide information about the local biomolecular epidemiology of HPV infection and cervical diseases in high-risk women recruited from nine clinical centres and one faith-based organisation. The study will estimate the overall and type-specific prevalence of HPV infection and cervical abnormalities. It also aims to compare standard Pap screening with biomolecular screening, and to assist in the design of targeted regional prevention programs directed specifically at high-risk groups. Three groups of high-risk women: 1000 HIV-infected women (aged 26–65 years, 1000 recent migrant women (aged 26–65 years and 3000 young women (aged 13–26 years and 1 control group: 2000 women (aged 26–45 years attending a spontaneous screening program, will be recruited. Sample sizes will be revised after the first year. Adult participants will undergo conventional cervical cytology, HPV DNA screening and genotyping. Paediatric participants will undergo HPV DNA testing and genotyping of urine samples. HPV DNA, cytological abnormalities and HPV types will be analysed according to demographic, epidemiological, behavioural, and clinical data collected in an electronic case report form. Overall and stratified prevalences will be estimated to analyse the associations between HPV infection and selected characteristics. Logistic regression models

  8. Rationale and design of decision: a double-blind, randomized, placebo-controlled phase III trial evaluating the efficacy and safety of sorafenib in patients with locally advanced or metastatic radioactive iodine (RAI)-refractory, differentiated thyroid cancer

    International Nuclear Information System (INIS)

    The incidence of thyroid cancer and the number of patients who die from this disease are increasing globally. Differentiated thyroid cancer (DTC) is the histologic subtype present in most patients and is primarily responsible for the increased overall incidence of thyroid cancer. Sorafenib is a multikinase inhibitor that targets several molecular signals believed to be involved in the pathogenesis of thyroid cancer, including those implicated in DTC. In phase II studies of patients with DTC, sorafenib treatment has yielded a median progression-free survival (PFS) of 58 to 84 weeks and disease control rates of 59% to 100%. The DECISION trial was designed to assess the ability of sorafenib to improve PFS in patients with locally advanced or metastatic, radioactive iodine (RAI)-refractory DTC. DECISION is a multicenter, double-blind, randomized, placebo-controlled phase III study in patients with locally advanced/metastatic RAI-refractory DTC. Study treatment will continue until radiographically documented disease progression, unacceptable toxicity, noncompliance, or withdrawal of consent. Efficacy will be evaluated every 56 days (2 cycles), whereas safety will be evaluated every 28 days (1 cycle) for the first 8 months and every 56 days thereafter. Following disease progression, patients may continue or start sorafenib, depending on whether they were randomized to receive sorafenib or placebo, at investigator discretion. Patients originally randomized to receive sorafenib will be followed up every 3 months for overall survival (OS); patients originally randomized to receive placebo will be followed up every month for 8 months after cross-over to sorafenib. The duration of the trial is expected to be 30 months from the time the first patient is randomized until the planned number of PFS events is attained. The primary endpoint is PFS; secondary endpoints include OS, time to disease progression, disease control rate, response rate, duration of response, safety, and

  9. A randomized multicenter comparison of hybrid sirolimus-eluting stents with bioresorbable polymer versus everolimus-eluting stents with durable polymer in total coronary occlusion: rationale and design of the Primary Stenting of Occluded Native Coronary Arteries IV study

    Directory of Open Access Journals (Sweden)

    Teeuwen Koen

    2012-12-01

    Full Text Available Abstract Background Percutaneous recanalization of total coronary occlusion (TCO was historically hampered by high rates of restenosis and reocclusions. The PRISON II trial demonstrated a significant restenosis reduction in patients treated with sirolimus-eluting stents compared with bare metal stents for TCO. Similar reductions in restenosis were observed with the second-generation zotarolimus-eluting stent and everolimus-eluting stent. Despite favorable anti-restenotic efficacy, safety concerns evolved after identifying an increased rate of very late stent thrombosis (VLST with drug-eluting stents (DES for the treatment of TCO. Late malapposition caused by hypersensitivity reactions and chronic inflammation was suggested as a probable cause of these VLST. New DES with bioresorbable polymer coatings were developed to address these safety concerns. No randomized trials have evaluated the efficacy and safety of the new-generation DES with bioresorbable polymers in patients treated for TCO. Methods/Design The prospective, randomized, single-blinded, multicenter, non-inferiority PRISON IV trial was designed to evaluate the safety, efficacy, and angiographic outcome of hybrid sirolimus-eluting stents with bioresorbable polymers (Orsiro; Biotronik, Berlin, Germany compared with everolimus-eluting stents with durable polymers (Xience Prime/Xpedition; Abbott Vascular, Santa Clara, CA, USA in patients with successfully recanalized TCOs. In total, 330 patients have been randomly allocated to each treatment arm. Patients are eligible with estimated duration of TCO ≥4 weeks with evidence of ischemia in the supply area of the TCO. The primary endpoint is in-segment late luminal loss at 9-month follow-up angiography. Secondary angiographic endpoints include in-stent late luminal loss, minimal luminal diameter, percentage of diameter stenosis, in-stent and in-segment binary restenosis and reocclusions at 9-month follow-up. Additionally, optical coherence

  10. A review of antithrombotic therapy and the rationale and design of the randomized edoxaban in patients with peripheral artery disease (ePAD) trial adding edoxaban or clopidogrel to aspirin after femoropopliteal endovascular intervention.

    Science.gov (United States)

    Tangelder, Marco J D; Nwachuku, Chuke E; Jaff, Michael; Baumgartner, Iris; Duggal, Anil; Adams, George; Ansel, Gary; Grosso, Michael; Mercuri, Michele; Shi, Minggao; Minar, Erich; Moll, Frans L

    2015-04-01

    Compared with the coronary setting, knowledge about antithrombotic therapies after endovascular treatment (EVT) is inadequate in patients with peripheral artery disease (PAD). Based on a review of trials and guidelines, which is summarized in this article, there is scant evidence that antithrombotic drugs improve outcome after peripheral EVT. To address this knowledge gap, the randomized, open-label, multinational edoxaban in patients with Peripheral Artery Disease (ePAD) study (ClinicalTrials.gov identifier NCT01802775) was designed to explore the safety and efficacy of a combined regimen of antiplatelet therapy with clopidogrel and anticoagulation with edoxaban, a selective and direct factor Xa inhibitor, both combined with aspirin. As of July 2014, 203 patients (144 men; mean age 67 years) from 7 countries have been enrolled. These patients have been allocated to once-daily edoxaban [60 mg for 3 months (or 30 mg in the presence of factors associated with increased exposure)] or clopidogrel (75 mg/d for 3 months). All patients received aspirin (100 mg/d) for the 6-month duration of the study. The primary safety endpoint is major or clinically relevant nonmajor bleeding; the primary efficacy endpoint is restenosis or reocclusion at the treated segment(s) measured at 1, 3, and 6 months using duplex ultrasound scanning. All outcomes will be assessed and adjudicated centrally in a masked fashion. The ePAD study is the first of its kind to investigate a combined regimen of antiplatelet therapy and anticoagulation through factor Xa inhibition with edoxaban. PMID:25809373

