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. Integrated design of cam mechanisms and servo-control systems

    Institute of Scientific and Technical Information of China (English)

    姚燕安[1; 颜鸿森[2; 张策[3; 邹慧君[4

    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.

  7. 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...

  8. 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

  9. Design of Cam Mechanism with Negative Radius Roller-Follower

    Directory of Open Access Journals (Sweden)

    Hsieh Jung-Fa

    2016-01-01

    Full Text Available Cam mechanisms with a negative radius roller-follower allow the design of simple machines capable of exerting remarkably high forces. Furthermore, the concave-convex nature of the contact surface between the cam and the follower results in a low contact stress and the ready formation of a lubricating layer. This paper presents a simple method for the design and analysis of a cam mechanism with a negative radius roller-follower. In the proposed approach, conjugate surface theory is employed to derive a kinematic model of the cam mechanism. Analytical expressions for the pressure angle and principal curvatures of the cam profile are then derived. The validity of the proposed design methodology is demonstrated by machining a cam mechanism having a negative radius rollerfollower with a radius of 100 mm.

  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.

    Science.gov (United States)

    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; Subramaniam, Naresh; Suckling, John

    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 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. 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.

  13. 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...

  14. 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.

  15. 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...

  16. 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...

  17. 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.

  18. 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.

  19. 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

  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. 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.

  3. 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.

  4. The International Takotsubo Registry: Rationale, Design, Objectives, and First Results.

    Science.gov (United States)

    Ghadri, Jelena-R; Cammann, Victoria L; Templin, Christian

    2016-10-01

    Takotsubo syndrome (TTS) was first described in Japan in 1990. The clinical presentation is similar to that of acute coronary syndrome (ACS). Cardiac enzymes are commonly elevated. A global initiative was launched and the InterTAK Registry was established to provide a systematic database. The major goals of the International Takotsubo Registry (InterTAK Registry) are to provide a comprehensive clinical characterization on natural history, treatment, and outcomes. We linked a biorepository to identify biomarkers for the diagnosis and prognosis and to investigate the genetic basis as well as disease-related factors. We focus on the rationale, objectives, design, and first results of the InterTAK Registry. PMID:27638029

  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. FastCam optomechanical system design and manufacture

    Science.gov (United States)

    Murga, Gaizka; Sanquirce, Rubén; Campo, Ramón; Oscoz, Alex; López, Roberto; Rebolo, Rafael

    2010-07-01

    FastCam is an instrument jointly developed by the Instituto de Astrofísica de Canarias (IAC) and the Universidad Politécnica de Cartagena (UPCT), designed to obtain high spatial resolution images in the optical wavelength range from ground-based telescopes (http://www.iac.es/proyecto/fastcam and http://www.iac.es/telescopes/Manuales/manualfastcam.pdf). The instrument is equipped with a very low noise and very fast readout speed EMCCD camera which provides short exposure images to an FPGA-based processor which performs the selection, recenterg and combination of images in real-time (applying Lucky Imaging techniques) to provide diffraction limited resolution images in 1-4 m class telescopes from 500 to 1100 nm. IDOM has contributed to this new state-of-the-art instrument with the design of an optomechanical system conceived to maximize the image scale stability of the system for astrometry. The combination of aluminum plates, carbon fiber (CFRP) rods and stainless steel mounts in the optical bench defines an athermalized and stiff design to meet the requirements of thermal and mechanical stability. This work has been done with the support of the Aerospace Subprogramme of the Spanish Centre for the Development of Industrial Technology (CDTI) and the INTEK programme of the Basque Development Agency (SPRI).

  7. 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.

  8. Achieving Both Creativity And Rationale: Reuse In Design With Images And Claims

    Directory of Open Access Journals (Sweden)

    D. Scott McCrickard

    2011-01-01

    Full Text Available Although designers often try to create novel designs, many designs are based on previous work. In this paper we argue for the reuse of rationale, in the form of claims, as a central activity in design, and explore how this can be used to inspire creativity. We present a design activity in which images and claims are reused to create a storyboard and illustrate how creativity and rationale complement each other. Our work serves to demonstrate that an appropriate design activity can be used to leverage creativity with the use of rationale.

  9. The Danish Alzheimer Intervention Study: Rationale, Study Design and Baseline Characteristics of the Cohort

    DEFF Research Database (Denmark)

    Waldemar, G.; Waldorff, F.B.; Buss, D.V.;

    2011-01-01

    There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline characteristics...

  10. 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.

  11. 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.

  12. Piezoelectric hydrogen bonding: computational screening for a design rationale.

    Science.gov (United States)

    Werling, Keith A; Griffin, Maryanne; Hutchison, Geoffrey R; Lambrecht, Daniel S

    2014-09-01

    Organic piezoelectric materials are promising targets in applications such as energy harvesting or mechanical sensors and actuators. In a recent paper (Werling, K. A.; et al. J. Phys. Chem. Lett. 2013, 4, 1365-1370), we have shown that hydrogen bonding gives rise to a significant piezoelectric response. In this article, we aim to find organic hydrogen bonded systems with increased piezo-response by investigating different hydrogen bonding motifs and by tailoring the hydrogen bond strength via functionalization. The largest piezo-coefficient of 23 pm/V is found for the nitrobenzene-aniline dimer. We develop a simple, yet surprisingly accurate rationale to predict piezo-coefficients based on the zero-field compliance matrix and dipole derivatives. This rationale increases the speed of first-principles piezo-coefficient calculations by an order of magnitude. At the same time, it suggests how to understand and further increase the piezo-response. Our rationale also explains the remarkably large piezo-response of 150 pm/V and more for another class of systems, the "molecular springs" (Marvin, C.; et al. J. Phys. Chem. C 2013, 117, 16783-16790.).

  13. Piezoelectric hydrogen bonding: computational screening for a design rationale.

    Science.gov (United States)

    Werling, Keith A; Griffin, Maryanne; Hutchison, Geoffrey R; Lambrecht, Daniel S

    2014-09-01

    Organic piezoelectric materials are promising targets in applications such as energy harvesting or mechanical sensors and actuators. In a recent paper (Werling, K. A.; et al. J. Phys. Chem. Lett. 2013, 4, 1365-1370), we have shown that hydrogen bonding gives rise to a significant piezoelectric response. In this article, we aim to find organic hydrogen bonded systems with increased piezo-response by investigating different hydrogen bonding motifs and by tailoring the hydrogen bond strength via functionalization. The largest piezo-coefficient of 23 pm/V is found for the nitrobenzene-aniline dimer. We develop a simple, yet surprisingly accurate rationale to predict piezo-coefficients based on the zero-field compliance matrix and dipole derivatives. This rationale increases the speed of first-principles piezo-coefficient calculations by an order of magnitude. At the same time, it suggests how to understand and further increase the piezo-response. Our rationale also explains the remarkably large piezo-response of 150 pm/V and more for another class of systems, the "molecular springs" (Marvin, C.; et al. J. Phys. Chem. C 2013, 117, 16783-16790.). PMID:24576213

  14. 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。

  15. 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...

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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”.

  1. 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...

  2. LucKi Birth Cohort Study: rationale and design

    OpenAIRE

    de Korte-de Boer, Dianne; Mommers, Monique; Creemers, Huub MH; Dompeling, Edward; Feron, Frans JM; Gielkens-Sijstermans, Cindy ML; Jaminon, Mariëlle; Mujakovic, Suhreta; van Schayck, Onno CP; Thijs, Carel; Jansen, Maria

    2015-01-01

    Background Infancy and childhood are characterized by rapid growth and development, which largely determine health status and well-being across the lifespan. Identification of modifiable risk factors and prognostic factors in critical periods of life will contribute to the development of effective prevention and intervention strategies. The LucKi Birth Cohort Study was designed and started in 2006 to follow children from birth into adulthood on a wide range of determinants, disorders, and dis...

  3. 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.

  4. Rationale, design and methods of the HEALTHY study behavior intervention component

    OpenAIRE

    Venditti, EM; Elliot, DL; Faith, MS; Firrell, LS; Giles, CM; Goldberg, L.; Marcus, MD; Schneider, M; Solomon, S.; Thompson, D.; Yin, Z.

    2009-01-01

    HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physical education, behavior change and communications and promotion. The conceptual rationale as well as the design and development of the behavior intervention component are described. Pilot study data...

  5. 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.

  6. Design & Reality of CAD/CAM in Laser Beam Scanning Manufacturing System

    Institute of Scientific and Technical Information of China (English)

    SUN Jianjun; SUN Huilai; ZHAO Fangfang; LIN Shuzhong; QI Xiangyang

    2006-01-01

    In laser beam scanning manufacturing (LSM) system the PLT file was adopted as design file. The data of design file were processed by CAD software programmed. And the control model was adopted DEA control model. The DEA model was concerned with not only the distance of the two swaying mirrors, the distance between the swaying mirror and convex lens, the mirror swaying angle and the lens focal length but also the lens central height, the lens convex radius and the medium refractive index. It improved the precision and reduced the error in LBM system. The application of CAD/CAM system in LSM improved the LSM manufacturing velocity and manufacturing quality.

  7. 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.

  8. 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.

  9. 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

  10. 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...

  11. 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...

  12. 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...

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

    Science.gov (United States)

    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 teeth and digital impressions of prepared teeth were made. BI, BC, and BR crowns were designed. Occlusal images of designs including occlusal contacts were superimposed on the gypsum cast images and corresponding contacts were determined. Three designs were evaluated by the students. RESULTS The results of the study revealed that there was significant difference among the number of contacts of gypsum cast and digital models (P<.05). The comparison of the percentage of virtual contacts of three crown designs which were identical to the contacts of original gypsum cast revealed that BI and BR designs showed significantly higher percentages of identical contacts compared with BC design (P<.05). Subjective assessment revealed that students generally found BI designs and BR designs natural regarding naturalness of fissure morphology and cusp shape and cusp tip position. For general occlusal morphology, student groups generally found BI design "too strong" or "perfect", BC design "too weak", and BR design "perfect". CONCLUSION On a prepared tooth, three different biogeneric design modes of a CAD/CAM software reveals different crown designs regarding occlusal contacts and morphology. PMID:26816572

  14. 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.

  15. 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.

  16. 基于Visual LISP的凸轮参数化设计%Cam Parametric Design based on Visual Lisp

    Institute of Scientific and Technical Information of China (English)

    孟建; 刘猛

    2012-01-01

    The parametric drawing program of cam is discussed based on Visual lisp in AutoCAD. Cam parameters input using dialog box,modular design of rise and return profile curve and cam drawing automatic generation are developed. It provides an effective method for similar product design to improve design efficiency.%在AutoCAD平台上,利用Visual lisp语言开发了凸轮参数化绘图程序.实现了凸轮参数的对话框输入,推程、回程曲线的模块化设计,凸轮图形的自动生成.为同类产品实现参数化设计与绘图提供了一种提高设计效率的方法.

  17. 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

  18. 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.

  19. Design and Experimental Investigation of Pneumatic Movement Mechanism Supported by Mechanic Cam and Crank Shaft

    Directory of Open Access Journals (Sweden)

    Salih KORUCU

    2015-02-01

    Full Text Available The pressurized air is applied to many sectors required purity and velocity. One of these sectors is to use of air as impulsive force in the moving mechanisms. In this study, the movement mechanism prototype worked with compressed air was designed and produced forlight vehicle engine as motorbike and ATV (All-Terrain Vehicle. In developed mechanisms, pneumatic artificial muscles were used for a given movement of crankshaft. A cam system was also designed for synchronization pneumatic muscles. In this way, these muscles transmit the synchronous movement to crankshaft. At the end of the study, the developed mechanism was mounted on an ATV vehicle(110 cc/ Cubic Centimeter, engine displacement capacityand its performance was tested using the four different weights (50, 75, 100 and 150 kg, three different pressures (4, 5 and 6 bar and two different hoses (Ø 6 and Ø 8 mm. By considering experimental results and design criteria, power of the movement mechanism was obtained as 886 Watt. With this study, minimization of energy consumption for movement of passenger cars, and using clean and cheap energy as ATV which can be alternative for single or two passenger vehicles.

  20. 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.)

  1. 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...

  2. Rationale, design and methods of the HEALTHY study behavior intervention component.

    Science.gov (United States)

    Venditti, E M; Elliot, D L; Faith, M S; Firrell, L S; Giles, C M; Goldberg, L; Marcus, M D; Schneider, M; Solomon, S; Thompson, D; Yin, Z

    2009-08-01

    HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physical education, behavior change and communications and promotion. The conceptual rationale as well as the design and development of the behavior intervention component are described. Pilot study data informed the development of the behavior intervention component. Principles of social learning and health-related behavior change were incorporated. One element of the behavior intervention component was a sequence of peer-led, teacher-facilitated learning activities known as FLASH (Fun Learning Activities for Student Health). Five FLASH modules were implemented over five semesters of the HEALTHY study, with the first module delivered in the second semester of the sixth grade and the last module in the second semester of the eighth grade. Each module contained sessions that were designed to be delivered on a weekly basis to foster self-awareness, knowledge, decision-making skills and peer involvement for health behavior change. FLASH behavioral practice incorporated individual and group self-monitoring challenges for eating and activity. Another element of the behavior intervention component was the family outreach strategy for extending changes in physical activity and healthy eating beyond the school day and for supporting the student's lifestyle change choices. Family outreach strategies included the delivery of newsletters and supplemental packages with materials to promote healthy behavior in the home environment during school summer and winter holiday breaks. In conclusion, the HEALTHY behavior intervention component, when integrated with total school food and physical education environmental changes enhanced by communications and promotional campaigns, is a feasible and

  3. 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

  4. 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.

  5. Rationale, design, methodology and hospital characteristics of the first gulf acute heart failure registry (gulf care

    Directory of Open Access Journals (Sweden)

    Kadhim J Sulaiman

    2014-01-01

    Full Text Available Background: There is paucity of data on heart failure (HF in the Gulf Middle East. The present paper describes the rationale, design, methodology and hospital characteristics of the first Gulf acute heart failure registry (Gulf CARE. Materials and Methods: Gulf CARE is a prospective, multicenter, multinational registry of patients >18 year of age admitted with diagnosis of acute HF (AHF. The data collected included demographics, clinical characteristics, etiology, precipitating factors, management and outcomes of patients admitted with AHF. In addition, data about hospital readmission rates, procedures and mortality at 3 months and 1-year follow-up were recorded. Hospital characteristics and care provider details were collected. Data were entered in a dedicated website using an electronic case record form. Results: A total of 5005 consecutive patients were enrolled from February 14, 2012 to November 13, 2012. Forty-seven hospitals in 7 Gulf States (Oman, Saudi Arabia, Yemen, Kuwait, United Gulf Emirates, Qatar and Bahrain participated in the project. The majority of hospitals were community hospitals (46%; 22/47 followed by non-University teaching (32%; 15/47 and University hospitals (17%. Most of the hospitals had intensive or coronary care unit facilities (93%; 44/47 with 59% (28/47 having catheterization laboratory facilities. However, only 29% (14/47 had a dedicated HF clinic facility. Most patients (71% were cared for by a cardiologist. Conclusions: Gulf CARE is the first prospective registry of AHF in the Middle East, intending to provide a unique insight into the demographics, etiology, management and outcomes of AHF in the Middle East. HF management in the Middle East is predominantly provided by cardiologists. The data obtained from this registry will help the local clinicians to identify the deficiencies in HF management as well as provide a platform to implement evidence based preventive and treatment strategies to reduce the burden

  6. 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

  7. 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

  8. Prospective study of one million deaths in India: rationale, design, and validation results.

    Directory of Open Access Journals (Sweden)

    Prabhat Jha

    2006-02-01

    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

  9. 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

  10. The Land Use Model Intercomparison Project (LUMIP) contribution to CMIP6: rationale and experimental design

    Science.gov (United States)

    Lawrence, David M.; Hurtt, George C.; Arneth, Almut; Brovkin, Victor; Calvin, Kate V.; Jones, Andrew D.; Jones, Chris D.; Lawrence, Peter J.; de Noblet-Ducoudré, Nathalie; Pongratz, Julia; Seneviratne, Sonia I.; Shevliakova, Elena

    2016-09-01

    complementary to simulations requested in the CMIP6 DECK and historical simulations and other CMIP6 MIPs including ScenarioMIP, C4MIP, LS3MIP, and DAMIP. LUMIP includes a two-phase experimental design. Phase one features idealized coupled and land-only model simulations designed to advance process-level understanding of LULCC impacts on climate, as well as to quantify model sensitivity to potential land-cover and land-use change. Phase two experiments focus on quantification of the historic impact of land use and the potential for future land management decisions to aid in mitigation of climate change. This paper documents these simulations in detail, explains their rationale, outlines plans for analysis, and describes a new subgrid land-use tile data request for selected variables (reporting model output data separately for primary and secondary land, crops, pasture, and urban land-use types). It is essential that modeling groups participating in LUMIP adhere to the experimental design as closely as possible and clearly report how the model experiments were executed.

  11. The Design of Cam Based on NX Motion Simulation%基于NX运动仿真的凸轮设计

    Institute of Scientific and Technical Information of China (English)

    王东凤; 李秀玲

    2011-01-01

    基于NX运动仿真的凸轮设计,特别适合于具有复杂运动特征的凸轮机构。通过对粽子扎线机核心机构排线凸轮的轮廓设计,详细阐述设计的一般过程。所作CAE运动参数分析的结果,与纯数学分析大致吻合,标明设计方法正确可行。%The design of cam based on NX motion simulation is especially suitable for the cam mechanism with the characteristics of complicated movement.The arranging line cam is a core mechanism of tying line machine for Zongzi,through the contour design of arranging line cam,the general design process of the cam was expounded in the paper.The CAE movement parameters were analyzed,the result is approaching to that of the mathematic analysis,the comparisons show that the design method is correct and feasible.

