Coronary CT angiography using 64 detector rows: methods and design of the multi-centre trial CORE-64

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Miller, Julie M.; Vavere, Andrea L.; Arbab-Zadeh, Armin; Bush, David E.; Lardo, Albert C.; Texter, John; Brinker, Jeffery; Lima, Joao A.C. [Johns Hopkins Hospital, Johns Hopkins University, Department of Medicine, Division of Cardiology, Baltimore, MD (United States); Dewey, Marc [Charite - Universitaetsmedizin Berlin, Medical School, Humboldt-Universitaet und Freie Universitaet zu Berlin, Department of Radiology, Berlin, PO Box 10098 (Germany); Rochitte, Carlos E.; Lemos, Pedro A. [University of Sao Paulo Medical School, Heart Institute (InCor), Sao Paulo (Brazil); Niinuma, Hiroyuki [Iwate Medical University, Department of Cardiology, Morioka (Japan); Paul, Narinder [Toronto General Hospital, Department of Medical Imaging, Toronto (Canada); Hoe, John [Medi-Rad Associates Ltd, CT Centre, Mt Elizabeth Hospital, Singapore (Singapore); Roos, Albert de [Leiden University Medical Center, Department of Radiology, Leiden (Netherlands); Yoshioka, Kunihiro [Iwate Medical University, Department of Radiology, Morioka (Japan); Cox, Christopher [Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD (United States); Clouse, Melvin E. [Harvard University, Department of Radiology, Beth Israel Deaconess, Boston, MA (United States)

2009-04-15

Multislice computed tomography (MSCT) for the noninvasive detection of coronary artery stenoses is a promising candidate for widespread clinical application because of its non-invasive nature and high sensitivity and negative predictive value as found in several previous studies using 16 to 64 simultaneous detector rows. A multi-centre study of CT coronary angiography using 16 simultaneous detector rows has shown that 16-slice CT is limited by a high number of nondiagnostic cases and a high false-positive rate. A recent meta-analysis indicated a significant interaction between the size of the study sample and the diagnostic odds ratios suggestive of small study bias, highlighting the importance of evaluating MSCT using 64 simultaneous detector rows in a multi-centre approach with a larger sample size. In this manuscript we detail the objectives and methods of the prospective ''CORE-64'' trial (''Coronary Evaluation Using Multidetector Spiral Computed Tomography Angiography using 64 Detectors''). This multi-centre trial was unique in that it assessed the diagnostic performance of 64-slice CT coronary angiography in nine centres worldwide in comparison to conventional coronary angiography. In conclusion, the multi-centre, multi-institutional and multi-continental trial CORE-64 has great potential to ultimately assess the per-patient diagnostic performance of coronary CT angiography using 64 simultaneous detector rows. (orig.)

Fast neutrons in the treatment of head and neck cancers: the results of a multi-centre randomly controlled trial

International Nuclear Information System (INIS)

Duncan, W.; Arnott, S.J.; Orr, J.A.; Kerr, G.R.; Schmitt, G.

1984-01-01

The results are presented of a multi-centre randomly controlled trial of fast neutron irradiation and mega-voltage X-rays in the treatment of patients with locally advanced squamous cell carcinoma of the head and neck region. No significant difference was observed in local tumour control rates. Salvage surgery was performed in a similar number of patients in the two groups. Late morbidity was also similar in the two treatment groups. Patients in a subgroup with cancer of the larynx treated by photons had a significantly better survival than those in the neutron treated group. (Auth.)

Design and performance of a multi-centre randomised controlled trial and economic evaluation of joint tele-consultations [ISRCTN54264250

Directory of Open Access Journals (Sweden)

Thompson Simon

2002-01-01

Full Text Available Abstract Background Appropriate information flow is crucial to the care of patients, particularly at the interface between primary and secondary care. Communication problems can result from inadequate organisation and training, There is a major expectation that information and communication technologies may offer solutions, but little reliable evidence. This paper reports the design and performance of a multi-centre randomised controlled trial (RCT, unparalleled in telemedicine research in either scale or range of outcomes. The study investigated the effectiveness and cost implications in rural and inner-city settings of using videoconferencing to perform joint tele-consultations as an alternative to general practitioner referral to the hospital specialist in the outpatient clinic. Methods Joint tele-consultation services were established in both the Royal Free Hampstead NHS Trust in inner London, and the Royal Shrewsbury Hospitals Trust, in Shropshire. All the patients who gave consent to participate were randomised either to joint tele-consultation or to a routine outpatients appointment. The principal outcome measures included the frequency of decision by the specialist to offer a follow-up outpatient appointment, patient satisfaction (Ware Specific Questionnaire, wellbeing (SF12 and enablement (PEI, numbers of tests, investigations, procedures and treatments. Results A total of 134 general practitioners operating from 29 practices participated in the trial, referring a total of 3170 patients to 20 specialists in ENT medicine, general medicine (including endocrinology, and rheumatology, gastroenterology, orthopaedics, neurology and urology. Of these, 2094 patients consented to participate in the study and were correctly randomised. There was a 91% response rate to the initial assessment questionnaires, and analysis showed equivalence for all key characteristics between the treatment and control groups. Conclusion We have designed and

Person-centred web-based support--development through a Swedish multi-case study.

Science.gov (United States)

Josefsson, Ulrika; Berg, Marie; Koinberg, Ingalill; Hellström, Anna-Lena; Nolbris, Margaretha Jenholt; Ranerup, Agneta; Lundin, Carina Sparud; Skärsäter, Ingela

2013-10-19

Departing from the widespread use of the internet in modern society and the emerging use of web applications in healthcare this project captures persons' needs and expectations in order to develop highly usable web recourses. The purpose of this paper is to outline a multi-case research project focused on the development and evaluation of person-centred web-based support for people with long-term illness. To support the underlying idea to move beyond the illness, we approach the development of web support from the perspective of the emergent area of person-centred care. The project aims to contribute to the ongoing development of web-based supports in health care and to the emerging field of person-centred care. The research design uses a meta-analytical approach through its focus on synthesizing experiences from four Swedish regional and national cases of design and use of web-based support in long-term illness. The cases include children (bladder dysfunction and urogenital malformation), young adults (living close to persons with mental illness), and two different cases of adults (women with breast cancer and childbearing women with type 1 diabetes). All of the cases are ongoing, though in different stages of design, implementation, and analysis. This, we argue, will lead to a synthesis of results on a meta-level not yet described. To allow valid comparisons between the four cases we explore and problematize them in relation to four main aspects: 1) The use of people's experiences and needs; 2) The role of use of theories in the design of person-centred web-based supports; 3) The evaluation of the effects of health outcomes for the informants involved and 4) The development of a generic person-centred model for learning and social support for people with long-term illness and their significant others. Person-centred web-based support is a new area and few studies focus on how web-based interventions can contribute to the development of person-centred care. In

Study protocol, rationale and recruitment in a European multi-centre randomized controlled trial to determine the efficacy and safety of azithromycin maintenance therapy for 6 months in primary ciliary dyskinesia

DEFF Research Database (Denmark)

Kobbernagel, Helene Elgaard; Buchvald, Frederik F; Haarman, Eric G

2016-01-01

maintenance therapy in PCD. METHODS: The BESTCILIA trial is a European multi-centre, double-blind, randomized, placebo-controlled, parallel group study. The intervention is tablets of azithromycin 250/500 mg according to body weight or placebo administered three times a week for 6 months. Subjects...... prescribed in other chronic respiratory disorders. Furthermore, the trial will utilize the Lung clearance index and new, PCD-specific quality of life instruments as outcome measures for PCD. Recruitment is hampered by frequent occurrence of Pseudomonas aeruginosa infection, exacerbations at enrolment...

Multi-disciplinary facilities at the centre for nuclear sciences, U.W.I

International Nuclear Information System (INIS)

Lalor, G.C.; Robotham, H.

1994-01-01

The Centre for Nuclear Sciences was established in 1984 with the mandate to introduce Caribbean scientists to the application of nuclear technology in multi-disciplinary studies, and to carry out research in areas of national and regional importance. It describes the present facilities and the major programmes being carried out at the Centre. (author) 9 refs

Oxygen titration after resuscitation from out-of-hospital cardiac arrest: a multi-centre, randomised controlled pilot study (the EXACT pilot trial).

Science.gov (United States)

Bray, Janet E; Hein, Cindy; Smith, Karen; Stephenson, Michael; Grantham, Hugh; Finn, Judith; Stub, Dion; Cameron, Peter

2018-04-20

Recent studies suggest the administration of 100% oxygen to hyperoxic levels following return-of-spontaneous-circulation (ROSC) post-cardiac arrest may be harmful. However, the feasibility and safety of oxygen titration in the prehospital setting is unknown. We conducted a multi-centre, phase-2 study testing whether prehospital titration of oxygen results in an equivalent number of patients arriving at hospital with oxygen saturations SpO2 ≥ 94%. We enrolled unconscious adults with: sustained ROSC; initial shockable rhythm; an advanced airway; and an SpO2 ≥ 95%. Initially (Sept 2015-March 2016) patients were randomised 1:1 to either 2 litres/minute (L/min) oxygen (titrated) or >10 L/min oxygen (control) via a bag-valve reservoir. However, one site experienced a high number of desaturations (SpO2 titrated arm and this arm was changed (April 2016) to an initial reduction of oxygen to 4 L/min then, if tolerated, to 2 L/min, and the desaturation limit was decreased to titrated (n = 37: 2L/min = 20 and 2-4 L/min = 17) oxygen or control (n = 24). Patients allocated to titrated oxygen were more likely to desaturate compared to controls ((SpO2 titrated: 90% vs. control: 100%) and all patients had a SpO2 ≥ 90%. One patient (control) re-arrested. Survival to hospital discharge was similar. Oxygen titration post-ROSC is feasible in the prehospital environment, but incremental titration commencing at 4L/min oxygen flow may be needed to maintain an oxygen saturation >90% (NCT02499042). Copyright © 2018. Published by Elsevier B.V.

Evaluation of the preliminary auditory profile test battery in an international multi-centre study

NARCIS (Netherlands)

van Esch, T.E.M.; Kollmeier, B.; Vormann, M.; Lijzenga, J.; Houtgast, T.; Hallgren, M.; Larsby, B.; Athalye, S.P.; Lutman, M.E.; Dreschler, W.A.

2013-01-01

Objective: This paper describes the composition and international multi-centre evaluation of a battery of tests termed the preliminary auditory profile. It includes measures of loudness perception, listening effort, speech perception, spectral and temporal resolution, spatial hearing, self-reported

Authorship issues in multi-centre clinical trials

DEFF Research Database (Denmark)

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

2015-01-01

Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for th...

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial.

Science.gov (United States)

Freeman, Jennifer; Fox, Esther; Gear, Margaret; Hough, Alan

2012-04-05

People with Multiple Sclerosis (MS) frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK) provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect.This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training; 2 Comparing core stability training with standardised physiotherapy exercise; 3 Exploring underlying mechanisms of change associated with this intervention This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control). All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12), the Functional Reach (forwards and lateral), a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC) Scale. In addition, ultrasound imaging of the abdominal muscles will be performed before

Pilates based core stability training in ambulant individuals with multiple sclerosis: protocol for a multi-centre randomised controlled trial

Directory of Open Access Journals (Sweden)

Freeman Jennifer

2012-04-01

Full Text Available Abstract Background People with Multiple Sclerosis (MS frequently experience balance and mobility impairments, including reduced trunk stability. Pilates-based core stability training, which is aimed at improving control of the body's stabilising muscles, is popular as a form of exercise with people with MS and therapists. A replicated single case series study facilitated by the Therapists in MS Group in the United Kingdom (UK provides preliminary evidence that this approach can improve balance and mobility in ambulant people with MS; further evidence is needed to substantiate these findings to ensure that limited time, energy, finances and resources are used to best effect. This study builds upon the pilot work undertaken in the case series study by implementing a powered randomised controlled study, with the aims of: 1 Establishing the effectiveness of core stability training 2 Comparing core stability training with standardised physiotherapy exercise 3 Exploring underlying mechanisms of change associated with this intervention Methods This is a multi-centre, double blind, block randomised, controlled trial. Eligible participants will be recruited from 4 UK centres. Participants will be randomly allocated to one of three groups: Pilates based core stability training, standardised physiotherapy exercise or contract-relax relaxation sessions (placebo control. All will receive face to face training sessions over a 12 week period; together with a 15 minute daily home programme. All will be assessed by a blinded assessor before training, at the end of the 12 week programme and at 4 week follow-up. The primary outcome measure is the 10 metre timed walk. Secondary outcome measures are the MS walking Scale (MSWS-12, the Functional Reach (forwards and lateral, a 10 point Numerical Rating Scale to determine "Difficulty in carrying a drink when walking", and the Activities-specific Balance Confidence (ABC Scale. In addition, ultrasound imaging of the

Prevalence of maternal anaemia and its predictors: a multi-centre study.

Science.gov (United States)

Barroso, Filipa; Allard, Shubha; Kahan, Brennan C; Connolly, Catriona; Smethurst, Heather; Choo, Louise; Khan, Khalid; Stanworth, Simon

2011-11-01

To investigate the prevalence, predictors, and management of anaemia in pregnancy. A multi centre study across 11 maternity units in the UK. Data were collected over a two week study period in 2008 on maternal history, haemoglobin (Hb) and ferritin concentrations, iron therapy during pregnancy and in the postpartum period. Logistic regression models were used to explore factors associated with anaemia during pregnancy. Main outcomes included anaemia, defined as Hbanaemia by 32 weeks gestation included young maternal age (odds ratio 1.96, 95% CI 1.38-2.79), non-white ethnic origin (odds ratios varied 1.37-2.89 depending on ethnic origin) and increasing parity (odds ratio 1.24, 95% CI 1.08-1.41). Of women who had postnatal Hb levels checked, 30% (309/1031) were anaemic and, depending on centre, 16% to 86% of these received iron therapy. Anaemia was reported in nearly one in four women in the antenatal period, and nearly one in three of the women who had a postpartum Hb checked. Despite national guidelines, there was considerable variation in administration of iron including low utilisation of parenteral iron therapy. Future research needs to focus on the consequences of iron deficiency anaemia for maternal and infant health outcomes and effectiveness of implementation strategies to reduce anaemia. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Harmonization process and reliability assessment of anthropometric measurements in the elderly EXERNET multi-centre study.

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Alba Gómez-Cabello

Full Text Available BACKGROUND: The elderly EXERNET multi-centre study aims to collect normative anthropometric data for old functionally independent adults living in Spain. PURPOSE: To describe the standardization process and reliability of the anthropometric measurements carried out in the pilot study and during the final workshop, examining both intra- and inter-rater errors for measurements. MATERIALS AND METHODS: A total of 98 elderly from five different regions participated in the intra-rater error assessment, and 10 different seniors living in the city of Toledo (Spain participated in the inter-rater assessment. We examined both intra- and inter-rater errors for heights and circumferences. RESULTS: For height, intra-rater technical errors of measurement (TEMs were smaller than 0.25 cm. For circumferences and knee height, TEMs were smaller than 1 cm, except for waist circumference in the city of Cáceres. Reliability for heights and circumferences was greater than 98% in all cases. Inter-rater TEMs were 0.61 cm for height, 0.75 cm for knee-height and ranged between 2.70 and 3.09 cm for the circumferences measured. Inter-rater reliabilities for anthropometric measurements were always higher than 90%. CONCLUSION: The harmonization process, including the workshop and pilot study, guarantee the quality of the anthropometric measurements in the elderly EXERNET multi-centre study. High reliability and low TEM may be expected when assessing anthropometry in elderly population.

ZOOM or Non-ZOOM? Assessing Spinal Cord Diffusion Tensor Imaging Protocols for Multi-Centre Studies.

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Rebecca S Samson

Full Text Available The purpose of this study was to develop and evaluate two spinal cord (SC diffusion tensor imaging (DTI protocols, implemented at multiple sites (using scanners from two different manufacturers, one available on any clinical scanner, and one using more advanced options currently available in the research setting, and to use an automated processing method for unbiased quantification. DTI parameters are sensitive to changes in the diseased SC. However, imaging the cord can be technically challenging due to various factors including its small size, patient-related and physiological motion, and field inhomogeneities. Rapid acquisition sequences such as Echo Planar Imaging (EPI are desirable but may suffer from image distortions. We present a multi-centre comparison of two acquisition protocols implemented on scanners from two different vendors (Siemens and Philips, one using a reduced field-of-view (rFOV EPI sequence, and one only using options available on standard clinical scanners such as outer volume suppression (OVS. Automatic analysis was performed with the Spinal Cord Toolbox for unbiased and reproducible quantification of DTI metrics in the white matter. Images acquired using the rFOV sequence appear less distorted than those acquired using OVS alone. SC DTI parameter values obtained using both sequences at all sites were consistent with previous measurements made at 3T. For the same scanner manufacturer, DTI parameter inter-site SDs were smaller for the rFOV sequence compared to the OVS sequence. The higher inter-site reproducibility (for the same manufacturer and acquisition details, i.e. ZOOM data acquired at the two Philips sites of rFOV compared to the OVS sequence supports the idea that making research options such as rFOV more widely available would improve accuracy of measurements obtained in multi-centre clinical trials. Future multi-centre studies should also aim to match the rFOV technique and signal-to-noise ratios in all

Authorship issues in multi-centre clinical trials

DEFF Research Database (Denmark)

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian

2015-01-01

to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference...... to the original source....

A pragmatic multi-centre randomised controlled trial of fluid loading and level of dependency in high-risk surgical patients undergoing major elective surgery: trial protocol

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Norrie John

2010-04-01

Full Text Available Abstract Background Patients undergoing major elective or urgent surgery are at high risk of death or significant morbidity. Measures to reduce this morbidity and mortality include pre-operative optimisation and use of higher levels of dependency care after surgery. We propose a pragmatic multi-centre randomised controlled trial of level of dependency and pre-operative fluid therapy in high-risk surgical patients undergoing major elective surgery. Methods/Design A multi-centre randomised controlled trial with a 2 * 2 factorial design. The first randomisation is to pre-operative fluid therapy or standard regimen and the second randomisation is to routine intensive care versus high dependency care during the early post-operative period. We intend to recruit 204 patients undergoing major elective and urgent abdominal and thoraco-abdominal surgery who fulfil high-risk surgical criteria. The primary outcome for the comparison of level of care is cost-effectiveness at six months and for the comparison of fluid optimisation is the number of hospital days after surgery. Discussion We believe that the results of this study will be invaluable in determining the future care and clinical resource utilisation for this group of patients and thus will have a major impact on clinical practice. Trial Registration Trial registration number - ISRCTN32188676

The impact of study design and diagnostic approach in a large multi-centre ADHD study: Part 2: Dimensional measures of psychopathology and intelligence

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Roeyers Herbert

2011-04-01

Full Text Available Abstract Background The International Multi-centre ADHD Genetics (IMAGE project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with ADHD and 1446 unselected siblings. The aim was to describe and analyse questionnaire data and IQ measures from all probands and siblings. In particular, to investigate the influence of age, gender, family status (proband vs. sibling, informant, and centres on sample homogeneity in psychopathological measures. Methods Conners' Questionnaires, Strengths and Difficulties Questionnaires, and Wechsler Intelligence Scores were used to describe the phenotype of the sample. Data were analysed by use of robust statistical multi-way procedures. Results Besides main effects of age, gender, informant, and centre, there were considerable interaction effects on questionnaire data. The larger differences between probands and siblings at home than at school may reflect contrast effects in the parents. Furthermore, there were marked gender by status effects on the ADHD symptom ratings with girls scoring one standard deviation higher than boys in the proband sample but lower than boys in the siblings sample. The multi-centre design is another important source of heterogeneity, particularly in the interaction with the family status. To a large extent the centres differed from each other with regard to differences between proband and sibling scores. Conclusions When ADHD probands are diagnosed by use of fixed symptom counts, the severity of the disorder in the proband sample may markedly differ between boys and girls and across age, particularly in samples with a large age range. A multi-centre design carries the risk of considerable phenotypic differences between centres and, consequently, of additional heterogeneity of the sample even if standardized diagnostic procedures are

The impact of study design and diagnostic approach in a large multi-centre ADHD study: Part 2: Dimensional measures of psychopathology and intelligence.

LENUS (Irish Health Repository)

Muller, Ueli C

2011-04-07

Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with ADHD and 1446 unselected siblings. The aim was to describe and analyse questionnaire data and IQ measures from all probands and siblings. In particular, to investigate the influence of age, gender, family status (proband vs. sibling), informant, and centres on sample homogeneity in psychopathological measures. Methods Conners\\' Questionnaires, Strengths and Difficulties Questionnaires, and Wechsler Intelligence Scores were used to describe the phenotype of the sample. Data were analysed by use of robust statistical multi-way procedures. Results Besides main effects of age, gender, informant, and centre, there were considerable interaction effects on questionnaire data. The larger differences between probands and siblings at home than at school may reflect contrast effects in the parents. Furthermore, there were marked gender by status effects on the ADHD symptom ratings with girls scoring one standard deviation higher than boys in the proband sample but lower than boys in the siblings sample. The multi-centre design is another important source of heterogeneity, particularly in the interaction with the family status. To a large extent the centres differed from each other with regard to differences between proband and sibling scores. Conclusions When ADHD probands are diagnosed by use of fixed symptom counts, the severity of the disorder in the proband sample may markedly differ between boys and girls and across age, particularly in samples with a large age range. A multi-centre design carries the risk of considerable phenotypic differences between centres and, consequently, of additional heterogeneity of the sample even if standardized diagnostic procedures are used. These

I-MOVE multi-centre case control study 2010-11: overall and stratified estimates of influenza vaccine effectiveness in Europe.

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Esther Kissling

Full Text Available BACKGROUND: In the third season of I-MOVE (Influenza Monitoring Vaccine Effectiveness in Europe, we undertook a multicentre case-control study based on sentinel practitioner surveillance networks in eight European Union (EU member states to estimate 2010/11 influenza vaccine effectiveness (VE against medically-attended influenza-like illness (ILI laboratory-confirmed as influenza. METHODS: Using systematic sampling, practitioners swabbed ILI/ARI patients within seven days of symptom onset. We compared influenza-positive to influenza laboratory-negative patients among those meeting the EU ILI case definition. A valid vaccination corresponded to > 14 days between receiving a dose of vaccine and symptom onset. We used multiple imputation with chained equations to estimate missing values. Using logistic regression with study as fixed effect we calculated influenza VE adjusting for potential confounders. We estimated influenza VE overall, by influenza type, age group and among the target group for vaccination. RESULTS: We included 2019 cases and 2391 controls in the analysis. Adjusted VE was 52% (95% CI 30-67 overall (N = 4410, 55% (95% CI 29-72 against A(H1N1 and 50% (95% CI 14-71 against influenza B. Adjusted VE against all influenza subtypes was 66% (95% CI 15-86, 41% (95% CI -3-66 and 60% (95% CI 17-81 among those aged 0-14, 15-59 and ≥60 respectively. Among target groups for vaccination (N = 1004, VE was 56% (95% CI 34-71 overall, 59% (95% CI 32-75 against A(H1N1 and 63% (95% CI 31-81 against influenza B. CONCLUSIONS: Results suggest moderate protection from 2010-11 trivalent influenza vaccines against medically-attended ILI laboratory-confirmed as influenza across Europe. Adjusted and stratified influenza VE estimates are possible with the large sample size of this multi-centre case-control. I-MOVE shows how a network can provide precise summary VE measures across Europe.

CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi-centre, randomized, controlled pilot study.

Science.gov (United States)

Carling, Anna; Forsberg, Anette; Gunnarsson, Martin; Nilsagård, Ylva

2017-09-01

Imbalance leading to falls is common in people with multiple sclerosis (PwMS). To evaluate the effects of a balance group exercise programme (CoDuSe) on balance and walking in PwMS (Expanded Disability Status Scale, 4.0-7.5). A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised 60-minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late. Primary outcome was Berg Balance Scale (BBS). A total of 51 participants were initially enrolled; three were lost to follow-up. Post-intervention, the exercise group showed statistically significant improvement ( p = 0.015) in BBS and borderline significant improvement in MS Walking Scale ( p = 0.051), both with large effect sizes (3.66; -2.89). No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before ( p balance and reduced perceived walking limitations, compared to no exercise. The intervention reduced falls and near falls frequency.

Use of platelet rich plasma to treat plantar fasciitis: design of a multi centre randomized controlled trial

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Peerbooms Joost C

2010-04-01

Full Text Available Abstract Background If conservative treatment for chronic plantar fasciitis fails, often a corticosteroid injection is given. Corticosteroid injection gives temporarily pain reduction, but no healing. Blood platelets initiate the natural healing rate. GPS® gives an eightfold concentrate platelets of patients own blood. Injection of these platelets in the attachment of the fascia to the os calcis might induce a healing rate. Methods and design A randomized controlled multi centre trial will be performed. The study population consists of 120 patients of 18 years and older. Patients with chronic plantar fasciitis will be allocated randomly to have a steroid injection or an autologous platelet concentrate injections. Data will be collected before the procedure, 4,8,12,26 weeks and 1 year after the procedure. The main outcome measures of this study are pain and function measured with questionnaires. Conclusion Recent literature show positive effects for the treatment of tendinosis with autologous platelet injections. The forthcoming trial will compare treatment for chronic plantar fasciitis with a steroid injection versus an autologous platelet injection. Our results will be published as soon as they become available. Trial Registration Trial registration number: http://www.clinicaltrials.gov NCT00758641.

Surgical timing after chemoradiotherapy for rectal cancer, analysis of technique (STARRCAT): results of a feasibility multi-centre randomized controlled trial.

Science.gov (United States)

Foster, J D; Ewings, P; Falk, S; Cooper, E J; Roach, H; West, N P; Williams-Yesson, B A; Hanna, G B; Francis, N K

2016-10-01

The optimal time of rectal resection after long-course chemoradiotherapy (CRT) remains unclear. A feasibility study was undertaken for a multi-centre randomized controlled trial evaluating the impact of the interval after chemoradiotherapy on the technical complexity of surgery. Patients with rectal cancer were randomized to either a 6- or 12-week interval between CRT and surgery between June 2012 and May 2014 (ISRCTN registration number: 88843062). For blinded technical complexity assessment, the Observational Clinical Human Reliability Analysis technique was used to quantify technical errors enacted within video recordings of operations. Other measured outcomes included resection completeness, specimen quality, radiological down-staging, tumour cell density down-staging and surgeon-reported technical complexity. Thirty-one patients were enrolled: 15 were randomized to 6 and 16-12 weeks across 7 centres. Fewer eligible patients were identified than had been predicted. Of 23 patients who underwent resection, mean 12.3 errors were observed per case at 6 weeks vs. 10.7 at 12 weeks (p = 0.401). Other measured outcomes were similar between groups. The feasibility of measurement of operative performance of rectal cancer surgery as an endpoint was confirmed in this exploratory study. Recruitment of sufficient numbers of patients represented a challenge, and a proportion of patients did not proceed to resection surgery. These results suggest that interval after CRT may not substantially impact upon surgical technical performance.

The effect of TCM acupuncture on hot flushes among menopausal women (ACUFLASH study: A study protocol of an ongoing multi-centre randomised controlled clinical trial

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Borud Einar K

2007-02-01

Full Text Available Abstract Background After menopause, 10–20% of all women have nearly intolerable hot flushes. Long term use of hormone replacement therapy involves a health risk, and many women seek alternative strategies to relieve climacteric complaints. Acupuncture is one of the most frequently used complementary therapies in Norway. We designed a study to evaluate whether Traditional Chinese Medicine acupuncture-care together with self-care is more effective than self-care alone to relieve climacteric complaints. Methods/Design The study is a multi-centre pragmatic randomised controlled trial with two parallel arms. Participants are postmenopausal women who document ≥7 flushes/24 hours and who are not using hormone replacement therapy or other medication that may influence flushes. According to power calculations 200 women are needed to detect a 50% reduction in flushes, and altogether 286 women will be recruited to allow for a 30% dropout rate. The treatment group receives 10 sessions of Traditional Chinese Medicine acupuncture-care and self-care; the control group will engage in self-care only. A team of experienced Traditional Chinese Medicine acupuncturists give acupuncture treatments. Discussion The study tests acupuncture as a complete treatment package including the therapeutic relationship and expectation. The intervention period lasts for 12 weeks, with follow up at 6 and 12 months. Primary endpoint is change in daily hot flush frequency in the two groups from baseline to 12 weeks; secondary endpoint is health related quality of life, assessed by the Women's Health Questionnaire. We also collect data on Traditional Chinese Medicine diagnoses, and we examine treatment experiences using a qualitative approach. Finally we measure biological variables, to examine potential mechanisms for the effect of acupuncture. The study is funded by The Research Council of Norway.

Dosimetry audit for a multi-centre IMRT head and neck trial

International Nuclear Information System (INIS)

Clark, Catharine H.; Hansen, Vibeke Nordmark; Chantler, Hannah; Edwards, Craig; James, Hayley V.; Webster, Gareth; Miles, Elizabeth A.; Guerrero Urbano, M. Teresa; Bhide, Shree A.; Bidmead, A. Margaret; Nutting, Christoper M.

2009-01-01

Background and purpose: PARSPORT was a multi-centre randomised trial in the UK which compared Intensity-Modulated Radiotherapy (IMRT) and conventional radiotherapy (CRT) for patients with head and neck cancer. The dosimetry audit goals were to verify the plan delivery in participating centres, ascertain what tolerances were suitable for head and neck IMRT trials and develop an IMRT credentialing program. Materials and methods: Centres enrolling patients underwent rigorous quality assurance before joining the trial. Following this each centre was visited for a dosimetry audit, which consisted of treatment planning system tests, fluence verification films, combined field films and dose point measurements. Results: Mean dose point measurements were made at six centres. For the primary planning target volume (PTV) the differences with the planned values for the IMRT and CRT arms were -0.6% (1.8% to -2.4%) and 0.7% (2.0% to -0.9%), respectively. Ninety-four percent of the IMRT fluence films for individual fields passed gamma criterion of 3%/3 mm and 75% of the films for combined fields passed gamma criterion 4%/3 mm (no significant difference between dynamic delivery and step and shoot delivery). Conclusions: This audit suggests that a 3% tolerance could be applied for PTV point doses. For dose distributions tolerances of 3%/3 mm on individual fields and 4%/3 mm for combined fields are proposed for multi-centre head and neck IMRT trials.

Multi-port versus single-port cholecystectomy: results of a multi-centre, randomised controlled trial (MUSIC trial).

Science.gov (United States)

Arezzo, Alberto; Passera, Roberto; Bullano, Alberto; Mintz, Yoav; Kedar, Asaf; Boni, Luigi; Cassinotti, Elisa; Rosati, Riccardo; Fumagalli Romario, Uberto; Sorrentino, Mario; Brizzolari, Marco; Di Lorenzo, Nicola; Gaspari, Achille Lucio; Andreone, Dario; De Stefani, Elena; Navarra, Giuseppe; Lazzara, Salvatore; Degiuli, Maurizio; Shishin, Kirill; Khatkov, Igor; Kazakov, Ivan; Schrittwieser, Rudolf; Carus, Thomas; Corradi, Alessio; Sitzman, Guenther; Lacy, Antonio; Uranues, Selman; Szold, Amir; Morino, Mario

2017-07-01

Single-port laparoscopic surgery as an alternative to conventional laparoscopic cholecystectomy for benign disease has not yet been accepted as a standard procedure. The aim of the multi-port versus single-port cholecystectomy trial was to compare morbidity rates after single-access (SPC) and standard laparoscopy (MPC). This non-inferiority phase 3 trial was conducted at 20 hospital surgical departments in six countries. At each centre, patients were randomly assigned to undergo either SPC or MPC. The primary outcome was overall morbidity within 60 days after surgery. Analysis was by intention to treat. The study was registered with ClinicalTrials.gov (NCT01104727). The study was conducted between April 2011 and May 2015. A total of 600 patients were randomly assigned to receive either SPC (n = 297) or MPC (n = 303) and were eligible for data analysis. Postsurgical complications within 60 days were recorded in 13 patients (4.7 %) in the SPC group and in 16 (6.1 %) in the MPC group (P = 0.468); however, single-access procedures took longer [70 min (range 25-265) vs. 55 min (range 22-185); P risk of incisional hernia following SPC do not appear to be justified. Patient satisfaction with aesthetic results was greater after SPC than after MPC.

Multi-technology control centre to integrate 460 MW renewables; Centro de control multitecnología para la integración de 460 MW renovables

Energy Technology Data Exchange (ETDEWEB)

NONE

2016-07-01

The new RWE Innogy Aersa Control Centre that has been certified to act as an interface with CECRE (the Renewable Energy Control Centre) since February 2015, connects RWE’s 20 renewable energy facilities with REE, the Spanish Electricity Grid. As a result, it ensures that wind farms, in addition to hydropower and solar plants, can inject the energy generated by its 460 MW installed safely and with no penalties. Green Eagle Solutions, a provider of software solutions for renewable energy companies, has collaborated with RWE in the development of this Control Centre, meeting the high standards of quality and safety required by RWE. This centre uses CompactSCADA® technology to integrate power generation facilities that need to be integrated in a Control Centre to communicate with REE’s CECRE. (Author)

The outcome of a multi-centre feasibility study of online adaptive radiotherapy for muscle-invasive bladder cancer TROG 10.01 BOLART

International Nuclear Information System (INIS)

Foroudi, Farshad; Pham, Daniel; Rolfo, Aldo; Bressel, Mathias; Tang, Colin I.; Tan, Alex; Turner, Sandra; Hruby, George; Williams, Stephen; Hayne, Dickon; Lehman, Margot; Skala, Marketa; Jose, Chakiath C.; Gogna, Kumar; Kron, Tomas

2014-01-01

Purpose: To assess whether online adaptive radiotherapy for bladder cancer is feasible across multiple Radiation Oncology departments using different imaging, delivery and recording technology. Materials and methods: A multi-centre feasibility study of online adaptive radiotherapy, using a choice of three “plan of the day”, was conducted at 12 departments. Patients with muscle-invasive bladder cancer were included. Departments were activated if part of the pilot study or after a site-credentialing visit. There was real time review of the first two cases from each department. Results: 54 patients were recruited, with 50 proceeding to radiotherapy. There were 43 males and 7 females with a mean age of 78 years. The tumour stages treated included T1 (1 patient), T2 (35), T3 (10) and T4 (4). One patient died of an unrelated cause during radiotherapy. The three adaptive plans were created before the 10th fraction in all cases. In 8 (16%) of the patients, a conventional plan using a ‘standard’ CTV to PTV margin of 1.5 cm was used for one or more fractions where the pre-treatment bladder CTV was larger than any of the three adaptive plans. The bladder CTV extended beyond the PTV on post treatment imaging in 9 (18%) of the 49 patients. Conclusions: From a technical perspective an online adaptive radiotherapy technique can be instituted in a multi-centre setting. However, without further bladder filling control or imaging, a CTV to PTV margin of 7 mm is insufficient

CCS-MIP: Low cost Customizable Control Centre

Science.gov (United States)

Labezin, Christian; Vielcanet, Pierre

1994-01-01

The positioning and station keeping of French national satellites are among the main missions of CNES French Space Agency CNES. The related experience and skills of the Toulouse Space Centre are reknown and often required at international level for a wide range of missions. CISI, a software engineering company, has been contributing during the last 20 years to the development of the French space programs, particularly in the field of space missions ground control segments. The CCS-MIP system, presented here, is a satellite positioning and station-keeping system designed to answer the CNES multi-mission needs, easily adaptable for a wide range of applications.

Species distribution and susceptibility profile to fluconazole, voriconazole and MXP-4509 of 551 clinical yeast isolates from a Romanian multi-centre study

NARCIS (Netherlands)

Minea, B; Nastasa, V; Moraru, R F; Kolecka, A; Flonta, M M; Marincu, I; Man, A; Toma, F; Lupse, M; Doroftei, B; Marangoci, N; Pinteala, M; Boekhout, T; Mares, M

This is the first multi-centre study regarding yeast infections in Romania. The aim was to determine the aetiological spectrum and susceptibility pattern to fluconazole, voriconazole and the novel compound MXP-4509. The 551 isolates were identified using routine laboratory methods, matrix-assisted

Distributed Scheduling to Support a Call Centre: a Co-operative Multi-Agent Approach

NARCIS (Netherlands)

Brazier, F.M.; Jonker, C.M.; Jungen, F.J.; Treur, J.; Nwana, H.S.

1998-01-01

This paper describes a multi-agent system architecture to increase the value of 24 hour a day call centre service. This system supports call centres in making appointments with clients on the basis of knowledge of employees and their schedules. Relevant activities of employees are scheduled for

Efficacy of night-time compression for breast cancer related lymphedema (LYNC): protocol for a multi-centre, randomized controlled efficacy trial

International Nuclear Information System (INIS)

McNeely, Margaret L.; Campbell, Kristin L.; Webster, Marc; Kuusk, Urve; Tracey, Karen; Mackey, John

2016-01-01

Lymphedema is a prevalent long-term effect of breast cancer treatment that is associated with reduced quality of life. More recent observational data suggest that the addition of night-time compression to day-time use of a compression garment results in better long-term control of arm lymphedema. The primary objectives of the randomized controlled phase of the trial are to determine the efficacy of night-time compression on arm lymphedema volume maintenance and quality of life in breast cancer survivors who have completed intensive reduction treatment for their lymphedema. The study will be a parallel 3-arm, multi-centre randomized fast-track trial. A total of 120 women with breast cancer related lymphedema will be recruited from 3 centres in Canada and randomized to group 1: Day-time compression garment alone or Group 2: Day-time compression garment + night-time compression bandaging or Group 3: Day-time compression garment + use of a night-time compression system garment. The duration of the primary intervention period will be 12 weeks. The follow-up period after the intervention (weeks 13 to 24) will follow a longitudinal observational design. The primary outcome variables: differences from baseline to week 12 in arm volume and quality of life (Lymphoedema Functioning, Disability and Health Questionnaire: Lymph-ICF). Secondary outcomes include bioimpedance analysis, sleep disturbance and self-efficacy. All measurements are standardized and will be performed prior to randomization, and at weeks 6, 12, 18 and 24. The use of night-time compression as a self-management strategy for chronic breast cancer related lymphedema is seen as an innovative approach to improve long-term control over the condition. This trial aims to advance the knowledge on self-management strategies for lymphedema

Planning a multi-institutional information for development study centre

CSIR Research Space (South Africa)

Moreno, A

2010-05-01

Full Text Available . The I4D Study Centre tasks are to increase both the research expertise pool available for Meraka and the partner university, and the joint development of study programs with universities that will prepare students for a researcher career with an ICT4D...

Consent: an event or a memory in lumbar spinal surgery? A multi-centre, multi-specialty prospective study of documentation and patient recall of consent content.

Science.gov (United States)

Lo, William B; McAuley, Ciaran P; Gillies, Martin J; Grover, Patrick J; Pereira, Erlick A C

2017-11-01

Prospective, multi-centre, multi-specialty medical notes review and patient interview. The consenting process is an important communication tool which also carries medico-legal implications. While written consent is a pre-requisite before spinal surgery in the UK, the standard and effectiveness of the process have not been assessed previously. This study assesses standard of written consent for elective lumbar decompressive surgery for degenerative disc disease across different regions and specialties in the UK; level of patient recall of the consent content; and identifies factors which affect patient recall. Consent forms of 153 in-patients from 4 centres a, b, c, d were reviewed. Written documentation of intended benefits, alternative treatments and operative risks was assessed. Of them, 108 patients were interviewed within 24 h before or after surgeries to assess recall. The written documentation rates of the operative risks showed significant inter-centre variations in haemorrhage and sphincter disturbance (P = 0.000), but not for others. Analysis of pooled data showed variations in written documentation of risks (P recall of these risks, there was no inter-centre variation. Patients' recall of paralysis as a risk was highest (50.9%) and that of recurrence was lowest (6.5%). Patients recalled risks better than those ≥65, significantly so for infection (29.9 vs 9.7%, P = 0.027). Patients consented >14 days compared to recall for paralysis (65.2 vs 43.7%) and recurrence (17.4 vs 2.8%). Patient recall was independent of consenter grade. Overall, the standard of written consent for elective lumbar spinal decompressive surgery was sub-optimal, which was partly reflected in the poor patient recall. While consenter seniority did not affect patient recall, younger age and longer consent-to-surgery time improved it.

A pragmatic multi-centre randomised controlled trial of fluid loading in high-risk surgical patients undergoing major elective surgery--the FOCCUS study.

Science.gov (United States)

Cuthbertson, Brian H; Campbell, Marion K; Stott, Stephen A; Elders, Andrew; Hernández, Rodolfo; Boyers, Dwayne; Norrie, John; Kinsella, John; Brittenden, Julie; Cook, Jonathan; Rae, Daniela; Cotton, Seonaidh C; Alcorn, David; Addison, Jennifer; Grant, Adrian

2011-01-01

Fluid strategies may impact on patient outcomes in major elective surgery. We aimed to study the effectiveness and cost-effectiveness of pre-operative fluid loading in high-risk surgical patients undergoing major elective surgery. This was a pragmatic, non-blinded, multi-centre, randomised, controlled trial. We sought to recruit 128 consecutive high-risk surgical patients undergoing major abdominal surgery. The patients underwent pre-operative fluid loading with 25 ml/kg of Ringer's solution in the six hours before surgery. The control group had no pre-operative fluid loading. The primary outcome was the number of hospital days after surgery with cost-effectiveness as a secondary outcome. A total of 111 patients were recruited within the study time frame in agreement with the funder. The median pre-operative fluid loading volume was 1,875 ml (IQR 1,375 to 2,025) in the fluid group compared to 0 (IQR 0 to 0) in controls with days in hospital after surgery 12.2 (SD 11.5) days compared to 17.4 (SD 20.0) and an adjusted mean difference of 5.5 days (median 2.2 days; 95% CI -0.44 to 11.44; P = 0.07). There was a reduction in adverse events in the fluid intervention group (P = 0.048) and no increase in fluid based complications. The intervention was less costly and more effective (adjusted average cost saving: £2,047; adjusted average gain in benefit: 0.0431 quality adjusted life year (QALY)) and has a high probability of being cost-effective. Pre-operative intravenous fluid loading leads to a non-significant reduction in hospital length of stay after high-risk major surgery and is likely to be cost-effective. Confirmatory work is required to determine whether these effects are reproducible, and to confirm whether this simple intervention could allow more cost-effective delivery of care. Prospective Clinical Trials, ISRCTN32188676.

CANDU 9 Control Centre Mockup

International Nuclear Information System (INIS)

Webster, A.; Macbeth, M.J.

1996-01-01

This paper provides a summary of the design process being followed, the benefits of applying a systematic design using human factors engineering, presents an overview of the CANDU 9 control centre mockup facility, illustrates the control centre mockup with photographs of the 3D CADD model and the full scale mockup, and provides an update on the current status of the project. (author)

Authorship issues in multi-centre clinical trials: the importance of making an authorship contract.

Science.gov (United States)

Rosenberg, Jacob; Burcharth, Jakob; Pommergaard, Hans-Christian; Vinther, Siri

2015-02-01

Discussions about authorship often arise in multi-centre clinical trials. Such trials may involve up to hundreds of contributors of whom some will eventually co-author the final publication. It is, however, often impossible to involve all contributors in the manuscript process sufficiently for them to qualify for authorship as defined by the International Committee of Medical Journal Editors. Therefore, rules for authorship in multi-centre trials are strongly recommended. We propose two contracts to prevent conflicts regarding authorship; both are freely available for use without pay but with reference to the original source.

Council celebrates CERN Control Centre

CERN Multimedia

2006-01-01

With the unveiling of its new sign, the CERN Control Centre was officially inaugurated on Thursday 16 March. To celebrate its startup, CERN Council members visited the sleek centre, a futuristic-looking room filled with a multitude of monitoring screens.

WHEDA study: Effectiveness of occupational therapy at home for older people with dementia and their caregivers - the design of a pragmatic randomised controlled trial evaluating a Dutch programme in seven German centres

Directory of Open Access Journals (Sweden)

Vernooij-Dassen Myrra

2009-10-01

Full Text Available Abstract Background A recent Dutch mono-centre randomised controlled trial has shown that occupational therapy improves daily functioning in dementia. The aim of this present study is to compare the effects of the Dutch community occupational therapy programme with a community occupational therapy consultation on daily functioning in older people with mild or moderate dementia and their primary caregivers in a German multi-centre context. Methods/Design A multi-centre single blind randomised controlled trial design is being used in seven health care centres (neurological, psychiatric and for older people in urban regions. Patients are 1:1 randomised to treatment or control group. Assessors are blind to group assignment and perform measurements on both groups at baseline, directly after intervention at 6 weeks and at 16, 26 and 52 weeks follow-up. A sample of 140 community dwelling older people (aged >65 years with mild or moderate dementia and their primary caregivers is planned. The experimental intervention consists of an evidence-based community occupational therapy programme including 10 sessions occupational therapy at home. The control intervention consists of one community occupational therapy consultation based on information material of the Alzheimer Society. Providers of both interventions are occupational therapists experienced in treatment of cognitively impaired older people and trained in both programmes. 'Community' indicates that occupational therapy intervention occurs in the person's own home. The primary outcome is patients' daily functioning assessed with the performance scale of the Interview for Deterioration in Daily Living Activities in Dementia and video tapes of daily activities rated by external raters blind to group assignment using the Perceive, Recall, Plan and Perform System of Task Analysis. Secondary outcomes are patients' and caregivers' quality of life, mood and satisfaction with treatment; the caregiver

The CERN Control Centre is up and running!

CERN Multimedia

2006-01-01

The CERN Control Centre (CCC) that combines all the control rooms for the accelerators, the cryogenic system and the technical infrastructure came into operation on 1st February. This is not a mock-up but the real thing! The CERN Control Centre has been built and put into operation in only 15 months.On 1st February, at 2.00 p.m., Patrick Villeton Pachot started the first Technical Infrastructure shift at the brand new CERN Control Centre. From now on, when you dial 72201 to report a leak or an electrical fault, your call will ring out in the brand new CERN Control Centre. The much anticipated CCC came on line on 1st February, exactly as planned. The 2.00 p.m. shift by the operators of the former Technical Control Room (TCR), now renamed TI for Technical Infrastructure, marked the start of operations at the Centre. The PCR, MCR, TCR and QCR are no more, and all the individual control rooms have been merged into one. And what a control room it is! True to the streamlined image announced when the project was f...

Computerized detection of breast lesions in multi-centre and multi-instrument DCE-MR data using 3D principal component maps and template matching

Science.gov (United States)

Ertas, Gokhan; Doran, Simon; Leach, Martin O.

2011-12-01

In this study, we introduce a novel, robust and accurate computerized algorithm based on volumetric principal component maps and template matching that facilitates lesion detection on dynamic contrast-enhanced MR. The study dataset comprises 24 204 contrast-enhanced breast MR images corresponding to 4034 axial slices from 47 women in the UK multi-centre study of MRI screening for breast cancer and categorized as high risk. The scans analysed here were performed on six different models of scanner from three commercial vendors, sited in 13 clinics around the UK. 1952 slices from this dataset, containing 15 benign and 13 malignant lesions, were used for training. The remaining 2082 slices, with 14 benign and 12 malignant lesions, were used for test purposes. To prevent false positives being detected from other tissues and regions of the body, breast volumes are segmented from pre-contrast images using a fast semi-automated algorithm. Principal component analysis is applied to the centred intensity vectors formed from the dynamic contrast-enhanced T1-weighted images of the segmented breasts, followed by automatic thresholding to eliminate fatty tissues and slowly enhancing normal parenchyma and a convolution and filtering process to minimize artefacts from moderately enhanced normal parenchyma and blood vessels. Finally, suspicious lesions are identified through a volumetric sixfold neighbourhood connectivity search and calculation of two morphological features: volume and volumetric eccentricity, to exclude highly enhanced blood vessels, nipples and normal parenchyma and to localize lesions. This provides satisfactory lesion localization. For a detection sensitivity of 100%, the overall false-positive detection rate of the system is 1.02/lesion, 1.17/case and 0.08/slice, comparing favourably with previous studies. This approach may facilitate detection of lesions in multi-centre and multi-instrument dynamic contrast-enhanced breast MR data.

Psychological and psychosocial functioning of children with burn scarring using cosmetic camouflage: a multi-centre prospective randomised controlled trial.

Science.gov (United States)

Maskell, Jessica; Newcombe, Peter; Martin, Graham; Kimble, Roy

2014-02-01

Burns leave patients with long-term physical scarring. Children with scarring are required to face challenges of reintegration into their community, including acceptance of an altered appearance and acceptance by others. This can be difficult given society's preoccupation with physical appearance. Limited research exists investigating validity of cosmetic camouflage as a psychosocial intervention for children with scarring. This study investigated whether using cosmetic camouflage (Microskin™) had a positive impact on health-related quality of life, self-concept and psychopathology for children and adolescents (8-17 years) with burn scarring. A prospective multi-centre randomised controlled trial was conducted across Australian and New Zealand paediatric hospitals. 63 participants (49 females, mean age 12.7 ± 2.1 years) were enrolled. Data points were baseline (Time 1) and at 8 weeks (Time 2) using reliable and valid psychometric measures. Findings indicate there were significant improvements in socialisation, school and appearance scales on the Paediatric Quality of Life Inventory and psychopathology scores particularly peer problems decreased. However self-concept remained stable from baseline throughout intervention use. Cosmetic camouflage appears to have a positive impact on quality of life particularly socialisation. Cosmetic camouflage is a valid tool to assist children with scarring to actively participate socially within their communities. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study

Science.gov (United States)

Kjærgaard, Hanne; Olsen, Jørn; Ottesen, Bent; Nyberg, Per; Dykes, Anna-Karin

2008-01-01

Background In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria. Methods A multi-centre population based cohort study with prospectively collected data from 2810 nulliparous women in term spontaneous labour with a singleton infant in cephalic presentation. Data were collected by self-administered questionnaires and clinical data-records. Logistic regression analyses were used to estimate adjusted Odds Ratios (OR) and 95% confidence intervals (CI) are given. Results The following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI): dilatation of cervix dystocia. Conclusion Vaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern. PMID:18837972

Obstetric risk indicators for labour dystocia in nulliparous women: A multi-centre cohort study

Directory of Open Access Journals (Sweden)

Ottesen Bent

2008-10-01

Full Text Available Abstract Background In nulliparous women dystocia is the most common obstetric problem and its etiology is largely unknown. The frequency of augmentation and cesarean delivery related to dystocia is high although it is not clear if a slow progress justifies the interventions. Studies of risk factors for dystocia often do not provide diagnostic criteria for the diagnosis. The aim of the present study was to identify obstetric and clinical risk indicators of dystocia defined by strict and explicit criteria. Methods A multi-centre population based cohort study with prospectively collected data from 2810 nulliparous women in term spontaneous labour with a singleton infant in cephalic presentation. Data were collected by self-administered questionnaires and clinical data-records. Logistic regression analyses were used to estimate adjusted Odds Ratios (OR and 95% confidence intervals (CI are given. Results The following characteristics, present at admission to hospital, were associated with dystocia during labour (OR, 95% CI: dilatation of cervix Conclusion Vaginal examinations at admission provide useful information on risk indicators for dystocia. The strongest risk indicator was use of epidural analgesia and if part of that is causal, it is of concern.

Splinting after contracture release for Dupuytren's contracture (SCoRD: protocol of a pragmatic, multi-centre, randomized controlled trial

Directory of Open Access Journals (Sweden)

Chojnowski Adrian J

2008-04-01

Full Text Available Abstract Background Splinting as part of the overall post-surgical management of patients after release of Dupuytren's contracture has been widely reported, though there is variation in practice and criteria for using it. The evidence on its effectiveness is sparse, of poor quality and contradictory with studies reporting negative and positive effects. Methods/Design A multi-centre, pragmatic, randomized, controlled trial is being conducted to evaluate the effect of static night splinting for six months on hand function, range of movement, patient satisfaction and recurrence at 1 year after fasciectomy or dermofasciectomy. Using a centrally administered computer randomization system consented patients will be allocated to one of two groups: i splint group who will be given a static splint at approximately 10 to 14 days after surgery to be worn for 6 months at night time only as well as hand therapy; ii non-splint group, who will receive hand therapy only. The primary outcome measure is the patient-reported Disabilities of the Arm, Hand and Shoulder Questionnaire (DASH. Secondary outcomes are total active flexion and extension of fingers, patient satisfaction and recurrence of contracture. Outcome measures will be collected prior to surgery, 3 months, 6 months and 1 year after surgery. Using the DASH as the primary outcome measure, where a difference of 15 points is considered to be a clinically important difference a total of 51 patients will be needed in each group for a power of 90%. An intention-to-treat analysis will be used. Discussion This pragmatic randomized controlled trial will provide much needed evidence on the clinical effectiveness of post-operative night splinting in patients who have undergone fasciectomy or dermofasciectomy for Dupuytren's contracture of the hand. Trial Registration Current Controlled Trials ISRCTN 57079614

Study Protocol. IDUS -- Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

LENUS (Irish Health Repository)

Murphy, Deirdre J

2012-09-13

AbstractBackgroundInstrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice.Methods\\/DesignA multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha.DiscussionIt is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries.Trial registrationCurrent Controlled Trials ISRCTN72230496

The CERN Control Centre is up and running!

CERN Multimedia

Maximilien Brice

2006-01-01

The CERN Control Centre (CCC) that combines all the control rooms for the accelerators, the cryogenic system and the technical infrastructure came into operation on 1st February. On 1st February, at 2.00 p.m., Patrick Villeton Pachot started the first Technical Infrastructure shift at the brand new CERN Control Centre.

Multi-centre audit of VMAT planning and pre-treatment verification.