  11. Healthy eating and active living for diabetes in primary care networks (HEALD-PCN: rationale, design, and evaluation of a pragmatic controlled trial for adults with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Johnson Steven T

    2012-06-01

    Full Text Available Abstract Background While strong and consistent evidence supports the role of lifestyle modification in the prevention and management of type 2 diabetes (T2DM, the best strategies for program implementation to support lifestyle modification within primary care remain to be determined. The objective of the study is to evaluate the implementation of an evidence-based self- management program for patients with T2DM within a newly established primary care network (PCN environment. Method Using a non-randomized design, participants (total N = 110 per group will be consecutively allocated in bi-monthly blocks to either a 6-month self-management program lead by an Exercise Specialist or to usual care. Our primary outcome is self-reported physical activity and pedometer steps. Discussion The present study will assess whether a diabetes self-management program lead by an Exercise Specialist provided within a newly emerging model of primary care and linked to available community-based resources, can lead to positive changes in self-management behaviours for adults with T2DM. Ultimately, our work will serve as a platform upon which an emerging model of primary care can incorporate effective and efficient chronic disease management practices that are sustainable through partnerships with local community partners. Clinical Trials Registration ClinicalTrials.gov identifier: NCT00991380

  12. Project FIT: Rationale, design and baseline characteristics of a school- and community-based intervention to address physical activity and healthy eating among low-income elementary school children

    Directory of Open Access Journals (Sweden)

    Oh Hyun J

    2011-07-01

    Full Text Available Abstract Background This paper describes Project FIT, a collaboration between the public school system, local health systems, physicians, neighborhood associations, businesses, faith-based leaders, community agencies and university researchers to develop a multi-faceted approach to promote physical activity and healthy eating toward the general goal of preventing and reducing childhood obesity among children in Grand Rapids, MI, USA. Methods/design There are four overall components to Project FIT: school, community, social marketing, and school staff wellness - all that focus on: 1 increasing access to safe and affordable physical activity and nutrition education opportunities in the schools and surrounding neighborhoods; 2 improving the affordability and availability of nutritious food in the neighborhoods surrounding the schools; 3 improving the knowledge, self-efficacy, attitudes and behaviors regarding nutrition and physical activity among school staff, parents and students; 4 impacting the 'culture' of the schools and neighborhoods to incorporate healthful values; and 5 encouraging dialogue among all community partners to leverage existing programs and introduce new ones. Discussion At baseline, there was generally low physical activity (70% do not meet recommendation of 60 minutes per day, excessive screen time (75% do not meet recommendation of rd-5th grade children (n = 403. Trial registration ClinicalTrials.gov NCT01385046

  13. Menstrual pain and quality of life in women with primary dysmenorrhea: Rationale, design, and interventions of a randomized controlled trial of effects of a treadmill-based exercise intervention.

    Science.gov (United States)

    Kannan, Priya; Chapple, Cathy M; Miller, Dawn; Claydon, Leica S; Baxter, G David

    2015-05-01

    Dysmenorrhea in the absence of pelvic abnormality is termed primary dysmenorrhea (PD). The health burden and social and economic costs of PD are high as it is reported to be the leading cause of recurrent absenteeism from school or work in adolescent girls and young adults. The belief that exercise works for relieving symptoms in women with PD is based on anecdotal evidence and non-experimental studies. There is very limited evidence from randomized controlled trials (RCTs) to support the use of exercise to reduce the intensity of menstrual pain. The objective of this study is to evaluate the effectiveness of exercise to reduce intensity of pain and improve quality of life in women with PD. We describe the study design of a single-blind (assessor), prospective, two-arm RCT, and the participant characteristics of the 70 women recruited in the age-group 18 to 43 years. The primary outcome of the study is pain intensity. The secondary outcomes of the study are quality of life, functional limitation, sleep, global improvement with treatment, and protocol adherence. The outcomes assessments are done at first menstrual period (baseline, Week 0), 2nd menstrual period (Week 4) and at two additional time points (Week 16 and Week 28) during the trial. The results of the study will provide physiotherapists, medical practitioners, and researchers as well as the women who have PD with new insights, knowledge, and evidence about the use of exercise to manage pain in women with PD. PMID:25839713

  14. Rationale and study design of a cross sectional study documenting the prevalence of Heart Failure amongst the minority ethnic communities in the UK: the E-ECHOES Study (Ethnic - Echocardiographic Heart of England Screening Study

    Directory of Open Access Journals (Sweden)

    Freemantle Nick

    2009-09-01

    Full Text Available Abstract Background Heart failure is an important cause of cardiovascular morbidity and mortality. Studies to date have not established the prevalence heart failure amongst the minority ethnic community in the UK. T'he aim of the E-ECHOES (Ethnic - Echocardiographic Heart of England Screening Studyis to establish, for the first time, the community prevalence and severity of left ventricular systolic dysfunction (LVSD and heart failure amongst the South Asian and Black African-Caribbean ethnic groups in the UK. Methods/Design This is a community based cross-sectional population survey of a sample of South Asian (i.e. those originating from India, Pakistan, Bangladesh and Black African-Caribbean male and female subjects aged 45 years and over. Data collection undertaken using a standardised protocol comprising a questionnaire incorporating targeted clinical history taking, physical examination, and investigations with resting electrocardiography and echocardiography; and blood sampling with consent. This is the largest study on heart failure amongst these ethnic groups. Full data collection started in September 2006 and will be completed by August 2009. Discussion The E-ECHOES study will enable the planning and delivery of clinically and cost-effective treatment of this common and debilitating condition within these communities. In addition it will increase knowledge of the aetiology and management of heart failure within minority ethnic communities.

  15. Integration of solid modeling and database management for CAD/CAM

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Y.C.

    1984-01-01

    Focusing on geometric completeness and data independence respectively, solid modeling and database management could be bridged together so as to provide a CAD/CAM environment with a unified geometric database for multiple application uses. The proposed approach is based on the CSG (Constructive Solid Geometry) scheme for solid modeling and the generic relational model for database management, primarily for the purpose of data conciseness while obeying a rigorous database design discipline. To facilitate data scheme definition, a systematic procedure was devised to convert a set of grammar rules into a generic scheme. A relational query language, SEQUEL, was modified to define, control, and manipulate the flat relations that represent the highly structural generic relational model. To further justify the usefulness of the proposed geometric database management system as well as its supporting query language, two application issues, namely, a solid modeler for CAD and a preprocessor for CAM, were also investigated. The solid modeler implemented not only acts as an application to be interfaced by the query language but also serves as a tool to visually verify the geometric data. Research efforts on CAM issues have also resulted in an algorithm capable of extracting and unifying certain manufacturing features that are embedded in CSG trees.