  12. 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...

  13. 基于Pro/ENGINEER的高精度盘形凸轮造型设计%High Precision Disc Cam Design Based on Pro/ENGINEER

    Institute of Scientific and Technical Information of China (English)

    肖苏华

    2014-01-01

    凸轮是广泛使用的传动机构,传动的图解法不能精确描述凸轮轮廓曲线。选用Pro/E野火软件,依据从动件运动规律,通过方程精确建立曲线和图形基准,采用可变截面扫描指令和关系式,确定图形基准函数和凸轮轮廓的对应关系,设计出三维的凸轮实体零件。实践证明,该方法能实现凸轮的高效、高精设计,能广泛应用于实际生产中。%The cam drive mechanism is widely used, but the drive can not accurately describ graphically cam profile. Optional software Pro/E wildfire, according to the movement of the follower, established by the equation curves and precise graphics benchmark, using a variable cross-section scanning instructions and relationship to determine the correspondence between the reference function and the cam profile graphics, design three-dimensional cam solid parts. Practice has proved that this method can achieve cam efficient, high-precision design, can be widely used in actual production.

  14. CAMS achievements in 1995

    Energy Technology Data Exchange (ETDEWEB)

    Berg, Oe.; Fantoni, P.; Iguchi, Y.; Meyer, G.; Soerensen, A.; Dyck, C. van

    1996-01-01

    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).

  15. Application of design rationale for a robotic system for single-incision laparoscopic surgery and natural orifice transluminal endoscopic surgery.

    Science.gov (United States)

    Yao, Wei; Childs, Peter R N

    2013-07-01

    Current endoscopes and instruments are inadequate in some respects for complex intra-abdominal surgery because they are too flexible and cannot provide robust grasping and anatomic retraction. Minimal invasive surgery devices represent a sophisticated class of mechanical instruments making use of a range of mechanisms integrated into modular platforms that can be combined to undertake complex medical procedures. Although the machine elements concerned represent classic mechanical engineering devices, issues of miniaturization, surgical procedure compliance and location control conspire to present a design challenge. In order to capture, document and resolve the design requirements for this complex application, quality functional deployment has been applied in combination with design rationale, captured through issue-based information system mapping. This article reports the use of these tools to produce robot designs with improved dexterity and triangulation that are basic requirements in laparoscopy.

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

    DEFF Research Database (Denmark)

    Bennedsen, Jens; Caspersen, Michael Edelgaard

    2003-01-01

    Web-based distance education is becoming more and more popular in particular for part-time educations primarily because it flexibly adapts to a busy life where family and work has first priority. Students can follow the course without wasting precious time traveling to and from campus several...... evenings a week, and participation can take place also in situations where it would otherwise be impossible (e.g. a sick child or a business trip). However, these advantages don't come for free: the students lose the social relations following from face-to-face contact with the lecturer and teaching...... 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...

  17. 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.

  18. 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…

  19. Engineering specification and system design for CAD/CAM of custom shoes: UMC project effort

    Science.gov (United States)

    Bao, Han P.

    1991-01-01

    The goal of this project is to supplement the footwear design system of North Carolina State University (NCSU) with a software module to design and manufacture a combination sole. The four areas of concentration were: customization of NASCAD (NASA Computer Aided Design) to the footwear project; use of CENCIT data; computer aided manufacturing activities; and beginning work for the bottom elements of shoes. The task of generating a software module for producing a sole was completed with a demonstrated product realization. The software written in C was delivered to NCSU for inclusion in their design system for custom footwear known as LASTMOD. The machining process of the shoe last was improved using a spiral tool path approach.

  20. 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...

  1. Design Rationale Behind the Serious Self-Regulation Game Intervention "Balance It" : Overweight Prevention Among Secondary Vocational Education Students in The Netherlands

    NARCIS (Netherlands)

    Spook, Jorinde E; Paulussen, Theo; Paulissen, Rosie; Visschedijk, Gillian; Kok, Gerjo; van Empelen, Pepijn

    2015-01-01

    OBJECTIVE: This article describes the design rationale behind a serious self-regulation game intervention. The aim of the game is to promote healthy dietary intake and physical activity among secondary vocational educational students in The Netherlands (approximately 16-20 years of age). MATERIALS A

  2. Design Rationale Behind the Serious Self-Regulation Game Intervention “Balance-It”: Overweight Prevention Among Secondary Vocational Education Students in the Netherlands

    NARCIS (Netherlands)

    Spook, J.E.; Paulussen, T.G.W.M.; Paulissen, R.T; Visschedijk, G.C.; Kok, G.; Empelen, P. van

    2015-01-01

    Objective: This article describes the design rationale behind a serious self-regulation game intervention. The aim of the game is to promote healthy dietary intake and physical activity among secondary vocational educational students in The Netherlands (approximately 16-20 years of age). Materials a

  3. 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...

  4. 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

  5. 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.

  6. 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

  7. 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.

  8. 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...

  9. [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.

  10. [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

  11. 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.

  12. 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

  13. Rationale and design of the Feeding Dynamic Intervention (FDI) study for self-regulation of energy intake in preschoolers.

    Science.gov (United States)

    Eneli, Ihuoma U; Tylka, Tracy L; Hummel, Jessica; Watowicz, Rosanna P; Perez, Susana A; Kaciroti, Niko; Lumeng, Julie C

    2015-03-01

    In 2011, the Institute of Medicine Early Childhood Prevention Policies Report identified feeding dynamics as an important focus area for childhood obesity prevention and treatment. Feeding dynamics includes two central components: (1) caregiver feeding practices (i.e., determining how, when, where, and what they feed their children) and (2) child eating behaviors (i.e., determining how much and what to eat from what food caregivers have provided). Although there has been great interest in overweight and obesity prevention and treatment in young children, they have not focused comprehensively on feeding dynamics. Interventions on feeding dynamics that reduce caregivers' excessive controlling and restrictive feeding practices and encourage the development of children's self-regulation of energy intake may hold promise for tackling childhood obesity especially in the young child but currently lack an evidence base. This manuscript describes the rationale and design for a randomized controlled trial designed to compare a group of mothers and their 3-to 5-year old children who received an intervention focused primarily on feeding dynamics called the Feeding Dynamic Intervention (FDI) with a Wait-list Control Group (WLC). The primary aim of the study will be to investigate the efficacy of the FDI for decreasing Eating in the Absence of Hunger (EAH) and improving energy compensation (COMPX). The secondary aim will be to examine the effect of the FDI in comparison to the WLC on maternal self-reported feeding practices and child satiety responsiveness.

  14. 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…

  15. 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.

  16. Perioperative rehabilitation in operation for lung cancer (PROLUCA) – rationale and design

    DEFF Research Database (Denmark)

    Sommer, Maja S; Trier, Karen; Vibe-Petersen, Jette;

    2014-01-01

    postoperative rehabilitation (starting six weeks after surgery); (3) early postoperative rehabilitation alone; (4) today's standard care which is postoperative rehabilitation initiated six weeks after surgery. The preoperative rehabilitation program consists of an individually designed, 30-minute home......-based exercise program performed daily. The postoperative rehabilitation program consists of a supervised group exercise program comprising cardiovascular and resistance training two-hour weekly for 12 weeks combined with individual counseling. The primary study endpoint is VO2peak and secondary endpoints......BACKGROUND: The purpose of the PROLUCA study is to investigate the efficacy of preoperative and early postoperative rehabilitation in a non-hospital setting in patients with operable lung cancer with special focus on exercise. METHODS: Using a 2x2 factorial design with continuous effect endpoint...

  17. 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

    unknown whether a combination of metformin and insulin analogues is superior to insulin analogues alone. Nor is it known which insulin analogue regimen is the optimal. OBJECTIVE: The primary objective of this trial is to evaluate the effect of an 18-month treatment with metformin vs. placebo...... in 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......-acting insulin analogue. RANDOMIZATION: Central randomization stratified for age (above 65 years), previous insulin treatment and treatment centre. INTERVENTIONS: Metformin 1 g x two times daily vs. placebo (approximately 475 patients vs. 475 patients) in combination with insulin detemir before bedtime...

  18. 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

  19. 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...

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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...

  6. 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

  7. 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

  8. 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

  9. The COS-Halos Survey: Rationale, Design, and A Census of Circumgalactic Neutral Hydrogen

    CERN Document Server

    Tumlinson, Jason; Werk, Jessica; Prochaska, J Xavier; Tripp, Todd; Katz, Neal; Dave, Romeel; Oppenheimer, Benjamin D; Meiring, Joseph; Ford, Amanda Brady; O'Meara, John; Peeples, Molly; Sembach, Ken; Weinberg, David

    2013-01-01

    We present the design and methods of the COS-Halos survey, a systematic investigation of the gaseous halos of 44 z = 0.15-0.35 galaxies using background QSOs observed with the Cosmic Origins Spectrograph aboard the Hubble Space Telescope. This survey has yielded 39 spectra of z_em ~ 0.5 QSOs with S/N ~ 10-15 per resolution element. The QSO sightlines pass within 150 physical kpc of the galaxies, which span early and late types over stellar mass log M* / Msun= 9.5 - 11.5. We find that the CGM exhibits strong HI, averaging 1 Ang in Lya equivalent width out to 150 kpc, with 100% covering fraction for star-forming galaxies and 75% covering for passive galaxies. We find good agreement in column densities between this survey and previous studies over similar range of impact parameter. There is weak evidence for a difference between early- and late-type galaxies in the strength and distribution of HI. Kinematics indicate that the detected material is bound to the host galaxy, such that >~90% of the detected column d...

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

  18. 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

  19. Rationale and Design of the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) Study. Sarcoidosis Protocol.

    Science.gov (United States)

    Moller, David R; Koth, Laura L; Maier, Lisa A; Morris, Alison; Drake, Wonder; Rossman, Milton; Leader, Joseph K; Collman, Ronald G; Hamzeh, Nabeel; Sweiss, Nadera J; Zhang, Yingze; O'Neal, Scott; Senior, Robert M; Becich, Michael; Hochheiser, Harry S; Kaminski, Naftali; Wisniewski, Stephen R; Gibson, Kevin F

    2015-10-01

    Sarcoidosis is a systemic disease characterized by noncaseating granulomatous inflammation with tremendous clinical heterogeneity and uncertain pathobiology and lacking in clinically useful biomarkers. The Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study is an observational cohort study designed to explore the role of the lung microbiome and genome in these two diseases. This article describes the design and rationale for the GRADS study sarcoidosis protocol. The study addresses the hypothesis that distinct patterns in the lung microbiome are characteristic of sarcoidosis phenotypes and are reflected in changes in systemic inflammatory responses as measured by peripheral blood changes in gene transcription. The goal is to enroll 400 participants, with a minimum of 35 in each of 9 clinical phenotype subgroups prioritized by their clinical relevance to understanding of the pathobiology and clinical heterogeneity of sarcoidosis. Participants with a confirmed diagnosis of sarcoidosis undergo a baseline visit with self-administered questionnaires, chest computed tomography, pulmonary function tests, and blood and urine testing. A research or clinical bronchoscopy with a research bronchoalveolar lavage will be performed to obtain samples for genomic and microbiome analyses. Comparisons will be made by blood genomic analysis and with clinical phenotypic variables. A 6-month follow-up visit is planned to assess each participant's clinical course. By the use of an integrative approach to the analysis of the microbiome and genome in selected clinical phenotypes, the GRADS study is powerfully positioned to inform and direct studies on the pathobiology of sarcoidosis, identify diagnostic or prognostic biomarkers, and provide novel molecular phenotypes that could lead to improved personalized approaches to therapy for sarcoidosis.

  20. 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.

  1. 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.

  2. Taking the Blood Bank to the Field: The Design and Rationale of the Prehospital Air Medical Plasma (PAMPer) Trial.

    Science.gov (United States)

    Brown, Joshua B; Guyette, Francis X; Neal, Matthew D; Claridge, Jeffrey A; Daley, Brian J; Harbrecht, Brian G; Miller, Richard S; Phelan, Herb A; Adams, Peter W; Early, Barbara J; Peitzman, Andrew B; Billiar, Timothy R; Sperry, Jason L

    2015-01-01

    Hemorrhage and trauma induced coagulopathy remain major drivers of early preventable mortality in military and civilian trauma. Interest in the use of prehospital plasma in hemorrhaging patients as a primary resuscitation agent has grown recently. Trauma center-based damage control resuscitation using early and aggressive plasma transfusion has consistently demonstrated improved outcomes in hemorrhaging patients. Additionally, plasma has been shown to have several favorable immunomodulatory effects. Preliminary evidence with prehospital plasma transfusion has demonstrated feasibility and improved short-term outcomes. Applying state-of-the-art resuscitation strategies to the civilian prehospital arena is compelling. We describe here the rationale, design, and challenges of the Prehospital Air Medical Plasma (PAMPer) trial. The primary objective is to determine the effect of prehospital plasma transfusion during air medical transport on 30-day mortality in patients at risk for traumatic hemorrhage. This study is a multicenter cluster randomized clinical trial. The trial will enroll trauma patients with profound hypotension (SBP ≤ 70 mmHg) or hypotension (SBP 71-90 mmHg) and tachycardia (HR ≥ 108 bpm) from six level I trauma center air medical transport programs. The trial will also explore the effects of prehospital plasma transfusion on the coagulation and inflammatory response following injury. The trial will be conducted under exception for informed consent for emergency research with an investigational new drug approval from the U.S. Food and Drug Administration utilizing a multipronged community consultation process. It is one of three ongoing Department of Defense-funded trials aimed at expanding our understanding of the optimal therapeutic approaches to coagulopathy in the hemorrhaging trauma patient.

  3. 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...

  4. 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

  5. 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...

  6. Rationale, design, methodology and sample characteristics for the family partners for health study: a cluster randomized controlled study

    Directory of Open Access Journals (Sweden)

    Berry Diane C

    2012-03-01

    Full Text Available Abstract Background Young children who are overweight are at increased risk of becoming obese and developing type 2 diabetes and cardiovascular disease later in life. Therefore, early intervention is critical. This paper describes the rationale, design, methodology, and sample characteristics of a 5-year cluster randomized controlled trial being conducted in eight elementary schools in rural North Carolina, United States. Methods/Design The first aim of the trial is to examine the effects of a two-phased intervention on weight status, adiposity, nutrition and exercise health behaviors, and self-efficacy in overweight or obese 2nd, 3 rd, and 4th grade children and their overweight or obese parents. The primary outcome in children is stabilization of BMI percentile trajectory from baseline to 18 months. The primary outcome in parents is a decrease in BMI from baseline to 18 months. Secondary outcomes for both children and parents include adiposity, nutrition and exercise health behaviors, and self-efficacy from baseline to 18 months. A secondary aim of the trial is to examine in the experimental group, the relationships between parents and children's changes in weight status, adiposity, nutrition and exercise health behaviors, and self-efficacy. An exploratory aim is to determine whether African American, Hispanic, and non-Hispanic white children and parents in the experimental group benefit differently from the intervention in weight status, adiposity, health behaviors, and self-efficacy. A total of 358 African American, non-Hispanic white, and bilingual Hispanic children with a BMI ≥ 85th percentile and 358 parents with a BMI ≥ 25 kg/m2 have been inducted over 3 1/2 years and randomized by cohort to either an experimental or a wait-listed control group. The experimental group receives a 12-week intensive intervention of nutrition and exercise education, coping skills training and exercise (Phase I, 9 months of continued monthly contact

  7. 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…

  8. 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.

  9. 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

  10. The potential for distributed generation in Japanese prototype buildings: A DER-CAM analysis of policy, tariff design, building energy use, and technology development (Japanese translation)

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; Marnay, Chris; Firestone, Ryan; Gao, Weijun; Nishida, Masaru

    2004-10-15

    The August 2003 blackout of the northeastern U.S. and CANADA caused great economic losses and inconvenience to New York City and other affected areas. The blackout was a warning to the rest of the world that the ability of conventional power systems to meet growing electricity demand is questionable. Failure of large power systems can lead to serious emergencies. Introduction of on-site generation, renewable energy such as solar and wind power and the effective utilization of exhaust heat is needed, to meet the growing energy demands of the residential and commercial sectors. Additional benefit can be achieved by integrating these distributed technologies into distributed energy resource (DER) systems. This work demonstrates a method for choosing and designing economically optimal DER systems. An additional purpose of this research is to establish a database of energy tariffs, DER technology cost and performance characteristics, and building energy consumption for Japan. This research builds on prior DER studies at the Ernest Orlando Lawrence Berkeley National Laboratory (LBNL) and with their associates in the Consortium for Electric Reliability Technology Solutions (CERTS) and operation, including the development of the microgrid concept, and the DER selection optimization program, the Distributed Energy Resources Customer Adoption Model (DER-CAM). DER-CAM is a tool designed to find the optimal combination of installed equipment and an idealized operating schedule to minimize a site's energy bills, given performance and cost data on available DER technologies, utility tariffs, and site electrical and thermal loads over a test period, usually an historic year. Since hourly electric and thermal energy data are rarely available, they are typically developed by building simulation for each of six end use loads used to model the building: electric-only loads, space heating, space cooling, refrigeration, water heating, and natural-gas-only loads. DER-CAM provides a

  11. 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 ...

  12. 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)

  13. 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...