Science.gov (United States)

Jurado-Bruggeman, Diego; Hernández, Victor; Sáez, Jordi; Navarro, David; Pino, Francisco; Martínez, Tatiana; Alayrach, Maria-Elena; Ailleres, Norbert; Melero, Alejandro; Jornet, Núria

2017-08-01

We performed a multi-centre intercomparison of VMAT dose planning and pre-treatment verification. The aims were to analyse the dose plans in terms of dosimetric quality and deliverability, and to validate whether in-house pre-treatment verification results agreed with those of an external audit. The nine participating centres encompassed different machines, equipment, and methodologies. Two mock cases (prostate and head and neck) were planned using one and two arcs. A plan quality index was defined to compare the plans and different complexity indices were calculated to check their deliverability. We compared gamma index pass rates using the centre's equipment and methodology to those of an external audit (global 3D gamma, absolute dose differences, 10% of maximum dose threshold). Log-file analysis was performed to look for delivery errors. All centres fulfilled the dosimetric goals but plan quality and delivery complexity were heterogeneous and uncorrelated, depending on the manufacturer and the planner's methodology. Pre-treatment verifications results were within tolerance in all cases for gamma 3%-3mm evaluation. Nevertheless, differences between the external audit and in-house measurements arose due to different equipment or methodology, especially for 2%-2mm criteria with differences up to 20%. No correlation was found between complexity indices and verification results amongst centres. All plans fulfilled dosimetric constraints, but plan quality and complexity did not correlate and were strongly dependent on the planner and the vendor. In-house measurements cannot completely replace external audits for credentialing. Copyright © 2017 Elsevier B.V. All rights reserved.

Development of the Advanced CANDU Reactor control centre

International Nuclear Information System (INIS)

Malcolm, S.; Leger, R.

2004-01-01

The next generation CANDU control centre is being designed for the Advanced CANDU Reactor (ACR) station. The design is based upon the recent Qinshan control room with further upgrades to meet customer needs with respect to high capacity factor with low Operation, Maintenance and Administration (OM and A) costs. This evolutionary design includes the long proven functionality at several existing CANDU control centres such as the 4-unit station at Darlington, with advanced features made possible by new control and display technology. Additionally, ACR control centres address characteristics resulting from Human Factors Engineering (HFE) analysis of control centre operations in order to further enhance personnel awareness of system and plant status. Statistics show that up to 70% of plant significant events, which have caused plant outages, have a root cause attributable to the human from such sources as complex interfaces, procedures, maintenance and management practices. Consequently, special attention is made for the application of HFE throughout the ACR design process. The design process follows a systematic analytical approach to define operations staff information and information presentation requirements. The resultant human-system interfaces (HSI) such as those for monitoring, annunciation and control information are then verified and validated against the system design requirements to provide a high confidence level that adequate and correct information is being provided in a timely manner to support the necessary operational tasks. The ACR control centre provides plant staff with an improved operability capability due to the combination of systematic design and enhanced operating features. Significant design processes (i.e. development) or design features which contribute to this improved operability, include: Design Process: Project HFE Program Plan - intent, scope, timeliness and interfacing; HFE aspects of design process - procedures and instructions

Development of the advanced CANDU reactor control centre

International Nuclear Information System (INIS)

Malcolm, S.; Leger, R.

2004-01-01

The next generation CANDU control centre is being designed for the Advanced CANDU Reactor (ACR) station. The design is based upon the recent Qinshan control room with further upgrades to meet customer needs with respect to high capacity factor with low Operation, Maintenance and Administration (OM and A) costs. This evolutionary design includes the long proven functionality at several existing CANDU control centres such as the 4-unit station at Darlington, with advanced features made possible by new control and display technology. Additionally, ACR control centres address characteristics resulting from Human Factors Engineering (HFE) analysis of control centre operations in order to further enhance personnel awareness of system and plant status. Statistics show that up to 70% of plant significant events, which have caused plant outages, have a root cause attributable to the human from such sources as complex interfaces, procedures, maintenance and management practices. Consequently, special attention is made for the application of HFE throughout the ACR design process. The design process follows a systematic analytical approach to define operations staff information and information presentation requirements. The resultant human-system interfaces (HSI) such as those for monitoring, annunciation and control information are then verified and validated against the system design requirements to provide a high confidence level that adequate and correct information is being provided in a timely manner to support the necessary operational tasks. The ACR control centre provides plant staff with an improved operability capability due to the combination of systematic design and enhanced operating features. Significant design processes (i.e. development) or design features which contribute to this improved operability, include: Design Process: Project HFE Program Plan - intent, scope, timeliness and interfacing; HFE aspects of design process - procedures and instructions

Study Protocol. IDUS – Instrumental delivery & ultrasound. A multi-centre randomised controlled trial of ultrasound assessment of the fetal head position versus standard care as an approach to prevent morbidity at instrumental delivery

Directory of Open Access Journals (Sweden)

Murphy Deirdre J

2012-09-01

Full Text Available Abstract Background Instrumental deliveries are commonly performed in the United Kingdom and Ireland, with rates of 12 – 17% in most centres. Knowing the exact position of the fetal head is a pre-requisite for safe instrumental delivery. Traditionally, diagnosis of the fetal head position is made on transvaginal digital examination by delineating the suture lines of the fetal skull and the fontanelles. However, the accuracy of transvaginal digital examination can be unreliable and varies between 20% and 75%. Failure to identify the correct fetal head position increases the likelihood of failed instrumental delivery with the additional morbidity of sequential use of instruments or second stage caesarean section. The use of ultrasound in determining the position of the fetal head has been explored but is not part of routine clinical practice. Methods/Design A multi-centre randomised controlled trial is proposed. The study will take place in two large maternity units in Ireland with a combined annual birth rate of 13,500 deliveries. It will involve 450 nulliparous women undergoing instrumental delivery after 37 weeks gestation. The main outcome measure will be incorrect diagnosis of the fetal head position. A study involving 450 women will have 80% power to detect a 10% difference in the incidence of inaccurate diagnosis of the fetal head position with two-sided 5% alpha. Discussion It is both important and timely to evaluate the use of ultrasound to diagnose the fetal head position prior to instrumental delivery before routine use can be advocated. The overall aim is to reduce the incidence of incorrect diagnosis of the fetal head position prior to instrumental delivery and improve the safety of instrumental deliveries. Trial registration Current Controlled Trials ISRCTN72230496

Involving older people in a multi-centre randomised trial of a complex intervention in pre-hospital emergency care: implementation of a collaborative model.

Science.gov (United States)

Koniotou, Marina; Evans, Bridie Angela; Chatters, Robin; Fothergill, Rachael; Garnsworthy, Christopher; Gaze, Sarah; Halter, Mary; Mason, Suzanne; Peconi, Julie; Porter, Alison; Siriwardena, A Niroshan; Toghill, Alun; Snooks, Helen

2015-07-10

Health services research is expected to involve service users as active partners in the research process, but few examples report how this has been achieved in practice in trials. We implemented a model to involve service users in a multi-centre randomised controlled trial in pre-hospital emergency care. We used the generic Standard Operating Procedure (SOP) from our Clinical Trials Unit (CTU) as the basis for creating a model to fit the context and population of the SAFER 2 trial. In our model, we planned to involve service users at all stages in the trial through decision-making forums at 3 levels: 1) strategic; 2) site (e.g. Wales; London; East Midlands); 3) local. We linked with charities and community groups to recruit people with experience of our study population. We collected notes of meetings alongside other documentary evidence such as attendance records and study documentation to track how we implemented our model. We involved service users at strategic, site and local level. We also added additional strategic level forums (Task and Finish Groups and Writing Days) where we included service users. Service user involvement varied in frequency and type across meetings, research stages and locations but stabilised and increased as the trial progressed. Involving service users in the SAFER 2 trial showed how it is feasible and achievable for patients, carers and potential patients sharing the demographic characteristics of our study population to collaborate in a multi-centre trial at the level which suited their health, location, skills and expertise. A standard model of involvement can be tailored by adopting a flexible approach to take account of the context and complexities of a multi-site trial. Current Controlled Trials ISRCTN60481756. Registered: 13 March 2009.

A large multi-centre European study validates high-sensitivity C-reactive protein (hsCRP) as a clinical biomarker for the diagnosis of diabetes subtypes

DEFF Research Database (Denmark)

Thanabalasingham, G.; Shah, N.; Vaxillaire, M.

2011-01-01

CRP) levels are lower in UK patients with hepatocyte nuclear factor 1 alpha (HNF1A)-MODY than in other diabetes subtypes. In this large multi-centre study we aimed to assess the clinical validity of hsCRP as a diagnostic biomarker, examine the genotype-phenotype relationship and compare different hsCRP assays....... High-sensitivity CRP levels were analysed in individuals with HNF1A-MODY (n = 457), glucokinase (GCK)-MODY (n = 404), hepatocyte nuclear factor 4 alpha (HNF4A)-MODY (n = 54) and type 2 diabetes (n = 582) from seven European centres. Three common assays for hsCRP analysis were evaluated. We excluded 121......) a parts per thousand yenaEuro parts per thousand 0.91, p a parts per thousand currency signaEuro parts per thousand 1 x 10(-5)). Across the seven centres, the C-statistic for distinguishing HNF1A-MODY from young adult-onset type 2 diabetes ranged from 0.79 to 0.97, indicating high discriminative accuracy...

The new AMS control centre

CERN Multimedia

Anaïs Schaeffer

2011-01-01

Construction work for the future AMS control room began in November 2010 and should be finished this June. The new building, which will have been completed in record time thanks to the professionalism of the project team, will soon be ready to receive the initial data from the AMS experiment.     Luigi Scibile and Michael Poehler, from the GS department, at the AMS control centre construction site.   The Alpha Magnetic Spectrometer (AMS) is due to wing its way towards the International Space Station (ISS) on board the shuttle Discovery in April. Mainly intended for research on antimatter and dark matter, the data collected by AMS will be sent to Houston in the United States and then directly to CERN’s new Building 946. Construction work for the AMS control centre building on the Route Gentner at CERN’s Prévessin site started in November 2010 and must be completed in time to receive the first data from the spectrometer in June. “It normall...

A multi-centre evaluation of oral cancer in Southern and Western Nigeria: an African oral pathology research consortium initiative.

Science.gov (United States)

Omitola, Olufemi Gbenga; Soyele, Olujide Oladele; Sigbeku, Opeyemi; Okoh, Dickson; Akinshipo, Abdulwarith Olaitan; Butali, Azeez; Adeola, Henry Ademola

2017-01-01

Oral cancer is a leading cause of cancer deaths among African populations. Lack of standard cancer registries and under-reporting has inaccurately depicted its magnitude in Nigeria. Development of multi-centre collaborative oral pathology networks such as the African Oral Pathology Research Consortium (AOPRC) facilitates skill and expertise exchange and fosters a robust and systematic investigation of oral diseases across Africa. In this descriptive cross-sectional study, we have leveraged the auspices of the AOPRC to examine the burden of oral cancer in Nigeria, using a multi-centre approach. Data from 4 major tertiary health institutions in Western and Southern Nigeria was generated using a standardized data extraction format and analysed using the SPSS data analysis software (version 20.0; SPSS Inc. Chicago, IL). Of the 162 cases examined across the 4 centres, we observed that oral squamous cell carcinomas (OSCC) occurred mostly in the 6 th and 7 th decades of life and maxillary were more frequent than mandibular OSCC lesions. Regional variations were observed both for location, age group and gender distribution. Significant regional differences was found between poorly, moderately and well differentiated OSCC (p value = 0.0071). A multi-centre collaborative oral pathology research approach is an effective way to achieve better insight into the patterns and distribution of various oral diseases in men of African descent. The wider outlook for AOPRC is to employ similar approaches to drive intensive oral pathology research targeted at addressing the current morbidity and mortality of various oral diseases across Africa.

Protocol for the combined immunosuppression & radiotherapy in thyroid eye disease (CIRTED trial: A multi-centre, double-masked, factorial randomised controlled trial

Directory of Open Access Journals (Sweden)

Kingston Laura

2008-01-01

Full Text Available Abstract Background Medical management of thyroid eye disease remains controversial due to a paucity of high quality evidence on long-term treatment outcomes. Glucocorticoids are known to be effective initially but have significant side-effects with long-term use and recrudescence can occur on cessation. Current evidence is conflicting on the efficacy of radiotherapy and non-steroid systemic immunosuppression, and the majority of previous studies have been retrospective, uncontrolled, small or poorly designed. The Combined Immunosuppression and Radiotherapy in Thyroid Eye Disease (CIRTED trial was designed to investigate the efficacy of radiotherapy and azathioprine in combination with a standard course of oral prednisolone in patients with active thyroid eye disease. Methods/design Patients with active thyroid eye disease will be randomised to receive (i azathioprine or oral placebo and (ii radiotherapy or sham-radiotherapy in this multi-centre, factorial randomised control trial. The primary outcome is improvement in disease severity (assessed using a composite binary measure at 12 months and secondary end-points include quality of life scores and health economic measures. Discussion The CIRTED trial is the first study to evaluate the role of radiotherapy and azathioprine as part of a long-term, combination immunosuppressive treatment regime for Thyroid Eye Disease. It will provide evidence for the role of radiotherapy and prolonged immunosuppression in the management of this condition, as well as pilot data on their use in combination. We have paid particular attention in the trial design to establishing (a robust placebo controls and masking protocols which are effective and safe for both radiotherapy and the systemic administration of an antiproliferative drug; (b constructing effective inclusion and exclusion criteria to select for active disease; and (c selecting pragmatic outcome measures. Trial registration Current controlled trials

A day in the CERN Control Centre

CERN Multimedia

Rosaria Marraffino

2015-01-01

The CERN Control Centre (CCC) is the nerve centre of the CERN beam systems. From this room, the experts prepare, monitor, adjust, and control the particle beams that circulate throughout the accelerator complex while ensuring that the services and the technical infrastructure work flawlessly. Buttons, screens, telephones, lights (but no sound): in the CCC, everything is ready to make it possible for the LHC to reach the unprecedented energies expected at Run 2.   Seen from above, the CERN Control Centre resembles the shape of a quadrupole magnet. The consoles are distributed in four circles, called “islands”, dedicated to the LHC, the SPS, the PS Complex and the Technical Infrastructure (TI) respectively. Spread between TI and LHC are the Cryogenics consoles. Being in the same room allows the 24h-manned islands to be constantly in touch with one another, thus ensuring the best performance of the machines. At the LHC island, operators are currently busy training the magnet...

A multi-dimensional framework to assist in the design of successful shared services centres

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Mark Borman

2012-04-01

Full Text Available Organisations are increasingly looking to realise the benefits of shared services yet there is little guidance available as to the best way to proceed. A multi-dimensional framework is presented that considers the service provided, the design of the shared services centre and the organisational context it sits within. Case studies are then used to determine what specific attributes from each dimension are associated with success and how they should be aligned. It is concluded that there appears to be a single, broadly standard pattern of attributes for successful Shared Services Centres (SSCs across the proposed dimensions of Activity, Environment, History, Resources, Strategy, Structure, Management, Technology and Individual Skills. It should also be noted though that some deviation from the identified standard along some dimensions is possible without adverse effect – ie that the alignment identified appears to be relatively soft.

Evaluation of a multi-herb supplement for erectile dysfunction: a randomized double-blind, placebo-controlled study

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Shah Gaurang R

2012-09-01

Full Text Available Abstract Background Evidence is lacking for multi-ingredient herbal supplements claiming therapeutic effect in sexual dysfunction in men. We examined the safety and efficacy of VigRX Plus (VXP – a proprietary polyherbal preparation for improving male sexual function, in a double blind, randomized placebo-controlled, parallel groups, multi-centre study. Methods 78 men aged 25–50 years of age; suffering from mild to moderate erectile dysfunction (ED, participated in this study. Subjects were randomized to receive VXP or placebo at a dose of two capsules twice daily for 12 weeks. The international index of erectile function (IIEF was the primary outcome measure of efficacy. Other efficacy measures were: Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS, Serum testosterone, Semen analysis, Investigator’s Global assessment and Subjects’ opinion. Results In subjects receiving VXP, the IIEF-Erectile Function (EF scores improved significantly as compared to placebo. After 12 weeks of treatment, the mean (sd IIEF-EF score at baseline increased from 16.08 (2.87 to 25.08 (4.56 in the VXP group versus 15.86 (3.24 to 16.47 (4.25 in the placebo group (P P  Conclusions VigRX Plus was well tolerated and more effective than placebo in improving sexual function in men. Trial Registration Clinical Trial Registry India, CTRI/2009/091/000099, 31-03-2009

SLA-based optimisation of virtualised resource for multi-tier web applications in cloud data centres

Science.gov (United States)

Bi, Jing; Yuan, Haitao; Tie, Ming; Tan, Wei

2015-10-01

Dynamic virtualised resource allocation is the key to quality of service assurance for multi-tier web application services in cloud data centre. In this paper, we develop a self-management architecture of cloud data centres with virtualisation mechanism for multi-tier web application services. Based on this architecture, we establish a flexible hybrid queueing model to determine the amount of virtual machines for each tier of virtualised application service environments. Besides, we propose a non-linear constrained optimisation problem with restrictions defined in service level agreement. Furthermore, we develop a heuristic mixed optimisation algorithm to maximise the profit of cloud infrastructure providers, and to meet performance requirements from different clients as well. Finally, we compare the effectiveness of our dynamic allocation strategy with two other allocation strategies. The simulation results show that the proposed resource allocation method is efficient in improving the overall performance and reducing the resource energy cost.

An elementary components of variance analysis for multi-centre quality control

International Nuclear Information System (INIS)

Munson, P.J.; Rodbard, D.

1978-01-01

The serious variability of RIA results from different laboratories indicates the need for multi-laboratory collaborative quality-control (QC) studies. Simple graphical display of data in the form of histograms is useful but insufficient. The paper discusses statistical analysis methods for such studies using an ''analysis of variance with components of variance estimation''. This technique allocates the total variance into components corresponding to between-laboratory, between-assay, and residual or within-assay variability. Problems with RIA data, e.g. severe non-uniformity of variance and/or departure from a normal distribution violate some of the usual assumptions underlying analysis of variance. In order to correct these problems, it is often necessary to transform the data before analysis by using a logarithmic, square-root, percentile, ranking, RIDIT, ''Studentizing'' or other transformation. Ametric transformations such as ranks or percentiles protect against the undue influence of outlying observations, but discard much intrinsic information. Several possible relationships of standard deviation to the laboratory mean are considered. Each relationship corresponds to an underlying statistical model and an appropriate analysis technique. Tests for homogeneity of variance may be used to determine whether an appropriate model has been chosen, although the exact functional relationship of standard deviation to laboratory mean may be difficult to establish. Appropriate graphical display aids visual understanding of the data. A plot of the ranked standard deviation versus ranked laboratory mean is a convenient way to summarize a QC study. This plot also allows determination of the rank correlation, which indicates a net relationship of variance to laboratory mean

The role of function analysis in the ACR control centre design

International Nuclear Information System (INIS)

Leger, R.P.; Davey, E.C.

2006-01-01

An essential aspect of control centre design is the need to characterize: plant functions and their inter-relationships to support the achievement of operational goals, and roles for humans and automation in sharing and exchanging the execution of functions across all operational phases. Function analysis is a design activity that has been internationally accepted as an approach to satisfy this need. It is recognized as a fundamental and necessary component in the systematic approach to control centre design and is carried out early in the design process. A function analysis can provide a clear basis for: the control centre design for the purposes of design team communication, and customer or regulatory review, the control centre display and control systems, the staffing and layout requirements of the control centre, assessing the completeness of control centre displays and controls prior and supplementary to mock-up walkthroughs or simulator evaluations, and the design of operating procedures and training programs. This paper will explore the role for function analysis in supporting the design of the control centre. The development of the ACR control room will be used as an illustrative context for the discussion. The paper will also discuss the merits of using function analysis in a goal-or function-based approach resulting in a more robust, operationally compatible, and cost-effective design over the life of the plant. Two former papers have previously outlined, the evolution in AECL's application approach and lessons learned in applying function analysis in support of control room design. This paper provides the most recent update to this progression in application refinement. (author)

Effectiveness of a Hospital-Based Work Support Intervention for Female Cancer Patients – A Multi-Centre Randomised Controlled Trial

Science.gov (United States)

Tamminga, Sietske J.; Verbeek, Jos H. A. M.; Bos, Monique M. E. M.; Fons, Guus; Kitzen, Jos J. E. M.; Plaisier, Peter W.; Frings-Dresen, Monique H. W.; de Boer, Angela G. E. M.

2013-01-01

Objective One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. Methods Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65) or control group (n = 68). The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial), quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. Results Return-to-work rates were 86% and 83% (p = 0.6) for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14–435) versus 192 days (range 82–465) (p = 0.90) with a hazard ratio of 1.03 (95% CI 0.64–1.6). Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. Conclusion The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which aspects of

Efficacy and safety of rasagiline as an adjunct to levodopa treatment in Chinese patients with Parkinson's disease: a randomized, double-blind, parallel-controlled, multi-centre trial.

Science.gov (United States)

Zhang, Lina; Zhang, Zhiqin; Chen, Yangmei; Qin, Xinyue; Zhou, Huadong; Zhang, Chaodong; Sun, Hongbin; Tang, Ronghua; Zheng, Jinou; Yi, Lin; Deng, Liying; Li, Jinfang

2013-08-01

Rasagiline mesylate is a highly potent, selective and irreversible monoamine oxidase type B (MAOB) inhibitor and is effective as monotherapy or adjunct to levodopa for patients with Parkinson's disease (PD). However, few studies have evaluated the efficacy and safety of rasagiline in the Chinese population. This study was designed to investigate the safety and efficacy of rasagiline as adjunctive therapy to levodopa treatment in Chinese PD patients. This was a randomized, double-blind, placebo-controlled, parallel-group, multi-centre trial conducted over a 12-wk period that enrolled 244 PD patients with motor fluctuations. Participants were randomly assigned to oral rasagiline mesylate (1 mg) or placebo, once daily. Altogether, 219 patients completed the trial. Rasagiline showed significantly greater efficacy compared with placebo. During the treatment period, the primary efficacy variable--mean adjusted total daily off time--decreased from baseline by 1.7 h in patients treated with 1.0 mg/d rasagiline compared to placebo (p rasagiline treatment. Rasagiline was well tolerated. This study demonstrated that rasagiline mesylate is effective and well tolerated as an adjunct to levodopa treatment in Chinese PD patients with fluctuations.

Assessment of data quality in an international multi-centre randomised trial of coronary artery surgery

Directory of Open Access Journals (Sweden)

Bochenek Andrzej

2011-09-01

Full Text Available Abstract Background ART is a multi-centre randomised trial of cardiac surgery which provided a unique opportunity to evaluate the data from a large number of centres from a variety of countries. We attempted to assess data quality, including recruitment rates, timeliness and completeness of the data obtained from the centres in different socio-economic strata. Methods The analysis was based on the 2-page CRF completed at the 6 week follow-up. CRF pages were categorised into "clean" (no edit query and "dirty" (any incomplete, inconsistent or illegible data. The timelines were assessed on the basis of the time interval from the visit and receipt of complete CRF. Data quality was defined as the number of data queries (in percent and time delay (in days between visit and receipt of correct data. Analyses were stratified according to the World Bank definitions into: "Developing" countries (Poland, Brazil and India and "Developed" (Italy, UK, Austria and Australia. Results There were 18 centres in the "Developed" and 10 centres in the "Developing" countries. The rate of enrolment did not differ significantly by economic level ("Developing":4.1 persons/month, "Developed":3.7 persons/month. The time interval for the receipt of data was longer for "Developing" countries (median:37 days compared to "Developed" ones (median:11 days (p Conclusions In this study we showed that data quality was comparable between centres from "Developed" and "Developing" countries. Data was received in a less timely fashion from Developing countries and appropriate systems should be instigated to minimize any delays. Close attention should be paid to the training of centres and to the central management of data quality. Trial registration ISRCTN46552265

Peptic Ulcer Disease in Bangladesh: A Multi-centre Study.

Science.gov (United States)

Ghosh, C K; Khan, M R; Alam, F; Shil, B C; Kabir, M S; Mahmuduzzaman, M; Das, S C; Masud, H; Roy, P K

2017-01-01

The incidence of peptic ulcer has steadily declined through out the world. This decreasing trend is also noticeable in this subcontinent. The point prevalence of peptic ulcer (PUD) in Bangladesh was around 15% in eighties. The aim of this study was to see the present prevalence of peptic ulcer at endoscopy and to identify changing trends in the occurrence of peptic ulcer in Bangladesh. This retrospective analysis of the endoscopic records of multiple tertiary referral centres of Dhaka city were done from January 2012 to July 2013. A total of 5608 subjects were the study samples. We included those patients having peptic ulcer in the form of duodenal ulcer, benign gastric ulcer including pre-pyloric ulcer and gastric outlet obstruction due to peptic ulcer. Duodenal ulcer and benign gastric ulcer were found in 415(7.4%) and 184(3.28%) patients respectively and gastric outlet obstruction due to peptic ulcer was found in 23(0.40%) patients.

Frequency of participation of 8-12-year-old children with cerebral palsy: a multi-centre cross-sectional European study

DEFF Research Database (Denmark)

Michelsen, Susan I; Flachs, Esben M; Uldall, Peter

2008-01-01

might influence participation. We undertook a multi-centre, population-based study in children with and without cerebral palsy. Working from the Life-H instrument, we developed a questionnaire to capture frequency of participation in 8-12-year-old children. In nine regions of seven European countries......, parents of 813 children with cerebral palsy and 2939 children from the general populations completed the questionnaire. Frequency of participation for each question was dichotomised about the median; multivariable logistic regressions were carried out. In the general population, frequency of participation...... varied between countries. Children with cerebral palsy participated less frequently in many but not all areas of everyday life, compared with children from the general population. There was regional variation in the domains with reduced participation and in the magnitude of the differences. We discuss...

The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial.

Science.gov (United States)

Lindholt, J S; Gottschalksen, B; Johannesen, N; Dueholm, D; Ravn, H; Christensen, E D; Viddal, B; Flørenes, T; Pedersen, G; Rasmussen, M; Carstensen, M; Grøndal, N; Fasting, H

2011-05-01

To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study. Eleven Scandinavian centres enrolled 569 patients with chronic functional or critical lower limb ischaemia who were scheduled to undergo femoro-femoral bypass or femoro-poplitaeal bypass. The patients were randomised 1:1 stratified by centre. Patency was assessed by duplex ultrasound scanning. A total of 546 patients (96%) completed the study with adequate follow-up. Perioperative bleeding was, on average, 370 ml with PTFE grafts and 399 ml with Heparin-bonded PTFE grafts (p = 0.32). Overall, primary patency after 1 year was 86.4% for Hb-PTFE grafts and 79.9% for PTFE grafts (OR = 0.627, 95% CI: 0.398; 0.989, p = 0.043). Secondary patency was 88% in Hb-PTFE grafts and 81% in PTFE grafts (OR = 0.569 (0.353; 0.917, p = 0.020)). Subgroup analyses revealed that significant reduction in risk (50%) was observed when Hb-PTFE was used for femoro-poplitaeal bypass (OR = 0.515 (0.281; 0.944, p = 0.030)), and a significant reduction in risk (50%) was observed with Hb-PTFE in cases with critical ischaemia (OR = 0.490 (0.249; 0.962, p = 0.036)). The Hb-PTFE graft significantly reduced the overall risk of primary graft failure by 37%. Risk reduction was 50% in femoro-poplitaeal bypass cases and in cases with critical ischaemia. Copyright © 2011. Published by Elsevier Ltd.

A multi-centre phase 3 study comparing efficacy and safety of Bemfola® versus Gonal-f® in women undergoing ovarian stimulation for IVF

DEFF Research Database (Denmark)

Rettenbacher, M; Andersen, A N; Garcia-Velasco, J A

2015-01-01

injection (n = 372) showed Bemfola yielding similar efficacy and safety profiles to Gonal-f. Women aged 20-38 years of age were randomized 2:1 to receive a single, daily, subcutaneous 150 IU dose of either Bemfola or Gonal-f. This study tested equivalence in the number of retrieved oocytes using a pre......Bemfola (follitropin alfa) (Finox AG, Switzerland), a new recombinant FSH, has a comparable pharmacological profile to that of Gonal-f (Merck Serono, Germany), the current standard for ovarian stimulation. A randomized, multi-centre, Phase 3 study in women undergoing IVF or intracytoplasmic sperm...

Multi-centre experience of implementing image-guided intensity-modulated radiotherapy using the TomoTherapy platform

International Nuclear Information System (INIS)

Dean, J.C.; Tudor, G.S.J.; Mott, J.H.; Dunlop, P.R.; Morris, S.L.; Harron, E.C.; Christian, J.A.; Sanghera, P.; Elsworthy, M.; Burnet, N.G.

2013-01-01

Use of image guided (IG) intensity modulated radiotherapy (IMRT) is increasing, and helical tomotherapy provides an effective, integrated solution. Practical experience of implementation, shared at a recent UK TomoTherapy Users' meeting, may help centres introducing these techniques using TomoTherapy or other platforms. Seven centres participated, with data shared from 6, varying from 2500 - 4800 new patients per year. Case selection of patients “most likely” to benefit from IG-IMRT was managed in all centres by multi-professional groups comprising clinical oncologists, physicists, treatment planners and radiographers. Radical treatments ranged from 94% to 100%. The proportions of tumour types varied substantially: head and neck: range 0%–100% (mean of centres 50%), prostate: 3%–96% (mean of centres 28%). Head and neck cases were considered most likely to benefit from IMRT, prostate cases from IGRT, or IG-IMRT if pelvic nodes were being treated. IMRT was also selected for complex target volumes, to avoid field junctions, for technical treatment difficulties, and retreatments. Across the centres, every patient was imaged every day, with positional correction before treatment. In one centre, for prostate patients including pelvic treatment, the pelvis was also imaged weekly. All centres had designed a ‘ramp up’ of patient numbers, which was similar in 5. One centre, treating 96% prostate patients, started with 3 and increased to 36 patients per day within 3 months. The variation in case mix implies wide applicability of IG-IMRT. Daily on-line IGRT with IMRT can be routinely implemented into busy departments

Current management of intracerebral haemorrhage in China: a national, multi-centre, hospital register study

Directory of Open Access Journals (Sweden)

Heeley Emma L

2011-01-01

Full Text Available Abstract Background We aimed to examine current practice of the management and secondary prevention of intracerebral haemorrhage (ICH in China where the disease is more common than in Western populations. Methods Data on baseline characteristics, management in-hospital and post-stroke, and outcome of ICH patients are from the ChinaQUEST (QUality Evaluation of Stroke Care and Treatment study, a multi-centre, prospective, 62 hospital registry in China during 2006-07. Results Nearly all ICH patients (n = 1572 received an intravenous haemodiluting agent such as mannitol (96% or a neuroprotectant (72%, and there was high use of intravenous traditional Chinese medicine (TCM (42%. Neurosurgery was undertaken in 137 (9% patients; being overweight, having a low Glasgow Coma Scale (GCS score on admission, and Total Anterior Circulation Syndrome (TACS clinical pattern on admission, were the only baseline factors associated with this intervention in multivariate analyses. Neurosurgery was associated with nearly three times higher risk of death/disability at 3 months post-stroke (odd ratio [OR] 2.60, p Conclusions The management of ICH in China is characterised by high rates of use of intravenous haemodiluting agents, neuroprotectants, and TCM, and of antihypertensives for secondary prevention. The controversial efficacy of these therapies, coupled with the current lack of treatments of proven benefit, is a call for action for more outcomes based research in ICH.

New concepts of control centre design and development

International Nuclear Information System (INIS)

Dittmar, E.; Kiersch, J.J.; Schmudlach, U.; Weihrauch, J.

1977-02-01

The concept of modern control centre technology is shown, its realization at project including the supervision of an electric power distribution system is described. A modern control centre is characterized by the fact that the conventional control elements are more and more replaced by elements of computer technology, i.e. computer and displays. The different functions implemented by hard- and software set new standards relative to flexibility, adaptability, dimensioning. The communication interface man/process is defined and designed in a new way allowing dynamic and more efficent supervisionstrategy of technical processes via display in different operation modes. Special attention is paid to adjustments and extensions of process elements and their integration into the supervised network. (orig./WB) [de

Cost-effectiveness of the Australian Medical Sheepskin for the prevention of pressure ulcers in somatic nursing home patients: study protocol for a prospective multi-centre randomised controlled trial (ISRCTN17553857).

Science.gov (United States)

Mistiaen, Patriek; Achterberg, Wilco; Ament, Andre; Halfens, Ruud; Huizinga, Janneke; Montgomery, Ken; Post, Henri; Francke, Anneke L

2008-01-07

Pressure ulcers are a major problem, especially in nursing home patients, although they are regarded as preventable and there are many pressure relieving methods and materials. One such pressure relieving material is the recently developed Australian Medical Sheepskin, which has been shown in two randomized controlled trials 12 to be an effective intervention in the prevention of sacral pressure ulcers in hospital patients. However, the use of sheepskins has been debated and in general discouraged by most pressure ulcer working groups and pressure ulcer guidelines, but these debates were based on old forms of sheepskins. Furthermore, nothing is yet known about the (cost-)effectiveness of the Australian Medical sheepskin in nursing home patients. The objective of this study is to assess the effects and costs of the use of the Australian Medical Sheepskin combined with usual care with regard to the prevention of sacral pressure ulcers in somatic nursing home patients, versus usual care only. In a multi-centre randomised controlled trial 750 patients admitted for a primarily somatic reason to one of the five participating nursing homes, and not having pressure ulcers on the sacrum at admission, will be randomized to either usual care only or usual care plus the use of the Australian Medical Sheepskin as an overlay on the mattress. Outcome measures are: incidence of sacral pressure ulcers in the first month after admission; sacrum pressure ulcer free days; costs; patient comfort; and ease of use. The skin of all the patients will be observed once a day from admission on for 30 days. Patient characteristics and pressure risk scores are assessed at admission and at day 30 after it. Additional to the empirical phase, systematic reviews will be performed in order to obtain data for economic weighting and modelling. The protocol is registered in the Controlled Trial Register as ISRCTN17553857.

Improved operability of the CANDU 9 control centre

International Nuclear Information System (INIS)

Macbeth, M. J.; Webster, A.

1996-01-01

The next generation CANDU nuclear power plant being designed by AECL is the 900 MWe class CANDU 9 station. It is based upon the Darlington CANDU station design which is among the world leaders in capacity factor with low Operation, Maintenance and Administration (OM and A) costs. This Control Centre design includes the proven functionality of existing CANDU control centres (including the Wolsong 2,3, and 4 control centre improvements, such as the Emergency Core Cooling panels), the characteristics identified by systematic design with human factors analysis of operations requirements and the advanced features needed to improve station operability which is made possible by the application of new technology. The CANDU 9 Control Centre provides plant staff with an improved operability capability due to the combination of proveness, systematic design with human factors engineering and enhanced operating features. Significant features which contribute to this improved operability include: · Standard NSP, BOP and F/H panels with controls and indicators integrated by a standard display/presentation philosophy. · Common plant parameter signal database for extensive monitoring, checking, display and annunciation. · Powerful annunciation system allowing alarm filtering, prioritizing and interrogation to enhance staff recognition of events, plant state and required corrective procedural actions. · The use of an overview display to present immediate and uncomplicated plant status information to facilitate operator awareness of unit status in a highly readable and recognizable format. · Extensive cross checking of similar process parameters amongst themselves, with the counterpart safety system parameters and as well as with 'signature' values obtained from known steady state conditions. · Powerful calculation capabilities, using the plant wide database, providing immediate recognizable and readable and readable output data on plant state information and plant state change

Studies on the coordinated operation and autonomous control for multi-modular nuclear power plants

International Nuclear Information System (INIS)

Hui Chao; Huang Xiaojin; Wang Jie

2011-01-01

The tendency has always been to build ever larger single-modular reactor plants with the objective of benefiting from economies of scale. These plants have compiled admirable safety records. Nevertheless, there is concern that conventional large single reactors have become too complex by reason of placing too much reliance on engineered safeguards. The multi-modular approach offers a solution in that its use of many small reactors in conjunction with several shared turbines permits a simpler core design while, at the same time, at least partially retaining economies of scale by increasing the number of modules. Specific advantages to the multi-modular approach are as follows. First, the small-sized of the reactor core may allow the incorporation of passive safety features such as natural circulation cooling on loss of off-site electricity. Second, the individual modules are to be sized so that components related to nuclear safety can be factory-fabricated. Moreover, once the major components are made, they are to be transported to the site for rapid installation. This construction method is expected to reduce the licensing effort because the modules will be pre-licensed, and only site-specific issues will have to be considered in the final licensing process. At present, related studies show that the multi-modular approach for Generation IV can retain both the inherent safety and good economies of scale. However, the unbalanced load operation of the multi-modular power plant in which each module operates at a different power level and strong coupling between multi modules creates a complex control challenge to safe operation and control. Firstly, this paper summarizes the unbalanced load operation characteristics and challenges faced by operation and control of multi-modular power plant in the dynamic operational characteristics and requirements of coordinated control between multi modules. Secondly, detailed analysis and comparison are given in the integral

Short video interventions to reduce mental health stigma: a multi-centre randomised controlled trial in nursing high schools.

Science.gov (United States)

Winkler, Petr; Janoušková, Miroslava; Kožený, Jiří; Pasz, Jiří; Mladá, Karolína; Weissová, Aneta; Tušková, Eva; Evans-Lacko, Sara

2017-12-01

We aimed to assess whether short video interventions could reduce stigma among nursing students. A multi-centre, randomised controlled trial was conducted. Participating schools were randomly selected and randomly assigned to receive: (1) an informational leaflet, (2) a short video intervention or (3) a seminar involving direct contact with a service user. The Community Attitudes towards Mental Illness (CAMI) and Reported and Intended Behaviour Scale (RIBS) were selected as primary outcome measures. SPANOVA models were built and Cohen's d calculated to assess the overall effects in each of the trial arms. Compared to the baseline, effect sizes immediately after the intervention were small in the flyer arm (CAMI: d = 0.25; RIBS: d = 0.07), medium in the seminar arm (CAMI: d = 0.61; RIBS: d = 0.58), and medium in the video arm (CAMI: d = 0.49 RIBS: d = 0.26; n = 237). Effect sizes at the follow-up were vanishing in the flyer arm (CAMI: d = 0.05; RIBS: d = 0.04), medium in the seminar arm (CAMI: d = 0.43; RIBS: d = 0.26; n = 254), and small in the video arm (CAMI: d = 0.22 RIBS: d = 0.21; n = 237). Seminar had the strongest and relatively stable effect on students' attitudes and intended behaviour, but the effect of short video interventions was also considerable and stable over time. Since short effective video interventions are relatively cheap, conveniently accessible and easy to disseminate globally, we recommend them for further research and development.

Study protocol: The development of a pilot study employing a randomised controlled design to investigate the feasibility and effects of a peer support program following discharge from a specialist first-episode psychosis treatment centre

Directory of Open Access Journals (Sweden)

Francey Shona

2010-05-01

Full Text Available Abstract Background Young people with first-episode psychosis (FEP are at risk of a range of negative outcomes. Specialist FEP services have been developed to provide comprehensive, multi-disciplinary treatment. However, these services are often available for a restricted period and the services that young people may be transferred to are less comprehensive. This represents a risk of drop out from treatment services in a group already considered to be at risk of disengagement. Peer support groups have been shown to improve social relationships among people with psychosis however individual peer support programs have not been tested on young people with first-episode psychosis; nor have they been tested at the point of discharge from services. Methods/design The study is an 18-month randomised controlled trial being conducted at Orygen Youth Health Research Centre in Melbourne, Australia. The aim of the study is to test the feasibility and effects of a 6-month peer support intervention delivered to young people with FEP over the period of discharge. Participants are young people aged 15-24 who are being discharged from a specialist first-episode psychosis treatment centre. There is a 6-month recruitment period. The intervention comprises two hours of contact per fortnight during which peer support workers can assist participants to engage with their new services, or other social and community activities. Participants will be assessed at baseline and post intervention (6 months. Discussion This paper describes the development of a randomised-controlled trial which aims to pilot a peer support program among young people who are being discharged from a specialist FEP treatment centre. If effective, the intervention could lead to benefits not only for participants over the discharge period, but for peer support workers as well. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry; number: ACTRN

European multi-centre case-control study on risk factors for rare cancers of unknown aetiology

DEFF Research Database (Denmark)

Lynge, Elsebeth; Afonso, Noemia; Kaerlev, Linda

2005-01-01

To search for occupational risk factors, we conducted a case-control study in nine European countries of cancers of the small intestine, male gall bladder, thymus, bone, male breast, melanoma of the eye, and mycosis fungoides. Recruitment was population based in Denmark, Latvia, France, Germany...... recruited 3374 population (61% interviewed) and 1284 colon cancer controls (86% interviewed). It was possible to undertake this complicated study across Europe, but we encountered three main problems. It was difficult to ensure complete case ascertainment, for population controls, we found a clear divide......, Italy, and Sweden, from hospital areas in Spain and Portugal, and from one United Kingdom (UK) hospital. We recruited 1457 cases (84% interviewed). Numbers identified corresponded to those in the EUROCIM database for Denmark, but were below those observed for France, Italy and Sweden in the database. We...

A novel SDN enabled hybrid oiptical packet/circuit switched data centre network - The LIGHTNESS approach

NARCIS (Netherlands)

Peng, S.; Simeonidou, D.; Zervas, G.; Nejabati, R.; Yan, Y; Shu, Yi; Spadaro, S.; Perelló, J.; Agraz, F.; Careglio, D.; Dorren, H.J.S.; Miao, W.; Calabretta, N.; Bernini, G.; Ciulli, N.; Sancho, J.C.; Iordache, S.; Becerra, Y.; Farreras, M.; Biancani, M.; Predieri, A.; Proietti, R.; Cao, Z.; Liu, L.; Yoo, S.J.B.

2014-01-01

Current over-provisioned and multi-tier data centre networks (DCN) deploy rigid control and management platforms, which are not able to accommodate the ever-growing workload driven by the increasing demand of high-performance data centre (DC) and cloud applications. In response to this, the EC FP7

Erythropoietin in traumatic brain injury: study protocol for a randomised controlled trial.

LENUS (Irish Health Repository)

Nichol, Alistair

2015-02-08

Traumatic brain injury is a leading cause of death and disability worldwide. Laboratory and clinical studies demonstrate a possible beneficial effect of erythropoietin in improving outcomes in the traumatic brain injury cohort. However, there are concerns regarding the association of erythropoietin and thrombosis in the critically ill. A large-scale, multi-centre, blinded, parallel-group, placebo-controlled, randomised trial is currently underway to address this hypothesis.

Anger management for people with mild to moderate learning disabilities: Study protocol for a multi-centre cluster randomized controlled trial of a manualized intervention delivered by day-service staff

Directory of Open Access Journals (Sweden)

Nuttall Jacqueline

2011-02-01

Full Text Available Abstract Background Cognitive behaviour therapy (CBT is the treatment of choice for common mental health problems, but this approach has only recently been adapted for people with learning disabilities, and there is a limited evidence base for the use of CBT with this client group. Anger treatment is the one area where there exists a reasonable number of small controlled trials. This study will evaluate the effectiveness of a manualized 12-week CBT intervention for anger. The intervention will be delivered by staff working in the day services that the participants attend, following training to act as 'lay therapists' by a Clinical Psychologist, who will also provide supervision. Methods/Design This is a multi-centre cluster randomized controlled trial of a group intervention versus a 'support as usual' waiting-list control group, with randomization at the level of the group. Outcomes will be assessed at the end of the intervention and again 6-months later. After completion of the 6-month follow-up assessments, the intervention will also be delivered to the waiting-list groups. The study will include a range of anger/aggression and mental health measures, some of which will be completed by service users and also by their day service key-workers and by home carers. Qualitative data will be collected to assess the impact of the intervention on participants, lay therapists, and services, and the study will also include a service-utilization cost and consequences analysis. Discussion This will be the first trial to investigate formally how effectively staff working in services providing day activities for people with learning disabilities are able to use a therapy manual to deliver a CBT based anger management intervention, following brief training by a Clinical Psychologist. The demonstration that service staff can successfully deliver anger management to people with learning disabilities, by widening the pool of potential therapists, would have

Integrating of renewable energy in operation system: the Special Regime Control Centre (CECRE)

International Nuclear Information System (INIS)

Division, M.

2007-01-01

The implementation of Red Electrica de Espana Special Regime Control Centre (CECRE) has demonstrated the Spanish System Operators commitment of integrating the maximum possible wind power generation into the electrical system compatible with secure operation. With this leadership initiative,for the first time in the world, a System Operator Control Centre (CECRE) has succeeded in sending power control instructions to wind power generators over the country through Generation Control Centres (CGC) to which these generators must be connected complying with the Spanish Rules. (Author)

Comparative Study of Evolutionary Multi-objective Optimization Algorithms for a Non-linear Greenhouse Climate Control Problem

DEFF Research Database (Denmark)

Ghoreishi, Newsha; Sørensen, Jan Corfixen; Jørgensen, Bo Nørregaard

2015-01-01

Non-trivial real world decision-making processes usually involve multiple parties having potentially conflicting interests over a set of issues. State-of-the-art multi-objective evolutionary algorithms (MOEA) are well known to solve this class of complex real-world problems. In this paper, we...... compare the performance of state-of-the-art multi-objective evolutionary algorithms to solve a non-linear multi-objective multi-issue optimisation problem found in Greenhouse climate control. The chosen algorithms in the study includes NSGAII, eNSGAII, eMOEA, PAES, PESAII and SPEAII. The performance...... of all aforementioned algorithms is assessed and compared using performance indicators to evaluate proximity, diversity and consistency. Our insights to this comparative study enhanced our understanding of MOEAs performance in order to solve a non-linear complex climate control problem. The empirical...

A design basis for the development of advanced CANDU control centres

Energy Technology Data Exchange (ETDEWEB)

Feher, M P; Davey, E C; Lupton, L R [Atomic Energy of Canada Ltd., Chalk River, ON (Canada)

1996-12-31

The basic design for current CANDU control centres was established in the early 1970`s. Plants constructed since then have, for the most part, retained the same basic design. Several factors have led to the need to re-examine CANDU control centre design for plants to be built beyond the year 2000. These factors include the changing roles and responsibilities for the operations staff, an improved understanding of operational issues associated with supervisory control, an improved understanding of human error in operational situations, the opportunity for improved plant performance through the introduction of new technologies, and marketing pressures. This paper describes the proposed design bases for the development of advanced control centres to be implemented in CANDU plants beyond the year 2000. Four areas have been defined covering design goals, design principles, operational bases, and plant functional bases. (author).

A design basis for the development of advanced CANDU control centres

International Nuclear Information System (INIS)

Feher, M.P.; Davey, E.C.; Lupton, L.R.

1995-01-01

The basic design for current CANDU control centres was established in the early 1970's. Plants constructed since then have, for the most part, retained the same basic design. Several factors have led to the need to re-examine CANDU control centre design for plants to be built beyond the year 2000. These factors include the changing roles and responsibilities for the operations staff, an improved understanding of operational issues associated with supervisory control, an improved understanding of human error in operational situations, the opportunity for improved plant performance through the introduction of new technologies, and marketing pressures. This paper describes the proposed design bases for the development of advanced control centres to be implemented in CANDU plants beyond the year 2000. Four areas have been defined covering design goals, design principles, operational bases, and plant functional bases. (author)

Cost-effectiveness of the Australian Medical Sheepskin for the prevention of pressure ulcers in somatic nursing home patients: study protocol for a prospective multi-centre randomised controlled trial (ISRCTN17553857

Directory of Open Access Journals (Sweden)

Montgomery Ken

2008-01-01

Full Text Available Abstract Background Pressure ulcers are a major problem, especially in nursing home patients, although they are regarded as preventable and there are many pressure relieving methods and materials. One such pressure relieving material is the recently developed Australian Medical Sheepskin, which has been shown in two randomized controlled trials 12 to be an effective intervention in the prevention of sacral pressure ulcers in hospital patients. However, the use of sheepskins has been debated and in general discouraged by most pressure ulcer working groups and pressure ulcer guidelines, but these debates were based on old forms of sheepskins. Furthermore, nothing is yet known about the (cost-effectiveness of the Australian Medical sheepskin in nursing home patients. The objective of this study is to assess the effects and costs of the use of the Australian Medical Sheepskin combined with usual care with regard to the prevention of sacral pressure ulcers in somatic nursing home patients, versus usual care only. Methods/Design In a multi-centre randomised controlled trial 750 patients admitted for a primarily somatic reason to one of the five participating nursing homes, and not having pressure ulcers on the sacrum at admission, will be randomized to either usual care only or usual care plus the use of the Australian Medical Sheepskin as an overlay on the mattress. Outcome measures are: incidence of sacral pressure ulcers in the first month after admission; sacrum pressure ulcer free days; costs; patient comfort; and ease of use. The skin of all the patients will be observed once a day from admission on for 30 days. Patient characteristics and pressure risk scores are assessed at admission and at day 30 after it. Additional to the empirical phase, systematic reviews will be performed in order to obtain data for economic weighting and modelling. The protocol is registered in the Controlled Trial Register as ISRCTN17553857.

Protocol for the ProFHER (PROximal Fracture of the Humerus: Evaluation by Randomisation trial: a pragmatic multi-centre randomised controlled trial of surgical versus non-surgical treatment for proximal fracture of the humerus in adults

Directory of Open Access Journals (Sweden)

Maffulli Nicola

2009-11-01

Full Text Available Abstract Background Proximal humeral fractures, which occur mainly in older adults, account for approximately 4 to 5% of all fractures. Approximately 40% of these fractures are displaced fractures involving the surgical neck. Management of this group of fractures is often challenging and the outcome is frequently unsatisfactory. In particular it is not clear whether surgery gives better outcomes than non-surgical management. Currently there is much variation in the use of surgery and a lack of good quality evidence to inform this decision. Methods/Design We aim to undertake a pragmatic UK-based multi-centre randomised controlled trial evaluating the effectiveness and cost-effectiveness of surgical versus standard non-surgical treatment for adults with an acute closed displaced fracture of the proximal humerus with involvement of the surgical neck. The choice of surgical intervention is left to the surgeon, who must use techniques that they are fully experienced with. This will avoid 'learning curve' problems. We will promote good standards of non-surgical care, similarly insisting on care-provider competence, and emphasize the need for comparable provision of rehabilitation for both groups of patients. We aim to recruit 250 patients from a minimum of 18 NHS trauma centres throughout the UK. These patients will be followed-up for 2 years. The primary outcome is the Oxford Shoulder Score, which will be collected via questionnaires completed by the trial participants at 6, 12 and 24 months. This is a 12-item condition-specific questionnaire providing a total score based on the person's subjective assessment of pain and activities of daily living impairment. We will also collect data for other outcomes, including general health measures and complications, and for an economic evaluation. Additionally, we plan a systematic collection of reasons for non-inclusion of eligible patients who were not recruited into the trial, and their baseline

Design principles for CANDU control centres in response to evolving utility business needs

International Nuclear Information System (INIS)

Davey, E.

2002-01-01

Nuclear generation operators are facing a challenging business environment at the beginning of the new millennium. Evolving changes in business context, competitive commercial pressures, and changes in technology have dictated recurring evaluation of operational practices and the adequacy of supporting tools, and the pursuit of opportunities for operational improvement. A key area of utility operations that has been impacted by these changes is the nuclear plant control centre. Changes to workspace layout, equipment provisions, staffing, and work organization are examples of some of the adjustments being introduced to improve operational and safety effectiveness. This paper discusses some of the key factors influencing these changes and identifies additional design principles for CANDU control centres that will enable new control centre designs and retrofits of existing control centres to remain relevant and responsive to utility needs. (author)

Information report on nuclear safety and radiation protection of the Manche storage Centre - 2012

International Nuclear Information System (INIS)

2013-06-01

After a presentation of the Manche Storage Centre (CSM), the first French centre of surface storage of weakly and moderately radioactive wastes, of its history, its buildings and activities, of the multi-layer cover, of the water management system (installation, controls, sampling), this report describes the measures related to nuclear safety (principles and objectives, prevention measures, technical measures, regulatory plan of control of the Centre and of its environment, control of releases from storage installations, quality organisation, archiving system). It describes measures related to radiation protection: principles, staff dosimetry, and personnel safety. The next part presents the nuclear event scale (INES) and indicates that no incident occurred. The effluents and releases from the Centre are then addressed: origin, locations and results of radiological controls of rainfalls, of risky effluents, of underground waters, of rivers, impacts of the Centre on its environment (releases in the sea, in rivers). The management of conventional and nuclear wastes produced by the Centre is reviewed as well as the actions related to information and transparency. Recommendations of the CHSCT are reported

Evaluating the PRASE patient safety intervention - a multi-centre, cluster trial with a qualitative process evaluation: study protocol for a randomised controlled trial.

Science.gov (United States)

Sheard, Laura; O'Hara, Jane; Armitage, Gerry; Wright, John; Cocks, Kim; McEachan, Rosemary; Watt, Ian; Lawton, Rebecca

2014-10-29

Estimates show that as many as one in 10 patients are harmed while receiving hospital care. Previous strategies to improve safety have focused on developing incident reporting systems and changing systems of care and professional behaviour, with little involvement of patients. The need to engage with patients about the quality and safety of their care has never been more evident with recent high profile reviews of poor hospital care all emphasising the need to develop and support better systems for capturing and responding to the patient perspective on their care. Over the past 3 years, our research team have developed, tested and refined the PRASE (Patient Reporting and Action for a Safe Environment) intervention, which gains patient feedback about quality and safety on hospital wards. A multi-centre, cluster, wait list design, randomised controlled trial with an embedded qualitative process evaluation. The aim is to assess the efficacy of the PRASE intervention, in achieving patient safety improvements over a 12-month period.The trial will take place across 32 hospital wards in three NHS Hospital Trusts in the North of England. The PRASE intervention comprises two tools: (1) a 44-item questionnaire which asks patients about safety concerns and issues; and (2) a proforma for patients to report (a) any specific patient safety incidents they have been involved in or witnessed and (b) any positive experiences. These two tools then provide data which are fed back to wards in a structured feedback report. Using this report, ward staff are asked to hold action planning meetings (APMs) in order to action plan, then implement their plans in line with the issues raised by patients in order to improve patient safety and the patient experience.The trial will be subjected to a rigorous qualitative process evaluation which will enable interpretation of the trial results. fieldworker diaries, ethnographic observation of APMs, structured interviews with APM lead and collection

Rehabilitation of traumatic brain injury in Italy: a multi-centred study.