  16. Cenozoic Antarctic DiatomWare/BugCam: An aid for research and teaching

    Science.gov (United States)

    Wise, S.W.; Olney, M.; Covington, J.M.; Egerton, V.M.; Jiang, S.; Ramdeen, D.K.; Kulhanek S.; Schrader, H.; Sims, P.A.; Wood, A.S.; Davis, A.; Davenport, D.R.; Doepler, N.; Falcon, W.; Lopez, C.; Pressley, T.; Swedberg, O.L.; Harwood, D.M.

    2007-01-01

    Cenozoic Antarctic DiatomWare/BugCam© is an interactive, icon-driven digital-image database/software package that displays over 500 illustrated Cenozoic Antarctic diatom taxa along with original descriptions (including over 100 generic and 20 family-group descriptions). This digital catalog is designed primarily for use by micropaleontologists working in the field (at sea or on the Antarctic continent) where hard-copy literature resources are limited. This new package will also be useful for classroom/lab teaching as well as for any paleontologists making or refining taxonomic identifications at the microscope. The database (Cenozoic Antarctic DiatomWare) is displayed via a custom software program (BugCam) written in Visual Basic for use on PCs running Windows 95 or later operating systems. BugCam is a flexible image display program that utilizes an intuitive thumbnail “tree” structure for navigation through the database. The data are stored on Micrsosoft EXCEL spread sheets, hence no separate relational database program is necessary to run the package

  17. SuperCam, a 64-pixel heterodyne imaging array for the 870 micron atmospheric window

    CERN Document Server

    Groppi, C; Kulesa, C; Pütz, P; Golish, D; Gensheimer, P; Hedden, A; Bussmann, S; Weinreb, S; Kuiper, T; Kooi, J; Jones, G; Bardin, J; Mani, H S; Lichtenberger, A; Narayanan, G; Groppi, Christopher; Walker, Christopher; Kulesa, Craig; Puetz, Patrick; Golish, Dathon; Gensheimer, Paul; Hedden, Abigail; Bussmann, Shane; Weinreb, Sander; Kuiper, Thomas; Kooi, Jacob; Jones, Glenn; Bardin, Joseph; Mani, Hamdi; Lichtenberger, Arthur; Narayanan, Gopal

    2006-01-01

    We report on the development of SuperCam, a 64 pixel, superheterodyne camera designed for operation in the astrophysically important 870 micron atmospheric window. SuperCam will be used to answer fundamental questions about the physics and chemistry of molecular clouds in the Galaxy and their direct relation to star and planet formation. The advent of such a system will provide an order of magnitude increase in mapping speed over what is now available and revolutionize how observational astronomy is performed in this important wavelength regime. Unlike the situation with bolometric detectors, heterodyne receiver systems are coherent, retaining information about both the amplitude and phase of the incident photon stream. From this information a high resolution spectrum of the incident light can be obtained without multiplexing. SuperCam will be constructed by stacking eight, 1x8 rows of fixed tuned, SIS mixers. The IF output of each mixer will be connected to a low-noise, broadband MMIC amplifier integrated in...

  18. Study Design and Rationale for the Phase 3 Clinical Development Program of Enobosarm, a Selective Androgen Receptor Modulator, for the Prevention and Treatment of Muscle Wasting in Cancer Patients (POWER Trials).

    Science.gov (United States)

    Crawford, Jeffrey; Prado, Carla M M; Johnston, Mary Ann; Gralla, Richard J; Taylor, Ryan P; Hancock, Michael L; Dalton, James T

    2016-06-01

    Muscle wasting in cancer is a common and often occult condition that can occur prior to overt signs of weight loss and before a clinical diagnosis of cachexia can be made. Muscle wasting in cancer is an important and independent predictor of progressive functional impairment, decreased quality of life, and increased mortality. Although several therapeutic agents are currently in development for the treatment of muscle wasting or cachexia in cancer, the majority of these agents do not directly inhibit muscle loss. Selective androgen receptor modulators (SARMs) have the potential to increase lean body mass (LBM) and hence muscle mass, without the untoward side effects seen with traditional anabolic agents. Enobosarm, a nonsteroidal SARM, is an agent in clinical development for prevention and treatment of muscle wasting in patients with cancer (POWER 1 and 2 trials). The POWER trials are two identically designed randomized, double-blind, placebo-controlled, multicenter, and multinational phase 3 trials to assess the efficacy of enobosarm for the prevention and treatment of muscle wasting in subjects initiating first-line chemotherapy for non-small-cell lung cancer (NSCLC). To assess enobosarm's effect on both prevention and treatment of muscle wasting, no minimum weight loss is required. These pivotal trials have pioneered the methodological and regulatory fields exploring a therapeutic agent for cancer-associated muscle wasting, a process hereby described. In each POWER trial, subjects will receive placebo (n = 150) or enobosarm 3 mg (n = 150) orally once daily for 147 days. Physical function, assessed as stair climb power (SCP), and LBM, assessed by dual-energy X-ray absorptiometry (DXA), are the co-primary efficacy endpoints in both trials assessed at day 84. Based on extensive feedback from the US Food and Drug Administration (FDA), the co-primary endpoints will be analyzed as a responder analysis. To be considered a physical function responder, a

  19. Rationale and design of EXPLORE: a randomized, prospective, multicenter trial investigating the impact of recanalization of a chronic total occlusion on left ventricular function in patients after primary percutaneous coronary intervention for acute ST-elevation myocardial infarction

    Directory of Open Access Journals (Sweden)

    Tuseth Vegard

    2010-09-01

    Full Text Available Abstract Background In the setting of primary percutaneous coronary intervention, patients with a chronic total occlusion in a non-infarct related artery were recently identified as a high-risk subgroup. It is unclear whether ST-elevation myocardial infarction patients with a chronic total occlusion in a non-infarct related artery should undergo additional percutaneous coronary intervention of the chronic total occlusion on top of optimal medical therapy shortly after primary percutaneous coronary intervention. Possible beneficial effects include reduction in adverse left ventricular remodeling and preservation of global left ventricular function and improved clinical outcome during future coronary events. Methods/Design The Evaluating Xience V and left ventricular function in Percutaneous coronary intervention on occLusiOns afteR ST-Elevation myocardial infarction (EXPLORE trial is a randomized, prospective, multicenter, two-arm trial with blinded evaluation of endpoints. Three hundred patients after primary percutaneous coronary intervention for ST-elevation myocardial infarction with a chronic total occlusion in a non-infarct related artery are randomized to either elective percutaneous coronary intervention of the chronic total occlusion within seven days or standard medical treatment. When assigned to the invasive arm, an everolimus-eluting coronary stent is used. Primary endpoints are left ventricular ejection fraction and left ventricular end-diastolic volume assessed by cardiac Magnetic Resonance Imaging at four months. Clinical follow-up will continue until five years. Discussion The ongoing EXPLORE trial is the first randomized clinical trial powered to investigate whether recanalization of a chronic total occlusion in a non-infarct related artery after primary percutaneous coronary intervention for ST-elevation myocardial infarction results in a better preserved residual left ventricular ejection fraction, reduced end-diastolic volume