  14. Introduction of a prognostic biomarker to strengthen risk stratification of acutely admitted patients: rationale and design of the TRIAGE III cluster randomized interventional trial

    DEFF Research Database (Denmark)

    Sandø, Andreas; Schultz, Martin; Eugen-Olsen, Jesper;

    2016-01-01

    complications or deaths. Our aim is to determine whether measurement of the blood level of the biomarker soluble urokinase plasminogen activator receptor (suPAR) can enhance early risk stratification leading to reduced mortality, lower rate of complications, and improved patient flow in acutely admitted adult......) 2016 and ends June 6(th) 2016. The study aims to include 10.000 patients in both the interventional and control arm. The results will be presented in 2017. DISCUSSION: The present article aims to describe the design and rationale of the TRIAGE III study that will investigate whether the availability...

  15. 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.

  16. 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.

  17. 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.

  18. Engineering specification and system design for CAD/CAM of custom shoes. Phase 5: UMC involvement (January 1, 1989 - June 30, 1989)

    Science.gov (United States)

    Bao, Han P.

    1989-01-01

    The CAD/CAM of custom shoes is discussed. The solid object for machining is represented by a wireframe model with its nodes or vertices specified systematically in a grid pattern covering its entire length (point-to-point configuration). Two sets of data from CENCIT and CYBERWARE were used for machining purposes. It was found that the indexing technique (turning the stock by a small angle then moving the tool on a longitudinal path along the foot) yields the best result in terms of ease of programming, savings in wear and tear of the machine and cutting tools, and resolution of fine surface details. The work done using the LASTMOD last design system results in a shoe last specified by a number of congruent surface patches of different sizes. This data format was converted into a form amenable to the machine tool. It involves a series of sorting algorithms and interpolation algorithms to provide the grid pattern that the machine tool needs as was the case in the point to point configuration discussed above. This report also contains an in-depth treatment of the design and production technique of an integrated sole to complement the task of design and manufacture of the shoe last. Clinical data and essential production parameters are discussed. Examples of soles made through this process are given.

  19. 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

  20. 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.

  1. 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 ...

  2. 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.

  3. 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

  4. 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

  5. Design of the Slot Cam Curve of an Axial and Radial Telescopic Tire Building Drum%轴向与径向伸缩式成型鼓槽凸轮曲线设计方法

    Institute of Scientific and Technical Information of China (English)

    汪菲; 刘贺宇; 杨玉虎

    2016-01-01

    Taking an axial and radial telescopic tire building drum with big telescopic ratio as the object,based on systematical analysis of its structure and working principle,kinematic model of the link mechanism was established,and the basic requirements of the inner and outer of drum shoulders were analyzed and summa-rized.Mechanism motion inversion was utilized by selecting the inner of drum shoulders as illusion rack,then the design of the slot cam curve fixedly connected with the main link was turned into the design of variable rotating cam curve.The basic parameters and the law of follower motion of slot cam mechanism were cleared,then mathematical model of oscillating roller follower variable rotating slot cam mechanism was established,and the equation of the slot cam curve was constructed.Finally,a simulation combined with the example shows that the design method is effec-tive.The modeling and design method proposed in thispaper provides a new idea for the design of the cam curve of building drum with big telescopic ratio.%以一种大伸缩比轴向与径向伸缩式成型鼓为对象,在系统分析其结构与工作原理的基础上,建立驱动内、外瓦鼓肩连杆机构的运动学模型,分析并归纳了内、外瓦鼓肩在伸缩运动中需满足的基本要求;运用机构运动倒置的方法,通过选取内瓦鼓肩为假想机架,将与主连杆固联的槽凸轮曲线设计转化为变速转动的盘形凸轮廓线设计问题。分析并确定机构的基本参数和从动件运动规律,进而建立摆动滚子从动件变速转动槽凸轮机构数学模型,推导槽凸轮曲线方程。最后结合算例验证了设计方法的有效性。文中提出的建模与设计方法可为大伸缩比成型鼓凸轮曲线设计提供一种新的思路。

  6. 全自动丝印机中的凸轮设计及应用%Design and Application of Cam in Automation Screen Printer

    Institute of Scientific and Technical Information of China (English)

    荆晓丽; 陈建军

    2001-01-01

    全自动丝印机是片式元件生产中的关键设备。该设备具有 两个工位,它适应于电阻、电容、厚膜电路的印刷。两个工位能够连续自动执行全部印刷过 程,并且可以实现左、右两个工位同时印刷两种不同的片式元件和浆料。印刷速度可达1 38 0 片/h,生产率高,可靠性好。其中对于保证基片定位精度达到0.015 mm和重复定位精度达 到0.01 mm,从而保证整机有较高的丝印精度,凸轮机构的作用至关重要。主要阐述全自动 丝印机中送料和定位装置的凸轮设计及应用。%The automatic screen-printing machine is the key equi pment for manufacturing chip components,which is also suitable for printing resi stor,capacitor and thick film circuit.The two working position of the printer ca n operate the whole process automatically and continuously and both of the left and the right working position may also print 2 differential kinds of chip compo nents and ink material on each side at the same time.The printing speed is up to 1 380 chip per hour,the productivity is high and reliability is good.The reliab ility is realized depending on using the cam.Mainly describe the design and ap plication of the cam of feeding and fixing of the automatic screen printer.

  7. Quality and cost improvement of healthcare via complementary measurement and diagnosis of patient general health outcome using electronic health record data: research rationale and design.

    Science.gov (United States)

    Stusser, Rodolfo J; Dickey, Richard A

    2013-12-01

    In this evolving 'third era of health', one of the US Health Care Reform Act's goals is to effectively facilitate the primary care physician's ability to better diagnose and manage the health outcome of the outpatient. That goal must include research on the complementary quantitative-qualitative assessment and rating of the patient's health status. This paper proposes an overview of the rationale and design of a research program for a balanced measurement and diagnostic clinical decision support system (CDSS) of the changing general health status of the patient -including disease- using electronic health record (EHR) data. The rationale, objectives, health metric-diagnostic tools architecture, simulation-optimization, and clinical trials are outlined. Resources, time frames, costs, feasibility, healthcare benefits and data-integration of the project are delineated. The basis and components of the research program to achieve an automated-CDSS to complement physician's clinical judgment, calculating a mathematical 'health equation' from each patient's EHR database, assisting physician-patient collaboration to diagnose, and improve general health outcomes is described. Use of multiple dimensional index, ways of classification, and causal factors' assessments, to arrive at the EHR-based CDSS algorithm-software providing a general health level and state rating of the patient are proposed. Its application could provide a compass for the general practitioner's best choice and use of the myriad of healthcare educational and technological options available with lower costs for everyday clinical practice and research. It could advance the approaches and focus of the 'eras of diseases', to the promising 'era of health', in an integrated, general approach to 'health.' PMID:24046235

  8. 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

  9. 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.

  10. 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…

  11. 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)…

  12. 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.

  13. Rationale, design, and baseline characteristics of a trial of prevention of cardiovascular and renal disease with Fosinopril and Pravastatin in nonhypertensive, nonhypercholesterolemic subjects with microalbuminuria (the Prevention of REnal and Vascular ENdstage Disease Intervention Trial [PREVEND IT])

    NARCIS (Netherlands)

    Diercks, GFH; Janssen, WMT; van Boven, AJ; Bak, AAA; de Jong, PE; Crijns, HJGM; van Gilst, WH

    2000-01-01

    This study describes the rationale, design, and baseline characteristics of a trial to determine whether treatment with fosinopril 20 mg/day and/or pravastatin 40 mg/day will prevent cardiovascular and renal disease in nonhypertensive (RR 10 mg/L once in an early morning spot urine and 15 to 300 mg/

  14. 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...

  15. The potential for distributed generation in Japanese prototype buildings: A DER-CAM analysis of policy, tariff design, building energy use, and technology development (English Version)

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; Marnay, Chris; Firestone, Ryan; Gao, Weijun; Nishida, Masaru

    2004-10-15

    The August 2003 blackout of the northeastern U.S. and CANADA caused great economic losses and inconvenience to New York City and other affected areas. The blackout was a warning to the rest of the world that the ability of conventional power systems to meet growing electricity demand is questionable. Failure of large power systems can lead to serious emergencies. Introduction of on-site generation, renewable energy such as solar and wind power and the effective utilization of exhaust heat is needed, to meet the growing energy demands of the residential and commercial sectors. Additional benefit can be achieved by integrating these distributed technologies into distributed energy resource (DER) systems. This work demonstrates a method for choosing and designing economically optimal DER systems. An additional purpose of this research is to establish a database of energy tariffs, DER technology cost and performance characteristics, and building energy consumption for Japan. This research builds on prior DER studies at the Ernest Orlando Lawrence Berkeley National Laboratory (LBNL) and with their associates in the Consortium for Electric Reliability Technology Solutions (CERTS) and operation, including the development of the microgrid concept, and the DER selection optimization program, the Distributed Energy Resources Customer Adoption Model (DER-CAM). DER-CAM is a tool designed to find the optimal combination of installed equipment and an idealized operating schedule to minimize a site's energy bills, given performance and cost data on available DER technologies, utility tariffs, and site electrical and thermal loads over a test period, usually an historic year. Since hourly electric and thermal energy data are rarely available, they are typically developed by building simulation for each of six end use loads used to model the building: electric-only loads, space heating, space cooling, refrigeration, water heating, and natural-gas-only loads. DER-CAM provides a

  16. 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…

  17. Rationale and design of A Trial of Sertraline vs. Cognitive Behavioral Therapy for End-stage Renal Disease Patients with Depression (ASCEND).

    Science.gov (United States)

    Hedayati, S Susan; Daniel, Divya M; Cohen, Scott; Comstock, Bryan; Cukor, Daniel; Diaz-Linhart, Yaminette; Dember, Laura M; Dubovsky, Amelia; Greene, Tom; Grote, Nancy; Heagerty, Patrick; Katon, Wayne; Kimmel, Paul L; Kutner, Nancy; Linke, Lori; Quinn, Davin; Rue, Tessa; Trivedi, Madhukar H; Unruh, Mark; Weisbord, Steven; Young, Bessie A; Mehrotra, Rajnish

    2016-03-01

    Major Depressive Disorder (MDD) is highly prevalent in patients with End Stage Renal Disease (ESRD) treated with maintenance hemodialysis (HD). Despite the high prevalence and robust data demonstrating an independent association between depression and poor clinical and patient-reported outcomes, MDD is under-treated when identified in such patients. This may in part be due to the paucity of evidence confirming the safety and efficacy of treatments for depression in this population. It is also unclear whether HD patients are interested in receiving treatment for depression. ASCEND (Clinical Trials Identifier Number NCT02358343), A Trial of Sertraline vs. Cognitive Behavioral Therapy (CBT) for End-stage Renal Disease Patients with Depression, was designed as a multi-center, 12-week, open-label, randomized, controlled trial of prevalent HD patients with comorbid MDD or dysthymia. It will compare (1) a single Engagement Interview vs. a control visit for the probability of initiating treatment for comorbid depression in up to 400 patients; and (2) individual chair-side CBT vs. flexible-dose treatment with a selective serotonin reuptake inhibitor, sertraline, for improvement of depressive symptoms in 180 of the up to 400 patients. The evolution of depressive symptoms will also be examined in a prospective longitudinal cohort of 90 HD patients who choose not to be treated for depression. We discuss the rationale and design of ASCEND, the first large-scale randomized controlled trial evaluating efficacy of non-pharmacologic vs. pharmacologic treatment of depression in HD patients for patient-centered outcomes.

  18. Working Inside for Smoking Elimination (Project W.I.S.E. study design and rationale to prevent return to smoking after release from a smoke free prison

    Directory of Open Access Journals (Sweden)

    Mello Jennifer

    2011-10-01

    Full Text Available Abstract Background Incarcerated individuals suffer disproportionately from the health effects of tobacco smoking due to the high smoking prevalence in this population. In addition there is an over-representation of ethnic and racial minorities, impoverished individuals, and those with mental health and drug addictions in prisons. Increasingly, prisons across the U.S. are becoming smoke free. However, relapse to smoking is common upon release from prison, approaching 90% within a few weeks. No evidence based treatments currently exist to assist individuals to remain abstinent after a period of prolonged, forced abstinence. Methods/Design This paper describes the design and rationale of a randomized clinical trial to enhance smoking abstinence rates among individuals following release from a tobacco free prison. The intervention is six weekly sessions of motivational interviewing and cognitive behavioral therapy initiated approximately six weeks prior to release from prison. The control group views six time matched videos weekly starting about six weeks prior to release. Assessments take place in-person 3 weeks after release and then for non-smokers every 3 months up to 12 months. Smoking status is confirmed by urine cotinine. Discussion Effective interventions are greatly needed to assist these individuals to remain smoke free and reduce health disparities among this socially and economically challenged group. Trial Registration NCT01122589

  19. 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.

  20. 凸轮-六杆式导苗机构设计及仿真%Design and Simulation of Cam-six-bar Guiding Seedling Mechanism

    Institute of Scientific and Technical Information of China (English)

    金鑫; 姬江涛; 杨传华; 杜新武; 刘卫想

    2016-01-01

    In order to improve the working quality of transplanter with chute and simplify the structure of core parts , the cam-six-bar guiding seedling mechanism was put forward and optimized by AHP-Fuzzy Comprehensive Evaluation Meth-od .The key structure and motion parameters of guiding seedling mechanism was determined on the basis of agronomic re -quirements of transplanter with chute and the rule of timing design of guiding seedling mechanism .When plant spacing was δ=225 mm and working efficiency was ξ=80 plants/( minutes · line ) , The key structure and motion parameters of guiding seedling mechanism was ωc=8.38rad/s,υm=0.30m/s,φc0∈(-15°,72°),φg0=350°,l1=24mm,l2=60mm,l3∈(285,295)mm,l4=180mm,l5=105mm,l6=45mm,l7=355mm,l9=290mm.Under the design parameters of cam-six-bar guiding seedling mechanism , the virtual prototype analysis of it was carried out , and the results showed that the seedling could keep upright posture when the seedling thrown into the bottom of opener .The results verified the correctness of the structural analysis and design .%为了提高导苗管式移栽机作业质量,简化核心部件结构,通过 AHP-模糊综合评价法优化提出了凸轮-六杆式导苗机构,根据导苗管式移栽机作业农艺要求,并结合导苗机构作业时序设计规定,确定了导苗机构的关键结构与运动参数。当株距δ=225mm、作业效率ξ=80株/( min·行)时,ωc=8.38rad/s,υm=0.30m/s,φc0∈(-15°,72°),φg 0=350°,l1=24mm,l2=60mm,l3∈(285,295) mm,l4=180mm,l5=105mm,l6=45mm,l7=355mm,l9=290mm。在该设计参数下,对凸轮-六杆式导苗机构进行了虚拟样机分析,结果表明:钵苗从导苗管滑道斜抛落入开沟器底部能够保持直立姿态,验证了结构分析和设计的正确性。

  1. Butterfly Girls; promoting healthy diet and physical activity to young African American girls online: Rationale and design

    Science.gov (United States)

    Young African American girls have a high risk of obesity. Online behavior change programs promoting healthy diet and physical activity are convenient and may be effective for reducing disparities related to obesity. This report presents the protocol guiding the design and evaluation of a culturally ...

  2. 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...

  3. 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.

  4. 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

  5. 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

    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......)), biomarkers, quality of life, and level of physical activity assessed by questionnaires. In addition, long-term maintenance of effects after the supervised training period will be determined. Assessments will be made at baseline, after the 12-week intervention programme, and at 1-year follow up. A total...

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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...

  12. Rationale and design of the Randomized Evaluation of patients with Stable angina Comparing Utilization of noninvasive Examinations (RESCUE) trial.

    Science.gov (United States)

    Stillman, Arthur E; Gatsonis, Constantine; Lima, João A C; Black, William C; Cormack, Jean; Gareen, Ilana; Hoffmann, Udo; Liu, Tao; Mavromatis, Kreton; Schnall, Mitchell D; Udelson, James E; Woodard, Pamela K

    2016-09-01

    RESCUE is a phase III, randomized, controlled, multicenter, comparative efficacy study, designed to compare two diagnostic imaging/treatment paradigms that use coronary computed tomography angiography (CCTA) or single photon emission computed tomography myocardial perfusion imaging (SPECT MPI) for assisting in the diagnosis of ischemic heart disease in patients with stable angina symptoms, and guiding subsequent treatment. The study is based on the hypothesis that CCTA as a diagnostic tool is associated with no increase in cardiac risk, decreased cost, and reduced radiation exposure compared with SPECT MPI. The RESCUE trial was funded by the Agency for Healthcare Research and Quality (AHRQ) and the American College of Radiology Imaging Network (ACRIN) Fund for Imaging Innovation, began in 2011, and completed in 2014. PMID:27595676

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

    DEFF Research Database (Denmark)

    Sørensen, Mona Have; Nielsen, Jacob Have; Gejl, Anne Kær;

    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...... in two municipalities in the Region of Southern Denmark were invited to participate in the study. After stratification by municipality, twelve schools were randomized to either an intervention group or a control group, comprising a total of 505 children with mean age 7.2 ± 0.3 years. The intervention...... was a 9-month classroom-based PA program that involved integration of PA into the math lessons delivered by the schools' math teachers. The primary study outcome was change in math achievement, measured by a 45-minute standardized math test. Secondary outcomes were change in executive function (using...