Science.gov (United States)

Zampolini, M; Zaccaria, B; Tolli, V; Frustaci, A; Franceschini, M

2012-01-01

The aims of this study were to analyse TBI rehabilitation in Italy, identifying the main factors conditioning motor and functional recovery and destination upon discharge of traumatic severe acquired brain injury (sABI) patients who had undergone intensive rehabilitative treatment. An observational prospective study of 863 consecutive patients admitted to 52 Rehabilitation Centres from January 2001 to December 2003. The main cause of trauma was road accidents (79.8%), the mean length of stay was 87.31 ± 77.26 days and 40.4% access to rehabilitation facilities after a month. Pressure sore rates fell from 26.1% to 6.6% during the rehabilitation programme. After discharge 615 patients returned home, whilst 212 were admitted to other health facilities. This study highlights some major criticisms of rehabilitation of TBI. The delay of admission and evitable complications such as pressure sores are correlated to a worse outcome. While LOS causes a problem of cost-effectiveness, the rate of home discharge is prevalent and very high compared with other studies.

Human factors engineering applied to Control Centre Design of a research nuclear reactor

Energy Technology Data Exchange (ETDEWEB)

Farias, Larissa P. de; Santos, Isaac J.A. Luquetti dos; Carvalho, Paulo V.R., E-mail: larissapfarias@ymail.com [Instituto de Engenharia Nuclear (DENN/SEESC/IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil). Lab, de Usabilidade e Confiabilidade Humana; Monteiro, Beany G. [Universidade Federal do Rio Janeiro (UFRJ), Rio Janeiro, RJ (Brazil). Departamento de Desenho Industrial

2017-07-01

The Human Factors Engineering (HFE) program is an essential aspect for the design of nuclear installations. The overall aim of the HFE program is the improvement of the operational reliability and safety of plant operation. The HFE program main purpose is to ensure that human factor practices are incorporated into the plant design, emphasizing man-machine interface issues and design improvement of the nuclear reactor Control Centre. The Control Centre of nuclear reactor is a combination of control rooms, control suites and local control stations, which are functionally connected and located on the reactor site. The objective of this paper is to present a design approach for the Control Centre of a nuclear reactor used to produce radioisotopes and for nuclear research, including human factor issues. The design approach is based on participatory design principles, using human factor standards, ergonomic guidelines, and the participation of a multidisciplinary team during all design phases. Using the information gathered, an initial sketch 3D of the Control Centre was developed. (author)

Human factors engineering applied to Control Centre Design of a research nuclear reactor

International Nuclear Information System (INIS)

Farias, Larissa P. de; Santos, Isaac J.A. Luquetti dos; Carvalho, Paulo V.R.; Monteiro, Beany G.

2017-01-01

The Human Factors Engineering (HFE) program is an essential aspect for the design of nuclear installations. The overall aim of the HFE program is the improvement of the operational reliability and safety of plant operation. The HFE program main purpose is to ensure that human factor practices are incorporated into the plant design, emphasizing man-machine interface issues and design improvement of the nuclear reactor Control Centre. The Control Centre of nuclear reactor is a combination of control rooms, control suites and local control stations, which are functionally connected and located on the reactor site. The objective of this paper is to present a design approach for the Control Centre of a nuclear reactor used to produce radioisotopes and for nuclear research, including human factor issues. The design approach is based on participatory design principles, using human factor standards, ergonomic guidelines, and the participation of a multidisciplinary team during all design phases. Using the information gathered, an initial sketch 3D of the Control Centre was developed. (author)

Recruiting ENT and Audiology patients into pharmaceutical trials: evaluating the multi-centre experience in the UK and USA.

Science.gov (United States)

Sanchez, Victoria A; Hall, Deborah A; Millar, Bonnie; Escabi, Celia D; Sharman, Alice; Watson, Jeannette; Thasma, Sornaraja; Harris, Peter

2018-01-21

Recruiting into clinical trials on time and on target is a major challenge and yet often goes unreported. This study evaluated the adjustment to procedures, recruitment and screening methods in two multi-centre pharmaceutical randomised controlled trials (RCTs) for hearing-related problems in adults. Recruitment monitoring and subsequent adjustment of various study procedures (e.g. eligibility criteria, increasing recruiting sites and recruitment methods) are reported. Participants were recruited through eight overarching methods: trial registration, posters/flyers, print publications, Internet, social media, radio, databases and referrals. The efficiency of the recruitment was measured by determining the number of people: (1) eligible for screening as a percentage of those who underwent telephone pre-screening and (2) randomised as a percentage of those screened. A total of 584 participants completed the pre-screening steps, 491 screened and 169 participants were randomised. Both RCTs completed adjustments to the participant eligibility, added new study sites and additional recruitment methods. No single recruitment method was efficient enough to serve as the only route to enrolment. A diverse portfolio of methods, continuous monitoring, mitigation strategy and adequate resourcing were essential for achieving our recruitment goals.

Creating probabilistic maps of the face network in the adolescent brain: A multi-centre functional MRI study

International Nuclear Information System (INIS)

Tahmasebi, Amir M.; Mareckova, Klara; Artiges, Eric; Martinot, Jean-Luc; Banaschewski, Tobias; Barker, Gareth J.; Loth, Eva; Schumann, Gunter; Bruehl, Ruediger; Ittermann, Bernd; Buchel, Christian; Conrod, Patricia J.; Flor, Herta; Strohle, Andreas; Garavan, Hugh; Gallinat, Jurgen; Heinz, Andreas; Poline, Jean-Baptiste; Rietschel, Marcella; Smolka, Michael N.; Paus, Tomas

2012-01-01

Large-scale magnetic resonance (MR) studies of the human brain offer unique opportunities for identifying genetic and environmental factors shaping the human brain. Here, we describe a dataset collected in the context of a multi-centre study of the adolescent brain, namely the IMAGEN Study. We focus on one of the functional paradigms included in the project to probe the brain network underlying processing of ambiguous and angry faces. Using functional MR (fMRI) data collected in 1,110 adolescents, we constructed probabilistic maps of the neural network engaged consistently while viewing the ambiguous or angry faces; 21 brain regions responding to faces with high probability were identified. We were also able to address several methodological issues, including the minimal sample size yielding a stable location of a test region, namely the fusiform face area (FFA), as well as the effect of acquisition site (eight sites) and scanner (four manufacturers) on the location and magnitude of the fMRI response to faces in the FFA. Finally, we provided a comparison between male and female adolescents in terms of the effect sizes of sex differences in brain response to the ambiguous and angry faces in the 21 regions of interest. Overall, we found a stronger neural response to the ambiguous faces in several cortical regions, including the fusiform face area, in female (vs. male) adolescents, and a slightly stronger response to the angry faces in the amygdala of male (vs. female) adolescents. (authors)

Dynamic multi-segmental postural control in patients with chronic non-specific low back pain compared to pain-free controls: A cross-sectional study.

Science.gov (United States)

McCaskey, Michael A; Wirth, Brigitte; Schuster-Amft, Corina; de Bruin, Eling D

2018-01-01

Reduced postural control is thought to contribute to the development and persistence of chronic non-specific low back pain (CNLBP). It is therefore frequently assessed in affected patients and commonly reported as the average amount of postural sway while standing upright under a variety of sensory conditions. These averaged linear outcomes, such as mean centre of pressure (CP) displacement or mean CP surface areas, may not reflect the true postural status. Adding nonlinear outcomes and multi-segmental kinematic analysis has been reported to better reflect the complexity of postural control and may detect subtler postural differences. In this cross-sectional study, a combination of linear and nonlinear postural parameters were assessed in patients with CNLBP (n = 24, 24-75 years, 9 females) and compared to symptom-free controls (CG, n = 34, 22-67 years, 11 females). Primary outcome was postural control measured by variance of joint configurations (uncontrolled manifold index, UI), confidence ellipse surface areas (CEA) and approximate entropy (ApEn) of CP dispersion during the response phase of a perturbed postural control task on a swaying platform. Secondary outcomes were segment excursions and clinical outcome correlates for pain and function. Non-parametric tests for group comparison with P-adjustment for multiple comparisons were conducted. Principal component analysis was applied to identify patterns of segmental contribution in both groups. CNLBP and CG performed similarly with respect to the primary outcomes. Comparison of joint kinematics revealed significant differences of hip (P postural differences in CNLBP patients with low to moderate pain status.

The role of dosimetry audit in lung SBRT multi-centre clinical trials.

Science.gov (United States)

Clark, Catharine H; Hurkmans, Coen W; Kry, Stephen F

2017-12-01

Stereotactic Body Radiotherapy (SBRT) in the lung is a challenging technique which requires high quality clinical trials to answer the un-resolved clinical questions. Quality assurance of these clinical trials not only ensures the safety of the treatment of the participating patients but also minimises the variation in treatment, thus allowing the lowest number of patient treatments to answer the trial question. This review addresses the role of dosimetry audits in the quality assurance process and considers what can be done to ensure the highest accuracy of dose calculation and delivery and it's assessment in multi-centre trials. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Evaluation of a multi-herb supplement for erectile dysfunction: a randomized double-blind, placebo-controlled study.

Science.gov (United States)

Shah, Gaurang R; Chaudhari, Manojkumar V; Patankar, Suresh B; Pensalwar, Shrikant V; Sabale, Vilas P; Sonawane, Navneet A

2012-09-15

Evidence is lacking for multi-ingredient herbal supplements claiming therapeutic effect in sexual dysfunction in men. We examined the safety and efficacy of VigRX Plus (VXP) - a proprietary polyherbal preparation for improving male sexual function, in a double blind, randomized placebo-controlled, parallel groups, multi-centre study. 78 men aged 25-50 years of age; suffering from mild to moderate erectile dysfunction (ED), participated in this study. Subjects were randomized to receive VXP or placebo at a dose of two capsules twice daily for 12 weeks. The international index of erectile function (IIEF) was the primary outcome measure of efficacy. Other efficacy measures were: Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Serum testosterone, Semen analysis, Investigator's Global assessment and Subjects' opinion. In subjects receiving VXP, the IIEF-Erectile Function (EF) scores improved significantly as compared to placebo. After 12 weeks of treatment, the mean (sd) IIEF-EF score at baseline increased from 16.08 (2.87) to 25.08 (4.56) in the VXP group versus 15.86 (3.24) to 16.47 (4.25) in the placebo group (P sexual desire, intercourse satisfaction, and overall satisfaction).There was a significant difference for VXP versus placebo comparison of mean (sd) EDITS scores of patients: 82.31(20.23) vs 36.78(22.53) and partners :(82.75(9.8) vs 18.50(9.44);P global assessment rated VXP therapy as very good to excellent in more than 50% patients and placebo therapy as fair to good in about 25% of patients. Incidence of side effects and subject's rating for tolerability of treatment was similar in both groups. VigRX Plus was well tolerated and more effective than placebo in improving sexual function in men. Clinical Trial Registry India, CTRI/2009/091/000099, 31-03-2009.

Multi-criteria decision analysis for bioenergy in the Centre Region of Portugal

Science.gov (United States)

Esteves, T. C. J.; Cabral, P.; Ferreira, A. J. D.; Teixeira, J. C.

2012-04-01

With the consumption of fossil fuels, the resources essential to Man's survival are being rapidly contaminated. A sustainable future may be achieved by the use of renewable energies, allowing countries without non-renewable energy resources to guarantee energetic sovereignty. Using bioenergy may mean a steep reduction and/or elimination of the external dependency, enhancing the countries' capital and potentially reducing of the negative effects that outcome from the use of fossil fuels, such as loss of biodiversity, air, water, and soil pollution, … This work's main focus is to increase bioenergy use in the centre region of Portugal by allying R&D to facilitate determination of bioenergy availability and distribution throughout the study area.This analysis is essential, given that nowadays this knowledge is still very limited in the study area. Geographic Information Systems (GIS) was the main tool used to asses this study, due to its unseeingly ability to integrate various types of information (such as alphanumerical, statistical, geographical, …) and various sources of biomass (forest, agricultural, husbandry, municipal and industrial residues, shrublands, used vegetable oil and energy crops) to determine the bioenergy potential of the study area, as well as their spatial distribution. By allying GIS with multi-criteria decision analysis, the initial table-like information of difficult comprehension is transformed into tangible and easy to read results: both intermediate and final results of the created models will facilitate the decision making process. General results show that the major contributors for the bioenergy potential in the Centre Region of Portugal are forest residues, which are mostly located in the inner region of the study area. However, a more detailed analysis should be made to analyze the viability to use energy crops. As a main conclusion, we can say that, although this region may not use only this type of energy to be completely

Evolution of the CANDU control centre retrofit and new stations

International Nuclear Information System (INIS)

Olmstead, R.A.; Mitchell, W.

1991-01-01

Significant event data from operating nuclear plants in many countries consistently indicates human errors are the root cause for 40-60% of operating station significant events. Because so much information is already in digital form, opportunities exist to improve the CANDU control centre with retrofits that exploit this information. These opportunities are enhanced because of rapid technological development in computers and electronics, coupled with significant progress in the behavioural sciences that greatly increases our knowledge of the cognitive strengths and weaknesses of human beings. CANDU control rooms are undergoing retrofits and for future CANDU stations, a new concept of the control centre is emerging. The objective is to significantly reduce the incidence of human error, reduce operations and maintenance costs and improve both reliability and safety

Evolution of the CANDU control centre retrofit and new stations

Energy Technology Data Exchange (ETDEWEB)

Olmstead, R A [AECL-CANDU, ON (Canada); Mitchell, W [Ontario Hydro, Darlington Nuclear Generating Station, Bowmanville, ON (Canada)

1991-04-01

Significant event data from operating nuclear plants in many countries consistently indicates human errors are the root cause for 40-60% of operating station significant events. Because so much information is already in digital form, opportunities exist to improve the CANDU control centre with retrofits that exploit this information. These opportunities are enhanced because of rapid technological development in computers and electronics, coupled with significant progress in the behavioural sciences that greatly increases our knowledge of the cognitive strengths and weaknesses of human beings. CANDU control rooms are undergoing retrofits and for future CANDU stations, a new concept of the control centre is emerging. The objective is to significantly reduce the incidence of human error, reduce operations and maintenance costs and improve both reliability and safety.

A designated centre for people with disabilities operated by Muiríosa Foundation, Westmeath

LENUS (Irish Health Repository)

Nichol, Alistair

2015-02-08

Traumatic brain injury is a leading cause of death and disability worldwide. Laboratory and clinical studies demonstrate a possible beneficial effect of erythropoietin in improving outcomes in the traumatic brain injury cohort. However, there are concerns regarding the association of erythropoietin and thrombosis in the critically ill. A large-scale, multi-centre, blinded, parallel-group, placebo-controlled, randomised trial is currently underway to address this hypothesis.

The nutrition-based comprehensive intervention study on childhood obesity in China (NISCOC: a randomised cluster controlled trial

Directory of Open Access Journals (Sweden)

Xu Guifa

2010-05-01

Full Text Available Abstract Background Childhood obesity and its related metabolic and psychological abnormalities are becoming serious health problems in China. Effective, feasible and practical interventions should be developed in order to prevent the childhood obesity and its related early onset of clinical cardiovascular diseases. The objective of this paper is to describe the design of a multi-centred random controlled school-based clinical intervention for childhood obesity in China. The secondary objective is to compare the cost-effectiveness of the comprehensive intervention strategy with two other interventions, one only focuses on nutrition education, the other only focuses on physical activity. Methods/Design The study is designed as a multi-centred randomised controlled trial, which included 6 centres located in Beijing, Shanghai, Chongqing, Shandong province, Heilongjiang province and Guangdong province. Both nutrition education (special developed carton style nutrition education handbook and physical activity intervention (Happy 10 program will be applied in all intervention schools of 5 cities except Beijing. In Beijing, nutrition education intervention will be applied in 3 schools and physical activity intervention among another 3 schools. A total of 9750 primary students (grade 1 to grade 5, aged 7-13 years will participate in baseline and intervention measurements, including weight, height, waist circumference, body composition (bioelectrical impendence device, physical fitness, 3 days dietary record, physical activity questionnaire, blood pressure, plasma glucose and plasma lipid profiles. Data concerning investments will be collected in our study, including costs in staff training, intervention materials, teachers and school input and supervising related expenditure. Discussion Present study is the first and biggest multi-center comprehensive childhood obesity intervention study in China. Should the study produce comprehensive results, the

Multi-criteria correlation of tephra deposits to source centres applied in the Auckland Volcanic Field, New Zealand

Science.gov (United States)

Hopkins, Jenni L.; Wilson, Colin J. N.; Millet, Marc-Alban; Leonard, Graham S.; Timm, Christian; McGee, Lucy E.; Smith, Ian E. M.; Smith, Euan G. C.

2017-07-01

Linking tephras back to their source centre(s) in volcanic fields is crucial not only to reconstruct the eruptive history of the volcanic field but also to understand tephra dispersal patterns and thus the potential hazards posed by a future eruption. Here we present a multi-disciplinary approach to correlate distal basaltic tephra deposits from the Auckland Volcanic Field (AVF) to their source centres using proximal whole-rock geochemical signatures. In order to achieve these correlations, major and trace element tephra-derived glass compositions are compared with published and newly obtained whole-rock geochemical data for the entire field. The results show that incompatible trace element ratios (e.g. (Gd/Yb)N, (La/Yb)N, (Zr/Yb)N) vary widely across the AVF (e.g. (La/Yb)N = 5 to 40) but show a more restricted range within samples from a single volcanic centre (e.g. (La/Yb)N = 5 to 10). These ratios are also the least affected by fractional crystallisation and are therefore the most appropriate geochemical tools for correlation between tephra and whole-rock samples. However, findings for the AVF suggest that each volcanic centre does not have a unique geochemical signature in the field as a whole, thus preventing unambiguous correlation of tephras to source centre using geochemistry alone. A number of additional criteria are therefore combined to further constrain the source centres of the distal tephras including age, eruption scale, and location (of centres, and sites where tephra were sampled). The combination of tephrostratigraphy, 40Ar/39Ar dating and morphostratigraphic constraints allow, for the first time, the relative and absolute ordering of 48 of 53 volcanic centres of the Auckland Volcanic Field to be resolved. Eruption frequencies are shown to vary between 0.13 and 1.5 eruptions/kyr and repose periods between individual eruptions vary from <0.1 to 13 kyr, with 23 of the 48 centres shown to have pre-eruptive repose periods of <1000 years. No spatial

Prophylactic antibiotic regimens in tumour surgery (PARITY) : a pilot multicentre randomised controlled trial

NARCIS (Netherlands)

Ghert, M.; Bhandari, M.; Deheshi, B.; Guyatt, G.; Holt, G.; O'Shea, T.; Randall, R. L.; Thabane, L.; Wunder, J.; Evaniew, N.; McKay, P.; Schneider, P.; Turcotte, R.; Madden, K.; Scott, T.; Sprague, S.; Simunovic, N.; Swinton, M.; Racano, A.; Heels-Ansdell, D.; Buckingham, L.; Rose, P.; Brigman, B.; Pullenayegum, E.; Ghert, M.; Evaniew, N.; Mckay, P.; Schneider, P.; Sobhi, G.; Chan, R.; Biljan, M.; Ferguson, P.; Wunder, J.; Griffin, A.; Mantas, I.; Wylie, A.; Han, A.; Grewal, G.; Turcotte, R.; Goulding, K.; Dandachli, F.; Matte, G.; Werier, J.; Abdelbary, H.; Paquin, K.; Cosgrove, H.; Dugal, A-M.; Jutte, P.; Ploegmakers, J. J. W.; Stevens, M.

2015-01-01

Objective Clinical studies of patients with bone sarcomas have been challenged by insufficient numbers at individual centres to draw valid conclusions. Our objective was to assess the feasibility of conducting a definitive multi-centre randomised controlled trial (RCT) to determine whether a

Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

Science.gov (United States)

Hermus, M A A; Boesveld, I C; Hitzert, M; Franx, A; de Graaf, J P; Steegers, E A P; Wiegers, T A; van der Pal-de Bruin, K M

2017-07-03

During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics. International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care. From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all

CMS Centre at CERN

CERN Multimedia

2007-01-01

A new "CMS Centre" is being established on the CERN Meyrin site by the CMS collaboration. It will be a focal point for communications, where physicists will work together on data quality monitoring, detector calibration, offline analysis of physics events, and CMS computing operations. Construction of the CMS Centre begins in the historic Proton Synchrotron (PS) control room. The historic Proton Synchrotron (PS) control room, Opened by Niels Bohr in 1960, will be reused by CMS to built its control centre. TThe LHC@FNAL Centre, in operation at Fermilab in the US, will work very closely with the CMS Centre, as well as the CERN Control Centre. (Photo Fermilab)The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Contro...

Floor heating in the multi-functional centre `Gelderhorst` in Ede, Netherlands; De Gelderhorst slaat bouwfase over

Energy Technology Data Exchange (ETDEWEB)

Wondergem, J. [Wondergem Intermedium, Weesp (Netherlands)

1997-11-01

The Gelderhorst is a multi-functional centre for elderly, deaf people. Building systems are installed normally after the rough building structure is finished. In the building process of Gelderhorst the floor heating is installed in a pre-phase of the construction of the building. Thereto, the cooperation between the installation company, the manufacturer, the wholesale business and the contractor had to be well planned. Also, problems had to be solved with respect to the choice of building materials and installation techniques. 4 ills.

Observation and control of blinking nitrogen-vacancy centres in discrete nanodiamonds.

Science.gov (United States)

Bradac, C; Gaebel, T; Naidoo, N; Sellars, M J; Twamley, J; Brown, L J; Barnard, A S; Plakhotnik, T; Zvyagin, A V; Rabeau, J R

2010-05-01

Nitrogen-vacancy colour centres in diamond can undergo strong, spin-sensitive optical transitions under ambient conditions, which makes them attractive for applications in quantum optics, nanoscale magnetometry and biolabelling. Although nitrogen-vacancy centres have been observed in aggregated detonation nanodiamonds and milled nanodiamonds, they have not been observed in very small isolated nanodiamonds. Here, we report the first direct observation of nitrogen-vacancy centres in discrete 5-nm nanodiamonds at room temperature, including evidence for intermittency in the luminescence (blinking) from the nanodiamonds. We also show that it is possible to control this blinking by modifying the surface of the nanodiamonds.

Enhancing Safety at Airline Operations Control Centre

Directory of Open Access Journals (Sweden)

Lukáš Řasa

2015-04-01

Full Text Available In recent years a new term of Safety Management System (SMS has been introduced into aviation legislation. This system is being adopted by airline operators. One of the groundbased actors of everyday operations is Operations Control Centre (OCC. The goal of this article has been to identify and assess risks and dangers which occur at OCC and create a template for OCC implementation into SMS.

An accountancy system for nuclear materials control in research centres

International Nuclear Information System (INIS)

Buttler, R.; Bueker, H.; Vallee, J.

1979-01-01

The Nuclear Accountancy and Control System (NACS) was developed at KFA Juelich in accordance with the requirements of the Non-Proliferation Treaty. The main features are (1) recording of nuclear material in inventory items. These are combined to form batches wherever suitable; (2) extrapolation of accounting data as a replacement for detailed measurement of inventory items data. Recording and control of nuclear material are carried out on two levels with access to a common data bank. The lower level deals with nuclear materials handling plus internal management while on the upper level there is a central control point which is responsible for nuclear safeguarding within the entire research centre. By keeping the organizational and technical infrastructure it was possible to develop a system which is both economical and operator-oriented. In this system the emphasis of nuclear safeguarding is placed on the acquisition of the nuclear material inventory. As much consideration has been given to the interests of the various operational levels and organizational units as to internal and national regulations. Since it is part of the safeguarding and control system, access to the NACS must be restricted to a limited number of users only. Furthermore, it must include facilities for manual control in the form of records. Authorization for access must correspond with the various tasks of different user groups. All necessary data are acquired decentrally in the organizational units and entered via a terminal. It is available to the user groups on both levels through a central data bank. To meet all requirements, the NACS has been designed as an integrated, computer-assisted information system for the automated processing of extensive and multi-level nuclear materials data. As part of the preventive measures entailed with nuclear safeguarding, the accountancy system enables the operator of a nuclear plant to furnish proof of non-diversion of nuclear material. (author)

Influence of quality of care and individual patient characteristics on quality of life and return to work in survivors of the acute respiratory distress syndrome: protocol for a prospective, observational, multi-centre patient cohort study (DACAPO).

Science.gov (United States)

Brandstetter, Susanne; Dodoo-Schittko, Frank; Blecha, Sebastian; Sebök, Philipp; Thomann-Hackner, Kathrin; Quintel, Michael; Weber-Carstens, Steffen; Bein, Thomas; Apfelbacher, Christian

2015-12-17

Health-related quality of life (HRQoL) and return to work are important outcomes in critical care medicine, reaching beyond mortality. Little is known on factors predictive of HRQoL and return to work in critical illness, including the acute respiratory distress syndrome (ARDS), and no evidence exists on the role of quality of care (QoC) for outcomes in survivors of ARDS. It is the aim of the DACAPO study ("Surviving ARDS: the influence of QoC and individual patient characteristics on quality of life") to investigate the role of QoC and individual patient characteristics on quality of life and return to work. A prospective, observational, multi-centre patient cohort study will be performed in Germany, using hospitals from the "ARDS Network Germany" as the main recruiting centres. It is envisaged to recruit 2400 patients into the DACAPO study and to analyse a study population of 1500 survivors. They will be followed up until 12 months after discharge from hospital. QoC will be assessed as process quality, structural quality and volume at the institutional level. The main outcomes (HRQoL and return to work) will be assessed by self-report questionnaires. Further data collection includes general medical and ARDS-related characteristics of patients as well as sociodemographic and psycho-social parameters. Multilevel hierarchical modelling will be performed to analyse the effects of QoC and individual patient characteristics on outcomes, taking the cluster structure of the data into account. By obtaining comprehensive data at patient and hospital level using a prospective multi-centre design, the DACAPO-study is the first study investigating the influence of QoC on individual outcomes of ARDS survivors.

Geodetic Control Points - Multi-State Control Point Database

Data.gov (United States)

NSGIC State | GIS Inventory — The Multi-State Control Point Database (MCPD) is a database of geodetic and mapping control covering Idaho and Montana. The control were submitted by registered land...

Effects and meanings of a person-centred and health-promoting intervention in home care services - a study protocol of a non-randomised controlled trial.

Science.gov (United States)

Bölenius, Karin; Lämås, Kristina; Sandman, Per-Olof; Edvardsson, David

2017-02-16

The literature indicates that current home care service are largely task oriented with limited focus on the involvement of the older people themselves, and studies show that lack of involvement might reduce older people's quality of life. Person-centred care has been shown to improve the satisfaction with care and quality of life in older people cared for in hospitals and nursing homes, with limited published evidence about the effects and meanings of person-centred interventions in home care services for older people. This study protocol outlines a study aiming to evaluate such effects and meanings of a person-centred and health-promoting intervention in home aged care services. The study will take the form of a non-randomised controlled trial with a before/after approach. It will include 270 older people >65 years receiving home care services, 270 relatives and 65 staff, as well as a matched control group of equal size. All participants will be recruited from a municipality in northern Sweden. The intervention is based on the theoretical concepts of person-centredness and health-promotion, and builds on the four pedagogical phases of: theory apprehension, experimental learning, operationalization, and clinical supervision. Outcome assessments will focus on: a) health and quality of life (primary outcomes), thriving and satisfaction with care for older people; b) caregiver strain, informal caregiving engagement and relatives' satisfaction with care: c) job satisfaction and stress of conscience among care staff (secondary outcomes). Evaluation will be conducted by means of self-reported questionnaires and qualitative research interviews. Person-centred home care services have the potential to improve the recurrently reported sub-standard experiences of home care services, and the results can point the way to establishing a more person-centred and health-promoting model for home care services for older people. NCT02846246 .

Burnout, psychological morbidity and use of coping mechanisms among palliative care practitioners: A multi-centre cross-sectional study.

Science.gov (United States)

Koh, Mervyn Yong Hwang; Chong, Poh Heng; Neo, Patricia Soek Hui; Ong, Yew Jin; Yong, Woon Chai; Ong, Wah Ying; Shen, Mira Li Juan; Hum, Allyn Yin Mei

2015-07-01

The prevalence of burnout, psychological morbidity and the use of coping mechanisms among palliative care practitioners in Singapore have not been studied. We aimed to study the prevalence of burnout and psychological morbidity among palliative care practitioners in Singapore and its associations with demographic and workplace factors as well as the use of coping mechanisms. This was a multi-centre, cross-sectional study of all the palliative care providers within the public healthcare sector in Singapore. The study was conducted in hospital palliative care services, home hospice and inpatient hospices in Singapore. The participants were doctors, nurses and social workers. The prevalence of burnout among respondents in our study was 91 of 273 (33.3%) and psychological morbidity was 77 (28.2%). Working >60 h per week was significantly associated with burnout (odds ratio: 9.02, 95% confidence interval: 2.3-35.8, p = 0.002) and psychological morbidity (odds ratio: 7.21, 95% confidence interval: 1.8-28.8, p = 0.005). Home hospice care practitioners (41.5%) were more at risk of developing psychological morbidity compared to hospital-based palliative care (17.5%) or hospice inpatient care (26.0%) (p = 0.007). Coping mechanisms like physical well-being, clinical variety, setting boundaries, transcendental (meditation and quiet reflection), passion for one's work, realistic expectations, remembering patients and organisational activities were associated with less burnout. Our results reveal that burnout and psychological morbidity are significant in the palliative care community and demonstrate a need to look at managing long working hours and promoting the use of coping mechanisms to reduce burnout and psychological morbidity. © The Author(s) 2015.

The CERN Control Centre Setting Standards for the 21st Century

CERN Document Server

Manglunki, Django

2008-01-01

In 2003, CERN decided to build a unified control centre to replace four of its control rooms: the â€ﾜMeyrin Control Room” which controlled the PS complex, the â€ﾜPrevessin Control Room” (PCR) which controlled the SPS and until 2000 LEP, the Technical Control Room (TCR), and the Cryogenics Control Room (QCR). After first contemplating a possible implementation next to the â€ﾜGlobe of Science and Innovation”, it was decided for budgetary reasons to build the new CERN Control Centre (CCC) on the same location as the PCR. This represented a 50% saving in construction costs as most of the technical infrastructure (computer network, water, electricity, ventilation) was already in place, but added stringent time constraints: civil engineering could not begin before the SPS shutdown in November 2004, yet the room had to be ready for the accelerator operations to resume in March 2006. Although this presented a strict construction schedule, it allowed the project to be completely driven by th...

A sit-ski design aimed at controlling centre of mass and inertia.

Science.gov (United States)

Langelier, Eve; Martel, Stéphane; Millot, Anne; Lessard, Jean-Luc; Smeesters, Cécile; Rancourt, Denis

2013-01-01

This article introduces a sit-ski developed for the Canadian Alpine Ski Team in view of the Vancouver 2010 Paralympic games. The design is predominantly based on controlling the mass distribution of the sit-ski, a critical factor in skiing performance and control. Both the antero-posterior location of the centre of mass and the sit-ski moment of inertia were addressed in our design. Our design provides means to adjust the antero-posterior centre of mass location of a sit-ski to compensate for masses that would tend to move the antero-posterior centre of mass location away from the midline of the binding area along the ski axis. The adjustment range provided is as large as 140 mm, thereby providing sufficient adaptability for most situations. The suspension mechanism selected is a four-bar linkage optimised to limit antero-posterior seat movement, due to suspension compression, to 7 mm maximum. This is about 5% of the maximum antero-posterior centre of mass control capacity (151 mm) of a human participant. Foot rest inclination was included in the design to modify the sit-ski inertia by as much as 11%. Together, these mass adjustment features were shown to drastically help athletes' skiing performance.

Phlebitis risk varies by peripheral venous catheter site and increases after 96 hours: a large multi-centre prospective study.

Science.gov (United States)

Cicolini, Giancarlo; Manzoli, Lamberto; Simonetti, Valentina; Flacco, Maria Elena; Comparcini, Dania; Capasso, Lorenzo; Di Baldassarre, Angela; Eltaji Elfarouki, Ghaleb

2014-11-01

This multi-centre prospective field study evaluated whether peripheral venous catheter site of insertion influences the risk of catheter-related phlebitis. Potential predictors of phlebitis were also investigated. Millions of patients worldwide use peripheral venous catheters, which frequently cause local complications including phlebitis, infection and obstruction. Although phlebitis predictors have been broadly investigated, uncertainties remain on the potential effect of cannulation anatomical site, duration and the appropriate time for catheter removal. A prospective cohort design was carried out from January-June 2012. The clinical course of each patient who received a new peripheral venous catheter for any cause in five Italian hospitals was followed by trained nurses until catheter removal. The presence of phlebitis was assessed every 24 hours using the Visual Infusion Phlebitis score. Analyses were based upon multilevel mixed-effects regression. The final sample consisted of 1498 patients. The average time for catheters in situ was 65·6 hours and 23·6% of the catheters were in place beyond 96 hours. Overall phlebitis incidence was 15·4%, 94·4% of which were grade 1. The likelihood of phlebitis independently increased with increasing catheter duration, being highest after 96 hours. Compared with patients with catheter placed in the dorsum of the hand (22·8% of the sample), those with the catheter located in the antecubital fossa (34·1%) or forearm were less likely to have a phlebitis of any grade. Antecubital fossa and forearm veins may be preferential sites for peripheral venous cannulation. Our results support Centers for Disease Control and Prevention recommendations to replace catheters in adults no later than 96 hours. A relevant proportion of healthcare personnel did not adhere to such guidelines - more attention to this issue is required. © 2014 John Wiley & Sons Ltd.

Manche storage Centre. Information report on nuclear safety and radiation protection 2015

International Nuclear Information System (INIS)

2016-01-01

After a presentation of the Manche Storage Centre (CSM), the first French center of surface storage of low- and intermediate-level radioactive wastes, of its history, its buildings and activities, of the multi-layer cover, of the water management system (installation, controls, sampling), this report then describes the measures related to nuclear safety, the management of conventional and nuclear wastes produced by the Centre, the other impacts, the control, maintenance and follow-up of installations, the radiation protection and security of the center, the incidents and accidents that occurred at the facility, and the public information and communication actions. Recommendations of the Health and safety Committee (CHSCT) are reported at the end

Experimental study of a novel capacity control algorithm for a multi-evaporator air conditioning system

International Nuclear Information System (INIS)

Xu Xiangguo; Pan Yan; Deng Shiming; Xia Liang; Chan Mingyin

2013-01-01

The use of a multi-evaporator air conditioning (MEAC) system is advantageous in terms of installation convenience, high design flexibility, being easy to maintain and commission, better indoor thermal comfort control and higher energy efficiency. While MEAC units worth billions of dollars are sold worldwide, the detailed accounts on compressor capacity control and refrigeration flow distribution amongst evaporators remain unavailable in public domain, mainly due to commercial confidentiality. Limited control algorithms for MEAC systems have been developed based on system simulation, and no experimental-based capacity controller developments and their controllability tests may be identified in open literature. In the study reported in this paper, a novel capacity control algorithm, which imitated On–Off control of a single evaporator air conditioning (A/C) system in each indoor unit of a MEAC system by using variable speed compressor and electronic expansion valves (EEVs), was developed. Controllability tests under various settings for experimentally validating the novel capacity control algorithm were carried out and the control algorithm was further improved based on the experimental results. - Highlights: ► A capacity control algorithm for a multi-evaporator air conditioning system was developed. ► Experimental controllability tests under various settings were carried out. ► The control algorithm was further improved based on the experimental results.

Range based power control for multi-radio multi-channel wireless mesh networks

CSIR Research Space (South Africa)

Olwal, TO

2009-08-01

Full Text Available Multi-Radio Multi-Channel (MRMC) systems are key to power control problems in Wireless Mesh Networks (WMNs). In this paper, researchers present a range based dynamic power control for MRMC WMNs. First, WMN is represented as a set of disjoint Unified...

Radiological and pathological findings of interval cancers in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-41 years

International Nuclear Information System (INIS)

Evans, A.J.; Kutt, E.; Record, C.; Waller, M.; Bobrow, L.; Moss, S.

2007-01-01

Aim: The aim of this study was to analyse the radiographic findings of the screening mammograms of women with interval cancer who participated in a multi-centre, randomized, controlled trial of mammographic screening in women from age 40-48 years. Materials and methods: The screening and diagnostic mammograms of 208 women with interval cancers were reviewed. Abnormalities were classified as malignant, subtle and non-specific. Results: Eighty-seven (42%) of women had true, 66 (32%) occult and 55 (26%) false-negative interval cancers. The features most frequently missed or misinterpreted were granular microcalcification (38%), asymmetric density (27%) and distortion (22%). Thirty-seven percent of abnormal previous screens were classified as malignant, 39% subtle change and 21% as non-specific. Granular calcifications were significantly more common on the diagnostic mammograms of false-negative interval cancers than those of true interval cancers (28 versus 14%, p = 0.04). Occult interval cancers were more likely to be <10 mm and <15 mm in invasive pathological size than other interval cancers (p = 0.03 and 0.005, respectively). True interval cancers were more likely to be histologically grade 3 than other interval cancers (p = 0.04). Women who developed true and false-negative interval cancers had similar background patterns, but women with occult cancers had a higher proportion of dense patterns (p < 0.05). Conclusion: Interval cancers in a young screening population have a high proportion of occult lesions that are small and occur in dense background patterns. The proportion of interval cancers that are false negative is similar that seen in older populations and granular microcalcification is the commonest missed mammographic feature

Outcome of physiotherapy after surgery for cervical disc disease: a prospective randomised multi-centre trial

Science.gov (United States)

2014-01-01

Background Many patients with cervical disc disease require leave from work, due to long-lasting, complex symptoms, including chronic pain and reduced levels of physical and psychological function. Surgery on a few segmental levels might be expected to resolve disc-specific pain and reduce neurological deficits, but not the non-specific neck pain and the frequent illness. No study has investigated whether post-surgery physiotherapy might improve the outcome of surgery. The main purpose of this study was to evaluate whether a well-structured rehabilitation programme might add benefit to the customary post-surgical treatment for cervical disc disease, with respect to function, disability, work capability, and cost effectiveness. Methods/Design This study was designed as a prospective, randomised, controlled, multi-centre study. An independent, blinded investigator will compare two alternatives of rehabilitation. We will include 200 patients of working age, with cervical disc disease confirmed by clinical findings and symptoms of cervical nerve root compression. After providing informed consent, study participants will be randomised to one of two alternative physiotherapy regimes; (A) customary treatment (information and advice on a specialist clinic); or (B) customary treatment plus active physiotherapy. Physiotherapy will follow a standardised, structured programme of neck-specific exercises combined with a behavioural approach. All patients will be evaluated both clinically and subjectively (with questionnaires) before surgery and at 6 weeks, 3 months, 6 months, 12 months, and 24 months after surgery. The main outcome variable will be neck-specific disability. Cost-effectiveness will also be calculated. Discussion We anticipate that the results of this study will provide evidence to support physiotherapeutic rehabilitation applied after surgery for cervical radiculopathy due to cervical disc disease. Trial registration ClinicalTrials.gov identifier: NCT01547611

Quantum state preparation using multi-level-atom optics

International Nuclear Information System (INIS)

Busch, Th; Deasy, K; Chormaic, S Nic

2007-01-01

One of the most important characteristics for controlling processes on the quantum scale is the fidelity or robustness of the techniques being used. In the case of single atoms localized in micro-traps, it was recently shown that the use of time-dependent tunnelling interactions in a multi-trap setup can be viewed as analogous to the area of multi-level optics. The atom's centre-of-mass can then be controlled with a high fidelity, using a STIRAP-type process. Here, we review previous work that led to the development of multi-level atom optics and present two examples of our most recent work on quantum state preparation

The impact of a disease management program (COACH) on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (The DISSEMINATE Study): a randomised controlled trial.

Science.gov (United States)

Selvaraj, Francis Jude; Mohamed, Mafauzy; Omar, Khairani; Nanthan, Sudha; Kusiar, Zainab; Subramaniam, Selvaraj Y; Ali, Norsiah; Karanakaran, Kamalakaran; Ahmad, Fauziah; Low, Wilson H H

2012-10-10

To evaluate the efficacy of Counselling and Advisory Care for Health (COACH) programme in managing dyslipidaemia among primary care practices in Malaysia. This open-label, parallel, randomised controlled trial compared the COACH programme delivered by primary care physicians alone (PCP arm) and primary care physicians assisted by nurse educators (PCP-NE arm). This was a multi-centre, open label, randomised trial of a disease management programme (COACH) among dyslipidaemic patients in 21 Malaysia primary care practices. The participating centres enrolled 297 treatment naïve subjects who had the primary diagnosis of dyslipidaemia; 149 were randomised to the COACH programme delivered by primary care physicians assisted by nurse educators (PCP-NE) and 148 to care provided by primary care physicians (PCP) alone. The primary efficacy endpoint was the mean percentage change from baseline LDL-C at week 24 between the 2 study arms. Secondary endpoints included mean percentage change from baseline of lipid profile (TC, LDL-C, HDL-C, TG, TC: HDL ratio), Framingham Cardiovascular Health Risk Score and absolute risk change from baseline in blood pressure parameters at week 24. The study also assessed the sustainability of programme efficacy at week 36. Both study arms demonstrated improvement in LDL-C from baseline. The least squares (LS) mean change from baseline LDL-C were -30.09% and -27.54% for PCP-NE and PCP respectively. The difference in mean change between groups was 2.55% (p=0.288), with a greater change seen in the PCP-NE arm. Similar observations were made between the study groups in relation to total cholesterol change at week 24. Significant difference in percentage change from baseline of HDL-C were observed between the PCP-NE and PCP groups, 3.01%, 95% CI 0.12-5.90, p=0.041, at week 24. There was no significant difference in lipid outcomes between 2 study groups at week 36 (12 weeks after the programme had ended). Patients who received coaching and advice from

Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels.

Science.gov (United States)

Brach, Michael; Nieder, Frank; Nieder, Ulrike; Mechling, Heinz

2009-11-24

There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL), the organisational-institutional level (OIL) and the political-cultural level (PCL). Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. The intervention consisted of (a) two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL), (b) a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL), (c) informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL). Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL), number of groups continued without external financial support (at the end of the project, and

Implementation of preventive strength training in residential geriatric care: a multi-centre study protocol with one year of interventions on multiple levels

Directory of Open Access Journals (Sweden)

Nieder Ulrike

2009-11-01

Full Text Available Abstract Background There is scientific evidence that preventive physical exercise is effective even in high age. In contrast, there are few opportunities of preventive exercise for highly aged people endangered by or actually in need of care. For example, they would not be able to easily go to training facilities; standard exercises may be too intensive and therefore be harmful to them; orientation disorders like dementia would exacerbate individuals and groups in following instructions and keeping exercises going. In order to develop appropriate interventions, these and other issues were assigned to different levels: the individual-social level (ISL, the organisational-institutional level (OIL and the political-cultural level (PCL. Consequently, this conceptional framework was utilised for development, implementation and evaluation of a new strength and balance exercise programme for old people endangered by or actually in need of daily care. The present paper contains the development of this programme labeled "fit for 100", and a study protocol of an interventional single-arm multi-centre trial. Methods The intervention consisted of (a two group training sessions every week over one year, mainly resistance exercises, accompanied by sensorimotor and communicative group exercises and games (ISL, (b a sustainable implementation concept, starting new groups by instructors belonging to the project, followed by training and supervision of local staff, who stepwise take over the group (OIL, (c informing and convincing activities in professional, administrative and governmental contexts, public relation activities, and establishing an advisory council with renowned experts and public figures (PCL. Participating institutions of geriatric care were selected through several steps of quality criteria assessment. Primary outcome measures were continuous documentation of individual participation (ISL, number of groups continued without external financial

Studies on the closed-loop digital control of multi-modular reactors

International Nuclear Information System (INIS)

Bernard, J.A.; Henry, A.F.; Lanning, D.D.; Meyer, J.E.

1992-11-01

This report describes the theoretical development and the evaluation via both experiment and simulation of digital methods for the closed-loop control of power, temperature, and steam generator level in multi-modular reactors. The major conclusion of the research reported here is that the technology is currently available to automate many aspects of the operation of multi-modular plants. This will in turn minimize the number of required personnel and thus contain both operating and personnel costs, allow each module to be operated at a different power level thereby staggering the times at which refuelings would be needed, and maintain the competitiveness of US industry relative to foreign vendors who are developing and applying advanced control concepts. The technology described in this report is appropriate to the proposed multi-modular reactor designs and to present-generation pressurized water reactors. Its extension to boiling water reactors is possible provided that the commitment is made to create a real-time model of a BWR. The work reported here was performed by the Massachusetts Institute of Technology (MIT) under contract to the Oak Ridge National Laboratory (ORNL) and to the United States Department of Energy (Division of Industry and University Programs, Contract No. DE-FG07-90ER12930.)

France. The Centre de la Manche disposal facility: Entering into the institutional control period

International Nuclear Information System (INIS)

2001-01-01

The Centre de la Manche disposal facility, created by decree in 1969, is the first French near-surface radioactive waste disposal facility. It lies at the northwest end of the Cotentin peninsula, next to the COGEMA-La Hague fuel reprocessing plant. The Centre de la Manche facility occupies an area of about 150,000 m 2 . Its operation was terminated in late June 1994 with about 500,000 m 3 of packages disposed of. Operating feedback from the Centre de la Manche was used to design the second French disposal facility, located in the Aube, which has been receiving LILW since 1992. Since the end of the operating period, ANDRA has been preparing the statutory files to prepare the Centre de la Manche for its entry into the institutional control period. A new government decree will set the framework in which the Centre will evolve in this period. The regulatory process includes the filing of an application with the ministries concerned, containing a file with the requisite statutory documents, including an impact study of the facility on its environment as well as a hazard study. The file will then be submitted to a public inquiry, an essential informative period of the project designed to make a compilation of criticisms and suggestions from the public. In support of the application, a safety report has been sent to the Nuclear Installation Safety Directorate (DSIN) for a decision on the admissibility of the application. Recently, the Group of experts appointed by the DSIN which examined it has come out in favor of the creation of a new basic nuclear installation (i.e., a new government agency) for the institutional control period. A draft decree will then be submitted to the approval of the Interministerial Commission for Basic Nuclear Installations. This process, initiated in 1994, is nearing completion

A computer simulation of the new Control Centre (CCC)

CERN Multimedia

2004-01-01

In a development crucial for the success of the LHC, CERN will build a Control Centre (CCC) for the operation of all its beams and accelerators. The CCC will be an extension of the existing PCR building at Prévessin and is due to be operational by 1 February 2006.

Study on collaborative optimization control of ventilation and radon reduction system based on multi-agent technology

International Nuclear Information System (INIS)

Dai Jianyong; Meng Lingcong; Zou Shuliang

2015-01-01

According to the radioactive safety features such as radon and its progeny, combined with the theory of ventilation system, structure of multi-agent system for ventilation and radon reduction system is constructed with the application of multi agent technology. The function attribute of the key agent and the connection between the nodes in the multi-agent system are analyzed to establish the distributed autonomous logic structure and negotiation mechanism of multi agent system of ventilation and radon reduction system, and thus to implement the coordination optimization control of the multi-agent system. The example analysis shows that the system structure of the multi-agent system of ventilation and reducing radon system and its collaborative mechanism can improve and optimize the radioactive pollutants control, which provides a theoretical basis and important application prospect. (authors)

Polarization control of multi-photon absorption under intermediate femtosecond laser field

International Nuclear Information System (INIS)

Cheng Wenjing; Liang Guo; Wu Ping; Liu Pei; Jia Tianqing; Sun Zhenrong; Zhang Shian

2017-01-01

It has been shown that the femtosecond laser polarization modulation is a very simple and well-established method to control the multi-photon absorption process by the light–matter interaction. Previous studies mainly focused on the multi-photon absorption control in the weak field. In this paper, we further explore the polarization control behavior of multi-photon absorption process in the intermediate femtosecond laser field. In the weak femtosecond laser field, the second-order perturbation theory can well describe the non-resonant two-photon absorption process. However, the higher order nonlinear effect (e.g., four-photon absorption) can occur in the intermediate femtosecond laser field, and thus it is necessary to establish new theoretical model to describe the multi-photon absorption process, which includes the two-photon and four-photon transitions. Here, we construct a fourth-order perturbation theory to study the polarization control behavior of this multi-photon absorption under the intermediate femtosecond laser field excitation, and our theoretical results show that the two-photon and four-photon excitation pathways can induce a coherent interference, while the coherent interference is constructive or destructive that depends on the femtosecond laser center frequency. Moreover, the two-photon and four-photon transitions have the different polarization control efficiency, and the four-photon absorption can obtain the higher polarization control efficiency. Thus, the polarization control efficiency of the whole excitation process can be increased or decreased by properly designing the femtosecond laser field intensity and laser center frequency. These studies can provide a clear physical picture for understanding and controlling the multi-photon absorption process in the intermediate femtosecond laser field, and also can provide a theoretical guidance for the future experimental realization. (paper)

Cervical cancer screening in women referred to healthcare centres in Tabriz, Iran.

Science.gov (United States)

Farshbaf-Khalili, Azizeh; Salehi-Pourmehr, Hanieh; Shahnazi, Mahnaz; Yaghoubi, Sina; Gahremani-Nasab, Parvaneh

2015-01-01

Cervical cancer is the second most common cancer among Iranian women and among the few cancers that could be easily diagnosed in the pre-malignant stage. We aimed to assess the status of cervical cancer screening in women referred to health care centres in Tabriz, northwest Iran. This descriptive-analytical study was done on 441 women referred to health care centres of Tabriz, northwest Iran. The centres were selected using the multi-stage cluster sampling method. The participants were selected from the active records of those centres. A questionnaire regarding the socio-demographic characteristics and cervical cancer screening and reasons for referring or not referring for screening was completed by the participants A P marriage or having sexual intercourse at a young age, history of obvious cervical infection, cautery, cryotherapy or repeated curettage), age and type of family planning] in screening was controlled. Suitable and continuous educational programmes especially for high risk women should be implemented through the health care services. Preparing educational brochures and pamphlets and providing adequate training on the necessity of early referral and marriage counseling could also be effective in improving woman's awareness and performance.

Admittance Control of a Multi-Finger Arm Based on Manipulability of Fingers

Directory of Open Access Journals (Sweden)

Jian Huang

2011-09-01

Full Text Available In the previous studies, admittance control and impedance control for a finger-arm robot using the manipulability of the finger were studied and methods of realizing the controls have been proposed. In this study, two 3-DOF fingers are attached to the end-effector of a 6-DOF arm to configure a multi-finger arm robot. Based on the previous methods, the authors have proposed an admittance control for a multi-finger arm robot using the manipulability of the fingers in this study. Algorithms of the averaging method and the mini-max method were introduced to establish a manipulability criterion of the two fingers in order to generate a cooperative movement of the arm. Comparison of the admittance controls combined with the top search method and local optimization method for the multi-finger arm robot was made and features of the control methods were also discussed. The stiffness control and damping control were experimentally evaluated to demonstrate the effectiveness of the proposed methods.

[A Multi-arm Placebo-controlled Study with Glutamic Acid Conducted in Rostock in 1953/1954].

Science.gov (United States)

Häßler, Frank; Weirich, Steffen

2017-09-01

A Multi-arm Placebo-controlled Study with Glutamic Acid Conducted in Rostock in 1953/1954 Glutamic acid was commonly used in the treatment of intellectually disabled children in the 50s. Koch reported first results of an observation of 140 children treated with glutamic acid in 1952. In this line is the multi-arm placebo-controlled study reported here. The original study protocols were available. 58 children with speech problems who attending a school of special needs received glutamic acid, or vitamin B, or St.-John's-wort. The effect of glutamic acid was in few cases an improvement of attention. On the other hand restlessness and stutter increased. The majority of all reported a weight loss. The treatment with vitamin B showed a positive effect concerning concentration. The treatment with St.-John's wort was stopped caused by headache and vomiting in eight of nine cases. The results of the study reported here are unpublished. The reason may be that until the 60s the effects of glutamic acid in the treatment of intellectually disabled children were in generally overestimated.

Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis.

Science.gov (United States)

Pan, An; Hui, Chi-Leung

2017-01-01

Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an ( Q , r ) inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.