  20. Rationale, design, and implementation protocol of the Dutch clinical practice guideline Pain in patients with cancer: a cluster randomised controlled trial with short message service (SMS and interactive voice response (IVR

    Directory of Open Access Journals (Sweden)

    te Boveldt Nienke

    2011-12-01

    Full Text Available Abstract Background One-half of patients with cancer have pain. In nearly one out of two cancer patients with pain, this was undertreated. Inadequate pain control still remains an important problem in this group of patients. Therefore, in 2008 a national, evidence-based multidisciplinary clinical practice guideline 'pain in patients with cancer' has been developed. Yet, publishing a guideline is not enough. Implementation is needed to improve pain management. An innovative implementation strategy, Short Message Service with Interactive Voice Response (SVS-IVR, has been developed and pilot tested. This study aims to evaluate on effectiveness of this strategy to improve pain reporting, pain measurement and adequate pain therapy. In addition, whether the active role of the patient and involvement of caregivers in pain management may change. Methods/design A cluster randomised controlled trial with two arms will be performed in six oncology outpatient clinics of hospitals in the Southeastern region of the Netherlands, with three hospitals in the intervention and three in the control condition. Follow-up measurements will be conducted in all hospitals to study the long-term effect of the intervention. The intervention includes training of professionals (medical oncologists, nurses, and general practitioners and SMS-IVR to report pain in patients with cancer to improve pain reporting by patients, pain management by medical oncologists, nurses, and general practitioners, and decrease pain intensity. Discussion This innovative implementation strategy with technical tools and the involvement of patients, may enhance the use of the guideline 'pain in patients with cancer' for pain management. Short Message Service alerts may serve as a tool to support self-management of patients. Therefore, the SMS-IVR intervention may increase the feeling of having control over one's life. Trail registration Netherlands Trial Register (NTR: NTR2739

  1. The impact of iron supplementation efficiency in female blood donors with a decreased ferritin level and no anaemia. Rationale and design of a randomised controlled trial: a study protocol

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    Tissot Jean-Daniel

    2009-01-01

    Full Text Available Abstract Background There is no recommendation to screen ferritin level in blood donors, even though several studies have noted the high prevalence of iron deficiency after blood donation, particularly among menstruating females. Furthermore, some clinical trials have shown that non-anaemic women with unexplained fatigue may benefit from iron supplementation. Our objective is to determine the clinical effect of iron supplementation on fatigue in female blood donors without anaemia, but with a mean serum ferritin ≤ 30 ng/ml. Methods/Design In a double blind randomised controlled trial, we will measure blood count and ferritin level of women under age 50 yr, who donate blood to the University Hospital of Lausanne Blood Transfusion Department, at the time of the donation and after 1 week. One hundred and forty donors with a ferritin level ≤ 30 ng/ml and haemoglobin level ≥ 120 g/l (non-anaemic a week after the donation will be included in the study and randomised. A one-month course of oral ferrous sulphate (80 mg/day of elemental iron will be introduced vs. placebo. Self-reported fatigue will be measured using a visual analogue scale. Secondary outcomes are: score of fatigue (Fatigue Severity Scale, maximal aerobic power (Chester Step Test, quality of life (SF-12, and mood disorders (Prime-MD. Haemoglobin and ferritin concentration will be monitored before and after the intervention. Discussion Iron deficiency is a potential problem for all blood donors, especially menstruating women. To our knowledge, no other intervention study has yet evaluated the impact of iron supplementation on subjective symptoms after a blood donation. Trial registration NCT00689793

  2. Evaluation of the appropriateness of the preclinical phase (stage A and stage B) of heart failure Management in Outpatient clinics in Italy rationale and design of the 'VASTISSIMO' study.

    Science.gov (United States)

    Mureddu, Gian F; Nistri, Stefano; Faggiano, Pompilio; Fimiani, Biagio; Misuraca, Gianfranco; Maggi, Antonio; Gori, Anna M; Uguccioni, Massimo; Tavazzi, Luigi; Zito, Giovanni B

    2016-07-01

    Early detection of heart failure, when still preclinical, is fundamental. Therefore, it is important to assess whether preclinical heart failure management by cardiologists is adequate. The VASTISSIMO study ('EValuation of the AppropriateneSs of The preclInical phase (Stage A and Stage B) of heart failure Management in Outpatient clinics in Italy') is a prospective nationwide study aimed to evaluate the appropriateness of diagnosis and management of preclinical heart failure (stages A and B) by cardiologists working in outpatient clinics in Italy. Secondary goals are to verify if an online educational course for cardiologists can improve management of preclinical heart failure, and evaluate how well cardiologists are aware of patients' adherence to medications. The study involves 80 outpatient cardiology clinics distributed throughout Italy, affiliated either to the Hospital Cardiologists Association or to the Regional Association of Outpatient Cardiologists, and is designed with two phases of consecutive outpatient enrolment each lasting 1 month. In phase 1, physicians' awareness of the risk of heart failure and their decision-making process are recorded. Subsequently, half of the cardiologists are randomized to undergo an online educational course aimed to improve preclinical heart failure management through implementation of guideline recommendations. At the end of the course, all cardiologists are evaluated (phase 2) to see whether changes in clinical management have occurred in those who underwent the educational program versus those who did not. Patients' adherence to prescribed medications will be assessed through the Morisky Self-report Questionnaire. This study should provide valuable information about cardiologists' awareness of preclinical heart failure and the appropriateness of clinical practice in outpatient cardiology clinics in Italy. PMID:27028840

  3. ELSID-Diabetes study-evaluation of a large scale implementation of disease management programmes for patients with type 2 diabetes. Rationale, design and conduct – a study protocol [ISRCTN08471887

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    Gensichen Jochen

    2005-10-01

    Full Text Available Background Diabetes model projects in different regions of Germany including interventions such as quality circles, patient education and documentation of medical findings have shown improvements of HbA1c levels, blood pressure and occurrence of hypoglycaemia in before-after studies (without control group. In 2002 the German Ministry of Health defined legal regulations for the introduction of nationwide disease management programs (DMP to improve the quality of care in chronically ill patients. In April 2003 the first DMP for patients with type 2 diabetes was accredited. The evaluation of the DMP is essential and has been made obligatory in Germany by the Fifth Book of Social Code. The aim of the study is to assess the effectiveness of DMP by example of type 2 diabetes in the primary care setting of two German federal states (Rheinland-Pfalz and Sachsen-Anhalt. Methods/Design The study is three-armed: a prospective cluster-randomized comparison of two interventions (DMP 1 and DMP 2 against routine care without DMP as control group. In the DMP group 1 the patients are treated according to the current situation within the German-Diabetes-DMP. The DMP group 2 represents diabetic care within ideally implemented DMP providing additional interventions (e.g. quality circles, outreach visits. According to a sample size calculation a sample size of 200 GPs (each GP including 20 patients will be required for the comparison of DMP 1 and DMP 2 considering possible drop-outs. For the comparison with routine care 4000 patients identified by diabetic tracer medication and age (> 50 years will be analyzed. Discussion This study will evaluate the effectiveness of the German Diabetes-DMP compared to a Diabetes-DMP providing additional interventions and routine care in the primary care setting of two different German federal states.