  14. Rationale, design, and results of the first screening round of a comprehensive, register-based, Chlamydia screening implementation programme in the Netherlands

    Directory of Open Access Journals (Sweden)

    Koekenbier Rik H

    2010-10-01

    Full Text Available Abstract Background Implementing Chlamydia trachomatis screening in the Netherlands has been a point of debate for several years. The National Health Council advised against implementing nationwide screening until additional data collected from a pilot project in 2003 suggested that screening by risk profiles could be effective. A continuous increase in infections recorded in the national surveillance database affirmed the need for a more active approach. Here, we describe the rationale, design, and implementation of a Chlamydia screening demonstration programme. Methods A systematic, selective, internet-based Chlamydia screening programme started in April 2008. Letters are sent annually to all 16 to 29-year-old residents of Amsterdam, Rotterdam, and selected municipalities of South Limburg. The letters invite sexually active persons to login to http://www.chlamydiatest.nl with a personal code and to request a test kit. In the lower prevalence area of South Limburg, test kits can only be requested if the internet-based risk assessment exceeds a predefined value. Results We sent invitations to 261,025 people in the first round. One-fifth of the invitees requested a test kit, of whom 80% sent in a sample for testing. The overall positivity rate was 4.2%. Conclusions This programme advances Chlamydia control activities in the Netherlands. Insight into the feasibility, effectiveness, cost-effectiveness, and impact of this large-scale screening programme will determine whether the programme will be implemented nationally.

  15. 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

  16. 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.

  17. 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

  18. Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD: Design and Rationale of the EFFORTLESS S-ICD Registry

    DEFF Research Database (Denmark)

    Pedersen, Susanne S; Lambiase, Pier; Boersma, Lucas V A;

    2012-01-01

    or in the vasculature. We present the rationale and study design of the Evaluation oF FactORs ImpacTing CLinical Outcome and Cost EffectiveneSS of the S-ICD (EFFORTLESS S-ICD) Registry which was designed to evaluate the long-term performance of the S-ICD including patient quality of life and long-term resource...

  19. 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)

  20. Design and rationale of the HCC BRIDGE study in China: a longitudinal, multicenter cohort trial in hepatocellular carcinoma

    Directory of Open Access Journals (Sweden)

    Qiao You-Lin

    2011-05-01

    Full Text Available Abstract Background More than 50% of the worldwide cases of hepatocellular carcinoma occur in China, and this malignancy currently represents the country's second leading cause of cancer death in cities and the leading cause in rural areas. Despite recent advances in the control and management of hepatocellular carcinoma within China, this disease remains a major health care issue. The global HCC BRIDGE study, designed to assess patterns of hepatocellular carcinoma therapy use and associated outcomes across real-world clinical practice, has recently been expanded as a national study in China, allowing a detailed analysis of hepatocellular carcinoma in this important country. Methods/Design The global HCC BRIDGE study is a multiregional longitudinal cohort trial including patients newly diagnosed with hepatocellular carcinoma between January 1, 2005, and June 30, 2011, who are receiving treatment for hepatocellular carcinoma via sites in the Asia-Pacific, European, and North American regions. The HCC BRIDGE China national study comprises the portion of the global HCC BRIDGE study conducted within mainland China. Patients will be followed from time of diagnosis of hepatocellular carcinoma (post-January 1, 2005 to time of death or December 31, 2011, whichever comes first. Data will be collected on demographic/clinical characteristics, relevant laboratory values, hepatocellular carcinoma/underlying liver disease treatment, tumor response, adverse events, hospitalizations, and overall survival. The primary study end point is overall survival; secondary end points are disease progression, treatment-limiting adverse events, and treatment failure. Results At the time of writing, 15 sites have selected for participation across all 7 traditional regions of China (North, North-East, East, South, South-West, North-West, and Central. The anticipated study population from the China national study is approximately 9000 patients. Discussion Findings from the

  1. 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

  2. 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

  3. Development and validation of the CAM Health Belief Questionnaire (CHBQ and CAM use and attitudes amongst medical students

    Directory of Open Access Journals (Sweden)

    Boker John

    2004-01-01

    impact these already positive attitudes. Unlike the IMAQ, which was intended for use with physicians, the CHBQ is generic in design and content and applicable to a variety of learner types. Evaluation measures must be appropriate for specific CAM instructional outcomes.

  4. 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.

  5. 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.

  6. 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

  7. Design and rationale of the Reduction of Infarct Expansion and Ventricular Remodeling with Erythropoietin After Large Myocardial Infarction (REVEAL) trial

    Science.gov (United States)

    Melloni, Chiara; Rao, Sunil V.; Povsic, Thomas J.; Melton, Laura; Kim, Raymond J.; Kilaru, Rakhi; Patel, Manesh; Talan, Mark; Ferrucci, Luigi; Longo, Dan L.; Lakatta, Edward G.; Najjar, Samer S.; Harrington, Robert A.

    2010-01-01

    Background Acute myocardial infarction (MI) remains a leading cause of death despite advances in pharmacologic and percutaneous therapies. Animal models of ischemia/reperfusion have demonstrated that single-dose erythropoietin (EPO) may reduce infarct size, decrease apoptosis, and increase neovascularization, possibly through mobilization of endothelial progenitor cells (EPCs). Study Design REVEAL is a randomized, double-blind, placebo-controlled, multicenter trial evaluating the effects of epoetin alfa on infarct size and left ventricular (LV) remodeling in patients with large MIs. The trial comprises a dose-escalation safety phase and a single-dose efficacy phase using the highest acceptable epoetin alfa dose up to 60,000 units. Up to 250 STEMI patients undergoing primary or rescue percutaneous coronary intervention (PCI) will be randomized to intravenous epoetin alfa or placebo within 4 hours of successful reperfusion. The primary study endpoint is infarct size expressed as a percentage of LV mass, as measured by cardiac magnetic resonance imaging 2–6 days post study medication administration. Secondary endpoints will assess changes in EPC numbers and changes in indices of ventricular remodeling. Conclusion The REVEAL trial will evaluate the safety and efficacy of the highest tolerated single dose of epoetin alfa in patients who have undergone successful rescue or primary PCI for acute STEMI. PMID:21095264

  8. 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

  9. 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.

  10. 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

  11. 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.

  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. 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

  14. 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

  15. Rationale, design, and sample characteristics of a practical randomized trial to assess a weight loss intervention for low-income women: the Weight-Wise II Program.

    Science.gov (United States)

    Samuel-Hodge, Carmen D; Garcia, Beverly A; Johnston, Larry F; Kraschnewski, Jennifer L; Gustafson, Alison A; Norwood, Arnita F; Glasgow, Russell E; Gold, Alison D; Graham, John W; Evenson, Kelly R; Stearns, Sally C; Gizlice, Ziya; Keyserling, Thomas C

    2012-01-01

    Obesity is common among low-income mid-life women, yet most published weight loss studies have not focused on this population and have been highly resourced efficacy trials. Thus, practical type 2 translational studies are needed to evaluate weight loss interventions for low-income women. In this paper, we present the rationale, study design, and baseline characteristics of a type 2 translational study that evaluates both the processes and outcomes of a weight loss intervention for low-income women given at 6 county health departments in North Carolina. Key features of this study include random selection of study sites, intervention delivery by current staff at study sites, efforts to integrate the intervention with local community resources, a focus on evaluating the processes of translation using the RE-AIM framework, use of an evidence-based weight loss intervention, a detailed description of participant recruitment and representativeness, and a practical randomized trial designed to assess the effectiveness of the intervention. Of 81 health departments invited to participate, 30 (37%) were eligible and willing, and 6 were selected at random to deliver the intervention. Of 432 potential participants screened by phone, 213 (49%) were eligible and of these, 189 (89%) completed baseline measures and were randomized to receive a 5-month weight loss intervention or a delayed intervention. The mean age was 51, mean BMI 37 kg/m(2), 53% were African American, and 43% had no health insurance. The results of this study should be informative to key stakeholders interested in real world weight loss interventions for low-income mid-life women.

  16. 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

  17. 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.

  18. Rationale and design of XAMOS

    DEFF Research Database (Denmark)

    Turpie, Alexander G G; Schmidt, André C; Kreutz, Reinhold;

    2012-01-01

    worldwide, with about 7500 patients receiving rivaroxaban and about 7500 standard of care. XAMOS will supplement the clinical data obtained in the Phase III RECORD 1, 2, 3, and 4 trials in which rivaroxaban was shown to be superior for the primary efficacy endpoints, and with a safety profile similar......, 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...

  19. Rationale and design of ARTS

    DEFF Research Database (Denmark)

    Pitt, Bertram; Filippatos, Gerasimos; Gheorghiade, Mihai;

    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......) are to evaluate the safety and tolerability of BAY 94-8862 in patients with heart failure associated with a reduced left ventricular ejection fraction (HFREF) and chronic kidney disease (CKD), and to examine the effects on biomarkers of cardiac and renal function. Methods ARTS is a multicentre, randomized, double....... placebo (primary endpoint) and vs. spironolactone, safety and tolerability, biomarkers of cardiac and renal function or injury, eGFR, and albuminuria. BAY 94-8862 pharmacokinetics are also assessed. Perspectives ARTS is the first phase II clinical trial of BAY 94-8862 and is expected to provide a wealth...

  20. 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

  1. Rationale and design of a long term follow-up study of women who did and did not receive HPV 16/18 vaccination in Guanacaste, Costa Rica.

    Science.gov (United States)

    Gonzalez, Paula; Hildesheim, Allan; Herrero, Rolando; Katki, Hormuzd; Wacholder, Sholom; Porras, Carolina; Safaeian, Mahboobeh; Jimenez, Silvia; Darragh, Teresa M; Cortes, Bernal; Befano, Brian; Schiffman, Mark; Carvajal, Loreto; Palefsky, Joel; Schiller, John; Ocampo, Rebeca; Schussler, John; Lowy, Douglas; Guillen, Diego; Stoler, Mark H; Quint, Wim; Morales, Jorge; Avila, Carlos; Rodriguez, Ana Cecilia; Kreimer, Aimée R

    2015-04-27

    The Costa Rica Vaccine Trial (CVT) was a randomized clinical trial conducted between 2004 and 2010, which randomized 7466 women aged 18 to 25 to receive the bivalent HPV-16/18 vaccine or control Hepatitis-A vaccine. Participants were followed for 4 years with cross-over vaccination at the study end. In 2010 the long term follow-up (LTFU) study was initiated to evaluate the 10-year impact of HPV-16/18 vaccination, determinants of the immune response, and HPV natural history in a vaccinated population. Herein, the rationale, design and methods of the LTFU study are described, which actively follows CVT participants in the HPV-arm 6 additional years at biennial intervals (3 additional study visits for 10 years of total follow-up), or more often if clinically indicated. According to the initial commitment, women in the Hepatitis-A arm were offered HPV vaccination at cross-over; they were followed 2 additional years and exited from the study. 92% of eligible CVT women accepted participation in LTFU. To provide underlying rates of HPV acquisition and cervical disease among unvaccinated women to compare with the HPV-arm during LTFU, a new unvaccinated control group (UCG) of women who are beyond the age generally recommended for routine vaccination was enrolled, and will be followed by cervical cancer screening over 6 years. To form the UCG, 5000 women were selected from a local census, of whom 2836 women (61% of eligible women) agreed to participate. Over 90% of participants complied with an interview, blood and cervical specimen collection. Evaluation of comparability between the original (Hepatitis-A arm of CVT) and new (UCG) control groups showed that women's characteristics, as well as their predicted future risk for cervical HPV acquisition, were similar, thus validating use of the UCG. LTFU is poised to comprehensively address many important questions related to long-term effects of prophylactic HPV vaccines.

  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. First-line antihypertensive treatment in patients with pre-diabetes: Rationale, design and baseline results of the ADaPT investigation

    Directory of Open Access Journals (Sweden)

    Bramlage Peter

    2008-07-01

    Full Text Available Abstract Background Recent clinical trials reported conflicting results on the reduction of new-onset diabetes using RAS blocking agents. Therefore the role of these agents in preventing diabetes is still not well defined. Ramipril is an ACE inhibitor (ACEi, that has been shown to reduce cardiovascular events in high risk patients and post-hoc analyses of the HOPE trial have provided evidence for its beneficial action in the prevention of diabetes. Methods The ADaPT investigation ("ACE inhibitor-based versus diuretic-based antihypertensive primary treatment in patients with pre-diabetes" is a 4-year open, prospective, parallel group phase IV study. It compares an antihypertensive treatment regimen based on ramipril versus a treatment based on diuretics or betablockers. The primary evaluation criterion is the first manifestation of type 2 diabetes. The study is conducted in primary care to allow the broadest possible application of its results. The present article provides an outline of the rationale, the design and baseline characteristics of AdaPT and compares these to previous studies including ASCOT-BLPA, VALUE and DREAM. Results Until March 2006 a total of 2,015 patients in 150 general practices (general physicians and internists throughout Germany were enrolled. The average age of patients enrolled was 67.1 ± 10.3 years, with 47% being male and a BMI of 29.9 ± 5.0 kg/m2. Dyslipidemia was present in 56.5%. 37.8% reported a family history of diabetes, 57.8% were previously diagnosed with hypertension (usually long standing. The HbA1c value at baseline was 5.6 %. Compared to the DREAM study patients were older, had more frequently hypertension and patients with cardiovascular disease were not excluded. Conclusion Comparing the ADaPT design and baseline data to previous randomized controlled trial it can be acknowledged that AdaPT included patients with a high risk for diabetes development. Results are expected to be available in 2010. Data

  4. 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

  5. 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 ...

  6. 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.

  7. 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.

  8. 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

  9. DATA TRANSLATION BETWEEN PADS AND CAM350

    Directory of Open Access Journals (Sweden)

    E. B. Romanova

    2015-07-01

    Full Text Available The subject matter of the paper is the process of data translation between computer-aided design system for electronic devices PADS VX and system for technological preparation of production of printed circuit boards CAM350 10. The object of this study is two-way translation of data in these systems. Experimental researches are applied as research methods based on repeated playback of forward and reverse data translation process between PADS and CAM350 systems. The aim is to examine the challenges of data exchange between systems and to find out the ways of their solution. The basis of the work is functionality analysis of PADS and CAM350 systems while data translation, which was carried out in the course of operating experience of these systems. The paper presents advantages and disadvantages of translation methods and their comparison. Errors arising in the process are analyzed. Possible reasons of errors origination are described. The main results are recommendations for data exchange between PADS and CAM350 systems. The proposed recommendations give the possibility to optimize the exchange of data between these systems. Practical significance of the work lies in the implementation of results at LLC «Abeo». Recommendations have been used in the development of dozens of different electronic devices. The use of these results made it possible to reduce the production run-up time, to increase data transmission correctness, thereby improving the quality of products and reduction of their cost.

  10. 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.

  11. 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.

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 蔬菜钵苗移栽机取苗臂凸轮机构的设计与试验%Design and test on cam mechanism of seedling pick-up arm for vegetable transplanter for pot seedling

    Institute of Scientific and Technical Information of China (English)

    叶秉良; 李丽; 俞高红; 刘安; 蔡迪

    2014-01-01

    采用解析法对蔬菜钵苗移栽机取苗臂凸轮机构进行了详细设计,以解决目前机构推苗作业时间长、速度慢而影响推苗成功率的问题。根据移栽机取苗和推苗作业时取苗针的运动要求,以及取苗臂的结构尺寸,建立凸轮机构设计的数学模型,优化凸轮推程运动角,进而得到凸轮实际轮廓曲线,进行了机构的运动及压力角分析。建立取苗机构的三维实体模型,制造出其物理样机,采用ADAMS软件进行虚拟样机运动仿真,开展高速摄像运动试验。仿真结果和试验结果基本一致,表明改进设计是正确和合理的,同时比较改进设计结果和原设计结果可知,所设计的凸轮机构能够满足蔬菜钵苗移栽的要求,且试验推苗时间比原设计有效缩短了27.9%,有助于提高推苗成功率和蔬菜钵苗移栽机的工作性能。%It is of important science meaning and application value to study the cam mechanism used in the seedling pick-up arm of vegetable transplanter because it is the key mechanism to influence the work performance of seedling transplanting. By exploring the shortcomings and deficiencies of the existing cam mechanism used in the seedling pick-up arm, it is not difficult to find that it takes a short time to push the seedlings, which affects the success rate of pushing the seedlings, and further affects the efficiency and success rate of transplanting the vegetable seedlings. In order to solve the problem, the analytical method with the advantages of a fast solving speed and high calculating accuracy was applied to further design the current cam mechanism in the seedling pick-up arm. According to the movement requirements of the seedling pick-up and seedling-push of the vegetable transplanter and the structure dimensions of seedling pick-up arm, the mathematical model of designing the cam mechanism was built and the push movement angle of the cam was optimized by

  17. 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.

  18. 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...

  19. 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

  20. Resin-composite blocks for dental CAD/CAM applications.

    Science.gov (United States)

    Ruse, N D; Sadoun, M J

    2014-12-01

    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.

  1. 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

  2. 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.

  3. 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.