Does it matter if clinicians recruiting for a trial don't understand what the trial is really about? Qualitative study of surgeons' experiences of participation in a pragmatic multi-centre RCT

Directory of Open Access Journals (Sweden)

Snowdon Claire

2007-01-01

Full Text Available Abstract Background Qualitative methods are increasingly used to study the process of clinical trials and patients understanding of the rationale for trials, randomisation and reasons for taking part or refusing. Patients' understandings are inevitably influenced by the recruiting clinician's understanding of the trial, yet relatively little qualitative work has explored clinicians' perceptions and understandings of trials. This study interviewed surgeons shortly after the multi-centre, pragmatic RCT in which they had participated had been completed. Methods We used in-depth interviews with surgeons who participated in the Spine Stabilisation Trial (a pragmatic RCT to explore their understanding of the trial purpose and how this understanding had influenced their recruitment procedures and interpretation of the results. A purposive sample of eleven participating surgeons was chosen from 8 of the 15 UK trial centres. Results Although the surgeons thought that the trial was addressing an important question there was little agreement about what this question was: although it was a trial of 'equivalent' treatments, some thought that it was a trial of surgery, others a trial of rehabilitation and others that it was exploring what to do with patients in whom all other treatment options had been unsuccessful. The surgeons we interviewed were not aware of the rationale for the pragmatic inclusion criteria and nearly all were completely baffled about the meaning of 'equipoise'. Misunderstandings about the entry criteria were an important source of confusion about the results and led to reluctance to apply the results to their own practice. Conclusion The study suggests several lessons for the conduct of future multi-centre trials. Recruiting surgeons (and other clinicians may not be familiar with the rationale for pragmatic designs and may need to be regularly reminded about the purpose during the study. Reassurance may be necessary that a pragmatic

Adherence to MRI protocol consensus guidelines in multiple sclerosis: an Australian multi-centre study

International Nuclear Information System (INIS)

Curley, Michael; Josey, Lawrence; Lucas, Robyn; Dear, Keith; Taylor, Bruce V.; Coulthard, Alan; Ausimmune Investigator Group

2012-01-01

Multiple sclerosis (MS) is a debilitating disease that causes significant morbidity within a young demographic. Diagnostic guidelines for MS have evolved, and imaging has played an increasingly important role in diagnosis over the last two decades. For imaging to contribute to diagnosis in a meaningful way, it must be reproducible. Consensus guidelines for MRI in MS exist to define correct sequence type and imaging technique, but it is not clear to what extent they are followed. This study reviewed MRI studies performed on Australian individuals presenting with a first clinical diagnosis of central nervous system demyelination (FCD) for adherence to published guidelines and discussed practical implementation of MS guidelines in light of recent updates. The Ausimmune study was a prospective case control study of Australian participants presenting with FCD from 2003 to 2006. Baseline cranial and spinal cord MRI studies of 226 case participants from four separate Australian regions were reviewed. MRI sequences were classified according to anatomical location, slice plane, tissue weighting and use of gadolinium-containing contrast media. Results were compared with the 2003 Consortium of Multiple Sclerosis Centres MRI protocol for the diagnosis of MS. The composition of core cranial MRI sequences performed varied across the 226 scans. Of the studies, 91% included sagittal fluid attenuated inversion recovery (FLAIR) sequences. Cranial axial T2-weighted, axial FLAIR and axial proton density-weighted sequences were performed in 88%, 60% and 16% (respectively) of scans. Only 25% of the studies included a T1-weighted contrast-enhanced sequence. Concordance with the guidelines in all sequences was very low (2). Only a small number of MRI investigations performed included all of the sequences stipulated by consensus guidelines. This is likely due to poor awareness in the imaging community of the guidelines and the rationale behind certain sequences. Radiologists with a sub

Implementation method of multi-terminal DC control system

Science.gov (United States)

Yi, Liu; Hao-Ran, Huang; Jun-Wen, Zhou; Hong-Guang, Guo; Yu-Yong, Zhou

2018-04-01

Currently the multi-terminal DC system (MTDC) has more stations. Each station needs operators to monitor and control the device. It needs much more operation and maintenance, low efficiency and small reliability; for the most important reason, multi-terminal DC system has complex control mode. If one of the stations has some problem, the control of the whole system should have problems. According to research of the characteristics of multi-terminal DC (VSC-MTDC) systems, this paper presents a strong implementation of the multi-terminal DC Supervisory Control and Data Acquisition (SCADA) system. This system is intelligent, can be networking, integration and intelligent. A master control system is added in each station to communication with the other stations to send current and DC voltage value to pole control system for each station. Based on the practical application and information feedback in the China South Power Grid research center VSC-MTDC project, this system is higher efficiency and save the cost on the maintenance of convertor station to improve the intelligent level and comprehensive effect. And because of the master control system, a multi-terminal system hierarchy coordination control strategy is formed, this make the control and protection system more efficiency and reliability.

A multi-centre clinical follow-up database as a systematic approach to the evaluation of mid- and long-term health consequences in Chernobyl acute radiation syndrome patients

International Nuclear Information System (INIS)

Fischer, B.; Weiss, M.; Fliedner, T.M.; Belyi, D.A.; Kovalenko, A.N.; Bebeshko, V.G.; Nadejina, N.M.; Galstian, I.A.

1996-01-01

This paper describes scope, design and first results of a multi-centre follow-up database that has been established for the evaluation of mid- and long-term health consequences of acute radiation syndrome (ARS) survivors. After the Chernobyl accident on 26 April 1986, 237 cases with suspected acute radiation syndrome have been reported. For 134 of these cases the diagnosis of ARS was confirmed in a consensus conference three years after the accident. Nearly all survivors underwent regular follow-up examinations in two specialized centres in Kiev and in Moscow. In collaboration with these centres we established a multi-centre clinical follow-up database that records the results of the follow-up examinations in a standardized schema. This database is an integral part of a five step approach to patient evaluation and aims at a comprehensive base for scientific analysis of the mid- and long-term consequences of accidental ionizing radiation. It will allow for a dynamic view on the development of the health status of individuals and groups of patients as well as the identification of critical organ systems that need early support, and an improvement of acute and follow-up treatment protocols for radiation accident victims

The study protocol for a randomized controlled trial of a family-centred tobacco control program about environmental tobacco smoke (ETS to reduce respiratory illness in Indigenous infants

Directory of Open Access Journals (Sweden)

Segan Catherine

2010-03-01

Full Text Available Abstract Background Acute respiratory illness (ARI is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand (NZ. Environmental tobacco smoke (ETS from household smoking is a significant and preventable contributor to childhood ARI. This paper describes the protocol for a study which aims to test the efficacy of a family-centred tobacco control program about ETS to improve the respiratory health of Indigenous infants in Australia and New Zealand. For the purpose of this paper 'Indigenous' refers to Australia's Aboriginal and Torres Strait Islander peoples when referring to Australian Indigenous populations. In New Zealand, the term 'Indigenous' refers to Māori. Methods/Design This study will be a parallel, randomized, controlled trial. Participants will be Indigenous women and their infants, half of whom will be randomly allocated to an 'intervention' group, who will receive the tobacco control program over three home visits in the first three months of the infant's life and half to a control group receiving 'usual care' (i.e. they will not receive the tobacco control program. Indigenous health workers will deliver the intervention, the goal of which is to reduce or eliminate infant exposure to ETS. Data collection will occur at baseline (shortly after birth and when the infant is four months and one year of age. The primary outcome is a doctor-diagnosed, documented case of respiratory illness in participating infants. Discussion Interventions aimed at reducing exposure of Indigenous children to ETS have the potential for significant benefits for Indigenous communities. There is currently a dearth of evidence for the effect of tobacco control interventions to reduce children's exposure to ETS among Indigenous populations. This study will provide high-quality evidence of the efficacy of a family-centred tobacco control program on ETS to reduce respiratory illness. Outcomes of

Multi-periodic nanostructures for photon control

DEFF Research Database (Denmark)

Kluge, Christian; Adam, Jost; Barié, Nicole

2014-01-01

We propose multi-periodic nanostructures yielded by superposition of multiple binary gratings for wide control over photon emission in thin-film devices. We present wavelength- and angle-resolved photoluminescence measurements of multi-periodically nanostructured organic light-emitting layers...

Multiple-state based power control for multi-radio multi-channel wireless mesh networks

CSIR Research Space (South Africa)

Olwal, TO

2009-01-01

Full Text Available Multi-Radio Multi-Channel (MRMC) systems are key to power control problems in wireless mesh networks (WMNs). In this paper, we present asynchronous multiple-state based power control for MRMC WMNs. First, WMN is represented as a set of disjoint...

The diagnostic and therapeutic impact of MRI: an observational multi-centre study

International Nuclear Information System (INIS)

Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K.

2000-01-01

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

The diagnostic and therapeutic impact of MRI: an observational multi-centre study

Energy Technology Data Exchange (ETDEWEB)

Hollingworth, William; Todd, Christopher J.; Bell, Matthew I.; Arafat, Qais; Girling, Simon; Karia, Kanti R.; Dixon, Adrian K

2000-11-01

AIM: To provide information about the diagnostic and therapeutic impact of magnetic resonance imaging (MRI) and to compare the findings across diagnostic groups. MATERIALS AND METHODS: A prospective, observational study of 2017 consecutive referrals for MRI of the head, spine or knee at four imaging centres. Clinicians completed questionnaires before MRI stating initial diagnoses, diagnostic confidence and treatment plans. After imaging, a second questionnaire evaluated clinicians' revised diagnosis and treatment plans in the light of imaging findings. Patients were grouped into nine diagnostic categories for analysis. Comparison between pre- and post-imaging was used to assess the diagnostic and therapeutic impact of MRI. RESULTS: In seven of nine diagnostic groups MRI findings were associated with a diagnostic impact. Diagnoses were revised or discarded following normal MR findings and diagnostic confidence was increased by confirmative MR findings. There was no statistically significant diagnostic impact for suspected pituitary or cerebello-pontine angle lesions. In five of nine diagnostic groups (knee meniscus, knee ligament, multiple sclerosis, lumbar and cervical spine) MRI findings had a clear impact on treatment plans. CONCLUSION: This study demonstrates that in most diagnostic categories, MRI influences diagnosis and treatment. However, experimental studies are needed to prove that these diagnostic and therapeutic impacts lead to improved health. Hollingworth (2000)

Adaptive fuzzy sliding-mode control for multi-input multi-output chaotic systems

International Nuclear Information System (INIS)

Poursamad, Amir; Markazi, Amir H.D.

2009-01-01

This paper describes an adaptive fuzzy sliding-mode control algorithm for controlling unknown or uncertain, multi-input multi-output (MIMO), possibly chaotic, dynamical systems. The control approach encompasses a fuzzy system and a robust controller. The fuzzy system is designed to mimic an ideal sliding-mode controller, and the robust controller compensates the difference between the fuzzy controller and the ideal one. The parameters of the fuzzy system, as well as the uncertainty bound of the robust controller, are tuned adaptively. The adaptive laws are derived in the Lyapunov sense to guarantee the asymptotic stability and tracking of the controlled system. The effectiveness of the proposed method is shown by applying it to some well-known chaotic systems.

Sensor-augmented pump therapy lowers HbA(1c) in suboptimally controlled Type 1 diabetes; a randomized controlled trial

NARCIS (Netherlands)

Hermanides, J.; Nørgaard, K.; Bruttomesso, D.; Mathieu, C.; Frid, A.; Dayan, C. M.; Diem, P.; Fermon, C.; Wentholt, I. M. E.; Hoekstra, J. B. L.; DeVries, J. H.

2011-01-01

To investigate the efficacy of sensor-augmented pump therapy vs. multiple daily injection therapy in patients with suboptimally controlled Type 1 diabetes. In this investigator-initiated multi-centre trial (the Eurythmics Trial) in eight outpatient centres in Europe, we randomized 83 patients with

Control System Design of the YWZ Multi-Fingered Dexterous Hand

Directory of Open Access Journals (Sweden)

Wenzhen Yang

2012-07-01

Full Text Available The manipulation abilities of a multi-fingered dexterous hand, such as motion in real-time, flexibility, grasp stability etc., are largely dependent on its control system. This paper developed a control system for the YWZ dexterous hand, which had five fingers and twenty degrees of freedom (DOFs. All of the finger joints of the YWZ dexterous handwere active joints driven by twenty micro-stepper motors respectively. The main contribution of this paper was that we were able to use stepper motor control to actuate the hand's fingers, thus, increasing the hands feasibility. Based the actuators of the YWZ dexterous hand, we firstly developed an integrated circuit board (ICB, which was the communication hardware between the personal computer (PC and the YWZ dexterous hand. The ICB included a centre controller, twenty driver chips, a USB port and other electrical parts. Then, a communication procedure between the PC and the ICB was developed to send the control commands to actuate the YWZ dexterous hand. Experiment results showed that under this control system, the motion of the YWZ dexterous hand was real-time; both the motion accuracy and the motion stability of the YWZ dexterous hand were reliable. Compared with other types of actuators related to dexterous hands, such as pneumatic servo cylinder, DC servo motor, shape memory alloy etc., experiment results verified that the stepper motors as actuators for the dexterous handswere effective, economical, controllable and stable.

Patient-centred performance monitoring systems and multi-agency care provision: a case study using a stakeholder participative approach.

Science.gov (United States)

Connell, N A; Goddard, A R; Philp, I; Bray, J

1998-05-01

We describe the processes involved in the development of an information system which can assess how care given by a number of agencies could be monitored by those agencies. In particular, it addresses the problem of sharing information as the boundaries of each agency are crossed. It focuses on the care of one specific patient group--the rehabilitation of elderly patients in the community, which provided an ideal multi-agency setting. It also describes: how a stakeholder participative approach to information system development was undertaken, based in part on the Soft Systems Methodology (SSM) approach (Checkland, 1981, 1990); some of the difficulties encountered in using such an approach; and the ways in which these were addressed. The paper goes on to describe an assessment tool called SCARS (the Southampton Community Ability Rating Scale). It concludes by reflecting on the management lessons arising from this project. It also observes, inter alia, how stakeholders have a strong preference for simpler, non-IT based systems, and comments on the difficulties encountered by stakeholders in attempting to reconcile their perceptions of the needs of their discipline or specialty with a more patient-centred approach of an integrated system.

Complete quantum control of exciton qubits bound to isoelectronic centres.

Science.gov (United States)

Éthier-Majcher, G; St-Jean, P; Boso, G; Tosi, A; Klem, J F; Francoeur, S

2014-05-30

In recent years, impressive demonstrations related to quantum information processing have been realized. The scalability of quantum interactions between arbitrary qubits within an array remains however a significant hurdle to the practical realization of a quantum computer. Among the proposed ideas to achieve fully scalable quantum processing, the use of photons is appealing because they can mediate long-range quantum interactions and could serve as buses to build quantum networks. Quantum dots or nitrogen-vacancy centres in diamond can be coupled to light, but the former system lacks optical homogeneity while the latter suffers from a low dipole moment, rendering their large-scale interconnection challenging. Here, through the complete quantum control of exciton qubits, we demonstrate that nitrogen isoelectronic centres in GaAs combine both the uniformity and predictability of atomic defects and the dipole moment of semiconductor quantum dots. This establishes isoelectronic centres as a promising platform for quantum information processing.

Direct Energy Centre underground parking integrated light control system

Energy Technology Data Exchange (ETDEWEB)

NONE

2010-10-15

LightSavers is a project undertaken by the Toronto Atmospheric Fund to accelerate the use of lighting technologies. As part of the project a pilot test has been carried out in the Direct Energy Center in Toronto. The aim of this report is to present the study and its results. The Direct Energy Center is a large event facility with an large underground parking facility. A lighting energy management system, the energy control system (ECS), capable of adjusting lighting levels based on occupancy was implemented in the centre and data was collected during over one year. Results showed that the ECS permitted a reduction in energy consumption and thus greenhouse gas emissions by 47% and the payback will take less than 6 years. This project demonstrated that the energy control system provides better energy, environmental and economic performance than a traditional automation system.

Large multi-centre pilot randomized controlled trial testing a low-cost, tailored, self-help smoking cessation text message intervention for pregnant smokers (MiQuit).

Science.gov (United States)

Naughton, Felix; Cooper, Sue; Foster, Katharine; Emery, Joanne; Leonardi-Bee, Jo; Sutton, Stephen; Jones, Matthew; Ussher, Michael; Whitemore, Rachel; Leighton, Matthew; Montgomery, Alan; Parrott, Steve; Coleman, Tim

2017-07-01

To estimate the effectiveness of pregnancy smoking cessation support delivered by short message service (SMS) text message and key parameters needed to plan a definitive trial. Multi-centre, parallel-group, single-blinded, individual randomized controlled trial. Sixteen antenatal clinics in England. Four hundred and seven participants were randomized to the intervention (n = 203) or usual care (n = 204). Eligible women were 5 pre-pregnancy), were able to receive and understand English SMS texts and were not already using text-based cessation support. All participants received a smoking cessation leaflet; intervention participants also received a 12-week programme of individually tailored, automated, interactive, self-help smoking cessation text messages (MiQuit). Seven smoking outcomes, including validated continuous abstinence from 4 weeks post-randomization until 36 weeks gestation, design parameters for a future trial and cost-per-quitter. Using the validated, continuous abstinence outcome, 5.4% (11 of 203) of MiQuit participants were abstinent versus 2.0% (four of 204) of usual care participants [odds ratio (OR) = 2.7, 95% confidence interval (CI) = 0.93-9.35]. The Bayes factor for this outcome was 2.23. Completeness of follow-up at 36 weeks gestation was similar in both groups; provision of self-report smoking data was 64% (MiQuit) and 65% (usual care) and abstinence validation rates were 56% (MiQuit) and 61% (usual care). The incremental cost-per-quitter was £133.53 (95% CI = -£395.78 to 843.62). There was some evidence, although not conclusive, that a text-messaging programme may increase cessation rates in pregnant smokers when provided alongside routine NHS cessation care. © 2017 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.

Inventory Control System for a Healthcare Apparel Service Centre with Stockout Risk: A Case Analysis

Directory of Open Access Journals (Sweden)

An Pan

2017-01-01

Full Text Available Based on the real-world inventory control problem of a capacitated healthcare apparel service centre in Hong Kong which provides tailor-made apparel-making services for the elderly and disabled people, this paper studies a partial backordered continuous review inventory control problem in which the product demand follows a Poisson process with a constant lead time. The system is controlled by an (Q,r inventory policy which incorporate the stockout risk, storage capacity, and partial backlog. The healthcare apparel service centre, under the capacity constraint, aims to minimize the inventory cost and achieving a low stockout risk. To address this challenge, an optimization problem is constructed. A real case-based data analysis is conducted, and the result shows that the expected total cost on an order cycle is reduced substantially at around 20% with our proposed optimal inventory control policy. An extensive sensitivity analysis is conducted to generate additional insights.

Linear and Non-linear Multi-Input Multi-Output Model Predictive Control of Continuous Stirred Tank Reactor

Directory of Open Access Journals (Sweden)

Muayad Al-Qaisy

2015-02-01

Full Text Available In this article, multi-input multi-output (MIMO linear model predictive controller (LMPC based on state space model and nonlinear model predictive controller based on neural network (NNMPC are applied on a continuous stirred tank reactor (CSTR. The idea is to have a good control system that will be able to give optimal performance, reject high load disturbance, and track set point change. In order to study the performance of the two model predictive controllers, MIMO Proportional-Integral-Derivative controller (PID strategy is used as benchmark. The LMPC, NNMPC, and PID strategies are used for controlling the residual concentration (CA and reactor temperature (T. NNMPC control shows a superior performance over the LMPC and PID controllers by presenting a smaller overshoot and shorter settling time.

Reproducibility of a semi-automatic method for 6-point vertebral morphometry in a multi-centre trial

International Nuclear Information System (INIS)

Guglielmi, Giuseppe; Stoppino, Luca Pio; Placentino, Maria Grazia; D'Errico, Francesco; Palmieri, Francesco

2009-01-01

Purpose: To evaluate the reproducibility of a semi-automated system for vertebral morphometry (MorphoXpress) in a large multi-centre trial. Materials and methods: The study involved 132 clinicians (no radiologist) with different levels of experience across 20 osteo-centres in Italy. All have received training in using MorphoXpress. An expert radiologist was also involved providing data used as standard of reference. The test image originate from normal clinical activity and represent a variety of normal, under and over exposed films, indicating both normal anatomy and vertebral deformities. The image was represented twice to the clinicians in a random order. Using the software, the clinicians initially marked the midpoints of the upper and lower vertebrae to include as many of the vertebrae (T5-L4) as practical within each given image. MorphoXpress performs the localisation of all morphometric points based on statistical model-based vision system. Intra-operator as well inter-operator measurement of agreement was calculated using the coefficient of variation and the mean and standard deviation of the difference of two measurements to check their agreement. Results: The overall intra-operator mean differences in vertebral heights is 1.61 ± 4.27% (1 S.D.). The overall intra-operator coefficient of variation is 3.95%. The overall inter-operator mean differences in vertebral heights is 2.93 ± 5.38% (1 S.D.). The overall inter-operator coefficient of variation is 6.89%. Conclusions: The technology tested here can facilitate reproducible quantitative morphometry suitable for large studies of vertebral deformities

Project Based Learning in Multi-Grade Class

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Ciftci, Sabahattin; Baykan, Ayse Aysun

2013-01-01

The purpose of this study is to evaluate project based learning in multi-grade classes. This study, based on a student-centered learning approach, aims to analyze students' and parents' interpretations. The study was done in a primary village school belonging to the Centre of Batman, already adapting multi-grade classes in their education system,…

Applying human factors to the design of control centre and workstation of a nuclear reactor

Energy Technology Data Exchange (ETDEWEB)

Santos, Isaac J.A. Luquetti dos; Carvalho, Paulo V.R.; Goncalves, Gabriel de L., E-mail: luquetti@ien.gov.br [Instituto de Engenharia Nuclear (IEN/CNEN-RJ), Rio de Janeiro, RJ (Brazil); Souza, Tamara D.M.F.; Falcao, Mariana A. [Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ (Brazil). Dept. de Desenho Industrial

2013-07-01

Human factors is a body of scientific factors about human characteristics, covering biomedical, psychological and psychosocial considerations, including principles and applications in the personnel selection areas, training, job performance aid tools and human performance evaluation. Control Centre is a combination of control rooms, control suites and local control stations which are functionally related and all on the same site. Digital control room includes an arrangement of systems, equipment such as computers and communication terminals and workstations at which control and monitoring functions are conducted by operators. Inadequate integration between control room and operators reduces safety, increases the operation complexity, complicates operator training and increases the likelihood of human errors occurrence. The objective of this paper is to present a specific approach for the conceptual and basic design of the control centre and workstation of a nuclear reactor used to produce radioisotope. The approach is based on human factors standards, guidelines and the participation of a multidisciplinary team in the conceptual and basic phases of the design. Using the information gathered from standards and from the multidisciplinary team, an initial sketch 3D of the control centre and workstation are being developed. (author)

Applying human factors to the design of control centre and workstation of a nuclear reactor

International Nuclear Information System (INIS)

Santos, Isaac J.A. Luquetti dos; Carvalho, Paulo V.R.; Goncalves, Gabriel de L.; Souza, Tamara D.M.F.; Falcao, Mariana A.

2013-01-01

Human factors is a body of scientific factors about human characteristics, covering biomedical, psychological and psychosocial considerations, including principles and applications in the personnel selection areas, training, job performance aid tools and human performance evaluation. Control Centre is a combination of control rooms, control suites and local control stations which are functionally related and all on the same site. Digital control room includes an arrangement of systems, equipment such as computers and communication terminals and workstations at which control and monitoring functions are conducted by operators. Inadequate integration between control room and operators reduces safety, increases the operation complexity, complicates operator training and increases the likelihood of human errors occurrence. The objective of this paper is to present a specific approach for the conceptual and basic design of the control centre and workstation of a nuclear reactor used to produce radioisotope. The approach is based on human factors standards, guidelines and the participation of a multidisciplinary team in the conceptual and basic phases of the design. Using the information gathered from standards and from the multidisciplinary team, an initial sketch 3D of the control centre and workstation are being developed. (author)

Topology Control in Aerial Multi-Beam Directional Networks

Science.gov (United States)

2017-04-24

Topology Control in Aerial Multi-Beam Directional Networks Brian Proulx, Nathaniel M. Jones, Jennifer Madiedo, Greg Kuperman {brian.proulx, njones...significant interference. Topology control (i.e., selecting a subset of neighbors to communicate with) is vital to reduce the interference. Good topology ...underlying challenges to topology control in multi-beam direction networks. Two topology control algorithms are developed: a centralized algorithm

A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

Science.gov (United States)

2011-01-01

Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1%) met the protocol criteria for dystocia. Results Among the total cohort, 940 (35.4%) women reported experience of violence, and among these, 66 (2.5%) women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26) of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08), OR 0.90, 95% CI (0.54-1.50), respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96). Conclusions Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia. PMID:21338523

A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term.

Science.gov (United States)

Finnbogadóttir, Hafrún; Dejin-Karlsson, Elisabeth; Dykes, Anna-Karin

2011-02-21

Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1%) met the protocol criteria for dystocia. Among the total cohort, 940 (35.4%) women reported experience of violence, and among these, 66 (2.5%) women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26) of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08), OR 0.90, 95% CI (0.54-1.50), respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96). Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

Naltrexone versus acamprosate in the treatment of alcohol dependence: A multi-centre, randomized, double-blind, placebo-controlled trial.

Science.gov (United States)

Morley, Kirsten C; Teesson, Maree; Reid, Sophie C; Sannibale, Claudia; Thomson, Clare; Phung, Nghi; Weltman, Martin; Bell, James R; Richardson, Kylie; Haber, Paul S

2006-10-01

To compare the efficacy of acamprosate and naltrexone in the treatment of alcohol dependence. A double-blind, placebo-controlled trial. Three treatment centres in Australia. A total of 169 alcohol dependent subjects were given naltrexone (50 mg/day), acamprosate (1998 mg/day) or placebo for 12 weeks. All subjects were offered manualized compliance therapy, a brief intervention that targets problems that may affect treatment compliance such as ambivalence and misperceptions about medication. Time to the first drink, time to first relapse, drinks per drinking day and cumulative abstinence. In intention-to-treat analyses, there were no differences between groups on outcome measures of drinking, craving or biochemical markers. Similarly, analyses of the 94 subjects that completed the study in full and demonstrated 80% compliance, revealed no significant treatment effects. Differential treatment effects were identified after stratification according to scores on the Alcohol Dependence Scale (ADS) and Depression Anxiety and Stress Scale (DASS). A significant beneficial treatment effect on time to first relapse was revealed for subjects with 'no depression' allocated to naltrexone (n = 56; P relapse prevention of alcoholism amongst those with low levels of clinical depression and alcohol dependence severity. No effect of acamprosate was found in our sample.

Multi Car Elevator Control by using Learning Automaton

Science.gov (United States)

Shiraishi, Kazuaki; Hamagami, Tomoki; Hirata, Hironori

We study an adaptive control technique for multi car elevators (MCEs) by adopting learning automatons (LAs.) The MCE is a high performance and a near-future elevator system with multi shafts and multi cars. A strong point of the system is that realizing a large carrying capacity in small shaft area. However, since the operation is too complicated, realizing an efficient MCE control is difficult for top-down approaches. For example, “bunching up together" is one of the typical phenomenon in a simple traffic environment like the MCE. Furthermore, an adapting to varying environment in configuration requirement is a serious issue in a real elevator service. In order to resolve these issues, having an autonomous behavior is required to the control system of each car in MCE system, so that the learning automaton, as the solutions for this requirement, is supposed to be appropriate for the simple traffic control. First, we assign a stochastic automaton (SA) to each car control system. Then, each SA varies its stochastic behavior distributions for adapting to environment in which its policy is evaluated with each passenger waiting times. That is LA which learns the environment autonomously. Using the LA based control technique, the MCE operation efficiency is evaluated through simulation experiments. Results show the technique enables reducing waiting times efficiently, and we confirm the system can adapt to the dynamic environment.

REMCARE: Pragmatic Multi-Centre Randomised Trial of Reminiscence Groups for People with Dementia and their Family Carers: Effectiveness and Economic Analysis.

Directory of Open Access Journals (Sweden)

Robert T Woods

Full Text Available Joint reminiscence groups, involving people with dementia and family carers together, are popular, but the evidence-base is limited. This study aimed to assess the effectiveness and cost-effectiveness of joint reminiscence groups as compared to usual care.This multi-centre, pragmatic randomised controlled trial had two parallel arms: intervention group and usual-care control group. A restricted dynamic method of randomisation was used, with an overall allocation ratio of 1:1, restricted to ensure viable sized intervention groups. Assessments, blind to treatment allocation, were carried out at baseline, three months and ten months (primary end-point, usually in the person's home. Participants were recruited in eight centres, mainly through NHS Memory Clinics and NHS community mental health teams. Included participants were community resident people with mild to moderate dementia (DSM-IV, who had a relative or other care-giver in regular contact, to act as informant and willing and able to participate in intervention. 71% carers were spouses. 488 people with dementia (mean age 77.5were randomised: 268 intervention, 220 control; 350 dyads completed the study (206 intervention, 144 control. The intervention evaluated was joint reminiscence groups (with up to 12 dyads weekly for twelve weeks; monthly maintenance sessions for further seven months. Sessions followed a published treatment manual and were held in a variety of community settings. Two trained facilitators in each centre were supported by volunteers. Primary outcome measures were self-reported quality of life for the person with dementia (QoL-AD, psychological distress for the carer (General Health Questionnaire, GHQ-28. Secondary outcome measures included: autobiographical memory and activities of daily living for the person with dementia; carer stress for the carer; mood, relationship quality and service use and costs for both.The intention to treat analysis (ANCOVA identified no

Maximising value from a United Kingdom Biomedical Research Centre: study protocol.

Science.gov (United States)

Greenhalgh, Trisha; Ovseiko, Pavel V; Fahy, Nick; Shaw, Sara; Kerr, Polly; Rushforth, Alexander D; Channon, Keith M; Kiparoglou, Vasiliki

2017-08-14

Biomedical Research Centres (BRCs) are partnerships between healthcare organisations and universities in England. Their mission is to generate novel treatments, technologies, diagnostics and other interventions that increase the country's international competitiveness, to rapidly translate these innovations into benefits for patients, and to improve efficiency and reduce waste in healthcare. As NIHR Oxford BRC (Oxford BRC) enters its third 5-year funding period, we seek to (1) apply the evidence base on how best to support the various partnerships in this large, multi-stakeholder research system and (2) research how these partnerships play out in a new, ambitious programme of translational research. Organisational case study, informed by the principles of action research. A cross-cutting theme, 'Partnerships for Health, Wealth and Innovation' has been established with multiple sub-themes (drug development, device development, business support and commercialisation, research methodology and statistics, health economics, bioethics, patient and public involvement and engagement, knowledge translation, and education and training) to support individual BRC research themes and generate cross-theme learning. The 'Partnerships' theme will support the BRC's goals by facilitating six types of partnership (with patients and citizens, clinical services, industry, across the NIHR infrastructure, across academic disciplines, and with policymakers and payers) through a range of engagement platforms and activities. We will develop a longitudinal progress narrative centred around exemplar case studies, and apply theoretical models from innovation studies (Triple Helix), sociology of science (Mode 2 knowledge production) and business studies (Value Co-creation). Data sources will be the empirical research studies within individual BRC research themes (who will apply separately for NHS ethics approval), plus documentary analysis and interviews and ethnography with research

Second-Order Controllability of Multi-Agent Systems with Multiple Leaders

International Nuclear Information System (INIS)

Liu Bo; Han Xiao; Shi Yun-Tao; Su Hou-Sheng

2016-01-01

This paper proposes a new second-order continuous-time multi-agent model and analyzes the controllability of second-order multi-agent system with multiple leaders based on the asymmetric topology. This paper considers the more general case: velocity coupling topology is different from location coupling topology. Some sufficient and necessary conditions are presented for the controllability of the system with multiple leaders. In addition, the paper studies the controllability of the system with velocity damping gain. Simulation results are given to illustrate the correctness of theoretical results. (paper)

Theoretical and algorithmic advances in multi-parametric programming and control

KAUST Repository

Pistikopoulos, Efstratios N.; Dominguez, Luis; Panos, Christos; Kouramas, Konstantinos; Chinchuluun, Altannar

2012-01-01

This paper presents an overview of recent theoretical and algorithmic advances, and applications in the areas of multi-parametric programming and explicit/multi-parametric model predictive control (mp-MPC). In multi-parametric programming, advances include areas such as nonlinear multi-parametric programming (mp-NLP), bi-level programming, dynamic programming and global optimization for multi-parametric mixed-integer linear programming problems (mp-MILPs). In multi-parametric/explicit MPC (mp-MPC), advances include areas such as robust multi-parametric control, multi-parametric nonlinear MPC (mp-NMPC) and model reduction in mp-MPC. A comprehensive framework for multi-parametric programming and control is also presented. Recent applications include a hydrogen storage device, a fuel cell power generation system, an unmanned autonomous vehicle (UAV) and a hybrid pressure swing adsorption (PSA) system. © 2012 Springer-Verlag.

Theoretical and algorithmic advances in multi-parametric programming and control

KAUST Repository

Pistikopoulos, Efstratios N.

2012-04-21

This paper presents an overview of recent theoretical and algorithmic advances, and applications in the areas of multi-parametric programming and explicit/multi-parametric model predictive control (mp-MPC). In multi-parametric programming, advances include areas such as nonlinear multi-parametric programming (mp-NLP), bi-level programming, dynamic programming and global optimization for multi-parametric mixed-integer linear programming problems (mp-MILPs). In multi-parametric/explicit MPC (mp-MPC), advances include areas such as robust multi-parametric control, multi-parametric nonlinear MPC (mp-NMPC) and model reduction in mp-MPC. A comprehensive framework for multi-parametric programming and control is also presented. Recent applications include a hydrogen storage device, a fuel cell power generation system, an unmanned autonomous vehicle (UAV) and a hybrid pressure swing adsorption (PSA) system. © 2012 Springer-Verlag.

The impact of a disease management program (COACH on the attainment of better cardiovascular risk control in dyslipidaemic patients at primary care centres (The DISSEMINATE Study: a randomised controlled trial

Directory of Open Access Journals (Sweden)

Selvaraj Francis Jude

2012-10-01

Full Text Available Abstract Background To evaluate the efficacy of Counselling and Advisory Care for Health (COACH programme in managing dyslipidaemia among primary care practices in Malaysia. This open-label, parallel, randomised controlled trial compared the COACH programme delivered by primary care physicians alone (PCP arm and primary care physicians assisted by nurse educators (PCP-NE arm. Methods This was a multi-centre, open label, randomised trial of a disease management programme (COACH among dyslipidaemic patients in 21 Malaysia primary care practices. The participating centres enrolled 297 treatment naïve subjects who had the primary diagnosis of dyslipidaemia; 149 were randomised to the COACH programme delivered by primary care physicians assisted by nurse educators (PCP-NE and 148 to care provided by primary care physicians (PCP alone. The primary efficacy endpoint was the mean percentage change from baseline LDL-C at week 24 between the 2 study arms. Secondary endpoints included mean percentage change from baseline of lipid profile (TC, LDL-C, HDL-C, TG, TC: HDL ratio, Framingham Cardiovascular Health Risk Score and absolute risk change from baseline in blood pressure parameters at week 24. The study also assessed the sustainability of programme efficacy at week 36. Results Both study arms demonstrated improvement in LDL-C from baseline. The least squares (LS mean change from baseline LDL-C were −30.09% and −27.54% for PCP-NE and PCP respectively. The difference in mean change between groups was 2.55% (p=0.288, with a greater change seen in the PCP-NE arm. Similar observations were made between the study groups in relation to total cholesterol change at week 24. Significant difference in percentage change from baseline of HDL-C were observed between the PCP-NE and PCP groups, 3.01%, 95% CI 0.12-5.90, p=0.041, at week 24. There was no significant difference in lipid outcomes between 2 study groups at week 36 (12 weeks after the programme had

A patient-centred team-coaching concept for medical rehabilitation.

Science.gov (United States)

Körner, M; Becker, S; Dinius, J; Müller, C; Zimmermann, L; Rundel, M

2018-01-01

Team coaching enhances teamwork and subsequently improves patient-centredness in medical rehabilitation clinics. Even though interprofessional teamwork is regarded as a crucial factor in medical rehabilitation, to date no evaluated team-coaching approaches are available for improving interprofessional teamwork in medical rehabilitation in Germany. Based on a systematic literature search and interviews with staff, managers, and patients of rehabilitation clinics, we developed a team-coaching approach that is standardized in its process but based on the individual needs and requests of each clinic. It takes a systemic perspective and is goal-oriented and solution-focused. The approach mainly serves to provide impulses to make use of resources within the team and to support a self-directed organisational learning process. It is manualized and can, therefore, be used by professionals aiming to improve interprofessional teamwork in their clinic. A multi-centre, cluster-randomized controlled study that was conducted to evaluate the team-coaching approach showed positive results. Team organization, knowledge integration, and responsibility can be improved, and, therefore, the implementation of the patient-centred team-coaching approach in interprofessional rehabilitation teams can be recommended.

The Effect of Using Assessment Instruments on Substance-abuse Outpatients' Adherence to Treatment: a Multi-centre Randomised Controlled Trial

Directory of Open Access Journals (Sweden)

Broekaert Eric

2011-05-01

Full Text Available Abstract Background Drop-out is an important problem in the treatment of substance use disorder. The focus of this study was to investigate the effectiveness of within treatment assessment with feedback directly to patients with multiple substance use disorder on outpatient individual treatment adherence. Feedback consisted of personal resources' and readiness to change status and progress that facilitate or hinder change, thereby using graphical representation. Methods Informed consent was obtained from both the control and experimental groups to be involved in research and follow-up. Following Zelen's single consent design, baseline participants (n = 280 were randomised (sample-size-estimation: 80%power, p=.05, 2-sided and treatment consent was obtained from those allocated to the experiment (n = 142. In both groups, equal numbers of patients did not attend sessions after allocation. So, 227 persons were analyzed according to intention-to-treat analysis (ITT: experiment n = 116;control n = 111. Excluding refusals 211 participants remained for per-protocol analysis (PP: experiment n = 100; control n = 111, The study was conducted in five outpatient treatment-centres of a large network (De Sleutel in Belgium. Participants were people with multiple substance use disorder -abuse and dependence- who had asked for treatment and who had been advised to start individual treatment after a standardised admission assessment with the European Addiction Severity Index. The experimental condition consisted of informing the patient about the intervention and of subsequent assessments plus feedback following a protocol within the first seven sessions. Assessments were made with the Readiness to Change Questionnaire and the Personal Resources Diagnostic System. The control group received the usual treatment without within treatment assessment with feedback. The most important outcome measure in this analysis of the study was the level of adherence to treatment

Delay-based virtual congestion control in multi-tenant datacenters

Science.gov (United States)

Liu, Yuxin; Zhu, Danhong; Zhang, Dong

2018-03-01

With the evolution of cloud computing and virtualization, the congestion control of virtual datacenters has become the basic issue for multi-tenant datacenters transmission. Regarding to the friendly conflict of heterogeneous congestion control among multi-tenant, this paper proposes a delay-based virtual congestion control, which translates the multi-tenant heterogeneous congestion control into delay-based feedback uniformly by setting the hypervisor translation layer, modifying three-way handshake of explicit feedback and packet loss feedback and throttling receive window. The simulation results show that the delay-based virtual congestion control can effectively solve the unfairness of heterogeneous feedback congestion control algorithms.

Gabapentin in traumatic nerve injury pain: A randomized, double-blind, placebo-controlled, cross-over, multi-center study

DEFF Research Database (Denmark)

Gordh, Torsten E; Stubhaug, Audun; Jensen, Troels S

2008-01-01

A double-blind, randomized, placebo-controlled cross-over multi-center study was conducted to evaluate the efficacy and safety of gabapentin in the treatment of neuropathic pain caused by traumatic or postsurgical peripheral nerve injury, using doses up to 2400mg/day. The study comprised a run...

Multi-Objective Nonlinear Model Predictive Control: Lexicographic Method

OpenAIRE

Zheng, Tao; Wu, Gang; Liu, Guang-Hong; Ling, Qing

2010-01-01

In this chapter, to avoid the disadvantages of weight coefficients in multi-objective dynamic optimization, lexicographic (completely stratified) and partially stratified frameworks of multi-objective controller are proposed. The lexicographic framework is absolutely prioritydriven and the partially stratified framework is a modification of it, they both can solve the multi-objective control problem with the concept of priority for objective’s relative importance, while the latter one is mo...

Organization of Multi-controller Interaction in Software Defined Networks

Directory of Open Access Journals (Sweden)

Sergey V. Morzhov

2018-01-01

Full Text Available Software Defined Networking (SDN is a promising paradigm for network management. It is a centralized network intelligence on a dedicated server, which runs network operating system, and is called SDN controller. It was assumed that such an architecture should have an improved network performance and monitoring. However, the centralized control architecture of the SDNs brings novel challenges to reliability, scalability, fault tolerance and interoperability. These problems are especially acute for large data center networks and can be solved by combining SDN controllers into clusters, called multi-controllers. Multi-controller architecture became very important for SDN-enabled networks nowadays. This paper gives a comprehensive overview of SDN multi-controller architectures. The authors review several most popular distributed controllers in order to indicate their strengths and weaknesses. They also investigate and classify approaches used. This paper explains in details the difference among various types of multi-controller architectures, the distribution method and the communication system. Furthermore, it provides already implemented architectures and some examples of architectures under consideration by describing their design, communication process, and performance results. In this paper, the authors show their own classification of multi-controllers and claim that, despite the existence of undeniable advantages, all reviewed controllers have serious drawbacks, which must be eliminated. These drawbacks hamper the development of multi-controllers and their widespread adoption in corporate networks. In the end, the authors conclude that now it is impossible to find a solution capable to solve all the tasks assigned to it adequately and fully. The article is published in the authors’ wording.

Integrated control centre concepts for CANDU power plants

International Nuclear Information System (INIS)

Lupton, L.R.; Davey, E.C.; Lapointe, P.A.; Shah, R.R.

1990-01-01

The size and complexity of nuclear power plants has increased significantly in the last 20 years. There is general agreement that plant safety and power production can be enhanced if more operational support systems that are significantly different from the ones based on the more conventional technologies used in plant control rooms. In particular, artificial intelligence and related technologies will play a major role in the development of innovative methods for information processing and presentation. These technologies must be integrated into the overall management and control philosophy of the plant and not be treated as vehicles to implement point solutions. The underlying philosophy behind our approach is discussed in this paper. Operator support systems will integrate into the overall control philosophy by complementing the operator. Four support systems are described; each is a prototype of a system being considered for the CANDU 3 control centre

Integrated control centre concepts for CANDU power plants

Energy Technology Data Exchange (ETDEWEB)

Lupton, L. R.; Davey, E. C.; Lapointe, P. A.; Shah, R. R.

1990-01-15

The size and complexity of nuclear power plants has increased significantly in the last 20 years. There is general agreement that plant safety and power production can be enhanced if more operational support systems that are significantly different from the ones based on the more conventional technologies used in plant control rooms. In particular, artificial intelligence and related technologies will play a major role in the development of innovative methods for information processing and presentation. These technologies must be integrated into the overall management and control philosophy of the plant and not be treated as vehicles to implement point solutions. The underlying philosophy behind our approach is discussed in this paper. Operator support systems will integrate into the overall control philosophy by complementing the operator. Four support systems are described; each is a prototype of a system being considered for the CANDU 3 control centre.

Health status of children with cerebral palsy living in Europe: a multi-centre study

DEFF Research Database (Denmark)

Beckung, E; White-Koning, M; Marcelli, M

2008-01-01

AIM: The aim of this report is to describe the health status of 8-12-year-old children with cerebral palsy (CP) of all severities in Europe using the Child Health Questionnaire (CHQ). METHOD: A total of 818 children with CP from nine centres in defined geographical areas participated. CP type...

Person-centred care during prolonged weaning from mechanical ventilation, nurses' views: an interview study.

Science.gov (United States)

Cederwall, Carl-Johan; Olausson, Sepideh; Rose, Louise; Naredi, Silvana; Ringdal, Mona

2018-03-19

To determine: 1) if the three elements of person-centred care (initiating, working and safeguarding the partnership) were present, and 2) to identify evidence of barriers to person-centred care during prolonged weaning from mechanical ventilation. Secondary analysis of semi structured interviews with 19 critical care nurses using theoretical thematic analysis. This study was conducted in three Swedish intensive care units, one in a regional hospital and two in a university hospital. Three themes and nine subthemes related to person-centred care were identified. The three themes included: 1) 'finding a person behind the patient' related to the 'initiating the partnership' phase, 2) 'striving to restore patient́s sense of control' related to 'working the partnership' phase and 3) 'impact of patient involvement' related to 'safeguarding the partnership' phase of person-centred care'. Additionally a further theme 'barriers to person-centred care' was identified. We found evidence of all three person-centred care routines. Barriers to person-centred care comprised of lack team collaboration and resources. Facilitating patients to actively participate in decision-making during the weaning process may optimise weaning outcomes and warrants further research. Copyright © 2017 Elsevier Ltd. All rights reserved.

Robust multi-model predictive control of multi-zone thermal plate system

Directory of Open Access Journals (Sweden)

Poom Jatunitanon

2018-02-01

Full Text Available A modern controller was designed by using the mathematical model of a multi–zone thermal plate system. An important requirement for this type of controller is that it must be able to keep the temperature set-point of each thermal zone. The mathematical model used in the design was determined through a system identification process. The results showed that when the operating condition is changed, the performance of the controller may be reduced as a result of the system parameter uncertainties. This paper proposes a weighting technique of combining the robust model predictive controller for each operating condition into a single robust multi-model predictive control. Simulation and experimental results showed that the proposed method performed better than the conventional multi-model predictive control in rise time of transient response, when used in a system designed to work over a wide range of operating conditions.

Allocation of substance use disorder patients to appropriate levels of care: feasibility of matching guidelines in routine practice in Dutch treatment centres

NARCIS (Netherlands)

Merkx, Maarten J. M.; Schippers, Gerard M.; Koeter, Maarten J. W.; Vuijk, Pieter Jelle; Oudejans, Suzan; de Vries, Carlijn C. Q.; van den Brink, Wim

2007-01-01

AIMS: To examine the feasibility of implementing evidence-based guidelines for patient-treatment-matching to levels of care in two Dutch substance abuse treatment centres. DESIGN: Multi-centre observational follow-up study. SETTING: Two large substance abuse treatment centres (SATCs). PARTICIPANTS:

Control method for multi-input multi-output non-Gaussian random vibration test with cross spectra consideration

Directory of Open Access Journals (Sweden)

Ronghui ZHENG

2017-12-01

Full Text Available A control method for Multi-Input Multi-Output (MIMO non-Gaussian random vibration test with cross spectra consideration is proposed in the paper. The aim of the proposed control method is to replicate the specified references composed of auto spectral densities, cross spectral densities and kurtoses on the test article in the laboratory. It is found that the cross spectral densities will bring intractable coupling problems and induce difficulty for the control of the multi-output kurtoses. Hence, a sequential phase modification method is put forward to solve the coupling problems in multi-input multi-output non-Gaussian random vibration test. To achieve the specified responses, an improved zero memory nonlinear transformation is utilized first to modify the Fourier phases of the signals with sequential phase modification method to obtain one frame reference response signals which satisfy the reference spectra and reference kurtoses. Then, an inverse system method is used in frequency domain to obtain the continuous stationary drive signals. At the same time, the matrix power control algorithm is utilized to control the spectra and kurtoses of the response signals further. At the end of the paper, a simulation example with a cantilever beam and a vibration shaker test are implemented and the results support the proposed method very well. Keywords: Cross spectra, Kurtosis control, Multi-input multi-output, Non-Gaussian, Random vibration test

A designated centre for people with disabilities operated by Sunbeam House Services Ltd, Wicklow

LENUS (Irish Health Repository)

Muller, Ueli C

2011-04-07

Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit\\/hyperactivity disorder (ADHD-CT) and 1446 \\'unselected\\' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners\\' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband\\/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

Physical activity and asthma: A longitudinal and multi-country study.

Science.gov (United States)

Russell, Melissa A; Janson, Christer; Real, Francisco Gómez; Johannessen, Ane; Waatevik, Marie; Benediktsdóttir, Bryndis; Holm, Mathias; Lindberg, Eva; Schlünssen, Vivi; Raza, Wasif; Dharmage, Shyamali C; Svanes, Cecilie

2017-11-01

To investigate the impact of physical activity on asthma in middle-aged adults, in one longitudinal analysis, and one multi-centre cross-sectional analysis. The Respiratory Health in Northern Europe (RHINE) is a population-based postal questionnaire cohort study. Physical activity, height and weight were self-reported in Bergen, Norway, at RHINE II (1999-2001) and all centres at RHINE III (2010-2012). A longitudinal analysis of Bergen data investigated the association of baseline physical activity with follow-up asthma, incident asthma and symptoms, using logistic and zero-inflated Poisson regression (n = 1782). A cross-sectional analysis of all RHINE III centres investigated the association of physical activity with concurrent asthma and symptoms (n = 13,542) using mixed-effects models. Body mass index (BMI) was categorised (asthma (odds ratio [OR] 0.44, 95% confidence interval [CI] 0.22, 0.89), whilst an effect from undertaking vigorous activity 3+ times/week was not detected (OR 1.22, 95% CI 0.44, 2.76). The associations were attenuated with BMI adjustment. In the all-centre cross-sectional analysis an interaction was found, with the association between physical activity and asthma varying across BMI categories. These findings suggest potential longer-term benefit from lighter physical activity, whilst improvement in asthma outcomes from increasing activity intensity was not evident. Additionally, it appears the benefit from physical activity may differ according to BMI.

Control of multi-machine using adaptive fuzzy

Directory of Open Access Journals (Sweden)

Bouchiba Bousmaha

2011-01-01

Full Text Available An indirect Adaptive fuzzy excitation control (IAFLC of power systems based on multi-input-multi-output linearization technique is developed in this paper. The power system considered in this paper consists of two generators and infinite bus connected through a network of transformers and transmission lines. The fuzzy controller is constructed from fuzzy feedback linearization controller whose parameters are adjusted indirectly from the estimates of plant parameters. The adaptation law adjusts the controller parameters on-line so that the plant output tracks the reference model output. Simulation results shown that the proposed controller IAFLC, compared with a controller based on tradition linearization technique can enhance the transient stability of the power system.

Manche storage Centre. Information report on nuclear safety and radiation protection 2014. Annual report 2014

International Nuclear Information System (INIS)

2015-06-01

After a presentation of the Manche Storage Centre (CSM), the first French centre of surface storage of weakly and moderately radioactive wastes, of its history, its buildings and activities, of the multi-layer cover, of the water management system (installation, controls, sampling), this report then describes the measures related to nuclear safety (principles and objectives), the management of conventional and nuclear wastes produced by the Centre and its other environmental impacts. The follow up of the installations and of their effluents and releases are then addressed: origin, locations and results of radiological controls of rainfalls, of risky effluents, of underground waters, of rivers, impacts of the Centre on its environment (releases in the sea, in rivers, in sediments). The measures related to radiation protection are described: principles, staff dosimetry, and personnel safety. The next part presents the nuclear event scale (INES) and indicates that no incident occurred in 2014. Finally the actions related to public information and transparency are summarized. Recommendations of the CHSCT are reported at the end

Potential of Natural Ventilation in Shopping Centres

DEFF Research Database (Denmark)

Diederichsen, Alice; Friis, Kristina; Brohus, Henrik

2008-01-01

The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV) in shop......The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV......) in shopping centres with focus on both the achieved IEQ and energy consumptions for air movement. By thermal building simulations it is found that there exists an interesting potential for hybrid ventilation of shopping centres, which can lead to great savings in the electrical energy consumptions...

Virtual patients design and its effect on clinical reasoning and student experience: a protocol for a randomised factorial multi-centre study

Directory of Open Access Journals (Sweden)

Bateman James

2012-08-01

Full Text Available Abstract Background Virtual Patients (VPs are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent and structured clinical reasoning feedback (present or absent. Methods/Design This is a multi-centre randomised 2x2 factorial design study evaluating two independent variables of VP design, branching (present or absent, and structured clinical reasoning feedback (present or absent.The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded. In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for

An investigation into the organisation and structural design of multi-computer process-control systems

International Nuclear Information System (INIS)

Gertenbach, W.P.

1981-12-01

A multi-computer system for the collection of data and control of distributed processes has been developed. The structure and organisation of this system, a study of the general theory of systems and of modularity was used as a basis for an investigation into the organisation and structured design of multi-computer process-control systems. A multi-dimensional model of multi-computer process-control systems was developed. In this model a strict separation was made between organisational properties of multi-computer process-control systems and implementation dependant properties. The model was based on the principles of hierarchical analysis and modularity. Several notions of hierarchy were found necessary to describe fully the organisation of multi-computer systems. A new concept, that of interconnection abstraction was identified. This concept is an extrapolation of implementation techniques in the hardware implementation area to the software implementation area. A synthesis procedure which relies heavily on the above described analysis of multi-computer process-control systems is proposed. The above mentioned model, and a set of performance factors which depend on a set of identified design criteria, were used to constrain the set of possible solutions to the multi-computer process-control system synthesis-procedure

A multi-centre cohort study shows no association between experienced violence and labour dystocia in nulliparous women at term

Directory of Open Access Journals (Sweden)

Dykes Anna-Karin

2011-02-01

Full Text Available Abstract Background Although both labour dystocia and domestic violence during pregnancy are associated with adverse maternal and fetal outcome, evidence in support of a possible association between experiences of domestic violence and labour dystocia is sparse. The aim of this study was to investigate whether self-reported history of violence or experienced violence during pregnancy is associated with increased risk of labour dystocia in nulliparous women at term. Methods A population-based multi-centre cohort study. A self-administrated questionnaire collected at 37 weeks of gestation from nine obstetric departments in Denmark. The total cohort comprised 2652 nulliparous women, among whom 985 (37.1% met the protocol criteria for dystocia. Results Among the total cohort, 940 (35.4% women reported experience of violence, and among these, 66 (2.5% women reported exposure to violence during their first pregnancy. Further, 39.5% (n = 26 of those had never been exposed to violence before. Univariate logistic regression analysis showed no association between history of violence or experienced violence during pregnancy and labour dystocia at term, crude OR 0.91, 95% CI (0.77-1.08, OR 0.90, 95% CI (0.54-1.50, respectively. However, violence exposed women consuming alcoholic beverages during late pregnancy had increased odds of labour dystocia, crude OR 1.45, 95% CI (1.07-1.96. Conclusions Our findings indicate that nulliparous women who have a history of violence or experienced violence during pregnancy do not appear to have a higher risk of labour dystocia at term, according to the definition of labour dystocia in this study. Additional research on this topic would be beneficial, including further evaluation of the criteria for labour dystocia.

An Operational Event Announcer for the LHC Control Centre Using Speech Synthesis

CERN Document Server

Page, S

2011-01-01

The LHC Island of the CERN Control Centre is a busy working environment with many status displays and running software applications. An audible event announcer was developed in order to provide a simple and efficient method to notify the operations team of events occurring within the many subsystems of the accelerator. The LHC Announcer uses speech synthesis to report messages based upon data received from multiple sources. General accelerator information such as injections, beam energies and beam dumps are derived from data received from the LHC Timing System. Additionally, a software interface is provided that allows other surveillance processes to send messages to the Announcer using the standard control system middleware. Events are divided into categories which the user can enable or disable depending upon their interest. Use of the LHC Announcer is not limited to the Control Centre and is intended to be available to a wide audience, both inside and outside CERN. To accommodate this, it...