  4. Detection of coronary microembolization by Doppler ultrasound in patients with stable angina pectoris during percutaneous coronary interventions under an adjunctive antithrombotic therapy with abciximab: design and rationale of the High Intensity Transient Signals ReoPro (HITS-RP study

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    Kretzschmar Daniel

    2012-05-01

    Full Text Available Abstract Background Embolization of atherosclerotic debris from the rupture of a vulnerable atherosclerotic plaque occurs iatrogenically during percutaneous coronary interventions (PCI and can induce myocardial necrosis. These microembolizations are detected as high intensity transient signals (HITS using intracoronary Doppler technology. Presentation of the hypothesis In the presented study we will test if abciximab (ReoPro® infusion reduces high intensity transient signals in patients with stable angina pectoris undergoing PCI in comparison to standard therapy alone. Testing the hypothesis The High Intensity Transient Signals ReoPro® (HITS-RP study will enroll 60 patients. It is a prospective, single center, randomized, double-blinded, controlled trial. The study is designed to compare the efficacy of intravenous abciximab administration for reduction of microembolization during elective PCI. Patients will be randomized in a 1:1 fashion to abciximab or placebo infusion. The primary end point of the HITS-RP-Study is the number of HITS during PCI measured by intracoronary Doppler wire. Secondary endpoints are bleeding complications, elevation of cardiac biomarkers or ECG changes after percutaneous coronary interventions, changes in coronary flow velocity reserve, hs-CRP elevation, any major adverse cardio-vascular event during one month follow-up. Implications of the hypothesis The HITS-RP-Study addresses important questions regarding the efficacy of intravenous abciximab administration in reducing microembolization and periprocedural complications in stable angina pectoris patients undergoing PCI. Trial registration The trial is registered under http://www.drks-neu.uniklinik-freiburg.de/drks_web/:DRKS00000603.

  5. Rationale and design of dal-PLAQUE: A study assessing efficacy and safety of dalcetrapib on progression or regression of atherosclerosis using magnetic resonance imaging and 18F-fluorodeoxyglucose positron emission tomography/computed tomography

    Science.gov (United States)

    Fayad, Zahi A.; Mani, Venkatesh; Woodward, Mark; Kallend, David; Bansilal, Sameer; Pozza, Joseph; Burgess, Tracy; Fuster, Valentin; Rudd, James H. F.; Tawakol, Ahmed; Farkouh, Michael E.

    2014-01-01

    dal-PLAQUE is a placebo-controlled multicenter study designed to assess the effect of dalcetrapib on imaging measures of plaque inflammation and plaque burden. dal-PLAQUE is a multimodality imaging study in the context of the large dal-HEART Program. Decreased high-density lipoprotein cholesterol is linked to increased risk of coronary heart disease (CHD). Dalcetrapib, a compound that increases high-density lipoprotein cholesterol by modulating cholesteryl ester transfer protein, is being studied to assess if it can reduce the progression of atherosclerotic disease and thereby decrease cardiovascular morbidity and mortality. Patients with CHD or CHD-risk equivalents were randomized to receive 600 mg dalcetrapib or placebo daily for 24 months, in addition to conventional lipid-lowering medication and other medications for cardiovascular risk factors. The primary outcomes are the effect of dalcetrapib on 18F-fluorodeoxyglucose positron emission tomography target-to-background ratio after 6 months and magnetic resonance imaging (MRI) plaque burden (wall area, wall thickness, total vessel area, and wall area/total vessel area ratio) after 12 months. Secondary objectives include positron emission tomography target-to-background ratio at 3 months and MRI plaque burden at 6 and 24 months; plaque composition at 6, 12, and 24 months; and aortic compliance at 6 months. A tertiary objective is to examine the dynamic contrast-enhanced MRI parameters of plaque neovascularization. In total, 189 subjects entered screening, and 130 were randomized. dal-PLAQUE will provide important information on the effects of dalcetrapib on markers of inflammation and atherosclerotic plaque burden and, thereby, on the safety of cholesteryl ester transfer protein modulation with dalcetrapib. Results are expected in 2011. PMID:21835280

  6. Rationale and design of the Kanyini guidelines adherence with the polypill (Kanyini-GAP study: a randomised controlled trial of a polypill-based strategy amongst Indigenous and non Indigenous people at high cardiovascular risk

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    Usherwood Tim

    2010-08-01

    Full Text Available Abstract Background The Kanyini Guidelines Adherence with the Polypill (Kanyini-GAP Study aims to examine whether a polypill-based strategy (using a single capsule containing aspirin, a statin and two blood pressure-lowering agents amongst Indigenous and non-Indigenous people at high risk of experiencing a cardiovascular event will improve adherence to guideline-indicated therapies, and lower blood pressure and cholesterol levels. Methods/Design The study is an open, randomised, controlled, multi-centre trial involving 1000 participants at high risk of cardiovascular events recruited from mainstream general practices and Aboriginal Medical Services, followed for an average of 18 months. The participants will be randomised to one of two versions of the polypill, the version chosen by the treating health professional according to clinical features of the patient, or to usual care. The primary study outcomes will be changes, from baseline measures, in serum cholesterol and systolic blood pressure and self-reported current use of aspirin, a statin and at least two blood pressure lowering agents. Secondary study outcomes include cardiovascular events, renal outcomes, self-reported barriers to indicated therapy, prescription of indicated therapy, occurrence of serious adverse events and changes in quality-of-life. The trial will be supplemented by formal economic and process evaluations. Discussion The Kanyini-GAP trial will provide new evidence as to whether or not a polypill-based strategy improves adherence to effective cardiovascular medications amongst individuals in whom these treatments are indicated. Trial Registration This trial is registered with the Australian New Zealand Clinical Trial Registry ACTRN126080005833347.