  4. Different CAD/CAM-processing routes for zirconia restorations: influence on fitting accuracy.

    Science.gov (United States)

    Kohorst, Philipp; Junghanns, Janet; Dittmer, Marc P; Borchers, Lothar; Stiesch, Meike

    2011-08-01

    The aim of the present in vitro study was to evaluate the influence of different processing routes on the fitting accuracy of four-unit zirconia fixed dental prostheses (FDPs) fabricated by computer-aided design/computer-aided manufacturing (CAD/CAM). Three groups of zirconia frameworks with ten specimens each were fabricated. Frameworks of one group (CerconCAM) were produced by means of a laboratory CAM-only system. The other frameworks were made with different CAD/CAM systems; on the one hand by in-laboratory production (CerconCAD/CAM) and on the other hand by centralized production in a milling center (Compartis) after forwarding geometrical data. Frameworks were then veneered with the recommended ceramics, and marginal accuracy was determined using a replica technique. Horizontal marginal discrepancy, vertical marginal discrepancy, absolute marginal discrepancy, and marginal gap were evaluated. Statistical analyses were performed by one-way analysis of variance (ANOVA), with the level of significance chosen at 0.05. Mean horizontal discrepancies ranged between 22 μm (CerconCAM) and 58 μm (Compartis), vertical discrepancies ranged between 63 μm (CerconCAD/CAM) and 162 μm (CerconCAM), and absolute marginal discrepancies ranged between 94 μm (CerconCAD/CAM) and 181 μm (CerconCAM). The marginal gap varied between 72 μm (CerconCAD/CAM) and 112 μm (CerconCAM, Compartis). Statistical analysis revealed that, with all measurements, the marginal accuracy of the zirconia FDPs was significantly influenced by the processing route used (p < 0.05). Within the limitations of this study, all restorations showed a clinically acceptable marginal accuracy; however, the results suggest that the CAD/CAM systems are more precise than the CAM-only system for the manufacture of four-unit FDPs. PMID:20495937

  5. 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)

  6. 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

  7. 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...

  8. 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.

  9. 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...

  10. Rationale Management Challenges in Requirements Engineering

    NARCIS (Netherlands)

    Liang, Peng; Avgeriou, Paris; He, Keqing

    2010-01-01

    Rationale and rationale management have been playing an increasingly prominent role in software system development mainly due to the knowledge demand during system evaluation, maintenance, and evolution, especially for large and complex systems. The rationale management for requirements engineering,

  11. 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.

  12. 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.

  13. 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 ...

  14. Cam Shaft Design of Six Stroke Diesel Engine Based on Utilization of Exhaust Energy%基于部分排气六冲程单缸柴油机的节能分析与机械功能实现

    Institute of Scientific and Technical Information of China (English)

    陈昊; 刘亚坤; 斯涛; 赵旭毅; 徐孟龙

    2016-01-01

    废气能量回收利用是国内外内燃机行业的研究热点之一。为了达到缸内回收废气内能的目的,设计了六冲程发动机的工作原理;以ZH1105W 型四冲程单缸柴油机为设计基础与参考,以实现曲轴与凸轮轴转速比3∶1为目标,分别计算了进气凸轮的全包角、排气凸轮的全包角及排气凸轮两个凸起的相对相位角、异名凸轮相对相位角,凸轮轴正时齿轮的齿数、分度圆直径、齿顶高、齿根高、齿顶圆直径、齿根圆直径及基圆直径等参数;选择了正弦加速度曲线作为凸轮型线方程,选择6 mm与3 mm两种排气凸轮部分排气凸起最大升程以及ZH1105 W型六冲程单缸柴油机进排气凸轮的设计图;绘制了凸轮轴的效果图。研究结果表明:凸轮轴机械设计可以实现六冲程发动机的工作原理。%Research on recycling and using the exhaust gas energy is one of the most hot topics in the industry of internal combus -tion engine.In order to realize the purpose of recycling exhaust gas energy in the cylinder , the working principle of six stroke en-gine is designed;based on ZH1105 W four stroke single cylinder diesel engine , and aimed for 3:1 for ratio between crank shaft speed and cam shaft speed , fully included angle of inlet cam , the angle of emission cam and the relative phase angle between two noses of cam , the relative phase angle of synonym cam , teeth number of timing gear of cam shaft , pitch circle diameter , adden-dum, dedendum, addendum circle diameter , root circle diameter and base circle diameter are respectively calculated ;sine accel-eration curve is chosen as the profile equation of cam and 6mm and 3mm are chosen as two maximal lifts of partial cam noses , then the inlet cam , the exhaust cam and the timing gear of ZH 1105 W six stroke single cylinder diesel engine are designed; the effect maps are drawn .Results indicate that the working principle of six stroke engine can

  15. 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

  16. 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.

  17. CO2 Acquisition Membrane (CAM)

    Science.gov (United States)

    Mason, Larry W.; Way, J. Douglas; Vlasse, Marcus

    2003-01-01

    The objective of CAM is to develop, test, and analyze thin film membrane materials for separation and purification of carbon dioxide (CO2) from mixtures of gases, such as those found in the Martian atmosphere. The membranes are targeted toward In Situ Resource Utilization (ISRU) applications that will operate in extraterrestrial environments and support future unmanned and human space missions. A primary application is the Sabatier Electrolysis process that uses Mars atmosphere CO2 as raw material for producing water, oxygen, and methane for rocket fuel and habitat support. Other applications include use as an inlet filter to collect and concentrate Mars atmospheric argon and nitrogen gases for habitat pressurization, and to remove CO2 from breathing gases in Closed Environment Life Support Systems (CELSS). CAM membrane materials include crystalline faujasite (FAU) zeolite and rubbery polymers such as silicone rubber (PDMS) that have been shown in the literature and via molecular simulation to favor adsorption and permeation of CO2 over nitrogen and argon. Pure gas permeation tests using commercial PDMS membranes have shown that both CO2 permeance and the separation factor relative to other gases increase as the temperature decreases, and low (Delta)P(Sub CO2) favors higher separation factors. The ideal CO2/N2 separation factor increases from 7.5 to 17.5 as temperature decreases from 22 C to -30 C. For gas mixtures containing CO2, N2, and Ar, plasticization decreased the separation factors from 4.5 to 6 over the same temperature range. We currently synthesize and test our own Na(+) FAU zeolite membranes using standard formulations and secondary growth methods on porous alumina. Preliminary tests with a Na(+) FAU membrane at 22 C show a He/SF6 ideal separation factor of 62, exceeding the Knudsen diffusion selectivity by an order of magnitude. This shows that the membrane is relatively free from large defects and associated non-selective (viscous flow) transport

  18. 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

  19. Update: Rationale and design of the Sodium Lowering In Dialysate (SoLID) trial: a randomised controlled trial of low versus standard dialysate sodium concentration during hemodialysis for regression of left ventricular mass.

    Science.gov (United States)

    Dunlop, Joanna Leigh; Vandal, Alain Charles; de Zoysa, Janak Rashme; Gabriel, Ruvin Sampath; Haloob, Imad Adbi; Hood, Christopher John; Matheson, Philip James; McGregor, David Owen Ross; Rabindranath, Kannaiyan Samuel; Semple, David John; Marshall, Mark Roger

    2015-08-01

    After the publication of our paper Dunlop et al. "Rationale and design of the Sodium Lowering In Dialysate (SoLID) trial: a randomised controlled trial of low versus standard dialysate sodium concentration during hemodialysis for regression of left ventricular mass", we became aware of further data correlating left ventricular (LV) mass index at baseline and their corresponding mass at 12 months, using cardiac magnetic resonance imaging (MRI) in patients on hemodialysis. The original published sample size for the SoLID trial of 118 was a conservative estimate, calculated using analysis of covariance and a within person Pearson's correlation for LV mass index of 0.75. New data communicated to the SoLID trial group has resulted in re-calcuation of the sample size, based upon a within person Pearson's correlation of 0.8 but otherwise unchanged assumptions. As a result, the SoLID trial will now recruit 96 participants.

  20. 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...

  1. Analysis of 3D curve expansion of conical cam with oscillating tapered roller follower

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    This paper focuses on the analysis of running conditions and machining processes of conical cam with oscillating follower. We point out the common errors existing in the design and machining of the widely used plane expansion method of conical cam trough-out line. We show that the motion can be divided into two parts, i.e. the oscillating motion of oscillating bar and the rotary motion of oscillating bar relative to the conical cam. By increasing the rotary motion of oscillating bar, the motion path of tapered roller on oscillating bar (i.e. contour surface of conical cam) can be expanded on the cylinder. Based on these analyses,we present a creative and effective designing and machining method for 3D curve expansion of conical cam with oscillating follower.

  2. 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...

  3. 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...

  4. 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.

  5. 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

  6. 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…

  7. 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

  8. 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

  9. 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

  10. 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。

  11. 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 ...

  12. 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

  13. 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.

  14. 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.

  15. 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

  16. Humanities Program: Critique and Rationale.

    Science.gov (United States)

    Pinar, William Frederick

    The psychological impact of schooling is examined within the context of a new school of British psychoanalytic thought. It is concluded that schooling is maddening, in the sense used by Laing, Cooper, and others. A rationale for a sane humanities program is established consisting of two components: the nuclear and the cortical. The nuclear is the…

  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

    or 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. 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...

  19. 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; Chinapaw, Mai J. M.; van de Bovenkamp, Maaike; de Boer, Michiel R.; Jacob C Seidell; Brug, Johannes; De 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...

  20. 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...

  1. 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

  2. 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

  3. Childhood obesity prevention in rural settings: background, rationale, and study design of ‘4-Health,’ a parent-only intervention

    Directory of Open Access Journals (Sweden)

    Lynch Wesley C

    2012-04-01

    Full Text Available Abstract Background Childhood obesity in rural communities is a serious but understudied problem. The current experiment aims to assess a wide range of obesity risk factors among rural youth and to offer an 8-month intervention program for parents to reduce obesity risk in their preteen child. Methods/Design A two-group, repeated measures design is used to assess the effectiveness of the 4-Health intervention program. Assessments include anthropometric measures, child self-evaluations, parent self-evaluations, and parent evaluations of child. County Extension agents from 21 rural Montana counties recruit approximately 150 parent–child dyads and counties are semi-randomly assigned to the active intervention group (4-Health Educational Program or a “best-practices” (Healthy Living Information control group. Discussion This study will shed light on the effectiveness of this parent-only intervention strategy in reducing obesity risk factors among rural preteens. The 4-Health program is designed to provide information and skills development for busy rural parents that will increase healthy lifestyles of their preteen children and improve the parents’ ability to intervene effectively in the lives of their families during this critical developmental period. Trial registration ClinicalTrials.gov ID: NCT01510587

  4. 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

  5. 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.

  6. 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

  7. 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

  8. The Medical ANtiarrhythmic Treatment or Radiofrequency Ablation in Paroxysmal Atrial Fibrillation (MANTRA-PAF) trial: clinical rationale, study design, and implementation

    DEFF Research Database (Denmark)

    Jons, Christian; Hansen, Peter Steen; Johannessen, Arne;

    2009-01-01

    (MANTRA-PAF) trial is a randomized, controlled, parallel group, multicentre study designed to test whether catheter-based RFA is superior to optimized AAD therapy in suppressing relapse within 24 months of symptomatic and/or asymptomatic AF in patients with paroxysmal AF without prior AAD therapy...... centres in Scandinavia and Germany are participating in the study. Enrolment was started in 2005 and as of November 2008, 260 patients have been enrolled into the study. It is expected that enrolment will end by March 2009, when 300 patients have been included. CONCLUSION: The MANTRA-PAF trial...

  9. 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

  10. 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.

  11. 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

  12. 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

  13. 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...

  14. 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...

  15. 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.

  16. Prospective study of tricuspid valve regurgitation associated with permanent leads in patients undergoing cardiac rhythm device implantation: Background, rationale, and design

    Science.gov (United States)

    Dokainish, Hisham; Elbarasi, Esam; Masiero, Simona; Van de Heyning, Caroline; Brambatti, Michela; Ghazal, Sami; AL-Maashani, Said; Capucci, Alessandro; Buikema, Lisanne; Leong, Darryl; Shivalkar, Bharati; Saenen, Johan; Miljoen, Hielko; Morillo, Carlos; Divarakarmenon, Syam; Amit, Guy; Ribas, Sebastian; Brautigam, Aaron; Baiocco, Erika; Maolo, Alessandro; Romandini, Andrea; Maffei, Simone; Connolly, Stuart; Healey, Jeff

    2015-01-01

    Given the increasing numbers of cardiac device implantations worldwide, it is important to determine whether permanent endocardial leads across the tricuspid valve can promote tricuspid regurgitation (TR). Virtually all current data is retrospective, and indicates a signal of TR being increased after permanent lead implantation. However, the precise incidence of moderate or greater TR post-procedure, the exact mechanisms (mechanical, traumatic, functional), and the hemodynamic burden and clinical effects of this putative increase in TR, remain uncertain. We have therefore designed a multicenter, international, prospective study of 300 consecutive patients (recruitment completed, baseline data presented) who will undergo echocardiography and clinical assessment prior to, and at 1-year post device insertion. This prospective study will help determine whether cardiac device-associated TR is real, what are its potential mechanisms, and whether it has an important clinical impact on cardiac device patients. PMID:26779517

  17. Conceptual framework and rationale

    Directory of Open Access Journals (Sweden)

    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

  18. Rationale, Design and Methods of the Ecological Study of Sexual Behaviors and HIV/STI among African American Men Who Have Sex with Men in the Southeastern United States (The MARI Study.

    Directory of Open Access Journals (Sweden)

    DeMarc A Hickson

    Full Text Available This paper describes the rationale, design, and methodology of the Ecological Study of Sexual Behaviors and HIV/STI among African American Men Who Have Sex with Men (MSM in the Southeastern United States (U.S.; known locally simply as the MARI Study.Participants are African American MSM aged 18 years and older residing in the deep South.Between 2013 and 2015, 800 African American MSM recruited from two study sites (Jackson, MS and Atlanta, GA will undergo a 1.5-hour examination to obtain anthropometric and blood pressure measures as well as to undergo testing for sexually transmitted infections (STI, including HIV. Intrapersonal, interpersonal, and environmental factors are assessed by audio computer-assisted self-interview survey. Primary outcomes include sexual risk behaviors (e.g., condomless anal sex and prevalent STIs (HIV, syphilis, gonorrhea, and Chlamydia.The MARI Study will typify the HIV environmental 'riskscape' and provide empirical evidence into novel ecological correlates of HIV risk among African American MSM in the deep South, a population most heavily impacted by HIV. The study's anticipated findings will be of interest to a broad audience and lead to more informed prevention efforts, including effective policies and interventions, that achieve the goals of the updated 2020 U.S. National HIV/AIDS Strategy.

  19. 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

  20. 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

  1. 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

    Directory of Open Access Journals (Sweden)

    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

  2. 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

  3. 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

  4. 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.

  5. 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 ...

  6. Spatial data software integration - Merging CAD/CAM/mapping with GIS and image processing

    Science.gov (United States)

    Logan, Thomas L.; Bryant, Nevin A.

    1987-01-01

    The integration of CAD/CAM/mapping with image processing using geographic information systems (GISs) as the interface is examined. Particular emphasis is given to the development of software interfaces between JPL's Video Image Communication and Retrieval (VICAR)/Imaged Based Information System (IBIS) raster-based GIS and the CAD/CAM/mapping system. The design and functions of the VICAR and IBIS are described. Vector data capture and editing are studied. Various software programs for interfacing between the VICAR/IBIS and CAD/CAM/mapping are presented and analyzed.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  9. 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

    Directory of Open Access Journals (Sweden)

    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

  10. Diabetes MILES – The Netherlands: rationale, design and sample characteristics of a national survey examining the psychosocial aspects of living with diabetes in Dutch adults

    Directory of Open Access Journals (Sweden)

    Nefs Giesje

    2012-10-01

    Full Text Available Abstract Background As the number of people with diabetes is increasing rapidly worldwide, a more thorough understanding of the psychosocial aspects of living with this condition has become an important health care priority. While our knowledge has grown substantially over the past two decades with respect to the physical, emotional and social difficulties that people with diabetes may encounter, many important issues remain to be elucidated. Under the umbrella of the Diabetes MILES (Management and Impact for Long-term Empowerment and Success Study International Collaborative, Diabetes MILES – The Netherlands aims to examine how Dutch adults with diabetes manage their condition and how it affects their lives. Topics of special interest in Diabetes MILES - The Netherlands include subtypes of depression, Type D personality, mindfulness, sleep and sexual functioning. Methods/design Diabetes MILES – The Netherlands was designed as a national online observational study among adults with diabetes. In addition to a main set of self-report measures, the survey consisted of five complementary modules to which participants were allocated randomly. From September to October 2011, a total of 3,960 individuals with diabetes (40% type 1, 53% type 2 completed the battery of questionnaires covering a broad range of topics, including general health, self-management, emotional well-being and contact with health care providers. People with self-reported type 1 diabetes (specifically those on insulin pump therapy were over-represented, as were those using insulin among respondents with self-reported type 2 diabetes. People from ethnic minorities were under-represented. The sex distribution was fairly equal in the total sample, participants spanned a broad age range (19–90 years, and diabetes duration ranged from recent diagnosis to living with the condition for over fifty years. Discussion The Diabetes MILES Study enables detailed investigation of the

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  15. 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 ...

  16. The effects of nocturnal hemodialysis compared to conventional hemodialysis on change in left ventricular mass: Rationale and study design of a randomized controlled pilot study

    Directory of Open Access Journals (Sweden)

    Klarenbach Scott

    2006-02-01

    Full Text Available Abstract Background Nocturnal hemodialysis (NHD is an alternative to conventional three times per week hemodialysis (CvHD and has been reported to improve several health outcomes. To date, no randomized controlled trial (RCT has compared NHD and CvHD. We have undertaken a multi-center RCT in hemodialysis patients comparing the effect of NHD to CvHD on left ventricular (LV mass, as measured by cardiac magnetic resonance imaging (cMR. Methodology/design All patients in Alberta, Canada, expressing an interest in performing NHD are eligible for the study. Patients enrolled in the study will be randomized to either NHD or CvHD for a six month period. All patients will have a full clinical assessment, including collection of biochemical and cMR data at baseline and at 6 months. Both groups of patients will be monitored biweekly to optimize blood pressure (BP to a goal of Discussion To our knowledge, this study will be the first RCT evaluating health outcomes in NHD. The impact of NHD on LV mass represents a clinically important outcome which will further elucidate the potential benefits of NHD and guide future clinical endpoint studies.