Multi-criteria decision making approaches for quality control of genome-wide association studies.

Science.gov (United States)

Malovini, Alberto; Rognoni, Carla; Puca, Annibale; Bellazzi, Riccardo

2009-03-01

Experimental errors in the genotyping phases of a Genome-Wide Association Study (GWAS) can lead to false positive findings and to spurious associations. An appropriate quality control phase could minimize the effects of this kind of errors. Several filtering criteria can be used to perform quality control. Currently, no formal methods have been proposed for taking into account at the same time these criteria and the experimenter's preferences. In this paper we propose two strategies for setting appropriate genotyping rate thresholds for GWAS quality control. These two approaches are based on the Multi-Criteria Decision Making theory. We have applied our method on a real dataset composed by 734 individuals affected by Arterial Hypertension (AH) and 486 nonagenarians without history of AH. The proposed strategies appear to deal with GWAS quality control in a sound way, as they lead to rationalize and make explicit the experimenter's choices thus providing more reproducible results.

The effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc lactate on the microflora of oral halitosis patients : a dual-centre, double-blind placebo-controlled study

NARCIS (Netherlands)

Roldan, S; Winkel, EG; Herrera, D; Sanz, M; Van Winkelhoff, AJ

Aim: This study evaluated the microbial effects of a newly formulated mouthwash (Halita((R)) ) on oral halitosis patients. Methods: Forty subjects were included in this dual-centre, double-blind, placebo-controlled parallel study. Inclusion and exclusion criteria were used to select patients. At

Characterization and optimized control by means of multi-parameter controllers

Energy Technology Data Exchange (ETDEWEB)

Nielsen, Carsten; Hoeg, S.; Thoegersen, A. (Dan-Ejendomme, Hellerup (Denmark)) (and others)

2009-07-01

Poorly functioning HVAC systems (Heating, Ventilation and Air Conditioning), but also separate heating, ventilation and air conditioning systems are costing the Danish society billions of kroner every year: partly because of increased energy consumption and high operational and maintenance costs, but mainly due to reduced productivity and absence due to illness because of a poor indoor climate. Typically, the operation of buildings and installations takes place today with traditional build-ing automation, which is characterised by 1) being based on static considerations 2) the individual sensor being coupled with one actuator/valve, i.e. the sensor's signal is only used in one place in the system 3) subsystems often being controlled independently of each other 4) the dynamics in building constructions and systems which is very important to the system and comfort regulation is not being considered. This, coupled with the widespread tendency to use large glass areas in the facades without sufficient sun shading, means that it is difficult to optimise comfort and energy consumption. Therefore, the last 10-20 years have seen a steady increase in the complaints of the indoor climate in Danish buildings and, at the same time, new buildings often turn out to be considerably higher energy consuming than expected. The purpose of the present project is to investigate the type of multi parameter sensors which may be generated for buildings and further to carry out a preliminary evaluation on how such multi parameter controllers may be utilized for optimal control of buildings. The aim of the project isn't to develop multi parameter controllers - this requires much more effort than possible in the present project. The aim is to show the potential of using multi parameter sensors when controlling buildings. For this purpose a larger office building has been chosen - an office building with at high energy demand and complaints regarding the indoor climate. In order to

Manche centre

International Nuclear Information System (INIS)

1997-05-01

After a general presentation of radioactivity and radioactive wastes and of the French national agency for the management of radioactive wastes (ANDRA), this brochure gives a general overview of the Manche low- and medium-level radioactive waste disposal centre: principles of storage safety, waste containers (first confinement barrier), storage facility and cover (second confinement barrier), the underground (third confinement barrier), the impact of the centre on its environment, and the control of radioactivity in the vicinity of the centre. (J.S.)

A multi-channel humidity control system based on LabVIEW

International Nuclear Information System (INIS)

Zhang Aiwu; Xie Yuguang; Liu Hongbang; Liu Yingbiao; Cai Xiao; Yu Boxiang; Lu Junguang; Zhou Li

2011-01-01

A real time multi-channel humidity control system was designed based on LabVIEW, using the dry air branch of BESⅢ drying system. The hardware of this control system consist of mini humidity and temperature sensors, intelligent collection module, switch quantity controller and electromagnetic valves. The humidity can be controlled at arbitrary value from air humidity to 3% with accuracy better than 2%. Multi microenvironment with different humidity can be easily controlled and monitored in real time by this system. It can also be extended to hybrid control of multi channel humidity and temperature. (authors)

The importance of dietary change for men diagnosed with and at risk of prostate cancer: a multi-centre interview study with men, their partners and health professionals.

Science.gov (United States)

Avery, Kerry N L; Donovan, Jenny L; Horwood, Jeremy; Neal, David E; Hamdy, Freddie C; Parker, Chris; Wade, Julia; Lane, Athene

2014-05-03

The diagnosis of prostate cancer (PC) can provide a trigger for dietary change, and there is evidence that healthier diets may improve quality of life and clinical outcomes. However, men's views about dietary change in PC survivorship are largely unknown. This multi-centre qualitative interview study explored men's views about dietary change in PC survivorship, to better understand motivations for, and barriers to, achieving desired changes. The role of radical and active surveillance treatments on dietary change and the influence of men's partners were examined. Focus groups also evaluated stakeholder opinion, including healthcare professionals, about the provision of dietary advice to PC patients. A multi-centre interview study explored views about diet and motivations for, and barriers to, dietary change in men at elevated risk or diagnosed with PC following prostate specific antigen (PSA) testing. 58 men and 11 partners were interviewed. Interviews and focus groups were undertaken with 11 healthcare professionals, 5 patients and 4 partners to evaluate stakeholders' opinions about the feasibility and acceptability of providing dietary advice to PC patients. Data were analysed using methods of constant comparison and thematic analysis. Over half of diagnosed men reported making dietary changes, primarily to promote general or prostate health or facilitate coping, despite their uncertainty about diet-PC links. Interest in dietary advice was high. Information needs varied depending on treatment received, with men on active surveillance more frequently modifying their diet and regarding this as an adjunct therapy. Men considered their partners integral to implementing changes. Provision of dietary advice to men diagnosed with PC was considered by healthcare professionals and men to be feasible and appropriate in the context of a holistic 'care package'. Many men make positive dietary changes after PC diagnosis, which are perceived by men and their partners to bring

ASAP ECMO: Antibiotic, Sedative and Analgesic Pharmacokinetics during Extracorporeal Membrane Oxygenation: a multi-centre study to optimise drug therapy during ECMO

Directory of Open Access Journals (Sweden)

Shekar Kiran

2012-11-01

Full Text Available Abstract Background Given the expanding scope of extracorporeal membrane oxygenation (ECMO and its variable impact on drug pharmacokinetics as observed in neonatal studies, it is imperative that the effects of the device on the drugs commonly prescribed in the intensive care unit (ICU are further investigated. Currently, there are no data to confirm the appropriateness of standard drug dosing in adult patients on ECMO. Ineffective drug regimens in these critically ill patients can seriously worsen patient outcomes. This study was designed to describe the pharmacokinetics of the commonly used antibiotic, analgesic and sedative drugs in adult patients receiving ECMO. Methods/Design This is a multi-centre, open-label, descriptive pharmacokinetic (PK study. Eligible patients will be adults treated with ECMO for severe cardiac and/or respiratory failure at five Intensive Care Units in Australia and New Zealand. Patients will receive the study drugs as part of their routine management. Blood samples will be taken from indwelling catheters to investigate plasma concentrations of several antibiotics (ceftriaxone, meropenem, vancomycin, ciprofloxacin, gentamicin, piperacillin-tazobactum, ticarcillin-clavulunate, linezolid, fluconazole, voriconazole, caspofungin, oseltamivir, sedatives and analgesics (midazolam, morphine, fentanyl, propofol, dexmedetomidine, thiopentone. The PK of each drug will be characterised to determine the variability of PK in these patients and to develop dosing guidelines for prescription during ECMO. Discussion The evidence-based dosing algorithms generated from this analysis can be evaluated in later clinical studies. This knowledge is vitally important for optimising pharmacotherapy in these most severely ill patients to maximise the opportunity for therapeutic success and minimise the risk of therapeutic failure. Trial registration ACTRN12612000559819

Evaluating implementation of a fire-prevention injury prevention briefing in children's centres: Cluster randomised controlled trial.

Directory of Open Access Journals (Sweden)

Toity Deave

Full Text Available Many developed countries have high mortality rates for fire-related deaths in children aged 0-14 years with steep social gradients. Evidence-based interventions to promote fire safety practices exist, but the impact of implementing a range of these interventions in children's services has not been assessed. We developed an Injury Prevention Briefing (IPB, which brought together evidence about effective fire safety interventions and good practice in delivering interventions; plus training and facilitation to support its use and evaluated its implementation.We conducted a cluster randomised controlled trial, with integrated qualitative and cost-effectiveness nested studies, across four study sites in England involving children's centres in disadvantaged areas; participants were staff and families attending those centres. Centres were stratified by study site and randomised within strata to one of three arms: IPB plus facilitation (IPB+, IPB only, usual care. IPB+ centres received initial training and facilitation at months 1, 3, and 8. Baseline data from children's centres were collected between August 2011 and January 2012 and follow-up data were collected between June 2012 and June 2013. Parent baseline data were collected between January 2012 and May 2012 and follow-up data between May 2013 and September 2013. Data comprised baseline and 12 month parent- and staff-completed questionnaires, facilitation contact data, activity logs and staff interviews. The primary outcome was whether families had a plan for escaping from a house fire. Treatment arms were compared using multilevel models to account for clustering by children's centre.1112 parents at 36 children's centres participated. There was no significant effect of the intervention on families' possession of plans for escaping from a house fire (adjusted odds ratio (AOR IPB only vs. usual care: 0.93, 95%CI 0.58, 1.49; AOR IPB+ vs. usual care 1.41, 95%CI 0.91, 2.20. However, significantly more

A randomised controlled trial of oxytocin 5IU and placebo infusion versus oxytocin 5IU and 30IU infusion for the control of blood loss at elective caesarean section--pilot study. ISRCTN 40302163.

LENUS (Irish Health Repository)

Murphy, Deirdre J

2012-02-01

OBJECTIVE: To compare the blood loss at elective lower segment caesarean section with administration of oxytocin 5IU bolus versus oxytocin 5IU bolus and oxytocin 30IU infusion and to establish whether a large multi-centre trial is feasible. STUDY DESIGN: Women booked for an elective caesarean section were recruited to a pilot randomised controlled trial and randomised to either oxytocin 5IU bolus and placebo infusion or oxytocin 5IU bolus and oxytocin 30IU infusion. We wished to establish whether the study design was feasible and acceptable and to establish sample size estimates for a definitive multi-centre trial. The outcome measures were total estimated blood loss at caesarean section and in the immediate postpartum period and the need for an additional uterotonic agent. RESULTS: A total of 115 women were randomised and 110 were suitable for analysis (5 protocol violations). Despite strict exclusion criteria 84% of the target population were considered eligible for study participation and of those approached only 15% declined to participate and 11% delivered prior to the planned date. The total mean estimated blood loss was lower in the oxytocin infusion arm compared to placebo (567 ml versus 624 ml) and fewer women had a major haemorrhage (>1000 ml, 14% versus 17%) or required an additional uterotonic agent (5% versus 11%). A sample size of 1500 in each arm would be required to demonstrate a 3% absolute reduction in major haemorrhage (from baseline 10%) with >80% power. CONCLUSION: An additional oxytocin infusion at elective caesarean section may reduce blood loss and warrants evaluation in a large multi-centre trial.

Cities as command and control centres of the world economy: An empirical analysis, 2006–2015

Directory of Open Access Journals (Sweden)

Csomós György

2017-12-01

Full Text Available As a result of their rapid economic growth, several powerful corporate giants have emerged in developing countries, especially in China, operating not only in the traditional manufacturing sector, but also in high-tech industries and finance. Major cities in developing countries have gradually become important command and control centres of the global economy, and have also become powerful enough to be in the same tier as major cities of developed countries around the world. In this paper, I examine the position of cities as command and control centres on the basis of the power of their headquartered corporations. The result shows that until 2012, New York, London, Tokyo, and Paris; i.e. the global cities, were the leading command and control centres. However, the gap between these global cities and Beijing gradually closed, and by 2015, the Chinese capital outranked all the global cities. The outstanding performance of Beijing-based corporations that operate in financial, energy, and construction services sectors is the driving force behind Beijing’s increasing global power. In addition, the leading position of the global cities as command and control centres has been threatened by the San Francisco-San Jose metropolitan region, a newly emerging economic hub in the United States.

Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study: a randomized clinical trial.

Science.gov (United States)

Ephraim, Patti L; Hill-Briggs, Felicia; Roter, Debra L; Bone, Lee R; Wolff, Jennifer L; Lewis-Boyer, LaPricia; Levine, David M; Aboumatar, Hanan J; Cooper, Lisa A; Fitzpatrick, Stephanie J; Gudzune, Kimberly A; Albert, Michael C; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary J; Fagan, Peter J; Ramamurthi, Hema C; Ameling, Jessica M; Charlston, Jeanne; Sam, Tanyka S; Carson, Kathryn A; Wang, Nae-Yuh; Crews, Deidra C; Greer, Raquel C; Sneed, Valerie; Flynn, Sarah J; DePasquale, Nicole; Boulware, L Ebony

2014-07-01

Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses. However, studies of multi-level interventions designed specifically to improve urban African American patients' blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients' improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients' blood pressure control at 12months. Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients' hypertension control. Copyright © 2014 Elsevier Inc. All rights reserved.

FY1995 distributed control of man-machine cooperative multi agent systems; 1995 nendo ningen kyochogata multi agent kikai system no jiritsu seigyo

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-03-01

In the near future, distributed autonomous systems will be practical in many situations, e.g., interactive production systems, hazardous environments, nursing homes, and individual houses. The agents which consist of the distributed system must not give damages to human being and should be working economically. In this project man-machine cooperative multi agent systems are studied in many kind of respects, and basic design technology, basic control technique are developed by establishing fundamental theories and by constructing experimental systems. In this project theoretical and experimental studies are conducted in the following sub-projects: (1) Distributed cooperative control in multi agent type actuation systems (2) Control of non-holonomic systems (3) Man-machine Cooperative systems (4) Robot systems learning human skills (5) Robust force control of constrained systems In each sub-project cooperative nature between machine agent systems and human being, interference between artificial multi agents and environment and new function emergence in coordination of the multi agents and the environment, robust force control against for the environments, control methods for non-holonomic systems, robot systems which can mimic and learn human skills were studied. In each sub-project, some problems were hi-lighted and solutions for the problems have been given based on construction of experimental systems. (NEDO)

Asymptomatic population reference values for three knee patient-reported outcomes measures: evaluation of an electronic data collection system and implications for future international, multi-centre cohort studies.

Science.gov (United States)

McLean, James M; Brumby-Rendell, Oscar; Lisle, Ryan; Brazier, Jacob; Dunn, Kieran; Gill, Tiffany; Hill, Catherine L; Mandziak, Daniel; Leith, Jordan

2018-05-01

The aim was to assess whether the Knee Society Score, Oxford Knee Score (OKS) and Knee Injury and Osteoarthritis Outcome Score (KOOS) were comparable in asymptomatic, healthy, individuals of different age, gender and ethnicity, across two remote continents. The purpose of this study was to establish normal population values for these scores using an electronic data collection system. There is no difference in clinical knee scores in an asymptomatic population when comparing age, gender and ethnicity, across two remote continents. 312 Australian and 314 Canadian citizens, aged 18-94 years, with no active knee pain, injury or pathology in the ipsilateral knee corresponding to their dominant arm, were evaluated. A knee examination was performed and participants completed an electronically administered questionnaire covering the subjective components of the knee scores. The cohorts were age- and gender-matched. Chi-square tests, Fisher's exact test and Poisson regression models were used where appropriate, to investigate the association between knee scores, age, gender, ethnicity and nationality. There was a significant inverse relationship between age and all assessment tools. OKS recorded a significant difference between gender with females scoring on average 1% lower score. There was no significant difference between international cohorts when comparing all assessment tools. An electronic, multi-centre data collection system can be effectively utilized to assess remote international cohorts. Differences in gender, age, ethnicity and nationality should be taken into consideration when using knee scores to compare to pathological patient scores. This study has established an electronic, normal control group for future studies using the Knee society, Oxford, and KOOS knee scores. Diagnostic Level II.

Integrated control centre: Trading system for operation in a deregulated power market

International Nuclear Information System (INIS)

Nyland, S.; Reinertsen, T.; Gunnestad, J.; Botnan, G.O.

1995-01-01

The paper presents a trade system for operation in a deregulated power market. The trade system (ICC-Trade) is one of the application programs in the Integrated Control Centre (ICC). The Norwegian deregulated power market is briefly described in order to discuss the consequences of the new power market for the power utilities. The paper will also deal with the interconnection to other ICC application programs and how to make use of the communication with SCADA systems for support of managing market activities. Finally some future developments are presented. The trade system is developed in cooperation between a research institute, vendors of control centres, and power utilities, and is planned to be a commercial product during the spring of 1995. Before release the product will be tested in real life by a pilot customer. 4 figs

The Australian centre for RF bioeffects research (ACRBR) - an NHMRC centre of research excellence

International Nuclear Information System (INIS)

Wood, A.; Croft, R.; Abramson, M.; Anderson, V.; Cosic, I.; Finnie, J.; McKenzie, R.

2004-01-01

Full text: The Australian Centre for Radiofrequency Bioeffects Research (ACRBR) is a newly established multi-institutional research centre which seeks to research questions pertaining to possible health effects of exposure to radiofrequency devices, such as mobile phones and which is funded under the Australian National Health and Medical Research Council (NHMRC) Centres of Research Excellence funding program. The Centre of Research Excellence in Electromagnetic Energy is combining the efforts of engineers, epidemiologists, physicists, psychophysiologists and veterinary pathologists from RMIT University, the Institute of Medical and Veterinary Science in South Australia (IMVS), Monash University, Swinburne University of Technology and Telstra Research Laboratories (TRL). The centre is funded at $2.5 M over five years and will undertake a program of research to address the issue of exposure to radiofrequency (RF) devices and health. It will also train new scientists, keep the community informed of ongoing developments and help the development of government policies in this area of considerable public concern. The 5-year program has the following components: Neurobiology: One important area where there is a perceived research gap is in the area of potential neurological effects, which will hence be a major focus of this Centre. The proposed studies range from in vitro and in vivo research studies of RF effects on neuron and neural system functioning in rodents, to that of RF effects on simple neural function, cognition and subjective report in humans. The latter series of studies have been developed to account for the consensus view that more emphasis needs to be placed on possible differences in RF population sensitivity (e.g. youth versus aged, and ' electromagnetic hypersensitives'). Epidemiological studies are an important tool in studying the impact on public health from exposure of whole populations to modern radio technologies. Cancer outcomes in this area of

DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic.

Science.gov (United States)

Roberts, Jason A; De Waele, Jan J; Dimopoulos, George; Koulenti, Despoina; Martin, Claude; Montravers, Philippe; Rello, Jordi; Rhodes, Andrew; Starr, Therese; Wallis, Steven C; Lipman, Jeffrey

2012-07-06

The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals) on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study) is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs) will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.

Demand controlled ventilation for multi-family dwellings

DEFF Research Database (Denmark)

Mortensen, Dorthe Kragsig

for centrally balanced DCV systems with heat recovery. A design expected to fulfill this requirement was investigated in detail with regard to its electricity consumption by evaluating a control strategy that resets the static pressure set point at part load. The results showed that this control strategy can......The present thesis “Demand controlled ventilation for multi-family dwellings” constitutes the summary of a three year project period during which demand specification and system design of demand controlled ventilation for residential buildings were studied. Most standards and buildings codes...... can be reduced compared to a system with constant air flow. A literature study on indoor pollutants in homes, their sources and their impact on humans formed the basis for the demand specification. Emission of pollutants in residential buildings roughly fall into constantly emitted background sources...

A multi-centre cohort study evaluating the role of inflammatory markers in patient’s presenting with acute ureteric colic (MIMIC

Directory of Open Access Journals (Sweden)

T.T. Shah

Full Text Available Background: Spontaneous Stone Passage (SSP rates in acute ureteric colic range from 47 to 75%. There is conflicting evidence on the role of raised inflammatory markers in acute ureteric colic. The use of an easily applicable biomarker that could predict SSP or need for intervention would improve the management of obstructing ureteric stones. Thus, there is a need to determine in an appropriately powered study, in patients who are initially managed conservatively, which factors at the time of acute admission can predict subsequent patient outcome such as SSP and the need for intervention. Particularly, establishing whether levels of white cell count (WBC at presentation are associated with likelihood of SSP or intervention may guide clinicians on the management of these patients’ stones. Design: Multi-center cohort study disseminated via the UK British Urology Researchers in Surgical Training (BURST and Australian Young Urology Researchers Organisation (YURO. Primary research question: What is the association between WBC and SSP in patients discharged from emergency department after initial conservative management? Patient population: Patients who have presented with acute renal colic with CT KUB evidence of a solitary ureteric stone. A minimum sample size of 720 patients across 15 centres will be needed. Hypothesis: A raised WBC is associated with decreased odds of spontaneous stone passage. Primary outcome: The occurrence of SSP within six months of presentation with acute ureteric colic (YES/NO. SSP was defined as absence of need for intervention to assist stone passage. Statistical analysis plan: A multivariable logistic regression model will be constructed, where the outcome of interest is SSP using data from patients who do not undergo intervention at presentation. A random effect will be used to account for clustering of patients within hospitals/institutions. The model will include adjustments for gender, age as control variables

Quality control for retinal OCT in multiple sclerosis

DEFF Research Database (Denmark)

Schippling, S; Balk, Lj; Costello, F

2015-01-01

to provide guidance on the use of validated quality control (QC) criteria for the use of OCT in MS research and clinical trials. METHODS: A prospective multi-centre (n = 13) study. Peripapillary ring scan QC rating of an OCT training set (n = 50) was followed by a test set (n = 50). Inter-rater agreement...

The human factors specialist in nuclear control centre design

International Nuclear Information System (INIS)

Wilson, R.B.; Beattie, J.D.

The main focus at Ontario Hydro for man-machine interface design is in the design of control centres. Because the control of a nuclear generating unit is highly centralized there is an increasing need for effective information display and control layout. Control panel design innovations such as the use of CRT displays and the extended use of computerized control in the Darlington station have made it possible for Ontario Hydro to continue to have one first operator for each generating unit. The human factors specialist involved in control panel design must deal with people who know much more about the specific systems being controlled, and must become a generalist in all these systems as well. Designers have to use conceptual techniques such as task analysis, systems design, panel mock-ups, anthropometric data, and personal judgement based on experience as they design panels. They must find a balance between becoming locked into existing technology and methods, slavishly following the latest technological trends, and forgetting that real people will be using what they design

A task-based usage strategy for control centre wall displays

International Nuclear Information System (INIS)

Davey, E.

2005-01-01

This paper summarizes the findings from an exploratory definition of a usage strategy for multiple control centre wall displays in CANDU nuclear power plants. Wall displays are defined as large sized, vertically oriented display surfaces that may be positioned in various locations about a control room to support user information needs. The paper begins by discussing the need for a usage strategy for all control room information resources, and then reviews the history in wall display implementation and usage in nuclear power plant control rooms. The balance of the paper discusses the approach used in characterization and review of control room task information needs and definition of a wall display usage strategy. The paper concludes by outlining some of the possible impacts on future control room design and operations that the introduction of wall displays may imply. (author)

The impact of mild induced hypothermia on the rate of transfusion and the mortality in severely injured patients: a retrospective multi-centre study.

Science.gov (United States)

Jensen, Kai Oliver; Held, Leonhard; Kraus, Andrea; Hildebrand, Frank; Mommsen, Philipp; Mica, Ladislav; Wanner, Guido A; Steiger, Peter; Moos, Rudolf M; Simmen, Hans-Peter; Sprengel, Kai

2016-10-06

Although under discussion, induced hypothermia (IH) is an established therapy for patients with cardiac arrest or traumatic brain injuries. The influences on coagulopathy and bleeding tendency in severely injured patients (SIP) with concomitant traumatic brain injury are most widely unclear. Therefore, the aim of this study was to quantify the effect of mild IH in SIP with concomitant severe traumatic brain injuries on transfusion rate and mortality. In this retrospective multi-centre study, SIP from three European level-1 trauma centres with an ISS ≥16 between 2009 and 2011 were included. At hospital A, patients qualified for IH with age ≤70 years and a severe head injury with an abbreviated injury scale (AIS Head ) of ≥3. IH was defined as target core body temperature of 35 °C. Hypothermic patients were matched with two patients, one from hospital B and one from hospital C using age and AIS Head . The effect of IH on the transfusion rate, complications and mortality was quantified with 95 % confidence intervals (CI). Patients not treated with IH in hospital A and those from hospital B and C, who were not matched, were used to adjust the CI for the effect of inter-hospital therapy protocol differences. Mean age of patients in the IH-group (n = 43) was 35.7 years, mean ISS 30 points and sex distribution showed 83.7 % male. Mean age of matched patients in the normotherm-group (n = 86) was 36.7 years, mean ISS 33 points and there were 75.6 % males. For the hypothermic patients, we pointed out an estimate of mean difference for the number of transfused units of packed red blood cells as well as for mortality which does not indicate a decrease in the benefit gained by hypothermia. It is suggested that hypothermic patients tend to a higher rate of lung failure and thromboembolisms. Though tending to an increased rate of complications, there is no evidence for a difference in both; rate of transfusion and mortality in SIP. Mild IH as an option for

Effectiveness and cost-effectiveness of transmural collaborative care with consultation letter (TCCCL) and duloxetine for major depressive disorder (MDD) and (sub)chronic pain in collaboration with primary care: design of a randomized placebo-controlled multi-Centre trial: TCC:PAINDIP.

Science.gov (United States)

de Heer, Eric W; Dekker, Jack; van Eck van der Sluijs, Jonna F; Beekman, Aartjan Tf; van Marwijk, Harm Wj; Holwerda, Tjalling J; Bet, Pierre M; Roth, Joost; Hakkaart-Van Roijen, Leona; Ringoir, Lianne; Kat, Fiona; van der Feltz-Cornelis, Christina M

2013-05-24

The comorbidity of pain and depression is associated with high disease burden for patients in terms of disability, wellbeing, and use of medical care. Patients with major and minor depression often present themselves with pain to a general practitioner and recognition of depression in such cases is low, but evolving. Also, physical symptoms, including pain, in major depressive disorder, predict a poorer response to treatment. A multi-faceted, patient-tailored treatment programme, like collaborative care, is promising. However, treatment of chronic pain conditions in depressive patients has, so far, received limited attention in research. Cost effectiveness of an integrated approach of pain in depressed patients has not been studied. This study is a placebo controlled double blind, three armed randomized multi centre trial. Patients with (sub)chronic pain and a depressive disorder are randomized to either a) collaborative care with duloxetine, b) collaborative care with placebo or c) duloxetine alone. 189 completers are needed to attain sufficient power to show a clinically significant effect of 0.6 SD on the primary outcome measures (PHQ-9 score). Data on depression, anxiety, mental and physical health, medication adherence, medication tolerability, quality of life, patient-doctor relationship, coping, health resource use and productivity will be collected at baseline and after three, six, nine and twelve months. This study enables us to show the value of a closely monitored integrated treatment model above usual pharmacological treatment. Furthermore, a comparison with a placebo arm enables us to evaluate effectiveness of duloxetine in this population in a real life setting. Also, this study will provide evidence-based treatments and tools for their implementation in practice. This will facilitate generalization and implementation of results of this study. Moreover, patients included in this study are screened for pain symptoms, differentiating between nociceptive

Multi-terminal direct-current grids modeling, analysis, and control

CERN Document Server

Chaudhuri, Nilanjan; Majumder, Rajat; Yazdani, Amirnaser

2014-01-01

A comprehensive modeling, analysis, and control design framework for multi-terminal direct current (MTDC) grids is presented together with their interaction with the surrounding AC networks and the impact on overall stability. The first book of its kind on the topic of multi-terminal DC (MTDC) grids  Presents a comprehensive modeling framework for MTDC grids which is compatible with the standard AC system modeling for stability studies Includes modal analysis and study of the interactions between the MTDC grid and the surrounding AC systems Addresses the problems of autonomous power sharing an

Doping strategies to control A-centres in silicon: Insights from hybrid density functional theory

KAUST Repository

Wang, Hao; Chroneos, Alexander I.; Londos, Charalampos A.; Sgourou, Efstratia N.; Schwingenschlö gl, Udo

2014-01-01

Hybrid density functional theory is used to gain insights into the interaction of intrinsic vacancies (V) and oxygen-vacancy pairs (VO, known as A-centres) with the dopants (D) germanium (Ge), tin (Sn), and lead (Pb) in silicon (Si). We determine the structures as well as binding and formation energies of the DVO and DV complexes. The results are discussed in terms of the density of states and in view of the potential of isovalent doping to control A-centres in Si. We argue that doping with Sn is the most efficient isovalent doping strategy to suppress A-centres by the formation of SnVO complexes, as these are charge neutral and strongly bound. © 2014 the Owner Societies.

Multi-centre diagnostic classification of individual structural neuroimaging scans from patients with major depressive disorder.

Science.gov (United States)

Mwangi, Benson; Ebmeier, Klaus P; Matthews, Keith; Steele, J Douglas

2012-05-01

Quantitative abnormalities of brain structure in patients with major depressive disorder have been reported at a group level for decades. However, these structural differences appear subtle in comparison with conventional radiologically defined abnormalities, with considerable inter-subject variability. Consequently, it has not been possible to readily identify scans from patients with major depressive disorder at an individual level. Recently, machine learning techniques such as relevance vector machines and support vector machines have been applied to predictive classification of individual scans with variable success. Here we describe a novel hybrid method, which combines machine learning with feature selection and characterization, with the latter aimed at maximizing the accuracy of machine learning prediction. The method was tested using a multi-centre dataset of T(1)-weighted 'structural' scans. A total of 62 patients with major depressive disorder and matched controls were recruited from referred secondary care clinical populations in Aberdeen and Edinburgh, UK. The generalization ability and predictive accuracy of the classifiers was tested using data left out of the training process. High prediction accuracy was achieved (~90%). While feature selection was important for maximizing high predictive accuracy with machine learning, feature characterization contributed only a modest improvement to relevance vector machine-based prediction (~5%). Notably, while the only information provided for training the classifiers was T(1)-weighted scans plus a categorical label (major depressive disorder versus controls), both relevance vector machine and support vector machine 'weighting factors' (used for making predictions) correlated strongly with subjective ratings of illness severity. These results indicate that machine learning techniques have the potential to inform clinical practice and research, as they can make accurate predictions about brain scan data from

Multi-robot control interface

Science.gov (United States)

Bruemmer, David J [Idaho Falls, ID; Walton, Miles C [Idaho Falls, ID

2011-12-06

Methods and systems for controlling a plurality of robots through a single user interface include at least one robot display window for each of the plurality of robots with the at least one robot display window illustrating one or more conditions of a respective one of the plurality of robots. The user interface further includes at least one robot control window for each of the plurality of robots with the at least one robot control window configured to receive one or more commands for sending to the respective one of the plurality of robots. The user interface further includes a multi-robot common window comprised of information received from each of the plurality of robots.

Multi-model Simulation for Optimal Control of Aeroacoustics.

Energy Technology Data Exchange (ETDEWEB)

Collis, Samuel Scott; Chen, Guoquan

2005-05-01

Flow-generated noise, especially rotorcraft noise has been a serious concern for bothcommercial and military applications. A particular important noise source for rotor-craft is Blade-Vortex-Interaction (BVI)noise, a high amplitude, impulsive sound thatoften dominates other rotorcraft noise sources. Usually BVI noise is caused by theunsteady flow changes around various rotor blades due to interactions with vorticespreviously shed by the blades. A promising approach for reducing the BVI noise isto use on-blade controls, such as suction/blowing, micro-flaps/jets, and smart struc-tures. Because the design and implementation of such experiments to evaluate suchsystems are very expensive, efficient computational tools coupled with optimal con-trol systems are required to explore the relevant physics and evaluate the feasibilityof using various micro-fluidic devices before committing to hardware.In this thesis the research is to formulate and implement efficient computationaltools for the development and study of optimal control and design strategies for com-plex flow and acoustic systems with emphasis on rotorcraft applications, especiallyBVI noise control problem. The main purpose of aeroacoustic computations is todetermine the sound intensity and directivity far away from the noise source. How-ever, the computational cost of using a high-fidelity flow-physics model across thefull domain is usually prohibitive and itmight also be less accurate because of thenumerical diffusion and other problems. Taking advantage of the multi-physics andmulti-scale structure of this aeroacoustic problem, we develop a multi-model, multi-domain (near-field/far-field) method based on a discontinuous Galerkin discretiza-tion. In this approach the coupling of multi-domains and multi-models is achievedby weakly enforcing continuity of normal fluxes across a coupling surface. For ourinterested aeroacoustics control problem, the adjoint equations that determine thesensitivity of the cost

Controlling the dynamics of multi-state neural networks

International Nuclear Information System (INIS)

Jin, Tao; Zhao, Hong

2008-01-01

In this paper, we first analyze the distribution of local fields (DLF) which is induced by the memory patterns in the Q-Ising model. It is found that the structure of the DLF is closely correlated with the network dynamics and the system performance. However, the design rule adopted in the Q-Ising model, like the other rules adopted for multi-state neural networks with associative memories, cannot be applied to directly control the DLF for a given set of memory patterns, and thus cannot be applied to further study the relationships between the structure of the DLF and the dynamics of the network. We then extend a design rule, which was presented recently for designing binary-state neural networks, to make it suitable for designing general multi-state neural networks. This rule is able to control the structure of the DLF as expected. We show that controlling the DLF not only can affect the dynamic behaviors of the multi-state neural networks for a given set of memory patterns, but also can improve the storage capacity. With the change of the DLF, the network shows very rich dynamic behaviors, such as the 'chaos phase', the 'memory phase', and the 'mixture phase'. These dynamic behaviors are also observed in the binary-state neural networks; therefore, our results imply that they may be the universal behaviors of feedback neural networks

A study of goiter among female adolescents referred to centre for nuclear medicine, Lahore

International Nuclear Information System (INIS)

Elahi, S; Hassan, M.; Syed, Z.; Hyder, S.W.; Nazeer, L.; Nagra, S.A.

2005-01-01

Objective: To study goiter and thyroid dysfunction in female adolescents residing in Lahore referred to Centre for Nuclear Medicine (CENUM), Mayo Hospital for thyroid scanning and thyroid function tests. Design: Retrospective study of thyroid size, thyroid scan patterns and serum FT/sub 4/ and TSH levels. Setting: Centre for Nuclear Medicine (CENUM), Mayo Hospital, Lahore. Patients: 350 female adolescent referred during September 2002 to April 2003. Main outcome measures: adolescent goiter, thyroid nodules, hyperthyroidism, hypothyroidism, Graves' disease, toxic multi nodular goiter. Results: Among 350 adolescents 212(60.6%) had goiter of various grades mostly visible. Among goiterous patients 136(64.2%) had diffuse and 76 (35.8%) had nodular presentation. The number of patients with solitary nodular goiter (20.7%) was more than multi nodular goiter (15.1%) and number of patients with solitary cold nodule (16.5%) was more than functioning nodule (4.2%). The incidence of biochemical thyroid dysfunction, both overt and subclinical, was detected in 42(19.8%) patients and was significantly more frequent in patients with nodular than diffuse presentation (29% VS 14.7%; p<0.001) and in multinodular than solitary nodular goiter (p<0.005). More than 80% of the patients with solitary nodular goiter were euthyroid. Simple goiter was detected in 116(54.7%), Graves' disease in 5(2.4%) and toxic multinodular goiter in 4(1.9%) patients. Overall incidence of hypothyroidism was more than double as compared to hyperthyroidism. Incidence of nodularity and hypothyroidism was more in large goiter but duration of goiter was not significant in promoting nodularity. Conclusion: Goiterous adolescents need urgent attention because they don't have just diffuse hypertrophy with normal thyroid function. Many are afflicted with dysfunction and nodularity, particularly solitary cold nodule bearing risk of thyroid malignancy. (author)

Validation of the 24-item recovery assessment scale-revised (RAS-R) in the Norwegian language and context: a multi-centre study.

Science.gov (United States)

Biringer, Eva; Tjoflåt, Marit

2018-01-25

The Recovery Assessment Scale-revised (RAS-R) is a self-report instrument measuring mental health recovery. The purpose of the present study was to translate and adapt the RAS-R into the Norwegian language and to investigate its psychometric properties in terms of factor structure, convergent and discriminant validity and reliability in the Norwegian context. The present study is a cross-sectional multi-centre study. After a pilot test, the Norwegian version of the RAS-R was distributed to 231 service users in mental health specialist and community services. The factor structure of the instrument was investigated by a confirmatory factor analysis (CFA), and internal consistency was assessed by Cronbach's alpha. The RAS-R was found to be acceptable and feasible for service users. The original five-factor structure was confirmed. All model fit indices, including the standardised root mean square residual (SRMR), which is independent of the χ 2 -test, met the criteria for an acceptable model fit. Internal consistencies within sub-scales as measured by Cronbach's alpha ranged from 0.65 to 0.85. Cronbach's alpha for the total scale was 0.90. As expected, some redundancy between factors existed (in particular among the factors Personal confidence and hope, Goal and success orientation and Not dominated by symptoms). The Norwegian RAS-R showed acceptable psychometric properties in terms of convergent validity and reliability, and fit indices from the CFA confirmed the original factor structure. We recommend the Norwegian RAS-R as a tool in service users' and health professionals' collaborative work towards the service users' recovery goals and as an outcome measure in larger evaluations.

The role of the sexual assault centre.

LENUS (Irish Health Repository)

Eogan, Maeve

2013-02-01

Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

Multi-leg Seat Inventory Control Based on EMSU and Virtual Bucket

Directory of Open Access Journals (Sweden)

Wei Fan

2014-01-01

Full Text Available Expected marginal seat revenue (EMSR is a well-known method for airline seat inventory control airlines. However, this method employs a static model to study the dynamic reservation process, and does not take into account the risk tolerance of policy makers. Expected marginal seat utility (EMSU replaces revenue by utility, which addresses the real situation of seat inventory control. However, there is still a lack of multi-leg seat control algorithms based on EMSU. Therefore, using EMSU and bucket algorithms, this paper applies the Markov decision-making process to simulate the flight reservation process and builds a dynamic multi-leg seat inventory control model. Experimental results validate the effectiveness of the proposed method.

Predicting Species Distributions Using Record Centre Data: Multi-Scale Modelling of Habitat Suitability for Bat Roosts.

Science.gov (United States)

Bellamy, Chloe; Altringham, John

2015-01-01

Conservation increasingly operates at the landscape scale. For this to be effective, we need landscape scale information on species distributions and the environmental factors that underpin them. Species records are becoming increasingly available via data centres and online portals, but they are often patchy and biased. We demonstrate how such data can yield useful habitat suitability models, using bat roost records as an example. We analysed the effects of environmental variables at eight spatial scales (500 m - 6 km) on roost selection by eight bat species (Pipistrellus pipistrellus, P. pygmaeus, Nyctalus noctula, Myotis mystacinus, M. brandtii, M. nattereri, M. daubentonii, and Plecotus auritus) using the presence-only modelling software MaxEnt. Modelling was carried out on a selection of 418 data centre roost records from the Lake District National Park, UK. Target group pseudoabsences were selected to reduce the impact of sampling bias. Multi-scale models, combining variables measured at their best performing spatial scales, were used to predict roosting habitat suitability, yielding models with useful predictive abilities. Small areas of deciduous woodland consistently increased roosting habitat suitability, but other habitat associations varied between species and scales. Pipistrellus were positively related to built environments at small scales, and depended on large-scale woodland availability. The other, more specialist, species were highly sensitive to human-altered landscapes, avoiding even small rural towns. The strength of many relationships at large scales suggests that bats are sensitive to habitat modifications far from the roost itself. The fine resolution, large extent maps will aid targeted decision-making by conservationists and planners. We have made available an ArcGIS toolbox that automates the production of multi-scale variables, to facilitate the application of our methods to other taxa and locations. Habitat suitability modelling has the

A tailored implementation strategy to reduce the duration of intravenous antibiotic treatment in community-acquired pneumonia : a controlled before-and-after study

NARCIS (Netherlands)

Engel, M. F.; Bruns, A. H. W.; Hulscher, M. E. J. L.; Gaillard, C. A. J. M.; Sankatsing, S. U. C.; van Berkhout, F. Teding; Emmelot-Vonk, M. H.; Kuck, E. M.; Steeghs, M. H. M.; den Breeijen, J. H.; Stellato, R. K.; Hoepelman, A. I. M.; Oosterheert, J.J.

2014-01-01

We previously showed that 40 % of clinically stable patients hospitalised for community-acquired pneumonia (CAP) are not switched to oral therapy in a timely fashion because of physicians' barriers. We aimed to decrease this proportion by implementing a novel protocol. In a multi-centre controlled

A tailored implementation strategy to reduce the duration of intravenous antibiotic treatment in community-acquired pneumonia: a controlled before-and-after study

NARCIS (Netherlands)

Engel, M.F.; Bruns, A.H.; Hulscher, M.E.; Gaillard, C.A.; Sankatsing, S.U.; Berkhout, F. Teding van; Emmelot-Vonk, M.H.; Kuck, E.M.; Steeghs, M.H.; Breeijen, J.H. den; Stellato, R.K.; Hoepelman, A.I.; Oosterheert, J.J.

2014-01-01

We previously showed that 40 % of clinically stable patients hospitalised for community-acquired pneumonia (CAP) are not switched to oral therapy in a timely fashion because of physicians' barriers. We aimed to decrease this proportion by implementing a novel protocol. In a multi-centre controlled

Study of multi-pixel Geiger-mode avalanche photodiodes as a read-out for PET

CERN Document Server

Musienko, Yuri; Lecoq, Paul; Reucroft, Stephen; Swain, John; Trummer, Julia

2007-01-01

We have studied the performance of two multi-pixel Geiger-mode APDs (recently developed by the Centre of Perspective Technologies and Apparatus (CPTA) in Moscow) with 1×1 mm2 and 3×3 mm2 sensitive area as a readout for LSO and LYSO scintillator crystals. Energy and timing spectra were measured using a 22Na γ-source. The results of this study allow us to conclude that this photodetector is a very promising candidate for PET applications.

A multi-centre study of interactional style in nurse specialist- and physician-led Rheumatology clinics in the UK.

Science.gov (United States)

Vinall-Collier, Karen; Madill, Anna; Firth, Jill

2016-07-01

Nurse-led care is well established in Rheumatology in the UK and provides follow-up care to people with inflammatory arthritis including treatment, monitoring, patient education and psychosocial support. The aim of this study is to compare and contrast interactional style with patients in physician-led and nurse-led Rheumatology clinics. A multi-centre mixed methods approach was adopted. Nine UK Rheumatology out-patient clinics were observed and audio-recorded May 2009-April 2010. Eighteen practitioners agreed to participate in clinic audio-recordings, researcher observations, and note-taking. Of 9 nurse specialists, 8 were female and 5 of 9 physicians were female. Eight practitioners in each group took part in audio-recorded post-clinic interviews. All patients on the clinic list for those practitioners were invited to participate and 107 were consented and observed. In the nurse specialist cohort 46% were female; 71% had a diagnosis of Rheumatoid Arthritis (RA). The physician cohort comprised 31% female; 40% with RA and 16% unconfirmed diagnosis. Nineteen (18%) of the patients observed were approached for an audio-recorded telephone interview and 15 participated (4 male, 11 female). Forty-four nurse specialist and 63 physician consultations with patients were recorded. Roter's Interactional Analysis System (RIAS) was used to code this data. Thirty-one semi-structured interviews were conducted (16 practitioner, 15 patients) within 24h of observed consultations and were analyzed using thematic analysis. RIAS results illuminated differences between practitioners that can be classified as 'socio-emotional' versus 'task-focussed'. Specifically, nurse specialists and their patients engaged significantly more in the socio-emotional activity of 'building a relationship'. Across practitioners, the greatest proportion of 'patient initiations' were in 'giving medical information' and reflected what patients wanted the practitioner to know rather than giving insight into

Deterministic methods for multi-control fuel loading optimization

Science.gov (United States)

Rahman, Fariz B. Abdul

We have developed a multi-control fuel loading optimization code for pressurized water reactors based on deterministic methods. The objective is to flatten the fuel burnup profile, which maximizes overall energy production. The optimal control problem is formulated using the method of Lagrange multipliers and the direct adjoining approach for treatment of the inequality power peaking constraint. The optimality conditions are derived for a multi-dimensional multi-group optimal control problem via calculus of variations. Due to the Hamiltonian having a linear control, our optimal control problem is solved using the gradient method to minimize the Hamiltonian and a Newton step formulation to obtain the optimal control. We are able to satisfy the power peaking constraint during depletion with the control at beginning of cycle (BOC) by building the proper burnup path forward in time and utilizing the adjoint burnup to propagate the information back to the BOC. Our test results show that we are able to achieve our objective and satisfy the power peaking constraint during depletion using either the fissile enrichment or burnable poison as the control. Our fuel loading designs show an increase of 7.8 equivalent full power days (EFPDs) in cycle length compared with 517.4 EFPDs for the AP600 first cycle.

Conflicting Multi-Objective Compatible Optimization Control

OpenAIRE

Xu, Lihong; Hu, Qingsong; Hu, Haigen; Goodman, Erik

2010-01-01

Based on ideas developed in addressing practical greenhouse environmental control, we propose a new multi-objective compatible control method. Several detailed algorithms are proposed to meet the requirements of different kinds of problem: 1) A two-layer MOCC framework is presented for problems with a precise model; 2) To deal with situations

Multi-Model Adaptive Fuzzy Controller for a CSTR Process

Directory of Open Access Journals (Sweden)

Shubham Gogoria

2015-09-01

Full Text Available Continuous Stirred Tank Reactors are intensively used to control exothermic reactions in chemical industries. It is a very complex multi-variable system with non-linear characteristics. This paper deals with linearization of the mathematical model of a CSTR Process. Multi model adaptive fuzzy controller has been designed to control the reactor concentration and temperature of CSTR process. This method combines the output of multiple Fuzzy controllers, which are operated at various operating points. The proposed solution is a straightforward implementation of Fuzzy controller with gain scheduler to control the linearly inseparable parameters of a highly non-linear process.

Layered Multi-mode Optimal Control Strategy for Multi-MW Wind Turbine

Institute of Scientific and Technical Information of China (English)

KONG Yi-gang; WANG Zhi-xin

2008-01-01

The control strategy is one of the most important renewable technology, and an increasing number of multi-MW wind turbines are being developed with a variable speed-variable pitch (VS-VP) technology. The main objective of adopting a VS-VP technology is to improve the fast response speed and capture maximum energy. But the power generated by wind turbine changes rapidly because of the centinuous fluctuation of wind speed and direction. At the same time, wind energy conversion systems are of high order, time delays and strong nonlinear characteristics because of many uncertain factors. Based on analyzing the all dynamic processes of wind turbine, a kind of layered multi-mode optimal control strategy is presented which is that three control strategies: bang-bang, fuzzy and adaptive proportienai integral derivative (PID) are adopted according to different stages and expected performance of wind turbine to capture optimum wind power, compensate the nonlinearity and improve the wind turbine performance at low, rated and high wind speed.

The prognostic value of pimonidazole and tumour pO2 in human cervix carcinomas after radiation therapy: a prospective international multi-center study

DEFF Research Database (Denmark)

Nordsmark, Marianne; Loncaster, Julie; Aquino-Parsons, Christina

2006-01-01

BACKGROUND AND PURPOSE: Hypoxia adversely affects treatment outcome in human uterine cervical cancer. Here, we present the results of a prospective international multi-centre study evaluating the prognostic value of pre-treatment tumour oxygen partial pressure (pO(2)) and the hypoxia marker pimon...... pimonidazole (pimo). MATERIALS AND METHODS: One hundred and twenty-seven patients with primary cervix cancer were entered. Pre-treatment tumour pO(2) measurements were obtained, and reported by the median tumour pO(2), the fraction of pO(2) values......BACKGROUND AND PURPOSE: Hypoxia adversely affects treatment outcome in human uterine cervical cancer. Here, we present the results of a prospective international multi-centre study evaluating the prognostic value of pre-treatment tumour oxygen partial pressure (pO(2)) and the hypoxia marker...

Greenidge Multi-Pollutant Control Project

Energy Technology Data Exchange (ETDEWEB)

Connell, Daniel

2008-10-18

The Greenidge Multi-Pollutant Control Project was conducted as part of the U.S. Department of Energy's Power Plant Improvement Initiative to demonstrate an innovative combination of air pollution control technologies that can cost-effectively reduce emissions of SO{sub 2}, NO{sub x}, Hg, acid gases (SO{sub 3}, HCl, and HF), and particulate matter from smaller coal-fired electric generating units (EGUs). There are about 400 units in the United States with capacities of 50-300 MW that currently are not equipped with selective catalytic reduction (SCR), flue gas desulfurization (FGD), or mercury control systems. Many of these units, which collectively represent more than 55 GW of installed capacity, are difficult to retrofit for deep emission reductions because of space constraints and unfavorable economies of scale, making them increasingly vulnerable to retirement or fuel switching in the face of progressively more stringent environmental regulations. The Greenidge Project sought to confirm the commercial readiness of an emissions control system that is specifically designed to meet the environmental compliance requirements of these smaller coal-fired EGUs by offering a combination of deep emission reductions, low capital costs, small space requirements, applicability to high-sulfur coals, mechanical simplicity, and operational flexibility. The multi-pollutant control system includes a NO{sub x}OUT CASCADE{reg_sign} hybrid selective non-catalytic reduction (SNCR)/in-duct SCR system for NO{sub x} control and a Turbosorp{reg_sign} circulating fluidized bed dry scrubbing system (with a new baghouse) for SO{sub 2}, SO{sub 3}, HCl, HF, and particulate matter control. Mercury removal is provided as a co-benefit of the in-duct SCR, dry scrubber, and baghouse, and by injection of activated carbon upstream of the scrubber, if required. The multi-pollutant control system was installed and tested on the 107-MW{sub e}, 1953-vintage AES Greenidge Unit 4 by a team including

An inter-centre quality assurance network for IMRT verification: Results of the ESTRO QUASIMODO project

International Nuclear Information System (INIS)

Gillis, Sofie; Wagter, Carlos de; Bohsung, Joerg; Perrin, Bruce; Williams, Peter; Mijnheer, Ben J.

2005-01-01

Background and purpose: IMRT necessitates extension of existing inter-centre quality assurance programs due to its increased complexity. We assessed the feasibility of an inter-centre verification method for different IMRT techniques. Materials and methods: Eight European radiotherapy institutions of the QUASIMODO network, have designed an IMRT plan for a horseshoe-shaped PTV surrounding a cylindrical OAR in a simplified pelvic phantom. All centres applied common plan objectives but used their own equipment for planning and delivery. They verified the delivery of this plan according to a common protocol with radiographic film and ionisation chamber measurements. The irradiated films, the results of the ionisation chamber measurements and the computed dose distributions were sent to one analysis centre that compared the measured and computed dose distributions with the gamma method and composite dose-area histograms. Results: 4% (relative to the prescribed dose) and 3 mm (distance-to-agreement) were decided feasible gamma criteria. The composite dose-area histograms showed a maximum local deviation of 3.5% in the mean dose of the PTV and 5% in the OAR. Systematic differences could be identified, and in some cases explained. Conclusions: This multi-centre dosimetric verification study demonstrated both the feasibility of a multi-centre quality assurance network to evaluate any IMRT planning and delivery system combination, as well as the validity of the methodology involved

Quality assurance in clinical trials : a multi-disciplinary approach

International Nuclear Information System (INIS)

Cornes, D.

2001-01-01

Full text: Multi-disciplinary groups, such as medical physicists and radiation therapists, which work effectively together, can ensure continued improvements in radiation therapy quality. The same is also true for clinical trials, which have the added complication of requiring multi-institutional participation to collate sufficient data to effectively assess treatment benefits. It can be difficult to manage quality across all aspects of a multi-disciplinary and multi-institutional trial. A planned system of quality assurance is necessary to provide support for participating centres and facilitate a collaborative approach. To ensure protocol compliance a good relationship between the clinical trial group and treatment centre is idea with definition of mutual goals and objectives before and during the trial, and ongoing consultation and feedback throughout the trial process. To ensure good quality data and maximise the validity of results the study protocol must be strictly adhered to. Because of the need for meticulous attention to detail, both in treatment delivery and standards of documentation, clinical trials are often seen to further complicate the process of delivery of radiation therapy treatment. The Declaration of Helsinki and Good Clinical Practise Guidelines (adopted in May 1996, ICH) provide 'international ethical and scientific standards for designing, conducting, recording and reporting clinical research' and multi-disciplinary groups in each participating centre should also adhere to these guidelines. Copyright (2001) Australasian College of Physical Scientists and Engineers in Medicine

An operational event announcer for the LHC control centre using speech synthesis

International Nuclear Information System (INIS)

Page, S.; Alemany Fernandez, R.