  7. Long-term effects of an inpatient weight-loss program in obese children and the role of genetic predisposition-rationale and design of the LOGIC-trial

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    Rank Melanie

    2012-03-01

    Full Text Available Abstract Background The prevalence of childhood obesity has increased worldwide, which is a serious concern as obesity is associated with many negative immediate and long-term health consequences. Therefore, the treatment of overweight and obesity in children and adolescents is strongly recommended. Inpatient weight-loss programs have shown to be effective particularly regarding short-term weight-loss, whilst little is known both on the long-term effects of this treatment and the determinants of successful weight-loss and subsequent weight maintenance. The purpose of this study is to evaluate the short, middle and long-term effects of an inpatient weight-loss program for children and adolescents and to investigate the likely determinants of weight changes, whereby the primary focus lies on the potential role of differences in polymorphisms of adiposity-relevant genes. Methods/Design The study involves overweight and obese children and adolescents aged 6 to 19 years, who participate in an inpatient weight-loss program for 4 to 6 weeks. It started in 2006 and it is planned to include 1,500 participants by 2013. The intervention focuses on diet, physical activity and behavior therapy. Measurements are taken at the start and the end of the intervention and comprise blood analyses (DNA, lipid and glucose metabolism, adipokines and inflammatory markers, anthropometry (body weight, height and waist circumference, blood pressure, pubertal stage, and exercise capacity. Physical activity, dietary habits, quality of life, and family background are assessed by questionnaires. Follow-up assessments are performed 6 months, 1, 2, 5 and 10 years after the intervention: Children will complete the same questionnaires at all time points and visit their general practitioner for examination of anthropometric parameters, blood pressure and assessment of pubertal stage. At the 5 and 10 year follow-ups, blood parameters and exercise capacity will be additionally

  8. Rationale, design and conduct of a comprehensive evaluation of a primary care based intervention to improve the quality of life of osteoarthritis patients. The PraxArt-project: a cluster randomized controlled trial [ISRCTN87252339

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    Muth Christiane

    2005-07-01

    Full Text Available Abstract Background Osteoarthritis (OA has a high prevalence in primary care. Conservative, guideline orientated approaches aiming at improving pain treatment and increasing physical activity, have been proven to be effective in several contexts outside the primary care setting, as for instance the Arthritis Self management Programs (ASMPs. But it remains unclear if these comprehensive evidence based approaches can improve patients' quality of life if they are provided in a primary care setting. Methods/Design PraxArt is a cluster randomised controlled trial with GPs as the unit of randomisation. The aim of the study is to evaluate the impact of a comprehensive evidence based medical education of GPs on individual care and patients' quality of life. 75 GPs were randomised either to intervention group I or II or to a control group. Each GP will include 15 patients suffering from osteoarthritis according to the criteria of ACR. In intervention group I GPs will receive medical education and patient education leaflets including a physical exercise program. In intervention group II the same is provided, but in addition a practice nurse will be trained to monitor via monthly telephone calls adherence to GPs prescriptions and advices and ask about increasing pain and possible side effects of medication. In the control group no intervention will be applied at all. Main outcome measurement for patients' QoL is the GERMAN-AIMS2-SF questionnaire. In addition data about patients' satisfaction (using a modified EUROPEP-tool, medication, health care utilization, comorbidity, physical activity and depression (using PHQ-9 will be retrieved. Measurements (pre data collection will take place in months I-III, starting in June 2005. Post data collection will be performed after 6 months. Discussion Despite the high prevalence and increasing incidence, comprehensive and evidence based treatment approaches for OA in a primary care setting are neither established nor

  9. Rationale and design of a randomised controlled trial evaluating the effectiveness of an exercise program to improve the quality of life of patients with heart failure in primary care: The EFICAR study protocol

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    de la Torre Maria M

    2010-01-01

    Full Text Available Abstract Background Quality of life (QoL decreases as heart failure worsens, which is one of the greatest worries of these patients. Physical exercise has been shown to be safe for people with heart failure. Previous studies have tested heterogeneous exercise programs using different QoL instruments and reported inconsistent effects on QoL. The aim of this study is to evaluate the effectiveness of a new exercise program for people with heart failure (EFICAR, additional to the recommended optimal treatment in primary care, to improve QoL, functional capacity and control of cardiovascular risk factors. Methods/Design Multicenter clinical trial in which 600 patients with heart failure in NYHA class II-IV will be randomized to two parallel groups: EFICAR and control. After being recruited, through the reference cardiology services, in six health centres from the Spanish Primary Care Prevention and Health Promotion Research Network (redIAPP, patients are followed for 1 year after the beginning of the intervention. Both groups receive the optimized treatment according to the European Society of Cardiology guidelines. In addition, the EFICAR group performs a 3 month supervised progressive exercise program with an aerobic (high-intensity intervals and a strength component; and the programme continues linked with community resources for 9 months. The main outcome measure is the change in health-related QoL measured by the SF-36 and the Minnesota Living with Heart Failure Questionnaires at baseline, 3, 6 and 12 months. Secondary outcomes considered are changes in functional capacity measured by the 6-Minute Walking Test, cardiac structure (B-type natriuretic peptides, muscle strength and body composition. Both groups will be compared on an intention to treat basis, using multi-level longitudinal mixed models. Sex, age, social class, co-morbidity and cardiovascular risk factors will be considered as potential confounding and predictor variables. Discussion

  10. Efficacy of n-3 polyunsaturated fatty acids and feasibility of optimizing preventive strategies in patients at high cardiovascular risk: rationale, design and baseline characteristics of the Rischio and Prevenzione study, a large randomised trial in general practice

    Directory of Open Access Journals (Sweden)

    2010-05-01

    Full Text Available Abstract Background The optimization of preventive strategies in patients at high risk of cardiovascular events and the evaluation of bottlenecks and limitations of transferring current guidelines to the real world of clinical practice are important limiting steps to cardiovascular prevention. Treatment with n-3 polyunsaturated fatty acids improves prognosis after myocardial infarction, but evidence of this benefit is lacking in patients at high cardiovascular risk, but without a history of myocardial infarction. Methods/design Patients were eligible if their general practitioner (GP considered them at high cardiovascular risk because of a cardiovascular disease other than myocardial infarction, or multiple risk factors (at least four major risk factors in non-diabetic patients and one in diabetics. Patients were randomly allocated to treatment with n-3 polyunsaturated fatty acids (1 g daily or placebo in a double-blind study and followed up for five years by their GPs to assess the efficacy of the treatment in preventing cardiovascular mortality (including sudden death and hospitalization for cardiovascular reasons. The secondary, epidemiological, aim of the study is to assess whether it is feasible to adopt current guidelines in everyday clinical practice, with a view to optimizing all the available preventive strategies in people at high cardiovascular risk. A nation-wide network of 860 GPs admitted 12,513 patients to the study between February 2004 and March 2007. The mean age was 64 years and 62% were males. Diabetes mellitus plus one or more cardiovascular risk factors was the main inclusion criterion (47%. About 30% of patients were included because of a history of atherosclerotic cardiovascular disease, 21% for four or more risk factors, and less than 1% for other reasons. Discussion The Rischio and Prevenzione (R&P project provides a feasible model to test the efficacy of n-3 polyunsaturated fatty acid therapy in patients at high

  11. Rationale and design of the B-PROOF study, a randomized controlled trial on the effect of supplemental intake of vitamin B12 and folic acid on fracture incidence

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    van Wijngaarden Janneke P