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

    Directory of Open Access Journals (Sweden)

    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

  18. Minimally invasive 'step-up approach' versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial: design and rationale of a randomised controlled multicenter trial [ISRCTN13975868

    Directory of Open Access Journals (Sweden)

    Houdijk Lex PJ

    2006-04-01

    Full Text Available Abstract Background The initial treatment of acute necrotizing pancreatitis is conservative. Intervention is indicated in patients with (suspected infected necrotizing pancreatitis. In the Netherlands, the standard intervention is necrosectomy by laparotomy followed by continuous postoperative lavage (CPL. In recent years several minimally invasive strategies have been introduced. So far, these strategies have never been compared in a randomised controlled trial. The PANTER study (PAncreatitis, Necrosectomy versus sTEp up appRoach was conceived to yield the evidence needed for a considered policy decision. Methods/design 88 patients with (suspected infected necrotizing pancreatitis will be randomly allocated to either group A minimally invasive 'step-up approach' starting with drainage followed, if necessary, by videoscopic assisted retroperitoneal debridement (VARD or group B maximal necrosectomy by laparotomy. Both procedures are followed by CPL. Patients will be recruited from 20 hospitals, including all Dutch university medical centres, over a 3-year period. The primary endpoint is the proportion of patients suffering from postoperative major morbidity and mortality. Secondary endpoints are complications, new onset sepsis, length of hospital and intensive care stay, quality of life and total (direct and indirect costs. To demonstrate that the 'step-up approach' can reduce the major morbidity and mortality rate from 45 to 16%, with 80% power at 5% alpha, a total sample size of 88 patients was calculated. Discussion The PANTER-study is a randomised controlled trial that will provide evidence on the merits of a minimally invasive 'step-up approach' in patients with (suspected infected necrotizing pancreatitis.

  19. 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

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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

  2. Clinical, Functional, and Biological Correlates of Cognitive Dimensions in Major Depressive Disorder - Rationale, Design, and Characteristics of the Cognitive Function and Mood Study (CoFaM-Study).

    Science.gov (United States)

    Baune, Bernhard T; Air, Tracy

    2016-01-01

    Cross-sectional and longitudinal studies exploring clinical, functional, and biological correlates of major depressive disorder are frequent. In this type of research, depression is most commonly defined as a categorical diagnosis based on studies using diagnostic instruments. Given the phenotypic and biological heterogeneity of depression, we chose to focus the phenotypic assessments on three cognitive dimensions of depression including (a) cognitive performance, (b) emotion processing, and (c) social cognitive functioning. Hence, the overall aim of the study is to investigate the long-term clinical course of these cognitive dimensions in depression and its functional (psychosocial) correlates. We also aim to identify biological "genomic" correlates of these three cognitive dimensions of depression. To address the above overall aim, we created the Cognition and Mood Study (CoFaMS) with the key objective to investigate the clinical, functional, and biological correlates of cognitive dimensions of depression by employing a prospective study design and including a healthy control group. The study commenced in April 2015, including patients with a primary diagnosis of a major depressive episode of major depressive disorder or bipolar disorder according to DSM-IV-TR criteria. The assessments cover the three cognitive dimensions of depression (cognitive performance, emotion processing, and social cognition), cognitive function screening instrument, plus functional scales to assess general, work place, and psychosocial function, depression symptom scales, and clinical course of illness. Blood is collected for comprehensive genomic discovery analyses of biological correlates of cognitive dimensions of depression. The CoFaM-Study represents an innovative approach focusing on cognitive dimensions of depression and its functional and biological "genomic" correlates. The CoFaMS team welcomes collaborations with both national and international researchers. PMID:27616997

  3. Rationale and study design for a randomised controlled trial to reduce sedentary time in adults at risk of type 2 diabetes mellitus: project stand (Sedentary Time ANd diabetes

    Directory of Open Access Journals (Sweden)

    Wilmot Emma G

    2011-12-01

    Full Text Available Abstract Background The rising prevalence of Type 2 Diabetes Mellitus (T2DM is a major public health problem. There is an urgent need for effective lifestyle interventions to prevent the development of T2DM. Sedentary behaviour (sitting time has recently been identified as a risk factor for diabetes, often independent of the time spent in moderate-to-vigorous physical activity. Project STAND (Sedentary Time ANd Diabetes is a study which aims to reduce sedentary behaviour in younger adults at high risk of T2DM. Methods/Design A reduction in sedentary time is targeted using theory driven group structured education. The STAND programme is subject to piloting and process evaluation in line with the MRC framework for complex interventions. Participants are encouraged to self-monitor and self-regulate their behaviour. The intervention is being assessed in a randomised controlled trial with 12 month follow up. Inclusion criteria are a aged 18-40 years with a BMI in the obese range; b 18-40 years with a BMI in the overweight range plus an additional risk factor for T2DM. Participants are randomised to the intervention (n = 89 or control (n = 89 arm. The primary outcome is a reduction in sedentary behaviour at 12 months as measured by an accelerometer (count Conclusions This is the first UK trial to address sedentary behaviour change in a population of younger adults at risk of T2DM. The results will provide a platform for the development of a range of future multidisciplinary interventions in this rapidly expanding high-risk population. Trial registration Current controlled trials ISRCTN08434554, MRC project 91409.

  4. The China Patient-Centred Evaluative Assessment of Cardiac Events (China PEACE)-Prospective Study of 3-Vessel Disease: rationale and design

    Science.gov (United States)

    Rao, Chenfei; Bongiovanni, Tasce; Li, Xi; Gao, Huawei; Zhang, Heng; Li, Jing; Zhao, Yan; Yuan, Xin; Hua, Kun; Hu, Shengshou; Krumholz, Harlan M; Jiang, Lixin; Zheng, Zhe

    2016-01-01

    Introduction Complex coronary artery disease (left main and three-vessel disease) carries high risks of adverse events and cost burden. However, in China, little is known about which patients are directed toward which treatment strategies and what outcomes are being achieved. Methods and analysis Using the China PEACE (Patient-centered Evaluative Assessment of Cardiac Events) research network, this prospective study of three-Vessel Disease, the China PEACE-3VD study, has a plan to consecutively register over 4000 patients with a diagnosis of 3VD and/or left-main disease by elective coronary angiography at 24 large cardiovascular centres in China. We centrally conducted medical record abstraction and SYNTAX Score calculation for all registered patients. The sites invited patients to the prospective cohort, and conducted 1-year follow-up on major events, including cardiac events, symptoms, secondary prevention and quality of life. The estimated entire sample size of eligible patients of 4000 was determined based on both feasibility and consideration of adequate statistical precision for describing the treatment decisions, guidelines adherence and appropriateness of treatment for patients with complex coronary artery diseases. The study is designed to investigate patient, clinician and hospital factors associated with each treatment strategy (percutaneous coronary intervention, coronary artery bypass grafting or medical therapy) as well as appropriateness of treatment choice, current guideline compliance and patient-reported outcomes for patients with complex coronary artery disease in large cardiovascular centres in China, as a foundation for enhanced knowledge in the field and to assist quality improvement initiatives. Ethics and dissemination The study protocol was approved by the ethics committee at the China National Center for Cardiovascular Diseases. Findings will be shared with participating hospitals, policymakers and the academic community, to promote

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

    Science.gov (United States)

    Nosè, Michela; Accordini, Simone; Artioli, Paola; Barale, Francesco; Barbui, Corrado; Beneduce, Rossella; Berardi, Domenico; Bertolazzi, Gerardo; Biancosino, Bruno; Bisogno, Alfredo; Bivi, Raffaella; Bogetto, Filippo; Boso, Marianna; Bozzani, Alberto; Bucolo, Piera; Casale, Marcello; Cascone, Liliana; Ciammella, Luisa; Cicolini, Alessia; Cipresso, Gabriele; Cipriani, Andrea; Colombo, Paola; Dal Santo, Barbara; De Francesco, Michele; Di Lorenzo, Giorgio; Di Munzio, Walter; Ducci, Giuseppe; Erlicher, Arcadio; Esposito, Eleonora; Ferrannini, Luigi; Ferrato, Farida; Ferro, Antonio; Fragomeno, Nicoletta; Parise, Vincenzo Fricchione; Frova, Maria; Gardellin, Francesco; Garzotto, Nicola; Giambartolomei, Andrea; Giupponi, Giancarlo; Grassi, Luigi; Grazian, Natalia; Grecu, Lorella; Guerrini, Gualtiero; Laddomada, Francesco; Lazzarin, Ermanna; Lintas, Camilla; Malchiodi, Francesca; Malvini, Lara; Marchiaro, Livio; Marsilio, Alessandra; Mauri, Massimo Carlo; Mautone, Antonio; Menchetti, Marco; Migliorini, Giuseppe; Mollica, Marco; Moretti, Daniele; Mulè, Serena; Nicholau, Stylianos; Nosè, Flavio; Occhionero, Guglielmo; Pacilli, Anna Maria; Pecchioli, Stefania; Percudani, Mauro; Piantato, Ennio; Piazza, Carlo; Pontarollo, Francesco; Pycha, Roger; Quartesan, Roberto; Rillosi, Luciana; Risso, Francesco; Rizzo, Raffella; Rocca, Paola; Roma, Stefania; Rossattini, Matteo; Rossi, Giuseppe; Rossi, Giovanni; Sala, Alessandra; Santilli, Claudio; Saraò, Giuseppe; Sarnicola, Antonio; Sartore, Francesca; Scarone, Silvio; Sciarma, Tiziana; Siracusano, Alberto; Strizzolo, Stefania; Tansella, Michele; Targa, Gino; Tasser, Annamarie; Tomasi, Rodolfo; Travaglini, Rossana; Veronese, Antonio; Ziero, Simona

    2009-01-01

    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 rather than with haloperidol

  6. Rationale, design and methodology for Intraventricular Pressure Gradients Study: a novel approach for ventricular filling assessment in normal and falling hearts

    Directory of Open Access Journals (Sweden)

    Vouga Luís

    2011-05-01

    Full Text Available Abstract Background Intraventricular pressure gradients have been described between the base and the apex of the left ventricle during early diastolic ventricular filling, as well as, their increase after systolic and diastolic function improvement. Although, systolic gradients have also been observed, data are lacking on their magnitude and modulation during cardiac dysfunction. Furthermore, we know that segmental dysfunction interferes with the normal sequence of regional contraction and might be expected to alter the physiological intraventricular pressure gradients. The study hypothesis is that systolic and diastolic gradients, a marker of normal left ventricular function, may be related to physiological asynchrony between basal and apical myocardial segments and they can be attenuated, lost entirely, or even reversed when ventricular filling/emptying is impaired by regional acute ischemia or severe aortic stenosis. Methods/Design Animal Studies: Six rabbits will be completely instrumented to measuring apex to outflow-tract pressure gradient and apical and basal myocardial segments lengthening changes at basal, afterloaded and ischemic conditions. Afterload increase will be performed by abruptly narrowing or occluding the ascending aorta during the diastole and myocardial ischemia will be induced by left coronary artery ligation, after the first diagonal branch. Patient Studies: Patients between 65-80 years old (n = 12, both genders, with severe aortic stenosis referred for aortic valve replacement will be selected as eligible subjects. A high-fidelity pressure-volume catheter will be positioned through the ascending aorta across the aortic valve to measure apical and outflow-tract pressure before and after aortic valve replacement with a bioprosthesis. Peak and average intraventricular pressure gradients will be recorded as apical minus outflow-tract pressure and calculated during all diastolic and systolic phases of cardiac cycle

  7. Onzichtbare beugels dankzij CAD-CAM

    NARCIS (Netherlands)

    F.R. de Winter

    2011-01-01

    De introductie van de cad-cam-techniek in de tandheelkunde heeft in de orthodontie geleid tot het orthodontisch verplaatsen van gebitselementen met een serie opeenvolgende dieptrekplaten, ontworpen en gefabriceerd met behulp van cad-cam. Daarbij is iedere plaat een kleine stap in de richting van de

  8. Immediate CAD/ CAM Custom Fabricated Dental Implants

    Directory of Open Access Journals (Sweden)

    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.

  9. 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.

  10. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  13. Psychological risk factors of micro- and macrovascular outcomes in primary care patients with type 2 diabetes: rationale and design of the DiaDDZoB Study

    Directory of Open Access Journals (Sweden)

    Pop Victor JM

    2010-07-01

    Full Text Available Abstract Background Depression is a common psychiatric complication of diabetes, but little is known about the natural course and the consequences of depressive symptoms in primary care patients with type 2 diabetes. While depression has been related to poor glycemic control and increased risk for macrovascular disease, its association with microvascular complications remains understudied. The predictive role of other psychological risk factors such as Type D (distressed personality and the mechanisms that possibly link depression and Type D personality with poor vascular outcomes are also still unclear. Methods/Design This prospective cohort study will examine: (1 the course of depressive symptoms in primary care patients with type 2 diabetes; (2 whether depressive symptoms and Type D personality are associated with the development of microvascular and/or macrovascular complications and with the risk of all-cause or vascular mortality; and (3 the behavioral and physiological mechanisms that may mediate these associations. The DiaDDZoB Study is embedded within the larger DIAZOB Primary Care Diabetes study, which covers a comprehensive cohort of type 2 diabetes patients treated by over 200 primary care physicians in South-East Brabant, The Netherlands. These patients will be followed during their lifetime and are assessed annually for demographic, clinical, lifestyle and psychosocial factors. Measurements include an interviewer-administered and self-report questionnaire, regular care laboratory tests and physical examinations, and pharmacy medication records. The DiaDDZoB Study uses data that have been collected during the original baseline assessment in 2005 (M0; N = 2,460 and the 2007 (M1; N = 2,225 and 2008 (M2; N = 2,032 follow-up assessments. Discussion The DiaDDZoB Study is expected to contribute to the current understanding of the course of depression in primary care patients with type 2 diabetes and will also test whether depressed

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  20. 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

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

    Directory of Open Access Journals (Sweden)

    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

  2. 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

  3. CamOn: A Real-Time Autonomous Camera Control System

    DEFF Research Database (Denmark)

    Burelli, Paolo; Jhala, Arnav Harish

    2009-01-01

    This demonstration presents CamOn, an autonomous cam- era control system for real-time 3D games. CamOn employs multiple Artificial Potential Fields (APFs), a robot motion planning technique, to control both the location and orienta- tion of the camera. Scene geometry from the 3D environment...... on real-time motion planning of the camera. Moreover, the recasting of camera constraints into potential fields is visually more accessible to game designers and has the potential to be implemented as a plug-in to 3D level design and editing tools currently avail- able with games. Introduction...... contributes to the potential field that is used to determine po- sition and movement of the camera. Composition constraints for the camera are modelled as potential fields for controlling the view target of the camera. CamOn combines the compositional benefits of constraint- based camera systems, and improves...

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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…

  6. 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

  7. 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.

  8. 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-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......: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...

  9. Rationale and Design of the 'MITOCARE' Study

    DEFF Research Database (Denmark)

    Clemmensen, Peter

    2012-01-01

    40303 targets the mitochondrial permeability transition pore, a promising target for the prevention of reperfusion injury. This multicenter, double-blind study will randomize patients with STEMI to TRO40303 or placebo administered just before balloon inflation or thromboaspiration during PCI...

  10. 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

  11. Design and rationale of the GAUSS-2 study trial: a double-blind, ezetimibe-controlled phase 3 study of the efficacy and tolerability of evolocumab (AMG 145) in subjects with hypercholesterolemia who are intolerant of statin therapy.

    Science.gov (United States)

    Cho, Leslie; Rocco, Michael; Colquhoun, David; Sullivan, David; Rosenson, Robert S; Dent, Ricardo; Xue, Allen; Scott, Rob; Wasserman, Scott M; Stroes, Erik

    2014-03-01

    Statins effectively lower low-density lipoprotein cholesterol (LDL-C), reducing cardiovascular morbidity and mortality. Most patients tolerate statins well, but approximately 10% to 20% experience side effects (primarily muscle-related) contributing to diminished compliance or discontinuation of statin therapy and subsequent increase in cardiovascular risk. Statin-intolerant patients require more effective therapies for lowering LDL-C. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a compelling target for LDL-C-lowering therapy. Evolocumab (AMG 145) is a fully human monoclonal antibody that binds PCSK9, inhibiting its interaction with the LDL receptor to preserve LDL-receptor recycling and reduce LDL-C. Phase 2 studies have demonstrated the safety, tolerability, and preliminary efficacy of subcutaneous evolocumab in diverse populations, including statin-intolerant patients. This article describes the rationale and design of the Goal Achievement After Utilizing an anti-PCSK9 Antibody in Statin-Intolerant Subjects 2 (GAUSS-2) trial, a randomized, double-blind, ezetimibe-controlled, multicenter phase 3 study to evaluate the effects of 12 weeks of evolocumab 140 mg every 2 weeks or 420 mg every month in statin-intolerant patients with hypercholesterolemia. Eligible subjects were unable to tolerate effective doses of ≥2 statins because of myalgia, myopathy, myositis, or rhabdomyolysis that resolved with statin discontinuation. The primary objective of the study is to assess the effects of evolocumab on percentage change from baseline in LDL-C. Secondary objectives include evaluation of safety and tolerability, comparison of the effects of evolocumab vs ezetimibe on absolute change from baseline in LDL-C, and percentage changes from baseline in other lipids. Recruitment of approximately 300 subjects was completed in August 2013.

  12. 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

  13. 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.