2012-01-01

The LHC Island of the CERN Control Centre is a busy working environment with many status displays and running software applications. An audible event announcer was developed in order to provide a simple and efficient method to notify the operations team of events occurring within the many subsystems of the accelerator. The LHC Announcer uses speech synthesis to report messages based upon data received from multiple sources. General accelerator information such as injections, beam energies and beam dumps are derived from data received from the LHC Timing System. Additionally, a software interface is provided that allows other surveillance processes to send messages to the Announcer using the standard control system middle-ware. Events are divided into categories which the user can enable or disable depending upon their interest. Use of the LHC Announcer is not limited to the Control Centre and is intended to be available to a wide audience, both inside and outside CERN. To accommodate this, it was designed to require no special software beyond a standard web browser. This paper describes the design of the LHC Announcer and how it is integrated into the LHC operational environment. (authors)

Tuning method for multi-variable control system with PID controllers

International Nuclear Information System (INIS)

Fujiwara, Toshitaka

1983-01-01

Control systems, including thermal and nuclear power plants, generally and mainly use PID controllers consisting of proportional, integral and differential actions. These systems consist of multiple control loops which interfere with each other. Therefore, it is present status that the fine control of the system is carried out by the trial and error method because the adjusting procedure for a single control loop cannot be applied to a multi-loop system in most cases. In this report, a method to effectively adjust PID controller parameters in a short time in a control system which consists of multi-loops that interfere with each other. This method makes adjustment by using the control area as the evaluation function, which is the time-dependent integration of control deviation, the input to the PID controllers. In other words, the evaluation function is provided for each control result for every parameter (gain constant, reset rate, and differentiation time), and all parameters are simultaneously changed in the direction of minimizing the values of these evaluation functions. In the report, the principle of tuning method, the evaluation function for each of three parameters, and the adjusting system configuration for separately using for actual plant tuning and for control system design are described. It also shows the examples of application to the actual tuning of the control system for a thermal power plant and to a control system design. (Wakatsuki, Y.)

Multi-objective PID Optimization for Speed Control of an Isolated Steam Turbine using Gentic Algorithm

OpenAIRE

Sanjay Kr. Singh; D. Boolchandani; S.G. Modani; Nitish Katal

2014-01-01

This study focuses on multi-objective optimization of the PID controllers for optimal speed control for an isolated steam turbine. In complex operations, optimal tuning plays an imperative role in maintaining the product quality and process safety. This study focuses on the comparison of the optimal PID tuning using Multi-objective Genetic Algorithm (NSGA-II) against normal genetic algorithm and Ziegler Nichols methods for the speed control of an isolated steam turbine. Isolated steam turbine...

Optical network control plane for multi-domain networking

DEFF Research Database (Denmark)

Manolova, Anna Vasileva

This thesis focuses on multi-domain routing for traffice engineering and survivability support in optical transport networks under the Generalized Multi-Protocol Label Switching (GMPLS) control framework. First, different extensions to the Border Gateway Protocol for multi-domain Traffic...... process are not enough for efficient TE in mesh multi-domain networks. Enhancing the protocol with multi-path dissemination capability, combined with the employment of an end-to-end TE metric proves to be a highly efficient solution. Simulation results show good performance characteristics of the proposed...... is not as essential for improved network performance as the length of the provided paths. Second, the issue of multi-domain survivability support is analyzed. An AS-disjoint paths is beneficial not only for resilience support, but also for facilitating adequate network reactions to changes in the network, which...

Distributed model based control of multi unit evaporation systems

International Nuclear Information System (INIS)

Yudi Samyudia

2006-01-01

In this paper, we present a new approach to the analysis and design of distributed control systems for multi-unit plants. The approach is established after treating the effect of recycled dynamics as a gap metric uncertainty from which a distributed controller can be designed sequentially for each unit to tackle the uncertainty. We then use a single effect multi-unit evaporation system to illustrate how the proposed method is used to analyze different control strategies and to systematically achieve a better closed-loop performance using a distributed model-based controller

DALI: Defining Antibiotic Levels in Intensive care unit patients: a multi-centre point of prevalence study to determine whether contemporary antibiotic dosing for critically ill patients is therapeutic

Directory of Open Access Journals (Sweden)

Roberts Jason A

2012-07-01

Full Text Available Abstract Background The clinical effects of varying pharmacokinetic exposures of antibiotics (antibacterials and antifungals on outcome in infected critically ill patients are poorly described. A large-scale multi-centre study (DALI Study is currently underway describing the clinical outcomes of patients achieving pre-defined antibiotic exposures. This report describes the protocol. Methods DALI will recruit over 500 patients administered a wide range of either beta-lactam or glycopeptide antibiotics or triazole or echinocandin antifungals in a pharmacokinetic point-prevalence study. It is anticipated that over 60 European intensive care units (ICUs will participate. The primary aim will be to determine whether contemporary antibiotic dosing for critically ill patients achieves plasma concentrations associated with maximal activity. Secondary aims will compare antibiotic pharmacokinetic exposures with patient outcome and will describe the population pharmacokinetics of the antibiotics included. Various subgroup analyses will be conducted to determine patient groups that may be at risk of very low or very high concentrations of antibiotics. Discussion The DALI study should inform clinicians of the potential clinical advantages of achieving certain antibiotic pharmacokinetic exposures in infected critically ill patients.

A designated centre for people with disabilities operated by Daughters of Charity Disability Support Services Ltd., Dublin 7

LENUS (Irish Health Repository)

Muller, Ueli C

2011-04-07

Abstract Background The International Multi-centre ADHD Genetics (IMAGE) project with 11 participating centres from 7 European countries and Israel has collected a large behavioural and genetic database for present and future research. Behavioural data were collected from 1068 probands with the combined type of attention deficit\\/hyperactivity disorder (ADHD-CT) and 1446 \\'unselected\\' siblings. The aim was to analyse the IMAGE sample with respect to demographic features (gender, age, family status, and recruiting centres) and psychopathological characteristics (diagnostic subtype, symptom frequencies, age at symptom detection, and comorbidities). A particular focus was on the effects of the study design and the diagnostic procedure on the homogeneity of the sample in terms of symptom-based behavioural data, and potential consequences for further analyses based on these data. Methods Diagnosis was based on the Parental Account of Childhood Symptoms (PACS) interview and the DSM-IV items of the Conners\\' teacher questionnaire. Demographics of the full sample and the homogeneity of a subsample (all probands) were analysed by using robust statistical procedures which were adjusted for unequal sample sizes and skewed distributions. These procedures included multi-way analyses based on trimmed means and winsorised variances as well as bootstrapping. Results Age and proband\\/sibling ratios differed between participating centres. There was no significant difference in the distribution of gender between centres. There was a significant interaction between age and centre for number of inattentive, but not number of hyperactive symptoms. Higher ADHD symptom frequencies were reported by parents than teachers. The diagnostic symptoms differed from each other in their frequencies. The face-to-face interview was more sensitive than the questionnaire. The differentiation between ADHD-CT probands and unaffected siblings was mainly due to differences in hyperactive

Cooling solutions in an operational data centre: A case study

International Nuclear Information System (INIS)

Fakhim, B.; Behnia, M.; Armfield, S.W.; Srinarayana, N.

2011-01-01

The rapid growth in data centres - large computing infrastructures containing vast quantities of data processing and storage equipment - has resulted in their consumption of up to 100 times more energy per square metre than office accommodation. The decrease in processing server sizes and the more efficient use of space and server processing are challenging data centre facilities to provide more power and cooling, significantly increasing energy demands. Energy consumption of data centres can be severely and unnecessarily high due to inadequate localised cooling and densely packed server rack layouts. However, as heat dissipation in data centres rises by orders of magnitude, inefficiencies such as air recirculation causing hot spots and flow short-circuiting will have a significant impact on the thermal manageability and energy efficiency of the cooling infrastructure. Therefore, an efficient thermal management of high-powered electronic equipment is a significant challenge for cooling of data centres. To highlight the importance of some of these issues, in this project, an operational data centre has been studied. Field measurements of temperature have been performed. Numerical analysis of flow and temperature fields is conducted in order to evaluate the thermal behaviour of the data centre. A number of undesirable hot spots have been identified. To rectify the problem, a few practical design and remedial solutions to improve the cooling effectiveness have been proposed and examined to allow a reduced air-conditioning power requirement. The findings lead to a better understanding of the cooling issues and the respective proposed solutions allow an improved design for future data centres. - Highlights: → Study of flow and temperature distribution in an operational data centre. → Both field measurements and numerical simulations are conducted. → Numerical simulations are validated by field measurements. → Various modifications to improve the thermal

Hybrid Multi-Layer Network Control for Emerging Cyber-Infrastructures

Energy Technology Data Exchange (ETDEWEB)

Summerhill, Richard [Internet2, Washington, DC (United States); Lehman, Tom [Univ. of Southern California, Los Angeles, CA (United States). Information Sciences Inst. (ISI); Ghani, Nasir [Univ. of New Mexico, Albuquerque, NM (United States). Dept. of Electrical & Computer Engineering; Boyd, Eric [Univ. Corporation for Advanced Internet Development (UCAID), Washington, DC (United States)

2009-08-14

There were four basic task areas identified for the Hybrid-MLN project. They are: Multi-Layer, Multi-Domain, Control Plane Architecture and Implementation; Heterogeneous DataPlane Testing; Simulation; Project Publications, Reports, and Presentations.

Cognitive task load in a naval ship control centre: from identification to prediction.

Science.gov (United States)

Grootjen, M; Neerincx, M A; Veltman, J A

Deployment of information and communication technology will lead to further automation of control centre tasks and an increasing amount of information to be processed. A method for establishing adequate levels of cognitive task load for the operators in such complex environments has been developed. It is based on a model distinguishing three load factors: time occupied, task-set switching, and level of information processing. Application of the method resulted in eight scenarios for eight extremes of task load (i.e. low and high values for each load factor). These scenarios were performed by 13 teams in a high-fidelity control centre simulator of the Royal Netherlands Navy. The results show that the method provides good prediction of the task load that will actually appear in the simulator. The model allowed identification of under- and overload situations showing negative effects on operator performance corresponding to controlled experiments in a less realistic task environment. Tools proposed to keep the operator at an optimum task load are (adaptive) task allocation and interface support.

Cooperative control of multi-agent systems optimal and adaptive design approaches

CERN Document Server

Lewis, Frank L; Hengster-Movric, Kristian; Das, Abhijit

2014-01-01

Task complexity, communication constraints, flexibility and energy-saving concerns are all factors that may require a group of autonomous agents to work together in a cooperative manner. Applications involving such complications include mobile robots, wireless sensor networks, unmanned aerial vehicles (UAVs), spacecraft, and so on. In such networked multi-agent scenarios, the restrictions imposed by the communication graph topology can pose severe problems in the design of cooperative feedback control systems.  Cooperative control of multi-agent systems is a challenging topic for both control theorists and practitioners and has been the subject of significant recent research. Cooperative Control of Multi-Agent Systems extends optimal control and adaptive control design methods to multi-agent systems on communication graphs.  It develops Riccati design techniques for general linear dynamics for cooperative state feedback design, cooperative observer design, and cooperative dynamic output feedback design.  B...

Collaborative-Hybrid Multi-Layer Network Control for Emerging Cyber-Infrastructures

Energy Technology Data Exchange (ETDEWEB)

Lehman, Tom [USC; Ghani, Nasir [UNM; Boyd, Eric [UCAID

2010-08-31

At a high level, there were four basic task areas identified for the Hybrid-MLN project. They are: o Multi-Layer, Multi-Domain, Control Plane Architecture and Implementation, including OSCARS layer2 and InterDomain Adaptation, Integration of LambdaStation and Terapaths with Layer2 dynamic provisioning, Control plane software release, Scheduling, AAA, security architecture, Network Virtualization architecture, Multi-Layer Network Architecture Framework Definition; o Heterogeneous DataPlane Testing; o Simulation; o Project Publications, Reports, and Presentations.

The Aube centre; Le Centre de l`Aube

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-07-01

This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

Experimental study on cascaded attitude angle control of a multi-rotor unmanned aerial vehicle with the simple internal model control method

International Nuclear Information System (INIS)

Song, Jun Beom; Byun, Young Seop; Jeong, Jin Seok; Kim, Jeong; Kang, Beom Soo

2016-01-01

This paper proposes a cascaded control structure and a method of practical application for attitude control of a multi-rotor Unmanned aerial vehicle (UAV). The cascade control, which has tighter control capability than a single-loop control, is rarely used in attitude control of a multi-rotor UAV due to the input-output relation, which is no longer simply a set-point to Euler angle response transfer function of a single-loop PID control, but there are multiply measured signals and interactive control loops that increase the complexity of evaluation in conventional way of design. However, it is proposed in this research a method that can optimize a cascade control with a primary and secondary loops and a PID controller for each loop. An investigation of currently available PID-tuning methods lead to selection of the Simple internal model control (SIMC) method, which is based on the Internal model control (IMC) and direct-synthesis method. Through the analysis and experiments, this research proposes a systematic procedure to implement a cascaded attitude controller, which includes the flight test, system identification and SIMC-based PID-tuning. The proposed method was validated successfully from multiple applications where the application to roll axis lead to a PID-PID cascade control, but the application to yaw axis lead to that of PID-PI

Experimental study on cascaded attitude angle control of a multi-rotor unmanned aerial vehicle with the simple internal model control method

Energy Technology Data Exchange (ETDEWEB)

Song, Jun Beom [Dept. of Aviation Maintenance, Dongwon Institute of Science and Technology, Yangsan (Korea, Republic of); Byun, Young Seop; Jeong, Jin Seok; Kim, Jeong; Kang, Beom Soo [Dept. of Aerospace Engineering, Pusan National University, Busan (Korea, Republic of)

2016-11-15

This paper proposes a cascaded control structure and a method of practical application for attitude control of a multi-rotor Unmanned aerial vehicle (UAV). The cascade control, which has tighter control capability than a single-loop control, is rarely used in attitude control of a multi-rotor UAV due to the input-output relation, which is no longer simply a set-point to Euler angle response transfer function of a single-loop PID control, but there are multiply measured signals and interactive control loops that increase the complexity of evaluation in conventional way of design. However, it is proposed in this research a method that can optimize a cascade control with a primary and secondary loops and a PID controller for each loop. An investigation of currently available PID-tuning methods lead to selection of the Simple internal model control (SIMC) method, which is based on the Internal model control (IMC) and direct-synthesis method. Through the analysis and experiments, this research proposes a systematic procedure to implement a cascaded attitude controller, which includes the flight test, system identification and SIMC-based PID-tuning. The proposed method was validated successfully from multiple applications where the application to roll axis lead to a PID-PID cascade control, but the application to yaw axis lead to that of PID-PI.

Study protocol. ECSSIT - Elective Caesarean Section Syntocinon Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section.

LENUS (Irish Health Repository)

Murphy, Deirdre J

2012-02-01

BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

Study protocol. ECSSIT - Elective Caesarean Section Syntocinon Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section.

LENUS (Irish Health Repository)

Murphy, Deirdre J

2009-01-01

BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

Factors influencing choice of care-seeking for acute fever comparing private chemical shops with health centres and hospitals in Ghana: a study using case-control methodology.

Science.gov (United States)

Ansah, Evelyn K; Gyapong, Margaret; Narh-Bana, Solomon; Bart-Plange, Constance; Whitty, Christopher J M

2016-05-25

Several public health interventions to improve management of patients with fever are largely focused on the public sector yet a high proportion of patients seek care outside the formal healthcare sector. Few studies have provided information on the determinants of utilization of the private sector as against formal public sector. Understanding the differences between those who attend public and private health institutions, and their pathway to care, has significant practical implications. The chemical shop is an important source of care for acute fever in Ghana. Case-control methodology was used to identify factors associated with seeking care for fever in the Dangme West District, Ghana. People presenting to health centres, or hospital outpatients, with a history or current fever were compared to counterparts from the same community with fever visiting a chemical shop. Of 600 patients, 150 each, were recruited from the district hospital and two health centres, respectively, and 300 controls from 51 chemical shops. Overall, 103 (17.2 %) patients tested slide positive for malaria. Specifically, 13.7 % (41/300) of chemical shop patients, 30.7 % (46/150) health centre and 10.7 % (16/150) hospital patients were slide positive. While it was the first option for care for 92.7 % (278/300) chemical shop patients, 42.7 % (64/150) of health centre patients first sought care from a chemical shop. More health centre patients (61.3 %; 92/150) presented with fever after more than 3 days than chemical shop patients (27.7 %; 83/300) [AOR = 0.19; p private drug retail sector is the first option for the majority of patients, including poorer patients, with fever in this setting. Most patients with fever arrive at chemical shops with less delay and fewer signs of severity than at public health facilities. Improving chemical shop skills is a good opportunity to diagnose, treat or refer people with fever early.

Explicit/multi-parametric model predictive control (MPC) of linear discrete-time systems by dynamic and multi-parametric programming

KAUST Repository

Kouramas, K.I.

2011-08-01

This work presents a new algorithm for solving the explicit/multi- parametric model predictive control (or mp-MPC) problem for linear, time-invariant discrete-time systems, based on dynamic programming and multi-parametric programming techniques. The algorithm features two key steps: (i) a dynamic programming step, in which the mp-MPC problem is decomposed into a set of smaller subproblems in which only the current control, state variables, and constraints are considered, and (ii) a multi-parametric programming step, in which each subproblem is solved as a convex multi-parametric programming problem, to derive the control variables as an explicit function of the states. The key feature of the proposed method is that it overcomes potential limitations of previous methods for solving multi-parametric programming problems with dynamic programming, such as the need for global optimization for each subproblem of the dynamic programming step. © 2011 Elsevier Ltd. All rights reserved.

Integrating of renewable energy in operation system: the Special Regime Control Centre (CECRE); Integracion de la energia renovable en la operacion del sistema: El Centro de Control de regimen especial (CECRE)

Energy Technology Data Exchange (ETDEWEB)

Division, M.

2007-07-01

The implementation of Red Electrica de Espana Special Regime Control Centre (CECRE) has demonstrated the Spanish System Operators commitment of integrating the maximum possible wind power generation into the electrical system compatible with secure operation. With this leadership initiative,for the first time in the world, a System Operator Control Centre (CECRE) has succeeded in sending power control instructions to wind power generators over the country through Generation Control Centres (CGC) to which these generators must be connected complying with the Spanish Rules. (Author)

Cognitive task load in a naval ship control centre : from identification to prediction

NARCIS (Netherlands)

Grootjen, M.; Neerincx, M.A.; Grootjen, M.; Veltman, J.

2006-01-01

Deployment of information and communication technology will lead to further automation of control centre tasks and an increasing amount of information to be processed. A method for establishing adequate levels of cognitive task load for the operators in such complex environments has been developed.

Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

Science.gov (United States)

Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats

2017-01-06

Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises

Music therapy in Huntington's disease: a protocol for a multi-center randomized controlled trial.

Science.gov (United States)

van Bruggen-Rufi, Monique; Vink, Annemieke; Achterberg, Wilco; Roos, Raymund

2016-07-26

Huntington's disease is a progressive, neurodegenerative disease with autosomal dominant inheritance, characterized by motor disturbances, cognitive decline and behavioral and psychological symptoms. Since there is no cure, all treatment is aimed at improving quality of life. Music therapy is a non-pharmacological intervention, aiming to improve the quality of life, but its use and efficacy in patients with Huntington's disease has hardly been studied. In this article, a protocol is described to study the effects of music therapy in comparison with a control intervention to improve quality of life through stimulating expressive and communicative skills. By targeting these skills we assume that the social-cognitive functioning will improve, leading to a reduction in behavioral problems, resulting in an overall improvement of the quality of life in patients with Huntington's disease. The study is designed as a multi-center single-blind randomised controlled intervention trial. Sixty patients will be randomised using centre-stratified block-permuted randomisation. Patients will be recruited from four long-term care facilities specialized in Huntington's disease-care in The Netherlands. The outcome measure to assess changes in expressive and communication skills is the Behaviour Observation Scale Huntington and changes in behavior will be assessed by the Problem Behaviour Assesment-short version and by the BOSH. Measurements take place at baseline, then 8, 16 (end of intervention) and 12 weeks after the last intervention (follow-up). This randomized controlled study will provide greater insight into the effectiveness of music therapy on activities of daily living, social-cognitive functioning and behavior problems by improving expressive and communication skills, thus leading to a better quality of life for patients with Huntington's disease. Netherlands Trial Register: NTR4904 , registration date Nov. 15, 2014.

Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

NARCIS (Netherlands)

Hermus, M.A.A.; Boesveld, I.C.; Hilzert, M.; Franx, A.; Graaf, J.P. de; Steegers, E.A.P.; Wiegers, T.A.; Pal-de Bruin, K.M. van der

2017-01-01

Background: During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not

Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study

NARCIS (Netherlands)

Hermus, Marieke A. A.; Boesveld, I. C.; Hitzert, Marrit M; Franx, A.; de Graaf, J. P.; Steegers, E. A P; Wiegers, Therese A.; van der Pal-de Bruin, Karin M.

2017-01-01

Background: During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not

Cardiac patients' perception of patient-centred care: a qualitative study.

Science.gov (United States)

Esmaeili, Maryam; Cheraghi, Mohammad A; Salsali, Mahvash

2016-03-01

The aim of this study was to explore cardiac patients' perception of patient-centred care. Despite patient's importance in the process of care, less attention has been paid to experiences and expectations of patients in definitions of patient-centred care. As patients are an important element in process of patient-centred care, organizing care programs according to their perceptions and expectations will lead to enhanced quality of care and greater patient satisfaction. This study is a descriptive qualitative study. Content analysis approach was performed for data analysis. Participants were 18 cardiac patients (10 women and 8 men) hospitalized in coronary care units of teaching hospitals affiliated to Tehran University of Medical Sciences. We collected the study data through conducting personal face-to-face semi-structured interviews. The participants' perceptions of patient-centred care fell into three main themes including managing patients uncertainty, providing care with more flexibility and establishing a therapeutic communication. The second theme consisted of two sub-themes: empathizing with patients and having the right to make independent decisions. Receiving patient-centred care is essential for cardiac patients. Attention to priorities and preferences of cardiac patients and making decisions accordingly is among effective strategies for achieving patient-centred care. Cardiac care unit nurses ought to be aware that in spite of technological developments and advances, it is still important to pay attention to patients' needs and expectations in order to achieve patient satisfaction. In planning care programs, they should consider accountability towards patients' needs, flexibility in process of care and establishing medical interactions as an effective strategy for improving quality of care. © 2014 British Association of Critical Care Nurses.

[Structured care in an ISO certified centre for patients with cystic fibrosis and their families].

Science.gov (United States)

Ellemunter, H; Eder, J; Steinkamp, G

2011-10-01

Cystic fibrosis (CF) is a chronic, life-shortening disease of multiple organ systems. Guidelines recommend that patients should be treated in specialised CF centres with multi-professional teams. We describe the organisation of medical care at the CF centre of Innsbruck University as well as results of treatment. Procedures and delivery of multi-professional care have been elaborated and structured. Since 2006 the Centre has been repeatedly certified according to DIN ISO 9001:2000. The patient database is being used during the doctor's consultation and for the continuous monitoring of treatment results. In 2010, 71 of the 148 patients (48%) were between 18 and 56 years old. The total number of patients has doubled and the proportion of adults tripled since 1995. Nevertheless, median FEV1 remained stable (>80% of predicted) during the last 15 years. Compared with 18 CF centres of the German Benchmarking Group, patients treated in Innsbruck had favourable FEV1 values: 52% of adults had a normal FEV1 (>80% pred.) and only 23% an FEV1 <50% of predicted. A structured programme of multi-professional care was associated with favourable treatment results, both longitudinally and in comparison to other CF centres. © Georg Thieme Verlag KG Stuttgart · New York.

Multi-hazard assessment using GIS in the urban areas: Case study - Banja Luka municipality, B&H

Directory of Open Access Journals (Sweden)

Tošić Radislav

2013-01-01

Full Text Available The research presents a techniques for natural hazard assessment using GIS and cartographic approaches with multi-hazard mapping in urban communities, because natural hazards are a multi-dimensional phenomena which have a spatial component. Therefore the use of Remote Sensing and GIS has an important function and become essential in urban multi-hazard assessment. The first aim of this research was to determine the geographical distributions of the major types of natural hazards in the study area. Seismic hazards, landslides, rockfalls, floods, torrential floods, and excessive erosion are the most significant natural hazards within the territory of Banja Luka Municipality. Areas vulnerable to some of these natural hazards were singled out using analytical maps. Based on these analyses, an integral map of the natural hazards of the study area was created using multi-hazard assessment and the total vulnerability was determined by overlapping the results. The detailed analysis, through the focused research within the most vulnerable areas in the study area will highlight the administrative units (urban centres and communes that are vulnerable to various types of natural hazard. The results presented in this article are the first multi-hazard assessment and the first version of the integral map of natural hazards in the Republic of Srpska.

Large-scale fuel cycle centres

International Nuclear Information System (INIS)

Smiley, S.H.; Black, K.M.

1977-01-01

The US Nuclear Regulatory Commission (NRC) has considered the nuclear energy centre concept for fuel cycle plants in the Nuclear Energy Centre Site Survey 1975 (NECSS-75) Rep. No. NUREG-0001, an important study mandated by the US Congress in the Energy Reorganization Act of 1974 which created the NRC. For this study, the NRC defined fuel cycle centres as consisting of fuel reprocessing and mixed-oxide fuel fabrication plants, and optional high-level waste and transuranic waste management facilities. A range of fuel cycle centre sizes corresponded to the fuel throughput of power plants with a total capacity of 50,000-300,000MW(e). The types of fuel cycle facilities located at the fuel cycle centre permit the assessment of the role of fuel cycle centres in enhancing the safeguard of strategic special nuclear materials - plutonium and mixed oxides. Siting fuel cycle centres presents a smaller problem than siting reactors. A single reprocessing plant of the scale projected for use in the USA (1500-2000t/a) can reprocess fuel from reactors producing 50,000-65,000MW(e). Only two or three fuel cycle centres of the upper limit size considered in the NECSS-75 would be required in the USA by the year 2000. The NECSS-75 fuel cycle centre evaluation showed that large-scale fuel cycle centres present no real technical siting difficulties from a radiological effluent and safety standpoint. Some construction economies may be achievable with fuel cycle centres, which offer opportunities to improve waste-management systems. Combined centres consisting of reactors and fuel reprocessing and mixed-oxide fuel fabrication plants were also studied in the NECSS. Such centres can eliminate shipment not only of Pu but also mixed-oxide fuel. Increased fuel cycle costs result from implementation of combined centres unless the fuel reprocessing plants are commercial-sized. Development of Pu-burning reactors could reduce any economic penalties of combined centres. The need for effective fissile

PLC-Based Pressure Control in Multi-Pump Applications

Directory of Open Access Journals (Sweden)

Vodovozov Valery

2015-12-01

Full Text Available The paper is devoted to the centrifugal pumps represented the most popular type of pumping equipment used in different areas. The pressure control approach for variable speed driven (VSD parallel connected centrifugal pumps is reported. The goal of the study is optimization of some quality indices, such as efficiency, consumed power, productivity, energy carrier temperature, heat irradiation, etc. One of them – efficiency – has been studied in the paper more carefully. The mathematical model of pumping process is discussed and a vector-matrix description of the multi-pump application is given. The program-based pressure control system is developed which productivity is changed by regulating the number of working pumps. The paper introduces new pressure control algorithms based on the working point estimation intended for programmable logical controllers (PLC. Experiments prove correctness of the offered methodology.

A multi-channel AC power supply controller

International Nuclear Information System (INIS)

Su Hong; Li Xiaogang; Ma Xiaoli; Zhou Bo; Yin Weiwei

2003-01-01

A multi-channel ac power supply controller developed recently by authors is introduced briefly in this paper. This controller is a computer controlled multi-electronic-switch device. This controller was developed for the automatic control and monitoring system of a 220 V ac power supply system, it is a key front-end device of the automatic control and monitoring system. There is an electronic switch in each channel, the rated load power is ≤1 kW/each channel. Another function is to sample the 220 V ac output voltage so that computer can monitor the operation state of each electronic switch. Through these switches, the 220 V ac power supply is applied to some device or apparatus that need to be powered by 220 V ac power supply. In the design, a solid-state relay was employed as an electronic switch. This controller can be connected in cascade mode. There are 8 boxes at most can be connected in cascade mode. The length of control word is 8 bit, which contains addressing information and electronic switch state setting information. The sampling output of the controller is multiplexed. It is only one bit that indicates the operating state of an electronic switch. This controller has been used in an automatic control and monitoring system for 220 V ac power supply system

Undergraduate nursing students' performance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: an Australian multi-centre study.

Science.gov (United States)

Bogossian, Fiona; Cooper, Simon; Cant, Robyn; Beauchamp, Alison; Porter, Joanne; Kain, Victoria; Bucknall, Tracey; Phillips, Nicole M

2014-05-01

Early recognition and situation awareness of sudden patient deterioration, a timely appropriate clinical response, and teamwork are critical to patient outcomes. High fidelity simulated environments provide the opportunity for undergraduate nursing students to develop and refine recognition and response skills. This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Mixed-method multi-centre study. High fidelity simulated acute clinical environment in three Australian universities. A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p=.034), overall situation awareness (p=.05) and clinical performance in two of the three scenarios

Hormone-Balancing Effect of Pre-Gelatinized Organic Maca (Lepidium peruvianum Chacon): (II) Physiological and Symptomatic Responses of Early-Postmenopausal Women to Standardized doses of Maca in Double Blind, Randomized, Placebo-Controlled, Multi-Centre Clinical Study.

Science.gov (United States)

Meissner, H O; Mscisz, A; Reich-Bilinska, H; Kapczynski, W; Mrozikiewicz, P; Bobkiewicz-Kozlowska, T; Kedzia, B; Lowicka, A; Barchia, I

2006-12-01

This was a double-blind, randomized, placebo-corrected, outpatient, multi-centre (five sites) clinical study, in which a total of 168 Caucasian early-postmenopausal women volunteers (age>49 years) participated after fulfilling the criteria: follicle stimulating hormone (FSH) >30 IU/ml and estrogen (E2) Maca (Maca-GO) treatment, according to different monthly treatment sequences scheduled for each site. Two 500 mg vegetable hard gel capsules with Maca-GO or Placebo powder were self-administered twice daily with meals (total 2 g/day) during three (Trial I; n=102) or four (Trial II; n=66) months study periods. At the baseline and follow- up monthly intervals, blood levels of FSH, E2, progesterone (PRG) and lutinizing hormone (LH), as well as serum cholesterol (CHOL), triglycerides (TRG), high- and low density lipoproteins (HDL and LDL) were measured. Menopausal symptoms were assessed according to Greene's Score (GMS) and Kupperman's Index (KMI). Data were analyzed using multivariate technique on blocs of monthly results in one model and Maca versus Placebo contrast in another model. A total of 124 women concluded the study. Maca-GO significantly stimulated production of E2 (PMaca-GO significantly reduced both frequency and severity of individual menopausal symptoms (hot flushes and night sweating in particular) resulting in significant (P<0.001) alleviation of KMI (from 22 to 10), thus, offering an attractive non-hormonal addition to the choices available to early-postmenopausal women in the form of a natural plant alternative to Hormone Replacement Therapy (HRT) - hence, reducing dependence on hormone therapy programs.

Concurrent Learning of Control in Multi agent Sequential Decision Tasks

Science.gov (United States)

2018-04-17

Concurrent Learning of Control in Multi-agent Sequential Decision Tasks The overall objective of this project was to develop multi-agent reinforcement... learning (MARL) approaches for intelligent agents to autonomously learn distributed control policies in decentral- ized partially observable... learning of policies in Dec-POMDPs, established performance bounds, evaluated these algorithms both theoretically and empirically, The views

Multi-agent based distributed control architecture for microgrid energy management and optimization

International Nuclear Information System (INIS)

Basir Khan, M. Reyasudin; Jidin, Razali; Pasupuleti, Jagadeesh

2016-01-01

Highlights: • A new multi-agent based distributed control architecture for energy management. • Multi-agent coordination based on non-cooperative game theory. • A microgrid model comprised of renewable energy generation systems. • Performance comparison of distributed with conventional centralized control. - Abstract: Most energy management systems are based on a centralized controller that is difficult to satisfy criteria such as fault tolerance and adaptability. Therefore, a new multi-agent based distributed energy management system architecture is proposed in this paper. The distributed generation system is composed of several distributed energy resources and a group of loads. A multi-agent system based decentralized control architecture was developed in order to provide control for the complex energy management of the distributed generation system. Then, non-cooperative game theory was used for the multi-agent coordination in the system. The distributed generation system was assessed by simulation under renewable resource fluctuations, seasonal load demand and grid disturbances. The simulation results show that the implementation of the new energy management system proved to provide more robust and high performance controls than conventional centralized energy management systems.

12 A multi-centre randomised feasibility study evaluating the impact of a prognostic model for management of blunt chest wall trauma patients: stumbl trial.

Science.gov (United States)

Battle, Ceri; Hutchings, Hayley; Abbott, Zoe; O'neill, Claire; Groves, Sam; Watkins, Alan; Lecky, Fiona; Jones, Sally; Gagg, James; Body, Rick; Evans, Phillip

2017-12-01

A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the Emergency Department (ED). A definitive randomised controlled trial (impact trial), is required to assess the clinical and cost effectiveness of the new model, before it can be accepted in clinical practice. The purpose of this trial is to assess the feasibility and acceptability of such a definitive trial and inform its design. This feasibility trial is designed to test the methods of a multi-centre, cluster-randomised (stepped wedge) trial, with a substantial qualitative component. Four EDs in England and Wales will collect data for all blunt chest wall trauma patients over a five month period; in the initial period acting as the controls (normal care) and the second period, acting as the interventions (in which the new model will be used). Baseline measurements including completion of the SF-12v2 will be obtained on initial assessment in the ED. Patient outcome data will then be collected for any subsequent hospitalisations. Data collection will conclude with a six week follow-up completion of two surveys (SF-12v2 and Client Services Receipt Inventory).Analysis of outcomes will focus on feasibility, acceptability and trial processes and will include recruitment and retention rates, attendance at clinician training rates and use of model in the ED. Qualitative feedback will be obtained through clinician interviews and a research nurse focus group. An evaluation of the feasibility of health economics outcomes data will be completed. Wales Research Ethics Committee 6 granted approval for the trial in September 2016. Health Care Research Wales Research Permissions and the HRA have granted approval for the study. Patient recruitment commenced in February 2017. Planned dissemination is through publication in a peer-reviewed Emergency Medicine Journal, presentation at appropriate conferences and to

Energy control centres and traction power management of the OeBB infrastructure; Energieleitstellen und Traktionsstrommanagement der OeBB-Infrastruktur

Energy Technology Data Exchange (ETDEWEB)

Gammer, Michael; Heinze, Florian [OeBB-Infrastruktur AG, Vienna (Austria). Geschaeftsbereich Energie

2013-04-15

According to the OeBB control centre concept, the currently four operations management sites for the 15 kV railway power network will be reduced to just two locations which will be reoriented to operate as energy control centres. For the support of the operators, tools have been developed under the title traction power management, which are based on combined simulations of overhead line network and train operations. (orig.)

Development of a Multi-Centre Clinical Trial Data Archiving and Analysis Platform for Functional Imaging

Science.gov (United States)

Driscoll, Brandon; Jaffray, David; Coolens, Catherine

2014-03-01

Purpose: To provide clinicians & researchers participating in multi-centre clinical trials with a central repository for large volume dynamic imaging data as well as a set of tools for providing end-to-end testing and image analysis standards of practice. Methods: There are three main pieces to the data archiving and analysis system; the PACS server, the data analysis computer(s) and the high-speed networks that connect them. Each clinical trial is anonymized using a customizable anonymizer and is stored on a PACS only accessible by AE title access control. The remote analysis station consists of a single virtual machine per trial running on a powerful PC supporting multiple simultaneous instances. Imaging data management and analysis is performed within ClearCanvas Workstation® using custom designed plug-ins for kinetic modelling (The DCE-Tool®), quality assurance (The DCE-QA Tool) and RECIST. Results: A framework has been set up currently serving seven clinical trials spanning five hospitals with three more trials to be added over the next six months. After initial rapid image transfer (+ 2 MB/s), all data analysis is done server side making it robust and rapid. This has provided the ability to perform computationally expensive operations such as voxel-wise kinetic modelling on very large data archives (+20 GB/50k images/patient) remotely with minimal end-user hardware. Conclusions: This system is currently in its proof of concept stage but has been used successfully to send and analyze data from remote hospitals. Next steps will involve scaling up the system with a more powerful PACS and multiple high powered analysis machines as well as adding real-time review capabilities.

Development of a Multi-Centre Clinical Trial Data Archiving and Analysis Platform for Functional Imaging

International Nuclear Information System (INIS)

Driscoll, Brandon; Jaffray, David; Coolens, Catherine

2014-01-01

Purpose: To provide clinicians and researchers participating in multi-centre clinical trials with a central repository for large volume dynamic imaging data as well as a set of tools for providing end-to-end testing and image analysis standards of practice. Methods: There are three main pieces to the data archiving and analysis system; the PACS server, the data analysis computer(s) and the high-speed networks that connect them. Each clinical trial is anonymized using a customizable anonymizer and is stored on a PACS only accessible by AE title access control. The remote analysis station consists of a single virtual machine per trial running on a powerful PC supporting multiple simultaneous instances. Imaging data management and analysis is performed within ClearCanvas Workstation® using custom designed plug-ins for kinetic modelling (The DCE-Tool®), quality assurance (The DCE-QA Tool) and RECIST. Results: A framework has been set up currently serving seven clinical trials spanning five hospitals with three more trials to be added over the next six months. After initial rapid image transfer (+ 2 MB/s), all data analysis is done server side making it robust and rapid. This has provided the ability to perform computationally expensive operations such as voxel-wise kinetic modelling on very large data archives (+20 GB/50k images/patient) remotely with minimal end-user hardware. Conclusions: This system is currently in its proof of concept stage but has been used successfully to send and analyze data from remote hospitals. Next steps will involve scaling up the system with a more powerful PACS and multiple high powered analysis machines as well as adding real-time review capabilities.

Variable cycle control model for intersection based on multi-source information

Science.gov (United States)

Sun, Zhi-Yuan; Li, Yue; Qu, Wen-Cong; Chen, Yan-Yan

2018-05-01

In order to improve the efficiency of traffic control system in the era of big data, a new variable cycle control model based on multi-source information is presented for intersection in this paper. Firstly, with consideration of multi-source information, a unified framework based on cyber-physical system is proposed. Secondly, taking into account the variable length of cell, hysteresis phenomenon of traffic flow and the characteristics of lane group, a Lane group-based Cell Transmission Model is established to describe the physical properties of traffic flow under different traffic signal control schemes. Thirdly, the variable cycle control problem is abstracted into a bi-level programming model. The upper level model is put forward for cycle length optimization considering traffic capacity and delay. The lower level model is a dynamic signal control decision model based on fairness analysis. Then, a Hybrid Intelligent Optimization Algorithm is raised to solve the proposed model. Finally, a case study shows the efficiency and applicability of the proposed model and algorithm.

Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study

Directory of Open Access Journals (Sweden)

Grant Adrian M

2006-12-01

Full Text Available Abstract Background Securing and managing finances for multicentre randomised controlled trials is a highly complex activity which is rarely considered in the research literature. This paper describes the process of financial negotiation and the impact of financial considerations in four UK multicentre trials. These trials had met, or were on schedule to meet, recruitment targets agreed with their public-sector funders. The trials were considered within a larger study examining factors which might be associated with trial recruitment (STEPS. Methods In-depth semi-structured telephone interviews were conducted in 2003–04 with 45 individuals with various responsibilities to one of the four trials. Interviewees were recruited through purposive and then snowball sampling. Interview transcripts were analysed with the assistance of the qualitative package Atlas-ti. Results The data suggest that the UK system of dividing funds into research, treatment and NHS support costs brought the trial teams into complicated negotiations with multiple funders. The divisions were somewhat malleable and the funding system was used differently in each trial. The fact that all funders had the potential to influence and shape the trials considered here was an important issue as the perspectives of applicants and funders could diverge. The extent and range of industry involvement in non-industry-led trials was striking. Three broad periods of financial work (foundation, maintenance, and resourcing completion were identified. From development to completion of a trial, the trialists had to be resourceful and flexible, adapting to changing internal and external circumstances. In each period, trialists and collaborators could face changing costs and challenges. Each trial extended the recruitment period; three required funding extensions from MRC or HTA. Conclusion This study highlights complex financial aspects of planning and conducting trials, especially where multiple

Financial considerations in the conduct of multi-centre randomised controlled trials: evidence from a qualitative study.

Science.gov (United States)

Snowdon, Claire; Elbourne, Diana R; Garcia, Jo; Campbell, Marion K; Entwistle, Vikki A; Francis, David; Grant, Adrian M; Knight, Rosemary C; McDonald, Alison M; Roberts, Ian

2006-12-21

Securing and managing finances for multicentre randomised controlled trials is a highly complex activity which is rarely considered in the research literature. This paper describes the process of financial negotiation and the impact of financial considerations in four UK multicentre trials. These trials had met, or were on schedule to meet, recruitment targets agreed with their public-sector funders. The trials were considered within a larger study examining factors which might be associated with trial recruitment (STEPS). In-depth semi-structured telephone interviews were conducted in 2003-04 with 45 individuals with various responsibilities to one of the four trials. Interviewees were recruited through purposive and then snowball sampling. Interview transcripts were analysed with the assistance of the qualitative package Atlas-ti. The data suggest that the UK system of dividing funds into research, treatment and NHS support costs brought the trial teams into complicated negotiations with multiple funders. The divisions were somewhat malleable and the funding system was used differently in each trial. The fact that all funders had the potential to influence and shape the trials considered here was an important issue as the perspectives of applicants and funders could diverge. The extent and range of industry involvement in non-industry-led trials was striking. Three broad periods of financial work (foundation, maintenance, and resourcing completion) were identified. From development to completion of a trial, the trialists had to be resourceful and flexible, adapting to changing internal and external circumstances. In each period, trialists and collaborators could face changing costs and challenges. Each trial extended the recruitment period; three required funding extensions from MRC or HTA. This study highlights complex financial aspects of planning and conducting trials, especially where multiple funders are involved. Recognition of the importance of financial

Luteinizing hormone-releasing hormone analogue (Buserelin) treatment for central precocious puberty: a multi-centre trial.

Science.gov (United States)

Werther, G A; Warne, G L; Ennis, G; Gold, H; Silink, M; Cowell, C T; Quigley, C; Howard, N; Antony, G; Byrne, G C

1990-02-01

A multi-centre open trial of Buserelin, a luteinizing hormone-releasing hormone (LHRH) analogue, was conducted in 13 children with central precocious puberty. Eleven children (eight girls and three boys), aged 3.4-10.2 years at commencement, completed the required 12 month period of treatment. Initially all patients received the drug by intranasal spray in a dose of 1200 micrograms/day, but by the end of the 12 month period two were having daily subcutaneous injections and three were receiving an increased dose intranasally. The first month of treatment was associated in one boy with increased aggression and masturbation, and in the girls with an increase in the prevalence of vaginal bleeding. Thereafter, however, both behavioural abnormalities and menstruation were suppressed. Median bone age increased significantly during the study, but without any significant change in the ratio of height age to bone age. The median predicted adult height for the group therefore did not alter significantly over the twelve months of the study. Buserelin treatment caused a reduction in the peak luteinizing hormone and follicle-stimulating hormone (FSH) responses to LHRH, mostly to prepubertal levels, and also suppressed basal FSH. In the first weeks of treatment, the girls' serum oestradiol levels rose significantly and then fell to prepubertal or early pubertal levels. A similar pattern was seen for serum testosterone levels. Serum somatomedin-C levels, however, showed little fluctuation over the course of the study. Buserelin treatment was safe and well accepted, and offers the promise of improved linear growth potential in precocious puberty.

Quantum control of multi-wave mixing

CERN Document Server

Zhang, Yanpeng; Xiao, Min

2013-01-01

Multi-wave mixing gives rise to new frequency components due to the interaction of light signals with a suitable nonlinear medium. In this book a systematic framework for the control of these processes is used to lead readers through a plethora of related effects and techniques.

Protocol for a multi-centre randomised controlled trial comparing arthroscopic hip surgery to physiotherapy-led care for femoroacetabular impingement (FAI): the Australian FASHIoN trial.

Science.gov (United States)

Murphy, Nicholas J; Eyles, Jillian; Bennell, Kim L; Bohensky, Megan; Burns, Alexander; Callaghan, Fraser M; Dickenson, Edward; Fary, Camdon; Grieve, Stuart M; Griffin, Damian R; Hall, Michelle; Hobson, Rachel; Kim, Young Jo; Linklater, James M; Lloyd, David G; Molnar, Robert; O'Connell, Rachel L; O'Donnell, John; O'Sullivan, Michael; Randhawa, Sunny; Reichenbach, Stephan; Saxby, David J; Singh, Parminder; Spiers, Libby; Tran, Phong; Wrigley, Tim V; Hunter, David J

2017-09-26

Femoroacetabular impingement syndrome (FAI), a hip disorder affecting active young adults, is believed to be a leading cause of hip osteoarthritis (OA). Current management approaches for FAI include arthroscopic hip surgery and physiotherapy-led non-surgical care; however, there is a paucity of clinical trial evidence comparing these approaches. In particular, it is unknown whether these management approaches modify the future risk of developing hip OA. The primary objective of this randomised controlled trial is to determine if participants with FAI who undergo hip arthroscopy have greater improvements in hip cartilage health, as demonstrated by changes in delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) index between baseline and 12 months, compared to those who undergo physiotherapy-led non-surgical management. This is a pragmatic, multi-centre, two-arm superiority randomised controlled trial comparing hip arthroscopy to physiotherapy-led management for FAI. A total of 140 participants with FAI will be recruited from the clinics of participating orthopaedic surgeons, and randomly allocated to receive either surgery or physiotherapy-led non-surgical care. The surgical intervention involves arthroscopic FAI surgery from one of eight orthopaedic surgeons specialising in this field, located in three different Australian cities. The physiotherapy-led non-surgical management is an individualised physiotherapy program, named Personalised Hip Therapy (PHT), developed by a panel to represent the best non-operative care for FAI. It entails at least six individual physiotherapy sessions over 12 weeks, and up to ten sessions over six months, provided by experienced musculoskeletal physiotherapists trained to deliver the PHT program. The primary outcome measure is the change in dGEMRIC score of a ROI containing both acetabular and femoral head cartilages at the chondrolabral transitional zone of the mid-sagittal plane between baseline and

Validation of protein carbonyl measurement: A multi-centre study

Directory of Open Access Journals (Sweden)

Edyta Augustyniak

2015-04-01

Full Text Available Protein carbonyls are widely analysed as a measure of protein oxidation. Several different methods exist for their determination. A previous study had described orders of magnitude variance that existed when protein carbonyls were analysed in a single laboratory by ELISA using different commercial kits. We have further explored the potential causes of variance in carbonyl analysis in a ring study. A soluble protein fraction was prepared from rat liver and exposed to 0, 5 and 15 min of UV irradiation. Lyophilised preparations were distributed to six different laboratories that routinely undertook protein carbonyl analysis across Europe. ELISA and Western blotting techniques detected an increase in protein carbonyl formation between 0 and 5 min of UV irradiation irrespective of method used. After irradiation for 15 min, less oxidation was detected by half of the laboratories than after 5 min irradiation. Three of the four ELISA carbonyl results fell within 95% confidence intervals. Likely errors in calculating absolute carbonyl values may be attributed to differences in standardisation. Out of up to 88 proteins identified as containing carbonyl groups after tryptic cleavage of irradiated and control liver proteins, only seven were common in all three liver preparations. Lysine and arginine residues modified by carbonyls are likely to be resistant to tryptic proteolysis. Use of a cocktail of proteases may increase the recovery of oxidised peptides. In conclusion, standardisation is critical for carbonyl analysis and heavily oxidised proteins may not be effectively analysed by any existing technique.

Passivity-Based Control of Multi-Terminal HVDC Systems under Control Saturation Constraints

NARCIS (Netherlands)

Doria-Cerezo, Arnau; Olm, Josep M.; Scherpen, Jacquelien M.A.

2015-01-01

This paper proposes a decentralized, passivity-based control design for power stations in a multi-terminal High Voltage Direct Current transmission system. The control algorithm is shown to asymptotically stabilize the closed-loop system when the voltage set points are appropriately selected. The

Multi-sensor control for precise assembly of optical components

Directory of Open Access Journals (Sweden)

Ma Li

2014-06-01

Full Text Available In order to perform an optical assembly accurately, a multi-sensor control strategy is developed which includes an attitude measurement system, a vision system, a loss measurement system and a force sensor. A 3-DOF attitude measuring method using linear variable differential transformers (LVDT is designed to adjust the relation of position and attitude between the spherical mirror and the resonator. A micro vision feedback system is set up to extract the light beam and the diaphragm, which can achieve the coarse positioning of the spherical mirror in the optical assembly process. A rapid self-correlation method is presented to analyze the spectrum signal for the fine positioning. In order to prevent the damage of the optical components and realize sealing of the resonator, a hybrid force-position control is constructed to control the contact force of the optical components. The experimental results show that the proposed multi-sensor control strategy succeeds in accomplishing the precise assembly of the optical components, which consists of parallel adjustment, macro coarse adjustment, macro approach, micro fine adjustment, micro approach and optical contact. Therefore, the results validate the multi-sensor control strategy.

Design and analysis of the location of an online resale business distribution centre in Japan

Directory of Open Access Journals (Sweden)

K. Suzuki

2016-01-01

Full Text Available The location of distribution centres for online retailers has become an important issue for many companies. The operation of the distribution centre for e-commerce seems to be different from the traditional concept of distribution centres. This study considers how the location of distribution centres are designed and operated for online retailing using a computer simulation with actual data. This paper analyses current issues in order to propose an effective location for e-commerce distribution centres. An effective location for a multi-distribution system over a wide geographical area is required. This paper clearly points out the importance of locating e-commerce distribution centres over a wide geographical area by performing a computer simulation using actual data on the assumption that online resale business customers live in a metropolitan area. The study created a business model in which a buffer warehouse, which primarily handled commodities with high-frequency shipments, was located near a large consumption area and was used in addition to a large-scale distribution centre. The validity of the created business model was verified by performing a simulation based on actual data. The result revealed that these recommended improvement measures for the location of e-commerce distribution centres can function effectively.

Integrated production planning and control: A multi-objective optimization model

Directory of Open Access Journals (Sweden)

Cheng Wang

2013-09-01

Full Text Available Purpose: Production planning and control has crucial impact on the production and business activities of enterprise. Enterprise Resource Planning (ERP is the most popular resources planning and management system, however there are some shortcomings and deficiencies in the production planning and control because its core component is still the Material Requirements Planning (MRP. For the defects of ERP system, many local improvement and optimization schemes have been proposed, and improve the feasibility and practicality of the plan in some extent, but study considering the whole planning system optimization in the multiple performance management objectives and achieving better application performance is less. The purpose of this paper is to propose a multi-objective production planning optimization model Based on the point of view of the integration of production planning and control, in order to achieve optimization and control of enterprise manufacturing management. Design/methodology/approach: On the analysis of ERP planning system’s defects and disadvantages, and related research and literature, a multi-objective production planning optimization model is proposed, in addition to net demand and capacity, multiple performance management objectives, such as on-time delivery, production balance, inventory, overtime production, are considered incorporating into the examination scope of the model, so that the manufacturing process could be management and controlled Optimally between multiple objectives. The validity and practicability of the model will be verified by the instance in the last part of the paper. Findings: The main finding is that production planning management of manufacturing enterprise considers not only the capacity and materials, but also a variety of performance management objectives in the production process, and building a multi-objective optimization model can effectively optimize the management and control of enterprise

Motion control of multi-actuator hydraulic systems for mobile machineries: Recent advancements and future trends

Science.gov (United States)

Xu, Bing; Cheng, Min

2018-06-01

This paper presents a survey of recent advancements and upcoming trends in motion control technologies employed in designing multi-actuator hydraulic systems for mobile machineries. Hydraulic systems have been extensively used in mobile machineries due to their superior power density and robustness. However, motion control technologies of multi-actuator hydraulic systems have faced increasing challenges due to stringent emission regulations. In this study, an overview of the evolution of existing throttling control technologies is presented, including open-center and load sensing controls. Recent advancements in energy-saving hydraulic technologies, such as individual metering, displacement, and hybrid controls, are briefly summarized. The impact of energy-saving hydraulic technologies on dynamic performance and control solutions are also discussed. Then, the advanced operation methods of multi-actuator mobile machineries are reviewed, including coordinated and haptic controls. Finally, challenges and opportunities of advanced motion control technologies are presented by providing an overall consideration of energy efficiency, controllability, cost, reliability, and other aspects.

MultiController: the PLC-SCADA object for advanced regulation

CERN Document Server

Ortola, J

2007-01-01

Nowadays, industrial solutions with PLCs (Programmable Logic Controllers) have basic control loop features. The SCADA (Supervisory Control And Data Acquisition) system is a key point of the process control system due to an efficient HMI (Human Machine Interfaces) that provides an open method of tuning and leading possibilities. As a consequence, advanced control algorithms have to be developed and implemented for those PLC-SCADA solutions in order to provide perspectives in solving complex and critical regulation problems. The MultiController is an object integrated for a large scale project at CERN (the European Organization for Nuclear Research) named LHC-GCS (Large Hadron Collider - Gas Control System). It is developed for a Framework called CERN-UNICOS based on PLC-SCADA facilities. The MultiController object offers various advanced control loop strategies. It gives to the user advanced control algorithms like PID, Smith Predictor, PFC, GPC and RST. It is implemented as a monolithic entity (in PLC and SCA...

Community-centred eco-bio-social approach to control dengue vectors: an intervention study from Myanmar.