    2011-12-01

    Full Text Available Abstract Background Osteoporosis is a major health problem, and the economic burden is expected to rise due to an increase in life expectancy throughout the world. Current observational evidence suggests that an elevated homocysteine concentration and poor vitamin B12 and folate status are associated with an increased fracture risk. As vitamin B12 and folate intake and status play a large role in homocysteine metabolism, it is hypothesized that supplementation with these B-vitamins will reduce fracture incidence in elderly people with an elevated homocysteine concentration. Methods/Design The B-PROOF (B-Vitamins for the PRevention Of Osteoporotic Fractures study is a randomized double-blind placebo-controlled trial. The intervention comprises a period of two years, and includes 2919 subjects, aged 65 years and older, independently living or institutionalized, with an elevated homocysteine concentration (≥ 12 μmol/L. One group receives daily a tablet with 500 μg vitamin B12 and 400 μg folic acid and the other group receives a placebo tablet. In both tablets 15 μg (600 IU vitamin D is included. The primary outcome of the study is osteoporotic fractures. Measurements are performed at baseline and after two years and cover bone health i.e. bone mineral density and bone turnover markers, physical performance and physical activity including falls, nutritional intake and status, cognitive function, depression, genetics and quality of life. This large multi-center project is carried out by a consortium from the Erasmus MC (Rotterdam, the Netherlands, VUmc (Amsterdam, the Netherlands and Wageningen University, (Wageningen, the Netherlands, the latter acting as coordinator. Discussion To our best knowledge, the B-PROOF study is the first intervention study in which the effect of vitamin B12 and folic acid supplementation on osteoporotic fractures is studied in a general elderly population. We expect the first longitudinal results of the B

  12. Rationale and design of a multicenter prospective cohort study for the eVALuation and monitoring of HPV infections and relATEd cervical diseases in high-risk women (VALHIDATE study)

    International Nuclear Information System (INIS)

    Pap screening, an effective method for cervical cancer prevention, is now supported by molecular human papillomavirus (HPV) testing. Recently commercialised preventive vaccines also provide new tools for the primary prevention of cervical cancer. To determine appropriate prevention strategies, the Health General Direction, Lombardy Region, funded a project that aims to characterize and monitor HPV infections and related cervical diseases in high-risk women. VALHIDATE is a 5-year multicentre open prospective cohort study. It will recruit 7000 consenting women aged 13–65 years to provide information about the local biomolecular epidemiology of HPV infection and cervical diseases in high-risk women recruited from nine clinical centres and one faith-based organisation. The study will estimate the overall and type-specific prevalence of HPV infection and cervical abnormalities. It also aims to compare standard Pap screening with biomolecular screening, and to assist in the design of targeted regional prevention programs directed specifically at high-risk groups. Three groups of high-risk women: 1000 HIV-infected women (aged 26–65 years), 1000 recent migrant women (aged 26–65 years) and 3000 young women (aged 13–26 years) and 1 control group: 2000 women (aged 26–45 years) attending a spontaneous screening program, will be recruited. Sample sizes will be revised after the first year. Adult participants will undergo conventional cervical cytology, HPV DNA screening and genotyping. Paediatric participants will undergo HPV DNA testing and genotyping of urine samples. HPV DNA, cytological abnormalities and HPV types will be analysed according to demographic, epidemiological, behavioural, and clinical data collected in an electronic case report form. Overall and stratified prevalences will be estimated to analyse the associations between HPV infection and selected characteristics. Logistic regression models will be used to estimate crude and adjusted odds ratios. Cox

  13. "Socialized Music": Historical Formations of Community Music through Social Rationales

    Science.gov (United States)

    Yerichuk, Deanna

    2014-01-01

    This article traces the formation of community music through professional and scholarly articles over the last century in North America, and argues that community music has been discursively formed through social rationales, although the specific rationales have shifted. The author employs an archaeological framework inspired by Michel Foucault to…

  14. Prevalence of Cam Morphology in Females with Femoroacetabular Impingement

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    David M Levy

    2015-12-01

    Full Text Available Cam and pincer are two common morphologies responsible for femoroacetabular impingement. Previous literature has reported that cam deformity is predominantly a male morphology, while being significantly less common in females. The purpose of this study was to determine the prevalence of cam morphology in female subjects diagnosed with symptomatic FAI. All females presenting to the senior author’s clinic diagnosed with symptomatic FAI between December 2006 and Cam and pincer are two common morphologies responsible for femoroacetabular impingement. Previous literature has reported that cam deformity is predominantly a male morphology, while being significantly less common in females. Cam morphology is commonly assessed with the alpha angle, measured on radiographs. The purpose of this study was to determine the prevalence of cam morphology utilizing the alpha angle in female subjects diagnosed with symptomatic FAI. All females presenting to the senior author’s clinic diagnosed with symptomatic FAI between December 2006 and January 2013 were retrospectively reviewed. Alpha (α angles were measured on AP (anteroposterior and lateral (Dunn 90°, cross-table lateral, and/or frog-leg lateral plain radiographs by two blinded physicians, and the largest measured angle was used. Using Gosvig et al.’s classification, alpha angle was characterized as (pathologic > 57°, borderline (51-56°, subtle (46-50°, very subtle (43-45°, or normal (≤42°. Three hundred and ninety-one patients (438 hips were analyzed (age 36.2 ± 12.3 years. Among the hips included, 35.6% were normal, 14.6% pathologic, 15.1% borderline, 14.6% subtle, and 20.1% very subtle. There was no correlation between alpha angle and patient age (R = 0.17 or body mass index (BMI (R = 0.05. The intraclass correlation coefficient (ICC for α-angle measurements was 0.84. Sixty-four percent of females in this cohort had an alpha angle > 42°. Subtle cam deformity plays a significant role in

  15. PRODUCT DATA MANAGEMENT DALAM KAITAN DENGAN CAD/CAM

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    Bernardo Nugroho Yahya

    2004-01-01

    Full Text Available The future industry is the one who can manage the information system. Today, communication technology and distributed system computerization already have the ability to implement system that able to exchange and share information between different users. Product Data Management (PDM is an up-to-date and excellent method on managing the exchange and share of information. PDM is able to integrate and manage data analyzing process and documentation of the related product component physically. By adjusting the CAD/CAM on certain condition, the PDM will function maximally by using the information based on STEP (Standard for the Exchange of Product Data model. This article will explain the relationship between PDM system and CAD/CAM on industry. Abstract in Bahasa Indonesia : Sistem informasi merupakan ujung tombak sebuah perusahaan yang unggul di masa depan. Komputerisasi dengan sistem yang terdistribusi dan teknologi komunikasi saat ini memiliki kemampuan untuk mengimplementasikan sistem yang dapat menukar dan men-share informasi antar user yang berbeda. Teknologi yang mendapat cukup perhatian luas dalam hal pertukaran dan sharing informasi ini adalah Product Data Management (PDM. PDM dapat mengintegrasikan dan mengatur proses pengolahan data dan dokumen teknik yang berhubungan dengan komponen fisik produk yang bersangkutan. PDM akan berfungsi maksimal apabila kesesuaian dengan CAD/CAM diatur sedemikian rupa, dihubungkan dengan informasi berbasiskan STEP (Standard for the Exchange of Product Data model. Artikel ini akan menjelaskan hubungan antara sistem PDM dengan CAD/CAM dalam industri. Kata kunci: PDM, Manajemen Data, CAD/CAM, STEP.