  14. 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,...

  15. 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.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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

  1. 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 ...

  2. 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)

  3. 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

  4. 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

  5. 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

  6. 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

  7. 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...

  8. 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...

  9. 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.

  10. 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.

  11. 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…

  12. 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)

  13. 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

  14. 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.

  15. Transparency in Dutch CAM practices: a comparison between CAM and GP physicians.

    NARCIS (Netherlands)

    Heiligers, P.; Dulmen, S. van

    2009-01-01

    Introduction: CAM (Complementary and Alternative Medicine) is increasing worldwide because the demand is growing. Transparency is needed to provide more objective information about CAM services, to date largely unknown by a majority of care users and mainstream care providers. Despite the fact that

  16. 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...

  17. Advances in computer-aided engineering: CAD/CAM-research at Delft University of Technology. Report of the VF-project CAD/CAM 1989-1994

    NARCIS (Netherlands)

    1994-01-01

    This book contains a collection of articles describing on-going CAD/CAM-research at several engineering faculties at Delft University of Technology. Two main themes covered in this book are 'Conceptual design of complex products' and 'Product modelling and product data exchange'.

  18. 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

  19. 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

  20. 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...

  1. Documentary analysis in CAM research: Part 1.

    Science.gov (United States)

    Dew, Kevin

    2005-12-01

    The analysis of documents can provide insights into important social and political issues related to complementary and alternative medicine (CAM). This paper identifies some important sources of documents and outlines some of the advantages and disadvantages of using documents in social research. A number of analytic strategies are illustrated with examples to demonstrate the potential for documentary analysis to answer particular CAM-related research questions. These strategies are described as quantitative content analysis, qualitative descriptive analysis, qualitative interpretive analysis and semiotic analysis. It is argued that documents are a convenient source of data and that their analysis can enrich our understanding of CAM. Part 1 covers quantitative and qualitative strategies and Part 2 focuses on semiotic analysis.

  2. Documentary analysis in CAM research: Part 2.

    Science.gov (United States)

    Dew, Kevin

    2006-03-01

    The analysis of documents can provide insights into important social and political issues related to complementary and alternative medicine (CAM). This paper identifies some important sources of documents and outlines some of the advantages and disadvantages of using documents in social research. A number of analytic strategies are illustrated with examples to demonstrate the potential for documentary analysis to answer particular CAM-related research questions. These strategies are described as quantitative content analysis, qualitative descriptive analysis, qualitative interpretive analysis and semiotic analysis. It is argued that documents are a convenient source of data and that their analysis can enrich our understanding of CAM. Part 1 covered quantitative and qualitative strategies. Part 2 focuses on semiotic analysis and the methodological strengths and weaknesses of the different strategies.

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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...

  8. Georeferencing CAMS data: Polynomial rectification and beyond

    Science.gov (United States)

    Yang, Xinghe

    The Calibrated Airborne Multispectral Scanner (CAMS) is a sensor used in the commercial remote sensing program at NASA Stennis Space Center. In geographic applications of the CAMS data, accurate geometric rectification is essential for the analysis of the remotely sensed data and for the integration of the data into Geographic Information Systems (GIS). The commonly used rectification techniques such as the polynomial transformation and ortho rectification have been very successful in the field of remote sensing and GIS for most remote sensing data such as Landsat imagery, SPOT imagery and aerial photos. However, due to the geometric nature of the airborne line scanner which has high spatial frequency distortions, the polynomial model and the ortho rectification technique in current commercial software packages such as Erdas Imagine are not adequate for obtaining sufficient geometric accuracy. In this research, the geometric nature, especially the major distortions, of the CAMS data has been described. An analytical step-by-step geometric preprocessing has been utilized to deal with the potential high frequency distortions of the CAMS data. A generic sensor-independent photogrammetric model has been developed for the ortho-rectification of the CAMS data. Three generalized kernel classes and directional elliptical basis have been formulated into a rectification model of summation of multisurface functions, which is a significant extension to the traditional radial basis functions. The preprocessing mechanism has been fully incorporated into the polynomial, the triangle-based finite element analysis as well as the summation of multisurface functions. While the multisurface functions and the finite element analysis have the characteristics of localization, piecewise logic has been applied to the polynomial and photogrammetric methods, which can produce significant accuracy improvement over the global approach. A software module has been implemented with full

  9. PillCam(TradeMark), a Noninvasive Endoscopic Device for the Measurement of Gastrointestinal Motility Changes

    Science.gov (United States)

    Vaksman, Zahman; Crady, Camille; Raju, G. S.; Putcha, Lakshmi

    2007-01-01

    Introduction: Bioavailability and effectiveness of drugs given by mouth are governed in part by gastrointestinal (GI) motility and function. Microgravity has been shown to decrease GI motility as indicated by a 3 fold increase in gastrointestinal transit time (GITT). The PillCam(TradeMark), an endoscopic camera embedded in a capsule, is a novel noninvasive and unobtrusive device that is used for the diagnosis of GI pathology. The purpose of this study is to evaluate the usefulness of PillCam(TradeMark) as an alternative to the Lactulose Breath Hydrogen Test (LBHT) for estimating GI motility. The sensitivity and applicability of this device for detection and estimation of the effect of promethazine, a deterrent, and caffeine, a prokinetic, on GI motility were also examined. Method: In this semi-randomized cross-over design study, six male and six female subjects were administered the following 4 treatments: PillCam(TradeMark) alone, PillCam(TradeMark)+Lactulose (10g), PillCam(TradeMark)+caffeine (200mg), and PillCam(TradeMark)+Promethazine (50mg). Results: GITT ranged between 1:24 and 7:52 hr:min. Lactulose did not alter GITT. A significant increase in GITT was noticed after administration of PMZ when compared to values from PillCam(TradeMark) treatment alone or PillCam(TradeMark)+Lactulose treatment. No difference in GITT after caffeine treatment was noticed. While there were no gender related differences in GITT after administration of PillCam(TradeMark) or with lactulose, a significant difference (pgenders was observed after promethazine administration with mean GITT higher in males (5:50 hr:min) than females (4:15 hr:min). Conclusion: The PillCam(TradeMark) capsule is applicable for the determination of GITT using time stamped GI images. It can be successfully used for the assessment of drug induced changes in GI motility and therefore, may be applicable for microgravity and analog environment studies on GI motility and function.

  10. 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.

  11. 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.

  12. Complementary and Alternative Medicine (CAM) Treatments and Pediatric Psychopharmacology

    Science.gov (United States)

    Rey, Joseph M.; Walter, Garry; Soh, Nerissa

    2008-01-01

    Children and adolescents often use complementary and alternative medicine (CAM) treatments outside their indications, particularly to lose weight. Some of the herbal remedies and dietary supplements that may of relevance for psychopharmacological practice are discussed with respect to CAM treatments.

  13. 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

  14. 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.

  15. 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...

  16. 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 ...

  17. 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…

  18. 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)

  19. Patients’ views of CAM as spiritual practice

    DEFF Research Database (Denmark)

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

    2011-01-01

    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...

  20. 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.

  1. Faint stars and OmegaCAM

    NARCIS (Netherlands)

    Kuijken, K; Cristiani, S; Renzini, A; Williams, RE

    2001-01-01

    OmegaCAM will be the wide-field imager on the VLT Survey Telescope. In this contribution I present applications of this instrument to the study of faint stellar populations. Two projects are highlighted: a proper motion study to uncover the galactic halo population, and a microlensing study towards

  2. ESA ExoMars: Pre-launch PanCam Geometric Modeling and Accuracy Assessment

    Science.gov (United States)

    Li, D.; Li, R.; Yilmaz, A.

    2014-08-01

    ExoMars is the flagship mission of the European Space Agency (ESA) Aurora Programme. The mobile scientific platform, or rover, will carry a drill and a suite of instruments dedicated to exobiology and geochemistry research. As the ExoMars rover is designed to travel kilometres over the Martian surface, high-precision rover localization and topographic mapping will be critical for traverse path planning and safe planetary surface operations. For such purposes, the ExoMars rover Panoramic Camera system (PanCam) will acquire images that are processed into an imagery network providing vision information for photogrammetric algorithms to localize the rover and generate 3-D mapping products. Since the design of the ExoMars PanCam will influence localization and mapping accuracy, quantitative error analysis of the PanCam design will improve scientists' awareness of the achievable level of accuracy, and enable the PanCam design team to optimize its design to achieve the highest possible level of localization and mapping accuracy. Based on photogrammetric principles and uncertainty propagation theory, we have developed a method to theoretically analyze how mapping and localization accuracy would be affected by various factors, such as length of stereo hard-baseline, focal length, and pixel size, etc.

  3. Benign synthesis of 2-ethylhexanoic acid by cytochrome P450cam: enzymatic, crystallographic, and theoretical studies.

    Science.gov (United States)

    French, K J; Strickler, M D; Rock, D A; Rock, D A; Bennett, G A; Wahlstrom, J L; Goldstein, B M; Jones, J P

    2001-08-14

    This study examines the ability of P450cam to catalyze the formation of 2-ethylhexanoic acid from 2-ethylhexanol relative to its activity on the natural substrate camphor. As is the case for camphor, the P450cam exhibits stereoselectivity for binding (R)- and (S)-2-ethylhexanol. Kinetic studies indicate (R)-2-ethylhexanoic acid is produced 3.5 times as fast as the (S)-enantiomer. In a racemic mixture of 2-ethylhexanol, P450cam produces 50% more (R)-2-ethylhexanoic acid than (S)-2-ethylhexanoic acid. The reason for stereoselective 2-ethylhexanoic acid production is seen in regioselectivity assays, where (R)-2-ethylhexanoic acid comprises 50% of total products while (S)-2-ethylhexanoic acid comprises only 13%. (R)- and (S)-2-ethylhexanol exhibit similar characteristics with respect to the amount of oxygen and reducing equivalents consumed, however, with (S)-2-ethylhexanol turnover producing more water than the (R)-enantiomer. Crystallographic studies of P450cam with (R)- or (S)-2-ethylhexanoic acid suggest that the (R)-enantiomer binds in a more ordered state. These results indicate that wild-type P450cam displays stereoselectivity toward 2-ethylhexanoic acid synthesis, providing a platform for rational active site design. PMID:11583152

  4. 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...

  5. 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)

  6. 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.

  7. 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

  8. 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.

  9. 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…

  10. 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.

  11. 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...

  12. 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.

  13. 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

  14. 特发性流出道室性心律失常研究:基本原理和设计方案%Idiopathic outflow tract ventricular arrhythmias study (IOTVA Study) :rationale and design

    Institute of Scientific and Technical Information of China (English)

    曹克将; 张澍; 姚焰; 吴书林; 陈明龙; 张凤祥; 杨兵; 李小荣; 魏薇

    2014-01-01

    Background Idiopathic ventricular arrhythmias (IOTVA) in patients without structural heart disease mostly originate from left or right ventricular outflow tract.Data about the epidemiology,nature prognosis and treatment of idiopathic outflow tract premature ventricular complexes/nonsustained ventricular tachycardia (IOTPVC/NSVT),which based on the large sample of clinical trial,are scarce at present.Rationale Some studies have demonstrated that effects on cardiac function of IOTPVC/NSVT are related to its burden.Antiarrhythmic drugs (class IC agents and β-blockers) and catheter ablation are effective for IOTVA.This study will assess effects on cardiac function of IOTPVC burden and compare safety and effectiveness of antiarrhythmic drugs with catheter ablation in patients with IOTPVC/NSVT.Design The IOTVA study will includes the following:①to investigate the proportion of IOTVA to ventricular arrhythmias in outpatients and inpatients at the department of cardiology; ②to inquire the prognosis and its cardiac function in IOTVA patients without any treatment; ③to assess the safety of antiarrhythmic drugs therapy compared with control therapy in IOTVA patients; ④to compare safety and effectiveness of antiarrhythmic drugs with catheter ablation in IOTPVC/NSVT patients with PVCs burden more than 15%.Based on these studies,we would establish the clinical treatment approach for IOTVA.Conclusion IOTVA study will assess effects on cardiac function of IOTPVC burden and evaluate safety and effectiveness of antiarrhythmic drugs and catheter ablation in patients with IOTPVC/NSVT.%背景 发生在无器质性心脏病的室性心律失常又称为特发性室性心律失常(IVA),其中大多数起源于左心室或右心室流出道.目前关于特发性流出道室性早搏(IOTPVC)与非持续性室性心动过速(NSVT)的流行病学调查、预后以及临床干预均缺乏大样本的循证医学证据.基本原理 相关研究表明,不同负荷的IOTPVC/NSVT可

  15. 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.

  16. 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...

  17. 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

  18. 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

  19. 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

  20. 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.

  1. 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.

  2. An investigation of cam-roller mechanism applied in sphere cam engine

    Institute of Scientific and Technical Information of China (English)

    张雷; 潘存云; 徐小军; 徐海军; 张正洲

    2016-01-01

    As an alternative power source for hybrid electrical vehicle(HEV), electric generating system(EGS) driven by sphere cam engine(SCE) is said to own higher power density and integration. In this work, the structure and working principle of EGS were introduced, based on which the advantages of EGS were displayed. The profile of sphere cam was achieved after the desired motion of piston was given. After establishing the dynamic model of power transmission mechanism, the characteristics of cam-roller mechanism were studied. The results show that the optimal cam profile of SCE is a sinusoid curve which has two peaks and two valleys and a mean pressure angle of 47.19°. Because of the special cam shape, the trace of end surface center of piston is an eight-shape curve on a specific sphere surface. SCE running at speed of 3000 r/min can generate the power of 33.81 kW, which could satisfy the need of HEVs. However, the force between cylinder and piston skirt caused by Coriolis acceleration can reach up to 1182 N, which leads to serious wear between cylinder liner and piston skirt and may shorten the lifespan of SCE.

  3. Modeled hydraulic redistribution in tree-grass, CAM-grass, and tree-CAM associations: the implications of crassulacean acid metabolism (CAM).

    Science.gov (United States)

    Yu, Kailiang; Foster, Adrianna

    2016-04-01

    Past studies have largely focused on hydraulic redistribution (HR) in trees, shrubs, and grasses, and recognized its role in interspecies interactions. HR in plants that conduct crassulacean acid metabolism (CAM), however, remains poorly investigated, as does the effect of HR on transpiration in different vegetation associations (i.e., tree-grass, CAM-grass, and tree-CAM associations). We have developed a mechanistic model to investigate the net direction and magnitude of HR at the patch scale for tree-grass, CAM-grass, and tree-CAM associations at the growing season to yearly timescale. The modeling results show that deep-rooted CAM plants in CAM-grass associations could perform hydraulic lift at a higher rate than trees in tree-grass associations in a relatively wet environment, as explained by a significant increase in grass transpiration rate in the shallow soil layer, balancing a lower transpiration rate by CAM plants. By comparison, trees in tree-CAM associations may perform hydraulic descent at a higher rate than those in tree-grass associations in a dry environment. Model simulations also show that hydraulic lift increases the transpiration of shallow-rooted plants, while hydraulic descent increases that of deep-rooted plants. CAM plants transpire during the night and thus perform HR during the day. Based on these model simulations, we suggest that the ability of CAM plants to perform HR at a higher rate may have different effects on the surrounding plant community than those of plants with C3 or C4 photosynthetic pathways (i.e., diurnal transpiration).

  4. 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.

  5. 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.

  6. 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.

  7. Comparison of CAD-CAM and hand made sockets for PTB prostheses.

    Science.gov (United States)

    Köhler, P; Lindh, L; Netz, P

    1989-04-01

    The aim of the present study was to compare sockets for below-knee (BK) prostheses made by Computer Aided Design-Computer Aided Manufacture (CAD-CAM) to those made by hand. The patients in the study were provided with two prostheses each, which apart from the sockets, were identical. One socket was made by the CAD-CAM technique developed at the Bioengineering Centre, Roehampton, University College London and one was made by hand at the OT-Centre, Stockholm, Sweden. The results were based on investigation of eight unilateral below-knee amputees evaluating their own sockets by Visual Analogous Scale with respect to comfort, pressure, and pain. The sockets were evaluated on seven occasions, at two tests, on delivery, after use every second day for six days and every second week for two weeks. All CAD-CAM sockets except one had to be changed once as compared to the hand made of which only two had to be changed. As to comfort it could not be demonstrated that there was any significant difference between the two types of sockets and both types were well accepted by all patients. Differences in pressure and pain were rarely reported. There were obvious differences between the two types of socket with respect to height, width, and inner surface configuration. The authors feel that CAD-CAM will in the near future be an excellent tool for design and manufacture of prosthetic sockets.

  8. Advanced control room evaluation: General approach and rationale

    Energy Technology Data Exchange (ETDEWEB)

    O' Hara, J.M. (Brookhaven National Lab., Upton, NY (USA)); Wachtel, J. (Nuclear Regulatory Commission, Washington, DC (USA))

    1991-01-01

    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.

  9. Research in non-equalization machining method for spatial cam

    Institute of Scientific and Technical Information of China (English)

    Jun-hua CHEN; Yi-jie WU

    2008-01-01

    Many kinds of devices with cam have been widely used in various mechanical equipments.However,non-equalization machining for spatial cam trough remains to be a difficult problem.This paper focuses on the analysis of ruaning conditions and machining processes of spatial cam with oscillating follower.We point out the common errors in the biased distance cutting.By analyzing the motion of oscillating follower of spatial cam,we present a new 3D curve expansion model of spatial cam trough-outline.Based on this model.we have proposed a machining method for trochoidal milling with non-equalization diameter cutter.This new method has led to a creative and effective Way for non.equalization diameter machining for spatial cam with oscillating follower.