Science.gov (United States)

Wai, Khin Thet; Htun, Pe Than; Oo, Tin; Myint, Hla; Lin, Zaw; Kroeger, Axel; Sommerfeld, Johannes; Petzold, Max

2012-12-01

To build up and analyse the feasibility, process, and effectiveness of a partnership-driven ecosystem management intervention in reducing dengue vector breeding and constructing sustainable partnerships among multiple stakeholders. A community-based intervention study was conducted from May 2009 to January 2010 in Yangon city. Six high-risk and six low-risk clusters were randomized and allocated as intervention and routine service areas, respectively. For each cluster, 100 households were covered. Bi-monthly entomological evaluations (i.e. larval and pupal surveys) and household acceptability surveys at the end of 6-month intervention period were conducted, supplemented by qualitative evaluations. Intervention description: The strategies included eco-friendly multi-stakeholder partner groups (Thingaha) and ward-based volunteers, informed decision-making of householders, followed by integrated vector management approach. Pupae per person index (PPI) decreased at the last evaluation by 5·7% (0·35-0·33) in high-risk clusters. But in low-risk clusters, PPI remarkably decreased by 63·6% (0·33-0·12). In routine service area, PPI also decreased due to availability of Temephos after Cyclone Nargis. As for total number of pupae in all containers, when compared to evaluation 1, there was a reduction of 18·6% in evaluation 2 and 44·1% in evaluation 3 in intervention area. However, in routine service area, more reduction was observed. All intervention tools were found as acceptable, being feasible to implement by multi-stakeholder partner groups. The efficacy of community-controlled partnership-driven interventions was found to be superior to the vertical approach in terms of sustainability and community empowerment.

SU-C-BRD-01: Multi-Centre Collaborative Quality Assurance Program for IMRT Planning and Delivery: Year 3 Results

Energy Technology Data Exchange (ETDEWEB)

McNiven, A; Jaffray, D; Letourneau, D [Princess Margaret Cancer Centre and Department of Radiation Oncology, University of Toronto, Toronto, ON (Canada)

2015-06-15

Purpose: A multi-centre quality assurance program was developed to enable quality improvement by coupling measurement of intensity modulated radiotherapy (IMRT) planning and delivery performance for site-specific planning exercises with diagnostic testing. The third year of the program specifically assessed the quality of spine stereotactic body radiotherapy (SBRT) planning and delivery amongst the participating centres. Methods: A spine SBRT planning exercise (24 Gy in 2 fractions) was created and completed by participants prior to an on-site visit. The delivery portion of the on-site visit included spine SBRT plan delivery and diagnostic testing, which included portal image acquisition for quantification of phantom positioning error and multi-leaf collimator (MLC) calibration accuracy. The measured dose was compared to that calculated in the treatment planning system (TPS) using 3%/2mm composite analysis and 3%/3mm gamma analysis. Results: Fourteen institutions participated, creating 17 spine SBRT plans (15 VMAT and 2 IMRT). Three different TPS, two beam energies (6 MV and 6 MV FFF), and four MLC designs from two linac vendors were tested. Large variation in total monitor units (MU) per plan (2494–6462 MU) and dose-volume parameters was observed. The maximum point dose in the plans ranged from 116–149% and was dependent upon the TPS used. Pass rates for measured to planned dose comparison ranged from 89.4–100% and 97.3–100% for 3%/2mm and 3%/3mm criteria respectively. The largest measured MLC error did Result in one of the poorer pass rates. No direct correlation between phantom positioning error and pass rates overall. Conclusion: Significant differences were observed in the planning exercise for some plan and dose-volume parameters based on the TPS used. Standard evaluation criteria showed good agreement between planned and measured dose for all participants, however on an individual plan basis, diagnostic tests were able to identify contributing

SU-C-BRD-01: Multi-Centre Collaborative Quality Assurance Program for IMRT Planning and Delivery: Year 3 Results

International Nuclear Information System (INIS)

McNiven, A; Jaffray, D; Letourneau, D

2015-01-01

Purpose: A multi-centre quality assurance program was developed to enable quality improvement by coupling measurement of intensity modulated radiotherapy (IMRT) planning and delivery performance for site-specific planning exercises with diagnostic testing. The third year of the program specifically assessed the quality of spine stereotactic body radiotherapy (SBRT) planning and delivery amongst the participating centres. Methods: A spine SBRT planning exercise (24 Gy in 2 fractions) was created and completed by participants prior to an on-site visit. The delivery portion of the on-site visit included spine SBRT plan delivery and diagnostic testing, which included portal image acquisition for quantification of phantom positioning error and multi-leaf collimator (MLC) calibration accuracy. The measured dose was compared to that calculated in the treatment planning system (TPS) using 3%/2mm composite analysis and 3%/3mm gamma analysis. Results: Fourteen institutions participated, creating 17 spine SBRT plans (15 VMAT and 2 IMRT). Three different TPS, two beam energies (6 MV and 6 MV FFF), and four MLC designs from two linac vendors were tested. Large variation in total monitor units (MU) per plan (2494–6462 MU) and dose-volume parameters was observed. The maximum point dose in the plans ranged from 116–149% and was dependent upon the TPS used. Pass rates for measured to planned dose comparison ranged from 89.4–100% and 97.3–100% for 3%/2mm and 3%/3mm criteria respectively. The largest measured MLC error did Result in one of the poorer pass rates. No direct correlation between phantom positioning error and pass rates overall. Conclusion: Significant differences were observed in the planning exercise for some plan and dose-volume parameters based on the TPS used. Standard evaluation criteria showed good agreement between planned and measured dose for all participants, however on an individual plan basis, diagnostic tests were able to identify contributing

Colorectal cancer and its association with the metabolic syndrome: a Malaysian multi-centric case-control study.

Science.gov (United States)

Ulaganathan, V; Kandiah, M; Zalilah, M S; Faizal, J A; Fijeraid, H; Normayah, K; Gooi, B H; Othman, R

2012-01-01

Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two. Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280). MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed. This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Malaysian population is a high priority to confirm these findings.

Reliability analysis and component functional allocations for the ESF multi-loop controller design

International Nuclear Information System (INIS)

Hur, Seop; Kim, D.H.; Choi, J.K.; Park, J.C.; Seong, S.H.; Lee, D.Y.

2006-01-01

This paper deals with the reliability analysis and component functional allocations to ensure the enhanced system reliability and availability. In the Engineered Safety Features, functionally dependent components are controlled by a multi-loop controller. The system reliability of the Engineered Safety Features-Component Control System, especially, the multi-loop controller which is changed comparing to the conventional controllers is an important factor for the Probability Safety Assessment in the nuclear field. To evaluate the multi-loop controller's failure rate of the k-out-of-m redundant system, the binomial process is used. In addition, the component functional allocation is performed to tolerate a single multi-loop controller failure without the loss of vital operation within the constraints of the piping and component configuration, and ensure that mechanically redundant components remain functional. (author)

Doxycycline in the treatment of respiratory tract infections. Results of a pan-European multi-centre trial.

Science.gov (United States)

Pestel, M

1975-01-01

In the winter of 1973-4, general practitioners from seven European countries took part in a multi-centre trial of doxycycline in the treatment of infections of the respiratory tract. The carefully designed protocol was observed by all participants. A total of 1,747 patients were admitted to the trial; their ages ranged from 6 years to over 80. The commonest diagnoses (50%) were acute bronchitis and acute exacerbations of chronic bronchitis. On the recommended dosage of 200 mg doxycycline on the first day, followed by 100 mg daily thereafter (though 200 mg could be continued daily in severe cases), 87% of patients achieved good or very good results. Both subjective (pain) and objective (sputum volume and viscosity, temperature, cough) measures showed rapid improvement, usually by the third to fifth days. Side-effects were minimal and mainly gastrointestinal and caused only 4 patients to discontinue treatment. Overall, doxycycline proved its effectiveness and rapidity of action.

Towards Coordination and Control of Multi-robot Systems

DEFF Research Database (Denmark)

Quottrup, Michael Melholt

This thesis focuses on control and coordination of mobile multi-robot systems (MRS). MRS can often deal with tasks that are difficult to be accomplished by a single robot. One of the challenges is the need to control, coordinate and synchronize the operation of several robots to perform some...... specified task. This calls for new strategies and methods which allow the desired system behavior to be specified in a formal and succinct way. Two different frameworks for the coordination and control of MRS have been investigated. Framework I - A network of robots is modeled as a network of multi...... a requirement specification in Computational Tree Logic (CTL) for a network of robots. The result is a set of motion plans for the robots which satisfy the specification. Framework II - A framework for controller synthesis for a single robot with respect to requirement specification in Linear-time Temporal...

Disk access controller for Multi 8 computer

International Nuclear Information System (INIS)

Segalard, Jean

1970-01-01

After having presented the initial characteristics and weaknesses of the software provided for the control of a memory disk coupled with a Multi 8 computer, the author reports the development and improvement of this controller software. He presents the different constitutive parts of the computer and the operation of the disk coupling and of the direct access to memory. He reports the development of the disk access controller: software organisation, loader, subprograms and statements

Minimum ten-year follow-up of acetabular fracture fixation from the Irish tertiary referral centre.

LENUS (Irish Health Repository)

Magill, Paul

2012-04-01

Successful outcome from acetabular fracture fixation is multi-factorial. Long-term results are not frequently reported. Pooling such data from high output centres will help progress acetabular fixation. This paper presents the first ten-year data from the Irish tertiary referral centre.

L1 Adaptive Control Augmentation System with Application to the X-29 Lateral/Directional Dynamics: A Multi-Input Multi-Output Approach

Science.gov (United States)

Griffin, Brian Joseph; Burken, John J.; Xargay, Enric

2010-01-01

This paper presents an L(sub 1) adaptive control augmentation system design for multi-input multi-output nonlinear systems in the presence of unmatched uncertainties which may exhibit significant cross-coupling effects. A piecewise continuous adaptive law is adopted and extended for applicability to multi-input multi-output systems that explicitly compensates for dynamic cross-coupling. In addition, explicit use of high-fidelity actuator models are added to the L1 architecture to reduce uncertainties in the system. The L(sub 1) multi-input multi-output adaptive control architecture is applied to the X-29 lateral/directional dynamics and results are evaluated against a similar single-input single-output design approach.

The centre of the action

CERN Multimedia

2008-01-01

The CERN Control Centre (CCC) has all the ingredients of an action movie control room: hundreds of screens, technicians buzzing in and out, huge floor-to-ceiling windows revealing the looming vista of a mountain range, flashing lights, microphones… This is the place where not just the LHC, but the whole of CERN’s accelerator complex and technical support is based - truly the centre of the action at CERN.

A Novel Secondary Control for Microgrid Based on Synergetic Control of Multi-Agent System

Directory of Open Access Journals (Sweden)

Zhiwen Yu

2016-03-01

Full Text Available In power systems, the secondary control is a very useful way to restore the system frequency and voltage to the rated value. This paper tries to propose a secondary frequency and voltage control of islanded microgrids based on the distributed synergetic control of multi-agent systems. In the proposed control, since each distributed generation only requires its own information and that of the neighbors, the secondary control is fully distributed. The system is more reliable because the central controller and complex communication network are reduced in the distributed structure. Based on multi-agent systems, the dynamic model is established, and distributed synergetic control algorithms are given to design the secondary control of the islanded microgrid. Meanwhile, the system has globally asymptotic stability under the proposed control, which is proved by the direct Lyapunov method. Simulation results about a test microgrid are given to verify the effectiveness of the proposed control.

A Reconfiguration Scheme for Accommodating Actuator Failures in Multi-Input, Multi-Output Flight Control Systems

Science.gov (United States)

Siwakosit, W.; Hess, R. A.; Bacon, Bart (Technical Monitor); Burken, John (Technical Monitor)

2000-01-01

A multi-input, multi-output reconfigurable flight control system design utilizing a robust controller and an adaptive filter is presented. The robust control design consists of a reduced-order, linear dynamic inversion controller with an outer-loop compensation matrix derived from Quantitative Feedback Theory (QFT). A principle feature of the scheme is placement of the adaptive filter in series with the QFT compensator thus exploiting the inherent robustness of the nominal flight control system in the presence of plant uncertainties. An example of the scheme is presented in a pilot-in-the-loop computer simulation using a simplified model of the lateral-directional dynamics of the NASA F18 High Angle of Attack Research Vehicle (HARV) that included nonlinear anti-wind up logic and actuator limitations. Prediction of handling qualities and pilot-induced oscillation tendencies in the presence of these nonlinearities is included in the example.

Development of a QFD-based expert system for CNC turning centre selection

Science.gov (United States)

Prasad, Kanika; Chakraborty, Shankar

2015-12-01

Computer numerical control (CNC) machine tools are automated devices capable of generating complicated and intricate product shapes in shorter time. Selection of the best CNC machine tool is a critical, complex and time-consuming task due to availability of a wide range of alternatives and conflicting nature of several evaluation criteria. Although, the past researchers had attempted to select the appropriate machining centres using different knowledge-based systems, mathematical models and multi-criteria decision-making methods, none of those approaches has given due importance to the voice of customers. The aforesaid limitation can be overcome using quality function deployment (QFD) technique, which is a systematic approach for integrating customers' needs and designing the product to meet those needs first time and every time. In this paper, the adopted QFD-based methodology helps in selecting CNC turning centres for a manufacturing organization, providing due importance to the voice of customers to meet their requirements. An expert system based on QFD technique is developed in Visual BASIC 6.0 to automate the CNC turning centre selection procedure for different production plans. Three illustrative examples are demonstrated to explain the real-time applicability of the developed expert system.

Multi-agent control system with information fusion based comfort model for smart buildings

International Nuclear Information System (INIS)

Wang, Zhu; Wang, Lingfeng; Dounis, Anastasios I.; Yang, Rui

2012-01-01

Highlights: ► Proposed a model to manage indoor energy and comfort for smart buildings. ► Developed a control system to maximize comfort with minimum energy consumption. ► Information fusion with ordered weighted averaging aggregation is used. ► Multi-agent technology and heuristic intelligent optimization are deployed in developing the control system. -- Abstract: From the perspective of system control, a smart and green building is a large-scale dynamic system with high complexity and a huge amount of information. Proper combination of the available information and effective control of the overall building system turns out to be a big challenge. In this study, we proposed a building indoor energy and comfort management model based on information fusion using ordered weighted averaging (OWA) aggregation. A multi-agent control system with heuristic intelligent optimization is developed to achieve a high level of comfort with the minimum power consumption. Case studies and simulation results are presented and discussed in this paper.

International Workshop on Service Orientation in Holonic and Multi-Agent Manufacturing

CERN Document Server

Trentesaux, Damien; Thomas, André; McFarlane, Duncan

2016-01-01

This volume gathers the peer reviewed papers which were presented at the 5th edition of the International Workshop “Service Orientation in Holonic and Multi-agent Man-ufacturing – SOHOMA’15” organized in November 5-6, 2015 by the Institute for Manufacturing (IfM) of the University of Cambridge, UK in collaboration with the CIMR Research Centre in Computer Integrated Manufacturing and Robotics of the University Politehnica of Bucharest, Romania, the LAMIH Laboratory of Industrial and Human Automation Control, Mechanical Engineering and Computer Science of the University of Valenciennes and Hainaut-Cambrésis, France and the CRAN Re-search Centre for Automatic Control, Nancy of the University of Lorraine, France. The book is structured in seven parts, each one grouping a number of chapters de-scribing research in actual domains of the digital transformation in manufacturing and trends in future manufacturing control: (1) Applications of Intelligent Products; (2) Advances in Control of Physical Internet ...

Conceptual design of an ALICE Tier-2 centre. Integrated into a multi-purpose computing facility

Energy Technology Data Exchange (ETDEWEB)

Zynovyev, Mykhaylo

2012-06-29

This thesis discusses the issues and challenges associated with the design and operation of a data analysis facility for a high-energy physics experiment at a multi-purpose computing centre. At the spotlight is a Tier-2 centre of the distributed computing model of the ALICE experiment at the Large Hadron Collider at CERN in Geneva, Switzerland. The design steps, examined in the thesis, include analysis and optimization of the I/O access patterns of the user workload, integration of the storage resources, and development of the techniques for effective system administration and operation of the facility in a shared computing environment. A number of I/O access performance issues on multiple levels of the I/O subsystem, introduced by utilization of hard disks for data storage, have been addressed by the means of exhaustive benchmarking and thorough analysis of the I/O of the user applications in the ALICE software framework. Defining the set of requirements to the storage system, describing the potential performance bottlenecks and single points of failure and examining possible ways to avoid them allows one to develop guidelines for selecting the way how to integrate the storage resources. The solution, how to preserve a specific software stack for the experiment in a shared environment, is presented along with its effects on the user workload performance. The proposal for a flexible model to deploy and operate the ALICE Tier-2 infrastructure and applications in a virtual environment through adoption of the cloud computing technology and the 'Infrastructure as Code' concept completes the thesis. Scientific software applications can be efficiently computed in a virtual environment, and there is an urgent need to adapt the infrastructure for effective usage of cloud resources.

Conceptual design of an ALICE Tier-2 centre. Integrated into a multi-purpose computing facility

International Nuclear Information System (INIS)

Zynovyev, Mykhaylo

2012-01-01

This thesis discusses the issues and challenges associated with the design and operation of a data analysis facility for a high-energy physics experiment at a multi-purpose computing centre. At the spotlight is a Tier-2 centre of the distributed computing model of the ALICE experiment at the Large Hadron Collider at CERN in Geneva, Switzerland. The design steps, examined in the thesis, include analysis and optimization of the I/O access patterns of the user workload, integration of the storage resources, and development of the techniques for effective system administration and operation of the facility in a shared computing environment. A number of I/O access performance issues on multiple levels of the I/O subsystem, introduced by utilization of hard disks for data storage, have been addressed by the means of exhaustive benchmarking and thorough analysis of the I/O of the user applications in the ALICE software framework. Defining the set of requirements to the storage system, describing the potential performance bottlenecks and single points of failure and examining possible ways to avoid them allows one to develop guidelines for selecting the way how to integrate the storage resources. The solution, how to preserve a specific software stack for the experiment in a shared environment, is presented along with its effects on the user workload performance. The proposal for a flexible model to deploy and operate the ALICE Tier-2 infrastructure and applications in a virtual environment through adoption of the cloud computing technology and the 'Infrastructure as Code' concept completes the thesis. Scientific software applications can be efficiently computed in a virtual environment, and there is an urgent need to adapt the infrastructure for effective usage of cloud resources.

Multi-level Control Framework for Enhanced Flexibility of Active Distribution Network

DEFF Research Database (Denmark)

Nainar, Karthikeyan; Pokhrel, Basanta Raj; Pillai, Jayakrishnan Radhakrishna

2017-01-01

In this paper, the control objectives of future active distribution networks with high penetration of renewables and flexible loads are analyzed and reviewed. From a state of the art review, the important control objectives seen from the perspective of a distribution system operator are identifie......-ordination and management of the network assets at different voltage levels and geographical locations. The paper finally shows the applicability of the multi-level control architecture to some of the key challenges in the distribution system operation by relevant scenarios....... to be hosting capacity improvement, high reliable operation and cost effective network management. Based on this review and a state of the art review concerning future distribution network control methods, a multi-level control architecture is constructed for an active distribution network, which satisfies...... the selected control objectives and provides enhanced flexibility. The control architecture is supported by generation/load forecasting and distribution state estimation techniques to improve the controllability of the network. The multi-level control architecture consists of three levels of hierarchical...

Dynamic clustering scheme based on the coordination of management and control in multi-layer and multi-region intelligent optical network

Science.gov (United States)

Niu, Xiaoliang; Yuan, Fen; Huang, Shanguo; Guo, Bingli; Gu, Wanyi

2011-12-01

A Dynamic clustering scheme based on coordination of management and control is proposed to reduce network congestion rate and improve the blocking performance of hierarchical routing in Multi-layer and Multi-region intelligent optical network. Its implement relies on mobile agent (MA) technology, which has the advantages of efficiency, flexibility, functional and scalability. The paper's major contribution is to adjust dynamically domain when the performance of working network isn't in ideal status. And the incorporation of centralized NMS and distributed MA control technology migrate computing process to control plane node which releases the burden of NMS and improves process efficiently. Experiments are conducted on Multi-layer and multi-region Simulation Platform for Optical Network (MSPON) to assess the performance of the scheme.

HIV and childhood disability: a case-controlled study at a paediatric antiretroviral therapy centre in Lilongwe, Malawi.

Directory of Open Access Journals (Sweden)

Akash Devendra

Full Text Available BACKGROUND: As paediatric antiretroviral therapy (ART is rapidly scaled up in Southern Africa, Human Immunodeficiency Virus (HIV infection is becoming a chronic illness. Children growing up with HIV may begin to encounter disabilities. The relationship between HIV, disability and the need for rehabilitation has added an additional element that needs to be addressed by paediatric HIV treatment programmes. STUDY OBJECTIVES: 1 Estimate the prevalence of disabilities in HIV-infected and HIV-uninfected children in Lilongwe, Malawi. 2 Examine types of disability and associated clinical and socio-demographic factors. 3 Identify needs, opportunities and barriers for rehabilitation in Malawi. METHODS: A case-controlled study of 296 HIV-infected children aged 2-9 years attending an ART centre in Lilongwe (cases and their uninfected siblings (controls was conducted. Disability was assessed using the WHO Ten Question Screen (TQS. Socio-demographic and clinical data were collected using a parent-proxy questionnaire and medical records. RESULTS: Of 296 case and control pairs recruited, 33% (98 versus 7% (20 screened positive for a disability (OR 8.4, 4.4-15.7 respectively. Of these 98 HIV-infected cases, 6%, 36%, 33%, 53%, 46% and 6% had a vision, hearing; physical, learning/comprehension, speech or seizure-related disability respectively and 51% had multiple coexisting disabilities. HIV-infected cases with a disability were more likely to be WHO stage III or IV at enrolment (71% vs. 52%, OR 2.7, 1.5-4.2, to have had TB (58% vs. 39%, OR 2.3, 1.4-3.8 and to have below-average school grades (18% vs. 2%, OR 11.1, 2.2-54.6 than those without. Sixty-seven percent of cases with a disability had never attended any rehabilitative service. Twenty-nine percent of caregivers reported facing stigma and discrimination because of the child's disability. CONCLUSION: This study reveals the magnitude of disability among HIV-infected children and the large unmet need for

Coordinated Control of Multi-terminal DC Grid for Wind Power Integration

DEFF Research Database (Denmark)

Hao, Yu; Zhao, Haoran; Wu, Qiuwei

2016-01-01

Multi-terminal HVDC (MTDC) technology using voltage source converter (VSC) is a good option for wind power integration. Compared with point to point DC connection, MTDC provide better controllability based on different control strategies. In this paper, proportional-integral (PI) controllers...... with tuned PI parameters are designed to coordinate DC flow among the DC grid with good dynamic performance. In order to overcome the disadvantages of the conventional PI control, a simple adaptive PI control strategy is proposed based on the system transfer function. Case studies were conducted with PowerFactory....

Distributed Cooperative Control of Nonlinear and Non-identical Multi-agent Systems

DEFF Research Database (Denmark)

Bidram, Ali; Lewis, Frank; Davoudi, Ali

2013-01-01

This paper exploits input-output feedback linearization technique to implement distributed cooperative control of multi-agent systems with nonlinear and non-identical dynamics. Feedback linearization transforms the synchronization problem for a nonlinear and heterogeneous multi-agent system...... for electric power microgrids. The effectiveness of the proposed control is verified by simulating a microgrid test system....

Soft X-ray excited colour-centre luminescence and XANES studies of calcium oxide

International Nuclear Information System (INIS)

Ko, J.Y.P.; Heigl, F.; Yiu, Y.M.; Zhou, X.-T.; Regier, T.; Blyth, R.I.R.; Sham, T.-K.

2007-01-01

In this study, we show that colour centres can be produced by irradiating calcium oxide with soft X-rays from a synchrotron radiation source. Using the X-ray excited optical Iuminescence (XEOL) technique, two colour centres, F-centre, and F + -centre can be identified. These colour centres emit photons at characteristic wavelengths. In addition, by performing time-resolved XEOL (TRXEOL), we are able to reveal timing and decay characteristics of the colour centres. We also present X-ray absorption near-edge structure (XANES) spectra collected across oxygen K-edge, calcium L 3,2 -edge, and calcium K-edge. Experimental results are compared with density functional theory (DFT) calculations. (author)

Controlled assembly of multi-segment nanowires by histidine-tagged peptides

Energy Technology Data Exchange (ETDEWEB)

Wang, Aijun A; Lee, Joun; Jenikova, Gabriela; Mulchandani, Ashok; Myung, Nosang V; Chen, Wilfred [Department of Chemical and Environmental Engineering, University of California, Riverside, CA 92521 (United States)

2006-07-28

A facile technique was demonstrated for the controlled assembly and alignment of multi-segment nanowires using bioengineered polypeptides. An elastin-like-polypeptide (ELP)-based biopolymer consisting of a hexahistine cluster at each end (His{sub 6}-ELP-His{sub 6}) was generated and purified by taking advantage of the reversible phase transition property of ELP. The affinity between the His{sub 6} domain of biopolymers and the nickel segment of multi-segment nickel/gold/nickel nanowires was exploited for the directed assembly of nanowires onto peptide-functionalized electrode surfaces. The presence of the ferromagnetic nickel segments on the nanowires allowed the control of directionality by an external magnetic field. Using this method, the directed assembly and positioning of multi-segment nanowires across two microfabricated nickel electrodes in a controlled manner was accomplished with the expected ohmic contact.

Multi-purpose use of the advanced CANDU compact simulator

International Nuclear Information System (INIS)

Lam, K.Y.; MacBeth, M.J.

1997-01-01

A near full-scope dynamic model of a CANDU-PHWR (Canadian Deuterium Uranium Pressurized Heavy Water) nuclear power plant was constructed as a multi-purpose advanced Compact Simulator using CASSIM (Cassiopeia Simulation) development system. This Compact Simulator has played an integral part in the design and verification of the CANDU 900 MW control centre mock-up located in the Atomic Energy of Canada (AECL) design office, providing CANDU plant process dynamic data to the Plant Display System (PDS) and the Distributed Control System (DCS), as well as mock-up panel devices. As a design tool, the Compact Simulator is intended to be used for control strategy development, human factors studies, analysis of overall plant control performance, tuning estimates for major control loops. As a plant commissioning and operational strategy development tool, the simulation is intended to be used to evaluate routine and non-routine operational procedures, practice 'what-if' scenarios for operational strategy development, practice malfunction recovery procedures and verify human factors activities

Attitude and Configuration Control of Flexible Multi-Body Spacecraft

Science.gov (United States)

Cho, Sung-Ki; Cochran, John E., Jr.

2002-06-01

Multi-body spacecraft attitude and configuration control formulations based on the use of collaborative control theory are considered. The control formulations are based on two-player, nonzero-sum, differential game theory applied using a Nash strategy. It is desired that the control laws allow different components of the multi-body system to perform different tasks. For example, it may be desired that one body points toward a fixed star while another body in the system slews to track another satellite. Although similar to the linear quadratic regulator formulation, the collaborative control formulation contains a number of additional design parameters because the problem is formulated as two control problems coupled together. The use of the freedom of the partitioning of the total problem into two coupled control problems and the selection of the elements of the cross-coupling matrices are specific problems addressed in this paper. Examples are used to show that significant improvement in performance, as measured by realistic criteria, of collaborative control over conventional linear quadratic regulator control can be achieved by using proposed design guidelines.

Attitude and Configuration Control of Flexible Multi-Body Spacecraft

Directory of Open Access Journals (Sweden)

Sungki Cho

2002-06-01

Full Text Available Multi-body spacecraft attitude and configuration control formulations based on the use of collaborative control theory are considered. The control formulations are based on two-player, nonzero-sum, differential game theory applied using a Nash strategy. It is desired that the control laws allow different components of the multi-body system to perform different tasks. For example, it may be desired that one body points toward a fixed star while another body in the system slews to track another satellite. Although similar to the linear quadratic regulator formulation, the collaborative control formulation contains a number of additional design parameters because the problem is formulated as two control problems coupled together. The use of the freedom of the partitioning of the total problem into two coupled control problems and the selection of the elements of the cross-coupling matrices are specific problems addressed in this paper. Examples are used to show that significant improvement in performance, as measured by realistic criteria, of collaborative control over conventional linear quadratic regulator control can be achieved by using proposed design guidelines.

Attitude Control of Quad-rotor by Improving the Reliability of Multi-Sensor System

Energy Technology Data Exchange (ETDEWEB)

Yu, Dong Hyeon; Chong, Kil To [Chon-bok National University, Jeonju (Korea, Republic of); Park, Jong Ho [Seonam University, Namwon (Korea, Republic of); Ryu, Ji Hyoung [ETRI, Daejeon (Korea, Republic of)

2015-05-15

This paper presents the results of study for improving the reliability of quadrotor attitude control by applying a multi-sensor along with a data fusion algorithm. First, a mathematical model of the quadrotor dynamics was developed. Then, using the quadrotor mathematical model, simulations were performed using the improved reliability multi-sensor data as the inputs. From the simulation results, we designed a Gimbal-equipped quadrotor system. With the quadrotor in a hover state, we performed experiments according to the angle change of the user's specifications . We then calculated the attitude control data from the actual experimental data. Furthermore, with additional simulations, we verified the performance of the designed quadrotor attitude control system with multiple sensors.

Explicit/multi-parametric model predictive control (MPC) of linear discrete-time systems by dynamic and multi-parametric programming

KAUST Repository

Kouramas, K.I.; Faí sca, N.P.; Panos, C.; Pistikopoulos, E.N.

2011-01-01

This work presents a new algorithm for solving the explicit/multi- parametric model predictive control (or mp-MPC) problem for linear, time-invariant discrete-time systems, based on dynamic programming and multi-parametric programming techniques

An organisational change intervention for increasing the delivery of smoking cessation support in addiction treatment centres: study protocol for a randomized controlled trial.

Science.gov (United States)

Bonevski, Billie; Guillaumier, Ashleigh; Shakeshaft, Anthony; Farrell, Michael; Tzelepis, Flora; Walsberger, Scott; D'Este, Catherine; Paul, Chris; Dunlop, Adrian; Searles, Andrew; Kelly, Peter; Fry, Rae; Stirling, Robert; Fowlie, Carrie; Skelton, Eliza

2016-06-14

The provision of smoking cessation support in Australian drug and alcohol treatment services is sub-optimal. This study examines the cost-effectiveness of an organisational change intervention to reduce smoking amongst clients attending drug and alcohol treatment services. A cluster-randomised controlled trial will be conducted with drug and alcohol treatment centres as the unit of randomisation. Biochemically verified (carbon monoxide by breath analysis) client 7-day-point prevalence of smoking cessation at 6 weeks will be the primary outcome measure. The study will be conducted in 33 drug and alcohol treatment services in four mainland states and territories of Australia: New South Wales, Australian Capital Territory, Queensland, and South Australia. Eligible services are those with ongoing client contact and that include pharmacotherapy services, withdrawal management services, residential rehabilitation, counselling services, and case management services. Eligible clients are those aged over 16 years who are attending their first of a number of expected visits, are self-reported current smokers, proficient in the English language, and do not have severe untreated mental illness as identified by the service staff. Control services will continue to provide usual care to the clients. Intervention group services will receive an organisational change intervention, including assistance in developing smoke-free policies, nomination of champions, staff training and educational client and service resources, and free nicotine replacement therapy in order to integrate smoking cessation support as part of usual client care. If effective, the organisational change intervention has clear potential for implementation as part of the standard care in drug and alcohol treatment centres. Australian and New Zealand Clinical Trials Registry, ACTRN12615000204549 . Registered on 3 March 2015.

[The role of CCLINs in the event of an epidemic of multi-drug and highly resistant bacteria].

Science.gov (United States)

Landriu, Danièle

2015-01-01

The management of epidemics of multi-drug and highly resistant bacteria must be based on a structured organisation. Within each region it requires the expertise of centres for the interregional coordination of nosocomial infection control (CCLINs) and their regional branches of nosocomial infection control (Arlin) which support hospitals in reporting these types of epidemics. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

ALICE opens its new nerve centre

CERN Multimedia

Antonella Del Rosso

2014-01-01

Twenty-nine fully equipped and ergonomic workstations, one meeting area and 11 large format screens in a completely refurbished room: the ALICE Run Control Centre (ARC) implements the best and newest solutions for its shift workers and expert operators, including access for persons with reduced mobility and very soon a magic window for Point 2 visitors.   The ALICE Run Control Centre. “Our initial intention was just to optimise the old layout,” says Federico Ronchetti from Laboratori Nazionali di Frascati (Italy), a CERN scientific associate currently appointed as ALICE Run Coordinator and person in charge of the ALICE Consolidation Task Force. “However, during the review process, we carried out a study of all the existing control rooms at CERN and became aware we needed a radical change. Hence we started planning a complete redesign of the workspace.” Designed and equipped over many years, the old ALICE control room did not have enough space to fit al...

Low social interactions in eating disorder patients in childhood and adulthood: a multi-centre European case control study.

Science.gov (United States)

Krug, Isabel; Penelo, Eva; Fernandez-Aranda, Fernando; Anderluh, Marija; Bellodi, Laura; Cellini, Elena; di Bernardo, Milena; Granero, Roser; Karwautz, Andreas; Nacmias, Benedetta; Ricca, Valdo; Sorbi, Sandro; Tchanturia, Kate; Wagner, Gudrun; Collier, David; Treasure, Janet

2013-01-01

The objective of this article was to examine lifestyle behaviours in eating disorder (ED) patients and healthy controls. A total of 801 ED patients and 727 healthy controls from five European countries completed the questions related to lifestyle behaviours of the Cross-Cultural Questionnaire (CCQ). For children, the ED sample exhibited more solitary activities (rigorously doing homework [psocializing with friends [pgroup and this continued in adulthood. There were minimal differences across ED sub-diagnoses and various cross-cultural differences emerged. Reduced social activities may be an important risk and maintaining factor for ED symptomatology.

Multi-stage fuzzy load frequency control using PSO

International Nuclear Information System (INIS)

Shayeghi, H.; Jalili, A.; Shayanfar, H.A.

2008-01-01

In this paper, a particle swarm optimization (PSO) based multi-stage fuzzy (PSOMSF) controller is proposed for solution of the load frequency control (LFC) problem in a restructured power system that operate under deregulation based on the bilateral policy scheme. In this strategy the control is tuned on line from the knowledge base and fuzzy inference, which request fewer sources and has two rule base sets. In the proposed method, for achieving the desired level of robust performance, exact tuning of membership functions is very important. Thus, to reduce the design effort and find a better fuzzy system control, membership functions are designed automatically by PSO algorithm, that has a strong ability to find the most optimistic results. The motivation for using the PSO technique is to reduce fuzzy system effort and take large parametric uncertainties into account. This newly developed control strategy combines the advantage of PSO and fuzzy system control techniques and leads to a flexible controller with simple stricture that is easy to implement. The proposed PSO based MSF (PSOMSF) controller is tested on a three-area restructured power system under different operating conditions and contract variations. The results of the proposed PSOMSF controller are compared with genetic algorithm based multi-stage fuzzy (GAMSF) control through some performance indices to illustrate its robust performance for a wide range of system parameters and load changes

Multi-stage fuzzy load frequency control using PSO

Energy Technology Data Exchange (ETDEWEB)

Shayeghi, H. [Technical Engineering Department, University of Mohaghegh Ardabili, Ardabil (Iran); Jalili, A. [Islamic Azad University, Ardabil Branch, Ardabil (Iran); Shayanfar, H.A. [Center of Excellence for Power Automation and Operation, Electrical Engineering Department, Iran University of Science and Technology, Tehran (Iran)

2008-10-15

In this paper, a particle swarm optimization (PSO) based multi-stage fuzzy (PSOMSF) controller is proposed for solution of the load frequency control (LFC) problem in a restructured power system that operate under deregulation based on the bilateral policy scheme. In this strategy the control is tuned on line from the knowledge base and fuzzy inference, which request fewer sources and has two rule base sets. In the proposed method, for achieving the desired level of robust performance, exact tuning of membership functions is very important. Thus, to reduce the design effort and find a better fuzzy system control, membership functions are designed automatically by PSO algorithm, that has a strong ability to find the most optimistic results. The motivation for using the PSO technique is to reduce fuzzy system effort and take large parametric uncertainties into account. This newly developed control strategy combines the advantage of PSO and fuzzy system control techniques and leads to a flexible controller with simple stricture that is easy to implement. The proposed PSO based MSF (PSOMSF) controller is tested on a three-area restructured power system under different operating conditions and contract variations. The results of the proposed PSOMSF controller are compared with genetic algorithm based multi-stage fuzzy (GAMSF) control through some performance indices to illustrate its robust performance for a wide range of system parameters and load changes. (author)

The Aube centre

International Nuclear Information System (INIS)

1996-07-01

This educational booklet is devoted to a general presentation of the Aube radioactive wastes storage centre. After a short presentation of the Andra, the French national agency for the management of radioactive wastes, it gives some general information about radioactive wastes (origin, classification), containers (quality assurance and different types), wastes transportation (planning, safety), and about the Aube centre itself: description, treatment and conditioning of drums (compacting and injection), storage facilities, geological situation of the site, and environmental controls. (J.S.)

The burden of endometriosis: costs and quality of life of women with endometriosis and treated in referral centres.

Science.gov (United States)

Simoens, Steven; Dunselman, Gerard; Dirksen, Carmen; Hummelshoj, Lone; Bokor, Attila; Brandes, Iris; Brodszky, Valentin; Canis, Michel; Colombo, Giorgio Lorenzo; DeLeire, Thomas; Falcone, Tommaso; Graham, Barbara; Halis, Gülden; Horne, Andrew; Kanj, Omar; Kjer, Jens Jørgen; Kristensen, Jens; Lebovic, Dan; Mueller, Michael; Vigano, Paola; Wullschleger, Marcel; D'Hooghe, Thomas

2012-05-01

This study aimed to calculate costs and health-related quality of life of women with endometriosis-associated symptoms treated in referral centres. A prospective, multi-centre, questionnaire-based survey measured costs and quality of life in ambulatory care and in 12 tertiary care centres in 10 countries. The study enrolled women with a diagnosis of endometriosis and with at least one centre-specific contact related to endometriosis-associated symptoms in 2008. The main outcome measures were health care costs, costs of productivity loss, total costs and quality-adjusted life years. Predictors of costs were identified using regression analysis. Data analysis of 909 women demonstrated that the average annual total cost per woman was €9579 (95% confidence interval €8559-€10 599). Costs of productivity loss of €6298 per woman were double the health care costs of €3113 per woman. Health care costs were mainly due to surgery (29%), monitoring tests (19%) and hospitalization (18%) and physician visits (16%). Endometriosis-associated symptoms generated 0.809 quality-adjusted life years per woman. Decreased quality of life was the most important predictor of direct health care and total costs. Costs were greater with increasing severity of endometriosis, presence of pelvic pain, presence of infertility and a higher number of years since diagnosis. Our study invited women to report resource use based on endometriosis-associated symptoms only, rather than drawing on a control population of women without endometriosis. Our study showed that the economic burden associated with endometriosis treated in referral centres is high and is similar to other chronic diseases (diabetes, Crohn's disease, rheumatoid arthritis). It arises predominantly from productivity loss, and is predicted by decreased quality of life.

Robust multi-model control of an autonomous wind power system

Energy Technology Data Exchange (ETDEWEB)

Cutululis, Nicolas Antonio; Hansen, Anca Daniela; Soerensen, Poul [Risoe National Lab., Wind Energy Dept., Roskilde (Denmark); Ceanga, Emil [' Dunarea de Jos' Univ., Faculty of Electrical Engineering, Galati (Romania)

2006-07-01

This article presents a robust multi-model control structure for a wind power system that uses a variable speed wind turbine (VSWT) driving a permanent magnet synchronous generator (PMSG) connected to a local grid. The control problem consists in maximizing the energy captured from the wind for varying wind speeds. The VSWT-PMSG linearized model analysis reveals the resonant nature of its dynamic at points on the optimal regimes characteristic (ORC). The natural frequency of the system and the damping factor are strongly dependent on the operating point on the ORC. Under these circumstances a robust multi-model control structure is designed. The simulation results prove the viability of the proposed control structure. (Author)

Robust multi-model control of an autonomous wind power system

Science.gov (United States)

Cutululis, Nicolas Antonio; Ceanga, Emil; Hansen, Anca Daniela; Sørensen, Poul

2006-09-01

This article presents a robust multi-model control structure for a wind power system that uses a variable speed wind turbine (VSWT) driving a permanent magnet synchronous generator (PMSG) connected to a local grid. The control problem consists in maximizing the energy captured from the wind for varying wind speeds. The VSWT-PMSG linearized model analysis reveals the resonant nature of its dynamic at points on the optimal regimes characteristic (ORC). The natural frequency of the system and the damping factor are strongly dependent on the operating point on the ORC. Under these circumstances a robust multi-model control structure is designed. The simulation results prove the viability of the proposed control structure. Copyright

A multi-agent design for a pressurized water reactor (P.W.R.) control system

International Nuclear Information System (INIS)

Aimar-Lichtenberger, M.

1999-01-01

This PhD work is in keeping with the complex industrial process control. The starting point is the analysis of control principles in a Pressurized Water Reactor (P.W.R). In order to cope with the limits of the present control procedures, a new control organisation by objectives and means is defined. This functional organisation is based on the state approach and is characterized by the parallel management of control functions to ensure the continuous control of the installation essential variables. With regard to this complex system problematic, we search the most adapted computer modeling. We show that a multi-agent system approach brings an interesting answer to manage the distribution and parallelism of control decisions and tasks. We present a synthetic study of multi-agent systems and their application fields.The choice of a multi-agent approach proceeds with the design of an agent model. This model gains experiences from other applications. This model is implemented in a computer environment which combines the mechanisms of an object language with Prolog. We propose in this frame a multi-agent modeling of the control system where each function is represented by an agent. The agents are structured in a hierarchical organisation and deal with different abstraction levers of the problem. Following a prototype process, the validation is realized by an implementation and by a coupling to a reactor simulator. The essential contributions of an agent approach turn on the mastery of the system complexity, the openness, the robustness and the potentialities of human-machine cooperation. (author)

Study Protocol. ECSSIT – Elective Caesarean Section Syntocinon® Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon® 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section

Directory of Open Access Journals (Sweden)

Montgomery Alan A

2009-08-01

Full Text Available Abstract Background Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4–10 minutes therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. Methods and design A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml. A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. Discussion It is both important and timely that we evaluate the optimal approach to the management

Study Protocol. ECSSIT – Elective Caesarean Section Syntocinon® Infusion Trial. A multi-centre randomised controlled trial of oxytocin (Syntocinon®) 5 IU bolus and placebo infusion versus oxytocin 5 IU bolus and 40 IU infusion for the control of blood loss at elective caesarean section

Science.gov (United States)

Murphy, Deirdre J; Carey, Michael; Montgomery, Alan A; Sheehan, Sharon R

2009-01-01

Background Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4–10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. Methods and design A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. Discussion It is both important and timely that we evaluate the optimal approach to the management of the third stage at

Multi-professional clinical medication reviews in care homes for the elderly: study protocol for a randomised controlled trial with cost effectiveness analysis

Directory of Open Access Journals (Sweden)

Sach Tracey

2011-10-01

Full Text Available Abstract Background Evidence demonstrates that measures are needed to optimise therapy and improve administration of medicines in care homes for older people. The aim of this study is to determine the clinical and cost effectiveness of a novel model of multi-professional medication review. Methods A cluster randomised controlled trial design, involving thirty care homes. In line with current practice in medication reviews, recruitment and consent will be sought from general practitioners and care homes, rather than individual residents. Care homes will be segmented according to size and resident mix and allocated to the intervention arm (15 homes or control arm (15 homes sequentially using minimisation. Intervention homes will receive a multi-professional medication review at baseline and at 6 months, with follow-up at 12 months. Control homes will receive usual care (support they currently receive from the National Health Service, with data collection at baseline and 12 months. The novelty of the intervention is a review of medications by a multi-disciplinary team. Primary outcome measures are number of falls and potentially inappropriate prescribing. Secondary outcome measures include medication costs, health care resource use, hospitalisations and mortality. The null hypothesis proposes no difference in primary outcomes between intervention and control patients. The primary outcome variable (number of falls will be analysed using a linear mixed model, with the intervention specified as a fixed effect and care homes included as a random effect. Analyses will be at the level of the care home. The economic evaluation will estimate the cost-effectiveness of the intervention compared to usual care from a National Health Service and personal social services perspective. The study is not measuring the impact of the intervention on professional working relationships, the medicines culture in care homes or the generic health-related quality of life of

Quality Management Framework for Total Diet Study centres in Europe.

Science.gov (United States)

Pité, Marina; Pinchen, Hannah; Castanheira, Isabel; Oliveira, Luisa; Roe, Mark; Ruprich, Jiri; Rehurkova, Irena; Sirot, Veronique; Papadopoulos, Alexandra; Gunnlaugsdóttir, Helga; Reykdal, Ólafur; Lindtner, Oliver; Ritvanen, Tiina; Finglas, Paul

2018-02-01

A Quality Management Framework to improve quality and harmonization of Total Diet Study practices in Europe was developed within the TDS-Exposure Project. Seventeen processes were identified and hazards, Critical Control Points and associated preventive and corrective measures described. The Total Diet Study process was summarized in a flowchart divided into planning and practical (sample collection, preparation and analysis; risk assessment analysis and publication) phases. Standard Operating Procedures were developed and implemented in pilot studies in five organizations. The flowchart was used to develop a quality framework for Total Diet Studies that could be included in formal quality management systems. Pilot studies operated by four project partners were visited by project assessors who reviewed implementation of the proposed framework and identified areas that could be improved. The quality framework developed can be the starting point for any Total Diet Study centre and can be used within existing formal quality management approaches. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Study on a Control Method with a Ventilation Requirement of a VAV System in Multi-Zone

Directory of Open Access Journals (Sweden)

Hyo-Jun Kim

2017-11-01

Full Text Available The objective of this study was to propose a control method with a ventilation requirement of variable air volume (VAV system in multi-zone. In order to control the VAV system inmulti-zone, it is essential to control the terminal unit installed in each zone. A VAV terminal unit with conventional control method using a fixed minimum air flow can cause indoor air quality (IAQ issues depending on the variation in the number of occupants. This research proposes a control method with a ventilation requirement of the VAV terminal unit and AHU inmulti-zone. The integrated control method with an air flow increase model in the VAV terminal unit, AHU, and outdoor air intake rate increase model in the AHU was based on the indoor CO2 concentration. The conventional and proposed control algorithms were compared through a TRNSYS simulation program. The proposed VAV terminal unit control method satisfies all the conditions of indoor temperature, IAQ, and stratification. An energy comparison with the conventional control method showed that the method satisfies not only the indoor thermal comfort, IAQ, and stratification issue, but also reduces the energy consumption.

Multi-region fuzzy logic controller with local PID controllers for U-tube steam generator in nuclear power plant

Directory of Open Access Journals (Sweden)

Puchalski Bartosz

2015-12-01

Full Text Available In the paper, analysis of multi-region fuzzy logic controller with local PID controllers for steam generator of pressurized water reactor (PWR working in wide range of thermal power changes is presented. The U-tube steam generator has a nonlinear dynamics depending on thermal power transferred from coolant of the primary loop of the PWR plant. Control of water level in the steam generator conducted by a traditional PID controller which is designed for nominal power level of the nuclear reactor operates insufficiently well in wide range of operational conditions, especially at the low thermal power level. Thus the steam generator is often controlled manually by operators. Incorrect water level in the steam generator may lead to accidental shutdown of the nuclear reactor and consequently financial losses. In the paper a comparison of proposed multi region fuzzy logic controller and traditional PID controllers designed only for nominal condition is presented. The gains of the local PID controllers have been derived by solving appropriate optimization tasks with the cost function in a form of integrated squared error (ISE criterion. In both cases, a model of steam generator which is readily available in literature was used for control algorithms synthesis purposes. The proposed multi-region fuzzy logic controller and traditional PID controller were subjected to broad-based simulation tests in rapid prototyping software - Matlab/Simulink. These tests proved the advantage of multi-region fuzzy logic controller with local PID controllers over its traditional counterpart.

Multi-centre evaluation of recent troponin assays for the diagnosis of NSTEMI

Directory of Open Access Journals (Sweden)

Camille Chenevier-Gobeaux

2018-07-01

Full Text Available Objectives: We aimed to compare the use of nine different cardiac troponin (cTn assays (2 cTnT and 7 cTnI for the diagnosis of NSTEMI in a single multi-centre population. Design and methods: One hundred and fifty-eight patients were included (mean age 60 years, SD 17 years, including 23 patients (14% with NSTEMI. Results: The analytical comparison highlighted a large heterogeneity of cTn assays, as reflected by percentages of patients with detectable cTn, correlation coefficients, Passing-Bablok comparisons and concordance coefficients. Correlations within cTnI assays were good and correlation within cTnT assays was excellent. Diagnostic performances demonstrated that each cTn assay has specific threshold values. Furthermore, some assays (HS-cTnI and T, cTnI-Pathfast and cTnI-Centaur indicated high sensitivity and negative predictive value using the limit of detection (LoD diagnostic strategy. For the latter assays, a significant increase in specificity was found when using the 99th percentile or the H0-H3 strategies, in comparison to the LoD strategy. When applying the European Society of Cardiology H0-H3 algorithm, comparable diagnostic performances were obtained. Conclusion: All 9 cTn assays indicated overall good diagnostic performances for the diagnosis of NSTEMI in emergency departments when the recommended algorithm based on the variation of cTn value between two measurements at admission and 3 h later was used. Keywords: Cardiac troponin, High-sensitivity assay, Chest pain, Emergency department, NSTEMI, Analytical evaluation

HIV and childhood disability: a case-controlled study at a paediatric antiretroviral therapy centre in Lilongwe, Malawi.

Science.gov (United States)

Devendra, Akash; Makawa, Atupele; Kazembe, Peter N; Calles, Nancy R; Kuper, Hannah

2013-01-01

As paediatric antiretroviral therapy (ART) is rapidly scaled up in Southern Africa, Human Immunodeficiency Virus (HIV) infection is becoming a chronic illness. Children growing up with HIV may begin to encounter disabilities. The relationship between HIV, disability and the need for rehabilitation has added an additional element that needs to be addressed by paediatric HIV treatment programmes. 1) Estimate the prevalence of disabilities in HIV-infected and HIV-uninfected children in Lilongwe, Malawi. 2) Examine types of disability and associated clinical and socio-demographic factors. 3) Identify needs, opportunities and barriers for rehabilitation in Malawi. A case-controlled study of 296 HIV-infected children aged 2-9 years attending an ART centre in Lilongwe (cases) and their uninfected siblings (controls) was conducted. Disability was assessed using the WHO Ten Question Screen (TQS). Socio-demographic and clinical data were collected using a parent-proxy questionnaire and medical records. Of 296 case and control pairs recruited, 33% (98) versus 7% (20) screened positive for a disability (OR 8.4, 4.4-15.7) respectively. Of these 98 HIV-infected cases, 6%, 36%, 33%, 53%, 46% and 6% had a vision, hearing; physical, learning/comprehension, speech or seizure-related disability respectively and 51% had multiple coexisting disabilities. HIV-infected cases with a disability were more likely to be WHO stage III or IV at enrolment (71% vs. 52%, OR 2.7, 1.5-4.2), to have had TB (58% vs. 39%, OR 2.3, 1.4-3.8) and to have below-average school grades (18% vs. 2%, OR 11.1, 2.2-54.6) than those without. Sixty-seven percent of cases with a disability had never attended any rehabilitative service. Twenty-nine percent of caregivers reported facing stigma and discrimination because of the child's disability. This study reveals the magnitude of disability among HIV-infected children and the large unmet need for rehabilitation services. This expanding issue demands further

Multi-agent system-based event-triggered hybrid control scheme for energy internet

DEFF Research Database (Denmark)

Dou, Chunxia; Yue, Dong; Han, Qing Long

2017-01-01

This paper is concerned with an event-triggered hybrid control for the energy Internet based on a multi-agent system approach with which renewable energy resources can be fully utilized to meet load demand with high security and well dynamical quality. In the design of control, a multi-agent system...