  16. Concerns of Hydrothermal Degradation in CAD/CAM Zirconia

    Science.gov (United States)

    Kim, J.-W.; Covel, N.S.; Guess, P.C.; Rekow, E.D.; Zhang, Y.

    2010-01-01

    Zirconia-based restorations are widely used in prosthetic dentistry; however, their susceptibility to hydrothermal degradation remains elusive. We hypothesized that CAD/CAM machining and subsequent surface treatments, i.e., grinding and/or grit-blasting, have marked effects on the hydrothermal degradation behavior of Y-TZP. CAD/CAM-machined Y-TZP plates (0.5 mm thick), both with and without subsequent grinding with various grit sizes or grit-blasting with airborne alumina particles, were subjected to accelerated aging tests in a steam autoclave. Results showed that the CAD/CAM-machined surfaces initially exhibited superior hydrothermal degradation resistance, but deteriorated at a faster rate upon prolonged autoclave treatment compared with ground and grit-blasted surfaces. The accelerated hydrothermal degradation of CAD/CAM surfaces is attributed to the CAD/CAM machining damage and the absence of surface compressive stresses in the fully sintered material. Clinical relevance for surface treatments of zirconia frameworks in terms of hydrothermal and structural stabilities is addressed. PMID:19966039

  17. Exploring adolescent complementary/alternative medicine (CAM) use in Canada.

    Science.gov (United States)

    Patterson, Chris; Arthur, Heather; Noesgaard, Charlotte; Caldwell, Patricia; Vohra, Julie; Francoeur, Chera; Swinton, Marilyn

    2008-01-01

    A qualitative study using a grounded theory approach investigated adolescents' perceptions about complementary/alternative medicine (CAM) use. Adolescents, attending a clinic at the Canadian College of Naturopathic Medicine, were interviewed after receiving ethics approval. Data were collected using semi-structured interviews. The decision of adolescents to use CAM was based within the context of their world and how it shaped influencing factors. Factors that influenced adolescents' decision to use CAM were identified as certain personality traits, culture, media, social contacts and the ability of CAM providers to develop therapeutic relationships. The barriers and benefits of CAM use influenced evaluation of choices. The importance of barriers in limiting freedom of choice in health care decisions should be investigated by practitioners as they provide care to adolescents. Health care planning for integrative models of care requires determining the "right" blend of expertise by knowing interprofessional boundaries, determining mixed skill sets to provide the essential services and ensuring appropriate regulation that allows practitioners to use their full scope of practice. PMID:18202985

  18. Accelerated partial breast irradiation trials: Diversity in rationale and design

    International Nuclear Information System (INIS)

    Seven randomised trials are currently testing accelerated partial breast irradiation against whole breast radiotherapy after breast conservation surgery. The trials are varied in the techniques used to deliver partial breast radiotherapy, reflecting the range of opportunities offered by advanced brachytherapy and teletherapy modalities. Dose schedules also vary between trials, but the most important point of difference between them reflects alternative concepts of clinical and planning target volumes. These are based mainly on the spatial pattern of relapse in retrospective and prospective studies, which report the majority of first local relapses close to the primary tumour site, and on the assumption that radiotherapy does not prevent the development of new primary tumours developing elsewhere in the breast. However, the pattern of ipsilateral breast tumour relapse is not accurately defined in the clinical literature and does not correspond closely to pathological findings. In addition, published data are consistent with a significant reduction in the rate of other quadrant relapse after whole breast radiotherapy. Regardless of the biological model of local tumour relapse and responsiveness to radiation, the ongoing trials will generate level I evidence for or against accelerated partial breast irradiation, provided patients are followed up long enough before the first reporting of results.

  19. Flow rate calibration for absolute cell counting rationale and design.

    Science.gov (United States)

    Walker, Clare; Barnett, David

    2006-05-01

    There is a need for absolute leukocyte enumeration in the clinical setting, and accurate, reliable (and affordable) technology to determine absolute leukocyte counts has been developed. Such technology includes single platform and dual platform approaches. Derivations of these counts commonly incorporate the addition of a known number of latex microsphere beads to a blood sample, although it has been suggested that the addition of beads to a sample may only be required to act as an internal quality control procedure for assessing the pipetting error. This unit provides the technical details for undertaking flow rate calibration that obviates the need to add reference beads to each sample. It is envisaged that this report will provide the basis for subsequent clinical evaluations of this novel approach. PMID:18770842

  20. Rationale and design: telepsychology service delivery for depressed elderly veterans

    Directory of Open Access Journals (Sweden)

    Richardson Lisa K

    2009-04-01

    Full Text Available Abstract Background Older adults who live in rural areas experience significant disparities in health status and access to mental health care. "Telepsychology," (also referred to as "telepsychiatry," or "telemental health" represents a potential strategy towards addressing this longstanding problem. Older adults may benefit from telepsychology due to its: (1 utility to address existing problematic access to care for rural residents; (2 capacity to reduce stigma associated with traditional mental health care; and (3 utility to overcome significant age-related problems in ambulation and transportation. Moreover, preliminary evidence indicates that telepsychiatry programs are often less expensive for patients, and reduce travel time, travel costs, and time off from work. Thus, telepsychology may provide a cost-efficient solution to access-to-care problems in rural areas. Methods We describe an ongoing four-year prospective, randomized clinical trial comparing the effectiveness of an empirically supported treatment for major depressive disorder, Behavioral Activation, delivered either via in-home videoconferencing technology ("Telepsychology" or traditional face-to-face services ("Same-Room". Our hypothesis is that in-homeTelepsychology service delivery will be equally effective as the traditional mode (Same-Room. Two-hundred twenty-four (224 male and female elderly participants will be administered protocol-driven individual Behavioral Activation therapy for depression over an 8-week period; and subjects will be followed for 12-months to ascertain longer-term effects of the treatment on three outcomes domains: (1 clinical outcomes (symptom severity, social functioning; (2 process variables (patient satisfaction, treatment credibility, attendance, adherence, dropout; and (3 economic outcomes (cost and resource use. Discussion Results from the proposed study will provide important insight into whether telepsychology service delivery is as effective as the traditional mode of service delivery, defined in terms of clinical, process, and economic outcomes, for elderly patients with depression residing in rural areas without adequate access to mental health services. Trial registration National Institutes of Health Clinical Trials Registry (ClinicalTrials.gov identifier# NCT00324701.