  10. 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

  11. 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.

  12. 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...

  13. 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.

  14. 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...

  15. 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...

  16. 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.

  17. THE FOURIER SERIES USED IN ANALYSE OF THE CAM MECHANISMS FOR THE SHOEMAKING MACHINES (PART II

    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.

  18. 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.

  19. Evaluation of the effect of zirconia all-ceramic fixed dental prostheses designed and manufactured by CAD/CAM in restoration of posterior teeth%CAD/CAM二氧化锆全瓷固定桥的修复效果评价

    Institute of Scientific and Technical Information of China (English)

    宓勇

    2015-01-01

    To observe the 36 months follow-up outcome of zirconia all-ceramic posterior fixed dental prostheses(FDPs)designed and manu-factured by computer aided design and computer aided manufacture (CAD /CAM)from clinical aspect,and to evaluate the success rate of zirconia framework and veneering porcelain.78 patients with less than three teeth lost which had natural opposing teeth were included.A to-tal of ninty-two zirconia all-ceramic FDPs (59 three-unit FDPs,20 four-unit FDPs and 13 five-unit FDPs)were made by CAD /CAM.Three years after cementation of the restorations,the reasons for complication and failure of FDPs in different lengths were analysed.Six FDPs were removed (frame fracture:1;porcelain fracture:1;secondary caries:2;vertical root fractures and post-core fracture after root canal therapy of premolars:2).The success rate of these FDPs was 93.5%.The success rate of zirconia all-ceramic crowns and bridges was higher.Their clinical effect was satisfactory.The main complications of these FDPs were porcelain fracture and de-bonding.%选择78名口内最多缺失2颗牙且存在对颌牙用 CAD/CAM氧化锆固定桥修复的患者,制作92件固定桥:3单位桥59件,4单位桥20件,5单位桥13件。在修复体粘接后,随访3年,分析不同长度的全瓷桥并发症的发生和失败原因的差异。6件固定桥需要拆除,修复成功率93.5%;1例因支架断裂拆除,1例由于崩瓷面积较大而拆除,2例因继发龋脱落而不能重新粘接,另外 2例前磨牙根管治疗后牙根纵裂和核折断导致修复失败。二氧化锆全瓷冠桥具有较高的成功率,临床效果满意,主要并发症是崩瓷和脱粘接。

  20. 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

  1. 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.

  2. 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

  3. 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

  4. Status of the photomultiplier-based FlashCam camera for the Cherenkov Telescope Array

    Science.gov (United States)

    Pühlhofer, G.; Bauer, C.; Eisenkolb, F.; Florin, D.; Föhr, C.; Gadola, A.; Garrecht, F.; Hermann, G.; Jung, I.; Kalekin, O.; Kalkuhl, C.; Kasperek, J.; Kihm, T.; Koziol, J.; Lahmann, R.; Manalaysay, A.; Marszalek, A.; Rajda, P. J.; Reimer, O.; Romaszkan, W.; Rupinski, M.; Schanz, T.; Schwab, T.; Steiner, S.; Straumann, U.; Tenzer, C.; Vollhardt, A.; Weitzel, Q.; Winiarski, K.; Zietara, K.

    2014-07-01

    The FlashCam project is preparing a camera prototype around a fully digital FADC-based readout system, for the medium sized telescopes (MST) of the Cherenkov Telescope Array (CTA). The FlashCam design is the first fully digital readout system for Cherenkov cameras, based on commercial FADCs and FPGAs as key components for digitization and triggering, and a high performance camera server as back end. It provides the option to easily implement different types of trigger algorithms as well as digitization and readout scenarios using identical hardware, by simply changing the firmware on the FPGAs. The readout of the front end modules into the camera server is Ethernet-based using standard Ethernet switches and a custom, raw Ethernet protocol. In the current implementation of the system, data transfer and back end processing rates of 3.8 GB/s and 2.4 GB/s have been achieved, respectively. Together with the dead-time-free front end event buffering on the FPGAs, this permits the cameras to operate at trigger rates of up to several ten kHz. In the horizontal architecture of FlashCam, the photon detector plane (PDP), consisting of photon detectors, preamplifiers, high voltage-, control-, and monitoring systems, is a self-contained unit, mechanically detached from the front end modules. It interfaces to the digital readout system via analogue signal transmission. The horizontal integration of FlashCam is expected not only to be more cost efficient, it also allows PDPs with different types of photon detectors to be adapted to the FlashCam readout system. By now, a 144-pixel mini-camera" setup, fully equipped with photomultipliers, PDP electronics, and digitization/ trigger electronics, has been realized and extensively tested. Preparations for a full-scale, 1764 pixel camera mechanics and a cooling system are ongoing. The paper describes the status of the project.

  5. 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...

  6. UY Puppis A New Anomalous Z Cam Type Dwarf Nova

    CERN Document Server

    Stubbings, Rod

    2016-01-01

    The defining characteristic of Z Cam stars are standstills in their light curves. Some Z Cams exhibit atypical behaviour by going into outburst from a standstill. It has previously been suggested that UY Pup had been a Z Cam star, but it was ruled out due to its long-term light curve. However, in December 2015 UY Pup went into outburst and unexpectedly entered into a short standstill instead of returning to quiescence. Furthermore, UY Pup exhibited additional unusual behaviour with two outbursts detected during its standstill. After this standstill UY Pup made a brief excursion to a quiescence state and slowly rose to a longer and well-defined standstill, where it again went into another outburst. Through comparative analysis, researching and observational data of UY Pup it is evident and thus concluded that it is indeed a Z Cam star, in which renders it to be one of only four known anomalous Z Cam stars.

  7. 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。

  8. NectarCAM, a camera for the medium sized telescopes of the Cherenkov Telescope Array

    CERN Document Server

    Glicenstein, J-F

    2016-01-01

    NectarCAM is a camera proposed for the medium-sized telescopes of the Cherenkov Telescope Array (CTA) which covers the core energy range of ~100 GeV to ~30 TeV. It has a modular design and is 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 8 degrees. Each module includes photomultiplier bases, high voltage supply, pre-amplifier, trigger, readout and Ethernet transceiver. The recorded events last between a few nanoseconds and tens of nanoseconds. The expected performance of the camera are discussed. Prototypes of NectarCAM components have been built to validate the design. Preliminary results of a 19-module mini-camera are presented, as well as future plans for building and testing a full size camera.

  9. Modeling the corrosion of high-level waste containers: CAM-CRM interface

    Energy Technology Data Exchange (ETDEWEB)

    Farmer, J.C.; Bedrossian, P.J.; McCright, R.D.

    1998-06-01

    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.

  10. 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.

  11. 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

  12. 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.

  13. CIM's bridge from CADD to CAM: Data management requirements for manufacturing engineering

    Science.gov (United States)

    Ford, S. J.

    1984-01-01

    Manufacturing engineering represents the crossroads of technical data management in a Computer Integrated Manufacturing (CIM) environment. Process planning, numerical control programming and tool design are the key functions which translate information from as engineered to as assembled. In order to transition data from engineering to manufacturing, it is necessary to introduce a series of product interpretations which contain an interim introduction of technical parameters. The current automation of the product definition and the production process places manufacturing engineering in the center of CAD/CAM with the responsibility of communicating design data to the factory floor via a manufacturing model of the data. A close look at data management requirements for manufacturing engineering is necessary in order to establish the overall specifications for CADD output, CAM input, and CIM integration. The functions and issues associated with the orderly evolution of computer aided engineering and manufacturing are examined.

  14. 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.

  15. 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

  16. 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.

  17. 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

  18. 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…

  19. 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

  20. 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.

  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. 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...

  3. 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...

  4. 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...

  5. 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.

  6. 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

  7. 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.

  8. 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 ...

  9. 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.

  10. Heart Failure Therapeutics on the Basis of a Biased Ligand of the Angiotensin-2 Type 1 Receptor Rationale and Design of the BLAST-AHF Study (Biased Ligand of the Angiotensin Receptor Study in Acute Heart Failure)

    NARCIS (Netherlands)

    Felker, G. Michael; Butler, Javed; Collins, Sean P.; Cotter, Gad; Davison, Beth A.; Ezekowitz, Justin A.; Filippatos, Gerasimos; Levy, Phillip D.; Metra, Marco; Ponikowski, Piotr; Soergel, David G.; Teerlink, John R.; Violin, Jonathan D.; Voors, Adriaan A.; Pang, Peter S.

    2015-01-01

    The BLAST-AHF (Biased Ligand of the Angiotensin Receptor Study in Acute Heart Failure) study is designed to test the efficacy and safety of TRV027, a novel biased ligand of the angiotensin-2 type 1 receptor, in patients with acute heart failure (AHF). AHF remains a major public health problem, and n

  11. 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.

  12. 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,…

  13. 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...

  14. 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...

  15. 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.

  16. CAM use in dermatology. Is there a potential role for honey, green tea, and vitamin C?

    Science.gov (United States)

    Barbosa, Naiara S; Kalaaji, Amer N

    2014-02-01

    Complementary and alternative medicine (CAM) is a group of non-traditional medical practices that includes natural products, manipulations, and mind and body medicine. CAM use has grown and become popular among patients. In dermatology, honey, green tea, and vitamin C have been used as topical treatments for a variety of diseases. We performed a systematic review to explore the cutaneous effects of each of these three products. Honey's unique antibacterial, anti-inflammatory, and antioxidant properties were shown to contribute to wound healing, especially in ulcers and burns. Green tea, among many health benefits, demonstrated protection from ultraviolet-induced events, such as photoimmunosuppression and skin cancer growth. Vitamin C, known for its antioxidant properties and key role in collagen production, has been shown to produce positive effects on skin hyperpigmentation and aging. Future large well-designed clinical trials are needed in order to further investigate the potential of these agents as dermatological therapies.

  17. 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.).

  18. 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

  19. 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

  20. 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.

  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. 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

  3. 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

  4. 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

  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

    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.

  6. 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

  7. 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

  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. 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.

  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. Finding the Evidence in CAM: a Student's Perspective

    Directory of Open Access Journals (Sweden)

    Jeffrey Ghassemi

    2005-01-01

    Full Text Available This commentary offers a future health care provider's perspective on the role of complementary and alternative medicine (CAM in Western (namely, in US medical education and practice. As a student of both public health and medicine in the United States, Jeffrey Ghassemi is interested in CAM's contribution to improving medical practice and teaching. The commentary highlights the ambiguous definitions of CAM to Westerners despite the rising popularity of and expenditures for alternative modalities of care. It then argues for collaboration between alternative and established medical communities to ascertain the scientific merits of CAM. It concludes by calling for a new medical paradigm that embraces the philosophies of both communities to advance education and patient care.

  12. 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.

  13. Special Section: Complementary and Alternative Medicine (CAM): Time to Talk

    Science.gov (United States)

    ... with your health care providers any complementary and alternative medicines you take or are thinking about starting. Photo: ... and older use some form of complementary and alternative medicine (CAM). But less than one-third who use ...

  14. 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

  15. Communication style and exercise compliance in physiotherapy (CONNECT. A cluster randomized controlled trial to test a theory-based intervention to increase chronic low back pain patients’ adherence to physiotherapists’ recommendations: study rationale, design, and methods

    Directory of Open Access Journals (Sweden)

    Lonsdale Chris

    2012-06-01

    Full Text Available Abstract Background Physical activity and exercise therapy are among the accepted clinical rehabilitation guidelines and are recommended self-management strategies for chronic low back pain. However, many back pain sufferers do not adhere to their physiotherapist’s recommendations. Poor patient adherence may decrease the effectiveness of advice and home-based rehabilitation exercises. According to self-determination theory, support from health care practitioners can promote patients’ autonomous motivation and greater long-term behavioral persistence (e.g., adherence to physiotherapists’ recommendations. The aim of this trial is to assess the effect of an intervention designed to increase physiotherapists’ autonomy-supportive communication on low back pain patients’ adherence to physical activity and exercise therapy recommendations. Methods/Design This study will be a single-blinded cluster randomized controlled trial. Outpatient physiotherapy centers (N =12 in Dublin, Ireland (population = 1.25 million will be randomly assigned using a computer-generated algorithm to either the experimental or control arm. Physiotherapists in the experimental arm (two hospitals and four primary care clinics will attend eight hours of communication skills training. Training will include handouts, workbooks, video examples, role-play, and discussion designed to teach physiotherapists how to communicate in a manner that promotes autonomous patient motivation. Physiotherapists in the waitlist control arm (two hospitals and four primary care clinics will not receive this training. Participants (N = 292 with chronic low back pain will complete assessments at baseline, as well as 1 week, 4 weeks, 12 weeks, and 24 weeks after their first physiotherapy appointment. Primary outcomes will include adherence to physiotherapy recommendations, as well as low back pain, function, and well-being. Participants will be blinded to treatment allocation, as

  16. 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

  17. OmegaCAM at the VLT Survey Telescope

    NARCIS (Netherlands)

    Cappellaro, E.; Baruffolo, A.; Cascone, E.; Greggio, L.; Kuijken, K.; Bender, R.; Muschielok, B.; Iwert, O.; Mitsch, W.; Nicklas, H.; Valentijn, E. A.

    2003-01-01

    We present the status of the VLT Survey Telescope (VST) and OmegaCAM projects. VST is a 2.6m telescope which will be integrated in the ESO-VLT environment at Paranal and will be equipped with a 16k × 16k CCD camera (OmegaCAM) covering 1 square degree with a resolution of 0.21 arcsec/pix. The main sc

  18. 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 ...

  19. 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

  20. 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.

  1. 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

  2. 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

  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. 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

  5. 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

  6. 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

  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. 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

  9. 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

  10. 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

  11. 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

  12. 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.; ,; 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

  13. 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.

  14. 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...

  15. 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

  16. Preservation of micronutrients during rapeseed oil refining: a tool to optimize the health value of edible vegetable oils? Rationale and design of the Optim'Oils randomized clinical trial.

    Science.gov (United States)

    Gladine, C; Meunier, N; Blot, Adeline; Bruchet, Lucile; Pagès, X; Gaud, M; Floter, E; Metin, Z; Rossignol, A; Cano, N; Chardigny, J M

    2011-03-01

    Numerous micronutrients naturally abundant in oilseeds prevent the risk of cardiovascular diseases by reducing cholesterolemia and oxidative stress. These micronutrients include phytosterols and various antioxidants such as polyphenols, tocopherols and coenzyme Q10/Q9 but most of them are lost during the oilseed oil refining. The main objective of the Optim'Oil project was to modify the processes of oil refining in order to reduce the lost of micronutrients. Two clinical trials (cross-over, monocentric, randomized, double-blind and controlled) were designed to investigate the effect of an optimized rapeseed oil 1) on cardiovascular biomarkers (long-term study) and 2) on oxidative stress parameters (post-prandial study). For the long-term study, 59 volunteers ingested daily 20 g of oil and 22 g of margarine (optimized or standard) for 2 periods of 3 weeks separated by a 3-week wash-out period. Blood samples were collected at the beginning and at the end of each period. For the post-prandial study, a sub-group of 16 volunteers came fasted at the laboratory and took 300 mL of a test meal containing 60% of the optimized or standard oils. Blood samples were collected before and during 6h after the test meal intake. In comparison with the standard oil and margarine, the optimized oil and margarine exhibit as expected an increased content of phytosterol (+22%), polyphenols (× 11), tocopherols (+131%) and coenzyme Q10/Q9 (+165%). Overall, conditions of this study were relevant to investigate the effect of the optimized rapeseed oil and margarine on the cardiovascular risk and the oxidative stress.

  17. 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

  18. 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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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

    Directory of Open Access Journals (Sweden)

    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

  20. Cluster-randomized non-inferiority trial to compare supplement consumption and adherence to different dosing regimens for antenatal calcium and iron-folic acid supplementation to prevent preeclampsia and anaemia: rationale and design of the Micronutrient Initiative study

    Directory of Open Access Journals (Sweden)

    Moshood O. Omotayo

    2015-11-01

    Full Text Available Background: To prevent pre-eclampsia in populations with insufficient dietary calcium (Ca intake, the World Health Organisation (WHO recommends routine Ca supplementation during antenatal care (ANC. WHO guidelines suggest a complex dosing regimen, requiring as many as 5 pill-taking events per day when combined with iron and folic acid (IFA supplements. Poor adherence may undermine public health effectiveness, so simpler regimens may be preferable. This trial will compare the effect of the WHO-recommended (higher-dose regimen vs. a simpler, lower-dose regimen on supplement consumption and pill-taking behaviours in Kenyan ANC clients. Design and methods: This is a parallel, non-inferiority, cluster-randomized trial; we examined 16 primary care health facilities in Kenya, 1047 pregnant women between 16-30 weeks gestational age. Higher-dose regimen: 1.5 g elemental calcium in 3 separate doses (500 mg Ca/pill and IFA (60 mg Fe + 400 μg folic acid taken with evening dose. Lower-dose regimen: 1.0 g calcium in 2 separate doses (500 mg Ca/pill with IFA taken as above. Measurements: Primary outcome is Ca pills consumed per day, measured by pill counts. Secondary outcomes include IFA pills consumed per day, client knowledge, motivation, social support, and satisfaction, measured at 4 to 10 weeks post-enrolment. Statistical analyses: Unit of randomization is the health-care facility; unit of analysis is individual client. Intent-to-treat analysis will be implemented with multi-level models to account for clustering. Expected public health impact: If pregnant women prescribed lower doses of Ca ingest as many pills as women prescribed the WHO-recommended regimen, developing a lower-dose recommendation for antenatal Ca and IFA supplementation programs could save resources.