Greenridge Multi-Pollutant Control Project Preliminary Public Design Report

Energy Technology Data Exchange (ETDEWEB)

Connell, Daniel P

2009-01-12

The Greenidge Multi-Pollutant Control Project is being conducted as part of the U.S. Department of Energy's Power Plant Improvement Initiative to demonstrate an innovative combination of air pollution control technologies that can cost-effectively reduce emissions of SO{sub 2}, NO{sub x}, Hg, acid gases (SO{sub 3}, HCl, and HF), and particulate matter from smaller coal-fired electrical generating units (EGUs). The multi-pollutant control system includes a hybrid selective non-catalytic reduction (SNCR)/in-duct selective catalytic reduction (SCR) system to reduce NOx emissions by {ge}60%, followed by a Turbosorp{reg_sign} circulating fluidized bed dry scrubber system to reduce emissions of SO{sub 2}, SO{sub 3}, HCl, and HF by {ge}95%. Mercury removal of {ge}90% is also targeted via the co-benefits afforded by the in-duct SCR, dry scrubber, and baghouse and by injection of activated carbon upstream of the scrubber, as required. The technology is particularly well suited, because of its relatively low capital and maintenance costs and small space requirements, to meet the needs of coal-fired units with capacities of 50-300 MWe. There are about 440 such units in the United States that currently are not equipped with SCR, flue gas desulfurization (FGD), or mercury control systems. These smaller units are a valuable part of the nation's energy infrastructure, constituting about 60 GW of installed capacity. However, with the onset of the Clean Air Interstate Rule, Clean Air Mercury Rule, and various state environmental actions requiring deep reductions in emissions of SO{sub 2}, NO{sub x}, and mercury, the continued operation of these units increasingly depends upon the ability to identify viable air pollution control retrofit options for them. The large capital costs and sizable space requirements associated with conventional technologies such as SCR and wet FGD make these technologies unattractive for many smaller units. The Greenidge Project aims to confirm

Modeling, Control and Analyze of Multi-Machine Drive Systems using Bond Graph Technique

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J. Belhadj

2006-03-01

Full Text Available In this paper, a system viewpoint method has been investigated to study and analyze complex systems using Bond Graph technique. These systems are multimachine multi-inverter based on Induction Machine (IM, well used in industries like rolling mills, textile, and railway traction. These systems are multi-domains, multi-scales time and present very strong internal and external couplings, with non-linearity characterized by a high model order. The classical study with analytic model is difficult to manipulate and it is limited to some performances. In this study, a “systemic approach” is presented to design these kinds of systems, using an energetic representation based on Bond Graph formalism. Three types of multimachine are studied with their control strategies. The modeling is carried out by Bond Graph and results are discussed to show the performances of this methodology

PM 2.5 and NO 2 assessment in 21 European study centres of ECRHS II: annual means and seasonal differences

Science.gov (United States)

Hazenkamp-von Arx, Marianne E.; Götschi, Thomas; Ackermann-Liebrich, Ursula; Bono, Roberto; Burney, Peter; Cyrys, Josef; Jarvis, Deborah; Lillienberg, Linnea; Luczynska, Christina; Maldonado, Jose A.; Jaén, Angeles; de Marco, Roberto; Mi, Yahong; Modig, Lars; Bayer-Oglesby, Lucy; Payo, Felix; Soon, Argo; Sunyer, Jordi; Villani, Simona; Weyler, Joost; Künzli, Nino

The follow-up of cohorts of adults from more than 20 European centres of the former ECRHS I (1989-1992) investigates long-term effects of exposure to ambient air pollution on respiratory health, in particular asthma and change of pulmonary function. Since PM 2.5 is not routinely monitored in Europe, we measured PM 2.5 concentrations in 21 participating centres to estimate 'background' exposure in these cities. Winter (November-February), summer (May-August) and annual mean (all months) values of PM 2.5 were determined from measuring periods between June 2000 and November 2001. Sampling was conducted for 7 days per month for a year. Annual and winter mean concentrations of PM 2.5 vary substantially being lowest in Iceland and highest in centres in Northern Italy. Annual mean concentrations ranged from 3.7 to 44.9 μg m -3, winter mean concentrations from 4.8 to 69.2 μg m -3, and summer mean concentrations from 3.3 to 23.1 μg m -3. Seasonal variability occurred but did not follow the same pattern across all centres. Therefore, ranking of centres varied from summer to winter. Simultaneously, NO 2 concentrations were measured using passive sampling tubes. Annual mean NO 2 concentrations range from 4.9 to 72.1 μg m -3 with similar seasonal variations across centres and constant ranking of centres between seasons. The correlation between annual NO 2 and PM 2.5 concentrations is fair (Spearman correlation coefficient rs=0.75), but when considered as monthly means the correlation is far less consistent and varies substantially between centres. The range of PM 2.5 mass concentrations obtained in ECRHS II is larger than in other current cohort studies on long-term effects of air pollution. This substantial variation in PM 2.5 exposure will improve statistical power in future multi-level health analyses and to some degree may compensate for the lack of information on within-city variability. Seasonal means may be used to indicate potential differences in the toxicity

Study on control schemes of flexible steering system of a multi-axle all-wheel-steering robot

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Pingxia Zhang

2016-05-01

Full Text Available It is well known that a multi-axle wheeled robot possesses larger load capability and also higher drive performance. However, its steering flexibility is degraded due to the large number of wheels. In order to solve this problem, in this article, we proposed three control schemes based on the center of rotation or the steering angles of both the first- and last-axle wheels. To release these control schemes, steering mode selection and also the left wheel’s steering angle in a specific axle are added approaching a practical application. Thereafter, the remaining wheels’ steering angles can be calculated with the Ackerman steering theorem. In order to verify the control effects, a five-axle all-wheel-steering wheeled robot has been developed with the Bluetooth wireless monitor system. Based on the newly designed robot, validation experiments are carried out, such as lateral movement, situ rotation, and multi-mode steering within a narrow space. The results indicate that the proposed design in this article can ensure a more flexible and faster movement within a narrow space. It shows large potential in obstacle avoidance compared with the conventional partial-wheel steering mode.

Learning from a mouse - how adoption of Disney methods could assist development of CANDU control centres

Energy Technology Data Exchange (ETDEWEB)

Davey, E. [Crew Systems Solutions, Deep River, Ontario (Canada)

2005-07-01

Many organizations are challenged with the tasks of identifying customer needs and expectations for their products, anticipating future product needs, communicating a future product vision to clients, and designing with today's technology to bring a future vision to successful realization. The design evolution of plant control centres is one aspect of CANDU development that faces such challenges. The Disney Corporation is an example of an organization that has been successful in consistently meeting these challenges for over fifty years; and some of the design practices proven in moviemaking, theme park and resort layout, and vacation experience organization may be helpful and effective when applied in other domains. This paper summarizes the findings from an examination of Disney Corporation design practices, and suggests how some practices could be used to simplify and enhance the design of future CANDU control centres. (author)

Learning from a mouse - how adoption of Disney methods could assist development of CANDU control centres

International Nuclear Information System (INIS)

Davey, E.

2005-01-01

Many organizations are challenged with the tasks of identifying customer needs and expectations for their products, anticipating future product needs, communicating a future product vision to clients, and designing with today's technology to bring a future vision to successful realization. The design evolution of plant control centres is one aspect of CANDU development that faces such challenges. The Disney Corporation is an example of an organization that has been successful in consistently meeting these challenges for over fifty years; and some of the design practices proven in moviemaking, theme park and resort layout, and vacation experience organization may be helpful and effective when applied in other domains. This paper summarizes the findings from an examination of Disney Corporation design practices, and suggests how some practices could be used to simplify and enhance the design of future CANDU control centres. (author)

The Emergence and Impact of MNC Centres of Excellence

DEFF Research Database (Denmark)

Holm, Ulf; Pedersen, Torben

This study explores an important element in the development of the multinational corporation. Whilst previously the parent company was seen as the centre, and the foreign subsidiaries as the periphery, today, it is recognized that different subsidiaries have different roles, and are linked to each...... they emerge and analysing their impact on corporate strategy. In the development of the multinational corporation different subsidiaries have different roles, and some become "Centres of Excellence" (COE) controlling resources on which other parts of the corporation depend. This work investigates COEs...... other in a complicated pattern. One crucial aspect of this is that some subsidiaries become "Centres of Excellence" (COE) controlling resources on which other parts of the corporation depend for their operations. This work investigates the existence of COEs in different countries, examining why...

Study protocol: SPARCLE – a multi-centre European study of the relationship of environment to participation and quality of life in children with cerebral palsy

Directory of Open Access Journals (Sweden)

Colver Allan

2006-04-01

Full Text Available Abstract Background SPARCLE is a nine-centre European epidemiological research study examining the relationship of participation and quality of life to impairment and environment (physical, social and attitudinal in 8–12 year old children with cerebral palsy. Concepts are adopted from the International Classification of Functioning, Disability and Health which bridges the medical and social models of disability. Methods/Design A cross sectional study of children with cerebral palsy sampled from total population databases in 9 European regions. Children were visited by research associates in each country who had been trained together. The main instruments used were KIDSCREEN, Life-H, Strength and Difficulties Questionnaire, Parenting Stress Index. A measure of environment was developed within the study. All instruments were translated according to international guidelines. The potential for bias due to non response and missing data will be examined. After initial analysis using multivariate regression of how the data captured by each instrument relate to impairment and socio-economic characteristics, relationships between the latent traits captured by the instruments will then be analysed using structural equation modelling. Discussion This study is original in its methods by directly engaging children themselves, ensuring those with learning or communication difficulty are not excluded, and by studying in quantitative terms the crucial outcomes of participation and quality of life. Specification and publication of this protocol prior to analysis, which is not common in epidemiology but well established for randomised controlled trials and systematic reviews, should avoid the pitfalls of data dredging and post hoc analyses.

Multi-rate sensor fusion-based adaptive discrete finite-time synergetic control for flexible-joint mechanical systems

International Nuclear Information System (INIS)

Xue Guang-Yue; Ren Xue-Mei; Xia Yuan-Qing

2013-01-01

This paper proposes an adaptive discrete finite-time synergetic control (ADFTSC) scheme based on a multi-rate sensor fusion estimator for flexible-joint mechanical systems in the presence of unmeasured states and dynamic uncertainties. Multi-rate sensors are employed to observe the system states which cannot be directly obtained by encoders due to the existence of joint flexibilities. By using an extended Kalman filter (EKF), the finite-time synergetic controller is designed based on a sensor fusion estimator which estimates states and parameters of the mechanical system with multi-rate measurements. The proposed controller can guarantee the finite-time convergence of tracking errors by the theoretical derivation. Simulation and experimental studies are included to validate the effectiveness of the proposed approach. (general)

Service orientation in holonic and multi-agent manufacturing

CERN Document Server

Thomas, André; Trentesaux, Damien

2015-01-01

This volume gathers the peer reviewed papers presented at the 4th edition of the International Workshop “Service Orientation in Holonic and Multi-agent Manufacturing – SOHOMA’14” organized and hosted on November 5-6, 2014 by the University of Lorraine, France in collaboration with the CIMR Research Centre of the University Politehnica of Bucharest and the TEMPO Laboratory of the University of Valenciennes and Hainaut-Cambrésis.   The book is structured in six parts, each one covering a specific research line which represents a trend in future manufacturing: (1) Holonic and Agent-based Industrial Automation Systems; (2) Service-oriented Management and Control of Manufacturing Systems; (3) Distributed Modelling for Safety and Security in Industrial Systems; (4) Complexity, Big Data and Virtualization in Computing-oriented Manufacturing; (5) Adaptive, Bio-inspired and Self-organizing Multi-Agent Systems for Manufacturing, and (6) Physical Internet Simulation, Modelling and Control.   There is a clear ...

The impact of PET-CT in suspected recurrent ovarian cancer: A prospective multi-centre study as part of the Australian PET Data Collection Project.

Science.gov (United States)

Fulham, M J; Carter, J; Baldey, A; Hicks, R J; Ramshaw, J E; Gibson, M

2009-03-01

To assess the impact of FDG PET-CT on the management of patients with suspected recurrent ovarian cancer and to determine the incremental information provided by PET-CT. This was a prospective, multi-centre, cohort study. Ninety women (mean age 59.9 years; age range 35-85 years) with a previous history of treated epithelial ovarian carcinoma and suspected recurrence based on elevated CA-125, anatomical imaging or clinical symptoms were studied with FDG PET-CT across two States. Referring doctors were asked to specify a management plan pre-PET, if management was altered after PET-CT and, the impact (rated - none, low, medium, high) of PET-CT on patient management. The pre-PET management plan could include radiotherapy, chemotherapy, surgery, and 'other' including observation. Patients were followed at 6 and 12 months and clinical status, evidence of recurrence and progression were recorded. Patients were referred by 34 individual specialists. At least 168 additional sites of disease in 61 patients (68%), not identified by conventional imaging were identified by PET-CT. In 77% the additional lesions were located below the diaphragm and most were nodal or peritoneal. PET-CT affected management in 60% (49% high, 11% medium impact). Patients where more disease was detected with PET-CT were more likely to progress in the following 12 months. For women with previously treated ovarian carcinoma with recurrent disease, PET-CT can: a) alter management in close to 60% of patients, b) detect more sites of disease than abdominal and pelvic CT, c) is superior in the detection of nodal, peritoneal and subcapsular liver disease and d) offers the opportunity for technology replacement in this setting.

Enantiopure Ferrocene-Based Planar-Chiral Iridacycles: Stereospecific Control of Iridium-Centred Chirality.

Science.gov (United States)

Arthurs, Ross A; Ismail, Muhammad; Prior, Christopher C; Oganesyan, Vasily S; Horton, Peter N; Coles, Simon J; Richards, Christopher J

2016-02-24

Reaction of [IrCp*Cl2 ]2 with ferrocenylimines (Fc=NAr, Ar=Ph, p-MeOC6 H4 ) results in ferrocene C-H activation and the diastereoselective synthesis of half-sandwich iridacycles of relative configuration Sp *,RIr *. Extension to (S)-2-ferrocenyl-4-(1-methylethyl)oxazoline gave highly diastereoselective control over the new elements of planar chirality and metal-based pseudo-tetrahedral chirality, to give both neutral and cationic half-sandwich iridacycles of absolute configuration Sc ,Sp ,RIr . Substitution reactions proceed with retention of configuration, with the planar chirality controlling the metal-centred chirality through an iron-iridium interaction in the coordinatively unsaturated cationic intermediate. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Development of an advanced mechanised gait trainer, controlling movement of the centre of mass, for restoring gait in non-ambulant subjects.

Science.gov (United States)

Hesse, S; Sarkodie-Gyan, T; Uhlenbrock, D

1999-01-01

The study aimed at further development of a mechanised gait trainer which would allow non-ambulant people to practice a gait-like motion repeatedly. To simulate normal gait, discrete stance and swing phases, lasting 60% and 40% of the gait cycle respectively, and the control of the movement of the centre of mass were required. A complex gear system provided the gait-like movement of two foot plates with a ratio of 60% to 40% between the stance and swing phases. A controlled propulsion system adjusted its output according to patient's efforts. Two eccenters on the central gear controlled phase-adjusted the vertical and horizontal position of the centre of mass. The patterns of sagittal lower limb joint kinematics and of muscle activation of a normal subject were similar when using the mechanised trainer and when walking on a treadmill. A non-ambulatory hemiparetic subject required little help from one therapist on the gait trainer, while two therapists supported treadmill walking. Gait movements on the trainer were highly symmetrical, impact-free, and less spastic. The weight-bearing muscles were activated in a similar fashion during both conditions. The vertical displacement of the centre of mass was bi-instead of mono-phasic during each gait cycle on the new device. In conclusion, the gait trainer allowed wheelchair-bound subjects the repetitive practice of a gait-like movement without overstraining therapists.

Psychosocial development of full term singletons, born after preimplantation genetic diagnosis (PGD) at preschool age and family functioning: a prospective case-controlled study and multi-informant approach.

Science.gov (United States)

Winter, C; Van Acker, F; Bonduelle, M; Desmyttere, S; Nekkebroeck, J

2015-05-01

Do full term singletons born after preimplantation genetic diagnosis (PGD) differ in their psychosocial functioning from children born after intracytoplasmic sperm injection (ICSI) and spontaneous conceived controls (SC)? The psychosocial maturation process of 5-6-year-old PGD children is comparable between the three conception groups (PGD, ICSI and SC). In general, a lot of research has been published regarding follow-up of children born after artificial reproductive technologies (ART), which mainly is reassuring. But the ART population itself is marked by broad diversity [IVF, ICSI, gamete donation, preimplantation genetic screening (PGS) or PGD] which complicates comparisons. Some literature concerning the socio-emotional development of PGD/PGS children is available and it suggests a normal maturation process. However, the complex reality of PGD families (e.g. safety of the technique and psychological burden of genetic histories) asks for an exclusive PGD sample with matched control groups and a multi-informant approach. Between April 2011 and May 2013, the psychosocial wellbeing of preschoolers and their families born after PGD was assessed in a prospective case-controlled, matched follow-up study, with a multi-informant approach. A group of 47 PGD, 50 ICSI and 55 SC 5-6-year-old children participated in a follow-up study performed at the Centre for Medical Genetics of the Universitair Ziekenhuis Brussel (UZ Brussel). Assessments took place in the hospital and in kindergartens. Children performed the Bene-Anthony family relations test (FRT), yielding their perceptions upon family relationships. Parents and teachers completed the child behaviour checklist (CBCL) and Caregiver Teacher Report Form (C-/TRF), respectively. Parental and family functioning were measured by the NEO-FFi, the parenting stress index (PSI), the Greenberger Work-Parenting Investment Questionnaire and the Marlowe-Crowne Social Desirability Scale (MCSDS). Statistical analysis was performed by

Simulation study of multi-step model algorithmic control of the nuclear reactor thermal power tracking system

International Nuclear Information System (INIS)

Shi Xiaoping; Xu Tianshu

2001-01-01

The classical control method is usually hard to ensure the thermal power tracking accuracy, because the nuclear reactor system is a complex nonlinear system with uncertain parameters and disturbances. A sort of non-parameter model is constructed with the open-loop impulse response of the system. Furthermore, a sort of thermal power tracking digital control law is presented using the multi-step model algorithmic control principle. The control method presented had good tracking performance and robustness. It can work despite the existence of unmeasurable disturbances. The simulation experiment testifies the correctness and effectiveness of the method. The high accuracy matching between the thermal power and the referenced load is achieved

Dynamic Neuromuscular Control of the Lower Limbs in Response to Unexpected Single-Planar versus Multi-Planar Support Perturbations in Young, Active Adults.

Science.gov (United States)

Malfait, Bart; Staes, Filip; de Vries, Aijse; Smeets, Annemie; Hawken, Malcolm; Robinson, Mark A; Vanrenterghem, Jos; Verschueren, Sabine

2015-01-01

An anterior cruciate ligament (ACL) injury involves a multi-planar injury mechanism. Nevertheless, unexpected multi-planar perturbations have not been used to screen athletes in the context of ACL injury prevention yet could reveal those more at risk. The objective of this study was to compare neuromuscular responses to multi-planar (MPP) and single-planar perturbations (SPP) during a stepping-down task. These results might serve as a basis for future implementation of external perturbations in ACL injury screening programs. Thirteen young adults performed a single leg stepping-down task in eight conditions (four MPP and four SPP with a specified amplitude and velocity). The amplitudes of vastus lateralis (VL), vastus medialis (VM), hamstrings lateralis (HL), hamstrings medialis (HM) EMG activity, medio-lateral and anterior-posterior centre of mass (COM) displacements, the peak knee flexion and abduction angles were compared between conditions using an one-way ANOVA. Number of stepping responses were monitored during all conditions. Significantly greater muscle activity levels were found in response to the more challenging MPP and SPP compared to the less challenging conditions (p neuromuscular activity were found between the MPP conditions and their equivalents in the SPP. Eighteen stepping responses were monitored in the SPP versus nine in the MPP indicating that the overall neuromuscular control was even more challenged during the SPP which was supported by greater COM displacements in the SPP. The more intense MPP and SPP evoked different neuromuscular responses resulting in greater muscle activity levels compared to small perturbations. Based on the results of COM displacements and based on the amount of stepping responses, dynamic neuromuscular control of the knee joint appeared less challenged during the MPP. Therefore, future work should investigate extensively if other neuromuscular differences (i.e. co-activation patterns and kinetics) exist between MPP

Family Access to a Dentist Study (FADS): A Multi-Center Randomized Controlled Trial

Science.gov (United States)

Nelson, Suchitra; Riedy, Christine; Albert, Jeffrey M; Lee, Wonik; Slusar, Mary Beth; Curtan, Shelley; Ferretti, Gerald; Cunha-Cruz, Joana; Milgrom, Peter

2015-01-01

Introduction Many low-income parent/caregivers do not understand the importance of cavity-free primary (baby) teeth and the chronic nature of dental caries (tooth decay). As a consequence, dental preventive and treatment utilization is low even when children are screened in schools and referred for care. This study aims to test a referral letter and Dental Information Guide (DIG) designed using the Common-Sense Model of Self-Regulation (CSM) framework to improve caregivers’ illness perception of dental caries and increase utilization of care by children with restorative dental needs. Methods A multi-site randomized controlled trial with caregivers of Kindergarten to 4th grade children in urban Ohio and rural Washington State will compare five arms: (1) CSM referral letter alone; (2) CSM referral letter + DIG; (3) reduced CSM referral letter alone; (4) reduced CSM referral letter + DIG; (5) standard (control) referral. At baseline, children will be screened at school to determine restorative dental needs. If in need of treatment, caregivers will be randomized to study arms and an intervention packet will be sent home. The primary outcome will be dental care based on a change in oral health status by clinical examination 7 months post-screening (ICDAS sealant codes 1 and 2; restoration codes 3–8; extraction). Enrollment commenced summer 2015 with results in summer 2016. Conclusion This study uses the CSM framework to develop and test behavioral interventions to increase dental utilization among low-income caregivers. If effective this simple intervention has broad applicability in clinical and community-based settings. PMID:26500170

Human-centred automation: an explorative study

International Nuclear Information System (INIS)

Hollnagel, Erik; Miberg, Ann Britt

1999-05-01

The purpose of the programme activity on human-centred automation at the HRP is to develop knowledge (in the form of models and theories) and tools (in the form of techniques and simulators) to support design of automation that ensures effective human performance and comprehension. This report presents the work done on both the analytical and experimental side of this project. The analytical work has surveyed common definitions of automation and traditional design principles. A general finding is that human-centred automation usually is defined in terms of what it is not. This is partly due to a lack of adequate models and of human-automation interaction. Another result is a clarification of the consequences of automation, in particular with regard to situation awareness and workload. The experimental work has taken place as an explorative experiment in HAMMLAB in collaboration with IPSN (France). The purpose of this experiment was to increase the understanding of how automation influences operator performance in NPP control rooms. Two different types of automation (extensive and limited) were considered in scenarios having two different degrees of complexity (high and low), and involving diagnostic and procedural tasks. Six licensed NPP crews from the NPP at Loviisa, Finland, participated in the experiment. The dependent variables applied were plant performance, operator performance, self-rated crew performance, situation awareness, workload, and operator trust in the automation. The results from the diagnostic scenarios indicated that operators' judgement of crew efficiency was related to their level of trust in the automation, and further that operators trusted automation least and rated crew performance lowest in situations where crew performance was efficient and vice versa. The results from procedural scenarios indicated that extensive automation efficiently supported operators' performance, and further that operator' judgement of crew performance efficiency

Low back pain and postural control, effects of task difficulty on centre of pressure and spinal kinematics.

Science.gov (United States)

Schelldorfer, Sarah; Ernst, Markus Josef; Rast, Fabian Marcel; Bauer, Christoph Michael; Meichtry, André; Kool, Jan

2015-01-01

Association of low back pain and standing postural control (PC) deficits are reported inconsistently. Demands on PC adaptation strategies are increased by restraining the input of visual or somatosensory senses. The objectives of the current study are, to investigate whether PC adaptations of the spine, hip and the centre of pressure (COP) differ between patients reporting non-specific low back pain (NSLBP) and asymptomatic controls. The PC adaption strategies of the thoracic and lumbar spine, the hip and the COP were measured in fifty-seven NSLBP patients and 22 asymptomatic controls. We tested three "feet together" conditions with increasing demands on PC strategies, using inertial measurement units (IMUs) on the spine and a Wii balance board for centre of pressure (COP) parameters. The differences between NSLBP patients and controls were most apparent when the participants were blindfolded, but remaining on a firm surface. While NSLBP patients had larger thoracic and lumbar spine mean absolute deviations of position (MADpos) in the frontal plane, the same parameters decreased in control subjects (relative change (RC): 0.23, 95% confidence interval: 0.03 to 0.45 and 0.03 to 0.48). The Mean absolute deviation of velocity (MADvel) of the thoracic spine in the frontal plane showed a similar and significant effect (RC: 0.12 95% CI: 0.01 to 0.25). Gender, age and pain during the measurements affected some parameters significantly. PC adaptions differ between NSLBP patients and asymptomatic controls. The differences are most apparent for the thoracic and lumbar parameters of MADpos, in the frontal plane and while the visual condition was removed. Copyright © 2014 Elsevier B.V. All rights reserved.

Dietary management practices in phenylketonuria across European centres

DEFF Research Database (Denmark)

Ahring, Kirsten; Bélanger-Quintana, Amaya; Dokoupil, Katharina

2009-01-01

, and the definition of foods that could be eaten without restriction ('free foods'). Eighty percent (n=8/10) of centres encouraged breastfeeding together with protein substitute in infants with PKU. CONCLUSIONS: Important differences exist among centres across Europe in the dietary management of PKU, and in support...... systems designed to assist patients in managing their diets. Further studies are needed to compare different dietary treatments with the aim of identifying best practice to optimise phenylalanine control and dietary adherence....

MULTI-LOOP CONTROL DESIGN IN MULTIVARIABLE (2X2 CONTINUOUS STIRRED TANK REACTOR

Directory of Open Access Journals (Sweden)

Abdul Wahid

2015-06-01

Full Text Available With this study, the design and tuning of multi-loop for multivariable (2x2 CSTR will be made in order to achieve optimum CSTR control performance. This study used Bequette model reactor and MATLAB software and is expected to be able to cope with disturbances in the reactor so that the reactor system is able to stabilize quickly despite the distractions. In this study, the design will be made using multi-loop approach, along with PI controller as the next step. Then, BLT and auto-tune tuning method will be used in PI controller and given disturbances to both of tuning method. The controller performances are then compared. Results of the study are then analyzed for discussions and conclusions. Results from this study have shown that in terms of disturbance rejection, BLT is better than auto-tune based on comparison between both of controller performances. For IAE for the case of temperature, BLT is 30% better than auto-tune, but it is almost the same for the case of concentration. For settling time for the case of concentration, BLT is 30% better than auto-tune, and for the case of temperature, BLT is 18% better than auto-tune. For rise time for the case of concentration and temperature, BLT is 30% better than auto-tune.

Associations between community-based physiotherapy for musculoskeletal injury and health related quality of life (EQ-5D): a multi-centre retrospective analysis.

Science.gov (United States)

Caplan, Nick; Robson, H; Robson, A; Barry, G; Wilkes, G

2017-10-25

Community-based musculoskeletal physiotherapy is used to improve function and health related quality of life (HRQoL). The purpose of this retrospective, multi-centre observational study was to determine the association between community-based physiotherapy management for musculoskeletal disorders and changes in HRQoL. Four thousand one hundred twelve patients' data were included in the study. Patients were included if they received a single period of treatment for a musculoskeletal injury or disorder. Patients were only included if they were being treated for a single morbidity. Patients received standard physiotherapy appropriate to their specific disorder, which could include health education/advice, exercise therapy, manual therapy, taping, soft tissue techniques, electrotherapy and/or acupuncture. Health related quality of life was assessed using the EQ-5D index. EQ-5D improved by 0.203 across all patients (d = 1.10). When grouped by anatomical site of symptom, the largest increases in EQ-5D was in foot pain (0.233; d = 1.29) and lumbar pain (0.231; d = 1.13). Improvements in EQ-5D greater than the minimum clinically important difference (MCID) were seen in 68.4% of all patients. The highest proportion of patients with positive responses to treatment were in ankle pain (74.2%) and thoracic pain (73.4%). The hand (40.5%), elbow (34.7%), and hip (33.9%) showed the greatest proportion of patients that did not respond to treatment. Community-based musculoskeletal physiotherapy is associated with improved health related quality of life. A randomised controlled trial is needed to determine any causal relationship between community-based physiotherapy and health related quality of life improvements.

On the design of multi-rate tracking controllers : application to rotorcraft guidance and control

NARCIS (Netherlands)

Guerreiro Tome Antunes, D.J.; Silvestre, C.J.; Cunha, R.

2010-01-01

This paper presents a new methodology for the design and implementation of gain-scheduled controllers for multi-rate systems. The proposed methodology provides a natural way to address the integrated guidance and control problem for autonomous vehicles when the outputs are sampled at different

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres.

Science.gov (United States)

Topp, Stephanie M; Chipukuma, Julien M

2016-03-01

Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational

A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

Science.gov (United States)

Topp, Stephanie M; Chipukuma, Julien M

2016-01-01

Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers’ organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers’ clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients’ trust in health workers’ service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance

A multi-centre, prospective, clinical in-market evaluation to assess the performance of Opsite™ Post-Op Visible dressings.

LENUS (Irish Health Repository)

O'Brien, Gillian

2010-10-01

The aim of this study was to assess the performance of Opsite™ Post-Op Visible as a post-surgical dressing in a typical clinical setting. In this multi-centre clinical evaluation, patients who underwent clean surgery were treated with Opsite Post-Op Visible dressing. Duration of dressing wear, visibility through the dressing and ability to handle exudate were assessed and the product was rated in comparison with those normally used. A total of 64 patients were recruited. Mean wear time was 4·5 days. Exudate management was rated very good or good at 96% of assessments. Visibility of the incision site was rated as very good or good at 72%, and as acceptable at 24%, of assessments. Patient comfort was rated very comfortable (63%) or comfortable (37%) at all assessments. Dressings were generally rated as satisfactory or exceeding expectations with clinicians stating that the Opsite Post-Op Visible dressing was better than the dressing they routinely used for 92% of patients. Opsite Post-Op Visible dressing is an innovative dressing combining good visibility with exudate management and patient comfort. It was found to have adequate wear time, visibility and exudate management properties making it suitable for use on a variety of surgical incision sites.

Market-based control strategy for long-span structures considering the multi-time delay issue

Science.gov (United States)

Li, Hongnan; Song, Jianzhu; Li, Gang

2017-01-01

To solve the different time delays that exist in the control device installed on spatial structures, in this study, discrete analysis using a 2 N precise algorithm was selected to solve the multi-time-delay issue for long-span structures based on the market-based control (MBC) method. The concept of interval mixed energy was introduced from computational structural mechanics and optimal control research areas, and it translates the design of the MBC multi-time-delay controller into a solution for the segment matrix. This approach transforms the serial algorithm in time to parallel computing in space, greatly improving the solving efficiency and numerical stability. The designed controller is able to consider the issue of time delay with a linear controlling force combination and is especially effective for large time-delay conditions. A numerical example of a long-span structure was selected to demonstrate the effectiveness of the presented controller, and the time delay was found to have a significant impact on the results.

A Droop Line Tracking Control for Multi-terminal VSC-HVDC Transmission System

DEFF Research Database (Denmark)

Irnawan, Roni; Silva, Filipe Miguel Faria da; Bak, Claus Leth

2018-01-01

Generally, a voltage-sourced converter (VSC) within a multi-terminal HVDC (MTDC) system can be operated either in constant DC voltage, constant flow (AC active power or DC current) or DC voltage droop control. These control modes can be easily represented as the droop characteristic line with dif......Generally, a voltage-sourced converter (VSC) within a multi-terminal HVDC (MTDC) system can be operated either in constant DC voltage, constant flow (AC active power or DC current) or DC voltage droop control. These control modes can be easily represented as the droop characteristic line...

Combining a leadership course and multi-source feedback has no effect on leadership skills of leaders in postgraduate medical education. An intervention study with a control group

Directory of Open Access Journals (Sweden)

Scherpbier Albert

2009-12-01

Full Text Available Abstract Background Leadership courses and multi-source feedback are widely used developmental tools for leaders in health care. On this background we aimed to study the additional effect of a leadership course following a multi-source feedback procedure compared to multi-source feedback alone especially regarding development of leadership skills over time. Methods Study participants were consultants responsible for postgraduate medical education at clinical departments. Study design: pre-post measures with an intervention and control group. The intervention was participation in a seven-day leadership course. Scores of multi-source feedback from the consultants responsible for education and respondents (heads of department, consultants and doctors in specialist training were collected before and one year after the intervention and analysed using Mann-Whitney's U-test and Multivariate analysis of variances. Results There were no differences in multi-source feedback scores at one year follow up compared to baseline measurements, either in the intervention or in the control group (p = 0.149. Conclusion The study indicates that a leadership course following a MSF procedure compared to MSF alone does not improve leadership skills of consultants responsible for education in clinical departments. Developing leadership skills takes time and the time frame of one year might have been too short to show improvement in leadership skills of consultants responsible for education. Further studies are needed to investigate if other combination of initiatives to develop leadership might have more impact in the clinical setting.

Patients' views of patient-centred care: a phenomenological case study in one surgical unit.

Science.gov (United States)

Marshall, Amy; Kitson, Alison; Zeitz, Kathryn

2012-12-01

To report a study of patients' views of patient-centred care. The study aimed to explore patients' understanding and conceptualization of patient-centred care and link it to existing literature on the topic. Patient-centred care currently lacks a widely accepted definition, with much of the literature based on definitions formulated by health professionals and researchers. Qualitative research study grounded in phenomenology. Interpersonal interviews were conducted with ten participants who were patients in a surgical ward in a large metropolitan hospital in South Australia in 2010. Participants were unfamiliar with the concept of patient-centred care, but despite this, were able to describe what the term meant to them and what they wanted from their care. Patients equated the type and quality of care they received with the staff that provided it and themes of connectedness, involvement and attentiveness were prevalent in their descriptions of what they wanted from their care. Ensuring that patients have a voice in the definition and conceptualization of patient-centred care is essential and further and regular consultation with patients about their needs and priorities will ensure an integrated approach to patient-centred care. © 2012 Blackwell Publishing Ltd.

Towards Human-Friendly Efficient Control of Multi-Robot Teams

Science.gov (United States)

Stoica, Adrian; Theodoridis, Theodoros; Barrero, David F.; Hu, Huosheng; McDonald-Maiers, Klaus

2013-01-01

This paper explores means to increase efficiency in performing tasks with multi-robot teams, in the context of natural Human-Multi-Robot Interfaces (HMRI) for command and control. The motivating scenario is an emergency evacuation by a transport convoy of unmanned ground vehicles (UGVs) that have to traverse, in shortest time, an unknown terrain. In the experiments the operator commands, in minimal time, a group of rovers through a maze. The efficiency of performing such tasks depends on both, the levels of robots' autonomy, and the ability of the operator to command and control the team. The paper extends the classic framework of levels of autonomy (LOA), to levels/hierarchy of autonomy characteristic of Groups (G-LOA), and uses it to determine new strategies for control. An UGVoriented command language (UGVL) is defined, and a mapping is performed from the human-friendly gesture-based HMRI into the UGVL. The UGVL is used to control a team of 3 robots, exploring the efficiency of different G-LOA; specifically, by (a) controlling each robot individually through the maze, (b) controlling a leader and cloning its controls to followers, and (c) controlling the entire group. Not surprisingly, commands at increased G-LOA lead to a faster traverse, yet a number of aspects are worth discussing in this context.

The study protocol of the Norwegian randomized controlled trial of electroconvulsive therapy in treatment resistant depression in bipolar disorder

Directory of Open Access Journals (Sweden)

Oedegaard Ketil J

2010-02-01

Full Text Available Abstract Background The treatment of depressive phases of bipolar disorder is challenging. The effects of the commonly used antidepressants in bipolar depression are questionable. Electroconvulsive therapy is generally considered to be the most effective treatment even if there are no randomized controlled trials of electroconvulsive therapy in bipolar depression. The safety of electroconvulsive therapy is well documented, but there are some controversies as to the cognitive side effects. The aim of this study is to compare the effects and side effects of electroconvulsive therapy to pharmacological treatment in treatment resistant bipolar depression. Cognitive changes and quality of life during the treatment will be assessed. Methods/Design A prospective, randomised controlled, multi-centre six- week acute treatment trial with seven clinical assessments. Follow up visit at 26 weeks or until remission (max 52 weeks. A neuropsychological test battery designed to be sensitive to changes in cognitive function will be used. Setting: Nine study centres across Norway, all acute psychiatric departments. Sample: n = 132 patients, aged 18 and over, who fulfil criteria for treatment resistant depression in bipolar disorder, Montgomery Åsberg Depression Rating Scale Score of at least 25 at baseline. Intervention: Intervention group: 3 sessions per week for up to 6 weeks, total up to 18 sessions. Control group: algorithm-based pharmacological treatment as usual. Discussion This study is the first randomized controlled trial that aims to investigate whether electroconvulsive therapy is better than pharmacological treatment as usual in treatment resistant bipolar depression. Possible long lasting cognitive side effects will be evaluated. The study is investigator initiated, without support from industry. Trial registration NCT00664976

Multi-centre, multi-database studies with common protocols

DEFF Research Database (Denmark)

Klungel, Olaf H.; Kurz, Xavier; de Groot, Mark C.H.

2016-01-01

was observed depending on design, exposure and outcome definitions, but none of the differences were statistically significant. The association between anti-epileptics and suicidality was inconsistent across the UK CPRD, Danish National registries and the French PGRx system. Calcium channel blockers were...

Intersection signal control multi-objective optimization based on genetic algorithm

Directory of Open Access Journals (Sweden)

Zhanhong Zhou

2014-04-01

Full Text Available A signal control intersection increases not only vehicle delay, but also vehicle emissions and fuel consumption in that area. Because more and more fuel and air pollution problems arise recently, an intersection signal control optimization method which aims at reducing vehicle emissions, fuel consumption and vehicle delay is required heavily. This paper proposed a signal control multi-object optimization method to reduce vehicle emissions, fuel consumption and vehicle delay simultaneously at an intersection. The optimization method combined the Paramics microscopic traffic simulation software, Comprehensive Modal Emissions Model (CMEM, and genetic algorithm. An intersection in Haizhu District, Guangzhou, was taken for a case study. The result of the case study shows the optimal timing scheme obtained from this method is better than the Webster timing scheme.

A New Control Strategy Based Multi Converter UPQC Using Fuzzy Logic Controller to Improve the Power Quality Issues

Directory of Open Access Journals (Sweden)

Chandra Babu Paduchuri

2014-01-01

Full Text Available A design of multiconverter unified power quality conditioner to improve the power quality issues is presents in this paper. Modified SRF theory and fuzzy logic controller technique are incorporated in this modelling. This newly designed controller is connected to a source in order to compensate voltage and current in the two feeders. The expanded concept of UPQC is multi converter-UPQC; this system has two series voltage source converter (VSC and one shunt VSC connected back to back. In the proposed system, the power can be conveyed from one feeder to another in order to mitigate the voltage sag, swell, interruption and transient response of the system. The control strategies of multi converter-UPQC are designed based on the modified synchronous reference frame theory with fuzzy logic controller. The transient response of the fuzzy logic controller in dc-link voltage controller will be very fast. The relevant simulation and compensation performance analysis of multi converter-UPQC with fuzzy logic controller is performed using MATLAB/Simulink software.

Control Prosody using Multi-Agent System

Directory of Open Access Journals (Sweden)

Kenji MATSUI

2014-03-01

Full Text Available Persons who have undergone a laryngectomy have a few options to partially restore speech but no completely satisfactory device. Even though the use of an electrolarynx (EL is the easiest way for a patient to produce speech, it does not produce a natural tone and appearance is far from normal. Because of that and the fact that none of them are hands-free, the feasibility of using a motion sensor to replace a conventional EL user interface has been explored. A mobile device motion sensor with multi-agent platform has been used to investigate on/off and pitch frequency control capability. A very small battery operated ARM-based control unit has also been developed to evaluate the motion sensor based user-interface. This control unit is placed on the wrist and the vibration device against the throat using support bandage. Two different conversion methods were used for the forearm tilt angle to pitch frequency conversion: linear mapping method and F0 template-based method A perceptual evaluation has been performed with two well-trained normal speakers and ten subjects. The results of the evaluation study showed that both methods are able to produce better speech quality in terms of the naturalness.

Who Multi-Tasks and Why? Multi-Tasking Ability, Perceived Multi-Tasking Ability, Impulsivity, and Sensation Seeking

OpenAIRE

Sanbonmatsu, David M.; Strayer, David L.; Medeiros-Ward, Nathan; Watson, Jason M.

2013-01-01

The present study examined the relationship between personality and individual differences in multi-tasking ability. Participants enrolled at the University of Utah completed measures of multi-tasking activity, perceived multi-tasking ability, impulsivity, and sensation seeking. In addition, they performed the Operation Span in order to assess their executive control and actual multi-tasking ability. The findings indicate that the persons who are most capable of multi-tasking effectively are ...

Scientists of Russian Federal Nuclear Centre - ARSRITP and arms control and nuclear weapons non-proliferation problems

International Nuclear Information System (INIS)

Avrorin, E.N.; Andrusenko, B.A.; Voznyuk, R.I.; Voloshin, N.P.

1994-01-01

The activity of scientists of Russian Federal Nuclear Centre (RFNC) -ARSRITP in the field of nuclear disarmament control for the period of 1974 -1993 is discussed. RFNC - ARSRITP scientists in collaboration with american specialists have developed and employed in practice the techniques and equipment to control the bilateral Treaty on the limitation of Nuclear -Weapon Test. Experience of control over nuclear tests of threshold power and realization of new RFNC - ARSRITP scientific and technical projects have made a basis for development of measures and means of possible control methods to observe complete nuclear test ban

CADC and CANFAR: Extending the role of the data centre

Science.gov (United States)

Gaudet, Severin

2015-12-01

Over the past six years, the CADC has moved beyond the astronomy archive data centre to a multi-service system for the community. This evolution is based on two major initiatives. The first is the adoption of International Virtual Observatory Alliance (IVOA) standards in both the system and data architecture of the CADC, including a common characterization data model. The second is the Canadian Advanced Network for Astronomical Research (CANFAR), a digital infrastructure combining the Canadian national research network (CANARIE), cloud processing and storage resources (Compute Canada) and a data centre (Canadian Astronomy Data Centre) into a unified ecosystem for storage and processing for the astronomy community. This talk will describe the architecture and integration of IVOA and CANFAR services into CADC operations, the operational experiences, the lessons learned and future directions

Advances in Multi-Pollutant Control

Energy Technology Data Exchange (ETDEWEB)

NONE

2013-11-01

Pollutants, such as nitrogen oxides (nitrogen dioxide (NO2) and nitric oxide (NO)), sulphur dioxide (SO2), sulphur trioxide (SO3), carbon dioxide (CO2), mercury (Hg) and particulate matter (PM), are formed when coal is combusted in a power plant boiler. With the concern over the environmental and health consequences of these pollutants, legislation and regulations have been implemented limiting the amounts that can be emitted to the atmosphere. Emission control systems on conventional coal-fired power plants typically employ technologies designed to remove one specific pollutant.These are then combined, in series, to remove several pollutants in order to meet the emission regulations. This report discusses multi-pollutant systems which remove two or more of the principal regulated pollutants (SO2, NOx, mercury, particulate matter and CO2) in a single reactor or a single system designed for the purpose. The emphasis is on commercial or near commercial processes, and those that are under active development. Ways to improve the co-benefit removal of oxidised mercury in conventional limestone wet scrubbers, spray dry scrubbers and circulating dry scrubbers are also included. Multi-pollutant systems can have lower capital and operating costs than a series of traditional systems to remove the s ame number of pollutants. Nevertheless, many of the multi-pollutant technologies rely on by-product sales to be economically competitive. Their footprint is often smaller than conventional single pollutant counterparts treating a similar volume of flue gas, making them easier to install in retrofit applications. Some of the systems use modular designs that ensures easy scalability for larger boilers.

A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol.

NARCIS (Netherlands)

Hafskjold, L.; Sundler, A.J.; Holmström, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.

2015-01-01

Introduction: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of

A cross-sectional study on person-centred communication in the care of older people: the COMHOME study protocol

NARCIS (Netherlands)

Hafskjold, L.; Sundler, A.J.; Holmstrom, I.K.; Sundling, V.; Dulmen, S. van; Eide, H.

2015-01-01

INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of

Inter-observer agreement for Crohn's disease sub-phenotypes using the Montreal Classification: How good are we? A multi-centre Australasian study.

Science.gov (United States)

Krishnaprasad, Krupa; Andrews, Jane M; Lawrance, Ian C; Florin, Timothy; Gearry, Richard B; Leong, Rupert W L; Mahy, Gillian; Bampton, Peter; Prosser, Ruth; Leach, Peta; Chitti, Laurie; Cock, Charles; Grafton, Rachel; Croft, Anthony R; Cooke, Sharon; Doecke, James D; Radford-Smith, Graham L

2012-04-01

Crohn's disease (CD) exhibits significant clinical heterogeneity. Classification systems attempt to describe this; however, their utility and reliability depends on inter-observer agreement (IOA). We therefore sought to evaluate IOA using the Montreal Classification (MC). De-identified clinical records of 35 CD patients from 6 Australian IBD centres were presented to 13 expert practitioners from 8 Australia and New Zealand Inflammatory Bowel Disease Consortium (ANZIBDC) centres. Practitioners classified the cases using MC and forwarded data for central blinded analysis. IOA on smoking and medications was also tested. Kappa statistics, with pre-specified outcomes of κ>0.8 excellent; 0.61-0.8 good; 0.41-0.6 moderate and ≤0.4 poor, were used. 97% of study cases had colonoscopy reports, however, only 31% had undergone a complete set of diagnostic investigations (colonoscopy, histology, SB imaging). At diagnosis, IOA was excellent for age, κ=0.84; good for disease location, κ=0.73; only moderate for upper GI disease (κ=0.57) and disease behaviour, κ=0.54; and good for the presence of perianal disease, κ=0.6. At last follow-up, IOA was good for location, κ=0.68; only moderate for upper GI disease (κ=0.43) and disease behaviour, κ=0.46; but excellent for the presence/absence of perianal disease, κ=0.88. IOA for immunosuppressant use ever and presence of stricture were both good (κ=0.79 and 0.64 respectively). IOA using MC is generally good; however some areas are less consistent than others. Omissions and inaccuracies reduce the value of clinical data when comparing cohorts across different centres, and may impair the ability to translate genetic discoveries into clinical practice. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Predictive control for stochastic systems based on multi-layer probabilistic sets

Directory of Open Access Journals (Sweden)

Huaqing LIANG

2016-04-01

Full Text Available Aiming at a class of discrete-time stochastic systems with Markov jump features, the state-feedback predictive control problem under probabilistic constraints of input variables is researched. On the basis of the concept and method of the multi-layer probabilistic sets, the predictive controller design algorithm with the soft constraints of different probabilities is presented. Under the control of the multi-step feedback laws, the system state moves to different ellipses with specified probabilities. The stability of the system is guaranteed, the feasible region of the control problem is enlarged, and the system performance is improved. Finally, a simulation example is given to prove the effectiveness of the proposed method.

Implementation of Safeguards at the Nuclear Studies Centre at La Maamora

International Nuclear Information System (INIS)

Jraut, A.; El Morabiti, A.

2015-01-01

Morocco entered into force its Comprehensive Safeguards Agreement in 1976 and its Additional Protocol in 2011. The Moroccan National Centre of Nuclear Energy, Sciences and Technologies (CNESTEN) has been licenced to operate the Nuclear Studies Centre at La Maamora (CENM), including a 2MW TRIGA Research Reactor, since January 2009. This reactor is mainly used for training, basic and applied research, neutron activation analysis and radioisotope production. In May 2006 and before performing the hot commissioning of the TRIGA RR, a training had been organized by the IAEA for CNESTEN staff in charge of accountancy for and control of nuclear material in this reactor. This training had been supported by some practical examples with regard to the preparation of accountancy reports and the conduct of inspections. For the implementation of AP at CENM, CNESTEN had signed an Action Sheet with the US/DOE on ''Technical Assistance in Implementation of the Additional Protocol''. This Action Sheet allowed CNESTEN to enhance its capabilities to meet the requirements set forth in the AP concerning the preparation of declarations and the conduct of IAEA complementary access activities. This paper focuses mainly on the approach developed by CNESTEN to fulfil the national safeguards commitments applicable to CENM. (author)

The oral food desensitization in the Italian allergy centres.

Science.gov (United States)

Meglio, P; Caminiti, L; Pajno, G B; Dello Iacono, I; Tripodi, S; Verga, M C; Martelli, A

2015-05-01

Attempts aimed at inducing food tolerance through oral food desensitization (OFD) for the treatment of IgE-mediated food allergies are increasing. In Italy, a number of allergy centres offer this procedure. To collect information on how these centres are organized, how patients are selected, the methods used to administer OFD and how adverse reactions are managed. A questionnaire was e-mailed to all the Italian allergy centres offering OFD. The survey shows a high degree of variability between centres. A correct diagnosis of food allergy is crucial for selecting patients for OFD. In the Italian allergy centres, oral food challenges are mostly open label (84%), but in 16% of cases they are single-blind (8%) or double-blind (8%). A high proportion of allergy centres (83%) offer OFD to children presenting forms of anaphylaxis triggered by traces--or very low doses--of food allergen. The majority of allergy centres (76%) enroll patients over 3 years of age, with 44% enrolling patients above the age of 5. Not-controlled asthma, unreliability of parents in the management of OFD and/or risk of adverse events, are the main reasons for exclusion from the procedure. Although OFD may sometimes be successful and may be considered a valid alternative to an elimination diet, further randomized controlled trials are needed, in order to clarify some controversial points, such as the characteristics of the child undergoing OFD, and the methods of food preparation and administration. Moreover, further studies should further investigate OFD safety, efficacy and costs.

Effectiveness and cost-effectiveness of body psychotherapy in the treatment of negative symptoms of schizophrenia – a multi-centre randomised controlled trial

Directory of Open Access Journals (Sweden)

Priebe Stefan

2013-01-01

Full Text Available Abstract Background Negative symptoms of schizophrenia are frequently associated with poor long term outcomes. Established interventions have little, if any, positive effects on negative symptoms. Arts Therapies such as Body Psychotherapy (BPT have been suggested to reduce negative symptoms, but the existing evidence is limited. In a small exploratory trial a manualised form of group BPT led to significantly lower negative symptom levels both at the end of treatment and at 4 months follow-up as compared to supportive counseling. We designed a large multi-site trial to assess the effectiveness of a manualised BPT intervention in reducing negative symptoms, compared to an active control. Methods/Design In a randomised controlled trial, 256 schizophrenic outpatients with negative symptoms will be randomly allocated either to BPT or Pilates groups. In both conditions, patients will be offered two 90 minutes sessions per week in groups of about 8 patients over a period of 10 weeks. Outcomes are assessed at the end of treatment and at six months follow-up. The primary outcome is severity of negative symptoms, as measured by the Positive and Negative Symptom Scale (PANSS, whilst a range of secondary outcome measures include general psychopathology, social contacts, and quality of life. We will also assess the cost-effectiveness of the intervention. Discussion The study aims to evaluate the effectiveness of a promising form of group therapy which may help alleviate negative symptoms that are associated with unfavourable long-term outcomes and have so far been difficult to treat. If the trial is successful, it will add a new and effective option in the treatment of negative symptoms. Group BPT is manualised, might be attractive to many patients because of its unusual approach, and could potentially be rolled out to services at relatively little additional cost. Trial registration Current Controlled Trials ISRCTN84216587

Childhood obesity prevention and control in city recreation centres and family homes: the MOVE/me Muevo Project.

Science.gov (United States)

Elder, J P; Crespo, N C; Corder, K; Ayala, G X; Slymen, D J; Lopez, N V; Moody, J S; McKenzie, T L

2014-06-01

Interventions to prevent and control childhood obesity have shown mixed results in terms of short- and long-term changes. 'MOVE/me Muevo' was a 2-year family- and recreation centre-based randomized controlled trial to promote healthy eating and physical activity among 5- to 8-year-old children. It was hypothesized that children in the intervention group would demonstrate lower post-intervention body mass index (BMI) values and improved obesity-related behaviours compared with the control group children. Thirty recreation centres in San Diego County, California, were randomized to an intervention or control condition. Five hundred forty-one families were enrolled and children's BMI, diet, physical activity and other health indicators were tracked from baseline to 2 years post-baseline. Analyses followed an intent-to-treat approach using mixed-effects models. No significant intervention effects were observed for the primary outcomes of child's or parent's BMI and child's waist circumference. Moderator analyses, however, showed that girls (but not boys) in the intervention condition reduced their BMI. At the 2-year follow-up, intervention condition parents reported that their children were consuming fewer high-fat foods and sugary beverages. Favourable implementation fidelity and high retention rates support the feasibility of this intervention in a large metropolitan area; however, interventions of greater intensity may be needed to achieve effects on child's BMI. Also, further research is needed to develop gender-specific intervention strategies so that both genders may benefit from such efforts. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Computer controlled multi-leaf conformation radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Matsuda, T [Tokyo Metropolitan Komagome Hospital (Japan); Inamura, K

1981-10-01

A conformation radiotherapy system with 5-split collimators of which openings can be controlled symmetrically by computerized techniques during rotational irradiation by a linear accelerator has been developed. Outline of the system performance and its clinical applications are described as follows. 1. Profile of the system: The hardware is composed of three parts, namely, the multi-split collimator, the electronic data processor, and the interface between those two parts. 1) The multi-leaf collimator is composed of 5 pairs (10 leaves) diaphragms. It can be mounted to the X-ray head of a linear accelerator when used, and can be dismounted after its use. 2) The electronic data processor sends control signal to the collimator according to the 5-leaf target volume data which can be stored into a minifloppy disc through the curve digitizer previously. This part is composed of a) dedicated micro processor, b) I/O expansion unit, c) color CRT display with key board, d) dual mini-floppy disc unit, e) curve digitizer and f) digital plotter for recording and verification of resulted accuracy. 2. Performance of the system: 1) Maximum field size: 15 cm x 15 cm at isocenter. 2) Maximum elongation ratio of the target volume: 3 : 1 when the longer diameter is 15 cm. 3) Control accuracy: Within +-3 mm deviation from planned beam focus at isocenter. 3. Clinical application: The method of treatment planning and clinical advantages of this irradiation method are explained by raising clinical experiences such as treating brain tumor and rectal cancer.

Computer controlled multi-leaf conformation radiotherapy

International Nuclear Information System (INIS)

Matsuda, Tadayoshi; Inamura, Kiyonari.

1981-01-01

A conformation radiotherapy system with 5-split collimators of which openings can be controlled symmetrically by computerized techniques during rotational irradiation by a linear accelerator has been developed. Outline of the system performance and its clinical applications are described as follows. 1. Profile of the system: The hardware is composed of three parts, namely, the multi-split collimator, the electronic data processor, and the interface between those two parts. 1) The multi-leaf collimator is composed of 5 pairs (10 leaves) diaphragms. It can be mounted to the X-ray head of a linear accelerator when used, and can be dismounted after its use. 2) The electronic data processor sends control signal to the collimator according to the 5-leaf target volume data which can be stored into a minifloppy disc through the curve digitizer previously. This part is composed of a) dedicated micro processor, b) I/O expansion unit, c) color CRT display with key board, d) dual mini-floppy disc unit, e) curve digitizer and f) digital plotter for recording and verification of resulted accuracy. 2. Performance of the system: 1) Maximum field size: 15 cm x 15 cm at isocenter. 2) Maximum elongation ratio of the target volume: 3 : 1 when the longer diameter is 15 cm. 3) Control accuracy: Within +-3 mm deviation from planned beam focus at isocenter. 3. Clinical application: The method of treatment planning and clinical advantages of this irradiation method are explained by raising clinical experiences such as treating brain tumor and rectal cancer. (author)

Conceptual design of a system for nuclear material control in a research centre according to the IAEA safeguards requirements

International Nuclear Information System (INIS)